Hulya Dede

Posterior sling (infracoccygeal sacropexy): An alternative procedure for vaginal vault prolapse

This study of 30 patients evaluated the effectiveness and safety of the posterior sling (infracoccygeal sacropexy) in the surgical treatment of vaginal vault prolapse. The patients were reevaluated 3 months, 6 months and yearly postoperatively. Coexisting preoperative symptoms of pelvic pain, urgency, nocturia and ‘obstructed’ micturition feeling were followed‐up. There was remarkable improvement in vault prolapse and in coexisting symptoms.

Neuroprotective effect of magnesium sulfate treatment on fetal brain in experimental intrauterine ischemia reperfusion injury

Objective. The aim of this study was to demonstrate the neuroprotective effect of magnesium sulfate on ischemia–reperfusion-induced injury in fetal rat brain. Methods. Twenty-four, 19-days pregnant rats were randomly allocated into four groups. Fetal brain ischemia was induced by clamping the utero-ovarian artery bilaterally for 20 min and reperfusion was achieved by removing the clamps for 30 min. The control group consisted of noninjured rats. No treatment was given in the ischemia–reperfusion group; whereas 1 ml saline and 600 mg/kg magnesium sulfate was administered in the vehicle and the treatment groups 30 min before ischemia reperfusion injury. Lipid peroxidation in the brain tissue was determined as the concentration of thiobarbituric acid-reactive substances (TBARS) for each fetal rat. A one-way analysis of variance and post hoc test were used for statistical analysis. Results. TBARS levels were found to be increased after ischemia reperfusion injury when compared with controls. Magnesium sulfate treatment prevented the increase in TBARS after ischemia reperfusion injury. Conclusions. We have shown that magnesium sulfate decreases TBARS levels significantly in fetal rat brain subjected to ischemia reperfusion injury and may have potential therapeutic benefits by reducing oxidative stress after intrauterine ischemia–reperfusion-induced fetal brain damage.

Misoprostol for Cervical Ripening and Labor Induction in Pregnancies with Oligohydramnios

The efficacy and safety of misoprostol for cervical ripening and labor induction in patients with oligohydramnios was investigated. 57 pregnancies with oligohydramnios and 58 cases with a normal amniotic fluid volume (controls) were enrolled in this prospective trial. All patients received 50 µg of intravaginal misoprostol every 5 h. Primary outcomes were: cesarean section rate; induction to delivery time; oxytocin augmentation; uterine hyperstimulation; meconium passage; fetal heart rate (FHR) changes; fetal distress requiring delivery, and Apgar scores. There were no differences in the mean time to delivery, cesarean section rate, oxytocin augmentation or Apgar scores. The mean induction to delivery time in oligohydramnios and control groups were, 11 h 43 min and 11 h 18 min, respectively (p > 0.05). FHR changes were observed in 26.3% of oligohydramnios group and 32.7% of control group (p > 0.05). There was no statistically significant difference in the cesarean section rate and the uterine hyperstimulation between the 2 groups. These data suggest that misoprostol can be used as an effective agent for cervical ripening and labor induction in pregnancies with oligohydramnios without increasing the risk for perinatal outcome, compared to those with normal amniotic fluid volumes.

Higher Level of Oxidative Stress Markers in Small for Gestational Age Newborns Delivered by Cesarean Section at Term

ABSTRACT Introduction: The aim of our study was to determine lipid peroxidation products and antioxidant enzyme activity in umbilical cord blood of small for gestational age (SGA) neonates. Materials and methods: Umbilical cord arterial blood samples were collected from 21-term singleton SGA newborn infants and 21 age- and sex-matched appropriate for gestational age (AGA) term neonates prospectively born by elective cesarean section for determination of malondialdehyde (MDA) as a marker of lipid peroxidation and superoxide dismutase (SOD) for antioxidant activity. Results: MDA levels were increased (5.20 vs. 3.52 nmol/mL; p < 0.001), while levels of SOD (6.24 vs. 8.99 U/mL; p < 0.01) were decreased in SGA neonates when compared with AGA newborn infants. Conclusions: Elevated MDA levels and decreased SOD activity in umbilical cord blood may show the possibility of insufficient protective mechanisms against increased oxidative stress in SGA neonates born by cesarean section.