OBJECTIVE: Threatened abortion is a stressful condition for a pregnant woman which may influence mental health. This study aims to investigate the relationship between threatened abortion, anxiety, and depression during pregnancy. STUDY DESIGN: Study group consisted of 121 pregnant women <20 weeks of gestation having vaginal bleeding; control group consisted of 129 pregnant women <20 weeks of gestation not having vaginal bleeding in their pregnancy until that time. Hospital anxiety and depression scale was used to assess potential anxiety and depression. RESULTS: Statistical analyses indicated that (i) vaginal bleeding group had significantly higher rates of moderate/ severe anxiety (28.1% vs. 14.7% p=0.010); (ii) there was no statistically significant difference between depression rates of the women according to the presence of vaginal bleeding (38.8% vs. 34.9% p=0.517); (iii) low education (OR=2.233; 95% CI: 1.177-4.236; p=0.014) was possible predictors of antenatal depression. Although in the univariate analyses age, gravidity, and parity were associated with anxiety, only nulliparity was found as possible predictors of anxiety (OR=2.589; 95% CI: 1.362-4.922, p=0.004). CONCLUSION: Pregnant women without obstetric complications had similar rates of depression and anxiety as in women with threatened abortion, although anxiety levels were higher in women with threatened abortion.
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OBJECTIVE: The aim of this study was to evaluate the frequency of postpartum depression, accompanying risk factors, and obstetrics and neonatal outcomes in adolescent pregnancies. STUDY DESIGN: This prospective study was conducted on adolescent and adult pregnant patients giving birth in Diyarbakir Gazi Yaşargil Training and Research Hospital of Health Sciences University between January 01 and 31, 2018. Groups were compared in terms of postpartum depression rates and postpartum depression-related factors were also determined in both groups. RESULTS: The frequency of postpartum depression was higher in adolescent patients than in adult patients but the difference was not considered statistically significant (p> 0.05). In adolescent and adult patients, the following factors were found to increase postpartum depression risk: illiteracy, living in an urban area, divorced parents, having fewer than 4 siblings, anemia and caesarean delivery (p>0.05, for all). CONCLUSION: The study showed no significant difference in postpartum depression rates between adolescent and adult pregnant patients. In both groups, the factors of illiteracy, living in an urban area, divorced parents, anemia, fewer than 4 siblings, and caesarean delivery were found to increase the risk of development of postpartum depression.
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Ozlem E. BASARAN, E. Seda GUVENDAG GUVEN, Suleyman GUVEN
Ozlem E. BASARAN, E. Seda GUVENDAG GUVEN, Suleyman GUVEN
Peripartum cardiomyopathy is one of the potentially life-threatening complications of pregnancy. It is characterized by symptoms of heart failure in the last months of gestation or within five months after birth. The objective of this case report was to report a case of peripartum cardiomyopathy. A 20-years-old (G1P0) pregnant woman was referred for further evaluation of heart failure in pregnancy. The patient’s family and medical histories were both unremarkable. She had a 36 weeks and 2 days dichorionic diamniotic twin pregnancy. Emergency cesarean section was performed under spinal anesthesia. During the early postoperative period, the patient complaint of respiratory distress and the diagnosis of peripartum cardiomyopathy was confirmed with physical examination, laboratory and echocardiography findings. She was transferred to the cardiac intensive care unit and received supplemental oxygen, noninvasive ventilation and intravenous infusion of lidocaine. She well tailored the medical therapy and she and her babies were discharged uneventfully after 10 days of delivery. The clinicians should keep in mind the diagnosis of peripartum cardiomyopathy in young woman with twin pregnancy in third trimester who presents with symptoms of heart failure even after delivery. Emergent cardiologic evaluation and intervention must be done for this rare and potentially morbid and mortal condition.
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OBJECTIVE: Stress urinary incontinence is one of the diseases that change the quality of life of women. Although there are various medical and surgical treatment modalities exist, transobturator tape surgery is one of the current options with the least complication rates. The aim of this systematic review was to evaluate sexual functional results after the transobturator tape procedure. STUDY DESIGN: Data were taken from those cohort, case-control and cross-sectional studies that were done with human subjects in full texts, were written in the English language. RESULTS:A total of 24 clinical trials were evaluated. The most frequently administered scales were the female sexual function index and The Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire-12. In total, 8 clinical studies employed female sexual function index whereas 8 clinical studies administered Prolapse/Urinary Incontinence Sexual Questionnaire -12. 4 of these studies tried to understand women’s sexual functions through questions determined by the researchers (N/A). 2 of the other studies used the Sexual Impact Questionnaire and a visual analogue scale, 1 study used Nine Questions on Sexual Functioning (NSF-9) and 1 study used International Consultation on Incontinence Questionnaire Vaginal Symptoms Module (ICIQ-VS). It was found that transobturator tape surgery that is performed for incontinence produces positive results on both sexual functions and urinary functions. CONCLUSION: Maintaining urinary continence is detected to directly be correlated with sexual functions. It is of high importance that before initiating surgical treatments, clinicians should give the patients a detailed medical examination in terms of both urinary and sexual functions.
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OBJECTIVE: There are cases where ultrasonographic evaluation is inadequate in determining firsttrimester
healthy pregnancy. In these cases, both the patient and the clinician are involved in a worrying
expectation. The single serum progesterone measurement was tried to predict pregnancy prognosis
in short time period. This study evaluated the predictive value of a single serum progesterone measurement
in first-trimester pregnancy loss.
STUDY DESIGN: A prospective case-control study was conducted between July 2013 and July 2014 in
Tertiary Hospital. The study compared 106 patients with threatened abortion (vaginal bleeding or spotting)
before 13 weeks of gestation with 110 healthy control pregnancies. Samples of serum progesterone
were obtained on the day each patient was admitted to the hospital. A Beckman-Coulter macro-Enzymelinked
immunoassay (ELISA) system was used to measure serum levels of progesterone (Beckman-
Coulter, Ireland).
RESULTS: Progesterone levels were measured when the patients first visited the hospital and they
were followed until the end of the first trimester. Progesterone levels differed significantly (p=0.013) between
the two groups. The spontaneous abortion rate was significantly (p=0.044) higher in the case
group. Progesterone levels differed significantly (p=0.001) between ongoing pregnancy and spontaneous
abortion groups. Using a cut-off level of 10.7 ng/mL, the sensitivity, specificity, and positive and
negative predictive values were 92.1%, 44%, 92.6%, and 42.3%, respectively, for viable pregnancies.
CONCLUSION: A single measurement of progesterone levels in serum can predict the prognosis of a
viable first-trimester pregnancy, while it is less effective for identifying non-viable pregnancies.
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OBJECTIVE: Obesity is a very common and important health problem and it has become widespread
all over the world. Fat tissue is one of the major endocrine organs. Subcutaneous adipose tissue is associated
with many diseases such as coronary artery disease, metabolic syndrome, diabetes, impaired
lipid profile. Pregnancy is a special condition with metabolic changes involving all systems. We aimed to
investigate the relationship and correlation between abdominal fat and HbA1c because of the specific
metabolic conditions in pregnancy.
STUDY DESIGN: This is a retrospective study. Ninety-nine (n=99) pregnant women between the ages
of 20 and 40 were included in the present study. They have not any other chronic diseases.
Ultrasonography was performed between 16.-28. weeks. Abdominal subcutaneous fat tissue was measured
during 16-28 weeks of pregnancy. Routine biochemical parameters and HbA1c were evaluated.
RESULTS: Subcutaneous fat tissue had a positive correlation with metabolic parameters such as weight
and BMI, and a negative correlation with vitamin D level. There is a positive strong correlation with
HbA1c level. There was not any correlation between HbA1c and metabolic parameters like triglyceride,
LDL, HDL, and cholesterol.
CONCLUSION: There was a strong positive correlation between abdominal subcutaneous fat tissue
thickness and HbA1c. However, we didn’t find any correlation between infant weight and metabolic parameters.
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OBJECTIVE: To determine whether there is a relationship between placental thickness and the umbilical
artery and uterine artery Doppler evaluation in the second trimester.
STUDY DESIGN: The placental thickness and the umbilical artery and uterine artery Doppler evaluations
were recorded by a single operator for patients who were admitted for an obstetric follow-up or fetal
anatomy screening at 18-28 gestational weeks. The relation between these variables was investigated
by evaluating the patients only once.
RESULTS: In our study, the mean placental thickness was 31.7 (SD±8.01) mm. The umbilical artery
Doppler parameters did not correlate with the placental thickness. The uterine artery Doppler systolic/
diastolic velocity, Pulsatility index and Resistance index values positively correlated with the placental
thickness. However, these correlations were not statistically significant.
CONCLUSIONS: Although there was no relationship between the placental thickness and obstetric
Doppler parameters in this study, we suggest that they are likely important factors and their significance
should be evaluated in future studies.
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OBJECTIVE: To investigate the effects of pre-delivery hematological parameters on birth weight and to
compare their relationship with maternal age and parity in women who had taken routine iron supplementation
during pregnancy
STUDY DESIGN: A retrospective study was conducted among low-risk pregnant women who were delivered
at term. Pre-delivery hematological parameters and clinical information were extracted from patient
files and compared with birth weights. Women with known hematological disorders, women with the
previous history of intravenous iron treatment and the ones who did not regularly use iron supplementation
were excluded.
RESULTS: All patients (1066) had undergone complete blood testing before delivery. Mean values for
hemoglobin, hematocrit, mean corpuscular volume, red blood cell count and red cell distribution width
were as follows; 10.9g/dL (±1.4), 34.6 % (±4.3), 84.6fL (±7.8), 4.1g/dL (±0.4), and 14.2 % (±2.5), respectively.
When all patients are evaluated, 300 (28%) of them were found to be anemic according to
Word Health Organization criteria but not for the former ACOG cut-off, which was 9.5 g/dL. There was
no significant association between pre-delivery anemia and birth weight. However, the anemic women
group was found to be slightly younger than non-anemic ones according to both criteria.
CONCLUSION: Our results documented that younger age was associated with more pronounced anemia
before delivery. This study did not show any association between pre-delivery anemia and low birth
weight irrespective of maternal age. There is a need for further reports investigating the prognostic importance
of hemoglobin reduction during pregnancy for infant birth weight in specific age groups and placental
insufficiency related conditions.
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OBJECTIVE: To compare clinical pregnancy rate through ICSI-ET between polycystic ovarian syndrome
patients and women with normal ovaries (control group). We also investigated whether serum anti-
Mullerian hormone level or LH/FSH ratio may predict clinical pregnancy rate in both groups.
STUDY DESIGN: In this retrospective study, endocrine/clinical parameters and cycle characteristics of
women with polycystic ovarian syndrome (n=32) and women with normal ovaries (n=115) aged <40
years were evaluated.
RESULTS: Clinical pregnancy rate in polycystic ovarian syndrome group did not differ from that in the
control group (31.3% vs. 32.2%, p>0.05, respectively). The LH/FSH ratio was significantly higher in
women who conceived compared to women who did not in the polycystic ovarian syndrome group (0.9
vs. 0.6, respectively, p=0.4). The cut-off value of 0.6 in the LH/FSH ratio predicted clinical pregnancy
with a specificity of 76% and a sensitivity of 65% in the polycystic ovarian syndrome group. Anti-
Mullerian hormone was significantly higher in women who conceived compared to women who did not
in the control group (4.0 ng/mL vs. 2.1 ng/mL, respectively, p=0.4).
CONCLUSION: Polycystic ovarian syndrome patients have a similar clinical pregnancy rate with women
having normal ovaries through ICSI-ET. The LH/FSH ratio assessed prior to ovulation induction was significantly
higher in pregnant polycystic ovarian syndrome patients compared to polycystic ovarian syndrome
patients who did not conceive. Anti-Mullerian hormone level was significantly higher in pregnant
women compared to non-pregnant women with normal ovaries.
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OBJECTIVE: This aim of this study is to assess the ovulation induction cycles based on clomiphene citrate
and gonadotropin administration and specify the factors associated with successful outcomes.
STUDY DESIGN: This is a prospective study of 631 patients who underwent 917 ovulation induction cycles.
While clomiphene citrate was used in 680 cycles (74.2%) and recombinant follicle-stimulating hormone
was administered in 237 cycles (25.8%).
RESULTS: A total of 153 pregnancies were achieved in 917 ovulation induction cycles, indicating a clinical
pregnancy rate of 16.7%. The ovulation induction cycles which ended up with clinical pregnancy had
a significantly lower frequency of smoking (p=0.005), shorter infertility duration (p=0.001), higher basal
luteinizing hormone (p=0.021) and lower basal progesterone (p=0.008) than unsuccessful cycles. The
clomiphene citrate cycles which ended up with clinical pregnancy had a significantly lower frequency of
smoking (p=0.011), shorter infertility duration (p=0.001) and lower basal progesterone (p=0.013) than
the unsuccessful cycles. The recombinant follicle-stimulating hormone cycles which ended up with clinical
pregnancy had a significantly higher basal luteinizing hormone (p=0.008) than the unsuccessful cycles.
Basal luteinizing hormone and progesterone concentrations could significantly distinguish the patients
who were able to conceive in ovulation induction cycles (p=0.021 and p=0.008, respectively).
CONCLUSIONS: Smoking, longer duration of infertility, and elevated basal progesterone are poor prognostic
factors for clinical pregnancy in clomiphene citrate and recombinant follicle-stimulating hormone
cycles.
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