Objectives The modified myocardial performance index (Mod‐MPI) can be used to assess myocardial function. Fetal growth restriction can affect fetal myocardial function, thereby altering the Mod‐MPI. The results of previous studies on the utility of the Mod‐MPI in growth‐restricted fetuses are conflicting. The aim of this study was to calculate the left modified‐MPI in growth‐restricted fetuses and to compare the results with those of healthy fetuses. Methods This was a prospective cross‐sectional case–control study. In total, 40 women with growth‐restricted fetuses and 40 women with fetuses of normal weight (controls) at 29–39 gestational weeks were enrolled in the study. An experienced obstetrician calculated the Mod‐MPI for each fetus. Women with systemic diseases or fetuses with chromosomal/structural abnormalities were excluded from the study. The results of Mod‐MPI measurements of the two groups were compared. Results The mean single deepest vertical pocket (SDVP) of amniotic fluid, estimated fetal weight (EFW), and isovolumetric relaxation time (IRT) was significantly lower in the fetal growth restriction (FGR) group as compared with these parameters in the control group (P < .05). The uterine artery (UtA) pulsatility index (PI) was significantly higher in the FGR group as compared with that in the control group (P < .05). There were six cases of absent end‐diastolic flow (AED) in the FGR group. There were no statistically significant between‐group differences in the Mod‐MPI, isovolumetric contraction time (ICT), and ejection time (ET) (P > .05). There was also no statistically significant correlation between the Mod‐MPI in the fetuses with AED and the control group for Mod‐MPI (P > .05). Conclusion The utility of the Mod‐MPI in FGR remains unclear. Future studies with larger populations are needed to determine the utility of the Mod‐MPI as a predictor of cardiac compromise in FGR.
Background. This study aimed to assess fetal cardiac left ventricular function in healthy pregnant women by calculating the modified myocardial performance index (Mod-MPI) and to construct reference ranges for the Turkish population.Methods. One-hundred-two randomly selected healthy singleton pregnant women ranging between 25 and 39 gestational weeks were included in the study. Left fetal Mod-MPI was measured for each pregnant woman. Women with chronic systemic diseases or fetuses with chromosomal or structural abnormalities were excluded from the study. Mitral valve (MV) and aortic valve (AoV) clicks were used as landmarks to define the following time periods that were used to calculate the Mod-MPI: isovolumetric contraction time (ICT), isovolumetric relaxation time (IRT), and ejection time (ET).Results. The mean Mod-MPI was 0.42±0.10. The mean IRT, ICT, and ET were 43.5±10.2, 27.27±8.1, and 170.5±16.9, respectively. A significant correlation was found between Mod-MPI and gestational age, umbilical artery systolic/diastolic (UA S/D) ratio and the middle cerebral artery pulsatility index (MCA PI) values (r=0.199, p=0.047, p=0.001, p=0.001, respectively) Conclusions. The current study's results will be a reference for future studies, especially studies investigating pathological conditions that impact fetal cardiac function.
Background and Design: Stria gravidarum (SG) is a cosmetically disfiguring condition that is commonly seen in pregnancy. Various parameters such as age of mother, family history, genetical factors like skin colour, various hormonal changes, weight gain seen in pregnancy and physical features of newborn are accused in the development. The studies reported primarily include primigravidas. In this study, the presence of SG and associated risk factors are aimed to be investigated in both primi and multigravidas. Materials and Methods: All attenders' gestastional week, prepregnancy and delivery weights, height, family history of stria, smoking habits and/or alcohol use during pregnancy, any use of cream and/or oil for preventing stria, delivery way, newborn's gender, height, weight and head circumference were recorded. In both primigravidas and multigravidas, factors that could be associated with SG were investigated by Spearman's correlation analysis and risk factors in the development of SG by logistic regression analysis. Results: Fifty of 128 pregnant women were primigravidas and 78 were multigravidas. In primigravidas, a correlation was detected between family history of stria, usage of cream and/or oil during pregnancy, head circumference of newborn and development of SG while in multigravidas, a correlation is detected between prepregnancy weight, delivery weight, smoking during pregnancy, not using of any cream and/or oil during pregnancy, family history of stria, head circumference of newborn, weight of newborn and SG development. Presence of family history of stria and not using of any cream and/or oil were found to be risk factors in development of SG in all pregnant women by logistic regression analysis.
<p><strong>Objectıves:</strong> Intrahepatic (also known as obstetric) cholestasis of pregnancy (ICP) is one of the most frequently diagnosed conditions for pregnancy-specific hepatic disease. It has consistently been found to be related to adverse pregnancy outcomes. In recent studies, a relationship between ICP and Gestational Diabetes Mellitus (GDM) was demonstrated. However, the association between serum total BA (TBA) level in ICP and GDM is not fully understood. This study aims to evaluate the association between serum TBA levels in ICP disease with GDM.</p><p><strong>Study Desıgn:</strong> Eighty pregnant women diagnosed with ICP and eighty healthy pregnant women as normal controls were included in the study. Their clinical characteristics and laboratory test results including liver function tests, glucose challenge tests (GCT), glucose tolerance tests (GTT), and fasting and postprandial TBA levels were recorded. Cases with serum TBA levels between 12-40 µmol/L were described as mild disease, >40 µmol/L was described as severe disease.</p><p><strong>Results:</strong> The mean 50-g GCT value was significantly higher in pregnant women with ICP compared to the healthy controls (128.7±28.2, 106.6±27.0; p < 0.0001) and it was slightly higher in women with severe disease than women with mild disease (132.7±30.1, 125.5±26.5; p=0.26). The percent of GDM diagnosis with ICP disease (11.25%) was higher than in healthy pregnant women (6.25%) but the difference was not found to be statistically significant (p=0.187) and it was similar in pregnant women with mild and severe disease (11.1%, 11.4%; p=0.31).</p><p><strong>Conclusıon:</strong> Our current study demonstrated that ICP was not associated with GDM, also, we did not demonstrate a relationship of TBA level with ICP and GDM. It may be due to our study’s small sample size. Further and well-designed studies with larger sample sizes are necessary to determine the relationship between GDM and ICP and also the function of TBA in the pathogenesis of GDM disease.</p>
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