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    The predictive value of maternal serum screening tests for adverse pregnancy outcomes
    (2020) Adanas Aydin, Gultekin; Ozgen, Gulten
    Aim: Free beta-human chorionic gonadotropin (Fβ-hCG), pregnancy-associated plasma protein-A (PAPP-A), alpha-fetoprotein (AFP), unconjugated estriol (uE3), and inhibin-A have been shown to be useful not only in identifying chromosomal abnormalities in the first and second trimesters, but also in predicting adverse pregnancy outcomes (APOs). In this study, we aimed to investigate the predictive value of maternal serum screening tests for various APOs including preeclampsia, intrauterine growth retardation (IUGR), preterm labor, and gestational diabetes mellitus (GDM).Material and Methods: The study was carried out at our clinics and included a total of 220 pregnant women who respectively underwent the double and quadruple marker testsduring the 11th to 14th and 15th to 22nd gestational weeksbetween January 2017 and December 2018. Patient data (maternal age, parity/gravidity, gestational age, history of infertility, use of in vitro fertilization, maternal/fetal complications, preterm labor, mode of delivery, birth weight, and length of stay in the neonatal intensive care unit) were reviewed retrospectively.Results: The AFP levels were statistically significantly higher in patients with IUGR (p=0.022),GDM (p=0.036), and preterm labor (p=0.021), compared to the control group with no APO. No significant correlation was found between preeclampsia and the serum markers.Conclusion: Our results show that elevated maternal serum AFP levels might be associated with various APOs,requiring closer patient follow-up for early diagnosis and treatment.
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    Serum ischemia modified albumin and dynamic thiol/disulfide homeostasis in early- and late-onset preeclampsia
    (2020) Adanas Aydin, Gultekin; Ozgen, Gulten; Neselioglu, Salim; Erel, Ozcan
    Aim: In the present study, we aimed to evaluate serum IMA, IMA/albumin ratio, and DTDH levels in patients with early- and late-onset PE compared to healthy controls.Impaired homeostasis between oxidant and antioxidant mechanisms, inflammatory processes, and endothelial dysfunction play a key role in the pathogenesis of preeclampsia (PE). Serum ischemia modified albumin (IMA) and dynamic thiol/disulfide homeostasis (DTDH) levels are elevated in the presence of inflammation, oxidative stress, and endothelial dysfunction. Material and Methods: A total of 24 patients with early-onset PE and 62 patients with late-onset PE were included.The control group consisted of 46 healthy controls with similar gestational weeks. Serum samples were collected and IMA, albumin, and native, total, and disulfide thiol levels analyzed. Corrected IMA/albumin ratios were also calculated.Results: Disulfide levels, disulfide/native and disulfide/total thiol levels were higher in patients with early-onset PE compared to late-onset patients(p=0.008, p=0.022, and p=0.021, respectively). However, there was no significant difference between the late-onset PE patients and late-onset PE controls. Although there was no significant difference in the IMA levels between the patient and control groups, the IMA/albumin ratio was higher in the early-onset and late-onset PE patients, compared to the control group. However, there was no significant difference between the early-onset and late-onset PE patients.Conclusion: Our study results showed increased disulfide levels, disulfide/native thiol, disulfide/total thiol and IMA/albumin ratio in the early-onset PE patients, indicating increased oxidative stress in the pathogenesis of PE. In the late-onset PE patients, there was an increase only in the IMA/albumin ratio. However, further large-scale, prospective studies are needed to confirm the diagnostic value of these markers in the clinical practice.