Perinatal outcomes of sonographically detected nuchal cord in southeastern Turkey.

PURPOSE: To investigate the outcomes of pregnancies with a sonographically detected nuchal cord (NC) from a single center in south-eastern Turkey. MATERIALS AND METHODS: A retrospective study was carried out at Maternity and Child Health Hospital Diyarbakir, Turkey, between 2011 and 2013. A-total of 477 pregnancies with sonographically detected NC during the second and third trimesteri of gestation (20-40 weeks) were included. The control group consisted of 1,043 randomly selected pregnancies without NC matched for gestational age at the time of ultrasound examination. Outcome variables, including maternal age, parity, gestational age at delivery, mnode of delivery, intrapartum fetal heart abnormalities, meconium-stained amniotic fluid, birth weight, and one- and five-minute Apgar scores, were compared between the two groups. RESULTS: There were no statistically significant differences in any of the outcome variables between patients with sonographically detected NC and controls. CONCLUSIONS: The presence of NC indicates a need for increased care but is not associated with adverse perinatal outcomes.

The effect of Ramadan fasting and maternal hypoalbuminaemia on neonatal anthropometric parameters and placental weight.

In Islamic religion, daytime fasting during the month called Ramadan is an annual practice. In this study, we aimed to investigate the effect of Ramadan fasting and maternal hypoalbuminaemia on neonatal growth parameters. A prospective case-control study was conducted in Diyarbakir and Istanbul, Turkey. The sample size of fasting group was 168 and that of non-fasting group was 170. Demographic characteristics, obstetrics ultrasonographic findings and laboratory parameters of the participants were recorded. Neonatal anthropometric parameters and placental weight were noted. The mean placental weight was significantly higher in the fasting group (p = 0.037). Also, in the fasting group, pregnant women with hypoalbuminaemia had significantly higher placental weight (p = 0.009). In conclusion, the mean placental weight in the fasting group was significantly higher. Also a significant correlation between placental weight and maternal serum albumin level was observed in the fasting group.

Granulosa cell tumors of the ovary: review of 43 cases.

PURPOSE: Granulosa cell tumors of the ovary (OGCT) are rarely seen tumors and display a quite interesting behavior profile. The purpose of this study was to evaluate the impact of stage, histological type (juvenile or adult type) and treatment on the prognosis of this disease. METHODS: Forty-three females with OGCT operated between January 1990 and June 2007 were retrospectively evaluated. Radical surgery was performed to 37 patients (86%) without fertility desire, whereas conservative surgery was performed to 6 patients with early-stage disease and fertility desire. RESULTS: Thirty-nine (90.6%) patients had stage I disease, whereas 4 (9.4%) had advanced-disease stage (stage II 2 and stage III 2 patients). All of the patients were surgically treated, but conservative surgery was applied to only 6 cases. Postoperative chemotherapy was administered to 18 cases and the remaining 25 cases were put under follow-up without chemotherapy. Recurrence was observed in 8 cases and 1 of these cases was of juvenile type. Mean time to recurrence was 55.14±32.18 months (range 15-122). Tumor stage was the most important prognostic factor, with 5-year overall survival of 96.77% in local disease, and 66.67% in advanced-stage disease (p<0.01). CONCLUSION: OGCT can recur many years after primary therapy. Consequently these patients must be followed-up for long periods of time. Disease stage at diagnosis was the most important factor affecting the recurrence rate and prognosis. The evaluation of all factors affecting survival needs further studies with larger numbers of patients.

The use of complementary and alternative medicine (CAM) therapies by Turkish women with gynecological cancer.

PURPOSE: To evaluate the prevalence and patterns of complementary and alternative medicine (CAM) utilization among Turkish women with gynecological cancer METHODS: In this cross-sectional study, a total of 156 patients treated between December 2002 and March 2005 at the Ministry of Health Aegean Obstetrics and Gynecology Teaching Hospital, Department of Gynecologic Oncology were evaluated. Data regarding CAM use were obtained from patients by means of face-to-face interviews. RESULTS: Sixty women (38.5%) had used CAM having been diagnosed with cancer; herbal medicine was the most common. The age, income, educational level, cancer site, FIGO stage, previous CAM usage, and time since patients were diagnosed with cancer were associated with CAM usage. The most (40%) commonly cited reason for CAM use was to boost the immune system. Although only 8.3% of CAM users received CAM information from health care professionals or CAM practitioners, this group of patients was more likely to discuss their CAM use with physicians. CONCLUSION: Our data suggest that physicians should increase their knowledge of CAM therapies and ask cancer patients about previous CAM history.

Emergency peripartum hysterectomy: our experience.

PURPOSE: To investigate the incidence of and reasons for emergency peripartum hysterectomy (EPH) between 2009 and 2013 in our hospital, one of the three hospitals with the highest rates of delivery in Turkey. METHODS: A retrospective study. Seventy-six peripartum hysterectomies were evaluated. We compared the modes of delivery and examined whether bilateral internal iliac artery ligation was performed. RESULTS: The incidence of EPH was 0.77 in 1000. The majority of cases involved multiparity, uterine rupture, placenta praevia, or placental invasion abnormalities. The most frequent reason for EPH was uterine atony (64.5 %). There was no statistically significant relationship with mode of delivery; however, the complication rate and requirement for fresh frozen plasma were significantly (p < 0.01) related to whether bilateral internal iliac artery ligation was performed. CONCLUSION: Uterine atony was the most common indication for EPH. The most important step to avoid performing EPH is to calculate patients' risks for postpartum bleeding. Postpartum haemorrhage may not be preventable, but when it happens, obstetricians must be prepared to perform EPH, and in high-risk patients, to perform internal iliac artery ligation.

Expression of PECAM-1 and E-Cadherin in the Umblical Cords of Gestational Diabetic Mothers / Expresión de PECAM-1 y E-cadherina en los Cordones Umbilicales de Madres con Diabetes Gestacional

The purpose of this study is to examine the changes in the umbilical cord in women diagnosed with gestational diabetes mellitus In this study, as a control group human placental tissues from normotensive pregnancies was collected from diabetic women at 28­35 weeks of gestation. Gestational diabetes (n= 20) and normal umbilical cord (n= 20) for a total of 40 units were received.GDM groups compared to the control group was significantly higher values was detected (p<0.01). In GDM group, light microscopy showed erosion of the endothelium and complete rupture of theumbilicalvessels resulting in extravasation of blood within Wharton's jelly. it was observed that the cytoplasmic fragments and cell infiltration of the spill to the subepithelial layer of apoptotic cell PECAM-1 positive reaction showed. E-Cadherin in endothelial side surface of diabetes group showed weak expression in the nucleus and showed positive reaction in smooth muscle.

El objetivo fue examinar los cambios que presenta el cordón umbilical de mujeres con diagnóstico de diabetes mellitus gestacional (DMG). Se incluyeron en el grupo control muestras de tejidos placentarios humanos de embarazos normotensos y de mujeres diabéticas de entre 28­35 semanas de gestación. Las muestras se divieron en cordones umbilicales con cambios de DMG (n= 20) y cordones umbilicales normales (n= 20), constituyendo un total de 40 muestras. El grupo de DMG, en comparación con el grupo control, presentó valores significativamente más elevados (p<0,01). En el grupo de DMG, la microscopía óptica demostró la erosión del endotelio y la ruptura completa de los vasos umbilicales, resultando en la extravasación de sangre dentro de la gelatina . Se observaron fragmentos citoplasmáticos e infiltración celular de la capa subepitelial de células apoptóticas mostró una reacción positiva a PECAM-1. En el grupo de DMG, la E-cadherina de la superficie lateral endotelial mostró una expresión débil en el núcleo y una reacción positiva en el músculo liso.

Expression of VEGF and CD68 in the placenta of gestational diabetic mothers (immunohistochemistry and ultrastructural study) / Expresión de VEGF y CD68 en la placenta de madres diabéticas gestacionales (estudio inmunohistoquímico y ultraestructural)

Placental angiogenesis, is essential for embryonic and fetal development. In this study, 18 gestational diabetes mellitus and 22 control pregnancies were included. Gestational diabetes mellitus (GDM) groups compared to the control group significantly higher values were detected (p<0.01). The following histological results were assessed; villous immaturity, chorangiosis, presence of, sncytial knots,mononuclear cell infiltration ischemia and fibrinoid necrosis. To evaluate and compare the placental histology of normal and GDM pregnancies. placentas of pregnant women with gestational diabetes also in terms of angiogenesis and macrophages and ultratructural revealed by examining the possible relationship between fetal complications were investigated.

La angiogénesis de la placenta es esencial para el desarrollo embrionario y fetal. En este estudio, se incluyeron 18 casos de diabetes mellitus gestacional (DMG) y 22 embarazos de control. En grupos los de DMG en comparación con el control, se detectaron valores significativamente mayores (p<0,01) en los siguientes parámetros histológicos que fueron evaluados: inmadurez vellosa, chorangiosis, presencia de nodos sincicial, infiltración celular isquémica mononuclear y necrosis fibrinoide. La investigación de las placentas de mujeres con DMG, reveló mediante el examen en términos de angiogénesis, macrófagos y ultraestructural, la posible relación entre las complicaciones fetales.

Expression of human chorionic gonadotropin (ßhCG) in pre-eclamptic placenta / Expresión de gonadotropina coriónica humana (ßhCG) en placenta preeclámptica

This study aimed to assess association between preeclampsia with trophoblast cells and serum level of b-human chorionic gonadotropin (ß-hCG). Were compared 20 patients with preeclampsia and 20 control patients with respect to demographics, hematological parameters and the presence of trophopblast in placental samples. Patchy necrosis with loss of microvilli and gross thinning of the syncytium with distorted microvilli were seen in terminal villi of placentae of women with pre-eclampsia Syncytial cells at the molecular level crossings, especially at the level of ßhCG in conjunction with the changes in the preeclampsia was made on the histopathological changes to clarify the villi.

El objetivo fue evaluar la asociación entre la preeclampsia con células trofoblásticas y concentración sérica de la gonadotropina coriónica humana b (ß-hCG). Se compararon 20 pacientes con preeclampsia y 20 pacientes de control con respecto a datos demográficos, parámetros hematológicos y la presencia de trofoblasto en muestras de placenta. Se observaron áreas dispersadas de necrosis, con pérdida de microvellosidades y adelgazamiento del sincitio con microvellosidades distorsionadas en las vellosidades terminales de placentas en mujeres con células sincitiales preeclámticas a nivel molecular, junto a altos niveles de ßhCG asociados a los cambios generados por la preeclampsia sobre los parámetros histopatológicos.

The effects of maternal low protein and estrogen on sexual behavior and testicular maturation in male rats / Efectos de niveles maternos bajos de estrógeno y proteína sobre el comportamiento sexual y maduración testicular en ratas macho

In recent years, disorders related to the development and function of the male reproductive tract has increased, thus generating a surprising decrease in semen volume and sperm count. We examined the effects of low protein and estrogen on sexual behavior and testicular maturation in male rats. We also examined FSH, LH and testosterone levels and histological damage of testis tissue. The male rats were subjected to standard long-term treatment with estradiol by oral and paranteral delivery. The number of mounts, copulatory efficiency and ejaculation latencies for the paranteral protein diet (PPD) group was significantly lower than those in a group nourished with a low protein diet (LPD) and oral protein diet (OPD) groups (P<0.05). Testes and epididymis sections were examined by four grades, according to the level of damage of epithelium in the testes and epididymis. Higher histological damage was also detected in the PPD group. In conclusion, the present study confirmed that unwanted estrogen effects were higher in the paranteral administered group on examination of sexual behavior and histological damage of epithelium in the testes and epididymis of male rats.

En los últimos años, los trastornos relacionados con el desarrollo y la función del tracto reproductivo masculino han aumentado, lo que genera una disminución importante en el volumen de semen y el conteo de espermatozoides. Se examinaron los efectos de niveles bajos en proteínas y estrógeno en el comportamiento sexual y la maduración testicular en ratas macho. También se examinaron FSH, LH y los niveles de testosterona y el daño histológico de tejido testicular. Las ratas macho fueron sometidas al tratamiento y administración estándar a largo plazo con estradiol por vias oral y parenteral. El número de montajes, eficiencia de copulación y latencias de eyaculación para el grupo de dieta de proteínas parenteral (DPP) fue significativamente menor que los del grupo con una dieta baja en proteínas (PBD) y de proteína oral baja (POB) grupos (P<0,05). Fueron examinados los testículos y epidídimo de acuerdo a cuatro grados, en relación al nivel de daño del epitelio en los testículos y epidídimo. También se detectó un mayor daño histológico en el grupo DPP. En conclusión, se confirma que los efectos no deseados del estrógeno fueron mayores en el grupo con administración parenteral en el examen de conducta sexual y en el daño histológico del epitelio en los testículos y el epidídimo de ratas macho.