The relation among steroid hormone levels, lipid profile and menopausal symptom severity.

INTRODUCTION: Many postmenopausal women experience hot flashes, night sweats, non-specific emotional and psychological distresses. Our aim was to investigate the relation among steroid hormone levels, lipid profile and menopausal symptom severity using the menopause rating scale (MRS). METHODS: A cross-sectional study was performed at our outpatient clinic with natural postmenopausal women. A total of 444 women were included in this study. The basic characteristics of the study population, such as age, gravidity, parity, time to menopause onset and body mass index (BMI) were recorded. Venous blood samples were collected from subjects after overnight fasting. The levels of high-density lipoprotein-cholesterol, low-density lipoprotein-cholesterol, total cholesterol, triglyceride (TG), fasting plasma glucose, C-reactive protein, thyroid-stimulating hormone (TSH), cortisol, estradiol (E2), progesterone, testosterone and dehydroepiandrostenedione sulfate (DHEA-S) were analyzed. The MRS questionnaire validated for the Turkish population was used to assess the menopausal symptoms. RESULTS: There was a statistically significant difference between mild and severe total symptom scores for TG, and elevated TG levels were observed in the severe group (p = 0.04). Elevated testosterone levels were observed with severe psychological symptom and total symptom scores. There were significant differences in progesterone level in psychological, urogenital, and total scores and lower levels were seen in severe symptom groups. There was a significant negative correlation between urogenital symptom scores and progesterone levels (p < 0.001). DISCUSSION: Elevated levels of testosterone were related to severe psychological symptom and total menopausal symptom scores. A decrease in progesterone levels was related to high psychological, urogenital and total menopausal symptom scores. Elevated TG levels were also related to the total severe symptom scores.

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.

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.

Comparing the efficacy of intrauterine lidocaine and paracervical block in decreasing the pain associated with endometrial biopsy: a randomised trial.

PURPOSE: Almost 50% of the patients experience moderate-to-severe pain during endometrial biopsy. The study aimed to examine the effectiveness of intrauterine lidocaine for relieving pain during endometrial biopsy. METHODS: A randomised trial was conducted in 120 patients undergoing endometrial biopsy. Sixty-seven women were assigned to the paracervical block group and 53 were assigned to the intrauterine lidocaine group. The main outcome measure was pain intensity, measured using the visual analogue scale, during and after the procedure. RESULTS: The groups were similar with regard to age, body mass index, gravidity, total number of previous vaginal deliveries, menopausal status, and uterine depth. The pain scores immediately after the procedure were similar in the groups (p = 0.079). However, the pain scores 30 min after the procedure were significantly lower in the intrauterine group than in the paracervical group (p = 0.0001). CONCLUSIONS: Compared to paracervical block, intrauterine lidocaine may be the preferred anaesthesia for endometrial biopsy, and it does not cause any serious complications.

Placental growth factor as a new marker for predicting abnormal glucose challenge test results.

BACKGROUND: To differentiate placental growth factor (PlGF) levels in pregnancies with normal and abnormal glucose challenge test (GCT) results. METHODS: A total of 94 pregnant women underwent a 50 -g GCT as part of our routine antenatal screening protocol from September 2011 to January 2012. The patients were divided into three groups: (i) normal GCT, (ii) abnormal GCT and (iii) gestational diabetes mellitus (GDM) based on the screening results for gestational diabetes. The main outcome measure of the study was the relationship between PlGF and GCT results in non-diabetic pregnancies. The Kolmogorov-Smirnov test was used to check the normality of the variables' distributions. The Kruskal-Wallis and analysis of variance tests (Tukey's test) were used to analyze the qualitative parameters. RESULTS: There were 53 (56.4%), 22 (23.4%) and 19 (20.2%) patients in the normal GCT, abnormal GCT and GDM groups, respectively. The PlGF level in the abnormal GCT group was 518 ± 307.6 pg/mL, which was the highest level in the study population, and there was a statistically significant difference compared with the other groups (p = 0.006). There were no statistically significant differences with respect to fetal birth weight among the three groups in our study. CONCLUSION: PlGF can be used as a laboratory marker to predict which patients will have abnormal GCT results.

Management of incidental adnexal masses on caesarean section.

BACKGROUND: The reported incidence of adnexal masses during pregnancy vary from 1 in 81 pregnancies to 1 in 8000 pregnancies. There is still a debate on management of incidental adnexal masses during the caesarean section concerning the risk of this additional procedure on postoperative morbidity and mortality. The aim of our study was to investigate the management of incidental adnexal masses which were observed during caesarean section in a tertiary health care centre. MATERIALS AND METHODS: The medical records of the patients who had incidental adnexal masses during caesarean section at Bakirkoy Dr. Sadi Konuk Teaching and Research Hospital, Department of Obstetrics and Gynecology from January 2006 to September 2011 were evaluated retrospectively. The data was processed with the SPSS 16.0 statistical software. RESULTS: The number of total live births was 17341 and 6624 of them were done by caesarean section (31%). There were 38 cases of incidental adnexal masses which were discovered at caesarean section. The most common pathologic diagnosis of the masses were paraovarian-paratubal cysts with the rate of 23.7% (n=9). Cystectomy procedure during caesarean section did not alter the morbidity of the patient. CONCLUSIONS: In conclusion for detecting adnexal masses during pregnancy follow-up of growth rate of adnexal mass will be a useful reference during the observation period if ideally all pregnant women have a first-trimester ultrasound examination with regular adnexa check-up.