Comparison of tissue prolidase enzyme activity and serum oxidative stress level between pregnant women with placental abruption and those with a healthy pregnancy.

PURPOSE: Although placental abruption is an acute condition, it is thought that the underlying pathology is chronic vasculopathy. Collagen is one of the important components of vascular structure, and there is a correlation between collagen turnover and prolidase enzyme activity (PEA). Thus, our aim was to assess whether there is a difference in serum oxidative stress level and PEA between pregnant women with placental abruption and those with a healthy pregnancy. METHODS: The study group consisted of 36 pregnant women who underwent caesarean section with a diagnosis of placental abruption, while the control group comprised 36 pregnant women who underwent caesarean section due to obstetric reasons. Venous blood samples were drawn from all patients before caesarean section. In addition, tissue samples were obtained during caesarean section to evaluate tissue PEA. RESULTS: No significant differences in demographic characteristics were detected between groups (p > 0.05). Oxidative stress parameters, such as total oxidant status and oxidative stress index, were found to be significantly higher in the study group (p < 0.001). Placental tissue PEA was found to be significantly higher in pregnant women with placental abruption (557.21 ± 135.41 vs. 426.68 ± 131.57 U/g, p < 0.001). In addition, a significant positive correlation was detected between PEA and oxidative stress parameters (r = 0.332, p = 0.004). CONCLUSIONS: Our results indicated that elevated tissue PEA and serum oxidative stress levels are closely related to placental abruption. Thus, we think that increased collagen turnover may have a significant role in the aetiopathogenesis of placental abruption.

Evaluation of the future atherosclerotic heart disease with oxidative stress and carotid artery intima media thickness in gestational diabetes mellitus.

BACKGROUND AND OBJECTIVE: In this study our aim was to evaluate paraoxonase (PON1) activity and free sulfhydryl groups (-SH) as antioxidative parameters and lipid hydroperoxide (LOOH) as oxidative parameter in the serum of women with gestational diabetes mellitus (GDM) and determine their relation with the degree of subclinical atherosclerosis. MATERIAL AND METHODS: Serum samples from 39 pregnant women complicated with GDM and 40 healthy pregnant women were collected for the analysis of oxidative markers. Common carotid artery intima media thickness (CIMT) was measured for both groups to assess future atherosclerotic heart disease risk. PON1 activity and -SH were measured spectrophotometrically. LOOH levels were measured by ferrous oxidation with a xylenol orange assay. RESULTS: CIMT and LOOH levels were significantly higher (p = 0.01, p < 0.001, respectively) in GDM group compared to controls, whereas PON1 and -SH levels were significantly lower (p < 0.001 for both). CIMT values were significantly correlated with body mass index (BMI), 50 g oral glucose tolerance test (OGTT), and mean arterial blood pressure (MABP) (p = 0.003, p = 0.02, and p = 0.03, respectively). However, there was no correlation between CIMT and oxidative markers. CONCLUSIONS: Increased levels of LOOH and decreased levels of PON1 and -SH showed disturbance of antioxidative mechanisms in GDM. These changes were associated with increased BMI and MABP which may be relevant to GDM pathophysiology. Furthermore, increased CIMT values in GDM compared to healthy controls designate increased risk of future atherosclerotic heart disease.

Internal iliac artery ligation for severe postpartum hemorrhage and severe hemorrhage after postpartum hysterectomy.

AIM: The aim of this study was to evaluate the effect of internal iliac artery (IIA) ligation performed for severe postpartum hemorrhage (PPH). METHODS: Thirty-three women who underwent IIA ligation to control PPH in a tertiary referral center between June 2007 and May 2009 were included in this retrospective analysis. IIA ligation was performed as the primary surgical intervention or to control bleeding following hysterectomy. RESULTS: The 33 women underwent IIA ligation due to uterine atony (n = 22), placenta previa accreta/increta/percreta (n = 5), uterine rupture (n = 4), and placental abruption (n = 2). Twenty-four women underwent IIA ligation as the primary surgical intervention. IIA ligation resulted in control of bleeding in 18/24 women (75%), and only 6/24 women (25%) showed unsuccessful management of bleeding with IIA ligation. In the six women for whom the bleeding was not controlled with IIA ligation, hysterectomy was urgently performed before closure of the abdomen. After obtaining adequate hemostasis with IIA ligation, no women required relaparotomy in the postoperative period. Nine women with persistent bleeding following hysterectomy were also treated with IIA ligation. In our study, there were no intraoperative or postoperative complications related to the procedure. CONCLUSION: IIA ligation may be an effective and safe treatment option to arrest severe PPH. This procedure may also be useful to arrest persistent hemorrhage after hysterectomy. Increased understanding of the retroperitoneal anatomy is needed to reduce the risk of intraoperative and postoperative serious complications.

Prenatal diagnosis of dicephalic parapagus conjoined twins.

Dicephalic parapagus is a rare anomaly of monochorionic twinning. We present prenatal diagnosis of this anomaly with ultrasonography and magnetic resonance imaging. She was at the 19th week of gestation. Even if earlier diagnosis is possible, this was her first examination unfortunately. Baby had two head and a common trunk. This is one of the rarest twinning. Termination of pregnancy is performed and baby is delivered by cesarean section. Imaging findings of the case are illustrated and discussed with the autopsy findings.

Uterine prolapse in a 19 year old pregnant woman: a case report.

It is well-known that multiparity and advanced age are major risk factors for pelvic organ prolapse which can rarely complicate pregnancy. We present the youngest case of uterine prolapse during pregnancy. She admitted with ruptured membranes at the 36th week of gestation and irreducible prolapse. As the edematous and thick, trapped and ulcerated cervix was not reducible, labor was obstructed due to cervical dystocia and a cesarean delivery was decided. A live male infant weighing 3100 gram was delivered. The prolapsed uterus recovered spontaneously following the cesarean operation. Uterine prolapse during pregnancy should be managed conservatively. It seems to be essential to perform elective cesarean section because of the risk of possible obstructed labor. We observed a rapid recovery of the anatomy, probably due to the young age.