Can first-trimester aspartate aminotransferase/platelet ratio index score predict intrahepatic cholestasis of pregnancy?

Background and Aim: The study aimed to investigate the effectiveness of aspartate aminotransferase (AST), alanine aminotransferase (ALT), and platelet values in predicting intrahepatic cholestasis of pregnancy (ICP) in the first trimester, together with the aspartate aminotransferase/platelet ratio index (APRI) score. Materials and Methods: This study consisted of a patient group diagnosed with ICP (n=49) and a control group (n=62). Laboratory tests of both groups were analyzed retrospectively. Results: The first-trimester APRI score and AST and ALT values were found to be statistically significantly higher than those of the control group. The platelet value was found to be statistically significantly lower in the study group, even though it was within the normal reference range. Conclusion: The first-trimester APRI score was found to be effective in predicting ICP. In addition, the first-trimester AST, ALT, and platelet values were found to be effective in predicting ICP diagnosed in the third trimester even though if not as much as the APRI score.

Ultrasonographic evaluation of the fetal thymic-thoracic ratio in preeclampsia.

OBJECTIVE: To compare the fetal thymic thoracic ratio in preeclamptic pregnant women and healthy pregnant women. METHOD: Fetal thymic thoracic ratio was evaluated in 240 pregnant women in the third trimester. Patients were examined in two groups. They included 120 preeclamptic pregnant women (study group) women and 120 healthy pregnant women (control group). RESULTS: The fetal thymic thoracic ratio was found to be statistically significantly lower in preeclamptic cases compared to that in the control group (p = .001). When the fetal thymic thoracic ratio was evaluated between the mild preeclampsia group (0.399 (0.388-0.413)), severe preeclampsia group (0.385 (0.350-0.394)), and the control group (0.43 (0.324-0.462)), it was found statistically significant differences between the groups (p = .001). CONCLUSION: The fetal thymic thoracic ratio decreased in preeclamptic pregnant women and this decrease was more pronounced in the severe preeclampsia group. The measurement of fetal thymic thoracic ratio was seen to be beneficial in determining the severity of the disease in preeclamptic pregnant women.

Finding the best method for screening for gestational diabetes mellitus: fetal thymic-thoracic ratio or fetal thymus transverse diameter.

OBJECTIVE: The aim of this study was to compare the efficiency of fetal thymic-thoracic ratio and fetal thymus transverse diameter measurements in gestational diabetes mellitus. METHODS: Fetal thymic-thoracic ratio and fetal thymus transverse diameter were assessed in 360 pregnant women. Patients were examined in two groups: 180 gestational diabetes mellitus (study group) and 180 healthy pregnant women (control group). RESULTS: There were no statistically significant differences between the cases with gestational diabetes mellitus and the control group in terms of fetal thymus transverse diameter; however, the fetal thymic-thoracic ratio was found to be significantly lower in cases with gestational diabetes mellitus compared to that in the control group (p<0.001). CONCLUSION: The fetal thymic-thoracic ratio is superior to the fetal thymus transverse diameter in evaluating the fetal thymus size.

Finding the best method for screening for gestational diabetes mellitus: fetal thymic-thoracic ratio or fetal thymus transverse diameter

SUMMARY OBJECTIVE: The aim of this study was to compare the efficiency of fetal thymic-thoracic ratio and fetal thymus transverse diameter measurements in gestational diabetes mellitus. METHODS: Fetal thymic-thoracic ratio and fetal thymus transverse diameter were assessed in 360 pregnant women. Patients were examined in two groups: 180 gestational diabetes mellitus (study group) and 180 healthy pregnant women (control group). RESULTS: There were no statistically significant differences between the cases with gestational diabetes mellitus and the control group in terms of fetal thymus transverse diameter; however, the fetal thymic-thoracic ratio was found to be significantly lower in cases with gestational diabetes mellitus compared to that in the control group (p<0.001). CONCLUSION: The fetal thymic-thoracic ratio is superior to the fetal thymus transverse diameter in evaluating the fetal thymus size.

Decreased fetal thymus size in pregnancies after assisted reproductive technologies.

OBJECTIVE: To compare the size of the fetal thymus, using both fetal thymic-thoracic ratio and fetal thymus transverse diameter values in Assisted reproductive technologies (ART) or naturally conceived pregnancies. METHODS: In this retrospective study, fetal thymic-thoracic ratio and fetal thymus transverse diameter were evaluated in 204 pregnant women. Patients were examined in two groups. The study included 58 Intracytoplasmic sperm injection (ICSI) patients (study group) and 146 healthy pregnant women (control group). RESULTS: Fetal thymic-thoracic ratio in ART pregnancies were found to be statistically significantly lower than that of the control group (p = .001). Also, the fetal thymus transverse diameter value was found to be statistically significantly lower in ART pregnancies compared to that of the control group (p = .001). CONCLUSIONS: The size of the fetal thymus, manifested with a decrease in both fetal thymic-thoracic ratio and thymus transverse diameter values, decreased in ART pregnancies.

Concerns of High-Risk Pregnancies During Pandemic: COVID-19 and Fear of Birth.

AIM: This study was conducted to determine the fear of birth and coronavirus disease 2019 in pregnant women who applied to the high-risk pregnancy outpatient clinic during the pandemic and investigate whether there is a relationship between these fears. METHOD: This study is a descriptive cross-sectional study using questionnaires. The Fear of COVID-19 Scale and Fear of Birth Scale for Pregnant Women were validated in Turkish in outpatient women with high-risk pregnancies. The study was carried out with 238 pregnant women between February 15 - April 15, 2021. RESULTS: The mean age of the pregnant women participating in the study was 30.22 ± 6.01, the mean week of gestation was 30.87 ± 5.56, the total mean of Fear of COVID-19 Scale score was found to be 18.23 ± 6.41, and Fear of Birth Scale for Pregnant Women total mean score was 62.30 ± 25.66. An increased prevalence of anxiety has been found in high-risk pregnant women during the coronavirus disease-2019 pandemic. It was observed that there was a significant, positive, and low-level relationship between Fear of COVID-19 Scale-19 and Fear of Birth Scale for Pregnant Women of high-risk pregnant women (r = .268; p = .000). CONCLUSION: Prenatal anxiety was prevalent among high-risk pregnant women who required routine anxiety screening and psychosocial support during the coronavirus disease-2019 pandemic.

The relationship of probable clinical anxiety with attitude-behaviour, coping styles and social support in healthy pregnant women during the late period COVID-19 pandemic.

The aim of the study is to investigate the prevalence of state and trait probable clinical anxiety and their relationship with socio-demographic factors, attitude-behaviour, coping styles and social support level in high-risk pregnant women in the late period of COVID-19 pandemic. The pregnant women followed up in the gynaecological outpatient clinic were evaluated during their admissions. About 191 healthy pregnant women were included in the study. Data were collected using the socio-demographic and pregnancy attitude-behaviour data form, STAI (Spielberger's State-Trait Anxiety Inventory), the Coping Styles Scale Brief Form (Brief-COPE) and the Multidimensional Scale of Perceived Social Support (MSPSS). Our study found that pregnant women had high anxiety levels (STAI-S:37.90 ± 8.88; STAI-T:42.46 ± 7.80) and probable clinical anxiety prevalences (STAI-S:81(42.4%); STAI-T:123(64.4%)) in the late period of the COVID-19 pandemic. The fact that COVID-19 determined the preference of the birth method and the level of knowledge about COVID-19 predicted state probable clinical anxiety. Educational status, concern for COVID-19 transmission to the baby during pregnancy/birth, behavioural disengagement, focussing on and venting emotions predicted trait probable clinical anxiety. Our results have emphasised the factors that should be taken into account and coping styles that may be functional to protect the mental well-being of healthy pregnants.IMPACT STATEMENTWhat is already known on this subject? The COVID-19 pandemic has been shown to increase the symptoms of stress, anxiety and depression of the general population and healthcare workers. There is limited studies about pregnant women.What do the results of this study add? According to our study, we can say that approximately half of the pregnant women in a pandemic need psychiatric evaluation due to probable clinical anxiety. The relationship between anxiety in the pandemic process and birth preference has been shown and coping styles in healthy pregnant women have been investigated for the first time, effective and ineffective coping styles have been shown. In addition, it has been found that the social support of pregnant women is effective in managing the pandemic process.What are the implications of these findings for clinical practice and/or further research? According to our current findings, a multidisciplinary approach in which pregnant women are screened with self-report psychiatry tests and appropriate pregnant women are consulted to psychiatry during pandemic processes will make it easier for obstetricians to manage the patient. Especially strengthening effective coping styles and social support will have a great effect in mental rehabilitation. In this respect, further studies on pregnant women are needed.

Efficacy of fetal left ventricular modified myocardial performance index in predicting adverse perinatal outcomes in intrahepatic cholestasis of pregnancy.

OBJECTIVE: This study aimed to evaluate the effectiveness of fetal left ventricular modified myocardial performance index in predicting adverse perinatal outcomes for intrahepatic cholestasis of pregnancy. METHODS: A cross-sectional study was conducted, including 51 women with intrahepatic cholestasis of pregnancy and 80 healthy controls. Using Doppler ultrasonography, E-wave, A-wave, isovolumetric contraction time, isovolumetric relaxation time, and ejection time were recorded and the left ventricular modified myocardial performance index was measured. RESULTS: Findings showed that the mean left ventricular modified myocardial performance index, isovolumetric contraction time, and isovolumetric relaxation time values were statistically significantly higher while the ejection time and E/A ratios were statistically significantly lower in the intrahepatic cholestasis of pregnancy group than the control group. In the intrahepatic cholestasis of pregnancy group, a statistically significant positive correlation was found between left ventricular modified myocardial performance index and adverse perinatal outcomes in the intrahepatic cholestasis of pregnancy group (r=0.478, p<0.001), while a statistically significant negative correlation was found between the E/A ratio and adverse perinatal outcomes (r=-0.701, p<0.001). CONCLUSIONS: For intrahepatic cholestasis of pregnancy cases, high fetal left ventricular modified myocardial performance index values were an indicator of ventricular dysfunction, and this correlated with negative perinatal outcomes.

Efficacy of fetal left ventricular modified myocardial performance index in predicting adverse perinatal outcomes in intrahepatic cholestasis of pregnancy

SUMMARY OBJECTIVE: This study aimed to evaluate the effectiveness of fetal left ventricular modified myocardial performance index in predicting adverse perinatal outcomes for intrahepatic cholestasis of pregnancy. METHODS: A cross-sectional study was conducted, including 51 women with intrahepatic cholestasis of pregnancy and 80 healthy controls. Using Doppler ultrasonography, E-wave, A-wave, isovolumetric contraction time, isovolumetric relaxation time, and ejection time were recorded and the left ventricular modified myocardial performance index was measured. RESULTS: Findings showed that the mean left ventricular modified myocardial performance index, isovolumetric contraction time, and isovolumetric relaxation time values were statistically significantly higher while the ejection time and E/A ratios were statistically significantly lower in the intrahepatic cholestasis of pregnancy group than the control group. In the intrahepatic cholestasis of pregnancy group, a statistically significant positive correlation was found between left ventricular modified myocardial performance index and adverse perinatal outcomes in the intrahepatic cholestasis of pregnancy group (r=0.478, p<0.001), while a statistically significant negative correlation was found between the E/A ratio and adverse perinatal outcomes (r=-0.701, p<0.001). CONCLUSIONS: For intrahepatic cholestasis of pregnancy cases, high fetal left ventricular modified myocardial performance index values were an indicator of ventricular dysfunction, and this correlated with negative perinatal outcomes.

Hematological Parameters to Predict the Severity of Hyperemesis Gravidarum and Ketonuria / Parâmetros hematológicos para prever a gravidade da hiperêmese gravídica e da cetonúria

Abstract Objective Hyperemesis gravidarum (HG) is a pregnancy complication that can progress with persistent nausea and vomiting. The aim of the present study is to evaluate the relationship between hematological parameters and HG. Method A total of 532 pregnant women with HG who were admitted to the Department of Obstetrics and Gynecology between March 2019 and February 2021, and 534 healthy pregnant women with characteristics similar to those of the case group were included in the study. The hematological parameters of both groups were compared. In addition, the hematological parametersof patients with HG according to the severity of ketonuria were compared. Results Themean age of the HG group (n=532) was 26.3 ± 4.1 years, and that of the control group (n=534) was 25.9 ± 4.8 years. Among patients with HG, 46% (n=249) had ketone(+), 33% (n=174), ketone(++), and 21% (n=109), ketone(+++). The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were higher in the HG group than in the control group: 3.8 (2.8-5.8)/3.2 (2.6-4.0); p<0.001; and 135.2 ± 30.4/108.9 ± 62.2; p<0.001 respectively. The neutrophil count, NLR, and PLR were higher in the group with ketone(+++) than in the groups with ketone(+) or ketone(++): 7.6 ± 1.9/5.5 ± 2.4; p<0.001; 3.8(2.8-4.6)/2.9(2.3- 3.6); p<0.001; and 149.9 ± 48.0/135.9 ± 65.7; p<0.001 respectively. The mean corpuscular hemoglobin (MCH) level, the NLR, and the PLR were identified as independent predictors of the presence of HG and the level of ketone positivity in HG patients. Conclusion The NLR and PLR were high in patients with HG, suggesting the its inflammatory activity. They may be important markers associated with the presence and severity of HG.

Resumo Objetivo A hiperêmese gravídica (HG) é uma complicação da gravidez que pode evoluir com náuseas e vômitos persistentes. O objetivo deste estudo é avaliar a relação entre os parâmetros hematológicos e a HG. Método Foram incluídas neste estudo 532 gestantes com HG internadas no Departamento de Obstetrícia e Ginecologia entre março de 2019 e fevereiro de 2021, e 534 gestantes saudáveis com características semelhantes às do grupo de caso. Os parâmetros hematológicos foram comparados entre gestantes com e sem HG. Além disso, os parâmetros hematológicos foram comparados entre as pacientes com HG de acordo com a gravidade da cetonúria. Resultados A média de idade do grupo GH (n=532) foi de 26,3 ± 4,1 anos, e a do grupo de controle (n=534) foi de 25,9 ± 4,8 anos. Entre as pacientes com HG, 46% (n=249) tinham cetona(+), 33% (n=174), cetona(++), e 21% (n=109), cetona (+++). A razão de neutrófilos para linfócitos (RNL) e a razão de plaquetas para linfócitos (RPL) forammaiores no grupo HG do que no grupo de controle: 3,8 (2,8-5,8)/3,2 (2,6-4,0); p<0,001; e 135,2 ± 30,4/108,9 ± 62,2; p<0,001, respectivamente). A contagem de neutrófilos, a RNL e a RPL foram maiores no grupo com cetona(+++) do que nos grupos comcetona(+) e cetona(++): 7,6 ± 1,9/5,5 ± 2,4; p<0,001; 3,8 (2,8- 4,6)/2,9 (2,3-3,6); p<0,001; e 149,9 ± 48,0/135,9 ± 65,7; p<0,001, respectivamente. O nível médio de hemoglobina corpuscular (MHC), a RNL e a RPL foram identificados como preditores independentes da presença de HG e do nível de positividade de cetona em pacientes com HG. Conclusão A RNL e RPL estavam elevadas em pacientes com HG, o que sugere a sua atividade inflamatória. Elas podem ser marcadores importantes associados à presença e à gravidade da HG.

Anxiety, attitudes-behaviors, coping styles, and social support among high-risk pregnant women in the late period of the coronavirus disease 2019 pandemic.

OBJECTIVE: The purpose of this study was to investigate the prevalence of anxiety among high-risk pregnant women in the late period of the coronavirus disease 2019 pandemic and to evaluate the relationship between anxiety levels, attitudes-behaviors, coping styles, and other psychometric parameters. METHODS: Pregnant women who were followed up in our gynecology outpatient clinic were evaluated during their admissions between November 15, 2020 and February 15, 2021. This cross-sectional study analyzes prospectively collected data from a university hospital. Inclusion criteria were those being at risk of pregnancy and between the age of 18 and 45 years, while exclusion criteria were mental retardation and the presence of serious psychiatric illness. The study included 140 participants. Sociodemographic and pregnant attitudes-behaviors data form, State-Trait Anxiety Inventory, Coping Styles Scale Brief Form (Brief-COPE), and Multidimensional Scale of Perceived Social Support were used to collect data. RESULTS: Participants had high anxiety levels (State-STAI: 40.32±9.88; Trait-STAI: 42.71±7.32) and high prevalence of probable clinical anxiety [State-STAI: 84 (60.0%); Trait-STAI: 92 (65.7%)]. The fact concerning the transmission of the coronavirus disease 2019 to the baby during pregnancy/birth, extent to which coronavirus disease 2019 pandemic prevents regular pregnancy checkups, and family subgroup-Multidimensional Scale of Perceived Social Support predicted state probable clinical anxiety. Use of disinfectants predicted trait probable clinical anxiety. Employment status predicted state/trait probable clinical anxiety. The existence of trait probable clinical anxiety was significantly associated with behavioral disengagement and substance use which are considered ineffective coping styles. Participants without trait probable clinical anxiety had significantly more adopted positive reinterpretation, one of emotion-focused coping styles. CONCLUSION: Based on our results, the concern of the transmission of the coronavirus disease 2019 to the babies during pregnancy/birth may be the main factor influencing anxiety among high-risk pregnant women.

Hematological Parameters to Predict the Severity of Hyperemesis Gravidarum and Ketonuria.

OBJECTIVE: Hyperemesis gravidarum (HG) is a pregnancy complication that can progress with persistent nausea and vomiting. The aim of the present study is to evaluate the relationship between hematological parameters and HG. METHOD: A total of 532 pregnant women with HG who were admitted to the Department of Obstetrics and Gynecology between March 2019 and February 2021, and 534 healthy pregnant women with characteristics similar to those of the case group were included in the study. The hematological parameters of both groups were compared. In addition, the hematological parametersof patients with HG according to the severity of ketonuria were compared. RESULTS: The mean age of the HG group (n = 532) was 26.3 ± 4.1 years, and that of the control group (n = 534) was 25.9 ± 4.8 years. Among patients with HG, 46% (n = 249) had ketone (+), 33% (n = 174), ketone (++), and 21% (n = 109), ketone (++ + ). The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were higher in the HG group than in the control group: 3.8 (2.8-5.8)/3.2 (2.6-4.0); p < 0.001; and 135.2 ± 30.4/108.9 ± 62.2; p < 0.001 respectively. The neutrophil count, NLR, and PLR were higher in the group with ketone (++ + ) than in the groups with ketone (+) or ketone (++): 7.6 ± 1.9/5.5 ± 2.4; p < 0.001; 3.8(2.8-4.6)/2.9(2.3-3.6); p < 0.001; and 149.9 ± 48.0/135.9 ± 65.7; p < 0.001 respectively. The mean corpuscular hemoglobin (MCH) level, the NLR, and the PLR were identified as independent predictors of the presence of HG and the level of ketone positivity in HG patients. CONCLUSION: The NLR and PLR were high in patients with HG, suggesting the its inflammatory activity. They may be important markers associated with the presence and severity of HG.

OBJETIVO: A hiperêmese gravídica (HG) é uma complicação da gravidez que pode evoluir com náuseas e vômitos persistentes. O objetivo deste estudo é avaliar a relação entre os parâmetros hematológicos e a HG. MéTODO: Foram incluídas neste estudo 532 gestantes com HG internadas no Departamento de Obstetrícia e Ginecologia entre março de 2019 e fevereiro de 2021, e 534 gestantes saudáveis com características semelhantes às do grupo de caso. Os parâmetros hematológicos foram comparados entre gestantes com e sem HG. Além disso, os parâmetros hematológicos foram comparados entre as pacientes com HG de acordo com a gravidade da cetonúria. RESULTADOS: A média de idade do grupo GH (n = 532) foi de 26,3 ± 4,1 anos, e a do grupo de controle (n = 534) foi de 25,9 ± 4,8 anos. Entre as pacientes com HG, 46% (n = 249) tinham cetona(+), 33% (n = 174), cetona(++), e 21% (n = 109), cetona(+ + +). A razão de neutrófilos para linfócitos (RNL) e a razão de plaquetas para linfócitos (RPL) foram maiores no grupo HG do que no grupo de controle: 3,8 (2,8­5,8)/3,2 (2,6­4,0); p < 0,001; e 135,2 ± 30,4/108,9 ± 62,2; p < 0,001, respectivamente). A contagem de neutrófilos, a RNL e a RPL foram maiores no grupo com cetona(++ + ) do que nos grupos com cetona(+) e cetona(++): 7,6 ± 1,9/5,5 ± 2,4; p < 0,001; 3,8 (2,8­4,6)/2,9 (2,3­3,6); p < 0,001; e 149,9 ± 48,0/135,9 ± 65,7; p < 0,001, respectivamente. O nível médio de hemoglobina corpuscular (MHC), a RNL e a RPL foram identificados como preditores independentes da presença de HG e do nível de positividade de cetona em pacientes com HG. CONCLUSãO: A RNL e RPL estavam elevadas em pacientes com HG, o que sugere a sua atividade inflamatória. Elas podem ser marcadores importantes associados à presença e à gravidade da HG.

Anxiety, attitudes-behaviors, coping styles, and social support among high-risk pregnant women in the late period of the coronavirus disease 2019 pandemic

SUMMARY OBJECTIVE: The purpose of this study was to investigate the prevalence of anxiety among high-risk pregnant women in the late period of the coronavirus disease 2019 pandemic and to evaluate the relationship between anxiety levels, attitudes-behaviors, coping styles, and other psychometric parameters. METHODS: Pregnant women who were followed up in our gynecology outpatient clinic were evaluated during their admissions between November 15, 2020 and February 15, 2021. This cross-sectional study analyzes prospectively collected data from a university hospital. Inclusion criteria were those being at risk of pregnancy and between the age of 18 and 45 years, while exclusion criteria were mental retardation and the presence of serious psychiatric illness. The study included 140 participants. Sociodemographic and pregnant attitudes-behaviors data form, State-Trait Anxiety Inventory, Coping Styles Scale Brief Form (Brief-COPE), and Multidimensional Scale of Perceived Social Support were used to collect data. RESULTS: Participants had high anxiety levels (State-STAI: 40.32±9.88; Trait-STAI: 42.71±7.32) and high prevalence of probable clinical anxiety [State-STAI: 84 (60.0%); Trait-STAI: 92 (65.7%)]. The fact concerning the transmission of the coronavirus disease 2019 to the baby during pregnancy/birth, extent to which coronavirus disease 2019 pandemic prevents regular pregnancy checkups, and family subgroup-Multidimensional Scale of Perceived Social Support predicted state probable clinical anxiety. Use of disinfectants predicted trait probable clinical anxiety. Employment status predicted state/trait probable clinical anxiety. The existence of trait probable clinical anxiety was significantly associated with behavioral disengagement and substance use which are considered ineffective coping styles. Participants without trait probable clinical anxiety had significantly more adopted positive reinterpretation, one of emotion-focused coping styles. CONCLUSION: Based on our results, the concern of the transmission of the coronavirus disease 2019 to the babies during pregnancy/birth may be the main factor influencing anxiety among high-risk pregnant women.

SARS-CoV-2 is not present in the vaginal fluid of pregnant women with COVID-19.

BACKGROUND: Data concerning the presence of SARS-CoV-2 in the female genital system is scarce; however, this information is important for understanding whether the virus can transmit sexually or from mother to child. The aim of this study was to investigate whether pregnant women with COVID-19 have virus in their lower genital tract. METHODS: In this cross-sectional study, we present an analysis of prospectively gathered data collected at a single tertiary university hospital from 19 April to 19 May 2020. We included 13 pregnant women hospitalized with suspected COVID-19. Results of laboratory tests, imaging tests, and nucleic acid tests on vaginal swabs for SARS-CoV-2 were also analyzed for pregnant women with a clinical diagnosis of COVID-19. RESULTS: Twelve pregnant women with confirmed COVID-19 were included in this study. Mean age was 32 ± 7.9 years. All patients had mild symptoms and were followed in the maternity ward, with none of them needing critical care unit follow-up. All lower genital tract samples were negative for SARS-CoV-2. CONCLUSION: We demonstrated that SARS-CoV-2 was not present in the vaginal fluid of pregnant women. This finding may indicate that the female genital tract is not a route of SARS-CoV-2 transmission.

Can the neutrophil-to-lymphocyte ratio (NLR) predicts fetal loss in preeclampsia with severe features?

INTRODUCTION: Preeclampsia (PE) is one of the most common causes of major maternal and fetal adverse events including mortality and preterm birth Grill et al. (2009). The neutrophil-to-lymphocyte ratio (NLR) and other hematologic indexes of systemic inflammation have been investigated in patients with PE for the prediction of the severity or presence of the disease. Despite these studies, we found no trials investigating the relationship between NLR and fetal outcomes in PE patients. In this study, we aimed to investigate the relationship between NLR and fetal outcomes. METHODS: We retrospectively analyzed the demographic data and laboratory tests to determine the NLR of 175 pregnant women with severe PE admitted to our clinic between January 2015 and December 2018. RESULTS: NLR in the first (2.4 ± 1.1 vs 2.9 ± 1.4, P = 0.18) and second trimesters (3.6 ± 0.7 vs 3.8 ± 1.3, P = 0.25) were not different between the groups, but third trimester NLR was significantly higher in patients with fetal loss (6.5 ± 5.4 vs 4.2 ± 2.7, P = 0.009). The area under the receiver operating characteristic curve for NLR in the third trimester was 0.66 and NLR > 3.9 predicted fetal loss with a sensitivity of 75% and a specificity of 61% (0.684, 95% confidence interval 0.48-0.83, P = 0.05). CONCLUSION: We demonstrated that third trimester NLR is associated with fetal loss in patients with severe PE.

Polymorphism of the Oxytocin Receptor (OXTR) Gene Affects the Circulating Oxytocin Receptor Levels in Late-Term Pregnancy in a Turkish Population.

INTRODUCTION: Postterm and late-term pregnancies still remain a serious health problem, and underlying exact mechanisms are not fully elucidated. These mechanisms are influenced by many factors. OBJECTIVE: The aim of this study was to investigate the relationship between plasma oxytocin and oxytocin receptor levels and oxytocin receptor polymorphisms in term and late-term pregnant women. METHODS: Sixty-eight singleton pregnant women with late-term pregnancy and 83 singleton pregnant women with term parturition were included in this study. A comparison was performed between pregnancies and neonates born at term (37 0/7 and 41 6/7 weeks' gestation). Plasma oxytocin, oxytocin receptor, estradiol, and progesterone levels were measured by using enzyme-linked immunosorbent assay kits. TaqMan® SNP Genotyping Assays and qPCR ProbesMaster were used to investigate the polymorphisms of rs237911, rs2228485, rs53576, and rs2254298. RESULTS: There was not any difference in gene distributions of 4 common single-nucleotide polymorphisms of oxytocin receptor of rs237911, rs2228485, rs53576, and rs2254298 between subjects in late-term and term pregnancy groups. With rs53576 of the GG genotype, serum oxytocin levels were 21.50 ± 10.69 (ng/L) in the late-term group and 62.71 ± 18.01 (ng/L) in the term group (p = 0.049). Oxytocin receptor levels in the late-term and term pregnancy groups of the GG genotype were 17.92 ± 8.15 (pg/mL) and 45.77 ± 11.66 (pg/mL), respectively (p = 0.046). CONCLUSION: Our findings suggest that the rs53576 oxytocin receptor single-nucleotide polymorphism is associated with late-term pregnancy through acting by direct modulation of oxytocin and oxytocin receptor levels.

The correlation of serum asymmetric dimethylarginine and anti-Müllerian hormone in primary dysmenorrhea.

In this study, we aimed to investigate the association of serum asymmetric dimethylarginine (ADMA) and anti-Müllerian hormone (AMH) levels in primary dysmenorrhea patients. The study employed a cross-sectional design. Eighty-nine female university students with primary dysmenorrhea were included in the study. All patients underwent complete clinical and laboratory investigations, including serum ADMA, AMH levels, pelvic ultrasonography, electrocardiography, and echocardiography. Pearson correlation and linear regression analysis were used to evaluate associations between continuous data. Categorical associations were evaluated using χ(2) test. Correlation analysis between serum ADMA and AMH levels in the study group showed a highly significant positive relationship (Pearson correlation = 0.978, p = 0.01). Our study has shown a significant positive correlation between serum ADMA and AMH levels in primary dysmenorrhea. Serum ADMA levels may have the potential to demonstrate ovarian reserve.

Successful treatment of Placenta Percreta through a combinatorial treatment involving a Bakri Balloon and Methotrexate--a case report.

Placental percreta is a complication involving an abnormally deep placental attachment to the myometrium, resulting in obstetric hemorrhage and peripartum hysterectomy A 38-year-old pregnant woman, with a history of 2 Cesarean births, myomectomy 9 pregnancies, and 6 spontaneous abortions, was admitted after experiencing intrauterine fetal death, which occurred at 19 weeks gestation. The patient was referred to our institution after 8 days of unsuccessful medical treatment. Doppler ultrasonography and vacuum curettage revealed possible signs of abnormal placentation. Because of the unsuccessful separation of the placenta and massive bleeding, we used a Bakri Balloon to treat excessive bleeding during the acute phase, followed by the conservative administration of parenteral methotrexate to treat the spontaneous involution of the placenta at 7 weeks of conservative therapy Bakri Balloon and methotrexate application to treat bleeding after curettage is a useful choice in placenta percreta and hemorrhage after abortion.