Psychological domain of quality of life, depression and anxiety levels in in vitro fertilization/intracytoplasmic sperm injection cycles of women with endometriosis: a prospective study.

OBJECTIVE: To evaluate the psychological domain of quality of life (PDQoL), anxiety and depression levels of infertile women with endometriosis versus non endometriosis who applied for Assisted Reproductive Technologies (ART). METHOD: This prospective case-control study compromised a total of 105 women who applied for IVF/ICSI program. Ninety-three women were divided into two groups as endometriosis (n = 37) and non-endometriosis (n = 56) after 12 patients who refused to participate in the study were excluded. The WHOQOL-BREF questionnaire, Beck Depression and Anxiety Inventory scales were used to determine the psychological stress levels. RESULTS: A significant difference was found between the endometriosis and non-endometriosis groups regarding depression scores, while no significant difference was reported with respect to PDQoL and anxiety (p < 0.01, p = 0.897 and p = 0.058, respectively). A weak but significant correlation was observed between depression and endometriosis (CC: 0.435, p < 0.01). Though anxiety scores were found to be higher in endometriosis group this can not reach statistical significance (p = 0.058). Impact of PDQoL, depression and anxiety scores on pregnancy outcomes were found to be insignificant. CONCLUSION: Women with endometriosis seem to be more susceptible to depression and anxiety than women without endometriosis. Although infertility treatment outcomes are not found to be significantly affected, the impact of depression and anxiety over ART treatment success merit further research.

Correlation between 25-hydroxy vitamin D levels and COVID-19 severity in pregnant women: a cross-sectional study.

OBJECTIVE: To evaluate the relationship between 25-hydroxy vitamin D (25(OH)D) levels and disease severity in hospitalized COVID-19 positive pregnant women. METHODS: The COVID-19 (+) pregnant women (confirmed by PCR test) were classified as asymptomatic, mild symptomatic, and severe disease according to their symptoms and laboratory results. Severe COVID-19 criteria were respiratory symptoms and/or findings. The following laboratory results were considered as poor prognostic factors: the number of lymphocytes <800/µl and/or CRP value >10 times the upper limit of the normal range and/or ferritin value >500 ng/ml and/or D-Dimer value >1000 µg/l. The patients were divided into two groups; asymptomatic or mild symptomatic group (Group 1), and severe disease and/or poor prognostic factor group (Group 2). The 25(OH)D levels were compared between groups. ROC curve analysis was used to analyze the cutoff value for vitamin D to predict the severity of COVID-19. RESULTS: 25(OH)D levels were found to be statistically significantly lower in group 2 (15.5 (10.25) ng/ml in Group 1, 13 (12) ng/ml in Group 2, p = .010). The 25(OH)D level under 14.5 ng/ml was associated with severe COVID-19 and/or poor prognostic factors (p = .010). The risk of severe COVID-19 and/or having poor prognostic factors was 1.87 times higher among pregnant women who had 25(OH)D levels below 14.5 ng/ml. This value was found to have 54.1% sensitivity and 61.3% specificity in predicting severe COVID-19 and/or poor prognostic laboratory findings in pregnant women. CONCLUSION: There is a relationship between vitamin D status and the severity of COVID-19 in pregnant women. During the pandemic period, vitamin D supplementation for pregnant women should gain more importance.

Comparison of postprandial 90th-minute plasma glucose level with 60th- and 120th-minute levels in patients with gestational diabetes: a prospective cohort study.

PURPOSE: The objective of the present study is to compare postprandial 90th-minute plasma glucose measurement with fasting, postprandial 60 and 120 min in gestational diabetes mellitus (GDM). METHODS: One hundred and thirty-one pregnant women with GDM were hospitalized for regulation of maternal plasma glucose levels. Plasma glucose levels were daily recorded for every patient and treatment option arranged without considering the 90th-minute plasma glucose level. All patients were followed up until birth and pregnancy results were compared. RESULT: At the admission, 69% of our patients were on diet and 31% were on insulin with diet therapy. The highest postprandial mean plasma glucose was seen at 90 min after breakfast (137.50 mg/dl), at 60 min after lunch (137.80 mg/dl), and 60 min after dinner (134.50 mg/dl). The cut-off level for postprandial glucose at 90th minute was determined as 130 mg/dl. The upper limit plasma glucose levels were most frequently exceeded at 90th minute for each meal. High plasma glucose levels and the need for neonatal intensive care unit were correlated (p < 0.05). CONCLUSIONS: The highest plasma glucose level was seen at 90 min after breakfast, 60 min after lunch, and 60 min after dinner. The upper limit plasma glucose levels were most frequently exceeded at the 90 min.

Obstetric outcomes in pregnancies with normal nuchal translucency and abnormal ductus venosus Doppler in the first trimester ultrasonography.

In the present case-control study, we evaluated obstetric outcomes of pregnancies with normal nuchal translucency (NT) and abnormal ductus venosus (DV) Doppler findings in the first trimester combined screening test for chromosomal abnormalities. All study patients underwent DV Doppler examination, concurrent with the combined screening test. DV Doppler revealed pathologic findings in 14 pregnant women despite normal NT after the elimination of lost to follow-up and foetal anomaly. Obstetric outcomes of the case patients were compared with a control group that were matched for mean gestational age, and Crown-rump length with normal NT and DV Doppler measurements was selected comprising 88 pregnant women. Regarding maternal outcomes, women with abnormal DV Doppler findings had a higher rate of placental abruption, delivered at an earlier mean gestational age (preterm delivery). Interestingly, a higher rate of spontaneous vaginal delivery rate was observed in these patients. From the foetal perspective, pregnancies with abnormal DV Doppler had lower birth weight and received lower Apgar scores. In conclusion, an abnormal DV Doppler test in the first trimester was associated with poor maternal and foetal obstetric outcomes. These findings should be elucidated in future studies.

The utility of endometrial thickness measurement in asymptomatic postmenopausal women with endometrial fluid.

The aim of this study was to assess the clinical usefulness of sonographic endometrium thickness measurement in asymptomatic postmenopausal women with endometrial fluid collection. Fifty-two asymptomatic postmenopausal women with endometrial fluid, who underwent endometrial sampling were evaluated. Histopathological findings revealed that 25 (48.1%) women had insufficient tissue, 20 (38.4%) had atrophic endometrium and 7 (13.5%) had endometrial polyps. No case of malignancy was found. There was no statistically significant difference between the various histopathological categories (insufficient tissue, atrophic endometrium and polyp) with regard to the mean single-layer endometrial thickness (1.54 ± 0.87, 2.04 ± 1.76 and 1.79 ± 0.69 mm, respectively, p = 0.436). Out of 44 patients with endometrial thickness of less than 3 mm, 38 (86.4%) had atrophic changes or insufficient tissue and 6 (13.6%) had endometrial polyps. In conclusion, if the endometrial thickness is 3 mm or less, endometrial sampling is not necessary in asymptomatic postmenopausal women with endometrial fluid.

Successful use of BT-Cath(®) balloon tamponade in the management of postpartum haemorrhage due to placenta previa.

OBJECTIVE: To investigate efficacy of the BT-Cath(®) in cases of uncontrollable haemorrhage due to placenta previa. STUDY DESIGN: Retrospective study of women treated with the BT-Cath in the event of postpartum haemorrhage (PPH) due to placenta previa, despite optimal management with medical treatment. RESULTS: Between 2011 and 2013, 237 women had placenta previa (0.45%) at the study hospital. This study evaluated 53 women who underwent uterine tamponade with a BT-Cath. Haemostasis was achieved in 45 women (85%), and hysterectomy was required in six women (11%). Two women required repeat laparotomy. The mean duration of balloon tamponade was 9.8h (standard deviation 6.4h). When the relationship between balloon volume and treatment success was evaluated, the area under the receiver operating characteristic curve was 0.803 (95% confidence interval 0.633-0.973; p=0.007) and the optimal cut-off point was 220ml, with sensitivity of 88% and specificity of 71%. CONCLUSION: The intra-uterine BT-Cath is simple to use, even among clinicians with little experience, and is an effective treatment choice in patients with PPH due to placenta previa when medical treatment is unsuccessful. Minimal inflation of the balloon, a shorter period of intra-uterine balloon tamponade and early deflation of the balloon are recommended.