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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]

Amniocentesis is one of the safest procedures of prenatal diagnosis. This study aimed to show amniocentesis indications, rate of successful amniocyte culture, complications and outcomes of these pregnancies undergoing prenatal diagnosis in eastern part of Turkey, especially Van province and its nearby. Between 2018 and 2020, 253 patients were referred to our center for amniocentesis and 120 patients giving consent were enrolled from Van and its surrounding provinces. The most frequent indication was high risk in prenatal screening tests whereas the highest chromosomal abnormality was found in fetuses with abnormal ultrasonographic findings. Overall, 11.6% of fetuses had chromosomal anomaly. The most abundant chromosomal abnormality was Trisomy 21, followed by trisomy 18 and 13. Except one case with amniotic leakage no complications were found. Eleven pregnancies were terminated whereas one fetus was born with Turner syndrome and two pregnancies resulted with stillbirth. In conclusion, fetuses with abnormal ultrasound screening had higher chromosome anomaly diagnosed by amniocentesis and compatible with the literature, amniocentesis is a safe and successful method of prenatal diagnosis of chromosomal abnormalities. Van and its surrounding provinces showed a high rate of chromosomal anomaly when prenatal diagnosis was done. [ABSTRACT FROM AUTHOR]

Abstract Background Infertility patients are a vulnerable group that often seeks a non-medical solution for their failure to conceive. World-wide, women use CAM for productive health, but only a limited number of studies report on CAM use to enhance fertility. Little is known about traditional and religious forms of therapies that are used in relation to conventional medicine in Turkey. We investigated the prevalence and types of complementary and alternative medicine (CAM) used by infertile Turkish women for fertility enhancement. Methods A face-to-face questionnaire inquiring demographic information and types of CAM used for fertility enhancement were completed by hundred infertility patients admitted to a primary care family planning centre in Van, Turkey between January and July 2009. Results The vast majority of infertile women had used CAM at least once for infertility. CAM use included religious interventions, herbal products and recommendations of traditional "hodja's" (faith healers). Of these women, 87.8% were abused in the last 12 months, 36.6% felt not being supported by her partner and 80.5% had never spoken with a physician about CAM. Conclusions Infertile Turkish women use complementary medicine frequently for fertility enhancement and are in need of information about CAM. Religious and traditional therapies are used as an adjunct to, rather than a substitute for, conventional medical therapy. Physicians need to approach fertility patients with sensitivity and should be able to council their patients about CAM accordingly.

Abstract Introduction We report an unusual case of upper airway compromise complicated by thyroid storm in a pregnant woman with Graves' disease, ending with the in utero death of the fetus. This complication might have developed due to upper airway edema as a result of poorly controlled hyperthyroidism. Case presentation A 41-year-old Turkish woman at 27 weeks' gestation suffering from Graves' disease was referred to our emergency department with a diagnosis of respiratory arrest. She was unconscious and had been intubated. Her laboratory results were compatible with thyrotoxicosis. The patient had suffered from respiratory difficulty for a long time and had stopped using her antithyroid medications after the first trimester of pregnancy. One day before, she had visited an obstetrician because her respiratory distress had increased. At that time, her fetus was still alive. She was given oxygen therapy and then sent home. With a presumptive diagnosis of thyroid storm, she was admitted to the intensive care unit and treated with aggressive medical therapy. The baby was found to be no longer alive and was delivered vaginally after labor induction. The mother was discharged 10 days later with maintenance therapy. Conclusion Hyperthyroidism during pregnancy warrants very close attention and should almost always be treated with appropriate antithyroid medications. Maternal respiratory distress in such patients can be an early sign of impending upper airway compromise and thyroid storm, which can endanger the mother and fetus unless prompt and aggressive therapy is initiated.

The objective of this study is to assess the 10-year incidence of peripartum hysterectomy that was performed in the province of Van, Turkey, as well as its clinical results. In this study, we retrospectively examined all patients who underwent peripartum hysterectomy, which was performed at Van Yuzuncu Yil University Dursun Odabas Medical Center between 2010 and 2020. 99 patients who underwent hysterectomy due to severe bleeding, which could not be stopped despite conservative treatments within 24 hours following the delivery, were included in the study. The overall rate of peripartum hysterectomy was 99 of 22242 or 4.4 per 1,000 deliveries. The mean maternal age was 31.98 ± 5.41 years. The most common indications for peripartum hysterectomy are placental adhesion disorders (70.7%), uterine atony (25.2%), and uterine rupture (4%). Ultimately, the most common indication for peripartum hysterectomy is placental adhesion disorders. The rise in the number of cesarean section might have increased the incidence of placental adhesion disorders. Thus, patients should be provided with healthcare in centers that have adequate equipment and staff. [ABSTRACT FROM AUTHOR]

Obstetric hemorrhages are still the most common cause of maternal mortality worldwide (1). Uterine rupture, which could be included among the causes of postpartum bleeding, results in serious mortality and morbidity. Although scarless uterine rupture is extremely rare, it might be seen with an approximate frequency of 1/5700 - 1/20000 in pregnancies (2-5). In general, it is diagnosed and treated in the early postpartum period as it usually presents symptoms at this very stage. A cas e of uterine rupture that was diagnosed and treated on the 28th postpartum day was discussed in this case. [ABSTRACT FROM AUTHOR]