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Iron supplementation during first trimester pregnancy was found to be associated with an increased oxidative stress.

ObjectiveTo compare the clinical validity of the Gynecologic Oncology Group-99 (GOG-99), the Mayo-modified and the European Society for Medical Oncology (ESMO)-modified criteria for predicting lymph node (LN) involvement in women with endometrioid endometrial cancer (EC) clinically confined to the uterus.MethodsA total of 625 consecutive women who underwent comprehensive surgical staging for endometrioid EC clinically confined to the uterus were divided into low- and high-risk groups according to the GOG-99, the Mayo-modified, and the ESMO-modified criteria. Lymphovascular space invasion is the cornerstone of risk stratification according to the ESMO-modified criteria. These 3 risk stratification models were compared in terms of predicting LN positivity.ResultsSystematic LN dissection was achieved in all patients included in the study. LN involvement was detected in 70 (11.2%) patients. LN involvement was correctly estimated in 51 of 70 LN-positive patients according to the GOG-99 criteria (positive likelihood ratio [LR+], 3.3; negative likelihood ratio [LR−], 0.4), 64 of 70 LN-positive patients according to the ESMO-modified criteria (LR+, 2.5; LR−, 0.13) and 69 of the 70 LN-positive patients according to the Mayo-modified criteria (LR+, 2.2; LR−, 0.03). The area under curve of the Mayo-modified, the GOG-99 and the ESMO-modified criteria was 0.763, 0.753, and 0.780, respectively.ConclusionThe ESMO-modified classification seems to be the risk-stratification model that most accurately predicts LN involvement in endometrioid EC clinically confined to the uterus. However, the Mayo-modified classification may be an alternative model to achieve a precise balance between the desire to prevent over-treatment and the ability to diagnose LN involvement.

Sarcomas of the vulva in the Bartholin's gland area are extremely rare in adults and only a few cases have been reported in the literature. A 65-year-old female patient without any previous complaint presented to our hospital complaining of a genital lump with progressive enlargement over the last six months. Pelvic examination revealed a 6 × 5 cm solid mass lesion with irregular margins localized in the left Bartholin's gland. Preoperative pathology results indicated a benign lesion, which was subsequently totally excised. Histopathological examination of the lesion revealed leiomyosarcoma. When a lesion is localized in the Bartholin's gland area, preoperative biopsy may suggest benign cytology, which can lead to a delay in diagnosis and curative treatment. Total local excision is the first choice for vulvar-complicated masses in the Bartholin's gland area. The present case is the ninth well-documented case reported in the literature.

Objective: We sought to determine the predictors of treatment response in simple endometrial hyperplasia without atypia. Material and Methods:We prospectively treated 67 women with simple endometrial hyperplasia without atypia who were administered cyclic oral medroxyprogesterone acetate 10 mg/day for 12 days of luteal phase for 3 months and underwent control endometrial sampling after treatment. All subjects were evaluated in terms of age, gravidity, parity, body mass index (BMI), menstrual cycle, endometrial thickness, uterine fibroids, ovarian cysts, serum CA 125 levels, systemic disorders and cigarette smoking. All parameters were used to predict treatment success.Results: Persistent hyperplasia was observed in 11 subjects. Endometrial thickness was significantly correlated with treatment failure (r=0.293, p=0.015). In ROC analysis, endometrial thickness was found to be predictive for persistent hyperplasia (area under curve: 0.724, P=0.019). Optimal cut off value was calculated to be 16.5 mm with 64% sensitivity, 72% specificity and 91% negative predictive value. The number of persistent hyperplasia in women with and without endometrial thickness greater than 16.5 mm was significantly different (7/23 vs. 4/45, p=0.029). Odds ratio of endometrial thickness higher than 16.5 mm for treatment failure was 4.4 (95% CI, 1.2-17.4, p=0.03). Conclusion:Results of this study suggest treatment modification according to the baseline endometrial thickness in patients with simple endometrial hyperplasia without atypia. (J Turkish-German Gynecol Assoc 2013; 14: 19-22) Key words: Endometrial hyperplasia, medroxyprogesterone acetate, endometrial thickness, ultrasonography, atypia Received: 13 October, 2012 Accepted: 8 February, 2013 Amaç: Bu çalışma ile atipisiz endometriyal hiperplazide tedaviye cevabı öngören faktörlerin belirlenmesi amaçlandı. Gereç ve Abstract ÖzetOriginal Investigation 19

TDH was impaired in women with preeclampsia, and this impairment increased with disease severity. Therefore, impaired TDH may have a role in the etiopathogenesis of the disease.

Preterm premature rupture of membranes (PPROM) is defined as a spontaneous membrane rupture that occurs before the onset of labor and 37 weeks gestation. Subclinical intrauterine infection has been suggested as a very important etiological factor in the pathogenesis and subsequent morbidity related with PPROM. This study was performed to assess the levels of maternal proadrenomedullin (pro-ADM) and serum amyloid A (AA) in PPROM and its association with fetomaternal infectious morbidity. A total of 63 pregnant women, of which 43 with PPROM between 24 and 34 weeks gestation and 20 normal pregnant women without PPROM were included in the study. The study group was separated into 2 subgroups as PPROM and PPROM-histological chorioamnionitis (PPROM-HC). The blood samples were taken before the administration of any medication. The mean serum interleukin-6 (IL-6), AA, and pro-ADM values in the PPROM-HC group were significantly higher than the PPROM and control group. The cutoff values of pro-ADM and AA were determined as 4.2 nM and 69 μg/mL, respectively. Both of them showed similar sensitivity, specificity to IL-6 and a better sensitivity and specificity as compared to C-reactive protein and white blood cell count. We determined the predictive value of pro-ADM and serum AA measurements in PPROM and PPROM with histological chorioamnionitis. We suggest using pro-ADM and serum AA biomarkers for detecting the histological chorioamnionitis at an earlier stage in PPROM without any clinical signs.

Uterine leiomyoma was associated with lipid profile, insulin resistance and CIMT in reproductive-aged women.