First trimester maternal serum PAPP-A levels and associated pregnancy complications in intrahepatic cholestasis of pregnancy.

PURPOSE: To investigate first trimester maternal serum pregnancy associated plasma protein A (PAPP-A) multiple of the median (MoM) in cases with intrahepatic cholestasis of pregnancy (ICP). Obstetric complications and relation with PAPP-A MoM were also evaluated. MATERIALS AND METHODS: This was a retrospective case-control study. After exclusions, for each ICP case, two controls with uncomplicated singleton pregnancies were randomly selected. PAPP-A MoM of ICP cases with and without obstetric complications, and the control group were compared with each other. RESULTS: Total incidence of ICP was 0.99 % (138/13988). The study included 113 singleton pregnant women. Rates of gestational diabetes mellitus (GDM), preeclampsia (PE), fetal growth restriction (FGR), preterm labor (PTL), and hypothyroidism in cases with ICP were 21.2%, 7.9%, 10.6%, 18.6%, and 5.3%, respectively. Median PAPP-A MoM were 0.93 in ICP group and 1.10 in control group (p > 0.05). PAPP-A MoM levels were not significantly different either between the ICP group with complicated pregnancies and the control group or between the ICP group without complicated pregnancies and the control group (p >0.05). CONCLUSION: ICP incidence was similar to other European countries. Rates of obstetric complications expecially GDM were higher than expected in general pregnant population. ICP is not considered as pregnancy complications that have low PAPP-A MoM levels.

Operative hysteroscopy preserving virginity: a new technique.

OBJECTIVE: To present a new technique of virginity-preserving operative hysteroscopy in the treatment of intrauterine pathologies. MATERIALS AND METHODS: The details of operative hysteroscopy in which the hymenal orifice was left intact to preserve virginity are presented. The technique briefly involved the following steps: holding the cervix with a tenaculum and its traction to the immediate posterior hymenal opening with use of office hysteroscopy, which was then followed by operative conventional hysteroscopy. RESULTS: The technique was performed successfully in all patients with an annular hymenal morphology. The technique enabled complete resection of intrauterine pathologies in all cases. There was no case of inadvertent hymenal injury during the procedure. CONCLUSION: The presented technique, makes it possible to easily treat intrauterine pathologies while preserving the hymen. It can be preferred in groups of patients in whom it is necessary to preserve virginity.

Uterine myoma in pregnancy: report of 19 patients.

PURPOSE OF INVESTIGATION: To evaluate the effect of pregnancy on uterine myoma and the effect of uterine myoma on the pregnancy prospectively. METHODS: Prospective evaluation of 19 pregnant women with uterine myomas was done between January 2005 and February 2008 at the Gynecology and Obstetrics Department Gaziantep University. The number and changes in size of the uterine myomas during pregnancy, and perinatal complications were documented. RESULTS: Totally 37 fibroids in 19 pregnant women were observed. Neither enlargement of myomas nor serious perinatal complications were observed. CONCLUSION: We suggest that in contrast with the general opinion there is not much effect of pregnancy on uterine myoma size, and most cases are not affected by the presence of uterine fibroids resulting in severe perinatal complications. Expectant management may be an option for uterine myomas determined before gestation.

Role of dietary habits on fetal anomaly development: review of 315 consecutive fetal anomaly cases.

OBJECTIVE: This study aimed to investigate and speculate on the dietary habits and certain environmental factors of the Southeast Anatolia region which are thought to be related with fetal anomaly development. MATERIALS AND METHODS: Patients admitted to Gaziantep University Faculty of Medicine Obstetrics and Gynecology Department with fetal anomalies between January 2003 and June 2007 were evaluated. Three hundred and fifteen patients with intrauterine fetal anomaly were detected. The number of total deliveries during this period were 7,554. Twenty-eight of the patients were above the age of 35. According to the history of patient, mean gravidity was 6.6 (1-13), consanguineous marriage rate was 25%, previous abnormal rate was 15%, and previous missed abortion was 35%. Eighty-eight percent of patients were of low sociocultural status. The frequency of daily dietary habits, especially tea consumption, red chili pepper consumption and eating barbecued meat were questioned with the anamnesis. RESULTS: Total fetal anomaly incidence was found to be 4.17%, neural tube defects 1.37%, renal anomalies 0.54%, non-immune fetal hydrops 0.46%, cystic hygroma 0.39%, central nervous system anomalies 0.36%, chromosomal anomalies 0.17%, gastrointestinal system anomalies 0.147%, sacrococcygeal teratoma 0.12%, cardiac anomalies 0.09%, and respiratory system anomalies 0.049%. Mean daily tea comsumption during pregnancy was 8 cups/day. Mean frequency of eating barbecued meat was 4 times/week. Mean chili pepper consumption was 10 g/day. CONCLUSION: In this study, four times higher overall fetal anomaly incidence appeared to be strongly correlated with Southeast Anatolia region's dietary habits. In the future monitoring women's dietary habits should have an important role in the prevention of fetal anomaly development.