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Bladder exstrophy (BE) is a rare congenital anomaly. Owing to the advanced reconstructive surgical techniques and effective antibiotics, the incidence of urinary and systemic complications in patients with BE has decreased and the life expectancy has increased. However, this brings along social, sexual, and psychological problems; particularly, successful pregnancy and delivery is extremely rare in females with BE. We present a pregnancy of an 18-year-old female with BE, who has been followed at our university hospital since birth., (Copyright © 2012 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.)

Objective: To analyze the cause of changing maternal mortality ratios (MMRs) in a tertiary women's health center in Turkey in the last eight years., Materials and Methods: Charts of patients seen between 1998 and 2005 were retrospectively reviewed. Statistical analysis was performed using the Chi-square test. The results were accepted to be significant when the p value was <0.05., Results: During this period, 27 pregnancy-related deaths were identified via hospital death records. The MMR was found to have decreased in rate by approximately 50% from 822.2/100,000 live births in the previous report including the years 1978-1997 to 412.0/100,000 during the last eight years (p < 0.01). Pregnancy-induced hypertension was still the most frequent cause of maternal death. The decrease in MMR was due to the decrease in the ratio of maternal infection (26.4% in 1978-1997 to 7.4% in 1998-2005, p < 0.01)., Conclusion: Although treatment in the antenatal care and health service has decreased maternal deaths, it was discovered that the MMR has not reached the optimum levels found in developed countries in the last eight years. Also the percentage of direct obstetric deaths (with the exception of those caused by infection) showed no change and was similar to that found in the previous report (1978-1997).

The aim of this study was to evaluate the validity of platelet count (PC) and indices, including mean platelet volume (MPV), platelet distribution width (PDW) and platelet crit (PCT), in identifying the pregnancies at risk for preeclampsia. Demographic data and laboratory tests for PC, MPV, PDW and PCT of 250 pregnant women (100 normotensive pregnants, 121 pregnants with severe preeclampsia and 29 pregnants with mild preeclampsia) were retrospectively analyzed. Platelet counts and indices were compared between the study groups. MPV and PDW were significantly higher in preeclamptic pregnant women when compared to the normal group (p=0.006, p=0.046) and area under ROC curve for MPV was found statistically significant. PC, MPV and PCT were found significantly increased in late-onset preeclampsia (p<0.05) whereas there was no significant difference in these three indices in terms of severity of the disease. ROC analysis for MPV levels to differentiate earlyonset and late-onset preeclamptic cases was also found statistically significant. Measurement of MPV may contribute to identify the pregnants at risk for preeclampsia and assess the onset-time. PDW may be also useful in detection of the pregnant at risk for preeclampsia. [ABSTRACT FROM AUTHOR]

Aim: This prospective, single-blind and controlled clinical study aimed to research if CA-125 levels could be a useful test in the differential diagnosis of intact and ruptured tubal ectopic pregnancy. Methods: Sixty-five women with tubal ectopic pregnancy of 5–10 weeks’ duration (27 women with ruptured tubal ectopic pregnancy [REP] and 38 women with unruptured tubal ectopic pregnancy [UREP]) and 65 women with normal intrauterine pregnancy (NIUP) of the same gestational age were studied prospectively. Serum CA-125 levels were measured in all women and these levels were compared among the REP, UREP, and NIUP groups. Results: The mean CA-125 levels didn’t show any significant difference between the REP and NIUP groups ( P > 0.05). The mean CA-125 levels of these two groups were higher than that in the UREP group ( P < 0.01, P < 0.001, respectively). The dispersion ratios of the CA-125 levels had a statistically significant difference between the REP and UREP groups (χ2: 42.44, P < 0.0001). CA-125 levels weren’t correlated with gestational weeks in the REP and UREP groups (r: 0.005, P > 0.05; r: 0.008, P > 0.05, respectively). Conclusion: In intact tubal ectopic pregnancies, expectant or managed with medical treatment, the increase of CA-125 levels in the serial measurements could be a supplementary test for an early diagnosis of tubal rupture. [ABSTRACT FROM AUTHOR]

Objective: The aim of the study was to evaluate the relationship between neutrophil to lymphocyte ratio (NLR) and preeclampsia. Methods: Demographic data and laboratory tests for NLR of 203 pregnant women (73 normotensive pregnants, 23 pregnants with mild preeclampsia and 107 pregnants with severe preeclampsia) were retrospectively analyzed. Neutrophil to lymphocyte ratios were compared between the study groups. Results: Preeclamptic pregnant women had smaller gestation weeks, lower hemoglobin level and fetal birth weight than that of normal pregnant women. NLR in preeclamptic group was significantly higher than that of normal group ( p = 0.023) and area under ROC curve was found statistically significant ( p = 0.023). However, there was no statistically significant relationship between NLR and severity, proteinuria level, subjective symptoms and onset time of the disease. Conclusion: The findings showed that the measurement of NLR periodically may be useful to predict high-risk pregnancies in terms of preeclampsia, but further studies are needed to determine its contribution. [ABSTRACT FROM AUTHOR]