This study aimed to compare the rates of postpartum depression (PPD) between women with a history of vaginal birth who delivered by cesarean section in the

Comparative analysis of hormonal and metabolic indices in phenotypic subgroups of polycystic ovary syndrome - Journal of the Turkish-German Gynecological Association

Objective: This study compared fetal adrenal gland ultrasound parameters between pregnancies complicated by fetal growth restriction (FGR) diagnosed according to Delphi consensus criteria and gestational-age-matched normally grown controls, and interpreted their apparent discriminatory performance cautiously. Methods: This prospective single-center case–control study with a cross-sectional ultrasound assessment enrolled 60 singleton pregnancies (30 FGR, 30 controls) between 24 and 41 weeks’ gestation. Controls were recruited contemporaneously from the same unit and had normal fetal biometry and Doppler findings. All examinations were performed using a Voluson E8 system by a single experienced operator; operator blinding to group status was not feasible in routine clinical practice. Standard fetal biometry and Doppler indices (umbilical artery [UA] PI, middle cerebral artery [MCA] PI, uterine artery [UtA] PI) were recorded and the cerebroplacental ratio (CPR) was calculated. Fetal adrenal assessment included the total adrenal gland volume, fetal zone (FZ) width, and middle adrenal artery (MAA) Doppler PI. Results: Maternal age, body mass index, and gestational age at scan were similar between groups (p > 0.05). Compared with controls, the FGR group had higher UA PI and UtA PI and lower MCA PI and CPR (all p < 0.001). Absolute adrenal gland volume was lower in FGR (0.46 ± 0.03 vs. 0.68 ± 0.04 cm³; mean difference −0.22 cm³, 95% CI −0.24 to −0.20; p < 0.001), and FZ width was smaller (median 4.70 vs. 6.55 mm; Hodges–Lehmann shift −1.80 mm, 95% CI −2.00 to −1.70; p < 0.001). MAA PI was higher in FGR (2.44 ± 0.14 vs. 1.79 ± 0.12; mean difference 0.65, 95% CI 0.58–0.72; p < 0.001). In this selected case–control dataset, adrenal volume, FZ width, and MAA PI each showed apparent complete separation (empirical AUC = 1.00); however, these findings should be interpreted cautiously because absolute adrenal measures were not adjusted for fetal size and such performance may reflect spectrum effects in a relatively small sample. Conclusions: In pregnancies with Delphi-defined FGR, absolute fetal adrenal volume and fetal zone width were lower, and MAA PI was higher than in controls. These findings should be considered hypothesis-generating and require external validation in larger multicenter cohorts using standardized and size-adjusted measurement approaches before clinical implementation.

Background: Peak total bile acids guide management of intrahepatic cholestasis of pregnancy (ICP), potentially influencing observed outcomes. We examined their association with a composite adverse perinatal outcome (CAPO) excluding preterm delivery. Methods: This retrospective cohort included 280 singleton pregnancies with ICP delivered at a tertiary hospital between January 2023 and May 2026. Peak bile acids were categorized as <40, 40–99, or ≥100 µmol/L. CAPO comprised meconium-stained amniotic fluid, nonreassuring fetal status, neonatal intensive care admission, respiratory distress syndrome, transient tachypnea, neonatal death, or intrauterine fetal death. Logistic regression and receiver operating characteristic analysis were performed; the exploratory threshold maximized the Youden index. Results: The categories included 185, 70, and 25 pregnancies, with CAPO in 31 (16.8%), 19 (27.1%), and 19 (76.0%), respectively (p < 0.001). In the ≥100 µmol/L group, the exact 95% confidence interval for CAPO was 54.9–90.6%. The apparent area under the curve was 0.700 (95% confidence interval 0.625–0.772). The 61.3 µmol/L threshold yielded 50.7% sensitivity and 83.9% specificity. Peak bile acids per 10 µmol/L (adjusted odds ratio 1.20, 95% confidence interval 1.11–1.31) and hypertensive disorders (3.27, 1.30–8.23) were independently associated with CAPO. Conclusions: Peak bile acids showed moderate discrimination within this managed cohort. The ≥100 µmol/L subgroup had higher morbidity but imprecise estimates. The same-cohort-derived 61.3 µmol/L threshold is exploratory and requires independent validation; it should not determine delivery timing.

SUMMARY OBJECTIVE: The aim of this study was to evaluate the association between oxidative stress and cervical human papillomavirus infection and cervical intraepithelial neoplasia by measuring total oxidant status, total antioxidant status, and ischemia-modified albumin levels. METHODS: In total, 50 human papillomavirus+ women, 50 cervical intraepithelial neoplasia2/3+ women, and 50 healthy women as a control group were enrolled in the prospective case–control study. The total oxidant status, total antioxidant status, and ischemia-modified albumin levels were measured with colorimetric systems. The clinical characteristics, total oxidant status, total antioxidant status, and ischemia-modified albumin levels of three groups were compared. RESULTS: The mean total antioxidant status level was higher in the control group (1.044±0.0959 mmol/L) than in the human papillomavirus+ group (0.931±0.1034 mmol/L) and the cervical intraepithelial neoplasia2/3+ group (0.927±0.0928 mmol/L) (p<0.001). The median total oxidant status level was lower in the control group than the cervical intraepithelial neoplasia2/3+ group (4.570 [4.390–4.783] μmol/L vs. 4.780 [4.443–5.035] μmol/L, p<0.05). The ischemia-modified albumin levels were similar in three groups (p=0.220). CONCLUSION: The total antioxidant status level was lower, and the total oxidant status level was higher in women with cervical intraepithelial neoplasia2/3+ compared to the control group. These findings suggest that oxidative stress is effective in the progression of human papillomavirus infection to the preinvasive lesions of the cervix. The ischemia-modified albumin was not found to be a useful biomarker to indicate oxidative stress in women with human papillomavirus infection or cervical intraepithelial neoplasia2/3 lesions.