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This cross-sectional study examined the biomechanical and viscoelastic properties of the Achilles tendon (AT) and plantar fascia (PF) and analyzed their relationship in pregnant women with pelvic girdle pain (PGP). The study was conducted in a public hospital between January and May 2021. Forty-four pregnant women (PGP+, n: 22; PGP-, n: 22) and 21 non-pregnant women were included. Navicular drop was determined and the tonus, stiffness, and creep of PF and AT were measured by Myometer. Navicular drop was significantly different between the PGP+ and the non-pregnant group in both feet (Right, p  = .001; Left, p  =< .001), and the PGP- and the non-pregnant group in the left foot ( p  = .009). At the right AT, the stiffness was found to be higher in non-pregnant women compared to the PGP+ group ( p  = .007). Furthermore, creep was higher in PGP- compared to the non-pregnant group ( p  = .016). Tissue properties of PF were similar in all groups ( p  > .05). A correlation between tissue properties and the presence of PGP was not found. No findings indicated that the biomechanical and viscoelastic properties of the AT and PF were affected by the physiology of pregnancy. Moreover, no relationship was observed between the presence of PGP and the tissue properties of the AT and PF.

Objective: The aim was to evaluate the effectiveness of Arabin pessary use in patients with cervical insufficiency or short cervix before the 24th week of gestation and the impact of cervical examination findings prior to pessary application on the outcome in terms of the gestational week., Materials and Methods: In our study, among the pregnancies between the 12th and 24th gestational weeks, 60 pregnant women with a preterm delivery history and/or cervical length less than 25 mm were included. Among these 60 patients, 43 of them had a short cervix, 17 of them had cervical insufficiency. Routine medical and obstetric history was obtained. In the vaginal examination, the cervix was evaluated in terms of patency, dilatation, and position. Cervical length, presence of debris, and funneling were evaluated by transvaginal ultrasound. After receiving patients' approval a cervical pessary was applied to patients. Pessaries of pregnant women with 37 weeks of gestation were removed. Before reaching the 37th gestation week, pessaries were withdrawn in patients who had ongoing vaginal bleeding, premature rupture of membranes, and preterm contractions unresponsive to tocolytic treatment., Results: Thirty-one pregnant women (51.7%) out of 60 pregnant women who underwent pessary, delivered at 37 weeks and below. Delivery rates in the short cervical measurement group and cervical insufficiency group at ≤28 weeks, ≤34 weeks and ≤37 weeks were respectively ( n  = 21) 34.8% vs 36.3% ( p  = 0.976), ( n  = 29) 41.8% vs 64.7% ( p  = 0.111), ( n  = 31) 44.2% vs 70.6% ( p  = 0.888). The presence of cervical funneling before pessary application shows a statistically significant difference in terms of patient's giving birth before or after 28 weeks ( p  = 0.033). In patients with cervical funneling, there was a significant increase in a birth before 28 weeks. Depending on whether or not patients applying with pain need for tocolysis, it shows the statistically meaningful difference in terms of the patients giving birth before or after 34 weeks ( p  = 0.001) (OR 7, 61, 95% GA 2.4-24.6). In the group without the need for tocolysis, there is a meaningful increase in birth after 34 weeks., Conclusions: Our findings showed that, alongside the defined cervical risk factors, cervical funneling and the need for tocolysis are remarkable prognostic variables in pessary application.

Changes in physiological and biochemical patterns in lucerne plants caused by the presence of 'Candidatus Phytoplasma australasia', which is one of the significant pathogens causing yield losses in lucerne plants, were investigated. Significant differences were evident in total chlorophyll, chlorophyll a, chlorophyll b, and protein amounts between 'Ca. Phytoplasma australasia'-positive and negative lucerne plants. Stress-related metabolites such as phenol, malondialdehyde, and proline accumulations in 'Ca. Phytoplasma australasia'-positive plants were remarkably higher than those of phytoplasma-negative plants. As a response to disease attack, phytoplasma-positive plants exhibited higher antioxidant enzymes (peroxidase and catalase) and non-enzymatic metabolite responses such as jasmonic and salicylic acids. We state that partial disease responses were revealed for the first time to breed resistant lucerne lines infected by 'Ca. Phytoplasma australasia'.

Objective: Decorin is a leucine-rich proteoglycan, affects the proliferation, migration, and invasion of extravillous trophoblasts (EVTs). In this study, we aimed to determine the localization of decorin in the implantation site in human tubal ectopic pregnancy, to compare decorin expression levels in ectopic and intrauterine pregnancy, and to investigate the relationship between implantation depth of the tubal wall and expression levels of decorin., Methods: 15 patients underwent salpingectomy for tubal ectopic pregnancy and 15 underwent curettage for voluntary interruption of pregnancy were included. All blocks were stained with decorin immunohistochemical staining. Trophoblastic cells of tubal Stage I-III and tubal epithelial and stromal cells were analyzed in terms of presence and intensity of decorin staining., Results: Decorin was expressed in both tubal and intrauterine trophoblasts, stroma, and surface epithelium during the first trimester of pregnancy. Decorin staining intensity was significantly lower in the villous cytotrophoblasts and syncytiotrophoblasts in tubal ectopic pregnancies, compared to intrauterine pregnancies (p = 0.001 for both). Decorin staining intensity also significantly lower in the extravillous cytotrophoblasts and syncytiotrophoblasts in the tubal ectopic pregnancies (p = 0.002 and p = 0.001, respectively). There was no significant difference in the staining intensity of the trophoblasts and surface epithelial between Stage II and Stage III tubal invasion; however, the decorin expression was lower in the stroma in Stage III (p = 0.094)., Conclusion: Decorin expression is significantly lower in trophoblastic cells of tubal ectopic pregnancies than the intrauterine pregnancies. Although it remains limited to explain the underlying cellular mechanisms, decorin seems to play a role in the development of tubal pregnancy., Competing Interests: Declaration of Competing of Interest The authors declare that they have no conflict of interest., (Copyright © 2021 Elsevier Masson SAS. All rights reserved.)

Background Preeclampsia (PE) is a multisystem disease and is still among the leading causes of maternal and neonatal morbidity and mortality. Inadequate trophoblast invasion plays a key role in the PE pathogenesis. The proliferation, migration, and invasion of extravillous trophoblasts (EVTs) is primarily controlled by the decidua-derived transforming growth factor beta (TGF-β) and decorin. In this study, we aimed to investigate the clinical utility of serum decorin levels measured in the 11th to 14th gestational weeks to predict preeclampsia during the following weeks of gestation. Materials and Methods A total of 600 pregnant women, whose age and gestational age ranged from 18 to 40 years and 11 to 14 weeks, were included. Venous blood samples were obtained and stored at -80 °C. Subsequently, the patients who developed preeclampsia and healthy controls with a similar body mass index were identified and their first-trimester blood samples were analyzed for serum decorin levels. Results The mean serum decorin level was 8.76 ± 6.88 ng/mL for the PE group while 9.75 ± 9.82 ng/mL for the control group. No statistically significant difference was found between the two groups (p=0.838). Conclusion We observed that the serum decorin levels during the 11th to 14th weeks of gestation showed no predictive value for preeclampsia in pregnant women. However, more accurate conclusions about the clinical utility of decorin as a biomarker of preeclampsia would require further studies with larger samples including more patients with EOS-PE.

Aim: To investigate the role of dynamic thiol-disulfide homeostasis in preeclamptic and idiopathic fetal growth restricted (FGR) pregnancies. Material and method: In this prospective case-control study, a total of 110 singleton pregnancies with FGR (study group) (51 preeclamptic and 59 idiopathic FGR's cases) were compared with 68 healthy pregnant controls at the same gestational weeks (control group). For serum disulfide-thiol homeostasis, a newly used method described by Erel and Neselioglu was used. Results: Serum native thiol and total thiol levels were lower in FGR pregnancies (285.63 ± 55.92 µmol/L, 324.41 ± 44.18 µmol/L, respectively) than control group (324.41 ± 44.18 µmol/L, 362.98 ± 51.43 µmol/L, p  < .001, p  = .004, respectively). In subgroup analysis, only preeclamptic FGR's have lower native and total thiol levels (254.41 ± 59.55, 324.41 ± 44.18 µmol/L, respectively) compare to both idiopathic FGR's and control's. There was no difference in native and total thiol levels with idiopathic FGR's with controls. Idiopathic FGR's have higher levels of disulfide than preeclamptic FGR's (21.72 ± 17.72 versus 16.80 ± 11.20 µmol/L). The serum albumin and total protein levels were positively and spot urine protein/creatinine ratio, 24-h urine protein levels were negatively correlated with native thiol and total thiol levels. Conclusion: The balance of thiol-disulfide homeostasis was shifted and native and total thiol levels were decreased only in preeclamptic FGR pregnancies. The serum disulfide level was increased in idiopathic FGR pregnancies compare to preeclamptic FGR pregnancies which may be a sign of oxidative stress in idiopathic FGR pregnancies with normal thiol pool.

Objective: To determine some major characteristic differences between two consecutive successful and unsuccessful intracytoplasmic sperm injection (ICSI) cycles in poor responders., Materials and Methods: Sixty women with poor ovarian response as determined using the Bologna criteria underwent ICSI cycles following an unsuccessful trial. Some parameters of both cycles including age, body mass index (BMI), serum follicle-stimulating hormone (FSH) and estradiol levels, antral follicle count, gonadotropin dosage, duration of stimulation, antagonist starting day, duration of antagonist administration, endometrial thickness at trigger day, number of total and fertilized oocytes, embryo transfer day, number of embryo cells, and fertilization rate were compared in the same patients to identify predictors of cycles with clinical pregnancy., Results: The mean age, BMI, serum FSH, estradiol concentrations, and antral follicle count were 35.9 years (range, 30-42 years), 25.9 kg/m 2 (range, 18.4-33.5 kg/m 2 ), 10.9 IU/mL (range, 7-13 IU/mL), 52.9 pg/mL (range, 11.6-75 pg/mL), and 4.7 (range, 2-10), respectively. A comparison of cycle characteristics showed a significantly higher total number of mature and fertilized oocytes in successful cycles. The fertilization rate was also significantly higher in cycles with clinical pregnancy. Early initiation of antagonist was shown to result in favorable outcomes. A comparison of embryo characteristics showed that transfer of higher-stage embryos and embryos with higher numbers of cells had a significant impact on cycle outcomes., Conclusion: Our comparison of parameters of failed and successful ICSI cycles in poor responders revealed significantly earlier antagonist initiation, higher total number of mature and fertilized oocytes, fertilization rate, and significantly higher stage of embryo development and cell numbers at transfer in cycles that resulted in clinical pregnancy., Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors.

The Ex-utero intrapartum treatment (EXIT) is a procedure performed during caesarean section while on fetal-placental circulation. We present a prenatally diagnosed cervical cystic mass causing tracheal compression which was managed successfully with the EXIT procedure.

Background: Proteinuria is a major component of preeclampsia. Urine protein measurement after 24-hour urine collection is the traditional standard method for the detection of proteinuria. It is time-consuming. As an alternative, random spot sampling for a urine protein to creatinine (P/C) ratio has been investigated., Aims: The aim of the study was to determine the diagnostic accuracy of the protein to creatinine ratio (P/C) compared with 24-hour urine collection for the detection of remarkable proteinuria and to evaluate the P/C ratio for different proteinuria ranges in patients with preeclampsia., Study Design: Case-control study., Methods: Two hundred and eleven pregnant women who met the criteria of preeclampsia comprised the study group and fifty three pregnant women were taken as the control group. Spot urine specimens for measuring P/C ratio were obtained taken immediately before 24-hour urine collection. The correlation between the P/C ratio in the spot urine samples and urinary protein excretion in the 24-hour collections was examined using the Spearman correlation test., Results: It was found a good positive correlation between the P/C ratio and 24-hour protein excretion, with a correlation coefficient (r) of 0.758. The best cut-off which gave the maximum area under the curve was 0.45 for 300 mg, 0.9 for 1000 mg, 1.16 for 2000 mg, 1.49 for 3000 mg, 2.28 for 4000 mg and 2.63 for 5000 mg per 24h. A P/C ratio above 0.9 strongly predicts significant proteinuria for more than 1 gram (AUC 0.97, 95% CI: 0.94-0.99 and sensitivity, specificity, positive and negative predictive value of 91%, 95.4%, 95.2%, and 91.2%, respectively)., Conclusion: The P/C ratio can be used as a screening test as a good predictor for remarkable proteinuria. The P/C ratio seems to be highly predictive for diagnosis to detect proteinuria over one gram and it could be used as a rapid alternative test in preeclamptic patients not to delay implementation treatment.

Objective: Iniencephaly is a rare neural tube defectwith consisting of a defect in the occipital bone,spina bifida of many vertebrae, and retroflexion of the head on the spine. In majorty of cases it is a le-\thal condition., Methods: We present the first case of iniencephalywith large bronchogenic cyst diagnosed prenatally., Results: At 19 week's gestation showed that fetalcardiac activity was present with normal placentaand amniotic fluid, fetus had occipital bone defect, anencephaly, retroflexion of the head, abnormally short cervicothoracic spine and posterior mediastinal unilocular anechoic cyst. Therapeutic abortion was induced., Conclusion: Iniencephaly is a rare condition during prenatal life. When diagnosed early in pregnancy amultidisciplinary approach is firmly suggested.