Could maternal serum MFG-E8 level predict adverse first trimester pregnancy outcome? A preliminary study.

BACKGROUND: Milk fat globule-epidermal growth factor 8 (MFG-E8) is expressed in the endometrial epithelium and its expression increases during the implantation process. Due to this knowledge, we aimed to investigate the maternal serum MFG-E8 levels on both healthy pregnant women in the first trimester and pregnant women complicated with missed abortion and threatened abortion in the first trimester. METHODS: This prospective, cross-sectional study was conducted in a tertiary referral hospital, department of obstetrics between July 2020 and February 2021 after ethical committee approval. The study population was consisted of 30 healthy pregnant women (HP) in the first trimester, 30 pregnant women suffering from threatened abortion (TA) in the first trimester and 30 pregnant women suffering from missed abortion (MA) in the first trimester. Maternal serum MFG-E8 levels were analyzed with enzyme linked immunosorbent assay. Delivery and neonatal outcomes of the study population was evaluated. The continuous variables were compared among three groups with variance analysis with post hoc tests. The categorical variables were compared with chi-square and Fisher's exact tests where applicable. RESULTS: The mean age of the study population was 29.36 ± 5.31 years. There was no significant difference among three groups for parameters of age, body mass index, parity number, and gestational week. Despite being within normal ranges, the mean neutrophil and international normalized ratio values of the three groups showed statistically significant difference (p < 0.05). The mean maternal serum MFG-E8 levels of MA, TA, and HP groups were 270 ± 152.3, 414.7 ± 236.7, and 474 ± 222.5 ng/mL, respectively (p = 0.001). It was found that mean of MFG-E8 of the MA group was statistically significantly lower than those of the other two groups (p < 0.05). DISCUSSION: Although maternal serum MFG-E8 level seems to be a parameter that differ between live and nonlive pregnancies, studies with large number of cases are needed to discuss our results and to determine a cut-off value for prediction.

Serum Copeptin Levels in Threatened Preterm Labor.

AIM: We investigated maternal copeptin level's usefulness in prediction of preterm birth. Materials and methods: The study was comprised of 97 pregnant women hospitalized for threatened preterm labor and 35 healthy pregnant women without preterm labor. Serum copeptin were compared with likelihood of threatened preterm labor timing of delivery and time interval to delivery. Result: Copeptin level of threatened preterm labor group was higher than of control group [7.76(0.39-35.62) ng/mL, 6.23(1.64-36.88) ng/mL, respectively, p = .04]. Copeptin levels of women did not differ according to preterm or term birth [7.76(0.69-35.62) ng/mL, 6.73(0.39-36.88) ng/mL, respectively, p = .22). Quartiles of copeptin levels were not associated with risk status or preterm birth. Conclusions: Serum copeptin is higher in threatened preterm labor. It does not differentiate those with threatened preterm labor verses preterm birth.

Comparison of Serum Ykl-40 and Ischemia Modified Albulmin Levels Between Pregnant Women with Hyperemesis Gravidarum and Normal Pregnant Women.

INTRODUCTION: The etiopathogenesis of HG is still unclear. AIM: The aim of this study was to investigate the levels of YKL-40 protein as an inflammatory marker and evaluate the levels of IMA as an oxidative marker in hyperemesis gravidarum women. MATERIALS AND METHODS: Totally 35 patients with hyperemesis gravidarum and 35 healthy pregnants were included in the study. Singleton pregnancies between 6+0 week and 13+6 weeks of gestation, with normal fetal anatomy were included in the study. Complete blood count, complete urine analyze, biochemical tests and thyroid function tests were done. RESULTS: There was no significant difference between groups for demographical features (age, gravidity, gestational age, body mass index). Also, there was no statistically significant difference between groups for IMA levels (p>0.05). The median level of YKL-40 was higher in pregnants with hyperemesis gravidarum than normal pregnants but the difference was not statistically significance (p>0.05). CONCLUSION: Further comprehensive studies with more number of patients are needed to show the efficacy of YKL-40 and IMA levels for predicting hyperemesis gravidarum and even monitoring of the treatment.

Is body mass index a risk factor for low cerebral oxygenation during spinal anesthesia in women undergoing cesarean section? A preliminary study

Background/aim: In this study, it was aimed to investigate the relationship between body mass index (BMI) and cerebral oxygenation during spinal anesthesia in women undergoing cesarean section. This study also aimed to demonstrate whether fetal cord blood oxygenation was affected by maternal BMI and/or delivery time. Materials and methods: The study included parturients with ASA I score undergoing cesarean section under spinal anesthesia in 2015 and 2016. They were divided into two groups according to BMI: Group 1 comprised parturients with BMI of <30 (n = 11) and Group 2 comprised parturients with BMI of ≥30 (n = 17). Right cerebral oxygenation (RSO2) and left cerebral oxygenation (LSO2) monitoring was performed using near-infrared spectroscopy (NIRS). The participants were divided into two groups according to the duration of fetal delivery. Group A included parturients with delivery time of <2 min (n = 7) and Group B those with delivery time of >2 min (n = 18), and fetal cord blood oxygenation was measured using a blood gas analyzer. Results: Evaluation was made of a total of 25 patients. The RSO2 values were measured at the 20th, 30th, and 35th minutes of the cesarean section procedure and the median values of all the time intervals in Group 1 were significantly lower than those of Group 2 (P < 0.05). The LSO2 value was significantly lower in Group 1 at the 35th minute compared to Group 2 (P < 0.05). The PO2 values of fetal cord blood were significantly lower in Group B (P < 0.05). Conclusion: The results of this study showed that parturients with BMI of <30 who are undergoing cesarean section under spinal anesthesia might have an increased risk of complications due to decreased cerebral oxygenation related with hypotension. Therefore, it can be suggested that before and during cesarean section these patients should be closely monitored for cerebral oxygenation using NIRS.

Sigmoid Colon Perforation Mimics a Tuboovarian Absces.

INTRODUCTION: An adnexal mass may be diagnosed after a routine pelvic ultrasonographic examination or an emergent hospital admission due to rupture of ectopic pregnancy, adnexal torsion or rupture of tuboovarian abscess. It is necessary to evaluate the origin of the mass initially and to classify patients who need further evaluation and treatment for an urgent condition. CASE PRESENTATION: We report a case of sigmoid colon rupture due to sigmoid colon adenocarcinoma presenting as acute abdomen with left adnexal mass in a 28 years old woman. Abdominopelvic computed tomography revealed a left adnexal mass with suspicion of tuboovarian abscess. In laparatomy, rupture of sigmoid colon was observed and resection of sigmoid colon was performed. Histological examination of resection part revealed diagnosis of sigmoid colon adenocarcinoma due to familial adenomatous polyposis. CONCLUSION: This case may be interesting for clinicians because pelvic pain, fever, increased infection markers in the laboratory and mass at ultrasonography or other screening methods could cause a misdiagnosis of tubaovarian abscess especially in reproductive age women. Before the operation of the pelvic mass of all age women with the diagnosis of tuboovarian abscess other causes of the pelvic abscess should come into mine and necessary preparation for operation must be done.

Retrospective Analysis of Endemic Melasma Patients.

Melasma is an acquired diffuse hypermelanosis characterized by localized, symmetrical, irregular, light-to-dark brown maculae occurring in sun-exposed areas of skin. The aim of this retrospective study was to determine demographics of patients, analysis of etiologic factors, clinical features, efficacy and side effects of available topical treatments due to high incidence of melasma patients. In this study melasma patients in Birecik State Hospital were investigated retrospectively. Between January 2014 and October 2015, 1008 patients had diagnosis of melasma in 49,809 applications of 24,603 different patients who admitted to Dermatology Outpatient Clinics. Of the 1008 patients, 263 had completed 3-month treatment period. These patients did not receive treatment in June, July, August and September. All melasma patients were rural and dealing with agriculture. There was no significant difference between female and male patients in terms of age. Of the 253 female melasma patients, only 2 of them had not child and none of them were using hormone drug. Of the 263 patients with melasma, Fitzpatrick skin type was 3 in 79 (30%) patients, 4 in 184 (70%) patients. Sanliurfa city showed higher fertility rate, sun exposure, and skin type than Turkey as a whole. These predisposing factors may explain higher melasma occurrence in Sanliurfa. Patient information about preventive measures and treatment play important role in treatment of cosmetic condition. The most important measure seems to advise patients about sun-protection especially during pregnancy.

Changes in the choroidal thickness in reproductive-aged women with iron-deficiency anemia.

BACKGROUND: The aim of this study was to investigate the potential significance of the central macular thickness (foveal thickness-FT) and choroidal thickness (CT) in the eyes of patients with iron-deficiency anemia, the most common form of the anemia, via enhanced-depth imaging optical coherence tomography (EDI-OCT). We also investigated whether such changes might serve as an early indicator of underlying hematological disease. METHODS: This prospective clinical study compared 96 female patients with iron-deficiency anemia and 60 healthy female control subjects. The macular and choroidal thicknesses in the temporal and nasal subfoveal areas were measured using enhanced-depth imaging optical coherence tomography (EDI-OCT) at 500 and 1500 microns and in five different regions (FCT, T1500, T500, N500, and N1500). RESULTS: The mean ages of the patients and healthy controls were 34.08 ± 10.39 years and 32.29 ± 8.28 years, respectively (P =0.232). There were no significant changes in macular thickness between the groups (225.58 ± 19.76 vs. 222.45 ± 13.51, P =0.2). The choroidal thickness was significantly reduced in the patient group relative to the controls at all measured points (foveal choroidal thickness, P = 0.042; nasal-500 microns, P = 0.033; temporal-500 microns, P = 0.033; and temporal-1500 microns, P = 0.019). At some points, the choroidal thickness findings correlated with the hemoglobin values (temporal-500 microns, r = -0.287, P = 0.001; nasal-500 microns, r = -0.287, P = 0.005; nasal-1500 microns, r = -0.245, P = 0.016; and temporal-1500 microns, r = -0.280, P = 0.06). CONCLUSIONS: Patients with iron-deficiency anemia had a significantly reduced choroidal thickness.