Nermin Kosus

Clitoral and labial sizes in women wıth PCOS.

The aim of this study was to examine the external genital features in Turkish women with polycystic ovary syndrome (PCOS). Thirty-two newly diagnosed PCOS cases and 35 healthy women were included the study. All women underwent a thorough gynaecological examination. Clitoral length, and labia minora length and width were recorded. The groups were compared for features of external genital structures. Clitoral and labial lengths were significantly higher in PCOS group. There was a strong correlation between clitoral length and modified Ferriman–Gallwey score. The most effective predictor of PCOS was found to be clitoral length. Clitoral length alone predicted 99.9% of PCOS patients. There were some subclinical genital changes in women with PCOS. These changes in PCOS patients may be a sign of hyperandrogenism and might have diagnostic value in indistinct cases.

Nail alterations during pregnancy: a clinical study

During pregnancy, cutaneous and appendageal alterations manifest and may cause concern in the subject. The nails may be affected by pregnancy. This study investigated the frequency and nature of nail changes occurring during pregnancy in 312 healthy, 18–40‐year‐old pregnant women in gestation weeks 16–40. After a routine obstetric examination at the obstetrics and gynecology clinic at the study institution, all subjects submitted to an examination of all fingernails and toenails. Only nail alterations that had developed during pregnancy were recorded. Any nail changes that had occurred before the start of gestation were not considered. Data were presented as percentages. The Shapiro–Wilk and chi‐squared tests were used to make categorical comparisons. A P‐value of < 0.05 was considered to indicate statistical significance. No nail pathologies were detected in 116 (37.2%) of the 312 subjects. The most commonly found nail change was leukonychia (24.4%). Ingrown toenail (9.0%) and onychoschizia (9.0%) represented the second most common nail changes. Rapid nail growth and subungual hyperkeratosis were observed in 6.7% and 4.2%, respectively, of subjects. When the alterations were evaluated according to gestational age, the most common nail pathology was leukonychia at both 14–28 weeks (16.3%) and 29–42 weeks (27.4%) of pregnancy. Leukonychia, onychoschizia, onycholysis, and brittle nail pathologies were frequently observed at 29–42 weeks of pregnancy (P = 0.047). A large proportion of nail changes that occur during pregnancy are benign and do not require treatment. However, these changes may cause significant cosmetic stress in women.

Does vitamin E prevent tubal damage caused by smoking? A light microscopy and animal study

OBJECTIVE To assess the histomorphological effects of smoking on the cilia of fallopian tubes in mice and the effect of vitamin E on the negative effects of smoke. STUDY DESIGN Eighteen 12-14 week-old Swiss albino type female mice were randomly divided into three groups, each consisting of six mice: Group A: control group; Group B: mice exposed to cigarette smoke; Group C: mice exposed to cigarette smoke together with vitamin E. Groups B and C were exposed to cigarette smoke for 10 weeks. After 10 weeks, tubal excision was performed in all animals. Histopathologic examination of excised tubal tissue was conducted under light microscopy. RESULTS The number of cilia was significantly lower in Group B. Although not statistically significant, the median number of cilia in Group C was measured to be higher than in Group B but lower than in Group A. CONCLUSION Based on the results, it can be concluded that smoking decreases tubal cilia numbers. Supplementation by vitamin E may treat or at least help to slow down the decrease in number of cilia caused by smoking; therefore it could be used therapeutically in the treatment of smoking-related tubal damage.

Is There a Relationship Between Pelvic Organ Prolapse and Tissue Fibrillin-1 Levels?

PURPOSE Pelvic organ prolapse is a multifactorial disorder in which extracellular matrix defects are implicated. Fibrillin-1 level is reduced in stress urinary incontinence. In Marfan syndrome, which is associated with mutations in Fibrillin-1, pelvic floor disorders are commonly observed. We hypothesize that Fibrillin-1 gene expression is altered in pelvic organ prolapse. METHODS Thirty women undergoing colporrhaphy or hysterectomy because of cystocele, rectocele, cystorectocele, or uterine prolapse were assigned to a pelvic prolapse study group, and thirty women undergone hysterectomy for nonpelvic prolapse conditions were assigned to a control group. Real-time polymerase chain reaction was conducted on vaginal tissue samples to measure the expression of Fibrillin-1. Expression levels were compared between study and control groups by Mann-Whitney U test with Bonferroni revision. RESULTS Fibrillin-1 gene expression was not significantly lower in the study group than in the control group. Similarly, no significant correlation between Fibrillin-1 levels and grade of pelvic prolapse was found. Age over 40 years (P=0.018) and menopause (P=0.027) were both associated with reduced Fibrillin-1 levels in the pelvic prolapse group, whereas the delivery of babies weighing over 3,500 g at birth was associated with increased Fibrillin-1 expression (P=0.006). CONCLUSIONS The results did not indicate a significant reduction in Fibrillin-1 gene expression in pelvic prolapse disorders; however, reduced Fibrillin-1 may contribute to increased pelvic organ prolapse risk with age and menopause. Increased Fibrillin-1 gene expression may be a compensatory mechanism in cases of delivery of babies with high birth weight. Further studies are needed for a better understanding of these observations.

Does quality of female sexual function improve after a transobturator tape procedure

Abstract The aim of this study was to use a questionnaire to evaluate any changes in sexual satisfaction of women who underwent a transobturator tape (TOT) procedure for stress urinary incontinence. A total of 30 women agreed to participate in the study and were invited to fill out the Female Sexual Function Index (FSFI) questionnaire prior to surgery and 3 months after surgery. As a result, after the TOT operation, there was a statistically significant improvement in libido (desire), arousal, lubrication, orgasm and satisfaction. The TOT procedure seems to have a positive effect on female sexual function by reducing the urinary leakage during sexual activity and by decreasing the pain during or after sexual activity.

Relation between serum PAPP-A level and umbilical cord thickness during first trimester of pregnancy.

Abstract Purpose: To evaluate the relation between umbilical cord diameter versus pregnancy associated plasma protein-A (PAPP-A) level in first trimester women. Method: Cord diameter were measured and patients were divided into two groups according to frequency distribution analysis as below or above 3.7 mm for free loop diameter (FCD) and below or above 3.4 mm for cord measurement at umbilicus (ACD). Groups were compared with each other. Results: Strong correlations were found between ACD versus PAPP-A. Conclusion: By using strong correlation between ACD versus PAPP-A, it may be possible to reduce unnecessary amniocentesis due to false positive screening results.

Do cigarette smoke and vitamin E affect the development of endometrial pinopods? An animal study

OBJECTIVES To study the effects of cigarette smoke and vitamin E on the development of endometrial pinopods. STUDY DESIGN Eighteen female and 12 male Swiss albino mice, 12-14 weeks old, with a mean weight of 25g (standard deviation 5g) were used in this study. Female mice were divided into three equal groups. Every day for 10 weeks, mice in Group 1 (control group) received normal saline intraperitoneally; mice in Group 2 were exposed to smoke from 20 cigarettes/day using a smoke machine; and mice in Group 3 were exposed to smoke from 20 cigarettes/day using a smoke machine and also received 50mg/kg vitamin E intraperitoneally. After 10 weeks, vaginal smears were taken from the female mice and they were copulated with the 12 male Swiss albino mice on the day of oestrus. Day 0 was defined as the day on which sperm were detected in the vagina by smear test. Mice were killed at the end of Day 5, which was considered to represent the optimal day for implantation. The uteri were removed and the effects of cigarette smoke and vitamin E on the development of endometrial pinopods were studied using an electron microscope. RESULTS The endometrial tissue of the control group appeared morphologically normal, with short microvilli, cytoplasm and pinopods in the form of cytoplasm and cell membrane enlargements in patches. In total, 149 pinopods were counted in the control group using a scanning electron microscope (two histologists performed the analysis and were blinded to each others findings). In the smoke-exposed group, the cytoplasmic structure was degenerated considerably, and fewer pinopods were counted (n=11). The number of pinopods in mice who were exposed to cigarette smoke and vitamin E (n=67) was significantly higher compared with the cigarette-exposed group (p=0.002), but considerably lower compared with the control group (p=0.002). CONCLUSION Smoke exposure led to a significant decrease in the development of endometrial pinopods. Vitamin E, an antioxidant, partially reversed the adverse effects of cigarette smoke. This suggests that cigarettes may have a negative effect on fertility by decreasing the number of pinopods. However, this negative effect can be reduced using vitamin E. More studies should be conducted to support this finding.

Factors affecting the rates of caesarean sections in cases with premature rupture of membranes (PROM) at term

Abstract The aim of this retrospective study was to investigate the factors affecting the rates of caesarean section in cases with premature rupture of membranes (PROM) in term pregnancies. Eighty-two term PROM patients who presented to Turgut Ozal University and Erzurum Nene Hatun Hospitals between 2012 and 2014 were included. The effects of demographics, nulliparity, active-latent phase durations, presence of meconium and chorioamnionitis, requirement of oxytocin and cervical dilation at the initial examination on C/S rates were assessed. The C/S rates were changed with the duration of active period and the duration of latent period. It was found that the presence of cervical dilation at the initial examination significantly reduced the risk for progress to C/S at a rate of 87.5%. C/S rates did not change with other variables. We conclude that the factors increasing the risk for C/S in PROM at term group are not different from the non-term PROM. Impact statement The aim of this retrospective study was to investigate the factors affecting the rates of caesarean section (C/S) in cases with premature rupture of membranes (PROM) in term pregnancies. The C/S rates were changed with the duration of active period and the duration of latent period. It was found that the presence of cervical dilation at the initial examination significantly reduced the risk for progress to C/S at a rate of 87.5%. We conclude that the factors increasing the risk for C/S in PROM at term group, are not different from the non-term PROM groups. Currently, the PROM is considered the start of a pathological process in both term and preterm pregnancies and also considered to increase the rates of caesarean sections. Studies on the management of PROM at term have concentrated rather on whether to intervene for accelerating the labour or spontaneous monitorisation. As found by the studies like this one in the literature, the factors having an impact on C/S rates in the cases of PROM at term are similar to those of non-PROM patients at term, may prevent clinicians from taking an invasive or aggressive approach towards the cases of PROM at term.

Hyperemesis gravidarum and its relation with maternal body fat composition.

The objective of this study was to determine if maternal body fat composition and body mass index were associated with hyperemesis gravidarum (HG) in the first trimester of pregnancy. Healthy pregnant women (n = 30) without nausea and vomiting (control group) and women with HG (n = 54; study group), all with singleton pregnancy at 6–14 weeks gestational age, were included. Body mass index was measured before and during pregnancy. Visceral adipose tissue (VAT) and subcutaneous fat thickness were measured during pregnancy. Comparison of the groups revealed that VAT and pre-pregnancy body mass index but not subcutaneous fat thickness were significantly higher in the HG group versus controls. VAT and pre-pregnancy body mass index predicted 83.8% and 67.1% of HG cases, respectively. VAT and pre-pregnancy body mass index were correlated with the development of hyperemesis gravidrum and hence could be considered as predictive markers for HG.