First and second trimester biochemical markers in familial mediterranean fever.

OBJECTIVES: Our aim was to investigate whether the maternal serum concentrations of first and second trimester serum analytes are altered in familial Mediterranean fever (FMF) pregnancies. MATERIALS AND METHODS: The screening tests were compared in a series of 16 serum samples from FMF pregnancies and in a cohort of 48 pregnant women with normal pregnancy. Serum samples were obtained between 11 and 13 weeks; 16 and 18 weeks gestation. RESULTS: Serum pregnancy-associated plasma protein-A (PAPP-A) levels, expressed as multiples of the median (0.9 ± 0.45 MoM) in the control group, were significantly higher than FMF patients (0.6 ± 0.3 MoM) (p = 0.027). Analyses of alpha-fetoprotein, human chorionic gonadotropin and oestriol levels showed no significant differences between FMF and normal pregnancies. CONCLUSIONS: Our study revealed that low levels of PAPP-A are associated with FMF.

Clavicular fracture: its incidence and predisposing factors in term uncomplicated pregnancy.

BACKGROUND AND OBJECTIVES: Our aim was to evaluate fetal and maternal predisposing factors associated with clavicular fracture. PATIENTS AND METHODS: In this study we reviewed all term uncomplicated deliveries in our Hospital between January 2009 and April 2010. The diagnosis of clavicular fracture was established by physical examination and in clinically diagnosed patients confirmed by radiology. We compared deliveries with clavicular fracture (study group) with a sample of 150 patients (control group) matched for time at active phase of labor from all vaginal deliveries. The data included maternal age, gestational age, fetal weight, and infant sex, presence of gestational diabetes, labor duration and induction and shoulder dystocia. RESULTS: In the Unit 16819 deliveries occurred during the period. The study included 9700 uncomplicated pregnancies at > or = 37 weeks of gestation delivered vaginally. We identified 73 cases of clavicular fracture with an prevalence of (73/9700) 0.75%. The study group had a significantly higher prevalence of shoulder dystocia (6.8% vs. 0.6%). Logistic regression analysis revealed maternal age and fetal weight as significant risk factors influencing clavicular fractures. CONCLUSIONS: Main risk factors for clavicular fracture identified from our study seem as maternal age and birth weight.  

Effectiveness of emergency cervical cerclage in patients with cervical dilation in the second trimester.

OBJECTIVE: Efficacy of emergency cerclage commensed in the second trimester is a controversial issue. In this study, we aimed to assess the success and associated complications of emergency cerclage in patients with cervical dilatation in the second trimester. MATERIAL AND METHODS: In this retrospective study, medical records of 75 pregnant women who had clinically and ultrasonographically confirmed cervical dilatation in the second trimester who had undergone cervical cerclage were analyzed. Pregnancy prolongation was the main outcome measure. RESULTS: Seventy-five women were included to the study. Mean age was 27 and mean gravidity of the patients was three. Mean cervical length was 28.5 mm (12-41 mm). The rate of spontaneous abortion, immature deliveries, prematurity and deliveries after 34 weeks were 2.7% (n = 2), 8% (n = 6), 12 (n = 9) and 77.7 (n = 58), respectively. Fetal survival rate was 89.1% (n = 65). Serious vaginal bleeding from the suture area was noted in two patients (2.6%). No postoperative complications occurred. CONCLUSION: Emergency cerclage is a simple surgical procedure with lower complication rates and can effectively prolong gestation to viability. It can be considered as a useful measure for patients with evidence of cervical changes in the second trimester.