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Objective: The objective of the study is to present the maternal near miss and maternal mortality cases from a tertiary hospital and to evaluate the factors associated with the presence of maternal near miss. Study Design: We performed a retrospective study, including all women who fulfilled the WHO criteria for maternal near miss or death between June 2009 and June 2014 at a tertiary referral education hospital. This study was conducted to evaluate the risk factors’ influence on near miss, multivariate logistic regression was used. Before setting logistic regression, univariate analyses were used to select candidate variables. Results: During the 5-year study, there were 82924 deliveries and 81673 live births. We identified 202 maternal near miss events and 11 maternal deaths. The maternal near miss ratio was 2.47 per 1.000 live births and the maternal mortality ratio was 13.46 per 100.000 live births. There were 213 women with a severe maternal outcome ratio (SMOR) (near miss + maternal death), with a ratio of 2.6 cases/1.000 live birth. Near miss events were associated with length of hospital stay (p

Objective: Prolongation of the third stage of labor may cause serious postpartum complications. Thus, timely expulsion of the placenta is essential for preventing complications of the third stage of labor. We conducted a prospective cohort study to determine the effect of placental cord drainage on the duration of the TSL in women administered intravenous oxytocin during this stage. Study Design: This was a prospective cohort study in which 112 low risk pregnant women were allocated to the study. There were 53 women in the placental cord drainage group, and 59 women in the cord clamping group without drainage. Immediately after fetal delivery, intravenous infusion of 20 IU oxytocin in 500 mL Ringers’ Lactate was started and infused within 2 hours in women in both groups. Outcome measures were the third stage duration and hemoglobin differences between admission and the postpartum sixth hour. Results: There were no significant differences between the two groups with regard to duration of stages 1 and 2 of labor, hemoglobin level on admission, and at the postpartum sixth hour, and hemoglobin differences between admission and the postpartum sixth hour. The median third stage duration in the study group was 3.40 (range: 0.35-16.20) minutes, and 5.10 (range: 2.30-11.00) minutes in the control group. This difference between the groups was statistically significant (p

Spontaneous uterine rupture during pregnancy can cause severe complications, even maternal and fetal demise. We report successful management of a spontaneous fundal uterine rupture in a 32 week pregnant who had undergone two previous cesarean sections due to preterm delivery. We explain causes of spontaneous uterine rupture and the management of this rare event in the presented case report.

Arthrogryposis multiplex congenita (AMC), characterized by multiple congenital joint contractures due to decreased fetal movements, is a non-progressive rare syndrome. Prevalence is determined to be 1 in 3000 deliveries. Although it is autosomal recessively inherited, sporadic cases have also been reported. Prenatal diagnosis of AMC is difficult. Here we report a case with a diagnosis of AMC not diagnosed during antenatal follow-up.

OBJECTIVE: In this study, we retrospectively compare the outcomes of anemia in 3rd trimester pregnant women who applied to our clinic, in terms of maternal factors and its fetal effects, in 0 and 6th months. STUDY DESIGN: 139 cases admitted to our clinic during December 2010 - May 2012 due to pregnancy in their 3rd trimester and were diagnosed with anemia and whose records were available were included in the study. The pregnant women were divided into two groups according to their hemoglobin (Hb) levels; hemoglobin levels below 11 g/dL formed the anemia group (AG Hb

OBJECTIVE: To investigate the effect of bile acids on meconium passage in utero in normal pregnancies. STUDY DESIGN: This prospective case control study was performed at Zekai Tahir Burak Women’s Health and Teaching Hospital between September 1, 2010 and January 1, 2011. Inclusion criteria were: singleton viable pregnancy, gestational age ≥37 weeks. Exclusion criteria were: presence of any maternal disease, obstetric cholestasis, hepatic infections and multiple pregnancies. Sixty one pregnant women were recruited for the study: 31 women with meconium stained amnion liquid and 30 women with normal amnion liquid. Demographic data and clinical data were collected. Each patient’s cord blood gases, cord blood bile acids levels, maternal serum liver function tests and bilirubin levels were investigated. RESULTS: There were no significant differences in maternal age, gestational age, parity and body mass index. We found no differences in the serum bilirubin levels and liver function tests. And there were also no differences in the cord blood gas values between the two groups. The mode of delivery was significantly different between the two groups. We didn’t find a statistically significant difference in cord blood bile acid levels between the two groups. CONCLUSION: Cord blood bile acid levels appeared to have no significant effect of meconium passage in normal pregnancies.

OBJECTIVE: The aim of this study is the assesment of relationship between mastalgia and hormonal parameters and frequency of mastalgia in polycystic ovary syndrome (PCOS). STUDY DESIGN: 141 patients who are admitted to our clinic were included in this study after taking their informed consent. 78 patients who were diagnosed as PCOS according to the Rotterdam Criteria constitute the patient group. 63 patients who are admitted for routine control and had no hormonal pathology constitute the control group. Age of the patients were noted, complaints of mastalgia were questioned and hormonal parameters (Follicle-Stimulating Hormone (FSH), Luteinizing Hormone (LH), Estradiol (E2), Testosterone, Dehydroepiandrosterone Sulphate (DHEAS), Thyroid-Stimulating Hormone (TSH), Body Mass Index (BMI)) were recorded. RESULTS: Frequency of mastalgia was found as 24.4% in PCOS group and 33.3% in control group and there is no statistical difference (p>0.05). It is apparent that the PCOS group, when compared with the control group, is characterized by higher LH levels and higher Testosterone, DHEAS and TSH levels (p

Pulmonary embolism is a major cause of death during pregnancy or the puerperium. The hemostatic changes in pregnancy creates a prothrombotic milieu. Hyperemesis gravidarum is one of the recognised risk factors for venous tromboembolism.Two cases of maternal mortality were attributed to PE associated with severe hyperemesis gravidarum in 2014 in Turkey. These two cases have been reported and discussed in the literature review. We aimed to alert clinicians that thromboprophylaxis should be considered when a pregnant woman suffers vomiting leading to clinical evidence of dehydration.

OBJECTIVE: To examine association between maternal antenatal serum biomarkers and post-term pregnancies. STUDY DESIGN: Singleton pregnant women (n=186) managed at the Zekai Tahir Burak Women’s Health, Education and Research Hospital in Turkey from July 2010 to December 2010 were analyzed retrospectively. Maternal serum levels of PAPP-A, free β-hCG, AFP, HCG and unconjugated E3 were noted routinely in antenatal screening programs. We compared these biomarkers in pregnancies between 37 and 41 gestational weeks (n=73) and ≥41 (n=113) gestational weeks. RESULTS: There was no statistically significant difference in maternal PAPP-A, free beta-hCG, AFP, total hCG and unconjugated E3 levels between the two groups. Although birth weights were higher in pregnant women ≥41 weeks, this difference was not considered significant (p=0.19). There were no SGA babies in the group of post-term pregnancies. CONCLUSION: There were no statistically significant differences in maternal serum markers for pregnant women having their period of ≥41 gestational week.

Rudimentary horn pregnancy is a rare but serious obstetric event. We presented a case of rudimentary horn pregnancy ruptured at 22 weeks. Rudimentary horn excision was performed during exploration.

OBJECTIVE: To analyse the results of the vaginal cultures and find out the prevalence of pathogens in patients with acute vulvovaginitis, retrospectively. STUDY DESIGN: Vaginal cultures results of patients with the diagnosis of acute vulvovaginitis were analyzed retrospectively between June 2005 and January 2006. RESULTS: Totally 241 patients were included in the study within 6 months time period. Mean age of patients was 30,63±6,87 changing between 19 and 57 years. While there was no pathogen detected in 18,3% (44/241) of vaginal cultures, various pathogens growed in 81,7% (197/241) of cultures. Normal vaginal flora was detected in 70,6% (139/197) of cultures with growth. The second most common pathogen was Candida subspecies with a rate of 14,2% (28/197). Other pathogens were Candida albicans, E.coli, Gardnerella vajinalis, Klebsiella pneumonia, Candida subspecies and Klebsiella, Candida albicans and Klebsiella, Candida albicans and Gardnerella vajinalis with a rate of %7,1 (14/197), %4,1 (8/197), %2 (4/197), %0,5 (1/197), %0,5 (1/197), %0,5 (1/197) and %0,5 (1/197) respectively. CONCLUSION: The most frequent pathogen detected in culture of patients with acute vulvovaginitis was candida subspecies in our clinic.

Subarachnoid hemorrhage (SAH) is a stroke subtype resulting from leakage of blood. The incidence of SAH during pregnancy varies from 1 to 2 per 10000 pregnancies. The most frequent (%85) cause of SAH is a ruptured cerebral aneurysm. A 39-year-old woman at 33 weeks’ gestation experienced abrupt onset of severe headache, neck stiffness, photophobia, and vomiting and was admitted to the hospital and diagnosed as SAH. On neurological examination, no deficits were apparent. A magnetic resonance imaging showed a subarachnoid hemorrhage. Lumbar puncture was performed and SAH was confirmed. It was decided to proceed with a caesarean section. After cesarean delivery of a healthy infant, the patient immediately underwent cerebral angiography, which was normal. Eight days after the initial cerebral angiography, a second angiography demonstrated a suspicious aneurysm and vasospasm; therefore a third angiography was performed and was found normal. At discharge and at clinical follow-up, our patient was asymptomatic. Patients with significant SAH and negative cerebral angiography findings should be considered for further diagnostic testing including repeat cerebral angiography.

Placental abruption although uncommon, can result in high rate of maternal and fetal morbidity and mortality. Several studies suggest abnormal placental vasculature, thrombosis and reduced placental perfusion in pathophysiology. Genetic variations may predispose to these problems. Case: A thirty year old 28 weeks pregnant women underwent cesarean section with the diagnosis of placental abruption, intrauterine dead fetus and previous cesarean section in our clinic. It was learned that she had a cesarean section due to placental abruption 1 year ago. In the postoperative period trombophilia markers, methylenetetrahydrofolate reductase , Factor V leiden and Prothrombin gene polymorphism, homocystein, folate and vitamin B12 levels and genetic karyotyping were evaluated. The only pathology was the metylenetetrahydrofolate reductase gene heterozygosity for the C to T substitution at nucleotide 677. Risk of recurrence is high in patients with a history of placental abruption. Antenatal care and delivery after fetal lung maturation is advised since the perinatal mortality is high with placental abruption.

The intrauterine devices (IUDs) have been used widely by women of childbearing years. In this report, we presented a case of a 25-year-old gravida 4, parity 3 woman with an abdominal wall penetration by an IUD. She had an IUD (TCu-380A) inserted immediately after dilatation & curettage. The IUD was removed laparoscopically.

Objective: The aim of this study is to determine bilateral tubal ligation incidence performed during C-section in women with a history of 2 or more C-section and the factors affecting sterilization demand. Study Design: Patients who were admitted to Zekai Tahir Burak Woman's Health, Education and Research Hospital between February 2017 and June 2017 and who had a history of 2 or more C-section between week 37 and 41 were included in this prospective cross-sectional study. These subjects were separated into 2 groups according to whether they wanted bilateral tubal ligation during C-section. Bilateral tubal ligation was performed by means of modified Pomeroy technique. Both groups were compared in terms of age, gravida, number of children living at home, education level and income status. Patients who did not want bilateral tubal ligation were asked to fill a questionnaire involving reasons for not asking for bilateral tubal ligation. Results: The number of patients who wanted bilateral tubal ligation was 51 (43%) while those who did not want bilateral tubal ligation was 67 (57%). Compared with patients who did not want bilateral tubal ligation, patients who wanted bilateral tubal ligation had more number of children at home and a higher number of previous C-section (p