Deniz Karcaaltincaba

A quantitative evaluation of total antioxidant status and oxidative stress markers in preeclampsia and gestational diabetic patients in 24–36 weeks of gestation

OBJECTIVE To assess the plasma and serum maternal total antioxidant status, circulating levels of lipid peroxidation breakdown products (MDA), protein oxidation markers (AOPPs), myeloperoxidase (MPO) and lipid hydroperoxide (LHP) in preeclampsia, gestational diabetes mellitus (GDM) patients and compare them with noncomplicated normal pregnancies between 24 and 36 weeks of gestation. STUDY DESIGN 27 GDM, 27 preeclampsia and 29 noncomplicated singleton pregnancies were included. The blood samples were taken at the diagnosis of disease. RESULTS TAS was decreased in GDM and preeclampsia when compared to normal pregnancies. MDA levels were higher only in GDM group than normal pregnancies. AOPP levels were increased but MPO and LHP levels were not changed both in GDM and preeclampsia when compared to normal pregnancies. CONCLUSIONS We concluded that increased oxidative stress and reduction in antioxidant defense mechanisms may contribute to disease processes both in GDM and preeclampsia.

Prevalence of gestational diabetes mellitus and gestational impaired glucose tolerance in pregnant women evaluated by National Diabetes Data Group and Carpenter and Coustan criteria.

To determine the prevalence of gestational diabetes mellitus (GDM) and gestational impaired glucose tolerance (GIGT) using National Diabetes Data Group (NDDG), and Carpenter and Coustan (CC) criteria.

Does brucellosis in human pregnancy increase abortion risk? Presentation of two cases and review of literature

Brucellosis is one of the most common zoonotic diseases that can be encountered during pregnancy. We present two pregnant women with brucellosis. One of them delivered normally and the other patient had an abortion. We reviewed the literature regarding the clinical course of brucellosis in pregnant women. Brucellosis during pregnancy can be associated with abortion, congenital and neonatal infections and infection of the delivery team. Therefore treatment with a combination of rifampicin and trimethoprim‐sulfamethoxazole should be started as soon as it is diagnosed to prevent possible complications.

Prenatal diagnosis of Pena-Shokeir syndrome phenotype by ultrasonography and MR imaging

Pena-Shokeir syndrome phenotype is characterized by neurogenic arthrogryposis, facial anomalies, polyhydramnios and lung hypoplasia. Prenatal US is crucial in showing Pena-Shokeir syndrome phenotype in addition to demonstrating reduced fetal movements or akinesia as an underlying aetiological factor as early as the 14th week of gestation. Several reports of prenatal diagnosis of Pena-Shokeir syndrome phenotype by US have been published. In this report, MRI findings providing prenatal diagnosis are presented.

Cigarette smoking and pregnancy: Results of a survey at a Turkish women's hospital in 1,020 patients

Summary We aimed to investigate the level of knowledge about the effects of cigarette smoking and status before and during pregnancy. The study was performed on 1,020 pregnant women who attended the clinic for a routine visit. The questionnaire consisting of questions about sociodemographic data, smoking habits and knowledge about harmful effects of smoking on fetus (miscarriage, intrauterine growth retardation, pre-term birth, fetal mortality-morbidity, postpartum infant death, pre-term premature rupture of membranes, lung disease, attention deficit) was administered. Data were analysed by SPSS 10.0 using χ2-test and binary regression analysis. Mean age was 26.3 years. Smoking rates before and after pregnancy were 34.7% and 14%, respectively. Passive smoking was seen in 69.2%. The number of cigarettes smoked before pregnancy had a significant impact on continuation of smoking during pregnancy [OR (95% CI) 29.94 (12.88–69.64)]. For passive smoking at home for a young age [OR (95% CI) = 1.33 (1.01–1.76)] had a positive impact and university education [OR (95% CI) = 0.40 (0.24–0.67)] had a negative impact. Most pregnant women (97.5%) knew smoking was harmful. Awareness of intrauterine fetal death as a harmful effect was the single most important factor associated with quitting active and passive smoking. Despite some level of knowledge of pregnant women regarding adverse effects of smoking, there is a strong need for education on quitting smoking during pregnancy. Prevention of passive smoking should have the highest priority.

Cord blood oxidative stress markers correlate with umbilical artery pulsatility in fetal growth restriction

Objective: To compare cord blood oxidative stress markers (OSM) between intrauterine small fetuses with high umbilical artery (UA) Doppler indices and normal indices. Methods: Forty women who had oligohydramnios and intrauterine growth-restricted fetuses with abnormal (n = 20, group I) or normal Doppler indices (n = 20, group II) were included. All patients underwent fetal Doppler ultrasound studies. Cord blood was collected at birth and six OSMs (ischemia-modified albumin (IMA), hepatocyte growth factor (HGF), malondialdehyde (MDA)) levels, total oxidant status (TOS), total antioxidant status (TAS), and oxidative stress index (OSI) were studied. Results: The mean cord blood IMA, MDA, TOS, and OSI values for group I were significantly increased when compared to the group II (p < 0.001 for IMA, MDA, TOS, and OSI). However the mean cord blood HGF and TAS values were statistically significantly decreased in group I, compared with group II (p < 0.001 for HGF, and TAS). A significant positive (for IMA, MDA,TOS levels, and OSI ratio) and negative (for HGF and TAS levels) correlations between UA pulsatility index (PI) and cord blood OSM were found. Conclusion: The correlation between cord blood OSM and Doppler blood flow changes shown in this study may contribute to understanding the underlying oxidative stress-related mechanisms.

Gestational Diabetes and Gestational Impaired Glucose Tolerance in 1653 Teenage Pregnancies: Prevalence, Risk Factors and Pregnancy Outcomes

STUDY OBJECTIVE The aim of this study was to determine the prevalence of gestational diabetes mellitus (GDM) and gestational impaired glucose tolerance (GIGT) in adolescent pregnancies, associated risk factors, and pregnancy complications. DESIGN Retrospective study. SETTINGS Community-based teaching hospital. PARTICIPANTS Results of 1653 pregnant women age ≤ 19 years in 2005-2007 were reviewed. INTERVENTION All pregnant women screened with 50-g glucose challenge test (GCT) and patients with a GCT result ≥ 140 mg/dl underwent a 3-hour 100-g oral glucose tolerance test (OGTT). MAIN OUTCOME MEASURES GDM was diagnosed with at least two abnormal results and GIGT was diagnosed with one abnormal result. GDM and GIGT cases were evaluated for the presence of any associated risk factors and effects of presence of risk factors on pregnancy outcomes. RESULTS The prevalence of GDM was 0.85% (95% CI, 0.41-1.29), GIGT was 0.5% (95% CI, 0.15-0.81) and GDM+GIGT was 1.35% (95% CI, 0.78-1.88) by Carpenter and Coustan criteria. 68% of patients had at least one of the risk factors including body mass index ≥ 25, family history of diabetes and polycystic ovary syndrome (PCOS). Only 9.1% (n = 2) of them required insulin for glucose regulation during pregnancy with 9.1% (n = 2) macrosomia rate. All patients were primiparous and cesarean delivery rate was 27.3% (n = 6). We could not find any effect of presence of risk factors on pregnancy outcomes in GDM and GIGT cases. CONCLUSION We demonstrated that GDM and GIGT are strongly associated with high BMI before pregnancy, PCOS, and family history of diabetes. Since GDM is a state of prediabetes, it is important to diagnose in adolescent pregnancies considering their life expectancy to take preventive measures to avoid diabetes mellitus.

Glycosylated hemoglobin level in the second trimester predicts birth weight and amniotic fluid volume in non-diabetic pregnancies with abnormal screening test

Objective. To investigate relationship between glycemic control in first half of pregnancy by measuring mid-pregnancy HbA1c and neonatal birth weight and amniotic fluid volume. Methods. We prospectively enrolled 220 pregnant women who received oral glucose tolerance test (OGTT) after positive gestational diabetes mellitus screening. We included 102 women with normal OGTT results into final analysis. We measured birth weight and amniotic fluid index (AFI) at 32–34 weeks. Results. Mean birth weight was 3313 ± 426 g, and 15.7% of neonates were classified as large-for-gestational age (LGA). Mean Hb1Ac was 4.96 ± 0.28%. Median AFI was 145 mm, and polyhydramnios rate was 2.9%. Birth weight was positively correlated with HbA1c level (r = 0.373, p < 0.001) and pre-pregnancy body mass index (BMI; r = 0.351, p < 0.001). Linear regression analysis showed that HbA1c and pre-pregnancy BMI were positive independent determinants of neonatal birth weight, and HbA1c was positive independent determinant of AFI. Receiver operating characeristics curve identified HbA1c level of 4.99 as optimal threshold for prediction of LGA with 93.8% sensitivity, 61.6% specificity and positive likelihood ratio (+LR) of 2.45 and pre-pregnancy BMI value of 25.2 as optimal threshold for prediction of LGA with 81.3% sensitivity, 57% specificity and +LR of 1.9. Conclusion. In non-diabetic pregnant women with abnormal screening test, mid-pregnancy HbA1c level and pre-pregnacy BMI may predict neonatal birth weight. AFI in 32–34 weeks of gestation is related with mid-pregnacy HbA1c level.

An unusual growth of ovarian cystic teratoma with multiple floating balls during pregnancy: A case report

We report a case of ovarian cystic teratoma with an important growth during pregnancy and the sonographic appearance of intracystic multiple, mobile, polygonal structures called intracystic “fat balls.” Due to the rapid growth of the lesion, which exceeded 15 cm in diameter, a right oophorectomy was performed. Histopathologic diagnosis confirmed the mature cystic teratoma. The presence of floating balls composed of keratin and fat is rarely seen but is pathognomonic of mature cystic teratomas. Growth of a teratoma during pregnancy is a rare condition.

Prevalence of gestational diabetes mellitus evaluated by universal screening with a 75-g, 2-hour oral glucose tolerance test and IADPSG criteria

To determine the prevalence of gestational diabetes mellitus (GDM) and its association with maternal age among Turkish women diagnosed by International Association of Diabetes and Pregnancy Study Group (IADPSG) criteria.