The aim of the present study was to explore the possible relations of maternal serum and amniotic fluid nitric oxide (NO) and of vascular endothelial growth factor A (VEGF-A) concentrations with uterine artery Doppler indices (UtADs) in a healthy second trimester obstetric population. In this regard, the levels of NO and VEGF-A were measured in maternal sera and the amniotic fluid samples were in 36 subjects who were in their early second trimester of pregnancy. The mean levels for VEGF-A were 110.3 ± 31.5 pg/ml in maternal serum and 149.6 ± 31.3 pg/ml in amniotic fluid. Mean levels for NO were 5.7 ± 4.7 µmol in maternal serum and 12.9 ± 3.4 µmol in amniotic fluid. UtADs were measured concurrently with the sample collections. The mean value for uterine artery pulsatility index (PI) was 1.3 ± 0.4. The measurements were then analysed for possible correlations, whereby no correlation was found between UtAD and maternal serum levels of either molecule (p = .828 and p = .662 for VEGF-A and NO, respectively). However, a positive correlation was found between the NO levels in the amniotic fluid compartment and UtAD (r = 0.432, p = .009 for PI). Therefore, a correlation of UtAD with amniotic fluid NO can be expected in pregnancies with a normal outcome. Impact Statement What is already known on this subject? Nitric oxide (NO) and vascular endothelial growth factor A (VEGF-A) are important vasoactive molecules that play significant roles in early angiogenesis and placentation. What the results of this study add? There is a positive correlation between the amniotic fluid NO levels and the uterine artery Doppler indices (UtADs) in the second trimester of pregnancies with normal outcomes. What the implications are of these findings for clinical practice and/or future research? A correlation between amniotic fluid NO levels and UtAD may indicate a normal trophoblastic invasion. Disturbance of this balance may be expected in certain adverse pregnancy outcomes. Additional studies are needed to further explore the molecular signs of early abnormal placentation and their clinical reflection.

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Background: Breast cancer is the most common treatment-related second malignancy among women with previous chest radiotherapy for Hodgkin lymphoma (HL). Little is known about the effects of this kind of radiotherapy on the outcomes of postmastectomy breast reconstruction (BR). This study compared adverse outcomes of BR after HL-related chest radiotherapy to matched controls. Methods: The authors conducted a retrospective, matched cohort study in two expert cancer centres in the Netherlands. BRs after therapeutic or prophylactic mastectomy in HL survivors who received chest radiotherapy were matched with BRs in nonirradiated patients without HL on age at mastectomy date, date of BR, and type of BR. The primary outcome was complication-related BR failure or conversion and secondary outcomes were complication-related re-operation, capsular contracture, major donor-site complications, and complication-related ICU admission. The authors analyzed all outcomes univariably using Fisher’s exact tests and the authors assessed reconstruction failure, complication-related re-operation, and capsular contracture with multivariable Cox regression analysis adjusting for confounding and data clustering. Results: Seventy BRs in 41 patients who received chest radiotherapy for HL were matched to 121 BRs in 110 nonirradiated patients. Reconstruction failure did not differ between HL survivors (12.9%) and controls (12.4%). The comparison groups showed no differences in number of reoperations, major donor-site complications, or capsular contractures. BR in HL survivors more often let to ICU admission due to complications compared with controls (P=0.048). Conclusions: We observed no increased risk of adverse outcomes following BR after previous chest radiotherapy for HL. This is important information for counselling these patients and may improve shared decision-making.

Öz Amaç: Sezeryan operasyonu tüm dünyada çok yaygın olarak ve giderek artan oranlarda yapılmaktadır. Sunulan bu çalışmada sezeryan sayısının maternal ve fetal sağlığı üzerine etkilerinin incelenmesidir. Gereç ve Yöntemler: Çalışmaya 1 Ekim 2014-1 Ekim 2017 tarihleri arasında kliniğimizde sezeryan operasyonu geçirmiş ve ek hastalığı olmayan, gebelik haftası 38-40 hafta arasında olan, gebeliği 18-40 yaşlarında olan kişiler dahil edilmiştir. Bu kişilerin doğum sonrası kayıtları retrospektif olarak incelenmiştir. Gebelik Objective: Cesarean operation is very common and it is being performed increasingly all over the world. In this study, the effect of the number of cesarean deliveries on maternal and fetal health was evaluated. Materials and Methods: We included patients who underwent cesarean section in our clinic between October 2014 and October 2017, who had no additional disease, between 38 and 40 gestational weeks, and ages between 18 and 40 years. Postnatal records were retrospectively reviewed. Patients who had pregnancy complications such as pregnancy hypertension, gestational diabetes, oligohydramnios, polyhydramnios, or who had a dysmorphic appearing baby or with any genetic syndrome were excluded. Patients were divided into three groups according to the number of cesareans they had undergone. Group 1 consisted of patients with history of two cesarean deliveries, group 2 consisted of patients with 3 cesarean deliveries and group three consisted of patients with 4 or more cesarean deliveries. Groups were then compared to each other for their demographic data and maternal-fetal outcomes. Results: Mean age of the patients studied was 32.4 years [standard deviation (SD): 4.4], mean gestational week was 38 weeks and 2 days (SD: 0.55), and mean hospitalization duration was: 4.4 days (SD: 1.0). There was no significant correlation between the number of cesarean section and the parameters of birth weight, duration of hospital stay, and appearance, pulse, grimace, activity, and respiration scores. Conclusion: The history for the number of previous cesarean deliveries for a pregnancy may not seem to be correlated with increased maternal or fetal complications up to four previous cesarean deliveries. There is a need for future studies with even larger patients to support our findings.