First trimester screening for GDM can be achieved based on maternal anthropometric measurements and HOMA-IR. In particular, if BMI is >25.95 kg/m(2) and the HOMA-IR score >2.08, controlling weight gain may protect against GDM.

Objective: Low-molecular-weight heparin (LMWH) and low-dose aspirin (LDA) given in combination were evaluated in females with five commonly inherited thrombophilia polymorphisms to address unexplained recurrent pregnancy loss (RPL). Materials and Methods: After excluding other causes of RPL, 106 of 183 females suffering RPL and diagnosed with inherited thrombophilia were studied along with 62 healthy, age-matched control subjects carrying one or more pregnancies successfully (no gestational complications or abortion). Test patients were given a combination of LMWH and LDA. All participants were screened for five thrombophilic mutations: factor V Leiden G1691A, prothrombin (FII) A20210G, PAI-1 4G/5G insertion/deletion, and two methylenetetrahydrofolate reductase (MTHFR) polymorphisms (C677T and A1298C). Results: With thromboprophylaxis, 73 of 84 (86.9%) pregnancies succeeded, representing a significant increase in the rate of live births (vs. 232 prior losses). Of the five test panel mutations, three or more (homozygous and/or heterozygous) were observed in 48 test patients (45.3%), whereas only three control subjects (4.8%) were similarly affected (p < 0.05). Frequencies of all five mutations were significantly higher in test patients (vs. controls), with PAI-1 4G/5G and MTHFR (C677T and A1298C) identified via binary logistic regression as independent correlates of habitual abortion. Conclusion: The risk of RPL increases with three or more homozygous or heterozygous genotypes in inherited thrombophilia, especially with PAI-1 4G/5G and MTHFR (C677T and A1298C). As in acquired thrombophilia, LMWH/LDA combination treatment may increase live birth rates in patients with inherited thrombophilia.

Risperidone may lead to transient DM type 1 and DKA.

Maternal smoking is known to have adverse effects on the foetus. This study aimed to evaluate the effects of maternal smoking during pregnancy on arterial blood flow velocities in the foetal-placental-maternal circulation, and the pathophysiological relationship with placental and foetal birth weight. A total of 148 singleton pregnancies in 59 smokers and 89 non-smoking controls were examined during the 37th week of gestation. Blood flow in the maternal uterine, foetal umbilical and middle cerebral arteries was analysed with Doppler ultrasonography. Statistically significant differences in Doppler waveforms were detected in the foetal umbilical artery (UmbA) (p < 0.05), but neither in uterine nor foetal middle cerebral arteries (p > 0.05). Both infant birthweight and placental weight were significantly decreased by maternal smoking (p< 0.001 for both). Maternal smoking during pregnancy did not affect either maternal uterine or foetal middle cerebral arterial blood flow, but caused abnormal blood flow in the foetal UmbA.

Objective:To generate a prediction model for miscarriage in women with a viable single pregnancy from first-trimester ultrasound findings and maternal characteristics. Methods: A prospective, cross-sectional study of 415 singleton pregnancies was performed. The initial ultrasound parameters were crown-rump length (CRL), mean gestational sac diameter (MGSD), yolk sac diameter (YSD), and the sum of the differences between gestational ages and embryonic heart rate (EHR). Potential predictors for spontaneous miscarriage occurring prior to 20 weeks were evaluated. Results: Fifty-three (12.8%) patients had miscarriages and 362 (87.2%) had normal outcomes. Forty-three (81.2%) miscarriages occurred in the first trimester, 5 (9.4%) in the second trimester, and 5 (9.4%) represented fetal anomalies. EHR, CRL, and MGSD were decreased in the miscarriage group (p<0.001); YSD showed no difference (p=0.21). Gestational age by CRL and by MGSD were different between the groups (p<0.001). The proposed sum of differences was higher in the miscarriage group (p<0.001). Maternal age, indication for scan, gestational age by MGSD and CRL, heart rate, and proposed sum of differences were found to be potential predictors. Predictive ability of our proposed model was calculated sensitivity as 0.509, and specificity as 0.975 with a cut-off=0.5. The prediction model's false positive rate is 0.025, and its false negative rate is 0.491. Conclusions: Miscarriage can be predicted via maternal characteristics and ultrasound findings. Advancing maternal age, low EHR, and high proposed sum of differences increase the probability of miscarriage.

To investigate the effect of anticoagulant treatment and perinatal outcomes in patients with primary or secondary recurrent pregnancy loss without cause other than inherited trombophilia. Methods: A total of 143 pregnant patients with recurrent pregnancy loss (≥2 abortus) and had no detected cause other than thrombophilia, were included in the study. Patients with no livebirth history were accepted as primary and patients with at least one livebirth were as secondary recurrent spontaneous aborters (PrimRSAs and SecRSAs). Inherited thrombophilia genetic results of the patients in both groups were compared. The effects of low-molecular weight heparin (LMWH) and low-dose aspirin (LDA) treatments alone or together, livebirth rates and pregnancy outcomes were investigated. Results: Sixty-eight patients were in PrimRSAs and 75 were in SecRSAs. Ages, numbers of total, early and late pregnancy loss of both groups were similar. In PrimRSAs 49 (72.1%) and in SecRSAs 50 (66.6%) patients had three or more inherited thrombophilia genetic mutations. Of 113 patients who used LMWH+LDA during pregnancy 88 (77.6%) had livebirth; however, of 19 patients who used LMWH 6 (31.6%) and of 11 women who used LDA 8 (72.7%) had livebirth. Livebirth rate was significantly higher in patients who used LMWH+LDA together (p=0.001). Livebirth rates were higher in SecRSAs than PrimRSAs irrespective to the anticoagulant treatment (p=0.002). Conclusion: LMWH and LDA treatment together may increase livebirth rates in patients with recurrent pregnancy loss and inherited thrombophilia. Having at least one livebirth of the patients is a good prognostic factor.

ÖzetAmaç: Anormal uterin kanamada (AUK) klinik, ultrason bulgularını değerlen-dirmek ve histopatolojik sonuçlarla karşılaştırmak. Gereç ve Yöntem: Toplam 404 AUK'li bayan hasta; Grup I: 18-39 yaş, Grup II: 40-50 yaş, Grup III: >50 yaş olarak sınıflandırıldı. Yaş, parite, kanama paterni, menstruel öykü, labaratuar sonuçları, ultrason ve histopatolojik bulgular değerlendirildi. Bulgular: AUK ile başvuranların yaklaşık yarısı premanopozal grupda idi [196 (48.51%)], bunları postmenopozal grup [150(37.13%)] ve reprodüktif yaş grubu takip ediyordu [58(14.36%)]. En sık görülen kanama paterni menometroraji olup bunu metroraji takip ediyordu. 306 (75.74%) hastada endometrial patolojiler izlenirken 98 (24.26%) hastada normal menstruel pattern izlendi. Endometrium kanseri 7(1.7%) bayanda izlendi. Reprodüktif periodda hormonal düzen-sizlik patern en sık patolojiydi. Premanopozal ve postmenopozal yaş gruplarında endometrial polip dominant patolojiydi. Tüm kanser vakaları postmenopozal gruptaydı. Üçten daha az doğum yapanlardan 4(19.04%) bayanda kanser izlenirken, ≥3 doğum yapanlardan 1(4.76%)'inde görüldü. Vajinal doğum yapanların 4'ünde kanser izlenirken sadece sezeryan ile doğum yapanlarda hiç kanser izlenmedi. Endometrial kalınlığı <4mm olan 109 hastadan, 15(13.76%)'inde düzensiz endometrial proliferasyon ve polip, 1 (0.92%)'inde endometrioid kanser mevcuttu. Endometrial kalınlığı >4mm 295 hastadan, 30 (10.17%)'unda endometrial hiperplazi, 6(2.03%) sında endometrium kanser izlendi. Tartışma: Transvajinal ultrasonografi endometrial kalınlık ve uterin patolojileri değerlendirmede tanısal metod olarak kullanılabilir. Fakat tekrarlayan uterin kanamalarda ultrason bulgularını dikkate almadan endometrial örnekleme yapılmalıdır. Anahtar KelimelerAnormal Uterin Kanama; Endometrial Kalınlık; Parite; Histopatoloji Abstract Aim: To evaluate the clinical manifestations of abnormal uterine bleeding (AUB), ultrasonography findings and compare with histopathological results. Material and Method: A total of 404 women with AUB were classified as; Group I: 18-39 years, Group II: 40-50 years, Group III: >50 years old. Age, parity, bleeding pattern, menstrual history, laboratory results, ultrasonography and histopathological findings were evaluated. Results: Almost half presented with AUB were in the premenopausal group [196 (48.51%)], followed by 150(37.13%) postmenopausal group and 58(14.36%) reproductive age group. The most common bleeding pattern was menometrorrhagia followed by metrorrhagia. Endometrial pathologies were observed in 306 (75.74%) and normal menstrual pattern in 98 (24.26%) participants of AUB. Endometrium cancer was seen in 7 (1.7%) women. In the reproductive period most common pathology was hormonal imbalance pattern. Endometrial polyp was the dominant pathology in premenopausal and postmenopausal age groups. All malignancy cases were in the postmenopausal age group. Malignancy was in 4(19.04%) women who gave birth < 3 and in 1(4.76%) who had ≥3 children. Four women with vaginal delivery had malignancy whereas no maligna...

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