Search

Objective: Preeclampsia is a highly morbid disease of placental origin, life-threatening condition for both a pregnant woman and her fetus. Cadherin 6 and 11 are adhesion molecules that play an important role in trophoblastic development and placentation. In our study, we investigated the change in serum cadherin 6 and 11 levels in pregnant women with preeclampsia. Materials and Methods: Pregnant women with preeclampsia were selected and compared with healthy women (as a control group) for a one-year study. The serum alanine aminotransferase, aspartate aminotransferase, and cadherin levels 6 and 11 of participants were analyzed and compared. Results: A total of 189 pregnant women were subdivided into 2 groups as preeclamptic (n=94) and women with healthy pregnancy (n=95). The cadherin 6 and cadherin 11 levels of the preeclamptic patients were significantly higher than those in the control group (p=0.001), and they were found to be significantly higher mainly in patients with early-onset and severe preeclampsia group (p=0.001). The cut-off cadherin 6 and 11 values for severe preeclampsia were found as 98.174 ng/mL and 1.92 ng/mL; with sensitivity of 88.3% and 84% respectively (p=0.001). Conclusion: The data analysis showed elevated serum cadherin 6 and 11 levels associated with the severity and early onset of pre-eclampsia. Serum cadherin 6 and 11 levels can be a candidate marker for the prediction of preeclampsia.

Objective: In this study, we investigated the association between first trimester lipid profile and postterm pregnancy (PTG) and whether lipid profile can be a predictive criterion for the development of PTG.Materials and Methods: 329 pregnant women with postterm delivery and 97 pregnant women with term delivery were included in the study. Demographic data, mode of delivery, first trimester lipid profiles (total cholesterol, triglyceride, HDL-C, LDL-C, VLDL-C), APGAR score of the babies born, and whether they required neonatal intensive care. In the study, the lipid profile differences between the groups were evaluated.Results: While no significant difference was found between the postterm and term pregnancy groups in terms of age, number of pregnancies, parity, and body mass index (BMI), a statistically significant difference was found in terms of mean APGAR score (p < 0.001) and YDYB requirement (p < 0.001). The rate of cesarean section in PTG group was higher than in term pregnancies and the difference was statistically significant (p < 0.001). When the lipid profiles were evaluated between the groups, it was found that the levels of total cholesterol, triglyceride, HDL-C, LDL-C and VLDL-C levels were significantly lower in the PTG group (p < 0.05).Conclusion: In our study, low lipid levels in the first trimester were found to be associated with PTG. Low lipid levels in the first trimester of pregnancy can be considered as a criterion for predicting PTG. However, because there are other factors that may cause PTG, supportive prospective studies are needed to better understand the relationship between lipid profile and PTG., Amaç: Çalışmada ilk trimesterdeki lipid profili ile postterm gebelik (PTG) arasındaki ilişkiyi ve lipid profilinin PTG için bir öngörü kriteri olup olamayacağını değerlendirmeyi amaçladık.Materyal ve Metot: Çalışmaya postterm dönemdeki 329 (vaka grubu) ve term dönemdeki 97 (kontrol grubu) gebe dahil edildi. Hastaların demografik bilgileri, doğum şekilleri, ilk trimester lipid profilleri (total kolesterol, trigliserid, HDL-K, LDL-K, VLDL-K düzeyleri) ile doğan bebeklerin APGAR skoru ve yenidoğan yoğun bakım (YDYB) kabulu kaydedildi. Çalışmada gruplar arasındaki lipid profil farklılıkları değerlendirildi.Bulgular: Gruplar arasında yaş, gebelik sayısı, parite ve vücut kitle indeksi (VKI) açısından anlamlı farklılık saptanmazken, ortalama APGAR skorları (p

Amaç: İlk trimester lipid profilinin preeklampsi öngörüsünde faydasını ve yenidoğan sonuçlarıyla olan ilişkisini araştırmaktır. Gereç ve Yöntemler: Çalışmaya preeklampsi (PE) tanısı almış 121 hasta ve 99 sağlıklı gebe kadın dahil edildi. Çalışma retrospektif olarak dizayn edilmiştir. Hastaların yaş, gravida, parite, vücut kütle indeksi (VKI), doğum şekli, doğum kilosu, APGAR skoru, yenidoğan yoğun bakım ünitesi (YYBÜ) kabulü ve doğum haftası kaydedildi. Laboratuvar analizlerinde ilk trimester (

Introduction the aim of this study was to determine whether maternal serum IL-6 and postnatal melatonin levels change with the mode of delivery. Materials and Methods a prospective controlled study was performed on pregnant women (17–43 years) over 37 weeks of pregnancy. Patients were divided into three groups according to the route of delivery: Group 1) 30 women delivering by vaginal route; Group 2) 30 delivering by iterative cesarean section (CS); Group 3) delivering by emergency CS. Maternal serum IL-6 levels were measured before and after delivery, and maternal colostrum melatonin levels after delivery, and the results between the 3 groups compared. Results pre-delivery and post-delivery maternal serum IL-6 levels were significantly higher in patients who delivered vaginally than in patients who delivered by the abdominal route (p Conclusion These data support, should there ever be a further need, the benefit of vaginal delivery over cesarean section, in which cytokine and melatonin levels are reduced compared to vaginal delivery.

Objective: Although several pathophysiological mechanisms are defined in the etiology of habitual abortion, still causes half of the cases haven’t been clarified yet. It has been reported that folate and vitamin B12 are effective in early pregnancy complications. In our study, we aimed to reveal the relationship between habitual abortion with folate and vitamin B12 levels.Materials and Methods: We included our study 124 pregnant having habitual abortion history and 242 pregnants without this, a total of 366 patients. Maternal and gestational age, height, weight, body mass index (BMI), gravidity, parity, abortion, and living children count and vitamin B12 and folate levels of these pregnants were evaluated retrospectively.Results: The ages, gravidity, and abortion counts of the study group were significantly higher than the control group (p0.05) between groups, the BMI measurements, living children count, and of the study group were significantly lower than the control group (p

Although several pathophysiological mechanisms are defined in etiology recurrent pregnancy loss, still causes of half of the cases haven’t revealed yet. It is reported that inflammatory processes take place in the etiology of the disease. In our study, we aimed to reveal the relationship between recurrent pregnancy loss with white blood cell count (WBC), C-reactive protein (CRP) and ferritin levels. We included our study 90 pregnant women having recurrent miscarriage history and 101 pregnant women without recurrent miscarriages, 191 patients in total. Maternal and gestational age, height, weight, body mass index (BMI), gravidity, parity, abortion and living children count and WBC, CRP and ferritin levels of these pregnant were evaluated retrospectively. According to outcomes, while the age (p = 0.01; p0.05). While WBC levels of the study group was found to be lower (p=0.045, p 0.05). In our study, WBC, CRP and ferritin parameters did not indicate the inflammatory background in recurrent pregnancy loss. We think that further prospective randomized controlled studies are required regarding these parameters.

The primary objectives of this study were to evaluate the impact of intramuscular meperidine on shortening of the active phase of labor, the neonatal outcome and the rate and severity of perineal lacerations in term pregnant women in the first stage of labor. A total of 571 primiparous term pregnant women delivered vaginally were included into this retrospective study. In 437 of them, meperidine (100 mg IM) at the beginning of the active phase was administered and 134 women did not receive any meperidine dose. The length of labor phases, obstetric lacerations, and neonatal outcomes were recorded. The results of this study showed that meperidine could be used safely as an obstetric analgesic with its additional benefit of shortening the active phase of the first stage and second stage of labor without increased risk of obstetric lacerations and perinatal adverse outcomes. In case of limited use of neuraxial analgesia in a busy state maternity hospital, intramuscular meperidine administration as obstetric analgesia seems beneficial in reducing the length of the active phase of the first stage of labor and the second stage of labor without adversely affecting obstetric lacerations and neonatal outcomes.

We conducted a prospective study to assess serum melatonin as a biomarker to predict the development of late-term and postterm pregnancies and spontaneous beginning of labor in women with term pregnancies. Population of this prospective study included pregnant women with late-term and postterm pregnancies and term pregnancies as controls. In these study groups, serum melatonin concentrations were measured in women with or without labor and their perinatal data were collected. In the postterm pregnancies without labor, the lowest median melatonin concentrations were measured (p0.05). In the late-term and postterm pregnancies with and without labor, the median serum melatonin concentrations were significantly lower than term ones (p0.05). In the term pregnancies with labor, the highest median melatonin concentration was measured (p0.05). A serum melatonin concentration≤34 pg/mL as a cut-off value determines late-term and postterm pregnancy with a sensitivity of 80.4% and a specificity of 81.4%. A serum melatonin concentration29.35 pg/mL as a cut-off value determines presence of labor with a sensitivity of 82.1% and a specificity of 55.0%. In women with term pregnancies, with the measurement of serum melatonin, it is possible to predict the development of late-term and postterm pregnancies and whether these pregnancies undergo spontaneous labor. With further studies, these findings need to be supported before their routine clinical use.We conducted a prospective study to assess serum melatonin as a biomarker to predict the development of late-term and postterm pregnancies and spontaneous beginning of labor in women with term pregnancies. Population of this prospective study included pregnant women with late-term and postterm pregnancies and term pregnancies as controls. In these study groups, serum melatonin concentrations were measured in women with or without labor and their perinatal data were collected. In the postterm pregnancies without labor, the lowest median melatonin concentrations were measured (p0.05). In the late-term and postterm pregnancies with and without labor, the median serum melatonin concentrations were significantly lower than term ones (p0.05). In the term pregnancies with labor, the highest median melatonin concentration was measured (p0.05). A serum melatonin concentration≤34 pg/mL as a cut-off value determines late-term and postterm pregnancy with a sensitivity of 80.4% and a specificity of 81.4%. A serum melatonin concentration29.35 pg/mL as a cut-off value determines presence of labor with a sensitivity of 82.1% and a specificity of 55.0%. In women with term pregnancies, with the measurement of serum melatonin, it is possible to predict the development of late-term and postterm pregnancies and whether these pregnancies undergo spontaneous labor. With further studies, these findings need to be supported before their routine clinical use.

The objective of this study is to determine if the second-trimester serum afamin is a reasonable predictor of preeclampsia (PE).In this nested case-control study, all pregnant women were screened by second-trimester screening test between 15 and 20 weeks of gestation and serum samples were collected and stored at -80 °C for biochemical analysis. All available stored samples from pregnant women who subsequently developed PE were thawed and the concentrations of afamin in the serum were measured. Control cases, chosen randomly from the same cohort whose blood was collected and stored in the same period as with the study group, who did not develop PE. Afamin levels were expressed ng/mL. Logistic regression was used to calculate adjusted odds ratio (aORs) for the prediction of PE.A total of 39 women with PE and 46 controls were studied. Afamin levels were found to be significantly higher during the second trimester in women who developed PE compared to the control group. Afamin, at a cut-off level of 96.2 ng/mL, the aORs for PE was 28.6 (95% CI: 7.458-110.193). After adjustment for BMI, age, smoking, the aORs for PE was 65.6 (95% CI: 11.6-371.4;High levels of afamin in the early weeks of gestation in patients going on to develop PE later may be promising as a potential marker to predict PE in the first and second trimesters.

Aim: To investigate the effects on delivery and neonatal outcomes of vaginal douching, which can be performed before the application of dinoprostone pessary in the vagina for labour induction. Materials and method: In this prospective study 240 women with singleton, term pregnancy who underwent labour induction, were randomized into two groups. Application of dinoprostone pessary intra-vaginally with vaginal douching group (n=103) and it without vaginal douching group (n=116) were compared firstly for duration of dinoprostone application intra-vaginally secondly for duration from the beginning of dinoprostone application intra-vaginally to the active phase of labor, duration from the beginning of dinoprostone application intra-vaginally to total cervical dilatation, induction need, route of delivery (vaginal/cesarean), and uterine hyperstimulation. The birth weight, 1 and 5-minute Apgar scores, intubation need, NICU admission, presence of meconium, and fetal infection were compared between the newborns of the two groups. Data were statistically compared using the Student’s-t test, Mann-Whitney U test and Pearson Chi-square test. Results: Intra-vaginal dinoprostone pessary application with vaginal douching compared it without douching had shorter duration of dinoprostone application (p=0.001), duration from the beginning of dinoprostone application to the active phase of labor (p=0.001) and duration from the beginning of dinoprostone application to total cervical dilatation (p=0.001). Route of delivery was not statistically different between the groups (p=0.414). Uterine hyperstimulation was more frequent in the vaginal douche group however it did not reach the statistical significance (p=0.058). Neonatal mean birth weight and 5-minute Apgar scores were higher in the vaginal douching group (p=0.660, 0.091) while intubation need, presence of meconium, and fetal infection rates were lower with statistical significance (p=0.007, 0.018, 0.011, respectively). Conclusion: As a safe, easy to perform and cheap procedure, vaginal douching prior to dinoprostone pessary application intra-vaginally can augment the induction of labour in women without increasing maternal or fetal adverse outcomes.

Intrahepatic cholestasis of pregnancy is a pregnancy-specific liver disease that usually emerges during the third trimester of pregnancy. It is characterized by itching and elevated serum total bile acid levels, and it may lead to severe fetal complications. This study aimed to investigate the role of interleukin-8, a pro-inflammatory cytokine; interleukin-10, an anti-inflammatory cytokine; and melatonin in intrahepatic cholestasis of pregnancy.This prospective, case-controlled study was conducted with 51 women with intrahepatic cholestasis of pregnancy (40 mild and 11 severe cases) and 43 healthy pregnant women. Serum interleukin-8, interleukin-10, and melatonin levels were evaluated.Melatonin and interleukin -10 were significantly lower in subjects with intrahepatic cholestasis of pregnancy (p=0.001; p=0.001, respectively p0.05). Interleukin-8 levels were found to be significantly higher in the cholestasis group than control group (p=0.001, p0.05).Because interleukin-8, interleukin-10, and melatonin were found to be significantly correlated with intrahepatic cholestasis of pregnancy, we believe this finding could shed light on the etiology of the disease.Intrahepatic cholestasis of pregnancy is a pregnancy-specific liver disease that usually emerges during the third trimester of pregnancy. It is characterized by itching and elevated serum total bile acid levels, and it may lead to severe fetal complications. This study aimed to investigate the role of interleukin-8, a pro-inflammatory cytokine; interleukin-10, an anti-inflammatory cytokine; and melatonin in intrahepatic cholestasis of pregnancy.This prospective, case-controlled study was conducted with 51 women with intrahepatic cholestasis of pregnancy (40 mild and 11 severe cases) and 43 healthy pregnant women. Serum interleukin-8, interleukin-10, and melatonin levels were evaluated.Melatonin and interleukin -10 were significantly lower in subjects with intrahepatic cholestasis of pregnancy (p=0.001; p=0.001, respectively p0.05). Interleukin-8 levels were found to be significantly higher in the cholestasis group than control group (p=0.001, p0.05).Because interleukin-8, interleukin-10, and melatonin were found to be significantly correlated with intrahepatic cholestasis of pregnancy, we believe this finding could shed light on the etiology of the disease.

Objective The second trimester triple test although declared inadequate for the screening of aneuploidies by the International Society for Prenatal Diagnosis remains a widely employed test. We aim to investigate the associations between the biochemical parameters of the triple test and the severity of intrahepatic cholestasis of pregnancy (ICP). Material and Methods The triple test parameters of 102 healthy pregnant women and 100 pregnant women with ICP were evaluated retrospectively. Serum bile acid level of ≥ 40 μmol/L was categorized as severe ICP. Serum α-fetoprotein (AFP), β-human chorionic gonadotropin (β-hCG), and unconjugated estriol (uE3) multiple of the median (MoM) values and the perinatal outcomes were recorded. The Student’s t-test, Mann–Whitney U test, Kruskal–Wallis test, and receiver operating characteristic curve analysis were used to compare the data. Results The AFP, β-hCG, and uE3 MoM values were higher in the severe ICP group when compared to those with mild ICP and those without ICP (p < 0.01). The sensitivity and specificity values for ICP were 80.95% and 73.42%, respectively, with AFP values ≥ 1.26 MoM, 76.19% and 88.61%, respectively, with β-hCG values ≥ 1.78 MoM, and 61.90% and 94.94%, respectively, with uE3 values ≥ 1.58 MoM [95% confidence interval; area under the curve (AUC) ± standard error (SE) = 0.810 ± 0.049, AUC ± SE: 0.790 ± 0.065, and AUC ± SE: 0.797 ± 0.065, respectively]. Conclusion An increase in the AFP, β-hCG, and uE3 MoM values in the triple test can predict the risk of developing severe ICP.

Amaç: Hiperemezis gravidarum ketonüri ile birlikte günden 3 defadan fazla kusma, sıvı elektrolit, asit-baz dengesizliği, beslenme bozukluğu ve kilo kaybına neden olan bir durumdur. Altta yatan çeşitli sebepleri olmakla birlikte tiroid fonksiyonlarındaki değişim ve vitamin D’nin de etyolojide rol oynadığı düşünülmektedir. Biz de çalışmamızda hiperemezisteki immün mekanizmalar üzerindeki D vitaminin rolünü ve tiroid fonksiyonlarının etkisini incelemeyi amaçladık. Gereç ve Yöntem: Çalışmamıza 2017 Ocak -2018 Temmuz ayları arasında Samsun Kadın Hastalıkları ve Doğum Hastanesi ve Sağlık Bilimleri Üniversitesi Samsun Eğitim ve Araştırma Hastanesi Kadın Hastalıkları ve Doğum Bölümü’ne başvuran hiperemezis gravidarum olan 132 ve vaka grubuyla benzer özelliklere sahip sağlıklı 233 gebe dahil edildi. Bu gebelerin TSH,T3,T4 ve vitamin D düzeyleri retrospektif olarak değerlendirildi. Bulgular: Çalışma sonuçlarımıza göre D vitamini seviyeleri hiperemezis gravidarum olan hastalarda anlamlı olarak daha düşük saptanmıştır (p=0.001; p0.05). Yapılan ikili karşılaştırma sonuçlarına göre; keton düzeyi pozitif (+) olan olguların D vitamini ölçümleri, keton düzeyi pozitif (++) ve pozitif (+++) olan olgulardan daha yüksektir (sırasıyla p=0.022; p=0.001; p0.05). Sonuç: Çalışmamızın sonuçlarında D vitamini eksikliğinin hiperemezis gravidarum ile bağlantılı olduğu bulgusuna ulaştık. Ayrıca hipermezis gravidarum olan bir hastayı değerlendirirken geçici gestasyonel hipertiroidizm tablosunu akılda tutmakta ve tedaviyi buna göre düzenlemekte yarar vardır.

Amaç: Vajinal prostaglandin E2 (PGE2) ile indüklenen multipar kadınlarda gebeliğin intrahepatik kolestazına (ICP) bağlı artan serum safra asit konsantrasyonları ile doğumun ilk evresi arasındaki ilişkiyi belirlemek.Gereç ve Yöntemler: Bu retrospektif vaka-kontrol çalışmasında 283 ICP’li ve 283 sağlıklı multipar gebe doğum indüksiyonu için kabul edildi, vajinal olarak PGE2 (10 mg dinoproston) yerleştirildi. Hafif, orta ve şiddetli ICP’li gruplar, PGE2’nin vajinal yerleştirilmesinin başlangıcından doğumun aktif evresine kadar geçen süreler, PGE2’nin vajinal yerleştirilmesinin başlangıcından serviksin tamamen dilatasyonuna kadar geçen süreler ve fetal sonuçlar açısından kontrol grubu ile karşılaştırıldı.Bulgular: Hafif, orta ve şiddetli ICP gruplarında PGE2’nin yerleştirilmesinin başlangıcından aktif evreye kadar geçen süre ICP olmayan gruptakine göre daha kısaydı; sırasıyla, 3,19±0,32, 7,26±0,34, 8,71±0,35 saat (p, Aim: To determine the relationship between increased serum bile acid concentrations and the first stage of labor in multiparous women induced by vaginal prostaglandin E2 (PGE2) with intrahepatic cholestasis of pregnancy (ICP).Material and Methods: In this retrospective case-control study 283 multiparous women with ICP and 283 healthy multiparous pregnant women were admitted for induction of delivery, were inserted PGE2 (10 mg dinoprostone) vaginally. The groups with mild, moderate and severe ICP were compared with control group in terms of the time from beginning of PGE2 vaginal insertion to active phase of labor, the time from beginning of PGE2 vaginal insertion to complete dilatation of cervix and fetal outcomes.Results: The time from beginning of PGE2 insertion to active phase in the mild, moderate and severe ICP groups were shorter than in the non-ICP group; 3.19±0.32, 7.26±0.34, 8.71±0.35 hours, respectively (p

Introduction Our study aims to evaluate the perinatal outcomes in twin pregnancies diagnosed with intrahepatic cholestasis of pregnancy (ICP) and to compare these with normal healthy twin pregnancies for perinatal outcomes. The second outcome of the study was to determine whether in vitro fertilization-embryo transfer (IVF-ET) affects the perinatal outcome in ICP patients. Materials and Methods In this study, 59 ICP and 641 healthy twin pregnancies were compared for perinatal outcomes retrospectively. According to the mode of conception, the twin pregnancies with ICP were divided into 2 groups. The twin pregnancies with ICP who were conceived with IVF were referred to as the IVF-ET group. The twin pregnancies with ICP who were conceived spontaneously or by ovulation induction and intrauterine insemination (IUI) were referred to as the non-IVF-ET group. Results Twin pregnancies with ICP give birth significantly earlier than normal twin pregnancies (p ˂ 0.001). The diagnosis of ICP occurred significantly earlier in the IVF-ET pregnancy with ICP than in the non-IVF-ET group. In twin pregnancies with IVF-ET, patients delivered significantly earlier than in the non-IVF-ET group (p=0.002). Twin pregnancies with ICP were found to have significantly higher rates of meconium-stained amniotic fluid, postnatal intubation, and admission to the neonatal intensive care unit (NICU) than healthy twin pregnancies. Conclusions ICP is a risk factor for preterm delivery in twin pregnancies. In addition, ICP develops earlier and more frequently in twin pregnancies from IVF-ET than in those from non-IVF twin pregnancies, and the disease may be more serious.

Tinelli, Andrea/0000-0001-8426-8490; erol, onur/0000-0002-7411-1200; GULER, OGUZ/0000-0001-7756-4267 WOS: 000514513400001 PubMed: 32064967 Objective: This multi-center study aims to determine the efficiency and safety of endometrial myomectomy (EM) for the removal of uterine fibroids during cesarean section (CS). Methods: Retrospective review of 360 women diagnosed for fibroids during pregnancy. They all delivered by CS between 2014 and 2019. The study groups included 118 women who only underwent EM, 120 women who only had subserosal myomectomy by traditional technique and 122 women with fibroids who decided to avoid cesarean myomectomy, as control group. They were analyzed and compared the surgical outcomes. Results: The EM, subserosal myomectomy and control groups were statistically (p > 0.05) similar for to age, body mass index (BMI), gravidity, parity, gestational age at delivery, indications for CS, number of excised fibroids, size of the largest myoma. Postoperative hemoglobin values and ? (?) hemoglobin concentrations were lower in SM group (10.39gr/dl vs 9.98 gr/dl vs 10.19 - 1.44 gr/dl vs 1.90 gr/dl vs 1.35; p = 0.047, p = 0.021; respectively) Hybrid fibroids were significantly more frequent in the EM group than subserosal myomectomy and control groups (respectively, 33.1% vs 23.3% vs 27.0%, p = 0.002). Surgery time was significantly longer in the subserosal myomectomy group than EM and control groups (respectively, 46.53 min vs 37.88 min vs 33.86 min, p = 0.001). Myomectomy took significantly longer time in the subserosal myomectomy than EM group (13.75 min vs 8.17 min, p = 0.001). Conclusions: Endometrial myomectomy is a feasible choice for treatment of fibroids during CS, and, basing on our results could be an alternative to traditional cesarean subserosal myomectomy.

Hypothesis: Vitamin D has been considered to play important roles in maintaining pregnancy. Also, this vitamin is considered to regulate immune response and thus may be important for pregnant women also to maintain no-infection of which preterm delivery is especially important. Since vitamin D regulates maternal anti-infection function and since Asymptomatic bacteriuria (ASB) causes various adverse outcomes in pregnancy, we hypothesized that maternal serum vitamin D level may be related with the presence/absence of ASB. The present study was an effort to determine this. The study included 215 pregnant women, attended the Ondokuz Mayis University Hospital antenatal care polyclinic, Samsun, Turkey, in the summer for initial visits between 6- and 14-weeks’ gestation. Women with symptoms suggestive of urinary tract infection, a history of antibiotic use within the previous two weeks, ongoing antibiotic therapy or urinary system instrumentation, a diagnosis of vitamin D insufficiency or deficiency, and those taking vitamin D supplements were excluded. Demographic data features of the sampled women were analyzed retrospectively. 10 ml maternal peripheral venous blood samples were collected and the concentrations of 25(OH)D3 in the serum were analyzed. Mid-stream morning urine samples were obtained and analyzed at the microbiology laboratory according to established procedures. ASB was reported if bacteria were present at specified quantitative counts (≥105 CFU/ml) in the urine without any sign or symptom. Participants were divided into two groups: ASB (-)—participants without ASB (n = 200) and: ASB (+)—participants with ASB (n = 15). There was no statistically significant relationship between the two groups in terms of demographic features. There was no statistically significant relationship between the distribution of maternal 25(OH)D3 levels in the two groups (p > 0.05). The comparison of maternal median 25(OH)D3 levels between the two groups showed no statistically significant difference (p = 0.576). No statistically significant correlation was found between 25(OH)D3 levels and age, gravida, parity, body weight, or gestation week (p > 0.05). Although there was no significant relationship between maternal vitamin D levels and ASB in this research, further studies in larger groups will increasingly highlight and clarify this topic.

Amaç: Polikistik over sendromu (PKOS) üreme çağındaki kadınlarda en sık rastlanan endokrinolojik bozukluktur. Metabolik ve kardiyovasküler ek hastalıklara zemin oluşturması yanı sıra kemik metabolizmasını da etkilemektedir. Çalışmamızda PKOS olgularının kemik mineral yoğunluğunu değerlendirmek ve bunu etkileyen faktörleri belirlemeyi amaçladık.Gereç ve yöntem: Araştırmaya Ocak 2019 ve Ocak 2021 tarihleri arasında poliklinik başvurusu olan 17-44 yaş arası 109 PKOS tanısı alan kadın dahil edilmiştir. PKOS tanısı Rotterdam kriterleri baz alınarak konulmuştur. Olguların kemik mineral yoğunluğu (KMY) dual enerji X ray absorbsiyometri (DEXA) ile ölçüldü. Ayrıca katılımcıların biyokimyasal ve hormonal değerlendirmeleri de yapılarak sol femur boynu ve lumbal 2,3 ve 4. vertebra bölgelerinden alınan DEXA ölçümlerinin Z ve T skorları, katılımcılar vücut kitle indeksine (VKİ) göre gruplandırılarak karşılaştırıldı.Bulgular: Fazla kilolu olan olguların insülin (p=0,006), homeaostatic model assessment –insulin resistance (HOMA-IR) (p=0,006) ve kortizol (p=0,009) ölçüm ortalamaları normal kilolu olgulara göre istatistiksel açıdan anlamlı olarak daha yüksek iken, tiroid stimülan hormon (TSH) ölçüm ortalamaları normal kilolu olgulara göre anlamlı olarak daha düşüktü (p=0,030). Fazla kilolu olan olguların femur boynu T skoru (FBTS) (p=0.038) ve femur boynu Z skoru (p=0.022) ölçüm ortalamaları normal kilolu olgulara göre daha yüksek olarak saptandı. Olgulara ait VKİ ölçümleri ile FBTS ölçümleri arasında pozitif bir (r=0.238) korelasyon saptanmıştır (p=0.013) ve bel çevresi/boy oranı ölçümleri ile FBZS ölçümleri arasında anlamlı, düşük düzeyde (r=0.198) ilişki saptanmıştır (p=0.039). Olguların FBZS (r=-0.212, p=0.028), lumbal 2-4 vertebra T skoru (L2L4TS)(r=-0.217, p=0.024) ve lumbal 2-4 vertebra Z skoru (L2L4ZS) (r=-0.277, p=0.004) ile dehidroepiandrosteron sülfat (DHEAS) arasında anlamlı negatif bir korelasyon saptanmıştır.Sonuç: Sonuç olarak VKİ ve bel çevresi/boy oranı PKOS olgularında KMY’i olumlu yönde etkilerken, DHEAS’nin olumsuz yönde etkilediği kanaatine vardık. Ancak mekanizmayı ortaya koymak için prospektif ve moleküler çalışmalara ihtiyaç vardır.

Aim Microbiota of the reproductive tract may be associated with unexplained infertility in women. We aimed to determine the derangements of vaginal and endometrial microbiota related to unexplained infertility by real-time polymerase chain reaction (real-time PCR) microbiota analyses of vaginal and endometrial samples of the unexplained infertility patients and fertile women. Materials and Methods Twenty-six women with unexplained infertility and 26 age-matched fertile women were included. Vaginal and endometrial samples were obtained in the mid-menstrual cycle for analysis by quantitative real-time PCR method. Results The proportion of lactobacilli-impaired microbiota was significantly higher in the vaginal samples of unexplained infertility patients (76.9% vs. 26.9%; p

Amaç: İntrauterininseminasyon (IUI), infertil çiftlerin gebelik şansını artırmak için yaygınolarak kullanılan bir işlemdir. hCG (human koryonik gonadotropin) uygulamasısonrası planlanan IUI zamanlaması pratikte 36. Saat olarak belirlenmiştir.Ancak klinik yoğunluk sebebi ile bu zamanlamada gecikmeler yaşanabilmektedir.Biz de çalışmamızda IUI’ları 36. Saate ve 42. Saate yapılan hastaların kliniksonuçlarını karşılaştırmayı amaçladık.Yöntem:Samsun Eğitim ve Araştırma Hastanesine açıklanamayan infertilite sebebi ilebaşvurmuş ve gonadotropin tedavisi sonrası IUI yapılmış 450 hastanın kayıtlarıgeriye dönük incelendi. Klinikteki yoğunluk sebebi ile hCG uygulaması sonrasıIUI zamanlaması 6 saat gecikmiş (42. Saat) olan hastalar ile zamanında (36.Saat) yapılmış hastaların demografik bilgileri, hormon düzeyleri, endometriumkalınlıkları, toplam folikül sayıları, β-hCG test pozitiflikleri, canlı doğumoranları ve spontan abort oranları değerlendirildi. Gruplar arasıkarşılaştırmalarda Student t test ve Ki-kare testi uygulandı.Bulgular:Hastaların 348’ine IUI prosedürü hCG uygulaması sonrasında 36. Saatteuygulanmışken 102’sine 42. Saatte uygulanmıştı. Gruplar arasında yaş,infertilite süresi, bazal hormon düzeyleri ve endometrial kalınlıklar açısındanfark izlenmedi (p, Aim: Intrauterine insemination (IUI) is acommonly used procedure to increase the chance of pregnancy in infertilecouples. The planned IUI timing after hCG (human chorionic gonadotropin)trigger was practically determined as at 36th hour. However, this timing may bedelayed due to clinical traffic. In our study, we aimed to compare the clinicalresults of patients who underwent IUIs at 36th hour versus at 42nd hour.Method: The records of 450 patients whowere admitted to Samsun Training and Research Hospital due to unexplainedinfertility and were performed IUI after gonadotropin treatment, wereretrospectively analyzed. Demographic information, hormone levels, endometrialthickness, total follicle numbers, β-hCG test positivity, live birth rates, andspontaneous abortion rates of patients with 6 hours delay (42 hours) in IUItiming after hCG trigger due to the traffic in the clinic, and patients with onthe time (36 hours) IUI performation were evaluated. Student's t-test andChi-square test were used for comparisons between groups.Results: IUI procedures were applied to 348patients at the 36th hour and 102 patients at the 42nd hour after the hCGtriggers. No difference was observed between the groups in terms of ages,infertility durations, basal hormone levels and endometrial thicknesses (p

WOS: 000466963400008 PubMed: 31059115 Objectives: Our objective was to evaluate in our clinic the perinatal outcomes of patients diagnosed with ICP based on pre-treatment maternal serum bile acid levels, attempt to identify the risk group and review the literature in light of this information. Material and methods: In total, 370 patients diagnosed with ICP were included in the study, divided into two groups based on the fasting total serum bile acid level before UDCA (Group 1: 10 >= 40 mu mol/L, and Group 2: >= 40 mu mol/L). The groups were examined for clinical characteristics and pregnancy outcomes. Results: It was found that preterm delivery and neonatal intensive care need increased at a serum bile acid cut-off value of 34 mu mol/L. Regardless of serum bile acid, significantly higher rates of meconium-stained amniotic fluid and foetal distress were observed in patients whose diagnoses were made before 34 weeks of gestation. Conclusions: Foetal complications over 40 mu mol/L of serum bile acid were significantly increased. However, slightly lower levels cut-off values (34 mu mol/L) were obtained in terms of preterm birth and neonatal intensive care need. The incidence of meconium-stained amniotic fluid and foetal distress was higher in patients whose diagnosis were made before 34 weeks of gestation.

Objective: Coronavirus disease 2019 (COVID 19) is a pandemic affecting pregnant women as well as lots of people. The aim of our study is to investigate the effects of inflammatory markers on the course of COVID-19 in pregnant women.Materials and methods: In this cross-sectional descriptive study, which included 125 pregnant women who were positive for Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and 40 women who were negative, patients with COVID-19 were grouped as mild, moderate, and severe according to oxygen saturation, lung involvement findings. Fibrinogen, ferritin, and procalcitonin values of the participants were compared.Results: While there was no significant difference between the ferritin (p = 0,241) and procalcitonin (p = 0,579) values of pregnant women according to the SARS-CoV-2 status, the fibrinogen values of pregnant women with positive test were found to be significantly higher (p, Amaç: Coronavirus Disease 2019 (COVID-19) birçok insanı olduğu kadar gebeleri de etkileyen bir pandemidir. Çalışmamızın amacı inflamatuar belirteçlerin gebelerde COVID-19 seyrine etkisini araştırmaktır.Gereç ve yöntem: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pozitif olan 125 ve negatif olan 40 gebenin dahil edildiği bu kesitsel tipe tanımlayıcı çalışmada, COVID-19 olan hastalar oksijen satürasyonu, akciğer tutulumu bulgularına göre hafif orta ve ağır olarak gruplandırılmıştır. Fibirnojen, ferritin ve prokalsitonin değerleri karşılaştırılmıştır.Bulgular: SARS-CoV-2 durumuna göre gebelerin ferritin (p=0,241) ve prokalsitonin (p=0,579) değerleri arasında da anlamlı fark saptanmazken, testi pozitif gebelerin fibrinojen değerleri anlamlı olarak yüksek bulunmuştur (p

Objectives: Morbidly adherent placenta (MAP) is one of leading causes of maternal mortality, with an increasing rate because of repeated cesarean sections (CS). The primary objective of this study is to compare two techniques of skin and uterine incisions in patients with MAP, evaluating the maternal fetal impact of the two methods. Retrospective multicentric cohort study. Material and methods: A total of 116 women with MAP diagnosis were enrolled and divided in two groups. Group one, comprised of 81 patients, abdominal entry was performed by Pfannenstiel skin incision plus an upper transverse lower uterine segment (LUS) incision (transverse-transverse), which was 2-3 cm above the MAP border, with the uterus in the abdomen. In group two, comprised of 35 patients, abdominal entry was performed by an infra-umbilical midline abdominal incision, by vertical-vertical technique, and the pregnant uterus was incised by a midline incision (vertical) from the fundus till the border of the MAP. Total surgery time, blood loss, blood product consumption, total hospital stay, cosmetic outcomes, and postoperative complications were investigated. Results: Total time of surgery was significantly shorter in group 1 (p < 0.05). Intraoperative blood loss was higher in group 2. Difference between preoperative and postoperative Hb and Htc levels were 3.30 +/- 1.04 and 12.99 +/- 5.07 respectively (p = 0.012; p = 0.033). The use of erythrocyte suspension (ES), fresh frozen plasma (FFP), and cryoprecipitate and thrombocyte suspension (TS) were found to be significantly lower in patients of group 1than vertical-vertical group (p = 0.008, p = 0.009, p = 0.001, p = 0.001, respectively). There was no difference in terms of total length of hospital stay between groups. Conclusions: In a subgroup of patients diagnosed for MAP, the transverse-transverse incision resulted in less bleeding, less blood and blood product use, and had better cosmetic results than vertical-vertical incision. Moreover, the total time of surgery, crucial for MAP patients, seems to be shorter also in transverse-transverse incision than in vertical-vertical incision. WOS:000661442400005 2-s2.0-85105788658 PubMed: 33844256

Midregional pro-adrenomedullin (MR-proADM) and matrix metalloproteinase-2 (MMP-2) are such proteins, that decreased levels are demonstrated in defective placental functions, as preeclampsia. The aim of the study is to compare maternal serum MR-proADM and MMP-2 levels across pregnancies with intrauterine growth restriction (IUGR), small for gestational age (SGA) and appropriate for gestational age (AGA), to biochemical screen the difference between SGA and IUGR.180 pregnant women were enrolled in a cross-sectional study: sixty pregnancies diagnosed for IUGR were included in group 1 (IUGR group), sixty pregnancies with SGA were in Group 2 (SGA group) and sixty pregnancies diagnosed for AGA, as control group. Maternal venous blood samples were collected at the time of enrollment, to assess serum MR-proADM and MMP-2 levels, by enzyme-linked immunosorbent assay (ELISA).The mean maternal serum MR-proADM and MMP-2 levels were lower in the IUGR group than in the SGA and AGA groups (Maternal serum MR-proADM and MMP-2 levels were significantly lower in pregnancies with IUGR. Maternal serum MR-proADM and MMP-2 measurements could be used to distinguish IUGR pregnancies from SGA pregnancies.

Polycystic ovary syndrome (PCOS) is the most common endocrinopathy which is frequently associated with metabolic syndrome. The aim of this study is to compare the clinical, biochemical and hormonal characteristics of healthy women and women with PCOS in Black Sea Region. 91 healthy women (Group 1) and 109 PCOS (Group 2) patients were included in this retrospective study. This study was conducted in Samsun Women and Children’s Health Research and Training Hospital between October 2019-May 2020.The anthropometric, clinical and laboratory characteristics of the women were recorded. The Institutional Review Board of the hospital approved the study. IBM SPSS Statistics 22 program was used for statistical analysis. Variables were expressed as mean ± standard deviation or as a number (percentage), and statistical significance was defined as a p value of less than 0.05. In this study, no statistically significant difference was found between patients with PCOS and control subjects in age, height, BMI, waist circumference and waist-to-hip ratio. Weight, BP systolic, BP diastolic and FG scores, were significantly higher in patients with PCOS compared to control subjects. In this study, no statistically significant difference was found between patients with PCOS and control subjects in FSH, estradiol prolactin, TSH, fT3, fT4 and DHEASO4 levels. But, LH, cortisol, total and free testosterone and 17-OH progesteron levels were significantly higher in patients with PCOS compared to control subjects. Also in this study, vitamin B12 and the 25-OH-D levels were significantly lower in patients with PCOS compared to control subjects. HbA1C, fasting blood glucose levels, fasting insulin levels and HOMA-IR were significantly higher in patients with PCOS compared to control subjects . Total-C, LDL-C and TG levels were significantly higher in women with PCOS compared to control subjects. Also, HDL-C levels were significantly lower in women with PCOS compared to control subjects. As a result, the risk of metabolic syndrome is increased in PCOS patients because of high androgen levels, obesity and insulin resistance.

To investigate cyclophilin A in early second trimester of pregnancy before the onset of preeclampsia.In this prospective case-control study, 51 pregnant women whose serum were collected and stored and who developed preeclampsia in later follow-up and 41 pregnant women as control group were included.Maternal serum cyclophilin A levels in the study group who developed preeclampsia in later follow-up were significantly higher than those of normal healthy pregnant women.Cyclophilin A may be a valuable predictor for pregnant women who subsequently develop preeclampsia in their pregnancies.

Amaç: Menopozal başlangıç kadınların hayat kalitesini belirleyen önemli faktörlerden biridir. Bu çalışmanın amacı postmenopozalkadınlarda doğal veya cerrahi menopozlu olmanın, menopozal sürenin ve serum gonadotropin düzeylerinin pre-diyabet (pre-DM) vediyabet (DM) gelişimi üzerine etkisini incelemektir.Gereç ve Yöntemler: Bu retrospektif olgu kontrol çalışmasına 140 pre-DM, 148 DM postmenopozal kadın ile 265 sağlıklı postmenopozalkadın dâhil edildi. Grupların menapoz tipi, süresi ve serum folikül stimüle edici hormon (FSH), luteinize edici hormon (LH) ve östradiol(E2) serum düzeyleri karşılaştırıldı. İstatistiksel değerlendirmede ANOVA ve Kruskal Wallis Testi kullanıldı.Bulgular: Doğal ya da cerrahi menopozlu olmanın pre-DM veya DM gelişimleri üzerine etkisi bulunmadı (p=0,393). Artmış menopozsüresi en fazla DM’li kadınlarda görüldü ve kontrollere göre farklılık istatistiksel olarak anlamlı bulundu (p=0,019). DM grubundadüşük serum FSH ve LH düzeyleri ile yüksek serum E2 düzeyleri gözlendi ve aradaki fark kontrol grubuna göre anlamlıydı (sırasıyla,p=0,001, p=0,001ve p=0,012).Sonuç: Cerrahi veya doğal yolla menopoza başlangıç yapmak kadınlarda gelişebilecek pre-DM ve DM oluşumunu etkilememektedir.DM’li kadınların menapozal süresi daha uzundur. DM öncesi ve DM’li kadınlar daha düşük serum FSH ve LH ve daha yüksek serumE2 düzeylerine sahiptir. Bu durum kısmen adiposite ve insulin direnci ile açıklanabilir., Aim: The onset of menopause is an important factor determining quality of life in females. The aim of this study was to evaluate theeffect of natural or surgical menopause, the duration of the menopausal period, and serum gonadotropin levels on the development ofpre-diabetes mellitus (pre-DM) and diabetes mellitus (DM) in postmenopausal women.Material and Methods: This retrospective study included 140 postmenopausal women with pre-DM, 148 postmenopausal women withDM and 265 healthy postmenopausal women. The groups were compared in respect of menopause type, the duration of the menopausalperiod, and serum follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2) levels. Statistical evaluations weremade.Results: There was found to be no significant effect of natural or surgical menopause on the development of pre-DM or DM (p=0.393).Increased duration of menopause was mostly seen in women with DM and the difference was statistically significant compared to thecontrols (p=0.019). Serum decreased FSH and LH levels and increased E2 level were observed in the DM group and the difference wassignificant compared to the control group (respectively, p=0.001, p=0.001 and p=0.012).Conclusion: The onset of natural or surgical menopause does not affect the development of pre-DM and DM. Women with DM havea longer menopausal period. Women with pre-DM and DM have lower serum FSH and LH levels and higher serum E2 levels. This canbe explained in part by adiposity and insulin resistance.

Hatirnaz, Safak/0000-0001-8859-0639 WOS: 000489951300001 PubMed: 31570023 Objectives: The aim of this study is to show whether bladder filling with saline before percreta surgery diminish the rate of bladder injuries or not. A secondary aim was to check the operative and postoperative outcomes between the cases of filled and unfilled bladder in placenta accreta surgery. Methods: This retrospective multicentric cohort study involved 88 patients who were diagnosed with placenta accreta and underwent cesarean hysterectomy between 1 January 2009 and 1 January 2019. Women who had cesarean hysterectomies due to the indication of placenta accreta and did not have bladder filling were used as the control group. Results: Eighty-eight women met the inclusion criteria. Forty-nine of the cases, the bladder was filled with saline solution before the operation, whereas in 39 the bladder was not filled. Intraoperative bladder injury occurred less in patients with preoperative filled bladders than in patients with unfilled bladders (p?=?.015; p?.05). There was a statistically significant difference between the duration of surgery according to bladder inflation (p?=?.001; p?

Objective: Retinol Binding Protein–4 (RBP–4) is an adipokine that has been identified as a novel regulator of insulin resistance. It has been suggested that insulin resistance might be associated with the pathophysiology of preeclampsia. The aims of this study were to determine whether the maternal serum levels of RBP-4 differ between patients with preeclampsia and those with normal pregnancies and to explore the relationship between the severity of disease and serum concentrations of RBP-4. Method: This case-control study included two groups: 1. Patients with preeclampsia (n=27) and 2. Patients with normal pregnancies (n=27). All subjects enrolled in the study were in their gestational age of 30 weeks or more. Serum RBP-4 concentrations were determined by ELISA. Results: Patients with preeclampsia had a higher serum concentration of RBP-4 than that of normal pregnant women (p < 0.001). When women with preeclampsia were categorized as those with preeclampsia and severe preeclampsia, no significant difference was observed in concentration of serum RBP-4 (p= 0.272). Conclusions: Our results support a role of RBP-4 in the pathogenesis of preeclampsia

Hatirnaz, Safak/0000-0001-8859-0639 WOS: 000465210500003 PubMed: 30560702 Objective: Spontaneous ovarian hyperstimulation syndrome (SOHSS) is an extremely rare complication that deserves a multidisciplinary approach together with a thorough investigation for the correct diagnosis of the underlying pathology. The aim of this study was to present a case of severe SOHSS resistant to all interventions and to discuss the available interventions to overcome such a rare and serious clinical situation. Case report: We report a case of severe, life-threatening spontaneous OHSS with a normal nine weeks singleton pregnancy in a 25-year-old nulliparous woman, which resulted with pregnancy termination and continuation of disease progression until the dose of cabergoline was increased to 1.5 mg/day. Conclusion: This case report emphasizes that patients with life-threatening SOHSS resistant to all medical and surgical interventions may benefit from higher doses of cabergoline. Although spontaneous OHSS is extremely rare, it is potentially a life-threatening clinical entity in its severe form and needs time management and detailed examination of the underlying causes.