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Öğe Ameliorative Effects of Resveratrol on Acute Ovarian Toxicity Induced by Total Body Irradiation in Young Adult Rats(Elsevier Science Inc, 2012) Simsek, Yavuz; Gurocak, Simay; Turkoz, Yusuf; Akpolat, Nusret; Celik, Onder; Ozer, Ali; Yilmaz, ErcanObjective: The purpose of this study was to investigate the ovarian protective effects of resveratrol in rats exposed to total body irradiation. Design: Experimental study. Settings: University hospital. Participants and Interventions: Thirty female rats were randomized into four groups: (1) control group (n = 7); (2) low-dose (10 mg/kg) resveratrol group (n = 8); (3) high-dose (100 mg/kg) resveratrol group (n =7); and (4) sham irradiation group (n = 8). The drugs were administered intraperitoneally as single doses, and the rats were exposed to total body radiation 24 h after the treatment. The animals were sacrificed the following day, and their ovaries were excised for histopathological and biochemical analysis. Main Outcome Measures: The ovarian follicle counts were calculated, and irradiation-dependent ovarian damage and tissue levels of antioxidant enzymes were evaluated. Results: Group 2 and Group 3 showed significantly higher numbers of total follicle counts compared with Group 1 (P < 0.01). The low-dose resveratrol treatment was associated with significantly higher numbers of primary follicles than the high-dose group. The tissue activities of glutathione peroxidase (GsH-Px) and catalase (CAT) were significantly elevated in the resveratrol-treated animals. Evaluation of ovarian histology revealed no remarkable changes in fibrosis and leucocyte infiltration among the resveratrol-treated and control rats; however, vascularity was significantly reduced in the high-dose group (P = 0.014). Conclusion: Resveratrol attenuated irradiation-dependent ovarian damage, suggesting that this natural antioxidant is effective in reducing the follicle loss induced by ionizing radiation.Öğe Atorvastatin exerts anti-nociceptive activity and decreases serum levels of high-sensitivity C-reactive protein and tumor necrosis factor-? in a rat endometriosis model(Springer Heidelberg, 2014) Simsek, Yavuz; Gul, Mehmet; Yilmaz, Ercan; Ozerol, Ibrahim Halil; Ozerol, Elif; Parlakpinar, HakanPurpose The purpose of this study was to examine the effects of atorvastatin in the treatment of experimental endometriosis. Methods Endometriosis was induced in 24 female rats. 4 weeks after the procedure dimensions of the foci were recorded. Rats were divided into three groups: in Group 1 (n = 8), a daily dose of 10 mg/kg atorvastatin was given for 14 days. In the second group (n = 8), a single dose of 1 mg/kg leuprolide acetate was injected intraperitoneally. The rats in Group 3 (n = 8) were received 1 mg/kg i.p. 0.9 % NaCl. At the end of the treatment, laparotomy was performed, and the dimensions of the endometriotic foci were recorded. Biochemical, histopathological and immunohistochemical studies were performed and nociception was compared in groups. Results Atorvastatin treatment exhibited significant analgesic activity in hot plate model (P = 0.022). The serum hs-CRP and tumor necrosis TNF-alpha levels were similar between the Group 2 and Group 3 (P > 0.05); however atorvastatin caused significant decrease in both serum markers. The histological and immunohistochemical scores were also found to be markedly lower in Group 1 and Group 2 (P < 0.05). Conclusion Atorvastatin treatment may have a therapeutic potential in the treatment of endometriosis through its anti-inflammatory and anti-nociceptive properties.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 Cord blood nesfatin-1 and apelin-36 levels in gestational diabetes mellitus(Springer, 2012) Aslan, Mehmet; Celik, Onder; Celik, Nilufer; Turkcuoglu, Ilgin; Yilmaz, Ercan; Karaer, Abdullah; Simsek, YavuzTo assess maternal serum and cord blood apelin-36 and nesfatin-1 concentrations in pregnant women with and without gestational diabetes mellitus (GDM). Thirty pregnant women with GDM and 30 gestational age matched healthy pregnant subjects participated to the study. Maternal serum and cord blood nesfatin-1 and apelin-36 levels were measured with ELISA, at the time of birth. The relationships between maternal serum and cord blood nesfatin-1 and apelin-36 levels, anthropometric and metabolic parameters were also assessed. Maternal serum apelin-36 levels were found higher (13.5 +/- A 8.3 vs. 9.6 +/- A 5.9 ng/ml, P = 0.001) and nesfatin-1 levels were found lower (5.5 +/- A 8.1 vs. 8.1 +/- A 23.9 ng/ml, P = 0.001) in patients with GDM compared with control pregnant women. However, the cord blood apelin-36 levels (8.8 +/- A 4.3 and 8.2 +/- A 1.9 ng/ml, P = 0.618) and nesfatin-1 levels (5.4 +/- A 4.0 and 6.2 +/- A 10.3 ng/ml, P = 0.688) were similar in the GDM and control groups, respectively. Maternal serum apelin-36 and nesfatin-1 levels correlated positively with their respective cord blood levels. Maternal serum and cord blood apelin-36 levels correlated negatively with the gestational age and birth weight. Similarly maternal serum and cord blood nesfatin-1 levels correlated negatively with the gestational age, but there was no correlation with the birth weight. We did not find a correlation between maternal serum apelin-36 and nesfatin-1 levels, maternal age, BMI, fasting glucose, fasting insulin, and HOMA-IR. Also cord blood apelin-36 and nesfatin-1 levels did not correlate with the maternal age, BMI, HOMA-IR, cord blood glucose, and cord blood insulin levels. Our results indicate that apelin-36 concentrations increase and nesfatin-1 concentrations decrease in maternal serum of women with GDM.Öğe Dual effects of melatonin on uterine myoelectrical activity of non-pregnant rats(Galenos Yayincilik, 2014) Simsek, Yavuz; Parlakpinar, Hakan; Turhan, Ugur; Tagluk, Mehmet Emin; Ates, BurhanObjective: In this experimental study, we aimed to investigate the role of melatonin on uterine myoelectrical activity of non-pregnant rats. Material and Methods: Forty-six female rats were assigned to six groups: (1) control; (0.2 mL 0.9% NaCl was injected intravenously (IV), n=6); (2) melatonin applied as 0.4 mg/kg/IV (n=8); (3) melatonin applied as 4 mg/kg/IV (n=8); (4) single dose of oxytocin (100 mU/kg) injected IV (n=8); (5) melatonin (0.4 mg/kg) plus oxytocin (100 mU/kg) (n=8); and (6) melatonin (4 mg/kg) plus oxytocin (100 mU/kg) injected IV (n=8). Each rat underwent a laparotomy, and uterine myoelectrical signals were recorded. The mean spectrum, averaged over the spectral content of signals in each group, was compared. Results: Melatonin induced uterine myoelectrical activity in a dose-dependent manner. Treatment of melatonin after oxytocin suppressed the mean power of the signals. Serum melatonin concentrations were significantly higher in melatonin-treated rats. Conclusion: Melatonin itself at two different dose levels was found to be equally effective in stimulating the uterine electrical signals, although oxytocin-induced uterine electrical activity was suppressed by melatonin. These findings merit further investigations on the possible beneficial role of melatonin in the treatment of conditions associated with abnormal uterine activity.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 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 Elevated cardiac oxidative stress in newborn rats from mothers treated with atosiban(Springer Heidelberg, 2012) Simsek, Yavuz; Celik, Onder; Karaer, Abdullah; Yilmaz, Ercan; Gul, Mehmet; Ozerol, Elif; Bilgic, SedatThe purpose of this study was to evaluate the cardiac and cerebral oxidative stress in the offspings of pregnant rats treated with oxytocin antagonist atosiban. Experimentally naive, adult female Wistar-albino rats (200-250 g) were mated with adult male rats for copulation. After confirming pregnancy, eight gravid rats were then randomly assigned into two equal groups. The animals were treated from days 15 to 20 of gestation. One group acted as a control group, and received intraperitoneal (i.p.) injections of saline in a daily dose volume of 6 mg/kg/day. The second group received 6 mg/kg/day i.p. atosiban. On day 21 of gestation, pups were delivered by cesarean. The heart and brain tissues of the newborn rats were dissected and sent for the measurement of total oxidant status, total antioxitant status and oxidative stress index. There was no significant difference in birthweight or in the number of pups between two groups. Newborns from atosiban-treated mothers showed significantly increased oxidative stress in the plasma and heart tissue than that of controls which was confirmed by histological examination (P < 0.05). Oxidative stress parameters and histopathological results of the brain tissues of newborns were similar between two groups (P > 0.05). Oxytocin receptor blockage for the treatment of premature delivery may be associated with increased fetal morbidity and mortality secondary to the elevated oxidative stress in the heart of the newborns.Öğe Frequency of hereditary thrombophilia, anticoagulant activity, and homocysteine levels in patients with hemolysis, elevated liver functions and low thrombocyte count (HELLP) syndrome(Wiley, 2011) Dogan, Ovgu Ozkan; Simsek, Yavuz; Celen, Sevki; Danisman, NuriAim: The purpose of this study was to investigate the correlations between thrombophilic mutations, anticoagulant activity and hemolysis, elevated liver functions and low thrombocyte count (HELLP) syndrome. Material and Methods: Twenty-five healthy pregnant women (control group) and 34 patients with HELLP syndrome (study group) were included in the study between April 2007 and January 2008. Homocysteine levels and activities of protein C, protein S and antithrombin III of the groups were compared. Frequency of factor V Leiden mutation, prothrombin 20210A mutation and C677 T mutation of methylenetetrahydrofolate reductase gene were also compared. Results: Frequencies of thrombophilic gene mutations of the two groups were not significantly different. Homocysteine levels were significantly higher in the study group. Protein C and protein S deficiencies of the two groups were similar. Antithrombin III deficiency was statistically higher in the patients with HELLP syndrome. Conclusion: The frequency of antithrombin III deficiency and homocysteine levels were higher in the patients with HELLP syndrome; however, there was no positive relationship between hereditary thrombophilic mutations and the disease. Larger prospective studies are needed to validate our findings.Öğe Fulminant hepatitis A infection in second trimester of pregnancy requiring living-donor liver transplantation(Wiley-Blackwell, 2012) Simsek, Yavuz; Isik, Burak; Karaer, Abdullah; Celik, Onder; Kutlu, Ramazan; Aydin, Nasuhi Engin; Yilmaz, SezaiWe present an 18-year-old pregnant woman who was referred to our emergency clinic as a case of acute hepatic failure and hepatic encephalopathy. Laboratory tests showed abnormal liver function tests and serological workup was consistent with acute hepatitis A infection. Ultrasonography revealed a single live fetus with fetal biometry compatible with 18 gestational weeks. The patient underwent a highly urgent liver transplantation using a right lobe graft from her husband. Histological examination of the explanted liver showed acute, lymphocyte-rich, diffuse necrotizing hepatitis, consistent with acute necrotizing hepatitis A. After the operation her allograft function gradually recovered. Her follow-up obstetrics ultrasound revealed a male fetus with severely decreased amniotic fluid. The patient was informed about the poor prognosis of her pregnancy and the pregnancy was terminated by vaginal misoprostol induction. She has maintained a good general condition and liver function for 4 months postoperatively, up to the present time.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 MEIGS' SYNDROME WITH ELEVATED SERUM CA125: CASE REPORT AND REVIEW OF THE LITERATURE(Galenos Yayincilik, 2012) Yilmaz, Ercan; Tanrikut, Emrullah; Karaer, Abdullah; Simsek, Yavuz; Celik, Onder; Minareci, YagmurBackround: Elevated serum CA125 levels in postmenopausal women with solid adnexal masses, ascites, and pleural effusion are highly suggestive for malignant ovarian tumor. We aimed, malignant ovarian tumors clinically mimicking a case of syndrome Meigs. Case: Forty-four years old patient with diagnosis of Meigs syndrome Conclusion: Adnexal mass in patients with high CA 125 levels should be consider malignancy. Presence of pleural efussion increases suspicion of malignancy.Öğe Mode of delivery changes oxidative and antioxidative properties of human milk: a prospective controlled clinical investigation(Taylor & Francis Ltd, 2015) Simsek, Yavuz; Karabiyik, Pinar; Polat, Kubra; Duran, Zeynep; Polat, AlaaddinObjective: To evaluate the influence of delivery mode on oxidative stress in human breast milk. Methods: Thirty-three women who delivered by vaginal birth and 55 women who underwent cesarean section (CS) were included in this study. Colostral samples were collected on the second day after delivery. Total antioxidative status (TAS), total oxidative status (TOS), oxidative stress index (OSI), malonyldialdehyde (MDA), and glutathione peroxidase (GSH-Px) levels were determined and compared. Results: Colostrum TAS was significantly higher in women of vaginal birth, than in women with CS (p<0.001). Milk TOS and OSI were found to be significantly increased in women with CS under general anesthesia. A marked increase in colostral GSH-Px levels after vaginal delivery was also noticed (p<0.001). Conclusion: This study revealed that vaginal birth is associated with decreased oxidative stress in colostrum than CS, which suggest that mode of delivery plays an important role in the antioxidative production of breast milk.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.Öğe Perinatal and Neonatal Outcomes of Patients Who Were Diagnosed with Neural Tube Defect in Midtrimester Fetal Ultrasound Scan and Refused Request for Termination of Pregnancy(Hindawi Ltd, 2016) Melekoglu, Rauf; Eraslan, Sevil; Celik, Ebru; Simsek, YavuzObjectives. In this study, we aimed to demonstrate the perinatal and neonatal outcomes of patients who were diagnosed with neural tube defect (NTD) in the midtrimester fetal ultrasound scan and refused the request for termination of pregnancy. Material and Methods. The records of 69 patients, for whom NTD was detected in the midtrimester fetal ultrasound scan and who preferred the continuation of the pregnancy after comprehensive counselling about the possible prognosis and treatment options during the period between January 2011 and February 2016, were reviewed retrospectively. Results. Of these patients, 66.7% were 25-35 years old; 95.7% were multiparous; and 1.4% had a history of a fetus having NTD in previous pregnancies. There were 7 (10.1%) neonatal deaths in these patients. Meningomyelocele closure procedure was the most performed surgery in the postnatal period (92%). Of these patients, 30.7% had paraplegia; 51.6% had neurogenic bladder; and 6.4% had infections due to surgery. Conclusion. The results of this study demonstrated perinatal and neonatal outcomes of fetuses with NTD who were not terminated by the preference of the family in midtrimester. The experience of our centre would be beneficial as a tool for nondirective counselling of these patients when considering the antenatal/postnatal care options and postnatal prognosis.Öğe The predictive value of maternal serum AFP to PAPP-A or b-hCG ratios in spontaneous preterm birth(Taylor & Francis Inc, 2022) Celik, Ebru; Melekoglu, Rauf; Baygul, Arzu; Kalkan, Uzeyir; Simsek, YavuzThe use of the second trimester alpha-fetoprotein (AFP) along with the first trimester pregnancy-associated plasma protein-A (PAPP-A) has been found to be useful in the estimation of unfavourable pregnancy outcome. Our aim in this study was to determine the relationship between maternal PAPP-A and b-hCG and AFP concentrations in spontaneous preterm birth (sPTB). This prospective cohort study included 372 singleton pregnancies with PAPP-A, b-hCG and AFP levels in the first trimester, which were converted to multiples of the median (MoM). The predictive ability of AFP-to-PAPP-A and AFP-to-b-hCG ratios for sPTB was evaluated. The risk for sPTB <= 34 weeks increased in women with AFP-to-PAPP-A ratio >7 (OR 2.9, 95% CI 1.2-6.4). Women with AFP-to-b-hCG ratio >0.6 had a 3.5-fold higher risk for sPTB <= 32 weeks. Increased maternal AFP-to-PAPP-A or AFP-to-b-hCG ratios in the first trimester may help to predict pregnant women at high risk for sPTB, and this may be beneficial in developing management plans.
