OBJECTIVES: We aimed to determine whether mean platelet volume value and/or neutrophil/lymphocyte ratio values are useful as a predictive marker for gestational cholestasis. STUDY DESIGN: Retrospective analysis of the data of patients diagnosed with pregnancy cholestasis between 2018-2019 in a perinatology clinic. 352 pregnant women were enrolled in the study (122 pregnant women with Intrahepatic cholestasis as study group and 230 pregnant women with no morbidity as the control group) RESULTS: Mean platelet volume was significantly higher in pregnant women with intrahepatic cholestasis compared to the healthy controls, 9.30 (7-18) and 8.6 (6.7-11.5), respectively. The neutrophil/lymphocyte ratio was significantly higher in pregnant women with intrahepatic cholestasis compared to the healthy controls, 3.93 (0.46-13.75) and 4.25 (0.87-17.1), respectively. There was a statistically significant difference between the two groups for mean platelet volume (p <0.001). In the roc analysis, 8.85 fL for mean platelet volume had a sensitivity of 65% and a specificity of 59%. CONCLUSION: When compared with healthy pregnancies, mean platelet volume value in gestational cholestasis increases significantly. However, the predictive strength of mean platelet volume for cholestasis is not strong enough to recommend its usage as a single parameter in clinical practice.
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Amaç: İlk trimester Down Sendromu tarama testi olarak biyokimyasal belirteçler olan gebelik ile ilişkili plazma protein A (PAPP-A) vehuman koriyonik gonadotropin serbest beta alt birimi (β-hCG) kullanılmaktadır. Bu çalışmada gebeliğin ilk üç ayında yapılan kombinetest sonuçlarının gestasyonel diabetes mellitus (GDM) ile ilişkisi araştırılmıştır.Gereç ve Yöntemler: Çalışma grubunu GDM tanısı alan ve doğumu 1 Ağustos 2018 ile 31 Ekim 2018 arasında hastanemizde gerçekleşen95 hasta oluşturmaktaydı. Kontrol grubu için hastanemizde termde doğum yapan, ek hastalığı olmayan, gebelik komplikasyonusaptanmayan ve kombine test sonuçlarına ulaşılabilen 100 hasta rastgele seçilmiştir. Gruplardaki hastaların ilk trimester serum β-hCGve PAPP-A düzeyleri karşılaştırılmıştır.Bulgular: PAPP-A düzeyi ve MoM değeri ile β-hCG düzeyi ve MoM değeri GDM grubunda daha düşük saptanmıştır (sırasıyla, p=0,013,p=0,081, p=0,001 ve p=0,007). En ideal kesme değeri PAPP-A için 1,715 ng/mL (duyarlılık %61 ve özgüllük %22) ve PAPP-A MoMiçin 0,905 (duyarlılık %51,6 ve özgüllük %39) olarak bulundu. En ideal kesme değeri Β-hCG için 25,75 mIU/mL (duyarlılık %56,8 veözgüllük %30) ve β-hCG MoM için 0,745 (duyarlılık %57,9 ve özgüllük %28) olarak bulundu.Sonuç: PAPP-A ve β-hCG düzeyleri GDM gelişenlerde sağlıklı gebelere kıyasla daha düşüktür. Ancak hem PAPP-A hem de β-hCG içinbulunan ideal kesme değerlerde yalancı pozitiflik oranları oldukça yüksektir.
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Objective: To evaluate perinatal outcomes in human immunodeficiency virus (HIV) infected pregnant women in Turkey.Material and Methods: Maternal characteristics, pregnancy complications, laboratory findings including HIV load, CD4 cell count, CD4/CD8ratio, neonatal features and final HIV status of the baby were retrospectively analyzed.Results: The sample included 26 singleton pregnancies, from 25 HIV-infected women. The ethnicities were Turkish (n=18), East European(n=4), Asian (n=2) and African (n=2). The majority (76.9%) was aware of their HIV status before becoming pregnant. Four cases (15.3%) werediagnosed during pregnancy and two (7.8%) at the onset of labor. The results for median HIV viral load, CD4 count, and CD4/CD8 ratio at birthwere 20 copies/mL (0-34 587), 577/mm3 (115-977), and 0.7 (0.1-1.9), respectively. The HIV viral load rate was 5.5% in eighteen women takinganti-retroviral treatment. The rates of gestational diabetes mellitus, gestational hypertension, intrauterine growth restriction, and preterm deliverywere 3.8%, 3.8%, 7.6%, and 8% (numbers are 1;1;2;2), respectively. The mean gestational week at birth was 38 weeks and mean birthweight is2972±329 g. Two babies were congenitally infected with HIV (infection rate of 8.3%). There was one needle-related accident during surgery.Conclusion: Timely diagnosis of HIV infection during pregnancy is important for preventing mother to child transmission. HIV infected womenmay give birth to HIV negative babies with the help of a multidisciplinary team, composed of perinatology, infectious diseases, and pediatricsspecialists. (J Turk Ger Gynecol Assoc 2020; 21: 180-6)
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Background. The aim of the current study was to demonstrate the neonatal outcomes of infants born to mothers with early-onset preeclampsia (EP) and late-onset preeclampsia (LP), and compare the neonatal outcomes before and after 34 weeks of gestation in EP group. Methods. In this retrospective study, we evaluated preeclamptic mother and child pairs who were followed-up at Hacettepe University Hospital between the years 2010 and 2017. The pregnant women were classified as having EP if diagnosed before 34 weeks of gestation (n=91) and LP if diagnosed after 34 weeks of gestation (n=34). The women in the EP group were further divided into subgroups according to the gestational week at birth, including those who gave birth before 34 weeks of gestation (early birth; n=57) and after 34 weeks of gestation (late birth; n=34). Necessary clinical and demographic data were withdrawn from the electronic registry and patient files. Results. Neonates in the EP/late birth subgroup had significantly lower gestational age and birthweight. Small for gestational age (SGA) frequency was higher in the early-onset subgroup born after 34 weeks’ gestation compared to the late-onset preeclampsia group (p= 0,016). The incidence of neutropenia was significantly higher in the EP/late birth subgroup than in the LP group (p= 0.002). After correcting for gestational week and birth weight, neutrophil count was still significantly lower in the EP/late birth subgroup (p= 0.002). EP/late birth subgroup and LP group had comparable outcomes regardless of neutrophil count and SGA rate. Conclusions. Close follow up and postponing delivery in stable and appropriate pregnant women with preeclampsia would be beneficial for neonates.
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Objective: This study aimed to compare the first trimester complete blood count (CBC) indices of pregnancies complicated by early-onset preeclampsia(EOPE) or late-onset preeclampsia (LOPE).Material and Methods: A retrospective case-control study was conducted with 186 patients. Patients were classified into three subgroups: EOPE,LOPE, and control groups. First trimester CBC results were obtained for each patient. Hemoglobin, hematocrit, red blood cell distribution width, meancorpuscular volume, white blood cell (WBC) count, neutrophil, eosinophil, basophil, lymphocyte, monocyte, mean platelet volume, platelet distributionwidth, plateletcrit, and platelet count were compared. The neutrophil lymphocyte ratio was calculated by dividing the absolute lymphocyte count by theabsolute neutrophil count. The platelet lymphocyte ratio was calculated by dividing the absolute lymphocyte count by the absolute platelet count.Results: The total number of cases was 21, 42, and 123, in the EOPE, LOPE, and control groups, respectively. There were statistically significant differencesin the total WBC and neutrophil counts between the three groups (both p<0.05). WBC and neutrophil counts were found to be highest in the EOPE group,and the LOPE group had higher levels compared with controls. The optimal cut-off values to predict EOPE for WBC and neutrophil counts were 9.55×103/μL (sensitivity 71.4% and specificity 70.7%) and 6.45×103/μL (sensitivity 66.7% and specificity 74.8%), respectively.Conclusion: Increased first trimester WBC and neutrophil counts may be predictive for EOPE.
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Objective: To investigate the effects of 17β-estradiol (E2) levels onblood lymphocyte counts in women.Methods: Blood samples were obtained from 428 healthy women. Serum E2 levels were measured using the solid-phase enzyme-labelledchemiluminescent method. Complete blood count was performed bya fully automated cell counter. White blood cell differential, includinglymphocytes, was performed by volume, conductivity, and five-partscatter measurements (VCS technology). The participants were divided into four groups, according to the blood lymphocyte levels: <1000cells/µL (Group A), 1001–2000 cells/µL (Group B), 2001–3000 cells/µL(Group C), and 3001–4000 cells/µL (Group D).Results: The mean age of the participants was 37.03 years (between15 and 66 years). E2 levels on admission in the study group rangedfrom <11 to 4264 pg/mL, and the median E2 level was 121.98. Twelvewomen had high levels of E2, as a result of the ovulation inductiontreatment. Total lymphocyte count varied between 0.9×103 to as highas 105×103 cells/µL, and the median lymphocyte count was 2.6×103cells/µL. Lymphocyte–white blood cell ratio (LWR) was also studiedin addition to lymphocyte levels. The lowest LWR value was 9.1 andthe highest was 99.7. The medium E2 concentration was 40.3±11,114±144, 117.2±128, and 192.2±595 in Groups A–D, respectively. Therelationship between lymphocyte counts and LWR was positive, as expected. There were no statistically significant differences in lymphocyte counts either with age or E2 levels.Conclusion: It is well established that estrogens affect lymphocytefunctions in several ways. In the present study, we were unable todemonstrate a correlation between the E2 serum levels and bloodlymphocyte counts in women.
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Objective: To evaluate “papillary thyroid carcinoma-pregnancy” interaction among cancer survivors.Material and Methods: The clinical records of 8 pregnant women who received treatment for papillary thyroid cancer before their pregnancy were evaluated. Clinical features, pregnancy/perinatal outcomes and high-risk factors were compared with 45 controls who were randomly assigned from the institutional perinatal medicine database.Results: Patients in the cancer group were older than the control group (34.3 vs 29.8 years). The cesarean section rate was higher (62.5% vs 33.3%) and the APGAR scores at the 1st and 5th minutes were lower in the cancer group.Conclusion: Management of pregnancies with papillary thyroid cancer treatment and follow-up requires a multidisciplinary approach with careful antenatal care and perinatal surveillance. Patients who have received papillary thyroid cancer treatment can safely undergo pregnancy. (J Turk Ger Gynecol Assoc 2018; 19: 94-7)
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