Human epididymis protein 4 and fetal lung maturity.

OBJECTIVES: To document the maternal and fetal cord blood levels of human epididymis protein 4 (HE-4) in term and preterm newborns in order to investigate the possible physiological role of HE-4 in fetal lung development. METHODS: This cross-sectional study was conducted in a university-affiliated hospital between April 2018 and September 2018. The study population consisted of cesarean section (C-section) deliveries after 24 weeks of pregnancy. Both maternal and umbilical cord HE-4 levels (mHE-4 and uHE-4, respectively) were measured using chemiluminescent microparticle immunoassay. Amniotic fluid was sampled from each case to determine the lamellar body count (LBC) as the gold standard test for lung maturation. All the parameters, including the uHE-4 levels, were compared between the term delivery (≥37 weeks) (n=52) and preterm delivery (24-37th weeks) (n=30) groups. The best cut-off value of uHE-4 was calculated for fetal lung maturity. RESULTS: There were no statistically significant differences between the groups regarding the demographic data. The mHE-4 levels did not statistically significantly differ between the groups (p>0.05) whereas the uHE-4 level of the preterm newborns was significantly higher than that of the term newborns (p<0.05). There was a significant negative association between the uHE-4 level and LBC (r=-0.389; p<0.001). The uHE-4 level was the only statistically significant fetal parameter indicating fetal lung maturity confirmed by LBC. At a cut-off value of 281 pmol/L, uHE-4 had 96.8% sensitivity, 45% specificity, 84.5% positive predictive value, and 81.8% negative predictive value for fetal lung maturity. CONCLUSIONS: Although the exact physiological role of HE-4 has not yet been elucidated, this preliminary study supports the idea that HE-4 plays a role in fetal lung maturation to some extent.

Vitamin D deficiency in adolescent pregnancy and obstetric outcomes.

OBJECTIVE: The aim of this study was to evaluate the rates of vitamin D deficiency in adolescent pregnants and its influence on the obstetric outcomes. MATERIALS AND METHODS: A total of 300 singleton pregnant women aged between 14 and 20 years, were divided into three groups according to their gestational weeks (100 pregnant adolescents from each trimester). Randomly selected 300 singleton pregnant women older than 20 years of age with the similar gestational ages were designed as the control group at the same time period. We divided serum 25(OH)D levels into three categories deficiency, inadequacy and adequate levels according to the Endocrine Society guidelines. Serum 25(OH)D levels were also evaluated according to age, seasons and gestational periods. Adverse obstetric outcomes were recorded. RESULTS: Overall, 86% of the subjects were found to have deficient 25(OH)D levels (<20 ng/ml). The levels indicated an inadequate state in 72 subjects (12%) and only 12 (2%) women had adequate 25 (OH) D levels. Among adult pregnant women the rates of deficient, inadequate and adequate levels were 88.3%, 11%, and 0.7% respectively. Among adolescent pregnant women these rates were 83.7%, 13%, and 3.3% respectively. The lowest 25(OH)D levels occurred during the winter while the highest levels were detected during the summer in both groups. Calcidiol, 25(OH)D, was a significant predictor for preterm delivery (AUC = 0,909; p < 0,001) and also for SGA (AUC = 0,915; p < 0,001). Maternal age was another significant predictor for SGA (AUC = 0,787; p < 0,001) and preterm delivery (AUC = 0,785; p < 0,001). CONCLUSION: We found a high incidence of 25(OH)D deficiency in Turkish pregnant women. Adolescent age and low 25(OH)D levels are significant risk factors for PTD and SGA. Effective prophylaxis programs for vitamin D deficieny and/or fortification of foods with vitamin D are essential in pregnant women especially in the winter season.

Can Variable Plasma Volume Alterations Affect the Efficiency of the First Trimester Screening Test?

BACKGROUND: The aim of this study was to assess the effect of plasma volume alteration determined by hematocrit on biochemical parameters of the first trimester screening test. METHODS: Enrolled in this study were 1,424 pregnant women in their first trimester who underwent a first trimester screening test. Fetal Nuchal Trancluciency measurement was obtained by ultrasonographic evaluation. Blood samples were taken for complete blood count, serum free ß-HCG, and PAPP-A between 11 and 14 weeks of gestation. The effect of plasma volume alteration on the screening test was evaluated. Mean corpuscular volume was used to rule out possible iron deficiency anemia. RESULTS: There were 59 women with combined risk > 1/270. Of these 59 women, there were 21 false positive results (1.5%). Serum Htc significantly predicted the false positive cases (AUC: 0.839, p < 0.001). The optimal cutoff value was obtained at a value of 30.2% with 85% sensitivity and 75% specificity. CONCLUSIONS: Our study suggests that the degree of plasma alterations may affect the serum levels of the biochemical components of the first trimester screening test for aneuploidy, thereby leading to false positive test results.

MaFOS-GDM trial: Maternal fish oil supplementation in women with gestational diabetes and cord blood DNA methylation at insulin like growth factor-1 (IGF-1) gene.

BACKGROUND: To evaluate the effects of maternal fish oil supplementation in women with gestational diabetes mellitus (GDM) on birthweight and DNA methylation at insulin like growth factor-1 (IGF-1) gene in their offspring. METHODS: Randomized controlled trial. A total of 120 women with GDM were randomized to one of the two groups between 24 and 28 weeks of the pregnancy: Group 1 (n = 52) received fish oil liquid softgel (Ocean plus®) and Group 2 (Placebo) (n = 68) sunflower oil liquid softgel. The birthweight and DNA methylation at IGF-1 gene of the offsprings were assessed. RESULTS: We observed a significant inverse association between fish oil use during pregnancy and birthweight (ß = -0.18, s.e.:125, P = .04), corresponding to a 250 g lower birthweight among infants born to fish oil users. This association didn't persist in multivariate analysis. Cord blood IGF-1 was lower in fish oil group (P = .001). Cord blood DNA methylation percentages at CpG-1044 and CpG-611 sites of IGF-1 gene promoter 1 (P1) region were higher in fish oil group compared to placebo group (P = .02 and P = .001, respectively). However, CpG-1044 and CpG-611 methylations were not associated to birthweight (ß = 0.04, s.e: 25.1, P = .66 and ß = 0.04, s.e: 22.7, P = 0.66, respectively). CONCLUSIONS: Maternal fish oil use has small effects on birthweight and DNA methylation when given to mothers with GDM at late pregnancy. Future studies are needed to show associations between maternal fish oil use and neonatal DNA methylations. CLINICAL TRIAL REGISTRATION: "Fish Oil Supplementation in Women with Gestational Diabetes". IDENTIFIER: NCT02371343.

Impact of body mass index, waist circumference and Pfannenstiel sitetissue thickness, and elastosonography on operative parameters

Background/aim: This study aimed to evaluate the impact of body fat distribution measured by body mass index (BMI), waist circumference (WC) and Pfannenstiel incision site tissue thickness, and elastosonography on bleeding and operation time during cesarean delivery.Materials and methods: A prospective study was made of 52 healthy, term pregnant women with prior cesarean deliveries. The impact of BMI, WC, incision site thickness, and elastosonography on preoperative and postoperative differences in hemoglobin (Hb) and hematocrit (Htc) levels and operation times was evaluated.Results: A moderate negative relationship was found between Htc levels and WC. Htc levels were found to decrease by 0.148 units for each 1-cm increase in WC. Skin-to-fascia time was found to increase by 0.697 s with each 1-unit increase in BMI, whereas fascia-to-uterus time was found to increase by 1.117 s with each 1-cm increase in Pfannenstiel site tissue thickness. None of the elastosonographies or differences in Hb levels were found to be significant for any parameter.Conclusion: Each of the evaluated parameters was found to have an impact on different factors: WC on Htc levels, BMI on skin-to-fascia time, and Pfannenstiel tissue thickness on fascia-to-uterus time.

Early initiation and exclusive breastfeeding: Factors influencing the attitudes of mothers who gave birth in a baby-friendly hospital.

OBJECTIVE: To investigate the initation time of breastfeeding, exclusive breastfeeding rates, and complementary feeding practices during the first six months of life among mothers who gave birth in a baby-friendly hospital. MATERIALS AND METHODS: A cross-sectional study was conducted with 350 mothers. Demographic characteristics, obstetric history and information about breastfeeding initiation were collected at the hospital. Information about factors affecting breastfeeding duration and feeding practices of the infants were obtained at the end of six months. RESULTS: Some 97.4% of the mothers initiated breastfeeding, 60.1% within the first hour. Exclusive breastfeeding was maintained for six months in 38.9%. Low education levels of mother/father, random breastfeeding, rare breastfeeding at night, nipple problems, bottle/pacifier use, and lack of social support were found associated with early cessation. Planned pregnancy [odds ratio (OR=2.02)] and vaginal delivery (OR=0.3) were found as the most important factors in early initiation, whereas antepartum breastfeeding education (OR=7.17) was the most important factor for exclusive breastfeeding duration in the logistic analysis. More than half (61.1%) of the infants were partially/bottle fed for six months; the most common reason was the belief that breast milk was insufficient. CONCLUSION: Efforts to encourage mothers and society to breastfeed exclusively should be made as part of a primary public health strategy to prevent early cessation of breastfeeding.

Comparison of Amniotic Fluid Cytokine Levels in Postterm and Term Pregnancy: a Prospective Study.

BACKGROUND: To evaluate amniotic fluid pro- and anti-inflammatory cytokine levels in women with postterm and term pregnancies in labor and not in labor. METHODS: The study involved three groups: postterm (Group 1, n = 29), term in labor (Group 2, n = 28), and control (Group 3, n = 30). All groups were compared with respect to age, gravidity, parity, obstetric history, gestation week, cervical dilatation and effacement, maternal serum C-reactive protein and white cell count, amniotic interleukin 4, 6, and 10 levels, birthweight, and cord blood pH. RESULTS: The amniotic fluid interleukin 10 level was 24.4 ± 8.8 pg/mL in the postterm group, 13.5 ± 5.1 pg/mL in the term in labor group, and 19.8 ± 5.4 pg/mL in the control group (p < 0.001). The amniotic fluid interleukin 4 level was 86.5 ± 57.7 pg/mL in the postterm group, 38.2 ± 29.2 pg/mL in the term in labor group, and 81.9 ± 68.4 pg/mL in the control group (p = 0.002). The amniotic fluid interleukin 6 level was 329 ± 135.1 pg/mL in the postterm group, 252.8 ± 138.7 pg/mL in the term in labor group, and 227.9 ± 114.4 pg/mL in the control group (p = 0.02). There was a positive correlation between gestational age and IL-10 levels (p < 0.05). CONCLUSIONS: Amniotic fluid IL-10 and IL-4 cytokine levels were increased in postterm pregnancy and they decreased with active labor.

Comparison of elastosonography and digital examination of cervix for consistency to predict successful vaginal delivery after induction of labor with oxytocin.

OBJECTIVE: To compare elastosonography and digital examination of cervix for consistency in the prediction of successful vaginal delivery. METHODS: A total of 64 pregnant women with the indication of induction of labor (IOL) were enrolled to the study. The uterine cervix is evaluated before and after the IOL with elastosonography and digital examination for consistency and sonography for length. Methods were compared in regard to the prediction of successful vaginal delivery. RESULTS: The median of gestational age was 41.00 (IQR = 2.32). Out of 64 participants, 40 (62.5%) had vaginal delivery and 24 (37.5%) had cesarean delivery. The preinduction and postinduction elastosonographic indices were insignificant in delivery groups. The preinduction and postinduction evaluations of cervical consistency with digital examination were significant within vaginal delivery group (p = 0.046), whereas it was insignificant within cesarean delivery group and between the delivery groups. The preinduction and postinduction Bishop scores were significant within vaginal delivery group (p = 0.005), whereas it was insignificant within cesarean delivery group and between the delivery groups. Postinduction Bishop score was significant between the delivery groups. CONCLUSION: Evaluation of cervix for consistency with either elastosonography or digital examination was found to be insignificant in prediction of successful vaginal delivery after IOL with oxytocin.

Relationship between anemia and depressive mood in the last trimester of pregnancy.

OBJECTIVE: To compare the relationship between the severity of anemia and depressive mood in the last trimester of pregnancy. METHODS: A cross-sectional study, enrolled a total of 450 pregnant women who attended the antenatal clinics in their third trimester for their routine antenatal follow-up. Depressive symptoms were assessed by the Edinburgh Postnatal Depression Scale. The study group was divided into two groups according to presence of anemia; anemic group (Hb < 11 gr/L; n = 150) and non-anemic group (Hb ≥ 11 gr/L; n = 300) and depression scores were compared. RESULTS: One hundred and fourteen (25.3%) women scored ≥13 points which were considered the cutoff value for depression on the EPDS. Anemia frequency was found as 33.3%. The total EPDS score was significantly higher in the anemic group (EPDS score 11 [min-max 0-29]) compared with the non-anemic group (EPDS score 7 [min-max 0-21]) (p = 0.000). Multiple regression analysis also revealed that serum Hb level was an independent factor for antenatal depressive mood. CONCLUSIONS: As anemia is associated with higher depressive symptom levels, it should be carefully considered during pregnancy. Prospective studies are needed to confirm our results.

Red blood cell distribution width: A simple parameter in preeclampsia.

OBJECTIVE: Preeclampsia is a serious disease and a leading cause of maternal and perinatal mortality and morbidity. Red blood cell distribution width (RDW), a measure of anisocytosis, is used as an inflammation marker in hypertension and cardiovascular diseases. Although the relationship between RDW and hypertension has been well documented, the association between preeclampsia and RDW is not clear. We aimed to investigate the relationship between RDW and preeclampsia and its severity. MATERIALS AND METHODS: One hundred eighteen pregnant women with preeclampsia and one hundred twenty uncomplicated pregnant women were included in the study. Blood samples for routine CBC and RDW levels were analyzed. RESULTS: The RDW values were significantly higher in preeclampsia group compared with the control group (15.23±1.96 vs 14.48±1.70, p<0.05). We also confirmed that RDW levels were significantly higher in severe preeclampsia group than mild preeclampsia group in subgroup analyses (15.08±2.07, 15.92±1.99, p<0.05). CONCLUSION: Our study showed that there is an association between RDW and preeclampsia and also its severity. RDW, a marker which is easy, inexpensive and calculated as a part of blood cell count, can be used as a significant diagnostic and prognostic marker in patient with preeclampsia like the other cardiovascular diseases.

Surgical reconstruction in female genital mutilation.

Female genital mutilation (FGM) is an unusual condition for our country. However, an increase in FGM in future days can be predicted with the increasing numbers of exchange students coming from African countries, migration of refugees and socioeconomic relations with the African countries. We want to share our experience of two FGM victims admitted to our clinic with the request of reconstructive vulvar surgery before their marriage. Both women had WHO Type III FGM. Physical examination findings and surgical reconstruction techniques were presented.

Factors Associated with Breastfeeding Initiation and Exclusive Breastfeeding Rates in Turkish Adolescent Mothers.

OBJECTIVE: This study aimed to determine the early initiation time of breastfeeding and exclusive breastfeeding (EBF) rates during the first 6 months and the main factors affecting EBF practice in Turkish adolescent mothers. STUDY DESIGN AND METHODS: A cross-sectional study was conducted with 200 adolescent mothers who were raising 6 to 24 month-old children. A face-to-face interview was conducted for sociodemographic characteristics, obstetric history, information about the baby, information about breastfeeding, and the factors affecting breastfeeding. We detected breastfeeding prevalence as well as its initiation time and duration. RESULTS: The mean age of the patients was 17.9 ± 1.15 years. The percentage of patients who started breastfeeding within 1 hour was 45.5%. Approximately, 74% of the adolescent mothers provided breastfeeding before any type of formula as the baby's first food. Women who initiated breastfeeding earlier had planned pregnancies, educated for breastfeeding, delivered vaginally, and had boy infants. The mothers who started breastfeeding earlier fed their babies significantly more frequently at night, had longer EBF times, and had longer total breastfeeding times than the mothers who started breastfeeding later than 2 hours. Planned pregnancy, vaginal delivery, and having a boy infant were significantly associated with early breastfeeding. Age, planned pregnancy, postpartum education, frequent breastfeeding at night, and formula initiation time were predictors of EBF. CONCLUSIONS: Adolescent pregnants may start breastfeeding earlier when had planned pregnancy, educated and encouraged for breastfeeding from the family and medical staff. Therefore, strategies should be formed to improve breastfeeding programs.

To what extent do the presentation of fetus, amniotic fluid index and fetal weight at term affect the cardiac axis?

OBJECTIVE: To analyse the change in cardiac axis with advancing gestational age and the factors that may affect it. METHODS: 45 healthy pregnant women in 20th weeks of gestation were enrolled to the study. The cardiac axis was noted for each participant. The same group was once more assessed at term and the change in cardiac axis was calculated with the difference of cardiac axis at term and the 20th gestational weeks. Change in cardiac axis with advancing gestational weeks and factors that may affect it such as amniotic fluid index (AFI), estimated fetal weight (EFW) at term, actual birth weight and presentation of the fetus at term were evaluated. RESULTS: The median of ages was 28.0 (IQR=12.0)years within a range of 18-39years. The median of change in cardiac axis was 11.0 (IQR=9.0) degrees within a range of 3.0-47.0 degrees. The change in cardiac axis in regard to the fetal presenting part was 11.0 (IQR=8.0) degrees in vertex presentation and 23.50 (IQR=21.0) degrees in breech presentation. 81.1% of the variation in change in cardiac axis was found to be due to the actual birth weight and fetal presentation, with each 100g increase in actual birth weight leads to an increase of 0.375 degrees in cardiac axis. CONCLUSION: EFW at term, presentation of the fetus and the actual birth weight were all found to be significant in predicting the change in cardiac axis, but not AFI. These findings may have future potential value in evaluating electrocardiogram (ECG), especially of pregnants with extremes of left axis deviation (polyhydramnios, large fetus or breech presentation). Clinicians should be cautious during the interpretation of the ECG in pregnants, especially in those with extremes of left axis deviation because of either polyhydramnios, large fetus or breech presentation.

Does diurnal variation affect the first trimester fetal aneuploidy screening test biochemical parameters of fetuses with normal nuchal translucency?

OBJECTIVE: The purpose of this study was to investigate the effect of diurnal variation on biochemical results of first trimester aneuploidy screening test. METHODS: A total of 2725 singleton pregnant female, who had normal fetal nuchal translucency (NT) thickness, were included in the study during this period. Individuals were divided into two groups according to the sampling time (morning group: 09:00-11:00 am and afternoon group: 02:00-04:00 pm). Hormonal parameters (free-beta human chorionic gonadotropin [free ß-hCG] and pregnancy-associated plasma protein-A [PAPP-A] multiples of median [MoM] levels) of first trimester (11(+0)-13(+6) weeks) combined aneuploidy screening test were compared between morning and afternoon groups. RESULTS: PAPP-A MoM levels were significantly lower in the afternoon group when compared to the morning group (p = 0.001), whereas free ß-hCG MoM levels were similar in the both groups (p = 0.392). Rate of high risk for Down syndrome (Combine risk >1/300) and amniocentesis ratio were found higher in the afternoon group than morning group, but there were no difference between groups for the number of fetuses with Down syndrome. CONCLUSION: Receiving the venous blood sample for first trimester aneuploidy screening test in the afternoon causes low PAPP-A MoM levels.

Nausea and Vomiting in Early Pregnancy of Adolescents: Relationship with Depressive Symptoms.

STUDY OBJECTIVE: To determine the relationship between severity of nausea and vomiting during pregnancy (NVP) and depressive symptoms in pregnant adolescents. DESIGN: Prospective cross-sectional study. SETTING: A maternity research hospital outpatient clinic, Ankara, Turkey. PARTICIPANTS: A total of 200 pregnant adolescents. INTERVENTIONS AND MAIN OUTCOME MEASURES: Demographic features and obstetric histories of the participants were assessed. The Rhodes test was performed to determine nausea and vomiting severity in a face-to-face interview, and the self-reported Edinburgh Postnatal Depression Scale was administered with supervision. RESULTS: The Rhodes test results showed that 52/200 patients (26%) were classified with none, 83/200 patients (41.5%) with mild, 48/200 patients (24.0%) with moderate, and 17/200 patients (8.5%) with severe symptoms. The mean depression score in the severe vomiting group was significantly higher than that in the no NVP and mild NVP groups (P = .028 and .041, respectively). No differences were found between the other groups. CONCLUSION: Severe nausea and vomiting was associated with greater depressive symptom severity in pregnant adolescents.

Waist Circumference as a Predictor of Failure of Sonographic Estimation of Fetal Birth Weight.

OBJECTIVE: Several factors may interfere with the success of fetal birth weight (BW) prediction. In this study we tried to determine the most probable factors that may lead to unsuccessful BW estimation. METHODS: 200 consecutive pregnancies between 34 and 41 weeks of gestation were enrolled for the study. All subjects underwent sonographic fetal BW estimation before membrane rupture or engagement of presented part. Sonography was performed by the same sonographer blinded to the study design. Failure of estimation was determined when deviation was found to be >15%. RESULTS: Both amniotic fluid index (AUC = 0.768, p < 0.001) and maternal waist circumference (AUC = 0.698, p = 0.004) were significant predictors for failure of estimation. Optimal cut-off values were 80 mm for amniotic fluid index (77% sensitivity, 65% specificity) and 105 cm for maternal waist circumference (70% sensitivity, 61% specificity). The number of pregnancies with anteriorly located placenta was significantly higher in the group with failed estimation (12/20 vs. 39/180, p = 0.001). CONCLUSION: Amniotic fluid volume, body mass index, maternal waist circumference and placental location may all cause failure of fetal weight estimation and may need to be adjusted. Moreover, our results indicate that waist circumference may be a more reliable predictor of failure of fetal weight estimation compared to body mass index.

The Diagnostic Role of Vitamin D and Cathelicidin Levels in Pelvic Inflammatory Disease.

BACKGROUND: The aim of this study was to evaluate the effect of 25-hydroxyvitamin D [25(OH)D] and cathelicidin levels on pelvic inflammatory disease [PID] in reproductive aged women. METHODS: A total of 81 reproductive aged women, 43 with PID and 38 without PID, were included in the study. Five millilitres of venous blood were collected from subjects and controls for complete hemogram and serum for CRP, IL-6, 25(OH)D and cathelicidin. RESULTS: There were significant differences between the study group and the control group for 25(OH)D (study group, 47.3 ± 2.01 ng/mL, control group, 28.38 ± 1.35 ng/mL, p = 0.001), for cathelicidin (study group, 165.56 ± 65.92 ng/mL, control group, 10.34 ± 6.48 ng/mL, p = 0.001). There was a positive correlation between 25(OH)D, cathelicidin, and other markers (WBC, CRP, and IL-6). Receiver operator curve analysis showed that the best cutoff value for 25(OH)D was 34.25 ng/mL, sensitivity 88%, and specificity 89%, and for cathelicidin 15 ng/mL, sensitivity 91%, specificity 90%. CONCLUSIONS: 25(OH)D and cathelicidin can be used as acute phase reactants like conventional markers in PID. Future studies are needed to understand the roles of these molecules in both diagnosis and follow-up of infectious situations.

Relationship between the body iodine status and menopausal symptoms during postmenopausal period.

AIM: The aim of this study was to assess the effect of body iodine status on hot flashes and cardiovascular disease risk in postmenopausal women. METHODS: Two hundred and ten consecutive postmenopausal women without known any risk factor for cardiovascular disease risk or systemic disorder were recruited for the study. All participants underwent serum screening consisted of lipid profile including lipoprotein-a (Lp(a)) and urinary iodine excretion. Participants were also asked for the frequency and the duration of hot flashes. All parameters were assessed for the association between urine iodine excretion and other parameters. RESULTS: Urine spot iodine level was significantly correlated with Lp(a) (r = -0.287, p < 0.001), low-density lipoprotein cholesterol (LDL-C) (r = -0.187, p = 0.006), cholesterol level (r = -0.573, p < 0.001), TG level (r = -0.211, p = 0.02), frequency of hot flashes per a day (r = -0.467, p < 0.001), durations of hot flashes (r = -0.424, p < 0.001), fasting glucose level (r = 0.331, p < 0.001), and fT3 level (r = 0.475, p < 0.001). In multivariate analysis, Lp(a) levels were significantly associated with the urine iodine level (beta coefficient = -0.342, p < 0.001) after adjustment for LDL-C (beta coefficient = 0.225, p < 0.001), glucose (beta coefficient = 0.303, p < 0.001), and age (beta coefficient = 0.146, p < 0.017). CONCLUSION: Body iodine status during postmenopausal period is associated with the menopausal symptoms and lipid profile including Lp(a).

The utility of cervical elastosonography in prediction of cervical insufficiency: cervical elastosonography and cervical insufficiency.

OBJECTIVE: To evaluate the utility of cervical elastosonography (ES) in prediction of cervical insufficiency (CI). METHODS: A total of 40 women, of which 20 who had previously received the diagnosis of CI and 20 healty women were included in the study. None of the women were pregnant. All subjects underwent sonographic evaluation including cervical length measurement and ES of uterine cervix. Adjacent muscular tissue was the reference point for elastosonography evaluation. Tissue strain ratio values were obtained from all the patients. RESULTS: The area around the internal cervical os of the group with CI was found to be significantly softer as compared to the control group (higher SR rate, p < 0.05). Furthermore, the outer parts of the cervix (sites A and D) were also found harder in the group that had CI (lower SR rate, p < 0.05). CONCLUSIONS: According to our knowledge, this is preliminary study to evaluate the predictive value of cervical ES in CI and we concluded that ES can be used as reliable method to determine CI but it is necessary to be studied in different cohort groups.

Do we need readjustment of the biochemical parameters in first trimester combined aneuploidy screening test in women with polycystic ovary syndrome?

OBJECTIVE: The aim of this study was to determine whether polycystic ovary syndrome (PCOS) affects the biochemical components of first trimester combined aneuploidy screening test. METHOD: A case-control study was performed at a tertiary referral hospital between years 2007-2013. Singleton pregnancies in the first trimester (11(+0) -13(+6) week) who had a history of PCOS and underwent first trimester combined aneuploidy screening test were included in the study. Three hundred and seventeen women met the criteria for inclusion. Control group was formed by 942 healthy pregnant women with similar gestational and maternal ages using a 1 : 3 ratio. Pregnancy-associated plasma protein-A (PAPP-A), free ß-human chorionic gonadotropin (fß-hCG) and fetal nuchal translucency were compared between the study group and the controls. RESULTS: The biochemical components PAPP-A and fß-hCG were significantly lower in the PCOS group compared with the control group (p = 0.001). There was no difference among groups with regard to the nuchal translucency measurements (p = 0.128). CONCLUSION: Our study shows that the levels of biochemical components of first trimester combined aneuploidy screening test (PAPP-A and fß-hCG) are altered in pregnant women with PCOS. Future trials of larger scale are needed to asses any need for readjustment of the risk in the patient population with PCOS.