Plasma homocysteine, vitamin B12 and folate levels in hydatidiform moles and histopathological subtypes.

OBJECTIVE: To investigate the association of mole hydatidiform with plasma homocysteine, vitamin B(12), and folate levels. METHODS: Sixty-eight patients diagnosed with mole hydatidiform at our clinic between February and October 2007 were assessed in a case-control study. Plasma homocysteine, vitamin B12, and folate levels, taken before evacuation of patients with hydatidiform mole, were compared with the results of 100 healthy normal pregnants of first trimester; and also plasma homocysteine, vitamin B12, and folate levels were compared according to histopathological types of mole hydatidiforms. SPSS 14.0 package program was used to analyze the data. Logarithmic transformation was applied for variables. Parameters were expressed as mean+/-standard deviation. RESULTS: The mean of plasma homocysteine levels was higher in molar group (0.8+/-0.13) than in normal pregnant group (0.7+/-0.13) and the difference was statistically significant (P<0.001). The mean of plasma vitamin B12 levels was found to be similar both in normal pregnant women (2.4+/-0.17) and in the molars (2.4+/-0.15) (P=0.272). The mean of plasma folate levels was lower in molar group (1.0+/-0.15) than in normal pregnant women (1.2+/-0.17) and the difference was statistically significant (P<0.001). The hydatidiform moles of 68 patients were divided into two groups according to histopathological examination: 36 patients were partial moles and the others were complete. The difference of plasma mean homocysteine, vitamin B12, and folate levels in these two groups was not statistically significant. There were statistically significant differences of plasma mean homocysteine and folate levels one by one in complete and in partial moles when compared with the normal pregnants. The mean of plasma folate levels were lower (1.0+/-0.17 for partials, 1.0+/-0.13 for completes) and the homocysteine levels were higher (0.9+/-0.14 for partials, 0.8+/-0.12 for completes) than the levels of normal group. CONCLUSION: This study suggests that there may be an association between plasma folate and homocysteine levels with hydatidiform moles. Folate may play a protective role in preventing molar pregnancy. Further controlled prospective studies are needed to investigate the possible effect of homocysteine, vitamin B12, and folate in molar pregnancies.

Factors influencing the postpartum length of hospital stay in eclamptic women.

OBJECTIVE: To determine which variables are associated with postpartum length of hospital stay in eclamptic patients. MATERIALS AND METHODS: The study sample comprised 98 eclamptic patients who were admitted to our perinatology unit during the period between January 1998 and May 2003. The study sample was divided into two postpartum length-of-stay groups: the short-stay group (1-3 days) consisted of 33 patients and the long-stay group (4 days and longer) consisted of 65 patients. The groups were compared with respect to the demographic characteristics, clinical and laboratory variables, and complications. RESULTS: The mean hospitalization periods for the short-stay and long-stay groups were 2.48 +/- 0.79 and 5.60 +/- 2.12 days, respectively ( p = 0.010). The mean prepartum follow-up period after the onset of eclampsia was longer in the long-stay group than in the short-stay group (12.11 +/- 27.63 vs. 5.08 +/- 6.08 hours). The proportion of patients receiving magnesium sulfate therapy longer than 12 hours was higher in the long-stay group ( p = 0.014). The long-stay group had higher diastolic arterial blood pressure than that of the short-stay group ( p = 0.006). The total cesarean delivery rate for the short-stay group was 48.5%, compared with 67.7% in the long-stay group ( p = 0.081). CONCLUSION: The duration of magnesium therapy, the timing, and the mode of delivery should be individualized to reduce the length of hospital stay in eclamptic patients.

Surgical termination of pregnancy: evaluation of 14,903 cases.

OBJECTIVE: To evaluate the demographic and clinical characteristics of patients who underwent surgical termination of pregnancy and to assess the efficacy of the termination methods. MATERIALS AND METHODS: This retrospective study was carried out on 14,903 healthy women who had intrauterine pregnancy of

Depo-Provera: use of a long-acting progestin injectable contraceptive in Turkish women.

OBJECTIVE: To assess the demographic and clinical characteristics and experience of Turkish women treated with depot medroxyprogesterone acetate (DMPA). STUDY DESIGN: This prospective clinical study was carried on 9262 subjects, treated with DMPA at Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey, between 1996 and 2004. RESULTS: The mean age of study population was 28.4+/-4.6 years; 1759 (19%) subjects were breast-feeding at the time of the first injection. Eight (0.08%) pregnancies occurred, within 3 months of injection in 9262 women. Of 9262 cases, irregular bleeding occurred in 80% (7410) of the women. Discontinuation rate with this contraceptive method was recorded as 71% (6576) of the subjects. The rate of other predominant side effects was observed as follows: 8% for increase in weight, 8% for breast engorgement, 7% for mastalgia, 5% for headache. CONCLUSION: The results of this study suggest that DMPA may be an attractive contraceptive choice for both the patient and the physician in some clinical situations, especially in women at risk for complications with oral hormonal contraceptives and women who have had low compliance with other contraceptive methods. Moreover, DMPA contraception might be particularly appropriate in some cases such as in the postpartum period and in lactating women.

Clinical outcomes of early postplacental insertion of intrauterine contraceptive devices.

OBJECTIVES: To assess the efficacy, safety and, thus, advantages and disadvantages, of early postplacental intrauterine device (IUD) insertion. METHODS: IUDs were inserted within 10 min after postplacental expulsion in term pregnancy both in vaginal and cesarean deliveries via a ring forceps. Of the 276 patients enrolled, 235 were included in the study. Recipients were scheduled for examination before hospital discharge and at 6 weeks, 6 months and 12 months after postplacental insertion. RESULTS: The percentages of women returning for a follow-up visit were 221 (94%), 210 (89%) and 183 (78%) at 6 weeks, 6 months and 12 months, respectively. Among IUD acceptors, 74% of the cases had vaginal deliveries and 26% had cesarean deliveries. Continuation rates were relatively high, 87.6% and 76.3%, at 6 and 12 months, respectively, after postplacental insertion of IUD. In this study, the 1-year cumulative expulsion rate with TCu 380A device was 12.3%, which may be regarded as a standard expulsion rate for immediate postplacental insertion of similar models of IUDs. CONCLUSION: The evidence from this study suggests that immediate postplacental insertion of CuT 380 models is an effective, useful, safe, convenient and low-cost procedure for early postpartum contraception.