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1.
Acta Radiol ; 65(3): 318-323, 2024 Mar.
Article in English | MEDLINE | ID: mdl-38111238

ABSTRACT

BACKGROUND: Gestational diabetes mellitus (GDM) is a common disease, and the placenta shows various functional and morphological changes in these patients. Superb microvascular imaging (SMI) and shear wave elastography (SWE) are innovative ultrasound (US) methods that provide detailed information about tissue vascularization and elasticity. PURPOSE: To evaluate placental changes in patients with GDM with SMI and SWE methods. MATERIAL AND METHODS: For this case-control study, 20 healthy and 20 women with GDM were included. Women at >21 weeks of pregnancy were evaluated with SMI and SWE by two independent radiologists. Mean SMI values and mean SWE values from three different region of interest-based measurements were compared between the two groups. RESULTS: We identified that the mean SMI and SWE value ​​of the GDM group was found to be significantly higher than that of the control group (P = 0.002, P = 0.001 respectively). Using a receiver operating characteristic curve, the cutoff value of the SMI ratio, which maximizes the prediction of the presence of GDM, was 0.1234279750 (95% confidence interval [CI] = 0.625-0.920), the SWE cut-off value was 15.5 kPa (95% CI = 0.794-0.989). CONCLUSION: We have demonstrated that evaluation with SMI and SWE might allow quantitative assessment of the morphological changes of placentas in women with GDM. We believe that the use of innovative methods such as SMI and SWE in addition to conventional US examinations in daily practice and studies will provide significant clinical benefits to patient management.


Subject(s)
Diabetes, Gestational , Elasticity Imaging Techniques , Humans , Female , Pregnancy , Diabetes, Gestational/diagnostic imaging , Placenta/diagnostic imaging , Case-Control Studies , Elasticity Imaging Techniques/methods , Ultrasonography, Doppler/methods
2.
Investig Clin Urol ; 64(3): 279-288, 2023 05.
Article in English | MEDLINE | ID: mdl-37341008

ABSTRACT

PURPOSE: The Acute Cystitis Symptom Score (ACSS) was developed as a self-reporting questionnaire for diagnosing and monitoring acute uncomplicated cystitis (AC) in female patients. The study aims at the translation of the ACSS into Turkish from the original Uzbek including its linguistic, cognitive and clinical validation. MATERIALS AND METHODS: After forward and backward translation of the ACSS from Uzbek to Turkish and vice versa, the cognitive assessment of the Turkish ACSS was performed on 12 female subjects to achieve the final study version. RESULTS: The clinical validation was performed on a total of 120 female respondents including 64 Patients with AC and 56 controls without AC. For clinical diagnosis of AC, the predefined summary score of the typical symptoms of >6 showed high values (95% confidence interval) for sensitivity (0.88 [0.77-0.94]), specificity (0.98 [0.91-1.00]), and diagnostic accuracy (0.93 [0.86-0.97]). All patients were followed up between five to nine days after the baseline visit. Forty-four (68.75%) patients used antimicrobial treatment, whereas the rest (31.25%) preferred non-antimicrobial treatment. The severity scores of the typical symptoms and the quality of life were reduced significantly at follow-up. Using different (favored) thresholds for successful and non-successful treatment a clinical success rate between 54.7% and 64.1% (60.9%) was achieved. CONCLUSIONS: After translation from the original Uzbek and cognitive assessment, the Turkish ACSS showed similar good results for clinical diagnosis and patient-reported outcome as in other languages validated so far and could therefore now be used for clinical studies as well as in everyday practice.


Subject(s)
Cystitis , Quality of Life , Humans , Female , Cystitis/diagnosis , Cystitis/drug therapy , Language , Patient Reported Outcome Measures , Linguistics , Acute Disease
3.
Arch Gynecol Obstet ; 306(6): 1959-1965, 2022 12.
Article in English | MEDLINE | ID: mdl-35279727

ABSTRACT

PURPOSE: The recurrence of PPROM (Preterm Premature Rupture of Membranes) has multifactorial etiology. The aim of this study is to discuss outcome measures of subsequent PPROMs after pregnancy with PPROM before 37 weeks 'gestation. METHOD: One hundred fifty-one patients were identified with PPROM between 20 + 0- 36 + 6 weeks of gestation between 2012 and 2017 in Trakya University Hospital. The subsequent pregnancy (n = 68) outcomes were retrospectively analyzed. RESULTS: The rate of PPROMs among all deliveries was 4.7%. The recurrence rate of PPROM in the next pregnancies was 13.2%. No differences in smoking, comorbidity, latency, antibiotic use, levels of leucocytes and C-Reactive Protein were observed between women with PPROM and without PPROM in previous and subsequent pregnancies. The interpregnancy intervals in subsequent pregnancies with PPROM were significantly longer than those without PPROM (p = 0.015). The subsequent pregnancies without PPROM had longer gestational weeks of PPROM and birth according to previous pregnancies (p = 0.049; p = 0.014). CONCLUSION: The short interpregnancy interval may be considered in the planning of pregnancies of these women who had previous PPROM.


Subject(s)
Fetal Membranes, Premature Rupture , Premature Birth , Pregnancy , Infant, Newborn , Humans , Female , Retrospective Studies , Pregnancy Outcome/epidemiology , Tertiary Care Centers , Fetal Membranes, Premature Rupture/epidemiology , Fetal Membranes, Premature Rupture/etiology , Gestational Age , Premature Birth/etiology
4.
J Obstet Gynaecol ; 42(5): 923-928, 2022 Jul.
Article in English | MEDLINE | ID: mdl-34693872

ABSTRACT

Our objective is to investigate maternal midtrimester plasma and amniotic fluid (AF) levels of angiopoietin-2 (Ang-2) and thrombomodulin (TM), which are involved in vascular remodelling and endothelium activation, in placental disorders including foetal growth restriction (FGR) and preeclampsia (PE). This prospective multiparametric pilot study was conducted at the Perinatology Division of Trakya University in a population undergoing genetic amniocentesis. Both AF and plasma aliquots were kept in -80 °C until ELISA assay. The pregnancies were followed up until the end of gestation in terms of obstetric results. Amniotic fluid and plasma aliquots from 127 pregnancies who underwent genetic amniocentesis between 16 and 24 weeks of gestation were analysed. During the final data evaluation, 39 were excluded with various reasons. Twelve subsequently developed FGR and 11 complicated with PE. The control group (n = 65) was consisted of women delivered >37th week with an uncomplicated outcome. The midtrimester maternal Ang-2 levels in both AF and plasma and also TM levels in plasma were found to be significantly increased in pregnancies who subsequently developed FGR or PE (p< .05). The midtrimester Ang-2, which rises in both plasma and AF and the midtrimester TM, which only significantly increase in plasma compartment in PE group, as compensatory mechanism may be the precursors of placental disorders including FGR and PE.Impact StatementWhat is already known on this subject? It is known that angiopoietin-2 (Ang-2) has important role in placental angiogenesis and vascular remodelling. TM which is a receptor for Ang-2 plays a protective role in pregnancy by preventing the uteroplacental circulation from thrombosis.What do the results of this study add? The present study demonstrates that both midtrimester maternal plasma Ang-2/TM and amniotic fluid (AF) Ang-2 levels were significantly higher in PE and FGR group than uncomplicated group. Midtrimester AF TM levels were not significantly higher in PE group than the control group.What the implications are of these findings for clinical practice and/or further research? In the clinical practice, high levels of midtrimester Ang-2 and TM in plasma may be used for the prediction of FGR and PE. Although amniocentesis is not practical in the clinical use, the levels of these two markers in both AF and plasma compartments may contribute to explain the pathophysiology of FGR and PE.


Subject(s)
Amniotic Fluid , Pre-Eclampsia , Angiopoietin-2/genetics , Female , Fetal Growth Retardation/etiology , Humans , Pilot Projects , Placenta , Pre-Eclampsia/etiology , Pregnancy , Pregnancy Outcome , Pregnancy Trimester, Second , Prospective Studies , Thrombomodulin , Vascular Remodeling
6.
Fetal Pediatr Pathol ; 41(6): 1035-1040, 2022 Dec.
Article in English | MEDLINE | ID: mdl-34807794

ABSTRACT

Background: The coexistence of a hydatidiform mole and a fetus can occur in a multiple pregnancy, being less frequent in triplets and quadruplets because of their infrequency. With assisted reproduction, multiple pregnancies are becoming more frequent, and we can expect more frequent coexistence with a molar pregnancy. Case report: This G3, P1 30-year-old mother, after assisted conception, was diagnosed with a quadruplet pregnancy, one of which was a molar conceptus. Due to the potential for malignancy, the pregnancy was electively terminated. Conclusion: Despite the difficulty in conceiving, elective termination of a multiple pregnancy associated with a molar pregnancy may be the most judicious course of action to protect the mother's life.


Subject(s)
Hydatidiform Mole , Pregnancy, Quadruplet , Uterine Neoplasms , Pregnancy , Female , Humans , Aged, 80 and over , Uterine Neoplasms/complications , Uterine Neoplasms/diagnosis , Uterine Neoplasms/pathology , Hydatidiform Mole/diagnosis , Hydatidiform Mole/pathology , Pregnancy, Multiple , Fetus/pathology
7.
Taiwan J Obstet Gynecol ; 60(2): 350-354, 2021 Mar.
Article in English | MEDLINE | ID: mdl-33678341

ABSTRACT

OBJECTIVE: The objective of this study was to report the first case of prenatal diagnosis of the fetal 20p13 microdeletion syndrome in the literature. CASE REPORT: The mother was 31 years old and had a first trimester serum screening that indicated the fetus was at low risk. The prenatal ultrasound at 23 weeks of gestation showed mild ventriculomegaly (10.2 mm) and absent septum pellucidum. She underwent amniocentesis because of the abnormal imaging results. Karyotype analysis revealed normal results. Chromosome microarray analysis (CMA) was then performed to provide genetic analysis of the fetus and parents. CMA detected 317.902 kb deletion of 20p13 in fetus. Finally, pregnancy was terminated at 32 weeks of gestation. CONCLUSION: This study is the first to report the prenatal diagnosis of a 20p13 microdeletion syndrome. Our results further confirmed that genes in this region, including SOX12, NRSN2 are essential for normal fetal growth and TBC1D20 for normal brain development.


Subject(s)
Chromosome Disorders/diagnosis , Prenatal Diagnosis/methods , Abortion, Induced , Adult , Amniocentesis , Chromosome Deletion , Chromosome Disorders/embryology , Chromosome Disorders/genetics , Chromosomes, Human, Pair 20/genetics , Female , Humans , Karyotyping , Pregnancy
8.
J Matern Fetal Neonatal Med ; 32(10): 1688-1695, 2019 May.
Article in English | MEDLINE | ID: mdl-29262756

ABSTRACT

INTRODUCTION: To identify the prevalence and types of fetal chromosomal polymorphisms in pregnant women and to examine possible associations with screening test parameters. MATERIALS AND METHODS: Fetal chromosomal polymorphism rate was investigated in pregnant women who had been implemented for invasive prenatal test in a tertiary reference center in Thrace Region of Turkey. Fetal chromosomal polymorphisms were determined and their effects on screening tests' parameters were investigated. Possible differences in the first and second-trimester screening test parameters between women; with fetal chromosomal polymorphism who had screening test results (Group 1) and those with a normal karyotype (Group 2) were evaluated. RESULTS: Fetal chromosomal polymorphism prevalence was 5.3% (n = 101). The most common polymorphisms were identified on chromosome 9, 1, and 16 [54.5% (n = 55); 8.9% (n = 9), and 6.9% (n = 7), respectively]. The most common polymorphic variant was 9qh+ (n = 23; 22.8%). Among the screening test parameters, significantly lower pregnancy-associated plasma protein-A (PAPP-A) (p = .028) and higher unconjugated estriol (uE3) (p = .019) values were found in Group 1. In patients having fetuses with polymorphic variants on chromosome 9, a significantly lower PAPP-A values were observed compared to women with other fetal polymorphic variants (p = .048) or women having fetuses with normal karyotype (p = .007). CONCLUSIONS: Lower PAPP-A and higher uE3 levels were observed in women having fetuses with chromosomal polymorphisms, which might affect screening test results. Lower PAPP-A levels were apparent in women having fetuses with polymorphism on chromosome 9.


Subject(s)
Chorionic Gonadotropin, beta Subunit, Human/blood , Chromosomes, Human, Pair 9/genetics , Pregnancy-Associated Plasma Protein-A/analysis , Adult , Amniocentesis/statistics & numerical data , Biomarkers/blood , Case-Control Studies , Chorionic Villi Sampling/statistics & numerical data , Estriol/blood , Female , Fetal Blood , Humans , Karyotyping , Polymorphism, Genetic , Pregnancy , Retrospective Studies , Young Adult
9.
Taiwan J Obstet Gynecol ; 57(5): 692-695, 2018 Oct.
Article in English | MEDLINE | ID: mdl-30342653

ABSTRACT

OBJECTIVE: Scorpion stings remain a serious health problem in many parts of the world. There is very limited information regarding the effects of therapies delivered for scorpion stings in pregnant women on the mother and fetus. They can cause acute conditions such as fetal loss, preterm delivery, or placental abnormalities and can also result in other conditions that may have an effect on the baby in the long term. MATERIALS AND METHODS: In this study the medical records of 24 pregnant women who were admitted to the emergency room at Suruç State Hospital due to scorpion stings between January 1, 2013 and January 1, 2014 were retrospectively reviewed. Age, gestational week, monthly distribution of the cases, type of delivery, status of the fetus, affected body sites, and local and systemic findings were evaluated. The clinical severity of each case was assessed using Abroug's classification. A fetal biophysical profile test was administered in pregnant women above 24 weeks of gestation. The newborns underwent follow-up for mental and motor functions in the pediatric department at three-month intervals for 12 months. RESULTS: 24 patients, with a mean age of 26.1 ± 2.4 years, were included in the study. The most common region stung by scorpions was Lower extremity (58.3%). The most common symptom occurred in cases was immediate localized pain (58%). In terms of gestational age, 41.6% of scorpion sting were within the third trimester. Biophysical profile scores were 8 and above. Only symptomatic treatment, without use of anti-venom, was done to all the patients in this study. And neither death nor major sequel happened. CONCLUSION: Scorpion stings during pregnancy may not have significant adverse effects on the fetus and the mother. Decisions regarding the use of anti-venom in pregnant women should be considered carefully when only limited safety information, especially in those patients with only local symptoms.


Subject(s)
Pregnancy Complications/therapy , Scorpion Stings/complications , Scorpion Stings/therapy , Adult , Antivenins/adverse effects , Apgar Score , Biophysical Phenomena , Emergency Service, Hospital , Female , Fetus/physiology , Gestational Age , Humans , Infant, Newborn , Mental Disorders/diagnosis , Motor Disorders/diagnosis , Pain , Pregnancy , Retrospective Studies , Scorpion Stings/physiopathology , Turkey
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