Objective: To determine the role of vascular endothelial growth factor (VEGF) in placental hypoperfusion in obesity. Methods: The prospective study enrolled women with a first-trimester singleton pregnancy in Izmir, Turkey, between January and April 2011. Participants were divided into three groups: obese (body mass index [BMI, calculated as weight in kilograms divided by the square of height in meters] >30) with cesarean delivery; normal weight (BMI <30) with vaginal delivery (NVD); and healthy controls (BMI <30) with cesarean delivery. Before delivery, serum C-reactive protein (CRP), and uterine and fetal Doppler measurements were taken. VEGF was evaluated immunohistochemically from the umbilical cord. Results: Overall, 109 women completed the study: obesity group (n=13, 11.9%), NVD group (n=50, 45.9%), and control group (n=46, 42.2%). Serum CRP was higher in the obesity group than in the control or NVD groups (P=0.009). VEGF score was highest in the NVD group (9.39 ± 3.11), and lowest in the obesity group (4.58 ± 2.78) (P<0.001). VEGF score decreased by 0.81 for each increase in BMI of 1 (P=0.002). Conclusions: Maternal obesity was related to decreased VEGF expression. Although not supported by Doppler findings, decreased VEGF expression owing to maternal obesity might trigger endothelial dysfunction and inflammation.

Recurrent ectopic pregnancy in the ipsilateral fallopian tube is rare, but it is important to be suspicious of the diagnosis to prevent serious morbidity. This case also demonstrates transtubal or transperitoneal migration of the gametes because ovulation and ectopic pregnancy occurred on opposite sides.

Problemin aktuallığı. Mamalıq elminin aktual problemi rezus immunoloji konfliktin hamiləliyin gedişatına, dölə və yenidoğulmuşa təsirinin öyrənilməsidir. Aparılan tədqiqatlar əsasında müəyyən edilmişdir ki, hamiləliyin rezus sensibilizasiyası olan qadınlarda perinatal ölüm göstəriciləri 64,8%, postnatal 41,4%. Müəyyən olunmuşdur ki, hər bir rezus mənfi qanı olan ananın hamiləlik müddətində rezus müsbət döl arasında immunoloji konfliktin yaranması mütləqdir [1-4].

We aimed to report a case with acute renal insufficiency and hydronephrosis treated by surgical repair of the total uterine prolapse. A 61-year-old woman presented to our clinic with a general weakness, lower abdominal pain, decreased urination and dysuria. Her pelvic examination revealed the fourth-degree uterine prolapse and blood tests demonstrated failure of renal function tests. Abdominal computed tomography showed bilateral hydroureteronephrosis and the prolapsed uterus and the bladder through the pelvis. After acute vital intervention surgical repair of the pelvic floor with vaginal hysterectomy was performed. There were no complications associated with the surgery. The patient's renal function tests returned to normal and urine extraction increased. We suggest renal evaluation should be considered for cases with severe prolapse of the uterus and if hydroureteronephrosis exists, surgical treatment should be performed as soon as possible to prevent irreversible consequences.