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Background: Intrauterine growth restriction (IUGR) refers to fetuses that are small for their gestational age. There is no effective test to predict this disease. The aim of our study is whether fetal three-dimensional (3D) ultrasonography (USG)-assisted thymus volume (TV) measurement predicts IUGR cases. Methods: Fetal 3D USG thymus measurement between 15 and 24 weeks of gestation was performed in a total of 100 women of reproductive age. Fetal TV was measured using the virtual organ computer-assisted analysis system program. All cases were followed up in terms of pregnancy complications until delivery. Results: IUGR was developed in six cases in total. In cases with IUGR, mean fetal TV was found to be statistically significantly lower than in healthy cases without it. When the fetal TV was taken as 0.1645, the sensitivity was calculated as 89.5% and the specificity as 50% for predicting IUGR. The use of low fetal volume parameters is a significant and good indicator for predicting IUGR according to the binary logistic regression analysis result. Conclusion: According to the results of this study, 3D fetal TV measurement may be used in routine second-trimester sonographic anomaly screening to predict the development of fetal IUGR. In this way, fetal mortality and morbidity caused by IUGR may be reduced.
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INTRODUCTION: To assess the effect of low-dose combined oestradiol and norethindrone acetate hormone therapy (HT) on serum C-reactive protein (CRP) levels and life quality in natural menopause women. MATERIAL AND METHODS: Forty-five natural menopause women admitted to the clinic during a 1-year period and diagnosed as menopause, who planned to have HT for menopausal symptoms, were enrolled in this prospective study. The serum CRP levels were measured, and vasomotor symptoms scores were graded according to the Blatt-Kupperman menopause index, and life quality scores according to the Menopause-Specific Quality of Life Questionnaire (MENQOL) were recorded before and after (3 months later) hormone therapy. RESULTS: The Blatt-Kupperman menopause index and MENQOL scores were significantly decreased after 3 months of low-dose treatment. No significant difference was found between white blood cell counts and serum CRP levels before and after 3 months of hormone therapy. CONCLUSIONS: Considering all HT types and biochemical effects, low-dose HT, which had positive results in terms of quality of life, was a safe treatment and could be preferred to conventional-dose preparations in cases without contraindications. Low-dose combined HT containing oestradiol and norethindrone acetate did not alter the serum CRP level in postmenopausal cases.
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INTRODUCTION: To assess the effect of hormone therapy (HT) on serum ischemia modified albumin (IMA) levels in healthy menopausal women. MATERIAL AND METHODS: Thirty surgical menopausal women who were admitted to our menopausal polyclinic during a 1-year period and diagnosed with menopause and planned to have HT for menopausal symptoms were enrolled in this prospective study. The serum IMA levels were recorded before and after (3 months, 6 months, 12 months later) hormone treatment (2 mg estradiol hemihydrate). RESULTS: The mean age of women was 47.60 ± 2.34 years. The mean serum IMA levels were 0.610 ± 0.096 absorbance units (ABSU) at the beginning and 0.484 ± 0.080 ABSU after 3 months of hormone therapy. Following 6 months of hormone therapy, serum IMA level was 0.546 ± 0.075, and reached 0.580 ± 0.089 ABSU following 12 months of therapy. CONCLUSIONS: These findings suggest that HT may not block the menopause induced ischemia process. Although HT had a positive effect on serum IMA levels following 3 months' use, serum IMA levels returned to baseline levels after 12 months' use. Based on this study's findings, long-term use of HT may not have a positive effect on cardiovascular disease protection.
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OBJECTIVE: This study aimed to evaluate the diagnostic efficacy of T2 dark spot, T2 dark rim, and T2 shading signs on magnetic resonance imaging in the differentiation of endometriomas from hemorrhagic cysts. METHODS: Seventy-two hemorrhagic lesions were included in this retrospective study. The presence of T2 dark spot, T2 dark rim, and T2 shading signs in the lesions and the presence of complete or incomplete rim in lesions exhibiting T2 dark rim signs were evaluated. RESULTS: Of 72 lesions, 50 were diagnosed with endometrioma and 22 were diagnosed with hemorrhagic cyst. Twenty-six of 50 endometriomas and none of the hemorrhagic cysts showed T2 dark spot sign. T2 shading was observed in 90% of endometriomas and 18% of hemorrhagic cysts. Incomplete T2 dark rim was detected in 67% of endometriomas and 21% of hemorrhagic cysts. CONCLUSIONS: T2 dark spot and T2 dark rim signs could be useful for distinguishing endometriomas from hemorrhagic cysts.
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Endometriosis/diagnóstico por imagen , Interpretación de Imagen Asistida por Computador/métodos , Imagen por Resonancia Magnética/métodos , Quistes Ováricos/diagnóstico por imagen , Neoplasias Ováricas/diagnóstico por imagen , Adolescente , Adulto , Diagnóstico Diferencial , Femenino , Hemorragia/diagnóstico por imagen , Humanos , Persona de Mediana Edad , Adulto JovenRESUMEN
The aim of this study was to determine the serum biotin levels in patients with hyperemesis gravidarum (HG). Ninety pregnant women with HG (mild (n = 30), moderate (n = 30) and severe (n = 30)), and 80 pregnant women without HG were included for this study. In both groups, serum biotin levels were measured. There were no statistically significant differences in demographic and clinical characteristics between the HG groups and the control group except for PUQE scores. Serum biotin levels in all hyperemesis gravidarum groups were statistically significantly lower than control group. Negative statistically significant correlation between hyperemesis gravidarum severity and serum biotin levels was noted. This is the first study that shows low serum biotin levels in women with hyperemesis gravidarum. Impact statement What is already known on this subject? Almost 80% of pregnant women have nausea and vomiting. If nausea and vomiting became severe and the symptoms combined with weight loss and ketonuria; the diagnosis should be hyperemesis gravidarum (HG). The etiopathogenetic factors of this unwanted condition have not been exactly known. Biotin is an essential water-soluble vitamin. Biotin catabolism increases in pregnancy. Marginal biotin deficiency occurs in approximately 50% of the gestations despite the "normal" biotin intake on the diet. What do the results of this study add? Current study results elucidated that serum biotin levels were lower in HG cases compared to non HG cases. This study is the first study that reports the association between low serum level of biotin and HG. What are the implications of these findings for clinical practice and/or further research? Further research is needed to show the importance of biotin supplementation in women with hyperemesis gravidarum.
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Biotina/sangre , Deficiencia de Biotinidasa/epidemiología , Hiperemesis Gravídica/sangre , Adulto , Deficiencia de Biotinidasa/sangre , Femenino , Edad Gestacional , Humanos , Embarazo , Complicaciones del Embarazo/sangre , Factores de Riesgo , Índice de Severidad de la EnfermedadRESUMEN
BACKGROUND: Urinary tract infections are among the most common bacterial infections of humans. Urine culture is the gold standard for asymptomatic bacteriuria and pyuria is not always present in bacteriuria, nor is it specific for bacteriuria. OBJECTIVE: The aim of the present study was to determine neutrophil activation and the contributions of this activation in the differentiation of infection and contamination. METHODS: The serum and urine myeloperoxidase (MPO) levels of 50 pregnant females with symptoms suggesting UTI and 25 healthy non-pregnant control subjects were measured using the enzyme-linked immunosorbent assay (ELISA) method and the obtained values were compared with the results of urine microscopy and urine culture. RESULTS: The leukocyte count in urine was significantly higher in group 1 (infection) and group 2 (contamination) when compared with the control group (group 1 mean: 18.2; group 2 mean: 14.2; control mean: 4.8; ANOVA test, p ≤ 0.00). According to the obtained ELISA values, a statistical difference in the levels of urine MPO between the patient and control groups was seen (p ≤ 0.00). There was no statistical difference among the groups for serum MPO levels (p ≥ 0.451). CONCLUSION: The study findings suggest that standardized measurement techniques such as dipstick screening assay for urine MPO level may be useful in differentiating infection and contamination, especially in pregnant patients.
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Activación Neutrófila/inmunología , Complicaciones Infecciosas del Embarazo/orina , Infecciones Urinarias/orina , Orina/microbiología , Adulto , Femenino , Humanos , Recuento de Leucocitos , Embarazo , Complicaciones Infecciosas del Embarazo/sangre , Urinálisis , Infecciones Urinarias/sangreRESUMEN
AIM: The aim of this study is to evaluate the diagnostic value of serum oxidative stress marker levels (ischemia-modified albumin, IMA; malondialdehyde, MDA) and total oxidant status (TOS), total antioxidant status (TAS) and oxidative stress index (OSI) levels that occur in ovarian torsion and to determine the threshold value of these markers in the diagnosis of ovarian torsion. METHODS: In this prospective case-control study, 34 women (the study group) with acute pelvic pain (20 with and 14 without ovarian torsion) and 40 control subjects were included. The diagnosis of ovarian torsion was confirmed with laparoscopy in all cases. Preoperative serum samples were collected in the study group. Serum oxidative stress marker levels (IMA and MDA) and TOS, TAS and OSI levels were measured. RESULTS: Serum MDA, TOS and IMA concentrations were significantly higher in women with ovarian torsion than in the healthy control group. However, serum TAS, TOS and OSI concentrations were significantly higher in women without ovarian torsion than within the healthy control group. Only IMA significantly distinguished patients with or without ovarian torsion. The best IMA value, according to the receiver operating characteristic curve, was 0.7045 absorbance units, with 90.00% sensitivity and 92.31% specificity. The patients in the ovarian torsion group had significantly lower serum TAS and OSI levels compared with patients without ovarian torsion. CONCLUSION: The elevated serum IMA levels with high sensitivity-specificity values observed in women with ovarian torsion seem to have a potential role as a serum marker in the preoperative diagnosis of ovarian torsion in emergency settings.
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Pruebas Hematológicas/normas , Enfermedades del Ovario/diagnóstico , Estrés Oxidativo/fisiología , Torsión Mecánica , Dolor Agudo/etiología , Adulto , Biomarcadores/sangre , Estudios de Casos y Controles , Femenino , Humanos , Laparoscopía , Persona de Mediana Edad , Enfermedades del Ovario/sangre , Enfermedades del Ovario/complicaciones , Enfermedades del Ovario/cirugía , Dolor Pélvico/etiología , Sensibilidad y Especificidad , Albúmina Sérica , Albúmina Sérica HumanaRESUMEN
In this study, we compared psychiatric symptoms, quality of life and disability in patients with pre-menstrual dysphoric disorder (PMDD) and pre-menstrual syndrome (PMS). Forty-nine women with PMDD were compared with 43 women with PMS. All participants were asked to complete a socio-demographic data collection form, a Brief Disability Questionnaire, a medical study short form-36 (SF-36) and Hospital Anxiety and Depression Scale (HADS) forms. The patients with PMDD had higher HAD-A and HAD-D scores than the patients in PMS group (p < 0.01). No statistically significant differences were found on brief disability between two groups (p > 0.05), but both groups had medium level of brief disability. The PMDD group had a lower SF-36 scoring than the PMS group in every compared parameters (p < 0.01). PMS and PMDD may lead to brief disability, and PMDD may cause loss of quality of life and psychological problems. The evaluation of patients with PMS and PMDD pre-menstrual disorders should be more detailed.
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Trastornos del Humor/psicología , Trastorno Disfórico Premenstrual/psicología , Síndrome Premenstrual/psicología , Calidad de Vida , Adolescente , Adulto , Ansiedad , Estudios Transversales , Depresión , Femenino , Humanos , Persona de Mediana Edad , Trastorno Disfórico Premenstrual/diagnóstico , Síndrome Premenstrual/diagnóstico , Encuestas y Cuestionarios , Adulto JovenRESUMEN
PURPOSE: Nausea and vomiting is an important health problem which adversely affects the daily routine and quality of life in pregnant women. The purpose of this study was to measure the level of change in the quality of life, depression and anxiety in hyperemesis gravidarum (HG) patients in relation to social-demographic data and disease variables. METHODS: One hundred pregnant women hospitalized with the diagnosis of HG were included in the study. A total of 100 healthy pregnant women were also evaluated as the control group. All the patients in the study completed the socio-demographic data form, the Hospital Anxiety and Depression Scale (HADS-A and D) and Brief Disability Questionnaire (BDQ). RESULTS: The mean HADS-D subscale score was 7.09 ±3.91 in HG patients and 5.73 ± 3.32 in controls. The depression score in the HG patients were significantly higher than that of the control group (p = 0.009). The mean HADS-A subscale score was 7.73 ± 3.86, which was significantly higher in HG patients compared to 6.70 ± 3.31 in controls (p = 0.045). The mean BDQ score was 11.2 ± 4.40 in HG patients and 8.5 ± 3.31 in the control group of pregnant women, thus, significantly higher in the HG group as compared to controls (p < 0.0001). In the HADS-D, 52 patients in the HG group and 40 patients in the control group scored above the threshold value (p = 0.089). In the HADS-A, 28 patients in the HG group and 20 in the control group scored above the threshold value (p = 0.185). CONCLUSIONS: In patients with HG, a significant deterioration of physical and social health was encountered. HG disease is independent of any underlying psychiatric condition and adversely affects the quality of life of the sufferer.
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Ansiedad/diagnóstico , Depresión/diagnóstico , Hiperemesis Gravídica/complicaciones , Calidad de Vida/psicología , Adulto , Ansiedad/complicaciones , Ansiedad/psicología , Estudios de Casos y Controles , Depresión/complicaciones , Depresión/psicología , Femenino , Humanos , Hiperemesis Gravídica/psicología , Embarazo , Escalas de Valoración Psiquiátrica , Encuestas y Cuestionarios , Salud de la Mujer , Adulto JovenRESUMEN
PURPOSE: To present the outcomes of four cases of cesarean scar pregnancy treated with suction curettage. METHODS: Four patients were ultrasonographically diagnosed with cesarean scar pregnancies treated with suction curettage in a tertiary care center. RESULTS: Serum ß-human chorionic gonadotropin levels ranged between 1,681 and 15,573 mU/mL, gestational sac diameter measured from 10 to 24 mm and scar thickness was between 4.7 and 6.8 mm. All patients underwent suction curettage under general anesthesia with transabdominal ultrasonography guidance. No complications were observed during or after operation. CONCLUSION: Suction curettage is a viable alternative for conservative treatment in selected cases of patients who are diagnosed with CSP early in gestation and who have a myometrial thickness of more than 4.5 mm.
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Cesárea/efectos adversos , Cicatriz/complicaciones , Embarazo Ectópico/cirugía , Legrado por Aspiración , Adulto , Anestesia General , Pérdida de Sangre Quirúrgica , Gonadotropina Coriónica Humana de Subunidad beta/sangre , Diagnóstico Precoz , Femenino , Humanos , Embarazo , Embarazo Ectópico/diagnóstico por imagen , Ultrasonografía IntervencionalRESUMEN
PURPOSE: Hand and wrist complaints can decrease the quality of life of pregnant women, which can occur or aggravate during pregnancy and advance to chronic state if left untreated. The purpose of this study was to describe hand and wrist complaints in relation to pregnancy and assess their significance in pregnancy. METHODS: In a prospective cross-sectional study, 383 participants were randomly selected from among pregnant women on or over 28 weeks of gestation, attending the primary care maternal health clinic in a university hospital. The prevalence and severity of hand and wrist complaints were assessed using the Boston Carpal Tunnel Questionnaire (BCTQ). The symptomatic pregnant women were consulted by an orthopedist. The specific diagnoses of the patients were made based on patient history and physical examination. RESULTS: According to BCTQ scoring 258 (67.4 %) pregnant women were symptomatic. The diagnoses were as follows: asymptomatic 125 (32.6 %), nonspecific symptoms 138 (36 %), tendinitis 80 (20.9 %), carpal tunnel syndrome (CTS) 39 (10.2 %) and cubital syndrome 1 (0.3 %). There was no association noted between the diagnoses and numbers of pregnancies, occupational status, age, gestational weeks, weight gain or body mass index (BMI) (p > 0.05). CONCLUSION: The prevalence of hand and wrist complaints is high in pregnant women. All pregnant women should be investigated for hand and wrist complaints in routine antenatal checks to ensure good life quality during pregnancy and for avoiding these complaints advancing to chronic state. Further studies are needed to evaluate the effect of musculoskeletal systems disorders in pregnancy.
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Síndrome del Túnel Carpiano/diagnóstico , Síndrome del Túnel Cubital/diagnóstico , Complicaciones del Embarazo/diagnóstico , Tendinopatía/diagnóstico , Actividades Cotidianas , Adolescente , Adulto , Enfermedades Asintomáticas , Estudios Transversales , Femenino , Humanos , Anamnesis , Persona de Mediana Edad , Examen Físico , Embarazo , Estudios Prospectivos , Índice de Severidad de la Enfermedad , Encuestas y Cuestionarios , Muñeca , Adulto JovenRESUMEN
The fetal splenic artery pulsatility index is a parameter that reflects fetal well-being and has been used as a predictor of adverse pregnancy outcomes. The aim of this study was to investigate the predictive value of the splenic artery pulsatility index in gestational diabetes mellitus class A1 cases for intensive care unit admission. In this prospective case-controlled study, only sixty single pregnancy cases diagnosed with gestational diabetes mellitus class A1 were evaluated. Fetal splenic artery Doppler parameters such as peak systolic velocity, pulsatility index, resistivity index, and end-diastolic velocity were measured in all cases. The rate of requirements for the neonatal intensive care unit was noted. In cases requiring fetal intensive care, the fetal splenic pulsatility index was found to be statistically significantly lower than in healthy cases without it (0.94 ± 0.29 vs. 1.70 ± 0.53, respectively, p < 0.001, Student's t-test). When the fetal splenic PI cutoff value was selected as 1.105 cm3, the sensitivity was calculated as 97.9% and the specificity as 58.3% for predicting the need for fetal intensive care (AUC 0.968, p < 0.001, 95% CI 0.929-0.998). The use of a low fetal splenic artery PI parameter is a significant and good indicator for predicting the need for fetal intensive care according to the binary logistic regression analysis result (p = 0.006). This study suggests that evaluation of fetal splenic artery Doppler in mothers with gestational diabetes mellitus may be used to predict neonates requiring a newborn intensive care unit. Therefore, it is recommended that obstetricians use this simple, rapid, and valuable evaluation of fetal splenic artery Doppler and alert the neonatologist that a newborn intensive care unit may be required.
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The aim of this study to evaluate the effect of cabergoline on follicular microenvironment by measuring follicular fluid (FF) insulin like growth hormone -I (IGF-I), antimullerian hormone (AMH), inhibin B and hepatocyte growth factor (HGF) levels in women with PCOS and high risk of ovarian hyperstimulation syndrome (OHSS). In this prospective cohort study, 41 women with PCOS undergoing controlled ovarian hyperstimulation for assisted reproduction and having the high risk factors for OHSS are included. The women in the study group (n = 15) received cabergoline for OHSS prevention while the women in the control did not received any medications for OHSS prevention. FF samples were collected during oocyte pick-up procedure for all women were determined using commercially available ELISA kits. Concentrations of FF IGF-I, AMH, inhibin B and HGF were assessed. In the study group FF AMH (2.96 ± 1.27 versus 1.91 ± 0.64 ng/mL), Inhibin B (1339.47 ± 198.56 versus 1200.09 ± 133.64 pg/mL), HGF (5623.21 ± 2411.09 versus 3787.42 ± 2269.89 pg/mL) and IGF-I (298.60 ± 37.80 versus 219.90 ± 71.40 pg/mL) concentrations were significantly decreased compared with control group. Cabergolin prevents OHSS in high risk patients by disrupting FF hormone microenvironment.
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Microambiente Celular/efectos de los fármacos , Ergolinas/administración & dosificación , Líquido Folicular/efectos de los fármacos , Folículo Ovárico/efectos de los fármacos , Síndrome de Hiperestimulación Ovárica/prevención & control , Adulto , Hormona Antimülleriana/metabolismo , Cabergolina , Estudios de Cohortes , Femenino , Fertilización In Vitro , Líquido Folicular/metabolismo , Factor de Crecimiento de Hepatocito/metabolismo , Humanos , Inhibinas/metabolismo , Factor I del Crecimiento Similar a la Insulina/metabolismo , Folículo Ovárico/metabolismo , Síndrome de Hiperestimulación Ovárica/etiología , Síndrome de Hiperestimulación Ovárica/metabolismo , Síndrome del Ovario Poliquístico/metabolismo , Síndrome del Ovario Poliquístico/terapia , Factores de Riesgo , Adulto JovenRESUMEN
PURPOSE: To investigate height of the corpus callosum (CC) in order to describe the corpus callosum anomalies in fetuses with meningomyelocele (MMC) and compare these findings with the corpus callosum of healthy fetuses. METHODS: In this study, fetal MRI examinations were performed on 44 fetal MMC malformation cases. As the control group, 34 fetal MRI examinations, which were anatomically normal, were evaluated retrospectively. In the study group, lateral ventricle diameter, the level and diameter of the MMC defect, and CC height were measured. In the control group, CC height and lateral ventricular diameter were measured. RESULTS: The mean CC body height was 1.36 mm in the study group, and 2.48 mm in the control group. The height of the CC body region of the study population was inclined to be thinner compared with the control population (p<0.001). CONCLUSIONS: The fact that the height of the CC body region was found to be thinner in fetal MRI in cases of MMC compared with normal fetuses suggests that various callosal anomalies are uncertain, investigation of additional callosal anomalies may be beneficial in the decision for the continuation of pregnancy, and termination or intrauterine surgery in cases with MMC. Further large case group studies are needed.
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Meningomielocele , Femenino , Embarazo , Humanos , Meningomielocele/diagnóstico por imagen , Meningomielocele/cirugía , Cuerpo Calloso/diagnóstico por imagen , Estudios Retrospectivos , Feto , Atención PrenatalRESUMEN
Background: This study aimed to investigate the serum levels of mucoprotein 3 in hypertensive diseases of pregnancy. Methods: In total, 60 consecutive women with gestational hypertensive diseases (gestational hypertension (n = 20), severe preeclampsia (n = 20), HELLP syndrome (n = 20)) and 20 pregnant women without any gestational hypertensive diseases were included for this prospective controlled study. Serum MUC3 protein levels were measured with commercially available ELISA kits. Results: Serum MUC3 protein level was the lowest in normal pregnant women (0.1047 ± 0.0295 ng/ml); while the severity of the disease increases, it significantly increased in severe preeclampsia (0.2700 ± 0.0199 ng/mL) and HELLP syndrome group (0.3494 ± 0.0455 ng/mL), but less in the gestational hypertension (0.2172 ± 0.0354 ng/mL) group. Mean serum MUC3 protein level differences were found the least in gestational hypertension (0.1125 ± 0.0107, p < 0.001), the most in HELLP syndrome (-0.2546 ± 0.0107, p < 0.001) compared with the pregnant control group. Conclusion: The increase in serum MUC3 protein concentration in these women supported the argument that serum MUC3 protein may be used as a marker indicating the severity of the gestational hypertensive diseases.
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Our aim was to assess the influence of ratios of oestradiol (E2) to either number of follicles ≥ 14 mm on the day of human chorionic gonadotropin administration (E2/fol) or the number of oocytes retrieved (E2/o) during oocyte pick up and total serum E2 levels on the day of embryo transfer (ETE2) on the outcome of ICSI cycles. The assessed outcomes were number of oocytes retrieved (NRO), number of mature oocytes (NMO), number of fertilised oocytes (NFO), number of transferred embryos (NTE), qualities of oocytes (OQS), qualities of embryos (EQS) and pregnancy rates (PR). Two hundred and twenty-seven ICSI-ET cycles admitted to our IVF clinic during a 2-year period with normal ovarian reserve receiving long luteal GnRH agonist protocol were included. The E2/fol levels correlated positively with NRO (r = 0.202, p = 0.002), NMO (r = 0.199, p = 0.003) and NFO (r = 0.159, p = 0.018). However, we observed negative correlations between E2/o and NMO (r = -0.329, p <0.001), NFO (r = -0.219, p = 0.001), EQ5 (r = -0.203, p = 0.040). Oocyte quality scores were not affected from either E2/fol or E2/o levels. Implantation, clinical and ongoing PRs were comparable between groups categorised due to E2/fol, E2/o and ETE2. It seems that high E2/fol ratio may have beneficial effects on NRO, NMO and NFO while E2/o may adversely affect these parameters. Neither of the E2 levels is associated with pregnancy rates in women with normal ovarian reserve.
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Embrión de Mamíferos/fisiología , Estradiol/sangre , Oocitos/fisiología , Índice de Embarazo , Inyecciones de Esperma Intracitoplasmáticas , Adulto , Biomarcadores/sangre , Femenino , Humanos , EmbarazoRESUMEN
OBJECTIVES: The aim of this study was to evaluate ovarian immunohistochemical CD95 expression in a rabbit carbon dioxide pneumoperitoneum model. MATERIALS AND METHODS: The study group including seven rabbits was subjected to intra-abdominal pressure (IAP) (12 mmHg); the control group was not subjected to IAP (the sham group, n = 7). At the end of the experiment, ovariectomy was performed. Immunohistochemical stained histologic specimen of the ovary with CD95 was evaluated. Based on the degree of cytoplasmic or membranous staining for CD95 from 0 (none) to 3 (severe), a microscopic apoptosis scoring system was used. RESULTS: Statistically significantly higher apoptosis scores in ovarian surface epithelial cells (2.57 ± 0.53, vs. 1.14 ± 0.38, P = 0.002, Mann-Whitney U-test, respectively), follicular epithelial cells (2.85 ± 0.38, vs. 1.85 ± 0.38, P = 0.002, Mann-Whitney U-test, respectively), and stromal cells (2.71 ± 0.49, vs. 1.29 ± 0.49, P = 0.002, Mann-Whitney U-test, respectively) were observed in pneumoperitoneum group, compared with no-pneumoperitoneum group. CONCLUSION: Even at safe IAP (12 mmHg) for an acceptable operation time period, there was a significant increase in apoptosis of ovarian cells.
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OBJECTIVE: The immunological factors have role in the development of preeclampsia. The thymus is one of the main organs of the fetal immune system. The aim of this prospective clinical study was to investigate the association between fetal thymus volume and preeclampsia by adding the 3-dimensional measurement of thymus volume to the routine fetal ultrasound scan at 11-14 week of gestation. STUDY DESIGN: Totally 72 pregnant women in their first trimester of pregnancy were included and 3-D fetal thymus volume was measured with sonographic VOCAL programme. All women gestational period was followed. The data of women with preeclampsia (n = 10, study group) and without preeclampsia (n = 62, control group) were compared. MAIN OUTCOME MEASURES: Fetal thymus volume, preeclampsia development. RESULTS: Fetal thymus volume, mean gestational age at birth and newborn birthweight were found to be statistically lower in cases with preeclampsia compared with those without any complications. When the fetal thymus volume measured by the VOCAL programme in the study group was used as a marker for preeclampsia development, the limit value was 0.0375 cm3; sensitivity was 87.1% and specificity was 50% (AUC 85.3%, P < .001, 95% CI 0.751-0.949). As a result of binary logistic regression analysis; the low fetal thymus volume measured at 11-14 gestational weeks can be used as a predictive factor for preeclampsia (P < .001). CONCLUSIONS: According to the results of this study; the development of preeclampsia may be predicted by measuring 3-D fetal thymus volume at the first trimester.
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Preeclampsia/diagnóstico , Timo/embriología , Adulto , Biomarcadores/análisis , Estudios de Casos y Controles , Femenino , Humanos , Imagenología Tridimensional/métodos , Embarazo , Primer Trimestre del Embarazo , Estudios Prospectivos , Sensibilidad y Especificidad , Timo/diagnóstico por imagen , Ultrasonografía Prenatal/métodosRESUMEN
OBJECTIVE: To compare the success rates of single and multiple dose methotrexate protocols for the treatment of unruptured tubal ectopic pregnancy. DESIGN: Prospective randomized controlled trial. SETTING: Maternity and teaching hospital in Turkey. POPULATION: One hundred twenty women treated with methotrexate therapy for unruptured tubal ectopic pregnancy. METHODS: Sixty-two women received a single dose and 58 received a multiple dose methotrexate regimen. MAIN OUTCOME MEASURES: Success rate of methotrexate therapy (women successfully treated with one injection and women who completed four doses). RESULTS: In the single dose group, treatment was considered successful in 50 women (80.6%), whereas in the multiple dose group, 52 women (89.7%) responded to treatment (p = 0.21; OR 0.90, 95%CI 0.77-1.05). The average number of days required for human chorionic gonadotropin (hCG) levels to fall below 5 mU/mL was longer in the single dose (22.3 +/- 7.6) compared with the multiple dose group (18.3 +/- 10.7) (p = 0.03). In the single dose group fewer or 17 women (24.7%) experienced side-effects compared to 28 (48.3%) of those who had multiple doses (p = 0.02, OR 0.57, 95%CI 0.35-0.92). CONCLUSION: A multiple dose methotrexate regimen for the treatment of unruptured tubal ectopic pregnancy is not more effective than a single dose one. In addition, multiple doses may cause more side-effects, but the time for hCG levels to fall below 5 mU/mL is shorter.
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Abortivos no Esteroideos/administración & dosificación , Metotrexato/administración & dosificación , Resultado del Embarazo , Embarazo Tubario/tratamiento farmacológico , Abortivos no Esteroideos/efectos adversos , Adolescente , Adulto , Distribución de Chi-Cuadrado , Relación Dosis-Respuesta a Droga , Esquema de Medicación , Femenino , Edad Gestacional , Humanos , Metotrexato/efectos adversos , Persona de Mediana Edad , Oportunidad Relativa , Paridad , Embarazo , Embarazo Tubario/diagnóstico por imagen , Estudios Prospectivos , Medición de Riesgo , Estadísticas no Paramétricas , Resultado del Tratamiento , Ultrasonografía , Adulto JovenRESUMEN
Brucellosis is one of the most common zoonotic diseases that can be encountered during pregnancy. We present two pregnant women with brucellosis. One of them delivered normally and the other patient had an abortion. We reviewed the literature regarding the clinical course of brucellosis in pregnant women. Brucellosis during pregnancy can be associated with abortion, congenital and neonatal infections and infection of the delivery team. Therefore treatment with a combination of rifampicin and trimethoprim-sulfamethoxazole should be started as soon as it is diagnosed to prevent possible complications.