Predictive effect of thiol/disulfide homeostasis dynamics on early pregnancy viability: A case-control study

Objective

The main aim of this study was to investigate the differences in maternal serum thiol/disulfide homeostasis among women with abortion imminens (AI), missed abortion (MA), and healthy pregnancies during the first trimester.

Materials and Methods

This was a prospective case-control study. This study was conducted on pregnant women who visited the Obstetrics Clinic at University of Health Sciences Turkey, Etlik Zübeyde Hanım Gynecology Training and Research Hospital and were diagnosed with either AI or MA during the 6th to 14th weeks of pregnancy. The participants had a normal pregnancy follow-up, no chronic illnesses, and did not take any multivitamin or antioxidant supplements except for folic acid. The study incorporated 33 pregnant women with AI, 36 with MA, and 40 with normal pregnancies. Age, and body mass index were matched across the three groups. This study used a recently developed automated spectrophotometric technique to quantify thiol/disulfide concentrations.

Results

The AI group had considerably elevated levels of total thiol and native thiol (SH) compared with the MA group. Nevertheless, there was no notable disparity observed between the group of healthy pregnancies and the other two groups. Serum disulfide (SS) levels did not exhibit any significant variations among the three groups. Similarly, the ratios of SS/SH, SS/total thiol, and SH/total thiol did not show any significant differences between the groups (p>0.05).

Conclusion

Patients with MA had decreased levels of total thiol and SH, which possess antioxidant capabilities, compared to the AI group. A decrease in antioxidant levels in the body may contribute to the etiology of MA. When considering our findings alongside existing literature, it remains inconclusive whether the serum thiol-disulfide ratio can predict a healthy pregnancy or MA following AI. Therefore, it is not yet seen as a promising diagnostic tool for assessing pregnancy viability. Additional investigation is required to establish the influence of dynamic thiol/disulfide homeostasis on early pregnancy loss.

Persistent Left Superior Vena Cava: Why is Prenatal Diagnosis Important?

ObjectiveTo investigate fetal anomalies and pregnancy outcomes in pregnancies with persistent left superior vena cava (PLSVC) to provide assistance in prenatal counseling.MethodsCases diagnosed with PLSVC between January 2015 and January 2020 were obtained from the hospital's electronic system and were analyzed retrospectively.ResultsTwenty-seven cases were analyzed. The prevalence of PLSVC among congenital heart diseases (CHD) was 6.9%. Conotruncal anomalies and renal anomalies were the most common accompanying cardiac and extracardiac anomalies, respectively. Chromosomal abnormality was detected in one fetus.In the postpartum period coarctation of aorta (CoA) was found in one fetus.ConclusionsWhen PLSVC is detected during prenatal ultrasonography, fetal anatomy should be carefully examined because of the anomalies that may accompany it. Prenatal genetic counseling should be given especially to cases with additional anomalies. In isolated cases, cardiac anatomy should be evaluated with repeated echocardiography because of the risk of CoA.

Tetanus vaccine during pregnancy: data of a tertiary hospital in Turkey

Background/aim

To evaluate the prevalence of tetanus vaccination in pregnant women and determine the factors affecting the vaccination and barriers to vaccination.

Materials and methods

An observational-descriptive study was conducted on 494 women who gave birth at the Etlik Zübeyde Hanım Women’s Health Training and Research Hospital, Ankara, Turkey. Participants were divided into 2 groups, vaccinated and unvaccinated. Sociodemographic characteristics, obstetric history, and prenatal care status were compared between the 2 groups.

Results

There were 242 (48.9%) and 252 (51.1%) women in the vaccinated and unvaccinated groups, respectively. The vaccination rate decreased as the number of pregnancies increased (P = 0.009). As the level of income increased, there was a statistically significant increase in the vaccination rate (P = 0.048). The status of education and having an occupation did not affect the vaccination rate (P > 0.05). The vaccination rate was higher in women with regular follow-ups when compared to those who did not get a regular follow-up (76.5% vs. 38.7%) (P = 0.001). The vaccination rate was significantly higher in women who had knowledge about tetanus vaccine during pregnancy (P < 0.005).

Conclusions

All pregnant women should be encouraged to get regular antenatal care to increase vaccination rates. Health care providers should give all pregnant women detailed information about the safety, effectivity, and benefits of vaccines.

Vitamin D deficiency in adolescent pregnancy and obstetric outcomes

OBJECTIVE

The aim of this study was to evaluate the rates of vitamin D deficiency in adolescent pregnants and its influence on the obstetric outcomes.

MATERIALS AND METHODS

A total of 300 singleton pregnant women aged between 14 and 20 years, were divided into three groups according to their gestational weeks (100 pregnant adolescents from each trimester). Randomly selected 300 singleton pregnant women older than 20 years of age with the similar gestational ages were designed as the control group at the same time period. We divided serum 25(OH)D levels into three categories deficiency, inadequacy and adequate levels according to the Endocrine Society guidelines. Serum 25(OH)D levels were also evaluated according to age, seasons and gestational periods. Adverse obstetric outcomes were recorded.

RESULTS

Overall, 86% of the subjects were found to have deficient 25(OH)D levels (<20 ng/ml). The levels indicated an inadequate state in 72 subjects (12%) and only 12 (2%) women had adequate 25 (OH) D levels. Among adult pregnant women the rates of deficient, inadequate and adequate levels were 88.3%, 11%, and 0.7% respectively. Among adolescent pregnant women these rates were 83.7%, 13%, and 3.3% respectively. The lowest 25(OH)D levels occurred during the winter while the highest levels were detected during the summer in both groups. Calcidiol, 25(OH)D, was a significant predictor for preterm delivery (AUC = 0,909; p < 0,001) and also for SGA (AUC = 0,915; p < 0,001). Maternal age was another significant predictor for SGA (AUC = 0,787; p < 0,001) and preterm delivery (AUC = 0,785; p < 0,001).

CONCLUSION

We found a high incidence of 25(OH)D deficiency in Turkish pregnant women. Adolescent age and low 25(OH)D levels are significant risk factors for PTD and SGA. Effective prophylaxis programs for vitamin D deficieny and/or fortification of foods with vitamin D are essential in pregnant women especially in the winter season.