Low cord blood serum levels of vitamin D: cause or effect of fetal macrosomia?

UNLABELLED: Aim: The aim of the study was to compare cord blood vitamin D levels of macrosomic large for gestational age (LGA) and appropriate gestational age (AGA) newborns. MATERIALS AND METHODS: Seventy-nine healthy, normal term newborns were included in the study. They were divided by birth weight into two groups: 37 in the LGA group above 4,000 g, and 42 newborns in the AGA group birth weight between 3,000 g and 4,000 g. Cord blood samples from groups were collected. Circulating 25(OH)D was measured as 25 hydroxyvitamin D3 (25(OH)D3) by high-performance liquid chromatography (HPLC) in serum using a kit. RESULTS: Maternal characterstics (age, body mass index [BMI], and gestational age) did not differ between the AGA and LGA groups. Cord blood 25 OH vitamin D levels were significantly low in neonates with LGA (p = 0,02). CONCLUSIONS: The authors found that macrosomic infants had low levels of vitamin D. Providing vitamin D supplements to pregnant women may prevent macrosomia. Randomized controlled trials are needed to prove this assertion.

Ankaferd blood stopper in episiotomy repair.

BACKGROUND AND OBJECTIVE: Ankaferd blood stopper (ABS) is a new hemostatic agent that is licensed for external hemorrhages. ABS comprises of a standard mixture of Thymus vulgaris, Glycyrrhiza glabra, Vitis vinifera, Alpinia officinarum, and Urtica dioica which has also been approved in Turkey for the management of bleeding. The authors, aim was to evaluate the efficacy of ABS spray in terms of blood loss during episiotomy repair. MATERIALS AND METHODS: The authors included pregnant women with a term singleton fetus (37-40 wks) in a vertex position, who were at least 18-years-old, had delivered vaginally, and required a mediolateral episiotomy. The patients were randomly assigned to one of the two approaches: 20 (Group 1) to ABS and 20 (Group 2) to isotonic saline solution (0.9% NaCl). The authors applied 4 ml ABS spray solution (1 ml/puff X 4) or isotonic saline solution (0.9% NaCl) (4 ml) topically on a sponge applied on the episiotomy. The sponge was weighed before and after the episiotomy repair to determine the amount of bleeding. Hemoglobin values were also recorded on admission and 12 hours after delivery. RESULTS: Both groups were similar in terms of maternal age, parity, body mass index and gestational age. The sponges weighed heavier in Group 2. Baseline hemoglobin values measured on admission showed no significant differences between the groups. Hemoglobin on the first postpartum day was significantly higher in the ABS group (p < 0.05). The operative time for episiotomy repair for the two groups was also statistically insignificant. No major immediate or delayed complications were observed in either group. CONCLUSION: In this study group, the application of 4 ml of ABS instead of isotonic saline solution lessened bleeding.