Cesarean section: requested mode of delivery?.

AIM: To constitute accurate policies for reducing the cesarean section (C/S) the authors evaluated the attitudes and knowledge of health workers and public population towards the mode of delivery, C/S on demand, and delivery complications in a large population. MATERIALS AND METHODS: 1,892 female volunteers in reproductive age were enrolled in the study and 589 of them were health workers. Patients were evaluated with questionnaire about their delivery mode and their answers were analyzed. RESULTS: The overall cesarean rate of the study population was 45.4%. This rate were 51.4% and 28.2%, respectively, for the health workers and public group (p < 0.001). Medical indication ratio ivere 57.7% and 40.1% for the healthcare group and the public population respectively and 20.2% of health workers and 13.9% of the public group had C/S by their preference without any medical indications (p < 0.001). CONCLUSION: C/S rate is high in Turkey and an action plan is needed to decrease the rate. When a patient's preference towards the mode of the delivery is C/S on demand, obstetricians, in their capacity as patient advocate, should help guide their patient through the sophisticated detailed medical information toward a decision that respects both the patient's attitude and the physician's obligation to optimize the health of both the mother and the newborn.

Fertility characteristics and family planning methods used by women delivering at a University Hospital in Eastern Turkey.

The aim of this study was to assess the fertility characteristics and family planning methods in the city of Elazig, Turkey. This cross-sectional descriptive study included all the women who had delivered babies at the Elazig Firat Medical Center Obstetrics and Gynecology Clinic. Across the entire group, the mean number of pregnancies was found to be 2.98 ± 1.89. Among the family planning methods used, the first choice of most women was the condom, which ranked first with 32.2%; the oral contraceptive ranked second with 15.1%. The question, 'Have you ever used any contraceptive methods?' was asked and 55.4% answered 'yes'. The most common method was condom use. The most common method of contraception used by married women for the first time was the condom, and the most common method used during marriage was, again, the condom.

Effects of raloxifene and estradiol on bone turnover parameters in intact and ovariectomized rats.

This study was designed to investigate effects of raloxifene (RLX) and estradiol on bone formation and resorption in intact and ovariectomized (ovx) rat models. In the intact model, a total of 24 adult female rats were divided into three groups: Controls subcutaneously received saline alone. RLX (2 mg/kg) and estradiol (30 microg/kg) were injected to two groups of animals for a period of 6 weeks at two daily intervals. In the second model, rats (n = 24) were ovx and allowed to recover for a period of at least 3 weeks. Control group received vehicle alone. Remaining rats were divided into two groups and injected with RLX (2 mg/kg) and estradiol (30 microg/kg) for 6 weeks. Urine samples were collected from all animals 24 h after the last drug administration. Urinary deoxypyridinoline (DPD) was measured by ELISA. Serum parathyroid hormone (PTH), calcitonin, and osteocalcin levels were measured by immunoradiometric method. Serum concentrations of alkaline phosphatase (ALP), Ca, and inorganic phosphate were determined by enzymatic-colorimetric method. Lumbar vertebrae (L2) of all animals were dissected out and processed for histopathological evaluation. Removal of ovaries significantly elevated urinary DPD levels (p < 0.01) compared with intact controls. Treatment of both intact and ovx rats with estradiol resulted in significant decreases (p < 0.01) in DPD values. RLX administration had no significant effect in the intact rats, but it remarkably reduced bone turnover in the ovx animals (p < 0.001). Both estradiol and RLX produced conflicting effects on serum ALP, osteocalcin, and PTH levels in both animal models. These findings suggest that RLX exerts its protective effects by reducing bone resorption, similar to that of estradiol, in ovx rats.

Effects of raloxifene and estradiol on bone turnover parameters in intact and ovariectomized rats

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This study was designed to investigate effects of raloxifene (RLX) and estradiol on bone formationand resorption in intact and ovariectomized (ovx) rat models. In the intact model, a total of 24 adult female rats were divided into three groups: Controls subcutaneously received saline alone. RLX (2 mg/kg) and estradiol (30 μg/kg) were injected to two groups of animals for a period of 6 weeks at two daily intervals. In the second model, rats (n = 24) were ovx and allowed to recover for a period of at least 3 weeks. Control group received vehicle alone. Remaining rats were divided into two groups and injected with RLX (2 mg/kg) and estradiol (30 µg/kg) for 6 weeks. Urine samples were collected from all animals 24 h after the last drug administration. Urinary deoxypyridinoline (DPD) was measured by ELISA. Serum parathyroid hormone (PTH), calcitonin, and osteocalcin levels were measured by immunoradiometric method. Serum concentrations of alkaline phosphatase (ALP), Ca, and inorganic phosphate were determined by enzymatic–colorimetric method. Lumbar vertebrae (L2) of all animals were dissected out and processed for histopathological evaluation. Removal of ovaries significantly elevated urinary DPD levels (p < 0.01) compared with intact controls. Treatment of both intact and ovx rats with estradiol resulted in significant decreases (p < 0.01) in DPD values. RLX administration had no significant effect in the intact rats, but it remarkably reduced bone turnover in the ovx animals (p < 0.001). Both estradiol and RLX produced conflicting effects on serum ALP, osteocalcin, and PTH levels in both animal models. These findings suggest that RLX exerts its protective effects by reducing bone resorption, similar to that of estradiol, in ovx rats (AU)

Use of GnRH antagonists in ovarian remnant syndrome experimentally induced in rats.

PURPOSE: The objective of this study was to demonstrate the efficacy of cetrorelix, a GnRH antagonist, in rats with experimentally induced ovarian remnant syndrome. METHODS: 25 Wistar female rats at seven to eight weeks of age and weighing 200-250 g were used. The rats were randomly divided into five groups: the first group was used as a control group; the second and third groups underwent a sham operation; and the fourth and fifth groups underwent bilateral hemiovariectomy. At the first proestrus detected by vaginal cytology from postoperative day 2, the animals in groups 1, 2 and 5 received placebo and the animals in groups 3 and 4 received cetrorelix subcutaneously. In the study, the Kruskal-Wallis analysis of variance was used for comparison of the results of vaginal irrigation, histopathblogical examination, and of blood FSH and LH values, and the Mann Whitney U-test was used for determination of the differences between the groups. RESULTS: It was determined that according to vaginal cytology results, estrus-like cytological changes disappeared in a shorter time and according to histopathology results, the number of follicles were fewer in the ovarian remnant syndrome-induced and cetrorelix-injected group 4 (p < 0.05), but there was no difference between the groups for FSH and LH concentrations. CONCLUSIONS: Ovarian remnant syndrome is a complication of bilateral ovariohysterectomy. In cases with this syndrome, certain treatment is possible with re-operation. However, it may not always be possible to perform an operation, or even if operated, it is difficult to determine the place of the residual ovarian tissue. In this study, it was determined that the use of cetrorelix as a GnRH antagonist in rats with ovarian remnant syndrome reduced the duration of estrogenic affect.

Serum leptin and ghrelin concentrations of maternal serum, arterial and venous cord blood in healthy and preeclamptic pregnant women.

Preeclampsia, a common complication of pregnancy, is associated with alteration in the concentration of leptin in maternal blood. The action of leptin is antagonistic to that of ghrelin. Here, we compared the levels of leptin and ghrelin in maternal serum and in arterial and venous cord blood between healthy pregnant women and those suffering from mild and severe preeclampsia. The levels of leptin in maternal and newborn's blood were elevated in both mild and severe preeclamptic patients (p < 0.05). Moreover, serum ghrelin levels were negatively correlated with blood pressure and leptin/ghrelin ratio was decreased in preeclampsia (p < 0.05). We concluded that increased production of ghrelin may represent a compensatory hypotensive mechanism in preeclamptic women.

Serum leptin and ghrelin concentrations of maternal serum, arterial and venous cord blood in healthy and preeclamptic pregnant women

Preeclampsia, a common complication of pregnancy, is associated with alterationin the concentration of leptin in maternal blood. The action of leptin is antagonisticto that of ghrelin. Here, we compared the levels of leptin and ghrelin in maternalserum and in arterial and venous cord blood between healthy pregnant women andthose suffering from mild and severe preeclampsia. The levels of leptin in maternaland newborn’s blood were elevated in both mild and severe preeclamptic patients(p<0.05). Moreover, serum ghrelin levels were negatively correlated with blood pressureand leptin/ghrelin ratio was decreased in preeclampsia (p<0.05). We concludedthat increased production of ghrelin may represent a compensatory hypotensivemechanism in preeclamptic women (AU)

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Does the copper intrauterine device affect serum cancer antigen 125 levels?

PURPOSE: This study aimed to reveal the effect of the copper IUD, if any, on serum CA-125 levels in patients who use the device as a contraceptive. METHODS: Blood samples were obtained two times from 20 healthy volunteers before and after IUD insertion, and sera were isolated. The sera, centrifuged at 2000 G and kept at -70 degrees C in a deep freezer until analyzed, were processed for CA-125 levels by the CA-125 kit using VIDAS PC analyzer (Biomerieux, France) and results were compared. RESULTS: The CA-125 level of the serum obtained from the first blood samples was significantly higher than that of the second sample (24.63 +/- 25.40 mIU/ml and 14.44 +/- 10.08 mIU/ml, respectively) (p < 0.05). CONCLUSION: The results of this study indicate that the serum level of CA-125 may be lower in patients using copper IUDs which may be helpful in evaluation of ovarian masses in women in reproductive age.

Differential regulation of preovulatory luteinizing hormone and follicle-stimulating hormone release by opioids in the proestrous rat.

We have investigated the role of mu- and kappa-opioid receptors in the central control of preovulatory LH and FSH release in the proestrous rat. Animals were anesthetized with chloral hydrate at 14:00 h on proestrus day. Following femoral artery cannulation, they were mounted in a stereotaxic apparatus. Morphine and U-50488H (benzene-acetamide methane sulphonate) were infused intracerebroventricularly either alone or in combination with naloxone and MR1452, respectively. Controls received sterile saline alone. Blood samples were obtained at hourly intervals between 15:00 h and 17:00 h. Plasma LH and FSH levels were measured by radioimmunoassay. Morphine did not significantly change plasma LH levels at 15:00 h and 16:00 h sampling intervals. A significant increase was observed at 17:00 h compared to the controls (p<0.05). U-50488H significantly increased LH levels at 16:00 h and 17:00 h (p<0.05). The co-administration of naloxone and MR1452 with mu- and kappa-agonist had no significant effect on LH levels at any sampling interval. In all groups, LH levels showed a linear rise over the sampling period between 15:00 h and 17:00 h. None of the treatments significantly altered plasma FSH levels which however, declined towards the end of the afternoon surge. In conclusion, we suggest that the secretion of LH and FSH is differentially regulated by mu- and kappa-opioid receptors. It is thought that in all groups chloral hydrate interfered with the LH surge secretory systems.

Blood plasma levels of lipoperoxides, glutathione peroxidase, beta carotene, vitamin A and E in women with habitual abortion.

The plasma levels of lipoperoxides, glutathione peroxidase (GSH-Px), reduced glutathione (GSH), beta carotene, vitamin A, E, some plasma biochemical and blood haematological parameters were investigated in 40 women with habitual abortion (HA) and controls. The levels of GSH, vitamin A, E and beta carotene were significantly lower in women with HA than in controls. However, the plasma levels of lipid peroxidation, alkaline phosphatase (ALP), glucose and blood haemoglobin were significantly higher in HA than in controls. In addition, plasma levels of GSH-Px, AST, ALT, total bilirubin, total protein, albumin, sodium, potassium, calcium and number of white blood cells, red blood cells, platelet and values of packet cell volume showed no significant differences between HA and controls. According to the results of this study, we observed that the levels of lipid peroxidation were increased and plasma levels of vitamin A, E and beta carotene were decreased in HA. The decrease of those antioxidants may play a significant role in women with habitual abortion.