OBJECTIVE: The aim of this study is to evaluate perinatal outcome of fetal echogenic bowel.STUDY DESIGN: In this retrospective cohort study, fetuses with echogenic bowel diagnosed and followed in our center between 2013-2017 were included. Fetuses and infants were evaluated in terms ofantenatal comorbidities and postnatal persistent diseases. Infants were followed-up to June 2018 fromtime of diagnosis. Demographic questionnaire and face to face interview were used to obtain data including immune system diseases and respiratory system pathologies in infants.RESULTS: A total of 100 fetuses with echogenic bowel were included in the study. Fetal aneuploidy wasdetected in 7 (7%) cases. Trisomy 21 was the most common aneuploidy and identified in 4 (4%) cases.Other chromosomal disorders were tetrasomy 12p (1%), 69XXX (1%) and 46 XX, t (2,22) (9q9) (1%). Afetal echogenic bowel was associated with major congenital malformations in 25 (%25) cases. Cardiacabnormality was the most prevalent (%7). First and second trimester vaginal bleeding history was foundin 5 pregnant women. In 3 case with isolated echogenic bowel (no congenital malformation and aneuploidy), lactose intolerance, celiac disease, and non-obstructive hydrocephalus were diagnosed in earlychildhood.CONCLUSION: Isolated fetal echogenic bowel which can be considered as a soft marker for aneuploidymay be associated with lactose intolerance and celiac disease. Further clinical studies are warranted toevaluate this relationship.
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OBJECTIVE: To analyze whether the time the patients entering into prenatal care affects the route ofdelivery, maternal, and fetal outcomes.STUDY DESIGN: The electronic medical files of 17,035 women who delivered at the same hospital between January 2008 and December 2014, were retrospectively reviewed. Pregnant women were distributed into one of 5 groups (No-prenatal-visit group, Only-pregestational-visit group, First-visit-prior-to24-weeks-follow-up group, Early-third-trimester-follow-up group, Late-third-trimester-follow-up group)according to the time of their first pregnancy follow-up visit. The route of delivery, maternal anemia, andfetal outcomes were compared among the groups.RESULTS: Pregnant women in the no-prenatal-visit group were younger and showed higher rates ofvaginal delivery (56%), term deliveries (90.7%), and postpartum anemia. Those in the first-visit-prior-to24-weeks group were older and showed higher rates of both primary and secondary cesarean (58%),and higher rates of term deliveries (93.6%) and lower postpartum anemia. Both the primary and secondary cesarean rates were higher in groups with frequent and early follow-up visits than in a no-prenatal-visit group and late-third-trimester-follow-up group (p<0.001).CONCLUSION: The rates of cesarean deliveries were found to be increased prominently in pregnantwomen who began antenatal care early in pregnancy with frequent follow-ups.
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OBJECTIVE: In this study, we aimed to determine the frequency of etiologic factors that causes postmenopausal bleeding.STUDY DESIGN: For the purpose, a total number of 200 women with postmenopausal bleeding wereincluded in the study. Medical records regarding history, physical examination, and endometrium biopsyof these cases were retrospectively analyzed. The frequency of etiologic factors and relevancy of pathological results with demographic factors were determined.RESULTS: Most frequent histopathologic diagnosis of the women with postmenopausal bleeding wereestablished as endometrial atrophy, endometrial polyp, inadequate material, cancer, proliferative endometrium, endometrial hyperplasia, and other disorders respectively. Contrarily the previous studies,our study showed that estrogen replacement therapy was not a reason for postmenopausal bleeding.CONCLUSION: Although endometrial atrophy is the most frequent cause, postmenopausal bleedingshould promptly be evaluated since endometrial hyperplasia and cancer are frequently the underlyingcause. We found that premalignant and malignant lesions were related to the patients’ BMI (body massindex), duration of postmenopause, the presence of diabetes, determination of thick endometrium by ultrasonography.
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OBJECTIVE: Iodine deficiency is a commonly seen problem and associated with pregnancy complications. In this study, we aimed to evaluate urinary iodine status in pregnant women with hyperemesisgravidarumSTUDY DESIGN: A total of 121 women experiencing singleton pregnancies between 6 and 18 weeksof gestation were included in the study. The participants were divided into two groups; group 1 comprised 81 healthy pregnant women, and group 2 comprised 40 pregnant women with HyperemesisGravidarum.RESULTS: Urinary iodine levels were found to be significantly higher in healthy pregnant women thanwomen with Hyperemesis Gravidarum (p=0.008). Urinary iodine was significantly correlated with the urinary ketone (r= -0.252, p=0.005) and FT3 (r= -0.190, p=0.037).CONCLUSION: In pregnant women with hyperemesis gravidarum, oxidative stress was increased, urinary iodine levels were significantly low and negatively correlated with disease severity. Thus, ıodine replacement might be essential to prevent pregnancy complications.
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OBJECTIVE: Placenta previa may cause massive hemorrhage at antenatal, intrapartum or postpartumperiods and is one of the leading causes of maternal morbidity and mortality. Anterior or posterior location of placenta previa can change cesarean technique and management of the operation. Aim of thisstudy is to assess factors increasing intraoperative complications in patients with placenta previa and investigate the significance of anterior placenta location apart from other factors.STUDY DESIGN: This is a retrospective cohort study which was conducted in one center including 83patients followed with placenta previa in three years’ duration. Placental location, presence, and depthof myometrial invasion, previous uterine surgery and the type of uterine incision were evaluated.Intraoperative hemorrhage, need for blood transfusion and hysterectomy, complete blood count parameters of mother and newborn were compared between the anterior and posterior placenta previa.RESULTS: Previous uterine surgery, abnormally invasive placenta and need for blood transfusion weresignificantly higher in patients with anterior placenta previa. The increasing number of previous cesareanoperations enhanced placental invasion to cesarean scar area in anterior placentation, leading to higherrates of blood transfusion, classical incision, and hysterectomy. Also, when the patients with previouscesarean or classical incision were excluded, anterior placentation differed significantly when comparedwith posterior placentation with respect to hemoglobin differences between preoperative and postoperative values.CONCLUSION: Anterior location of placenta previa increases hemorrhagic complications. Placental location, presence, and depth of invasion should be assessed and timing of delivery should be plannedwith appropriate preparation of blood products before delivery.
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OBJECTIVE: To evaluate the subsequent pregnancy outcomes of women who have experienced unexplained stillbirth in their previous gestations.STUDY DESIGN: This retrospective cohort consisted of 14 pregnancies who had stillbirth (withoutknown risk factors) in their previous pregnancies. These patients had been included in a special preconceptional care program to be evaluated in terms of etiological risk factors for stillbirth. At least oneof the risk factors, such as methylenetetrahydrofolate reductase polymorphisms, hereditary thrombophilias and autoimmune problems, were defined in this study population. After detection of pregnancy,the patients were administered low-dose low-molecular-weight heparin (enoxaparin, 1×2000 Anti-XAIU/0.2 mL/day), low-dose salicylic acid (100 mg/day) and low-dose corticosteroid (methylprednisolone,1×4 mg/day orally) in necessary cases.RESULTS: Out of 14 pregnancies, 4 (28.5%) ended up with miscarriages at 9, 11, 11 and 15 gestationalweeks, respectively. The remaining 10 pregnancies ended up with alive deliveries. The mean gestational week at birth was 36.4±0.51, while the mean birthweight was 2882±381.01 g. Out of 10 pregnancies, only one was diagnosed as IUGR. Only two newborn necessitated hospitalization in the neonatal intensive care unit due to respiratory problems. Both newborns were discharged from the neonatalintensive care unit without any further complication at the post-partum 5th day.CONCLUSION: Patients with a prior stillbirth should be screened for methylenetetrahydrofolate reductase polymorphisms, autoimmune problems and hereditary thrombophilias, especially in case of absence of any etiological factor. Management of these patients with low-dose aspirin, low-dose lowmolecular weight heparin and corticosteroids seemed to be beneficial for increasing live birth rates andavoiding obstetric complications.
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OBJECTIVE: In recent years, the number of infertile couples who desire pregnancy with assisted reproduction techniques is increasing. Smoking and alcohol consumption are important factors affectingthe treatment of fertility and assisted reproductive techniques. To evaluate the effect of smoking and alcohol consumption on spermiogram resultsSTUDY DESIGN: This prospective case-control study was conducted at current urology and infertilitydepartment in a tertiary research hospital and a total of 6171 cases included in the study. Data collectedand evaluated were age and sperm parameters (liquefaction, semen volume, sperm concentration, totalnumber, total motility, progressive motility, slow motility, non-progressive motility, morphology).RESULTS: Of 6171 patients; a total of 3247 men was smoker (n:3247, %52.6) and 3511 was alcoholusers (n:3511, %56.9). Mean age of the patients in the study group was 32.8±6.5 years. There was a statistically significant difference between the smoker and nonsmoker in terms of sperm concentration andslow motility (p <0.05). There was a statistically significant difference between alcohol consumption andno alcohol consumption in terms of; semen volume, sperm concentration, normal morphology (p <0.05).CONCLUSION: According to this study, smoking has a negative effect on sperm concentration and slowmotility. Alcohol consumption has a negative impact on semen volume, sperm concentration, normalmorphology. Smoking and alcohol consumption separately and combined were found to have a deleterious effect on sperm parameters. It is suggested that both habits may contribute to infertility problems.
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OBJECTIVE: This study aimed to investigate the effect of the COVID-19 outbreak on infertile couplesdealing with stress and anxiety during in vitro fertilization treatment.STUDY DESIGN: 252 infertile patients who applied for in vitro fertilization treatment were included inthis cross-sectional study. Data were collected via four data collection tools including socio-demographicform, COVID-19 Inventory (COVID-I), COMPI fertility problem stress scale (COMPI-FPSS), and statetrait anxiety scale. Data analysis was conducted by SPSS statistical software included statistical analysis such as averages, standard deviations, correlation, regression, and t-test.RESULTS: Both negative and weak correlations were found between COMPI fertility problem stressscale and subscales of state-trait anxiety scale as well as the total score of state-trait anxiety scale. Interms of socio-demographic characteristics of the participants and their responses in state-trait anxietyscale and ISS forms, the correlation coefficients were also so low. The results also showed that publicofficials, health professionals, and educators showed lower state-trait anxiety scale (stress-related anxiety) scores.CONCLUSION: During the COVID-19 pandemic, there was an increase in spontaneous pregnancy expectations. Although participants were mostly stressed because of the COVID-19 outbreak, they didn’tchange their in vitro fertilization treatment plans during the outbreak.
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OBJECTIVE: The aim of this study was to assess whether cigarette smoking weakens the pelvic floorand to determine its effective impact relative to other factors.STUDY DESIGN: Between September 2017 and September 2018, 250 patients admitted to an outpatient gynecology clinic was examined by a single physician and their anamnesis were taken, the dataobtained were evaluated retrospectively. As a result of the examination, the pelvic floor muscle strengthwas evaluated according to the Modified Oxford Scale and the patients evaluated as 1/5 and 2/5 weregrouped as having weak muscle strength and the rest were grouped as having high muscle strength.The intention was then to compare these two groups. The SPSS 21.0 for Windows program was usedto perform statistical evaluations. Comparative analysis was performed with regression analysis.RESULTS: 250 women participated in the study. 4 patients had muscle strength of 1/5; while 40 patientshad muscle strength of 2/5 (17.6%). Patients with muscle strength of 1/5 and 2/5 were grouped as weakmuscle strength. Advanced age, increased parity, smoking, and obesity are risk factors for a decreasein pelvic floor muscle strength (p < 0.05). Binary logistic regression analysis was performed to determinewhich of these factors has the greatest impact on pelvic floor muscle strength. Smoking has a 7-fold effect on decreased muscle strength (OR: 7.925) and obesity has a 5-fold impact (OR: 5.374).CONCLUSION: Although the mechanism of the effect of cigarette smoking on the pelvic floor is notknown, it should be remembered that this effect has an adverse impact together with other factors whichalso have proven detrimental effects.
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OBJECTIVE: Postoperative hematoma following abdominal surgery is relatively rare and mainly depends on the type of surgery. Specific treatment including surgery or interventional radiology is sometimes necessary. The aim of this study is to evaluate the cases of postoperative hematoma after gynecologic and obstetric surgery.STUDY DESIGN: This is a retrospective cohort study of 30 patients with hematoma developed after gynecologic and obstetric surgery. We included the patients who hospitalized with the diagnosis of a postoperative hematoma between June 2017 and April 2019 at Gazi Yasargil Training and ResearchHospital of Health Sciences University. Hematomas occurring after endoscopic surgery and episiotomywere not included. The diagnosed cases were divided into three groups as wound hematoma, rectussheath hematoma and intra-abdominal hematoma (intraperitoneal and retroperitoneal). All cases wereassessed by patient demographics and clinical findings, hematoma of characteristics, treatment methods and results.RESULTS: A total of 30 patients were included in the study with a mean age of 33.0±8.6 years.Incidence of hematoma account for 0.2%. The mean c-reactive protein was 37.9±47.4 mg/dL at admission and 14.6±25.8 mg/dL at discharge, respectively. The decrease was statistically significant (p <0.001). The mean hemoglobin was 10.6±2.1 g/dL at admission and 10.7±1.5 g/dL at discharge. Feverwas detected in 7 (23.3%) patients. Only 12 patients (40%) were followed up by observation and symptom management. In 10 (33.3%) patients, antibiotics were included in the treatment due to infection. Inaddition, 4 patients (13.3%) had relaparotomy, 5 patients (16.7%) underwent percutaneous radiologicaldrainage and 8 (26.7%) received blood transfusion. The mean time of resorption of the hematoma was4.6 ± 2.0 days. The evaluation of the hematoma locations revealed that 14 patients (46.7%) had woundhematoma, 7 patients (23.3%) had rectus sheath hematoma (Type I: 2 cases, type II: 3 cases, type III:2 cases), 8 patients (26.7%) had pelvic hematoma and 2 patients (6.7%) had a retroperitonealhematoma. The mean hematoma size was 68.1±15.18 mm.CONCLUSIONS: In cases of hematoma resistant to antibiotic treatment and non-resorbable hematoma,we can consider percutaneous catheter drainage as an alternative to surgical intervention
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