An analytical cross-sectional study: determining gestational age using fetal clavicle length during the second trimester.

PURPOSE: To investigate the correlation between fetal clavicle length and gestational age in pregnant patients from 14 and 27 weeks of gestation. METHODS: This was a retrospective cross-sectional study of patients from 14 and 27 weeks of gestation. Ultrasonographic measurements such as abdominal circumference (AC), femur length (FL), humerus length (HL), clavicle length (CL), head circumference (HC), biparietal diameter (BPD), estimated fetal weight (EFW), and transverse cerebellum diameter (TCD) were made and compared. RESULTS: A total of 552 patients were evaluated in our clinic and CL was measured properly and successfully in all fetuses. Fetal AC, FL, HL, CL, BPD, HC, EFW and TCD measurements were significantly and strongly correlated with gestational week, and Pearson's correlation values were 0.964, 0.965, 0.959, 0.965, 0.951, 0.917, 0.925, and 0.954, respectively (p < 0.001). In the regression analysis equation, gestational week = 0.894 + CL × 0.961. CONCLUSION: There was a significant positive correlation between fetal CL (mm) and gestational week. We suggest that the 1 mm = 1 week rule can be used for patients with anomalies of the cerebellum and vermis, as well as for patients with unknown last menstrual period.

Factors associated with antenatal depression during the COVID-19 (SARS-CoV2) pandemic: A cross-sectional study in a cohort of Turkish pregnant women.

PURPOSE: To determine the effect of the COVID-19 pandemic on antenatal depression in Turkish pregnant women. DESIGN AND METHODS: In this cross-sectional study, data were collected from 497 pregnant women between May and July 2020 using the Edinburgh Depression Scale (EDS) to determine the effect of obstetrics history, fear of hospitalization, concerns about the pandemic, birth, and the health of both mother and infant, on antenatal depression during the COVID-19 outbreak in Turkey. FINDINGS: The general EDS mean score of the total group was determined as mean 13.70 ± 6.22, which was higher than the critical cutoff point of 13. According to the multiple linear regression model applied in the study, the best predictive variables for the mean EDS score were determined to be concerned about completing a healthy pregnancy (r = -0.45), social media and news programs related to COVID-19 increasing levels of concern (r = -0.31), fear of hospitalization as the birth approaches (r = -0.45), having bad dreams during the COVID-19 pandemic (r = -0.41), the request for an elective cesarean delivery because of fear of catching COVID-19 (r = -0.40), fear of breastfeeding the infant (r = -0.45), and concerns that their own health would be negatively affected because of the pandemic (r = - 0.39), and these variables affected the mean EDS score negatively (total variance 40.5%, R = 0.642). PRACTICAL IMPLICATIONS: The COVID-19 pandemic has created an urgent need to implement specific antenatal programs to promote the psychological health of pregnant women and reduce antenatal depression during this or similar crises.

Effects of Propofol versus Sevoflurane on Postoperative Pain and Neuroendocrine Stress Response in Oocyte Pickup Patients.

Background: Pain aggravates the autonomic response to stress and raises neuroendocrine stress hormone levels. We compared the effects of propofol and sevoflurane on postoperative pain and neuroendocrine stress hormones. A prospective, randomized, and controlled trial was conducted with 60 patients. Methods: We randomly allocated patients to groups P (remifentanil/propofol, n = 30) and S (remifentanil/sevoflurane, n = 30). Preoperative blood samples were taken to measure serum adrenocorticotropic hormone (ACTH), corticotropin-releasing hormone (CRH), glucagon, cortisol, aldosterone, and prostaglandin E2 (PGE2) levels. Intraoperatively and postoperatively, clinical parameters were monitored at different time points. The hormone levels were again measured in the follicular fluid and blood postoperatively. Result: Demographic data were similar. The preoperative serum aldosterone levels were significantly higher in group P (p=0.001). Preoperative and postoperative serum ACTH, glucagon, cortisol, and PGE2 levels were significantly different in group P (p=0.009, p=0.004, p=0.029, and p=0.002); serum ACTH, glucagon, and PGE2 levels increased while serum cortisol levels decreased postoperatively. In group S, serum CRH and aldosterone levels, both increased in the postoperative period compared to the preoperative (p=0.001, p=0.006). Postoperatively, glucagon and PGE2 levels were both higher in group P than group S (p=0.019, p=0.015). In postoperative follicular fluid, glucagon and PGE2 levels were higher in group P, while cortisol levels were higher in group S (p=0.001, p=0.007, and p=0.001). Conclusion: The effects of anesthetic agents were different. In group P, in the preoperative and postoperative evaluation, ACTH, glucagon, and PGE2 increased postoperatively, while cortisol decreased. In group S, aldosterone and CRH increased postoperatively. Glucagon and PG E2 were higher in group P than S, postoperatively.

An examination by year of cases applied with caesarean hysterectomy because of placenta percreta in a tertiary centre: a retrospective cohort study.

OBJECTIVES: To examine cases applied with caesarean hysterectomy because of placenta percreta by comparing changes in treatment strategies and complications according to year. MATERIAL AND METHODS: A retrospective examination was made of 93 patients applied with caesarean hysterectomy with a diagnosis of placenta percreta in 5-year periods of 2005-2009, 2010-2014, and 2015-2019. Demographic characteristics were recorded, and previous caesareans, history of myomectomy and curettage, gestational weeks, and infant birthweight. Intraoperative and postoperative findings were recorded as operating time, length of stay in hospital and Intensive Care Unit (ICU), transfusion requirement, the amount of erythrocyte suspension (ES) and fresh frozen plasma (FFP) transfused, and requirement for massive transfusion. Anaesthesia type, complications, and the preferred skin-uterus incision were also recorded. RESULTS: The 93 patients comprised 8 cases in the period 2005-2009, 23 in 2010-2014, and 62 in 2015-2019. The number of previous caesarean procedures was observed to increase in parallel with these case numbers. A significant increase was observed in the gestational week of birth, and infant birthweight, and a decrease in operating times. In later years there was seen to be a lower amount of ES and FFP transfused and fewer patients with massive transfusion. Preoperative diagnosis of placenta percreta, the highest preference for general anaesthesia, selection of midline vertical skin incision and uterine fundal incision were greatest in the period 2015-2019. CONCLUSIONS: In cases with placenta percreta, of which there is an increasing incidence, maternal and infant outcomes can be optimised with prenatal diagnosis and planned caesarean hysterectomy by a multidisciplinary team with optimal prenatal preparation.

The efficacy of LigaSure™ open instruments in cases of cesarean hysterectomy due to placenta percreta: a retrospective, record-based, comparative study.

OBJECTIVE: The standard treatment for patients with placenta percreta is cesarean hysterectomy that can cause severe bleeding. New-generation vessel sealing systems like LigaSure can cut and seal vascular structures and tissues. The aim of this study was to retrospectively compare hysterectomies performed with traditional instruments and those performed with LigaSure instruments to determine the possible advantages with the latter. MATERIALS AND METHODS: Patients with placenta percreta who underwent elective cesarean hysterectomy by the same surgeon were divided into two groups based on the type of instruments used. Group 1, the standard conventional hysterectomy group, operated with conventional instruments for cutting and tying; and Group 2, the LigaSure hysterectomy group, operated with the new-generation bipolar sealing and cutting instruments. The groups were retrospectively compared for bleeding, operating time, and complications. RESULTS: In Group 2, the operating time, intraoperative and total transfused erythrocyte suspension units, total fluid in the drain, and total hospital stay were lower than in Group 1 (p < .05), as was the need for internal iliac artery ligation (p = .013). The complication rates were similar between the two groups (p > .05). CONCLUSION: The use of LigaSure open instruments in cesarean hysterectomies in patients with placenta percreta may reduce operating times and the amount of bleeding.

The efficacy of different insulin-sensitizing agents on treatment outcomes in patients with polycystic ovary syndrome who underwent in-vitro fertilization: A retrospective, record-based, comparative study.

INTRODUCTION: It is not clear which metformin or inositol is more effective on IVF results. The aim of this study was to compare the effects of Metformin and Inositol co-treatments on IVF outcomes in Polycystic ovary syndrome patients. METHODS: A retrospective examination was made of the demographic characteristics and the follicular-embryonic development results of PCOS patients applied with an antagonist protocol of ovarian hyperstimulation in the first cycle of IVF with co-treatment of Metformin at 2000 mg/day regularly for 3 months (Metformin co-treatment group, n:35) or Inositol at 4000 mg/day myo-inositol for 3 months (Inositol co-treatment group, n:34) and those not using any co-treatment (FSH only group [control group], n:40). RESULTS: No significant difference was determined between the groups in respect of demographic characteristics. The HOMA-IR scores and hCG day E2 level were significantly higher in the control group than in both co-treatment groups (p = 0.021, p = 0.018, respectively). The M1 oocyte count was significantly lower in the Metformin group than in the Inositol and control groups (p = 0.001). The GVDJ oocyte count was significantly lower in both co-treatment groups than in the control group (p = 0.042). No statistically significant difference was determined between the groups in respect of other follicular and embryological development parameters, implantation, clinical pregnancy, live births and abortus rates. CONCLUSION: Insulin-sensitizing agents may have positive effects on follicular development in PCOS patients applied with IVF.

A randomized pilot study of electro-acupuncture treatment for hysterosalpingography pain relief and related anxiety.

OBJECTIVE: To investigate the effect of acupuncture on reducing pain and anxiety related to hysterosalpingography (HSG). MATERIALS AND METHODS: A total of 107 patients planned to undergo HSG were randomly separated into 3 groups; the acupuncture group (n=36), intramuscular diclofenac sodium group (n=35), and control group (n=37). In the acupuncture group, electro-acupuncture was applied to specified points for 20 mins before the procedure. In the intramuscular diclofenac sodium group, an intramuscular injection of 75 mg diclofenac sodium was applied 30 mins before the procedure. No analgesics were administered to the patients in the control group before intervention. Pain was evaluated with a Visual Analog scale (VAS) and anxiety with the State-trait Anxiety inventory -state (STAI-S), preoperatively and at specified times postoperatively. RESULTS: The VAS scores at 1 and 5 minutes after HSG were similar in acupuncture group and intramuscular diclofenac sodium group, and significantly lower than in the control group. At 30 mins postoperatively, there was no significant difference between the 3 groups in respect of the VAS scores. The STAI-S scores at 1 hour preoperatively were similar in all the groups (p=0.563). In the comparisons of the STAI-S values at preoperative 5 mins, following acupuncture in acupuncture group and the diclofenac injection in intramuscular diclofenac sodium group, and at postoperative 30 mins, the acupuncture group values were determined to be statistically significantly lower than those of the other groups (p<0.001, p<0.001). CONCLUSION: Acupuncture has similar effects on the reduction of pain as other analgesics and reduces anxiety. It can therefore be used in HSG in suitable clinics.

Assessment of Somatic Support Process for Pregnant Brain Death Patients Occurring in a Transition Country Between Asia and Europe from Medical, Ethical, Legal and Religious Aspects.

In spite of the fact that brain death during pregnancy is not a common occurrence, it is an important ethical problem for all cultures and religions can have a significant influence on the donation decision after brain death. Therefore, this study aimed to present the case of a pregnant patient developing brain death which occurred in our intensive care unit and to compare the medical, ethical and legal problems relating to pregnant cases developing brain death with 24 cases in the literature. A 21-year-old 19-week pregnant case with gestational diabetes was monitored in the anesthesia intensive care unit and developed brain death due to intracranial mass and intraventricular hemorrhage. Though brain death is a situation well understood by organ transplant professionals, brain death developing in pregnant patients still involves many medical, ethical and legal problems.

A comparison in an experimental rat model of the effects on adhesion formation of different hemostatic methods used in abdominopelvic surgery.

OBJECTIVES: To evaluate the effects of different hemostasis methods used in abdominal surgery on the development ofabdominal adhesion. MATERIAL AND METHODS: A total of 48 Wistar albino female rats were separated into six groups; Group 1 - Control group,Group 2 - Hemorrhage group, Group 3 - Electrocoautery group, Group 4 - Gel Spon-P®, Group 5 - PAHACEL®, andGroup 6 - Ankaferd-Blood Stopper®. Adhesions that developed were scored according to the Knightly classification andthe prevalence of adhesions according to the Linsky classification. The total adhesion score was calculated as the total ofthe severity and prevalence scores. RESULTS: The lowest total adhesion values were determined in Group 1 (control) and the highest adhesion values were inGroup 2 (hemorrhage) group in terms of all parameters. The adhesion values in Group 3, where the rats were administeredhemostasis with electrocautery were similar to those of Group 2 (hemorrhage). When the alternative methods were evaluated,the lowest adhesion scores were in Group 6 (Ankaferd-Blood Stopper®). CONCLUSIONS: In cases of minor pelvic or abdominal bleeding, not providing hemostasis or applying hemostasis withelectrocautery can increase the development of intra-abdominal adhesions. The use of alternative hemostatic materialsinstead of electrocautery for hemostasis may reduce the formation of adhesions.

Posterior ocular blood flow in preeclamptic patients evaluated with optical coherence tomography angiography.

OBJECTIVE: The aim of the present study was to examine the effects of preeclampsia on posterior ocular blood flow through optic coherence tomography angiography (OCTA). STUDY DESIGN: The study included preeclamptic pregnant women (group PPW), healthy pregnant women (group HPW) and control non-pregnant women (group CNPW). The blood flow area of retina, optic nerve head and choriocapillaris were assessed through OCTA. RESULTS: Retinal superficial blood flow area (RSBFA) was similar in group PPW, HPW and CNPW (p = 0.101); likewise, there was not any difference in retinal superficial parafoveal vessel density (RSPFD) between the groups (p = 0.685). There was not any difference detected in retinal deep blood flow area (RDBFA) in group PPW, HPW and CNPW), likewise retinal deep parafoveal vessel density (RDPFD) was found similar between the groups (p = 0.184). The choriocapillaris blood flow area (CBFA) was different between the groups (p = 0.000) and less in the group PPW than in group HPW. The CBFA was 1.875 ±â€¯0.05 mm2 in group the PPW, 1.928 ±â€¯0.05 mm2 in the group HPW and 1.464 ±â€¯0.06 mm2 in the group CNPW. Similarly, the optic nerve head blood flow area was lower in the group PPW compared to the group HPW (1.567 ±â€¯0.38 mm2, 1.690 ±â€¯0.20 mm2 and 1.592 ±â€¯0.25 mm2 in the group PPW, group HPW and group CNPW respectively; p = 0.002). CONCLUSION: Posterior segment ocular blood flow may be diminished in preeclamptic women. OCTA may enable to monitor ocular blood flow dynamics and give important clues in the diagnosis of retinal vascular pathologies accompanied by systemic diseases.

Preoperative Serum Leptin Level Is Associated with Preoperative Pain Threshold and Postoperative Analgesic Consumption in Patients Undergoing Cesarean Section.

OBJECTIVE: This study aimed to investigate the preoperative level of serum leptin in cesarean section (C-section) patients with and without acute labor pain and its association with postoperative analgesic consumption and preoperative pain threshold. MATERIALS AND METHODS: Preoperative leptin levels, preoperative pain threshold, postoperative analgesic consumption in the first 24 h, and postoperative pain severity (visual analog scale (VAS) scores at 1, 2, 4, 6, 12, and 24 h postoperatively) in C-section patients with labor pain (emergency C-section; n = 21) and without labor pain (elective C-section; n = 25) were compared. RESULTS: There were no significant differences between the groups regarding the demographic characteristics. Leptin levels, postoperative VAS scores, and analgesic consumption were significantly higher in the group with labor pain, while the preoperative pain threshold was lower. Serum leptin levels correlated negatively with pain threshold and positively with postoperative analgesic consumption. Multiple linear regression analyses in our study revealed that the preoperative leptin levels and having an emergency C-section independently affected the postoperative analgesic consumption and preoperative pain threshold, whereas their combined effects on these parameters were statistically not significant. CONCLUSION: Preoperative levels of serum leptin were higher in C-section patients with labor pain than in those without labor pain, and increased serum leptin levels were associated with decreased preoperative pain threshold and increased postoperative analgesic consumption in our study population. Postoperative analgesic requirements may vary among patients, and their requirements might be predicted using preoperative indicators. Serum levels of leptin might be one such indicator and this warrants further studies with larger sample sizes.

Efficacy of the Evaluation of Inflammatory Markers for the Reduction of Negative Appendectomy Rates.

Unnecessary appendectomy can cause complications; ways of reducing negative appendectomy rates (NAR) using biochemical and imaging methods are desirable. We retrospectively examined 640 patients who underwent appendectomy for suspected AA. Patients with histologically confirmed appendicitis were designated the positive appendectomy group (n = 565), whereas those with unconfirmed appendicitis were designated the negative appendectomy group (n = 75). The positive appendectomy group was subdivided into the non-perforated (n = 511) and perforated (n = 54) appendectomy groups according to pathology reports. We compared the age, sex, lymphocyte count, neutrophil percentage, pathologic positivity or negativity for appendicitis, C-reactive protein (CRP) level, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) of the patients. When the perforated, non-perforated, and negative appendectomy groups were compared, the highest CRP level, NLR, and PLR were evident in the perforated appendectomy group (p = 0.001), whereas the lowest neutrophil percentage was found in the non-perforated appendectomy group (p = 0.001). Multiple logistic regression analysis identified neutrophil percentage, CRP value, and NLR as independent variables and demonstrated that AA could be diagnosed with 88.9 % accuracy using the cutoff values determined. In patients with suspected AA, particularly in rural areas with limited access to advanced imaging modalities, the evaluation of neutrophil percentage, CRP level, and NLR, in combination with the findings of a physical examination, may aid diagnosis and reduce NAR.

Efficacy of bispectral index monitoring for prevention of anestheticawareness and complications during oocyte pick-up procedure

Background/aim: This study was planned by considering that the use of bispectral index (BIS) monitoring ensures sufficient depth of anesthesia and avoids anesthetic awareness and patient movement in the oocyte pick-up (OPU) procedure.Materials and methods: Ninety-eight patients undergoing OPU were randomly divided into 2 groups as the control group (n = 48) and BIS group (n = 50). After propofol and remifentanil induction, the control group was given additional propofol according to reaction response, while the BIS group was given propofol at BIS values of 60 and above with the aim that BIS values be 40?60. Total procedure time, recovery time, patient movement, additional propofol consumption, total number of oocytes, and awareness during anesthesia were recorded. Results: Demographic data were similar in the two groups (P > 0.05 for all). The recovery time in the BIS group was significantly shorter compared to the control group (P < 0.001) while additional propofol consumption was found to be significantly lower (P < 0.001). Baseline BIS values fell compared to all other times after induction significantly (P < 0.001). No patient had anesthesia awareness.Conclusion: During the OPU procedure BIS monitoring is considered to prevent anesthesia awareness, intraoperative movement, and complications caused by insufficient anesthetic use as it ensures optimal doses of anesthetic agents used and early recovery.

Ultrasound-guided versus surgical transversus abdominis plane block in obese patients following cesarean section: a prospective randomised study / Bloqueio cirúrgico do plano transverso abdominal versus guiado por ultrassom em pacientes obesas após cesárea: estudo prospectivo e randomizado

Abstract Background and objectives Ultrasound-guided transversus abdominis plane block demonstrated efficacy in providing post-operative analgesia by prolonging the time to first analgesic requirement and reducing the total analgesic consumption. The surgical transversus abdominis plane block, a novel technique, can be performed safely in obese patients in whom muscle layers cannot be sufficiently exposed. Here, we compared applicability, efficacy and complications of surgical transversus abdominis plane and ultrasound-guided transversus abdominis plane blocks in obese pregnant women following cesarean section under general anesthesia. Methods Seventy-five pregnant women with pre- and post-pregnancy body mass index > 30 were randomized and allocated into two groups: Ultrasound-guided transversus abdominis plane block (UT group; n = 38) and surgical TAP block (ST group; n = 37). Visual analogue scale scores at post-operative 0, 2, 6, 12 and 24 hours (h), time to first analgesic requirement, total analgesic consumption amount in 24 h, post-operative side effects, complications and patient satisfaction were recorded. Results and conclusions Age, American Society of Anesthesiologist score, operative duration, body mass index, mean time to first analgesic requirement and total analgesic consumption in 24 h were similar between groups, while significant differences in pre- and post-pregnancy body mass index were observed between groups. Block procedure durations were 7 and 10 minutes in ST and UT groups, respectively. No significant differences in visual analogue scale scores were observed between the groups at all times; itching and nausea was observed in one (UT group) and four (UT and ST groups) patients, respectively. Surgical transversus abdominis plane block was safe in obese pregnant patients and provided similar post-operative analgesia to ultrasound-guided transversus abdominis plane block.

Resumo Justificativa e objetivos O bloqueio do plano transverso abdominal (TAP) guiado por ultrassom (US) demonstrou eficácia no fornecimento de analgesia no pós-operatório ao prolongar o tempo até a primeira necessidade de analgésico e reduzir o consumo total de analgésico. O bloqueio TAP cirúrgico (uma nova técnica) pode ser realizado com segurança em pacientes obesas nas quais as camadas musculares não podem ser suficientemente expostas. Comparamos a aplicabilidade, a eficácia e as complicações do bloqueio TAP cirúrgico e do bloqueio TAP-US em gestantes obesas submetidas à cesárea sob anestesia geral. Método Setenta e cinco mulheres grávidas com índice de massa corporal (IMC) pré e pós-gravidez > 30 foram randomicamente alocadas em dois grupos: bloqueio TAP-US (Grupo TAP-US, n = 38) e bloqueio TAP cirúrgico (Grupo TAP-C, n = 37). Os escores da escala visual analógica (VAS) nos tempos 0, 2, 6, 12 e 24 horas de pós-operatório, o tempo até a primeira necessidade de analgésico, o consumo total de analgésico em 24 horas, os efeitos colaterais no pós-operatório, as complicações e a satisfação do paciente foram registrados. Resultados e conclusões Idade, estado físico ASA, tempo cirúrgico, IMC, média de tempo até a primeira necessidade de analgésico e consumo total de analgésico em 24 horas foram semelhantes entre os grupos, enquanto diferenças significativas foram observadas entre os grupos em relação ao IMC pré- e pós-gravidez. As durações dos procedimentos de bloqueio foram de 7 e 10 minutos nos grupos TAP-US e TAP-C, respectivamente. Não houve diferença significativa nos escores VAS entre os grupos em todos os momentos; prurido e náusea foram observados em um paciente (Grupo TAP-US) e em quatro (Grupo TAP-C), respectivamente. O bloqueio TAP cirúrgico foi seguro nas pacientes grávidas obesas e forneceu analgesia similar à do bloqueio TAP-US no pós-operatório.

Bloqueio cirúrgico do plano transverso abdominal versus guiado por ultrassom em pacientes obesas após cesárea: estudo prospectivo e randomizado.

BACKGROUND AND OBJECTIVES: Ultrasound-guided transversus abdominis plane block demonstrated efficacy in providing post-operative analgesia by prolonging the time to first analgesic requirement and reducing the total analgesic consumption. The surgical transversus abdominis plane block, a novel technique, can be performed safely in obese patients in whom muscle layers cannot be sufficiently exposed. Here, we compared applicability, efficacy and complications of surgical transversus abdominis plane and ultrasound-guided transversus abdominis plane blocks in obese pregnant women following cesarean section under general anesthesia. METHODS: Seventy-five pregnant women with pre- and post-pregnancy body mass index>30 were randomized and allocated into two groups: Ultrasound-guided transversus abdominis plane block (UT group; n=38) and surgical TAP block (ST group; n=37). Visual analogue scale scores at post-operative 0, 2, 6, 12 and 24hours (h), time to first analgesic requirement, total analgesic consumption amount in 24h, post-operative side effects, complications and patient satisfaction were recorded. RESULTS AND CONCLUSIONS: Age, American Society of Anesthesiologist score, operative duration, body mass index, mean time to first analgesic requirement and total analgesic consumption in 24h were similar between groups, while significant differences in pre- and post-pregnancy body mass index were observed between groups. Block procedure durations were 7 and 10minutes in ST and UT groups, respectively. No significant differences in visual analogue scale scores were observed between the groups at all times; itching and nausea was observed in one (UT group) and four (UT and ST groups) patients, respectively. Surgical transversus abdominis plane block was safe in obese pregnant patients and provided similar post-operative analgesia to ultrasound-guided transversus abdominis plane block.

Comparison of the T2-star Values of Placentas Obtained from Pre-eclamptic Patients with Those of a Control Group: an Ex-vivo Magnetic Resonance Imaging Study.

BACKGROUND: Endotel dysfunction, vasoconstriction, and oxidative stress are described in the pathophysiology of pre-eclampsia, but its aetiology has not been revealed clearly. AIMS: To examine whether there is a difference between the placentas of pre-eclamptic pregnant women and those of a control group in terms of their T2 star values. STUDY DESIGN: Case-control study. METHODS: Twenty patients diagnosed with pre-eclampsia and 22 healthy controls were included in this study. The placentas obtained after births performed via Caesarean section were taken into the magnetic resonance imaging area in plastic bags within the first postnatal hour, and imaging was performed via modified DIXON-Quant sequence. Average values were obtained by performing T2 star measurements from four localisations on the placentas. RESULTS: T2 star values measured in the placentas of the control group were found to be significantly lower than those in the pre-eclampsia group (p<0.01). While the mean T2 star value in the pre-eclamptic group was found to be 37.48 ms (standard deviation ± 11.3), this value was 28.74 (standard deviation ± 8.08) in the control group. The cut-off value for the T2 star value, maximising the accuracy of diagnosis, was 28.59 ms (area under curve: 0.741; 95% confidence interval: 0.592-0.890); sensitivity and specificity were 70% and 63.6%, respectively. CONCLUSION: This study, the T2 star value, which is an indicator of iron amount, was found to be significantly lower in the control group than in the pre-eclampsia group. This may be related to the reduction in blood flow to the placenta due to endothelial dysfunction and vasoconstriction, which are important in pre-eclampsia pathophysiology.

Evaluation of Malondialdehyde, Superoxide Dismutase and Catalase Activity in Fetal Cord Blood of Depressed Mothers.

OBJECTIVE: The umbilical cord consists of two arteries and one vein and it functions in the transport between the maternal and fetal circulation. Biochemical analysis of fetal cord blood (FCB) during delivery could be beneficial in terms of understanding the fetal environment. In this study, we aimed to investigate oxidative parameters like malondialdehyde (MDA), superoxide dismutase (SOD), and catalase (CAT) levels in FCB during delivery. METHODS: We collected FCB samples during caesarean section. Our study included 33 depressed mothers and 37 healthy controls. We investigated MDA, SOD, and CAT levels in FCB samples. RESULTS: We found no significant difference between groups in terms of MDA (p=0.625), SOD (p=0.940), and CAT (p=0.413) levels. CONCLUSION: Our study reveals probable protective effects of the placenta from oxidative stress. Future studies should include larger samples.

Comparison of the landmark and ultrasound methods in cesarean sections performed under spinal anesthesia on obese pregnants.

Difficulties in the palpation of anatomical landmarks in pregnancy due to obesity may create problems in the regional anaesthesia. Objective of this study was to compare ultrasound examination carried out before the procedure with conventional spinal anaesthesia method with papation of bony landmarks in caesarean sections performed under spinal anaesthesia in obese pregnants. Ninety-seven obese pregnants having pre- and post-pregnancy body mass index > 30 kg/m2 were prospectively examined. Patients were randomised to two groups as landmark group (n = 49) and ultrasound group (n = 48). The needle insertion point was determined at L4-L5 level before the procedure through palpation in the landmark group and with the examination in the ultrasound. The numbers of skin punctures and needle passes, total procedure time (TPT) and spinal block occurrence time (SBOT) were recorded. TPT was significantly longer in the ultrasound than in the landmark group (p < 0.001) (8 ± 2 and 5 ± 1; respectively). Whereas SBOT values were similar (p = 0.063). The numbers of skin punctures and needle passes were significantly fewer in the ultrasound than in the landmark group (p < 0.001). We believe that, accurate determination of the needle introducing site before the procedure by viewing the vertebral structures through ultrasound examination in obese pregnants could increase the success rate.

Increased oxidative stress is associated with insulin resistance and infertility in polycystic ovary syndrome.

OBJECTIVES: The present study aims to investigate the role of oxidant-antioxidant status in young women with polycystic ovary syndrome (PCOS). MATERIAL AND METHODS: Seventy-one women with PCOS and 53 healthy controls are compared in aspect of demographic characteristics, biochemical data, hormones, and oxidant-antioxidant status. RESULTS: The PCOS group had significantly lower zinc, higher malondialdehyde and gluthathione peroxidase and lower serum catalase levels than the control group (p = 0.016, p < 0.001, p = 0.043 and p = 0.025 respectively). The PCOS patients with IR had significantly higher malondialdehyde, lower catalase and serum zinc levels than the PCOS patients without IR (p = 0.015, p = 0.010, p = 0.001 respectively). The infertile PCOS patients had significantly higher malondialdehyde, lower catalase and serum zinc levels than the fertile PCOS patients (p = 0.022, p = 0.045,p = 0.001 respectively). There was a statistically significant and positive correlation between HOMA-IR and malondialdehyde values (r = 0.523, p = 0.001), between HOMA-IR and glutathione peroxidase values (r = 0.468, p = 0.001) and between HOMA-IR and zinc values (r = 0.601, p = 0.001). There was a statistically significant and negative correlation between HOMA-IR and catalase values (r = -0.493, p = 0.001). CONCLUSIONS: The patients with PCOS are under oxidative stress and this oxidative stress seems to be the highest in patients with IR and with infertility. Despite the prominent increase in the oxidative stress, there was a variation in the antioxidant response.

Depression in pregnancy is associated with decreased glutathione peroxidase activity in fetal cord blood.

The investigation of fetal cord blood (FCB) during child delivery has created a novel topic in the field of psychiatric research. The umbilical vein receives nutrients and oxygen from the mother's circulation and transports them to the fetal circulation. Investigating fetal cord blood during delivery is beneficial for understanding the fetal environment. Depression in pregnancy is associated with medical and emotional burdens. In this study, we aimed to investigate glutathione peroxidase (Gpx) and myeloperoxidase (MPO) activity in the FCB of depressed mothers and healthy controls. Our study included 45 depressed mothers and 59 healthy controls. The FCB samples were collected from the umbilical vein during delivery. We found that Gpx levels were significantly decreased in the FCB of depressed mothers than healthy controls, medians were 0.14 U/ml and 0.16 U/ml respectively, Z: -3.567 and p < 0.001. MPO levels were similar in both groups, medians were 1.0 U/L and 1.2 U/L respectively, Z: -1.837 and p:0.066. Depression in pregnancy may be associated with decreased antioxidant levels, and this condition may cause an oxidative load, which may lead to improper brain development. Future studies should be performed in larger samples to clarify our preliminary results.