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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OBJECTIVE: The aim of the present study was to compare the differences in symptom distress, quality
of life, and pelvic floor muscle function among Turkish women with mild, moderate, or severe urinary
incontinence.
STUDY DESIGN: One hundred and twenty women with a diagnosis of urinary incontinence (54.2%
stress urinary incontinence and 45.8% mixed-urinary incontinence) participated in the present study. The
severity of the urinary incontinence was stratified by the Incontinence Severity Index. The Turkish versions
of the Urinary Distress Inventory-6 and the Incontinence Impact Questionnaire-7 were used to assess
symptom distress and quality of life, respectively. Pelvic floor muscle strength and endurance were
measured using a non-invasive vaginal perineometer.
RESULTS: Symptom distress and quality of life significantly differed among the mild, moderate, and severe
urinary incontinence groups (p<0.001). Patients with severe stress urinary incontinence displayed
a higher decrease in quality of life than those with mild stress urinary incontinence (p<0.001).
Furthermore, severe mixed urinary incontinence had a greater impact on symptom distress and quality
of life compared to mild and moderate mixed urinary incontinence (p<0.05). The Incontinence Severity
Index score was significantly associated with the Urinary Distress Inventory-6 and Incontinence Impact
Questionnaire-7 scores (p<0.001).
CONCLUSION: Urinary incontinence affected the symptom distress and quality of life of patients in proportion
to the severity of the symptoms. Therefore, the relationship between the severity of urinary incontinence
and patients’ quality of life should be evaluated in clinical settings. To prevent the greater influence
of incontinence on the quality of life of women with urinary incontinence, early detection of urinary
incontinence and early management strategies are essential.
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OBJECTIVE: Investigate the relationship between the maximum standardize uptake value (SUVmax)
values and the prognostic factors in endometrioid-type endometrial cancer (EEC) patients undergoing
preoperative positron emission tomography / computed tomography (PET/CT).
STUDY DESIGN: We reviewed retrospectively the records of patients with EEC diagnosis who underwent
hysterectomy in Gynecologic Oncology Clinic of Tepecik Training and Research Hospital between
January 2010 and January 2017 in this retrospective study. Receiver operating characteristic (ROC)
curve analysis was performed to determine the cut-off values of SUVmax for predicting clinical parameters.
The area under the ROC curve (AUC) is presented as a measure of discrimination.
RESULTS: It was calculated that the SUVmax values in the uterine tumor were higher and statistically
significant in the presence of advanced stage (III-IV), histologic grade III, deep myometrial invasion (≥1
/ 2) and large tumor size (≥4 cm) from prognostic factors. The SUVmax values of the groups with and
without cervical invasion did not different from each other. In order to use the SUVmax value as a diagnostic
test in the ROC analysis, the AUC values were as follows; the grade of advanced stage tumor
was 0,685, the grade 3 tumor was 0,797, the depth of myometrial invasion was 0,781, and the size of
the large tumor was 0,905.
CONCLUSION: SUVmax value in primary uterine tumor was found to be higher in prognostic factors in
patients with advanced stage, high grade, deep myometrial invasion and large tumor.
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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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