Investigation of human papilloma virus frequency in pregnant women.

OBJECTIVE: The aim of this study was to determine the frequency of human papillomavirus (HPV), HPV types, and the association with age, pregnancy, and childbirth in pregnant women. METHOD: Four hundred and forty-eight pregnant women who visited our clinic were enrolled in the study. Polymerase chain reaction was used to determine HPV DNA and typing by cervical smear in the initial applications of patients with detailed history. Statistical Package for the Social Sciences (SPSS) 13.0 was used to analyze the data. RESULTS: HPV DNA was positive in 26 (5.8%) of 448 patients who participated in the study. High-risk HPV types were detected in 77% of HPV-positive cases and low-risk HPV types in 23% of cases. Only one HPV type was detected in 13 patients (50%), while multiple HPV types were detected in 13 patients (50%) of the HPV-positive cases. A significant negative association was found between gravidity and positivity of HPV DNA. HPV is more common in women with lower parity and gravidity. CONCLUSION: Studies conducted in different populations in different regions of Turkey have shown that the incidence of HPV in women ranges from 2.2% to 26%. In our study, the incidence of HPV DNA in pregnant women was 5.8%. It was found that there was an inverse relationship between parity and HPV DNA positivity. The HPV DNA positivity decreased with the number of births.

Investigation of CD56, ADAM17 and FGF21 Expressions in the Placentas of Preeclampsia Cases.

Objective: In the present study, we investigated the expression of CD56, ADAM17 and FGF21 antibodies (Ab), which we think have an effect on the pathophysiology of preeclampsia (PE), in pregnant patients with healthy placentas and placentas with PE. The expression of these antibodies has been investigated in a limited amount of former research, but their role in PE has not yet been clarified. With this study, we aimed to contribute to the elucidation of the pathophysiology of PE and the detection of new target molecules for treatment. Materials and Methods: Parturients with singleton pregnancy at 32 weeks or above without any maternal or fetal pathology who were admitted to the Department of Obstetrics and Gynecology, Zonguldak Bülent Ecevit University Practice and Research Hospital between 11 January 2020 and 7 January 2022 were included in the present study. Pregnant women with coexisting disease or a pathology related to the placenta (ablation placenta, vasa previa, hemangioma, etc.) were excluded. CD56, ADAM17 and FGF21 antibodies were histopathologically and immunohistochemically detected in 60 placentas with PE (study group) and 43 healthy placentas (control group). Results: CD56, ADAM17 and FGF21 proteins were all more intensely expressed in preeclamptic placentas and a statistically significant difference was found between the two groups for all three antibodies (p < 0.001). Deciduitis, perivillous fibrin deposition, intervillous fibrin, intervillous hemorrhage, infarct, calcification, laminar necrosis and syncytial node were found to be significantly more common in the study group (p < 0.001). Conclusions: We observed that CD56, ADAM17 and FGF21 expressions increased in preeclamptic placentas. These Ab may be responsible for the pathogenesis of PE, which can be illuminated with further studies.

Accuracy of the 24-h urine protein excretion value in patients with preeclampsia: correlation with instant and 24-h urine protein/creatinine and albumin/creatinine ratios.

The aim of this study was to determine the accuracy of the 24-h urine collection in preeclamptic pregnant women. This study included 65 singletons with preeclampsia and 53 singleton patients in a control-matched group. The ratio of inaccurate 24-h urine collection was measured by calculating expected urine creatinine excretion according to the proportion of pre-pregnancy weight and the lean body mass (LBM) of the patients. Comparisons were made between the accurately-collected 24-h urine protein excretion rates and the instant and 24-h urine protein/creatinine (P/Cr) and albumin/creatinine (A/Cr) ratios. Twenty-four-hour urine collection used to diagnose patients with preeclampsia was incorrectly collected 15-73.5% of the time among the patients and the control group. Instant and 24-h urine P/Cr and A/Cr ratios were correlated with total 24-h proteinuria among the patients in whom urine was collected correctly. Considering the 24-h urine P/Cr ratio, rather than the 24-h urine protein excretion value, is a better way to diagnose preeclampsia. IMPACT STATEMENT What is already known on this subject? Twenty-four-hour urine collection is considered as the gold standard of diagnosing proteinuria in preeclampsia, in case of the correctly collected. What do the results of this study add? Generally, in the literature the correctness of 24-h proteinuria is not questioned. However, it is actually quite important in daily practice to make the correct diagnosis of the proteinuria not to misdiagnose preeclampsia. What are the implications of these findings for clinical practice and/or further research? In this article, we aimed to show the importance of accurately collected 24-h urine in preeclampsia. We consider and advise to change the gold standard of this technique to 24-h protein/creatinine (P/Cr) ratio, in order to make correct diagnosis of the preeclampsia.

The genetics of recurrent hydatidiform moles: new insights and lessons from a comprehensive analysis of 113 patients.

Hydatidiform mole is an aberrant human pregnancy characterized by early embryonic arrest and excessive trophoblastic proliferation. Recurrent hydatidiform moles are defined by the occurrence of at least two hydatidiform moles in the same patient. Fifty to eighty percent of patients with recurrent hydatidiform moles have biallelic pathogenic variants in NLRP7 or KHDC3L. However, in the remaining patients, the genotypic types of the moles are unknown. We characterized 80 new hydatidiform mole tissues, 57 of which were from patients with no mutations in the known genes, and we reviewed the genotypes of a total of 123 molar tissues. We also reviewed mutation analysis in 113 patients with recurrent hydatidiform moles. While all hydatidiform moles from patients with biallelic NLRP7 or KHDC3L mutations are diploid biparental, we demonstrate that those from patients without mutations are highly heterogeneous and only a small minority of them are diploid biparental (8%). The other mechanisms that were found to recur in patients without mutations are diploid androgenetic monospermic (24%) and triploid dispermic (32%); the remaining hydatidiform moles were misdiagnosed as moles due to errors in the analyses and/or their unusual mechanisms. We compared three parameters of genetic susceptibility in patients with and without mutations and show that patients without mutations are mostly from non-familial cases, have fewer reproductive losses, and more live births. Our data demonstrate that patients with recurrent hydatidiform moles and no mutations in the known genes are, in general, different from those with mutations; they have a milder genetic susceptibility and/or a multifactorial etiology underlying their recurrent hydatidiform moles. Categorizing these patients according to the genotypic types of their recurrent hydatidiform moles may facilitate the identification of novel genes for this entity.

The Use of Thiol/Disulfide as a Novel Marker in Premature Ovarian Failure.

The study aimed to compare the dynamic thiol/disulfide homeostasis between patients with premature ovarian failure (POF) and healthy women. A total of 77 women, 40 POF and 37 healthy controls, were recruited from a university hospital between December 2013 and June 2015. Blood samples were taken from patients to evaluate follicle stimulating hormone (FSH), luteinizing hormone, estradiol and thiol/disulfide levels. A new, fully automated method was used to measure plasma thiol, total thiol and disulfide levels. Disulfide levels, disulfide/native thiol and disulfide/total thiol ratios were significantly increased, native thiol/total thiol levels were significantly decreased in POF patients compared to controls (p < 0.001). FSH was negatively correlated with native thiol and native thiol/total thiol levels and positively with disulfide, disulfide/native thiol, and disulfide/total thiol levels. This is the first study demonstrating the thiol/disulfide homeostasis in women with POF and may help us understanding the pathophysiology.

Sexual dysfunction in infertile couples: evaluation and treatment of infertility.

OBJECTIVE: To evaluate the diagnostic and the predictive value of Arizona Sexual Experience Scale among primary infertile couples regarding sexual dysfunction. METHODS: The cross-sectional and prospective pre, post study comprising primary infertile patients was carried out at Bulent Ecevit University Hospital, Zonguldak, Turkey. Fifty consecutive primary infertile couples not treated previously were investigated between 2003 and 2007 for the presence of sexual dysfunction by a psychiatrist. Arizona Sexual Experience Scale scoring was self-administered to determine sexual dysfunction among couples before treatment and also 3 months after the initiation of the treatment. RESULTS: Pretreatment mean values of the index parametres in both women and men were significantly increased after treatment. Statistically significant positive correlation was observed between pre- and post-treatment total scores in both women (r = 0.83; p < .001) and men (r = 0.92; p < .001). Receiver operating characteristic curve analyses revealed optimum cut-offs of pre- and post-treatment scores in women were were > 14 (Sensitivity: 57%; Specificity: 90%) and > 13 (Sensitivity: 83%; Specificity: 93%), respectively. Pre- and post-treatment scores in men were > 10 (Sensitivity: 65%; Specificity: 61%), > 11 (Sensitivity: 83%; Specificity: 62%), respectively. Binary logistic regression analyses revealed women's pre-treatment and post-treatment scores as a significant factor for prediction of sexual dysfunction independent of sociodemographic factors (p = 0.001 and p = 0.001, respectively). CONCLUSION: Evaluation and treatment of infertility is an important risk factor for sexual dyfunction. Pre- and posttreatment Arizona Sexual Experience Scale score could be used as a screening test for sexual dysfunction and might be used to decide pre/post-treatment consultation of couples with a specialist.

Placental chorangiosis: the association with oxidative stress and angiogenesis.

BACKGROUND/AIMS: Chorangiosis is considered to be strongly associated with fetal, maternal, and placental disorders, and has been found to be correlated with increased fetal morbidity and mortality. In this study, it is aimed to investigate the association of angiogenesis and oxidative stress with the pathogenesis of chorangiosis. METHODS: Expressions of heat shock protein 70 (HSP70), vascular endothelial growth factor-A (VEGF-A) and basic fibroblast growth factor (b-FGF), which are investigated with avidin-biotin-peroxidase method in formalin-fixed, paraffin-embedded sections from placental tissues diagnosed as no chorangiosis (n = 18) and chorangiosis (n = 18), have been evaluated in a semiquantitative manner. RESULTS: There were significant differences between chorangiosis and no chorangiosis cases with respect to birth weight, birth length, and Apgar scores (p < 0.001). Statistically significant (p < 0.001), diffuse and strong expressions with HSP70, VEGF-A and b-FGF were observed in the villous tissue of placental chorangiosis cases when compared with no chorangiosis cases. CONCLUSION: The majority of the chorangiosis cases had an accompanying poor perinatal outcome, and also those with accompanying angiogenesis and increased oxidative stress demonstrated diffuse and strong expressions of HSP70, VEGF-A and b-FGF. The interaction of maternal, placental, and fetal factors with increased oxidative stress and angiogenesis may possibly contribute to this arising pathologic change.

Comparison of the histopathological diagnoses of preoperative dilatation and curettage and hysterectomy specimens.

AIM: A biopsy is often taken as part of the preoperative workup, regardless of the indication for hysterectomy. Some authors believe that dilatation and curettage is a poor diagnostic procedure for intrauterine pathologies, but dilatation and curettage has been the method of choice for obtaining an endometrial sample. The aim of this study was to investigate the concordance between endometrial histopathological diagnoses from preoperative dilatation and curettage and hysterectomy specimens. The differences between premenopausal and postmenopausal women were also investigated. METHODS: Histopathological results for dilatation and curettage specimens from 645 women (401 premenopausal and 244 postmenopausal) who underwent a hysterectomy between 2003 and 2009 were analyzed retrospectively. RESULTS: High sensitivity (87.8%), specificity (100%), positive (100%) and negative (98.7%) predictive values, and accuracy (98.8%) were observed for all malignant endometrial pathologies obtained at dilatation and curettage. In postmenopausal women, eight malignancies were missed when the preoperative diagnosis from the dilatation and curettage sample indicated inadequate tissue or premalignant lesions. For premenopausal women, we found only two missed malignancies. The accuracy was 99.5% and 96.8% for malignant pathologies diagnosed from curettage material for pre- and postmenopausal women, respectively. CONCLUSIONS: Dilatation and curettage remains the 'gold standard' for diagnosing endometrial pathologies, especially malignancies.

Comparative study of oxidative stress in maternal blood with that of cord blood and maternal milk.

OBJECTIVE: Oxidative stress has been implicated in pregnancy-induced hypertension and preeclampsia. There is still some debate over whether this is confined to the placenta or occurs in the maternal circulation. This study was designed to investigate this question by comparing parameters of oxidative stress in samples of maternal blood and cord blood taken from normotensive and hypertensive pregnant women. A further aim was to compare these parameters in maternal milk from the two populations. STUDY DESIGN: Forty-six hypertensive (31 preeclamptic and 15 chronic hypertensive) and 60 normotensive pregnant women were recruited. Antecubital blood was collected from each woman before and after delivery, cord blood just after delivery, and maternal milk for the first 3 days postpartum. Total antioxidant capacity, total peroxides and sulphydryl concentration were measured and total antioxidant capacity calculated for each specimen. RESULTS: For all specimens (maternal blood plasma, cord blood plasma, maternal milk) total antioxidant capacity and sulphydryl concentration were significantly lower in the hypertensive women than in the normotensive, while total peroxide and oxidative stress index were significantly higher. CONCLUSION: These results support the association between hypertension in pregnancy and oxidative stress and the view that this occurs throughout the maternal circulation. They show further that oxidative stress may be transmitted from mother to newborn in maternal milk. Supplementation with antioxidants could, in view of our findings, possibly provide protection to the mother and fetus and also, through transmission in maternal milk, to the newborn.

Primary pulmonary sarcoma metastasising to the skin during pregnancy.

Lung cancer during pregnancy is a rare situation which is being increasingly reported during the past two decades due to a rising trend of cigarette smoking among young women and the tendency to delay pregnancy to a later age in life. We describe the case of a 32-year-old woman with primary pulmonary sarcoma, diagnosed at 31st week of pregnancy. X-ray chest and thoracic magnetic resonance imaging revealed a 9 x 6 cm mass in the left mediastinum, with tracheal shift, and pleural effusion. Biopsy performed during broncoscopy, was reported as mesenchymal tumour. She delivered a baby by Caesarean section at the 32nd week of gestation due to the development of superior vena cava syndrome. A skin biopsy taken 3 weeks later from the nodular lesion at the periumblical region was reported as a tumour metastasis. She received radiotherapy for 10 days, but died in the intensive care unit. Malignancies, even those as uncommon as a pulmonary sarcoma, should be considered in the differential diagnosis of pleural effusion during pregnancy.

Evaluation of HPV, smear and colposcopy results in patients with diabetes.

BACKGROUND AND AIMS: This study aimed to evaluate whether there is a difference in human papillomavirus (HPV), smear, and cervical biopsy results between patients with and without diabetes mellitus (DM). METHODS: Retrospectively, 136 patients with positive high risk (HR) HPV screening results with and without DM who underwent colposcopy between 2015 and 2019 were identified. The clinicopathological characteristics and HR HPV screening results were reported and analyzed. The results of the patients with and without DM were compared. RESULTS: HPV 16 positivity, Atypical Squamous Cells of Undetermined Significance (ASCUS), and Cervical Intraepithelial Neoplasia 1 (CIN 1) in smear and biopsy results were higher in patients with DM than patients without DM. CONCLUSIONS: The higher HPV positivity in patients with diabetes may require reforming the frequency and method of cervical cancer screening to be applied to this patient group.

Inflammatory markers in preeclamptic patients.

BACKGROUND: Preeclampsia is characterized by hypertension and proteinuria that begins in the second half of pregnancy. Endothelial dysfunction and trophoblastic hypoperfusion seen in preeclampsia suggested to be part of an increased maternal inflammatory response to pregnancy. In this study, we aimed to evaluate some inflammatory markers in pre-eclamptic and normotensive pregnants. METHODS: The study included 36 cases with mild preeclamp-sia, 36 cases with severe preeclampsia and 33 cases of normotensive pregnant. High sensitive C-reactive protein (hsCRP) and serum amyloid A (SAA) were measured by enzyme-linked immunosorbent assays, serum procalcitonin was measured by enzyme-linked fluorescent immunassay. Mean arterial pressure (MAP) was used as an indicator of the severity of the disease. RESULTS: In severe preeclampsia group hsCRP, serum amyloid A and procalcitonin levels were significantly higher than mild preeclamptic and normotensive groups. SAA and hsCRP levels were higher in mild preeclamptic group when compared with normotensive pregnant but no significant difference was found in procalcitonin between these groups. There were significant correlations betweeen hsCRP, SAA, procalcitonin and MAP. CONCLUSIONS: The results confirm that inflammatory reactions are closely associated with preeclampsia.

Idiopathic ileoileal invagination two days after cesarean section.

Postoperative enteroenteric invagination is rare. The only previously reported case post-cesarean was secondary to colonic adenocarcinoma. A 27-year-old woman with preeclampsia delivered a baby by cesarean section. On the second postoperative day, she had abdominal pain, nausea, vomiting, constipation, and distention. An abdominal x-ray showed air-fluid levels, while free fluid (ascites) was detected by ultrasonography. A computed tomography scan did not show the typical invagination picture. Her condition did not improve after 72 h of conservative treatment, and diagnostic laparotomy was performed. A 10 × 3-cm ileoileal invagination 80 cm proximal to the ileocecal valve was found and manually reduced. The patient was discharged on the fifth postoperative day, and her six-month follow-up was normal.

Ovarian cancer during pregnancy.

The frequency of cancer during pregnancy is approximately 1 per 1000 live births. This rate may increase as more women postpone childbirth until later in life, when cancer becomes more frequent. Pregnancy affects management of the cancer, and the cancer affects the management of pregnancy. The most common malignancies, in order of frequency, are breast cancer, leukaemia and lymphomas as a group, melanoma, gynaecologic cancers, and bone tumours. Ovarian tumours are found in about 1 in 1000 pregnancies and 3-6% of these are malignant. Thus, ovarian cancer occurs in approximately 1 in 12,500-25,000 pregnancies. Here, we report a case of ovarian mucinous carcinoma that was diagnosed at 22 weeks of gestation. After conservative surgery, she was given three cycles of carboplatin chemotherapy. She delivered at 33 weeks of gestation and after undergoing surgery she was given six cycles of paclitaxel and carboplatin chemotherapy. The patient is now being followed by the oncology department with no evidence of disease.

Recurrent partial hydatidiform mole.

Hydatidiform moles are abnormal conceptions characterised by atypical hyperplastic trophoblasts and hydropic villi. Their incidence is approximately 1 in 1000 pregnancies. The recurrence risk of hydatidiform mole is approximately 1 in 60 in a subsequent pregnancy and 1 in 6.5 in the third pregnancy. In cases with recurrence, the majority of moles are of the same type as that in the preceding pregnancy. Here, we describe the case of a recurrent partial hydatidiform mole after an initial healthy pregnancy. Both pregnancies were evacuated by suction curettage, and the patient was followed by serial monitoring of beta-human chorionic gonadotropin levels. Recurrent molar pregnancy is not an indication for chemotherapy, and subsequent pregnancies do not have an increased risk for other obstetric complications.

Endothelial nitric oxide synthase expression in gestational trophoblastic diseases.

OBJECTIVE: Nitric oxide is thought to play a role in the regulation of trophoblast activity. The aim of this study was to compare endothelial nitric oxide synthase expression in tissue samples taken from gestational trophoblastic diseases and placentas of normal pregnancies. METHODS: The expression of endothelial nitric oxide synthase was tested in formalin-fixed, paraffin-embedded tissues from specimens including 8 first trimester placentas, 3 partial hydatidiform moles, 20 complete hydatidiform moles, 2 invasive moles, and 5 choriocarcinomas. The expression of antibody was scored by a semiquantitative scale to define staining intensity. RESULTS: The first trimester placentas showed moderate expression in the villous. Gestational trophoblastic diseases displayed strong to very strong endothelial nitric oxide synthase expression in the syncytiotrophoblast, villous, and proliferating mononuclear trophoblasts. CONCLUSIONS: Endothelial nitric oxide synthase expression seems to have a strong correlation with proliferation of trophoblastic cells, in gestational trophoblastic diseases and in normal pregnancy.

The comparison of pegylated liposomal doxorubicin and beta-carotene effects on JAR and JEG-3 choriocarcinoma human cell culture models

Objective: The aim was to investigate the effectiveness of pegylated liposomal doxorubicin (PLD), beta-carotene, and a combination of PLD and beta-carotene on JAR and JEG-3 human choriocarcinoma (CC) cell lines for the treatment of CC. Material and Methods: JAR and JEG-3 cells were cultured. PLD and beta-carotene trial groups were determined with different doses (for single drug trial; PLD 1, 2, 5 µg/mL and beta-carotene 1, 5, 10 µg/mL, and for combined drug trial; all PLD doses combined with beta-carotene 5 µg/mL). Drugs were administered to cultures simultaneously, and 72 hours later the cells were detached using trypsin-ethylenediamine tetraacetic acid solution. The percentage of apoptotic cells was determined by flow cytometry after annexin V staining. One set of the supernatant was collected before trypsin application to investigate beta-human chorionic gonadotropin (ß-hCG) and hyperglycosylated hCG (H-hCG) levels. Statistical analyses of the apoptotic ratios were performed using Shapiro-Wilk, Kruskal-Wallis and Mann-Whitney U tests. Results: Apoptosis increased in JAR and JEG-3 cultures after treatment with all doses of PLD (p<0.05). A single application of each betacarotene dose increased apoptosis in JAR cells (p<0.05) but had no apoptotic effects on JEG-3 cells. In the PLD and beta-carotene combination group, apoptosis increased in both JAR and JEG-3 cells (p<0.05). Conclusion: To our knowledge, this is the first investigation of the effectiveness of PLD, beta-carotene, and PLD + beta-carotene combination therapy in two different CC cell lines. PLD is a promising chemotherapeutic drug, and beta-carotene can be used as a novel non-chemotherapeutic agent for treatment of CC. Based on the results of this study, vitamin A supplementation may have promise as a preventive measure. However, these data need support from animal experiments and clinical trials.

Comparison of outcomes of Burch colposuspension and transobturator tape and single incision needleless procedures (DynaMesh®-SIS minor) for the surgical treatment of female stress urinary incontinence patients who underwent combined pelvic reconstructive surgery or hysterectomy.

PURPOSE: Women with stress urinary incontinence (SUI) often require combined pelvic reconstructive surgeries because of shared risk factors of pelvic organ prolapse. The purpose of this study was to evaluate efficacies of Burch colposuspension, transobturator tape (TOT), and single-incision needleless (DynaMesh®-SIS minor) procedures in patients with SUI who also underwent combined pelvic reconstructive surgery or hysterectomy. METHODS: We performed this retrospective cohort study that comprising 122 patients who either underwent Burch colposuspension (n:43), TOT (n:40), or SIS (n:39) procedures along with pelvic reconstructive surgery or hysterectomy between January 2010 and July 2018. During the clinical follow-up, we analyzed cure rates, and surgical success rates of SUI surgery, quality of life, and symptom severity by IIQ-7, UDI-6, SSI, SSQ-8, OAB-V8, and PGI-I scale scores. The primary outcome was surgical success, whereas secondary outcomes included complications and patient-reported outcomes in the quality of life. RESULTS: We found that surgical success rates were higher in Burch group than SIS group and higher in TOT group than in SIS group (88.4% vs 61.5% and 87.5% vs 61.5%, p = 0.003). The quality of life was lower in SIS group than in Burch group. CONCLUSIONS: Both Burch and TOT are effective procedures in patients with SUI who require additional pelvic surgeries. Although surgical outcomes of SIS procedure in patients with SUI who underwent concomitant pelvic surgeries in our study were not promising, further studies with SIS are needed to clarify these observations.

Successful management of cesarean scar pregnancy with vacuum extraction under ultrasound guidance.

AIM: Cesarean scar pregnancy (CSP) is a rare type of ectopic pregnancy. The gestational sac is implanted in the myometrium at the site of a previous cesarean section. Mothers with CSP are faced with risks of unpredictable massive bleeding or more fatal complications. The purpose of this retrospective study was to assess the feasibility, efficacy, and reliability of the intraoperative ultrasound-guided vacuum aspiration method as an effective treatment option for CSP. METHODS: We undertook a retrospective analysis of CSP patients who had undergone the vacuum aspiration method, by reviewing patient records from the period October 2015 to January 2018. All of the operations were carried out under general anesthesia, with patients in the lithotomy position, using suprapubic ultrasonography guidance. A vacuum aspirator was used to aspirate the whole pregnancy material without perforating the previous cesarean section scar. RESULTS: Ten women with CSP were managed successfully by ultrasound-guided vacuum extraction without complications or further interventions, such as reoperation or methotrexate administration. Three of the 10 patients needed uterine Foley catheter tampon (50 cc) for 4 h after vacuum extraction alone was applied. During the study period, two additional patients who did not meet the criteria for the vacuum extraction method alone were managed with methotrexate plus vacuum application. Because of the rarity of the condition, the majority of CSPs are case reports or small case series reported in published works, with no consensus on the preferred course of treatment. CONCLUSION: The vacuum extraction method seems to be a good and practical way of treating CSP. Comparisons of efficacy should be undertaken but large sample sizes are required. We hope this study brings a new perspective for larger sample-sized studies, considering the technique is feasible and applicable.

Defective placentation and resultant oxidative stress play a similar role in complete hydatidiform mole to that in preeclampsia and early pregnancy loss.

Defective placentation and resultant oxidative stress are believed to be largely responsible for preeclampsia and early pregnancy loss. In experiments to test the hypothesis that these factors may also be important in complete hydatidiform mole (CHM). CHM cases were found to have significantly higher levels of mean total peroxide, mean oxidative stress index, protein carbonyls and endogenous DNA damage, and lower levels of total antioxidant potential and thiols compared with healthy pregnant patients, pointing to a role for oxidative stress in the condition. Whether this role is primary, secondary or incidental remains to be determined.