Does lymphadenectomy have influence on postoperative body fluid distribution?

OBJECTIVE: We compared the fluid volume parameters in women undergoing gynaecological surgery for benign and malignant conditions before and after surgery using bioelectrical impedance vectors. STUDY DESIGN: A total of 181 patients were enrolled. In all, 89 patients had surgery for benign conditions and 92 patients underwent oncological procedures, including lymph node dissection, for malignant diseases. Bioelectrical impedance analysis (BIA) parameters were measured on the day of hospitalisation before any treatment and at 24h and 1 month after the surgical intervention. The BIA parameters measured included extracellular water (ECW), intracellular water (ICW), and total body water (TBW). RESULTS: TBW increased significantly 1 month after surgery in all cases (p<0,05 in both group). ECW was significantly higher (p<0.05) and ICW was significantly lower (p<0,05) in the malignant group than the benign group. CONCLUSION: Radical gynaecological surgeries, including lymph node dissection, have a greater effect on body water distribution than surgeries performed for benign conditions.

Screening and genotyping of group B streptococcus in pregnant and non-pregnant women in Turkey.

INTRODUCTION: The purpose of this study was to investigate group B streptococcus (GBS) colonization, to compare the methods, to determine the relationship between GBS carriage and risk factors, and to genotype the GBS isolates. METHODOLOGY: Recto-vaginal swab specimens were obtained from 500 women, and a questionnaire was administered to each to assess their risk factors for GBS carriage. A culture, GBS antigen test, and polymerase chain reaction (PCR) were performed on all samples. Antibiotic susceptibility testing was performed, and the clonal relationship was determined by pulsed-field gel electrophoresis (PFGE) on all viable isolates. RESULTS: Of the 500 women, sixty-eight (13.6%) women were GBS carriers, of whom 9.8% were pregnant and 16.5% not. There was a significant difference between GBS carriage and history of premature rupture of membrane (PROM). GBS was isolated from 65 (13%) samples. GBS was positive in 70 (14%) samples by antigen test and in 62 (12.4%) by PCR. Sixty-eight of the 70 positive antigen tests were confirmed by PCR or culture. Fifty-five isolates were resistant to tetracycline, 16 to erythromycin and clindamycin, and 13 to levofloxacin. Thirteen different pulsotypes and 17 sporadic strains were determined by PFGE. CONCLUSIONS: GBS carriage rate in non-pregnant women was higher than in pregnant women. The GBS antigen test was more sensitive than culture and PCR. GBS isolates did not originate from a single clone and contained sporadic strains. There was a significant difference between GBS carriage and history of PROM. Epidemiologic data obtained in this study will help future studies.

Serum levels of neopterin in gestational diabetes mellitus: the relationship with Apgar scores.

PURPOSE: This study was designed to evaluate neopterin levels and low Apgar scores in pregnancies with gestational diabetes mellitus (GDM) vs. normal control pregnancies. METHODS: We carried out a cross-sectional study by enrolling 81 pregnant women with GDM and 38 pregnant women without GDM. RESULTS: Maternal and cord blood neopterin levels were higher in women with GDM. There was a significant positive association between fasting blood glucose levels and maternal serum neopterin levels. The results of 50-g oral glucose challenge tests revealed a correlation between maternal and cord neopterin levels. Pregnancies complicated by GDM exhibited lower fetal Apgar scores than those of control subjects. The levels of cord blood neopterin were inversely correlated with an fetal Apgar score of 1 min in patients with GDM. CONCLUSIONS: Patients with GDM had higher maternal and cord blood neopterin levels, and the cord blood neopterin levels are inversely associated with lower Apgar scores in women with GDM. The neopterin levels might be potential predictors of low fetal Apgar scores in women with GDM.

Predictive value of second and third trimester fetal renal artery Doppler indices in idiopathic oligohydramnios and polyhydramnios in low-risk pregnancies: a longitudinal study.

AIM: Intermittent assessment of renal artery flow velocity waveforms during the early stages of pregnancy may help in predicting changes in amniotic fluid dynamics. The current study sought to determine the relation of renal artery and umbilical artery flow velocity waveforms with normal pregnancies and pregnancies complicated by either polyhydramnios or oligohydramnios. MATERIAL AND METHODS: Renal and umbilical artery Doppler values were evaluated at 22, 28 and 34 weeks' gestation in 300 low-risk pregnant women with singleton pregnancies. Pulsatility index (PI) and resistance index (RI) were recorded and the amniotic fluid volume was evaluated. Three groups were formed according to the amniotic fluid volume at birth. Group I consisted of 264 pregnant women with normal amniotic fluid, group II included 30 pregnant women with oligohydramnios and group III included six pregnant women with polyhydramnios. Doppler parameters were compared between the groups and within each group according to gestational age. RESULTS: Renal artery PI values were higher in group II than group I at 22 weeks, 28 weeks and 34 weeks. The PI value at 28 weeks' gestation was statistically significant (P = 0.011). At 28 weeks' gestation, group II also had higher umbilical artery PI and RI values than group I. CONCLUSION: An increase in renal artery PI develops in early pregnancy before the development of oligohydramnios. In pregnancies developing polyhydramnios, renal artery PI was lower; however, our study included a small number of women with polyhydramnios.