Impact of gestational diabetes mellitus and maternal obesity on cord blood dynamic thiol/disulphide homeostasis
Sibel Özler1, Efser Öztaş1, Özcan Erel2, Başak Gümüş Güler3, Merve Ergin4, Dilek Uygur1, Nuri Danışman1
1Zekai Tahir Burak Women’s Health Training and Research Hospital, Department of Perinatology, Ankara, Turkey
2Yildirim Beyazit University Faculty of Medicine, Department of Clinical Biochemistry, Ankara, Turkey
3Liv Hospital, Department of Obstetrics and Gynecology, Ankara, Turkey
425 Aralık State Hospital, Gaziantep, Turkey
Aim: Our aim was to investigate the effect of maternal obesity and gestational diabetes mellitus (GDM) on cord blood dynamic thiol/disulphide homeostasis.
Methods: A prospective case-control study was carried out including 125 pregnant women (27 patients with GDM, 30 obese and 68 healthy controls). Cord blood samples were collected from all participants and native thiol-disulphide exchanges were examined with a novel, automated method (Native thiol-disulphide exchanges were examined with a novel, automated method enabling the measurement of both sides of thiol-disulphide balance).
Results: Disulphide amounts, disulphide/native thiol ratios and disulphide/total thiol ratios were increased (p<0.001), while native thiol/total thiol ratios were decreased in the cord blood of offsprings born to an obese or diabetic mother (p<0.001). Moreover, increased disulphide amounts, disulphide/native thiol and disulphide/total thiol ratios and also decreased native/total thiol ratio were found to be significantly associated with adverse outcomes in GDM group. Conclusion: The current study suggests that the offsprings born to obese or diabetic mothers are exposed to increased oxidative stress.
Keywords: Adverse perinatal outcomes, maternal obesity, gestational diabetes mellitus,
[PS-031]
Factors Affecting the Clinical Course and Treatment Outcome of Ectopic Pregnancy: A retrospective analysis from a tertiary referral center
Fatma Beyazıt, Eren Pek, Ayşe Nur Çakır Güngör, Meryem Gencer, Ahmet Uysal, Servet Hacıvelioglu, Mesut Abdülkerim Ünsal
Department of Obstetrics and Gynecology, Canakkale Onsekiz Mart University, Canakkale, Turkey
Objective: Ectopic pregnancy (EP) is a life-threatening serious medical condition in which the embryo implants outside the uterine cavity. Without appropriate treatment it has an increased morbidity and mortality rates. The aim of this retrospective study is to identify the incidence, clinical characteristics and treatment outcomes associated with EP in a tertiary referral center. Material-Methods: In this study, we retrospectively evaluated a total of 79 EP cases that was diagnosed and treated between 2011 and 2015 in Department of Obstetrics and Gynecology at Çanakkale Onsekiz Mart University. The medical records of EP patients were retrieved from hospital patient database and recorded to the data-entry forms designed for this purpose.
Results: During a 5 years period a total of 1920 deliveries with 79 EP diagnoses recorded. The incidence of EP was found to be 4.1%. A great majority of the patients was between 30-34 years (Table 1), and 21.5% was primigravida (17/79). Abdominal and/or pelvic pain and amenorrhea was most consistent symptoms in 56.9 % and 65.8% of women respectively. The diagnosis was mostly achieved by ultrasound and serial βhCG measurements. The majority of patients had a βhCG values between 1501-3000 (36.7%). Medical treatment with methotrexate was applied to 59 (74.7%) patients and surgery was performed to 15 (18.9%) patients. No mortality was observed in EP patients.
Conclusion: EP still considered to be a major health problem with considerable morbidity and mortality rates. Early and appropriate treatment is necessary for a favorable outcome and to avoid various complications. Greater emphasis should be laid on prevention and early detection of EP so as to give patients opportunities for tubal conservation and decreasing surgical requirement.
[PS-032]
Influence of Behçet's Disease on First and Second Trimester Serum Screening Markers
Zehra Vural Yılmaz1, Gülenay Gençosmanoğlu Türkmen1, Elif Yılmaz2, Korkut Dağlar1, Ayşe Kırbaş1, Cem Sanhal1, Aykan Yücel1, Dilek Uygur1
1Zekai Tahir Burak Kadın Sağlığı Eğitim ve Araştırma Hastanesi,Perinatoloji Bölümü,Ankara
2Dr. Sami Ulus Kadın Doğum Çocuk Sağlığı ve Hastalıkları Eğitim Araştırma Hastanesi
Aim:
Behçet’s disease (BD) is a rare, chronic and inflammatory disorder of unknown etiology involving the oral and genital mucosa, eyes, joints and central nervous system. As the disease is more prevalent during fertile years, disease activity in pregnancy and whether it has any adverse effect on pregnancy outcome needs to be investigated. Prenatal screening tests for chromosomal abnormalities in the fetus have been used since the 1970s. The correct evaluation of Down syndrome risk is dependent on the correct assessment of these serum markers. Various diseases could change the levels and result in an under or over estimate of Down syndrome risk with serious consequences. In this study we aimed to investigate whether BD had any effect on biochemical components of first and second trimester aneuploidy screening tests.
Methods:
A case-control retrospective study was conducted with 32 pregnant women with BD and 60 healthy pregnant women as controls. All pregnant women’s first trimester maternal serum PAPP-A, free β-hCG and second trimester serum AFP, uE3 and total β-hCG levels were examined from medical records. First and second serum screening markers were compared between pregnancies with BD and without disease.
Results:
There was no difference in age, BMI and obstetric history between the groups. No significant difference was observed between groups in terms of first and second trimester serum screening test results in the absence of aneuploidy or neural tube defect. Gestational age at birth, birth weight and NICU admission rate were also similar between the groups.
Conclusion:
Both first and second serum screening tests for Down syndrome may be recommended to pregnant women with BD without need of readjusting these markers. Pregnancy with BD was not associated with adverse perinatal outcome with respect to gestational age at birth and birth weight.
Prenatal diagnosis of adrenal hemorrhage; A case report
Fedi Ercan1, Nurcan Coşkun2, Nazlı Dilay Gültekin3, Sevcan Sarıkaya1, Ali Acar1
1Necmettin Erbakan University, Faculty of Medicine, Department of Obstetrics and Gynecology
2Necmettin Erbakan University, Faculty of Medicine, Department of Pediatric Surgery
3Necmettin Erbakan University, Faculty of Medicine, Department of Pediatrics
INTRODUCTİON
The differential diagnosis for an echogenic suprarenal mass includes: adrenal hemorrhage, exophytic renal tumor, neuroblastoma, and extralobar sequestration. Less common lesions are adrenal adenoma, adrenal carcinoma, duplication of the renal system, Wilms tumor, congenital mesoblastic nephroma, and mesenteric and enteric duplication cysts. The following case demonstrates the appearance of adrenal hemorrhage detected by prenatal ultrasonography. CASE REPORT
A 30-year-old primigravid woman, who had a normal 20-week anomaly scan. This revealed a homogeneous, hypoechoic mass between the upper pole of the right kidney and the diaphragm measuring 38×33×30 mm and displacing the kidney inferiorly (Figure 1A,B) at 34 weeks obstetric ultrasound examination. An adrenal hemorrhage was suspected. Repeated ultrasound scans at 37 weeks showed a cystic structure of identical size with basal internal echoes(Figure 1C,D). At 38 weeks, the size of the mass had increased (41×41 ×39 mm) and there were multiple septae seen within the lesion. Color Doppler sonography convincingly demonstrated that the tumor was arising from the adrenal gland. At 39+1 weeks, a 2800-g neonate was delivered by elective Cesarean section for breech presentation. The Apgar scores were 8 and 10 at 1 and 5 min, respectively, the umbilical arterial blood pH was 7.15. A 24-h urine collection for measurement of vanilmandelic acid and catecholamine levels was negative. Postnatal MRI and ultrasound scans confirmed a right adrenal multicystic semi-solid mass of adrenal hemorrhage (Figure 2). Serial postnatal magnetic resonance imaging (MRI) and ultrasound scans confirmed the diagnosis of adrenal hemorrhage that progressively decreased in size. At 6 months of age, MR and ultrasound scans revealed normal adrenals, and the specific follow-up was stopped.
CONCLUSİON
There is no single test or imaging modality that can safely and accurately separate surrenal masses prenatally. Our case help to refine the ultrasound appearance of fetal adrenal hemorrhage, and we support postnatal MRI.