Ali Rüştü Ergür

Longitudinal study of platelet size changes in gestation and predictive power of elevated MPV in development of pre-eclampsia

The aim of this cohort is to investigate whether any haematologic changes detectable by simple complete blood count (CBC) precede pre‐eclampsia development and the diagnostic value of these markers in clinical practice for prediction of pre‐eclampsia.

The effect of hormone therapy on plasma homocysteine levels: a randomized clinical trial.

Objective: An elevated plasma homocysteine level is a risk factor for cardiovascular diseases. Hormone therapy (HT) may reduce fasting plasma homocysteine levels. We studied 80 postmenopausal women to determine the effect of medroxyprogesterone acetate (MPA) combined with conjugated equine estrogens (CEE) on fasting plasma homocysteine levels. Design: In a randomized, double blind, prospective, placebo-controlled study, we randomly assigned 80 healthy postmenopausal women between CEE 0.625 mg/d combined with MPA 2.5 mg/d (n = 20), CEE 0.625 mg/d combined with MPA 5 mg/d (n = 20), unopposed CEE 0.625 mg/d (n = 20), and placebo (n = 20) all given for a duration of 6 months. Fasting plasma homocysteine levels were measured before and at the end of the treatment. Results: Before treatment, plasma homocysteine concentrations were similar in all groups. After 6 months of unopposed CEE, the mean fasting plasma homocysteine levels decreased by 19.02% when compared with baseline levels (P < 0.05). The mean fasting plasma homocysteine concentrations decreased by 17.63% and 19.56% from baseline in both the CEE plus MPA 2.5 mg/d and CEE plus MPA 5 mg/d groups, respectively (P < 0.05 for each group). In contrast, plasma homocysteine levels increased by 11.66% in the placebo group. The homocysteine lowering effect did not differ significantly among the three groups of women receiving unopposed CEE alone and CEE plus MPA at two different doses. Conclusion: Six months of estrogen therapy (ET) and combined estrogen-progestogen therapy (EPT) significantly lower fasting plasma homocysteine levels in healthy postmenopausal women with equal efficacy.

Second trimester amniotic fluid annexin A5 levels and subsequent development of intrauterine growth restriction

The purpose of this study was to investigate the levels of annexin A5 in second trimester amniotic fluid, and evaluate its correlation with subsequent development of intrauterine growth restriction (IUGR).

Expression of P-cadherin (cadherin-3) and E-selectin in the villous trophoblast of first trimester human placenta.

OBJECTIVE Although trophoblastic invasion has a critical role in human placental development, very little is known about them. The aim of the present study was to localise the expression of P-cadherin (cadherin-3) and E-selectin in first trimester placenta. MATERIAL AND METHODS This study was conducted on 140 patients who had applied to Gülhane Military Medical Academy, Haydarpaşa Education Hospital, Department of Obstetrics and Gynaecology between 2005 and 2006. The patients were divided into three groups: ectopic pregnancy group (Group 1), spontaneous abortion group (group 2) and curettage group (group 3 and/or control group). Patients with a history of systemic diseases (such as thrombophilia), a disease or anatomical diagnosis that may cause recurrent abortion or an aetiological factor for ectopic pregnancy were excluded from the study. Paraffin blocks were stained with E-selectin and P-cadherin in accordance with the procedure. Demographic characteristics of patients (patient age, gravida, parity, number of previous abortions, and last menstrual period) and staining intensities were compared using Analysis of Variance (ANOVA) among groups. RESULTS According to the average scale score of P-cadherin staining of cells, the three groups were statistically different from each other (p=0.0001). This difference stems from statistically significantly lower scores in the spontaneous abortion group than in both the ectopic pregnancy group (p<0.001) and the control group (p<0.001). E-selectin immunostaining showed no positive staining in the groups. CONCLUSION In placental trophoblasts, decreased P-cadherin immunoreactivity plays a role in the aetiopathogenesis of spontaneous abortion.

The Effects Of The Second Trimester Maternal Hemoglobin Levels On The Birth Weight And Birth Time

Objectives: The aim of our study is to investigate the effects of anemia at the second trimester on birth weight and birth time. Patients and Methods: The medical reports of 1116 pregnant women who attended and delivered at our clinic between January 2005 and October 2007 were analyzed retrospectively. The patients were divided into two groups as having alt;9 gr/dl hemoglobin or age;9 gr/dl hemoglobin levels. The gestational and the perinatal outcomes of the normal and anemic groups were compared. Results: The age and the parity were higher in the non-anemic group than in the anemic pregnants. (p=0.03, p=0.001). There was no statistically significant difference in the mode of birth and gestational complications between the two groups. While there was no statistically significant difference in the gestational age at delivery and birth weight, prematurity and oligohydramnios ratios were significantly higher in the anemic group compared to the group with Hbagt;9 gr/dL (p=0.041, p=0.004, respectively). Conclusion: The anemia of second trimester is related with prematurity and increased rate of oligohydramnios. Iron supplementation should be given during pregnancy to improve pregnancy outcomes. Amac: Bu calismanin amaci ikinci trimester anemisinin dogum agirligi ve dogum haftasina etkisini arastirmaktir. Hastalar ve Yontemler: Ocak 2005 ve Ekim 2007 tarihleri arasinda klinigimizde takip edilen ve dogum yapan 1116 hastanin kayitlari retrospektif olarak incelendi. Hastalar ikinci trimester hemoglobin degerleri alt;9 gr/dl olanlar ve age;9 gr/dl olmak uzere iki gruba ayrildi. Anemik olan ve normal hemoglobin seviyelerine sahip gebelerin gebelik seyri ve perinatal sonuclari karsilastirildi. Bulgular: Anemik olmayan grupta yas ve parite anemik gebelere kiyasla yuksekti (sirasiyla p=0.03, p=0.001). Gruplar arasinda dogum sekilleri ve gestasyonel komplikasyonlar acisindan anlamli bir farklilik gorulmedi. Ortalama dogum zamani ve dogum kilosu acisindan anlamli bir farklilik gorulmezken ikinci trimester anemisi olan grupta prematurite ve oligohidramnios orani daha fazla goruldu ve bu fark istatistiksel olarak anlamli bulundu (p=0.041, p=0.004). Sonuc: Ikinci trimester anemisi prematurite ve artan oligohidramnios oranlariyla iliskili olabilmektedir. Gebelik sonuclarini iyilestirmek icin gebelik suresince demir destegi yapilmalidir.

Recurrent Idiopathic Nonimmune Hydrops Fetalis: A Case Report

A recurrent idiopathic nonimmune hydrops fetalis case in two subsequent pregnancies was observed in a woman with no child. In both pregnancies, all the detailed analysis, including a high level of ultrasonography, amniocentesis, serologic evaluation, routine blood work, hemoglobin electrophoresis, and glucose 6-phosphate/dehydrogenase level and postdelivery autopsy, was done, and after no clue of etiologic agent, pregnancy termination was applied for both. This case report illustrates the importance of recurrence of nonimmune hydrops fetalis in the absence of any etiology. Mostly, it is hard to establish an etiologic diagnosis for adequate management of subsequent pregnancies.