Complete blood count parameters may have a role in diagnosis of gestational trophoblastic disease

Objective: The goal of this study was to investigate whether gestational trophoblastic disease [GTD] and healthy pregnancy differ with respect to complete blood count parameters and these parameters can be used both to explain the pathophysiologic mechanisms and differentiate the two conditions from each other. Methods: The data obtained from 37 women with GTD and 61 healthy pregnancies [control group] regarding platelet [PLT], mean PLT volume [MPV] and PLT distribution width [PDW], and white blood cell [WBC] levels were evaluated. Patients with GTD were further subdivided into two groups composed of 20 partial mole [PM] and 17 complete mole [CM] cases. Results: PDW and WBC were lower in the GTD than the control. There were no differences for PLT and MPV. WBC was lower in PM and both WBC and PDW were lower in CM compared with control. ROC curve analysis revealed an area under curve [AUC] 75.5% for WBC and AUC 69.3% for PDW. A cut-off value was determined 8.19 for WBC with 81.0% sensitivity and 54.1% specificity. While, 15.85 were accepted for PDW, with 87.9% sensitivity and 44.4% specificity. Conclusion: Lower WBC in GTD may suggest that molar pregnancy requires a lower inflammatory reaction facilitating trophoblastic invasion. Lower PDW as an indicator of platelet activation in CM may suggest that CM requires less PLT activation than healthy pregnancy that needs stronger trophoblast invasion for normal placental development. Decreased PDW levels especially < 15.85 and WBC levels < 8.19 may alert clinicians for risk of GTD

Evaluation of the effects of different anesthetic techniques on neonatal bilirubin levels

The aim of the present study was to determine whether different anesthetic techniques applied for vaginal delivery and cesarean section affect neonatal bilirubin levels in the first 24 hours of life. A total of 511 neonates delivered by vaginal route or cesarean section were included in the study. The neonates were classified according to method of delivery and anesthetic agents as group A [cesarean section / general anesthesia with sevoflurane], group B [cesarean section / spinal anesthesia with bupivacaine hydrochloride], group C [vaginal delivery with episiotomy / local anesthesia with prilocaine hydrochloride] and group D [vaginal delivery/ no anesthesia]. The levels of neonatal serum bilirubin in the groups were compared. There was no difference between group A and group B when compared in terms of neonatal bilirubin levels [p = 0.98]. Depending on the use of prilocaine hydrochloride as local anesthetic agent in the vaginal delivery, there was no significant difference between the groups C and D, who had vaginal delivery, in terms of the neonatal bilirubin levels [p = 0.99]. The serum levels of bilirubin in cesarean section groups were significantly higher than those of the vaginal delivery groups [p < 0.001]. Prilocaine hydrochloride used for episiotomy is not effective on neonatal hyperbilirubinemia. However, sevoflurane and bupivacaine hydrochloride used in cesarean section seem to be increasing bilirubin levels