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Öğe Amnioinfusion vs. standard management for the second trimester PPROM: a systematic review and meta-analysis of observational studies and RCTs(Taylor & Francis Ltd, 2023) Celik, Ebru; Yildiz, Abdullah Burak; Cekic, Sebile Guler; Unal, Ceren; Ayhan, Isil; Melekoglu, Rauf; Gursoy, TugbaObjective This meta-analysis aims to review the effect of serial transabdominal amnioinfusion (TAI) on short-term and long-term perinatal outcomes in mid-trimester preterm premature rupture of membranes (PPROM). Methods Literature searches of PubMed, Web of Sciences, Scopus, and Cochrane Library were performed from their inception to April 2022. Studies comparing conventional treatment with serial TAI in women with proven PPROM at less than 26 + 0 weeks of gestation with oligohydramnios were included. Studies that included oligohydramnios due to other reasons such as fetal growth retardation or renal anomalies were excluded. Risk of bias in observational studies was assessed using the tool of the Cochrane Review group identified as risk of bias in non-randomized studies - of interventions. The risk of bias assessments for RCTs were performed according to the Cochrane risk-of-bias tool for randomized trials. An I (2) score was used to assess the heterogeneity of included studies. The analyses were performed by using random-effect model, and the results were expressed as relative risk (RR) or mean difference with 95% confidence intervals (CIs). Results Overall, eight relevant studies including five observational studies (n = 252; 130 women allocated to the intervention) and three RCTs (n = 183; 93 women allocated to the intervention) were eligible. The pooled latency period was 21.9 days (95% CI, 13.1-30.8) and 5.8 days (95% CI, -11.6-23.2) longer in the TAI group in the observational studies and RCTs, respectively. The perinatal mortality rate reduced in the intervention group when tested in observational studies (RR 0.68; 95% CI, 0.51-0.92), but not in RCTs (RR 0.79; 95% CI, 0.56-1.13). The rate of long-term healthy survival was higher in the children whose mothers were treated with the TAI (35.7%) than those were treated with the standard management (28.6%) (RR 1.30, 95% CI 0.47-3.60, best case scenario). Conclusions The efficacy of serial TA on early PPROM associated morbidity and mortality is not attested. Additional randomized control trials with adequate power are needed.Öğe Amniotic fluid urocortin-1 concentrations for the prediction of preterm delivery(Wiley, 2013) Karaer, Abdullah; Celik, Ebru; Celik, Onder; Simsek, Omer Yavuz; Ozerol, Ibrahim Halil; Yilmaz, Ercan; Turkcuoglu, IlginAim The aim of this study was to analyze whether urocortin-1 concentration in midtrimester amniotic fluid could serve as an indicative marker of preterm labor. Material and Methods A retrospective cohort study was conducted. Urocortin-1 concentrations in midtrimester amniotic fluid were measured in 22 pregnant women with preterm deliveries and 45 women who delivered at term using enzyme-linked immunosorbent assay. Results The median amniotic fluid urocortin-1 concentration was significantly lower in the women with preterm birth (40.06pg/mL; range, 13.77-67.58pg/mL) than in the women who gave birth at term (49.56pg/mL; range, 26.25-175.9pg/mL; P=0.022). The result of receiver-operator curve analysis indicates that an amniotic fluid urocortin-1 concentration57.88pg/mL had an area under the curve of 0.673 (95% confidence interval, 0.55-0.78; P=0.01) with a sensitivity of 81.8%, specificity of 40.0%, positive predictive value of 40%, and a negative predictive value of 82% in identifying which of the patients subsequently delivered prematurely. Conclusions These results suggest that low urocortin-1 concentration in midtrimester amniotic fluid could be used as an indicative marker of preterm birth.Öğe Association of folic acid receptor ? in maternal serum with neural tube defects(Informa Healthcare, 2014) Celik, Ebru; Karaer, Abdullah; Turkcuoglu, Ilgin; Turhan, Ugur; Gungoren, Arif; Taskapan, Cagatay; Ozyalin, FatmaObjective: To evaluate whether serum folic receptor alpha levels are changed in women whose previous pregnancies were complicated with neural tube defects (NTDs). Methods: This was a case-control study that included 41 women as the control group who had previously had at least one healthy pregnancy and 37 women as the study group who had a previous pregnancy complicated with NTDs. Blood samples were obtained from all of the participants six weeks after the termination of pregnancy or delivery of a baby. Serum folate receptor alpha concentrations were analyzed using a commercially available enzyme-linked immunosorbent assay (ELISA) kit. Results: The mean concentrations of serum folate receptor alpha were significantly lower in the NTD cases compared to those in the control group (p = 0.02). There was no significant difference in mean serum folate titers between the NTD cases and the control group (p = 0.07). Conclusion: Low serum folic acid receptor alpha levels in the current study did not appear to be a regulatory marker of maternal folate homeostasis per se but rather a factor that contributed to the development of NTDs.Öğe Association of low maternal levels of salusins with gestational diabetes mellitus and with small-for-gestational-age fetuses(Elsevier, 2013) Celik, Ebru; Celik, Onder; Yilmaz, Ercan; Turkcuoglu, Ilgin; Karaer, Abdullah; Turhan, Ugur; Aydin, SuleymanObjectives: To evaluate maternal and cord serum concentrations of salusin-alpha and salusin-beta in women with gestational diabetes mellitus (GDM) and with small-for-gestational age (SGA) fetuses. Study design: Pregnant women with GDM (n = 25), women with SGA (n = 20) and maternal age-matched normal healthy pregnant subjects (n = 25) participated in the study. Maternal serum and cord blood salusin-alpha and salusin-beta levels at the time of birth were measured using ELISA, and their relation with metabolic parameters was also assessed. Results: Mean concentrations of maternal and fetal serum salusin-alpha in the GDM and SGA groups were significantly lower than those of the controls (P < 0.001, P < 0.001, P < 0.001 and P < 0.001, respectively). Mean concentrations of maternal and cord blood salusin-beta also decreased in both the GDM and the SGA groups in comparison to the control group (P < 0.001, P < 0.001, P < 0.001 and P < 0.001, respectively). The concentrations of maternal serum salusin-alpha and salusin-beta were strongly positively correlated with the concentrations of cord blood salusin-alpha and salusin-beta (R = 0.92, P < 0.001 and R = 0.94, P < 0.001, respectively). Conclusions: The low levels of maternal serum salusin-alpha and salusin-beta may have negative impact on metabolic disorders and vascular dysfunction. (C) 2012 Elsevier Ireland Ltd. All rights reserved.Öğe Associations between second-trimester amniotic fluid levels of ADAMTS4, ADAMTS5, IL-6, and TNF-? and spontaneous preterm delivery in singleton pregnancies(Walter De Gruyter Gmbh, 2019) Melekoglu, Rauf; Yilmaz, Ercan; Ciftci, Osman; Kafadar, Yusuf Taner; Celik, EbruBackground: We investigated the roles of inflammatory cytokines and the A disintegrin and metalloproteinase with thrombospondin motifs (ADAMTS) family in the etiopathogenesis of spontaneous preterm delivery by comparing the ADAMTS4, ADAMTS5, interleukin (IL)-6, and tumor necrosis factor-alpha (TNF-alpha) levels in second-trimester amniotic fluid between pregnant women with preterm birth and term controls. Methods: All pregnant women who underwent second-trimester amniocentesis for genetic analysis between January 1, 2016, and January 1, 2018, were enrolled in this study. From this cohort, 22 patients who subsequently experienced spontaneous preterm delivery before 34 weeks of pregnancy formed the study group, and 22 age- and body mass index (BMI)-matched patients without preterm birth constituted the control group. Results: No significant differences were observed between the preterm birth and control groups in terms of age, BMI, obstetric history of preterm delivery, gestational age at amniocentesis, or indication for amniocentesis. The mean amniotic fluid levels of ADAMTS4 and ADAMTS5 were significantly increased in the preterm birth group compared to the control group (248.3 +/- 22.6 and 182.4 +/- 19.8 pg/mL, P = 0.012; and 198.6 +/- 21.6 and 159.1 +/- 21.7 pg/mL, P = 0.035, respectively). Significantly increased IL-6 and TNF-a levels were also detected in the amniotic fluid of women who experienced spontaneous preterm delivery, relative to controls (142.1 +/- 16.2 and 95.8 +/- 16.4 pg/mL, P < 0.001; and 139.4 +/- 12.5 and 89.6 +/- 11.2 pg/mL, P < 0.001, respectively). Conclusion: The results of this study imply that increased mid-trimester amniotic fluid levels of ADAMTS4, ADAMTS5, IL-6, and TNF-alpha play an important role in the pathophysiology of spontaneous preterm delivery.Öğe The beneficial effects of Montelukast against 2,3,7,8-tetrachlorodibenzo-p-dioxin toxicity in female reproductive system in rats(Acta Cirurgica Brasileira, 2016) Melekoglu, Rauf; Ciftci, Osman; Cetin, Ash; Basak, Nese; Celik, EbruPURPOSE: To determine the toxic effect of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) on reproductive system and the beneficial effects of Montelukast (ML) with histological and biochemical analysis. METHODS: Rats were randomly divided into four equal groups (control, TCDD, ML and TCDD+ML). Tissue samples were collected on day 60 and oxidative status and histological alterations were analyzed. RESULTS: The results showed a significant increase in oxidative and histological damage on uterine and ovarian tissues. Otherwise, the oxidative and histological damages caused by TCDD were prevented with ML treatment. CONCLUSION: The toxic effects of 2,3,7,8-tetrachlorodibenzo-p-dioxin on female reproductive system were reversed with Montelukast treatment. Therefore, we claimed that ML treatment might be useful for TCDD toxicity.Öğe c-Kit proto-oncogene expression in endometrial hyperplasia and endometrial cancer(Springer Heidelberg, 2012) Yilmaz, Ercan; Celik, Onder; Simsek, Yavuz; Turkcuoglu, Ilgin; Celik, Ebru; Gul, Mehmet; Hascalik, SeymaTo evaluate the expression of c-kit (CD117) in endometrial hyperplasia and endometrial cancer. Expression of c-kit in 10 normal endometrium, 18 simple endometrial hyperplasia, 16 complex endometrial hyperplasia (10 cases with atypia and 6 cases without atypia), and 6 endometrial cancer were investigated by immunohistochemistry. c-Kit expression decreased as the lesion progressed to endometrial cancer. Immunostaining was mostly focal and weak in the normal endometrium and was mostly diffuse and strong in the simple and complex endometrial hyperplasia. Simple and complex hyperplastic endometrial tissues express diffuse cytoplasmic staining for c-kit and the expression decreases with the progression of the lesion.Öğe A comparative study on oxidative and antioxidative markers of serum and follicular fluid in GnRH agonist and antagonist cycles(Springer/Plenum Publishers, 2012) Celik, Ebru; Celik, Onder; Kumbak, Banu; Yilmaz, Ercan; Turkcuoglu, Ilgin; Simsek, Yavuz; Karaer, AbdullahTo determine whether concentrations of oxidative stress markers of follicular fluid and serum are different in GnRH agonist protocol from GnRH antagonist protocol. This was a cross-sectional study. Eighty-four women undergoing controlled ovarian stimulation with either GnRH agonist (n = 39) or GnRH antagonist protocols (n = 45) for IVF/ICSI treatment were assigned by a physician. Blood was obtained at the time of oocyte retrieval, and follicular fluid (FF) from the mature follicles of each ovary was centrifuged and frozen until analysis. Malondialdehyde (MDA), nitric oxide (NO), protein carbonyl (PC), hydroxyl proline (OH-P), sodium oxide dismutase (SOD), reduced glutathione (GSH), glutathione peroxidase (GSH-Px), adenosine deaminase (ADA) and xanthine oxidase (XO) were assessed in the serum and follicular fluid of each participants. The mean serum concentrations of GSH-Px, GSH and MDA were lower in the GnRH antagonist group compared to GnRH agonist group, but mean serum SOD was higher in the GnRH antagonist group. The mean follicular SOD, ADA and NO were higher in GnRH antagonist group than GnRH agonist group. The IVF/ICSI outcomes were similar in both groups. GnRH antagonist protocol is associated with increased oxidative stress. The relation of GnRH analogues with oxidative stress and its implication in follicular growth needs to be addressed in further studies.Öğe ECTOPIC PELVIC KIDNEY MIMICKING ADNEXAL MASS(Galenos Yayincilik, 2012) Yilmaz, Ercan; Simsek, Yavuz; Karaer, Abdullah; Celik, Ebru; Turkcuoglu, Ilgin; Dogan, Cagdas; Aydin, EnginEctopic kidney, common developmental disorder in women with abnormalities of the genitourinary system and in clinic, mimicking adnexal pathologies. In this case report, hydronephrosis developed a pelvic ectopic kidney mimicking adnexal cystic pathology.Öğe Effect of ovarian stimulation with recombinant follicle-stimulating hormone, gonadotropin-releasing hormone agonist and antagonists, on follicular fluid stem cell factor and serum urocortin 1 levels on the day of oocyte retrieval(Springer Heidelberg, 2013) Celik, Onder; Celik, Ebru; Yilmaz, Ercan; Celik, Niluefer; Turkcuoglu, Ilgin; Ulas, Mustafa; Kumbak, BanuTo compare the serum and follicular fluid (FF) concentrations of stem cell factor (SCF) as well as the serum urocortin 1 (UCN1) concentration in gonadotropin-releasing hormone antagonist (GnRH-ant) and gonadotropin-releasing hormone agonist (GnRH-a) protocols for controlled ovarian hyperstimulation (COH) in IVF patients. Follicular fluids and blood samples of 42 infertile women undergoing COH for IVF-embryo transfer with either GnRH agonist (n = 22) or GnRH antagonist (n = 20) protocols from 2010 to 2011 were collected during oocyte retrieval. SCF concentrations of serum and FF were assessed by sandwich enzyme immunoassay using ELISA Kit for SCF kid. Serum UCN1 concentration were measured using commercially available enzyme-linked immunosorbent assay. Concentrations of serum UCN1, serum and FF SCF were similar in the two groups. The serum SCF levels correlated strongly with the follicular SCF levels (r = 0.770, p < 0.001). The mean implantation rate, biochemical and clinical pregnancy rate and live birth rate per cycle were also similar in the groups. These observations suggest that there is no significant difference in follicular microenvironment in terms of SCF and UCN1 between agonist and antagonist protocols.Öğe The Effects of Body Mass Index on Second-Trimester Amniotic Fluid Cytokine and Matrix Metalloproteinase Levels(Karger, 2018) Melekoglu, Rauf; Ciftci, Osman; Eraslan, Sevil; Basak, Nese; Celik, EbruAim: The aim of this study was to determine the effects of obesity on amniotic fluid (AF) inflammatory markers in second-trimester AF, testing the hypothesis that there is a relationship between maternal body mass index (BMI) and fetal inflammatory exposure. Methods: AF was obtained from 84 singleton pregnant women undergoing elective amniocentesis for karyotype analysis at 16-24 weeks of gestation between April 2014 and May 2016. The cell-free AF was used to analyze interleukin (IL)-1 beta and IL-6, and matrix metalloproteinase (MMP)-1, MMP-6, and MMP-13. Results: IL-1 beta levels were significantly higher in class II-III obese patients than in class I obese, overweight, and normal weight patients (14.68 +/- 1.37 vs. 13.34 +/- 1.86 vs. 13.00 +/- 2.22 vs. 10.78 +/- 1.92, respectively; p < 0.05). IL-6 levels were lowest in the normal weight group and highest in class II-III obese patients. MMP-1, MMP-6, and MMP-13 levels were also significantly higher in class II-III obese patients than in the other groups. Conclusion: This study demonstrated that the fetuses of class II-III obese women are exposed in utero to higher cytokine and MMP levels than fetuses of lean women. Modification of current cutoff levels of intra-amniotic cytokines and MMPs according to the BMI could improve the accuracy of the prenatal diagnosis of intra-amniotic infection and inflammation. (C) 2017 S. Karger AG, BaselÖğe EFFICACY OF INTERNAL ILIAC ARTERY LIGATION ON THE MANAGEMENT OF POSTPARTUM HEMORRHAGE AND ITS IMPACT ON THE OVARIAN RESERVE(Galenos Yayincilik, 2012) Simsek, Yavuz; Yilmaz, Ercan; Celik, Ebru; Turkcuoglu, Ilgin; Karaer, Abdullah; Turhan, Ugur; Celik, OnderAim: Time of surgical treatment for postpartum hemorrhage, still being the most important cause of maternal mortality in the developing countries, could be lifesaving. In the present report, the results of bilateral internal iliac artery ligation in cases with postpartum hemorrhage were presented, in addition, the impact of the procedure on ovarian reserve were discussed. Design and patients: Patients who gave birth between August 2010 and August 2011 in our center, treated surgically due to a diagnosis of postpartum hemorrhage were retrospectively examined. Setting: A tertiary referral center Main outcome measures: The obstetric and demographic characteristics, applied surgical procedures, the need for intensive care unit, the amount of transfusion, length of hospital stay and associated morbidities and mortalities were evaluated. Postpartum concentrations of follicle stimulation hormone (FSH) and estradiol with ovarian volume calculated by ultrasonography to evaluate the impact of procedure on ovarian reserve were also examined anc compared normal controls. Results: The prevalence of postpartum hemorrhage requiring a surgical treatment was 12.5% during the period of study. Thirteen of those underwent the ligation of bilateral internal iliac artery. The mean age of 32 (24 -44), mean gravida 3,2 (1-5), mean parity 2 (0-4), mean birth week 38 (35-41) and mean birth weight were 3373 g (2500 -4200). The effectiveness of bilateral internal iliac artery ligation was 84,7%. FSH and estradiol concentrations and the mean volume of the ovaries were similar between the study (n: 10) and control (n: 56) groups (P=0.650, P=0.245 and P=0.281, respectively). Conclusion: The ligation of bilateral iliac artery, a fertility preserving method, possess high efficacy for the management of postpartum hemorrhage. The ovarian reserves of patients were not adversely affected by the surgical procedure, as well.Öğe Evaluation of second trimester amniotic fluid ADAMTS4, ADAMTS5, interleukin-6 and tumor necrosis factor-? levels in patients with gestational diabetes mellitus(Wiley, 2019) Melekoglu, Rauf; Ciftci, Osman; Celik, Ebru; Yilmaz, Ercan; Bastemur, Ayse G.Aim To test the hypothesis that altered A Disintegrin and Metalloproteinase Domains with Thrombospondins motifs (ADAMTS) is implicated in the etiopathogenesis of gestational diabetes mellitus (GDM). Methods All pregnant women who underwent elective amniocentesis for karyotype analysis between January 1, 2016, and January 1, 2018, were included in this study. From this cohort, the study group consisting of 20 patients diagnosed with GDM was selected and compared against a control group consisting of 20 age- and body mass index (BMI)-matched patients without GDM. ADAMTS4, ADAMTS5, interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-alpha) levels were compared in the second trimester amniotic fluid of patients with GDM and normoglycemic pregnant women. Results No significant differences were observed between GDM and control groups regarding age, BMI, gestational age at amniocentesis and indication for amniocentesis. Mean amniotic fluid ADAMTS4 and ADAMTS5 levels were significantly increased in the GDM group compared with the control group (253.5 +/- 18.7 pg/mL and 188.5 +/- 21.3 pg/mL, P < 0.001; 192.9 +/- 16.4 pg/mL and 154.8 +/- 19.9 pg/mL, P = 0.021, respectively). Significant increases in IL-6 and TNF-alpha levels were also detected in the amniotic fluid of GDM patients relative to controls (136.2 +/- 17.3 pg/mL and 98.3 +/- 11.5 pg/mL, P < 0.001; 154.2 +/- 12.5 pg/mL and 86.2 +/- 10.8 pg/mL, P < 0.001, respectively). Conclusion The data presented here suggest that increased levels of ADAMTS4, ADAMTS5, IL-6 and TNF-alpha may play an important role in the progression of GDM.Öğe Germline cells in ovarian surface epithelium of mammalians: a promising notion(Bmc, 2012) Celik, Onder; Celik, Ebru; Turkcuoglu, Ilgin; Yilmaz, Ercan; Simsek, Yavuz; Tiras, BulentIt is a long held doctrine in reproductive biology that women are born with a finite number of oocytes and there is no oogenesis during the postnatal period. However, recent evidence challenges this by showing the presence of germ line stem cells in the human ovarian surface epithelium (OSE), which can serve as a source of germ cells, and differentiate into oocyte like structures. Postnatal renewal of oocytes may have enormous therapeutic potential especially in women facing the risk of premature ovarian failure idiopathically or iatrogenically after exposure to gonadotoxic chemotherapy and radiation for cancer therapy. This article reviews current knowledge on germ line stem cells in human OSE.Öğe The major clinical determinants of maternal death among obstetric near-miss patients: a tertiary centre experience(Pakistan Medical Assoc, 2013) Simsek, Yavuz; Yilmaz, Ercan; Celik, Ebru; Aydogan, Mustfa Salt; Celik, Onder; Togal, TurkanObjective: To evaluate the characteristics of obstetric near-miss patients to clarify the major risk factors of maternal mortality. Methods: From among the patients referred to the Department of Obstetrics and Gynaecology, Inonu University of Medical Sciences, Turkey, between August 1, 2010 and March 1, 2012, electronic records of obstetric near-miss cases were retrospectively analysed. The obstetric and demographic characteristics of cases that were successfully treated (Group 1) as well as cases with maternal death (Group 2) were analysed and compared. SPSS 11.5 was used for statistical analysis. Results: Of the total 2687 cases handled during the study period, 95 (3.53%) were of the near-miss nature. The most frequently encountered underlying aetiology was severe preeclampsia (n=55; 57.89%) and haemolysis, elevated liver enzymes, low platelet count syndrome (n=20; 21.1%). These were followed by cases of postpartum bleeding (n=18; 18.9%). Maternal mortality occurred in 10 (10.5%) patients, representing Group 2. The amount of haemorrhage and blood transfused were significantly higher in the group. Maternal mortality cases had also significantly longer duration of intensive care unit admission. Conclusion: Early diagnosis and immediate management of the complications noted by the study can be the most important measures to prevent the occurrence of mortality.Öğe Maternal and fetal adropin levels in gestational diabetes mellitus(Walter De Gruyter Gmbh, 2013) Celik, Ebru; Yilmaz, Ercan; Celik, Onder; Ulas, Mustafa; Turkcuoglu, Ilgin; Karaer, Abdullah; Simsek, YavuzAim: To evaluate maternal and cord blood serum adropin concentrations in pregnant women with gestational diabetes mellitus (GDM). Study design: Twenty pregnant women with GDM and 20 gestational age-matched healthy pregnant women participated in the study. Maternal serum and cord blood adropin levels were assessed using an enzyme immunosorbent assay, at the time of birth. The relation of maternal serum and cord blood adropin levels with metabolic parameters were also assessed. Results: The mean maternal and cord serum adropin in the GDM group were significantly lower than those of the control women (P = 0.01 and P<0.001, respectively). Maternal serum adropin levels did not correlate with either fetal serum adropin levels or maternal metabolic values. Conclusion: The data suggest that low adropin levels may contribute to the underlying pathogenesis of GDM.Öğe Maternal and fetal serum orexin-A levels in gestational diabetes mellitus(Wiley, 2013) Yilmaz, Ercan; Celik, Onder; Celik, Nilufer; Celik, Ebru; Turkcuoglu, Ilgin; Simsek, Yavuz; Minareci, YagmurAim: Evidence suggests that orexin regulates food consumption, glucose metabolism and insulin secretion. Orexin may have a role in the pathogenesis of type II diabetes mellitus, however its role in gestational diabetes mellitus is not known. We aimed to assess maternal serum and cord blood orexin-A (OXA) concentrations in pregnant women with gestational diabetes mellitus (GDM). Material and Methods: Thirty-five pregnant women with GDM and 35 gestational-age-matched healthy pregnant subjects participated in the study. Maternal serum and cord blood OXA levels were measured with enzyme immunoassay at the time of birth. The correlations between maternal serum and cord blood OXA levels, anthropometric and metabolic parameters were also assessed. Results: The mean maternal and cord serum OXA (1.16 +/- 0.37 and 1.35 +/- 0.20 ng/mL, respectively) in the GDM group were significantly different from those of the controls (1.58 +/- 0.59 and 1.25 +/- 0.21 ng/mL, respectively). The mean maternal fasting-glucose-to-OXA ratio was significantly higher in the GDM group. In the GDM group, the mean maternal serum OXA levels were similar in the insulin (n = 24) and diet (n = 11) treated cases, respectively (1.13 +/- 0.36 ng/mL and 1.21 +/- 0.41 ng/mL). Maternal serum OXA levels positively correlated with fetal serum OXA and maternal glucose levels. OXA concentrations in maternal serum were negatively correlated with the fasting glucose, fasting insulin and homeostasis model assessment insulin resistance index. Conclusions: Maternal serum OXA levels decrease, and fetal serum OXA levels increase in women with GDM.Öğe Maternal plasma levels of interleukin-6, C-reactive protein, vitamins C, E and A, 8-isoprostane and oxidative status in women with preterm premature rupture of membranes(Informa Healthcare, 2015) Ilhan, Nevin; Celik, Ebru; Kumbak, BanuObjective: Preterm premature rupture of membranes (PPROM) is associated with significant maternal and perinatal morbidity. This study examined maternal oxidative stress in PPROM. Methods: This was a prospective cross-sectional study conducted in a university hospital. A total of 72 pregnant women were recruited into two groups, those with PPROM (38 cases) and those without PPROM (34 controls) matched for gestational age. Plasma interleukin-6, C-reactive protein, vitamins C, E and A, 8-isoprostane, total oxidant status (TOS) and antioxidant status (TAS) were determined for all study participants and the data were compared between the PPROM and control groups. Results: Both case and control groups were comparably matched in age, parity, gestational age and smoking status. There was a significant association between low 8-isoprostane, low vitamin C and high total oxidant status and the occurrence of PPROM (p < 0.001). Conclusions: Plasma vitamin C and 8-isoprostane levels were lower and TOS higher in women with PPROM. Further research is needed to identify robust biological markers for the prevention and also prognosis of PPROM.Öğe Metabolic and carbohydrate characteristics of different phenotypes of polycystic ovary syndrome(Aves, 2016) Celik, Ebru; Turkcuoglu, Ilgin; Ata, Baris; Karaer, Abdullah; Kirici, Pinar; Eraslan, Sevil; Taskapan, CagatayObjective: To compare the prevalence of various metabolic and cardiovascular risk factors and insulin resistance between polycystic ovary syndrome (PCOS) patients with or without hyperandrogenism. Material and Methods: This is a retrospective cross-sectional study involving women with PCOS as diagnosed according to the Androgen Excess (AE) Society definition (n=504) and women with normoandrogenemic PCOS (n=183). Anthropometrics, lipid profile, glucose, insulin, oral glucose tolerance test (OGTT), and reproductive hormone levels were evaluated. Results: Women with PCOS diagnosed according to the AE Society had a significantly higher prevalence of metabolic syndrome compared with the normoandrogenemic PCOS phenotype: odds ratio (OR) 2.95 [95% confidence interval (CI) 1.21-7.21]. There was no significant difference in the prevalence glucose intolerance test between the groups [OR: 2.15, 95% CI 0.71-6.56]. The prevalence of low high density lipoprotein (HDL)-cholesterol in the group under the AE-PCOS Society criteria was higher than that of the normoandrogenemic PCOS group [OR: 2.82, 95% CI 1.29-3.36]. Conclusion: The risks of metabolic syndrome and cardiovascular disease may vary among the phenotypes of PCOS based on the Rotterdam criteria. This new data may be of reference in informing women with PCOS, although further prospective studies are needed to validate this proposition.Öğe Nuclear transcription factor-kappa beta-dependent ultrastructural alterations within the placenta and systemic inflammatory activation in pregnant patients with hemolysis, elevated liver functions and low thrombocyte count (HELLP) syndrome: a case-control study(Taylor & Francis Inc, 2013) Simsek, Yavuz; Gul, Mehmet; Celik, Onder; Aydin, Nasuhi Engin; Duz, Senem Arda; Celik, Ebru; Ozerol, ElifObjective: Preeclampsia appears to be associated with a higher extent of inflammation than in uncomplicated pregnancies. We aimed to test whether this was the case in patients with hemolysis, elevated liver functions and low platelet count (HELLP) syndrome and to clarify the contribution of placental and systemic inflammatory variables in the development of this syndrome. Materials and methods: Thirty healthy pregnant women (control group) and 20 patients with HELLP syndrome (study group) were included in the study. Placental inflammatory activity was evaluated by quantifying immunohistochemically the levels of p65/RelA expression of nuclear transcription factor-kappa beta (NF-kB) in paraffin-embedded tissue samples. In addition, ultrastructural changes in placental morphology in HELLP patients were evaluated by transmission electron microscopy (TEM). The serum concentrations of myeloperoxidase (MPO) and C-reactive protein (CRP) were also measured and compared. Results: p65/RelA immunoexpression and serum MPO and CRP levels were significantly higher in patients with HELLP syndrome (p < 0.05). TEM of placenta in the study group revealed severely vacuolized syncytiotrophoblasts, irregular basal lamina and damaged capillary endothelium when compared with the placenta of control subjects. Conclusion: Our results suggest that over-expression of placental NF-kB is correlated with elevation of serum inflammatory markers and placental ultrastructural changes, which may point to an important role of local and systemic inflammatory activation in the pathogenesis of HELLP syndrome.
