Analyses of soluble endoglin and matrix metalloproteinase 14 using enzyme-linked immunosorbent assay in the diagnosis and assessment of severity of early- and late-onset pre-eclampsia

Objective: Abnormal trophoblastic invasion and impaired placentation have a crucial role in the etiopathogenesis of preeclampsia (PrE). Trophoblastic cells are involved in invading the maternal decidua and remodelling of the spiral arteries with matrix metalloproteinase-14 (MMP-14). MMP-14 cleavage of endoglin releases its extracellular region, the soluble form of endoglin (s-ENG), into the maternal circulation. In PrE, there is a relationship between endothelial dysfunction and s-ENG concentration. The aim was to determine and compare the serum levels of s-ENG and MMP-14 in different groups of PrE patients and healthy subjects. Material and Methods: The study included 30 patients with late-onset preeclampsia (L-PrE) (group 1; gestational age ≥34 weeks), 33 patients with normal pregnancy (group 2; gestational age ≥34 weeks), 31 patients early-onset preeclampsia (E-PrE) (group 3; gestational age <34 weeks), and 31 patients with normal pregnancy (group 4; gestational age <34 weeks). s-ENG and MMP-14 concentrations measured using enzyme-linked immunosorbent assays were compared. Results: In all groups, MMP-14 concentrations decreased with increasing gestational age. s-ENG concentrations were highest in the E-PrE group. In groups 1 and 3, 29 had mild PrE while 32 suffered severe PrE and s-ENG concentrations did not differ between mild and severe preeclampsia (p=0.133). However, there was a significant difference in MMP-14 concentration comparing mild with severe PrE (3.11±0.61 vs 3.54±1.00; p=0.047, respectively). There was no correlation between s-ENG and MMP-14 concentrations. Conclusion: MMP-14 and s-ENG concentrations can be predictive biomarkers for the diagnosis of PrE. Maternal serum MMP-14 concentration may be a biomarker for determining the severity of PrE.

Amniotic fluid concentrations of soluble endoglin and endothelial cell-specific molecule-1 in pregnancies complicated with neural tube defects.

Objective To determine the concentrations of soluble endoglin (sCD105) and endothelial cell-specific molecule-1 (ESM-1) in the amniotic fluid (AF) of pregnant women, and to investigate the relationship between these concentrations and neural tube defects (NTDs). Methods AF concentrations of sCD105 and ESM-1 were measured in the study group, which included 60 pregnant women complicated with NTDs, and 64 pregnant women with unaffected healthy fetuses (control group). The AF concentrations of sCD105 and ESM-1 in both groups were measured using enzyme-linked immunosorbent assay and compared. Results There were no significant differences in terms of the mean AF concentrations of sCD105 and ESM-1 between the groups (P=0.141, P=0.084, respectively). There was a significant difference between the AF sCD105 concentrations in those with gestational age <24 weeks (n=101) and ≥24 weeks (n=23) (X̅<24=76.35±126.62 vs. X≥24=39.87±58.32, P=0.041). AF ESM-1 concentrations were found to be statistically significant in the gestational age <22 weeks (n=90) and ≥22 weeks (n=34) groups (X̅<22=135.91±19.26 vs. X̅≥22=148.56±46.85, P=0.035). A positive and low-level relation at a statistically significant level was determined between the gestational age and AF ESM-1 concentration in the study group (r=0.257; P=0.048). Conclusion AF concentrations of sCD105 and ESM-1 were not associated with the development of NTDs. Unlike studies that reported that ESM-1 concentrations decreased in maternal plasma with increased gestational age, we determined an increase that was proportionate to gestational age in AF.

Amniotic fluid levels of selected trace elements and heavy metals in pregnancies complicated with neural tube defects.

The aims of this study were to determine the levels of trace elements and heavy metals, namely aluminum (Al), chromium (Cr), manganese (Mn), cobalt (Co), nickel (Ni), copper (Cu), zinc (Zn), arsenic (As), molybdenum (Mo), cadmium (Cd), tin (Sn), antimony (Sb), mercury (Hg), and lead (Pb), in the amniotic fluid of pregnant women, and to investigate their relationship with neural tube defects (NTDs). The study included 36 pregnant women whose fetuses were complicated with NTDs (study group) and 39 pregnant women with unaffected healthy fetuses (control group), who were matched for body mass index and gestational weeks. The amniotic fluid levels of trace elements and heavy metals were measured using inductively coupled plasma-mass spectrometry and compared between the two groups. Significantly lower mean levels of Zn and Mo and significantly higher levels of Al, Sn, Sb, and Hg in the study group than in the healthy control group were observed, which implied that these elements are possibly correlated with risk factors for the occurrence of NTDs. In contrast, there were no significant differences in the levels of Cr, Mn, Co, Ni, Cu, As, Cd, and Pb between the groups (P ≥ .05).

Fetal fibular hemimelia with focal femoral deficiency: A case report.

Fibular hemimelia (FH) is a congenital deficiency in which a part or all of the fibular bone is hypoplastic or aplastic and associated with hypoplastic tibia and foot anomalies. The main differential diagnoses include proximal focal femoral dysplasia, Femur-Fibula-Ulna syndrome, and Femoral Hypoplasia-Unusual Facies syndrome. Proximal focal femoral dysplasia, which has a short, angulated femur with normal mineralization may be associated with FH. We report a case of unilateral FH with focal femoral deficiency detected at 18 weeks of gestation during a routine ultrasonographic anatomic screening. Sonographic findings were a unilateral short femur (1.8 cm, 3 weeks shorter than expected for gestational weeks), agenesis of ipsilateral fibula and angulation of ipsilateral tibial shaft. During a routine ultrasonographic anatomic scan, all the long bones are carefully measured and evaluated. Long bone shortness can be a part of syndrome or an isolated finding.

Neural and cardiac injury markers in fetal growth restriction and their relation to perinatal outcomes.

OBJECTIVE: To compare the levels of umbilical cord blood Neuron-Specific Enolase (NSE) and troponin T and venous blood gas samples between healthy newborns and growth-retarded fetuses with impaired Doppler velocity or low APGAR scores. MATERIALS AND METHODS: This study was a prospective cohort study. The study group comprised 26 patients with intrauterine growth restriction and pathologic Doppler symptoms, and the control group included 24 healthy fetuses. Umbilical cord blood and blood gas samples were taken from all patients. The blood samples were centrifuged and sent to a laboratory to study NSE and troponin T Perinatal outcomes were evaluated from the medical records of the newborns. RESULTS: Both groups were similar in terms of demographic characteristics. Fetuses with fetal growth restriction (FGR) were born earlier and had lower APGAR scores than the study group. Chronic hypoxemic fetuses in the study group had lower cord pH and HCO3 levels. Further, troponin T levels were higher in the study group than in the control group. There were no major differences in Doppler velocity measurements. CONCLUSION: It has been understood that cardiac and neuronal injury detection on fetuses with FGR, troponin T, and NSE are indicators that can be used. In the literature there are studies with heterogeneous paradigms using different indicators to find neuronal injury. As a result of this study, it is clear that to assess neonatal prognosis, wider-scoped and comparative studies will provide more information about the subject.

Maternal serum endocan concentrations are elevated in patients with preterm premature rupture of membranes.

Objectives To evaluate the maternal serum endocan levels in pregnant women complicated by preterm premature rupture of membranes (PPROM) and to compare the results with healthy pregnancies. Methods This cohort study included 31 pregnant women with PPROM and 34 gestational age-matched healthy subjects in the third trimester of pregnancy. The blood for analysis was obtained on the day of diagnosis and serum endocan levels were measured using a commercially available enzyme-linked immunosorbent assay (ELISA) kit. The pregnant women were observed until the delivery and perinatal data were noted. Results No significant differences regarding maternal age, body mass index, gravidity, parity and gestational age at sampling were observed (P > 0.05). Mean serum endocan level was significantly higher in the PPROM group than in healthy controls (1490 ± 632 pg/mL vs. 972 ± 586 pg/mL, respectively; P: 0.001). Serum endocan concentration was positively correlated with C-reactive protein (CRP) (r = 0.754, P < 0.001) and white blood cells count (WBC) (r = 0.712, P:0.001). The receiver operating characteristic (ROC) curve analysis showed that endocan with a cut-off point of 1198 ng/dL indicated women with PPROM with sensitivity of 64.5% and specificity of 35.1% (area under curve 0.731, confidence interval 0.61-0.85). Conclusion Serum endocan level was significantly elevated in the PPROM patients than in healthy controls. The endocan level may be a useful indicator of endothelial dysfunction/inflammation in PPROM cases.

Concurrent Septal and Right Ventricular Aneurysms Detected on Second Trimester Ultrasound Scan: A Case Report.

Congenital aneurysms and diverticula of the heart are rare anomalies and their prenatal diagnosis is challenging. Fetuses with suspected cardiac aneurysms on ultrasound (US) screening should undergo targeted fetal echocardiography, postnatal imaging, and follow-ups. Herein, we describe the second trimester US scan and postnatal cardiac magnetic resonance imaging (MRI) findings of a baby girl with concurrent septal and right ventricular cardiac aneurysms. Other cardiac and extra-cardiac structures were normal. Upon consultation about the prognostic uncertainty of the situation, the family chose to continue the pregnancy. The rest of the pregnancy and birth was without any complications. Follow-up postnatal echocardiograms showed no progression regarding the size of the aneurysms. The baby is still on follow-up without any medication and is thriving. To the best of our knowledge, this case report is the first to show the prenatal diagnosis of two concurrent rare cardiac aneurysms.

Efficacy of second-trimester termination procedure; medical, mechanic, or combine?

OBJECTIVES: During mid-trimester, it is necessary to terminate pregnancy due to some fetal anomalies and intrauterine death. Therefore, in this study, we aimed to compare abortion induction methods and combined use retrospectively. METHODS: About 112 out of 223 pregnant patients were included in the study. The groups were determined as follows: Group 1 including pregnant patients who were administered misoprostol only (50 patients), Group 2 including pregnant patients who were administered single dose misoprostol (according to FIGO) and subsequently received cervical Foley catheter (30 patients), and Group 3 including pregnant patients who received Foley catheter only (32 patients). These three groups were compared in terms of effectiveness of the method, side effects, and complications as well as their characteristics. RESULTS: In terms of characteristic of the groups, the average age of the women in the Group 1 was significantly higher than other two groups (p < 0.001). In terms of effectiveness of the method, the termination period in Groups 1 and 2 was significantly lower than Group 3 (p < 0.001). However, in terms of complications, it was observed that uterine rupture was developed in Group 1. CONCLUSIONS: Although medical methods may seem to be more effective in the process of termination, mechanical methods seem more reliable in terms of reliability. Especially combined methods can be used to increase effectiveness and also to reduce complications.

Comparison of Melatonin Levels in the Colostrum between Vaginal Delivery and Cesarean Delivery.

OBJECTIVE: This study aims to compare melatonin levels in colostrum between vaginal and cesarean delivery. STUDY DESIGN: This cross-sectional study was conducted with 139 mothers who gave live births between February 2016 and December 2016. The mothers were divided into three groups according to the mode of delivery: 60 mothers (43.2%) in the vaginal delivery group, 47 mothers (33.8%) in the elective cesarean delivery, and 32 mothers (23.0%) in the emergency cesarean delivery group. Colostrum of the mothers was taken between 01:00 and 03:00 a.m. within 48 to 72 hours following the delivery, and the melatonin levels were measured using the enzyme-linked immunosorbent assay (ELISA) and compared between the groups. RESULTS: The melatonin levels in the colostrum were the highest in the vaginal delivery group, lower in the elective cesarean section group, and the lowest in the emergency cesarean group (265.7 ± 74.3, 204.9 ± 55.6, and 167.1 ± 48.1, respectively; p < 0.001). The melatonin levels in the colostrum did not differ according to the demographic characteristics of the mothers, gestational age, birth weight, newborn sex, the Appearance, Pulse, Grimace, Activity, and Respiration (APGAR) scores, and for the requirement for neonatal intensive care. CONCLUSION: Our study results showed that melatonin levels in the colostrum of the mothers who delivered vaginally were higher than those who delivered by cesarean section. Considering the known benefits of melatonin for the newborns, we believe that vaginal delivery poses an advantage.

ADAMTS 1, 4, 12, and 13 levels in maternal blood, cord blood, and placenta in preeclampsia.

The aim of this study is to compare ADAMTS (A Disintegrin and Metalloprotease Domains with Thrombospondins motifs) 1, 4, 12, and 13 levels in maternal and cord blood and placental tissue between preeclampsia and uncomplicated pregnancies. The enzyme-linked immunosorbent assay (ELISA) results showed that ADAMTS 1, 4, 12, and 13 levels in the maternal and cord blood were lower in the preeclampsia group than in the control group. Based on the immunohistochemistry (IHC) results, ADAMTS 1, 4, and 12 levels in placental tissues were higher in the preeclampsia group. According to the polymerase chain reaction (PCR) results, ADAMTS 1, 4, and 12 were higher, whereas ADAMTS 13 was lower in the preeclampsia group than in the control group.

Effects of obstetric gel on the process and duration of labour in pregnant women: Randomised controlled trial.

The present study investigated maternal and neonatal outcomes in pregnant women who used obstetric lubricant gels during active labour. This prospective randomised controlled study included 180 pregnant women. Women were randomly assigned to two groups during the first-stage of labour. Pregnant women in the obstetric gel group received standard antepartum care plus vaginal application of obstetric gel. Women in the control group received standard antepartum care without obstetric gel. Mean duration of the second stage of labour was significantly shorter in the obstetric gel group than control group (45 ± 34 min vs. 58 ± 31 min, respectively; p = .005). Mean APGAR values at 5 min were significantly higher in the obstetric gel group (9.5 ± 0.6 vs. 9.2 ± 0.7; p = .0014). Among nulliparous women, mean duration of the second stage of labour was significantly shorter in the gel group than control group (53 ± 52 min vs. 83 ± 45 min, respectively; p = .003). Using obstetric gel at the beginning of the first stage decreases the length of the second stage of labour, particularly in nulliparous women, and may be associated with an improved APGAR score at 5 min. Impact statement A limited number of studies in the literature have demonstrated that obstetric gels shorten the second stage of labour and are protective for the pelvic floor. The results of this study show that using obstetric gel shortens the second stage of labour in only nulliparous, but not multiparous women. In addition, a significant improvement in the 5 min APGAR score was seen in the neonates of women who used obstetric gel. The application of obstetric gels during the labour of nulliparous women may be a useful clinical practice and may have a widespread use in the future.

Lower serotonin level and higher rate of fibromyalgia syndrome with advancing pregnancy.

OBJECTIVE: The aim of the study is to investigate the relationship between changes in serotonin levels during pregnancy and fibromyalgia syndrome (FS) and the relationships between FS and the physical/psychological state, biochemical and hormonal parameters, which may be related to the musculoskeletal system. STUDY DESIGN: This study is a prospective case-control study conducted with 277 pregnant women at the obstetric unit of Ankara University Faculty of Medicine, in the period between January and June 2015. FS was determined based on the presence or absence of the 2010 ACR diagnostic criteria and all the volunteers were asked to answer the questionnaires as Fibromyalgia Impact Criteria (FIQ), Widespread Pain Index (WPI), Symptom Severity Scale (SS), Beck Depression Inventory and Visual Analog Scale (VAS). Biochemical and hormonal markers (glucose, TSH, T4, Ca (calcium), P (phosphate), PTH (parathyroid hormone) and serotonin levels) relating to muscle and bone metabolism were measured. RESULTS: In the presence of fibromyalgia, the physical and psychological parameters are negatively affected (p < 0.001). There was no significant difference between the fibromyalgia and control groups in terms of glucose, Ca (calcium), P (phosphorus), PTH (parathyroid hormone), TSH (thyroid stimulant hormone), fT4 (free T4) levels (p = 0.060, 0.799, 0.074, 0.104, 0.797, 0.929, respectively). A reduction in serotonin levels may contribute to the development of fibromyalgia but this was not statistically significant. The Beck Depression Inventory scale statistically showed that increasing scores also increase the risk of fibromyalgia (p <0.001). CONCLUSION: Our study has shown that serotonin levels in women with FS are lower than the control group and that serotonin levels reduce as pregnancy progresses. Anxiety and depression in pregnant women with FS are higher than the control group. The presence of depression increases the likelihood of developing FS at a statistically significant level. Serotonin impairment also increases the chance of developing FS, but this correlation has not been shown to be statistically significant.

Pessary use in pregnant women with short cervix.

The purpose of this case series is to provide preliminary evidence on the efficacy of pessary application in women with short cervix and at risk for preterm labor. Between May 2015 and July 2015, four pregnant women were followed-up with Arabin pessaries. The gestational age at the time of diagnosis was between the 23(th) and 29(th) weeks. Pessary application was associated with a prolongation of pregnancy lasting between 28 and 98 days. The gestational age at the time of delivery was between the 33rd and 39th weeks. Pessary use is non-invasive for the prolongation of pregnancy in pregnant women with shortened cervix. The major advantage of pessary use is its easy application without requiring anesthesia.

A prospective randomized trial comparing the use of tolterodine or weighted vaginal cones in women with overactive bladder syndrome.

OBJECTIVE: To compare the efficacy of pelvic floor muscle exercises (PFME) using weighted vaginal cones (WVC) on the symptoms, clinical findings, urodynamic findings and quality of life (QoL) in overactive bladder (OAB) patients with tolterodine. STUDY DESIGN: Thirty-nine patients with urinary frequency (≥ 8/day), nocturia (≥ 2/night), urgency and a total score of ≥ 8 to the overactive bladder-awareness tool (OAB-V8) were diagnosed as OAB and were randomized into two treatment groups; WVC and extended release tolterodine (tolterodine ER) 4 mg/day for 8 weeks. Results of the clinical findings, 3-day urinary diary, validated questionnaires for symptom bother and QoL (Urinary distress inventory (UDI-6), incontinence impact questionnaire (IIQ-7), OAB-V8, Wagner questionnaire) and urodynamic examination before and after treatment were compared. RESULTS: A reduction of frequency, nocturia and urinary incontinence was observed in WVC group (p=0.006, p=0.034 and p=0.008, respectively) and in tolterodine group (p<0.001, p=0.002 and p=0.035, respectively). 24-h dry pad test results were improved significantly in both groups (p=0.003 and p=0.001, respectively). Pelvic muscle strength was significantly improved in WVC group but not in tolterodine group (p=0.010 and p=0.180, respectively). UDI-6, IIQ-7, OAB-V8 scores were improved significantly in both groups. Improvements in Wagner questionnaire were observed in WVC group but not in tolterodine group (p=0.002 and p=0.591, respectively). First sensation of bladder filling was significantly improved after WVC treatment but not in tolterodine group (p=0.035 and p=0.550, respectively). After treatment, detrusor overactivity (DO) resolved in 8 patients in the WVC group (p=0.003) and in 2 patients in the tolterodine group (p=0.426). CONCLUSIONS: WVC treatment seems to be an efficacious therapeutic option for the improvement of overactive bladder syndrome (OABS).

Preterm premature rupture of membrane assessment via transperineal ultrasonography: a diagnostic accuracy study.

OBJECTIVE: The objective of this study is to evaluate diagnostic accuracy of transperineal ultrasound assessment compared to speculum examination by using placental alfa-microglobulin (PAMG)-1 tests as reference. METHODS: This was a prospective observational study conducted in Ankara University Hospital. Women with early and late preterm pregnancies with suspected rupture of membranes, i.e. women with a complaint of fluid leakage (105 in total) were enrolled. Prior to speculum examination, sagittal and transverse plane views of the fornices and cervix were obtained via transperineal ultrasonography and images were stored. Then the speculum examination for amniotic fluid pooling was performed. Definite diagnoses were made with PAGM-1 assays. After collection of the data, ultrasound images were analyzed by an observer blind to physical examination findings. Hypoechogenic fluid appearance around the cervix and in the fornices was considered positive for preterm premature rupture of membranes (PPROM). Results of physical and ultrasound examination were compared with PAMG-1 test as a reference method. The diagnostic performance of transperineal ultrasound was tested with accuracy parameters and receiver-operating characteristics (ROC) curves. Inter-rater reliability was analyzed with Cohen's kappa. RESULTS: In total, 103 pregnant women were evaluated. The prevalence of PPROM in our study population was 43.14%. At a 5 mm diagnostic threshold, the sensitivity and specificity values of transperineal assessment were 95.45% (95% CI: 84.50-99.31%) and 96.55% (95% CI: 88.07-99.48%), respectively, and they were comparable with speculum examination in a population of preterm pregnant women with suspected PPROM (p > 0.05). Interobserver reliability analysis with Cohen's kappa has shown good very good agreement with the kappa value of 0.93 (95% CI 0.87-1.00). CONCLUSIONS: Transperineal ultrasonography is a novel method that can be used to assess vaginal pooling of amniotic fluid. Ultrasonography offers similar sensitivity and specificity compared with speculum examination and it is non-invasive.

Association of first trimester serum uric acid levels gestational diabetes mellitus development.

OBJECTIVE: To investigate the association of first trimester serum uric acid levels with the development of gestational diabetes mellitus (GDM) in low-risk pregnant women. MATERIALS AND METHODS: In this retrospective data analysis, the results of pregnant women who completed both first trimester biochemical panel and two-step GDM screening were compared with an age-, body mass index, and gestational age-matched control group. The women were grouped as either GDM or impaired glucose tolerance (IGT) according to 100-g oral glucose challenge results. Uric acid levels were compared between the groups and diagnostic utility was tested with receiver-operating characteristics curves. RESULTS: Sixty-six women in GDM group and 358 women in the IGT group were compared against 202 healthy pregnant women. The groups did not differ significantly in terms of parity, pre-gestational body mass index and gestational age. Serum samples for uric acid levels were obtained. The mean serum uric acid levels were significantly higher in the GDM and IGT groups (5.95 mg/dL (±0.97 mg/dL) and 4.76 mg/dL (±1.51 mg/dL), respectively) compared with the control group (3.76 mg/dL (±1.07 mg/dL) (p<0.001). The area under the curve for uric acid levels was 0.92 (95% confidence interval 0.88-0.95) for diagnosis of GDM. At a diagnostic threshold of 3.95 mg/dL, uric acid levels predicted development of GDM with 60% specificity and 100% sensitivity. CONCLUSION: First trimester serum uric acid has a linear association with the development of GDM and IGT.

The views of nulliparous pregnant women on the types of delivery.

OBJECTIVE: To evaluate the relevant thoughts of nulliparous pregnant women in the second trimester without an absolute indication for cesarean on delivery preferences. MATERIALS AND METHODS: This study was conducted on pregnant women who presented to the Ankara University Faculty of Medicine, Department of Obstetrics and Gynecology Pregnant Outpatients Department for antenatal follow-up between May 2014 and February 2015. A total of 237 nulliparous patients voluntarily completed the survey form and the data were evaluated using various parameters. Parameters consistent with normal distribution were evaluated using the t-test, and parameters that were not normally distributed were evaluated using the Mann-Whitney U test. Parameters with a p value <0.05 were considered significant. RESULTS: We found that 221 (93.2%) of the 237 nulliparous pregnant women preferred vaginal delivery and the remaining 16 (6.8%) preferred delivery by cesarean section. CONCLUSION: Women should be informed on the type of birth and both methods should be explained in a realistic and scientific manner in terms of benefit and risk. An effort is being made to increase vaginal birth rates worldwide and the same effort should be made in Turkey.

Placental, hepatic, and supraclavicular lymph node metastasis in pancreatic adenocarcinoma during pregnancy: A case report.

The occurrence of coexisting cancer in pregnant women is not a common phenomenon. It complicates approximately 1 in 1000 to 1500 pregnancies. We present a multiparous woman aged 27 years in her 28th week of pregnancy who was admitted to our clinic with right upper quadrant pain and was finally revealed to have multiple metastatic pancreatic adenocarcinoma. To the best of our knowledge, this is the first documented case of pancreatic adenocarcinoma to metastasize both to the placenta and multiple maternal sites (liver, supraclavicular, para-aortic lymph nodes) in a pregnant patient. Unpredictable metastases to the placenta may be encountered and may even lead to definitive diagnosis, as in our case. Therefore, the placenta in any patient with known malignancy should be sent for pathologic evaluation.

Decreased mean platelet volume is associated with the developing stage of fetoplacental unit in spontaneous abortion.

AIM: The aim was to evaluate the place of mean platelet volume (MPV) in predicting spontaneous miscarriage and to identify any differences in its values following miscarriage after biochemical and clinical pregnancy. MATERIAL AND METHOD: We retrospectively evaluated the data of 305 spontaneous miscarriages and 168 control subjects. The miscarriage subjects were evaluated in two groups: miscarriage after biochemical pregnancy (n=79) (BA group) and miscarriage after clinical pregnancy (n=226) (CA group). Demographic and laboratory data of all subjects were statistically compared. RESULTS: No statistically significant difference was found between the miscarriage and control subjects in terms of demographic data and Hb, Htc, WBC, and Plt values. The mean platelet volume (MPV) value in the miscarriage group (8.99±1.47 fl) was statistically significantly lower than in the control group (9.66±1.64 fl) (P<0.001). A statistically significant difference was present between the BA, CA and control group, with the lowest MPV value in the BA group (8.64±1.34 fl, 9.11±1.49 fl, and 9.66±1.64 fl, respectively) (P<0.001). DISCUSSION: MPV was significantly lower in patients with miscarriage than the control group, and this was correlated with the gestational stage when the miscarriage occurred.

Effects of in utero cord blood collection on post-cesarean hemoglobin levels.

OBJECTIVE: To assess effects of in utero cord blood collection on postoperative hemoglobin, hematocrit levels. STUDY DESIGN: Elective cesarean deliveries in which cord blood was collected were compared with match paired elective cesarean deliveries without cord blood collection. Pre-post-operative hemoglobin and hematocrit level differences were compared between study groups with Student's t test. Multivariate regression models were used to address confounders. Correlation between volume of collected UCB and mean decrease in blood count parameters was analyzed. RESULTS: A total of 399 cesarean deliveries during a 12 months period were included in the analysis. Mean decrease in hemoglobin levels was 1.08g/dL (SD=1.0) in UCB collected group compared to 0.84g/dL (SD=1.0) in control group (p=0.002). Mean decrease in hematocrit levels was 3.1% (SD=3.4) in cord blood collected cesarean delivery group compared to 1.9% (SD=2.4) in control group (p=0.002). Univariate analysis has shown the collected UCB volume to be uncorrelated with the change in hemoglobin levels (r=0.013). Multivariate regression models, after adjusting for birth weight, age and number of prior cesarean, have shown the UCB collection to be significantly associated with the mean decrease in blood count parameters (estimate=0.23g/dL, t=-2.23, p=0.02). CONCLUSION: In utero UCB collection is associated with a small increase in bleeding of little clinical importance. Amount of UCB is not associated with amount of change in hemoglobin and hematocrit levels. In utero UCB collection seems to be safe for expectant mothers scheduled for low-risk cesarean delivery.