Erdinç Özkinay

The effectiveness of live lactobacilli in combination with low dose oestriol (Gynoflor) to restore the vaginal flora after treatment of vaginal infections

Objective  To evaluate the effectiveness of live lactobacilli in combination with low dose oestriol for restoration of the vaginal flora after anti‐infective treatment.

The comparison of uterine artery Doppler velocimetry with the histopathology of the placental bed.

We determined the relationship between the histopathological findings of the placental bed and Doppler flow measurements of the uterine artery in women with preeclampsia and fetal growth retardation. Doppler velocimetry in the uterine artery was evaluated in 17 pregnant women with preeclampsia, 15 of whom had fetal growth retardation, and 20 normal pregnant women, within 14 days of Caesarean delivery and placental bed biopsy. The placental bed biopsies were evaluated in terms of trophoblast migration into the myometrium and physiological changes of the spiral arteries. The results were compared with Doppler velocimetry values. Trophoblast migration and physiological changes were not detected in 10 (59%) cases with preeclampsia and in 4 (20%) with normal pregnancies (p<0.05). In the preeclamptic group, 9 of 15 cases that were complicated with intrauterine growth retardation had no trophoblastic migration into the myometrium. The mean systolic/diastolic ratio, resistance index and pulsatility index of the uterine artery in women with preeclampsia and fetal growth retardation was significantly higher than women with normal pregnancies (p<0.01). The mean resistance index of the uterine artery in the impaired migration group was significantly higher than the migration group (p=0.02). The incidence of impaired trophoblast migration was significantly higher in the group with a high systolic/diastolic ratio (above 2.5) and resistance index (above 0.58) than cases with low systolic/diastolic ratio and resistance index (72%, 23% respectively, p<0.05). The incidence of early diastolic notch in the impaired trophoblast migration group was significantly higher than the migration group (57% versus 13%, p<0.01). Our study supports the hypothesis that high uterine artery flow resistance is related to the reduced trophoblast migration into the myometrium and inadequate physiological changes in the spiral arteries in women with intrauterine growth retardation and preeclampsia.

Post-mortem Caesarean section performed 30 minutes after maternal cardiopulmonary arrest.

During the past century post-mortem Caesarean sections were held in ill repute because infant salvage rates were very poor among the reported cases. Over the past 50 years as the nature of maternal mortality has changed, the potential for infant survival has increased. Changes in common causes of maternal deaths from chronic diseases and infection to acute causes, such as anaesthetic complications, embolism and cerebrovascular accidents in a previously healthy mother, have increased the potential for infants survival. In addition, improvements in neonatal care have led to a strong motivation that, with appropriate and timely management, a healthy infant can be saved by perimortem Caesarean delivery. The actual percentage of post-mortem Caesarean sections remains difficult to ascertain, probably because of underreporting of unsuccessful cases. Nevertheless, because of the potential for survival of normal infants, obstetricians must consider a Caesarean delivery in a woman who has a cardiopulmonary arrest in the third trimester. We present a case of post-mortem Caesarean section performed 30 mins after maternal cardiopulmonary arrest. The infant survived with minimal neurological sequelae.

Single dose oral azithromycin versus seven day doxycycline in the treatment of non‐gonococcal mucopurulent endocervicitis

The aim of this study was to compare single dose oral azithromycin versus seven‐day doxycycline in the treatment of non‐gonococcal mucopurulent cervicitis (MPC). One hundred and thirty‐one women with non‐gonococcal MPC were enrolled in a prospective‐randomised study to compare the efficacy and safety of a single oral dose of 1 g azithromycin and a seven‐day course of 100 mg doxycycline twice daily Clinical examination and culture samples for Chlamydia trachomatis and other microorganisms were performed before and approximately 14 days after starting the treatment.

Intracranial Venous Thrombosis Associated with Severe Antithrombin-III Deficiency in Pregnancy

We report a patient with intracranial venous thrombosis in the third trimester of pregnancy associated with severe antithrombin‐III deficiency. The evaluation of protein C, protein S and antithrombin‐III levels in patients with thrombotic events during pregnancy may reveal the specific cause of the thrombotic event and thereby influence patient management