Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item The Effects of Magnesium Sulphate on The Contractile Activity of Uterus in an Animal Model of Preeclampsia(2014) Yildirim, E.; Macun, H. C.; Cinar, M.; Yigit, A. A.; Ustuner, I.; Aydos, T. R.; Aktuna, Z.; https://orcid.org/0000-0002-1832-9336; 24779245; AAJ-7279-2020Purpose: This study was undertaken to evaluate the effects of magnesium sulfate (MgSO4) on the contractile activity of the uterus in a pregnant rat model of preeclampsia induced by N-nitro-arginine methyl ester (L-NAME). Materials and Methods: Twenty-eight, 160220 gram, three to four month old female Sprague-Dawley rats were used in this study. After conception was confirmed by vaginal smears on the first day of pregnancy, the animals were allocated into four groups according to the chemicals fed in their drinking water as control (nothing administered), L-NAME (50 mg/kg L-NAME), MgSO4 (600 mg/kg MgSO4), and MgSO4 + L-NAME group (600 mg/kg MgSO4 + 50 mg/kg L-NAME). The pregnant uterus strips were isolated on the 19th day and the contractile activity of uterus was examined by applying 0, 0.1, 0.2, 0.4, 0.8, and 2.5 mIU/mloxytocin to each group and responses are recorded accordingly. Results: There were no statistically significant differences regarding fetal parameters and peak amplitudes of the oxytocin stimulated pregnant rat myometrial strips among groups. In L-NAME group at 0 and 0.1 mIU/ml oxytocin, the contraction frequency in a ten-min period was statistically lower than the control group (Z = -2.850, p = 0.004; Z = -2.902, p = 0.004, respectively). In MgSO4 group only at 0 mIU/ml oxytocin, the frequencies of the contractions in ten-min period were statistically lower than the control group (Z = -2.973,p = 0.003). In L-NAME + MgSO4 group at 0, 0.1 and 0.2 mIU/ml oxytocin concentrations the frequencies of the contractions in ten-min period were statistically lower than the control group (Z = -4.018, p = 0.000; Z= -3.23'7,p = 0.001; Z= -2.902, p = 0.004, respectively). In L-NAME + MgSO4 given group at each oxytocin concentrations, the frequencies of the contractions in ten-min period were lower but not statistically different than the L-NAME group. Conclusion: MgSO4 has no significant effect on the amplitude of spontaneous or oxytocin induced myometrial contractions, but decreased the frequency of spontaneous contractions. At each doses of oxytocin, MgSO4 has no significant effect on the frequency of contraction in a pregnant rat model of preeclampsia induced by L-NAME.Item Combined past preeclampsia and gestational diabetes is associated with a very high frequency of coronary microvascular dysfunction(2021) Kul, Seref; Guvenc, Tolga Sinan; Baycan, Omer Faruk; Celik, Fatma Betul; Caliskan, Zuhal; Guvenc, Rengin Cetin; Ciftci, Faika Ceylan; Caliskan, Mustafa; 33189732Background: A history of preeclampsia (pPE) and gestational diabetes (pGDM) are female-specific risk markers for atherosclerosis and future cardiovascular risk. In addition to increasing the risk of established risk factors for atherosclerosis, such as hypertension or diabetes, evidence suggests that pregnancy-related complications can also directly accelerate atherosclerosis by inducing endothelial dysfunction. A combination of both conditions is seen in a subset of patients with pregnancy, though it is not known whether this combination increases the overall risk for cardiovascular events. Aims: Present study aimed to find the impact of combined pPE/pGDM on the prevalence of coronary micro vascular dysfunction (CMD). Methods: A total of 24 patients with combined pPE/pGDM, 19 patients with isolated pPE and 63 patients with pGDM were included to the present study and a further 36 healthy women with no previous pregnancy-related complications served as controls. Coronary flow reserve was measured using echocardiography and CMD was defined as a coronary flow reserve <= 2.5. Results: Patients with combined pPE/pGDM had a high prevalence of CMD (91%), which was significantly higher than controls (5.6%, p < 0.001) and patients with pGDM (55%, p = 0.01). A history of pPE on top of pGDM was associated with an increased risk of CMD (HR:6.28, 95%CI:1.69-23.37, p = 0.006) after multivariate adjustment, but pGDM did not increase the odds for CMD in those with pPE. Conclusions: Combined pPE/pDM is associated with a very high prevalence of CMD, which may indicate an increased risk for future cardiovascular events.Item Do preeclampsia symptoms resolve after intrauterine death of a fetus?(2016) Balci, Serdar; Bodur, Tayfan; Tohma, Yusuf Aytac; Okyay, Recep Emre; Saatli, Bahadir; Altunyurt, Sabahattin; 0000-0002-1782-7325; 28913102; AAJ-1097-2021We present two cases of twin pregnancies without resolution of preeclamptic symptoms after intrauterine death of one twin. Case 1: A nulliparous woman aged 37 years was referred at 26 weeks of gestation because of arterial hypertension, edema, and growth restriction in one twin. Three weeks later the restricted twin died. During the following three weeks, ultrasound examinations showed a reduced growth velocity of the surviving fetus and reversed umbilical flow. At the end of the 34th week of gestation, cesarean section was performed and a healthy female infant was delivered. Case 2: A nulliparous woman aged 33 years with a 27-week twin pregnancy was referred because of arterial hypertension and discordant growth. The restricted twin died at 31 weeks of gestation. Following the death, within two weeks the growth of the co-twin started to slow down and reversed end diastolic flow presented. At the end of the 33rd week of gestation, cesarean section was performed and a healthy female infant was delivered. The interesting point of these cases was the secondary effects on the co-twins. During the time after intrauterine deaths of one twin, the surviving fetuses started to show a reduced growth velocity and reversed umbilical flow and mothers had increased blood pressure and proteinuria again. We think that both cases are evidence of late on-set systemic maternal effects (such as systemic maternal endothelial activation and/or systemic maternal inflammatory response) depends on preeclampsia.Item Proteinuria in preeclampsia: is it important?(2018) Okten, Sabri Berkem; Ozkara, Atilla; Kaya, Aski Ellibes; Basbug, Alper; Dogan, Ozan; Caglar, Mete; Kumru, Selahattin; 0000-0001-7473-761X; 30084477Objectives: Our aim is to evaluate the laboratory results arid proteinuria levels of preeclamptic women arid their relationships to maternal and fetal outcomes. Material and methods: One hundred preeclamptic pregnant women who gave birth in our clinic between 2013 and 2015 were included in our study retrospectively. The data collected from the patients included gestational week, age, gravidity, parity, abortus history, blood pressure, biochemical parameters, delivery method, maternal hospitalization time, cesarean indication, complications, blood products required, plasmapheresis use and dialysis need. The details about the newborns were recorded retrospectively. The relationships between preeclampsia signs and maternal and neonatal outcomes were analyzed. The protein amounts were analyzed via 24-hour collected urine analyses and spot urine analyses. Results: A statistically significant positive correlation was observed between neonatal intensive care unit needs and proteinuria levels. Fetal growth restriction, respiratory distress syndrome and sepsis were observed as the level of proteinuria increased, but the result was not statistically significant. Eclampsia was observed only in patients with massive proteinuria, and it was statistically significant. An increase in cesarean sections, placental abruptions, antihypertensive drug needs and blood product replacement rates was observed as the amount of proteinuria increased in preeclamptic women, but the results were not statistically significant. Conclusions: The severity of preeclampsia cannot be determined by the level of proteinuria. However, when massive proteinuria is detected, the clinician should be more cautious about maternal and fetal complications.