Deniz Hizli

Sleep deprivation in the last trimester of pregnancy and inadequate vitamin D: Is there a relationship?

Background Disturbed sleep is a significant health issue for pregnant women. Inadequate vitamin D intake is common among pregnant women and can affect many bodily systems. The purpose of this cross‐sectional study was to test the hypothesis that serum vitamin D levels are low in pregnant women who have poor sleep quality in their last trimester. Methods We enrolled 92 pregnant women who were admitted to the Maternity Clinic of Turgut Ozal University (Ankara, Turkey) in their last trimester. Venous blood sampling was performed to determine serum 25‐hydroxyvitamin D levels. Sleep quality was measured by the Pittsburgh Sleep Questionnaire. The Student t test and Chi‐square test were used to evaluate the relationships between variables. Logistic regression analysis was used to identify independent predictors of the vitamin D level. Results The median score of the Pittsburgh Sleep Questionnaire was 6.2 ± 3.3 (range, 1–17). We determined that 43.5% (40) of participants had poor sleep quality. The mean number of sleep hours at night was 8.6 ± 1 hours (range, 6.30–11 hours), and the mean sleep latency was 20.3 ± 12.7 minutes (range, 5–60 minutes). Vitamin D levels were measured for 87 participants; the median serum level of 25 (OH) vitamin D was 22.9 ± 16.2 ng/mL (range, 4.9–99 ng/mL). Among all patients, we did not determine any significance between the vitamin D‐deficient group and the non–vitamin D‐deficient group with regard to the Pittsburgh Sleep Questionnaire Inventory (PSQI) total score and subcomponents scores of the questionnaire (p > 0.05). Among 37 patients with poor sleep quality and for whom the vitamin D level was measured, 56.8% (21) women had vitamin D deficiency, and 81% (30) women had vitamin D insufficiency. However, we did not find any significance between participants with poor sleep and participants with good sleep quality with regard to age, occupational status, relationship with her partner, prepregnancy body mass index (BMI), weight gain during pregnancy, being primiparus, length of labor, and mode of delivery. Our findings further showed that being in a low income family was associated with poor sleep quality. Conclusion Inadequate vitamin D and poor sleep quality are prevalent in pregnant women, but low levels of vitamin D are not associated with poor sleep quality. Further studies with larger sample sizes and studies that include preterm deliveries and special sleep disorders should be performed to understand this issue better.

Clitoral and labial sizes in women wıth PCOS.

The aim of this study was to examine the external genital features in Turkish women with polycystic ovary syndrome (PCOS). Thirty-two newly diagnosed PCOS cases and 35 healthy women were included the study. All women underwent a thorough gynaecological examination. Clitoral length, and labia minora length and width were recorded. The groups were compared for features of external genital structures. Clitoral and labial lengths were significantly higher in PCOS group. There was a strong correlation between clitoral length and modified Ferriman–Gallwey score. The most effective predictor of PCOS was found to be clitoral length. Clitoral length alone predicted 99.9% of PCOS patients. There were some subclinical genital changes in women with PCOS. These changes in PCOS patients may be a sign of hyperandrogenism and might have diagnostic value in indistinct cases.

Does vitamin E prevent tubal damage caused by smoking? A light microscopy and animal study

OBJECTIVE To assess the histomorphological effects of smoking on the cilia of fallopian tubes in mice and the effect of vitamin E on the negative effects of smoke. STUDY DESIGN Eighteen 12-14 week-old Swiss albino type female mice were randomly divided into three groups, each consisting of six mice: Group A: control group; Group B: mice exposed to cigarette smoke; Group C: mice exposed to cigarette smoke together with vitamin E. Groups B and C were exposed to cigarette smoke for 10 weeks. After 10 weeks, tubal excision was performed in all animals. Histopathologic examination of excised tubal tissue was conducted under light microscopy. RESULTS The number of cilia was significantly lower in Group B. Although not statistically significant, the median number of cilia in Group C was measured to be higher than in Group B but lower than in Group A. CONCLUSION Based on the results, it can be concluded that smoking decreases tubal cilia numbers. Supplementation by vitamin E may treat or at least help to slow down the decrease in number of cilia caused by smoking; therefore it could be used therapeutically in the treatment of smoking-related tubal damage.

Is There a Relationship Between Pelvic Organ Prolapse and Tissue Fibrillin-1 Levels?

PURPOSE Pelvic organ prolapse is a multifactorial disorder in which extracellular matrix defects are implicated. Fibrillin-1 level is reduced in stress urinary incontinence. In Marfan syndrome, which is associated with mutations in Fibrillin-1, pelvic floor disorders are commonly observed. We hypothesize that Fibrillin-1 gene expression is altered in pelvic organ prolapse. METHODS Thirty women undergoing colporrhaphy or hysterectomy because of cystocele, rectocele, cystorectocele, or uterine prolapse were assigned to a pelvic prolapse study group, and thirty women undergone hysterectomy for nonpelvic prolapse conditions were assigned to a control group. Real-time polymerase chain reaction was conducted on vaginal tissue samples to measure the expression of Fibrillin-1. Expression levels were compared between study and control groups by Mann-Whitney U test with Bonferroni revision. RESULTS Fibrillin-1 gene expression was not significantly lower in the study group than in the control group. Similarly, no significant correlation between Fibrillin-1 levels and grade of pelvic prolapse was found. Age over 40 years (P=0.018) and menopause (P=0.027) were both associated with reduced Fibrillin-1 levels in the pelvic prolapse group, whereas the delivery of babies weighing over 3,500 g at birth was associated with increased Fibrillin-1 expression (P=0.006). CONCLUSIONS The results did not indicate a significant reduction in Fibrillin-1 gene expression in pelvic prolapse disorders; however, reduced Fibrillin-1 may contribute to increased pelvic organ prolapse risk with age and menopause. Increased Fibrillin-1 gene expression may be a compensatory mechanism in cases of delivery of babies with high birth weight. Further studies are needed for a better understanding of these observations.

Does quality of female sexual function improve after a transobturator tape procedure

Abstract The aim of this study was to use a questionnaire to evaluate any changes in sexual satisfaction of women who underwent a transobturator tape (TOT) procedure for stress urinary incontinence. A total of 30 women agreed to participate in the study and were invited to fill out the Female Sexual Function Index (FSFI) questionnaire prior to surgery and 3 months after surgery. As a result, after the TOT operation, there was a statistically significant improvement in libido (desire), arousal, lubrication, orgasm and satisfaction. The TOT procedure seems to have a positive effect on female sexual function by reducing the urinary leakage during sexual activity and by decreasing the pain during or after sexual activity.

Hyperemesis gravidarum and its relation with maternal body fat composition.

The objective of this study was to determine if maternal body fat composition and body mass index were associated with hyperemesis gravidarum (HG) in the first trimester of pregnancy. Healthy pregnant women (n = 30) without nausea and vomiting (control group) and women with HG (n = 54; study group), all with singleton pregnancy at 6–14 weeks gestational age, were included. Body mass index was measured before and during pregnancy. Visceral adipose tissue (VAT) and subcutaneous fat thickness were measured during pregnancy. Comparison of the groups revealed that VAT and pre-pregnancy body mass index but not subcutaneous fat thickness were significantly higher in the HG group versus controls. VAT and pre-pregnancy body mass index predicted 83.8% and 67.1% of HG cases, respectively. VAT and pre-pregnancy body mass index were correlated with the development of hyperemesis gravidrum and hence could be considered as predictive markers for HG.

Uterin Rüptür, Plasenta Previa ve Akreata Birlikteliği ile Gelen Gebede Başarılı Bakri Balon Kateter Uygulaması

Ucuncu trimester kanamalari hemorojik obstetrik aciller icerisinde yer alip, gebeliklerin % 2-5’unde gorulmektedir. Bu aciller icerisinde plasenta previa %30’unu olustururken, uterin ruptur daha az siklikta gorulmektedir. Plasenta akreata tanisi siklikla sezaryen operasyonu sirasinda koyulmaktadir ve sonuc olarak bircok vakada uygulanacak nihayi tedavi halen peripartum histerektomidir. Olgu sunumuzda genel durum bozuklugu, solunum sikintisi ve karin agrisi sikâyeti ile klinigimize basvuran 34 haftalik gebede plasenta previa, plasenta akreata ve uterin ruptur birlikteligi mevcuttu. Uterin kanama nedeniyle uygulanan Bakri balon kateterinin basarisi sunulmustur. Anahtar kelimeler: Bakri balon, uterin ruptur, plasenta previa, plasenta akreata