By routine histopathologic assessment of products of first-trimester spontaneous miscarriages, important pathologies such as molar pregnancy and placental trophoblastic disease can be diagnosed. Histopathological assessment has great value in the identification of an ectopic pregnancy or infection when compared with clinical and laboratory findings.
Objective: We investigated the utility of maternal fetuin-A, N-terminal proatrial natriuretic peptide (pro-ANP), high-sensitivity C-reactive protein (hs-CRP), and fasting glucose levels at 11-14 gestation weeks for predicting pregnancies complicated by gestational diabetes mellitus (GDM). Subjects and methods: This prospective cohort study included 327 low-risk pregnant women who completed antenatal follow-up at a tertiary research hospital between January and April 2014. Maternal blood samples were collected between 11-14 gestational weeks in the first trimester of pregnancy and then stored at-80 °C until further analyses. During follow-up, 29 (8.8%) women developed GDM. The study population was compared 1:2 with age-and body mass index-matched pregnant women who did not develop GDM (n = 59). Fasting plasma glucose (FPG) levels and serum fetuin-A, pro-ANP, and hs-CRP levels were measured using automated immunoassay systems. Results: There was a significant negative correlation between fetuin-A and hs-CRP (CC =-0.21, p = 0.047) and a positive correlation between FPG and hs-CRP (CC = 0.251, p = 0.018). The areas under the receiver operating characteristic curve for diagnosing GDM were 0.337 (p = 0.013), 0.702 (p = 0.002), and 0.738 (p < 0.001) for fetuin-A, hs-CRP, and FPG, respectively. The optimal cutoff values were > 4.65, < 166, and > 88.5 mg/dL for maternal hs-CRP, fetuin-A, and FPG, respectively. Conclusion: Reduced fetuin-A, elevated hs-CRP, and FPG levels in women in the first trimester can be used for the early detection of GDM. Further research is needed before accepting these biomarkers as valid screening tests for GDM. Arch
Objectives: The effect of exogenous progesterone on fetal nuchal translucency (NT) has been proposed recently. In this study, we aimed to compare the thickness of NT of patients receiving and not receiving progesterone for threatened miscarriage.
Material and methods:This study was designed as a retrospective comparative study. Ninety five women treated with progesterone constituted the study group whereas 97 women who were not treated with progesterone constituted the control group. An ultrasonographic examination was performed on all of the women to measure NT. All patients were treated with oral micronized progesterone in the study group. The main parameters recorded for each woman were; age, body mass index (BMI), obstetrical characteristics, and gestational age at first examination, treatment duration of progesterone therapy, and results of combined and triple tests.Results: A total of 192 pregnant women with threatened miscarriage were included in this study. The mean NT thickness was statistically significantly higher in the study group (p < 0.001), and mean serum level of human chorionic gonadotropin (hCG) was also higher in this group (p < 0.05). There was no statistically significant difference between groups in terms of age, BMI, and gestational age at first examination. ROC curve analysis demonstrated that only increased NT (area under the curve: 0.634, p = 0.005, 95% CI: 0.541-0.727) was a discriminative factor for women receiving progesterone for threatened miscarriage. Also there was a positive correlation between NT and treatment duration (r = 0.269; p < 0.001).
Conclusions:We think that oral progesterone therapy may increase NT depending on treatment duration without causing abnormal prenatal screening test results.
Higher maternal calcium and lower 25(OH)D levels detected in patients with Grade 3 placental calcification indicated the importance of placenta on vitamin D regulation.
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