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Copyright of Namık Kemal Tıp Dergisi is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Preeclampsia is a serious complication of pregnancy leading to maternal and perinatal morbidity and mortality. The etiopathogenesis still remains unsolved, however, various theories currently become well-proved. The leading etiopathogenetic mechanisms are impaired placentation, and placental hypoxia, immune mechanisms, systemic inflammatory reaction, endothelial damage and maternal cardiovascular maladaptation. These mechanisms overlap and induce each other. There are some preventive interventions only if the patients at high-risk are identified timely. This study aimed to investigate the relationship between the inflammatory pathway and placental insufficiency in the first trimester, utilizing the clinical markers of both. It also aims to find out a cheap and easy test to identify those who absolutely need to undergo a comprehensive risk assessment. Methods: This retrospective observational study included 28 patients with high uterine artery resistance (pulsatility index gt;90th centile) in the first trimester as study group and 67 patients with normal uterine artery resistance in the first trimester as control group. The two groups were compared in terms of risk factors for preeclampsia. Neutrophil/lymphocyte ratio and platelet/lymphocyte ratio as systemic inflammatory markers were compared between the groups. ROC analysis was performed to obtain a cut-off value for predicting high uterine artery pulsatility index. Results: Demographic data, anamnestic and examination risk factors for preeclampsia did not differ between the groups. However, neutrophil/lymphocyte ratio and platelet/lymphocyte ratio were significantly higher in the patients with uterine artery pulsatility index above 90th centile. A cut off value of 3.58 and 136.9 of Neutrophil/lymphocyte ratio and platelet/lymphocyte ratio, respectively were determined for predicting first trimester uterine artery pulsatility index above 90th centile. Conclusions: Neutrophil/lymphocyte and platelet/lymphocyte ratio can simply be used to identify the patients who need referral for uterine artery doppler assessment. Keywords: preeclampsia, uterine artery, pulsatil flow, neutrophil, lymphocyte, placenta

Purpose: Visualization of the three-dimensional structures is performed by examining two-dimensional sections in histology. It is not always possible to comprehend structure-function integrity. Therefore, it was planned to obtain three-dimensional (3D) models of the capillaries in the placenta terminal villus by using the program developed in the Başkent University's laboratory and used in studies in different disciplines. The program's suitability for histology studies will also be assessed. Materials and Methods: A term placenta tissue sample was obtained from a 33-year-old healthy woman. Following the plastic embedding procedure, semi-thin serial sections were taken from these blocks. The sections were stained using toluidine blue and examined and photographed by using a light microscope. The 3D modeling procedure was conducted on the light micrographs of serial sections in order to reconstruct villous capillaries. Results: 3D images were obtained from two-dimensional light micrographs by using the same program. It was determined that the vessels running parallel to each other branched harmoniously, forming a capillary network in the terminal villus. Additionally, challenges encountered during the utilization of this program in histological studies are also presented in this study. Conclusion: Fetal blood reaches every part of the terminal villus through the branching capillary network. This feature would increase the surface area of vasculo-syncytial membrane and facilitate feto-maternal exchange. This can be clearly visualized by using 3D models. Three-dimensional modeling helps to understand the structure of all organs and tissues. Given that the current program is freely accessible, it will not incur additional costs for researchers and is open to further improvement by the programmer (erhankiziltan@gmail.com). [ABSTRACT FROM AUTHOR]

Background: Preeclampsia is a pregnancy complication with a high morbidity and mortality rate. Bax is a proapoptotic protein and in recent years, 14-3-3 tau proteins are considered as key regulators of many processes, such as apoptosis. In this study, we investigated the expression of phospho-tau and Bax in preeclampsia apoptosis immunohistochemically. Materials and Methods: Placental tissues of 25 healthy and 25 preeclamptic pregnant were included in the study. Placental samples were fixed with 10% neutral buffered formalin. Routine paraffin wax tissue protocol was used. Results: According to histological micrograf, the trophoblastic cells in the villi were normal in the control group. Mild dilatation in blood vessels was seen. Hyalinized and necrotic areas in chorionic villi and an increase in fibrinoid tissue in root villi were detected in preeclampsia sections. Phospho-tau and Bax primary antibodies were used for immunohistochemical evaluation. The sections from of the preeclampsia group were highly positive for syncytiotrophoblasts and villous connective tissue. It was also statistically different from the control group (p<0.05). Conclusions: When we evaluate the results shows that phospho-tau and Bax may be determinant proteins in the apoptosis pathway of preeclampsia. [ABSTRACT FROM AUTHOR]

Copyright of Harran University Journal of the Faculty of Veterinary Medicine / Harran Üniversitesi Veteriner Fakültesi Dergisi is the property of Harran University, Faculty of Veterinary Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: Veneral Disease Research Laboratory (VDRL) test is an important screening tool for syphilis in pregnancy (because of adverse pregnancy outcomes, particularly congenital syphilis {CS}) and can be combined with the placental histopathological examination in the diagnosis of CS. Thus, we aimed to compare VDRL test results from HIV-positive/HIV-negative pregnant women with relevant historical data and perinatal/placental histopathological findings. Methods: A prospective hospital-based cross-sectional survey of VDRL tests for two study groups (HIV-positive {tests} and HIVnegative {controls} pregnant women) at ante-natal care (ANC)/delivery. A convenient sampling method was used. Relevant (maternal/fetal) historical data were extracted from their case notes, and placentas of reactive VDRL cases were histopathologically examined. Results: We surveyed 145 pregnant women (49 tests and 96 controls). The VDRL tests, for both groups, were not strongly associated with maternal age (p-value = 0.097), booking for ANC (p-value = 0.770), gravidity (p-value = 0.331), and HIV/AIDS stage (for tests only). Notably, one subject from the tests had a reactive VDRL test, and she was in HIV/AIDS clinical stage 2, her baby had microcephaly (fetal head circumference of 31 cm), low birth weight (of 2.4 kilograms), and intermediate APGAR score. Histopathological examination of her placenta showed avascular villi, large hypercellular villi, and obliterative vasculopathy with an onion-skinning pattern in the placental disk. Conclusions: The obstetrical, fetal, and placental histopathological features of the reactive VDRL case were consistent with CS and syphilitic placentitis. Hence placental histopathological evaluation can play a critical role in the diagnosis of maternal/congenital syphilis. [ABSTRACT FROM AUTHOR]

Pregnancy gingivitis is caused by an increase in estrogen and progesterone levels. These are essential hormones that help baby grow and develop, but they also cause many changes to your body. One of these changes is increased inflammation of your gums. Although the exact way this happens isn't clear, healthcare providers think it may be due to: decreased ability of your body to respond to plaque bacteria. Increased blood flow to the gum tissue. There is no evidence that mild red or swollen gums harm your baby's health or cause a miscarriage or premature birth. But if left untreated, gingivitis can lead to periodontitis which is linked to preterm delivery and low birth weight. In periodontitis, inflammation causes your gums to pull away from your teeth, leaving pockets that can become infected. Eventually, this can lead to tooth loss. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to evaluate the relationship of hyperemesis gravidarum (HG) with placental thickness, pregnancy-associated plasma protein-A (PAPP-A), and free beta-human chorionic gonadotropin (beta-HCG) levels. Methods: A total of 263 pregnant women (93 with HG and 172 controls) who applied to the gynecology and obstetrics outpatient clinic for a combined test between 11 and 14 weeks of gestation were included in this study. Crown-rump length (CRL, measured in millimeter) values were measured using ultrasonography, and PAPP-A and free beta-HCG values (MoM) were recorded from laboratory reports. Results: The placental thickness (p<0.001) and free beta-HCG (p=0.029) values of pregnant women with HG were higher than controls. In the HG group, the placental thickness was positively and weakly correlated with gestational week (p<0.001) and CRL (p<0.001). We also found that higher CRL values and the presence of HG were related to increased placental thickness (R2=0.159, p<0.001) by performing linear regression analysis. Conclusion: Being diagnosed with HG and having increased CRL is related to increased placental thickness. In relation to this result, increased placental thickness and free beta-HCG also seem to cause a higher risk for HG. [ABSTRACT FROM AUTHOR]

Copyright of Balikesir Health Sciences Journal / Balıkesir Sağlık Bilimleri Dergisi is the property of Balikesir Health Sciences Journal (BAUN Health Sci J) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Turkish Journal of Obstetrics & Gynecology is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Jurnal Veteriner is the property of Fakultas Kedokteran Hewan, Universitas Udayana and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Ahi Evran Medical Journal is the property of Ahi Evran University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Anadolu Tarım Bilimleri Dergisi is the property of Ondokuz Mayis Universitesi, Ziraat Fakultesi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The present study aimed at the direct detection of parasitic DNA in placenta samples of ewes by PCR targeting the B1 gene of Toxoplasma gondii. We identified also the possible risk factors associated with the infection. A total of 307 female sheep from 23 farms were collected between 2019 and 2020 in the Tebessa region in northeastern Algeria. Data showed that T. gondii DNA was detected in 114 of the 307 tested females (37.1%). The on-farm molecular prevalence was 82.6%. High rates were revealed in Bir Al Ater (32.4%) and Tlidjen (43.6%). Th e level of contamination was high in farms applying a sedentary mode (47.6%); this system tends to have a positive eff ect on the prevalence of toxoplasmosis (P<0.05; 95% CI: 0.409-0.544). Moreover, it appears that the relationship between the presence of cats on the farm and the prevalence of the disease was significant (P<0.05; 95% CI: 0.445-0.597). In the same context, primiparous females were 2.54 times more likely to be infected with T. gondii than multiparous animals (P=0.001). To conclude, the prevalence noticed in the present study indicates a generalized exposure of sheep to T. gondii in the northeast of Algeria, which represents a major risk for animal and public health. Therefore, management measures should be implemented and improved in the farms of this region for better disease control and eradication. [ABSTRACT FROM AUTHOR]

Copyright of Istanbul Gelisim University Journal of Health Sciences / İstanbul Gelişim Üniversitesi Sağlık Bilimleri Dergisi is the property of Istanbul Gelisim Universitesi Saglik Bilimleri Yuksekokulu and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The placenta is crucial to the development of a fetus, playing a vital role from fertilization of an egg by sperm until the delivery of the fetus. Without the placenta, the fetus would not receive essential nutrients or oxygen from the mother and be able to rid itself of toxic wastes. Given the necessity of this temporary organ, improper formation of the placenta can lead to many health problems. These complications have an effect on the mother as well as the fetus given the essential link the placenta makes between fetal and maternal circulation. The main concerns with impaired placental function are commonly known as the triad of placental dysfunction. The triad of placental dysfunction includes preeclampsia, HELLP Syndrome, and IUGR (Intrauterine Growth Restriction) . The purpose of this review article is to explore the pathogenesis, the diagnostic and predictive criteria, and treatment for the disorders composing the triad of placental dysfunction to allow better outcomes for both the mother and fetus.

Objective Stress can affect negatively mother and fetuses during pregnancy. We aimed to investigate the effects of chronic immobilization stress on placental maturation and fetal development. Materials And Methods Balb/c virgin female mice (20-30 g) were mated with male mice in a 2 to 1 female to male ratio. Pregnant mice in control group (n=6) were left undisturbed, whereas pregnant mice in the stress group (n=6) were exposed to 45 min chronic immobilization stress for three times/day starting from gestational day 6 till 18. Fetuses and placentas were removed from dams on the gestational day 18 under anesthesia. Results The prenatal stress significantly increased apoptosis in several placental cells including trophoblastic giant cells, glycogen cells and labyrinth trophoblastic cells and resulted in intrauterine growth restriction. The stress caused a decreased superoxide dismutase and glutathione levels. Alizarin Red S staining shows the ossification center of the fetuses to see developmental abnormality. Conclusion Gestational stress causes placental dysfunctions by triggering apoptosis, reducing the labyrinth zone as well as increasing collagen levels, which may impair fetal development that may contribute to pathogenesis of intrauterine growth restriction. [ABSTRACT FROM AUTHOR]

Perdarahan postpartum merupakan salah satu penyebab utama kematian ibu selain penyakit kardiovaskuler. Diantara penyebab perdarahan post partum adalah plasenta akreta dimana insidennya semakin meningkat dari tahun ke tahun seiring dengan peningkatan jumlah persalinan dengan seksio sesarea. Kami laporkan dua kasus ibu hamil dengan plasenta akreta yang direncanakan tindakan seksio sesarea emergency yang dikelola dengan general anesthesia rapid sequence induction. Kasus pertama, perempuan berusia 31 tahun G3P1A1 usia kehamilan 36–37 minggu dalam persalinan, perdarahan antepartum ec plasenta previa totalis, plasenta akreta dengan hemodinamik stabil. Intraoperatif, perdarahan sekitar 7000 cc, dan diberikan transfusi 8 unit PRC, 4 unit WB, 4 unit FFP, dan 4 unit Tc. Pascaoperasi pasien dirawat di ICU, dan komplikasi yang terjadi produk drain abdomen sekitar 1900 cc bercampur darah. tidak ada komplikasi mayor lainnya, pasien pindah ruang rawat inap pada hari keempat pascaoperasi. Kasus kedua, perempuan berusia 40 tahun G3P2A0 usia kehamilan 37–38 minggu dalam persalinan, perdarahan antepartum ec plasenta previa totalis, plasenta akreta dengan hemodinamik stabil. Intraoperatif, perdarahan sekitar 9000 cc, dan dilakukan transfusi 8 unit PRC, 8 unit WB, 4 unit FFP, dan 4 unit Tc. Pascaoperasi pasien dirawat di ICU, dan. tidak ada komplikasi signifikan terjadi. Hari kedua pascaoperasi pasien pindah ke ruang rawat inap. Case Series: Anesthesia Management in Pregnant Woman with Placenta Accreta Planned for Caesarean Section Abstract Postpartum hemorrhage is one of the leading causes of maternal morbidity besides cardiovascular disease. Among the causes of postpartum hemorrhage is placenta accreta, where the incidence increases from year to year along with the increase in the number of cesarean delivery. We report two cases of pregnant women with placenta accreta planned for emergency cesarean section managed with general anesthesia rapid sequence induction. The first case, 31-year-old woman G3P1A1 36–37 weeks of gestation in labor, antepartum hemorrhage ec placenta previa totalis, placenta accreta with hemodynamically stable. During procedure, blood loss about 7000 cc, and given transfusion of 8 units of PRC, 4 units of WB, 4 units of FFP, and 4 units of Tc. In the end of procedure, the patient was transferred to intensive care unit, and complications that occurred around 1900 cc of abdominal drain product mixed with blood. After that, there were no other major complications, then the patient moved the ward on the fourth day. The second case, a 40-year-old woman G3P2A0 37–38 weeks of gestation in labor, antepartum hemorrhage ec placenta previa totalis, placenta accreta with hemodynamically stable. During procedure, blood loss about 9000 cc, and given transfusion of 8 units of PRC, 8 units of WB, 4 units of FFP, and 4 units of Tc. In the end of procedure, the patient was transferred to intensive care unit, and no significant complications happen. The second day after surgery the patient moved to the ward.

Investigate the changes that occur in the placenta tissues of pregnant rats that were administered acrylamide (AA) and vitamin E as a protective agent during pregnancy. Thirty rats that were proven positive for pregnancy with vaginal smear test were randomly distributed into control, corn oil, vitamin E, acrylamide and vitamin E + acrylamide groups. Pregnant rats were decapitated on the 20th day of the experiment. Malondialdehyde (MDA), reduced glutathione (GSH), total antioxidant capacity (TAS), total oxidant capacity (TOS) and Xanthine oxidase (XO) levels were measured in placenta tissues. It was determined that acrylamide application during pregnancy statistically significantly increased MDA, TOS and XO levels and reduced GSH and TAS levels in the placenta tissue of pregnant rats when compared to all other groups, and GAS and TAS levels statistically significantly increased in vitamin E administered group when compared to all other groups and TOS and XO levels were decreased to control group levels. It was observed that orally administered AA changed the antioxidant / oxidant equilibrium favoring the oxidants by increasing MDA, XO and TOS levels in pregnant rats and caused oxidative stress, while vitamin E administration returned the antioxidant / oxidant equilibrium back to normal levels, preventing oxidative stress induced toxicity.

Objective: This study determined the effect of skin-to-skin contact (SSC) between mother and infant during the third stage of labor on postpartum levels of oxytocin and pain and placental separation time. Methods: This randomized controlled trial was composed of 64 parturients: 32 in the intervention group and 32 in the control group. SSC interventions between infants and their mothers occurred for 30 min after birth, whereas infants in the control group were provided routine care. Data were gathered using an introductory information form, Visual Analog Scale, determination of placental separation degree form, and time and records of oxytocin analyses. Results: There was no significant difference regarding placental separation time and 1st and 30th min oxytocin levels of mothers (p > 0.05), whereas postpartum 5th, 15th and 30th min pain levels of women in the intervention group were significantly lower than women in the control group (p < 0.05). Conclusion: SSC is a valuable practice for both mother and infant, which especially reduces a mother's pain. The study should be reiterated by excluding other variables that are likely to affect oxytocin levels. [ABSTRACT FROM AUTHOR]

Objective: Normal embryonic and fetal development is strictly bound to maternal health and functioning placenta. Besides the invasion and differentiation of trophoblastic cell lineage; development of effective vasculature is crucial for the function of placenta. Placental vessels first arise by vasculogenesis in early development of villi and then succeeded by angiogenesis during fetal life. In the recent decades a new form of angiogenesis, "intussusceptive angiogenesis", besides classical sprouting angiogenesis is well documented. The presence of intussusception was shown at multiple organs but in placenta, in recent literature. We aimed to determine whether intussusceptive angiogenesis is present in human placenta to obtain further evidence on the development of vascular bed. Methods: The term placenta samples were obtained from 10 healthy pregnancies following caesarean sections. Tissues were processed using routine plastic embedding technique; thin sections were contrasted with uranyl acetate & lead citrate; observed and photographed by transmission electron microscope. Results: Our examinations revealed that both sprouting and intussusceptive angiogenesis is present in floating villi of term placenta. Phases of intussusception were documented in various samples. Conclusion: The presence of intussusceptive angiogenesis will help our understanding of microvascular bed remodeling during pregnancy. We believe that this new finding will help us to determine the relation of microvascular bed development in normal and abnormal placentas. [ABSTRACT FROM AUTHOR]

Aim: The objectives of this study are to investigate the placenta and umbilical cord specimens histopathologically, and to determine the relationship between pregnancy outcomes. Patients and Methods: 112 placenta specimens obtained from the archive of Uşak University Education and Research Hospital of Pathology Department were retrospectively evaluated. The criteria of term placenta measurement were determined as 37-40 weeks, 18 cm size, 350-750g weight, 2-2.5 cm thickness in accordance with the Kaufmann's Pathology. Umbilical cord's number of vessels, membrane structure, chorioangioma, infarct, hematoma, and hemorrhage were recorded. Infarct, chorioamnionitis, subchorionic fibrin deposition, congestion of chorionic vessel, sub-chorionic hemorrhage (SCH), chorangiosis, chorioangioma, calcification, perivillous fibrin deposition, effect of meconium, fibrinoid necrosis, villitis, and ectasia of chorionic vessel were found in histopathological examinations. The gender, mode of delivery, maternal disease, birth weight, maternal age, parity, birth length, head circumference, and APGAR scores between 0-9 were recorded. Results: 112 placental specimens were evaluated. As a result of evaluations, 4 of 29 (13.7%) placental infarct cases, 2 of 19 (10.5%) placental chorangiosis cases, on e of 17 (5.8%) SCH cases, 2 of 29 (6.8%) chorioamnionitis cases, and one of 12 (8.3%) umbilical cord congestion cases were found to have abnormal pregnancy outcomes. Statistically significant relationships were found between sub-chorionic hemorrhage and placenta size (p = 0.004), between maternal age and umbilical cord dimension (p = 0.001), and between birth weight and placenta and umbilical cord dimensions (p = 0.000). However, no association was found between these parameters and pregnancy outcomes. The relationship was determined between birth weight, placenta and umbilical cord size among diabetes, preterm delivery, ablatio placenta, and stillbirths and pregnancies. No significant association was found between histopathological findings and pregnancy outcomes. Conclusion: Based on the findings obtained in present study, the regular gestational USG follow-up and a good gestational hemorrhage anamnesis may be useful in predicting or preventing these pathologies in terms of abortus that can be seen in SCH, preterm delivery, and the psychomotor pathologies that can be seen in further years in case of intrauterine growth retardatio n (IUGR) and short cord length. [ABSTRACT FROM AUTHOR]

The aim of this study was to determine the immunohistochemical distribution of atrial natriuretic peptide (ANP) and C-type natriuretic peptide (CNP) in normal and pre-eclamptic human placentas. Tissue samples from maternal and fetal parts of pre-eclamptic (n:6) and healthy human placentas (n:6) were subjected to routine tissue processing. Avidin-biotin-peroxidase complex (ABC) immunohistochemistry was applied to formalin-fixed, paraffin-embedded placenta sections collected onto poly-l-lysine slides to demonstrate ANP and CNP expression. Immunohistochemistry revealed immunoreactivity for ANP and CNP in fetal and maternal tissues. On the fetal side of the preeclampsia group, strong ANP and CNP immunoreactivity were detected in the amniotic epithelium, fetal vessels, villous syncytiotrophoblast plate, villous vascular endothelial cells and smooth muscle cells than the healthy group. On the maternal side of the pre-eclampsia group, decidual cells exhibited lower ANP and CNP immunoreactivity than healthy group. These data indicate that increased ANP and CNP expression relating to preeclampsia might serve as a compensatory function to properly maintain uteroplacental perfusion and fetal development during pregnancy. [ABSTRACT FROM AUTHOR]

Anti-apoptotic Bcl-2 and proapoptotic Bax genes are the most significant genes that are involved in the regulation of apoptosis. Abnormal apoptotic activity in preeclampsia and gestational diabetes is caused by dysregulation of these genes. In this study; we examined Bcl-2 and Bax protein expressions using immunohistochemical techniques in human placental tissue samples from cases of gestational diabetes (n: 20) and preeclampsia (n: 20). It was observed that Bax expression showed positive reaction compared to Bcl-2 expression so; Bax protein was thought to be an effective marker in determining apoptotic changes in placentas with gestational diabetes and preeclampsia.

Objective: The aim of this study was to assess the interactive training on placenta and umbilical cord given to midwives who provide care for pregnant women and newborns. Methods: The midwives accepted the invitation for interactive presentation before the training. The introductory information of participants was collected by a questionnaire form prepared by researchers. Assessment of the knowledge of the participants on placenta and umbilical cord was performed by using a 24-question questionnaire form prepared by the researchers in accordance with the literature. A pre-test was conducted before the training. The participants were not informed whether the test would be repeated at first and third months after the training or not. The test was repeated 1 and 3 months later. Friedman test was used in the comparison of the mean values of more than two dependent groups as the data did not provide parametric characteristics, and Kruskall-Wallis test was used for the comparison of two groups. Statistically significant level was considered p<0.05 for all the data. Results: The mean age of midwives included in the study was 37.23±6.19 (range: 25 to 51) years, 52.9% of them had bachelor's degree, 88.2% of them were married, their total experience in their profession was 15.88±6.90 years and they were working in the same unit for 7.5 (range: 1 to 26) years. Of the participants, the mean pretest score was 12.88±2.15, and mean final test scores 1 month and 3 months later were 21.61±1.75 and 23.23±0.85, respectively. Conclusion: Interactive training given on placenta and umbilical cord provides a positive contribution to increase the knowledge score of midwives. It may be suggested to repeat in-service trainings in the organization regularly. [ABSTRACT FROM AUTHOR]

Objective: In our study, we aimed to investigate the impacts of amniotic fluid index, placental localization and fetal sex on the estimation of fetal weight by ultrasonographic method. Methods: The medical files of the patients who delivered between September 1 and December 31, 2016 in Department of Obstetrics and Gynecology, Faculty of Medicine, Selçuk University were reviewed retrospectively after obtaining the approval of ethics committee. The patients with birth weight less than 2500 g and higher than 4500 g, patients with fetal intrauterine development, diabetes and additional diseases, multiple pregnancies, the deliveries with intrauterine death or fetuses with anomalies, the patients whose cervical dilation was ≥4 cm during admission, and the patients with maternal body mass index (BMI) ≥25 were excluded from the study. The maximum duration from the ultrasonographic examination up to delivery of the patients was determined 72 hours, and the patients who delivered more than this duration were also excluded from the study. The data were compared according to fetal sex, anterior, posterior and lateral placental localizations, and oligohydramnios, polyhydramnios and normal values in the amniotic fluid index. The statistical analysis was carried out by SPSS 22.0 (SPSS Inc., Chicago, IL, USA). Kruskal- Wallis H and Student's t-tests were used for the data analysis. Results: We evaluated a total of 387 patients. The mean age was 28, the cesarean section rate was 39.8%, normal delivery rate was 60.2%, mean ultrasonographic birth weight was 3319 g (±413 g), and mean birth weight was 3330 g (±376 g). Weight deficit was calculated as 7.2% in all patients. No statistically significant difference was observed between the groups in terms of fetal sex, placental localization and amniotic fluid index. Conclusion: We found in our study that the amniotic fluid index, placental localization and fetal sex do not have a determining role on the estimation of fetal weight. [ABSTRACT FROM AUTHOR]

Amaç: Kompleman sistemi (C) ile tümör nekroz faktörü-alfa (TNFa), sistemik lupus eritematozus (SLE) ve antifosfolipid sendromunda (AFS) önemli mediatörlerdir. Çalışmamızda SLE/AFS'li gebelerde, C aktivasyonu ile TNFa'nın fetal/maternal prognozla ilişkisini inceledik. Yöntem: SLE/AFS'li gebelerin serumlarında (s) C3b, C5, TNFa düzeyleri (ELISA) belirlendi. Plasentalarının histopatolojik incelemesi yapıldı; C4d ve TNFa ile boyanmaları değerlendirildi. Gebelik seyir ve sonuçları ile ilişkileri saptandı, kontrol gruplarıyla karşılaştırıldı. Bulgular: SLE/AFS'li gebeler (n=37), SLE/AFS'li gebe olmayanlar (n=15), sağlıklı gebeler (n=15) ve sağlıklılardan (n=14) oluşan dört grup analiz edildi. SC3b ortalama değeri ve pozitiflik oranı SLE/AFS gebelerde; SLE/AFS gebe olmayanlara, sağlıklı gebelere ve sağlıklılara göre daha yüksekti (tümü için p<0,05). SLE/AFS'li gebelerde en sık morbiditeler gebelik kaybı (%18,9) ve preeklampsi (%16,2), en sık aktivasyon nefrit (%30,5) ve trombositopeniydi (%19,44). Preeklampsi gelişenlerde sTNFa pozitifliği anlamlı derecede yüksekti (%43 vs. 11, p<0,05); C5a ve C3b ise istatistiksel anlamlılığa erişmese de bu grupta fazlaydı. SLEDAI-2K ortalaması belirtilen biyomarkerların pozitif/negatif olduğu gruplar arasında anlamlı farklılık sergilemedi. sTNFa pozitifliği ile nefrit ve trombositopeni arasında anlamlı ilişki saptandı (p<0,05). Yenidoğanların (YD) %56,7'si preterm iken, %36,7'sinde intrauterin gelişme geriliği (İUGG) saptandı. SLE/AFS'de sağlıklı gebelerden daha düşük YD doğum ağırlığı, boy ve APGAR skorları mevcuttu. Plasental C4d ve TNFa ile boyanma SLE/AFS gebelerde sağlıklı gebelerden yüksek ve şiddetliydi (p<0,001). Preeklampsi, HELLP ve gebelik kayıplarında boyanma pozitiflik ve şiddeti fazla olsa da istatistiksel anlamlılığa erişemedi. Desidual vaskülopati (en sık; %85), desidual enflamasyon, villöz enfarkt SLE/AFS'li gebe plasentalarında, sağlıklı gebelerinkine göre daha fazlaydı (p<0,001). Belirtilen bulgular preeklampsi, İUGG, YDYB ihtiyacı olanlarda anlamlı derecede fazlaydı (p<0,001). Lupus antikoagülanı olanlarda desidual enflamasyon ve C4d boyanması anlamlı derecede fazlaydı (p<0,05). Sonuç: Bulgularımız SLE/AFS'li gebelerde TNFa ve kompleman sisteminin aktivasyonunu serum ve özellikle plasenta düzeyinde göstermekte ve olumsuz gebelik seyir ve sonuçlarıyla ilişkisini desteklemektedir. Gelecekte bu biyobelirteçlerin gebelik takibinde kullanımı ilgili yolakları hedef alan yeni tedavilere olanak tanıyarak maternal/fetal prognozu olumlu etkileyebilir. [ABSTRACT FROM AUTHOR]

Preeclampsia is a pregnancy complication that can be life threatening for both mother and baby when clinical findings are severe. The pathogenesis of the disease, in which the main findings are hypertension and proteinuria, is not precisely understood, but abnormal placenta formation could explain the mechanism of the clinical findings. Because of this abnormal placentation, the ischemic plasenta secretes sFLT-1 (soluble fms-like tirozine kinase-1; synonym, sVEGFR-1, soluble vascular endothelial growth factor receptor-1) and sEng (soluble endoglin), which binds to VEGF (vascular endothelial growth factor); the consequent low levels of VEGF may, along with other factors such as genetics, explain the clinical findings of preeclampsia. Babies born to pregnancies where preeclampsia is present may have complications due to prematurity and intrauterine growth restriction. The main problem for the fetus or the newborn is uteroplacental ischemia. Plasental ischemia and infarct may cause damaged decidual cells to bleed. Ablatio placenta can bring on fetal death if the bleeding occurs in the uteroplacental space. Recent studies report that not only uteroplacental insufficiency, but also the factors responsible for the pathogenesis of preeclampsia play a part in the neonatal complications. Understanding the mechanisms of the clinical findings of preeclampsia throws light on possible treatment options. Animal experiments have guided researchers with regard to reduction of sFLT-1 expression and administration of VEGF for preventing or treating preeclampsia. [ABSTRACT FROM AUTHOR]

Objective: The marginal, basal and subchorial regions of the placenta are considered to be more hypoxic than other regions. Therefore, it is not recommended to determine the increase in syncytiotrophoblast knots, based on the major morphological change in placental hypoxia, from the samples taken from these regions. However, the normal count of knots at various regions of placenta is not investigated. Material and Method: In this study we have sampled morphologically and clinically normal placenta with eccentric cord insertion from various sites, either close to cord entrance or away from it (marginal, non-marginal basal, non-marginal subchorial, and nonmarginal midparanchymal). The number of knots was calculated on a total of at least 100 villi for each placental sample. The normal amount of knots in different regions and comparison between them were investigated. Twenty-eight placentas with eccentric cord insertion were sampled in the same manner. Hot spots from the above mentioned regions were counted in a total of 100 villi. Results: No significant difference was found between the dual comparison of the mean percentages of different regions (p: 0.148). The variety of hypoxia in different regions of the placenta could not be demonstrated in this study. Conclusion: It is found that there is no difference in perfusion that can be morphologically demonstrated with increase in syncytiotrophoblast knot, between different regions of placenta. [ABSTRACT FROM AUTHOR]

Aim: To investigate the effects of hypertension on the placenta and fetus in pregnancy. Method: 25 hypertensive pregnants, 114 control women, and their infants were included in the study. Results: There was significant correlation between to the body mass index, weight before pregnancy, gestational week, hematocrit, birth weight, placenta size and weight between two groups (p=.002, .003, .003, .004, .000, .050, .032, respectively). The age, gravida, parity, abortus, living child, height, weight gain in pregnancy, hemoglobin, placenta diameter and thickness, volume of clot were similar between groups. Conclusion: As a result, hypertension in pregnancy affects the development of the fetus and placenta as well. [ABSTRACT FROM AUTHOR]

Objective: Obesity is a well-known risk factor for the pregnancy outcome. We aimed to assess the relationship among pre-conceptional obesity, birth weight and placental weight. Methods: Regularly followed-up 259 women were divided into two groups according to their pre-conceptional body mass index (BMI). There were 177 patients in the non-obese group who had BMI below 25 and 82 patients in the obese group who had BMI equal to or above 25. Babies and placentas were weighted, placental weight to birth weight ratio (PW/BW) were calculated. Results: While birth weight did not differ between the groups significantly (3294±420 vs. 3389±425), mean placental weight was significantly higher in the obese group (610±114 vs. 659±128) (p=0.004). There was a strong relationship between PW/BW ratio and maternal pre-pregnancy body mass index (BMI). This ratio was higher in the obese group when compared to the non-obese patients (18.63±3.11 vs. 19.44±2.95) (p=0.054). Conclusion: Our findings may be interpreted as the obesity causes ineffective nutrition of the baby so that relatively bigger placentas are needed by the fetus to reach its potential size. Further studies must be done to clarify the relationship between placental sufficiencies of obese patients. [ABSTRACT FROM AUTHOR]

Techniques for cesarean delivery, reliable anesthesia, blood products and antibiotics has led to the expansion of indications for cesarean birth. Nowadays, to be comfortable in anesthesia, medicine and materials used in, severe sterilization techniques, advances in surgery and postoperative care were reduced mortality and morbidity. However; caesarean section still include infection, bleeding, need for transfusion, thromboembolic risks of a longer stay in the hospital, later to be healing, but rather risks, such as the withdrawal of the pain continues. Postpartum hemorrhage inside the remaining placentas compared to normal primary complaint is that too much. At the same time ultrasonographic examination of the uterine involution does not occur, the uterus larger than normally. The aim of this case report, and the absence of postoperative bleeding, complete involution of the uterus that have not been diagnosed, and threatened her life was to present a case which is characterized by abdominal abscess. [ABSTRACT FROM AUTHOR]

Objective: We aimed in this study to determine if trophoblastic apoptosis is increased in placentas from preeclamptic women compared to healthy term control placentas. Patients and methods: 28 preeclamptic and 10 healthy control placentas were used for the study. Apoptosis in the trophoblasts were analyzed using TUNEL method and electron microscopy techniques. Results: Both groups were comparable in terms of age and parity. However, mean gestational week was significantly lower (33.2(3.2 vs. 39.1(0.5p<0.0001, respectively), and apoptotic rate in the trophoblasts were significantly higher (40.7(17.9 vs. 25.2(10.6, p<0.05, respectively) in the preeclamptic group compared to controls. Conclusion: These results suggest that trophoblast apoptosis is increased in the preeclamptic placentas and that this form of apoptosis is different from that occurring with placental aging as a consequence of cell turnover. [ABSTRACT FROM AUTHOR]

Objective: The cause of meconium stained amniotic fluid in term healthy pregnancies is not clearly understood yet. The aim of this study was to investigate the placental ultrastructural changes and placental apoptosis in pregnancies complicated with meconium stained amniotic fluid. Material and Method: The study group was composed of mothers (n: 13) and their term, appropriate for gestational age newborns with meconium stained amniotic fluid but without meconium aspiration syndrome. The control group consisted of mothers (n: 24) and their term appropriate for gestational age babies. We studied placental ultrastructural changes by transmission electron microscopy and placental apoptosis by transmission electron microscopy and the TUNEL method. Results: The incidence of placental apoptosis by the TUNEL method was significantly higher in the study group compared to the control group. Transmission electron microscopy investigation revealed more remarkable ultrastructural changes in the study group compared to the control group. Conclusion: The increased apoptosis and ultrastructural findings in placentas with meconium stained amniotic fluid may be related to the placental adaptation to the hypoxic fetuses. [ABSTRACT FROM AUTHOR]

Objective: Placental factors and hypoxemia are the keys to intrauterine growth restriction (IUGR) and stillbirth. The aim of the study is to analyze histological changes in placentas of IUGR fetuses in pregnancies with no apparent etiologic factor and unexplained intrauterine fetal deaths. Material and Methods: A total of 110 placentas were collected; 26 placentas of IUGR fetuses with no apparent cause, 58 placentas from unexplained intrauterine deaths over 20 weeks of gestation, and 26 placentas from uncomplicated pregnancies who delivered a healthy live baby. Microscopic examinations of placentas were performed for histopathological analyzes. Results: Gestational age at delivery was 33.67±4.37 weeks, 29.15±8.36 weeks, and 39.0±1.52 weeks in women in group I, group II and group III, respectively (p<0.01). Infarction and intervillous thrombosis are significantly more frequent in placentas of Group I and group II.Chronic villitis occurred in 69%, 63% and 30% of group I, group II, and group III, respectively. Placental intravascular thrombi (Group I, 31% and group II, 26%), perivillous fibrin deposition and fibrinoid necrosis(65% in Group I and 53% in group II), infarction, intervillous thrombosis, chronic villitis, hemorrhagic endovasculitis, placental intravascular thrombi, perivillous fibrin deposition, fibrinoid necrosis, erythroblastosis and villous edema were found in the study group. Conclusion: The results reported here indicate that a relationship exists between morphological changes in the placentas of IUGR and intrauterinefetal deaths. [ABSTRACT FROM AUTHOR]

Amniotic band syndrome takes different synonyms in the literature and refers to a wide spectrum of congenital anomalies. Constriction ring syndrome is one of these subgroups and the incidence varies from 1 in 3,000 to 1 in 15,000 live births. Here, we report a severe case of constriction ring syndrome presented by preterm premature rupture of membranes and placental abruption. An 18 years old, 27 weeks' pregnant, primigravid patient admitted to emergency clinic with preterm premature rupture of membranes and vaginal bleeding. During the emergency cesarean section, which was performed for fetal bradycardia, a constriction ring surrounding fetal abdomen was detected. Examination of the newborn revealed multiple extremity defects originating from amniotic bands. The risk factors causing amniyotic band syndrome are still not clear. As the syndrome is usually diagnosed at the prenatal period; the complications and the possible risks should be discussed with the patient. Postnatal surgical management of the possible deformities is reported of favorable outcome by a multidisciplinary approach. [ABSTRACT FROM AUTHOR]

Background: Preeclampsia is a disorder that occurs only during pregnancy and the postpartum period and affects both the mother and the unborn baby. It is a rapidly progressive condition characterized by high blood pressure and the presence of protein in the urine. The study was designed to investigate the histological and ultrastructural changes in placentas from pregnancies complicated by preeclampsia. Methods: Paraffin sections from placenta biopsies were prepared for light microscopic examination. For ultrastructural examination, biopsies were prepared and examined by digital scanning electron microscope. Results: Light microscopic examinations showed that the nuclei of syncytiotrophoblast layer were aggregated into clusters in numerous sprouts and in long anastomosing strands. Villous connective tissue core was progressively condensed while the fetal placental capillaries regressed up to complete disappearance. Endothelial degenerative and atheromatous changes were seen in placental stem vessels, also basal decidual arterioles showed endothelial degeneration, progressive fibrosis, and obliteration. By SEM, villous tissues from the preeclamptic cases demonstrated elongated villi with wrinkled surfaces and covered with fibrin-like plaques. Capillary loops in preeclamptic cases were sparse in number and significantly longer compared to the control cases. They exhibited fewer branches and majority of the loops were uncoiled. Conclusions: In placentas complicated by preeclampsia, ischemic damage of placental tissue with maldeveloped terminal villi occurs. These findings are consistent with an increase in fetoplacental vascular impedance where absent end-diastolic flow velocity was demonstrated in umbilical artery before delivery. These findings account for impaired gas and nutrient transfer in this disorder. [ABSTRACT FROM AUTHOR]

Objective: The microscopic and macroscopic features of placenta can contribute to the clinical understanding of premature delivery. The aim of our study was to relate the histopathological findings in the placentas of premature infants to pregnancy and explore its relation to neonatal morbidity. Materials and Methods: Placentas of 86 singleton preterm infants were examined and the association between placental pathology and the initiator of the preterm delivery such as preterm labor (PTL), preterm premature rupture of membranes (P-PROM) and pregnancy induced hypertension (PIH) were evaluated. The findings associated with acute placental inflammation or placental evidence of PIH were correlated to the initiators of preterm delivery and the clinical findings of the neonates. Results: The initiator of preterm delivery was PTL in 45%, P-PROM in 20% and PIH in 21% of the infants. Twenty percent of placentas had one or more findings associated with acute inflammation, 43% had findings associated with PIH, 23% had no identifiable pathology and 14% had other findings (intervillous thrombus, villous edema, etc.). Among mothers with placental evidence of acute inflammation, 56% had P-PROM, 38% had PTL and 6% had PIH. The mothers who had histological chorioamnionitis delivered at a younger gestational age than the mothers who had placental evidence of PIH (29 and 32 weeks, respectively; p=0.001). Histological chorioamnionitis was found to be more frequent in the placentas of infants with bronchopulmonary dysplasia (p=0.001). Discussion: This preliminary study revealed that the placental pathological findings appear to be correlated to the initiator of preterm delivery. Examination of the preterm delivery placentas gains importance in determining the etiology of preterm delivery and morbidity in infants. [ABSTRACT FROM AUTHOR]