Filiz Yanik

Early onset of subclinical atherosclerosis in women with gestational diabetes mellitus

Common carotid artery intima‐media thickness (CIMT) is a non‐invasively assessed marker of subclinical atherosclerosis. Our aim in this study was to investigate CIMT in women with gestational diabetes mellitus (GDM).

Prediction of preterm delivery among women with threatened preterm labor.

Background/Aims: To determine predictive values of fetal fibronectin and phosphorylated insulin-like growth factor binding protein-1 (phIGFBP-1) in cervicovaginal secretions and ultrasonographic measurement of cervical length for delivery <35 weeks in patients with uterine contractions. Methods: Our study included 51 women between 24 and 35 weeks’ gestation with uterine contractions and 90 controls. Cervicovaginal samples were analyzed for presence of fetal fibronectin and phIGFBP-1. Cervical length was measured by transvaginal sonography. Results: Preterm birth rate was 19.6% (10/51) in the study group. Negative predictive values of fetal fibronectin, phIGFBP-1 and ultrasonographic cervical length <20 mm, and <25 mm for delivery <35 weeks were 91.9, 92.3, 91.1, and 90.5%, respectively. Positive predictive values were 50, 58.3, 100 and 66.7%, respectively. When results of fetal fibronectin/phIGFBP-1 test and ultrasonographic cervical length <25 mm were combined, specificity and positive predictive values of each test for delivery within 7 days increased. Conclusion: Fetal fibronectin and phIGFBP-1 tests have approximately equivalent ability to predict delivery <35 weeks’ gestation. An ultrasonographic cervical length measurement >20 mm or a negative fetal fibronectin/phIGFBP-1 test obtained from patients with uterine contractions at 24–35 weeks’ gestation may avoid overdiagnosis.

Helicobacter pylori infection detected by 14C-urea breath test is associated with iron deficiency anemia in pregnant women.

Aims:  To determine whether there is a relationship between Helicobacter pylori (H. pylori) infection, iron deficiency anemia and thrombocytopenia in pregnant women.

Diagnosis of gestational diabetes mellitus by use of the homeostasis model assessment–insulin resistance index in the first trimester

Objective. Gestational diabetes mellitus (GDM) affects 2–10% of all pregnant women, causing increased morbidity and mortality, and is tested for in the second trimester of pregnancy. The purpose of the present study was to predict GDM in the first trimester. Design and methods. The study included 271 patients who were between the 10th and 14th week of gestation. Fasting glucose and insulin were measured in the first trimester and the homeostasis model assessment–insulin resistance index (HOMA-IR) was calculated for each patient. These values were compared with the results of the second-trimester glucose tolerance test. Results. HOMA-IR values were higher in women with GDM. A cut-off value of 2.60 for HOMA-IR was calculated at the end of the study. Conclusion. Accepting patients whose HOMA-IR value is higher than 2.60 in the first trimester seems to be a good method to predict GDM.

Large pseudocyst of the umbilical cord associated with patent urachus

Cystic masses of the umbilical cord have been detected in the second and third trimesters of pregnancy in association with fetal abdominal wall defects and chromosomal anomalies. We present a case of an umbilical cord pseudocyst diagnosed using routine ultrasound at the 20 weeks of gestation. Serial sonography followed the progression of the cystic masses. A 2960‐g male infant was delivered at term, in whom a patent urachus was detected. The infant underwent repair with closure of the patent urachus and plastic reconstruction of the abdominal wall, and the postoperative course was uneventful. This case demonstrated an uneventful outcome despite the persistent multiple cord cysts.

Quality of life and postmenopausal symptoms among women in a rural district of the capital city of Turkey

Objective. To determine menopause-related symptoms and quality of life in women aged 40–80 years living in a rural area of Turkey. Methods. A total of 338 women were evaluated in this cross-sectional study. As data sources we used a questionnaire that elicited information on the descriptive, fertility and menopausal characteristics of the women, the Menopause Rating Scale (MRS) and the Short Form-36 (SF-36). Results. The mean age at menopause was 46.5 ± 0.4 years. The complaint stated most often as ‘severe or very severe’ was ‘hot flushes and sweating’ (50.7%). The physical functioning, physical role, bodily pain, general health, social functioning, emotional role and mental health scores of postmenopausal women were statistically higher (p < 0.05) than those of premenopausal women. Scores on physical function, physical role, general health and social function decreased significantly with age in postmenopausal women (p < 0.05), while none of the quality-of-life domain scores differed significantly with age in premenopausal women. Conclusions. Quality of life is worse in postmenopausal women than premenopausal women, and in older than younger women in the postmenopausal period. Thus rural populations are primarily in need of public health care in the postmenopausal period.

Early oral hydration after cesarean delivery performed under regional anesthesia.

To establish an early, safe, and well‐tolerated time to start oral hydration after cesarean delivery.

Effects of Ringer’s Lactate, Medroxyprogesterone Acetate, Gonadotropin-Releasing Hormone Analogue and Its Diluent on the Prevention of Postsurgical Adhesion Formation in Rat Models

Fifty adult female rats were randomly divided into five groups. Before the standard surgical procedure which consisted of creating a lesion with electrocautery over the uterus, leuprolide acetate (LA) together with its diluent, the diluent alone and medroxyprogesterone acetate (MPA) were injected to the third, fourth, and fifth groups, respectively. Ringer’s lactate (RL) solution was applied intraperitoneally to the second group at the end of the surgery. Group I received no medication. Relaparotomy was performed 3 weeks later to evaluate the adhesions. The mean adhesion scores were (mean ± SD) 2.6 ± 0.7, 1.4 ± 0.8, 0.9 ± 0.6, 2.3 ± 0.8, and 0.8 ± 0.6 in groups I, II, III, IV, and V, respectively. The postsurgical adhesions were significantly less in the groups treated with RL, LA, and MPA.

First trimester maternal serum PAPP‐A and free β‐HCG levels in hyperemesis gravidarum

To evaluate whether hyperemesis gravidarum (HG) affects first‐trimester maternal serum PAPP‐A and free β‐hCG levels.

Serum Nitric Oxide and Glutathione Levels in Preeclamptic and Normotensive Women during Labor

This study was performed on 38 preeclamptic women, including 26 severely preeclamptic and eclamptic cases, as well as 50 normotensive pregnant controls. Twenty cases in the preeclamptic group and 34 cases in the control group were in labor. Serum nitric oxide levels were measured as total nitrites after reduction of nitrates to nitrites. Among the control subjects, nitric oxide levels were significantly lower in the cases in labor when compared to those not in labor (p < 0.05), but glutathione levels were not significantly different (p >0.05). Among the preeclamptic patients, although nitric oxide levels were not significantly different between the cases in and not in labor (p > 0.05), glutathione levels were significantly higher in the latter group (p < 0.05). Thus, in preeclamptic patients there might be a compensatory increase in nitric oxide production during labor in order to maintain the systemic circulation. Glutathione levels might also be increased to compensate for the marked oxidative stress.