Early Prediction of Gestational Diabetes Mellitus Using Placental Strain Elastography and Subcutaneous Adipose Tissue Thickness.

AIM: The aim of this study is to investigate the efficacy of placental strain ratio values measured by real-time sonoelastography and maternal subcutaneous adipose tissue thickness measured by two-dimensional ultrasonography in predicting gestational diabetes mellitus in the first trimester. MATERIALS AND METHODS: The population of the study consisted of the first 210 consecutive singleton pregnant women who applied for routine first-trimester screening between the 11th and 14th week of gestation.B-mode subcutaneous adipose tissue thickness sonography and real-time placental strain elastography scanning were performed.All patients underwent 75 g oral glucose tolerance test between the 24th and 28th week of gestation. American Diabetes Association criteria were used in the diagnosis of gestational diabetes mellitus. RESULTS: It was observed that body mass index (p<0.001), first-trimester fasting blood sugar (p<0.001), subcutaneous adipose tissue thickness (p<0.001), and placental strain ratio value (p<0.001) affected the development of gestational diabetes mellitus statistically. The multivariate analysis shown that subcutaneous adipose tissue thickness (odds ratio=1.271, 95% CI=1.142-1.416, p<0.001) and placental strain ratio value (odds ratio=3.664, 95% CI=1.927-6.969, p<0.001) were the independent risk factors affecting the development of gestational diabetes mellitus. CONCLUSIONS: The findings of this study indicated a positive correlation between 75 g oral glucose tolerance test application and first trimester subcutaneous adipose tissue thickness and placental strain ratio. Using the cut-off values of>11.5 mm for subcutaneous adipose tissue and>0.986 for placental strain ratio, the development of gestational diabetes mellitus may be predicted in the early weeks of pregnancy.

Comparison of Uterine manipulators types in total Laparoscopic Hysterectomy: A retrospective study.

Objective: To compare the results of operations of commercial uterine manipulators. Considering that the optimal uterine manipulator is still not found, our goal was to give an idea for gynecologists to choose the most suitable uterine manipulator for their purposes and expectations. Methods: Between January 2016 and September 2021, 294 laparoscopic hysterectomy cases met the inclusion criteria and were operated in Izmir Katip Çelebi University Atatürk Training and Research Hospital Gynecology and Obstetrics Clinic. They were divided into four groups according to the type of manipulator used. Group-1 (RUMI-I), Group-2 (Clermont-Ferrand), Group-3 (sharp intrauterine curette-tenaculum), and Group-4(without uterine manipulator). All four groups were compared with operation time, hospital stay, absolute change in hemoglobin (g/dl), and per-op complications. Results: Considering the operation times in all groups, the mean operation time in the first Group-was 180 minutes (98-349); in Group-2 was 159 minutes (96-564); in the 3rd Group was 178 minutes (141-540); in the 4th Group was 189 minutes (115-453). The group with the shortest operation time was Group-2; the difference was statistically significant (p=0.015). In general terms, the effect of all manipulators on patient parameters wasn't very different. Clermont-Ferrand seems more advantageous than others in making the surgeon's work more straightforward regarding operation time only. Conclusions: In our study, the choice of uterine manipulator did not affect the surgical results except for the duration of the operation. The personalization of uterine manipulators according to the needs of the surgery and the easiness of use of the surgeon should be at the forefront.

Evaluation of the Ki-67 Proliferation Index and Urocortin Expression in Women with Ovarian Endometriomas.

OBJECTIVE: The reasons why endometriosis is more aggressive and invasive in some patients are unknown. Despite the importance of population-based clinically defined risk factors in the prediction of recurrence, biochemical markers obtained from the patient are more valuable for prediction on an individual basis. Therefore, the discovery of significant potential biomarkers could be useful to clinicians for shedding light on the pathogenesis of endometriosis and in the monitoring recurrence. MATERIALS AND METHODS: This study included 50 patients who underwent surgery for ovarian cysts that were diagnosed as endometrioma. The age of the patients, stage of the endometriosis, diameter and localization of endometriomas, type of surgery, and pre- and postoperative cancer antigen 125 (CA125) levels were compared between patients with and without recurrence. The archived pathology slides were stained with Ki-67 and anti-urocortin antibodies for reevaluation. By comparing the pathology parameters of the patients with and without recurrence, the association between these parameters and recurrence was investigated. RESULTS: The median Ki-67 proliferation index of the patients with recurrence (7.5±6.5) was statistically significant compared with that of the patients without recurrence (1±4) (p=0.003). The urocortin epithelial staining intensity and percentage were not found to be statistically significant in comparison. A statistically significant difference was determined between postoperative CA125 median levels of patients without recurrence (10±17.6) and those of patients with recurrence (29.9±18.1) (p=0.003). CONCLUSION: The Ki-67 proliferation index may be useful for predicting prognosis and recurrence risk.