Gökhan Demirayak

First-trimester maternal serum metastin, placental growth factor and chitotriosidase levels in pre-eclampsia

OBJECTIVE To investigate whether the serum levels of metastin and PIGF and chitotriosidase activity early in pregnancy differ in women who develop pre-eclampsia from those who remain normotensive. STUDY DESIGN A retrospective case-control study of prospectively collected data. Thirty healthy pregnant women and 31 women with pre-eclampsia were included in the study. Serum samples were collected at 11-14 weeks and stored at -70°C. Levels of metastin, PIGF and chitotriosidase activity were measured in serum from pregnant women with subsequent development of pre-eclampsia and matched controls. RESULTS Mean maternal serum metastin (1554 ± 385 pmol/L vs 1995 ± 375 pmol/L, p<0.001) and PIGF (111.9 ± 7.0 pg/mL vs 124.9 ± 3.5 pg/mL, p<0.001) levels were significantly lower and chitotriosidase activity was significantly higher (681.6 ± 248.3 nmol/mL/h vs 527.7 ± 223.1 nmol/mL/h, p<0.01) in women who subsequently developed pre-eclampsia than in those who remained normotensive. The areas under the curve equal to 0.797, 0.831 and 0.681 (p<0.001, p<0.001 and p<0.01) for metastin, PIGF, and chitotriosidase respectively were determined for the prediction of pre-eclampsia. CONCLUSIONS Metastin and PIGF levels and chitotriosidase activity are altered in the first trimester serum of women destined to become pre-eclamptic, reflecting placental dysfunction. Metastin, like PIGF, may have a potential to be used as a first-trimester biomarker of pre-eclampsia.

Craniorachischisis with a variant of pentalogy of Cantrell, with lung extrophy.

A case of cranioraschischisis including incomplete pentalogy of Cantrell (PC) is described. The female fetus had a large omphalocele with evisceration of the heart, left lung, liver, stomach, and intestines accompanying anencephaly, cervical, thoracal lumbar, spina bifida. The fetus had ectopia cordis and diaphragmatic agenesia with an intact sternum. We present a case of a neonate with the stigmata for PC with the exception of a sternal defect. A literature review is also included. Sonographers should check for ventral and dorsal anomalies with PC because they may occur simultaneously.

Myomectomy for intramural fibroids during caesarean section: A therapeutic dilemma

Abstract The aim of the present study was to assess the safety of myomectomy for intramural fibroids during caesarean section. A retrospective study of 63 women who underwent myomectomy during caesarean section and 63 women who underwent caesarean delivery without myomectomy was conducted. The study group was divided into subgroups according to the volume of fibroids and total incision count. The volume of fibroids, the preoperative and postoperative haemoglobin values and the difference between them, incidence of haemorrhage and blood transfusion, duration of operation and postoperative fever of patients were investigated. Duration of operation was longer (p < .001) and haemoglobin loss was higher (p = .01) in the myomectomy group. There was no difference between one incision and two incisions subgroups in terms of mean haemoglobin change (p = .068). Haemoglobin loss was higher in volume >50 cm3 group than volume <50 cm3 and control groups. These differences were statistically significant (p = .02; p = .001, respectively). Although intramural fibroids can be safely removed during caesarean section, large fibroids and extra incisions for myomectomy are risk factors for haemorrhage.

Immediate biopsy of cervical cytology-negative and non-HPV-16/18 oncogenic types positive patients

According to the American Society of Colposcopy and Cervical Pathology (ASCCP), a co‐test is recommended for patients one year after the detection of non‐HPV 16/18 viral types in association with a negative cervical cytology. In this study, we used immediate colposcopy to evaluate the risks to the patient during the one year waiting period.