Search

Introduction: One-third of fetal soft tissue tumors are malignant and include congenital fibrosarcoma (CF). We report two fetal CFs arising in the posterior mediastinum. Case Presentation: In case 1, the CF resulted in a mediastinal shift, extensive infiltration of the tumor around adjacent structures, pulmonary hypoplasia, pleural effusion, and rapid growth. The pregnancy was terminated. Case 2 had multiple intrathoracic masses, thoracic hypoplasia, pleural effusion, and fetal death. Both were diagnosed as fibrosarcoma at fetopsy. Discussion: Although congenital CF tends to be locally aggressive with a low metastatic rate, it tends to grow rapidly and the tumor location can affect fetal survival. In Case 1, the tumor demonstrated locally aggressive behavior whereas multiple distant metastases such as lung, liver, adrenals, and left eye were detected in Case 2. The tumor was directly responsible for intrauterine fetal demise in the second case. [ABSTRACT FROM AUTHOR]

Aim: The aim of the present study was to determine a cutoff level for a decrease in human chorionic gonadotropin (hCG) on postoperative day 1 to confirm intrauterine pregnancy (IUP) in patients who have undergone dilatation and curettage (D/C) with a presumptive diagnosis of nonviable pregnancy of unknown location (PUL). Material and Methods: This retrospective case-control study included patients who underwent D/C with a presumptive diagnosis of failing PUL between January 2010 and June 2015. Patients with failing PUL or confirmed to have an IUP were placed in Group 1 (n=164) and patients subsequently diagnosed with ectopic pregnancy were placed in Group 2 (n=19). In all patients, serum hCG levels were obtained on the day of D/C and on the following day. Results: The decline in serum hCG percentage on day 1 after D/C was 54.2% in patients with failing PUL/abortion and 14.3% in patients with ectopic pregnancy (p<0.001). A decrease in hCG of more than 35% was the most sensitive marker, with sensitivity, specificity, and positive and negative predictive values of 90%, 89%, 99%, and 50%, respectively. Conclusion: Determining post curettage day 1 hCG might aid clinicians in confirming failing IUP and in ruling out an ectopic pregnancy at an earlier date. [ABSTRACT FROM AUTHOR]

Purpose: The aim of our study was to evaluate the oxidative stress (OS) in pregnant women with intrahepatic cholestasis of pregnancy (ICP) by evaluating thiol/disulphide homeostasis using an alternative technique.Methods: A total of 57 pregnant women with ICP were compared with 50 gestational age and body mass index matched controls. A recently defined method was used for the measurement of plasma native-total thiol and disulphide levels. The independent two-sample t test, Mann-Whitney-U test, Chi-square test, binary logistic regression with backward elimination and receiver operating characteristic (ROC) curve was performed for statistical analyses.Results: Pregnant women with ICP (n = 57) versus controls (n = 50) had significantly lower serum levels of native thiol (233.8 ± 47.4 μmol/L vs. 308.5 ± 51.7 μmol/L, p < .001), total thiol (258.4 ± 46.5 μmol/L vs. 328.0 ± 52.0 μmol/L, p < .001) and higher levels of disulphide (12.3 ± 3.6 μmol/L vs. 9.7 ± 3.4 μmol/L, p < .001). Binary logistic regression showed that the most important variables related to ICP were native thiol and total thiol. According to the ROC curve, the optimal cut-off level for native thiol was 280.0 μmol/L (sensitivity: 86%, specificity: 84.2%, area under the curve (AUC):0.896, 95% CI: 0.831-0.962, p < .001), and the optimal cut-off level for total thiol was 300.0 μmol/L (sensitivity: 86%, specificity: 80.7%, AUC: 0.883, 95% CI: 0.815-0.951, p < .001).Conclusions: To our knowledge, this is the first study in the literature exploring thiol/disulphide balance in ICP. We found that thiol/disulphide balance indicate OS in pregnant woman with ICP. [ABSTRACT FROM AUTHOR]

Objective: Vitamin D (VD) deficiency is a common public health problem worldwide in all age groups. Receptors and enzymes related to VD metabolism have been shown in many cells and tissues of the body. VD plays a crucial role in cellular growth and differentiation during embryogenesis. It has been suggested that VD deficiency may be associated with various diseases, and that lower maternal serum levels may be associated with adverse perinatal outcomes. In this study, we aimed to compare serum VD levels of pregnant women whose pregnancies complicated by congenital diaphragmatic hernia (CDH) with healthy pregnant women. We also evaluated perinatal outcomes of these pregnancies.Methods: Total of 77 patients was included in this prospective and cross-sectional case-controlled study. 24 pregnant women having a fetus with CDH diagnosed prenatally formed the study group, and 53 healthy pregnants were eligible for the control group. Demographics and clinical characteristics of the cases with some laboratory parameters were recorded. Perinatal outcomes were also investigated.Results: No significant differences were observed between two groups in terms of demographics and clinical features. Mean maternal serum VD levels were significantly lower in the study group than in the controls (p: 0.019). Ionized calcium and corrected calcium levels were also found to be lower in pregnant women with CDH (p < 0.001). Moreover, the calcium-rich dietary habits were also more common in the control group. Four (16.7%) patients chose termination and one (4.2%) experienced a stillbirth. Fourteen (58.3%) infants died in the early neonatal period; although some had undergone surgical interventions, only 5 (20.8%) were still alive after surgery.Conclusions: Maternal serum VD and calcium levels were significantly lower in pregnancies complicated by CDH than healthy pregnant women. Hipovitaminosis D may play a vital role in the pathogenesis of CDH. [ABSTRACT FROM AUTHOR]