Identification of patients at risk for preeclampsia with the use of uterine artery Doppler velocimetry and copeptin.

PURPOSE: To investigate the relationship between maternal copeptin levels and uterine artery Doppler examination and progress of preeclampsia. MATERIALS AND METHODS: A cross-sectional study was designed with women those were screened at 20 + 0 - 24+ 6 weeks' gestation between May 2014 and August 2014. The obstetric records of all normotensive women were examined. Uterine artery Doppler velocimetry results and serum copeptin levels were measured. The patients were divided into two groups according to normal (n = 67) and abnormal uterine artery Doppler (n = 21) findings. RESULTS: Maternal age was significantly lower in group 1 (n = 21, 23.9%) than in group 2 (n= 67, 76.1%) (p < 0.05). We found no differences in maternal characteristics, birth weight, gestational age at delivery and copeptin levels between the two groups. Maternal serum copeptin levels were higher in women who subsequently developed preeclampsia. There was also a significant correlation between copeptin levels and the presence of preeclampsia. (p = 0.002). CONCLUSIONS: Copeptin levels are significantly higher in patients who develop preeclampsia.

Intramuscular versus intravenous prophylactic oxytocin for postpartum hemorrhage after vaginal delivery: a randomized controlled study.

PURPOSE: Prevention of postpartum haemorrhage (PPH) is essential in the pursuit of improved health care for women. Oxytocin, the most commonly used uterotonic agent to prevent PPH, has no established the route of administration. In this study we aimed to compare whether the mode of oxytocin administration, i.e., intravenous and intramuscular administration, has an effect on the potential benefits and side effects. MATERIALS AND METHODS: A total of 256 women were randomised into two groups: intramuscular group (128) or intravenous group (128). RESULTS: Estimated blood loss during the third stage of labour was similar between the two groups (p = 0.572). Further there were no statistically significant difference was noted between the two groups in terms of the mean duration of labor, duration of the third stage of labor, manual removal of the placenta, need for instrumental delivery, need for blood transfusion, PPH ≥500 mL, PPH ≥1000 mL, or length of hospital stay. CONCLUSION: Using oxytocin by intravenous and intramuscular route has a similar efficacy and adverse effects.

Ischemia-modified albumin as an oxidative stress biomarker in early pregnancy loss.

BACKGROUND/AIMS: This study aimed to determine the association between early pregnancy loss and serum ischemia-modified albumin (IMA) concentrations. METHODS: Serum samples of 180 women that included healthy pregnant women, women admitted for termination of pregnancy due to the absence of fetal cardiac activity or absence of fetal pole on ultrasonographic examination, and healthy non-pregnant women attending for gynecological examination. Each group included 60 patients. Serum concentrations of IMA were compared among the groups, and the correlations with patients' age, gravidity, BMI, gestational age and total serum albumin concentrations were calculated. RESULTS: When the groups were compared with respect to IMA concentrations, the group with early pregnancy loss was found to have significantly higher IMA concentrations (p < 0.001). An IMA threshold of >163 ng/mL had a sensitivity of 75%, specificity of 55% to discriminate between healthy pregnant patients and patients with early pregnancy loss in first trimester. CONCLUSION: Our findings support the theory that possible oxidative stress, a more hypoxic environment and defective placentation lead to increased serum IMA concentrations. These findings may help to shed light on the complicated pathogenesis of early pregnancy loss.

Plasma serotonin levels are elevated in pregnant women with hyperemesis gravidarum.

PURPOSE: This study aimed to determine the association between serotonin and hyperemesis gravidarum. MATERIALS AND METHODS: Plasma samples of 87 women in their first trimester pregnancies with HG (n = 28), morning sickness of pregnancy (n = 30) and control (n = 29) groups were obtained. Plasma levels of serotonin were compared between the groups, and the correlations with severity of symptoms using modified PUQE (Pregnancy Unique Quantification of Emesis) scoring, BMI, E2, hCG and TSH were calculated. RESULTS: When the groups were compared with respect to serotonin levels, the group with hyperemesis gravidarum was found to have significantly higher serotonin levels (p = 0.001). A significant positive correlation was found between the serotonin level and the PUQE score in all study subjects (r = 0.578, p = 0.0001). A serotonin threshold of >277.58 ng/mL had a sensitivity of 75%, specificity of 86.4%, positive predictive value of 72.4%, negative predictive value of 87.9%, and a likelihood ratio of 5.53 (p = 0.0001). CONCLUSIONS: Our findings support the possible role of serotonin in the pathogenesis of hyperemesis gravidarum.

Comparison of serum anti-Müllerian hormone levels in normal weight and overweight-obese adolescent patients with polycystic ovary syndrome.

OBJECTIVE: To evaluate serum concentration of anti-Müllerian hormone (AMH) in adolescent patients with polycystic ovary syndrome (PCOS) with respect to body mass index (BMI), and to investigate the relationship with clinical, metabolic and hormonal parameters. STUDY DESIGN: Fifty-eight adolescent girls (29 normal weight and 29 overweight-obese) diagnosed with PCOS and 28 apparently healthy girls (controls) were enrolled in the study. BMI was calculated in all cases. Serum AMH, hormonal and metabolic parameters were compared between patients with PCOS (normal weight and overweight-obese) and controls. RESULTS: Serum AMH did not differ between patients with PCOS and controls (p=0.283), and no correlation was found between BMI and AMH. A significant positive correlation was found between 2-h plasma glucose on 75-g oral glucose tolerance test and AMH (R=0.364, p=0.005). HOMA-IR index and insulin were significantly higher in overweight-obese patients with PCOS than in controls, but no significant difference was found between controls and normal-weight patients with PCOS. CONCLUSIONS: AMH was not found to be a reliable predictor for the presence of PCOS, and serum AMH did not differ between obese and non-obese adolescent patients with PCOS.

Domestic violence against pregnant women: A prospective study in a metropolitan city, Istanbul.

OBJECTIVE: Violence against women, particularly against pregnant women, is increasingly being recognized as a significant problem around the world. Limited studies were found about domestic violence among pregnant women. The aim of this study was to determine the prevalence of domestic violence during pregnancy and the factors affecting it. MATERIAL AND METHODS: This prospective study was conducted at the Department of Obstetrics and Gynecology, between January 2012 and April 2013. A total of 1349 pregnant women, irrespective of age and socioeconomic status, were interviewed using a questionnaire in the local language. RESULTS: The incidence of domestic violence in this study was 2.37%. The mean age of women who reported violence was 29.06±5.53 years. Age, marriage duration, gravidity, parity, educational level, partner's educational level, and monthly income exerted no significant influences on women who experienced domestic violence during their pregnancies (p>0.05). Women who resided in the same houses with large extended families were at significantly higher risk of domestic violence during pregnancy in comparison with the pregnant women who lived within a core family (p=0.018). CONCLUSION: Domestic violence during pregnancy is a potential public health problem. Education, improvements in economic autonomy, and society's attitudes may reduce domestic violence. Health-care providers should increase their awareness of risk factors to protect women from domestic violence.