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Öğe Evaluation of hepatic venous pulsatility and portal venous velocity with doppler ultrasonography during the puerperium(Elsevier Sci Ireland Ltd, 1999) Pekindil, G; Varol, FG; Yüce, MA; Yardim, TObjective: The aim of this study is to evaluate pregnancy-induced changes of hepatic venous pulsatility and portal venous velocity in the puerperium and to determine if these changes disappeared by the end of the puerperium. Methods and material: Healthy normal volunteers (90) were examined on the 2nd and 7th days of puerperium and between the Gth and 8th weeks postpartum Doppler waveform patterns were obtained in the middle hepatic vein and main portal vein. The hepatic venous pulsatility was named as normal, damped or flat. Results: On the 2nd day postpartum, the hepatic vein pulsatility was shown as normal in 8 (26%), damped in 11 (37%) and flat in 11 (37%) cases. On the 7th day postpartum, 15 (50%) cases had normal, 9 (30%) cases had dampened, and 6 (20%) cases had still flat pattern. The majority of the cases (60%) displayed normal hepatic venous pulsatility in the 6th and 8th weeks of puerperium, whereas 23% had still dampened and 17%, had flat patterns. There was a trend toward normal pulsatility with increasing puerperal age. The mean portal venous velocity was still higher than the non-pregnant levels and did not showed significant alterations during puerperium. Conclusion: This study emphasised that, since pregnancy-induced alterations in hepatic venous pulsatility and portal venous velocity had not completely returned to normal in most cases until the end of the puerperium. these physiological changes should be considered whenever hepatic and portal systems are interpreted with Doppler sonography during the puerperal period. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved.Öğe Evaluation of natural coagulation inhibitor levels in various hypertensive states of pregnancy(Elsevier Science Bv, 2005) Sayin, M; Varol, FG; Sayin, NCObjective: To evaluate the role of natural coagulation inhibitors in various classifications of pregnancy associated hypertension in Turkish population living in Trakya region of Turkey. Study design: Serum uric acid levels, plasma protein C (PC), protein S (PS), antithrombin III (AT 111) activities and activated protein C resistance (APCR) were measured in 80 pregnant women with hypertension (preeclampsia, n = 32; severe preeclampsia, n = 25; eclampsia, n = 14; chronic hypertension, n = 9) and 58 healthy pregnant women. Tukey and Tamhane multiple comparison tests, Kruskal-Wallis, X 2 and Fisher's exact tests were performed for comparison of means and/or medians. Results: Serum uric acid levels were significantly elevated in women with preeclampsia and severe preeclampsia, but PS activity decreased in women with severe preeclampsia (33.2 +/- 18.9% versus 50.4 +/- 22.7%, p = 0.015) and chronic hypertension (29.5 +/- 14.5% versus 50.4 22.7%, p = 0.045) compared to healthy controls. There was no significant difference in APCR, and PC or AT III activity between the groups. Platelet counts were significantly lower in women with severe preeclampsia, compared to controls and women with chronic hypertension. Conclusion(s): Serum uric acid levels and plasma protein S activity may be useful as indices of severity of pathology in pregnancy associated hypertension. (c) 2005 Elsevier Ireland Ltd. All rights reserved.Öğe Nerve growth factor (NGF) and NGF mRNA change in rat uterus during pregnancy(Elsevier Sci Ireland Ltd, 2000) Varol, FG; Duchemin, AM; Neff, NH; Hadjiconstantinou, MDuring pregnancy, the uterus undergoes a profound sympathetic denervation. To explore whether this is associated with changes in neurotrophic factors, we assayed nerve growth factor (NGF) and NGF mRNA in the uterus of non-pregnant and pregnant rats. In the uterine horn, the concentration of NGF and its mRNA decreased during middle and late pregnancy. However, when values were corrected for the increase of uterine weight and total RNA yield during pregnancy, NGF content and mRNA per horn increased during middle and late pregnancy. Similar, but less pronounced, changes were observed in the cervix. By seven days postpartum, both parameters returned to near normal. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved.Öğe Oral nifedipine maintenance therapy after acute intravenous tocolysis in preterm labor(Walter De Gruyter & Co, 2004) Sayin, NC; Varol, FG; Balkanli-Kaplan, P; Sayin, MAims: Our aim was to evaluate the efficacy of maintenance oral nifedipine in pregnant women initially treated with intravenous ritodrine plus verapamil for preterm labor. Methods: The study included 73 patients with preterm labor with intact membranes. Patients were randomized to receive either maintenance oral nifedipine therapy (n=37) administered 20 mg every six hours or no treatment (controls, n=36) after discontinuation of acute intravenous tocolysis. Results: Compared to the control group, the mean +/- SD time gained from initiation of maintenance therapy to delivery (26.65 +/- 18.89 vs. 16.14 +/- 12.91 days, p = 0.007) and the gestational age at delivery (37.03 +/- 2.06 vs. 35.1 +/- 3 weeks, p = 0.003) were higher in the nifedipine maintenance therapy group. The proportion of patients who required one or more courses of subsequent intravenous therapy and perinatal outcomes were similar in the maintenance therapy and control groups. Conclusions: The gestational age and time gained from initiation of maintenance therapy to delivery were longer in women receiving oral maintenance tocolysis with nifedipine. However, maintenance therapy did not decrease the recurrence of preterm labor episodes or improve perinatal outcomes.Öğe Third trimester maternal plasma total fibronectin levels in pregnancy-induced hypertension: Results of a tertiary center(Sage Publications Inc, 2006) Aydin, T; Varol, FG; Sayin, NCThe aim of this study was to evaluate maternal plasma total fibronectin values in pregnancy-associated hypertension in women in the third trimester of pregnancy. A total of 125 pregnant women at the 24th week of gestation participated in this study. Nonpregnant normotensive women were included as control group (n = 30). Plasma samples for fibronectin were obtained at the 24th, 28th, and 32nd weeks of gestation from all pregnant patients. From this cohort, 10 patients met the criteria for the diagnosis of gestational hypertension and 15 women met the stringent requirements of preeclampsia, whereas 100 patients were normotensive later in gestation. Plasma total fibronectin levels were determined by radial immunodiffusion technique. Data were analyzed using the SPSS program. The mean plasma fibronectin levels of the pregnant women in whom gestational hypertension and preeclampsia developed were significantly higher at the 24th, 28th, and 32nd weeks in comparison to normotensive pregnant women (p < 0.001). However, throughout the period from the 24th to 32nd weeks of pregnancy, plasma total fibronectin levels did not exhibit a significant change in normotensive pregnant patients or in patients with preeclampsia and gestational hypertension. There was also no correlation between plasma fibronectin levels and gestational age, mean arterial pressure, birth weight, and 5-minute Apgar scores in all groups (p < 0.05). The elevated maternal plasma fibronectin level over 40 mg/dL is capable of predicting preeclampsia with a sensitivity of 73% and a specificity of 92%. These results suggest that serial plasma fibronectin measurements before 24 weeks' of gestation may be helpful in the early detection of preeclampsia in normotensive gravid women who are destined to become clinically preeclamptic.
