The Effect of Preoperative Carbohydrate-containing Fluid Consumption on Maternal Oxidative Stress Markers During Elective Cesarean Delivery.

PURPOSE: The purpose of this study was to evaluate the effect of carbohydrate loading prior to the cesarean surgery under spinal anesthesia on thiols and ischemia-modified albumin (IMA) levels. DESIGN: Prospective, randomized placebo-controlled study. METHODS: Seventy-nine pregnant women planned for cesarean sections under spinal anesthesia at Karaman Training and Research Hospital were randomized into a control group (group C) (n = 42), and an oral carbohydrate preloading group (group OCH) (n = 37). OCH loading requires consuming 400 mL the night before surgery and 200 mL up to 2 hours before anesthesia. Group OCH consumed an oral carbohydrate-rich beverage (Nutricia-Fantomalt), and group C consumed an equal volume of water. This study investigated thiol-disulfide homeostasis after preoperative carbohydrate consumption. Preoperative gastric fluid, volume, antral cross-sectional area, hypotension following the birth, and fetal blood gas parameters were compared across groups. FINDINGS: Thiols and IMA levels did not differ across groups before and after surgery (P > .05). Gastric ultrasonography showed similar antral cross-sectional area and stomach volume between groups (P = .172, P = .128, respectively). When surgery caused hypotension, group OCH received more ephedrine for surgery-induced hypotension, although this difference is not statistically significant (P = .704). A clustered error bar (95% confidence interval) plot with an interpolation line was used for a time-based comparison of mean differences in heart rate and mean arterial pressure between the groups. CONCLUSIONS: This study supports that mothers' thiols and IMA levels were unaffected by preoperative OCH loading before cesarean surgery. We did not examine thiol and its derivatives in umbilical cord blood; hence, we can not comment on thiol/disulfide homeostasis levels in neonates.

Fetal Biometric Parameter Reference Charts of a Central Anatolian Turkish Population.

PURPOSE: The assessment of fetal biometry using ultrasound provides accurate pregnancy dating and also screening of fetal growth. Fetal biometry, which is common practice in the second and third trimesters of pregnancy, is fetal morphometry, which involves taking measurements of the different anatomical body parts. These fetal dimensions vary on ethnicity. The aim of this study is to demonstrate fetal biometric parameters measurement results of the Central Anatolia Turkish population with detailed percentile tables and graphs to screen fetal growth more accurately. METHODS: This cross-sectional study was performed on a total of 1132 fetuses (47% girl, and 53% boy) between 15 and 40 weeks of gestation. Biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), and femur length (FL) measurements are performed in a standardized manner every gestational week. BPD and HC were measured at the level of the thalami on the horizontal plane of the fetal head. HC was measured using the ellipse method. AC measurement was taken at the circular cross-section of the upper fetal abdomen. FL was measured along with the ossified diaphysis of the femur. All measurements were taken in millimeters. RESULTS: Pregnant women's mean age was 27.58 (17-43), and the mean body mass index was 27.68 (15.06-50.78) as demographic data. 38.13% of women had their first, 29.74% had their second, and 32.13% had three or more gestations within our study. Percentile data of fetuses for each parameter (BPD, HC, AC, and FL) and for each week were shown as tables and percentile graphics. Fetal 50th percentile measurements were compared between our study and other studies from different countries. The Kruskal-Wallis test results showed that BPD (p = 0.827), HC (p = 0.808), AC (p = 0.846), and FL (p = 0.725) values have a statistically similar mean in all studies. Hierarchical cluster analysis results showed that our results for BPD, HC, AC, and FL percentile curves have been found closer to Italian population results. However, our results were statistically different from Asian, Nigerian, non-Hispanic American, and Brazilian populations for each of the different parameters. CONCLUSION: The specialization of fetal biometric charts for a particular population can ensure a more accurate assessment of fetal growth rate. We showed fetal biometric percentile tables and graphics of the Central Anatolian Turkish population in this study. These results may provide a valuable contribution to obstetrical practice. Further studies can be conducted in different regions of Turkiye, thus comparisons could be possible over the country.

Comparative cross-sectional study on sexual function of couples during pregnancy: Assisted reproductive techniques versus spontaneous conceptions.

This study aims to compare the sexual functions of couples undergoing assisted reproductive techniques (ART) with those conceiving spontaneously during pregnancy. A total of 102 couples participated in this cross-sectional study, with 68 couples in the spontaneous conception group and 34 couples in the ART group. Data collection was conducted face-to-face in the antenatal clinic using separate "Descriptive Information Form" for women and men, "Female Sexual Function Index (FSFI)" for women, and "Libido Scoring System (LSS)" for men. Descriptive statistical methods, Chi-square and Fisher exact tests, t-test, and Pearson correlation test were used for data analysis. It was observed that the mean FSFI total scores of women who conceived spontaneously and through ART during pregnancy were at a good level (≥30), while the mean LSS scores of their partners were at a moderate level (5-7). No statistically significant distinction existed among the groups. Further research is advisable by adjusting the sample selection criteria, such as gravida, duration of ART treatment, and gestational age.

Cette étude vise à comparer les fonctions sexuelles des couples soumis à des techniques de procréation assistée (ART) avec ceux qui conçoivent spontanément pendant la grossesse. Au total, 102 couples ont participé à cette étude transversale, dont 68 couples dans le groupe conception spontanée et 34 couples dans le groupe ART. La collecte de données a été réalisée en face-à-face dans la clinique prénatale en utilisant un « formulaire d'informations descriptives ¼ distinct pour les femmes et les hommes, un « indice de fonction sexuelle féminine (FSFI) ¼ pour les femmes et un « système de notation de la libido (LSS) ¼ pour les hommes. Des méthodes statistiques descriptives, les tests exacts du chi carré et de Fisher, le test t et le test de corrélation de Pearson ont été utilisés pour l'analyse des données. Il a été observé que les scores totaux moyens FSFI des femmes ayant conçu spontanément et par TAR pendant la grossesse étaient à un bon niveau (≥30), tandis que les scores moyens LSS de leurs partenaires étaient à un niveau modéré (5-7). Aucune distinction statistiquement significative n'existait entre les groupes. Des recherches plus approfondies sont recommandées en ajustant les critères de sélection des échantillons, tels que la gravité, la durée du traitement ART et l'âge gestationnel.

Levels and Predictors of Anxiety and Depression in Turkish Pregnant Woman During the Covid-19 Pandemic.

OBJECTIVE: In addition to being a medical phenomenon, pandemics affect the individual and society on several levels and lead to disruptions. In the pandemic process, different groups in the population, including pregnant women as a defenseless group, are subjected to psychological threat. The present study aimed to determine the levels of anxiety and depression and related factors in pregnant women during the the coronavirus disease 2019 (Covid-19) pandemic. METHODS: The present cross-sectional study was conducted with 269 pregnant women through face-to-face interviews held in Istanbul, Turkey. Regarding the data collection tools, the Cronbach α reliability coefficient was of 0.90 for the Beck Anxiety Inventory, and of 0.85 for the Beck Depression Inventory. RESULTS: Among the participating pregnant women, 30.5% had mild, 17.5% had moderate, and 5.9% had severe anxiety symptoms, whereas 35.3% had mild, 16.7% had moderate, and 2.2% had severe depression symptoms. We found that those who were concerned about their health had 5.36 times (p = 0.04) more risk of developing anxiety, and 4.82 times (p = 0.01) more risk of developing depression than those who were not concerned. Those who had a history of psychiatric disease had 3.92 times (p = 0.02) more risk of developing anxiety than those without it. CONCLUSION: We determined that about half of the pregnant women included in the study had some degree of anxiety and depression during the COVID-19 pandemic. The risk factors for anxiety and depression among the pregnant women were determined as smoking, concerns about health and getting infected with the coronavirus, history of psychiatric disease, and undergoing regular antenatal care.

OBJETIVO: Além de ser um fenômeno médico, as pandemias também afetam o indivíduo e a sociedade em vários níveis, e causam perturbações. No processo de pandemia, diferentes grupos da população, incluindo mulheres grávidas como um grupo indefeso, estão sujeitos a ameaças psicológicas. Este estudo teve como objetivo determinar os níveis de ansiedade e depressão e os fatores relacionados em mulheres grávidas durante a pandemia de doença do coronavírus 2019 (coronavirus disease 2019, Covid-19, em inglês). MéTODOS: Este estudo transversal foi realizado com 269 mulheres grávidas por meio de entrevistas pessoais em Istambul, Turquia. Com relação às ferramentas de coleta de dados, o coeficiente de confiabilidade alfa de Cronbach foi de 0,90 para a Escala de Ansiedade de Beck, e de 0,85 para a Escala de Depressão de Beck. RESULTADOS: Entre as gestantes participantes, 30,5% apresentaram sintomas de ansiedade leves, 17,5%, moderados, e 5,9%, graves, ao passo que 35,3% apresentaram sintomas de depressão leves, 16,7%, moderados, e 2,2%, graves. Verificou-se que as participantes que se preocupavam com sua saúde tinham 5,36 vezes (p = 0,04) mais risco de desenvolver ansiedade e 4,82 vezes (p = 0,01) mais risco de desenvolver depressão do que aquelas que não se preocupavam. As pacientes que tinham histórico de doença psiquiátrica tinham 3,92 vezes (p = 0,02) mais risco de desenvolver ansiedade do que as que não tinham. CONCLUSãO: Determinou-se que cerca de metade das gestantes incluídas no estudo tiveram algum nível de ansiedade e depressão durante a pandemia de Covid-19. Os fatores de risco para ansiedade e depressão nas gestantes foram determinados como tabagismo, preocupação com a saúde e infecção pelo coronavírus, histórico de doença psiquiátrica, e cuidados pré-natais regulares.

A comparative randomized study on effect of vaginally administered glyceryl trinitrate placebo on cervical ripening prior to induction of labor in overdue pregnancies.

OBJECTIVE: The aim of this study is to examine the effectiveness and adverse effects of local glyceryl trinitrate (GTN) application during labor compared with a placebo group. METHODS: The study consisted of 70 pregnant women with overdue pregnancies who presented to the hospital for labor induction between January 2009 and January 2011 in the Obstetrics Clinic of Istanbul Süleymaniye Gynecology and Obstetrics Education and Training Hospital. Vaginal suppositories-containing GTN (36/70) or placebo (34/70) was administered to the participants in a randomized fashion. The placebo and GTN involving vaginal ovules used in the study were prepared in the Pharmacy Department of Istanbul University Faculty of Pharmacy. Maternal effects during labor, rates of normal vaginal and C/S deliveries, the interval between the initial medication and delivery, and amount of total oxytocin used were compared between the GTN and placebo groups. RESULTS: There were no significant differences between the GTN and placebo groups regarding bishop scores, the interval between medication and delivery, delivery types, indications for cesarean section, and complications including hyperstimulation, tachysystole, uterine rupture, placental abruption, and uterine atony (P > 0.05). CONCLUSION: Our results revealed that there were no differences between GTN and placebo regarding their effect on cervical ripening in overdue pregnant women.

Uterine sarcoma in a 14 year-old girl presenting with uterine rupture.

•Uterine sarcomas are rare in adolescents. Adenosarcomas are even more rare. Uterine rupture, as a presentation is a rare entity.•It is hard to diagnose sarcomas preoperatively. It is still hard even postoperatively due to variable morphologic features.•Experience of the gynecopathologists and oncologic surgeons is the hallmark of the treatment option.