Ultrasonographic detection of single umbilical artery: a simple marker of fetal anomaly.

OBJECTIVE: To detect associated anomalies, karyotypes and perinatal prognosis of fetuses with single umbilical artery. METHOD: Fifteen fetuses who have single umbilical artery were evaluated in the obstetrical ultrasonography and medical genetics departments of Osmangazi University. RESULTS: Fifteen fetuses with single umbilical artery were detected during antenatal ultrasonographic examinations. Associated sonographic abnormalities include oligohydramnios (two), intrauterine growth retardation (one), renal agenesis (one), fetal ascites (one), diaphragmatic hernia (one), hydrocephalus (two), and meningomyelocele (one). Complications related to the pregnancy were pre-eclampsia in one case and abruptio placenta in another. Karyotype analysis was available in 11 cases and the only cytogenetic abnormality detected was trisomy 18 in one case. Two cases with hydrocephalus and single umbilical artery were delivered by cesarean section at 34 and 38 weeks, but both died (on the first and fifth days after birth). Five pregnancies were terminated because of intrauterine death (one), severe pre-eclampsia (one), cytogenetic abnormality (one), and multiple congenital anomalies associated with single umbilical artery (two) at 36, 27, 22, 26 and 29 weeks, respectively. Eight of the neonates who had no additional congenital or cytogenetic abnormality were completely normal at birth and during the neonatal period. Diagnoses were confirmed pathologically in all cases. CONCLUSION: Scanning the umbilical cord should be one of the essential parts of ultrasonographic examination. When single umbilical artery is detected, a detailed ultrasonographic examination is necessary to rule out associated abnormalities. We advise fetal karyotyping even when no additional pathology can be detected on ultrasonographic examination.

Isolated torsion of fallopian tube during pregnancy; report of two cases.

Isolated torsion of fallopian tube is very uncommon during pregnancy. Predisposing factors for torsion are hydrosalpinx, prior tubal operation, pelvic congestion, ovarian and paraovarian masses and trauma. Although the most important clinical symptom is abdominal pain in lower quadrants, the diagnosis is usually established during the operation performed for acute abdomen and salpingectomy is almost always necessary. Two cases of torsion of fallopian tube during pregnancy, one with hydrosalpinx, the other with paratubal cyst are presented and symptoms and predisposing factors are discussed.

Effects of postmenopausal hormone replacement and alpha-tocopherol on the lipid profiles and antioxidant status.

Sixty-six postmenopausal women were randomly divided into three groups. The first group (n = 22) received transdermal oestradiol (0.05 g/day) for six months. Transdermal oestradiol was given during three weeks but was not given in the following week of each month during six months. In addition to the first group's therapy, medroxyprogesterone acetate (MPA; 10 mg/day, per orally) was administered to the second group (n = 22) for the last ten days. Vitamin E (600 mg/day, per orally) was given to the third group (n = 22) in addition to the first and second group therapy every day during six months. Total cholesterol, high density lipoprotein (HDL), very low density lipoprotein (VLDL) and low density lipoprotein (LDL) cholesterol, malondialdehyde (MDA), superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) levels of the three groups were measured at the beginning and at the end of therapy. In the transdermal oestradiol and transdermal oestradiol + MPA groups, post-treatment serum total, VLDL and LDL cholesterol levels decreased (P < 0.05) whereas HDL cholesterol level increased (P < 0.05). No significant difference was found in the levels of MDA, SOD and GSH-Px. In the third group, pre-treatment levels of total (P < 0.05), VLDL (P < 0.05), LDL cholesterol (P < 0.01) and MDA (P < 0.05) were high compared to post-treatment. Inversely, HDL cholesterol (P < 0.05) and vitamin E (P < 0.01) levels increased after the treatment. However, there was no significant difference in the levels of SOD and GSH-Px. In conclusion, in the post-menopausal period, because of the positive changes after hormone replacement plus vitamin E therapy, we suggest that hormone replacement and vitamin E combined therapy is effective in prevention of cardiovascular diseases.