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To determine individual characteristics (i.e. sociodemographic and medical, obstetric and gynecological, and musculoskeletal and anthropometric parameters) for greater pelvic floor distress (PFD). A cross-sectional study was performed in 253 women with pelvic floor dysfunction. PFD was assessed using the Pelvic Floor Distress Inventory-20 (PFDI-20). The score of Urogenital Distress Inventory-6 (UDI-6) was used to perform secondary analyses. Sociodemographic, medical, and obstetric & gynecological parameters were recorded. Waist and hip circumferences and pelvic diameters were measured as anthropometric parameters. Pearson test, t-test, and linear regression analyses were conducted with a significance level of 0.05. Education level (r = −0.23, p <.001; r = −0.24, p <.001), number of vaginal births (r = 0.15, p =.012; r = 0.12, p =.048), total vaginal birth weight (r = 0.15, p =.021; r = 0.16, p =.019), and Body Mass Index (r = 0.12, p =.043; r = 0.16, p =.007) were significantly correlated with the higher PFDI-20 and UDI-6 scores. The maternal age at the first vaginal birth (r = −0.13, p =.049) and pelvic antero-posterior diameter (r = 0.17, p =.013) were also significantly correlated with higher UDI-6 score. Linear regression analyses revealed that younger age (Beta coefficient (β) = −1.10, p =.005), greater symptom duration (β = 2.28, p =.001), the presence of chronic cough/constipation (β = 25.72, p =.001), and increased total vaginal birth weight (β = 2.38, p =.030) were associated with the greater PFDI-20 score. Increased pelvic antero-posterior diameter (β = 0.88, p =.049) was a contributory factor for the greater UDI-6 score. This study showed that younger age, chronic cough/constipation, higher total vaginal birth weight, greater symptom duration, and pelvic antero-posterior diameter can be contributors of greater PFD. We suggest further longitudinal studies that better reveal the causal relationship between individual characteristics and PFD. [ABSTRACT FROM AUTHOR]

Objective: To demonstrate the impact of scoliosis on pregnancy and gestational outcome. Material and Methods: We retrospectively evaluated gestational outcomes of pregnant women with scoliosis at Hacettepe University Hospital between 2008 and 2018. Cases were grouped according to the presence of previous scoliosis surgery and compared in terms of gestational week at birth, birthweight, rate of neonatal intensive care unit admission, hospitalization during pregnancy, route of delivery, type of anesthesia at labor and postpartum intensive care unit admission rate. Ejection fraction (EF), functional vital capacity (FVC), forced expiratory volume (FEV1) and FEV1/FVC ratio values were also recorded. Results: A total of 23 women were included, of whom 12 (52.2%) had a prior scoliosis surgery. One of the 23 (4.3%) cases was terminated due to respiratory problems, while the remaining 22 cases resulted in deliveries. The median gestational week at birth was 38.2 and the median birth weight was 3150 g. Median (range) maternal height was 143 (80-160) cm while median (range) maternal weight was 51 (35-86) kg. Three (13.6%) were diagnosed with restrictive lung disease. No significant difference was found between operated and non-operated groups in terms of respiratory function test results, cardiac EF and other related demographic and clinical features. Overall cesarean delivery rate was 63.6% (14/22) and cesarean section rate was significantly higher in the operated group (83.3% versus 40%) (p=0.04). Conclusion: Cesarean section rate was increased in this cohort of pregnancies in women with scoliosis and who had previous scoliosis surgery. [ABSTRACT FROM AUTHOR]

Objectives: Cell‐free DNA has been found in all body fluids, but DNAs emerging from locations that are not in direct contact with breath in exhaled breath condensate (EBC) are yet to be found. The potential of EBC for prenatal and cancer screening prompted us to investigate whether fetal DNA is present in maternal EBC. Method: A total of 20 pregnant women's EBC and blood samples were collected. Four Y chromosome‐specific assays were tested on all EBC and plasma samples by quantitative PCR (qPCR). The best‐performing assay was used for digital droplet PCR (ddPCR) on all EBC and the six plasma samples. Results: The sex of the fetuses was accurately determined from plasma samples. DNA sequences could not be properly amplified in EBC samples by the qPCR. By ddPCR, the Y chromosome sequence was amplified in two of the 11 EBC samples, from women carrying male fetuses (2/11), and the Y chromosome sequence was not amplified in the EBC of women carrying female fetuses (9/9). Exhaled breath condensate ddPCR result's specificity was 100%, the detection rate of Y chromosome was 18.18% (2/11), and the corrected accuracy was 59.09%. Conclusion: Our finding of "the presence of fetal DNA in maternal EBC", despite the low detection rate, might have a major impact on prenatal diagnosis and cancer screening. Key points: What's already known about this topic? DNA/RNA sequences of lung cancer, Mycobacterium tuberculosis, and SARS‐Cov‐2 were detected in exhaled breath condensate (EBC). Cell‐free DNA (cfDNA) has been detected in various body fluids like blood, urine, cerebrospinal fluid, sweat, and breast milk, and cell‐free fetal DNA (cffDNA) has been shown in maternal plasma. Also, the lungs are thought to be filters of fetal cells in the maternal circulation. What does this study add? This is the first study that showed the presence of Y chromosome sequence in the EBC of a woman carrying a male fetus. Additionally, the presence of a DNA sequence that does not belong to the gastrointestinal tract or respiratory system in the breath has not been shown until now. The findings of this study may have an impact on non‐invasive prenatal diagnosis and cancer screening. [ABSTRACT FROM AUTHOR]

Urinary incontinence (UI) is a common pelvic floor dysfunction in pregnancy. The relationship between biomechanical changes and pregnancy-related UI has not been fully elucidated. To investigate the association of various musculoskeletal and anthropometric changes in pregnancy that affect gestational UI. The study was conducted with 275 pregnant women. Ninety-three, 110 and 72 women were in first, second and third trimesters, respectively. Incontinence Impact Questionnaire for UI, Urogenital Distress Inventory-Short Form and Incontinence Severity Index were applied. Lumbar lordosis measurement was performed by Baseline Bubble Inclinometer while diastasis recti abdominis (DRA) measurement was carried out by finger-width method. Manual muscle test for rectus abdominis and right and left external oblique abdominal muscles, and Benign joint hypermobility test with Beighton scoring method were also applied as musculoskeletal measurements. Tape measurement at the waist, umbilical and hip levels, caliper with bi-iliac and bi-trochanteric diameters were also recorded as anthropometric measurements. Significant associated factors for UI were: umbilical DRA (OR = 1.57; p =.012); rectus abdominis muscle strength (values of 3 and below, OR = 1.2; p =.014); umbilical environment (OR = 1.1; p =.029); bi-iliac diameter (OR = 1.1; p =.05;) and bi-trochanteric diameter (OR = 1.3; p =.05), respectively. Changing musculoskeletal and anthropometric characteristics of pregnant women should be taken into consideration in UI follow-up during pregnancy. [ABSTRACT FROM AUTHOR]

Aims. To demonstrate the coexistence of skin disorders and diabetes mellitus (DM) in women with poor obstetric history. Methodology. This retrospective study comprised 69 women having poor obstetric history and skin disorders. The patients were grouped as control group (51 women without type 2 DM, with 84 skin disorders in total) and study group (18 women with type 2 DM, with 30 skin disorders in total). Skin disorders were grouped as follows: herpes zoster, viral warts, fungal diseases, melanocytic nevi, bacterial infections, hidradenitis suppurativa, dermatitis, psoriasis, lichen planus, urticaria, hair and nail disorders, acneiform diseases, epidermal cyst, melanine hyperpigmentation, hypertrophic disorders of the skin, mycosis fungoides and vitiligo. Beksaç Obstetric Index (BOI), which is “(the number of living child + π/10)/gravida”, was used for the evaluation of obstetric history. Results. The rate of DM was found to be 26.1% in this specific study population. We have demonstrated multiple skin disorders in 50% (9/18) of DM (+) women, while this rate was 37.3% (19/51) in the DM (-) women (p=0.504). A total of 114 skin disorders in 69 women were evaluated, and the rates of the dermatitis (38.9% versus 19.6%) and acneiform diseases (27.8% versus 13.7%) were found to be more frequent in DM (+) patients compared to DM (-) women (p>0.05, for all). Conclusions. Skin disorders are easy to detect in medical examinations and can be used as a remark for the investigation of DM, especially in women with poor obstetric history. [ABSTRACT FROM AUTHOR]

Aim. The validation of an artificial intelligent system (AIS) - Ankara System Version 5.0 - for the interpretation of antepartum fetal heart rate (FHR) tracings. Methodology. This study consisted of 3100 assuring FHR tracings obtained from normal pregnancies and 467 non-assuring FHR tracings (13.09% of all cases) obtained from pregnancies with various types of maternal health risk factors and/or obstetric complications. Assuring tracings from complicated pregnancies and non-assuring tracings from normal pregnancies were not included in the study, in order to have a qualified database. All tracings were evaluated twice by a single expert. The first evaluation took place just after data acquisition and the second occurred two weeks later without knowledge of the clinical characteristics of the patient (unmatched tracing evaluations were not included in the database). A total of 3032 of them were used for the training of the algorithms, while 535 of them were used for testing and validation. A Doppler ultrasound fetal heart rate monitor with autocorrelation (Hewlett Packard, 8040A) was connected to a computer system by a special frame grabber. Ten-minute recordings were kept in a special file for pattern recognition and decision making. Wavelet transformation was used for feature extraction as the first step of pattern recognition. Unsupervised and supervised artificial neural networks (vector quantization and backpropagation learning algorithm, respectively), the second step of pattern recognition, were used as the classification steps of the hybrid AIS. Results. The testing group consisted of 480 assuring and 55 non-assuring tracings. The sensitivity and specificity of the Ankara System (Version 5.0) were found to be 61.25% and 98.68%, respectively, while the positive predictive value and negative predictive value were calculated to be 89.1% and 93.5%, respectively. Conclusions. This hybrid AIS (Ankara System Version 5.0) might be an effective alternative decision-making tool in the routine practice for the interpretation of FHR tracings. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to adapt the Pregnancy Sexual Response Inventory (PSRI) into Turkish and to determine the psychometric properties for pregnant women. Methods: A total of 139 pregnant women were included in the study. The psychometric features of the questionnaire were analyzed in terms of internal consistency, test–retest reliability, content and criterion validity. The Turkish version of the PSRI and the Female Sexual Function Index (FSFI) was completed by the pregnant women. Criterion validity was tested by measuring the correlations between the total and subscale scores of the PSRI and the FSFI. Results: The test–retest reliability of the Turkish PSRI was found to be moderate to very strong (ICC = 0.57–0.96, p < 0.001). The internal consistency [Cronbach's alpha (α) coefficient] was found to be 0.65–0.70 before pregnancy and 0.73–0.80 during pregnancy. The criterion validity of the PSRI was supported by moderate to strong correlations between the subscales of the FSFI (desire, arousal, orgasm, satisfaction, pain) and the subscales of the PSRI-during pregnancy (r = 0.59, r = 0.45, r = 0.64, r = 0.53, r = 0.41, p < 0.001, respectively). The total score of the PSRI was significantly correlated with the total score of the FSFI (r = 0.71, p < 0.001). Conclusion: The results of this study showed that the Turkish version of the PSRI has valid and reliable properties for assessing sexuality and sexual response during pregnancy. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the factors related to the severity of menstrual pain in Turkish women with primary dysmenorrhea (PD). The study included 504 women with PD aged 18 years or older. A Visual Analogue Scale (VAS), a self-developed structured questionnaire, the International Physical Activity Questionnaire-Short Form (IPAQ-SF), State and Trait Anxiety Inventory, Beck Depression Inventory, and Nottingham Health Profile (NHP) were used to measure outcomes. Multiple multinomial logistic regression analysis was used to determine the factors related to the severity of menstrual pain. In this model, categorical menstrual pain severity levels (mild, moderate, and severe) were considered as dependent variables and the category of "severe menstrual pain" was determined as the reference category. p value less than 0.05 was considered statistically significant. The individuals were divided into 3 groups according to their VAS scores: mild-pain group (n = 132, 26.19%), moderate-pain group (n = 189, 37.50%), and severe-pain group (n = 183, 36.30%). BMI increase (OR = 1.10 and OR = 1.09), decreased chocolate consumption (OR = 1.88), menstruation duration (OR = 2.48) and menstrual pain duration (OR = 1.33 and OR = 1.61), and increased physical activity level (OR = 1.10) were found to increase the tendency to have less severe pain. The positive family history (OR = 0.35), a decrease in the age of menarche (OR = 0.47), the presence of irregular menstruation (OR = 0.36), and decreased quality of life (OR = 0.98 for NHP pain and emotional reaction) were found to be associated with a reduced likelihood of less severe pain (p < 0.05). In Turkey as well as in the rest of the world, PD is an important public health problem and many factors are associated with menstrual pain in Turkish women. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the clinical characteristics and obstetric outcomes of pregnant women with epilepsy at a tertiary center. Material and Methods: A total of 81 pregnant women with epilepsy were included in this retrospective cohort study. Clinical characteristics and obstetric outcomes were evaluated. Results: The mean maternal age of our cohort was 28.81±5.2 years, mean gravida was 1.78±1.17, mean gestational week at delivery was 37.8±2.07, and mean birth weight was 2973±688.8 g with 4 (4.9%) preterm deliveries. Gestational diabetes mellitus was observed in 2 cases. Fetal growth restriction was detected in 3 (3.7%) cases. Ten neonates (12.3%) were admitted to the neonatal intensive care unit and no congenital chromosomal/structural anomalies were detected in any of the cases. Intrauterine fetal demise was observed in 1 (1.2%) case. The mean duration of epilepsy was 8.14 ± 5.8 years. Antiepileptic drugs were continued in 59 (72.8%) cases (11 polytherapy and 48 monotherapy). Six cases (7.4%) had seizures during pregnancy, and all 6 cases included patients who used medications during pregnancy. Conclusion: Favorable outcomes can be achieved in pregnant women with appropriately managed epilepsy. [ABSTRACT FROM AUTHOR]

Objective: Our goal was to highlight the prenatal diagnosis and management of central nervous system (CNS) anomalies through sharing our clinic's experience. Material and Methods: We evaluated prenatal findings and postnatal outcomes of neonates who had a CNS anomaly diagnosis in our clinic over a ten-year period. A total of 183 cases with various CNS anomalies were included in the study. Birth or termination preferences of mothers were recorded in all cases, and postnatal diagnosis concordance and prognosis after surgical procedures were evaluated in mothers who chose to continue the pregnancy. Results: The mean maternal age was 28.2±5.5 years, mean gravida was 2.2±1.3, and the mean gestational age at diagnosis was 30.5±5.5 weeks. Seventy-five out of 183 (41%) patients chose to terminate their pregnancy. Twenty babies (26.6%) in the termination of pregnancy group had additional anomalies. One hundred eight patients gave birth at our institution. The mean birth weight was 3060±647.5 g, the mean gestational week at delivery was 37.9±1.7 weeks, and mean APGAR score (5th minute) was 8.8±2.3. Four neonates died on the postpartum first day. The postnatal diagnosis of 60 of the 108 (55.5%) patients who gave birth was concordant with the prenatal diagnosis, and 32 of the 108 (29.6%) babies underwent surgical interventions. Conclusion: CNS anomalies have a broad spectrum and variable prognoses. This study highlights the limitations of prenatal diagnoses, and the need for parents to have this information in order to determine the course of their pregnancy and prepare themselves for the postnatal challenging treatment/rehabilitation process. [ABSTRACT FROM AUTHOR]

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Copyright of Turkish Journal of Obstetrics & Gynecology is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction and hypothesis: We evaluated whether vaginal tampon training (VTT) combined with pelvic floor muscle training (PFMT) results in better outcomes than PFMT alone for treating stress urinary incontinence (SUI).Methods: This was a randomized, controlled study. Patients were allocated to either the combined program, consisting of PFMT and VTT over 12 weeks [PFMT and VTT group (n = 24)] or to PFMT alone [PFMT group (n = 24)]. The primary outcome measure was self-reported improvement, while secondary outcome measures were severity of incontinence, quality of life (QoL), urinary parameters, and pelvic floor muscle strength (PFMS) and endurance (PFME). Values were analyzed with Friedman, Mann-Whitney U, Wilcoxon, and chi-square tests.Results: Between-group analysis showed no statistically significant differences in self-reported improvement, severity of incontinence, symptom distress score, PFMS, PFME, urinary parameters, and all domains of QoL scores, except social limitations, at weeks 4, 8, and 12 (p > 0.05). However, the increase in PFMS and PFME between baseline and week 12 and earlier improvement was significantly greater in the PFMT and VTT than in the PFMT group (both p < 0.05) Conclusion: Short-term results demonstrated that PFMT with and without VT exercises had similar effectiveness on the symptoms of SUI and QoL. [ABSTRACT FROM AUTHOR]

Introduction and hypothesis: The objective of the present study was to adapt the CONTILIFE, a quality-of-life questionnaire, into Turkish and to reveal its psychometric properties in women suffering from stress urinary incontinence (SUI).Methods: Ninety-eight patients with a symptom of SUI participated in the study and filled out the Turkish CONTILIFE. Cronbach's alpha (α) and intraclass correlation coefficients (ICCs) were evaluated for the internal consistency and test-retest reliability, respectively. Exploratory factor analysis was performed to determine the underlying structure. Criterion validity was analyzed using the correlation coefficients between the total and subscale scores of the CONTILIFE and King's Health Questionnaire (KHQ), the Incontinence Impact Questionnaire-7 (IIQ-7), and the Urinary Distress Inventory-6 (UDI-6).Results: Internal consistency was found to be strong to very strong (Cronbach's α: 0.90-0.96). Test-retest reliability was very strong (ICCs = 0.91-0.98, p < 0.001). Exploratory factor analysis revealed five significant factors, explained by 74% of the total variance. Total scores on the CONTILIFE were significantly correlated with the KHQ subscales (r = −0.43 − −0.81), IIQ-7 (r = −0.89), UDI-6 (r = −0.66), and ISI (r = −0.66); (p < 0.01).Conclusion: The Turkish CONTILIFE is a valid and reliable tool to determine the influence of SUI on health-related quality of life in Turkish women. [ABSTRACT FROM AUTHOR]

Background/aim: This study aimed to evaluate the effects of certain maternal, fetal, and umbilical cord blood unit factors on storage and/or discard incidence of collected cord blood units from perinatal medicine patients. Materials and methods: A total of 273 cord blood units collected between January 2011 and December 2016 in the Division of Perinatology of Hacettepe University Hospital were evaluated retrospectively in this study. Results: Of the collected cord blood units, 53.8% (147/273) were stored. Infant birth weight, cord blood unit volume, total nucleated cell count, and CD34+ cell count were statistically significantly different between the eligible and discarded cord blood unit groups (P < 0.001 for all). No cord blood units were discarded owing to contamination-related issues. The mean gestational age for pregnant women whose umbilical cord blood was stored was 36.6 ± 1.0 weeks. Conclusion: Infant birth weight, cord blood unit volume, total nucleated cell count, and CD34+ cell count were significantly different between the eligible and discarded cord blood unit groups. The low rate of specimen storage was most likely because of the unique characteristics of perinatal medicine patients. Physicians should choose appropriate donors for cord blood collection to increase the rate of cord blood utilization. [ABSTRACT FROM AUTHOR]

Context: Bacterial vaginosis (BV) is related to the increased risk of miscarriage, preterm labor, and postpartum endometritis. Aims: The aim of this study was to evaluate the association between BV and the history of spontaneous abortion and recurrent pregnancy losses. We also examined periods of gestation, including the first and second trimester miscarriages. Materials and Methods: The study population consisted of 200 fertile women. Sixty one (30.5%) of 200 women had the history of a spontaneous abortion in the last six months (N= 30) and at least three recurrent pregnancy losses (N= 31). BV was diagnosed either by using Papanicolaou staining, Gram staining, or by culturing with BV-associated bacteria, Gardnerella vaginalis. Results: The presence of BV was statistically associated with the history of a spontaneous abortion in the last 6 months (P < 0.05), whereas there was no significant relationship between BV and recurrent pregnancy losses (P > 0.05). These women were also evaluated in view of periods of gestation. Forty-seven (77%) of 61 women had first trimester miscarriage (≤12 weeks) and 14 (23%) of 61 women had second trimester miscarriage (>12 weeks). There was a statistically significant relationship between BV and second trimester miscarriage (P < 0.05). Positive BV findings were not associated with discharge, itching, and pain (P> 0.05). Conclusion: BV may contribute to spontaneous abortion and second trimester miscarriage. [ABSTRACT FROM AUTHOR]

Background: Right after opportunistic fungi become pathogenic, they face immune system cells including macrophages and neutrophil leukocytes. Although the relationship between fungi and immune cells are being widely studied by using animal models and culture techniques, cervicovaginal smears have not been used to evaluate this interaction yet. Aim: The aim of this study was to investigate the interactions between fungal infection, macrophages and neutrophil leukocytes in cervicovaginal smear. Materials and Methods: Papanicolaou-stained cervicovaginal smears from 2307 women, aged between 18 and 73 years, were examined by light microscopy. Periodic acid--Schiff stain was also used to confirm the presence of fungal cell walls. Results: Fungal infections were detected in 239 of 2307 patients (10.4%), and these cases were taken as the study group. Cases without any infectious agents (n = 1800, 78%) were considered as the control group. When the study and control groups were statistically compared in view of macrophages and neutrophil leukocytes, a significant relationship between presence of fungal infection, macrophages and neutrophil leukocytes was detected (P < 0.05). Furthermore, macrophages and neutrophil leukocytes were found to work against the fungal infection together (P < 0.05). Additionally, when the relationship between the existence of yeast or filamentous forms and these immune cells were evaluated, a significant correlation was not found (P > 0.05). Conclusions: Our findings indicate that macrophages and neutrophils may play a determining role in host defense against fungal infection together, but neither yeast nor filamentous forms affect the presence of neutrophil leukocytes and macrophages. As a result of this, both yeast and filamentous forms may have pathogenic effects. [ABSTRACT FROM AUTHOR]

Background: Actinomyces species are part of mucosal surfaces of oral cavity, gastrointestinal and genital tracts. When these mucosal surfaces disrupt, Actinomyces become pathogen and cause infection. Eosinophil leucocytes participate in host defense against helminthic infestation and they generally play a role in asthma and allergy. However, the role of eosinophil leucocytes in host defense against bacteria is conflicting. Aim: To determine whether there is a relationship between Actinomyces-like organisms (ALOs) and eosinophil leucocytes at light microscopic level. Materials and Methods: Cervicovaginal samples obtained from 200 patients were examined by both Pap smear microscopy and anaerobic culturing. Since the results obtained by these methods were not concordant for diagnosis of genital Actinomyces, 6 of 200 patients (3%) diagnosed with ALOs by Pap smear microscopy became the study group. Patients without any infectious agents (n=134) were the control group. Statistical analyses were conducted with c2 test using SPSS program. Results: The study and control groups were compared statistically in view of the presence of eosinophil leucocytes and it was found that there was a significant correlation between the presence of ALOs and eosinophil leucocytes (P<0.05). Abundant polymorphonuclear leucocytes (PMNLs) and macrophages were also detected in the study group. Conclusion: This study implies that eosinophil leucocytes might have a role in host defense against Actinomyces in addition to PMNLs and macrophages. [ABSTRACT FROM AUTHOR]