Işık Üstüner

Effect of maternal obesity and weight gain on gestational diabetes mellitus

The aim of the study is to evaluate the association between gestational diabetes mellitus (GDM) and maternal obesity and weight gain during pregnancy. A prospective cohort study screened 614 consecutive gravid patients for GDM using 50 g glucose challenge test (GCT). The pregnant women were divided into 4 groups according to their prepregnancy body mass index (BMI). Group I, II, III and IV constituted when the BMI < 18.5 kg/m2 (n = 16), 18.5–24.9 kg/m2 (n = 455), 25–29.9 kg/m2 (n = 122), and >30 kg/m2 (n = 21) respectively. All the pregnant women were also evaluated in terms of their weight gain during pregnancy and these cases were recruited in 3 groups as low, ideal and high weight gain groups. Overall, a positive 50 g GCT result was identified in 106/614 (17.8%) women. GDM was further diagnosed in 12/614 (1.95%) of subjects. The prevalence of GDM in Group II, III and IV was 1.31%, 3.28% and 9.52% respectively (p < 0.05). The cases of Group II in first and second trimester and Group III only in second trimester showed statistically significant positive results of 50 g GCT when they had excess weight gain compared to the ones whose weight gain were in normal range. Women planning pregnancy should be educated about the disadvantages of obesity, being over-weight and should be advised to have an ideal prepregnancy BMI and ideal weight gain during pregnancy.

Is There a Relationship between Mood Disorders and Dysmenorrhea

OBJECTIVE Menstrual problems are common among adolescent females. Mood changes are related to menstrual problems (menorrhagia, dysmenorrhea, and abnormal menstrual cycle length). The aim of this study was to determine the relationship between depressive symptoms, anxiety, and premenstrual syndrome (PMS) with dysmenorrhea in adolescent girls. METHODS A total of 159 adolescent girls (aged 13-19 y) with regular menstrual cycles presenting to the gynecology clinic with any complaints were included in the study during April-May 2013. All of the participants filled up the sociodemographic data collection form, FACES Pain Rating Scale, Beck anxiety inventory (BAI), Beck depression inventory (BDI), and a questionnaire form on criteria for PMS. Mann-Whitney U and chi-square tests were used to analyze the data. RESULTS The prevalence of dysmenorrhea was 67.9%. The mean BAI and BDI scores of the patients were 13.64 ± 12.81 and 11.88 ± 10.83, respectively. Statistically significant differences were observed between patients and control groups on the BAI and BDI scoring (P < .05). At least 1 of the symptoms of the PMS was detected in all of the participants and 29 (18.2%) of them were diagnosed as premenstrual dysphoric disorder (PMDD). The mean BAI score of the patients with PMS and PMDD were 9.65 ± 9.28 and 21.31 ± 15.75, respectively. The mean BDI score of the patients with PMS and PMDD were 8.39 ± 8.62 and 19.1 ± 11.85, respectively. Statistically significant differences were observed between PMS/PMDD and BAI/BDI scoring (P = .00). CONCLUSION Adolescent girls with dysmenorrhea have an increased risk of depression and anxiety. These results of our study are significant in emphasizing the importance of a multidisciplinary approach to primary dysmenorrhea follow-up and treatment.

Maternal serum 25(OH)D levels in the third trimester of pregnancy during the winter season

Objective. To measure serum 25(OH)D levels of pregnant women in the last trimester during the winter season and to determine the factors affecting their serum levels. Methods. In all, 79 pregnant women in the third trimester were examined between November 2008 and March 2009. Serum calcium, phosphorus, alkaline phosphatase, parathyroid hormone, and 25(OH)D levels were measured. Maternal age, education, socioeconomic status (SES), nutrition, dressing habits, and level of sunlight exposure were determined and their correlation with serum 25(OH)D levels were statistically compared. Results. The mean serum 25(OH)D level of the study group was 11.95 ± 7.20 ng/ml, and the prevalence of severe vitamin D deficiency [25(OH)D < 10 ng/ml] in pregnant women was 45.6%. No association was detected between severe vitamin D deficiency and maternal age, gravidity, skin phototype, benefiting from ultraviolet index, and educational status of the cases. Also in patients who used multivitamin supplements and good SES, 25(OH)D levels were significantly higher (p = 0.046, p = 0.025, respectively). Conclusions. This study showed a remarkable high rate of vitamin D deficiency in pregnant women during the winter season and we have found high levels of vitamin D in patients supplemented with multivitamins and in ones with good SES.

Coexistence of aplasia cutis congenita, faun tail nevus and fetus papyraceus.

BACKGROUND Aplasia cutis congenita is a disorder of the skin embryonic development characterized by a defect of localized or widespread areas of skin at birth. The lesions are mostly oval, 1-3 cm in diameter, with localization on the parietal part of scalp (60%) and rarely on the face and extremities. MAIN OBSERVATIONS Herein, we reported a case of aplasia cutis congenita termly born at 39 weeks of gestation to a 30-year-old mother with bronchial asthma attacks. She was referred for 3 punched-out punctate depressed defective lesions in 0.4 cms diameter on the vertex covered with necrotic and hemorrhagic crusts. There was a hypertrichotic area consisting of tufts of terminal hair on the lumbosacral area over a sinus tract. Maternal perinatal drugs included aerosol salbutamol sulfate, ipratropium bromide and oral montelukast sodium for bronchial asthma. The pregnancy was firstly started as a di-chorionic, di-amniotic twin gestation, but deteriorated after the fetal resorption of the co-twin in the 20th gestational week resulting in fetus papyraceus. CONCLUSION In multi-gestational pregnancies, the presence of the fetus papyraceus or the death of the co-twins should make the neonatologists and dermatologists be aware of the possible cutaneous defects like aplasia cutis congenita. We emphasize that the possibility of this rare entity should be kept in mind in the presence of fetus papyraceus, perinatal drug use, maternal cigarette smoke, or maternal diseases like bronchial asthma in multiple gestations.

Posterior Reversible Encephalopathy Syndrome in a Postpartum Preeclamptic Woman without Seizure.

Posterior reversible encephalopathy syndrome (PRES) is a cliniconeuroradiological entity presenting with headache, confusion, visual disturbances or blindness, and seizures. Parieto-occipital white matter changes due to vasogenic oedema can be observed on imaging modalities. It rarely occurs without seizures and after delivery. We report a 33-year-old multigravida with a history of preeclampsia in term pregnancy complicated by PRES without seizures at the postpartum period. Clinical improvement with complete resolution without any complications was observed on the 6th day after delivery. Posterior reversible encephalopathy syndrome is reversible when early diagnosis is established and appropriate treatment is started without delay.

The Role of Hypoxia at Primary Dysmenorrhea, Utilizing a Novel Hypoxia Marker—Scube1

STUDY OBJECTIVE To determine the SCUBE1 levels in adolescents with primary dysmenorrhea. DESIGN A prospective cross-sectional study. SETTING A university hospital outpatient clinic, Rize, Turkey. PARTICIPANTS A total of 40 adolescent girls, 15 on menses and 25 not on menses. INTERVENTIONS AND MAIN OUTCOME MEASURES Demographic features and menstrual history of the participants were assessed and blood samples were obtained for detecting the platelet volume, platelet counts, and SCUBE1 levels of the participants. RESULTS No difference was detected between the 2 groups in mean platelet volume, platelet count, and SCUBE1 levels. CONCLUSION Future trials are required to investigate the relation between SCUBE1 levels and primary dysmenorrhea.

Labial Adhesion with Acute Urinary Retention Secondary to Bartholin's Abscess

Labial adhesions are usually seen in early childhood or in the postmenopausal years, but this clinical entity is rarely seen in the reproductive years. We report a case of labial adhesion with acute urinary retention secondary to Bartholins abscess in a reproductive‐aged woman with normal menstrual periods. We emphasize the possible occurrence of labial adhesion following Bartholins abscess in the reproductive years with normal estrogen levels.

Factors affecting pregnancy weight gain and relationships with maternal/fetal outcomes in Turkey

Objectives: To determine the effects of pre-pregnancy body mass index (BMI) and gestational weight gain on maternal and fetal complications, and to examine whether Turkish women achieve the recommended gestational weight gain. We also investigated the relationship between pregnancy weight gain and mode of delivery, with an examination of maternal anthropometry. Methods: A retrospective cross-sectional study was conducted on a population of 986 pregnant women between November 2011 and November 2015 at Atatürk Education and Research Hospital, Ankara, Turkey. Maternal age, BMI, monthly weight gain during pregnancy, infant birth weight, gender, and maternal and fetal adverse outcomes were evaluated. Results: The frequency of maternal complications was positively associated with elevated pre-pregnancy BMI (p<0.05), and weight gain during pregnancy was associated with parity and increased infant birth weight (p<0.05). However, no correlations were observed between mean pregnancy weight gain and maternal complications (p>0.05). The percentage of women who gained the Institute of Medicine (IOM)-recommended amount of weight was the highest in the underweight BMI group (54.1%) and the lowest in the obese BMI group (24.3%). Pregnancy weight gain exceeded IOM recommendations in the overweight (56.3%) and obese (52.5%) groups. Conclusions: While maternal weight gain during pregnancy affects neonatal body weight, higher pre-pregnancy BMI has an adverse effect on recommended weight gain during pregnancy, with increased maternal complications.

Lower Urinary Tract Symptoms and Urinary Incontinence During Pregnancy

Lower urinary tract symptoms (LUTS) can frequently be seen in pregnant women. Pregnancy and delivery have been considered as risk factors in the occurrence of pelvic floor dysfunction and determinants of LUTS. The main associated risk factor is parity. In the present study, we aim to determine the frequency of LUTS and urinary incontinence (UI) during pregnancy and the associated risk factors.

Urinary Incontinence in Premenopausal Women: Prevalence, Risk Factors and Impact on Quality of Life

To determine the prevalence and risk factors of urinary incontinence (UI), and assess its impact on the quality of life (QOL) in premenopausal women.