Does Monopolar Electrocautery Affect the Fetus during Cesarean Section?

Background and Objectives: This study aimed to assess the impact of monopolar electrocautery on the fetus during cesarean section. Materials and methods: A retrospective analysis was conducted with 552 patients delivered by cesarean section. Patients were grouped based on usage of monopolar electrocautery. In 272 patients, monopolar electrocautery was used to separate the tissues before the delivery. In 280 patients, no electrocautery was used. Newborn vital signs, Apgar scores, umbilical cord blood parameters, newborn serum parameters collected within 6th postpartum hour, and rate of newborn intensive care unit admission were compared. Results: The 1st and 5th minute Apgar scores were significantly higher in the electrocautery group; however, this difference lost its significance at the 10th minute. The median newborn pulse rate (148 (7) vs. 146 (6) beats per minute, p = 0.026), umbilical cord blood pH, and partial oxygen pressure were significantly higher in the electrocautery group compared to the no-electrocautery group (7.34 ± 0.06 vs. 7.31 ± 0.06, p < 0.001, and 25.5 (14.77) vs. 23 (16.08) mmHg, p = 0.025, respectively). The median umbilical cord blood serum calcium level was 1.51 (0.64) mmol/L in the electrocautery group, which was significantly lower than 1.9 (0.82) mmol/L in the no-electrocautery group (p = 0.002). The incidence of hypoglycemia was significantly lower in the electrocautery group than in the no-electrocautery group (2.2% vs. 5.7%, p = 0.035). Conclusions: Monopolar electrocautery during cesarean section affects the fetus, but it is safe to use it. Electrocautery is independently associated with umbilical cord blood pH and calcium level. Electrocautery may be associated with a lower incidence of hypoglycemia.

Cervical dysplasia after renal transplantation: A retrospective cohort study.

OBJECTIVE: Since the first days of organ transplantation, it has been accepted that solid transplant recipients have a high risk of developing cancer. Chronic immunosuppression and environmental factors play a role in cancer development in recipients. In the present study, we tried to evaluate the cumulative incidence of cervical dysplasia after renal transplantation, risk factors for disease development, and the time until high-grade dysplasia occurred. MATERIALS AND METHODS: A total of 50 patients with renal transplantation who presented for gynecologic follow-up was included in the study. The medical records of the patients were reviewed until the last clinical visit, their demographic characteristics, transplant history, gynecologic history, and gynecologic examination results (cervical cytology and histology reports) were reviewed. RESULTS: Of the 50 women in the study population, 29 (58%; 95% confidence interval: 8.8-15.9) developed cervical dysplasia after the first transplant at a median follow-up of 7.8 (range: 4.6-12.9) years. Twenty-one women with benign cervical cytology before transplantation had evidence of low-grade intraepithelial lesions + after transplant (47% of these were within 2 years after transplant). During the follow-up, 8 women (18.2%) were diagnosed as having high-grade intraepithelial lesions + (within 5 years after transplantation). CONCLUSION: Renal transplant patients were found to have higher abnormal cervical cytology and histology rates than the normal population.

The Impact of Surgical Staging on the Prognosis of Mucinous Borderline Tumors of the Ovaries: A Multicenter Study.

BACKGROUND/AIM: The purpose of this study was to prove the effect of complete surgical staging of patients with mucinous borderline ovarian tumors (mBOTs) especially appendectomy on progression-free survival (PFS) and overall survival (OS). PATIENTS AND METHODS: The database of 14 gynecological oncology departments from Turkey and Germany were comprehensively searched for women who underwent primary surgery for an ovarian tumor between January 1, 1998, and December 31, 2015, and whose final diagnosis was mBOT. RESULTS: A total of 364 patients with mBOT with a median age of 43.1 years were included in this analysis. The median OS of all patients was 53.1 months. The majority of cases had Stage IA (78.6%). In univariate and multivariate analyses, radical surgery, omentectomy, appendectomy, lymphadenectomy, and adding adjuvant chemotherapy were not independent prognostic factors for PFS and OS. Furthermore, FIGO stage (≥IC vs.

The association between follicular fluid levels of cathepsin B, relaxin or AMH with clinical pregnancy rates in infertile patients.

OBJECTIVE: The aim of this study was to investigate the relationship of cathepsin B, relaxin and anti-Mullerian hormone (AMH) in follicular fluid (FF) with pregnancy rates in infertility patients. STUDY DESIGN: Seventy-nine infertile couples who underwent ICSI were included in the study. The FF levels of cathepsin B, relaxin and AMH were measured using ELISA kits. RESULTS: The FF cathepsin B levels were statistically higher in pregnant patients compared with non-pregnant patients (0.20±0.13 versus 0.13±0.03; P<0.001). There were statistically significant differences in the total number of oocytes (10.00±6.85 versus 5.96±3.94); the mean number of M2 oocytes (8.65±5.63 versus 4.58±3.36) between the pregnant and non-pregnant patients (P<0.05). There were no significant correlations between pregnancy rates and relaxin and AMH (P>0.05). The area under the curve of cathepsin B for prediction of pregnancy was 0.662 (p=0.024, 95% Confidence Interval 0.528-0.797). CONCLUSIONS: This study demonstrated that increased level of cathepsin B in FF significantly correlates with a better chance of clinical pregnancy. Further studies are needed to clarify the role of cathepsin B in the reproductive process of humans.

Is increased maternal endothelin-1 concentration associated with neonatal asphyxia and preterm delivery in intrahepatic cholestasis of pregnancy?

OBJECTIVES: To evaluate plasma endothelin-1 (ET-1) and fetuin-A concentrations in women with intrahepatic cholestasis of pregnancy (ICP) and to determine whether there is any association between these parameters and fetal asphyxia. METHODS: We carried out a prospective case-control study consisting of 32 women with ICP at third trimester of pregnancy and 32 pregnant women without ICP. Blood samples from maternal peripheral venous circulation were collected and ET-1 and fetuin-A levels were determined from the plasma samples. Pulse-wave Doppler and Apgar scores were also recorded. RESULTS: ET-1 concentrations were significantly higher in ICP patients. No difference was observed in fetuin-A levels between the two groups. Six newborns were declared as asphyctic (APGAR score at the 5 min <7). Maternal ET-1 levels did not correlate with the APGAR score at 5 min, total bile acid (TBA) and umbilical artery systolic/diastolic ratio with ICP patients. TBA levels were positively correlated with umbilical artery systolic/diastolic ratio negatively correlated with APGAR score at the 1' and 5'-Apgar score in all subjects. Plasma ET-1 concentration was higher in the preterm neonates of mothers with ICP compared with normal term neonates of mothers. CONCLUSIONS: Although these data did not show evidence that maternal ET-1 would be associated with fetal distress, we can speculate that maternal ET-1 may be playing a role in the underlying pathology regarding microvascular dysfunction especially in the preterm neonates of mothers with ICP. Elevated TBA levels may increase the risk of asphyxia whereas fetuin-a (as an anti-inflammation marker) does not seem to have effect in women with ICP.