Gökhan Açmaz

The Efficacy of Bevacizumab, Sorafenib, and Retinoic Acid on Rat Endometriosis Model

Blood vessels are necessary for development and maintenance of the endometriosis and blood flow supplies oxygen and essential nutrient to the disease. Local angiogenesis is regulated by vascular endothelial growth factor (VEGF) and inhibitors of VEGF may be a novel therapeutic approach. We inducted endometriosis in 43 rats and they were randomly allocated into 4 groups. The rats in group I (control n = 11) were given no medication. The rats in group II (n = 11) were given bevacizumab. The rats in group III (n = 11) were given Sorafenib, and the rats in group IV (n = 10) were given retinoic acid (RA). Then groups were compared for microvessel density, VEGF, soluble tyrosine-kinase receptor, ovarian reserve, and treatment effectivity. All these medications were effective on endometriosis and we detected that volume of endometriotic implants were significantly decreased. Ovarian reserve was not affected from the medication, in addition RA have induced reproductive capacity.

The effect of hyperemesis gravidarum on the 75 g oral glucose tolerance test screening and gestational diabetes mellitus

Abstract Objective: To clarify the effect of hyperemesis gravidarum (HG) on the 75u2009g oral glucose tolerance test (OGTT) and gestational diabetes mellitus. Methods: This retrospective cohort study was conducted via an evaluation of the hospital database medical records of 700 pregnant women. Of these, 60 were included in the study group as a result of hospitalization due to HG, 41 were excluded, and the remaining 599 formed a control group. The body mass index (BMI), urine ketone levels, and ages of all participants were separately recorded, both in the initial examination and during the 75u2009g OGTT. Results: At initial examination, no significant differences in maternal age and BMI were observed between the two groups. There was a significant decrease in BMI after 75u2009g OGTT in the study group. No significant difference in fasting serum glucose levels was found between the two groups, but significant differences in first and second hour serum glucose levels were observed. Conclusions: HG may improve in many women in the late second trimester, and loss of fatty tissue may affect the 75u2009g OGTT screening results. The appropriate cutoff value of 75u2009g OGTT for HG should be reevaluated following future, larger, studies.

The Effect of Anterior Uterocervical Angle on Primary Dysmenorrhea and Disease Severity

Background Primary dysmenorrhea, defined as painful menstrual cramps originating in the uterus without underlying pathology, is a gynecological disease that affects quality of life and school success. Our goal was to determine the effect of anterior uterocervical angle on primary dysmenorrhea and disease severity. Methods A total of 200 virgin adolescents, 16 to 20 years of age, were included in the study. The Andersch and Milsom scale was used to determine dysmenorrhea severity. Those with pathologies causing secondary dysmenorrhea were excluded from the study. Study subjects were grouped based on severity of pain. Demographic characteristics and uterocervical ultrasonographic measurements were compared among groups. Results Of the 200 participants enrolled in the study, 50 were healthy controls and 150 had primary dysmenorrhea. Those with primary dysmenorrhea had a significant family history of primary dysmenorrhea compared with controls (P < 0.001). Age (P=0.668), body mass index (P=0.898), menarche age (P=0.915), and length of menstrual cycles (P=0.740) were similar in all groups. The uterine corpus longitudinal axis, uterine corpus transverse axis, and uterine cervix longitudinal axis were also similar (P=0.359, P=0.279, and P=0.369, resp.). The mean uterocervical angle was 146.8u2009±u20096.0 in controls and 143.3u2009±u20097.3 in those with mild pain with no significant difference between the groups. In those with moderate pain, the mean uterocervical angle was 121.2u2009±u20097.3 compared with 101u2009±u20099.2 in those with severe pain, which was a significant difference. Additionally, there was also a significant difference in the uterocervical angle among those with mild, moderate, and severe pain (P < 0.001). Conclusion Our results indicate that a narrower anterior uterocervical angle is associated with primary dysmenorrhea and disease severity.

Effect of severe hyperemesis gravidarum on maternal vascular endothelial health: evaluation of soluble adhesion molecules

Abstract Purpose: This study aimed to clarify the effect of severe hyperemesis gravidarum (sHG) on maternal vascular endothelial health with evaluation of soluble adhesion molecules. Method: The study population consisted of two groups of pregnant participants between 18 and 35u2009years of age who were between 5 and 13u2009weeks of gestation: sHG group and a healthy control group. A group of 26 participants whose pregnancies were complicated by sHG was compared with 26 healthy participants regarding serum levels of the soluble adhesion molecules such as E-selectin, soluble intracellular cell adhesion molecule 1 (sICAM-1), and soluble vascular cell adhesion molecule one (sVCAM-1), as well as other biochemical markers. The two groups had similar baseline characteristics. Results: Maternal baseline characteristics were similar in both groups. Serum levels of E-selectin (pu2009<u2009.001), sICAM-1 (pu2009<u2009.001), and sVCAM-1 (pu2009<u2009.001) were higher in the sHG group compared with the control group. Higher blood urea nitrogen, creatinine, and sodium levels, serum osmolarity, and urine density (pu2009<u2009.001,u2009<u2009.001, .006, .041, and .001, respectively) were also observed in the sHG group compared with the control group. Conclusions: The findings of this study indicated that sHG could impact endothelial cell function and these changes represented hypovolemia and dehydration caused by severe vomiting. Large-scale studies are required to understand the clinical importance of this finding regarding the long-term consequences and underlying mechanisms of elevated sICAM-1, sVCAM-1, and sE-selectin synthesis.

Perinatal outcomes in uncomplicated late preterm pregnancies with borderline oligohydramnios

Abstract Purpose: The purpose of this study is to determine the adverse perinatal outcomes in uncomplicated late preterm pregnancies with borderline oligohydramnios. Methods: A total of 430 pregnant women with an uncomplicated singleton pregnancy at a gestational age of 34u2009+u20090–36u2009+u20096 weeks were included. Borderline oligohydramnios was defined as an amniotic fluid index (AFI) of 5.1–8u2009cm, which was measured using the four-quadrant technique. Adverse perinatal outcomes were compared between the borderline and normal AFI groups. Results: Approximately 107 of the 430 pregnant women were borderline AFI, and 323 were normal AFI. The demographic and obstetric characteristics were similar in both groups. Delivery <37 weeks, cesarean delivery for non-reassuring fetal heart-rate testing, meconium-stained amniotic fluid, Apgar 5u2009min <7, transient tachypnea of the newborn, respiratory distress syndrome, neonatal intensive care unit, and hyperbilirubinemia were not statistically different between the groups (pu2009=u2009.054, pu2009=u2009.134, pu2009=u2009.749, pu2009=u20090.858, pu2009=u2009.703, pu2009=u2009.320, pu2009=u2009.185, and pu2009=u2009.996, respectively). Although gestational age was full-term, induction of labor rates were significantly higher in the borderline AFI group (pu2009=u2009.040). In addition, fetal renal artery pulsatility index pulsatility index (PI) was significantly lower in the borderline AFI group than in the normal AFI group (pu2009=u2009.014). Conclusion: Our results indicated that borderline AFI was not a risk for adverse perinatal outcomes in uncomplicated, late preterm pregnancies.

Cervical Local Immune Response for High-Risk Human Papillomavirus Infection: Involvement With Cervical Mucus SLPI Proteins

Purpose: To evaluate cervical mucus secretory leukocyte protease inhibitor (SLPI) concentrations in patients with high-risk human papillomavirus (hrHPV) 16 or 18 positive and low-grade squamous intraepithelial lesions (LGSIL) or high-grade squamous intraepithelial lesions (HGSIL). Method: Patients with HPV 16 or 18 positive from 30 to 45 years of age whose cervical cancer screening results reported cytologically LGSIL or HGSIL were included in the study. In the control group, we included participants in the same age with cytology negative and HPV-negative healthy women. All cytological LGSIL or HGSIL results were histopathologically confirmed with colposcopic biopsy specimens. Finally, the study consisted of a total of 3 groups each containing 25 participants as follows: (1) Pap smear and HPV-negative control group, (2) HPV 16 or HPV 18 and LGSIL-positive participants, and (3) HPV 16 or 18 and HGSIL-positive participants. Cervical mucus SLPI levels were analyzed using the enzyme-linked immunosorbent assay method. Results: The mean cervical mucus SLPI levels were 32.94 ng/mL (range: 23-41.29 ng/mL) in the hrHPV + LGSIL group, 29.40 ng/mL (range: 21.03-38.95 ng/mL) in the hrHPV + HGSIL, and 18.75 ng/mL (range: 13.58-29.24 ng/mL) in the healthy control group. Cervical mucus SLPI levels were found to be significantly higher in the hrHPV + LGSIL and hrHPV + HGSIL groups compared to the control group (P < .001). Conclusions: The data from the present study indicate that SLPI seems to be one of the important immunomodulatory proteins that provide local immune response in cervical mucosa.

P50.13: Cephalothoracopagus janiceps disymmetricus with gastroschisis, a very rare form of conjoined twins: a case report

feet and at this moment the hypothesis of congenital arthrogryposis was placed. At 18 weeks the scan showed the fetus in the same position but with marked hypomobility and flexion of limbs. The hypothesis of fetal akinesia sequence was placed and after discussion, the couple decided for termination of pregnancy. Fetopathological examination showed a 200 g male fetus, with nuchal and neck edema, flexion contractures of limbs, marked scoliosis of all vertebral column extension, rocker-bottom feet and multiple pterygia of great joints, leading to diagnosis of lethal multiple pterygium. This case report demonstrates the importance of the first trimester scan in the diagnosis of early fetal syndromes.

P49.15: Torsion of the uterus in the second trimester

Objectives: To determine if low cervical volume predicts risk of spontaneous preterm birth in preterm contraction pregnancy. Study design: A prospective study that measured cervical volume by transvaginal XI VOCAL was performed among 100 patients with a singleton pregnancy hospitalized with signs of premature labor between 24 and 36 weeks’ gestation. Result: The rate of preterm birth was 32.2%. The sensitivity, specificity of transvaginal XI VOCAL were, respectively, 72.2%, 65.3% for delivery before 37 weeks’ gestation. When cervical volume was ≤ 17 CC, the gestational age at delivery was significantly lower than when it exceeded 17 CC (P < 0.05). Conclusion: Transvaginal XI VOCAL in cervical volum measurement provides an objective method for evaluating the risk of preterm delivery. Its predictive values are impressive and allow better discrimination between women at high risk of preterm delivery and those in false preterm labor.