Can M-30, M-65, and IL-6 serum levels be useful markers in the diagnosis of preeclampsia and gestational diabetes?

OBJECTIVE: We aimed to evaluate the maternal and fetal serum M-30, M-65 and IL-6 levels in preeclampsia and gestational diabetes mellitus (GDM) in both maternal and cord blood. PATIENTS AND METHODS: Women with preeclampsia (n=30), GDM (n=30), and uncomplicated pregnancy (n=28) were evaluated in a cross-sectional study. After clamping during delivery, the serum M-30, M-65, and IL-6 levels were measured in both maternal venous blood and cord blood. RESULTS: The serum M-30, M-65, and IL-6 levels were significantly higher in preeclampsia and GDM patients' maternal blood and cord blood samples compared to the control group. In the preeclampsia group, M-65 was significantly higher in cord blood compared with the level in maternal serum, but there was no significant difference between the GDM and control groups. The control group's IL-6 level in cord blood was statistically significantly lower than the other groups. Although the M-30 value in both maternal and cord blood was statistically lower in the control group than in the GDM group, there was no significant difference between the two groups when compared to the preeclampsia group. CONCLUSIONS: M-30 and M-65 molecules appear to have the potential to serve as biochemical markers in placental diseases, particularly preeclampsia and gestational diabetes. Due to the insufficient sample sizes, more research is needed.

Giant cervical myoma associated with urinary incontinence and hydroureteronephrosis.

Cervical leiomyomas compromise fewer than 5% of all uterine leiomyomas. Cervical myomas exacerbates surgical difficulties, such as poor operative field, difficult suture repairs, and blood loss. When performing myomectomy for cervical myomas, care must be taken to avoid injuries to neighboring structures in the pelvic cavity.These structures include the bladder in front of the cervix, the rectum behind the cervix, and the uterine arteries and ureters on both sides. Myomectomy for cervical myoma is empirically difficult and frequently problematic. The authors report a case of giant cervical myoma presenting with urinary incontinence.

Primary malignant melanoma of the cervix: a case report.

Primary malignant melanomas of the uterine cervix are extremely rare tumors. Diagnosis is confirmed by immunohistochemical methods and by exclusion of other primary sites of melanoma. The treatment of this condition is not yet standardized and the overall prognosis of these patients is very poor. The authors report a case of primary malignant melanoma of the uterine cervix.

Endometriosis of episiotomy scar: a case report.

Endometriosis is characterized by the presence of histologically normal endometrial glands and stroma outside the uterine cavity. Endometriosis predominantly locates on peritoneal surfaces, but it also affects the vagina, vulva, and perineum, usually secondary to surgical or obstetric trauma. Endometriosis in an episiotomy scar is a fairly rare phenomenon. The authors present a case of endometriosis in an episiotomy scar.

Serum oxidized low density lipoprotein levels in preeclamptic and normotensive pregnants.

UNLABELLED: BACKGROUNDS/AIM: The aim of the study was to determine serum lipids and oxidized low density lipoprotein (ox-LDL) levels in preeclamptic pregnants and compare with those of normotensives. MATERIALS AND METHODS: Ox-LDL levels were determined by enzyme linked immunosorbent assay (ELISA); total cholesterol, hight density lipoprotein (HDL)-cholesterol and triglyceride levels were measured by enzymatic colorimetric assay in 26 normotensive and 27 preeclamptic pregnants. LDL and very low density lipoprotein (VLDL) cholesterol was calculated by Friedwald formula. RESULTS: Serum levels of Ox-LDL (U/L), total-cholesterol (mg/dL), HDL-cholesterol (mg/dL), LDL-cholesterol (mg/dL), triglyceride (mg/dL), and VLDL-cholesterol (mg/dL) in normotensive and preeclamptic pregnants were found as 130±60 and 133±69; 248±49 and 248±81; 67±14 and 61±16; 147±61 and 135±59; 207±76 and 256±87; 41±15 and 50±17, respectively. Mean values of Ox-LDL and other lipid parameters were higher than the upper limits of their reference ranges in both of groups. However no significant differences were found in Ox-LDL, total, HDL and LDL-cholesterol levels between two groups. However, the levels of triglyceride and VLDL-cholesterol were significantly higher in preeclampsia group. CONCLUSIONS: The present results suggest that the levels of serum Ox-LDL and other lipid parameters rise as a result of pregnancy rather than as a result of preeclampsia.

Serum neutrophil gelatinase associated lipocalin and plasma nitric oxide levels in healthy and preeclamptic pregnants.

AIMS: The authors aimed to evaluate serum neutrophil gelatinase associated lipocalin (NGAL) and plasma nitric oxide (NO) levels in preeclamptic and healthy pregnant women above 24 gestation weeks. MATERIALS AND METHODS: Forty-nine healthy and 21 preeclamptic (total 70) pregnant women participated voluntarily in the study. Presence of 140 mmHg and above systolic and 90 mmHg and above diastolic blood pressure which emerges after 20th gestation week, proteinuria more than 300 mg/24 hour, and edema were used as diagnostic criterion for preeclamptic pregnant women. Measurements of serum NGAL and plasma NO were performed with enzyme linked immunosorbent assay (ELISA) and photometric method, respectively. RESULTS: Serum NGAL and plasma NO levels of healthy and preeclamptic groups did not show a statistical difference. In preeclamptic group, a statistically meaningful correlation was found between level of NGAL and body mass index (BMI) of sampling time, creatinine and NGAL, total protein and NO, and albumin and NO. CONCLUSIONS: Serum NGAL levels, correlated with serum creatinine levels in this study, may be the early marker of renal damage which may develop mainly due to inflammation and endothelial damage. The authors could not find a statistical difference for serum NGAL and plasma NO levels between healthy pregnant and preeclamptic groups. Varieties peculiar to humans in preeclampsia, impossibility of obtaining first trimester tissue material as an evidence of inadequate trophoblast invasion, and different appearance of maternal reaction to underlying main pathology in every case may restrict clarification of etiopathogenesis.

Intraparenchymal metastasis to the accessory spleen from ovarian cancer: a case report.

Splenic metastasis from ovarian cancer is a rare entity. A few case reports are present in the literature, but to the authors' knowledge, intraparenchymal metastasis to the accessory spleen has never been reported in the literature. The authors report a case of accessory splenic metastasis from ovarian carcinoma.

Endovascular management of postpartum massive vaginal bleeding. A case presenting with a pseudoaneurysm following subtotal hysterectomy.

In the management of massive vaginal bleeding resulting from obstetrics and gynecological diseases, the percutaneous endovascular embolization procedures have been widely used in recent years. We report a case of massive vaginal hemorrhage due to arterial pseudoaneurysm formation following postpartum subtotal hysterectomy which was successfully treated via the percutaneous endovascular embolization.

Carotid pulsatility indices in surgical menopause.

A large body of literature is available concerning association of hormone replacement therapy (HRT) and postmenopausal women; to our knowledge, only few publications in purely surgical menopausal women. The aim of this study was to evaluate pulsatility indices (PI) of internal carotid arteries in two groups of surgical menopausal women who underwent HRT vs who did not. Measurements of the PIs of internal carotid arteries in both Groups were performed with color Doppler ultrasound. Measurements of the untreated group (n = 38, mean age = 47.10 +/- 2.45, group 1) were compared to those of treated group (n = 42, mean age = 47.35 +/- 2.37, group 2). A statistically significant increase in PIs of the carotid arteries were observed in Group 1 as compared to Group 2 in post-operative follow-up (p < 0.001). Pre- and post-operative PIs in Group 1 measured at significantly different values pre- and post-operatively (right, 0.73 +/- 0.031 vs 0.80 +/- 0.049; left, 0.73 +/- 0.030 vs 0.80 +/- 0.052) (p < 0.001). No such pre- and post-operative difference in PIs were noted among patients in Group 2 (right, 0.74 +/- 0.046 vs 0.73 +/- 0.044, p = 0.200; left, 0.73 +/- 0.04 vs 0.73 +/- 0.04, p = 0.504). When comparing both groups, no statistical difference was noted pre-operatively (right, p = 0.501; left p = 0.625); however, postoperative PIs did reveal a statistically significant difference (p < 0.05). Pre- and post-operative side-to-side differences in the PIs of internal carotid arteries were not statistically significant (group 1, 0.158 vs 0.211; group 2, 0.152 vs 0.356). In surgical menopausal women, the beneficial effects of HRT are in concordance with previous studies in terms of PI, which were performed with natural menopausal women.

Percutaneous embolization in the management of intractable vaginal bleeding.

AIM: To assess the effectiveness of arterial embolization in gynecological malignancies by Polyvinyl Alcohol particles. MATERIAL AND METHODS: Six patients, four with cervix carcinoma, one endometrium carcinoma, and one vaginal metastasis of ovarian carcinoma underwent percutaneous embolization due to intractable vaginal bleeding. As an embolic agent PVA particles were used. RESULTS: Cessation of the bleeding was observed immediately after the embolization. Complete embolization has been achieved in all the patients Recurrent bleeding did not occur in any of the cases. There were no complications related to the embolization procedure. CONCLUSION: Transarterial embolization is a lifesaving procedure in treating intractable vaginal bleeding. PVA particles are effective and it is a simple way in ceasing the hemorrhage due to pelvic malignancies.