Predictive value of procalcitonin and IL-6 versus cervical length for the admission-to-delivery interval in preterm labour.

OBJECTIVE: The authors aimed to determine whether concentrations of IL-6 and procalcitonin in maternal circulation can be used and compared with cervical length to predict the admission-to-delivery interval in preterm labour. MATERIALS AND METHODS: Forty patients complicated with preterm labour between 24-34 weeks of gestation and having preterm birth were included in the study group. Fortyfour healthy pregnant women at similar gestational ages and having term labour ('> 37 weeks) were included in control group. Maternal concentrations of IL-6 was measured by an enzyme-linked immunosorbent assay (ELISA) and procalcitonin was measured by immunoturbidimetry with using human procalcitonin reagent kit. Transvaginal ultrasound to assess cervical length was perforned. RESULTS: Receiver operator characteristic (ROC) analysis results of IL-6 and procalcitonin for prediction of preterm delivery (PTD)< 48 hours, < seven days, <32 weeks, < 34 weeks, and < 37 weeks were not statistically significant (p > 0.05). ). It was shown through ROC analysis, that only cervical length had area under curve (AUC) 0.692 (0.511-0.873,p = 0.044) at cut off value ≤ 3.64 cm, AUC 0.758 (0.574-0.943, p = 0.015) at cut off value ≤ 3.50 cm, AUC 0.716 (0.553-0.879,p = 0.032) at cut off value < 3.80 cm, in predicting PTD within seven days, <32 weeks and < 37 week, respectively. CONCLUSION: This study suggests that in preterm labour, although IL-6 and procalcitonin have unsatisfactory predictive value for the admission-to-delivery interval, cervical length has better predictive values for the admission-to-delivery interval.

Impacts of maternal anxiety on non-stress test parameters.

OBJECTIVE: To determine the association between antenatal maternal anxiety with non-stress test (NST) parameters, which is an indi- cator test of fetal well-being in the third trimester. MATERIALS AND METHODS: Between January and December of 2013, 212 pregnant women, with 36-41 weeks of gestation were assessed with measures of distress and anxiety with Beck Anxiety Inventory (BAI) and with NST. The new National Institute Child Health and Human Development (NICHD) 2008 guideline criteria were used for interpretation of NST. Anxiety scores were grouped as minimal, mild, moderate, and severe. The impact of anxiety on NST parameters were investigated. RESULT: Anxiety scores were inversely correlated with fetal heart rate (FHR) accelerations (r = -0.631, and r = -0.855), number of fetal movements (r = -0.633, r = -0.860), FHR variability scores (r = -0.650, r = -0.877). and NST scores (r = -0.505, r = 0.729), (for all p < 0.001). NST scores were lower in severe anxiety group than the others. CONCLUSION: The study showed that severe form of anxiety significantly affects NST parameters in near-term pregnancies.

Comparison of diagnostic methods for evaluation of postmenopausal bleeding.

OBJECTIVE: To determine and compare diagnostic accuracy parameters of saline infusion sonohysterography (SIS), transvaginal ultrasonography (TVUSG), and hysteroscopy (H/S) based on histopathologic results which are accepted to be the gold standard in patients with postmenopausal bleeding (PMB). MATERIALS AND METHODS: Forty-seven patients who applied to Gynecology clinic of Adnan Menderes University, School of Medicine with PMB complaint aged between 43-76 years were included to the study. Fractioned curettage (F/C) and H/S guided biopsy were used for endometrial sampling. Diagnostic accuracy parameters (sensitivity, specificity, and positive and negative predictive values) of different methods; TVUSG, SIS, and H/S based on histopathologic findings were investigated. RESULTS: Specificity and sensitivity values calculated based on histopathologic results for all endometrial cavity lesions were found, respectively: 44.4% and 25% for TVUSG, 88.8% and 60.7% for SIS, and 100% and 77.7% for HIS. CONCLUSION: SIS is superior to TVUSG and as effective as H/S for assessment of endometrial cavity lesions in patients with PMB.