Aim To evaluate the effects of the etonogestrel contraceptive implant (Implanon ® ) on bone metabolism in lactating women using markers for bone formation and resorption. Study design This single-centre, prospective cohort study was conducted in Turgut Ozal University Medical Faculty Obstetrics and Gynecology Department with healthy lactating women aged between 24 and 38 years to compare the effect on bone metabolism of 6 months’ use of either the implant or a non-hormonal contraceptive method. The study group ( n =25) used an implant and the control group ( n =25) used a non-hormonal contraceptive intrauterine device inserted 40 days’ postpartum. Bone metabolism differences at the time of insertion and after 6 months were assessed quantitatively by biochemical analysis of serum and urine samples. Results At baseline, serum levels of bone metabolism parameters were similar for the two groups. In the implant group, serum alkaline phosphatase (ALP) levels decreased ( p =0.004) and total protein levels increased ( p =0.045) at 6 months. In the control group, serum levels of bone metabolism parameters did not change at 6 months compared to baseline. However, serum levels of phosphorus ( p =0.013) and ALP ( p =0.003) decreased at 6 months compared to baseline. Conclusion Six months’ postpartum use of Implanon was found to have no deleterious impact on bone turnover in healthy lactating women.
Coasting can reduce the ovarian hyperstimulation syndrome (OHSS) risk in ovulation induction cycles before intracytoplasmic sperm injection (ICSI). This study aimed to investigate the effect of gonadotropin-releasing hormone (GnRH) agonist and GnRH antagonist protocols to controlled ovarian hyperstimulation (COH) cycles with coasting on the parameters of ICSI cycles and the outcome.In a retrospective cohort study, 117 ICSI cycles were per- formed and coasting was applied due to hyperresponse, between 2006 and 2011. The ICSI outcomes after coasting were then compared between the GnRH agonist group (n=91) and the GnRH antagonist group (n=26).The duration of induction and the total consumption of gonadotropins were found to be similar. Estradiol (E2) levels on human chorionic gonadotropin (hCG) day were found higher in the agonist group. Coasting days were similar when the two groups were compared. The number of mature oocytes and the fertilization rates were similar in both groups; however, the number of grade 1 (G1) embryos and the number of transferred embryos were higher in the agonist group. Implantation rates were significantly higher in the antagonist group compared to the agonist group. Pregnancy rates/embryo transfer rates were higher in the antagonist group; however, this difference was not statistically significant (32.8% for agonist group vs. 39.1% for antagonist group, P>0.05).The present study showed that applying GnRH-agonist and GnRH-antago- nist protocols to coasted cycles did not result in any differences in cycle parameters and clinical pregnancy rates.
<i>Objective:</i> To assess the effects of gum chewing on postoperative bowel function after cesarean section. <i>Material and Methods:</i> Women who underwent cesarean section were randomized to either a gum-chewing group (n = 74) or a non-gum-chewing group (n = 76). The two groups were compared with respect to the return of bowel activity, postoperative analgesic and antiemetic drug requirement and postoperative hospital stay. <i>Results:</i> Bowel sounds appeared in a significantly shorter duration of time in the study group, the mean being 5.9 h as compared to 6.7 h in the control group (p < 0.01). The first passage of flatus postoperatively was 22.4 h in the gum-chewing group and 31 h in the control group (p < 0.001). The total length of hospital stay was shorter in the gum-chewing group (2.1 days) than in the control group (2.3 days), but it was not statistically significant (p > 0.05). Postoperative analgesic requirement in both groups was similar, but the postoperative antiemetic need in the gum-chewing group was lower than in the control group (p < 0.01). <i>Conclusion:</i> On the basis of the tolerability and results on bowel function, gum chewing provides a simple method for early recovery of bowel function after cesarean section.
The aim of the present study was to evaluate whether fasting may cause changes in maternal lipid profile, glucose level and ketonuria, and whether it has any adverse effects on fetal Doppler, birthweight, preterm delivery or cesarean section rate.Fifty-six consecutive, healthy women with singleton uncomplicated pregnancies of ≥ 28 week gestation who had fasted for at least 10 consecutive days during the study period were defined as the study group. Fifty-four healthy non-fasted women matched for age, parity, and gestational age were defined as the control group. Groups were compared according to fetal middle cerebral artery and umbilical artery systolic/diastolic ratio, maternal serum lipid levels and neonatal outcomes (gestational age at delivery, birthweight, delivery type and neonatal intensive care admission).No statistical difference was found between the groups according to fetal Doppler parameters, amniotic fluid index, gestational age at delivery, cesarean section rate, birthweight or NICU admission. However, lower levels of VLDL, triglyceride and higher incidence of ketonuria were detected in the fasting group (p < 0.05).Fasting of healthy women during pregnancy seems to have no adverse effects on amniotic fluid index, fetal Doppler and delivery parameters.
Posterior reversible encephalopathy syndrome (PRES) is a temporary condition which is clinically characterized by headache, confusion, blurring of consciousness, visual disturbances and convulsion and radiologically characterized by edema in the posterior areos of the brain. However, delayed diagnosis and treatment can lead to fatal complications. In this article, we presented a case with postpartum seizure who was clinically and radiologically diagnosed as PRES, to emphasize the necessity of keeping the PRES syndrome in mind.
To investigate whether spontaneous preterm labor (PTL) with intact membranes is associated with changes in maternal serum prohepcidin concentrations. Materials and methods: The study consisted of patients with spontaneous PTL with intact membranes (n = 25), a control group of healthy pregnant women between the 24th and 37th gestational weeks (n = 22), and uncomplicated term pregnancies in spontaneous labor (n = 19). Blood samples were collected from patients at the time of clinical diagnosis. Levels of prohepcidin, hemoglobin, serum ferritin, serum iron, unsaturated iron binding capacity, total iron binding capacity, transferrin and transferrin saturation, C reactive protein, and interleukin-6 were measured. Results: Patients with spontaneous PTL had significantly lower maternal serum prohepcidin concentrations than term delivery and control subjects. Conclusion: Maternal serum prohepcidin concentration is lower in patients with spontaneous PTL compared to term delivery and control subjects. This suggests that measuring maternal serum prohepcidin concentrations in PTL may be a feasible method for understanding etiologic causes of spontaneous preterm delivery, but, before suggesting this as a course of action, low levels of prohepcidin in patients with PTL need to be more fully investigated.
Familial Mediterranean Fever (FMF) is an autosomal recessive disease which is characterized by recurrent, self-limiting, short attacks of serositis while abdominal pain is the most common symptom. The underlying clinical and pathological picture is that of acute peritonitis. These abdominal signs are often so striking that they mimic an acute abdominal calamity suggesting several possible gastrointestinal, gynecologic or urologic diagnoses. Diagnosis of acute abdomen in pregnancy also remains one of the most challenging conditions as the physiological consequence of pregnancy and nonspecific laboratory parameters. A limited number of studies addressed FMF in pregnancy and none of them mentioned the diagnostic challenging of FMF during pregnancy because the patients had al been diagnosed previously. In this paper, we discussed a 20 year old, gravida 1, parity 0 patient whose twin pregnancy wash complicated by an acute abdominal condition after amniocentesis and the difficulties of making the diagnosis of FMF with the complications during this diagnostic period in pregnancy. Ailevi Akdeniz Ateşi (AAA) en yaygın belirtisi karın ağrısı olan; tekrarlayıcı, kendi kendini sınırlayan, kısa serozit ataklarıyla karakterize, otozomal resesif geçişli bir hastalıktır. Altta yatan klinik ve patolojik görünüm akut peritonitle uyumludur. Bu batın bulguları bazen o kadar dikkat çekici bir duruma gelir ki, bazı gastrointestinal, jinekolojik ve ürolojik tanıları düşündüren akut karın tablosunu taklit eder. Gebelik sırasında akut karın tanısı koymak, gebeliğin fizyolojik sonuçlarına ve spesifik olmayan laboratuvar parametrelere bağlı olarak en zor durumlardan biridir. Gebelikte AAA ile ilgili sınırlı sayıda çalışma mevcuttur ve hiçbirinde AAA′ nin gebelik sürecindeki tanısal zorluğundan bahsedilmemiştir, çünkü hepsi de gebelikten önce AAA tanısı almışlardır. Bu yazıda biz, 20 yaşında, gravida 1, parite 0 bir hastada amniosentez sonrasında akut karın tablosunu taklit ederek ikiz bir gebeliği komplike eden AAA′ nin gebelik sürecinde tanısının konulmasındaki zorlukları ve bu tanısal süreçte meydana gelen komplikasyonları tartıştık.
