The effect of body mass index value during labor on pregnancy outcomes in Turkish population (obesity and pregnancy outcomes).

PURPOSE: We investigated the relation between body mass index (BMI) value during labor and pregnancy outcomes in a group of Turkish population. METHODS: The data on 9,112 singleton pregnancies were reviewed retrospectively. Patients were classified into three groups according to their BMI values: normal (BMI 20-25 kg/m(2), n = 5,685, 62.4%), overweight (BMI 20-25 kg/m(2), n = 2,214, 24.3%) and obese (BMI >30 kg/m(2), n = 1,213, 33.3%). RESULTS: Gestational diabetes mellitus (P = 0.000), risk of delivering a baby >90th percentile (P = 0.000) and preeclampsia (P = 0.000) were increased in parallel with increased BMI. A statically significant difference was observed between the normal and obese groups in terms of the abdominal cesarean rates (P = 0.020). However, a significant difference was not observed in terms of preterm delivery (P = 0.846), birthweight <10th percentile (P = 0.484), placenta previa (P = 0.880), ablatio placenta (P = 0.499) and intrauterine death (P = 0.175) between the groups. CONCLUSIONS: Regardless of the gestation, BMI is a factor that affects the fetal and maternal outcomes. The obese and overweight women should be followed up carefully during the labor and delivery.

Residual and recurrent disease rates following LEEP treatment in high-grade cervical intraepithelial lesions.

INTRODUCTION: Loop electrosurgical excision procedure (LEEP) is a basic procedure in the conization performed on patients with CIN II/III. After excisional therapy, close follow up is essential for the earlier detection of residual and recurrent disease. The value of PAP-smear and HPV-DNA tests for investigation of residual and recurrent disease in patients diagnosed with high-grade intraepithelial lesion after LEEP treatment was purposed. MATERIALS AND METHODS: 42 patients were included in the study for whom epithelial cell anomalies were detected at PAP-smear screening. HPV-DNA test, colposcopy, cervical biopsy and endocervical curettage and then LEEP procedures were performed. The patients were followed with HPV DNA and PAP-smear tests in terms of recurrence and residual disease at 3-month intervals. RESULTS: HPV-DNA examination revealed that 36 patients (85.7%) were positive for high-risk HPV-DNA before treatment. Histopathological evaluation of LEEP materials revealed the presence of CIN I in 4 and CIN II/III in 38 patients. Surgical margin was positive in five patients. No sign of invasive cervical neoplasia was detected. The high-risk HPV DNA's persistence was observed in 11 (30.6%) of the 36 patients of whom HPV-DNA positivity had been detected before the treatment. HSIL was detected in four patients using PAP-smear on the third month examination. Positive LEEP surgical margins were found to be positively correlated both with HPV-DNA positivity detected during the follow-up examination and with the presence of residual disease in the follow-up PAP smear. CONCLUSION: LEEP is a basic procedure in the conization performed on patients with CIN II/III. In spite of high recurrence and residual disease rates, this kind of patients requires close monitoring. Follow-up with HPV and PAP-smear tests after LEEP treatment is of great importance in the detection of residual or recurrent disease.