n this review, we reviewed current literature on COVID-19 infection during pregnancy and provided... more n this review, we reviewed current literature on COVID-19 infection during pregnancy and provided up-to-date information and community/society recommendations. Although it has previous examples such as SARS and MERS and the infection findings appeared at an earlier period and have become known in China, the infection could not be limited and spread worldwide. Until June 8, 2020, a total of 6.8 million cases were reported and 397,000 cases died. As of the same date, the total case number in Turkey is 171,000 and total number of death is 4711. COVID-19 virus spread by droplets and its incubation period varies between 2 and 14 days. The rate of asymptomatic cases is 42% in non-pregnant patients while it is 44–89% in pregnant women. The disease progresses with mild-medium severity in about 80% of the patients, and it recovers by itself. A total of 17 maternal death cases has been reported. Although vertical transmission risk is very low according to a study investigating 265 pregnant wo...
Objective Previous studies have established the association between preeclampsia (PE)-induced str... more Objective Previous studies have established the association between preeclampsia (PE)-induced stress on fetus and elevated 17-hydroxyprogesterone levels (17-OHP) of which known as a stress markers. The aim of our study was to evaluate the relationship between these markers that were analyzed via cord blood with the severity of PE. Methods Consecutive PE women who were admitted to Dr. Lütfi Kırdar Training and Research Hospital Obstetrics and Gynecology Clinics from August 2009 to December 2009 were recruited. Uncomplicated pregnant women admitted at the same period consisted the control group. Umbilical blood samples were collected from umbilical artery immediately after birth and 17-OHP analyzed. Results The study group consisted of 40 mild PE (n=12) and severe PE patients (n=28) and the control group consisted of 35 patients. Maternal age and body mass index were similar between the study groups, but the fetuses in the severe PE group had a smaller mean gestational age and mean bi...
Turkish Journal of Obstetrics and Gynecology, 2009
OBJECTIVE: To investigate Hepatitis B virus (HBV) seroprevalance in pregnant women and establish ... more OBJECTIVE: To investigate Hepatitis B virus (HBV) seroprevalance in pregnant women and establish the relation between sociodemographic characteristics, risk factors and HBV seroprevalance. DESIGN: A cross sectional study. SETTING: A tertiary referral center. PATIENTS: A group of 236 pregnant women between 17-44 years of age, admitted to pregnancy outpatient clinic between May 2007 – November 2007 were enrolled. INTERVENTIONS: No intervention. MAIN OUTCOME MEASURES: Age, place of birth, health insurance, area, education, occupation, level of income, obstetric history, history of any past operations, history of dental operation, blood and/or blood products transfusion history, personal history of jaundice, family history, immunization for hepatitis B were recorded. HBV seroprevalance was investigated by serologic tests for Hepatitis B surface antigen (HbsAg) and Hepatitis B surface antigen antibody (Anti-HbsAg) examined by ELISA. Hepatitis B virus seroprevalance was defined as the rat...
Gynecology Obstetrics and Reproductive Medicine, 2011
OBJECTIVE: Low serum levels of high-density lipoprotein (HDL) cholesterol have been found to be a... more OBJECTIVE: Low serum levels of high-density lipoprotein (HDL) cholesterol have been found to be associated with the severity of the inflammatory disorders. Moreover; it has been shown that preeclampsia is a disorder of immune system with predominant involvement of proinflammatory molecules. Therefore the purpose of the present study was to assess whether blood serum HDL cholesterol levels could be used as a predictor of the severity of preeclampsia. STUDY DESIGN: Forty women with preeclampsia were recruited and thirty-five normal pregnant women were matched for both maternal age and gestastional age served as control. The materials were collected immediately after delivery of the fetus, before placenta expulsion and before clumping of the umblical cord in patients and controls whom were in fasting state. Total cholesterol, HDL cholesterol, triglyceride (TG) and low-density lipoprotein (LDL) cholesterol levels were assessed. RESULTS: Among the preeclamptic women, 12 were diagnosed wi...
Address for Correspondence / Yazışma Adresi: Uzm. Dr. Oluş Api, Acelya Sok. No: 12/2 34865 Dragos... more Address for Correspondence / Yazışma Adresi: Uzm. Dr. Oluş Api, Acelya Sok. No: 12/2 34865 Dragos, Kartal, Istanbul, Turkey Phone: +90 532 434 15 82 e.mail: [email protected] Objective: To present clinical and ultrasonographic features of two fetal diastematomyelia cases diagnosed prenatally. Cases: The first presented case was a 19 years old, gravida 1, para 0 woman and was admitted to our perinatology clinic at 21 weeks of gestation. She was referred with a prediagnosis of spina bifida at the level of the fifth lumbar vertebra. A widening of the spinal canal, echogenic bony spur traversing the spinal canal, intact skin and soft tissues overlying the affected spinal segment were detected upon detailed ultrasonographic examination. There were no associated spinal anomalies and maternal serum alphafetoprotein level was within normal ranges. The patient was counseled about the malformation and its favourable prognosis. The baby girl was delivered at 38 weeks of gestation and she under...
Gebelik ve tiroid konusunda son y›llarda yeni bulgular ve yorumla-r›n ortaya ç›kmas› ve bunun son... more Gebelik ve tiroid konusunda son y›llarda yeni bulgular ve yorumla-r›n ortaya ç›kmas› ve bunun sonucunda klinik uygulamada meydana gelen kar›fl›kl›klar›n a盤a kavuflturulmas› ve bilimsel verilerin belirlenmesi amac› ile Perinatal Tiroid Çal›fltay› gerçeklefltirilmifltir. Temel sonuç, maternal oral L-tiroksin al›m› intrauterin hayatta fetal hipotiroidiyi tedavi edemedi¤inden, L-tiroksin tedavisi almakta olan bir anneye, bu tedavinin fetüsteki olas› bir hipotiroidiyi de tedavi edebilece¤ini söylemek bilimsel olarak do¤ru de¤ildir. Aflikar hipotiroidinin kötü gebelik sonuçlar›yla iliflkisi kan›tlanm›fl oldu¤undan gebelik s›ras›nda saptan›r saptanmaz hemen tedaviye bafllanmal›d›r. Subklinik hipotiroidinin, aflikar hipotiroididen daha yayg›n olarak görüldü¤ü bilinmektedir. Subklinik hipotiroidi ile olumsuz gebelik sonuçlar› aras›nda bir iliflki gösterilmifl olmas›na karfl›n, randomize kontrollü çal›flmalarda böyle bir iliflki ortaya konmam›flt›r. Maternal oral L-tiroksin al›m› intrauterin hayatta fetal hipotiroidiyi tedavi etmemektedir. Aflikar hipertiroidizmin pek çok sebebi olmakla beraber, gebelikte en s›k Graves hastal›¤›na ba¤l› olarak ortaya ç›kar. Bu nedenle, gebelik s›ras›nda saptan›r saptanmaz hemen tedaviye bafllanarak annenin hafif hipertiroid durumda tutulmas› hedeflenir. Tedavide en s›k tercih edilen ilaç, plasentay› minimal oranlarda geçti¤inden dolay› propiltiyourasildir (PTU). Gebeli¤in bafllang›c›nda tarama, sadece tiroid stimülan hormon (TSH) düzeylerinin ölçümünü gerektirir. Serbest veya total T4 ölçümü sadece TSH'da bir de¤ifliklik oldu¤unda gereklidir. Benzer flekilde, gebelikte antitiroid antikor-lar›n, tarama lehine veya aleyhine öneride bulunmak için yeterli delil bulunmad›¤›ndan, rutin olarak taramada kullan›m› önerilmemektedir. Mevcut literatür, k›lavuzlar ve uzman görüflleri genel olarak de¤erlendirildi¤inde, tüm gebe kad›nlar›n ilk trimesterde TSH ile ta-ranmas›n›n uygun olmad›¤› ortaya ç›kmaktad›r. TSH ile tarama yal-n›zca riskli olgulara yap›lmal›d›r. Ülkemizde antenatal bak›m sürecinde tüm gebelere rutin iyot deste¤ini önermek için bilimsel veriler flimdilik yetersiz görünmektedir. Ancak, ülkemizdeki gebelerde iyot eksikli¤i prevalans›n›n belirlenmesi amac›yla yap›lacak genifl ölçekli ve toplum temelli çal›flmalara acil olarak ihtiyaç vard›r.
We described a fetus who is delivered at 32.weeks of gestation by elective cesarian because of th... more We described a fetus who is delivered at 32.weeks of gestation by elective cesarian because of the fetal anhydria and unilateral hydronephrosis.A breech coming,1950 gr, 44 cm a newborn was delivered with multiple malformations and postpartum he didn't cry and siyanosis was appeared. After first interventions the newborns respiration didn't start and bradicardy occured. For this reasons entubation was needed but several trials concluded with lack of success. There was no response to resuscitation and newborn was accepted dead. The first physical examination of the newborn,tracheal atresia, webs, left microophthalmy, bilateral corneal opaque points, bilateral finger and toes syndactyly, hypospadias, low set ears were determined. Postpartum, by our first physical examination we determined bilateral finger and toes syndactylies, laryngeal atresia, hypospadias, micreophthalmia, development abnormality of right palpeprally, absence of the eyelash at the medially part of the right palpepra and there is a adherance between the palpepra and cornea, broad nose with low nasal bridge and the left corneal opasity. These and postmortem autopsy findings confirmed the diagnosis of Fraser syndrome.In this report we will focus on postpartum examinations of severe olygohidroamnios in families even if hiperechogenic lungs, previously similarly affected children.
Turkish Journal of Obstetrics and Gynecology, 2010
OBJECTIVE: To investigate the effects of 5% dextrose and 0.9% NaCl solutions used as vehicles for... more OBJECTIVE: To investigate the effects of 5% dextrose and 0.9% NaCl solutions used as vehicles for oxytocin infusion on neonatal bilirubin levels. MATERIAL-METHOD: A total of 60 patients were included in this prospective, randomised trial. The 30 patients of the study group were randomly divided into isotonic % 0.9 saline (Group 1) (n=15) and 5% glucose solutions (Group 2) (n=15). Thirty patients without oxytocin infusion constituted the control group (Group 3). The total volume of fluid administered and total oxytocin dose were noted. Fetal umblical artery blood samples were collected for the assessment of fetal hematocrit, bilirubin, electrolytes and blood gas analyses and postpartum first day fetal capillary blood samples were collected for fetal bilirubin and hematocrit analyses. Mann-Whitney U and Kruskal- Wallis tests were used to assess the significance of statistical difference among study parameters. RESULTS: The difference between study and control groups regarding the rate...
OBJECTIVE This study was designed to evaluate the awareness, knowledge and attitudes of healthcar... more OBJECTIVE This study was designed to evaluate the awareness, knowledge and attitudes of healthcare providers related to HPV infection and vaccine. MATERIAL AND METHODS A total of 311 healthcare providers working in specialties other than obstetrics and gynecology at the Dr. Lutfi Kırdar Kartal Education and Research Hospital as physicians (n=142) or non-physician healthcare providers (n=169) were included in the present study. A questionnaire developed by researchers based on literature and including items concerning socio-demographic features, awareness of HPV infection and vaccine, attitudes related to HPV vaccine and regular gynecological controls and knowledge about HPV infection was applied to participants via a face to face interview method. Each correct answer was scored as one to decide the level of knowledge and awareness. RESULTS The frequency of parenthood was lower and the ratio of males was higher in the physician group compared to the non-physician group. Awareness of ...
These guidelines follow the mission of the World Association of Perinatal Medicine, which brings ... more These guidelines follow the mission of the World Association of Perinatal Medicine, which brings together groups and individuals throughout the world with the goal of improving outcomes of maternal, fetal and neonatal (perinatal) patients. Guidelines for auditing, evaluation, and clinical care in perinatal medicine enable physicians diagnose, treat and follow-up of COVID-19-exposed pregnant women. These guidelines are based on quality evidence in the peer review literature as well as the experience of perinatal expert throughout the world. Physicians are advised to apply these guidelines to the local realities which they face. We plan to update these guidelines as new evidence become available.
Gebelik diyabetinin tan›nmas›nda 50 g glukoz tarama testi ve pozitif tarama olgular›nda 100 g OGT... more Gebelik diyabetinin tan›nmas›nda 50 g glukoz tarama testi ve pozitif tarama olgular›nda 100 g OGTT ile tan›n›n sa¤lanmas› uygulanmakta olan bir yaklafl›m iken, Hyperglycemia and Adverse Pregnancy Outcome (HAPO) çal›flmas› sonucu kan flekeri düzeyleri ile gebelik sonuçlar› aras›nda do¤rusal iliflki oldu¤u, bunun da her de¤er art›fl› ile yak›n iliflkili bulundu¤unun saptanmas›ndan sonra, yeni bir yak-lafl›m gündeme gelmifltir. Giderek klinik uygulamada yer bulan 75 g OGTT ile tek seferde ve tek de¤ere dayal› tan› konulmas› yaklafl›-m›, gebe popülasyonunun %18'ine tan› koydurmakla beraber, son-ras›nda yap›lan diyet ve egzersiz uygulamas›n›n, gebelik sonuçlar›n› iyilefltirdi¤i ve hatta gebelik diyabeti tan›s› almayan obez olgularda bile gebelik sonuçlar›n› olumlu etkiledi¤i ortaya konulmufltur. Gebelik öncesi obezitenin gebelik sonuçlar› üzerine, gebelik diyabeti tan›s› olmad›¤› halde, etkili olmas› ve gebelikte kilo art›fl›n›n kontrol alt›na al›nmas›n›n gebelik sonuçlar›n› iyilefltirmesinin saptanmas›, konunun önemini daha da gözler önüne sermektedir. Tek de¤ere dayal› 75 g OGTT uygulamas›, iki aflamal› önce tarama ve akabinde tan› testi uygulamas›na oranla gebelik diyabeti tan›s› alan olgu say›-s›n› art›rmakla beraber; bu tan›y› alan olgularda diyet-egzersiz uygu-lamas›n›n, gebede kilo art›fl›n› kontrol alt›na alan ve ayr›ca gebelik sonuçlar› üzerine olumlu etki sa¤layan bir durumdur. Kan flekerinin 1-2 haftal›k izlemleri ile gliseminin istenen s›n›rlar›n üzerinde olma-s›, medikal tedaviyi gerektirecektir. Bu ise beklenen ve istenen bir hedef olmaktad›r. Bu nedenlerle, her gebeye tek de¤ere dayal› 75 g OGTT uygulanmas› yeni klinik uygulama olarak yerini alm›flt›r ve tavsiye edilmektedir. Bu klinik uygulama rehberi, Türk Perinatoloji Derne¤i Diyabet ve Gebelik Çal›flma Grubu taraf›ndan haz›rlan-m›flt›r.
‹zole aberan sa¤ subklavian arterin saptanmas›n›n prenatal tan›daki önemi Amaç: ‹zole aberan subk... more ‹zole aberan sa¤ subklavian arterin saptanmas›n›n prenatal tan›daki önemi Amaç: ‹zole aberan subklavian arter (ARSA) tan›s›n›n önemini de-¤erlendirmeyi amaçlad›k. Olgu: Biz bu olgu sunumunda, k›rk yafl›nda 20. gebelik haftas›nda ve yirmi sekiz yafl›nda 23. gebelik haftas›nda izole ARSA tan›s› alan iki olgunun prenatal tan›s› ve fetal sonucunu sunuyoruz. Sonuç: Normal popülasyonda görülme insidans› %1.4 olan aberan sa¤ subklavian arterin (ARSA) Down sendromlu olgularda in-sidans›n›n %40'a kadar ç›kmas›, ARSA'n›n vasküler iflaretlerden biri olarak prenatal ultrasonografik tan›s› konulabilen Down sendromu belirteçleri aras›na girmesini gündeme getirmifltir.
Amniyotik katlant› ve amniyotik bant sendromu: Birbirine kar›flabilen iki durum Amaç: Amniyotik k... more Amniyotik katlant› ve amniyotik bant sendromu: Birbirine kar›flabilen iki durum Amaç: Amniyotik katlant› tan›s› alan iki olgunun prenatal tan›s› ve fetal sonucunu de¤erlendirmek ve amniyotik bant sendromu ile amniyotik katlant›n›n ay›r›c› tan›s›n›n önemini vurgulamak ama-c›yla, prenatal dönemde amniyotik katlant› tespit edilen iki olguyu sunmay› planlad›k. Olgu: Yirmi yedi yafl›nda 22. gebelik haftas›nda ve otuz befl yafl›nda 18.gebelik haftas›ndaki 2 olgu amniyotik bant sendromu ön tan›s›yla perinatoloji klini¤imize refere edildi. Sonuç: Amniyotik katlant› ile ciddi fetal malformasyonlar ve kötü obstetrik sonuçlarla iliflkili amniyotik bant sendromunun ay›r›c› ta-n›s›n›n önemli oldu¤u, amniyotik katlant›n›n genellikle benign bir durum olmakla birlikte baz› kötü prognostik kriterler eflli¤inde perinatal morbidite ve mortalite için predispozan bir faktör olabile-ce¤i ak›lda tutulmal›d›r.
The Journal of Maternal-Fetal & Neonatal Medicine, 2015
To determine whether preeclampsia causes fetal cardiac cell damage by assessing umbilical artery ... more To determine whether preeclampsia causes fetal cardiac cell damage by assessing umbilical artery NT-proBNP, cardiac troponin I and homocysteine. A cross-sectional study with 73 fetuses between 26 and 40 weeks of gestation was performed. Thirty-three healthy mothers' fetuses were control group (Group I). While 12 mildly pre-eclamptic mothers' fetuses constituted Group II, 28 fetuses of severe pre-eclamptic mothers were Group III. Umbilical cord mean NT-proBNP levels of Group I, II and III are 520.8 ± 404.5 pg/ml; 664.2 ± 215.9 pg/ml; and 1932.8 ± 2979.5 pg/ml, respectively (p = 0.0001). The number of neonates with NT-proBNP > 500 pg/mL that indicates severe cardiac damage is higher in Group III (p = 0.001). The mean homocysteine levels are also statistically significantly higher in Group III. Cardiac troponin I levels are not different between the groups (p = 0.46). Increased NT-proBNP and homocysteine might not only indicate some degree of in-utero cardiac cell damage but also feto-placental endothelial injury in the fetuses of severe pre-eclamptic mothers. Our finding that shows no evidence of correlation between cardiac troponin I levels with cell damage and endothelial injury requires further research.
n this review, we reviewed current literature on COVID-19 infection during pregnancy and provided... more n this review, we reviewed current literature on COVID-19 infection during pregnancy and provided up-to-date information and community/society recommendations. Although it has previous examples such as SARS and MERS and the infection findings appeared at an earlier period and have become known in China, the infection could not be limited and spread worldwide. Until June 8, 2020, a total of 6.8 million cases were reported and 397,000 cases died. As of the same date, the total case number in Turkey is 171,000 and total number of death is 4711. COVID-19 virus spread by droplets and its incubation period varies between 2 and 14 days. The rate of asymptomatic cases is 42% in non-pregnant patients while it is 44–89% in pregnant women. The disease progresses with mild-medium severity in about 80% of the patients, and it recovers by itself. A total of 17 maternal death cases has been reported. Although vertical transmission risk is very low according to a study investigating 265 pregnant wo...
Objective Previous studies have established the association between preeclampsia (PE)-induced str... more Objective Previous studies have established the association between preeclampsia (PE)-induced stress on fetus and elevated 17-hydroxyprogesterone levels (17-OHP) of which known as a stress markers. The aim of our study was to evaluate the relationship between these markers that were analyzed via cord blood with the severity of PE. Methods Consecutive PE women who were admitted to Dr. Lütfi Kırdar Training and Research Hospital Obstetrics and Gynecology Clinics from August 2009 to December 2009 were recruited. Uncomplicated pregnant women admitted at the same period consisted the control group. Umbilical blood samples were collected from umbilical artery immediately after birth and 17-OHP analyzed. Results The study group consisted of 40 mild PE (n=12) and severe PE patients (n=28) and the control group consisted of 35 patients. Maternal age and body mass index were similar between the study groups, but the fetuses in the severe PE group had a smaller mean gestational age and mean bi...
Turkish Journal of Obstetrics and Gynecology, 2009
OBJECTIVE: To investigate Hepatitis B virus (HBV) seroprevalance in pregnant women and establish ... more OBJECTIVE: To investigate Hepatitis B virus (HBV) seroprevalance in pregnant women and establish the relation between sociodemographic characteristics, risk factors and HBV seroprevalance. DESIGN: A cross sectional study. SETTING: A tertiary referral center. PATIENTS: A group of 236 pregnant women between 17-44 years of age, admitted to pregnancy outpatient clinic between May 2007 – November 2007 were enrolled. INTERVENTIONS: No intervention. MAIN OUTCOME MEASURES: Age, place of birth, health insurance, area, education, occupation, level of income, obstetric history, history of any past operations, history of dental operation, blood and/or blood products transfusion history, personal history of jaundice, family history, immunization for hepatitis B were recorded. HBV seroprevalance was investigated by serologic tests for Hepatitis B surface antigen (HbsAg) and Hepatitis B surface antigen antibody (Anti-HbsAg) examined by ELISA. Hepatitis B virus seroprevalance was defined as the rat...
Gynecology Obstetrics and Reproductive Medicine, 2011
OBJECTIVE: Low serum levels of high-density lipoprotein (HDL) cholesterol have been found to be a... more OBJECTIVE: Low serum levels of high-density lipoprotein (HDL) cholesterol have been found to be associated with the severity of the inflammatory disorders. Moreover; it has been shown that preeclampsia is a disorder of immune system with predominant involvement of proinflammatory molecules. Therefore the purpose of the present study was to assess whether blood serum HDL cholesterol levels could be used as a predictor of the severity of preeclampsia. STUDY DESIGN: Forty women with preeclampsia were recruited and thirty-five normal pregnant women were matched for both maternal age and gestastional age served as control. The materials were collected immediately after delivery of the fetus, before placenta expulsion and before clumping of the umblical cord in patients and controls whom were in fasting state. Total cholesterol, HDL cholesterol, triglyceride (TG) and low-density lipoprotein (LDL) cholesterol levels were assessed. RESULTS: Among the preeclamptic women, 12 were diagnosed wi...
Address for Correspondence / Yazışma Adresi: Uzm. Dr. Oluş Api, Acelya Sok. No: 12/2 34865 Dragos... more Address for Correspondence / Yazışma Adresi: Uzm. Dr. Oluş Api, Acelya Sok. No: 12/2 34865 Dragos, Kartal, Istanbul, Turkey Phone: +90 532 434 15 82 e.mail: [email protected] Objective: To present clinical and ultrasonographic features of two fetal diastematomyelia cases diagnosed prenatally. Cases: The first presented case was a 19 years old, gravida 1, para 0 woman and was admitted to our perinatology clinic at 21 weeks of gestation. She was referred with a prediagnosis of spina bifida at the level of the fifth lumbar vertebra. A widening of the spinal canal, echogenic bony spur traversing the spinal canal, intact skin and soft tissues overlying the affected spinal segment were detected upon detailed ultrasonographic examination. There were no associated spinal anomalies and maternal serum alphafetoprotein level was within normal ranges. The patient was counseled about the malformation and its favourable prognosis. The baby girl was delivered at 38 weeks of gestation and she under...
Gebelik ve tiroid konusunda son y›llarda yeni bulgular ve yorumla-r›n ortaya ç›kmas› ve bunun son... more Gebelik ve tiroid konusunda son y›llarda yeni bulgular ve yorumla-r›n ortaya ç›kmas› ve bunun sonucunda klinik uygulamada meydana gelen kar›fl›kl›klar›n a盤a kavuflturulmas› ve bilimsel verilerin belirlenmesi amac› ile Perinatal Tiroid Çal›fltay› gerçeklefltirilmifltir. Temel sonuç, maternal oral L-tiroksin al›m› intrauterin hayatta fetal hipotiroidiyi tedavi edemedi¤inden, L-tiroksin tedavisi almakta olan bir anneye, bu tedavinin fetüsteki olas› bir hipotiroidiyi de tedavi edebilece¤ini söylemek bilimsel olarak do¤ru de¤ildir. Aflikar hipotiroidinin kötü gebelik sonuçlar›yla iliflkisi kan›tlanm›fl oldu¤undan gebelik s›ras›nda saptan›r saptanmaz hemen tedaviye bafllanmal›d›r. Subklinik hipotiroidinin, aflikar hipotiroididen daha yayg›n olarak görüldü¤ü bilinmektedir. Subklinik hipotiroidi ile olumsuz gebelik sonuçlar› aras›nda bir iliflki gösterilmifl olmas›na karfl›n, randomize kontrollü çal›flmalarda böyle bir iliflki ortaya konmam›flt›r. Maternal oral L-tiroksin al›m› intrauterin hayatta fetal hipotiroidiyi tedavi etmemektedir. Aflikar hipertiroidizmin pek çok sebebi olmakla beraber, gebelikte en s›k Graves hastal›¤›na ba¤l› olarak ortaya ç›kar. Bu nedenle, gebelik s›ras›nda saptan›r saptanmaz hemen tedaviye bafllanarak annenin hafif hipertiroid durumda tutulmas› hedeflenir. Tedavide en s›k tercih edilen ilaç, plasentay› minimal oranlarda geçti¤inden dolay› propiltiyourasildir (PTU). Gebeli¤in bafllang›c›nda tarama, sadece tiroid stimülan hormon (TSH) düzeylerinin ölçümünü gerektirir. Serbest veya total T4 ölçümü sadece TSH'da bir de¤ifliklik oldu¤unda gereklidir. Benzer flekilde, gebelikte antitiroid antikor-lar›n, tarama lehine veya aleyhine öneride bulunmak için yeterli delil bulunmad›¤›ndan, rutin olarak taramada kullan›m› önerilmemektedir. Mevcut literatür, k›lavuzlar ve uzman görüflleri genel olarak de¤erlendirildi¤inde, tüm gebe kad›nlar›n ilk trimesterde TSH ile ta-ranmas›n›n uygun olmad›¤› ortaya ç›kmaktad›r. TSH ile tarama yal-n›zca riskli olgulara yap›lmal›d›r. Ülkemizde antenatal bak›m sürecinde tüm gebelere rutin iyot deste¤ini önermek için bilimsel veriler flimdilik yetersiz görünmektedir. Ancak, ülkemizdeki gebelerde iyot eksikli¤i prevalans›n›n belirlenmesi amac›yla yap›lacak genifl ölçekli ve toplum temelli çal›flmalara acil olarak ihtiyaç vard›r.
We described a fetus who is delivered at 32.weeks of gestation by elective cesarian because of th... more We described a fetus who is delivered at 32.weeks of gestation by elective cesarian because of the fetal anhydria and unilateral hydronephrosis.A breech coming,1950 gr, 44 cm a newborn was delivered with multiple malformations and postpartum he didn't cry and siyanosis was appeared. After first interventions the newborns respiration didn't start and bradicardy occured. For this reasons entubation was needed but several trials concluded with lack of success. There was no response to resuscitation and newborn was accepted dead. The first physical examination of the newborn,tracheal atresia, webs, left microophthalmy, bilateral corneal opaque points, bilateral finger and toes syndactyly, hypospadias, low set ears were determined. Postpartum, by our first physical examination we determined bilateral finger and toes syndactylies, laryngeal atresia, hypospadias, micreophthalmia, development abnormality of right palpeprally, absence of the eyelash at the medially part of the right palpepra and there is a adherance between the palpepra and cornea, broad nose with low nasal bridge and the left corneal opasity. These and postmortem autopsy findings confirmed the diagnosis of Fraser syndrome.In this report we will focus on postpartum examinations of severe olygohidroamnios in families even if hiperechogenic lungs, previously similarly affected children.
Turkish Journal of Obstetrics and Gynecology, 2010
OBJECTIVE: To investigate the effects of 5% dextrose and 0.9% NaCl solutions used as vehicles for... more OBJECTIVE: To investigate the effects of 5% dextrose and 0.9% NaCl solutions used as vehicles for oxytocin infusion on neonatal bilirubin levels. MATERIAL-METHOD: A total of 60 patients were included in this prospective, randomised trial. The 30 patients of the study group were randomly divided into isotonic % 0.9 saline (Group 1) (n=15) and 5% glucose solutions (Group 2) (n=15). Thirty patients without oxytocin infusion constituted the control group (Group 3). The total volume of fluid administered and total oxytocin dose were noted. Fetal umblical artery blood samples were collected for the assessment of fetal hematocrit, bilirubin, electrolytes and blood gas analyses and postpartum first day fetal capillary blood samples were collected for fetal bilirubin and hematocrit analyses. Mann-Whitney U and Kruskal- Wallis tests were used to assess the significance of statistical difference among study parameters. RESULTS: The difference between study and control groups regarding the rate...
OBJECTIVE This study was designed to evaluate the awareness, knowledge and attitudes of healthcar... more OBJECTIVE This study was designed to evaluate the awareness, knowledge and attitudes of healthcare providers related to HPV infection and vaccine. MATERIAL AND METHODS A total of 311 healthcare providers working in specialties other than obstetrics and gynecology at the Dr. Lutfi Kırdar Kartal Education and Research Hospital as physicians (n=142) or non-physician healthcare providers (n=169) were included in the present study. A questionnaire developed by researchers based on literature and including items concerning socio-demographic features, awareness of HPV infection and vaccine, attitudes related to HPV vaccine and regular gynecological controls and knowledge about HPV infection was applied to participants via a face to face interview method. Each correct answer was scored as one to decide the level of knowledge and awareness. RESULTS The frequency of parenthood was lower and the ratio of males was higher in the physician group compared to the non-physician group. Awareness of ...
These guidelines follow the mission of the World Association of Perinatal Medicine, which brings ... more These guidelines follow the mission of the World Association of Perinatal Medicine, which brings together groups and individuals throughout the world with the goal of improving outcomes of maternal, fetal and neonatal (perinatal) patients. Guidelines for auditing, evaluation, and clinical care in perinatal medicine enable physicians diagnose, treat and follow-up of COVID-19-exposed pregnant women. These guidelines are based on quality evidence in the peer review literature as well as the experience of perinatal expert throughout the world. Physicians are advised to apply these guidelines to the local realities which they face. We plan to update these guidelines as new evidence become available.
Gebelik diyabetinin tan›nmas›nda 50 g glukoz tarama testi ve pozitif tarama olgular›nda 100 g OGT... more Gebelik diyabetinin tan›nmas›nda 50 g glukoz tarama testi ve pozitif tarama olgular›nda 100 g OGTT ile tan›n›n sa¤lanmas› uygulanmakta olan bir yaklafl›m iken, Hyperglycemia and Adverse Pregnancy Outcome (HAPO) çal›flmas› sonucu kan flekeri düzeyleri ile gebelik sonuçlar› aras›nda do¤rusal iliflki oldu¤u, bunun da her de¤er art›fl› ile yak›n iliflkili bulundu¤unun saptanmas›ndan sonra, yeni bir yak-lafl›m gündeme gelmifltir. Giderek klinik uygulamada yer bulan 75 g OGTT ile tek seferde ve tek de¤ere dayal› tan› konulmas› yaklafl›-m›, gebe popülasyonunun %18'ine tan› koydurmakla beraber, son-ras›nda yap›lan diyet ve egzersiz uygulamas›n›n, gebelik sonuçlar›n› iyilefltirdi¤i ve hatta gebelik diyabeti tan›s› almayan obez olgularda bile gebelik sonuçlar›n› olumlu etkiledi¤i ortaya konulmufltur. Gebelik öncesi obezitenin gebelik sonuçlar› üzerine, gebelik diyabeti tan›s› olmad›¤› halde, etkili olmas› ve gebelikte kilo art›fl›n›n kontrol alt›na al›nmas›n›n gebelik sonuçlar›n› iyilefltirmesinin saptanmas›, konunun önemini daha da gözler önüne sermektedir. Tek de¤ere dayal› 75 g OGTT uygulamas›, iki aflamal› önce tarama ve akabinde tan› testi uygulamas›na oranla gebelik diyabeti tan›s› alan olgu say›-s›n› art›rmakla beraber; bu tan›y› alan olgularda diyet-egzersiz uygu-lamas›n›n, gebede kilo art›fl›n› kontrol alt›na alan ve ayr›ca gebelik sonuçlar› üzerine olumlu etki sa¤layan bir durumdur. Kan flekerinin 1-2 haftal›k izlemleri ile gliseminin istenen s›n›rlar›n üzerinde olma-s›, medikal tedaviyi gerektirecektir. Bu ise beklenen ve istenen bir hedef olmaktad›r. Bu nedenlerle, her gebeye tek de¤ere dayal› 75 g OGTT uygulanmas› yeni klinik uygulama olarak yerini alm›flt›r ve tavsiye edilmektedir. Bu klinik uygulama rehberi, Türk Perinatoloji Derne¤i Diyabet ve Gebelik Çal›flma Grubu taraf›ndan haz›rlan-m›flt›r.
‹zole aberan sa¤ subklavian arterin saptanmas›n›n prenatal tan›daki önemi Amaç: ‹zole aberan subk... more ‹zole aberan sa¤ subklavian arterin saptanmas›n›n prenatal tan›daki önemi Amaç: ‹zole aberan subklavian arter (ARSA) tan›s›n›n önemini de-¤erlendirmeyi amaçlad›k. Olgu: Biz bu olgu sunumunda, k›rk yafl›nda 20. gebelik haftas›nda ve yirmi sekiz yafl›nda 23. gebelik haftas›nda izole ARSA tan›s› alan iki olgunun prenatal tan›s› ve fetal sonucunu sunuyoruz. Sonuç: Normal popülasyonda görülme insidans› %1.4 olan aberan sa¤ subklavian arterin (ARSA) Down sendromlu olgularda in-sidans›n›n %40'a kadar ç›kmas›, ARSA'n›n vasküler iflaretlerden biri olarak prenatal ultrasonografik tan›s› konulabilen Down sendromu belirteçleri aras›na girmesini gündeme getirmifltir.
Amniyotik katlant› ve amniyotik bant sendromu: Birbirine kar›flabilen iki durum Amaç: Amniyotik k... more Amniyotik katlant› ve amniyotik bant sendromu: Birbirine kar›flabilen iki durum Amaç: Amniyotik katlant› tan›s› alan iki olgunun prenatal tan›s› ve fetal sonucunu de¤erlendirmek ve amniyotik bant sendromu ile amniyotik katlant›n›n ay›r›c› tan›s›n›n önemini vurgulamak ama-c›yla, prenatal dönemde amniyotik katlant› tespit edilen iki olguyu sunmay› planlad›k. Olgu: Yirmi yedi yafl›nda 22. gebelik haftas›nda ve otuz befl yafl›nda 18.gebelik haftas›ndaki 2 olgu amniyotik bant sendromu ön tan›s›yla perinatoloji klini¤imize refere edildi. Sonuç: Amniyotik katlant› ile ciddi fetal malformasyonlar ve kötü obstetrik sonuçlarla iliflkili amniyotik bant sendromunun ay›r›c› ta-n›s›n›n önemli oldu¤u, amniyotik katlant›n›n genellikle benign bir durum olmakla birlikte baz› kötü prognostik kriterler eflli¤inde perinatal morbidite ve mortalite için predispozan bir faktör olabile-ce¤i ak›lda tutulmal›d›r.
The Journal of Maternal-Fetal & Neonatal Medicine, 2015
To determine whether preeclampsia causes fetal cardiac cell damage by assessing umbilical artery ... more To determine whether preeclampsia causes fetal cardiac cell damage by assessing umbilical artery NT-proBNP, cardiac troponin I and homocysteine. A cross-sectional study with 73 fetuses between 26 and 40 weeks of gestation was performed. Thirty-three healthy mothers' fetuses were control group (Group I). While 12 mildly pre-eclamptic mothers' fetuses constituted Group II, 28 fetuses of severe pre-eclamptic mothers were Group III. Umbilical cord mean NT-proBNP levels of Group I, II and III are 520.8 ± 404.5 pg/ml; 664.2 ± 215.9 pg/ml; and 1932.8 ± 2979.5 pg/ml, respectively (p = 0.0001). The number of neonates with NT-proBNP > 500 pg/mL that indicates severe cardiac damage is higher in Group III (p = 0.001). The mean homocysteine levels are also statistically significantly higher in Group III. Cardiac troponin I levels are not different between the groups (p = 0.46). Increased NT-proBNP and homocysteine might not only indicate some degree of in-utero cardiac cell damage but also feto-placental endothelial injury in the fetuses of severe pre-eclamptic mothers. Our finding that shows no evidence of correlation between cardiac troponin I levels with cell damage and endothelial injury requires further research.
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