Fetal Heart Evaluation

Congenital heart diseases are considered the most common fetal anomalies. While some of these anomalies may have a minimal impact on the life of a newborn, some may result in neonatal deaths in the early period. With early diagnosis, detection of anomalies that are incompatible with life and termination of pregnancy with the consent of the patient can be offered as options. In addition, since many cardiac anomalies are treated during the postpartum period, it is important to detect those having this type of anomaly and offer them an early and appropriate treatment option during the postpartum period. It is highly appropriate to have delivery in hospitals that are technically equipped to handle cardiac anomalies. For these reasons, fetal cardiac evaluations are now being performed recently. Technical difficulties, inability to spare enough time for the patient or lack of experience in the cardiac evaluation may facilitate the lack of detection of fetal heart anomalies. Cardiac anomalies are among the most undetected anomalies. Although it may seem like a very difficult evaluation at first, fetal cardiac evaluation is actually a very simple and easy to perform examination. By creating a certain algorithm, the most common cardiac anomalies can be detected easily. Each clinician should establish a certain order according to their own physical conditions and the basic structures to be considered should be evaluated in this order. In this article, we present suggestions on how to perform a fetal cardiac evaluation using current approaches

THE EFFICIENCY OF FIRST TRIMESTER SCREENING; DOKUZ EYLUL UNIVERSITY EXPERIMENT

Amaç: Dokuz Eylül Üniversitesi Tıp Fakültesi Hastanesi'nde (DEÜTF) ilk üç ay tarama testinin etkinliğini saptamak. Yöntemler: Ocak 2005 ve Mayıs 2006 tarihleri arasında kliniğimizde ilk üç ay testi yaptıran 1571 hasta retrospektif olarak değerlendirmeye alındı. Erken dönem gebelik kaybı olan, amniosentez yaptırmayan, geç dönem gebelik kaybı olan ve ulaşılamayan hastalar çalışmadan çıkarıldı. İlk üç ay testi biyokimyasal belirteçleri ve kombine riski ayrı ayrı hesaplanan 910 hasta cut-off değer 1/300 alındığında yüksek ve düşük riskli çıkanlar, yapılmışsa amniosentez sonuçlarına göre ayrı ayrı değerlendirildi. Sensitivite, spesifite, pozitif prediktif değer ve negatif prediktif değer hesaplanarak ilk üç ay testinin DEÜTF'de güvenilirliği ve etkinliği saptanmaya çalışıldı. Bulgular: İlk üç ay testi biyokimyasal belirteçleri bakılan hastalar için sensitivite %75, spesifite %87,6, pozitif prediktif değer %2,6, negatif prediktif değer % 99,8 olarak bulundu. Kombine risk için sensitivite %100, spesifite %92, pozitif prediktif değer %4, negatif prediktif değer %100 olarak bulundu. Sonuç: İkili teste NT ölçümünün eklenmesi, invaziv girişim oranını belirgin olarak azaltmıştır. Etkin bir laboratuar değerlendirme ile doğru NT ölçümünün DS tanısında ve normal gebelikleri ayırmadaki etkinliği açıktır Objective: To determine the efficiecy of the first trimester screening test in Dokuz Eylul University School of Medicine (DEUSM). Methods: 1571 patients which first trimester screening tests were performed in our clinic have been evaluated retrospectively between 2005 January and 2006 March. Patients which have early onset missing fetuses (before 20. pregnancy weeks) and late onset missing fetuses (after 20. pregnancy weeks), pateints which we did not performe amniocentesis and patients which we could not reach were removed from the study. Inside total 910 patients, which arising cut-off degree 1/300 for biochemical markers and combined test, whether amniocentesis results performed were determined respectively. Sensitivities, specifities, positive predictive values and negative predictive values were calculated and it has been tried to find out reliability and efficiency of first trimester screening test in DEUSM. Results: Sensitivity was 75%, specifity was 87.6%, positive predictive value was 2.6% and negative predictive value was 99.8% for biochemical markers in first trimester screening test. Sensitivity was 100%, specifity was 92%, positive predictive value was 4% and negative predictive value was 100% for combined test. Conclusion: Adding NT to first trimester screening test made distinctive reduction in invasive attempts rates. It is clear that effective laboratory assessment with correct NT measurement is very efficient in discrimination between DS diagnosis and normal pregnancie

BONE MINERAL DENSITY AND THYROID-STIMULATING HORMONE ASSOCIATION IN POSTMENOPAUSAL HEALTHY WOMEN

Amaç: Postmenopozal sağlıklı kadınlarda femoral ve lomber kemik mineralyoğunluğunun tiroid stimülan hormon düzeyi ile ilişkisini araştırmak.Gereç ve yöntem: Çalışmaya 152 postmenopozal sağlıklı kadın dahil edilmiştir.Kemik mineral yoğunluğu, DEXA ile anterior-posterior lomber (L1-L4) spine'ler ve femurüzerinden yapıldı ve TSH düzeyi kemilüminesans yöntemi kullanılarak ölçüldü.İstatistiksel analizde Pearson korelasyonu, t - testi, tek yönlü varyans analizi (ANOVA),multiple regresyon analizi kullanıldı p < 0,05 anlamlı kabul edildi.Bulgular: Tiroid stimülan hormon düzeyi ile kemik mineral yoğunluğu arasında anlamlıbir ilişki saptanmadı (toplam lomber spinal (L1-4) T skoru için p = 0,11 ve toplam femurT skoru için p = -0,03). Toplam femur T skoru ile yaş, menopoz yılı, vücut kitle indeksiarasındaki ilişki anlamlı bulundu (p<0,05) Toplam lomber spinal (L1-4) T skoru ile vücutkitle indeksi, menopoz yılı ve hormon replasman tedavisi kullanım süresi arasındakiilişki anlamlı bulundu (p < 0,05). Doğal menopozda, cerrahi menopoza göre toplamfemur T skoru ölçümleri anlamlı olarak daha düşük bulundu (p=0,04). Toplam femur vetoplam lomber spinal (L1-4) T skoru ölçümlerinin her ikisi ile VKI arasında anlamlı birilişki saptandı (p < 0,01) (femur için r2 = 0,15, lomber vertebra spine için r2 =0,12).Sonuç: Postmenopozal sağlıklı kadınlarda kemik mineral yoğunluğu ile iroid stimülanhormon değerleri arasında anlamlı bir korelasyon saptanmadı. Tiroid stimülan hormondeğerinin kemik mineral yoğunluğunu göstermek için iyi bir marker olmadığı düşünüldü.Vücut kitle indeksi ile hem spinal hem de femur T skorları arasında anlamlı bir ilişkiolması ile birlikte vücut kitle indeksinin kemik mineral yoğunluğu için iyi bir göstergeolabileceği görüldü. Benzer çalışmalar menopozal ve premenopozal dönemlerde de yapılarakkemik mineral yoğunluğunun tiroid stimülan hormon düzeyi ve vücut kitle indeksiile ilişkisi daha geniş profilde değerlendirilebilir ve tekrarlayan ölçümlerle bu değişimdaha iyi gösterilebilir.Objective: To investigate the association between bone mineral density (BMD) andserum Thyroid-Stimulating Hormone levels in postmenopausal healthy women.Postmenopozal sağlıklı kadınlarda kemik mineral yoğunluğu-tiroid stimülan 2 hormon ilişkisiMaterial and method: 152 postmenopausal healthy women were included in ourstudy. We measured BMD at the lumbar spine (L1-L4) and femur using dual energy Xrayabsorptiometry and serum TSH concentration using chemiluminisence. Pearson'sCorrelation, t-test, analysis of variance (ANOVA), multiple regression analysis wereused in statistical analysis and p<0.05 was considered statistically significant.Results: There was no significant relation between TSH levels and BMD scores (forlumbar spine p = 0,11 and femur p = -0,03). A significant relation was determinedbetween the total femur T score and age, years since menopause, body mass index(VKI) (p<0.05 ). Also there was a significant relation between total lumbar spine T scoreand VKI, years since menopause, duration for hormone replacement therapy (p<0.05).Total femur T score was lower in natural menopause group than surgical menopausegroup (p=0.04). There was a significant correlation between VKI and both T scores (p <0.01) (for femur r2 = 0.15, for lumber spine r2 =0.12)Conclusion: We did not determine a significant relation between BMD and TSH. TSHvalue seems not a good predictive marker for detecting bone mineral density. Therewas a close relation between VKI and BMD, so we conclude that VKI is a usefulindicator for detecting BMD. Similar studies can be performed in premenopausal andmenopausal women to show the association between TSH, VKI and BMD

EVALUATION OF FETAL AND MATERNAL RESULTS IN TWİN PREGNANCIES

Amaç: İkiz gebelikler tüm gebeliklerin %1-2’sini, perinatal mortalitenin ise %10-15’ini oluşturmaktadır. Perinatal mortalite ve morbidite başlıca prematür eylem nedeni ile ortaya çıkmaktadır. Bu çalışmada kliniğimizde doğumu gerçekleşen ikiz gebeliklerin maternal ve fetal sonuçların değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Ocak 2012-Mayıs 2014 tarihleri arasında kliniğimizde doğum yapmış 47 ikiz gebelik olgusunun dosya kayıtları incelenerek maternal yaş, doğum sırasında ortalama gebelik haftası, ortalama doğum kilosu, yenidoğan yoğun bakım ihtiyacı olup olmadığı, bebeklerin 1. ve 5. dakika Apgar skorları değerlendirildi. Sonuçlar ortalama ± standart sapma olarak ifade edildi. Bulgular: İkiz gebelik sıklığı %1,6 olarak tespit edildi. Ortalama maternal yaş 30,19 ± 5,59 (aralık: 18-45), ortalama gravida 2,35 ± 1,70, ortalama parite 0,95 ± 1,27, doğum sırasında ortalama gebelik haftası 33,43 ± 6,02 (aralık: 29-39) olarak tespit edildi. Olguların %19,14’de (9 olgu) hipertansiyon mevcuttu. Olguların %14,9’u (7 olgu) ise diyabet ile komplike idi. Yenidoğan doğum kiloları ortalama 2263,97 ± 585,85 gr (aralık: 820-3670 gr), 1.dakika Apgar skorları 8,50 ± 1,80 ve 5.dakika Apgar skorları 8,54 ± 1,25 olarak bulundu. Yenidoğan bebeklerin %20’sinde yenidoğan bakım ihtiyacı oldu; %10 bebekte solunum yolu ile ilgili komplikasyonlar gelişti. Sonuç: İkiz gebelikler halen perinatal ve maternal morbidite nedenidir. Bu gebelikler normal popülasyona göre daha sık diyabet ve hipertansiyon ile komplike olmaktadır. Perinatal sonuçlar özellikle doğum haftası ile ilişkilidir.Objective: Twin pregnancies account for 1-2% of all pregnancies and for 10-15% of perinatal mortality. Perinatal mortality and morbidity occurs mainly due to preterm birth. With this study, we aimed to analyse the fetal and maternal outcomes of twin pregnancies who gave birth in our clinic. Material and Method: The file records of 47 twin pregnancies giving birth in our clinic between January 2012 and May 2014 were analysed and the data about the maternal age, gestational age, mean fetal birth weight, the need of the admission to neonatal intensive care unit, the Apgar scores at 1 and 5th minutes was evaluated. The results were expressed as mean ± standard deviation. Results: The incidence of twinning was 1.6%. Mean maternal age was 30.19 ± 5.59 (range: 18-45), mean gravidity was 2.35 ± 1.70, mean parity was 0.95 ± 1.27, mean gestational week during labor was 33.43 ± 6.02 (range: 29-39). 9 cases (19.14%) were complicated with hypertension and 7 cases (14.9%) were complicated with diabetes. The mean birth weights of newborns were 2263.97 ± 585.85 gr (range: 820-3670 gr); Apgar scores at 1. and 5.minute were 8.50 ± 1.80 and 8.54 ± 1.25 respectively. 20% of newborns needed treatment at the neonatal intensive care unit and 10% of newborns developed complications regarding the respiratory system. Conclusion: Twin pregnancies are still a cause of perinatal and maternal morbidity. These pregnancies are complicated more commonly with diabetes and hypertension, compared with singleton pregnancies. Perinatal outcomes are especially related to the gestational ag

IS LAPAROSCOPY RELIABLE FOR THE TREATMENT OF PATIENTS WITH ADNEXIAL MASSES

Amaç: Adneksiyal kitle nedeni ile laparoskopik girişim uygulanan hastaların sosyodemografikve klinik özelliklerinin değerlendirilmesiGereç ve yöntem: Ocak 2002-Ocak 2007 arasında adneksiyal kitle nedeni ile laparoskopikişlem uygulanan hastaların dosyaları retrospektif olarak incelendi. Demografikve klinik bilgiler hasta kayıtlarından elde edildi.Bulgular: Çalışmaya 14 ile 76 yaş arasında 186 hasta alındı. Hastalarda ortalamayaş 34,0 ± 11,2 idi. Hastaların %88,2'si premenapozal dönemdeydi. Ortalama hastanedeyatış süresi 3,27 ± 2,09 gün olarak saptandı. Olguların %64,6'sına laparoskopikkistektomi, %33,7'sine laparoskopik ooferektomi, %1,7'sine laparoskopik histerektomi+ salpingo-ooferektomi prosedürü uygulandı. Major komplikasyon oranı %2,7 (n=5)olarak bulundu. Laparotomiye geçiş oranı %7,0 (n=13) olarak bulundu. Hastaların %49,4'ünde geçirilmiş ameliyat mevcut olup en sık jineko-obstetrik ameliyat öyküsü alındı(%27,3). Başvuru anında yapılan ultrasonografik görüntülemede olguların % 27,0'sindekitlenin çapı 10 cm olarak bulundu.Alınan materyallerin patolojik incelemesinde %98,4 benign patoloji, %1,6 malign patolojisaptandı.Sonuç: Patolojisi bilinmeyen adneksiyal kitlelerde laparoskopik yaklaşım benignlezyonların belirlenmesi ve çıkarılması, malign lezyonların ise tespitinde altın standartolarak düşünülmesi gerektiği kanaatindeyiz.Objectives: The aim of this study is to evaluate the feasibility and safety oflaparoscopic intervention for the diagnosis and treatment of adnexial masses.Material and method: A total of 186 patients with adnexial mass were treated withlaparoscopy from January 2002 to January 2007. All clinical and demographic data ofthe patients were reviewed retrospectively.Results: 186 women underwent laparoscopic evaluation for the adnexial mass. Theultrasonographic measurements of masses were 10 cm in 5,3% of the cases. Themedian age of patients was 34 years (range, 14-76 years), 88.2% of patients were inpremenopausal women and 27.3% of all patients had a previous gynecologic/obstetricoperative intervention. Thehistopathologic results werereported as benign in 98.4%of cases and primary ovarian cancerin 1.6% of the women. Among thesecases 64.6%of the women underwent laparoscopic ovarian cystectomy, 33.7% underwent laparoscopicoopherectomy and 1.7% underwent laparoscopic hysterectomy-salphingo -oopherectomy. Overall 7.0% (13/186) of all laparoscopic interventions required conversionto laparotomy. Complications occured in 2.7% (5/186) of the patients. Postoperativehospitalization period of the patients were approximately 3.27 ±2.09 days.Conclusion: We conclude that laparoscopy may be regarded as a gold standard forthe diagnosis and treatment of adnexial masses with a low risk for malignancy

EVALUATION OF THE CASES WITH TUBOOVARIAN ABSCESSES

Amaç: Kliniğimizde Tuboovarian Abse nedeniyle cerrahi operasyon uygulanan hastalarınretrospektif olarak araştırılarak, klinik ve laboratuar sonuçlarını, uygulanan tedaviyöntemlerini ve gelişen komplikasyonlarını incelemektir.Gereç ve yöntem: Ocak 2003 - Mart 2007 tarihleri arasında tuboovarian abse tanısıile opere edilen 39 hasta retrospektif olarak incelendi. Hastaların klinik ve laboratuarsonuçları, uygulanan operasyon yöntemleri ve gelişen komplikasyonlar kaydedildi.Bulgular: Hastaların %71,7'si multipardı. Hastaların başlıca şikayetleri pelvik ağrı(%92,3) ve ateş (%69,6)'idi. Rahim içi araç kullanımı prevelansı %48,7, son 6 ay içindegeçirilmiş intrauterin veya intraabdominal operasyon prevelansı %33,3 ve pelvikinflamatuar hastalık prevelansı %28,2 olarak saptandı. Klinik bulgu olarak; %69,2 hastada38,3ËšC üzerinde ateş, %64,1 hastada lökositoz, %92,3 hastada yükseksedimentasyon hızı, %89,7 hastada C-reaktif protein yüksekliği tespit edilmiştir. Doğurganlığınıkorumak isteyen hastalara abse drenajı uygulandı. TOA drenajı yapılan hastalarınoranı %71,8 idi. Kullanılan rezektif cerrahi yöntemler arasında; total abdominalhisterektomi oranı (%12,8), unilateral salpingoooferektomi oranı (%10,3), bilateralsalpingoooferektomi oranı (%5,1) saptandı. Hastaların 5'inde (%12,8) intra-operatifkomplikasyon olarak barsak hasarı gelişirken, 4 hastada (%10,3) postoperatif komplikasyonolarak yara yeri enfeksiyonu ve atelektazi gelişti.Sonuç: TOA'yi takip eden yüksek morbidite ve azalmış fertilite oranları nedeniyle erkentanı ve cerrahi müdahale oldukça önemlidir.Objective: The aim of study is retrospective evaluation of the clinical and laboratoryresults, the treatments and complications in patients who were managed for tuboovarianabscess (TOA) clinic in our department.Materials and method: The records of 39 patients who has operated with thediagnosis of tuboovarian abscess between January 2003 and March 2007 were studiedretrospectively. The patients clinical and laboratory results, operational methods appliedand the complications raised were recorded.Results: 71.7% of the patients were multipar. The main complaints of the patientswere pelvic pain (92.3%) and fever (69.6%). Prevelance of intrauterine device (IUD)usage, intrauterin or intraabdominal operations applied in the last 6 months, previouspelvic inflamatuary disease (PID) were as 48.7%, 33.3 %, 28.2%. As clinical andlaboratory signs; in 69.2 % of patients high axillary fever (>38.3ºC), in %64.1 of patientsleukocytosis, in 92.3 % of patients high sedimentation rate and in 89.7 % of patientshigh C-Reactive Protein (CRP) detected. For the patients who would like to preservereproductivity; TOA abscess drainage is applied with a ratio of 71.8%. As resectivesurgery methods that were applied; total abdominal hysterectomy ratio was 12.8 %,unilateral salphingoophorectomy ratio was 10.3 %, bilateral salphingoophorectomy ratiowas 5.1%. Intraoperative complications were observed in 5 (12.8%) patients (bowelinjury) where as postoperative complication were observed in 4 (10.3%) patients(wound enfection and atelectasia).Conclusion: Due to minimizing decreased fertility and high morbidity following TOA; itis important for the women health to apply early diagnosis and early surgery

Assessment of renal volume by 3D VOCAL Ultrasonography method in late-onset growth-restricted fetuses with normal amniotic fluid index

Objectives: The aim of this study was to study renal volumetric alterations and renal artery doppler changes in late-onsetfetal growth restricted (FGR) fetuses with normal amniotic fluid compared to healthy pregnancies.Material and methods: This prospective study was composed of pregnant women with late-onset FGR and a control groupof uncomplicated pregnancies within 32–37 weeks of gestation. Following the assessment of umbilical, bilateral uterine,middle cerebral using Doppler Ultrasonography (US), three dimensional (3D) US Virtual Organ Computer-aided Analysis(VOCAL) was executed to calculate bilateral renal volumes.Results: A total of 76 fetuses with FGR and 51 healthy fetuses (control group) were evaluated. Umbilical artery Dopplersystole/diastole and Pulsatility index values were found to be significantly different between the two groups (p = 0.001 andp = 0.001, respectively). Middle cerebral, bilateral uterine, and bilateral renal arteries’ Doppler indices revealed no differencebetween the two groups. Right, left, and mean renal volume of the fetuses with FGR were smaller than the controlgroup, and the differences were statistically significant (p = 0.025, p = 0.004, p = 0.004, respectively). Left renal volume wassignificantly greater than the right renal volume in the control group (p = 0.009).Conclusion: Although not accompanied by oligohydramnios, and having similar renal vascular resistance as the controlgroup, renal volumes of fetuses with late-onset FGR were still observed lower than the control group. This difference wasexplained by not decreased blood flow via redistribution but other mechanisms like glomeruli reduction and glomerularapoptosis

Evaluation of Fetal Central Nervous System Anomalies; Perinatology Council Data of a Reference Center

INTRODUCTION: Central nervous system (CNS) anomalies are the second most common congenital malformations detected during antenatal period. Rates of prenatal diagnosis are aroung 96% in anencephaly, but drops down to approximately 14 % in migration anomalies.We aimed to determine the frequency and features of CNS anomalies evaluated in the perinatology council of our hospital where high-risk pregnancies were discussed and also to emphasize the importance of antenatal diagnosis. METHODS: Pregnant women, with a CNS anomaly detected in their fetus, who were evaluated between January 2019-December 2019 in the perinatology council of Tepecik Training and Research Hospital were included in the study. Retrospectively, the records of the cases were examined, prenatal, and maternal risk factors at the time of council session, the council decision and the results were recorded. Statistical analyzes were done using SPSS 20.0 program. RESULTS: Data of 1272 pregnant women were evaluated in the study, and 261 cases (20.5%) with CNS anomalies were detected. A total of 129 pregnant women were excluded from the study because follow-up of these patients were not realized in our center or they didn't give birth yet.. Totally, 132 pregnant women were included in the study. The mean maternal age was 26.99+-6.50 (14-42) years, the mean gestational age was 22.63+-7.08 (10.4-38.6) weeks. Most common CNS anomalies detected were neural tube defects (n=54; 40%), hydrocephalus/ventriculomegaly (n=36; 27%), migration defects (n=21; 15%) and cerebellar malformations (n=9; 6%). Termination of pregnancy was decided for 29.8% (n=78) of pregnant women, but realized only for 62 pregnancies. Among pregnancies which were decided to be continued due to the fact that gestational week was 22 weeks or more (n=51), had fetuses with neural tube defects (n=25; 50%) and hydrocephalus/ventriculomegaly (n=36; 27%) with poor prognosis. DISCUSSION AND CONCLUSION: As the anomalies with high morbidity and mortality were referred to our hospital after the 22nd gestational week, termination option could not be offered to these pregnancies. High-risk pregnancies should be directed to perinatology centers in the early period so that this option can be presented to the family, appropriate follow-up and treatment of life-compatible ones

The relationship between serum resistin-adiponectin levels and clinical factors in gestational diabetes mellitus patients and pregnant women with normal glucose tolerance

Amaç: Gestasyonel Diabetes Mellitus (GDM) tanısı alan hastalarda ve glukoz intoleransı olmayan normal gebelerdeæ tanı esnasında (24-28. gebelik haftasında), doğumda (maternal dolaşım ve umbilikal kordda) ve doğum sonrası dönemde serum resistin ve adiponektin seviyelerini saptamak ve klinik faktörlerle ilişkilerini belirlemek. Yöntem: 24.-28. gebelik haftasında GDM tanısı almış 55 hasta ve glukoz intoleransı tespit edilmeyen 50 normal gebe çalışmaya alındı. Antenatal takiplerine devam etmeyen veya gebelik sürecinde tanımlanan komplikasyonları gelişen gebeler çalışma dışı bırakıldı (n=25). İstatistiksel değerlendirme, kalan 40 GDM ve 40 glukoz intoleransı olmayan gebe üzerinden yapıldı. 24.-28. gebelik haftasında, doğumda (maternal dolaşımda ve umbilikal kordda) ve doğumdan 24 saat sonra serum adiponektin ve resistin konsantrasyonları ELISA (Enzyme-Linked ImmunoSorbent Assay) yöntemi ile ölçüldü. Gruplar arasında ölçümlerdeki farklılıklar incelendi. Ayrıca bu değerlerin, tespit edilen diğer klinik ve laboratuar faktörlerle ilişkisi değerlendirildi. Bulgular: 24.-28. gebelik haftasında GDM'li hastalardaæ normal gebelere göre serum resistin seviyeleri anlamlı olarak yüksek (p=0,001) ve adiponektin düzeyleri anlamlı olarak düşüktü (p=0,02). Doğumda maternal serum adiponektin düzeyleriæ GDM'li hastalarda normal gebelere göre hala düşükken (p=0,03), resistin düzeyleri bakımından iki grup arasında fark yoktu (p=0,35). Doğum sonrası dönemde serum adiponektin düzeyleriæ GDM'li hastalarda normal gebelere göre yüksekken (p=0,009), resistin düzeyleri bakımından yine iki grup arasında fark yoktu (p=0,64). Doğumdaki umbilikal kord resistin seviyeleriæ GDM'li hastalarda normal gebelere göre yüksekken (p=0,006), adiponektin düzeyleri anlamlı olarak düşük bulundu (p=0,005). Sonuç: GDM'li hastalarda dolaşımdaki resistin ve adiponektin düzeylerini, glukoz ve insülin metabolizmasındaki değişiklikler düzenlemektedir. Serum adiponektin düzeylerindeki azalma ve resistin düzeylerindeki artışın, GDM'de insülin direnci gelişiminde rol oynadığı düşünülmektedir. Objective: To determine serum resistin- adiponectin levels and the relationship between these and clinical factors in Gestational Diabetes Mellitus (GDM) patients' and in normal pregnant women without glucose intolerance in course of diagnose (24th-28th week of gestation), in delivery (in maternal circulation and umbilical cord) and in postpartum period. Method: 55 GDM patients and 50 normal pregnant women without glucose intolerance, who were between 24th and 28th week of gestation were included in this study. 25 patients, who had not completed antenatal visits or had developed the defined complications during pregnancy period were excluded from the study. Statistical analysis was performed for the rest of 40 GDM and 40 normal pregnant women without glucose intolerance. Serum resistin and adiponectin concentrations were measured with ELISA (Enzyme-Linked ImmunoSorbent Assay) in 24th-28th week of gestation, in delivery (in maternal circulation and umbilical cord) and in postpartum 24th hour. The difference between the measurements of these groups was investigated. Also, the relationship between these results and the other established clinical-laboratory factors was considered. Results: Serum resistin concentrations were significantly higher (p=0,001) and adiponectin concentrations were significantly lower (p=0,02) in GDM patients, compared with the group of patients with normal glucose tolerance in 24th-28th week of gestation. In deliveryæ maternal serum adiponectin concentrations were significantly lower (p=0,03) in GDM patients compared with the group of patients with normal glucose tolerance, but there was no significant difference in resistin levels between these groups (p=0,35). In the postpartum periodæ serum adiponectin concentrations were significantly higher (p=0,009) in GDM patients compared with the group of patients with normal glucose tolerance, but there was no significant difference in resistin levels between these groups (p=0,64). Umbilical cord resistin concentrations in delivery were significantly higher (p=0,006) and adiponectin concentrations were significantly lower (p=0,005) in GDM patients compared with the group of patients with normal glucose tolerance. Conclusion: Resistin and adiponectin concentrations in GDM patients' circulation were regulated by the changes in glucose and insulin metabolism. Decrease in serum adiponectin levels and increase in resistin levels are thought to play a role in GDM patients' insulin resistance