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Aim: There is conflicting information in the literature regarding perinatal outcomes and management of isolated oligohydramniotic (IO) pregnancies. Recent studies show that IO is associated with poor perinatal outcomes. However, there is still no definitive method for deciding the optimal delivery timing for these patients. In this study, we aimed to assess the relationship between Doppler parameters, especially cerebro-placental ratio, and perinatal outcomes in isolated oligohydramnios (IO) patients.Methods: This prospective case control study was conducted between October-November 2018. A total of 98 patients were recruited and divided into two groups, as pregnant women with normal amounts of amniotic volume and the isolated oligohydramnios group. Oligohydramnios diagnosis was made by amniotic fluid index measurement (AFI, Amaç: İzole oligohidramniotik (IO) gebeliklerin perinatal sonuçları ve yönetimi ile ilgili literatürde hala çelişkili bilgiler mevcuttur. Son çalışmalarda ise IO’nun kötü perinatal sonuçlar ile ilişkili olduğu yönündedir. Yine de bu hastaların optimal doğum zamanlamasına karar vermek için elimizde hala kesin bir yöntem bulunamamaktadır. Biz de çalışmamızda IO hastalarında Doppler parametreleri, özellikle serebro-plasental oran ve perinatal sonuçlar arasındaki ilişkiyi değerlendirmektir.Yöntemler: Bu prospektif vaka kontrol çalışması Ekim-Kasım 2018 arasında gerçekleştirildi. Çalışmaya 98 hasta dahil edilmiştir. İzole oligohidroamnios ve normal amnion miktarı olan gebeler grubu olmak üzere iki gruba ayrıldı. Oligohidramnios tanısı amniyotik sıvı indeksi ölçümü ile konuldu (AFI

Objectives: There is not yet a consensus on the optimal surgical technique for cesarean section. This is the first study comparing two different (Cesarean Section) with respect to the following inflammatory reaction in means of changes in inflammatory marker levels.To evaluate the differences in inflammatory reactions following two different (Cesarean Section) techniques, the modified Misgav-Ladach versus the Pfannenstiel-Kerr technique.Study Desıgn: The study population included 88 pregnant women who met the inclusion criteria. These women were randomized into two groups according to Consolidated Standards of Reporting Trials guidelines: Group 1 (Misgav-Ladach group) and Group 2 (Pfannenstiel Kerr group). To compare the inflammatory reactions following surgery, Interleukin-6 (IL-6) and Tumor Necrosis Factor-α (TNF-α) levels were measured in venous blood samples drawn from the patients just before (0 hour) and 24 hours (24th hour) after the surgery. In 5 women from Group 1 and 2 women from Group 2, the 24th hour blood samples could not be obtained or were lost. Thus, a total of 81 women, 39 women from Group 1 and 42 women from Group 2, comprised the population of study. The differences in inflammatory reactions between the 0 and 24th hours were analyzed by calculating the percent change in IL-6 and TNF-α levels, and these percentages were then compared between the groups.Results: There was a statistically significant difference between Group 1 and Group 2 regarding the serum IL-6 level change between 0 and 24th hour (530±653% and 196±168%, respectively, p=0.022. The difference in TNF-α was also higher in Group 2, but the difference was not statistically significant (229±306% vs. 571±824%, p=0.12). The mean operation time was significantly shorter in Group 1 (9.44 min. vs. 16.86 min, p=0.0001).Conclusions: The results of this study indicate that the modified Misgav-Ladach technique has a weaker inflammatory reaction, which indicates fewer short- and long-term surgical complications.

Aim: To determine whether fetal pancreatic echogenicity assessment is associated with gestational diabetes mellitus (GDM).Methods: A prospective cross-sectional study was conducted in a cohort of 1...

Background: This study aims to investigate average gestational week in which mothers feel their baby's movements for the first time, and the maternal–fetal factors affecting this time. Methods: A total of 423 pregnant women between 11 and 25 weeks of gestation were included in this prospective study. The patient cohort was divided into three subgroups according to the gestational week in which fetal movements were felt for the first time by the pregnant women. The women who felt the first movement before 25th percentile value constituted Group 1; between 25th and 75th percentile value constituted Group 2; and beyond 75th percentile value constituted Group 3. These three groups were then compared in terms of maternal age, parity, body mass index (BMI), tea and coffee consumption during pregnancy, smoking, educational status, accordance of mother to regular pregnancy follow-ups, placental site, and gender of the baby. Results: These three groups were statistically and significantly different regarding the above mentioned determinants except for mothers' tea and coffee consumption, smoking, and gender of the baby (p

Objective: To evaluate serum dynamic thiol/disulphide concentrations in patients with suspected missed abortion (MA) and to determine whether this ratio has a predictive role in the viability in these pregnancies. Materials and Methods: In this prospective cohort study, 48 out of 120 recruited pregnant patients were confirmed MA in the study group. Following the recommended waiting time (7–10 days), the remaining 72 viable pregnancies that met the inclusion criteria were categorized as the control group. A novel, automated, and spectrophotometric assay, which can measure both sides of the thiol/disulphide balance, was used. The cut-off values were used for the ROC curve. Results: There were no statistically significant differences between the groups (MA and control) regarding maternal obstetric and demographic features. Significantly reduced levels of Total Thiol and Native Thiol were shown in patients with MA compared to the control group (p = 0.016 and p = 0.001, respectively). Serum levels of disulphide was significantly increased in the MA group (23.4 ± 7.8 μmol/l vs. 17.9 ± 4.99 μmol/l, p

Background: Down syndrome, which is the most common human chromosomal anomaly that can affect people of any race and age, can be diagnosed prenatally in most cases. Prenatal diagnosis via culture method is time-consuming; thus, genetic analysis has thus been introduced and is continually being developed for rapid prenatal diagnosis. For this reason, the effective use of microRNA profiling for the rapid analysis of prenatal amniotic fluid samples for the diagnosis of Down syndrome was investigated. Aims: To evaluate the expression levels of 14 microRNAs encoded by chromosome 21 in amniotic fluid samples and their utility for prenatal diagnosis of Down syndrome. Study Design: Case-control study. Methods: We performed invasive prenatal testing for 56 pregnant women; 23 carried fetuses with Down syndrome, and 33 carried fetuses with a normal karyotype. Advanced maternal age and increased risk for Down syndrome in the screening tests were indications for invasive prenatal testing. The age of gestation in the study and control groups ranged between 17 and 18 weeks. The expression levels of microRNA were measured by real-time polymerase chain reaction. Results: The expression levels of microRNA-125b-2, microRNA-155, and microRNA-3156 were significantly higher in the study group than in the control group. Conclusion: The presence of significantly dysregulated microRNAs may be associated with either the phenotype or the result of abnormal development. Further large-scale comparative studies conducted in a variety of conditions may bring novel insights in the field of abnormal prenatal conditions.

PubMed ID: 29212398, Objective: We aimed with this study to evaluate the role of pulmonary artery acceleration time to ejection time ratio (PATET) in the prediction of respiratory distress syndrome (RDS) in preterm neonates. Materials and methods: In this prospective cohort study, 105 singleton pregnant women with no congenital abnormalities and pregnancy complications who delivered before 37 weeks of gestational age were included. All the patients underwent ultrasound examination to obtain fetal pulmonary artery Doppler. 15 patients were excluded from the study as they did not give birth within 3 days subsequent to ultrasound examination, or inadequate Doppler measurements. After delivery the neonates were grouped according to diagnosis of RDS as RDS + and RDS-. Results: One hundred five women met the inclusion criteria. Regarding the Doppler findings; only the PATET ratio was significantly different between the groups (0.2965 ± 0.042 versus 0.386 ± 0.068 p

Joubert syndrome (JS) and related disorders (JSRD) are a group of multiple congenital anomaly syndromes in which the diagnostic hallmark is the molar tooth sign (MTS), a complex midbrain malformation visible on brain imaging. Detection of the MTS should be followed by a diagnostic protocol to assess multi-organ involvement. The incidence of JSRD ranges between 1/80,000 and 1/100,000 live births, although these values may represent an underestimate. The neurological components of JSRD include hypotonia, ataxia, intellectual disability, abnormal eye movements, and neonatal breathing problems. These may be associated with multi-organ involvement, mainly retinal dystrophy, nephronophthisis, hepatic fibrosis, and polydactyly. With the exception of rare X-linked recessive cases, JSRD follow autosomal recessive inheritance and are genetically heterogeneous. Ten causative genes have been identified to date, all encoding for proteins of the primary cilium, making JSRD part of a group of diseases called "ciliopathies". Analysis of causative genes is available in few laboratories worldwide on a research basis. The differential diagnosis must consider, in particular, the other ciliopathies, distinct cerebellar and brainstem congenital defects, and disorders with cerebro-oculo-renal manifestations. Recurrence risk is 25% in most families, although X-linked inheritance should also be considered. Optimal management requires a multidisciplinary approach, with particular attention paid to respiratory problems in neonates. After the first months of life, the prognosis varies among JSRD subgroups, depending on the extent and severity of organ involvement.

Dermatomyositis (DM), a subtype of idiopathic inflammatory myopathies (IIMs), is characterized by skin rash, proximal muscle weakness, and inflammatory infiltrates in the muscle tissue. The peak incidence of the disease is at the age of 50–60 years, and only 14% of the patients with IIMs are estimated to present during reproductive years. Because of the limited pregnancy experience in patients with IIMs, little is known regarding the effects of DM on pregnancy or vice versa. We herein report a 40-year-old woman who developed DM in the second trimester of her pregnancy and did not respond to treatment with methylprednisolone. Her pregnancy was terminated at the 32nd week of gestation, due to preeclampsia and fetal distress. She delivered a healthy baby and improved rapidly after delivery. We have searched PubMed for relevant articles and reviewed previously published cases.

Aim: To investigate the serum thiol/disulphide homeostasis in deliveries complicated by nuchal cord (NC) and to compare the results with healthy deliveries (without NC). Methods: This prospective controlled study included 48 pregnant women complicated by NC and 48 similar gestational aged healthy pregnant women during labor. Fetal umbilical cord serum samples were collected during labor and the thiol/disulphide homeostasis was measured by using an automated assay method. The patients were followed up until end of the delivery and perinatal outcomes were recorded. Results: Fetal umbilical cord native thiol, total thiol, and disulphide levels as well as disulphide/native thiol and disulphide/total thiol ratios are impaired in labor with the presence of NC. There were no statistically significant differences in terms of maternal and gestational age at delivery and maternal number of gravida and parity, fetal gender, fifth Apgar scores

Objective: To investigate the relationshipbetween properties of gestational period in which pregnant women feel theirbaby's movements for the first time, and pregnancy outcomes at term.Material and Methods:This longitudinal prospective studyconducted at a tertiary center between June 2016 and September 2016. Ofall, 272 pregnant women who gave birth at our clinic, were given aquestionnaire at the time of a routine follow-up visit between 12 and 25gestational weeks and were evaluated their pregnancy outcomes.The patientcohort was divided into two groups according to the gestational week in whichfetal movements were felt for the first time by the pregnant women andcomparisons were made between the groups.Results:The gestational week in which fetalmovements were felt for the first time by the pregnant women were affected byplacental settlement, maternal educational levels, and routine coffeeconsumption. There were no statistically significant differences between twogroups regarding to the time at birth, gender of baby, birth weight and lenght,mode of delivery, value of low 5 min APGAR score(, ÖzetAmaç:Gebelerin fetal hareketi ilkhissettiği dönemdeki özellikleriyle, termde doğum sonuçları arasındaki ilişkiyideğerlendirmektir.Gereçve Yöntem: Bu prospektif longitudinal çalışmada,tersiyer bir merkezde Haziran-Eylül 2016 tarihleri arasında yapıldı. Rutingebelik kontrolü için 12-25 hafta arası hastanemize başvurup çalışma anketidoldurulan ve kliniğimizde doğumu gerçekleşen 272 olgunun doğum sonuçlarıdeğerlendirildi. Tüm olgular fetal hareketin ilk hissedildiği zamana göre 2gruba ayrılarak karşılaştırmalar yapıldı.Bulgular:İlk fetalhareketi hissetme zamanı plasental yerleşim yeri, maternal eğitim düzeyleri vegebelikte rutin kahve tüketiminden etkilenmektedir. İstatistiksel olarak doğumun gerçekleştiği gebelik haftası,yenidoğan cinsiyet, boy ve kilo, doğum şekilleri, düşük 5. dakika APGAR skoru(

Background: Down syndrome, which is the most common human chromosomal anomaly that can affect people of any race and age, can be diagnosed prenatally in most cases. Prenatal diagnosis via culture method is time-consuming; thus, genetic analysis has thus been introduced and is continually being developed for rapid prenatal diagnosis. For this reason, the effective use of microRNA profiling for the rapid analysis of prenatal amniotic fluid samples for the diagnosis of Down syndrome was investigated. Aims: To evaluate the expression levels of 14 microRNAs encoded by chromosome 21 in amniotic fluid samples and their utility for prenatal diagnosis of Down syndrome. Study Design: Case-control study. Methods: We performed invasive prenatal testing for 56 pregnant women; 23 carried fetuses with Down syndrome, and 33 carried fetuses with a normal karyotype. Advanced maternal age and increased risk for Down syndrome in the screening tests were indications for invasive prenatal testing. The age of gestation in the study and control groups ranged between 17 and 18 weeks. The expression levels of microRNA were measured by real-time polymerase chain reaction. Results: The expression levels of microRNA-125b-2, microRNA-155, and microRNA-3156 were significantly higher in the study group than in the control group. Conclusion: The presence of significantly dysregulated microRNAs may be associated with either the phenotype or the result of abnormal development. Further large-scale comparative studies conducted in a variety of conditions may bring novel insights in the field of abnormal prenatal conditions.

WOS: 000394021800001, PubMed ID: 28149307, Objective. Controlling excessive bleeding in cesarean sections which may cause a life-threatening event even under well-prepared conditions. We used a novel atraumatic tourniquet technique to temporary arrest blood flow through the uterine and ovarian vessels and compare with other techniques. Toothless vascular clamps were used as clamp. Methods. Tourniquet technique performed postpartum hemorrhage (PPH) cases (19 out of 37) were compared with 18 other cases with PPH. Results. The difference between preoperative and postoperative hemoglobin values was significantly lower in the study group as well as the number of blood products needed during and after surgery. Conclusions. This technique not only prevented massive bleeding from the uterus but also allowed physicians time to consider the necessity of further interventions.

Objective: The aim of this study was to compare serum maternal adiponectin concentrations in pregnant women with isolated intrauterine growth retardation (IUGR) and in pregnant women with IUGR concomitant with pre-eclampsia (IUGRcwPE).Material and Methods: Thirty patients with isolated IUGR (group 1), 20 patients with IUGRcwPE (group 2), and 30 healthy controls (group 3) between age 18-40 were included into the study. Venous blood samples of those patients were obtained in the starving state. Adiponectin concentrations were measured by enzyme-linked immunosorbent assay in serum obtained after centrifugation. To find the differences between the groups, student t-test and one-way ANOVA statistical methods were used.Results: There were no differences between the groups in terms of age, body mass index, gestational age, and parity (p>0.05). The values of amniotic fluid index (p0.05).Conclusion: We found that IUGR increased maternal serum adiponectin concentrations; however, this rise does not occur in pregnant women with IUGRcwPE. © 2014 by the Turkish-German Gynecological Education and Research Foundation.

We present a case of a patient with a complete hydatidiform mole co-existing with a normal foetus (CMCF) who had a caesarean section in week 32 of gestation, resulting in a live female infant weighing 1590 grams. The mother, with a normal bleeding pattern, did not require any surgical intervention. She was discharged from hospital on the third post-operative day. Premature termination is recommended in this type of pregnancy because of the risks associated with molar pregnancies. However, with the close follow-up of these pregnancies, good maternal and perinatal results may be obtained. (

Objective:To investigate whether fetal pulmonary artery acceleration to ejection time (PATET) ratio can predict or rule out subsequent diagnosis of transient tachypnea of the newborn (TTN).Methods:This prospective cohort study included 105 pregnant women in labor, who met the inclusion criteria. Eighteen of these women were removed from the study cohort, because of an inability to acquire sufficient Doppler waveforms and a longer duration of deliveries. According to subsequent diagnosis of TTN in the neonate, the two groups were constituted, TTN+ and TTN−.Results:There were no statistically significant differences between the groups regarding maternal obstetric and demographic features. The neonatal intensive care unit (NICU) submission rate was significantly higher in the TTN+ group (100%, 17%, PConclusion:The fetal PATET ratio seems to serve as a promising tool to rule out subsequent diagnosis of TTN.

WOS: 000373461800001, PubMed ID: 27110565, Background. Currently, the data available on the utility of miRNAs in noninvasive prenatal testing is insufficient in the literature. We evaluated the expression levels of 14 miRNAs located on chromosome 21 in maternal plasma and their utility in noninvasive prenatal testing of Down Syndrome. Method. A total of 56 patients underwent invasive prenatal testing; 23 cases were carrying Down Syndrome affected fetuses, and 33 control cases carrying unaffected, normal karyotype fetuses were included for comparison. Indications for invasive prenatal testing were advanced maternal age, increased risk of Down Syndrome in screening tests, and abnormal finding in the sonographic examination. In both the study and control groups, all the pregnant women were at 17th and 18th week of gestation. miRNA expression levels were measured using real-time RT-PCR. Results. Significantly increased maternal plasma levels of miR-3156 and miR-99a were found in the women carrying a fetus with Down Syndrome. Conclusion. Our results provide a basis for multicenter studies with larger sample groups and microRNA profiles, particularly with the microRNAs which were found to be variably expressed in our study. Through this clinical research, the utility of microRNAs in noninvasive prenatal testing can be better explored in future studies., Ege University Faculty of MedicineEge University, This paper is funded by Ege University Faculty of Medicine.

Neuroblastoma is the most common extra cranial solid tumour in childhood and in infancy, but it is a rare fetal tumour, especially on neck region. Approximately, two thirds of the cases arise from adrenal gland and presentation of other localizations is extremely rare. Here, we report a case of cervical Neuroblastoma suspected at 20th gestational week. This is the fourth case detected on prenatal ultrasound on neck region and these cases that is identified in the second trimester fetal anatomy screening.

We report a case of right adnexal torsion during the embryo implantation period of an IVF/ICSI cycle. A 26-yearold woman who diagnosed as primary infertility was included in an IVF/ICSI program. In the following period right adnexal torsion occurred at the sixth day of the embryo transfer. Laparoscopic detortion was successfully performed with preserving the adnexia. The patient had positive pregnancy test in the subsequent week.