Can Stria Gravidarum Predict Surgical Fluid Loss in Cesarean Section?

INTRODUCTION: Alterations in collagen subtypes and matrix can potentially cause fluid loss in surgery which is important in terms of liquid loss. OBJECTIVES: The study aimed to analyze stria gravidarum (SG) and its severity in pregnant women who had undergone cesarean section (CS) and to evaluate surgical fluid loss (SFL) that occurred during CS operation. METHODS: The research was designed as a prospective clinical cohort study to compare the amount of SFL in the second cesarean section with the severity of SG at 34-37 weeks pregnant (N 308). The severity of SG was evaluated in the preoperative period using the Davey scoring. All patients were defined none, mild stria and severe stria. The SFL was calculated by weighing the pre-and post-operative weights of the sponges. RESULTS: The weight gain (P = 0.008) and body mass index (BMI, P = 0.017) gradually increased toward severe SG. In correlation analysis of SFL, a positive correlation was found with Davey (r=0.791; P = 0.0001), weight gained during pregnancy (r=0.328; P = 0.0001), BMI (r=0.453; P = 0.001) and newborn weight (r=0.139; P = 0.003). In the receiver operating characteristic for the predictability of SG severity on SFL, severe SG showed a potential for SFL with 95.1% specificity and 93.2% sensitivity at 791 cut-offs (area under the curve:0.987; P = 0.00001; 95% confidence interval: 0.977-0.997). CONCLUSIONS: The SG severity and SFL showed a very strong relationship, which was a very important finding that would affect the approach of the surgeons to the patients with SG in terms of fluid loss in CS.

The serum level of soluble CXCL16 is increased in preeclampsia and associated with hepatic/renal damage.

OBJECTIVE: To compare the serum level of the chemokine, CXCL 16, in preeclamptic and healthy pregnant patients. METHODS: This prospective case control study was conducted between January and December 2018 in a tertiary level hospital. The study group was formed of 70 pregnant women diagnosed with preeclampsia, and the control group was formed of 70 healthy pregnant women matched to the study group in respect of age, gestational week and body mass index (BMI). The study group was separated into two subgroups of mild preeclampsia (n = 35) and severe preeclampsia (n = 35). The groups were compared in terms of demographic and clinical parameters and the levels of serum CXCL 16. RESULTS: No statistically significant difference was determined between the study and control groups in respect of maternal age, gravida, parity, BMI, and gestational age at sampling. Neonatal birth weight was significantly lower in the study group than in the control group. Mean serum alanine aminotransferase (ALT), aspartate amino transferase (AST) and creatinine levels of the study group were significantly higher than those of the control group (p < .05 for all). There was a statistically significant difference between the study and control groups regarding the mean platelet count. Compared to the control group, the severe and mild preeclampsia groups had a significantly higher serum level of CXCL 16. The serum level of CXCL 16 was significantly higher in patients with severe preeclampsia than in patients with mild preeclampsia (2.94 ± 3.89 pg mL-1 vs. 1.08 ± 1.87 pg mL-1, p = .14). Correlation analysis revealed a significant positive correlation of serum CXCL 16 level with serum ALT level (r = 0.320, p ≤ .001) and serum AST level (r = 0.373, p ≤ .001) and serum creatinine level (r = 0.279, p = .01) in both groups. High values indicated presence of preeclampsia, with a diagnostic cut-off point of 0.225, sensitivity of 75.7% and specificity of 72.9% for CXCL 16 (area under curve: 0.820, p < .001 CI: 0.753-0.888). CONCLUSIONS: This is the first study in literature to show a significantly higher level of CXCL 16 in patients with severe preeclampsia compared to those with mild preeclampsia. The study can also be considered of value in respect of showing that CXCL 16 could play a role in the etiopathogenesis of preeclampsia and the emergence of renal-hepatic damage. Blocking the CXCL 16/CXCR six axis in preeclampsia treatment could lay the ground for the development of new drugs which could be used in the treatment of preeclampsia.

The role of melatonin in preventing ovarian tissue damage in rats exposed to magnetic fields

Objectives: We observed the efficacy of melatonin in preventing ovarian tissue damage in rats exposed to magnetic fields. Materials and methods: Forty rats were divided into four treatment groups: Group 1, control group (n = 10); Group 2, melatonin administration only (n = 10); Group 3, magnetic field exposure only (n = 10); Group 4, magnetic field exposure with melatonin administration (n = 10). The magnetic field was applied at a dose of 20 µT for 30 min/day for 10 days. Melatonin was orally administered at a dose of 10 mg/kg. We evaluated follicle count, degree of fibrosis, amount of adhesion, amount of apoptosis, ovarian dimensions, and follicular degeneration by dissecting the ovaries of the rats on day 11, and differences among the groups were evaluated. Results: Group 3 had an increased amount of follicle degeneration, more fibrosis, and more adhesion than Group 4, but these findings were not statistically significant. The apoptosis scores in Groups 1 and 2 were significantly lower than in the other groups. Ovarian dimensions were significantly decreased in Group 3. Follicular degeneration was significantly increased in Group 3. Conclusion: Exogenously administered melatonin, if used at much higher doses orally, may be a noncytotoxic, antiapoptotic agent and may also have a protective effect on ovarian tissue damage that radiation can cause at the level of fine structure.