Adolescent pregnancy and depression: is there an association?

OBJECTIVE: The impact of being an adolescent and socio-demographic parameters on depression development during pregnancy were evaluated in this study. MATERIALS AND METHODS: Between September 2010 and September 2011, 105 consecutive adolescent women ≤ 17 years of age were defined as the study group and 105 consecutive pregnant women over 18 years of age and matched for gestational age, were defined as the control group. Groups were compared according to depression development. The predictors of depression were analyzed by regression analysis. RESULTS: Median Beck Depression Inventory-II (BDI-II) scores in adolescent and control groups were 16 and 6, respectively. The difference was statistically significant. In the adolescent group, 39.0% of patients had mild depression, 37.1% moderate, and 10.5% had severe depression. Only 4.8% of patients in the control group had mild depression while none of the control cases had moderate or severe depression. Multivariate analysis showed that most important factor that was associated with depression development during pregnancy was being an adolescent. CONCLUSION: Depression risk was increased 18.2-fold in adolescent patients with pregnancy. Therefore psychiatric evaluation should be considered for these patients.

Cardiac arrest: an unexpected complication during laparoscopic bilateral tubal ligation--a rare case report.

Data consistently show that in experienced trained hands, laparoscopic tubal sterilization is safe and highly effective regardless of the approach or occlusive method. The known mortality rate is between four and eight deaths per 100,000 cases and the rate of intraoperative and postoperative major complications is less than 1%. The anesthetic complication rate for laparoscopy is between 0.016% and 0.75%. Carbon dioxide (CO2) pneumoperitoneum effects are still controversial. Here the authors present a case report of patient who suffered from intraoperative cardiac arrest during laparoscopic tubal ligation under general anesthesia. No definite cause has been identified. The authors outline several possible mechanisms that could have been involved and attempt to discuss these events in the face of published reports describing similar complications.

Diagnostic Accuracy of Neutrophil/Lymphocyte Ratio, Red Cell Distribution Width and Platelet Distribution Width in Ovarian Torsion.

The main aim of this diagnostic case-control study of 136 patients with ovarian cysts (44 patients with ovarian torsion and 92 controls) was to determine the diagnostic value of haematologic inflammatory markers (neutrophil/lymphocyte ratio [NLR], red cell distribution width [RDW] and platelet distribution width [PDW]) for torsioned ovarian cysts. The presence of a torsioned ovarian cyst was identified by a 1.18-fold increase in the NLR (95%CI: 1.04-1.34, P = 0.009), a 1.22-fold increase in the RDW (95%CI: 1.04-1.43, P = 0.023) and a 1.93-fold increase in the PDW (95%CI: 1.19-3.14, P = 0.007). The NLR was the best predictor of a torsioned ovarian cyst (AUC: 0.74; 95% CI: 0.68-0.83). When an NLR cut-off value of 2.44 was used to determine ovarian torsion, the sensitivity, specificity, + LR and -LR were 70.5%, 70.7%, 2.40 and 0.42, respectively. In conclusion, the NLR may have diagnostic and prognostic value in determining torsioned ovarian cysts.

A case of Cantrell syndrome diagnosed in the first trimester.

Here, the authors report a case of Cantrell's syndrome which was diagnosed by ultrasound at 12th week of pregnancy and confirmed by autopsy. Cantrell syndrome/pentalogy is defined as congenital combination of five main distinctive components: defects at the lower part of the sternum, anterior diaphragm, midline supraumbilical abdominal wall, diaphragmatic pericardium, and ectopia cordis. In the present case, in addition to these anomalies, there was cleft palate and cleft lip at the midline. Association of cleft lip and palate with Cantrell's syndrome may be due to the extension of defective migration of mesodennal primordial structures, which is mainly in abdomen and thorax, towards facial structures. Therefore, in prenatal diagnosis facial anomalies should be examined carefully in all cases with Cantrell syndrome.

The association between inherited thrombophilia and recurrent pregnancy loss in Turkish women.

OBJECTIVE: To investigate the relation between recurrent pregnancy loss (RPL) and factor V Leiden, prothrombin G20210A, and C677T methylenetetrahydrofolate reductase (MTHFR) mutations. MATERIALS AND METHODS: A case-control study was conducted on 95 consecutive cases with RPL, and 40 age-matched controls who had no history of pregnancy loss and had at least one successful pregnancy. After application of exclusion criteria, 60 patients in the study group and 40 control cases were compared for thrombophilic factors. RESULTS: Thirteen out of 60 RPL cases and one out of 40 in the control group were carriers of factor V Leiden mutation. While six patients were carriers of prothrombin G20210A gene mutation, none in the control group carried this mutation. Twenty-nine out of 60 RPL cases and 17 out of 40 control cases had MTHFR mutation. CONCLUSION: The authors found a positive correlation between RPL and FVL and FII gene mutations, but no significant association between RPL and MTHFR gene mutation.

Prevention of ischemia-reperfusion injury in rat ovarian tissue with the on-off method.

Ischemia is defined as cell death caused by insufficient perfusion of the tissue due to reduction in arterial or venous blood flow, depletion of cellular energy storages, and accumulation of toxic metabolites. The positive effects of controlled reperfusion are known and are used clinically. But the positive effects of controlled reperfusion on ovarian tissue have not been seen in the literature yet. The biochemical and histopathological comparative investigation of rat ovaries that were experimentally exposed to ischemia (IG), ischemia-reperfusion (I/R), and ischemia-controlled reperfusion (ICR) was aimed. Forty rats were divided into four groups (10 rats per group). First group: 3 h ischemia by vascular clips on ovarian tissue. Second group: 3 h ischemia + 1 h reperfusion. Third group: 3 h ischemia + 1 h controlled reperfusion (on-off method: controlled reperfusion by opening and closing the clips (on/off) in 10-second intervals, for 5 times for a total of 100 seconds). Fourth group: healthy rats. Biochemical (tGSH, MDA, and DNA damage level and SOD activity) and histopathological analysis were performed. The highest glutathione and superoxide dismutase measurements were found in ischemia/controlled reperfusion group among the ischemia or ischemia/reperfusion groups. Similarly the damage indicators (malondialdehyde, DNA damage level and histopathological damage grade) were the lowest in ischemia/controlled reperfusion group. These results indicate that controlled reperfusion can be helpful in minimizing ischemia-reperfusion injury in ovarian tissue exposed to ischemia for various reasons (ovarian torsion, tumor, etc.).