Relationship of red cell distribution width with the presence and severity of preeclampsia.

AIM: Although the relationship between red cell distribution width (RDW) and hypertension has been well documented, there is an absence of data on the association between RDW and preeclampsia. In the present study, we have aimed to investigate the correlation of RDW with preeclampsia and its severity. METHODS: The study population consisted of 52 (35 mild and 17 severe) patients with preeclampsia and 50 control pregnancy patients. For the entire study population, baseline RDW was measured using an automatic blood counter. RESULTS: Although there were no significant differences between the preeclampsia group and the control group in terms of hemoglobin and platelet counts, the RDW (14.1 ± 1.1 vs 16.9 ± 1.7, P < .001), systolic and diastolic blood pressure, proteinuria, white blood cell, and high-sensitivity C-reactive protein levels were significantly higher in the preeclampsia group. Moreover, subgroup analysis revealed that RDW levels were significantly increased in patients with severe preeclampsia when compared to the patients with mild preeclampsia (18 ± 1.5 vs 16.4 ± 1.5, P < .001). CONCLUSION: Our study results revealed that RDW levels were associated with both the presence and the severity of preeclampsia.

The Effects of Total Abdominal Hysterectomy on Ovarian Function - Serial Changes in Serum Anti-Müllerian Hormone, FSH and Estradiol Levels.

OBJECTIVES: The aim of this study was to evaluate ovarian function with longitudinal changes in serum levels of anti-mullerian hormone (AMH), follicle stimulating hormone (FSH) and estradiol (E2) after total abdominal hysterectomy (TAH) with ovarian conservation. MATERIAL AND METHODS: In this prospective longitudinal study, a total of 29 women, aged 39 to 48 years, suffering from uterine pathologies underwent TAH with ovarian conservation. Their serum AMH, FSH and E2 levels were measured at baseline, at the first month and the third month after TAH. RESULTS: There was a statistically significant decrease in AMH serum levels between the baseline and the first postoperative month; the values were 0.22 (0.16-1.49) ng/mL and 0.18 (0.04-0.52) ng/mL, respectively. However, significant differences were not seen for serum levels of FSH and E2 when baseline and one-month values were compared. In addition, no statistically significant differences were detected between the baseline and third-month serum AMH, FSH and E2 levels. CONCLUSIONS: The study demonstrated that TAH affects ovarian function temporarily.

Does Omegaven have beneficial effects on a rat model of ovarian ischemia/reperfusion?

OBJECTIVE: The beneficial effects of omega-3 fatty acids on an intestinal ischemia/reperfusion (I/R) model was shown previously. Therefore, we aimed to examine the potential beneficial effects of parenteral omega-3 fatty acids, a safe and inexpensive product, on a rat model of ovarian I/R. STUDY DESIGN: A group of 39 rats was divided into six groups. Group 1 (Sham Group; n=6) underwent two laparotomies with a 3-h interval and their ovaries were removed 3h later. Group 2 (torsion-detorsion Group; n=7) had their ovaries torsioned clockwise and fixed at 720°; 3h later a detorsion operation was done and after another 3h, their ovaries were removed. Group 3 (n=7) and Group 4 (n=7) received the same treatment as Group 2; however, half an hour prior to detorsion, these rats received Omegaven at 1mL/kg and 5mL/kg, respectively. Group 5 (n=6) and Group 6 (n=6) received the same treatment as Group 1; however, half an hour prior to the second laparotomy, these rats received Omegaven at 1mL/kg and 5mL/kg, respectively. One ovary from each rat was evaluated histologically by hematoxylin and eosin (H&E) staining and the other ovary was homogenized and evaluated for total oxidant status (TOS), total antioxidant status (TAS) and oxidative stress index (OSI). RESULTS: While we failed to show any significant relationship among groups in oxidative parameters, there was a significant worsening in the torsion-detorsion group in histological evaluation. High Omegaven doses, but not low doses, improved tissue injury scores of torsioned and detorsioned ovaries to the levels observed in the control group. CONCLUSION: Omegaven improves the detrimental effects of ovarian I/R when used in sufficient doses. Its effects and dose adjustment on women with ovarian torsion must be investigated by further studies.

Regression of endometrial autografts in a rat model of endometriosis treated with etanercept.

OBJECTIVE: To determine the efficacy of anti-tumor necrosis factor therapy (etanercept) for treating endometriosis in the rat endometriosis model. STUDY DESIGN: A randomized, placebo-controlled, blinded study using rat endometriosis model. After the peritoneal implantation of endometrial tissue, twenty-eight Wistar female rats were randomized to two equal intervention groups: the control group and the etanercept-treated group. After measuring implant volume, pretreatment blood and peritoneal fluid samples were obtained. A vehicle treatment of 2 mL saline to the rats in control group and 0. 4 mg/kg etanercept SC once weekly were administered in the etanercept-treated group. After four weeks treatment period, the volumes and histopathological properties of the implants were evaluated. A scoring system was used to evaluate preservation of epithelia. Endometrial explants were evaluated immunohistochemically for tumor necrosis factor receptor type 2 (TNFR2). A scoring system was used to evaluate expression grade of TNFR2. RESULTS: There was not a significant difference in spherical volume between control (131.0 (60.3-501.2)) and treatment groups (72.8 (31.2-149.6)) (p>0.025). There was a significant change in between the volumes of implants before and after treatment in etanercept group (p<0.05). At the end of the treatment significant differences among the groups were found in histopathological and immunohistochemical parameters (p<0.05) also histologic scores and HSCORES were decreased in the treatment group significantly (p<0.05). CONCLUSION: These results indicate that etanercept was found to effectively reduce the development of endometriosis in this experimental rat model.

Circulating levels of copeptin, a novel biomarker in pre-eclampsia.

AIMS: Increasing evidence supports the participation of metabolic syndrome and insulin resistance in the pathogenesis of pre-eclampsia. Copeptin is co-synthesized with vasopressin and is a new and promising novel marker of metabolic syndrome and insulin resistance. Our aim was to investigate copeptin levels in normotensive pregnant, mild and severe pre-eclamptic women. MATERIALS AND METHODS: We included 96 pregnant women who received antenatal and obstetric care at the perinatology clinic of our hospital. They were divided into three groups: women with normal ongoing pregnancy (n=32), those with mild pre-eclampsia (n=32) and those with severe pre-eclampsia (n=32). Doppler velocimetry measurements of the uterine and umbilical arteries were performed for each patient. Plasma levels of copeptin were quantified with enzyme-linked immunosorbent assay. RESULTS: Plasma levels of copeptin were 0.31±0.09 ng/mL in the normotensive pregnant group, 0.62±0.16 ng/mL in the mild pre-eclamptic group and 0.85±0.18 ng/mL in the severe pre-eclamptic group (P<0.001). Copeptin levels in pre-eclamptic patients with abnormal Doppler velocimetry were significantly higher than in those with normal Doppler velocimetry. CONCLUSIONS: These results suggest that increased maternal levels of copeptin may be involved in the pathogenesis of pre-eclampsia and it may be useful in the assessment of the severity of the disease.

Efficacy of anti-tumor necrosis factor therapy on endometriosis in an experimental rat model.

OBJECTIVE: To show the efficacy of anti-tumor necrosis factor therapy (etanercept) for treating endometriosis in an experimental model. DESIGN: A randomized, placebo-controlled, blinded study using rat endometriosis model. SETTING: Experimental research center of Ankara Education and Research Hospital. ANIMAL(S): Twenty-two Wistar female rats. INTERVENTION(S): After peritoneal implantation of endometrial tissue, rats were randomized to two equal intervention groups: control and etanercept-treated groups. After measuring implant volume, blood and peritoneal fluid samples were obtained. Vehicle treatments of 2 mL saline to rats in control and 0.4 mg/kg etanercept SC once weekly were administered in treatment group. Four weeks later, a third laparotomy was performed to remeasure implant volumes, blood, and peritoneal fluid samples. MAIN OUTCOME MEASURE(S): To compare spherical volume, peritoneal fluid and serum levels of VEGF, IL-6, and TNF-α between groups. RESULT(S): There was a significant difference in spherical volume between control [131.0 (60.3-501.2)] and treatment groups [72.8 (31.2-149.6)] (p < 0.025). In etanercept-treated group, a significant difference was found between peritoneal fluid and serum levels of VEGF, IL-6, and TNF-α (p < 0.01). CONCLUSION(S): These results indicate that etanercept was found to effectively reduce the development of endometriosis.

Abdominal and pelvic hydatid cyst obstructing the labor.

Hydatid cystic disease is a parasitic disease primarily infesting the sheep and cattle. It is a rare condition in pregnancy with an incidence of 1/20000 pregnancies. An eighteen-year-old primigravida was evaluated due to obstructed labor. Multiple abdominal and pelvic hydatid cysts were diagnosed by ultasonography and a healthy infant with birthweight of 3330 g was delivered by cesarean section. While the cysts situated on the posterior uterine wall, paraovarian region and omentum were removed totally, the hepatic cysts were only partially removed and then drained. The hydatid disease should be considered in differential diagnosis of adnexal masses obstructing the labor in pregnancy (Fig. 3, Ref. 9).

A long-standing incomprehensible matter of obstetrics: meconium-stained amniotic fluid, a new approach to reason.

OBJECTIVE: We sought to determine whether meconium-stained amniotic fluid is based on chronic hypoxia or not? In case of chronic hypoxia, higher red blood cell (Rbc) count and/or total hemoglobin levels (Hgb) and/or higher fetal hemoglobin (HbF) and/or lower adult hemoglobin (HbA) levels were expected when compared with controls. DESIGN: Case-control study. SETTING: Obstetric unit of a tertiary ministry of health hospital. SAMPLE: Fifty singleton pregnancies with meconium-stained amniotic fluid and 50 singleton pregnancies with clear amniotic fluid at all stages of labor. METHODS: Umbilical cord blood samples were collected for determination of total blood parameters and hemoglobin electrophoresis. MAIN OUTCOME MEASURES: Red blood cell count, total hemoglobin, fetal and adult hemoglobin contents (HbF and HbA). RESULTS: Red blood cell count, total hemoglobin, fetal hemoglobin (HbF) and adult hemoglobin (HbA) contents were not different between meconium stained and clear amniotic fluid groups. CONCLUSION: These results suggest that meconium passage may not be associated with chronic fetal hypoxia as demonstrated by similar red blood cell count, total hemoglobin values and fetal hemoglobin (HbF) and adult hemoglobin (HbA) contents.