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Objectives: To evaluate the maternal serum ischemia-modified albumin (IMA) concentration as an oxidative stress biomarker in pregnancies complicated by preterm pre-labor rupture of membranes (PPROM) without maternal clinical infection and compare these results with healthy pregnancies. Material and methods: The present cohort study included 40 pregnancies complicated by PPROM and 49 similar gestational age healthy pregnancies in the third trimester of gestation. Maternal venous blood specimens were obtained at the day of first diagnosis. Maternal serum IMA level was assayed with an Albumin Cobalt Binding test. The subjects were followed up until delivery and perinatal outcomes were recorded. Results: The maternal serum IMA concentrations were significantly higher in the study group (0.56 ± 0.05 absorbance units) as compared to controls (0.54 ± 0.03 absorbance units) (p = 0.020). The maternal serum IMA concentrations were not significantly correlated with the initial maternal white blood cell count (r: 0.118, p = 0.269) and C-reactive protein levels (r: 0.066, p = 0.541). The maternal serum IMA concentrations were negatively correlated with gestational age at delivery (r: --0.248, p = 0.019), birthweight (r: --0.247, p = 0.020) and Apgar scores (r: --0.200, p = 0.049; r: --0.245, p = 0.020). The threshold value of maternal serum IMA concentration above 0.55 absorbance units indicated the pregnancy complicated by PPROM by 57.5% sensitivity and 57.1% specificity (Area under curve 0.613, confidence interval 0.50--0.73). Conclusions: The current study supported for the first time that there is an association between increased maternal serum IMA levels and the development of PPROM in the third trimester of gestation without maternal clinical infection. Elevated maternal serum IMA levels may alert the obstetrician about poor ongoing perinatal outcomes in the early phase of PPROM before increased maternal C-reactive protein and white blood cell count. [ABSTRACT FROM AUTHOR]

Aims: Accurate prediction of changes in hemoglobin (Hb) levels, an indicator of blood loss, in cesarean deliveries is critical for reducing maternal morbidity and mortality. This study evaluated the potential relationship between the preoperative delta neutrophil index (DNI), an inflammatory marker, and changes in Hb levels after cesarean section. Methods: Women with a history of a single cesarean section and who underwent a second cesarean section for delivery between 2018 and 2020 were retrospectively analyzed. The difference between the preoperative and postoperative 6th-hour and 24th-hour Hb levels was defined as the delta Hb 1 (ΔHb1) level and delta Hb 2 (Hb2) level, respectively. The primary outcome was the relationship between preoperative DNI with ΔHb1 level and Hb2 level. We also investigated the relationships of the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) with DNI and changes in Hb levels. Results: The study included 368 women with a mean age of 28 (19 to 45) years. The mean DNI was -0.82±5.62, NLR was 4.31±2.16, and PLR was 141.89±55.22. A positive correlation was found between DNI and ΔHb1 level (r=0.624, p<0.05) and ΔHb2 level (r=0.372, p=0.05). No significant correlation was found between PLR and NLR. Conclusions: Among women who underwent cesarean section, preoperative DNI showed a positive relationship with changes in postoperative Hb levels. The significance of DNI in predicting changes in Hb levels after cesarean section needs to be explored. [ABSTRACT FROM AUTHOR]

Maternal vascular hypoperfusion is the most common cause of fetal growth restrict ion. Maternal oxidative status features are identifiable on placental pathology, and antepartum diagnostic methods are rapidly evolving. The current study was constructed to determine the maternal oxidative status by measuring serum ischemia modified albumin (IMA) levels in pregnancies complicated with idiopathic intrauterine growth restriction (IUGR). The current study was designed as a descriptive and cohort trial. A total of 87 pregnant women; 45 healthy controls and 42 pregnancies complicated with idiopathic IUGR were included to the study population. Maternal serum IMA concentration was measured prior to the administration of any medication. The perinatal outcomes of patie nts were also recorded. Maternal serum IMA concentration in pregnancies complicated by idiopathic IUGR was higher than in healthy controls. There was no significant difference between the groups (0.54±0.04 versus 0.55±0.06 ABSU, p: 0.314). IUGR is a significant pregnancy complication. Elevated oxidative stress which leads to an ischemic microenvironment is associated with IUGR. Maternal serum IMA which is a possible marker for oxidative stress is not increase in pregnancies complicated with idiopathic IUGR. [ABSTRACT FROM AUTHOR]

Objective: The pathophysiology of uterine scar dehiscence is not yet clear. The aim of this study was to investigate whether preoperative hemogram parameters can be used as predictive markers of uterine scar dehiscence, thus improving prediction and contributing to management of repeat Cesarean section. Material and Methods: Between 2015 and 2020, 36670 (47.6%) cesarean sections were delivered in our hospital and 16943 of them had a previous Cesarean section. All cases of uterine scar rupture detected during Cesarean section were identified, and a total of 40 patients were included after excluding cases with impairment of the systemic inflammatory response (SIR). Controls consisted of 40 randomly selected, ageand body mass index (BMI)-matched patients, and the groups were compared. Results: Age, BMI, and gravidity were similar (p>0.05). Although the gestational week and Apgar scores were similar between the groups (p>0.05), the birth weight amongst controls was significantly higher than the uterine dehiscence group (p=0.028). Platelet-to-lymphocyte ratio, neutrophil-to-lymphocyte ratio, and other hemogram values were similar in both groups (p>0.05). Mean platelet volume (MPV) in the control group was significantly higher than in the uterine rupture group (p=0.049). Regression analysis found no significant result between hemogram parameters, birth weight, and dehiscence. Conclusion: In this study, which set out to identify predictors of the risk of uterine scar dehiscence with SIR parameters, only the MPV value was lower in the dehiscence group. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to determine the levels of lipid peroxidation (MDA) and antioxidants such as reduced glutathione (GSH), catalase (CAT) and superoxide dismutase (SOD) in the blood serum of patients with cirrhosis and liver transplantation. Methods: In this study, serum malondialdehyde acid (MDA) levels, superoxide dismutase (SOD), reduced glutathione (GSH), and catalase (CAT) activities were measured spectrophotometrically and compared to the results of the healthy control group. Results: SOD, CAT and GSH activities were significantly decreased in the patient groups compared to the healthy control group (p<0.05). MDA levels were significantly higher in the patient group compared to the healthy control group (p <0.05). Conclusions: In conclusion, this study demonstrated that oxidative stress may play an important role in the development of liver cirrhosis and in liver transplantation. This study is the first one to show how MDA, SOD, CAT and GSH levels change in liver cirrhosis and liver transplantation, while further studies are essential to investigate antioxidant enzymes and oxidative stress status in patients with cirrhosis and liver transplantation. [ABSTRACT FROM AUTHOR]

Aim: To assess associated findings, chromosomal abnormalities and outcomes of the pregnancies diagnosed with fetal clubfoot. Materials and Methods: Ultrasonographic characteristics, pregnancy work-up and fetal outcomes of the pregnancies diagnosed with fetal clubfoot between January 2015 and October 2019 were evaluated retrospectively. Clubfoot was considered as complex or isolated depending on the presence or absence of additional structural abnormalities. The results of cases, which grouped according to the presence of additional abnormalities and laterality, were compared. Results: A total data of 46 pregnancies diagnosed with fetal clubfoot during the study period were included. The most associated abnormality with clubfoot was central nervous system (CNS) anomalies. Nineteen (41%) of fetuses were considered complex, and 27 (59%) were considered isolated. The ratio of the cases with poor outcomes was higher in the complex group than in the isolated group and was 15 (79%) and 1(3%) respectively (p=0.000 for bilateral group and p=0.013 for unilateral group). There were 7 (36%) cases with a chromosomal abnormality in the complex group and 1(4%) case in the isolated group. The deformity was unilateral in 16 (35%) and bilateral in 30 (65%) cases. The rate of poor outcomes was not different in cases with bilateral and unilateral clubfoot deformity (p=0.356). Conclusion: The prognosis of the fetuses diagnosed with clubfoot mostly depends on associated abnormalities. Therefore a careful evaluation of these fetuses must be performed even if karyotyping is normal. The laterality did not have any impact on the prognosis of cases with clubfoot. [ABSTRACT FROM AUTHOR]

Aim: We aimed to evaluate placental elasticity for the short‐time prediction of delivery in cases of threatened preterm labor (TPL). Methods: We performed a prospective study with consented pregnant women diagnosed with TPL (24th to 34th gestational week). According to the birth time, the patients were grouped into two groups, whether the delivery happened in the following first week or not. We compared the placental strain ratio (PSR) values between these two groups. Results: A total of 108 pregnant women divided into two groups according to the delivery time were enrolled in our study. The pregnant women who had a delivery in 1 week after hospitalization have increased PSR values when compared to those who have not delivered within 1 week (P < 0.001). Multivariate logistic regression analysis showed that cervical length and PSR were significantly associated with delivery in 1 week after hospitalization. When the cervical length was entered as a covariate (control) variable, PSR was significantly associated with delivery time (B = 0.504, odds ratio: 1.655, 95% confidence interval: 1.339–2.045, P < 0.001). A PSR value of 4.04 had a sensitivity of 77.78% and a specificity of 87.04% in terms of short‐time prediction of the delivery time, in the receiver–operator curves analysis to determine the cut‐off point PSR value. Conclusion: Elastography may contribute to predict the delivery time in high‐risk pregnants with TPL. [ABSTRACT FROM AUTHOR]

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