Sedat Kadanali

Maternal Serum Interleukin-10, Interleukin-2 and Interleukin-6 in Pre-Eclampsia and Eclampsia

The aim of the study was to investigate and compare the concentrations of interleukin (IL)‐2, IL‐6, and IL‐10 in serum of women with mild pre‐eclampsia, severe pre‐eclampsia, eclampsia, and normotensive pregnancy.

Comparison of labor induction with misoprostol vs. oxytocin/prostaglandin E2 in term pregnancy

Objective: To compare the efficacy and safety of intravaginal and oral misoprostol vs. oxytocin/prostaglandin E2 (PGE2) gel for third trimester labor induction. Methods: Two hundred twenty‐four pregnant women were randomized to induction of labor either with misoprostol or oxytocin and PGE2 gel. Patients in the misoprostol group (n = 112) received 100 μg intravaginal misoprostol followed by 100 μg p.o. every 2 h. The oxytocin/PGE2 group consisted of 112 patients who underwent PGE2 cervical instillation 6 h before continuous oxytocin infusion. The perinatal, intrapartum and neonatal characteristics of both groups were determined. Results: Induction to active phase of labor was successfully achieved in 96 women (85.7%) in the misoprostol group vs. 86 women (76.8%) in the oxytocin/PGE2 group, but the drug initiation‐delivery interval was significantly shorter in the misoprostol group (9.2 ± 2.4 h) than in the oxytocin/PGE2 group (15.2 ± 3.2 h, P < 0.001). The incidence of adverse intrapartum outcomes was similar for both methods. Intravaginal misoprostol 100 μg followed by a single oral dose of 100 μg misoprostol safely produced labor and a vaginal delivery in 70% of patients. More than three tablets were required in only 10% of patients. There was a higher prevalence of cesarean section for failed induction in the oxytocin/PGE2 group than in the misoprostol group (13.4 vs. 6.3%, P < 0.001). The neonatal outcomes of both groups were also similar. Conclusion: Misoprostol is significantly more effective for labor induction than oxytocin/PGE2 gel. The maternal intrapartum and neonatal outcomes were the same for both induction regimens. From a clinical and perinatal perspective, misoprostol is an acceptable choice for labor induction.

Anthropometric, clinical and laboratory comparison of four phenotypes of polycystic ovary syndrome based on Rotterdam criteria

Aim:  To compare all phenotypes of polycystic ovary syndrome (PCOS) for anthropometrical, hormonal, and metabolic differences according to Rotterdam criteria.

Serum levels of insulin, IGF‐1, and IGFBP‐1 in pre‐eclampsia and eclampsia

Objectives: To investigate whether the serum concentrations of insulin, insulin‐like growth factor‐1 (IGF‐1), and insulin‐like growth factor binding protein‐1 (IGFBP‐1) were altered in women with mild pre‐eclampsia, severe pre‐eclampsia, and eclampsia. Methods: In this prospective study, we investigated 20 mild pre‐eclamptic, 20 severe pre‐eclamptic, and 20 eclamptic patients in the third trimester. The control group consisted of 20 healthy pregnant women. Serum levels of insulin, IGF‐1, and IGFBP‐1 were measured. Results: In patients with eclampsia, serum levels of IGF‐1 were lower, and IGFBP‐1 were higher, respectively, than control and other study groups (P<0.001) The values of IGF‐1 in mild pre‐eclampsia and severe pre‐eclampsia were lower compared with control groups (both P<0.01), but there were no differences between mild and severe pre‐eclampsia. The serum levels of IGFBP‐1 in severe pre‐eclampsia were higher compared with control groups (P<0.01), but there was no statistical difference between mild pre‐eclampsia and other groups. Conclusions: IGF‐1 was lower, and IGFBP‐1 was higher in pre‐eclamptic and eclamptic patients than controls, these alterations were related to the severity of pre‐eclampsia.

Maternal carriage and neonatal colonisation of group B streptococcus in eastern Turkey: prevalence, risk factors and antimicrobial resistance

Our object is to determine the prevalence of group B streptococcus (GBS) carriage among pregnant women, the neonatal colonisation rate and the antimicrobial susceptibility to formulate a policy for treatment and prevention regarding perinatal GBS diseases in eastern Turkey. A total of 150 pregnant women were screened for GBS colonisation. Samples were collected from the vagina and the rectum of pregnant women, and the ear canal, throat and umbilicus of the neonates of colonised mothers. Antimicrobial susceptibility of the isolates was also investigated. GBS was isolated in at least one specimen from the 150 women in 48 cases; it was estimated that, overall, about 32% of the pregnant women and 17.3% of overall newborns were colonised with GBS. The overall rate of GBS vertical transmission was 54.2% in this study. Maternal colonisation rate was significantly higher in younger ages (p < 0.01) when maternal age of 20 years was taken as a cut‐off point. All isolates were found to be sensitive to penicillin, ampicillin, cefazolin and vancomycin. Resistance to erythromycin and clindamycin were found to be 13.5 and 2.7%, respectively.

Evaluation of active and passive transport mechanisms in genital tracts of IUD-bearing women with radionuclide hysterosalpingoscintigraphy

The objective of this study was to evaluate the active and passive transport mechanisms in the genital tracts of copper T-200 intrauterine device (IUD)-bearing women. (Tc-99m)HMPAO-labeled spermatozoa and (Tc-99m)-labeled albumin macrospheres were placed into the vagina at midcycle. Serial scintigraphic images were obtained over a period of 2 h. Migration of spermatozoa and particles in the genital tract and the direction of transport related to dominant follicle were evaluated. While active sperm migration was greatly inhibited, the passive transport of the particles was not affected in IUD-bearing women. The direction of radiolabeled particles and spermatozoa was toward the dominant follicle side. Passive transport was not affected, whereas active transport of spermatozoa was strongly inhibited in the genital tract by the presence of the IUD. However, the direction of active and passive transport related to dominant follicle side was unchanged in IUD-bearing women and was preferentially toward the tube ipsilateral to the dominant follicle.

Urinary calcium excretion in severe preeclampsia and eclampsia.

Abstract Urinary calcium levels in women with mild preeclampsia, severe preeclampsia and eclampsia were evaluated in this study. We collected 24-h urine samples from 35 mild preeclamptic (Group 1), 30 severe preeclamptic (Group 2), and 17 eclamptic patients (Group 3). The control group (Group 4) consisted of 35 healthy pregnant women. Serum levels of total calcium and creatinine, and urinary calcium were measured. These values were compared in the four groups. The mean maternal age and parity were similar in all groups. There were no statistically significant differences in the serum levels of total calcium and creatinine (p>0.05). Urinary calcium excretion in patients with preeclampsia and eclampsia was significantly lower than in controls (p<0.0001). Urinary calcium levels between mild preeclampsia and severe pre-eclampsia, and severe preeclampsia and eclampsia were similar (p>0.05), but were lower in eclampsia than in mild preeclampsia (p<0.05). In conclusion, urinary calcium excretion is reduced in patients with severe preeclampsia or eclampsia. However, the decrease in urinary calcium excretion cannot be used to identify the severity of preeclampsia, or to predict impending eclampsia.

Diminished growth hormone responses to l-Dopa in polycystic ovarian disease

OBJECTIVE To investigate the GH secretion capacity in polycystic ovarian syndrome (PCOS). DESIGN Prospective. SETTING Reproductive endocrinology unit. PATIENTS Nineteen women with clinical and endocrinologic signs of PCOS were compared with 10 healthy weight-matched volunteers with normal menstrual rhythm and no history of endocrine or reproductive abnormality. INTERVENTIONS Standard GH reserve estimates were affected in all subjects using oral L-Dopa. The test was carried out after an overnight fast on cycle days 5 to 8 in menstruating subjects; the test was done randomly in patients with amenorrhea. RESULTS Both PCOS and control groups responded to L-Dopa over a 3-hour period with significant elevations in GH concentrations. The control group showed significantly higher values than the PCOS group at 90, 120, and 180 minutes. CONCLUSION The findings indicate that PCOS patients demonstrate a relative deficiency in GH reserve.

Changes in leukocyte, granulocyte and lymphocyte counts following antenatal betamethasone administration to pregnant women

Objective: Preterm labor and premature rupture of membranes are associated with a mild leukocytosis. However, we have observed a higher maternal leukocyte count after antenatal betamethasone therapy. We planned this study to evaluate the effects of antenatal betamethasone treatment on maternal leukocyte, granulocyte and lymphocyte count. Methods: Forty‐six pregnant women with the diagnosis of preterm labor between 28 and 33 weeks of gestation age received 12 mg betamethasone at a 12‐h interval. The control group consisted of 50 pregnant women between 28 and 33 weeks of gestational age with no medical or obstetrics problems. After a baseline venous sampling, serial leukocyte, granulocyte and lymphocyte counts were obtained every 6 h until it returned to baseline value. Results: There were no statistically significant differences in the control group with respect to the total leukocyte, lymphocyte, and neutrophil count. Total leukocyte and granulocyte counts were increased by 29.8% and 17.8% within 24 and 12 h after betamethasone injection, respectively (P < 0.01). A significant reduction in lymphocyte count was observed within 12 h (45.4%) after betamethasone injection (P < 0.01). All changes in leukocyte, granulocyte and lymphocyte counts returned to baseline values within 3 days. Conclusion: Antenatal betamethasone therapy leads to an increase in maternal leukocyte count and a decrease in lymphocyte count. This effect is transient and any leukocytosis persisting for more than 3 days is not due to betamethasone administration.

Asymmetries in pelvic lymph nodes and their metastatic involvement by gynecologic cancer cells

Aim:  The aims of this study were to re‐examine left–right asymmetry in pelvic lymph node distribution in patients with gynecologic malignancies, and to investigate if there is a left–right asymmetry in pelvic lymph node metastatic involvement by gynecologic cancer cells.