Utility of superior mesenteric artery Doppler and maternal pancreatic size for predicting gestational diabetes mellitus.

AIM: The aim of this study was to assess the relationship between the maternal superior mesenteric artery Doppler, pancreatic size and gestational diabetes mellitus (GDM). METHODS: Two hundred and fifty-eight consecutive, pregnant women between 20 and 22 weeks of gestation underwent routine fetal anomaly screening. All subjects underwent maternal superior mesenteric artery Doppler and pancreatic size measurement of head, corpus and tail during screening. Screening was done with 50 g glucose challenge test (GCT) at gestational age 24-28 weeks. The patients who were having an abnormal GCT were subjected to 100 g GCT. Subjects were divided into two groups such as pregnancies with gestational diabetes and normal pregnancies. Relationship between Doppler and pancreatic measurements with GDM was analyzed. RESULTS: Out of 258 screened pregnancies, 28 (10.9 %) were diagnosed as GDM. There were significant differences between GDM positive and negative cases in terms of pancreatic body size (17.5 vs. 14.4 mm, p = 0.05), superior mesenteric artery Doppler systolic/diastolic ratio (S/D) (4.2 vs. 3.4) and resistance index (RI) (0.72 vs. 0.68) values. Superior mesenteric artery Doppler S/D (AUC = 0.761, p < 0.001) and RI (AUC = 0.762, p < 0.001) indices were significant predictors for GDM. CONCLUSION: Superior mesenteric artery Doppler and pancreatic size evaluation may be utilized to detect abnormal glucose metabolism during pregnancy care.

Evaluation of the histopathological diagnosis of patients preoperatively diagnosed with atypical endometrial hyperplasia after hysterectomy.

OBJECTIVE: To evaluate the patients diagnosed with atypical endometrial hyperplasia preoperatively, and compare preoperative and postoperative results. MATERIALS AND METHOD: We investigated the files of 58 patients diagnosed with atypical endometrial hyperplasia who were treated surgically after clinical evaluation. We compared sociodemographic diagnosis, preoperative and postoperative diagnosis. RESULTS: Mean-age of patients was 51.7. Obesity, diabetes mellitus, hypertension and infertility were seen, respectively, in eight cases (13.7%), 12 cases (20.6%), 19 cases (32.7%) and four cases (6.8%). While endometrial cancer was not found postoperatively in patients preoperatively diagnosed with simple atypical endometrial hyperplasia, we determined well differentiated endometrial adenocarcinoma in 44.7% of the patients. CONCLUSION: In the literature the probability of developing well differentiated endometrial cancer from complex atypical endometrial hyperplasia is 40-50%. All patients diagnosed with complex atypical hyperplasia should be evaluated preoperatively for well differentiated adenocarcinoma and undergo an appropriate surgical technique and staging.