Placental elasticity assessment by point shear wave elastography in pregnancies with intrauterine growth restriction.

Background Placental elasticity varies in different diseases. Our objective was to evaluate placental elasticity using point shear wave elastography (pSWE) in pregnancies with intrauterine growth restriction (IUGR). Methods A total of 66 pregnant women with IUGR and 81 healthy pregnant women were enrolled. Placental elasticity was measured using the transabdominal pSWE method. Ten measurements were made, and the mean was accepted as the mean placental elasticity value in each case. The results for IUGR pregnancies and controls were compared. Results The mean pSWE values were significantly higher in pregnancies with IUGR, which means that women with IUGR have stiffer placentas (P < 0.001). Furthermore, the pSWE values were significantly and positively correlated with Doppler indices and adverse perinatal outcomes. Conclusion The pregnancies with IUGR had stiffer placentas than the healthy controls. The utilization of pSWE for placental elasticity may be useful in the diagnosis and management of IUGR as a supplement to the existing ultrasonography methods.

Retrospective analysis of fetal anterior abdominal wall defects.

OBJECTIVE: To analyze fetal abdominal defects diagnosed during the prenatal period in the perinatology department in a tertiary center in Turkey. METHODS: This retrospective study consisted of 27 cases diagnosed with fetal abdominal wall defects between January 2011 and February 2014 in the perinatology outpatient clinic of Celal Bayar University, Manisa, Turkey. RESULTS: Eighteen (66.7%) cases were diagnosed with omphalocele, 6 (22.2%) had gastroschisis, and 3 (11.1%) had limb body wall defects. Twenty-one (77.7%) patients diagnosed either as omphalocele or limb body wall defect were offered karyotype analysis; 11 (52.4%) of them accepted the intervention, and 2 of the 11 patients (18.2%) had abnormal karyotype. Regarding the omphalocele cases; 12 (66.6%) cases had isolated omphalocele, whereas 6 of the 18 cases (33.3%) had associated anomalies. Expectant management was performed in 8 (66.7%) of 12 isolated omphalocele cases. Two of the isolated omphalocele group (16.7%) had missed abortion, the other 2 (16.7%) had termination of the pregnancy because of the associated chromosomal anomaly (47,XXY and 45,X0). Three of the gastroschisis group (50%) had missed abortion, and the other 3 (50%) had expectant management with cesarean delivery between 38-39 gestational weeks. Cases with limb body wall defect were terminated due to the lethal condition. CONCLUSION: The prenatal diagnosis of fetal abdominal wall defects is important, because they differ greatly in terms of perinatal and neonatal morbidity and mortality due to underlying chromosomal abnormalities and associated structural anomalies.

Postpartum depression: is mode of delivery a risk factor?

There are various factors related to postpartum depression. In this study we have aimed to determine the effect of mode of delivery on the risk of postpartum depression. A total of 318 women who applied for delivery were included in the study. Previously diagnosed fetal anomalies, preterm deliveries, stillbirths, and patients with need of intensive care unit were excluded from the study. Data about the patients were obtained during hospital stay. During the postpartum sixth week visit Edinburgh postnatal depression scale (EPDS) was applied. There was no significant difference between EPDS scores when compared according to age, education, gravidity, wanting the pregnancy, fear about birth, gender, family type, and income level (P > 0.05). Those who had experienced emesis during their pregnancy, had a history of depression, and were housewives had significantly higher EPDS scores (P < 0.05). Delivering by spontaneous vaginal birth, elective Cesarean section, or emergency Cesarean section had no effect on EPDS scores. In conclusion healthcare providers should be aware of postpartum depression risk in nonworking women with a history of emesis and depression and apply the EPDS to them for early detection of postpartum depression.

Insulin and oral antidiabetic agents for treatment of polycystic ovary syndrome.

Insulin plays a major role in polycystic ovary syndrome (PCOS). Insulin resistance and resultant hyperinsulinemia stimulate both the ovary and adrenal to produce androgens. Oral antidiabetic agents have been used to alleviate the symptoms and to induce ovulation in women with PCOS. This review focuses on the relation between insulin and PCOS and discusses the use of oral antidiabetic agents.

The effect of tibolone on endometrial IGF-1 and IGFBP-1 levels in ovariectomized rats.

OBJECTIVE: The goal of this study was to search the effects of two different doses of tibolone on endometrial IGF-1 and IGFBP-1 levels in ovariectomized rats. METHODS: Eighteen adult, female, 80-90-days-old, Wistar rats with an average weight of 250 g underwent bilateral ovariectomy under general anesthesia. After waiting for 4 weeks, they were randomized into three groups to receive either oral tibolone in two different doses or placebo. The treatment was continued for 5 weeks, and then the rats were sacrificed and the endometria were analyzed. RESULTS: Low columnar epithelium of the endometrial surface, longer epithelium and stratified squamous epithelium were seen in the control, low-dose and high-dose groups, respectively. The staining intensity of IGF-1 was mild in control, and moderate in both treatment groups, the difference between control the treatment groups was significant (P=0.015 for group L, and P=0.03 for group H). The staining intensity of IGFBP-1 was moderate in control, and strong in groups L and H. Again the difference was significant between control and both treatment groups (P=0.039 for grup L, and P=0.03 for group H). No significant difference was noted between each treatment group for both IGF-1 and IGFBP-1. CONCLUSION: Tibolone caused histological changes in endometrium and stimulated IGF-1 and IGFBP-1 staining. Both low and high dose treatments led to moderate and strong staining intensities for IGF-1 and IGFBP-1, respectively. The strong staining intensity of IGFBP-1 is likely due to the progestagenic effect of tibolone.