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The aim of this study was to investigate the effect of maternal serum Vitamin D levels on the elasticity of placenta. Seventy-four spontaneously conceived singleton pregnancies in their first trimester were enrolled into this study. Fifty-one of them had Vitamin D deficiency (<20 ng/mL), while 23 pregnancies had Vitamin D levels ≥20 ng/mL. The placental elasticity was measured by the transabdominal Point Shear Wave Elastography (pSWE) method. In each case, the mean of 10 consecutive measurements was accepted as the mean placental elasticity value. The mean pSWE values did not significantly differ between the Vitamin D deficient group and the control group ( p  > .05). Placental elasticity was not found to be different in the pregnancies with Vitamin D deficiency during the first trimester.IMPACT STATEMENT What is already known on this subject? The pSWE technique provides opportunity to determine the elasticity of any interested tissue. Placental elasticity has been found to be changed in inflammatory and fibrotic conditions such as in preeclampsia, intrauterine growth restriction or diabetes. On the other hand, Vitamin D deficiency is linked with several comorbidities such as autoimmune disorders, cancer and cardiovascular disorders. Vitamin D also plays a role in placental angiogenesis in the first trimester. Maternal Vitamin D levels are shown to be related with adverse pregnancy outcomes. What do the results of this study add? To the best of our knowledge, this study is the first assessing the association between Vitamin D levels and placental elasticity. Placental elasticity was not found to be changed by Vitamin D deficiency. What are the implications of these findings for clinical practice and/or further research? Our pilot study revealed that Vitamin D deficiency does not have any impact on placental elasticity in the first trimester. However, longitudinal studies concerning placental elasticity in subsequent trimesters are needed to support our findings.

Objective: To investigate serum cortistatin levels in women with gestational diabetes mellitus (GDM) and women with uncomplicated pregnancies. Material and methods: This case-control study consisted of 40 pregnancies with GDM and 41 healthy singleton pregnancies matched for maternal and gestational age. The maternal serum levels of cortistatin were measured with enzyme-linked immunosorbent assay and compared between groups. Results: Cortistatin levels were significantly lower in GDM group (48.85 ± 20.18 versus 65.84 ± 33.98 ng/ml, p  = .008). There was a statistically significant difference in cortistatin levels between different treatment modalities and control group ( χ 2 (2) = 8.828, p  = .012). Pairwise comparisons showed that diet group had significantly lower CST levels than control group ( p  = .012). Serum cortistatin levels were negatively correlated with serum insulin and glucose levels and HOMA-IR ( r  = -0.358, p  = .001; r  = -0.303, p  = .006; r  = -0.444, p  < .001, respectively). Conclusion: Cortistatin levels were significantly lower in GDM pregnancies and related to serum insulin and glucose levels and HOMA-IR in pregnancy. This may help to better clarify the mechanism of GDM pathogenesis.

Objective: The current study aimed to investigate renal cortical elasticity (RCE) in early- and late-onset preeclampsia patients and compare the results with healthy controls. Materials and methods: The study consisted of 136 pregnant women. Three groups were identified as; the late-onset preeclampsia (LOP) group ( n  = 40), the early-onset preeclampsia (EOP) group ( n  = 32) and the control group ( n  = 64). RCE values were measured by point shear wave elastography (pSWE). Nine measurements were taken for each kidney and the mean of nine measurements was accepted as the mean RCE value for each kidney. The arithmetic mean of left and right RCE values was accepted as the overall RCE value of a subject. Groups were compared in terms of clinical and biochemical parameters, ultrasonography findings and pSWE values. Results: There was a statistically significant difference between groups in terms of overall RCE values (F[2,133] = 17.96, p  < .001). Post hoc comparisons indicated that both preeclampsia groups exhibited significantly higher RCE values than the control group. However, overall RCE values were not significantly different between the EOP and LOP groups. Overall RCE values were significantly and positively correlated with systolic blood pressure ( r  = 0.363, p  < .001), diastolic blood pressure ( r  = 0.347, p  < .001), proteinuria ( r  = 0.343, p  < .001), serum creatinine level ( r  = 0.181, p  = .035), serum uric acid level ( r  = 0.243, p  = .004) and blood urea nitrogen ( r  = 0.27, p  = .001). Conclusion: Our study demonstrated that maternal renal cortical stiffness increased in women with preeclampsia. The increased RCE values may be indicative for the severity of preeclampsia due to positive correlations between renal cortical stiffness and systolic - diastolic blood pressure and serum creatinine level.

Objective : Perlecan is an extracellular matrix proteoglycan suggested to maintain endothelial functions. We aimed to measure maternal serum perlecan levels in different preeclampsia phenotypes. Methods : This study included 50 women with preeclampsia and 30 healthy pregnant women. Results : Serum perlecan levels were significantly higher (p = 0.016) in preeclamptic women with severe features(n = 23) than preeclampsia patients(n = 27). There were no statistically significant differences in serum perlecan levels between the early-onset preeclampsia(n = 25), late-onset preeclampsia(n = 25), and healthy pregnancies. Conclusion : Our findings suggest that preeclamptic women with severe features have higher serum perlecan levels than women with preeclampsia.

Spexin is a peptide that is involved in energy homeostasis and its expression is influenced by altered glucose metabolism. Gestational diabetes mellitus (GDM) is associated with increased insulin resistance (IR) and pregnancy is a progressive insulin resistant state. We hypothesized that spexin may have an effect on the pathophysiology of GDM which further could help to identify the disease. The aim of this study was to investigate spexin levels in the third trimester pregnancies with GDM and healthy controls. Thirty-nine women with GDM and 39 healthy singleton pregnancies were enrolled in this case-control study. Serum spexin concentrations were measured and correlated to biochemical and clinical parameters. Serum spexin levels were significantly higher in women with GDM (3686.25 ± 348.37 vs. 3472.33 ± 293.93 pg/ml, p =.004). Spexin levels ​​did not differ significantly according to treatment modality. Moreover, spexin levels were significantly positively correlated with homeostasis model assessment of IR (HOMA-IR). Spexin levels were significantly higher in women with GDM and closely related to HOMA-IR in the third trimester pregnancy. This may help to better clarify the pathophysiological role of spexin in GDM.

Objectives: We aimed to evaluate the placental volume and placental mean gray value in gestational diabetes mellitus (GDM) and healthy placentas using three-dimensional (3D) ultrasound and Virtual Organ Computer-aided AnaLysis (VOCAL)., Methods: This case-control prospective study consisted of 39 singleton pregnancies complicated by GDM and 42 healthy singleton pregnancies matched for gestational age, maternal age and parity. Placental volume and placental volumetric mean gray values were evaluated. The placental volume (cm(3)) was analyzed using the VOCAL imaging analysis program and 3D histogram was used to calculate the volumetric mean gray value (%)., Results: Placental volume was significantly larger in GDM (411.59 ± 170.82 versus 343.86 ± 128.94 cm(3); p = 0.046). There was no significant difference in mean gray value between GDM and healthy placentas (36.65 ± 7.02 versus 38.71 ± 7.91, respectively; p = 0.277). Placental volume was significantly correlated with gestational week (r = 0.219, p = 0.035) and parity (r = 0.228, p = 0.048). There was negative significant relation between placental volume and umbilical artery systolic/diastolic ratio, pulsatility index and resistance index (r = -0.278, p = 0.007; r = -0.315, p = 0.002; r = -0.322, p = 0.001, respectively)., Conclusions: Placental volume increases significantly in GDM, whereas mean gray values do not alter significantly. These data may reflect the placental changes in GDM placentas that may help to understand the pathophysiology better.

Objectives: We aimed to evaluate the placental volume and placental mean gray value in preeclampsia and healthy placentas by using three-dimensional (3D) ultrasonography and Virtual Organ Computer-aided AnaLysis (VOCAL)., Methods: This case-control prospective study consisted of 27 singleton pregnancies complicated by preeclampsia and 54 healthy singleton pregnancies matched for gestational age, maternal age and parity. Placental volume and placental volumetric mean gray values were evaluated. The placental volume (cm(3)) was analyzed using the VOCAL imaging program, and 3D histogram was used to calculate the volumetric mean gray value (%)., Results: Preeclamptic and control group consisted of 27 (mean age: 28.90 ± 5.95 years, mean gestation: 32.0 ± 4.55 weeks) and 54 (mean age: 29.48 ± 5.78 years, mean gestation: 32.61 ± 4.23 weeks) singleton pregnancies, respectively. Placental volume was significantly smaller in preeclampsia (250.62 ± 91.69 versus 370.98 ± 167.82 cm(3); p = 0.001). Volumetric mean gray value of the placenta was significantly higher in preeclampsia (38.24 ± 8.41 versus 33.50 ± 8.90%; p = 0.043). Placental volume was significantly correlated with the estimated fetal weight (r = 0.319; p = 0.003). There was negative significant relation between placental volume and umbilical artery pulsatility index, resistance index and systolic/diastolic ratio (r = -0.244, p = 0.024; r = -0.283, p = 0.005; r = -0.241, p = 0.024, respectively)., Conclusions: Placental volume diminishes significantly in preeclampsia, whereas volumetric mean gray values increases. This may reflect the early alterations in preeclamptic placentas, which may help to understand the pathophysiology better.

The aim of this study is to evaluate the relationship between three-dimensional (3D) ultrasound measurements of placenta at 11-13(6) weeks' gestation and maternal serum levels of pregnancy associated plasma protein-A (PAPP-A), free beta human chorionic gonadotrophin (fβhCG), Doppler parameters in early pregnancy. This prospective study consisted of 334 singleton pregnancies at 11-13(6) weeks' gestation. Placental volume and placental volumetric mean grey values were evaluated. The placental volume (cm(3)) was analysed using the Virtual Organ Computer-aided AnaLysis (VOCAL) imaging program and 3D histogram was used to calculate the volumetric mean grey value (%). Mean maternal age was 28.35 ± 7.55. Mean gestational age was 12.29 ± 0.68 weeks. Placental volume was 77.04 ± 35.74 cm(3). Mean grey value of the placenta was 34.38 ± 8.02%. Correlation analysis revealed that placental volume was significantly correlated with the crown-rump length (r = 0.173, p = 0.002), gestational week (r = 0.116, p = 0.036), ductus venosus pulsatility index (r = -0.101, p = 0.04) and maternal weight (r = 0.099, p = 0.037). There was a significant relation between the mean grey value of the placenta and maternal age (r = 0.131, p = 0.02), nuchal translucency (r = -0.109, p = 0.048), PAPP-A (r = 0.108, p = 0.04) and fβhCG (r = 0.104, p = 0.042). Volumetry of the placenta can be carried out with a high percentage of 1st trimester pregnancies. Volumetry during the 1st trimester could be helpful because of the less advanced state of placentation. This examination is easy to perform and the measurements can be acquired correctly and quickly.

Objective: This is a case of a prenatally diagnosed non-immune hydrops fetalis (NIHF) associated with translocation t(5;11)(q22;p15). An association between NIHF and this translocation has not been reported previously., Case Report: The patient was referred to the perinatology clinic with hydrops fetalis diagnosis at 23 weeks' gestation. We noted that the fetus had bilateral pleural effusion, ascites, widespread subcutaneous edema, membranous ventricular septal defect, hypoplastic fifth finger middle phalanx, clinodactyly, single umbilical artery. We performed cordocentesis. Chromosomal analysis on blood showed a balanced translocation between the long arm of chromosome 5 and the short arm of chromosome 11 with karyotype of 46,XX,t(5;11)(q22;p15)., Conclusion: We present prenatal diagnosis of a de novo translocation (5;11) in a hydropic fetus with ultrason abnormalities. In our case, karyotype analysis of the fetus, mother and father provided evidence of a de novo translocation, that might explain the NIHF.

We aimed to evaluate the volumetric and echogenic alterations in placentas between the intrauterine growth restriction (IUGR) and normal pregnancies using three-dimensional ultrasound and virtual organ computer-aided analysis (VOCAL) software. This case-control prospective study consisted of 48 singleton pregnancies complicated by IUGR and 60 healthy singleton pregnancies matched for maternal age, gestational age and parity. Placental volume (PV) and placental volumetric mean grey values (MGV) were evaluated. PV (cm(3)) was analysed using the VOCAL imaging analysis program, and 3D histogram was used to calculate the volumetric MGV (%). PV was 278.50 ± 63.68 and 370.98 ± 97.82 cm(3) in IUGR and control groups, respectively (p = 0.004). MGV of the placenta was 38.24 ± 8.41 and 38.24 ± 8.41 in IUGR and control groups, respectively (p = 0.30). receiver operator curve (ROC) curve analysis revealed that area under curve was 0.731 for PV. Correlation analysis revealed that PV was significantly associated with estimated fetal weight (r = 0.319, p = 0.003), biparietal diameter (r = 0.346, p = 0.002), head circumference (r = 0.269, p = 0.019), abdominal circumference (r = 0.344, p = 0.002) and femur length (r = 0.328, p = 0.004). PV was inversely related to the umbilical artery pulsatility index (r = - 0.244, p = 0.017). To the best of our knowledge, this is the first study evaluating volumetric MGV in IUGR placentas by comparing them with healthy pregnancies. Our study showed that PV diminishes significantly in IUGR pregnancies, whereas volumetric MGV does not alter significantly.

The aim of this study was to compare endometrial leukemia inhibitory factor (LIF) levels in spontaneous and clomiphene citrate (CC)-induced cycles of patients with unexplained infertility. The patients were followed in two consecutive cycles. Endometrial samples were obtained 7 days after ultrasonographic evidence that ovulation has occurred during the spontaneous cycle, then the patients were induced with CC from day 5 to day 9 during the subsequent cycle with 50 mg/day, and ovulation monitoring and endometrial biopsy were performed in the same manner. The samples were obtained using a Pipelle biopsy device without using local anesthesia, and kept in formaldehyde solution until the day of measurement. Then they were homogenized in phosphate buffered distilled water, and LIF levels were detected in the homogenized fluid by ELISA method. Endometrial LIF levels were 470 +/- 52 and 501 +/- 45 pg/1 gram wet tissue in spontaneous and CC-induced cycles respectively, revealing no significant difference. Ovulation induction with CC did not adversely affect endometrial LIF levels.