Browsing by Author "Pala, HG"

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    Pregnancy rhinitis in Turkish women: Do gestational week, BMI and parity affect nasal congestion?
    Ulkumen, B; Ulkumen, BA; Pala, HG; Celik, O; Sahin, N; Karaca, G; Demirdag, M
    Objective: To determine the cumulative incidence of pregnancy rhinitis along with prevalence in different trimesters and to find out whether gestational age, BMI and parity have any effect on pregnancy related nasal congestion. Methods: In the prospective protocol at the obstetrics outpatient clinic, 167 pregnant women were enrolled consecutively. According to exclusion criteria, 67 of them were excluded. Visual-Analogue-Scale (VAS), Nasal-Obstructive-Symptom-Evaluation (NOSE) scale and Discharge-Inflammation-Polyps/Oedema (DIP) scoring were utilized for diagnosis of pregnancy rhinitis. Besides, weight, length, age, parity and week of pregnancy were recorded. Results: Total prevalence of pregnancy rhinitis was 17.17% and cumulative incidence was 38.89%. Our study revealed significant relation of NOSE score with both gestational week (r=0.474, p=0.001) and BMI (r=0.301, p=0.003). VAS score was significantly related with gestational week (r=0.409, p=0.001) and BMI (r=0.270, p=0.007). DIP score was found to be correlated only with gestational week (r=0.375, p=0.001). Conclusion: Cumulative incidence of pregnancy rhinitis was 38.89%. Nasal congestion was significantly associated with BMI and gestational week. Patients should be informed about unfavorable fetal and maternal outcomes of pregnancy related nasal congestion which is triggered by obesity and excessive weight gain in pregnancy.
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    De novo Reciprocal Translocation t(5;11)(q22;p15) Associated with Hydrops Fetalis (Reciprocal Translocation and Hydrops Fetalis)
    Pala, HG; Artunc-Ulkumen, B; Uyar, Y; Bal, F; Baytur, YB; Koyuncu, FM
    Objective: This is a case of a prenatally diagnosed non-immune hydrops fetalis (NIHF) associated with translocation t(5;11)(q22;p15). An association between NIHF and this translocation has not been reported previously. Case Report: The patient was referred to the perinatology clinic with hydrops fetalis diagnosis at 23 weeks' gestation. We noted that the fetus had bilateral pleural effusion, ascites, widespread subcutaneous edema, membranous ventricular septal defect, hypoplastic fifth finger middle phalanx, clinodactyly, single umbilical artery. We performed cordocentesis. Chromosomal analysis on blood showed a balanced translocation between the long arm of chromosome 5 and the short arm of chromosome 11 with karyotype of 46,XX,t(5;11)(q22;p15). Conclusion: We present prenatal diagnosis of a de novo translocation (5;11) in a hydropic fetus with ultrason abnormalities. In our case, karyotype analysis of the fetus, mother and father provided evidence of a de novo translocation, that might explain the NIHF.
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    Impact of Pregnancy and Glucocorticoid Treatment on NF-kB and MUC5AC in Mucosa of Rat Larynx
    Ulkumen, B; Ulkumen, BA; Batir, MB; Pala, HG; Vatansever, S; Cam, S
    Objective. The aim of this study is to reveal physiological expression and distribution of nuclear factor-kappa B (NF-kappa B) and MUC 5 subtype AC (MUC5AC) in rat laryngeal mucosa and to find out the effect of pregnancy and glucocorticoid treatment on these biomolecules. Methods. This animal experiment was done in Experimental Animals Research and Application Center of Manisa Celal Bayar University in accordance with the accepted policy on the use of animals. A total of 30 young, adult Wister albino female rats were randomized into a control group (group A), a pregnant group (group B), and a steroid administered group (group C). Sacrification was done by injection of sodium-pentobarbitone (400 mg/kg) solution via intraperitoneal route in all groups. Serum estradiole (E2) and progesterone (PG) were determined by enzyme-linked immunosorbent assay. The relative expression and distribution of NF-kappa B and MUC5AC in laryngeal mucosa was studied both by immunohistochemistry (IHC) and polymerase chain reaction testing. Expression and immunohistochemical localization of NF-kappa B and MUC5AC was evaluated by light microscopy (Olympus BX41). In statistical analyses; relative expression of NF-kappa B and MUC5AC were compared on group basis. The effect of E2 and PG levels on these biomolecules was also evaluated. Results. NF-kappa B was found to be significantly low both in group B (P < 0.05) and C (P < 0.001) when compared with group A, while MUC5AC was found to be significantly high both in group B (P < 0.05) and group C (P < 0.05) when compared with group A. Concerning IHC; NF-B-k was found to be expressed in epithelium and lamina propria. MUC5AC was found to be expressed particularly in the epithelial layer in all groups. Statistically significant negative correlation between PG and NF-kappa B expression (P = 0.048), but no correlation between PG and MUC5AC expression (P = 0.487) were revealed. On the other hand, no correlation was found between E2 and the expression of relevant biomolecules (NF-kappa B [P = 0.270], MUC5AC [P = 0.829]). We also did found a significant negative correlation between the expression of NF-kappa B andMUC5AC(P = 0.031). Conclusions. In this study, the physiological expression of NF-kappa B and MUC5AC in rat laryngeal mucosa was shown for the first time both by polymerase chain reaction and IHC. The impact of pregnancy and glucocorticoid treatment on the expression and distribution of these biomolecules was also revealed. The expression of NF-kappa B was found to be decreased while the expression of MUC5AC was found to be increased both by pregnancy and glucocorticoid treatment. The inhibitory effect of serum PG on NF-kappa B expression in rat laryngeal mucosa was also shown for the first time. The expression of MUC5AC was found to be increased both in pregnant and glucocorticoid administered group. Negative correlation between NF-kappa B and MUC5AC expression was also revealed in rat larynx for the first time. These findings may partially unclose the histochemical background of voice changes caused by pregnancy and as well as by glucocorticoid treatment.
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    Adiponectin Levels in Gestational Diabetes Mellitus and in Pregnant Women Without Glucose Intolerance
    Pala, HG; Ozalp, Y; Yener, AS; Gerceklioglu, G; Uysal, S; Onvural, A
    Objectives. The aim of the study was to determine serum adiponectin levels among patients with gestational diabetes mellitus (GDM) and normal pregnant women without glucose intolerance, and to investigate the relationship between these levels and clinical factors at the time of the diagnosis, at delivery and in the post-partum period. Material and Methods. The subjects' serum adiponectin concentration was measured using the enzyme-linked immunosorbent assay (ELISA) method at 24th-28th week of gestation, at delivery (in maternal circulation and the umbilical cord) and 24 h after delivery. The relationship between these groups' measurements and other established clinical-laboratory factors were investigated. Results. Serum adiponectin concentrations were significantly lower (p = 0.02) in GDM patients compared with patients with normal glucose tolerance at 24th-28th week of gestation. During delivery, maternal serum adiponectin concentrations were significantly lower (p = 0.03) in GDM patients compared with patients with normal glucose tolerance. In the post-partum period, serum adiponectin concentrations were significantly higher (p = 0.009) in GDM patients compared with patients with normal glucose tolerance. Umbilical cord adiponectin concentrations were significantly lower (p = 0.005) in GDM patients compared with patients with normal glucose tolerance. Conclusions. Adiponectin concentrations in GDM patients' circulation were regulated by changes in glucose and insulin metabolism. A reduction in serum adiponectin levels seems to play a role in GDM patients' insulin resistance
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    Protective effects of dichloroacetic acid on endometrial injury and ovarian reserve in an experimental rat model of diabetes mellitus
    Pala, HG; Pala, EE; Ulkumen, BA; Erbas, O
    Aim To study (1) ovarian and endometrial damage caused by the hyperglycemia and (2) the effects of dichloroacetic acid (DCA) on follicular reserve and endometrial damage in streptozocin induced diabetic rats. Methods This study consisted 24 rats randomly separated into three groups. A diabetes model was achieved in 16 rats experimentally, and normoglycemic eight rats were assigned as control group (Group 1). The rats with diabetes were randomly separated to two groups: 1 mL/kg/day intraperitoneal 0.9% NaCl was given to eight rats as diabetic vehicle (Group 2) and 10 mg/kg/day DCA was given to other eight rats as DCA treated group (Group 3). Hysterectomy with bilateral oophorectomy was performed for histopathological evaluation and blood samples were collected after 4 weeks. Results Diabetes caused ovarian and endometrial damage (p < 0.0001). Pentraxin-3 (PTX-3), lactic acid, and transforming growth factor-beta (TGF-beta) were higher (p < 0.05, p < 0.05, and p < 0.0001, respectively), whereas anti-Mullerian hormone (AMH) was lower in diabetic rats (p < 0.05). These findings reflected the diabetic damage in the genital tract and diminished ovarian reserve occurred via fibrosis, severe inflammation, and oxidative stress. DCA improved the histopathological fibrosis and degeneration in the ovaries and endometrium (p < 0.05). There was a concominant decrease of TGF-beta and lactic acid levels with DCA treatment (p < 0.05). DCA also improved ovarian reserve with higher AMH levels (p < 0.05). Conclusions The several unfavored changes in the endometrium and ovaries due to diabetes have been determined in this present study. DCA might provide the continuity of the endometrial cycle, physiological endometrial structure, ovarian follicular growth, oocyte maturation, and physiological ovarian function by decreasing the lactate levels via inhibiting pyruvate dehydrogenase kinase enzyme.
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    Three-dimensional placental volume and mean grey value: Normal ranges in a Turkish population and correlation with maternal serum biochemistry and Doppler parameters
    Pala, HG; Ulkumen, BA; Uyar, Y; Koyuncu, FM; Baytur, YB
    The aim of this study is to evaluate the relationship between three-dimensional (3D) ultrasound measurements of placenta at 11-13(6) weeks' gestation and maternal serum levels of pregnancy associated plasma protein-A (PAPP-A), free beta human chorionic gonadotrophin (f beta hCG), Doppler parameters in early pregnancy. This prospective study consisted of 334 singleton pregnancies at 11-13(6) weeks' gestation. Placental volume and placental volumetric mean grey values were evaluated. The placental volume (cm(3)) was analysed using the Virtual Organ Computer-aided AnaLysis (VOCAL) imaging program and 3D histogram was used to calculate the volumetric mean grey value (%). Mean maternal age was 28.35 +/- 7.55. Mean gestational age was 12.29 +/- 0.68 weeks. Placental volume was 77.04 +/- 35.74 cm(3). Mean grey value of the placenta was 34.38 +/- 8.02%. Correlation analysis revealed that placental volume was significantly correlated with the crown-rump length (r = 0.173, p = 0.002), gestational week (r = 0.116, p = 0.036), ductus venosus pulsatility index (r = -0.101, p = 0.04) and maternal weight (r = 0.099, p = 0.037). There was a significant relation between the mean grey value of the placenta and maternal age (r = 0.131, p = 0.02), nuchal translucency (r = -0.109, p = 0.048), PAPP-A (r = 0.108, p = 0.04) and f beta hCG (r = 0.104, p = 0.042). Volumetry of the placenta can be carried out with a high percentage of 1st trimester pregnancies. Volumetry during the 1st trimester could be helpful because of the less advanced state of placentation. This examination is easy to perform and the measurements can be acquired correctly and quickly.
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    Normal ranges of biorbital and interorbital distances in healthy Turkish pregnancies at 19-23 weeks of gestation and correlation with craniofacial structures
    Pala, HG; Artunç-Ülkümen, B; Koyuncu, FM; Uyar, Y; Bülbül-Baytur, Y
    Objective: We aimed to determine the normal ranges for biorbital (BOD) and interorbital distances (IOD) during the second trimester in Turkish women with normal pregnancies and to assess the correlation between BOD, IOD, and other fetal craniofacial structures and biometric parameters. Material and Methods: Our retrospective study comprised 1328 women with singleton normal pregnancies who had undergone ultrasonography (USG) examinations at 19-23 weeks of gestation in the second trimester screening. The measurements of BOD and IOD were obtained with the coronal section of the fetal face at the plane of orbits. Results: Mean BOD was 3.4 +/- 0.33 cm, whereas mean IOD was 1.28 +/- 0.24 cm. Correlation analysis revealed that BOD was significantly correlated with IOD, transcerebellar diameter (TCD), cisterna manga (CM), nuchal fold (NF), nasal bone (NB), biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), femur length (FL), and gestational week. There was a significant relation between IOD and the lateral ventricle posterior horn, TCD, CM, NF, NB, BPD, HC, AC, and FL. Conclusion: The reference ranges obtained in our study enabled accurate evaluation of BOD and IOD in the second trimester of normal pregnancies. USG detection of fetal orbital biometric anomalies may alert the clinician for different anomalies associated with abnormal development of eye.
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    Can mean platelet volume and platelet distrubition width be possible markers for ectopic pregnancy and tubal rupture?
    Ulkumen, BA; Pala, HG; Calik, E; Koltan, SO
    Objective: We aimed to evaluate the alterations in serum levels of platelet indices such as mean platelet volume (MPV) and platelet distribution width (PDW) in ectopic pregnancy (EP) and discuss the mechanism of the alterations in MPV and PDW. Methods: This retrospective evaluation of 153 tubal EP patients (39 ruptured and 114 non-ruptured) admitted to our clinic between 2009 and 2013 and 67 healthy pregnancies was conducted. The data regarding the maternal age, hemoglobin level, platelet level, MPV, PDW was analyzed. Results: MPV was lower in the EP, especially in ruptured EP, compared to control group. However, no significant difference could be found between the groups (p=0.616). PDW was higher in the EP, especially in ruptured EP, compared to control group, however there was no statistical difference between the three groups (p=0.451). Platelet counts were significantly lower in ruptured EP compared to non-ruptured ectopic pregnancies and control groups (p=0.005). Conclusions: MPV seems to be lower in ruptured EP suggesting the possible high grade inflammation in pathology. Platelet counts tend to be lower in ruptured EP suggesting the consumption of the platelets at the inflammation site. However, further studies are needed to describe the usefulness of the platelet indices in the diagnosis and clinical follow-up of ER Our preliminary results show that MPV levels may decrease in the ruptured EP cases. At the same time, PDW levels may increase.
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    Ductus venosus doppler flow velocity after transplacental and non-transplacental amniocentesis during midtrimester
    Ulkumen, BA; Pala, HG; Baytur, YB; Koyuncu, FM
    Objective: We aimed to evaluate ductus venosus Doppler waveforms before and after amniocentesis in order to investigate any effect of amniocentesis on fetal myocardial hemodynamics. We also evaluated the umbilical artery, uterine artery and fetal mid-cerebral artery Doppler waveforms in order to investigate any relationship with ductus venosus Doppler changes. Methods: The study population consisted of 56 singleton pregnancies having genetic amniocentesis. Twenty seven of them had transplacental needle insertion; whereas 29 of them had non-transplacental amniocentesis. Uterine artery, umbilical artery, mid-cerebral artery and ductus venosus pulsatiliy index and resistance index were measured just before and after amniocentesis. Results: Amniocentesis does not cause any significant changes in fetal ductus venosus Doppler waveforms. There is also no significant changes in uterine artery, umbilical artery, mid-cerebral artery pulsatility and resistance index. Conclusion: Amniocentesis-whether transplacental or not- does not cause any significant effect on fetal myocardial hemodynamics.
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    Outcomes and management strategies in pregnancies with early onset oligohydramnios
    Ulkumen, BA; Pala, HG; Baytur, YB; Koyuncu, FM
    Objective: To evaluate the outcomes and management options in pregnancies with early onset oligohydramnios. Materials and Methods: The file datas of all pregnancies diagnosed as oligohydramnios or anhydramnios before 27 gestational weeks between January 2006 and September 2013 were evaluated retrospectively. The underlying pathology and associated anomalies, karyotype analysis, the outcome of the pregnancy (either termination or labour), and gestational week at the time of diagnosis were analyzed. Results: A total of 54 pregnancies were evaluated; mean gestational week at the time of the diagnosis was 19.8 +/- 4.6. Mean maternal age was 27.28 +/- 6.03. Thirty-seven pregnancies were anhydramniotic, 13 fetuses had associated anomalies, five of them had multicyctic dysplastic kidney, five had bilateral renal agenesis, one had hypoplastic right heart syndrome, one had clubfoot, and one had ventricular septal defect and cleft palate. Karyotyping was normal regarding the fetuses with structural anomalies. Nineteen patients had premature preterm rupture of membranes and 39 patients had termination of pregnancy. Conclusion: The prognosis of early onset oligohydramnios is poor. Main determinant is gestational week at the time of the diagnosis.
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    Three-dimensional ultrasonographic placental volume in gestational diabetes mellitus
    Pala, HG; Artunc-Ulkumen, B; Koyuncu, FM; Bulbul-Baytur, Y
    Objectives: We aimed to evaluate the placental volume and placental mean gray value in gestational diabetes mellitus (GDM) and healthy placentas using three-dimensional (3D) ultrasound and Virtual Organ Computer-aided AnaLysis (VOCAL).Methods: This case-control prospective study consisted of 39 singleton pregnancies complicated by GDM and 42 healthy singleton pregnancies matched for gestational age, maternal age and parity. Placental volume and placental volumetric mean gray values were evaluated. The placental volume (cm(3)) was analyzed using the VOCAL imaging analysis program and 3D histogram was used to calculate the volumetric mean gray value (%).Results: Placental volume was significantly larger in GDM (411.59170.82 versus 343.86 +/- 128.94cm(3); p=0.046). There was no significant difference in mean gray value between GDM and healthy placentas (36.65 +/- 7.02 versus 38.71 +/- 7.91, respectively; p=0.277). Placental volume was significantly correlated with gestational week (r=0.219, p=0.035) and parity (r=0.228, p=0.048). There was negative significant relation between placental volume and umbilical artery systolic/diastolic ratio, pulsatility index and resistance index (r=-0.278, p=0.007; r=-0.315, p=0.002; r=-0.322, p=0.001, respectively).Conclusions: Placental volume increases significantly in GDM, whereas mean gray values do not alter significantly. These data may reflect the placental changes in GDM placentas that may help to understand the pathophysiology better.
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    The assessment of placental volume and mean gray value in preeclamptic placentas by using three-dimensional ultrasonography
    Ulkumen, BA; Pala, HG; Uyar, Y; Koyuncu, FM; Baytur, YB
    Objectives: We aimed to evaluate the placental volume and placental mean gray value in preeclampsia and healthy placentas by using three-dimensional (3D) ultrasonography and Virtual Organ Computer-aided AnaLysis (VOCAL). Methods: This case-control prospective study consisted of 27 singleton pregnancies complicated by preeclampsia and 54 healthy singleton pregnancies matched for gestational age, maternal age and parity. Placental volume and placental volumetric mean gray values were evaluated. The placental volume (cm(3)) was analyzed using the VOCAL imaging program, and 3D histogram was used to calculate the volumetric mean gray value (%). Results: Preeclamptic and control group consisted of 27 (mean age: 28.90 +/- 5.95 years, mean gestation: 32.0 +/- 4.55 weeks) and 54 (mean age: 29.48 +/- 5.78 years, mean gestation: 32.61 +/- 4.23 weeks) singleton pregnancies, respectively. Placental volume was significantly smaller in preeclampsia (250.62 +/- 91.69 versus 370.98 +/- 167.82 cm(3); p = 0.001). Volumetric mean gray value of the placenta was significantly higher in preeclampsia (38.24 +/- 8.41 versus 33.50 +/- 8.90%; p = 0.043). Placental volume was significantly correlated with the estimated fetal weight (r = 0.319; p = 0.003). There was negative significant relation between placental volume and umbilical artery pulsatility index, resistance index and systolic/diastolic ratio (r = -0.244, p = 0.024; r = -0.283, p = 0.005; r = -0.241, p = 0.024, respectively). Conclusions: Placental volume diminishes significantly in preeclampsia, whereas volumetric mean gray values increases. This may reflect the early alterations in preeclamptic placentas, which may help to understand the pathophysiology better.
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    The effect of parity on first trimester uterine artery Doppler waveforms in low-risk singleton pregnancies
    Ulkumen, BA; Pala, HG; Uyar, Y; Baytur, YB; Koyuncu, FM
    Objectives: The aim of the study was to evaluate the effect of parity on uteroplacental blood flow during the first trimester in low-risk singleton pregnancies. Materials and methods: Uterine artery Doppler examinations were performed in 190 singleton pregnancies between 11-14 gestational weeks. Twenty-five pregnancies were excluded from the study due to history of preeclampsia, diabetes mellitus or inherited thrombophilia. A total of 165 low-risk singleton pregnancies were included in the study. Mean uterine artery pulsatility index (PI) was recorded and compared between nulliparous and multiparous women. The relation between maternal age, gestational week, maternal weight, parity, biochemical markers and abnormal uterine artery Doppler flows was evaluated. T-test and logistic regression analyses were used for the statistical analysis. Results: A total of 165 singleton pregnancies without any risk factors for uteroplacental insufficiency were included in the study. Of them, 58 (36.7%) were nulliparous and 107 (63.3%) were parous. Correlation analysis revealed that the uterine artery pulsatility indices during the first trimester were not affected by maternal age and parity. Conclusions: Mean uterine artery pulsatility indices are not different in nulliparous and multiparous low risk pregnancies at 11-14 weeks of gestation.
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    Acute abdomen and massive hemorrhage due to placenta percreta leading to spontaneous uterine rupture in the second trimester
    Ulkumen, BA; Pala, HG; Baytur, Y
    Placental invasion anomalies are rare obstetrical complications. They cause severe third trimester hemorrhage, severe postpartum bleeding, and maternal morbidity and mortality unless they are diagnosed antenatally. We present a rare case with placenta percreta leading to spontaneous uterine rupture during the second trimester with an acute abdomen and hypovolemia.
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    The alteration in placental volume and placental mean grey value in growth-restricted pregnancies assessed by 3D ultrasound
    Ulkumen, BA; Pala, HG; Uyar, Y; Koyuncu, FM; Baytur, YB
    We aimed to evaluate the volumetric and echogenic alterations in placentas between the intrauterine growth restriction (IUGR) and normal pregnancies using three-dimensional ultrasound and virtual organ computer-aided analysis (VOCAL) software. This case-control prospective study consisted of 48 singleton pregnancies complicated by IUGR and 60 healthy singleton pregnancies matched for maternal age, gestational age and parity. Placental volume (PV) and placental volumetric mean grey values (MGV) were evaluated. PV (cm(3)) was analysed using the VOCAL imaging analysis program, and 3D histogram was used to calculate the volumetric MGV (%). PV was 278.50 +/- 63.68 and 370.98 +/- 97.82 cm(3) in IUGR and control groups, respectively (p = 0.004). MGV of the placenta was 38.24 +/- 8.41 and 38.24 +/- 8.41 in IUGR and control groups, respectively (p = 0.30). receiver operator curve (ROC) curve analysis revealed that area under curve was 0.731 for PV. Correlation analysis revealed that PV was significantly associated with estimated fetal weight (r = 0.319, p = 0.003), biparietal diameter (r = 0.346, p = 0.002), head circumference (r = 0.269, p = 0.019), abdominal circumference (r = 0.344, p = 0.002) and femur length (r = 0.328, p = 0.004). PV was inversely related to the umbilical artery pulsatility index (r = - 0.244, p = 0.017). To the best of our knowledge, this is the first study evaluating volumetric MGV in IUGR placentas by comparing them with healthy pregnancies. Our study showed that PV diminishes significantly in IUGR pregnancies, whereas volumetric MGV does not alter significantly.
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    Normal range of intracranial translucency in healthy turkish pregnancies and its association with first trimester maternal serum biochemistry and ductus venosus Pulsatility Index
    Artunc-Ulkumen, B; Pala, HG; Uyar, Y; Bulbul-Baytur, Y; Koyuncu, FM
    Objective: To measure the intracranial translucency (IT) by establishing reference ranges in uncomplicated single ton Turkish pregnancies and to evaluate the association of IT with maternal serum biochemistry, gestational week, crown-rump length (CRL) measurement, nuchal translucency (NT) and ductus venosus Doppler velocimetry. Materials and methods: 190 uncomplicated singleton pregnancies were included in the study. IT, NT and CRL measurements between 11-14 gestational weeks were obtained with mid-sagittal plane. Two independent measurements were taken and averaged to obtain the final measurement used in the calculations. Statistical analysis was performed with SPSS for Windows 20.0 software package. Correlation analysis was used to determine the association between IT and NT, pregnancy-associated plasma protein-A (PAPP-A), free beta-human chorionic gonadotropin (f beta-hCG) and CRL length. A p-value of <0.05 was considered statistically significant. Results: The assessment rate of IT was 167/190 (87.89%). The mean CRL length, gestational week, NT and IT measurements were 63.63 +/- 10.05 mm, 12.28 +/- 0.75 weeks, 1.23 +/- 0.43 mm (range: 0.20-2.68) and 2,29 +/- 0,49 mm (range: 0.18-3.80), respectively. There was no significant correlation between IT and maternal serum PAPP-A MoM (r=-0.34, p=0.698) or maternal serum free beta-hCG MoM (r=-0.79, p=0.363), respectively. There was weak-but statistically significant correlation between IT with with maternal weight (r=0.172, p=0.047), CRL length (r=0.301, p<0.001), gestational week (r=0.286, p=0.001) and NT measurement (r=0.224, p=0.007), respectively. There was no significant association between IT with ductus venosus doppler pulsatility index (r=0.108, p=0.213). Conclusion: IT can be easily measured while scanning for NT. This study shows normal range values in healthy Turkish pregnancies. Consistent with recent data, our results show positive correlation with gestational week and CRL length. Maternal serum biochemistry does not have any effect on IT. Besides, our study highlights that IT is correlated with NT and adds newly to the literature that there is no correlation of IT with ductus venosus pulsatility index.
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    Maternal serum ADAMTS-9 levels in gestational diabetes: a pilot study
    Artunc-Ulkumen, B; Ulucay, S; Pala, HG; Cam, S
    Objective: Gestational diabetes mellitus (GDM) is characterized with insulin resistance which is diagnosed during pregnancy. Although pregnancy is a diabetogenic state, not all women develop GDM. Genetic factors together with enviromental factors cause the maladaptation of maternal pancreas to this diabetogenic state and GDM develops. ADAMTS-9 is a recently recognized molecule whose genetic variants have risk of GDM. Decreased levels have already been shown in fetal membranes. Maternal serum levels of this protein have not been studied yet. We hypothesized that the alteration of ADAMTS-9 expression should cause changes in maternal serum levels which further could help to identify the disease and develop new treatment strategies.Materials and methods: This prospective case-control study is consisted of 27 pregnancies with GDM and 30 healthy singleton pregnancies matched for matenal age, gestational week, and maternal weight. GDM diagnosis was made with 2-h 75g oral glucose tolerance test. ADAMTS-9 levels were compared between groups.Results: ADAMTS levels were 3.620.33ng/dL (range: 3.04-4.23) in GDM group and 4.65 +/- 1.70ng/dL (range: 3.07-8.21) in control group (p<0.001). ADAMTS levels were not affected by maternal age, gestational age, and maternal weight.Conclusion: ADAMTS-9 levels were significantly lower in GDM pregnancies. This may help to understand the mechanism of GDM pathogenesis. In future, target treatments with ADAMTS proteins may help to improve the severity of diabetes pathogenesis.
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