Mehmet Tayyar

Androgen levels of preeclamptic patients in the third trimester of pregnancy and six weeks after delivery

Background. The aim of this study was to measure the circulating levels of androgens in the third trimester of pregnancy and six weeks after delivery and to discuss androgen contribution in the pathogenesis of preeclampsia.

Hyaluronic acid plus heparin for improved efficacy in prevention of adhesion formation in rat uterine horn model

OBJECTIVE To determine the effectiveness of hyaluronic acid (HA) and heparin [unfractioned heparin (UH) or low molecular weight heparin (LMWH)] combination in reducing adhesion formation in a rat uterine horn model. STUDY DESIGN Prospective, randomized, comparative study in a rat model was done in Surgical Research Laboratory, Erciyes University. A standard lesion was created by unipolar electrocautery in 120 uterine horns of total 60 female Wistar-Albino rats. Animals were then randomly assigned into four groups, each consisting of 15 animals: (1) control, no adjuvant given; (2) HA, 1 ml of 0.4% solution given onto each horn preoperatively; (3) HA, 1 ml of 0.4% solution given preoperatively plus 1 ml of UH given postoperatively; (4) HA, 1 ml of 0.4% solution given before injury plus 1 ml of LMWH given after injury. A second-look laparotomy was performed two weeks after surgery. The number of horns with adhesion was determined and a scoring system applied. RESULT(S) The number of horns without adhesion formation was significantly higher in HA plus UH (P<0.05) and HA plus LMWH (P<0.01) groups compared to control group. The extent, severity and total scores of adhesion formation were also found to be significantly reduced in other groups when compared to control group. Combination of HA plus UH and HA plus LMWH significantly reduced all adhesion scores compared to HA alone. But a direct comparison of the ability of HA plus UH versus HA plus LMWH in reducing adhesion scores in the rat uterine horn yielded an insignificant difference. CONCLUSION Administration of HA before injury followed by UH or LMWH given after injury has been documented to improve the efficacy of HA alone in reducing adhesion formation.

Prenatal Ultrasonographic Diagnosis of Rhizomelic Chondrodysplasia punctata by Detection of Rhizomelic Shortening and Bilateral Cataracts

Antenatal sonographic diagnosis of rhizomelic chondrodysplasia punctata depends on recognization of the combination of rhizomelic bone shortening and epiphyseal stippling. This is the only report of prenatal ultrasonographic diagnosis of bilateral cataracts in a fetus with rhizomelic chondrodysplasia punctata (type 1). Also, this is the first report of severe rhizomelic limb shortening, and bilateral cataracts prior to the recognization of epiphyseal stippling.

Twenty two weeks of transdermal estradiol increases sex hormone-binding globulin in surgical menopausal women

OBJECTIVE To compare the effects of continuous noncombined transdermal estradiol versus oral conjugated estrogen on serum sex hormone-binding globulin (SHBG) levels prior to and during the 10th and 22nd weeks of therapy in patients with surgical menopause. STUDY DESIGN Open, comparative trial. Patients were consecutively assigned to three groups: group 1 (n = 18) received continuous transdermal estradiol (0.050 mg/day), group 2 (n = 18) continuous oral conjugated estrogens (0.625 mg/day), whereas group 3 (n = 15) received no treatment. Serum SHBG levels were determined before treatment and after 10 and 22 weeks of treatment. RESULTS Serum SHBG increased significantly with oral conjugated estrogens at 10 (p < 0.01) and 22 weeks (p < 0.01) compared with baseline. With transdermal estrogens there was a much smaller increase of SHBG. At 22 weeks, this increase was significant compared with baseline (p < 0.05), but not compared with the control group (p > 0.05). CONCLUSION Transdermal estrogen has no effect on SHBG, whereas oral conjugated estrogens causes considerable increase.

The effects of different doses of medroxyprogesterone acetate on serum lipids, lipoprotein levels and atherogenic index in the menopausal period

The purpose of our study was to make a contribution to research in determining the least harmful progestogen dose for women who have not had their uterus removed. The study was an open comparative trial. The patients were consecutively assigned to two groups. The first group (n = 19) were given 0.625-mg conjugated equine estrogen plus 5-mg medroxyprogesterone acetate (MPA), and the second (n = 18) 0.625-mg conjugated equine estrogen plus 2.5-mg MPA. Serum total cholesterol (T-cholesterol), triglyceride, high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) levels plus LDL-C/HDL-C values (atherogenic index) were measured before the study and again after 6 and 12 months. These values were compared with ANOVA and postANOVA tests (Scheffe) within the groups and with unpaired t-test between the two groups. The triglyceride serum levels in the first group were decreased in the 12th month compared to baseline levels. In addition, LDL-C/HDL-C values were significantly decreased in the 6th month, but these values slightly increased in the following 6 months. In the second group, T-cholesterol, triglyceride, LDL-C and atherogenic index were decreased in the 12th month when compared to baseline levels within the groups. This decrease was statistically significant (p < 0.05). There was no significant difference between the two groups (p > 0.05). Hormone replacement therapy with continuous 0.625-mg conjugated equine estrogen and 2.5-mg MPA had a better effect on lipid profiles than 0.625-mg conjugated equine estrogens and 5-mg MPA after 12 months of treatment.

Continuous versus cyclical transdermal oestrogen replacement therapy in postmenopausal women: effects on lipoprotein(a) and nitric oxide levels

The purpose of our study was to compare the effects of cyclical versus continuous transdermal oestrogen replacement therapy on lipoprotein (a) (Lp(a)) and nitric oxide levels.

Maternal erythrocyte malondialdehyde level in preeclampsia prediction: a longitudinal study

Abstract We aimed to determine the value of maternal erythrocyte malondialdehyde levels in the prediction of preeclampsia. 110 healthy women were included in this prospective study. Maternal erythrocyte malondialdehyde levels were measured at each trimester of pregnancy (10–14, 20–25 and 30–35 gestational weeks). On follow-up, patients were assigned to two groups as normotensive women and preeclamptic patients. Preeclampsia had developed in eight (8.9%) of the 90 pregnant women who completed the study. Preeclamptic patients were diagnosed between 36 and 39 gestational weeks (36.8±1.0 weeks). Malondialdehyde levels of preeclamptic patients increased significantly in the third trimester (p < 0.05), while there was no difference between values of malondialdehyde in the first and second trimester. Malondialdehyde levels were significantly higher in the patients who developed preeclampsia than in those who did not in the third trimester (p < 0.05). With the use of the receiver operating characteristics (ROC) 35.98 nmol malondialdehyde/gm hemoglobin was found to be a cut-off value predictive for the development of preeclampsia in the third trimester. However, cut-off values in the first and second trimesters could not be found. The sensitivity, specificity, positive and negative predictive values were 89, 75, 29 and 98%, respectively. Preeclampsia risk was found to increase nearly 24 times in values above 35.98 nmol malondialdehyde/ gm hemoglobin. Our results showed that maternal erythrocyte malondialdehyde could predict patients within a few weeks prior to onset of clinical symptoms of preeclampsia in the third trimester. There is no evidence of enhanced early lipid peroxidation in pregnancies with late onset preeclampsia.

Increased endothelin in infants of pre‐eclamptic mothers

Abstract Objective : Endothelin (ET), a vasoactive mediator, like others which originate from the endothelium or circulating cells, may participate in myocardial injury. In full‐term neonates of mild pre‐eclamptic mothers (NMPM), it identifies minor myocardial damage missed by other biochemical markers. The present study was designed to determine the diagnostic value of ET concentrations in NMPM.

Activated protein C resistance in Turkish women with severe preeclampsia.

The purpose of this study was to investigate the occurrence rate of APC resistance (APC-R) with severe preeclampsia in Turkish women. Thirty-two consecutive women having severe preeclampsia were included in the study. Thirty-two healthy pregnant women served as the control group. APC-R assays were performed in the third trimester of pregnancy, and 3 and 9 months after delivery. APC-R was demonstrated in the third trimester, 3 months and 9 months after delivery in 27 (84.4%), 23 (71.9%) and 5 (15.6%) of 32 preeclamptic patients, respectively. APC-R rates were significantly higher in preeclamptic group than in normal pregnant women in the third trimester of pregnancy (p < 0.05). Decreased mean APC activity and also increased APC-R rate was still persisting in preeclamptic group for 3 months after delivery. Nine months after delivery, the mean APC activity and also APC-R rates approached to the normal pregnant women; however, there was a significant difference between both groups (p < 0.05). Our results indicate that acquired APC-R may be a contributory factor in the pathogenesis of preeclampsia.

An evaluation of two different screening criteria in gestational diabetes mellitus

Abstract Background: The objective of this study was to identify the gestational diabetes mellitus (GDM) prevalence difference according to American Diabetes Association (ADA) criteria and International Association of Diabetes and Pregnancy Study Group (IADPSG) criteria for 75 g oral glucose tolerance test (OGTT). Methods: This study was conducted at Erciyes University Department of Obstetrics and Gynecology. A total of 320 pregnant who met the criteria were included in the study and 75 g OGTT was applied. Irrespective of the first results, the test was applied to most participants 2 weeks later. Results: The GDM prevalence was found to be 9.1% according to the ADA criteria and 19.4% according to the IADPSG criteria. According to the ADA criteria, GDM prevalence was found to be statistically significantly high (p < .05) in patients with risk factors. According to the IADPSG criteria no relationship was found between GDM prevalence and any of the risk factors (p > .05). The patients diagnosed with GDM were observed not to reach the threshold levels for HbA1c. Conclusion: According to the IADPSG criteria, GDM prevalence doubles and leads to an increase in healthcare costs and workloads. HbA1c has no role in the diagnosis of GDM.