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ABSTRACT: Background. The aim of this study was to measure the circulating levels of androgens in the third trimester of pregnancy and six weeks after delivery and to discuss androgen contribution in the pathogenesis of preeclampsia.Methods. Twenty-two preeclamptic and 20 normotensive women completed this prospective study. Blood samples were drawn in the third trimester (28–32 gestational weeks) and six weeks after delivery. Serum total testosterone (T), free testosterone (fT) dehydroepiandrosterone sulfate (DHEAS), androstenodione (A), sex hormone binding globulin (SHBG) and estradiol (E2) levels were measured. The statistical analyses of the data were performed by using Wilcoxon Rank test within the groups, Student unpaired t test and Chi-square test between the groups with the SPSS program.Results. T and fT levels were found to be significantly higher (p<0.05) in preeclamptic women in the third trimester compared to the values of normotensive controls. However, there were significant decreases (p<0.05) in T and fT levels six weeks after delivery, reaching values not significantly different from normotensive subjects (p>0.05). Futhermore, SHBG, DHEAS, A and E2 levels were not significantly different (p>0.05) between the groups in the third trimester or six weeks after delivery.Conclusion. We conclude that higher blood androgen levels measured in preeclamptic patients may be implicated in the pathogenesis of preeclampsia.
Acta Obstetricia Et Gynecologica Scandinavica 06/2008; 80(11):1009 - 1013. · 1.77 Impact Factor
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ABSTRACT: Isolated fallopian tube torsion during pregnancy is a rare condition, and only 16 cases have been reported. In all but 1 case the right tube was affected. We report the second case of isolated left fallopian tube torsion during pregnancy.
A 23-year-old primigravida presented at 22 weeks of gestation with left lower abdominal pain. Sonography depicted a simple cystic mass adjacent to the left uterine border. Laparotomy revealed torsion of the left hydrosalpinx together with a paraovarian cyst. The patient delivered a healthy infant at term after an otherwise-uneventful pregnancy.
As the gravid uterus increases the risk for fallopian tube torsion, this condition should be included in the differential diagnosis of lower abdominal pain during pregnancy.
The Journal of reproductive medicine 09/2007; 52(8):745-7. · 0.87 Impact Factor
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ABSTRACT: Our main aim was to investigate the effects of melatonin (ME), possibly the most powerful free-radical scavenger, on the prevention of i.p. adhesion formation in rat uterine horn. Our secondary aim was to determine whether different methods of administration of ME were beneficial.
Animals were randomly assigned into seven groups, each consisting of 13 rats. Measured serosal injury was created using a standard technique. While control and two sham groups were not given ME, two of the remaining four groups were given a single dose of 10 mg/kg (2 mg) of ME i.p. immediately after injury and 30 min prior to injury respectively. In the two other groups, ME treatment was continued daily for 5 days. All animals were killed 2 weeks after surgery and adhesions were determined and scored by a examiner blinded to the test.
The extent, severity and total scores of adhesion were found to be significantly reduced in all of the ME treatment groups when compared with control and sham groups. There were no statistically significant differences between the treatment groups.
This study showed that even single dose ME therapy was effective in the prevention of post- operative i.p. adhesion formation.
Human Reproduction 09/2003; 18(8):1703-6. · 4.47 Impact Factor
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ABSTRACT: We aimed to determine the value of maternal erythrocyte malondialdehyde levels in the prediction of preeclampsia. 110 healthy women were included in this prospective study. Maternal erythrocyte malondialdehyde levels were measured at each trimester of pregnancy (10-14, 20-25 and 30-35 gestational weeks). On follow-up, patients were assigned to two groups as normotensive women and preeclamptic patients. Preeclampsia had developed in eight (8.9%) of the 90 pregnant women who completed the study. Preeclamptic patients were diagnosed between 36 and 39 gestational weeks (36.8 +/- 1.0 weeks). Malondialdehyde levels of preeclamptic patients increased significantly in the third trimester (p < 0.05), while there was no difference between values of malondialdehyde in the first and second trimester. Malondialdehyde levels were significantly higher in the patients who developed preeclampsia than in those who did not in the third trimester (p < 0.05). With the use of the receiver operating characteristics (ROC) 35.98 nmol malondialdehyde/gm hemoglobin was found to be a cut-off value predictive for the development of preeclampsia in the third trimester. However, cut-off values in the first and second trimesters could not be found. The sensitivity, specificity, positive and negative predictive values were 89, 75, 29 and 98%, respectively. Preeclampsia risk was found to increase nearly 24 times in values above 35.98 nmol malondialdehyde/ gm hemoglobin. Our results showed that maternal erythrocyte malondialdehyde could predict patients within a few weeks prior to onset of clinical symptoms of preeclampsia in the third trimester. There is no evidence of enhanced early lipid peroxidation in pregnancies with late onset preeclampsia.
Journal of Perinatal Medicine 02/2003; 31(6):469-74. · 1.70 Impact Factor
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ABSTRACT: Endothelin (ET), a vasoactive mediator, like others which originate from the endothelium or circulating cells, may participate in myocardial injury. In full-term neonates of mild pre-eclamptic mothers (NMPM), it identifies minor myocardial damage missed by other biochemical markers. The present study was designed to determine the diagnostic value of ET concentrations in NMPM.
Seventeen NMPM were studied (10 boys and seven girls), and 17 healthy full-term (nine boys and eight girls) were selected for a control group. Birthweights in NMPM and control group were 2950 g (2.300-3.850) and 3.350 g (2.650-4.000), respectively. The ET measured by the radioimmunoassay method, Troponin T (TnT) were measured by enzyme-linked immunosorbent assay method and creatine kinase (CK-MB) determined in chemical 1 analysis.
Serum ET and TnT concentrations in NMPM (3.32 pg/mL vs 0.74 ng/mL) were significantly higher than the control group (0.82 pg/mL vs 0.10 ng/mL) (P < 0.01 and < 0.001).
Our study demonstrated high levels of ET, cardiac TnT in NMPM, presumably associated with myocardial damage in NMPM.
Pediatrics International 04/2002; 44(2):131-3. · 0.63 Impact Factor
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ABSTRACT: Objective: To investigate the relationship between results of maternal thyroid function tests and endothelin levels in preeclamptic or eclamptic women.
Methods: Thyroid hormones, TSH, and endothelin were measured in plasma or serum from 37 proteinuric, preeclamptic or eclamptic women and 20 normotensive, nonlaboring, pregnant women. Subjects were subdivided into four groups according to hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome and birth weights of infants with respect to gestational age.
Results: A significant decrease in concentrations of total thyroxine (T4) (13.76 ± 1.84 μg/dL versus 10.00 ± 1.48 μg/dL, P < .05), total triiodothyronine (T3) (180.58 ± 30.84 ng/dL versus 141.16 ± 27.31 ng/dL, P < .01), free T4 (1.45 ± 0.27 ng/dL versus 1.10 ± 0.21 ng/dL, P < .01) and free T3 (3.32 ± 0.56 pg/mL versus 2.41 ± 0.60 pg/mL, P < .01) and a significant increase in TSH (1.55 ± 0.89 μIU/mL versus 2.96 ± 1.07 μIU/mL, P < .05) and endothelin (2.31 ± 0.61 pg/mL versus 6.11 ± 1.41 pg/mL, P < .001) levels were observed in the preeclamptic-eclamptic group compared with the normotensive group. Also, women without HELLP syndrome and without small-for-gestational-age infants had elevated levels of thyroid hormones and decreased levels of TSH and endothelin compared with other subgroups, but stastical significance was reached only in total T4 (P < .05), TSH (P < .05), and endothelin (P < .001). Birth weights of infants born to preeclamptic or eclamptic women correlated positively with total T4 (P < .01) and total T3 (P < .01) and negatively with TSH (P < .01) levels. A more significant negative correlation was found in preeclamptic-eclamptics (P < .001) between birth weight and endothelin levels than in control subjects (P < .05). Endothelin levels in preeclamptic or eclamptic women correlated negatively with total T4 (P < .01), total T3 (P < .05), free T4 (P < .05), and free T3 (P < .05) and positively with TSH levels (P < .01) compared with control subjects.
Conclusion: Moderate decreases in thyroid hormones with concomitant increases in TSH levels in maternal serum correlated with severity of preeclampsia or eclampsia and high levels of endothelin. Changes in results of thyroid function tests induced by preeclampsia or eclampsia might be consequences of the dysfunction in the hypothalamic-pituitary-thyroid axis, secondary to the disease itself.
Pregnancy is associated with substantial but reversible changes in thyroid function. Although physiologic changes in thyroid function during pregnancy are well documented,1 only a few reports2-4 addressed thyroid function disturbances in preeclampsia and their adverse effects on fetuses, supporting the view that preeclamptic women have increased incidence of hypothyroidism that might correlate with the severity of preeclampsia.
Some authors believe that changes in thyroid function during pregnancy are accounted for by high levels of circulating estrogen,1,5 but the mechanism of hypothyroidism in preeclamptic or eclamptic women has not been identified. There are controversies about the mechanism and clinical significance of low concentrations of thyroid hormones in preeclampsia, which were attributed to decreased plasma protein concentrations.3
Vascular endothelium regulates the tone of smooth muscle by producing vasodilators and vasoconstrictors. Animal studies6 showed that nitric oxide, a vasodilator released from vascular endothelium, regulates secretion of thyroid hormones by modulating regional blood flow or activating follicular cells in the gland, and that its release was changed in rats with hypothyroidism.7 Vascular endothelial growth factor, a potent mitogen for in vitro endothelial cells, was shown to increase permeability of vascular endothelium and stimulate in vivo neoangiogenesis.8 Immunohistochemical studies showed that progression of goiter in rat thyroids was accompanied by increased capillary endothelial cell growth.9
Increasing evidence in the past decade supports the hypothesis that endothelial cell injury and disturbed endothelial cell function are important in the pathogenesis of preeclampsia.10 Endothelin, a potent vasoconstrictor peptide produced by vascular endothelium after a vascular injury, might be important in the pathophysiology of preeclampsia.11 Clark et al12 reported endothelin levels in women with preeclampsia that correlated with indicators of disease severity such as serum uric acid levels and renal dysfunction. Endothelin might be a mitogen that can be affected by systemic disorders associated with endothelial damage.13
Our objective was to test the hypothesis that vascular endothelial damage is implicated in the pathogenesis of biochemical hypothyroidism in preeclampsia and eclampsia by thyroid function tests and by measuring endothelin levels in preeclamptic or eclamptic women.
Obstetrics and Gynecology 09/1999; 94(4):551-555. · 4.73 Impact Factor
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ABSTRACT: BACKGROUND: Our main aim was to investigate the effects of melatonin (ME), possibly the most powerful free‐radical scavenger, on the prevention of i.p. adhesion formation in rat uterine horn. Our secondary aim was to determine whether different methods of administration of ME were beneficial. METHODS: Animals were randomly assigned into seven groups, each consisting of 13 rats. Measured serosal injury was created using a standard technique. While control and two sham groups were not given ME, two of the remaining four groups were given a single dose of 10 mg/kg (2 mg) of ME i.p. immediately after injury and 30 min prior to injury respectively. In the two other groups, ME treatment was continued daily for 5 days. All animals were killed 2 weeks after surgery and adhesions were determined and scored by a examiner blinded to the test. RESULTS: The extent, severity and total scores of adhesion were found to be significantly reduced in all of the ME treatment groups when compared with control and sham groups. There were no statistically significant differences between the treatment groups. CONCLUSIONS: This study showed that even single dose ME therapy was effective in the prevention of post‐ operative i.p. adhesion formation.
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ABSTRACT: Antenatal sonographic diagnosis of rhizomelic chondrodysplasia punctata depends on recognization of the combination of rhizomelic bone shortening and epiphyseal stippling. This is the only report of prenatal ultrasonographic diagnosis of bilateral cataracts in a fetus with rhizomelic chondrodysplasia punctata (type 1). Also, this is the first report of severe rhizomelic limb shortening, and bilateral cataracts prior to the recognization of epiphyseal stippling.
Fetal Diagnosis and Therapy 20(3):171-4. · 1.05 Impact Factor
