Background The aim of this study was to evaluate the effectiveness of current ovarian reserve tes... more Background The aim of this study was to evaluate the effectiveness of current ovarian reserve tests in unexplained infertile cases. Material And Methods This case-control study was conducted on 70 unexplained infertile women were included in Tertiary Iniversity hospital. Both groups of basal FSH, estradiol, Antimullerian hormone (AMH), inhibin B, ovarian volume, total antral follicle count (AFC), ovarian volume, ovarain stromal blood flow (Peak systolic velocity (PSV), S/D (systole and diastole ratio), Resistance index (RI) and pulsatility index (PI)) values were compared. Results The mean AMH, inhibin B, PSV and stromal blood flow values of the control group patients was higher than those in unexplained infertility group. However, the values of means of RI and PI of the cases in the control were lower than those in infertility group. When PI's value was ≥ 2.00, its sensitivity was 65.7%, and its specificity was 64.3%. In case of the RI's value was ≥ 0.745, its sensitivity w...
This study aimed to determine the change in neural tube defects (NTD) incidence in Trabzon, a pro... more This study aimed to determine the change in neural tube defects (NTD) incidence in Trabzon, a province of the Eastern Black Sea region, and evaluate the efficiency of folic acid use on NTD. Methods: The present study was a retrospective case-control study. The case group of the study consisted of those diagnosed with fetal NTD in the intrauterine period between 2015 and 2020. The control group were selected by matching the ages in the case group with ± two standardized years. The total number of births in the province was obtained from the Turkish Statistical Institute data, and the NTD incidence was determined accordingly. Results: Between the aforementioned years, the number of cases who had NTD-complicated pregnancies and were delivered in our clinic was 88. When the use of folic acid before and in the first trimester of pregnancy was compared, a statistically significant difference was determined between the groups (p<0.001). The use of folic acid during pregnancy was similar in both groups (p=1). Conclusion: Neural tube defects is a preventable condition by using folic acid before and during the first trimester of pregnancy. Hence, the importance of using folic acid in family planning and prenatal counseling should not be forgotten.
Objective: The aim of this study is to evaluate perinatal outcome of fetal echogenic bowel.Study ... more 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 of antenatal comorbidities and postnatal persistent diseases. Infants were followed-up to June 2018 from time 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 was detected 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%). A fetal echogenic bowel was associated with major congenital malformations in 25 (%25) cases. Cardiac abnormality was the most preval...
Background: The aim of this study was to compare fetal thymus volume in women who delivered at &l... more Background: The aim of this study was to compare fetal thymus volume in women who delivered at <36 weeks of pregnancy versus those who did not. Methods: A total of 32 dichorionic-diamniotic twin pregnantwomenwere included in the prospective cohort study. The fetal thymus volumesweremeasured in the second trimester for each fetus using the VOCAL ultrasonography program. The data of women who experienced preterm labor (delivered at<36 weeks of pregnancy) and the control group (delivered at≥36 weeks of pregnancy)were compared. Results: Themean thymus volumeof each fetuswas statistically significantly lower in pretermdelivery cases than in the control group. Mean fetal thymus volume could be used as a marker for predicting preterm birth in the study group. The parameter of fetal thymus volume measured in twins at 18–24 weeks can be used as a predictive factor (P < 0.001). When the fetal thymus volume, measured 3-dimensionally by ultrasonography in conjunction with the VOCAL pro...
Introduction: To assess the effect of low-dose combined oestradiol and norethindrone acetate horm... more Introduction: To assess the effect of low-dose combined oestradiol and norethindrone acetate hormone therapy (HT) on serum C-reactive protein (CRP) levels and life quality in natural menopause women. Material and methods: Forty-five natural menopause women admitted to the clinic during a 1-year period and diagnosed as menopause, who planned to have HT for menopausal symptoms, were enrolled in this prospective study. The serum CRP levels were measured, and vasomotor symptoms scores were graded according to the Blatt-Kupperman menopause index, and life quality scores according to the Menopause-Specific Quality of Life Questionnaire (MENQOL) were recorded before and after (3 months later) hormone therapy. Results: The Blatt-Kupperman menopause index and MENQOL scores were significantly decreased after 3 months of low-dose treatment. No significant difference was found between white blood cell counts and serum CRP levels before and after 3 months of hormone therapy. Conclusions: Considering all HT types and biochemical effects, low-dose HT, which had positive results in terms of quality of life, was a safe treatment and could be preferred to conventional-dose preparations in cases without contraindications. Low-dose combined HT containing oestradiol and norethindrone acetate did not alter the serum CRP level in postmenopausal cases.
Abstract This study aimed to examine whether the menstrual cycles of women with regular cycles ha... more Abstract This study aimed to examine whether the menstrual cycles of women with regular cycles have been affected by the COVID 19 pandemic. This cross-sectional online survey study evaluated the menstrual cycle characteristics of women in the reproductive phase of their lives during the COVID-19 pandemic in May 2020. Changes before and after COVID-19 were evaluated with a paired sample t-test and chi-square test. A Pearson correlation test was used to show the relationships between variables. The study was completed with 263 participants in total. The average age of the participants was 26.3 ± 6.9 (18–45). Participants’ duration of period (p = .003) and pads used per day (p = .002) decreased compared to their experience before the COVID-19 outbreak. The mean total MSQ score was 3.1 ± 0.8 (0–4), mean STAI-1 score was 45.1 ± 9 (20–78) and mean STAI-II score was 43.3 ± 5.9 (30–69). It was found that STAI-I and STAI-II scores showed a positive correlation with MSQ-Somatic subgroup scores(r = 0.153, p = .013; 0.190, p = .002) and MSQ-Total scores (0.144, p = .020; 0.175, p = .004). With the COVID-19 pandemic, increased anxiety scores increased women's menstrual symptoms while the length of periods and the number of pads used decreased. Impact statement What is already known on this subject? The COVID 19 pandemic, has caused enormous psychological distress potentially resulting in the development of posttraumatic stress disorder. The menstrual cycle is a process that can be affected by psychological stress. What do the results of this study add? This is the first study to examine the relationship between stress caused by the COVID-19 pandemic and the menstrual cycle. The increases in the degree of anxiety and stress as a result of the COVID-19 outbreak was found to be high enough to affect the characteristics of the menstrual cycle in the women surveyed. What are the implications of these findings for clinical practice and/or further research? In a prospective study intended to be carried out after the outbreak ends in the future, it will be possible to evaluate whether the menstrual cycle parameters return to their former order and consequently this hypothesis will be able to be more definitively confirmed.
Introduction: To assess the effect of hormone therapy (HT) on serum ischemia modified albumin (IM... more Introduction: To assess the effect of hormone therapy (HT) on serum ischemia modified albumin (IMA) levels in healthy menopausal women. Material and methods: Thirty surgical menopausal women who were admitted to our menopausal polyclinic during a 1-year period and diagnosed with menopause and planned to have HT for menopausal symptoms were enrolled in this prospective study. The serum İMA levels were recorded before and after (3 months, 6 months, 12 months later) hormone treatment (2 mg estradiol hemihydrate). Results: The mean age of women was 47.60 ± 2.34 years. The mean serum IMA levels were 0.610 ± 0.096 absorbance units (ABSU) at the beginning and 0.484 ± 0.080 ABSU after 3 months of hormone therapy. Following 6 months of hormone therapy, serum IMA level was 0.546 ± 0.075, and reached 0.580 ± 0.089 ABSU following 12 months of therapy. Conclusions: These findings suggest that HT may not block the menopause induced ischemia process. Although HT had a positive effect on serum IMA levels following 3 months' use, serum IMA levels returned to baseline levels after 12 months' use. Based on this study's findings, long-term use of HT may not have a positive effect on cardiovascular disease protection.
Journal of Obstetrics and Gynaecology Research, 2021
To evaluate whether there is a statistically significant difference between the cord blood gas pa... more To evaluate whether there is a statistically significant difference between the cord blood gas parameters of pregnancies complicated with preeclampsia and uncomplicated pregnancies and to show whether the amount of proteinuria affects fetal cord blood gas parameters in pregnancies complicated with preeclampsia.
In this prospective study, the aim was to determine the frequency and effectiveness of the coitus... more In this prospective study, the aim was to determine the frequency and effectiveness of the coitus interruptus method, to compare the demographic characteristics of women using modern contraception methods and those using the coitus interruptus method and to demonstrate how effective contraceptive counselling is in choosing a contraception method. The researchers collected data from 1000 sexually active women in their reproductive period at the gynaecological clinic of a university hospital in Turkey. The researchers used an introductory information contraceptive counselling form, which they prepared for the data collection tool. The rate of the coitus interruptus method use among the interviewed women was 42.8%. There was a statistically significant difference between the coitus interruptus group and the group using modern contraceptive methods regarding mean age, educational status, smoking, awareness of last menstrual period, number of pads used during the menstrual period, and information sources. Following effective contraception counselling, the rate of switching to a modern and proven contraceptive method was found to be 73.8%. IMPACT STATEMENT What is already known on this subject? Although the traditional method of coitus interruptus has been used for many years, its incidence is not clearly known. What we know about the subject is based on ancient research. All the studies on the subject are very old and need to be updated. What do the results of this study add? With the help of the data obtained from this study, it is understood that withdrawal method is still widely used today, it is still not known that it is not a modern contraceptive method and the rate of transition to modern methods with effective contraception counselling is very high. What are the implications of these findings for clinical practice and/or further research? In the outpatient clinic conditions, even a very short period of time for contraception counselling will be very beneficial for women and will contribute to family planning and prevent unwanted pregnancies.
Introduction: Many postmenopausal women experience hot flashes, night sweats, decreased sexual de... more Introduction: Many postmenopausal women experience hot flashes, night sweats, decreased sexual desire and vaginal dryness. In this study, we aimed to compare the menopause symptom levels of surgical menopause patients and natural menopause patients by using a Menopause Rating Scale (MRS) and investigate whether there is a relationship between lipid levels and menopausal symptoms in surgical menopause patients. Material and methods: This cross-sectional study was conducted on postmenopausal women who applied to the gynecology outpatient clinic. A total of 187 patients were analyzed. Of these,112 were the surgical menopause group and the remaining 75 were the natural menopause group. Total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol and triglycerides were measured by using an enzymatic color test. In order to evaluate the postmenopausal symptoms of postmenopausal women included in the study, the MRS questionnaire adapted to the Turkish population was used. Results: Considering the results of the MRS of the two groups, the results of surgical menopause patients were found to be statistically significantly higher. The results were statistically significantly higher in both the total score and in the two subgroups(somatic and psychological subgroups)in the surgical menopause group. When the MRS results(subgroups and total score)of women in the surgical menopause group were classified as mild and severe, no statistically significant relationship was found between symptom severity and blood lipid levels. Conclusions: In the surgically induced menopause group, it was shown by this study that menopausal symptoms were more severe than the natural menopause group. Unlike natural menopausal patients, no relationship was found between lipid levels and severity of menopausal symptoms in surgical menopausal patients.
European Journal of Obstetrics & Gynecology and Reproductive Biology, 2017
Elective repeat caesarean delivery may affect bone mineral density compared with normal vaginal d... more Elective repeat caesarean delivery may affect bone mineral density compared with normal vaginal delivery Values are given as mean and standard deviation. Student's t-test was used for comparison.
Turkiye Klinikleri Journal of Gynecology and Obstetrics, 2017
The aim of our study is to review previous studies in literature on caesarean scar ectopic pregna... more The aim of our study is to review previous studies in literature on caesarean scar ectopic pregnancy between 1978; the year the first case was reported and March 2017, and to compare the current diagnostic and treatment methods used in management of caesarean scar ectopic pregnancy. Measurement of serum human chorionic gonadotropin levels, ultrasonography, doppler ultrasonography and sometimes magnetic resonance imaging are used for differential diagnosis of caesarean scar ectopic pregnancy. The most common treatment methods are; dilatation and curettage, local or systemic methotrexate application, selective uterine artery embolization and hysterotomy.
Original Article introduction Laparoscopy has been used in gynecologic surgery for 30 years. Lapa... more Original Article introduction Laparoscopy has been used in gynecologic surgery for 30 years. Laparoscopic surgery is more preferable than laparotomy, and minimally invasive procedures such as robotic surgery are more trendy today. The shorter hospital stays, less pain, and smaller surgical incision make the gynecologic endoscopic surgery more preferable to other surgical approaches. However, there are some complications of laparoscopy. In particular, complications associated with high intra-abdominal pressure (IAP) due to carbon dioxide (CO 2) pneumoperitoneum are not well described. [1] As clearly described in previous studies, laparoscopy caused ischemia and reperfusion injury in intra-abdominal organs by altering organ blood perfusion. Previous studies have reported the effect of high IAP on intra-abdominal blood flow to empty and solid organs. [2,3] In our previous study, it was shown that pneumoperitoneum caused biochemical and histological damage by causing significant oxidative stress in ovaries, even at safe IAP levels. [4] Nowadays, researchers mostly focus on the effect of laparoscopy on apoptosis. CO 2 pneumoperitoneum causes substantial oxidative stress. This oxidative stress induced intra-abdominal organ apoptosis and also resulted in cell injury. [5] In many studies, the effect of CO 2 on intra/extra-abdominal organs (including gastrointestinal, urinary, pulmonary, and genital system) was evaluated in experimental pneumoperitoneum models. For the reduction of oxidative Objectives: The aim of this study was to evaluate ovarian immunohistochemical CD95 expression in a rabbit carbon dioxide pneumoperitoneum model. Materials and Methods: The study group including seven rabbits was subjected to intra-abdominal pressure (IAP) (12 mmHg); the control group was not subjected to IAP (the sham group, n = 7). At the end of the experiment, ovariectomy was performed. Immunohistochemical stained histologic specimen of the ovary with CD95 was evaluated. Based on the degree of cytoplasmic or membranous staining for CD95 from 0 (none) to 3 (severe), a microscopic apoptosis scoring system was used. Results: Statistically significantly higher apoptosis scores in ovarian surface epithelial cells (2.57 ± 0.53, vs. 1.14 ± 0.38, P = 0.002, Mann-Whitney U-test, respectively), follicular epithelial cells (2.85 ± 0.38, vs. 1.85 ± 0.38, P = 0.002, Mann-Whitney U-test, respectively), and stromal cells (2.71 ± 0.49, vs. 1.29 ± 0.49, P = 0.002, Mann-Whitney U-test, respectively) were observed in pneumoperitoneum group, compared with no-pneumoperitoneum group. Conclusion: Even at safe IAP (12 mmHg) for an acceptable operation time period, there was a significant increase in apoptosis of ovarian cells.
OZET Amac: Bu calismada klinigimizde yatirilarak tedavi alan Arnold chiari tip 2 malformasyonu ta... more OZET Amac: Bu calismada klinigimizde yatirilarak tedavi alan Arnold chiari tip 2 malformasyonu tanili, olgularin cinsiyet, dogum sekli, gestasyonel hafta, dogum agirligi, eslik eden ek anomaliler, egitim durumu, antenatal bakim ve folik asit kullanimi, yenidogan donemindeki operasyonlar, dogum sonrasi yenidoganda gozlenen problemler ve sekeller gibi postnatal sonuclar degerlendirilmesi amaclandi. Gerec ve Yontem: Karadeniz Teknik Universitesi, Tip Fakultesi, Kadin Hastaliklari ve Dogum AD’da Ocak 2016 ile Mayis 2018 tarihleri arasinda Arnold Chiari Tip 2 tanisiyla klinigˆine yatirilan tum bebekler bu tek merkezli retrospektif calis¸maya alindi. Hastalara ait verilere tibbi kayitlardan ulas¸ildi. Bulgular: Calismaya toplam 20 Arnold chiari tip 2 malformasyonu olan olgu dahil edildi. Akraba evliligi hicbir olguda yoktu. Gebelerde folik asit kullanimi sadece 2 (%20) olguda mevcuttu. 10(%50) olguda tani viyabilite sinirindan once konulmus ve aile gebelik terminasyonu istemisti. Terminasyonu kabul eden 10 olgudan 4 (%40) tanesine meningosel/ meningomyelosel eslik ediyordu. Gebeligin devamina karar veren 10 olgudan 6 (%60) tanesine meningosel-meningomyelosel eslik ediyordu. Olgularin medyan gebelik yasi 37 hafta, ortalama yenidogan agirligi 3117±522 gram, medyan 1.dakika ve 5.dakika APGAR skoru sirasiyla 6 ve 8 idi. Yenidoganlarin 6 ‘si erkek (%60), 4’u kiz (%40) idi. Bebekler ortalama postnatal 3. gunde opere edildi. %90’nina sant operasyonu uygulandi. 9 olguda fizik tedavi uygulamasi gerektiren hareket kisitliligi ve guc kaybi mevcuttu. 7(%70) olguda bir ekstremitede hareket kisitligi ve guc kaybi var iken, 2 (%20) olguda her iki alt ekstremitede hareket ve kas gucu izlenmedi. Bes (%50) yenioganda miksiyon ve defekasyon sorunu nedeni ile temiz aralikli katater uygulamasi gereksinimi olusmustu. Sonuc: Yapilan calismalardan ve klinigimizdeki olgulardan da anlasilacagi gibi NTD olgularinda folik asit kullanmama yada duzensiz kullanim oykuleri mevcut. Bu sebepten klinigimizde degerlendirilen olgulara yuksek oranda NTD eslik etmekte. Anahtar Sozcu¨kler: Arnold-Chiari Malformasyonu; Folik asit; Meningosel; Meningomyelosel; Noral tup defekti;Yenidogan ABSTRACT Background: The aim of this study evaluate to properties of patients such as gender, birth type, gestational week, birth weight, accompanied additional anomalies, education status, antenatal care and folic acid usage, neonatal operations, postnatal outcomes. Material and Methods: All infants were taken to this single center retrospective study who admitted to the clinic with the diagnosis of Arnold Chiari Type 2 between January 2016 and May 2018 in Karadeniz Technical University, Faculty of Medicine, Department of Obstetrics and Gynecology. Results: A total of 20 Arnold chiari type 2 malformation cases were included in the study. There was no consanguineous marriage. The use of folic acid in pregnancies was only 2 (20%). In 10 (50%) cases the diagnosis was made before the limit of viability and the family asked for pregnancy termination. Meningocele / meningomyelocele were associated with 4 (40%) of 10 cases who accepted the termination. Meningocelemeningomyelocele was associated with 6 (60%) of 10 cases who decided to continue their pregnancy. The median gestational age of the cases was 37 weeks, mean newborn weight was 3117 ± 522 grams, median 1st minute and 5th minute APGAR score was 6 and 8, respectively. 6 of the newborns were male (60%) and 4 were girls (40%). Babies were operated on average postnatal 3. day. Shunt operation was applied to 90%. In 9 cases, there was limitation of movement and loss of power which necessitated physical therapy. 7 (70%) had limb movement limitation and power loss while 2 (20%) had no movement and muscle strength in both lower limbs. Five (50%) newborns required the application of intermittent clean catheters with the reason of mass and defecation problem. Conclusion: There was an irregular use history and not using of folic acid in NTD cases as it is understood from the studies done and the events in our clinic. In this respect, the cases evaluated in our clinic are accompanied by NTD at a high level. Keywords: Arnold-Chiari Malformation; Folic asit; Meningolsel; Meningomyelosel; Neural tube defect; Newborn
Cesarean scar pregnancy (CSP) is one rare form of the ectopic pregnancies. The incidence of CSP i... more Cesarean scar pregnancy (CSP) is one rare form of the ectopic pregnancies. The incidence of CSP is increasing because the rates of cesarean delivery has increased in recent years. The mechanism of this rare condition may be explained with myometrial invasion. Endometrial and myometrial separation, scarring due to cesarean section scar, endometrial and myometrial line disruption are the main basis for the pathophysiology of caesarean scar pregnancy. Painless vaginal bleeding, abdominal pain, pain secondary to abdominal bleeding are the most common symptoms. It is a life–threatening emergency that must be rapidly diagnosed and quickly treated. A 38-yearsold woman was admitted to the gynecology outpatient clinic because of vaginal bleeding. A cesarean scar pregnancy was diagnosed with transvaginal and abdominal ultrasonography. Systemic methotrexate therapy was applied and pregnancy was terminated with suction curettage under the guide of ultrasonography. In this case, we present a cas...
Background The aim of this study was to evaluate the effectiveness of current ovarian reserve tes... more Background The aim of this study was to evaluate the effectiveness of current ovarian reserve tests in unexplained infertile cases. Material And Methods This case-control study was conducted on 70 unexplained infertile women were included in Tertiary Iniversity hospital. Both groups of basal FSH, estradiol, Antimullerian hormone (AMH), inhibin B, ovarian volume, total antral follicle count (AFC), ovarian volume, ovarain stromal blood flow (Peak systolic velocity (PSV), S/D (systole and diastole ratio), Resistance index (RI) and pulsatility index (PI)) values were compared. Results The mean AMH, inhibin B, PSV and stromal blood flow values of the control group patients was higher than those in unexplained infertility group. However, the values of means of RI and PI of the cases in the control were lower than those in infertility group. When PI's value was ≥ 2.00, its sensitivity was 65.7%, and its specificity was 64.3%. In case of the RI's value was ≥ 0.745, its sensitivity w...
This study aimed to determine the change in neural tube defects (NTD) incidence in Trabzon, a pro... more This study aimed to determine the change in neural tube defects (NTD) incidence in Trabzon, a province of the Eastern Black Sea region, and evaluate the efficiency of folic acid use on NTD. Methods: The present study was a retrospective case-control study. The case group of the study consisted of those diagnosed with fetal NTD in the intrauterine period between 2015 and 2020. The control group were selected by matching the ages in the case group with ± two standardized years. The total number of births in the province was obtained from the Turkish Statistical Institute data, and the NTD incidence was determined accordingly. Results: Between the aforementioned years, the number of cases who had NTD-complicated pregnancies and were delivered in our clinic was 88. When the use of folic acid before and in the first trimester of pregnancy was compared, a statistically significant difference was determined between the groups (p<0.001). The use of folic acid during pregnancy was similar in both groups (p=1). Conclusion: Neural tube defects is a preventable condition by using folic acid before and during the first trimester of pregnancy. Hence, the importance of using folic acid in family planning and prenatal counseling should not be forgotten.
Objective: The aim of this study is to evaluate perinatal outcome of fetal echogenic bowel.Study ... more 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 of antenatal comorbidities and postnatal persistent diseases. Infants were followed-up to June 2018 from time 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 was detected 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%). A fetal echogenic bowel was associated with major congenital malformations in 25 (%25) cases. Cardiac abnormality was the most preval...
Background: The aim of this study was to compare fetal thymus volume in women who delivered at &l... more Background: The aim of this study was to compare fetal thymus volume in women who delivered at <36 weeks of pregnancy versus those who did not. Methods: A total of 32 dichorionic-diamniotic twin pregnantwomenwere included in the prospective cohort study. The fetal thymus volumesweremeasured in the second trimester for each fetus using the VOCAL ultrasonography program. The data of women who experienced preterm labor (delivered at<36 weeks of pregnancy) and the control group (delivered at≥36 weeks of pregnancy)were compared. Results: Themean thymus volumeof each fetuswas statistically significantly lower in pretermdelivery cases than in the control group. Mean fetal thymus volume could be used as a marker for predicting preterm birth in the study group. The parameter of fetal thymus volume measured in twins at 18–24 weeks can be used as a predictive factor (P < 0.001). When the fetal thymus volume, measured 3-dimensionally by ultrasonography in conjunction with the VOCAL pro...
Introduction: To assess the effect of low-dose combined oestradiol and norethindrone acetate horm... more Introduction: To assess the effect of low-dose combined oestradiol and norethindrone acetate hormone therapy (HT) on serum C-reactive protein (CRP) levels and life quality in natural menopause women. Material and methods: Forty-five natural menopause women admitted to the clinic during a 1-year period and diagnosed as menopause, who planned to have HT for menopausal symptoms, were enrolled in this prospective study. The serum CRP levels were measured, and vasomotor symptoms scores were graded according to the Blatt-Kupperman menopause index, and life quality scores according to the Menopause-Specific Quality of Life Questionnaire (MENQOL) were recorded before and after (3 months later) hormone therapy. Results: The Blatt-Kupperman menopause index and MENQOL scores were significantly decreased after 3 months of low-dose treatment. No significant difference was found between white blood cell counts and serum CRP levels before and after 3 months of hormone therapy. Conclusions: Considering all HT types and biochemical effects, low-dose HT, which had positive results in terms of quality of life, was a safe treatment and could be preferred to conventional-dose preparations in cases without contraindications. Low-dose combined HT containing oestradiol and norethindrone acetate did not alter the serum CRP level in postmenopausal cases.
Abstract This study aimed to examine whether the menstrual cycles of women with regular cycles ha... more Abstract This study aimed to examine whether the menstrual cycles of women with regular cycles have been affected by the COVID 19 pandemic. This cross-sectional online survey study evaluated the menstrual cycle characteristics of women in the reproductive phase of their lives during the COVID-19 pandemic in May 2020. Changes before and after COVID-19 were evaluated with a paired sample t-test and chi-square test. A Pearson correlation test was used to show the relationships between variables. The study was completed with 263 participants in total. The average age of the participants was 26.3 ± 6.9 (18–45). Participants’ duration of period (p = .003) and pads used per day (p = .002) decreased compared to their experience before the COVID-19 outbreak. The mean total MSQ score was 3.1 ± 0.8 (0–4), mean STAI-1 score was 45.1 ± 9 (20–78) and mean STAI-II score was 43.3 ± 5.9 (30–69). It was found that STAI-I and STAI-II scores showed a positive correlation with MSQ-Somatic subgroup scores(r = 0.153, p = .013; 0.190, p = .002) and MSQ-Total scores (0.144, p = .020; 0.175, p = .004). With the COVID-19 pandemic, increased anxiety scores increased women's menstrual symptoms while the length of periods and the number of pads used decreased. Impact statement What is already known on this subject? The COVID 19 pandemic, has caused enormous psychological distress potentially resulting in the development of posttraumatic stress disorder. The menstrual cycle is a process that can be affected by psychological stress. What do the results of this study add? This is the first study to examine the relationship between stress caused by the COVID-19 pandemic and the menstrual cycle. The increases in the degree of anxiety and stress as a result of the COVID-19 outbreak was found to be high enough to affect the characteristics of the menstrual cycle in the women surveyed. What are the implications of these findings for clinical practice and/or further research? In a prospective study intended to be carried out after the outbreak ends in the future, it will be possible to evaluate whether the menstrual cycle parameters return to their former order and consequently this hypothesis will be able to be more definitively confirmed.
Introduction: To assess the effect of hormone therapy (HT) on serum ischemia modified albumin (IM... more Introduction: To assess the effect of hormone therapy (HT) on serum ischemia modified albumin (IMA) levels in healthy menopausal women. Material and methods: Thirty surgical menopausal women who were admitted to our menopausal polyclinic during a 1-year period and diagnosed with menopause and planned to have HT for menopausal symptoms were enrolled in this prospective study. The serum İMA levels were recorded before and after (3 months, 6 months, 12 months later) hormone treatment (2 mg estradiol hemihydrate). Results: The mean age of women was 47.60 ± 2.34 years. The mean serum IMA levels were 0.610 ± 0.096 absorbance units (ABSU) at the beginning and 0.484 ± 0.080 ABSU after 3 months of hormone therapy. Following 6 months of hormone therapy, serum IMA level was 0.546 ± 0.075, and reached 0.580 ± 0.089 ABSU following 12 months of therapy. Conclusions: These findings suggest that HT may not block the menopause induced ischemia process. Although HT had a positive effect on serum IMA levels following 3 months' use, serum IMA levels returned to baseline levels after 12 months' use. Based on this study's findings, long-term use of HT may not have a positive effect on cardiovascular disease protection.
Journal of Obstetrics and Gynaecology Research, 2021
To evaluate whether there is a statistically significant difference between the cord blood gas pa... more To evaluate whether there is a statistically significant difference between the cord blood gas parameters of pregnancies complicated with preeclampsia and uncomplicated pregnancies and to show whether the amount of proteinuria affects fetal cord blood gas parameters in pregnancies complicated with preeclampsia.
In this prospective study, the aim was to determine the frequency and effectiveness of the coitus... more In this prospective study, the aim was to determine the frequency and effectiveness of the coitus interruptus method, to compare the demographic characteristics of women using modern contraception methods and those using the coitus interruptus method and to demonstrate how effective contraceptive counselling is in choosing a contraception method. The researchers collected data from 1000 sexually active women in their reproductive period at the gynaecological clinic of a university hospital in Turkey. The researchers used an introductory information contraceptive counselling form, which they prepared for the data collection tool. The rate of the coitus interruptus method use among the interviewed women was 42.8%. There was a statistically significant difference between the coitus interruptus group and the group using modern contraceptive methods regarding mean age, educational status, smoking, awareness of last menstrual period, number of pads used during the menstrual period, and information sources. Following effective contraception counselling, the rate of switching to a modern and proven contraceptive method was found to be 73.8%. IMPACT STATEMENT What is already known on this subject? Although the traditional method of coitus interruptus has been used for many years, its incidence is not clearly known. What we know about the subject is based on ancient research. All the studies on the subject are very old and need to be updated. What do the results of this study add? With the help of the data obtained from this study, it is understood that withdrawal method is still widely used today, it is still not known that it is not a modern contraceptive method and the rate of transition to modern methods with effective contraception counselling is very high. What are the implications of these findings for clinical practice and/or further research? In the outpatient clinic conditions, even a very short period of time for contraception counselling will be very beneficial for women and will contribute to family planning and prevent unwanted pregnancies.
Introduction: Many postmenopausal women experience hot flashes, night sweats, decreased sexual de... more Introduction: Many postmenopausal women experience hot flashes, night sweats, decreased sexual desire and vaginal dryness. In this study, we aimed to compare the menopause symptom levels of surgical menopause patients and natural menopause patients by using a Menopause Rating Scale (MRS) and investigate whether there is a relationship between lipid levels and menopausal symptoms in surgical menopause patients. Material and methods: This cross-sectional study was conducted on postmenopausal women who applied to the gynecology outpatient clinic. A total of 187 patients were analyzed. Of these,112 were the surgical menopause group and the remaining 75 were the natural menopause group. Total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol and triglycerides were measured by using an enzymatic color test. In order to evaluate the postmenopausal symptoms of postmenopausal women included in the study, the MRS questionnaire adapted to the Turkish population was used. Results: Considering the results of the MRS of the two groups, the results of surgical menopause patients were found to be statistically significantly higher. The results were statistically significantly higher in both the total score and in the two subgroups(somatic and psychological subgroups)in the surgical menopause group. When the MRS results(subgroups and total score)of women in the surgical menopause group were classified as mild and severe, no statistically significant relationship was found between symptom severity and blood lipid levels. Conclusions: In the surgically induced menopause group, it was shown by this study that menopausal symptoms were more severe than the natural menopause group. Unlike natural menopausal patients, no relationship was found between lipid levels and severity of menopausal symptoms in surgical menopausal patients.
European Journal of Obstetrics & Gynecology and Reproductive Biology, 2017
Elective repeat caesarean delivery may affect bone mineral density compared with normal vaginal d... more Elective repeat caesarean delivery may affect bone mineral density compared with normal vaginal delivery Values are given as mean and standard deviation. Student's t-test was used for comparison.
Turkiye Klinikleri Journal of Gynecology and Obstetrics, 2017
The aim of our study is to review previous studies in literature on caesarean scar ectopic pregna... more The aim of our study is to review previous studies in literature on caesarean scar ectopic pregnancy between 1978; the year the first case was reported and March 2017, and to compare the current diagnostic and treatment methods used in management of caesarean scar ectopic pregnancy. Measurement of serum human chorionic gonadotropin levels, ultrasonography, doppler ultrasonography and sometimes magnetic resonance imaging are used for differential diagnosis of caesarean scar ectopic pregnancy. The most common treatment methods are; dilatation and curettage, local or systemic methotrexate application, selective uterine artery embolization and hysterotomy.
Original Article introduction Laparoscopy has been used in gynecologic surgery for 30 years. Lapa... more Original Article introduction Laparoscopy has been used in gynecologic surgery for 30 years. Laparoscopic surgery is more preferable than laparotomy, and minimally invasive procedures such as robotic surgery are more trendy today. The shorter hospital stays, less pain, and smaller surgical incision make the gynecologic endoscopic surgery more preferable to other surgical approaches. However, there are some complications of laparoscopy. In particular, complications associated with high intra-abdominal pressure (IAP) due to carbon dioxide (CO 2) pneumoperitoneum are not well described. [1] As clearly described in previous studies, laparoscopy caused ischemia and reperfusion injury in intra-abdominal organs by altering organ blood perfusion. Previous studies have reported the effect of high IAP on intra-abdominal blood flow to empty and solid organs. [2,3] In our previous study, it was shown that pneumoperitoneum caused biochemical and histological damage by causing significant oxidative stress in ovaries, even at safe IAP levels. [4] Nowadays, researchers mostly focus on the effect of laparoscopy on apoptosis. CO 2 pneumoperitoneum causes substantial oxidative stress. This oxidative stress induced intra-abdominal organ apoptosis and also resulted in cell injury. [5] In many studies, the effect of CO 2 on intra/extra-abdominal organs (including gastrointestinal, urinary, pulmonary, and genital system) was evaluated in experimental pneumoperitoneum models. For the reduction of oxidative Objectives: The aim of this study was to evaluate ovarian immunohistochemical CD95 expression in a rabbit carbon dioxide pneumoperitoneum model. Materials and Methods: The study group including seven rabbits was subjected to intra-abdominal pressure (IAP) (12 mmHg); the control group was not subjected to IAP (the sham group, n = 7). At the end of the experiment, ovariectomy was performed. Immunohistochemical stained histologic specimen of the ovary with CD95 was evaluated. Based on the degree of cytoplasmic or membranous staining for CD95 from 0 (none) to 3 (severe), a microscopic apoptosis scoring system was used. Results: Statistically significantly higher apoptosis scores in ovarian surface epithelial cells (2.57 ± 0.53, vs. 1.14 ± 0.38, P = 0.002, Mann-Whitney U-test, respectively), follicular epithelial cells (2.85 ± 0.38, vs. 1.85 ± 0.38, P = 0.002, Mann-Whitney U-test, respectively), and stromal cells (2.71 ± 0.49, vs. 1.29 ± 0.49, P = 0.002, Mann-Whitney U-test, respectively) were observed in pneumoperitoneum group, compared with no-pneumoperitoneum group. Conclusion: Even at safe IAP (12 mmHg) for an acceptable operation time period, there was a significant increase in apoptosis of ovarian cells.
OZET Amac: Bu calismada klinigimizde yatirilarak tedavi alan Arnold chiari tip 2 malformasyonu ta... more OZET Amac: Bu calismada klinigimizde yatirilarak tedavi alan Arnold chiari tip 2 malformasyonu tanili, olgularin cinsiyet, dogum sekli, gestasyonel hafta, dogum agirligi, eslik eden ek anomaliler, egitim durumu, antenatal bakim ve folik asit kullanimi, yenidogan donemindeki operasyonlar, dogum sonrasi yenidoganda gozlenen problemler ve sekeller gibi postnatal sonuclar degerlendirilmesi amaclandi. Gerec ve Yontem: Karadeniz Teknik Universitesi, Tip Fakultesi, Kadin Hastaliklari ve Dogum AD’da Ocak 2016 ile Mayis 2018 tarihleri arasinda Arnold Chiari Tip 2 tanisiyla klinigˆine yatirilan tum bebekler bu tek merkezli retrospektif calis¸maya alindi. Hastalara ait verilere tibbi kayitlardan ulas¸ildi. Bulgular: Calismaya toplam 20 Arnold chiari tip 2 malformasyonu olan olgu dahil edildi. Akraba evliligi hicbir olguda yoktu. Gebelerde folik asit kullanimi sadece 2 (%20) olguda mevcuttu. 10(%50) olguda tani viyabilite sinirindan once konulmus ve aile gebelik terminasyonu istemisti. Terminasyonu kabul eden 10 olgudan 4 (%40) tanesine meningosel/ meningomyelosel eslik ediyordu. Gebeligin devamina karar veren 10 olgudan 6 (%60) tanesine meningosel-meningomyelosel eslik ediyordu. Olgularin medyan gebelik yasi 37 hafta, ortalama yenidogan agirligi 3117±522 gram, medyan 1.dakika ve 5.dakika APGAR skoru sirasiyla 6 ve 8 idi. Yenidoganlarin 6 ‘si erkek (%60), 4’u kiz (%40) idi. Bebekler ortalama postnatal 3. gunde opere edildi. %90’nina sant operasyonu uygulandi. 9 olguda fizik tedavi uygulamasi gerektiren hareket kisitliligi ve guc kaybi mevcuttu. 7(%70) olguda bir ekstremitede hareket kisitligi ve guc kaybi var iken, 2 (%20) olguda her iki alt ekstremitede hareket ve kas gucu izlenmedi. Bes (%50) yenioganda miksiyon ve defekasyon sorunu nedeni ile temiz aralikli katater uygulamasi gereksinimi olusmustu. Sonuc: Yapilan calismalardan ve klinigimizdeki olgulardan da anlasilacagi gibi NTD olgularinda folik asit kullanmama yada duzensiz kullanim oykuleri mevcut. Bu sebepten klinigimizde degerlendirilen olgulara yuksek oranda NTD eslik etmekte. Anahtar Sozcu¨kler: Arnold-Chiari Malformasyonu; Folik asit; Meningosel; Meningomyelosel; Noral tup defekti;Yenidogan ABSTRACT Background: The aim of this study evaluate to properties of patients such as gender, birth type, gestational week, birth weight, accompanied additional anomalies, education status, antenatal care and folic acid usage, neonatal operations, postnatal outcomes. Material and Methods: All infants were taken to this single center retrospective study who admitted to the clinic with the diagnosis of Arnold Chiari Type 2 between January 2016 and May 2018 in Karadeniz Technical University, Faculty of Medicine, Department of Obstetrics and Gynecology. Results: A total of 20 Arnold chiari type 2 malformation cases were included in the study. There was no consanguineous marriage. The use of folic acid in pregnancies was only 2 (20%). In 10 (50%) cases the diagnosis was made before the limit of viability and the family asked for pregnancy termination. Meningocele / meningomyelocele were associated with 4 (40%) of 10 cases who accepted the termination. Meningocelemeningomyelocele was associated with 6 (60%) of 10 cases who decided to continue their pregnancy. The median gestational age of the cases was 37 weeks, mean newborn weight was 3117 ± 522 grams, median 1st minute and 5th minute APGAR score was 6 and 8, respectively. 6 of the newborns were male (60%) and 4 were girls (40%). Babies were operated on average postnatal 3. day. Shunt operation was applied to 90%. In 9 cases, there was limitation of movement and loss of power which necessitated physical therapy. 7 (70%) had limb movement limitation and power loss while 2 (20%) had no movement and muscle strength in both lower limbs. Five (50%) newborns required the application of intermittent clean catheters with the reason of mass and defecation problem. Conclusion: There was an irregular use history and not using of folic acid in NTD cases as it is understood from the studies done and the events in our clinic. In this respect, the cases evaluated in our clinic are accompanied by NTD at a high level. Keywords: Arnold-Chiari Malformation; Folic asit; Meningolsel; Meningomyelosel; Neural tube defect; Newborn
Cesarean scar pregnancy (CSP) is one rare form of the ectopic pregnancies. The incidence of CSP i... more Cesarean scar pregnancy (CSP) is one rare form of the ectopic pregnancies. The incidence of CSP is increasing because the rates of cesarean delivery has increased in recent years. The mechanism of this rare condition may be explained with myometrial invasion. Endometrial and myometrial separation, scarring due to cesarean section scar, endometrial and myometrial line disruption are the main basis for the pathophysiology of caesarean scar pregnancy. Painless vaginal bleeding, abdominal pain, pain secondary to abdominal bleeding are the most common symptoms. It is a life–threatening emergency that must be rapidly diagnosed and quickly treated. A 38-yearsold woman was admitted to the gynecology outpatient clinic because of vaginal bleeding. A cesarean scar pregnancy was diagnosed with transvaginal and abdominal ultrasonography. Systemic methotrexate therapy was applied and pregnancy was terminated with suction curettage under the guide of ultrasonography. In this case, we present a cas...
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