Maternal hydronephrosis in pregnant women without ureteral stones and characteristics of symptomatic cases who need treatment: A single-center prospective study with 1026 pregnant women.

PURPOSE: The aim of this study is to determine the proportion of maternal hydronephrosis and symptomatic cases requiring treatment in pregnant women without ureteral stones and the characteristics of these cases. MATERIALS AND METHODS: Between February 2018 and April 2019, all pregnant women followed for pregnancy in obstetrics and outpatient policlinic were evaluated prospectively. Maternal hydronephrosis rate, degree of hydronephrosis and side, symptomatic hydronephrosis rate, maximum renal anteroposterior diameter of renal pelvis and visual analogue scale were detected. Symptomatic patients were treated conservatively or surgically. Findings in both treatment groups were analyzed by t-test or Chi-squared test. Pearson or Spermean's tests were used for correlation analyzes. RESULTS: A total of 1026 pregnant women aged 18-45 (27.7 ± 5.2 years) were followed prospectively. The rate of maternal hydronephrosis was 28.7% and the rate of symptomatic hydronephrosis was 4.7%. Of the patients with symptomatic hydronephrosis, 73.4% (3.5% of total) were treated conservatively and 26.5% (1.3% of total) were treated surgically. There was a positive correlation between hydronephrosis and gestational week (p < 0.001), visual analogue scale (p < 0.001) and hematuria (p < 0.05). There was a negative correlation between hydronephrosis and maternal age (p < 0.05) and number of pregnancies (p < 0,001). The anteroposterior diameter of renal pelvis (p < 0.001), visual analogue scale (p < 0.05) and fetal body weight values (p < 0.05) on the right side were higher in the surgical treatment group than the conservative group. CONCLUSIONS: The majority of cases with maternal hydronephrosis in pregnant women without ureteral stones are asymptomatic. Most symptomatic cases can also be treated conservatively. In cases requiring surgical treatment (1.3%), fetal body weight, visual analogue scale and anteroposterior renal pelvis diameter are higher.

Association between FVL G1691A, FII G20210A, and MTHFR C677T and A1298C polymorphisms and Turkish women with recurrent pregnancy loss.

Aim Recurrent pregnancy loss (RPL) poses a challenge in reproductive medicine because the etiology is often unknown. Here we investigated the frequency of mutations in the Factor V Leiden (FVL), prothrombin (FII), and methylene tetrahydrofolate reductase (MTHFR) genes in women with RPL and healthy women. Methods Blood samples were obtained from patients with ≥2 consecutive pregnancy losses and no identifiable etiology before 12 weeks of pregnancy (n=145). The control group comprised 105 age-matched women with ≥2 live births. Results The frequency of homozygotes for FVL 1691AA was 15 (10.3%) in patients and three (2.86%) in controls (p=0.073), while for FII 20210AA it was eight (5.5%) and one (0.9%), respectively (p=0.055). For two polymorphisms in MTHFR, genotype frequencies of 89 (61.4%) were found in patients and 55 (52.4%) in controls for 677TT (p=0.322), and 89 (61.4%) and 62 (59%) for 1298CC, respectively (p=0.810). Conclusion Despite a trend towards significance for FII G20210A, no significant differences in genotype frequencies of these polymorphisms between patients and controls was found. No evidence of the role of FVL G1691A, MTHFR C677T, and MTHFR A1298C in RPL in our Turkish cohort was found; however, further investigation of FII as a culprit gene in RPL is warranted.

Cyproterone acetate or drospirenone containing combined oral contraceptives plus spironolactone or cyproterone acetate for hirsutism: randomized comparison of three regimens.

OBJECTIVE: To compare the effectiveness of three different combinations of combined oral contraceptives (COCs) and anti-androgens in the treatment of hirsutism. METHODS: A total of 134 women with moderate and severe hirsutism were randomly assigned to three treatment regimens: Group I received 30 µg of ethinyl estradiol (EE)/3 mg of drospirenone (DRSP) plus 100 mg of cyproterone acetate (CPA) (n = 45); group II received 30 µg of EE/3 mg of DRSP plus 100 mg of spironolactone (n = 44); and group III received 35 µg of EE/2 mg of CPA plus 100 mg of CPA (n = 45), daily for 6 months. The decrease in the modified Ferriman-Gallwey hirsutism score (mFGS) was the main outcome measure. RESULTS: The mean decrease in mFGS after 3 and 6 months of the treatment course was 26% and 49% in group I (both p < 0.01), 27% and 49% in group II (both p < 0.01), and 25% and 45% in group III (both p < 0.01), respectively, when compared with baseline. Although the mFGS was significantly decreased in all groups, there was no significant difference between groups. CONCLUSION: CPA or DRSP containing COCs in combination with CPA or spironolactone have similar effects for the treatment of hirsutism.