Comparison of Perinatal, Newborn, and Audiometry Results of COVID-19 Pregnant Women.

Objective: There are studies on the perinatal outcomes of COVID-19, but the audiometric effects of the maternal immune system against COVID-19 in the newborn are not clear. In this study, we aimed to investigate the relationship between the perinatal outcomes of COVID-19 positive pregnant women and the audiological outcomes of newborns. Materials and Methods: This retrospective, single-center cohort study was conducted with 65 polymerase chain reaction (PCR) positive pregnant women and newborns and 66 normal pregnant women and newborns who were admitted between January 2020-December 2021. Pregnancy data, perinatal outcomes, and newborn hearing test results of pregnant women and newborns were recorded and compared. Results: A total of 131 patients were enrolled in the study. The number of normal pregnant women was 66 (50.4%) and the number of pregnant women who had COVID-19 disease was 65 (49.6%). In general, gestational week, age, parity, biochemical parameters, duration of hospital stay, week of delivery, fetal weight, and apgar scores were compared between pregnant women with COVID-19 and normal. White blood cell (WBC), neutrophil, aspartate aminotransferase (AST), and C-reactive protein (CRP) parameters were found to be significantly higher, and lymphocyte and neutrophil/lymphocyte (N/L) ratios were significantly lower (p < 0.05). There was no statistically significant difference between the two groups (χ 2=0.001; p = 1,000). The normal delivery status, the normal delivery rate in patients with COVID-19 was found to be statistically significantly higher than the cesarean section delivery status (p = 0.012). In the statistical comparison between the COVID-19 and normal pregnant groups in the cesarean section group, the gestational week, delivery week, and apgar1 scores of the pregnant women with COVID-19 were found to be significantly higher. There was no statistically significant difference between the distributions of the rate of infants with hearing impairment in the comparison with hearing tests in pregnant women with COVID-19 (n=1) and normal pregnant women (n=1) (χ 2=0.001; p = 1,000). Conclusion: Although the negative effects of COVID-19 on pregnancy outcomes are rare, it was determined that there was no increased audiological risk factor, and the most important predictor of COVID-19 was lymphopenia.

An evaluation of nitric oxide, folate, homocysteine levels and lipid peroxidation in postmenopausal osteoporosis.

OBJECTIVES: In the current study, the risk coefficients of nitric oxide (NO), folate, homocysteine levels and lipid peroxidation in postmenopausal osteoporotic women were determined. MATERIAL AND METHODS: Bone mineral density was determined by dual-energy X-ray absorptiometry. The levels of serum lipid peroxidation products such as the thiobarbituric acid adduct of malondialdehyde (MDA) were measured spectrophotometrically. Plasma folate and homocysteine (Hcy) levels were measured by enzyme chemiluminescence immunoassay. Plasma nitrite levels were measured with the Griess reaction RESULTS: The odds ratios and 95% Confidence Intervals (CI) of the variables MDA, folate, NO, body-mass index (BMI), menopause age and age were found significant. MDA, NO and folate variables were found statistically significant in the analysis of receiver operating charecteristic (ROCs). The areas under the curve (AUCs, 95% CI) of MDA, NO and folate were found to be statistically significant. CONCLUSIONS: The current study indicates that NO, MDA and folate are risk variables for postmenopausal osteoporosis.

Prenatal diagnosis of 4p and 4q subtelomeric microdeletion in de novo ring chromosome 4.

Ring chromosomes are unusual abnormalities that are observed in prenatal diagnosis. A 23-year-old patient (gravida 1, para 0) referred for amniocentesis due to abnormal maternal serum screening result in the 16th week of second pregnancy. Cytogenetic analysis of cultured amniyotic fluid cells revealed out ring chromosome 4. Both maternal and paternal karyotypes were normal. Terminal deletion was observed in both 4p and 4q arms of ring chromosome 4 by fluorescence in situ hybridization (FISH). However deletion was not observed in the WHS critical region of both normal and ring chromosome 4 by an additional FISH study. These results were confirmed by means of array-CGH showing terminal deletions on 4p16.3 (130 kb) and 4q35.2 (2.449 Mb). In the 21th week of pregnancy, no gross anomalia, except two weeks symmetric growth retardation, was present in the fetal ultrasonographic examination. According to our review of literature, this is the first prenatal case with 4p and 4q subtelomeric deletion of ring chromosome 4 without the involvement of WHS critical region. Our report describes the prenatal case with a ring chromosome 4 abnormality completely characterized by array-CGH which provided complementary data for genetic counseling of prenatal diagnosis.

Clinical experience of adnexal torsion: evaluation of 143 cases.

We conducted this retrospective study to evaluate the outcomes, indications and post-operative findings of adnexal torsion cases and compared the features of benign cystic teratoma with the other cases. We analyzed a series of 143 cases of adnexal torsion from 2000 to 2009 at current clinic, retrospectively. The data were collected from the patient's specific files and hospital records descriptively. The demographic characteristics, sonographic findings and post-operative invention were evaluated. Statistical analyses were carried out by using the statistical packages for SPSS 15.0 for Windows (SPSS Inc., Chicago, IL, USA). A total of 143 cases were operated for adnexal torsion during the study period at our clinic. The clinical and demographic characteristics of the cases are shown in table 1. Of all patients, forty of them were diagnosed as benign cystic teratoma and this group of the adnexal torsion cases had statistically different gravidy, mass size and torsion number from the non-benign cystic teratoma group. Age was not a statistically different between two groups. According to this study, benign cystic teratoma increases risk of adnexal torsion. When detecting benign cystic teratoma the patients should be informed about the risk of torsion and explained the signs of this situation. The early diagnosis and appropriate surgical management of adnexal torsion is the only way to prevent complications and to preserve future fertility. Being aware of the different sonographic findings of torsionated adnexa may assist in the correct diagnosis of these patients.

18F-FDG PET-CT and USG/CT in benign and malignant ovarian tumors with postoperative histopathological correlation.

OBJECTIVES: The role of 18F-FDG (18F fluorodeoxyglucose) PET/CT** (Positron emission tomography) in the diagnosis, treatment and follow up of benign and malignant ovarian tumors had been investigated previously. The objective of the following study was to evaluate the predictive value of PET/CT in benign and malignant ovarian tumors and compare with computerized tomography and post-operative pathology. MATERIALS AND METHODS: In this retrospective study a total of sixty nine cases with benign or malignant pelvic masses underwent laparotomy at our clinic. Postoperative pathology of the patients was recorded and PET/CT results were compared with ultrasonography computerized tomography and postoperative pathology. RESULTS: The ROCs and AUCs values four predictors were shown in Figure 1. The AUCs (95 % CI) values calculated for CA 125, ultrasonography (USG), PET/CT and CT were as follows: 0.855 (0.752-0.958), 0.703 (0.540-0.866), 0.681 (0.514-0.848) and 0.631 (0.463-0.799) respectively CA 125 has the highest AUC value in order to predict the malignant potential of the patient. USG has the highest AUC value between the imaging techniques, following PET/CT and CT CONCLUSION: According to this study among four modalities that distinguish malignant potential preoperatively; CA 125 is the best parameter USG and PET provide similar benefits in detecting malignant ovarian masses preoperatively. Both of these parameters are superior to CT Combination of CA 125, USG and PET/CT may be useful in detecting malignant ovarian masses preoperatively resulting in less invasive surgeries.

Adnexal masses in postmenopausal and reproductive age women.

We aimed to evaluate and compare the management and clinical characteristics of adnexal masses in postmenopausal and reproductive age women. This prospective study was performed at Dicle University, School of Medicine, Department of Obstetrics and Gynecology, from January 2007 to June 2009.The data were collected from hospital records and patients files, descriptively. The cases were divided into two groups as cases with adnexal masses in postmenopausal age women (Group 1, n = 40), and reproductive age (Group 2, n = 40). All of the cases operated for benign adnexal masses. Statistical analyses were carried out by using the statistical packages for SPSS 15.0 for Windows (SPSS Inc., Chicago, IL, USA). The demographic characteristics of the cases that were enrolled in our study are depicted in Table 1.The initial compliant of the cases were abdominal pain in 62 (77.5%) of the cases and 8 (20%) vaginal bleeding and 10 (12.5%) were asymptomatic. The initial diagnose of the cases were; pelvic mass in 34 (75%) of the cases, ovarian cyst 26 (32.5%), dermoid cyst 10 (12.5%), endometrioma 7 (8.75%) and postmenopausal bleeding 4 (5%). The tumor markers were evaluated. All of the cases were subjected to laparotomy or laparoscopy. The frozen section diagnose were made by the pathology department. The postoperative characteristics of the masses were also evaluated. The adnexal masses in postmenopausal woman with benign characteristics can be followed conservatively, without surgery. Surgery may be indicated to women with family history of cancer, a mass that appears enlarging and symptomatic.

Risk factors for persistent gestational trophoblastic neoplasia.

This retrospective study evaluated the risk factors for persistent gestational trophoblastic disease (GTN) and determined their odds ratios. This study included 100 cases with GTN admitted to our clinic. Possible risk factors recorded were age, gravidity, parity, size of the neoplasia, and beta-human chorionic gonadotropin levels (beta-hCG) before and after the procedure. Statistical analyses consisted of the independent sample t-test and logistic regression using the statistical package SPSS ver. 15.0 for Windows (SPSS, Chicago, IL, USA). Twenty of the cases had persistent GTN, and the differences between these and the others cases were evaluated. The size of the neoplasia and histopathological type of GTN had no statistical relationship with persistence, whereas age, gravidity, and beta-hCG levels were significant risk factors for persistent GTN (p < 0.05). The odds ratios (95% confidence interval (CI)) for age, gravidity, and pre- and post-evacuation beta-hCG levels determined using logistic regression were 4.678 (0.97-22.44), 7.315 (1.16-46.16), 2.637 (1.41-4.94), and 2.339 (1.52-3.60), respectively. Patient age, gravidity, and beta-hCG levels were risk factors for persistent GTN, whereas the size of the neoplasia and histopathological type of GTN were not significant risk factors.

Assessment of bleeding disorders in Sheehan's syndrome: are bleeding disorders the underlying cause of Sheehan's syndrome?

Sheehan's syndrome (SS) is an adenopituitary insufficiency caused by hypovolemia secondary to excessive blood loss during or after childbirth. However, the mechanism of postpartum hemorrhage and ischemia is not clear. We aimed to evaluate the bleeding disorders among patients with SS, in comparison with healthy controls. In addition, we investigated underlying causes in postpartum hemorrhage that begin the event. The present study was conducted at the Dicle University School of Medicine. Forty-eight patients with SS and 50 age-matched female healthy controls were included. Biochemical and hormonal variables were measured, as was platelet function by means of closure times (PFA-100 testing using collagen plus epinephrine and collagen plus ADP), von Willebrand factor (vWF) level, prothrombin time (PT), activated partial thromboplastin time (aPTT), international normalized ratio (INR), and coagulation factors. Although PT and INR were significantly higher in patients with SS (both P<0.01), aPTT and levels of fibrinogen, vWF, and factors II, V, VII, VIII, IX, X, XI, and XII did not differ significantly. Closure times with collagen/epinephrine and collagen/ADP also did not differ significantly between patients with SS and control patients. The nonspecific etiology and presence of excessive postpartum hemorrhage in patients with SS suggest that coagulation disorders may play a role in their predisposition to bleeding. The increased PT and INR noted might implicate bleeding diathesis as the underlying etiology, although no significant decreases were noted in factor levels. Further studies are needed to elucidate this complex mechanism of this disorder.

Risk factors for postmenopausal osteoporosis: anthropometric measurements, age, age at menopause and the time elapsed after menopause onset.

OBJECTIVES: The aim of this study was to determine, how much the anthropometric measurements and age affect the femur and vertebra T-scores by using correlation and regression analysis in postmenopausal women. METHODS: Data of 540 healthy postmenopausal women were included in this analysis. Bone mineral density was determined by dual energy X-ray absorptiometry (DXA). The data of the patients related to height, weight, age, age at menopause were obtained from records, and body mass index (BMI) was calculated (BMI = W (kg)/H(m(2))). Statistical analyses were performed with SPSS 15.0 for Windows (SPSS, Chicago, IL). RESULTS: Mean age and standard deviation of 540 postmenopausal women was 59.3 +/- 8.4 years. The correlation coefficients among femur, vertebra T-scores, weight, the time elapsed after the menopause onset, age, BMI and height were found as follows, from higher to lower values with 0.465, 0.453, 0.411, 0.382, 0.232, respectively, and were statistically significant (p < 0.001). CONCLUSIONS: We determined the effects of the anthropometric measurements on osteoporosis from higher to lower influence as follows: weight, menopause age, age, BMI and height. Weight and menopause age of the patients were the major determinants for osteoporosis.

Prenatal diagnosis of a fetus with androgen insensitivity syndrome (AIS).

OBJECTIVE: The aim of this study is to describe a fetus with androgen insensitivity syndrome diagnosed at mid-second trimester. CASE AND METHODS: Nuchal translucency was measured thick and double test was found higher. The patient referred to our center at 16(th) weeks of gestation. Fetal ultrasound examination and amniocentesis was performed. RESULTS: The nuchal translucency (NT) of fetus in present pregnancy was measured approximately 10 mm at 13 weeks and Down syndrome risk was calculated 1 in 10 by double test. On ultrasound examination; thick nuchal fold (NF) and short fetal limbs were found, and the fetus was seen a female and amniocentesis was performed. Three weeks later the fetal karyotype was reported normal as 46,XY. Thereupon the fetus reexamined for 2D and 4D ultrasound, and confirmed previous findings. The fetus was terminated at 19(th) weeks and seen a female phenotype. The fetal gonads removed in abdomen and testicles confirmed histopatologically. CONCLUSION: In generally, diagnosis of AIS is most made postnatally. This is the second case in English literature, which diagnosed mid-second trimester. In this situation, the fetus with thick NT/NF and short limbs may be AIS, therefore appearance of fetal sex on ultrasound should be compared with genetic sex.

The relationship between thrombophilic mutations and preeclampsia: a prospective case-control study.

BACKGROUND: Preeclampsia and its association with thrombophilia remain controversial, due to inconsistent results in different studies, which include different ethnic groups, selection criteria, and patient numbers. The aim of this study was to determine the relationship between thrombophilia and preeclamptic patients in our region. METHODS: In a prospective case-control study, we compared 100 consecutive women with preeclampsia and eclampsia (group 1) with 100 normal pregnant women (group 2). All women were tested two months after delivery for mutations of factor V Leiden, methylenetetrahydrofolate reductase (MTHFR), and prothrombin gene mutation as well as for deficiencies of protein C, protein S, and antithrombin III. RESULTS: A thrombophilic mutation was found in 42 (42%) and 28 (28%) women in group 1 and group 2, respectively (P=0.27, OR 1.5, 95%CI 1.0-2.2). The incidence of Factor V Leiden mutation (heterozygous), prothrombin mutation (heterozygous), prothrombin mutation (homozygous), MTHFR mutation (homozygous) was not statistically significant in group 1 compared with group 2 (P>0.05). Also, deficiencies of protein S, protein C, and antithrombin III were not statistically significant in group 1 compared with group 2 (P>0.05). CONCLUSION: There was no difference in thrombophilic mutations between preeclamptic patients and normal pregnant women in our region. Therefore, we suggest that preeclamptic patients should not be tested for thrombophilia.