Does being infected with SARS-CoV-2 in the first-trimester increase the risk of miscarriage?

Aim of this study is to investigate whether the risk of miscarriage increases in pregnant women who had COVID-19 in first trimester. Our study included 52 patients with SARS-CoV-2 infection detected by RT-PCR and 53 patients with negative RT-PCR test in samples taken with nasopharyngeal swab in the first trimester between March 1 and December 31, 2020. Complete abortion, incomplete abortion, blighted ovum, intrauterine exitus, biochemical pregnancies were accepted as in the miscarriage group (MG). Pregnant women with COVID-19 and control group were compared in terms of demographic data, miscarriage rate and laboratory results. Patients were divided into MG and ongoing pregnancy groups (OPG) and compared in terms of the diagnosed weeks, clinical findings, laboratory results, treatments, and hospitalization. While miscarriage was observed in 15 (28.8%) of pregnant women infected with SARS-CoV-2 in the first trimester, this number was 7 (13.2%) in the control group. While the common symptoms in the MG were cough (60%), fever (53.3%), shortness of breath (53.3%), and fatigue (46.7%) (p<0.05); asymptomatic patients (51.4%) were higher in the OPG (p<0.001). Hospitalized patients were 33.3% in the MG and 8.1% in the OPG (p=0.02). According to the results of our study, the risk of miscarriage increases in pregnant women infected with SARS-CoV-2 (especially in severe infection) in the first trimester.

Examination of Treatment Duration, Treatment Success and Obstetric Results According to the Vaginismus Grades.

INTRODUCTION: In patients with vaginismus, the treatment becomes more challenging and the treatment may take longer as the grade of vaginismus is higher or worsens. However, the differences regarding treatment duration, success, and treatment methods by grades are not evident in the literature. AIM: The aim of this study is to answer the question, "Does the number of treatment sessions, dilator requirement, treatment success, pre-& post-treatment FSFI scores and obstetric results of vaginismus patients change depending on the vaginismus-grade?" METHODS: The patients were divided into 4 grades according to the Lamont classification. They underwent stepwise treatment sessions by a single gynecologist. Treatment success, duration of treatment, mechanical dilator requirement, duration from marriage, pre- and post-treatment FSFI scores, pregnancy rates, and delivery types were compared between patients at different grades. MAIN OUTCOME MEASURES: Assessment of the differences between vaginismus-grades by comparing clinical observations and FSFI-scores. RESULTS: Pain-free sexual intercourse occurred in 85 (93.4%) of 91 primary-vaginismus patients included in our study. The success rate was 100% in grade 1, 95.2% in grade 2, 92.1% in grade 3, and 92% in grade 4. Treatment session durations of the patients differed significantly by grades (P < .05). Same way the duration from marriage at the time of application differed significantly by the grade (P < .05). While there was a significant relationship between vaginismus grade and dilator requirement, there was no significant relationship between vaginismus grade and delivery type (P < .05). 54.5% of 44 patients, who got pregnant, delivered by cesarean-section. There was a significant increase in FSFI scores in all groups in the pre- and post-treatment third month (P < ,05). CONCLUSION: Patients should be notified that as the grades of vaginismus progress, the duration of the treatment may extend, and its success may decrease, the requirement for mechanical dilators will increase in the advanced grade, and the grade may progress as the application period for treatment is delayed. Kiremitli S, Kiremitli T. Examination of Treatment Duration, Treatment Success and Obstetric Results According to the Vaginismus Grades. Sex Med 2021;9:100407.

Are the body shape index, the body roundness index and waist-to-hip ratio better than BMI to predict recurrent pregnancy loss?

PURPOSE: Etiology could not be determined in approximately 50% of recurrent pregnancy loss cases, and it was named unexpected recurrent pregnancy loss(URPL). A body shape index(ABSI), body roundness index(BRI), and waist-to-hip ratio(WtHR) are new indexes that are superior to BMI in showing body fat distribution. We aimed to investigate the potency of ABSI, BRI, and WtHR in URPL, their superiority to BMI, and their suitability for clinical use. METHODS: One hundred and thirty-eight patients between the ages of 20-40 who applied to our hospital for URPL between January 2016 and December 31, 2020 were included in our study. Weight, height, waist circumference, and hip circumference were measured, and indexes were calculated. Differences between the URPL and control groups were calculated using the IBM SPSS program. RESULTS: There was a significant difference between the two groups for BRI, ABSI, and WtHR values, while there was no significant difference in BMI. BRI(4.4 ± 1.7vs3.9 ± 1.5), ABSI(0.08 ± 0.005 vs 0.078 ± 0.004), and WtHR(0.84 ± 0.06vs0.82 ± 0.05) values were higher in the URPL group. ROC analysis showed us that BRI, ABSI, and WtHR have a diagnostic value for URPL(P < .05). When indexes were above the cutoff values, RPL risk increased 3.59 times in ABSI, 2.26 times in BRI, and 2.9 times in WtHR(P < .05). CONCLUSIONS: The relationship between obesity and URPL can be explained more clearly by using effective indexes that show body fat distribution rather than BMI. Ethics committee approval was obtained from Erzincan Binali Yildirim University in 14.01.2021. Clinical Research Ethics Committee no: 01/01.

The effect of resveratrol on oxidative ovary-damage induced by methotrexate in rats (Resveratrol oxidative ovary-damage).

Methotrexate (MTX) is a commonly used folic acid antagonist for the treatment of neoplasia and some autoimmune diseases. Resveratrol has important anti-inflammatory, antioxidant and immunomodulatory properties. The aim of this study was to investigate the effects of resveratrol on MTX-induced ovary-damage and oxidative stress in rats. We hypothesized that supplement of resveratrol could counteract MTX-induced cytotoxicity in rat ovary. Albino Wistar female rats were randomly divided into three groups: Healthy control (HC), resveratrol + methotrexate (RMTX) and methotrexate (MTX) group. Their ovaries were removed. Biochemical and histopathological methods were utilized for evaluation of the oxidative ovary-damage. MDA was found to be higher but tGSH and SOD were lower in the ovarian tissue of the rat group administered MTX, but it is observed that these ratios are reversed in HC and in RMTX groups. MTX treatment induced ovary damage and especially pre-treatment with resveratrol provided protective effect against this MTX-induced ovary-damaged.

Could serum levels of irisin be used in gestational diabetes predicting?

OBJECTIVE: Gestational diabetes mellitus (GDM) is a metabolic disorder during pregnancy leading to acute and chronic complications in both mother and newborn. The pathogenesis of GDM has not been fully understood, However, since the disease shares risk factors with type 2 diabetes mellitus (T2DM), a relationship between these two disease states is plausible. The recently discovered peptide irisin has been hypothesized to be a regulator of body metabolism. However, studies ended up with controversial results. In the present study, we aimed to investigate the relationship between irisin levels and gestational diabetes mellitus and the possible benefits of the metabolic profile. MATERIALS AND METHODS: We performed a cross-sectional analysis of circulating levels of irisin in 100 pregnant women similar for age and body mass index and the groups included 50 gestational diabetic patients and 50 healthy pregnant volunteers. Serum irisin levels were measured by ELISA kit. RESULTS: Mean age and body mass index levels were similar in both groups. Median HbA1c, fasting blood glucose, Glucose 1 h, Glucose 2 h and fasting insülin levels were higher in with gestational diabetic patients compared to the control group. In gestational diabetic group, the median irisin level was lower than in the control group. CONCLUSION: Serum irisin levels were lower in gestational diabetic patients. Further investigations are needed to explore the underlying biological effects of irisin on pregnant women.

Effect of lycopene on oxidative ovary-damage induced by cisplatin in rats.

The anti-cancer drugs, particularly those used in reproductive period, may cause several complications such as ovarian insufficiency and infertility. The mechanism of action of cisplatin toxicity on the ovaries is not fully described. However, further production of free oxygen radicals and reduced production of antioxidants are thought to have an effect on the occurrence of cisplatin toxicity. The aim of this study was to investigate the effects of lycopene on cisplatin-induced ovary-damage, oxidative stres and histological changes in rats. Albino Wistar female rats were randomly divided into three groups. The control group (Group 1) received sunflower oil; animals in Group 2 received only cisplatin; one hour of lycopene pre-treatment was applied to the animals in Group 3 before administration of cisplatin. Cisplatin (5 mg/kg/day) was intraperitoneally injected as a single dose and lycopene (0.5 mg/kg/day) was administered by gavage. Biochemical and histopathological methods were utilised for evaluation of the oxidative ovary-damage. There was an increase in the levels of malondialdehyde, while total glutathione, glutathione reductase, and superoxide dismutase were decreased in Group 3, but it is observed that these ratios are reversed in the Group 1 and in the Group 2. Lycopene had protective effect against cisplatin-induced ovary-damaged.