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    Could magnetic resonance imaging contribute to detecting isolated fetal ventriculomegaly other than additional abnormalities?
    (Soc Peruana Obstetricia & Ginecologia, 2023) Omeroglu, Ibrahim; Golbasi, Hakan; Sever, Baris; Golbasi, Ceren; Oztekin, Deniz; Oztekin, Ozgur; Ekin, Atalay
    Objective: To assess the role of brain magnetic resonance imaging (MRI) in fetuses presenting with isolated ventriculomegaly (IVM) in the ultrasound (US) evaluation of the fetal brain. Methods: US and MRI findings of 197 fetuses diagnosed with IVM between November 2018 and November 2020 were retrospectively evaluated. Fetuses with abnormal karyotypes, additional anomalies, or known etiologies for ventriculomegaly were excluded. US and MRI findings were compared both in terms of mean ventricular measurements and IVM grade. Results: MRI measurements were significantly higher in mild IMV (10.33 +/- 0.38 mm vs. 11.11 +/- 0.51 mm, p< 0.001) compared to US. In mild IVM, MRI measured ventricles larger than US with a mean difference of 0.78 mm. There was no significant difference in US and MRI measurements in terms of mean values in moderate and severe IVM. There was good agreement between US and MRI in detecting right, left and mean IVM severity (Kappa=0.265, Kappa=0.324, and Kappa=0.261, respectively). Linear regression analyses revealed a statistically significant relationship between US and MRI measurements of the right, left, and mean IVM (p<0.001, p<0.001, and p<0.001, respectively). MRI showed perfect agreement with US in detecting IVM laterality (Kappa=1.0, p<0.001). Conclusions: In fetuses with mild IVM detected by US, fetal brain MRI evaluation should be considered for accurate diagnosis. This approach may provide effective strategies in the antenatal management and counseling of these pregnancies.
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    The effect of progesterone supplementation in women with threatened miscarriage on fetal fraction in non-invasive prenatal testing: A matched case-control study
    (Elsevier Masson, Corp Off, 2023) Ileri, Alper; Karaca, Suna Yildirim; Ileri, Hande; Karaca, Ibrahim; Golbasi, Hakan; Ozer, Mehmet; Budak, Adnan
    Aim: To evaluate the effect of progesterone use on fetal fraction (FF) in non-invasive prenatal testing (NIPT) due to the threat of first trimester miscarriage.Methods: This case control study included the pregnant who were referred to our clinic for non-invasive prenatal testing. The patients were categorized into three groups: Pregnant women with vaginal bleeding and using progesterone, pregnant women with vaginal bleeding and not using progesterone, and pregnant women without bleeding. The groups were formed by matching gestational week. Women with multiple pregnancy, BMI (body mass index) >= 25, abnormal fetal karyotype, and chronic disease were excluded from the study. Maternal characteristics, FF of the NIPT were recruited from the computer based medical records.Results: A total of 10,275 NIPT tests were performed during the study period. 3% of the patients (n = 308) were found at risk of miscarriage. 100 patients with a vaginal bleeding and 50 control patients were matched. The median value of the fetal fraction ratio was found to be 6.55 in pregnant women without vaginal bleeding, 7.05 in pregnant women who had vaginal bleeding and using progesterone, and 7.3 in pregnant women who had vaginal bleeding and did not use progesterone. Although the fetal fraction ratio was found to be higher in pregnant women with vaginal bleeding and lower in progesterone users, this situation could not reach the level of statistical significance (p = 0.351).Conclusions: The fetal fraction rate in maternal blood is not affected in pregnant women who use progesterone due to vaginal bleeding in early gestational weeks.
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    Prediction of gestational diabetes mellitus and perinatal outcomes by plasma zonulin levels
    (Springer Heidelberg, 2022) Oral, Serkan; Celik, Sebahattin; Akpak, Yasam Kemal; Golbasi, Hakan; Bayraktar, Burak; Unver, Gokhan; Sahin, Sami
    Purpose Zonulin has been shown to be associated with many metabolic disorders, including type 2 diabetes mellitus, metabolic syndrome, and obesity. In this study, we aimed to evaluate the association between maternal plasma zonulin levels and gestational diabetes mellitus (GDM) and its perinatal outcomes. Materials A total of 100 pregnant women, 56 with GDM and 44 controls, were included in this prospective case-control study. Maternal plasma zonulin levels were evaluated in each trimester. The association between zonulin levels and GDM, body mass index (BMI) and adverse perinatal outcomes was evaluated. The GDM predictability of zonulin levels for each trimester was analyzed with the receiver operator curve (ROC). Results Plasma zonulin levels were significantly higher in pregnant with GDM in all trimesters (p < 0.001; for all). Optimum cut-off values of plasma zonulin levels in predicting GDM: first trimester: 6.27 ng/mL, second trimester: 12.71 ng/mL, and third trimester: 18.38 ng/mL. BMI was significantly higher in pregnant women with GDM (30.5 vs 26.1; p < 0.001). Zonulin levels were significantly higher in pregnant women with GDM with overweight BMI [>= 25-30 (kg/m(2))] in all trimesters (p < 0.05; for all). Zonulin levels were significantly higher in pregnant women with composite adverse outcomes that included at least one of neonatal intensive care unit (NICU) admission, meconium-stained amniotic fluid, and 1st minute APGAR score < 7. Conclusion Increased maternal plasma zonulin levels were associated with increased risk of GDM and adverse perinatal outcomes. Zonulin may be a potential marker to predict GDM risk and perinatal outcomes.