ABSTRACT
Background: gestational diabetes mellitus [GDM] is defined as impaired glucose tolerance with onset during the second or third trimester of pregnancy
Aims: the purpose of this study was to investigate the prevalence of pregnant women who were not screened for gestational diabetes mellitus and compare the maternal and fetal outcomes of women who had undergone GDM screening
Methods: women who refused to attend the gestational diabetes screening test [n= 162] at a maternity hospital in Ankara, Turkey, between October 2014 and January 2015 were included in this prospective cohort study. The control group [matched for age and body mass index] was recruited from women who agreed to have the gestational diabetes screening test [n= 194]
Results: just 12% of pregnant women did not attend gestational diabetes screening test; these women were at higher risk for idiopathic polyhydramnios [P = 0.026]. Prevalence of GDM was 8.8% [n= 17] in the control group and 30.9% [n= 50] in those who refused GDM screening. The maternal and fetal outcomes of GDM patients were similar in both groups. Women who did not attend GDM screening test had increased risk for mild idiopathic polyhydramnios in late gestation
Conclusions: fasting and postprandial plasma glucose screening can replace gestational diabetes mellitus screening in women who refuse to have the glucose load test
ABSTRACT
Objective: To evaluate the relationship between striae gravidarum [SG] score and abdominal scar characteristics together with intraperitoneal adhesion [IPA] grades of patients who were hospitalized for second cesarean delivery
Methods: A total of 145 consecutive women undergoing scheduled cesarean section [CS] in a tertiary level maternity hospital between November 2013 and January 2014 were included in the study. All women had transverse suprapubic skin incision due to the previous CS and none of them had a history of vaginal delivery. Patients were classified according to the SG status, as women with no SG: Group-1[n=53], mild SG: Group-2[n=27] and severe SG: Group 3[n=65]. Groups were compared between themselves with regard to various sociodemographic properties, cesarean scar characteristics and IPA scores
Results: No significant difference in the length, width and color of the scar was detected among groups. While flat scar was the most prominent form of scar, the elevated scar was significantly more frequent in Group-1 compared to other groups [p=0.009]. IPA grades were 0 or 1 in 77.3% of Group-1, 81.3% of Group-2 and 76% of Group-3. There was no significant difference in IPA scores between groups [p=0.884]. After combining CS scar characteristics [flat, depressed and elevated] and SG status [SG [+] or SG [-]], we found no significant difference between the groups in terms of IPA severity
Conclusion: Striae gravidarum [SG] was found to be associated with scar characteristics, but not associated with the severity of intraperitoneal adhesion [IPA]
ABSTRACT
Objective: To investigate the effect of antenatal corticosteroid prophylaxis on neonatal respiratory morbidity between 34 and 37 weeks of gestation
Methods: This retrospective study evaluated the neonatal respiratory complications of 683 low risk singleton pregnancies delivered at 34-37 weeks of gestation in a tertiary care center between Jan 2012 and Sept 2015. Group-I [n=294] comprised data of woman who did not receive betamethasone and Group-II[n=396] comprised those who received betamethasone after 34 weeks of gestation for cases at risk of preterm birth. Primary outcome was neonatal respiratory morbidity [NRM]. NRM was defined as any respiratory disease that required medical support including supplemental oxygen, nasal continuous positive airway pressure, endotracheal intubation, or exogenous surfactant, with more than 25% oxygen for > 10 minute to maintain neonate oxygen saturation >90% Demographic characteristics, mode of delivery, fetal birth weight and neonatal respiratory complications was compared between the two groups
Results: There was no statistically significant difference for neonatal respiratory morbidity development rate between patients who received betamethasone or those who did not receive it. The incidence of neonatal respiratory morbidity was similar [15.3% in the control group and 14.9% in the intervention group; p=0.88]
Conclusion: We found no improvement with betamethasone administration empirically in late preterm birth as regards prevention of Neonatal Respiratory Morbidity[NRM]
ABSTRACT
Background: Polycystic ovary syndrome [PCOS] is highly associated with an ovulatory infertility, features of the metabolic syndrome, including obesity, insulin resistance and dyslipidemia. Serum concentrations of high sensitive C-reactive protein [hs-CRP] were significantly higher in obese than in non-obese PCOS patients at baseline, suggesting a relationship between elevated hs-CRP levels and obesity. The aim of this study was to evaluate whether cycle day 3 hs-CRP levels before clomiphene citrate [CC] treatment would predict cycle outcomes in women with PCOS
Materials and Methods: This cross-sectional study was conducted among 84 infertile women with PCOS who were treated with CC at Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey, between January 2014 and January 2015. Based on the exclusion criteria, cycle outcomes of remaining 66 infertile women with PCOS treated with CC were analyzed. The hs-CRP levels and insulin resistance indexes were evaluated on day 3 of the CC treatment cycle. The primary outcome measures were number of preovulatory follicles measuring>/=17 mm and pregnancy rates
Results: The mean +/- SD age of the patients was 24.0 +/- 3.8 years [range 18-36]. The mean +/- SD body mass index [BMI] of the patients was 25.7 +/- 4.9 [range 17-43]. Fifty patients developed dominant follicle [75%] and 5 patients established clinical pregnancy during the study [clinical pregnancy rate: 7%]. The mean +/- SD baseline hs-CRP, fasting insulin and Homeostasis Model Assessment-Insulin Resistance [HOMA-IR] values of the patients with and without dominant follicle generation during treatment cycle were 6.42 +/- 7.05 and 4.41 +/- 2.95 [P=0.27], 11.61 +/- 6.94 and 10.95 +/- 5.65 [P=0.73], 2.68 +/- 1.79 and 2.41 +/- 1.30 [P=0.58], respectively. The mean +/- SD baseline hs-CRP, fasting insulin and HOMA-IR values of the patients with and without clinical pregnancy establishment following treatment cycle were 6.30 +/- 2.56 and 5.90 +/- 6.57 [P=0.89], 11.60 +/- 7.54 and 11.44 +/- 6.61 [P=0.95], 2.42 +/- 1.51 and 2.63 +/- 1.70 [P=0.79], respectively
Conclusion: In this study, we did not observe a predictive value of cycle day 3 hs-CRP levels on preovulatory follicle development and pregnancy rates among infertile PCOS patients treated with CC. Also, no relationship between HOMA-IR values and dominant follicle generation or clinical pregnancy establishment was demonstrated in our study, confirming the previous studies emphasizing the neutral effect of metformin utilization before and/or during ovulation induction to pregnancy rates