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ABSTRACT: Inherited thrombophilia may cause important complications in pregnancies including maternal death, early and late pregnancy loss, preeclampsia, intrauterine growth restriction and placental abruption. This study was developed to investigate the fetal loss and successful birth rates in hereditary thrombophilic patients treated with low-dose acetylsalicylic acid and low molecular weight heparin to determine the necessity and effectiveness of this treatment. Ninety-three patients with the history of recurrent pregnancy loss or thromboembolism were included in this study. Eighty milligram acetylsalicylic acid treatment was started just after the diagnosis for the patients with hereditary thrombophilia, continued throughout pregnancy and ceased 3 days before the delivery. Low molecular weight heparin (LMWH) was started for the patients with the unsuccessful in-vitro fertilization (IVF) history, just after finishing the egg collection. For the other patients, LMWH was started after the positive result of the pregnancy test. Treatment was started for 67 (72%) of patients. Among the treated 67 patients, 38 had MTHFR C677T gene mutation, 25 had protein S deficiency, 19 had FV Leiden mutation, four had protein C deficiency, two had Prothrombin 20210A gene abnormality, two had antiphospholipid anticore syndrome and two had AT III deficiency. Fifty-seven (85.1%) of 67 patients under treatment had pregnancy. Forty-one (61.2%) of those 57 patients had a live birth, whereas 16 (23.9%) of them had abortus under treatment. In regression analysis, only protein C and S deficiencies were found to be independent risk factors. In conclusion, inherited thrombophilia should always be kept in mind as an etiological factor of recurrent abortus. With treatment, success rates are between 60 and 80%. Severe side effects due to treatment are rare. But randomized, double-blind, placebo-controlled studies are still necessary to evaluate the benefit of heparin and acetylsalicylic acid treatment in women with the history of inherited thrombophilia.
Blood coagulation & fibrinolysis: an international journal in haemostasis and thrombosis 10/2010; 22(1):14-8. · 1.25 Impact Factor
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ABSTRACT: To investigate the effectiveness of melatonin and rosiglitazone in reducing postoperative adhesion formation in a rat uterine horn model.
Thirty non-pregnant female Wistar albino rats, weighing 180-220 g, were used as a model for postoperative adhesion formation. The rats were randomised into three groups after seven standard lesions were inflicted in a 2-cm segment of each uterine horn and lower abdominal sidewall using bipolar cauterisation. The rats were treated with 10 mg/kg, intraperitoneal melatonin, and 1 mg/kg per day peroral rosiglitazone. No medication was given to the control group. As much as 20 uterine horns of 10 rats were evaluated in each group. Extent, severity, and degree of the adhesions to the uterine horns and, inflammation and fibrosis scores (histopathologically) were evaluated after 2 weeks of the treatment.
There was no mortality in the groups and all of the rats recovered without incident after operation. Rosiglitazone group had lower adhesion scores [median (min-max ranges)] regarding extent, severity, and degree of the adhesions [0 (0-3), 0 (0-3) and 0 (0-3), respectively], which were significantly different (P < 0.001, P < 0.05 and P < 0.01, respectively) from those of the controls [1 (0-3), 2 (0-2) and 2 (0-3), respectively]; however, there were no statistically significant differences between rosiglitazone versus melatonin groups [1 (0-4), 2 (0-3) and 1 (0-3), respectively] and melatonin versus control groups. Moreover, no significant differences were determined between groups regarding histopathologic findings.
Rosiglitazone, but not melatonin, is effective in prevention of adhesion formation in a rat uterine horn model.
Archives of Gynecology 10/2009; 282(1):55-61. · 0.91 Impact Factor
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ABSTRACT: Neurokinin (NK) B has been recently demonstrated to be secreted by the placenta in preeclampsia suggesting it may modulate pathophysiological events of the disease. The aim of this study was to investigate whether NKB is the circulating factor associated with preeclampsia or not. In 22 preeclamptic and normotensive pregnant women, the peripheral and umbilical cord blood NKB levels were measured by radioimmunoassay. The NKB levels in women with preeclampsia were 0.70 (0.53-0.92) nmol/L in peripheral blood and 1.92 (1.42-2.35) nmol/L in umbilical cord blood. In normotensive pregnant women, NKB levels were 0.43 (0.29-0.61) nmol/L and 0.14 (0.07-0.33), respectively. Significantly higher levels of NKB were measured in preeclamptic women compared with normotensive pregnant women in umbilical cord blood. These results suggest that NKB enters both fetal and maternal circulation and may modulate fetoplacental hemodynamics.
Journal of Perinatal Medicine 02/2007; 35(3):200-2. · 1.70 Impact Factor
