Department Of Perinatology Research Articles

The Relationship Between MicroRNAs And Congenital Kidney Anomalies

Objective: The purpose of this study was to identify diagnostic microRNAs (miRNAs) associated with congenital kidney anomalies. Methods: Twenty-five healthy pregnant women who were found to have fetal kidney anomaly in the second trimester of their pregnancy at Department of Perinatology, were included in the study. Serum samples were taken from the pregnant women at the moment of diagnosis in the antenatal 20th gestational week, whereas serum samples were taken from the cord blood of babies during birth. There were 11 multicystic dysplastic kidney patients, 6 autosomal recessive polycystic kidney patients, and 8 unilateral hypoplastic kidney patients. Expression of specific miRNAs was monitored using specific primer assays in Real-Time PCR. The expression of the following miRNAs was quantified: miR-17, miR-192, miR-194, miR-204, miR-215, and miR-216. Results: mir-17 expression was significantly lower in children with congenital kidney anomalies than in the control group. ROC curve analysis showed that the area under the curve was 0.700 for miR-17 in the prediction of congenital kidney anomalies. Conclusions: In children with congenital kidney anomalies, miR-17 expression was significantly different than in the control group. Thus, this miRNA may be used in the antenatal early detection of these congenital kidney anomalies.

A review of socio-demographic and clinical correlates of stillbirth at a teaching hospital with limited advanced fetal surveillance

Background: Stillbirth has a heavy burden of psychosocial and economic cost on women, families and nations. The study aimed at determining the rate of stillbirth and identifying the factors contributing to stillbirths in Ekiti State University Teaching Hospital (EKSUTH), Ado-Ekiti over the study period. Materials and Methods: The study was a retrospective descriptive one carried out at the Obstetric Unit of Obstetrics, Gynaecology and Perinatology Department of Ekiti State University Teaching Hospital (EKSUTH), Ado-Ekiti from 1st of January, 2012 to 31st of December, 2016. The data obtained were processed using Statistical Package for Social Sciences (SPSS) computer software version 20. Descriptive statistics was utilized to analyze the data; continuous variables were summarized with mean and discrete variables were summarized using numbers and percentages. Results: There were 532 stillbirths out of a total of 9,364 deliveries during the study period. This gave a stillbirth rate of 56.8/1000 total births. Macerated stillbirths accounted for 232 (43.6%) while fresh stillbirths accounted for 300 (56.4%) of the cases; with majority of the bereaved mothers (86.8%) being unbooked. Stillbirth rate was highest among women aged 15 to 19 years followed by those aged 40 years and above. Infections (chorioamnionitis), 69 (13.0%), obstructed labour. 59 (11.1.%) and antepartum haemorrhage 38 (7.1%) were the leading maternal causes of stillbirth. Prematurity 81 (15.2%) and multiple gestation 38 (7.1%) were the leading fetal causes. In 43 cases (8.1%), there were unexplained causes of stillbirth.Conclusion: As stillbirth remains a largely preventable condition, more aggressive measures should be instituted to ensure comprehensive maternity care for pregnant women; with more emphasis on advanced fetal surveillance arm of antenatal/intrapartum care. Appropriate evidence based post-delivery management, especially in the areas of conduct of baby autopsy and handling of bereavement, should be given to the mothers of the deceased.

Polymorphic Relationship of rs7526700, rs2278651, and rs611386 Of SLC30A1 Mothers’ Gene with Mothers’ High Levels of Zinc

The most common facial malformation in all populations and ethnic groups is Cleft lip and palate (CB/L). Various factors cause nonsyndromic cleft lip and palate abnormalities (CB/L NS) such as interactions between environmental and genetic factors, so that CB/L embryopathy is not clear. Deficiency of Zn with certain severity in pregnant women can be a risk factor for CB/L. The purpose of this study was to analyze the relationship of polymorphism of rs7526700, rs2278651, and rs611386 of the gene SCL30A1 mother with a group of deficiency events of Zinc maternal. The type of this research is an observational study through cross sectional approach with the research subjects are mothers and newborns diagnosed with CB/L NS in the Perinatology Department of Dr. Hasan Sadikin Hospital Bandung and other Network Hospitals. The research was conducted in September 2016 to June 2017 with 34 groups samples. Data were analyzed using fisher’s exact test and correlation test. The results showed that the majority of mothers who became the research respondents aged 25-29 years were 34% and the majority of infants who became the respondents were female as much as 60%, and most types of lip and palate disorders experienced by infants who became the respondents was Unilateral CB/L which is as much as 66%. Furthermore, the results of statistical tests indicated that there was no significant relationship between polymorphism of rs7526700, rs2278651, and rs611386SLC30A1 maternal gene with levels of Zinc maternal

Evaluations of pregnancy admitted to perinatology clinics that pregnants have fetal anomalies

Objective Our objective was to investigate the most common anomalies in our region with a retrospective evaluation of the congenital anomaly cases, who applied to the outpatient department of perinatology Materials and Methods: We was reviewed file of congenital anomaly cases, who applied to the outpatient department of perinatology in the Medical Faculty at Ondokuz Mayıs University between May 2014 and May 2019,and to determine the risk factors related to these anomalies. Seven hundred twenty-five pregnant women, whose infants were diagnosed with congenital anomalies in our center, were included in the present study. Parameters like the mother's age, consanguineous parents, history of previous habitual abortions, history of siblings with anomalies, number of parity and abortus history, gestational week at diagnosis, smoking, alcohol and drug consumption in the first trimester, periconceptional folic acid use, co-morbidities, ultrasonographic findings, presence of the karyotype analysis, double and triple screening tests, termination decisions were compared with the anomaly types. Results: In our study, we determined the incidence of anomalies in our region with some limitations. Except for the central nervous system anomalies (most common anomaly group), the incidence ranking of the anomalies in our region was different from the rankings reported in other national studies The CVS anomalies were the second most common anomaly group. Conclusion: An education program prepared for the pregnant women in our region about the goal of the diagnostic and screening tests and routine pregnancy controls will increase the chance of early diagnosis. We believe that the conduction of region-based prenatal and postnatal studies instead of hospital-based studies will contribute more to a clear understanding of the anomaly incidences in our region.

Early- and Late-Onset Preeclampsia: A Comprehensive Cohort Study of Laboratory and Clinical Findings according to the New ISHHP Criteria.

Recently, the diagnostic criteria of preeclampsia have been changed. No studies are available in the literature that analyzed in detail the differences between early-onset preeclampsia (EOP) and late-onset preeclampsia (LOP), taking into account the International Society for the Study of Hypertension in Pregnancy (ISSHP) criteria. Thus, we sought to retrospectively investigate in detail the differences in clinical and laboratory outcomes between EOP and LOP diagnosed according to the ISSHP criteria. A retrospective cohort study was conducted in 214 women with singleton pregnancies and preeclampsia admitted to the Department of Obstetrics and Perinatology of the University Hospital in Kraków, Poland, from 2013 to 2017 (113 (52.8%) women with EOP and 101 (47.2%) women with LOP). Electronic medical records were reviewed for demographics and medical history, laboratory tests, and delivery and neonatal data. Patients with preeclampsia accounted for 1.7% of the women who delivered during the study period. The EOP and LOP groups did not differ in the distribution of risk factors for preeclampsia. The most common risk factor was primiparity, which was observed in 72.0% of cases. Regarding the ISSHP diagnostic criteria, the two groups differed in the incidence of fetal growth restriction (p=0.0009), hemolysis (p=0.0416), and neurological complications (p=00342), which were found more often in the EOP group. In addition, the EOP group had more frequent occurrence of severe cardiorespiratory (p < 0.0001) and hematological (p=0.0127) complications, adverse fetoplacental conditions (p < 0.0001), and severe fetoplacental complications (p=0.0003). Children born to women with EOP had lower Apgar scores (p < 0.001) and higher rates of intraventricular hemorrhage (p < 0.0001), respiratory disorders requiring mechanical ventilation (p < 0.0001), and early (p=0.0004) and late sepsis (p=0.002). EOP differed from LOP in terms of maternal and perinatal adverse outcomes. The observed higher rates of fetoplacental adverse conditions and severe complications indicate a significant contribution of impaired placentation to the etiopathogenesis of EOP.

Evaluation of Pregnancy Outcomes at Advanced Maternal Age.

AIM:The study aimed to investigate the association between advanced maternal age (AMA) and the risk of adverse maternal, perinatal and neonatal outcomes about parity in singleton pregnancies.METHODS:We retrospectively analysed 950 women who gave birth in the Department of Obstetrics and Perinatology of the University Hospital in Kraków for six months (between 1st January and 30th June 2018). The patients were divided into 3 groups according to their age (30-34 years old, 35-39 years old and over 40 years old). Each of these groups was subsequently subdivided into 2 groups depending on parity (primiparae and multiparae). Maternal, perinatal and neonatal outcomes were compared between the groups and the subgroups.RESULTS:Comparison of the three age groups revealed that advanced maternal age might constitute a predisposing factor for preterm birth, caesarean section and large for gestational age (LGA). From these parameters, statistical significance was reached in case of greater risk of LGA (OR = 2.17), caesarean section (OR = 2.03) and elective C-section (OR = 1.84) in women over 40 years old when compared to the patients aged 30-34. Furthermore, AMA increases the risk of postpartum haemorrhage (OR = 6.43). Additionally, there is a negative correlation between maternal age and gestational age at delivery (R = -0.106, p < 0.05).CONCLUSIONS:Advanced maternal age can undoubtedly be associated with several adverse perinatal outcomes. At the same time, the risk of perinatal complications begins to increase after the age of 35 but becomes significant in women aged ≥ 40.

Emergency cerclage in twins during mid gestation may have favorable outcomes: Results of a retrospective cohort

PurposeCervical cerclage treatment for cervical changes at mid trimester is a very controversial topic in twins. The aim of the study was to present our maternal and fetal outcomes of mid-trimester cervical cerclage in twin pregnancies. Basic proceduresThis study was performed using data extracted from the medical files of the twin pregnancies whom performed emergency cervical cerclage between January 2012 and March 2018 at Trakya University, Facuty of Medicine, Department of Perinatology. Main findingsMean (min.–max.) gestational age at delivery was [27.3 (21–34) weeks]. The median time between cervical cerclage and delivery was 6.4 weeks, while the maximum prolongation of the pregnancy was 11 weeks. The median prolongation period of pregnancy was 4.1 weeks in patients with bulging membranes, but 10 weeks in patients with cervical effacement and cervical shortening.Eight infants died at the neonatal period. Two patients (20%) developed late abortions at 21 and 22 weeks of gestation, and 2 women (20%) delivered extremely premature neonates at the 24th weeks. Overall neonatal mortality rate was 40% (8/20 neonates). Twelve out of twenty were born alive (60%). Principal conclusionsDespite the lack of randomized controlled trials, it seems reasonable to offer emergency cervical cerclage to twin pregnancies with cervical shortening (<15mm). For the twin pregnancies with advanced cervical dilatation and protruding membranes, emergency cervical cerclage should be an option only for carefully selected patients after informing about the complications and low success rate.

Predictors of cesarean delivery in cervical ripening and labor induction with Foley catheter

Purpose: The aim of this paper is to identify predictors of cesarean delivery (CD) in patients with an unfavorable cervix undergoing cervical ripening and labor induction with Foley catheter.Materials and methods: A retrospective cohort study of singleton pregnancies induced using Foley catheter was performed to evaluate whether factors in the maternal history and during the process of labor induction are useful in predicting the risk of CD.Results: During the study period there were 2221 births in the Chair and Department of Obstetrics and Perinatology, Medical University of Lublin, Poland. From a cohort of 402 women with Foley catheter induction (FCI), 327 met inclusion criteria. There were 236 vaginal labors (72.2%) and 91 CDs (27.8%). Nulliparity (OR 2.344), Bishop score of 1–2 points (OR 1.473), and meconium-stained amniotic fluid (OR 1.980) are linked to the risk of CD. In nulliparous patients, factors associated with an increased risk of CD included maternal age greater than 30 years (OR 3.200), meconium-stained amniotic fluid (OR 2.505), and birthweight ≥3400 g (OR 1.803). Among multiparous women none of the evaluated factors was significantly connected to CD.Conclusions: Nulliparity, low Bishop score, and meconium-stained amniotic fluid are important risk factors of CD after FCI.

Relaparotomy following cesarean section – a single center study

IntroductionRelaparotomy is a serious complication of caesarean section. The aim of this study was to investigate its risk factors and postoperative outcome. MethodsWe conducted a retrospective case-control study examining 48 reoperations between January 2013 and June 2017 at the Obstetrics and Perinatology Department, Jagiellonian University Hospital in Cracow, Poland. This is tertiary referral center, in that time 8421 cesarean section were performed. The control group was randomly matched from all CS in a 1 to 2 ratio. The following figures were analyzed: demographic obstetrics data, indication for cesarean section, perioperative data and laboratory results. Patients’ follow up data was evaluated. ResultsThe frequency of relaparotomy was 0.57%. There were no statistically significant differences in indications for primary surgery between the control group and the relaparotomy group. There were only two perioperative factors which increased the risk of relaparotomy: general anesthesia and the duration of operation. Laboratory results were in reference range in both groups, however, in the relaparotomy group, platelets were lower, while APTT and INR were prolonged. The main indication for relaparotomy was bleeding into the peritoneal cavity. Patients with relaparotomy more often required blood transfusion, admission to ICU, as well as longer hospitalization. ConclusionRecognition of risk factors of relaparotomy and proper diligence in hemostasis may decrease its rate.

Effects of betamethasone on fetoplacental and maternal hemodynamics in preterm pregnancies.

To evaluate the possible effects of prenatal steroid administration onDoppler parameters of the umbilical artery, uterine artery, middle cerebral artery, and ductus venosus, the cerebroplacental ratio, and the amniotic fluid index in pretermfetuses. The present prospective observational study was performed at the Perinatology Department of Trakya University, Edirne, Turkey, between June 1, 2015, and September 1, 2016. It included patients with healthy singleton pregnancies who had received betamethasone at 24-34weeks of pregnancy. Doppler parameters were measured before (0hours) and 24, 48, and 72hours after the administration of betamethasone (two intramuscular doses of 12mg each, administered 24hours apart). There were 68 patients included. Pairwise comparisons demonstrated that, at 72hours after betamethasone administration, the umbilical artery resistance index (P=0.038), the middle cerebral artery systolic/diastolic velocity ratio (P=0.007), and the amniotic fluid index (P=0.017) were reduced, whereas the end-diastolic velocity of the middle cerebral artery was increased (P=0.012), compared with baseline values. Betamethasone had favorable effects on fetal cerebral circulation, with increased end-diastolic velocity in the middle cerebral artery; this could represent a positive effect on cerebral blood circulation and decreased flow resistance in the umbilical artery.

Strategy of effectiveness in the modern concept of reproductive health

The modern concept of reproductive health is based not only on the search for optimal methods of treatment of diseases, preservation of planned pregnancy, prevention of maternal and child morbidity and mortality, but, first of all, on preventive correction of pathological conditions. These problems were examined on the 17th World Congress of the International Academy of Human Reproduction which took place on March 15–18, 2017 in Rome. In particular, the section “Current Problems in Reproductive Surgery” examined the problems of diagnosing pathological conditions before surgery, as well as issues of effective prevention of the disease recurrence. Within the framework of the section the associate professor of the Department of Perinatology, Obstetrics and Gynecology of the Kharkov Medical Academy of Postgraduate Education V.V. Bobritskaya presented the report “Management of patients after surgical treatment for ovarian neoplasia.”The report described the results of data-analysis of the management of 140 patients after surgical treatment for benign ovarian tumors. A retrospective study of these results was presented: using combined oral contraceptives (COCs), combination of COCs and the metabolic oncoprotect drug Epigalin, as well as the results of the isolated use of Epigalin in the rehabilitation period (6–12 months). The aim of the study was to optimize the methods of preventing relapses of neoplastic processes in operated women of reproductive age.Among the observed patients, the best results were reported in the group receiving co-therapy COCs + Epigaline – no recurrence of ovarian neoplasia. In group I (COCs only) 1 case of the endometrioid cyst recurrence was observed, in group III (Epigalin only) – 1 case of the cyst of the yellow body recurrence. The expected maximum number of relapses (6) was observed in a group of women who did not take the recommended drugs during the rehabilitation period for various reasons.According to conclusion of the study authors, a combination of COCs with a low dose of 20 μg ethinyl estradiol and 150 μg desogestrel with 90 mg epigallocatechin-3-gallate and 400 mg indole-3-carbinol (Epigalin) can be considered as one of the optimal methods for preventing of ovarian neoplasia recurrence, and therapy of dyshormonal conditions. Preventative treatment must be performed in the postoperative period.

The effectiveness of extended fetal heart screening in a Tertiary Center

Our study is to evaluate the effectiveness of extended fetal heart screening in a tertiary center and research the sensitivity, specifity and the positive and negative values of echocardiography.316 patients who were diagnosed with congenital anomalies among those scanned with the extended fetal heart screening protocol in the perinatology department of our hospital were included in our study. Patients who were not diagnosed with congenital anomalies were excluded. Fetal echocardiographies were perfomed on patients who were admitted to our perinatology clinic, in accordance with the ISUOG extended fetal heart screening protocol. In our study, 55.3% of all cases with cardiac anomalies are concomitant with extracardiac anomalies. An interventional procedure was performed on 52.5% of the patients for karyotyping purposes. 19.3% was terminated early in the pregnancy, 5% and 12.5% were lost during the intrauterine and neonatal periods, respectively. In our study, upon comparison of the fetal and neonatal results, we determined that the false positive and negative rates for fetal echocardiography were 3.5% and 9.4% respectively.In our study, the sensitivity, specificity, positive predictive value and accuracy of echocardiography were determined as 91%, 99%, 98% and 99% respectively during the application of ISUOG recommendations in a tertiary center.

Incidence and Fetal Outcomes of HIV/Aids Patients at Hasan Sadikin General Hospital

Introduction: The increasing number of HIV/AIDS incidence over time begins to become global problems. One of the current concerns is the morbidity and mortality rates in the fetal outcomes patients with HIV/AIDS who can provide many complications. The importance of adequate pre-and antenatal care may help to reduce morbidity and mortality due to this condition. The purpose of this study is to determine incidence and morbidity of mother with HIV/AIDS and fetal outcomes after delivery in Hasan Sadikin General Hospital from 2011 to 2015. Method: With descriptive study, we use secondary data from medical record on Obstetrics and Gynecology Department. Results of fetal outcomes obtained from medical record on Perinatology Department and the management of HIV/AIDS in married couples and fetal after delivery was obtained from medical record on Teratai Clinic, Hasan Sadikin General Hospital. Results: The incidence of mother with HIV/AIDS who gave birth at Hasan Sadikin General Hospital from 2011 to 2015 tends to increase every year with the number of percentage is 0.06%, 0.29%, 0.24%, 0.72%, and 0.38% from total deliveries, respectively. Fetal outcomes vary from preterm labour 19.57%, low birth weight baby 15.22%, asphyxia 13.04%, small for gestational age (SGA) 4.35%, and early fetal death 2.17%. Conclusion: Incidence of delivery with HIV/AIDS tends to increase every year. Preterm labor has the highest morbidity on fetal outcomes.

COMPARATIVE EFFECTIVENESS OF TWO SCHEDULES OF GYNESTRIL ADMINISTRATION IN TREATMENT OF UTERINE FIBROIDS

Modern options of uterine fibroids pharmacotherapy allow for individual selection of therapy. Aim. To compare the effectiveness of uterine fibroids treatment with administration of mifepristone (Gynestril) on the basis of a differentiated approach to the assignment of two treatment schedules in various dosages: 25 mg or 50 mg per day for three months. Materials and methods. A prospective comparative study was conducted at the clinical bases of Department of Obstetrics and Gynecology with the Course of Perinatology of the Peoples’ Friendship University of Russia (Moscow) and the Department of Obstetrics, Gynecology and Perinatology of the Kuban State Medical University (Krasnodar). 160 women with uterine myoma were enrolled in the clinical groups. Randomization was carried out by a double-blind method using envelopes. Results. Administration of mifepristone (Gynestril) at a dosage of 50 mg per day for 12 weeks and 25 mg per day for 24 weeks has comparable efficacy. Conclusion. Due to the assessment of subjective and objective criteria of drug tolerance, an individual dose selection of mifepristone is possible without compromising the achievement of the therapeutic effect.

PECULIARITIES OF ANAMNESIS AND COMPLICATIONS OF PREGNANCY IN THE I-II TRIMESTERS AND PRETERM BIRTH RISK

Aim. Assess the significance of anamnestic data and complications of gestation in I-II trimesters in predicting PL depending on the gestational age. Materials and methods. A prospective comparative study was carried out at the clinical bases of the Department of Obstetrics, Gynecology and Perinatology of postgraduate education of the Kuban State Medical University (Krasnodar): in the Perinatal Centers of the Children's Regional Clinical Hospital (DKKB) and the Regional Clinical Hospital No. 2 (KKB No. 2). The perinatal center of theRegionalClinicalHospital "DKKB" (Krasnodar) is specialized in premature birth in theKrasnodarTerritory. Women with preterm labor (ICD code-O60) included in the study were divided into four groups included depending on the gestational age: very early premature births (22-276days, n = 37 women), early premature births (28-306 days) weeks, n = 40 women), premature birth (30-336 days, n = 38 women), late premature birth (33-366 days, n = 35 women). The control group consisted of conditionally healthy women with a full term of pregnancy and with physiological births (37- 403 days of weeks, n = 50). Results. The importance of pregnancy complications in I-II trimesters as risk factors for premature birth was established. Prophylaxis, timely diagnosis and treatment of these complications may be a measure of a decrease in the frequency of PL, or an increase in the duration of pregnancy with PL. Conclusion. Prophylaxis, timely diagnosis and treatment of these complications may be a measure of a reduction in the frequency of preterm labor or an increase in the duration of pregnancy in preterm labor.

Relationship between Ultrasonic Marker of Fetal Lung Maturity and Lamellar Body Count

BackgroundThe aim of this study was prediction the fetal lung maturity by ultrasonic markers and comparison by lamellar body count and fetal outcome. MethodsA prospective Longitudinal study Department of perinatology of performed Emam Khomeini hospital and Mirza Kochak Khan Hospital in Tehran, Iran from March 2013 to January 2014. 100 pregnant women (37-40 weeks of gestation) who were admitted for elective cesarean section and referred for an obstetric ultrasound scan at the same day of their elective cesarean section were included. Scanning with linear ultrasound with convex transducer frequency of 3.5 MHZ was utilized to measure the biparietal diameter, Amniotic fluid vernix and placental grading. Statistical analysis was performed using Spss version 20. Validity of the indicators compared with lamellar body count and fetal outcome. ResultsIn this study, from 100 patients under study, 8 cases were hospitalized in NICU (neonatal intensive care unit) which all of them had LAMELAR BODY COUNT < 14000 (10000-14000). There were 6 boys and 2 girls. In this study, there was no perinatal mortality. ConclusionsIn study we used ultrasonic marker of fetal lung maturity and related this to lamellar body count and neo natal outcome. The ultrasonic marker of fetal lung maturity can reduce mortality and morbidity in neonate.

Uporaba zdravil in dojenje v poporodnem obdobju v Sloveniji

Background: To date there are no known data about the use and administration of medicine in the postpartum period in Slovenia.Methods: We included 1,070 women after they gave birth in a prospective cross-sectional study while they were routinely admitted to the Maternal and Neonatal Unit of the Department of Perinatology at the University Medical Centre Ljubljana’s, from October 2011 to February 2012. Data were collected through written questionnaires and finally statistically analysed. The same questionnaires were given at time points of 3, 6, and 12 months after giving birth.Results: Three days after giving birth 96.5% of women were breastfeeding fully or partially. The most commonly used medications during this period were analgetics, laxatives and iron supplements. In the period of up to 3 months after giving birth, 84.0% of women were breastfeeding fully or partially, whereas the number decreased to 72.4% in the period from 3 to 6 months after giving birth. Analgetics, vitamins and/or minerals and folic acid supplements were the most used medications in both periods. From 6 to 12 months after giving birth 51.5% of women were breastfeeding. Vaginally administered antimycotics were most commonly used medicines in this time period in addition to analgetics, vitamins and/or mineral supplements.Conclusions: No significant difference could be determined in the frequency of medicine use in all three time periods after giving birth between both groups of breastfeeding and non-breastfeeding mothers. Moreover, no difference could be observed in the frequency of medicine use between the fully and partially breastfeeding mothers. This study has also shown that the most frequent used medicinal substances were folic acid, vitamins and/or minerals, analgetics, and antimycotics in the form of vaginal tablets.

Can We Determine The Time Elapsed Until The Birth In Preterm Premature Rupture Of Membranes (Pprom) And Preterm Labor (Pte) ? [Preterm Prematur Erken Membran Rupturu (Pprom) Ve Preterm Eylem (Pte)'De Doguma Kadar Gecen Sureyi Belirleyebilir Miyiz?

We aimed to determined; affect of clinical, laboratory, and ultrasonographic factors the time elapsed until the birth in midtrimester PPROM and PTE. Total 448 PPROM and PTE patients were conceived which applicant the Perinatology Department of zekai Tahir Burak Women's Health Education And Research Hospital between 2012-2014 years. PPROM group consisted of 237 patients, PTE group consisted of 211 patients. PPROM and PTE groups were divided into subgroups as cervical culture positive and negative PPROM and PTE groups. Risk factors of until the time of birth was determined by multivariate regression analysis in cervical culture positive PPROM and PTE groups. Cervical length measured by TVUSG=0,907, 95% Cl = 0,823-0,999 (p=0,047) and amniotic fluid index (or= 0,962, 95% Cl= 0,946-0,980 (p

Analysis of the validity of assumptions underlying a research on the heritability of quantitative traits.

Heritability is a statistical measure, expressing the proportion of phenotypic variance that is explained by the genetic variance. Heritability of a given trait can vary in time and may differ between populations, which is inter alia associated with interactions and correlations between genotype and environment or population-specific differences. Therefore, heritability measures are modulated by both genetic and environmental factors. Twin studies constitute one of the methods used to determine contributions of genes and environment to a given trait. However, studies of this type suffer from some methodological limitations and require certain conditions to be satisfied; both these factors were analyzed in the present study. The studied material, including 1,263 pairs of male and female twins (among them 424 pairs of monozygotic twins and 839 pairs of dizygotic twins), born between the 22nd and 41st week of gestation, was collected at the Department of Perinatology and Gynecology, Poznan University of Medical Sciences, between 2002 and 2009. We analyzed the variance of six somatic traits. The contribution of genetic factors to the phenotypic variance of the studied twin population was estimated on the basis of the two heritability measures. Failure to meet the assumption of additivity of genetic and environmental effects probably is the cause of high values of heritability coefficients documented in our study. Analyzing the phenotypic variance of a trait, one cannot ignore the role of genotype-environment interactions and covariance, as these are their effects which increase the genetic variance and related coefficients of heritability. Therefore, it can be concluded that the genotypic component of the phenotypic variance of the trait is potentiated by the effects of various environmental factors. Our study confirmed that the critical remarks regarding the methodology of heritability estimation are fully justified. Consequently, the heritability indices of somatic traits should be considered only a provisional measure of genetic polymorphism, expressing an estimated relative contribution of genotypic variance to the phenotypic variance of a given trait.

Interleukin-6 and C-reactive protein levels in the amniotic fluid as indicators of preterm delivery in Turkish women

Objective: The aim of this study was to determine the value of amniotic fluid interleukin-6 (IL-6) and C-reactive protein (CRP) levels in the prediction of preterm delivery in singleton pregnancies without any known risk factors for preterm delivery in Turkish women. Materials and Methods: Patients in the present perinatology department who underwent mid-trimester genetic amniocentesis due to evidence of increased risk of aneuploidy in their prenatal serum screening tests were included in the study. A sample of amniotic fluid from each patient was assessed for IL-6 and CRP. Concentrations of IL-6 and CRP in the amniotic fluid of preterm delivery and term delivery groups were compared. Results: Of 151 singleton pregnancies, 142 participants were included in the study. The participants were assigned to either the preterm or term delivery group based on pregnancy outcome. IL-6 levels in the amniotic fluid were significantly higher in the preterm delivery group, and there was a statistically significant negative correlation between IL-6 concentrations in the amniotic fluid and gestational age at delivery (correlation coefficient (CC): -18.5%, p p = 0.068). Conclusion: Measuring IL-6 in the amniotic fluid can identify women at risk of preterm delivery. Because it is not acceptable to perform amniocentesis for this screening, it is more convenient for patients in whom genetic amniocentesis is performed.