BACKGROUNDPreeclampsia and its association with thrombophilia remain controversial, due to inconsistent results in different studies, which include different ethnic groups, selection criteria, and patient numbers. The aim of this study was to determine the relationship between thrombophilia and preeclamptic patients in our region.METHODSIn a prospective case-control study, we compared 100 consecutive women with preeclampsia and eclampsia (group 1) with 100 normal pregnant women (group 2). All women were tested two months after delivery for mutations of factor V Leiden, methylenetetrahydrofolate reductase (MTHFR), and prothrombin gene mutation as well as for deficiencies of protein C, protein S, and antithrombin III.RESULTSA thrombophilic mutation was found in 42 (42%) and 28 (28%) women in group 1 and group 2, respectively (P=0.27, OR 1.5, 95%CI 1.0–2.2). The incidence of Factor V Leiden mutation (heterozygous), prothrombin mutation (heterozygous), prothrombin mutation (homozygous), MTHFR mutation (homozygous) was not statistically significant in group 1 compared with group 2 (P>0.05). Also, deficiencies of protein S, protein C, and antithrombin III were not statistically significant in group 1 compared with group 2 (P >0.05).CONCLUSIONThere was no difference in thrombophilic mutations between preeclamptic patients and normal pregnant women in our region. Therefore, we suggest that preeclamptic patients should not be tested for thrombophilia.
In generally, diagnosis of AIS is most made postnatally. This is the second case in English literature, which diagnosed mid-second trimester. In this situation, the fetus with thick NT/NF and short limbs may be AIS, therefore appearance of fetal sex on ultrasound should be compared with genetic sex.
We determined the effects of the anthropometric measurements on osteoporosis from higher to lower influence as follows: weight, menopause age, age, BMI and height. Weight and menopause age of the patients were the major determinants for osteoporosis.
Hysterosalpingography (HSG) is associated with pain during the four-step procedure. This prospective, double-blind, randomized, placebo-controlled study was conducted to investigate the effect of the analgesic flurbiprofen, administered prior to HSG, in 60 women. Thirty women were randomized to receive 100 mg of flurbiprofen, orally, 1 h prior to HSG and a further 30 women were randomized to receive placebo. Injection of contrast medium was more painful than the other steps in the HSG procedure in both groups; however, there was no significant between-group difference in terms of pain experienced in the individual steps of HSG. Pain scores at 5 and 30 min after the procedure were compared between the two groups. There was a significant decrease in the visual analogue scale pain score in the flurbiprofen-treated group compared with the placebo-treated group at both time points. Thus, the authors recommend flurbiprofen as a prophylactic analgesic to be administered before HSG procedures.
A AB BS S T TR RA AC CT T O Ob bj je ec ct ti iv ve e: : CA-125 has been found to be high in almost all the patients with ascites. In this study, we tried to determine cut-off values of CA-125 in serum and ascitic fluid levels in order to discriminate non-ovarian malignancies, ovarian carcinomas and benign diseases. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : A total of 119 patients were included in the study. The patients were divided into three groups: non-ovarian malignancies, ovarian carcinoma and benign diseases. Serum and ascitic fluid CA-125 levels were measured by electrochemiluminescence immunoassay, 'ECLIA' method. In determining the discriminitive ability of CA-125 levels between the groups, receiver operating characteristic (ROC) analysis was performed. R Re es su ul lt ts s: : A total of 119 patients were included in the study: 55 males and 64 females. Of patients, 53 had non-ovarian malignancy, 19 had ovarian carcinoma and 47 had benign diseases. Serum and ascitic fluid CA-125 levels were high in all of the three groups. When cut-off value of ascitic CA-125 was taken as 174 U/mL, the sensitivity and specificity were found to be 69.2% and 25.5%, respectively; however, when the value was accepted as 796.5 U/mL, these rates were observed as 30.8% and 80.9% respectively. In the discrimination between ovarian carcinoma and benign diseases, when the cut-off value of ascitic CA-125 was considered as 411 U/mL, the sensitivity and specificity were obtained as 94.7% and 63.8% respectively. When the value was taken as 971.9 U/mL, the sensitivity and specificity rates were 57.9% and 78.7% respectively. C Co on nc cl lu us si io on n: : In discriminating between malign and benign ascites, ascitic CA-125 levels rather than serum values are of significance, and it can be suggested that malignancy should be persistently searched when the value is over 1000 U/mL. K Ke ey y W Wo or rd ds s: : CA-125 antigen; ascites Ö ÖZ ZE ET T A Am ma aç ç: : Asitli hastaların neredeyse tümünde CA-125 yüksekliği görülmektedir. CA-125 serum ve asit düzeylerinin over-dışı malign, over adenokarsinomu ve benign hastalıkları ayırmada cut-off değerlerini belirlemeye çalıştık. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Çalışmaya toplam 119 asitli hasta dahil edildi. Hastalar over-dışı malign, over carsinomu ve benign hastalıklar şeklinde gruplandırıldı. Serum ve asit mayi CA-125 düzeyleri ölçüldü. CA-125 electrochemiluminescence immunoassay ''ECLIA'' metodu kullanılarak çalışıldı. CA-125 düzeyinin grupları birbirinden ayırt edebilme becerisini belirlemede "receiver operating characteristic (ROC)" analizi kullanıldı. B Bu ul lg gu ul la ar r: : Çalışmaya 64 bayan 55 erkek toplam 119 hasta dahil edildi. Elli üçü over-dışı malign, 19'u over adenokarsinomu ve 47'si benign hastalardı. Serum ve asit mayi CA-125 düzeyleri her üç grupta da yüksekti. Duyarlılık ve özgüllük over-dışı malign ve benign ayırımında asit CA-125 cut-off değeri 174.5 U/mL iken sırasıyla %69.2 ve %25.5; değer 796.5 U/mL iken sırasıyla %30.8 ve %...
ABSTRACT. We report a phenotypically normal couple with repeated spontaneous abortions and without other clinical features. Clinical, hematological, biochemical, and endocrinological aspects of the couple did not reveal any abnormalities. The karyotype of the wife was normal (46,XX), while the husband was found to have an abnormal karyotype, 47,XY,+der(22)mat. The marker chromosome was familial and non-satellite. Although the potential risk of small supernumerary marker chromosomes for spontaneous abortions cannot be defined precisely, marker chromosomes, together with methods used for ascertainment, are also factors to be considered when investigating infertility consequences. Furthermore, identification of the origin of a marker chromosome may provide additional information for patient karyotype-phenotype correlations. Further studies, such as molecular analyses to identify the breakpoint, are necessary for investigating phenotype-genotype correlations and assessment of genetic risks for small secondary chromosomes. The cause of repeated spontaneous abortions in this couple might be the presence of this marker chromosome in the husband. Consequently, we recommended genetic counseling before further pregnancies.
Ring chromosomes are unusual abnormalities that are observed in prenatal diagnosis. A 23-year-old patient (gravida 1, para 0) referred for amniocentesis due to abnormal maternal serum screening result in the 16th week of second pregnancy. Cytogenetic analysis of cultured amniyotic fluid cells revealed out ring chromosome 4. Both maternal and paternal karyotypes were normal. Terminal deletion was observed in both 4p and 4q arms of ring chromosome 4 by fluorescence in situ hybridization (FISH). However deletion was not observed in the WHS critical region of both normal and ring chromosome 4 by an additional FISH study. These results were confirmed by means of array-CGH showing terminal deletions on 4p16.3 (130 kb) and 4q35.2 (2.449 Mb). In the 21th week of pregnancy, no gross anomalia, except two weeks symmetric growth retardation, was present in the fetal ultrasonographic examination. According to our review of literature, this is the first prenatal case with 4p and 4q subtelomeric deletion of ring chromosome 4 without the involvement of WHS critical region. Our report describes the prenatal case with a ring chromosome 4 abnormality completely characterized by array-CGH which provided complementary data for genetic counseling of prenatal diagnosis.
Sheehan's syndrome (SS) is an adenopituitary insufficiency caused by hypovolemia secondary to excessive blood loss during or after childbirth. However, the mechanism of postpartum hemorrhage and ischemia is not clear. We aimed to evaluate the bleeding disorders among patients with SS, in comparison with healthy controls. In addition, we investigated underlying causes in postpartum hemorrhage that begin the event. The present study was conducted at the Dicle University School of Medicine. Forty-eight patients with SS and 50 age-matched female healthy controls were included. Biochemical and hormonal variables were measured, as was platelet function by means of closure times (PFA-100 testing using collagen plus epinephrine and collagen plus ADP), von Willebrand factor (vWF) level, prothrombin time (PT), activated partial thromboplastin time (aPTT), international normalized ratio (INR), and coagulation factors. Although PT and INR were significantly higher in patients with SS (both P<0.01), aPTT and levels of fibrinogen, vWF, and factors II, V, VII, VIII, IX, X, XI, and XII did not differ significantly. Closure times with collagen/epinephrine and collagen/ADP also did not differ significantly between patients with SS and control patients. The nonspecific etiology and presence of excessive postpartum hemorrhage in patients with SS suggest that coagulation disorders may play a role in their predisposition to bleeding. The increased PT and INR noted might implicate bleeding diathesis as the underlying etiology, although no significant decreases were noted in factor levels. Further studies are needed to elucidate this complex mechanism of this disorder.
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