An analytical cross-sectional study: determining gestational age using fetal clavicle length during the second trimester.

PURPOSE: To investigate the correlation between fetal clavicle length and gestational age in pregnant patients from 14 and 27 weeks of gestation. METHODS: This was a retrospective cross-sectional study of patients from 14 and 27 weeks of gestation. Ultrasonographic measurements such as abdominal circumference (AC), femur length (FL), humerus length (HL), clavicle length (CL), head circumference (HC), biparietal diameter (BPD), estimated fetal weight (EFW), and transverse cerebellum diameter (TCD) were made and compared. RESULTS: A total of 552 patients were evaluated in our clinic and CL was measured properly and successfully in all fetuses. Fetal AC, FL, HL, CL, BPD, HC, EFW and TCD measurements were significantly and strongly correlated with gestational week, and Pearson's correlation values were 0.964, 0.965, 0.959, 0.965, 0.951, 0.917, 0.925, and 0.954, respectively (p < 0.001). In the regression analysis equation, gestational week = 0.894 + CL × 0.961. CONCLUSION: There was a significant positive correlation between fetal CL (mm) and gestational week. We suggest that the 1 mm = 1 week rule can be used for patients with anomalies of the cerebellum and vermis, as well as for patients with unknown last menstrual period.

Could serum ß-hCG levels and gestational age be the indicative factors for the prediction of the degree of trophoblastic invasion into tubal wall in unruptured ampullary pregnancies?

OBJECTIVE: To evaluate the predictive value of gestational age and maternal serum ß-hCG concentration for the determination of the depth of trophoblastic invasion into the tubal wall. METHODS: This is a retrospective trial conducted on women with a diagnosis of ampullary pregnancy (71) who were submitted to salpingectomy. Serum ß-hCG measurements were obtained at the initial admission of hospital. Histological investigation was performed by a single well-experienced pathologist who was blind to the clinical and laboratory characteristics of the patients. Ampullary pregnancy was classified histologically according to the depth of trophoblastic infiltration into tubal wall: trophoblast limited to the tubal mucosa (stage I), extended to muscularis layer (stage II) and complete tubal wall infiltration up to serosal layer (stage III). RESULTS: There was a significant difference in maternal serum ß-hCG concentrations regarding the histological stages of trophoblastic invasion. The serum ß-hCG concentrations that the best predicted for stage III trophoblastic invasion was 6,475 mIU/ml, with a sensitivity of 100 %, a specificity of 92 %. CONCLUSION: The depth of trophoblastic tissue infiltration into tubal wall is correlated with serum ß-hCG levels, but not with gestational age. These findings may explain the reason for conservative management failure of EP in women with high ß-hCG concentrations.

Late recurrence of aggressive angiomyxoma of the vulva.

OBJECTIVE: Aggressive angiomyxoma (AA) is found mainly in the pelvis and perineum, with a female-to-male ratio of approximately 6:1. Although it is a slow growing tumor, AA has a marked tendency to local recurrence with a low metastasis capacity. The study aimed to describe a case of vulvar angiomyxoma recurred almost 20 years after its initial surgery. MATERIALS AND METHODS: We report the case of a 57-year-old gravida 5 para 4 woman with vulvar AA arising from the left labium majus, which recurred 20 years after initial surgery. There was a nontender, solid, mobile mass on the left vulva, which was 25 x 30 cm on physical examination. A pelvic computed tomographic scan showed a mass measuring 26 x 10 x 14 cm originating from left vulvar region, which has a fatty tissue density. RESULT: Under general anesthesia, total excision of the tumor was performed. Macroscopically, the tumor weighed 723 g and measured 33 x 20 x 10 cm. The histopathological examination of the specimen revealed a myxoid tumor with sparse infiltrates of spindle-shaped to stellate cells and vessels of varying sizes. The final histopathological diagnosis was AA. CONCLUSIONS: Aggressive angiomyxoma may form extremely large tumors, and recurrence is not rare even many years after primary surgery.

Family planning choices in couples using contraception without knowing they are infertile: should newly-wed men undergo a routine spermiogram?

INTRODUCTION: Newly-weds choose to use contraception either to spend the first years of their marriage more freely, because of economic reasons or because of the increase in working career women. We studied the reasons for infertility and the rate of contraception use in the first years of marriage among couples with primary infertility and evaluated the use of a spermiogram as a screening test in newly-wed men. SUBJECTS AND METHODS: In this cross-sectional study, 302 couples with primary infertility who were treated at our infertility clinic were included in the study. The couples were divided into 2 groups: group 1 (infertile couples who have used contraception) consisted of 67 couples and group 2 (infertile couples who did not use contraception) consisted of 235 couples. RESULTS: Sixty-seven (22.5%) infertile couples stated that they had used no contraception in the first years of their marriage. In group 1, 35.8% of couples were diagnosed as having unexplained infertility, while 28.4% of them had male factor, 31.3% female factor and 4.5% a combination of male and female factor infertility. Sixteen men with male factor infertility used coitus interruptus (3-36 months) or condoms (6-12 months) unnecessarily. CONCLUSIONS: Infertility counseling in the early days of marriage and a spermiogram performed at that time could be beneficial for the newly-wed couples even if they do not want a child at the time. To perform a spermiogram as a screening test in all newly-wed men should be discussed.

Turkish obstetricians' personal preference for mode of delivery and attitude toward cesarean delivery on maternal request.

OBJECTIVE(S): (1) To investigate the cesarean rate among actively practicing obstetricians in Turkey and reasons why they choose this mode of delivery for themselves/partners. (2) To investigate the attitudes, practices, and beliefs with respect to cesarean delivery on maternal request (CDMR) among actively practicing obstetricians in Turkey. STUDY DESIGN: This is a descriptive study performed at 7th Congress Of Turkish Society Of Gynecology and Obstetrics. A self-administered questionnaire was used for data collection. During the congress, from the obstetricians attending the congress, 500 were randomly selected; due to the room numbers, the questionnaires (total, 500) and the consent forms were distributed every fourth room. The sampled obstetricians were instructed to return the completed questionnaires and signed consent forms to the congress information desk located throughout the congress. In total, 387 (77.4%) obstetricians responded. RESULTS: Of the respondents (if female) or their partners (if male), 239 (61.8%) respondents had undergone at least one previous cesarean section (CS), and, of these, 212 (88.7%) were primary elective cesarean deliveries. The most common reason influencing the decision of obstetricians in choosing CS for themselves/partners was reduced anorectal trauma (63.6%). In addition, 158 (40.8%) of the respondents believe that every woman has the right to request a cesarean as a mode of delivery. About half of the respondents (53.2%) said that they would perform a patient-requested CS. The most common reason why obstetricians perform CS due to maternal request was 'anxiety of patient and her partner and due to their insistence'. CONCLUSIONS: Two-thirds of Turkish obstetricians prefer CS as mode of delivery for themselves/partners. Also half of the obstetricians in our study believe that a woman has the right to request and obtain CDMR, and half of them would agree to perform one.

Unilateral tubal twin ectopic pregnancy treated with single-dose methotrexate.

BACKGROUND: Spontaneous tubal twin pregnancy is a rare condition with an incidence of 1 in every 125,000 pregnancies. We present the case of a unilateral tubal twin ectopic pregnancy treated with single-dose methotrexate. CASE: A 26-year-old nulliparous woman was admitted to our clinic with a complaint of vaginal bleeding and leftside pelvic pain. Her serum ß-human chorionic gonadotropin (ß-hCG) level was 18,780 mIU/mL and ultrasound revealed tubal twin pregnancy of 7 weeks' gestation. Because her vital signs were stable and no sign of tubal rupture was present, we performed single-dose (100 mg) methotrexate intramuscularly. In the follow-up, serum ß-hCG levels were found to be 7,600 mIU/ml on day 7, 948 mIU/ml on day 20, 126 mIU/ml on day 26 and <10 mIU/ml on day 42. CONCLUSION: Methotrexate theraphy may be preferred in tubal twin ectopic pregnancies when the vital signs of the patient are stable and the fetal cardiac activities are negative.

Effects of lumbar lordosis and pelvic inlet orientation on the outcome of the transobturator tape sling operation in women.

PURPOSE: To determine the association between changes in lumbar lordosis (LL) and/or pelvic inlet (PI) orientation and the outcome of a transobturator tape (TOT) sling procedure. METHODS: The study population consisted of 70 patients who underwent the TOT sling procedure for stress urinary incontinence, and were evaluated by a stress test at the sixth month after the surgery. The women were defined as continent on the absence of both subjective complaint of leakage and objective leakage as a result of the test. Cases that failed, even though improvement may have been observed, were considered incontinent. With the use of a standardized protocol, lateral lumbosacral spine/pelvic X-rays were taken with the participants standing in their usual upright posture with hands kept at chest level. From these X-rays, the angle of LL and PI were measured. RESULTS: Of the 70 cases, 42 were continent and 28 were incontinent according to the evaluation done during the sixth month after the TOT procedure. There were no significant differences with respect to age, body mass index, gravidity, vaginal parity, pelvic organ prolapse and comorbid diseases between the continent and incontinent groups. The mean angle of PI in the continent group (34°, range 20-50) was significantly lower than in the incontinent group (37°, range 28-60) (p = 0.012). There was no significant difference in the median angle of LL (32°, range 15-50 in continent group, 34.5°, range 21-56 in incontinent group, p = 0.13) between the two groups. CONCLUSIONS: Women with continence after the TOT sling procedure have lower angle of PI than women with incontinence.

The evaluation of Nesfatin-1 levels in patients with and without intrauterine growth restriction.

OBJECTIVE: To evaluate Nesfatin-1 levels in patients with and without intrauterine growth restriction and to analyze the correlation between Nesfatin-1 levels and fetal birth weights. METHODS: This study comprised a total of 81 cases; 41 patients with IUGR and 40 healthy cases. Demographic data, pregnancy weeks, fetal birth weights and Nesfatin-1 levels were all recorded. The Nesfatin-1 levels were compared between the groups and the correlation between fetal birth weights and Nesfatin-1 levels was analyzed. RESULTS: No statistical significant difference was determined between the groups in terms of demographic data (p > 0.05). Average birth weights were determined as 3420 ± 259 g in the control group and 2041 ± 350 g in the IUGR group, which was found to be statistically unequal (p = 0.001). The average Nesfatin levels in the control group were 0.069 ± 0.011 and 0.094 ± 0.042 in the IUGR group. This difference was statistically unequal (p = 0.001). While no correlation was determined between Nesfatin levels and fetal birthweights in the control group (r = -0.034 versus p = 0.836), in the IUGR group and when all the cases were evaluated together, a statistically moderately significant negative correlation was determined (r = -0.469, p = 0.002 and r = -0.251, p = 0.024, respectively). CONCLUSIONS: Although intrauterine growth is a multifactorial process, the effect mechanism has not yet been established. The results of this study offer some indications about the possible effect of Nesfatin 1 on fetal growth.

The effect of intraspinal bupivacaine versus levobupivacaine on the QTc intervals during caesarean section: a randomized, double-blind, prospective study.

The aim of this study was to describe whether or not spinal anaesthesia with bupivacaine versus levobupivacaine has any effects on the QTc interval during caesarean section. Sixty healthy pregnant women scheduled for elective caesarean section were randomized to spinal anaesthesia with either bupivacaine (the bupivacaine group) or levobupivacaine (the levobupivacaine group). ECG recordings were performed prior to spinal anaesthesia at baseline (T1), 5 min. after spinal anaesthesia, but before uterine incision (T2), and after skin closure (T3). QT intervals were calculated and corrected with the patients' heart rate according to the Bazett formula. Compared with baseline values, mean maximum QTc intervals at T2 and T3 were significantly longer in the levobupivacaine group, but only at T2 in the bupivacaine group. In addition, compared with the bupivacaine group, the QTc maximum interval at T3 was significantly longer in the levobupivacaine group. At T2, the QTc maximum intervals were longer than baseline in both groups. By the end of the surgery, the prolongation of the QTc interval had disappeared in the bupivacaine group but not in the levobupivacaine group.

A randomized pilot study of acupuncture treatment for primary dysmenorrhea.

OBJECTIVE: To compare the therapeutic effect of acupuncture and non-steroidal anti-inflammatory drug (NSAID) therapy in primary dysmenorrhea patients. STUDY DESIGN: Thirty-five young women with a diagnosis of primary dysmenorrhea were recruited for the study. Their dysmenorrhea severity was rated by visual analog scale (VAS) immediately prior to entry into the study. They were randomly divided into two groups; and the following month they were given NSAID (group 1, n=24) or acupuncture treatment (group 2, n=11). Pain was rated again using VAS during menstruation in both groups. RESULTS: After one month's treatment, pain scores were significantly lower in both groups (p<0.05). Mean pain scores decreased by 52.2% and 69.5% in the NSAID and acupuncture groups, respectively. CONCLUSION: Acupuncture was as effective as NSAID therapy for patients with primary dysmenorrhea. Since this was a pilot study with a small sample size and short follow-up period, larger studies are needed to clarify the effect of acupuncture in the treatment of primary dysmenorrhea.

Plasma selenium levels in Turkish women with polycystic ovary syndrome.

OBJECTIVE(S): To evaluate selenium (Se) levels in serum and their relation with hyperandrogenism and insulin resistance (IR) in women with polycystic ovary syndrome (PCOS) and in control subjects. STUDY DESIGN: Women with any gynecological problem who presented to the Kahramanmaras Sutcuimam University Medical Faculty Gynecology and Obstetric Outpatient Clinic were invited to participate. Group 1 consisted of 36 cases with a diagnosis of PCOS according to the 2003 Rotterdam Consensus Criteria, and Group 2 (control group) consisted of 33 age- and BMI-matched healthy women. In all cases, serum total testosterone (tT), dihydroepiandrostenedione-sulfate (DHEAS), follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), insulin, glucose (mg/dL), total cholesterol (TC) (mg/dL), high density lipoprotein-cholesterol (HDL-C) (mg/dL), low density lipoprotein-cholesterol (LDL-C) (mg/dL), triglyceride (TG) (mg/dL) and Se levels were measured. RESULTS: The level of FSH was significantly lower, and the levels of LH, E2, tT, and DHEAS were significantly higher in group 1 than in group 2 (p<0.05). The hirsutism score was significantly higher among PCOS women compared to the control group (p<0.05). Although insulin levels and HOMA-IR were markedly increased in the PCOS group compared to the control group, the differences were not significant (p>0.05). The plasma Se level was significantly lower in PCOS women compared to the control group (p<0.05). When we combined the all women in two groups, regarding them as one group (combined group, n=69), a negative correlation between Se and LH and tT was present (p<0.05). CONCLUSION(S): Our results show decreased plasma concentrations of Se and a negative correlation between Se and LH, tT in women with PCOS. These results indicate that Se may play a role in the pathogenesis of PCOS related with hyperandrogenism.

Plasma IL-4, IL-8, IL-12, interferon-γ and CRP levels in pregnant women with preeclampsia, and their relation with severity of disease and fetal birth weight.

OBJECTIVE: The aim of the present study was to evaluate the hypothesis that preeclampsia is associated with increased systemic inflammatory responses of Th1-type as well as decreased Th2-type responses compared with normal pregnancy. We also sought to determine whether there was a correlation between these markers with severity of preeclampsia and fetal birth weight. METHODS: The study population consisted of maternal age, gestational age, and body mass index matched 138 pregnant women; 56 normotensive healthy pregnant women (group 1), 42 women with mild preeclampsia (group 2), 40 women with severe preeclampsia (group 3). RESULTS: Plasma interleukin (IL)-8 and C-reactive protein (CRP) levels were significantly higher in group 3 than group 1 (p<0.05). Plasma IL-4, IL-12, and interferon (IFN)-γ levels were similar in all groups. Although plasma IL-8 and CRP levels of mild preeclamptic group were higher than control group and lower than severe preeclamptic group, the differences were not statistically significant. There was a positive correlation between IL-12 and fetal birth weight in severe preeclamptic group (p<0.05). CONCLUSIONS: Elevated maternal serum pro-inflammatory cytokine IL-8 and CRP in severe preeclamptic women compared with normal pregnant women supports the hypothesis that preeclampsia is associated with increased inflammatory responses.

Comparison of transforming growth factor ß1 concentrations in the ovaries of rats stimulated by human menopausal gonadotropin or recombinant follicle-stimulating hormone.

OBJECTIVE: To compare the effects of human menopausal gonadotropins (hMG) and recombinant follicle stimulating hormone (rFSH) on transforming growth factor (TGF) ß1 concentration in the rat ovary. STUDY DESIGN: Twenty-one fertile Wistar-Albino rats were divided into 3 groups of 7. Groups 1, 2 and 3 were injected with saline, hMG or rFSH, respectively, over 5 days, after which they underwent ovariectomy. Hematoxylin and eosin (H&E) staining was used for histological examination. TGF ß1 staining levels in ovarian stroma, vessel walls, granulosa cells of Graafian follicles and corpus luteum cells were investigated immunohistochemically. RESULTS: On histological examination, the number of smaller antral follicles was higher in the control group, while there were more and larger antral follicles in the hyperstimulated groups. There were statistically significant differences in staining in vessel walls and granulosa cells between the control and stimulated groups. Both stimulation protocols caused an increased TGF ß1 concentration in vessel walls, while there was weak staining in granulosa cells in the treatment groups compared to the control group (p<0.05). There were no significant differences in staining scores between the two treatment groups (p>0.05). CONCLUSIONS: The effects of two different gonadotropin preparations on TGF ß1 concentrations in different localizations in the rat ovaries are comparable. It may be postulated that the luteinizing hormone (LH) content of hMG contributes little or nothing to the TGF ß1 mediated angiogenesis.

Selenium has a protective effect on ischemia/reperfusion injury in a rat ovary model: biochemical and histopathologic evaluation.

BACKGROUND/PURPOSE: The aim of the study was to evaluate the effects of selenium (Se) on ischemia/reperfusion (I/R) injury in rat ovaries. METHODS: Thirty-five female Sprague-Dawley rats were randomly divided into 5 groups (n = 7): sham (S), I/R1, I/R2, Se1, and Se2. In the I/R1 and Se1 groups, 4 hours of ischemia was followed by 6 hours of reperfusion, and in the I/R2 and Se2 groups, 4 hours of ischemia was followed by 12 hours of reperfusion. In the Se groups, 30 minutes before reperfusion, a single dose of 0.2 mg/kg Se was administered intraperitoneally. The ovarian tissue levels of malondialdehyde (MDA) and nitric oxide (NO), and the activities of superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx) were measured biochemically. Tissue damage to ovarian tissue was scored by histopathologic examination. RESULTS: The I/R groups had significantly higher MDA levels and lower CAT, SOD, and GPx activities than the sham group (P < .05). Although NO levels were significantly higher in the I/R1 group than in the sham group (P < .05), the NO levels in the I/R2 and sham groups were similar. Selenium pretreatment significantly lowered tissue MDA and NO levels and increased tissue SOD and GPx activities in the Se groups, compared with those in the I/R groups (P < .05). Catalase activities were significantly higher in the Se2 group than in the I/R2 group (P < .05). Catalase activities were higher in the Se1 group than in the I/R1 group, but the difference was not statistically significant. Treatment with Se significantly decreased the ovarian tissue damage scores in the Se2 group compared with those in the I/R2 group (P < .05). CONCLUSION: Selenium is effective in preventing tissue damage induced by I/R in rat ovaries.

Plasma selenium, zinc, copper and lipid levels in postmenopausal Turkish women and their relation with osteoporosis.

It has been shown that the trace elements and lipids play role in the growth, development and maintenance of bones. We aimed to investigate serum selenium (Se), zinc (Zn), copper (Cu) and lipid (total cholesterol, triglyceride (TG), high density lipoprotein-cholesterol, low-density lipoprotein-cholesterol) levels in postmenopausal women with osteoporosis, osteopenia and in healthy controls, and to determine the relationship between Se, Zn, Cu and lipid parameters and bone mineral density (BMD). The study included 107 postmenopausal women; 35 healthy (group 1), 37 osteopenic (group 2) and 35 osteoporotic (group 3). The women in all three groups were carefully matched for body mass index (BMI). Serum concentrations of Se, Zn and Cu were measured by atomic absorption spectrophotometry. Plasma Se, Cu, Zn and lipid levels were similar in all groups (p > 0.05). When we combined the women in each of the three groups, and considered them as one group (n = 107) we found a positive correlation between BMI and lumbar vertebra BMD, femur neck BMD, femur total BMD; a positive correlation between TG and femur neck BMD, femur total BMD; a positive correlation between Zn and lumbar vertebra BMD (total T score) (p < 0.05). There was no correlation between Se, Cu, Zn, P and lipid parameters (p > 0.05). Although BMI has a positive effect on BMD, trace elements and lipids, except Zn and TG, did not directly and correlatively influence BMD. Further studies are needed to clarify the role and relationship of trace elements and lipid parameters in postmenopausal osteoporosis.

Vulvar pyogenic granuloma in a postmenopausal woman: case report and review of the literature.

Introduction. Although pyogenic granulomas (PG) are common and benign vascular proliferations of the skin and mucous membranes, they are relatively rare on the vulva. Case Presentation. A 57-year-old G7P7 postmenopausal woman presented with a 3-year history of a foul smell and bleeding lesions in the genital region. A gynecologic examination revealed multiple large papillomatous, pedunculated, and lobulated lesions that were cherry-red and infective in appearance. There was a 2-cm lesion at the upper intersection of the labia majora, a 2-cm lesion on the right labium majus, and a 4-cm lesion on the clitoris. The patient complained of itching, and the lesions were asymptomatic, except for occasional bleeding. All lesions were excised and sent for histopathological examination, which revealed an ulcerated polypoidal structure with extensive proliferation of vascular channels lined by a single layer of endothelium. The histopathological features were consistent with PG. Conclusion. The present case is the first case of multiple pyogenic granulomas on the vulva in a postmenopausal woman.

Estradiol plus drospirenone therapy increases mammographic breast density in perimenopausal women.

OBJECTIVE: To investigate the effects of 17ß-estradiol 1mg plus drospirenone 2mg (E2/DRSP) treatment on mammographic breast density in perimenopausal women. STUDY DESIGN: In this prospective study, 80 healthy perimenopausal women aged 41-49 years were enrolled and assigned to either E2/DRSP (n=40) or a control group (n=40). Mammograms were performed at baseline and after 12 months of treatment. Mammographic breast density was quantified according to the Wolfe classification. RESULTS: We demonstrated an increase in mammographic breast density in 37% (95% CI (confidence interval): 18.8-55.3%) of women treated with E2/DRSP after 12 months. The percentage of women with increased density was 0% (95% CI: 0.0-0.0%) in the control group. The difference in breast density between the E2/DRSP group and the control group was statistically very significant (p<0.001). CONCLUSIONS: E2/DRSP therapy for 12 months in perimenopausal women significantly increased mammographic breast density in comparison to a control group. Further long-term and large scale prospective studies are needed to evaluate this issue.

Modified Ferriman-Gallwey hirsutism score and androgen levels in Turkish women.

OBJECTIVE(S): To evaluate a modified Ferriman-Gallwey (mFG) scoring system and serum total testosterone (tT) and dehydroepiandrosterone sulfate (DHEAS) levels, in women with polycystic ovary syndrome (PCOS) and in control subjects. STUDY DESIGN: Women with any gynecological problem who presented to the Kahramanmaras Sutcuimam University Medical Faculty Gynecology and Obstetric Outpatient Clinic in the Mediterranean region of Turkey were assessed prospectively. Oligo-anovulation, clinical and biochemical hyperandrogenism, and PCO appearance on ultrasound that met the 2003 Rotterdam Consensus Criteria were used for PCOS diagnosis. Group 1 consisted of 43 cases with a diagnosis of PCOS and group 2 (control group) consisted of 75 age and BMI matched control subjects without PCOS. RESULTS: In groups 1 and 2, clinical hyperandrogenism (hirsutism) appearance ratio was 86.0% (37/43) and 18.0% (15/75) (p < 0.001); while biochemical hyperandrogenism (high serum tT or DHEAS level) was 65.1% (28/43) and 36% (27/75) (p < 0.05), respectively. In groups 1 and 2, mean serum tT levels were 115.2 and 73.4 ng/dL (p < 0.001), mean serum DHEAS levels were 256.1 and 177.7 ng/dL (p < 0.001), and mean hirsutism scores were 11.2 and 5.5 (p < 0.001), respectively. Serum mean tT, DHEAS and hirsutism scores for group 1 were significantly higher than those of group 2 (<0.001). No correlation was observed between BMI and the hirsutism scores or the biochemical hyperandrogenism in both groups. CONCLUSION(S): In our study, mean serum androgen levels and hirsutism ratio in the PCOS group were higher than the control group. These values were also substantially higher than those previously published in the literature.

Plasma lipocalin-2 levels in pregnant women with pre-eclampsia, and their relation with severity of disease.

OBJECTIVE: To compare lipocalin-2 (LCN2) levels in pre-eclamptic women with those in healthy pregnant women, and to determine whether there is a correlation between LCN2 levels and the severity of the disease. METHODS: The study included 66 pregnant women: 22 healthy pregnant women (Group 1), 23 women with mild pre-eclampsia (Group 2), and 21 women with severe pre-eclampsia (Group 3). Pre-eclamptic women and normal controls were carefully matched for maternal age, gestational age, and body mass index (BMI). The maternal levels of plasma LCN2 were determined by enzyme-linked immunosorbent assay. RESULTS: Plasma LCN2 levels in the pre-eclamptic group were significantly lower than those in the healthy control group (p < 0.05). Although plasma LCN2 level was lower in the severe compared to the mild pre-eclamptic group, the difference was not statistically significant (p > 0.05). There was no significant correlation between LCN2 levels and the homeostasis model assessment of insulin resistance (HOMA-IR), BMI, triglyceride, gestational week at delivery, birth weight, and systolic and diastolic blood pressure in pre-eclamptic and healthy pregnant women (p > 0.05). CONCLUSIONS: Our results show that there are decreased concentrations of plasma LCN2 in pre-eclamptic subjects and this may indicate that LCN2 plays a role in the pathogenesis of pre-eclampsia. However, further experiments are needed to clarify this role.

Plasma visfatin levels in pregnant women with normal glucose tolerance, gestational diabetes and pre-gestational diabetes mellitus.

OBJECTIVE: Visfatin, an adipocytokine, is a peptide predominantly expressed in and secreted from visceral adipose. In this study, we aimed to compare visfatin levels in gestational (GDM) and pre-gestational diabetic (pre-GDM) women with healthy pregnant women. We also sought to determine whether there was a correlation between visfatin levels and serum glucose levels at 1 h after the 50-g oral glucose challenge test in pregnant women with GDM and normal glucose tolerance. METHODS: The study consisted of 65 pregnant women: 21 patients with GDM (Group 1), 20 patients with pre-GDM (Group 2) and 24 gestational age and BMI-matched healthy pregnant women (Group 3) were enrolled. RESULTS: Plasma visfatin levels in Groups 1 and 2 were significantly higher than in Group 3 (P < 0.001). Plasma visfatin levels in Groups 1 and 2 were similar (P > 0.05). There was no significant correlation between visfatin levels and serum glucose levels at 1 h after the glucose tolerance test in both Groups 1 and 3 (P > 0.05). CONCLUSIONS: Our results support the literature indicating higher visfatin levels in women with GDM compared to women with normal glucose tolerance. Interestingly, we found similarly high visfatin levels in women with pre-GDM.