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Background Perinatal mental health is a major public health concern. In Turkey, public hospitals operate pregnancy schools which provides an opportunity to integrate an evidence-based Thinking Healthy Programme (THP) for perinatal depression. The aim of this study is to adapt the THP for universal use in the group setting and to understand its acceptability and feasibility for integration into the existing antenatal care programme for both face-to-face and online delivery. Methods Following an expert-led adaptation process using the Bernal Framework, field testing was conducted on a group of women and facilitators followed by in-depth interviews (n:8) and group discussions (n = 13). Data were analysed using Thematic Framework Analysis. Results Minor but significant adaptations were made to the individually delivered THP for use in the universal group pregnancy schools. Initial findings indicate that the THP-group version was acceptable to its target population and could be integrated into the antenatal care plan for delivery during face-to-face and online group classes. Conclusion THP is transferable to the Turkish cultural and healthcare context. The THP–group version has the potential to add value to Turkey’s existing perinatal healthcare programme.

Objective: The purpose of this study was to analyze the fetal thymus size by sonography in healthy, small for gestational age (SGA), and fetal growth restriction (FGR) pregnancies and investigate if there is a difference between healthy fetuses and those with growth restriction. Study Design: The thymic-thoracic ratio (TTR), transverse diameter, and perimeter of the fetal thymus were prospectively measured in SGA and FGR pregnancies between the gestational ages of 20 and 37 weeks and compared with healthy controls. Fetal abdominal circumference (AC) or estimated fetal weight (EFW), Amaç: Bu çalışmanın amacı, sağlıklı, gestasyonel yaşa göre küçük (SGA) ve fetal gelişme geriliği (FGR) olan gebeliklerde ultrasonografi (USG) ile fetal timus boyutunu değerlendirmek ve sağlıklı fetüsler ile gelişme geriliği olan fetüsler arasında fark olup olmadığını araştırmaktı. Materyal ve Method: Fetal timusun timik-torasik oranı (TTR), transvers çapı ve çevresi, 20 ila 37. gebelik haftaları arasındaki SGA ve FGR gebeliklerinde prospektif olarak ölçüldü ve sağlıklı kontrollerle karşılaştırıldı. Gestasyonel yaşa göre fetal karın çevresi (AC) veya tahmini fetal ağırlık (EFW)

Introduction: From the beginning of pregnancy, pregnant women think about their birth and the birth is shaped according to the birth belief of the person.Objective: This study aims to determine the relationship between the birth beliefs of pregnant women and birth outcomes, traumatic birth perception levels and postpartum depression. Materials and Methods: This cross-sectional study was conducted in a province in eastern Türkiye. The data was collected using the Personal Information Form, Birth Beliefs Scale, Traumatic Birth Perception Scale, and Edinburgh Postpartum Depression Scale. Results: While there was no significant difference between the medical birth beliefs of women according to their descriptive characteristics (p>0.5), those who were at 28-36 weeks of gestation, who did not have a curettage, and those who went to pregnancy control ≥4 times, considered the birth more natural (p, Giriş: Gebeliğin başından itibaren, gebeler doğumunun nasıl olacağını düşünür ve doğum, kişinin doğum inancına göre şekillenir. Amaç: Bu çalışmanın amacı gebelerin doğum inançları ile travmatik doğum algı düzeyleri, doğum sonuçları ve doğum sonu depresyon görülme durumları arasındaki ilişkiyi belirlemektir. Gereç ve Yöntem: Kesitsel tür şekilinde tasarlanan bu çalışma, Türkiye’nin doğusundaki bir ilde yürütüldü. Verilerin toplanmasında Tanıtıcı Bilgi Formu, Doğum İnançları Ölçeği, Travmatik Doğum Algısı Ölçeği, Edinburgh Postpartum Depresyon Ölçeği kullanıldı. Bulgular: Kadınların tanıtıcı özelliklerine göre tıbbi doğum inançları arasındaki farkın önemli olmadığı belirlenirken (p>0,05); 28-36 gebelik haftasında olanların, küretaj yapmayanların, ≥4 kez gebelik kontrolüne gidenlerin doğumu daha doğal gördükleri belirlendi (p

Objective: Recently, some pregnant women in Türkiye are hesitant to undergo gestational diabetes mellitus (GDM) screening tests and this trend is more common. The objective of the study is to assess the pregnant women’s knowledges, decisions, reasons for hesitations about having the GDM screening tests and test rejection rates. Material and Methods: This cross-sectional study included 647 pregnant women who applied for an antenatal outpatient clinic and who had not yet been diagnosed with GDM and a survey was conducted using questionnaire designed by the authors. Results: At the beginning, 287 (44.4%) of the participants declared that they would have glucose challenge test, 169 (26.1%) would not and 191 (29.5%) were undecided. The rejection rate was lower in those who had knowledge about the screening tests. After a short information about the content of tests, 30% of the women who decided not to have the test and 78.3% of those who were undecided at the beginning, decided to have the test (p=0.001). Conclusion: The knowledge level of pregnant women about diabetes screening and diagnosis influences their decision-making. Organizing well-planned trainings for patients and healthcare professionals using public institutions and media may be effective in reducing the burden of diabetes on social health and the economic indicators.

Objectives: The rates of vaccination with human papillomavirus (HPV) vaccine, which can prevent many cancers, rank the last place when compared to other childhood vaccination rates. The purpose of the present study was to evaluate the knowledge levels of mothers living in our region about HPV vaccine and their perspectives regarding having the vaccine.Methods: The study was conducted between 15 July and 15 August 2022 in the Department of Obstetrics and Gynecology, Faculty of Medicine, Kafkas University with the mothers of 377 girls. The SPSS 21 program was used and p < 0.05 was accepted as significant.Results: No statistically significant differences were detected between the desire of the mother to have her child vaccinated against HPV and the age of her child (p = 0.740), income level of the household (p = 0.590) and the working status of the mother (p = 0.419). There were statistically significant differences between the desire of the mother to have her daughter vaccinated with HPV, the place where the mother lived (p = 0.001), age of the mother (p = 0.037), family type (p = 0.001), number of people living at home (p = 0.027), education year of the mother (p = 0.004), father’s approval for vaccination (p = 0.001), and mother’s hearing about the Smear Test (p = 0.001). Conclusions: Even if the HPV vaccine is given free of charge, there is resistance in mothers to the vaccine. It is necessary to inform mothers about HPV vaccination for their daughters and to make the vaccination more widespread.

Aim: Adolescent pregnancies; defined as pregnancies in women aged 10-19 years old are still an important public health problem and must be considered as high risk pregnancies with increased maternal and fetal mortality and morbidity rates. In this study, we aimed to examine the obstetric and perinatal outcomes in adolescent pregnancies delivered with cesarean section (CS) and compare the outcomes in determined adolescent age groups.Materials and Methods: In this retrospective study, the obstetric and perinatal outcomes in 2665 adolescent patients who delivered with cesarean section were examined in three groups divided according to the age of delivery: group 1 included the patients aged 14-15 years old, group 2 the patients aged 16-17 years old and group 3 the patients aged 18-19 years old. The outcomes were compared between the identified age groups.Results: The incidence of preterm delivery was higher in group 1 compared with group 2 and group 3 (p=0.001) and 52.3% of group 1 patients had delivered between 29-34 gestational weeks. Fetal birth weight and APGAR scores were lower and need for neonatal intensive care unit (NICU) was higher in group 1. In group 3 116 (8.4%) patients had postpartum hemorrhage which was higher than group 1 and group 2 with statistically significant difference (p=0.001). Conclusion: Preterm delivery, low birth weight, low APGAR scores and need for NICU are higher in 15-17 years old adolescents delivered with C/S whereas postpartum hemorrhage and need for blood transfusion is higher in adolescents aged 18-19 years old., Amaç: 10-19 yaş arası kadınların gebeliği olarak tanımlanan adölesan gebelikler halen önemli bir halk sağlığı sorunudur ve maternal ve fetal mortalite ve morbidite oranlarının arttığı yüksek riskli gebelikler olarak kabul edilmelidir. Bu çalışmada sezaryen (CS) ile sonuçlanan adolesan gebeliklerde obstetrik ve perinatal sonuçların incelenmesi ve belirlenen adolesan yaş gruplarında bu sonuçların karşılaştırılması amaçlandı.Gereç ve Yöntem: Bu retrospektif çalışmada sezaryen ile doğum yapan 2665 adolesan hastanın obstetrik ve perinatal sonuçları doğum yaşlarına göre oluşturulan 3 grupta incelendi: Grup 1; 14-15 yaş grubu, grup 2; 16-17 yaş grubu ve grup 3;18 -19 yaş grubundan oluşmaktaydı. Sonuçlar belirlenen yaş grupları arasında karşılaştırıldı.Bulgular: Erken doğum insidansı grup 1'de grup 2 ve grup 3'e göre daha yüksekti (p=0,001) ve grup 1'deki hastaların %52,3'ü 29-34 gebelik haftaları arasında doğum yapmıştı. Grup 1'de fetal doğum ağırlığı ve APGAR skorları daha düşük ve yenidoğan yoğun bakım ünitesi ihtiyacı daha yüksekti. Grup 3'te 116 (%8.4) hastada görülen postpartum kanama, grup 1 ve grup 2'ye göre istatistiksel olarak anlamlı farkla daha yüksekti ( p=0.001).Sonuç: 15-17 yaş arası sezaryen ile doğum yapan adolesanlarda erken doğum, düşük doğum ağırlığı, düşük APGAR skorları ve yenidoğan yoğun bakım ihtiyacı daha yüksek iken, 18-19 yaş arası adolesanlarda doğum sonu kanama ve kan transfüzyonu ihtiyacı daha yüksektir.

Amaç: 2011 yılında Uluslararası Jinekoloji ve Obstetrik Federasyonu’nun (FIGO) Menstrüel Bozukluklar Çalışma Grubu, anormal uterin kanama için “PALM-COEIN” adlı yeni bir sınıflandırma sistemi oluşturdu. Çalışmamızın amacı, anormal uterin kanama için yeni sınıflandırma sistemini araştırmak ve klasik terminoloji ile karşılaştırmaktır.Gereç ve Yöntem: Çalışmamız Şubat 2022 ile Temmuz 2022 tarihleri arasında Keçiören Eğitim ve Araştırma Hastanesi kadın hastalıkları kliniğinde retrospektif olarak yapılmıştır. Bilinen kronik hastalığı olmayan premenopozal kadınlar çalışmaya dahil edilmiştir. Çalışmaya alınan her hasta fizik muayene ve pelvik ultrasonografi ile değerlendirilmiştir. Gerekirse histerektomi materyali ve endometriyal spesmen histopatolojik inceleme için alındı. Olası nedenler yeni sınıflandırma sistemine göre sınıflandırıldı.Bulgular: Çalışmaya anormal uterin kanaması olan 135 premenopozal kadın dahil edildi. Kanama şikayeti ile başvuran hastalar; polipler, adenomiyozis, hiperplazi ve iyatrojenik nedenler gibi çeşitli nedenlere bağlı hipermenore, menoraji, metroraji ve menometroraji etiketleri altında gruplandırılmıştır. PALM-COEIN sınıflamasına göre 35 (%25,9) polip, 16 (%11,8) adenomyozis, 38 (%28,1) leiomyom, 4 (%2,9) malignite ve hiperplazi tespit edildi.Sonuç: Anormal uterin kanamanın sınıflandırılması genellikle tutarsızdır. Birçok nedenden dolayı oluşturulan yeni sınıflandırma sistemi, karmaşık durumları anlamak için önemli bir adımdır. Diğer bir ihtiyaç ise, yaygın olarak kabul edilen ve bilinen bir sınıflandırma sisteminin klinisyenler arasındaki iletişimi kolaylaştırması ve hedef popülasyonun gözden geçirilmesini netleştirmesidir. Yeni sınıflandırma sisteminin hastalar arasındaki iletişimi iyileştireceği de açıktır. Sistemin yaygın kullanımı anormal uterin kanamalar için de yeni tedavi seçeneklerini ortaya çıkaracaktır., Background: The Menstrual Disorders Working Group of the International Federation of Gynecology and Obstetrics (FIGO) created a new classification system called “PALM-COEIN” for abnormal uterine bleeding in 2011. The aim of our study is to investigate the new classification system and compare it with the classical terminology for abnormal uterine bleeding.Materials and Methods: Our study was conducted retrospectively between February 2022 and July 2022 in the gynecology clinic of Keciören Training and Research Hospital. Premenopausal women without known chronic disease were enrolled in the study. Each patient enrolled in the study was examined based on anatomical structure, physical examination, and pelvic ultrasonography. If necessary, endometrial specimens and hysterectomy material were obtained for histopathologic examination. Possible causes were classified according to the new classification system. Results: The study included 135 premenopausal women with abnormal uterine bleeding. In general, the patients with bleeding complaints had leiomyoma uteri and polyps according to the classical terminology. They were grouped under the labels of hypermenorrhea, menorrhagia, metrorrhagia, and menometrorrhagia, which were due to various causes, including polyps, adenomyosis, hyperplasia, and iatrogenic causes. According to the classification PALM-COEIN, 35 (25.9%) polyps, 16 (11.8%) adenomyosis, 38 (28.1%) leiomyomas, 4 (2.9%) malignancies and hyperplasia were detected. Conclusion: The classification of abnormal uterine bleeding is generally inconsistent. The new classification system, created for many reasons, is an important step towards understanding complex situations. Another need is that a widely accepted and known classification system should facilitate communication among clinicians and clarify the review of the target population. It is also clear that the new classification system will improve communication between patients. Widespread use of the system will also reveal new treatment options for abnormal uterine bleeding.

Aim: The purpose of this study is to present the importance of hemoperitoneum and retrospective analysis of tubal ectopic pregnancy cases treated in our clinic.Material and Methods: This study respectively included 86 women who were diagnosed and treated for tubal ectopic pregnancy (EP) in our single-centre clinic between January 2012 and August 2013. Age, date of last menstrual period, human chorionic gonadotropin (β-hCG) level, the size and the presence of tubal EP masses, fetal cardiac activity and treatment procedures were evaluated and compared. The presence of hemoperitoneum for predictive treatment methods and factors that affecting the success of treatment methods were investigated.Results: The mean age of the patients was 29.1±5.7 (16-41) years. Mean β-hCG level was 4448,5±8351,9 IU/L. Laparatomy was performed to 14 patients (16.3%), laparoscopy to 5 patients (5.8%), expectant management to 15 patients (17.4%). Methotrexate (MTX) treatment was given to 46 patients (53.5%) and laparoscopy was performed to 1 patient (1.2%) and laparatomy to 5 patients (5.8%) due to MTX treatment failure in 6 patients. Compared with the MTX treatment of tubal EP, the possible factors that affecting surgical management, such as the initial β-hCG level (p=0.004), whether there is hemorrhage in the abdominal cavity (p=0.03), the size of ectopic pregnancy mass (p=.005) and the presence of fetal heart activity (p, Amaç: Bu çalışmanın amacı kliniğimizde tedavi edilen tubal ektopik gebelik olgularının hemoperitonyumun önemini ve retrospektif analizini sunmaktır.Gereç ve Yöntemler: Bu çalışmaya Ocak 2012 ile Ağustos 2013 tarihleri arasında tek merkezli kliniğimizde tubal ektopik gebelik (EP) tanısı ve tedavisi konulan 86 kadın dahil edildi. Yaş, son adet tarihi, insan koryonik gonadotropin (β-hCG) ) düzeyi, tubal EP kitlelerinin büyüklüğü ve varlığı, fetal kardiyak aktivite ve tedavi prosedürleri değerlendirildi ve karşılaştırıldı. Prediktif tedavi yöntemleri için hemoperiton varlığı ve tedavi yöntemlerinin başarısını etkileyen faktörler araştırıldı.Bulgular: olguların yaş ortalaması 29,1±5,7 (16-41) yıl idi. Ortalama β-hCG düzeyi 4448,5±8351,9 IU/L idi. 14 olguya (%16.3) laparatomi, 5 olguya (%5.8) laparoskopi, 15 olguya (%17.4) ekspektan tedavi uygulandı. MTX tedavisi başarısızlığı nedeniyle 46 olguya (%53,5) metotreksat (MTX) tedavisi, 1 olguya (%1,2) laparoskopi, 5 olguya (%5,8) laparatomi uygulandı. Tubal EP'nin MTX tedavisi ile karşılaştırıldığında, başlangıç β-hCG düzeyi (p=0,004), intraabdominal kanama olup olmadığı (p=0,03), ektopik gebelik boyutu (p=0,005) ve fetal kalp aktivitesinin varlığı (p

Aim: Increasing cesarean section (C/S) rates have become a growing public health issue. Turkey ranked among the top countries in the world for the highest cesarean rates. Why women desire CS instead of vaginal birth may be the key to avoiding unnecessary C/Ss. In this study, we performed a questionnaire to evaluate the possible reasons for maternal CS requests in one of the largest maternity care hospitals in Turkey.Materials and Methods: A questionnaire was applied among pregnant women, focused on the preference of the mode of delivery and the reasons for the preferences.Results: Of the 1200 women who answered the questionnaire about the mode of delivery, 45.7% were nulliparous and of these, 85% preferred vaginal delivery. Of the women who had vaginal birth previously, 93.4% preferred vaginal delivery. Of the women who had a previous c-section, 11.8% preferred to try a vaginal delivery. The main factor that affected the preference for C/S was the previous history of C/S. When the patients with a previous history of C/S were excluded; a history of previous spontaneous abortion and longer marital relationships were found to be the factors associated with C/S preference. of women who preferred vaginal delivery 55.8% stated that vaginal delivery was preferred because the most natural way of childbirth was a vaginal birth. Discussion and Conclusion: Elective cesarean section in the absence of clinical indications is one of the most discussed topics of obstetric practice. The reason for the first C/S should be very well-reviewed to provide a logical approach to the current rates of C/S. Childbirth fear is also an important point to be carefully evaluated for especially nulliparous women., Giriş: Artan sezaryen (C/S) oranları giderek büyüyen bir halk sağlığı sorunu haline gelmiştir. Türkiye, son yıllarda dünyanın en yüksek sezaryen oranları olan ülkeleri arasında yer almaktadır. Kadınların neden vajinal doğum yerine sezaryen istemekte olduklarının bilinmesi, gereksiz sezaryenlerden kaçınmanın anahtarı olabilir. Bu çalışmada, Türkiye'nin en büyük doğum bakım hastanelerinden birinde anne adaylarının sezaryen taleplerinin olası nedenlerini değerlendirmeyi amaçladık.Gereç ve Yöntem: Gebelere doğum şekli tercihi ve tercih nedenlerine odaklanan bir anket uygulandı. Anket içerisinde doğum şekli tercihleri ve bu tercihlerini etkileyen nedenler sorgulandı. Bulgular: Doğum şekli ile ilgili anketi yanıtlayan 1200 kadının %45.7'si nullipardı ve bunların %85'i vajinal doğumu tercih etti. Daha önce vajinal doğum yapan kadınların %93.4'ü vajinal doğumu tercih etti.ğini bildirdi. Daha önce sezaryen olan kadınların %11.8'i vajinal doğum yapmayı tercih etti. C/S tercihini etkileyen ana faktör, daha önceki C/S öyküsü idi. Daha önce C/S öyküsü olan hastalar dışlandığında; önceki spontan abort öyküsü ve daha uzun evlilik süresinin C/S tercihiyle ilişkili faktörler olduğu bulundu. Vajinal doğumu tercih eden kadınların %55,8'i en doğal doğum şeklinin vajinal doğum olması nedeniyle bu tercihte bulunduğunu belirtmiştir.Tartışma ve Sonuç: Medikal bir endikasyon olmaksızın elektif sezaryen, obstetrik pratiğin en çok tartışılan konularından biridir. Mevcut C/S oranlarına mantıklı bir yaklaşım sağlamak için ilk C/S'nin nedeni çok iyi gözden geçirilmelidir. Doğum korkusu da özellikle nullipar kadınlar için dikkatle değerlendirilmesi gereken önemli bir noktadır.

Background: The aim of this study was to determine the risk factors for meconium-stained amniotic fluid in a low-risk pregnancy and to evaluate birth complications and neonatal outcomes in deliveries with meconium-stained amniotic fluid (MSAF).Material and Methods: This prospective study was conducted between April 2015 and September 2015 at Ankara Zekai Tahir Burak Women’s Health Education and Research Hospital. 351 women with singleton pregnancies and cephalic position who had reached 37 weeks of gestation were included in the study. Women with known chronic systemic diseases, pregnancy complications, and previous uterine surgery were excluded. 151 cases with MSAF and 200 randomly selected control cases with clear amniotic fluid were included in this study. We compared the two groups in terms of maternal age, gravidity, parity, gestational age, intrapartum maternal fever, body mass index (BMI), duration of labor, cardiotocographic values (CTG), mode of delivery, neonatal outcomes, and admission to the neonatal intensive care unit.Results: In our study, meconium aspiration syndrome (MAS) developed in 2.6% (4/151) of neonates with meconium staining at birth. Gestational age, intrapartum maternal fever and BMI were significantly increased in the MSAF group (p=0.003). The duration of the active phase of labor (cervical dilation from 6 cm to 10 cm) was similar in both groups, and the duration of the second phase of labor was longer in the MSAF group (p=0.002). MSAF was associated with an increased number of abnormal results in cardiotocographic examinations, birth complications, and neonatal outcome (p < 0.001).Conclusion: Deliveries with meconium-stained amniotic fluid are associated with increased morbidity; therefore, intrapartum examinations should be performed more frequently and carefully, and precautions should be taken during labor in collaboration with pediatricians to reduce potential adverse neonatal outcomes., Amaç: Bu çalışmanın amacı, düşük riskli bir gebelikte mekonyum boyalı amniyotik sıvı için risk faktörlerini belirlemek ve mekonyum boyalı amniyotik sıvı (MBAS) varlığındaki doğumlarda doğum komplikasyonlarını ve yenidoğan sonuçlarını değerlendirmektir.Gereç ve Yöntemler: Bu prospektif çalışma Nisan 2015-Eylül 2015 tarihleri arasında Ankara Zekai Tahir Burak Kadın Sağlığı Eğitim ve Araştırma Hastanesi’nde yapıldı. Çalışmaya 37. gebelik haftasına ulaşmış tekil gebelik ve baş pozisyonu olan 351 kadın dahil edildi. Bilinen kronik sistemik hastalıkları, gebelik komplikasyonları ve geçirilmiş uterin cerrahisi olan kadınlar çalışma dışı bırakıldı. Bu çalışmaya MBAS’lı 151 olgu ve berrak amniyotik sıvısı olan rastgele seçilmiş 200 kontrol olgusu dahil edildi. İki grubu anne yaşı, gravidite, parite, gebelik yaşı, intrapartum maternal ateş, vücut kitle indeksi (VKİ), doğum süresi, kardiyotokografik değerler, doğum şekli, neonatal sonuç ve yenidoğan yoğun bakım ünitesine yatış oranları açısından karşılaştırdık. Bulgular: Çalışmamızda doğumda mekonyum boyanması olan yenidoğanların %2,6’sında (4/151) mekonyum aspirasyon sendromu (MAS) gelişti. MBAS grubunda gebelik yaşı, intrapartum maternal ateş ve VKİ anlamlı olarak yüksekti (p=0,003). Doğumun aktif fazının süresi (6 cm’den 10 cm’ye servikal dilatasyon) her iki grupta benzerdi ve MBAS grubunda doğumun ikinci fazının süresi daha uzundu (p=0,002). MBAS, kardiyotokografik incelemelerde, doğum komplikasyonlarında ve yenidoğan sonuçlarında artan sayıda anormal sonuçla ilişkili bulundu (p < 0,001).Sonuç: Mekonyum boyalı amniyotik sıvı ile yapılan doğumlar artmış morbidite ile ilişkilidir; bu nedenle intrapartum muayeneler daha sık ve dikkatli yapılmalı ve olası olumsuz yenidoğan sonuçlarını azaltmak için doğum sırasında çocuk doktorları ile işbirliği içinde önlemler alınmalıdır.

Objectives: Since recurrent implantation failure (RIF) is a challenging fact, effects of different therapeutic immunomodulatory agents are being investigated to overcome this problem. This study aimed to evaluate the effect of intralipid on pregnancy outcomes of IVF patients with RIF.Methods: 116 of the participants who received only the short antagonist protocol allocated in the control group, whereas 106 patients were in intralipid group by additionally receiving intravenous lipid (SMOFlipid®). Intralipid was given on the day of embryo transfer, on the day of positive pregnancy test and continued weekly until the tenth week of pregnancy. Implantation rate, biochemical pregnancy rate, clinical pregnancy rate and live birth rate were evaluated.Results: The positive pregnancy test, clinical pregnancy rate and live birth rate were statistically significantly higher (p0.05).Conclusions: This study revealed that intralipid therapy has better pregnancy outcomes in patients with RIF compared to patients undergo standard IVF protocol only. Further prospective studies are needed to suggest the routine use of intralipid in patients with RIF., Amaç: Tekrarlayan implantasyon başarısızlığı (RIF) zorlu bir gerçek olduğundan, bu sorunun üstesinden gelmek için farklı terapötik immünomodülatör ajanların etkileri araştırılmaktadır. Bu çalışma, intralipidin RIF'li IVF hastalarının gebelik sonuçları üzerindeki etkisini değerlendirmeyi amaçlamıştır.Yöntemler: Katılımcıların 116'sı sadece kısa antagonist protokolünü alan kontrol grubuna, 106'sı ise intravenöz lipid (SMOFlipid®) verilerek intralipid grubunda yer aldı. İntralipid, embriyo transferinin olduğu gün, pozitif gebelik testinin olduğu gün verildi ve gebeliğin onuncu haftasına kadar haftalık olarak devam edildi. İmplantasyon oranı, biyokimyasal gebelik oranı, klinik gebelik oranı ve canlı doğum oranı değerlendirildi.Bulgular: Pozitif gebelik testi, klinik gebelik oranı ve canlı doğum oranı İntralipid grubunda istatistiksel olarak anlamlıydı (p

Amaç: Tubal açıklığın olduğu durumlarda, tubal patolojileri düşündüren diğer histerosalpingografi (HSG) bulgularının tanısal değeri tartışmalıdır. Fallop tüplerini değerlendirmek için altın standart kabul edilen yöntem ise laparoskopidir. Bu çalışmanın amacı HSG’de tubal açıklık saptanan ancak anormal bulguları olan hastaların laparoskopik bulgularını araştırmaktır.Yöntem: Çalışma popülasyonu, HSG'de saptanan anormal tubal bulguların ileri değerlendirmesi için laparoskopi yapılan infertil kadınları içermektedir. HSG görüntüleri tubal açıklık, kıvrımlı tüpler, peritubal alanda boyanın göllenmesi, tubal ektazi ve fimbrial fimosis varlığı açısından değerlendirilmiştir. Laparoskopik değerlendirmede saptanan pelvik patolojilerin tipi ve sıklığı araştırılmıştır.Bulgular: Toplam 73 laparoskopi vakası çalışmaya dahil edilmiştir. Bunların 18'inde (%25) normal laparoskopik bulgular saptanmıştır. Vakaların %75'inde laparoskopi sırasında en az bir pelvik patoloji tespit edilmiştir. En sık saptanan pelvik patoloji tubal adezyonlardır. 21 olguda (%29) tubal adezyon saptanmıştır. Vakaların %23’ünde endometriotik implantlar saptanmıştır. 11 olguda (%13) fimbrial fimozis, 7 olguda (%10) ise paratubal kistler tespit edilmiştir.Sonuç: HSG değerlendirmesi esnasında sadece tubal açıklığa odaklanmak, diğer tubal patolojilerin tespit edilememesine neden olabilir. Klinisyenler, tubal anormallikleri düşündüren anormal HSG bulgularına aşina olmalıdır. Bu patolojilerin infertiliteye sebep olması ve laparoskopik tedavilerinin fertilite üzerinde olumlu etkisi olması, HSG görüntülerinin bu patolojiler açısından dikkatli bir şekilde incelenmesini gerekli kılmaktadır., Objective: The diagnostic value of hysterosalpingography (HSG) findings suggestive of subtle tubal pathologies is controversial. The gold standard method to evaluate the fallopian tubes is laparoscopy. The aim of this study is to explore the laparoscopic findings of patients with abnormal findings but patent tubes detected on HSG.Methods: The study population included infertile women undergoing laparoscopy for further evaluation of abnormal tuba-related findings on HSG. The HSG views were evaluated for the presence of tubal patency and the convoluted tubes, loculation of the dye in the peritubal area, tubal ectasia, and fimbrial phimosis. The type and frequency of pelvic pathologies detected on laparoscopic examination and the predictive value of patent but abnormal fallopian tube finding on HSG were analyzed.Results: A total of 73 laparoscopy cases were eligible. Of these, 18 (25%) had normal laparoscopic findings. In 75% of the cases, there was at least one pelvic pathology detected during laparoscopy. The most common pelvic pathology detected was tubal adhesions. Tubal adhesions were detected in 21 cases (29%). Fimbrial phimosis was detected in 11 cases (13%). Paratubal cysts were detected in 7 cases (10%).Conclusion: While evaluating a HSG, focusing only on tubal patency may result in the failure of detecting subtle tubal pathologies. Clinicians should be familiar with abnormal HSG findings suggestive of tubal abnormalities. Careful examination of the HSG views regarding other tubal pathologies is warranted as these subtle conditions may impair fertility and laparoscopic correction of these pathologies has a positive impact on fertility.

Aim: To compare pain scores of infertile patients during and after hysterosalpingography (HSG) procedure using visual analoge scale (VAS) between cold and warm contrast medium and to investigate whether using warm contrast can alter spontaneous pregnancy rate.Materials and Methods: Prospective randomized study between March-September 2017. Primary infertile patients undergoing HSG procedure. Patients’ age, body mass index (BMI), history of previous surgery, duration of infertility and pain levels during the most painful menstrual period were recorded. The pain severity was questioned during and at the 30th minute after the procedure using VAS. While patients who underwent HSG using a contrast medium at body temperature 37 °C were defined as warm group(n:55), patients who underwent HSG using a contrast medium at room temperature 23 °C were defined as cold group (n:55). Results: There were no significant differences between the groups in terms of age, BMI, duration of infertility, previous surgery and VAS during menstruation. The mean duration of HSG of warm group patients was significantly lower(p=0.001). Warm group patients’ mean VAS score during and 30 minutes after HSG were significantly lower than in the control group ( 5.3±4.2 vs 7.5±2.0), (1.1±0.9 vs 2.4±1.4), respectively. While severe pain percentage during HSG in warm group was 25.5%, it was 66.7% in the control group. In logistic regression analysis, warm and cold groups were only found as significant related factors for severe pain felt during procedure (p, Amaç: İnfertil hastalarda soğuk ve sıcak kontrast madde kullanılarak çekimi yapılan histerosalpingografi (HSG) işlemi sırasında ve sonrasında vizüel analog skalası (VAS) kullanarak ağrı skorlarını karşılaştırmak ve sıcak kontrast kullanımının spontan gebelik oranını değiştirip değiştiremeyeceğini araştırmak.Gereçler ve Yöntem: Çalışma prospektif randomize kontrollü tasarlandı ve Mart-Eylül 2017 tarihleri arasında HSG prosedürü uygulanan primer infertil hastalar dahil edildi. Hastaların yaşı, vücut kitle indeksi (VKİ), geçirilmiş cerrahi öyküsü, infertilite süresi ve en ağrılı adet dönemindeki ağrı düzeyleri kaydedildi. İşlem sırasında ve işlem sonrası 30. dakikada ağrı şiddeti VAS ile sorgulandı. Hastaların yaşı, vücut kitle indeksi (VKİ), geçirilmiş cerrahi öyküsü, infertilite süresi ve en ağrılı adet dönemindeki ağrı düzeyleri kaydedildi. İşlem sırasında ve işlem sonrası 30. dakikada ağrı şiddeti VAS ile sorgulandı.Bulgular: Gruplar arasında yaş, VKİ, infertilite süresi, geçirilmiş cerrahi ve menstrüasyon sırasındaki VAS açısından istatistiksel olarak anlamlı fark yoktu. Sıcak gruptaki hastaların ortalama HSG süresi anlamlı olarak daha düşüktü (p=0,001). Sıcak gruptaki hastaların HSG sırasındaki ve 30 dakika sonraki ortalama VAS skoru, kontrol grubuna göre (sırasıyla 5,3±4,2 vs 7,5±2,0) (1.1±0,9 ve 2,4±1,4) anlamlı derecede düşüktü. HSG sırasında şiddetli ağrı yüzdesi sıcak grupta %25.5 iken kontrol grubunda %66.7 idi. Lojistik regresyon analizinde, iki grup arasında işlem sırasında hissedilen şiddetli ağrı için yalnızca anlamlı ilişkili faktörler olarak bulundu (p

Background: The rising incidence of endometrial cancer has been associated with increases in obesity and physical inactivity. We investigated the clinical significance of serum obestatin levels in women with endometrial cancer, endometrial hyperplasia, and age-matched healthy controls. Material and Methods: The present study was a case-control study conducted at a single center between May 2014 and July 2015. The medical records of 90 patients with a final histopathologic diagnosis after therapeutic curettage for abnormal uterine bleeding were reviewed and categorized by diagnosis. The study population included women with adenocarcinoma of the endometrium (n= 33), hyperplasia of the endometrium (n= 27), and proliferative endometrium (n=30) according to histopathological diagnosis. The women with proliferative endometrium formed the control group.Results: Endometrial cancer was diagnosed in 33 (36.6%) of the patients who presented to our clinic for abnormal uterine bleeding. In the group with endometrial cancer, the mean age was 55.2 ± 8.6 years. There were no differences in obestatin levels between groups (p > 0.05). In the ROC curve analysis, the area under the curve value was 0.574, and obestatin did not prove to be a significant marker for cancer prediction in the population involved in the study.Conclusion: This study did not demonstrate a clear association between circulating levels of obestatin and endometrial pathologies., Amaç: Artan endometriyal kanser insidansı, obezite ve fiziksel hareketsizlikteki artışlarla ilişkilendirilmiştir. Bu bilgiden yola çıkarak, endometriyal kanserli, endometriyal hiperplazili kadınlarda ve aynı yaştaki sağlıklı kontrollerde serum obestatin düzeylerinin klinik önemini araştırdık.Gereç ve Yöntem: Bu çalışma Mayıs 2014-Temmuz 2015 tarihleri arasında tek merkezde yürütülen bir vaka-kontrol çalışmasıdır. Anormal uterin kanamaya yönelik terapötik küretaj sonrası kesin histopatolojik tanısı konulan 90 hastanın tıbbi kayıtları incelenmiş ve tanılarına göre kategorize edilmiştir. Çalışma popülasyonu, histopatolojik tanıya göre endometrium adenokarsinomu (n= 33), endometrium hiperplazisi (n=27) ve proliferatif endometrium (n=30) olan kadınları içermiştir. Kontrol grubunu ise proliferatif endometriumlu kadınlar oluşturdu.Bulgular: Kliniğimize anormal uterin kanama ile başvuran hastaların 33’ünde (%36,6) endometrium kanseri tanısı konuldu. Endometrium kanserli grupta yaş ortalaması 55.2 ± 8.6 yıl idi. Gruplar arasında obestatin seviyelerinde fark yoktu (p > 0.05). ROC eğrisi analizinde, eğrinin altında kalan alan değeri 0,574 idi ve obestatin, çalışmaya dahil edilen popülasyonda kanser tahmini için önemli bir belirteç olduğunu kanıtlamadı.Sonuç: Bu çalışma, dolaşımdaki obestatin seviyeleri ile endometriyal patolojiler arasında net bir ilişki göstermedi.

Background: The aim was to evaluate the bacterial contamination rate of ultrasound probes and gels and the associated nosocomial infection risk. In this way, we aimed to assess whether our ultrasound probe disinfection protocols were effective in reducing the risk of hospital-wide infection.Material and Methods: Forty-eight swab samples were collected from the surfaces of transabdominal (TAP) and transvaginal ultrasound (TVP) probes and adhered to gel bottles, which were then cultured in the microbiology laboratory. In comparison, bacterial contamination of gynecology room door handles (12 swab cultures) was analyzed. These measurements were repeated every week for one month, so that each probe was cultured four times during the study period.Results: Non-pathogenic microorganisms (Staphylococcus epidermidis, S. hominis, S. haemolyticus, S. lugdunensis, Corynebacterium amycolatum, C. aurimucosum) common in human skin flora and the environment and two notable pathogens (Enterobacter cloacae, Escherichia coli) were isolated from the probe cultures. Non-pathogenic organisms (S. epidermidis, S. cohnii) were isolated from gel cultures. Also, no significant differences were also found between groups in contamination rates during various patient examinations and emergencies (p > 0.05).Conclusion: Bacterial contamination was found on ultrasound probes/gels in our department. Although the majority were non-pathogenic microorganisms, two pathogenic microorganisms were also identified. Hospital staff should remember that ultrasound probes can be a tool for bacterial infection and can lead to infectious complications. Decontamination of probes with dry, nonsterile paper towels is a cheap, simple, and effective method that does not damage the device and can also reduce bacterial exposure., AmaçBu çalışmanın amacı, ultrasonografi problarının (UP) ve jellerinin bakteriyel kontaminasyon oranlarını ve bunlarla ilişkili hastane enfeksiyonu riskini değerlendirmektir. Bu şekilde, hastane genelinde enfeksiyon riskini azaltmak için UP dezenfeksiyonu protokollerimizin yeterliliğinin değerlendirmesi amaçlanmıştır.Gereçler ve YöntemTransabdominal (TAP) ve transvajinal ultrason (TVP) prob yüzeyleri ve ultrasonografi jellerinden (UJ) toplam 48 sürüntü örneği alınmış ve mikrobiyoloji laboratuvarında kültüre edilmiştir. Karşılaştırma için, jinekoloji odaları kapı kollarındaki bakteriyel kontaminasyon (12 sürüntü kültürü) analiz edilmiştir. Bu ölçümler, bir ay boyunca her hafta uygulanmış ve her bir probdan, çalışma süresi boyunca 4 kez kültür alınmıştır.Bulgular: Prob kültürlerinden insan deri florasında ve çevrede yaygın olan, patojen olmayan, sekiz mikroorganizma (Staphylococcus epidermidis, S. hominis, S. haemolyticus, S. lugdunensis, Corynebacterium amycolatum, C. aurimucosum) ve iki önemli patojen mikroorganizma (Enterobacter cloacae, Escherichia coli) izole edildi. Metisilin dirençli staphylococcus aureus izole edilmedi. Jel kültürlerinden ise patojenik olmayan organizmalar (S. epidermidis, S. cohnii) izole edildi. Hasta muayene sayısı ve acil değerlendirme durumu açısından kontaminasyon oranlarında da gruplar arasında anlamlı bir fark bulunmadı (p > 0.05).Sonuç: Hastanemizin Kadın Hastalıkları ve Doğum kliniklerinde UP ve jellerinde bakteriyel kontaminasyon tespit edildi. Çoğunlukla patojen olmayan mikroorganizmalar (S. epidermidis, S. hominis, S. haemolyticus, S lugdinensis) saptanmasına rağmen, patojenik iki mikroorganizma da tanımlandı (Enterobacter cloacae, Escherichia coli). Hastane personeli, UP’lerin bakteriyel kontaminasyon için bir araç olabileceğini ve infeksiyöz komplikasyonlara yol açabileceğini unutmamalıdır. Probların kuru, steril olmayan kağıt havlu kullanılarak dekontaminasyonu, cihaza zarar vermeyen, bakteri yükünü de azaltabilen ucuz, basit ve etkili bir yöntemdir.

Funder: Amgen, Funder: Roche, Funder: Universitätsspital Basel, Funder: Merck, Funder: AstraZeneca, Funder: Pfizer, AIM: Demand for nipple- and skin- sparing mastectomy (NSM/SSM) with immediate breast reconstruction (BR) has increased at the same time as indications for post-mastectomy radiation therapy (PMRT) have broadened. The aim of the Oncoplastic Breast Consortium initiative was to address relevant questions arising with this clinically challenging scenario. METHODS: A large global panel of oncologic, oncoplastic and reconstructive breast surgeons, patient advocates and radiation oncologists developed recommendations for clinical practice in an iterative process based on the principles of Delphi methodology. RESULTS: The panel agreed that surgical technique for NSM/SSM should not be formally modified when PMRT is planned with preference for autologous over implant-based BR due to lower risk of long-term complications and support for immediate and delayed-immediate reconstructive approaches. Nevertheless, it was strongly believed that PMRT is not an absolute contraindication for implant-based or other types of BR, but no specific recommendations regarding implant positioning, use of mesh or timing were made due to absence of high-quality evidence. The panel endorsed use of patient-reported outcomes in clinical practice. It was acknowledged that the shape and size of reconstructed breasts can hinder radiotherapy planning and attention to details of PMRT techniques is important in determining aesthetic outcomes after immediate BR. CONCLUSIONS: The panel endorsed the need for prospective, ideally randomised phase III studies and for surgical and radiation oncology teams to work together for determination of optimal sequencing and techniques for PMRT for each patient in the context of BR.

Aim: The present study aims to examine the effects of zinc deficiency on maternal and fetal outcomes during pregnancy. Material-method: The study was carried out in a secondary care hospital between 2020 January and 2020 December. Demographic data of all patients, zinc, hemoglobin (Hb), hematocrit (Hct) levels at birth and adverse pregnancy outcomes such as oligohydramnios, preterm delivery, preeclampsia, preterm premature rupture of membranes (PPROM), intrauterine growth retardation (IUGR) were recorded. Maternal serum zinc levels of, Amaç: Bu çalışmanın amacı gebelikteki çinko eksikliğinin maternal ve fetal sonuçları üzerindeki etkisini araştırmaktır. Yöntem: Bu çalışma Ocak 2020 ile Aralık 2020 tarihleri arasında ikinci basamak bir hastanede yapıldı. Tüm hastaların demografik verileri, doğum sırasındaki çinko, hemoglobin (Hb), hematokrit (Hct) düzeyleri, oligohidramnios, preterm doğum, preeklampsi, preterm prematür membran rüptürü (PPROM), intrauterin gelişme geriliği (IUGR) gibi kötü gebelik sonuçları kaydedildi. Maternal serum çinko değeri

Aim: In our study, we aimed to evaluate whether pre-operative complete blood count and biochemical parameters are related to some prognostic markers and stage of the disease in patients who underwent surgery for endometrial cancer. Materials and Methods: One hundred seventy-five patients diagnosed with endometrial cancer operated in our clinic between January 2017 and December 2019 were retrospectively studied. We analyzed complete blood count parameters include hemoglobin (Hb), white blood cell count, platelet count, neutrophil count, and percentage, lymphocyte number and percentage, mean corpuscular volume (MCV), mean platelet volume (MPV), red blood cell distribution width (RDW), and NLR, which is the division of the neutrophil count to the lymphocyte count, PLR, which is the division of the platelet count to the lymphocyte count and other biochemical parameters. Statistical methods investigated their relationship with prognostic parameters such as tumor diameter, tumor differentiation, tumor type, myometrial invasion, and FIGO stage. Results: There was a statistically significant increase according to age, Hb, RDW, lymphocyte percentage, and NLR (p

Background/Aim: Uterine sarcomas are rare and aggressive tumors, and their clinical behavior is unpredictable. A clear-cut clinical course, proven treatment method or definitive prognostic factors affecting the survival of sarcoma patients are not reported in the literature. We aim to evaluate uterine sarcomas, determine clinicopathologic features, adjuvant therapies, and prognostic factors on survival while sharing our experience of these rare uterine tumors in light of the literature. Methods: This retrospective cohort study was conducted in Tepecik Training and Research Hospital, Izmir, Turkey between 2002-2020. Out of the total of 205 uterine sarcoma patients, 173 patients who underwent surgical procedures and were followed up in our hospital’s Gynecologic Oncology Clinic were included in the study. Data of patients were collected from the hospital database. Surgical interventions, clinicopathologic features, adjuvant therapies, and overall and disease-free survivals were evaluated. Patients were grouped as leiomyosarcoma (LMS), carcinosarcoma (CS), endometrial stromal sarcoma (ESS), adenosarcoma (AS), and undifferentiated sarcoma (US). Results: The mean age of the patients was 57.6 (11.2) years. According to the International Federation of Gynecology and Obstetrics (FIGO2009), 115 patients (66.5%) had stage 1, 17 patients (9.8%) had stage 2, 31 (17.9%) patients had stage 3, and 10 patients (5.8%) had stage 4 disease. One hundred and sixty-two patients (93.6%) received adjuvant therapy. Median follow-up period was 39 months (range 3-214). The 120-month OS for the entire group was 87.1%. Conclusion: Stage is a significant prognostic factor for survival in all sarcoma types and recurrence is a significant prognostic factor for survival for LMS and CS patients. Sarcoma type and adjuvant treatments have no impact on survival. ESS patients require extended surgical staging.

Background/Aim: Optimal management for HPV positive and cytology negative patients remains a controversial issue. Immediate colposcopy is suggested for HPV 16/18 positive patients, whereas patients with non 16/18 HPV oncogenic virus positive are recommended to co-test after a year. In this study, we aim to compare the immediate colposcopic biopsy results between HPV 16/18 and non-16/18 HPV positive patients with cytology negative patients. Methods: In this prospective cross-sectional study, we included 1028 HPV positive and cytology negative patients who were screened for cervical cancer between January 2017 and 2019. Liquid based preparations were used for cytology samples (ThinPrep Pap Test). Cervical specimens were analyzed with Hybrid Capture for HPV types. Patients underwent colposcopic examination, biopsy procedure and endocervical curettage. Results: A total of 424 (41.2%) patients were HPV 16/18 positive, while 604 (58.8%) were non-16/18 oncologic HPV positive. Colposcopic biopsy results of the patients revealed that of the HPV 16/18 positive patients, 246 (23.9) had no dysplasia, 101 (9.8) had LGSIL and 77 (7.5%) had HGSIL. Among the non 16/18 positive patients, 422 (41.1%) had no dysplasia, 144 (14%) had LGSIL and 38 (3.7) had HGSIL. All patients were referred for endocervical curettage, which resulted as follows: Among HPV 16/18 patients, 384 (37.4%) had no dysplasia, 21 (2%) had LGSIL and 19 (1.8%) had HGSIL. Five hundred seventy-one non 16/18 positive patients had no dysplasia, 26 (2.5%) had LGSIL and 7 (0.7) had HGSIL. The comparison of colposcopic biopsy results of HPV 16/18 and non-16/18 HPV positive patients were different in terms of no dysplasia and HGSIL (P=0.001 and P=0.001, respectively), while LGSIL results were similar. The endocervical curettage biopsy results of the patients revealed a significant difference in HGSIL results (P=0.03). The two groups were similar with respect to reports of no dysplasia and LGSIL. Conclusion: Direct referral of the patients, who are expected to be lost to follow-up, could be convenient for non-16/18 HPV positive patients with negative cytology to reduce progression of cervical cancer and the psychological burden of HPV positivity.

Aim: Postpartum urinary retention (PUR) is an important clinical condition that is frequently detected after both vaginal and cesarean delivery. The aim of this study was to evaluate PUR in women who did and did not have bladder flaps created during cesarean section and the effect of Kegel exercises on long-term bladder muscle function in those with high postnatal residual urine volume.Methods: This prospective randomized study was conducted with 100 primiparous pregnant women who were to undergo elective cesarean section between April and December 2019. Patients were divided into two groups: The experimental group (bladder flap group, n=50) and the control group (non-bladder flap group, n=50). The study data were collected with the Maternal Information Form and UDI-6. Kegel exercise results, post-void residual volume and urinary system symptoms were assessed on the 2nd and 5th postoperative day and 6 weeks after birth.Results: There were no significant differences between the groups in terms of socio-demographic characteristics, postoperative 5th day and 6th week residual urine volume, postoperative urinary retention volume, urinary system symptoms (UDI-6 scores) and bladder injury. There were significant differences between the groups in terms of residual urine volume, duration of surgery, and pain values assessed on the second day (P=0.045, P, Amaç: Postpartum idrar retansiyonu hem vajinal hem de sezaryen doğumdan sonra sıklıkla saptanan önemli bir klinik durumdur. Bu çalışma ile sezaryen sırasında mesane flebi olan ve olmayan kadınlarda idrar retansiyonunu ve ayrıca doğum sonrası rezidüel idrar hacmi yüksek olanlarda Kegel egzersizlerinin uzun süreli mesane kas fonksiyonu üzerindeki etkisini değerlendirmek amaçlanmıştır.Yöntemler: Bu ileriye dönük randomize çalışma, Nisan-Aralık 2019 tarihleri arasında elektif sezaryen operasyonu geçiren 100 primipar gebe kadınla gerçekleştirildi. Deney grubu (mesane flebi grubu, n=50) ve kontrol grup (mesane dışı flep grubu, n=50). Çalışma verileri Anne Bilgi Formu ve UDI-6 ile toplandı. Doğumdan sonraki 2. gün, 5. gün ve 6. haftalarda Kegel egzersiz sonuçları, işeme sonrası rezidüel hacim ve üriner sistem semptomları değerlendirildi.Bulgular: Gruplar arasında sosyo-demografik özellikler, postoperatif 5. gün ve 6. hafta rezidüel idrar hacmi, postoperatif idrar retansiyon hacmi, üriner sistem semptomları (UDI-6 skorları) ve mesane yaralanması açısından anlamlı farklılık yoktu. İkinci gün değerlendirilen rezidüel idrar hacmi, ameliyat süresi ve ağrı değerleri açısından gruplar arasında anlamlı farklılık vardı (sırasıyla P=0,045, P

Objective: Cervical cancer highlights the necessity of routine sexual rehabilitation in clinical care in women. It is stated that the sexual function problems of the patients can be significantly improved with the psychosexual counseling given by the nurses. In this context, a scope analysis was conducted to examine the effects of the counseling given by the nurse to women with cervical cancer receiving brachytherapy on sexual function.Methods: A scope review was conducted to compile and evaluate the available evidence for sexual dysfunction issues in nurse counseling to women with cervical cancer receiving brachytherapy treatment. The study population consisted of women with cervical cancer who received brachytherapy. Studies published in English until 2000-02.03.2021 were included in the compilation. Results: After applying the exclusion criteria, the full text of 13 articles were reviewed, and five of them were included in the present study. Considering the applied nursing interventions, there are sexual therapy, psychoeducation and nursing care intervention. Conclusion: The care practices given by the nurse had a positive effect on the sexual functions of womens with cervical cancer receiving brachytherapy., Amaç: Günümüzde serviks kanseri kadınlarda cinsel rehabilitasyonun, klinik bakımda rutin kullanımının gerekliliğini öne çıkarmaktadır. Hemşireler tarafından verilecek psikoseksüel danışmanlık ile hastaların cinsel işlev sorunlarının önemli düzeyde iyileştirilebileceği belirtilmektedir. Bu kapsamda, brakiterapi alan serviks kanseri kadınlara hemşirenin verdiği danışmanlığın cinsel işlev üzerine etkisinin incelemek amacıyla kapsam analizi yapılmıştır. Yöntem: Brakiterapi tedavisi alan serviks kanseri kadınlara hemşirenin verdiği danışmanlığın cinsel işlev sorunlarına yönelik etkisi ile ilgili mevcut kanıtları derlemek ve değerlendirmek için bir kapsam incelemesi yapıldı. Çalışma popülasyonu, brakiterapi alan serviks kanserli kadınlardan oluşmaktadır. Derlemeye 2000-02.03.2021 tarihine kadar İngilizce olarak yayınlanan retrospektif, prospektif ve deneysel çalışmalar dahil edilmiştir.Bulgular: Dışlama ölçütleri uygulandıktan sonra 13 makalenin tam metni incelenmiş olup 5 tanesi araştırmaya dahil edilmiştir. Uygulanan hemşirelik girişimlerine bakıldığında cinsel terapi, psikoeğitim ve hemşirelik bakım müdahalesi bulunmaktadır.Sonuç: Brakiterapi alan serviks kanserli kadınlara hemşire tarafından verilen bakım uygulamalarının cinsel fonksiyonları üzerinde olumlu etkisi olduğu görülmüştür.

Aim: Our aim was to investigate the value of serum estradiol (E2) on human chorionic gonadotrophin (hCG) trigger day in predicting pregnancy (ongoing pregnancy with live birth, abortion, iu ex, chemical pregnancy) outcomes and neonatal birth weight.Material-Methods: This retrospective study consisted of two groups: Group 1: Women who had live birth, labor after 22 gestational week (n= 417). Group 2: Women with clinical pregnancy: intrauterine ex, abortus, biochemical and anembryonic pregnancy (n=260). Demographic characteristics (maternal and paternal ages, body mass index (BMI), gravidity, abortion, and living child) were recorded. Clinical indications (male factor, diminished ovarian reserve...), duration of ovulation stimulation, day 3 (D3) E2, follicle stimulating hormone and luteinizing hormone levels, antral follicle count, total doses of stimulating agents, progesteron and estradiol levels on trigger day, number of oocytes retrieved, number of mature oocytes, endometrial thickness on trigger and oocyte pick-up day were compared between the two groups.Binary Logistic Regression, (Backward LR model) was used to determine the factors affecting the risk of not having a live birth.Results: Totally 677 pregnant women were included in the study. We found increased live birth rate in pregnant whom E2 level was higher on the trigger day. There was a statistically significant relation between E2 level on trigger day and newborn weight in live birth (p=0.005) It was determined that the male factor and age of the women are an important parameter that affect not having a live birth (p, Amaç: Bu çalışmadaki amacımız, insan koryonik gonadotropin (hCG) tetikleme günündeki serum estradiolün (E2) gebelik (canlı doğum ile sonuçlanan gebelik, düşük, iu ex, kimyasal gebelik) sonuçlarını ve yenidoğan doğum ağırlığını tahmin etmedeki rolünü araştırmaktır.Gereç ve yöntemler: Bu retrospektif çalışma iki gruptan oluşturuldu: Grup 1: 22. gebelik haftasından sonra canlı doğum yapan kadınlardan (n= 417) ve grup 2: Klinik gebelik tanısı konulan kadınlardan (intrauterin ex, abortus, biyokimyasal ve anembriyonik gebelik) (n=260) oluşmaktadır. Demografik özellikler (anne ve baba yaşı, vücut kitle indeksi (VKİ), gravidite, düşük ve yaşayan çocuk) kaydedildi.Klinik endikasyonlar (erkek faktörü, azalmış over rezervi..), ovulasyon stimülasyon süresi, 3. gün (D3) E2, folikül uyarıcı hormon ve luteinize edici hormon düzeyleri, antral folikül sayısı, stimüle edici ajanların toplam dozları, tetikleme gününde progesteron ve estradiol düzeyleri , toplanan oosit sayısı, matür oosit sayısı, tetikleme ve oosit toplama gününde endometrial kalınlık iki grup arasında karşılaştırıldı. Canlı doğum ile sonuçlanamama riskine etki eden faktörleri belirlemek için Binary Logistic Regresyon, (Backward LR modeli) kullanıldı.Bulgular: Toplam 677 gebe çalışmaya dahil edildi. Tetikleme gününde E2 düzeyi yüksek olan gebelerde canlı doğum oranı daha yüksek bulundu. Tetikleme günündeki E2 düzeyi ile yenidoğan doğum ağırlığı arasında istatistiksel olarak anlamlı bir ilişki izlendi. (p=0,005). Erkek faktörü ve kadın yaşının canlı doğum ile sonuçlanamama durumunu etkileyen en önemli parametreler olduğu görüldü (p

Aim: This study aimed to examine the clinical features of COVID-19 infection, maternal and fetal side effects related to infection and share experiences of our clinic in this context.Material and MethodsA total of 63 pregnant women diagnosed with COVID-19 were identified in a tertiary hospital between September-May 2021. Disease-related symptoms, laboratory parameters, maternal and fetal side effects were examined.Results: No statistically significant difference in age, BMI, and gestational week was detected between the groups receiving and not receiving antiviral therapy among 63 pregnant patients who were positive for COVID-19. Fever (41.2%) was the most common patients' complaint at admission.Conclusion: The COVID-19 disease has caused a pandemic that has affected the world since December 2019. There are limited data on maternal and fetal effects in pregnancy. The increased susceptibility to respiratory tract diseases during pregnancy makes this patient group more vulnerable to the devastating effects of disease agents. In this respect, COVID-19 infection during pregnancy necessitates the closer follow-up and faster control of the disease. We obtained findings consistent with the literature in terms of symptoms, laboratory values, and obstetric prognoses of pregnant women with COVID-19 infection that we followed up in our clinic, a tertiary center., Amaç: Bu çalışmadaki amaç, Covid-19 enfeksiyonunun klinik özelliklerini, enfeksiyona bağlı maternal fetal yan etkilerini incelemek, bu bağlamda kliniğimizin deneyimlerini paylaşmaktır.Gereç ve Yöntem: Ordu Üniversitesi Eğitim ve Araştırma Hastanesi’ne eylül-mayıs 2021 tarihleri arasında Covid-19 tanısı almış toplam 63 gebe tanımlandı. Hastalığa bağlı semptomları, laboratuvar parametreleri, maternal ve fetal yan etkileri incelendi.Bulgular: COVİD-19 pozitif olan 63 gebe hastadan antiviral tedavi alan ve almayan gruplar arasında yaş, BMI, gebelik haftası açısından istatistiksel olarak anlamlı bir fark saptanmadı. Hastaların en sık hastaneye başvuru şikayeti ateş (%41) idi. 63 gebelikten 1’inde ( % 1,5) covid pozitifliği sonrası fetal kayıp görüldü.Sonuç: Covid-19 hastalığı aralık 2019 tarihinden bu yana dünyayı etkisi altına alan bir pandemiye neden olmuştur. Yüksek ateş, öksürük ve nefes darlığı en yaygın semptomlardır. Gebelikte maternal ve fetal etkileri ile ilgili veriler kısıtlıdır. Gebelikte solunum yolu hastalıklarına karşı hassasiyetin artmış olması, bu hasta grubunu hastalık etkenlerinin yıkıcı etkisine daha açık hale getirmektedir. Bu açıdan gebelik döneminde geçirilen covid-19 enfeksiyonu daha yakın takip, hastalığın daha hızlı kontrol altına alınması gerekliliklerini doğurmaktadır. Tersiyer bir merkez olan kliniğimizde takip ettiğimiz covid-19 tanılı gebelerin semptomları, laboratuvar değerleri ve obstetrik prognozları açısından literatürle uyumlu bulgular elde ettik.

Amaç: Vajinal duş, vajinal floraya ve ekosisteme zarar verir. Vajinal flora dengesinin bozulması, kadın ve yenidoğan sağlığı üzerinde olumsuz etki yapan birçok nedene yol açmaktadır.Materyal ve metod: Çalışmaya vajinal duş uygulayan 105 hasta dahil edildi. Tüm kadınlardan Pap smear testi alındı. Hastalara neden vajinal duş alışkanlıklarını bırakmaları gerektiğine dair yazılı bilgi verildi. 30 günden önce olmamak üzere ikinci bir Pap smear testi için randevu günü verildi. Hastaların ilk Pap smearleri alındıktan sonra hiçbirine enfeksiyon tedavisi verilmedi. Vajinal duştan önce ve sonra alınan pap smear sonuçları karşılaştırıldı.Bulgular: Pap smear sonuçlarının detaylı karşılaştırmasında şiddetli inflamasyonu olan hasta oranının %11,4'ten %1,9'a düştüğü görüldü. Şiddetli inflamasyondaki azalma istatistiksel olarak anlamlı bulundu (p=0,006). Hafif veya şiddetli ayrımına bakılmaksızın enfeksiyonlu hastalar karşılaştırıldığında; tipik enfeksiyon bulgusu olan olguların oranının %48,5'ten %31,4'e düştüğü görüldü ve istatistiksel olarak anlamlı bulundu (p=0,01).Sonuçlar: Vajinal flora; bir çok faktörün etkisi altında olan, çok karmaşık ve dinamik bir bileşendir. Vajinal duş, vajinal flora yapısına ve dengesine zarar verir. Basit bir vajinal enfeksiyondan servikal neoplaziye kadar geniş bir yelpazede kadın sağlığını olumsuz etkiler., Objective: Vaginal douching damages vaginal flora and ecosystem. The disruption of the equilibrium of vaginal flora composition leads to many outcomes having a negative effect on women and newborn health.Materials and methods: 105 patients who applied vaginal douche were included in this study. All women taken of Pap smear test and the patients were informed in writing about the reasons why they must leave their vaginal douching habits, and a second Pap smear appointment day not earlier than 30 days were given. After taken of patients first Pap smears, none of them took an infection treatment. Pap smear results taken before and after vaginal douche have been compared.Results: It was seen in the detailed comparison of Pap smear outcomes that the rate of patients with violent inflammation decreased from 11.4% to 1.9%. The decrease in violent inflammation was found statistically significant (p=0.006). When the patients with infection were compared regardless of any discrimination of slightly or violent; the rate of the cases with typical infection findings was seen to decrease from 48.5% to 31.4% and found statistically significant (p=0.01).Conclusions: Vaginal flora is a very complex and dynamic component and is under the influence of many factors. Vaginal douching damages vaginal flora structure and balance, and adversely affects women’s health in a wide range from a simple vaginal infection to cervical neoplasia.

Objectives: Preeclampsia (PE), which affecting multi-organ systems, is one of the most common causes of feto-maternal morbidity and mortality. The fetal kidney is one of the vulnerable organs in PE caused by sustained vasospasm of the renal arteries. In this study, it was aimed to reveal the changes in the renal vascular bed with renal artery Doppler examinations in fetuses of pregnant women with PE. Methods: Fifty-five pregnant women with PE and 60 healthy pregnant women were included in this prospective study. Multiple pregnancies, those who did not want to participate in the study, and those with other co-morbidities were excluded from the study. Fetal renal artery Doppler studies included renal artery systolic/diastolic (S/D) ratio, pulsatility index (PI) and resistance index (RI) of the control and PE groups, and findings such as week of birth and birth weight were recorded and analyzed statistically. Results: Fetal renal artery PI values were found to be higher in pregnant women with PE compared to the control group (2.93 in the patient group, 2.28 in the control group, p < 0.001). There was no significant difference between RI values and S/D ratios between the two groups. In the preeclampsia group, gestational week and baby weight at birth were significantly lower. Conclusions: Due to preeclampsia, hypoxia occurs in peripheral tissues and organs at the maternal level. Fetal organs are also affected by these hypoxic conditions. Doppler is an extremely useful examination tool in the evaluation of the status of peripheral organs such as the kidney. This study suggests that PE increases the resistance of renal arteries in fetuses of mothers with PE compared to fetuses of mothers without PE, which may contribute critically to kidney disease later in life.

Objectives: The aim of this study is to evaluate the effect of coronavirus disease 2019 (COVID-19) diagnosed in the third trimester of pregnancy on maternal, fetal, and obstetric outcomes. Methods: This retrospective study included 109 pregnant women hospitalized with a diagnosis of COVID-19 during the third trimester of pregnancy (28-40 weeks) in a tertiary center between March 1 and December 31, 2020. Demographic characteristics, clinical signs, and obstetric outcomes of the patients were searched for analysis. Laboratory and x-ray results were reported, and treatment methods were summarized. Finally, mother-newborn results were recorded. Results: We included one hundred nine pregnant women in this study. We divided the patients into two groups as those with positive PCR test (n = 59) and negative PCR test and possible covid patients (n = 50) whose symptoms and histories meet the covid criteria. The mean age of the patients was 28.90 ± 6.21 years, and the mean week of gestation was 37.45 ± 2.29 weeks. Half of the patients were asymptomatic (n = 57, 47.7%), and 69% of all patients were delivered by cesarean section. The hospitalization time of antigen-positive cases was between 2-9 days. The mean lymphocyte count was 1.37 ± 0.45 ×103/mL in the PCR positive patient group, and this value was 1.67 ± 0.54 103/mL in the PCR negative patients (p = 0.007). While the mean neutrophil count was 8.13±3.16 ×103/mL in the PCR positive patient group, this value was 10.99 ± 4.14 ×103/mL in the PCR negative patients (p < 0.001). Fifteen patients required intensive care unit follow-up, and 2 of them died while receiving mechanical ventilator support. Conclusions: COVID-19 infection in the third trimester of pregnancy does not affect fetal and maternal outcomes if the disease is under control at an early stage. In hospitalized patients, symptoms are more precious than antigen testing.

Background: Partial oxygen saturation (SpO2) increases within minutes during transition from the intrauterine to extrauterine life. This study aims to determine the postnatal course of pulmonary regional oxygen saturation (rSO2) measured by Near-Infrared Spectroscopy (NIRS). Methods: We conducted an observational study at the delivery room in infants above 35 weeks of gestation who did not need resuscitation and did not develop respiratory distress. Preductal pulse oximetry (Covidien NellcorTM) and right pulmonary apex oxygen saturation (raSO2) and basal oxygen saturation (rbSO2) (Covidien INVOSTM) were measured, starting from the postnatal third minute of life, until the 15th minute. The correlations between SpO2 and pulmonary rSO2 were analyzed. Results: Of the 110 infants included in the study, 87 were term and 23 were late preterms. The gestational age and birth weight were 38.5 ± 1.36 weeks and 3285 ± 508 g, respectively. Median (5th–95th percentile) raSO2 and rbSO2 were 79% (58–95%) and 78% (46–95%) at the third minute, respectively. The rSO2 values measured from both sides increased and reached a steady-state around postnatal 9 min, similar to SpO2 values. The pulmonary NIRS values were significantly higher for babies born by C-Section compared to babies born by vaginal delivery (p < 0.05). Conclusion: We found that rSO2 measurements increased within minutes in the postnatal period in late preterm and term babies without respiratory distress and reached a plateau at the postnatal 9th minute. The normal values obtained from this preliminary study may be used to predict the prognosis of cases with respiratory distress.

Gelişmiş Cerrahi Sonrası İyileşme (ERAS) programları, 2000’li yılların başından beri birçok cerrahi uzmanlık dalında operasyon sonuçlarını iyileştirmiştir. Bu multidisipliner standart bakım programı, cerrahi hastalarının preoperatif, intraoperatif, postoperatif bakımını optimize etmeyi amaçlamıştır. Yeni yayınlar ERAS protokollerinin sezaryen doğumlarda başarıyla uygulandığını göstermiştir. Sezaryen doğumda ERAS programının temel öğeleri; antenatal eğitim/danışmanlık, cerrahi öncesi tıbbi optimizasyon, anestezi öncesi medikasyon, sınırlı açlık süresi, karbonhidrat suplementasyonu, intraoperatif anestezi yönetimi, cerrahi alan enfeksiyon profilaksisi, normotermi ve övoleminin sürdürülmesi, uygun cerrahi teknik, yenidoğan bakımı, postoperatif analjezi, bulantı ve kusmanın önlenmesi, erken beslenme, erken mobilizasyon, tromboembolizm profilaksisi, glukoz yönetimi, idrar yönetimi ve taburculuk danışmanlığıdır. Bu öğelerin uygulanması, maternal /neonatal sonuçların iyileşmesi ve hastanede kalış süresinin azalması ile sonuçlanmıştır. Bununla birlikte, bu konudaki mevcut literatür sezaryen doğum için standartlaştırılmış, küresel olarak uygulanan bir ERAS protokolü geliştirmek için yeterli değildir. Bakım programını ve önerileri geliştirmek için daha fazla çalışmaya ihtiyaç vardır., Enhanced Recovery After Surgery (ERAS) programs have been improved surgical outcomes in many surgical sub-specialties, since the early 2000s. This multidisciplinary standardized care program aimed to optimize preoperative, intraoperative, and postoperative care of patients undergoing surgery. Recent reports showed that the ERAS protocols have been successfully implemented in cesarean deliveries. The key elements of ERAS program in cesarean delivery are antenatal education/counseling, preoperative medical optimization, preanesthetic medication, limited fasting time, carbohydrate supplementation, intraoperative anesthetic management, surgical site infection prophylaxis, maintenance of normothermia and euvolemia, appropriate surgical technique, newborn care, postoperative analgesia, prevention of nausea and vomiting, early feeding, early mobilization, thromboembolism prophylaxis, glucose management, urinary management, and discharge counseling. The implementation of these elements resulted with improved maternal/neonatal outcomes and reduced length of hospital stay. However, the current literature on this topic is not enough to develop a standardized globally implemented ERAS protocol for cesarean delivery. Further studies are required to enhance the care program and recommendations.

Aim: Cervical cancer screening guidelines gradually recommend human papillomavirus (HPV) DNA testing since sensitivity of cytology is relatively low. This study aimed to evaluate correlation between HPV, cervical smear cytology and colposcopy directed biopsy results.Material and Methods: Patients who underwent colposcopy directed biopsy in Ordu University Training and Teaching Hospital between January 2018 and December 2021 were retrospectively reviewed. Patients with any high-risk HPV positivity who had cervical smear cytology and colposcopy directed biopsy results were included to this study. Results of HPV subtypes, cervical smear and histologic biopsy were recorded.Results: A total of 734 patients were included to this study. The mean age of the patients was 41.9 ± 7.36 years. Hundred and sixty-five (22.5%) patients had HPV 16 alone, 35 (4.8%) had HPV 18 alone, 354 (48.2%) had other high-risk HPV subtypes alone and 180 (24.5%) had more than one high-risk HPV subtypes. Two hundred and ninety-eight (40.6%) had HPV 16 or HPV 18 either alone or in combination with other subtypes. Majority of the patients (55.3%) had normal cervical smear results followed by ASC-US (27%). Colposcopy directed biopsy results were as follows: 452 (61.6%) normal, 199 (27.1%) CIN 1, 36 (4.9%) CIN 2, 42 (5.7%) CIN 3 and 5 (0.7%) squamous cell cancer. 66.1% of the patients with HPV 16 and/or HPV 18 had normal cervical cytology results, but they had significantly more ≥CIN 2 lesions compared to other high-risk HPV subtypes (19.8% vs 5.5%, p, Amaç: Sitolojinin sensitivitesi görece düşük olduğu için serviks kanseri taramasında Human papillomavirus (HPV) DNA ile tarama önerilmektedir. Bu çalışmanın amacı HPV, servikal smear ve kolposkopik biyopsi sonuçları arasındaki uyumu araştırmaktır.Gereçler ve Yöntem: Ordu Üniversitesi Eğitim ve Araştırma Hastanesi’nde Ocak 2018-Aralık 2021 yılları arasında kolposkopik biyopsi alınan hastalar geriye dönük taranmıştır. Herhangi bir yüksek riskli HPV pozitifliği olan, servikal smear ve kolposkopik biyopsi sonucu bulunan hastalar çalışmaya dahil edilmiştir. HPV tipleri, smear ve biyopsi sonuçları karşılaştırılmıştır.Bulgular: Çalışmaya 734 hasta dahil edilmiştir. Hastaların ortalama yaşı 41.9 ± 7.36’dır. 165 (%22.5) hastada tek başına HPV 16, 35 (%4.8) hastada tek başına HPV 18, 354 (%48.2) hastada diğer yüksek riskli HPV tiplerinden biri ve 180 (%24.5) hastada en az iki HPV tipi birlikte tespit edilmiştir. 298 (%40.6) hastada HPV 16 ve/veya HPV 18 tek başına ya da başka tiplerle bir arada bulunmaktadır. Hastaların çoğunda (%55.3) smear sonucu normal iken ASC-US en sık saptanan sitolojik anormallik olmuştur. Kolposkopi eşliğinde alınan biyopsi sonuçları şu şekildedir: 452 (%61.6) normal, 199 (%27.1) CIN 1, 36 (%4.9) CIN 2, 42 (%5.7) CIN 3 ve 5 (%0.7) skuamoz hücreli karsinom. HPV 16 ve/veya HPV 18 olan hastaların %66.1’inde smear sonucu normal olmasına karşın diğer yüksek-riskli HPV subtiplerine göre daha fazla ≥CIN 2 lezyon saptanmıştır (%19.8 vs %5.5, p

Amaç: Bu çalışma ile, gebelik sayısının sosyal destek algısı ve prenatal dönem bağlanma düzeyine etkisinin incelemesi amaçlanmıştır. Gereç ve Yöntem: Bu çalışmada tanımlayıcı analitik araştırma dizaynı kullanılmıştır. Araştırmanın örneklemini 98 primigravida, 107 multigravida oluşturmuştur. Verilerin toplanmasında, “Katılımcı Tanılama Formu”, “Çok Boyutlu Algılanan Sosyal Destek Ölçeği (ÇBASDÖ)” ve “Prenatal Bağlanma Envanteri (PBE)” kullanılmıştır. Bulgular: Gebelerin ÇBASDÖ ortanca puanı 74,0 (13-84), PBE puan ortalaması 41,16±10,65 olarak hesaplanmıştır. Multigravidaların PBE puanlarının primigravidalara göre daha yüksek olduğu belirlenmiştir. Gebelerin yaşı, eğitim düzeyi ve çalışma durumuna göre PBE puanları açısından gruplar arasında istatistiksel olarak anlamlı fark bulunmuştur. Primigravidalarda, üçüncü trimester PBE puanının birinci ve ikinci trimesterlere göre anlamlı olarak daha düşük olduğu belirlenmiştir. Gebelerin ÇBASDÖ ve alt boyutları arasında pozitif yönde yüksek düzeyde bir ilişki bulunmuştur. Tüm gebelerde ve multigravidalarda, ÇBASDÖ ve PBE arasında negatif yönde bir ilişki olduğu saptanmıştır.Sonuç: Eğitim düzeyi, yaş, ekonomik durum ve çalışma durumunun gebelikte sosyal destek algısı ve prenatal bağlanma düzeyini etkilediği bulunmuştur. Multigravidaların prenatal bağlanma düzeyinin yüksek olduğu, primigravidalarda ise, üçüncü trimesterde prenatal bağlanma düzeyinin düşük olduğu görülmüştür. Gebelerde prenatal bağlanma düzeyi arttıkça sosyal destek algısının azaldığı saptanmıştır., Purpose: The aim of this study was to evaluate the effect of gravidity on perception of social support and prenatal attachment of pregnant women. Materials and Methods: Descriptive analytical research design was used in this study. The sample consisted of 98 primigravid and 107 multigravid women. It was used “Participant Description Questionnaire”, “Multidimensional Scale of Perceived Social Support (MSPS)” and “Prenatal Attachment Inventory (PAI)” for the data collection.Results: Median score of MSPS was 74.0 (13-84) and the mean score of PAI was 41.16±10.65 for pregnant women. PAI score of multigravid was higher than primigravid. PAI scores of pregnant women were found statistically significant by age, education level and employment status. PAI score of primigravid was found significantly lower in the third trimester than the other trimesters. The high level positive correlation between the total score of MSPS and subscales of MSPS of pregnant women. There was negative correlation between the total score of MSPS and PAI in multigravid and all of the pregnant women. Conclusion: Education level, age, income, employment status effect of social support perception and prenatal attachment level during pregnancy. Multigravidity positively affects prenatal attachment; in primigravid women, prenatal attachment level to be low in the last trimester. While the prenatal attachment of pregnant women increases, perception of social support decreased.

Background: Data on educational hospital environment perceptions of obstetrics and gynecology residents in Turkey are limited. The present study aims to evaluate the educational environment perceptions of residents in (sub)specialty training in an obstetrics and gynecology departmentMethods: Postgraduate Hospital Educational Environment Measure (PHEEM) was administered to all residents (n=19) in specialty and subspecialty training at an obstetrics and gynecology department of a single university hospital. Item and subscale scores of gender and postgraduate experience groups were compared using student’s t-test. The participants were classified into two groups regarding postgraduate experience as “novice” (postgraduate year 1 and 2) and “experienced” (postgraduate year 3 and above). Cronbach’s alpha coefficient was calculated to estimate score reliability.Results: The overall Cronbach’s alpha coefficient and mean cumulative score was 0.938 and 85.8 ± 24.8 (more positive than negative, but room for improvement), respectively. Mean subscale scores were 28.3 ± 8.2 for role of autonomy (negative view), 33.4 ± 11.0 for teaching (moving in the right direction), and 24.1 ± 6.8 for social support (more pros than cons). Cumulative and category scores did not differ regarding gender (p > 0.05 for all). Experienced group had similar mean cumulative (p=0.06), but increased social perception scores (p=0.03) compared to novice group. Mean scores of three items were extremely low (

Amaç: Preterm erken membran rüptüründe (PPROM) ve preterm doğumda (PD) idrar yolu enfeksiyonunun olumsuz neonatal sonuçları ve doğum süresine ile arasındaki ilişkinin araştırılmasını amaçladık.Gereç ve Yöntem: 2008-2014 yılları arasında merkezimize başvuran 1033 gebe hastayı retrospektif olarak değerlendirdik. Çalışma grupları 446 PPROM ve 587 PD hastasından oluşuyordu. Bulgular: İdrar kültürü pozitif PPROM hastalarında transvajinal ultrasonografi ile ölçülen servikal uzunluk(OR = 0.806,) ve amniyon sıvısı indeksi (AFI), (OR = 0.961) ve idrar kültürü pozitif PD hastalarında sadece servikal uzunluk OR = 0.862 doğum süresinin yedi günden daha kısa olacağı ile ilişkili idi. Ayrıca idrar kültürü pozitif olan PPROM grubunda AFI’ nin (OR = 0.982) olumsuz neonatal sonuçlarla ilişkilendirileceğini belirledik.Sonuç: İdrar kültürü pozitif PPROM ve PD hastalarında olumsuz neonatal sonuçları ve doğum zamanını öngörmede AFI ve servikal uzunluk da kullanılabilir., urpose: We aimed to investigate the relationship between adverse neonatal outcomes and the time period of labor in between urinary tract infection in preterm premature rupture of membranes (PPROM) to preterm labor (PL). Materials and Methods: We evaluated a total number of 1033 pregnant patients who admitted to our center between 2008 and 2014, with retrospective analysis. Study groups consisted of 446 PPROM and 587 PL patients who had urine cultures. Results: We determined cervical lengths which were measured by transvaginal ultrasonography, with OR = 0.806 and amniotic fluid index (AFI), OR = 0.961 in PPROM group, which had positive urine culture, and also cervical length OR = 0.862 in PL group which had positive urine culture and to be associated with shorter than seven days of delivery. Additionally, we determined that only the AFI, with OR= 0.982, to be associated with adverse neonatal outcomes in the PPROM group, having positive urine culture. Conclusion: AFI and cervical length can also be used to predict adverse neonatal outcomes and time of delivery in urine culture positive PPROM and PL patients.

Aim: One of the factors affecting postpartum depression is anxiety during pregnancy. This study aims to provide early diagnosis of postpartum depression by investigating the impact of pre-operative anxiety of women, who had an elective or emergency cesarean, on postpartum depression.Methods: This case-control study was conducted on 103 patients (51 elective, 52 emergency cesarean section cases). Before the surgery, the patients filled State-Trait Anxiety Inventory (STAI) and a form surveying the descriptive properties and obstetric histories. Edinburg Postpartum Depression Scale (EPDS) was applied 6 weeks after delivery. The impact of these results and the anxiety levels in the preoperative period on postoperative depression were analyzed.Results: The mean value of STAI-1 in the emergency and elective cesarean section groups were 41.31 and 43.61, respectively. Both groups had higher than average (>41) anxiety levels. The mean values of the STAI-2 were equal (48.35) and the anxiety level was above average. As per EPDS, the mean scores of the emergency and elective cesarean section groups were 6.98 and 5.31, respectively. The difference of postpartum rates between two groups was statistically significant (P=0.050). Postpartum depression was observed in 11.53% of the emergency group and 3.92% of the elective group. Conclusion: Both groups had high state and trait anxiety, however, the postpartum depression rate in emergency patients was higher. It is significant to provide psychological support to the patients with high pre-operative anxiety and early treatment to the ones with a higher tendency of depression in the postpartum period., Amaç: Postpartum depresyonu etkileyen önemli etmenlerden biri hamilelik dönemindeki kaygıdır. Elektif şartlarda sezaryene alınan kadınlarla acil şartlarda sezaryene alınanların operasyon öncesindeki kaygılarının postpartum depresyon gelişiminde etkili olup olmadığı değerlendirilerek postpartum depresyonu erkenden tanımak amaçlanmıştır.Yöntemler: Bu vaka kontrol çalışmasında 51 planlı ve 52 acil olmak üzere 103 kişiyle gerçekleştirildi. Sezaryenden önce hastaların tanımlayıcı ve obstetrik özelliklerini içeren anket formu ile Durumluk Sürekli Kaygı Envanteri (STAI) doldurularak kaygı düzeyleri belirlendi. Doğumdan 6 hafta sonra Edinburg Postpartum Depresyon Ölçeği (EPDS) uygulandı. Elde edilen sonuçlarla preoperatif devredeki kaygı durumunun postoperatif depresyon gelişmesine etkili olup olmadığı analiz edildi.Bulgular: Acil gruptaki hastaların STAI-1 ortalaması 41,31, planlı gruptaki hastaların 43,61’di. Her iki grupta da kaygı seviyeleri ortalamanın üzerindeydi (>41). STAI-2 ortalamaları her iki grupta eşitti (48,35) ve kaygı seviyesi ortalamanın üzerindeydi. EPDS’de acil hastaların puan ortalaması 6,98, planlı hastaların puan ortalaması 5,31 olarak tespit edildi. Bu sonuç istatistikî olarak anlamlıydı (P=0,050). Buna göre acil grubun %11,53’ü, planlı grubun %3,92’sinde postpartum dönemde depresyon tespit edildi.Sonuç: Her iki grubun durumluk ve sürekli kaygıları yüksek olmakla birlikte acil sezaryen yapılanlarda postpartum depresyon daha yüksekti. Bu nedenle preoperatif yüksek kaygısı olan hastalara gerekli psikolojik desteğin sağlanması ve postpartum dönemde depresyon eğilimi olanların erken tedaviye alınmaları önemlidir.

Objective: Epidural anaesthesia (EA) is the most efficient method of pain reduction and its total elimination during delivery. The aim of this study was to establish an influence of EA on the first and the second part of delivery process and the effect of EA on the newborn and mother.Method : A total of 153 primiparas in our hospital were selected and divided into two groups according to whether they accepted epidural labor analgesia, including 90 cases in the study group and 63 cases in the control group. Both groups had vaginal delivery. As anaesthetic, Bupivacain (0,25% or 0, 125%) +2µg/ml fentanyl was used by the 18 G catheters. Level of application was L2-L3 part of spine. Dilatation and efesman level, duration of the first, second and third stages of labor, the abnormal situation and complications of primiparas were evaluated.Result: As a result of the analysis the birth weight of the babies of the pregnant women in the the study group was significantly higher than the control group (p, Amaç: Epidural anestezi (EA), ağrının azaltılmasında ve doğum sırasında tamamen ortadan kaldırılmasında en etkili yöntemdir. Bu çalışmanın amacı, EA'nın doğum sürecinin birinci ve ikinci kısmı üzerindeki etkisini ve EA'nın yenidoğan ve anne üzerindeki etkisini belirlemektir.Yöntem : Hastanemizde toplam 153 primipar gebe seçildi. Epidural doğum analjezisini kabul edip etmemesine göre çalışma grubu 90 primipar gebe, kontrol grubun 63 primipar olmak üzere iki ayrı gruptan oluşturuldu. Her iki grup da vajinal doğum yaptı. Anestezik olarak 18 G kateterlerle Bupivakain (%0,25 veya %0,125) +2µg/ml fentanil kullanıldı. Uygulama seviyesi omurganın L2-L3 seviyesi idi. Dilatasyon ve efesman düzeyi, doğumun birinci, ikinci ve üçüncü evrelerinin süresi, primiparların anormal durumu ve komplikasyonları değerlendirildi.Bulgular: Analiz sonucunda çalışma grubundaki gebelerin bebeklerinin doğum ağırlıkları kontrol grubuna göre anlamlı olarak yüksek bulundu (p

Background/Aim: It is believed that patients with rheumatological diseases (RDs) are more prone to infectious diseases, possibly due to both disease-related immune dysfunction and chronic inflammation, and immunosuppressive agents used in the treatment of rheumatological diseases. In this context, we aimed to evaluate the prevalence of high-risk human papillomavirus (Hr-HPV) infection and cervical cytological abnormalities in Turkish female patients with RDs and compare them with healthy controls (HCs).Methods: 362 sexually active patients with RDs followed up between January 2014 and June 2021 were included in this cross-sectional study. Patients with RDs were classified as autoimmune and non-autoimmune groups according to seropositivity. Data of 883 age-matched HCs were used for comparison. Demographic features, cervical cytology reports of the patients and HPV test results were retrieved from hospital database. Cervical cytological abnormalities was categorized according to Bethesda 2014. Cobas assay was used for detecting and typing for Hr-HPV.Results: The RDs group and the HCs group were similar in terms of mean age, BMI, and rate of smokers (P>0.05). Cytological evaluation was carried out in all of 362 patients with RDs (161 autoimmune and 201 non-autoimmune) and in all of 883 HCs. HPV test was applied in 286 patients with RDs and 776 of HCs. 16 (4.4%) patients with RDs and 58 (6.6%) HCs had cervical cytological abnormality. Of the patients who underwent HPV testing; 22 (7.7%) patients with RDs and 75 (9.7%) HCs had Hr-HPV. The prevalence of cervical cytologic abnormalities and Hr-HPV infection rate were similar between patient groups and HCs (P=0.186 and P=0.400, respectively).Conclusion: It was determined that chronic systemic inflammation, which plays a role in the pathogenesis of rheumatological diseases, and immunosuppressive agents used in the treatment did not increase the prevalence of Hr-HPV infection and cervical cytological abnormalities.

Objective: In women with abnormal uterine bleeding, the appropriate age for endometrial biopsy remains controversial. In this study, we aimed to evaluate the importance of endometrial biopsy in premenopausal women aged 40-49 years who presented with menorrhagia but did not have risk factors for endometrial cancer.Material And Methods: The records of patients who underwent endometrial biopsy for diagnostic purposes at the gynecology and obstetrics clinic of our hospital between January 1, 2017 and October 31, 2021 were retrospectively reviewed. Among these patients, premenopausal women aged 40-49 years with menorrhagia who had endometrial biopsy results were included in the sample. Patients with risk factors were excluded from the study.Results: A total of 176 premenopausal patients with menorrhagia were included in the study. According to the biopsy results of these patients without risk factors, no malignancy was detected. Endometrial hyperplasia was present in six patients (3.4%), of whom (0.6%) had hyperplasia with atypia and five (2.8%) had hyperplasia without atypia.Conclusion: We found a minimal risk of neoplastic and preneoplastic disease in premenopausal women aged 40-49 years with menorrhagia but no risk factors for endometrial cancer. Endometrial biopsy indications should be reviewed in this patient group., Amaç: Anormal uterin kanaması olan kadınlarda endometrial biyopsi için uygun yaş tartışmalıdır. Bu çalışmada endometriyum kanser için risk faktörü olmayan ve menorajisi olan 40-49 yaş arası premenopozal kadınlarda endometriyal biyopsinin önemini değerlendirmeyi amaçladık.Gereçler ve Yöntem: 1 Ocak 2017-31 Ekim 2021 tarihleri arasında hastanemizin Kadın Hastalıkları ve Doğum kliniğinde diagnostik amaçlı endometrial biyopsi yapılan hastaların kayıtları retrospektif olarak incelendi. Bu hastalardan endometrial biyopsi sonuçları olan menorajili 40-49 yaş arası premenopozal kadınlar çalışmaya dahil edildi. Risk faktörü olan hastalar çalışma dışı bırakıldı.Bulgular: Çalışmaya, menorajisi olan 176 premenopozal hasta dahil edildi. Risk faktörleri olmayan hastaların biyopsi sonuçlarında malignite saptanmadı. Toplam 6 olguda endometrial hiperplazi (EH) (%3.4) saptandı. EH saptanan olguların 1’i (%0.6) atipili hiperplazi, 5’i (%2.8) atipisiz hiperplazi olarak saptandı.Sonuç: Risk faktörleri olmayan ve menorajisi olan 40-49 yaş arası premenopozal kadınlarda neoplastik ve preneoplastik hastalık riskini minimal olarak tespit ettik. Bu hasta grubunda endometriyal biyopsi endikasyonları gözden geçirilmelidir.

Background/Aim: In recent years, developing an embryo in in vitro conditions has been one of the most challenging and popular objectives in reproductive biology. In vitro models make observing the relationship between the two possible. Various cell culture and matrix models have been created to overcome embryonic disorganization during culturing. The primary aim of this study was to evaluate and compare the effects of fibrin, Ishikawa cell line, and a combination of both on the 3D multilayer uterine tissue cultures on a rat model, including a control group.Methods: This study was designed as a prospective controlled cohort study. The standard uterine culture model [CNT] (N: 3) constituted the control group. In addition, fibrin matrix-supported [FIB] (N: 3), Ishikawa cells-supported [ISH] (N: 3), and a combination of both [FIB+ISH] (N: 3) culture models were designated as the exposures. All models were cultured for 14 days. Afterwards, the optimal model was determined regarding glucose consumption, lactate production, endometrial thickness and gland count (primary outcomes) with semi-quantitative and statistical methods. Finally, the optimal model was implanted with blastocytes, and the survival duration was observed (secondary outcome).Results: There were significant differences between the groups in terms of glucose, lactate, endometrial thickness (millimeter), and the number of endometrial glands (P

© 2022 by the Turkish-German Gynecological Education and Research Foundation.Objective: The aim of this study was to evaluate the knowledge and practice behavior of Turkish obstetrician-gynecologists regarding oral healthcare during pregnancy and the association between periodontal disease and adverse pregnancy outcomes. Material and Methods: A cross-sectional study was conducted on randomly selected Turkish obstetrician-gynecologists using a questionnaire consisting of 26 questions during 11th Turkish-German Gynecological Association Congress. Participation in the survey was voluntary. Results: Out of 435 attendees approached, 382 (88%) of the gynecologists at the Congress participated in the written questionnaire. Most of the participants (96.1%) acknowledged a connection between oral health and pregnancy, and 77.5% agreed that periodontal disease may affect the outcome of pregnancy. Moreover, a high proportion of participants were aware of the clinical signs of periodontal diseases, mainly gingival bleeding (92.1%). However, almost 20% of participants thought that dental treatment could be performed safely in the first or last trimester of pregnancy. Only 36.9% of participants recommended guidance on dental examination for their patients during prenatal care. Conclusion: This study demonstrated that Turkish obstetrician-gynecologists have a relatively high degree of knowledge with respect to the relationship between periodontal disease and pregnancy outcomes, but practice behavior was poorly correlated with their knowledge. (J Turk Ger Gynecol Assoc 2022; 23: 275-86).

Amaç: Bu çalışma Gebelikte Sağlıklı Yaşam Davranışları Ölçeği’nin geliştirilmesi, geçerlik ve güvenirliğinin incelenmesi amacıyla yapılmıştır. Gereç ve Yöntem: Araştırma 12 Mart-12 Eylül 2018 tarihleri arasında, Karabük Üniversitesi Eğitim Araştırma Hastanesi’nde uygulanmıştır. Araştırmanın çalışma grubunu, anılan hastanenin gebe izlem polikliniğine başvuran ve çalışmaya katılmayı kabul eden 718 gebe oluşturmuştur.Bulgular: Geliştirilmeye çalışılan “çok bileşenli ayrık yapıya” sahip ölçeğin; gebelik sorumluluğu, beslenme, hijyen, fiziksel aktivite, seyahat ve gebeliği kabullenme olmak üzere 6 (altı) alt ölçekten oluştuğu bulunmuştur. Ayrıca Cronbach alfa katsayıları; ölçek toplamı için 0.83, gebelik sorumluluğu alt boyutu için 0.71, hijyen alt boyutu için 0.64, beslenme alt boyutu için 0.72, fiziksel aktivite için 0.69, seyahat alt boyutu için 0.80 ve gebeliği kabullenme alt boyutu için 0.63 olup, test-tekrar test sonucunda Sınıf İçi Korelasyon katsayıları (SKK) 0.70-0.91 arasındadır. Sonuç: Bu sonuçlar Gebelerde Sağlıklı Yaşam Davranışları Ölçeği’nin geçerli ve güvenilir bir ölçme aracı olduğu ve çalışmalarda kullanılabileceğini göstermektedir., Purpose: This study was conducted with the purpose of developing Healthy Lifestyle Behaviours in Pregnancy Scale and investigating its validity and reliability.Materials and Methods: The research was implemented between 12 March–12 September 2018 at Karabük University Training and Research Hospital. Study group of the research consisted of 718 pregnant women who applied to the pregnant follow-up polyclinic of the said hospital and who agreed to participate in the study. Results: It was found that the scale with “multi-component discrete structure” that is tried to be developed consists of 6 (six) subscales as pregnancy responsibility, nutrition, hygiene, physical activity, travel and accepting pregnancy. In addition, Cronbach’s Alpha coefficients were 0.83 for total scale, 0.71 for pregnancy responsibility subdimension, 0.64 for hygiene subdimension, 0.72 for nutrition subdimension, 0.69 for physical activity subdimension, 0.80 for travel subdimension and 0.63 for accepting pregnancy subdimension and Intraclass Correlation Coefficients (ICC) are between 0.70-0.91 as a result of test-retest. Conclusion: Healthy Lifestyle Behaviours in Pregnancy Scale is a valid and reliable measurement instrument and can be used in studies.

Objective: The mechanism of the leiomyoma formation process is still unknown. However, the menstrual cycle is associated with hypoxia, and ongoing hypoxia is associated with cellular events leading to the conversion of myometrial cells into uterine fibroids. After the hypoxic environment, the balance of cellular cytokines and growth factors changes. It was planned to evaluate the balance of oxidative agents and the role of oxidative stress in the formation of uterine fibroids.Study Design: The study was conducted in patients of gynecology outpatient clinic of Ankara Oncology Training and Research Hospital. Those volunteers with fibroids formed the study group, and the healthy ones were identified as the control group. A total of 64 subjects, 32 in both groups were included. The levels of catalase, ceruloplasmin, myeloperoxidase, native thiol, disulfide, and total thiol levels were investigated in groups.Results: Antioxidant parameters such as native thiol, disulfide, and total thiol levels were significantly decreased in uterine fibroid group. Catalase, ceruloplasmin, and myeloperoxidase levels were not statistically different between groups.Conclusion: Decrease in these antioxidant parameters showed that the hypoxia and the balance of oxidant and antioxidant substances changes may probably have associated with the pathophysiology of uterine fibroids.

Purpose: Infertile women have a higher rate of psychiatric symptoms compared to fertile women. Depression and anxiety are among the most common psychiatric disorders in this group. Self-compassion might be a variable in predicting depression, anxiety and stress in infertile women and thus more research is required.Methods: This study included a total number of 122 participants. The study group (n=50) consisted women who applied to the gynaecology and obstetrics clinic for infertility treatment. The control group (n=72) was recruited from hospital staff and their relatives, of the similar age and gender as the study group. The participants filled Self-Compassion Scale (SCS) and Hospital Anxiety and Depression Scale (HADS) in addition to sociodemographic data form. Results: The mean age of the study and control group were 31.50±5.104 and 31.86±7.681 years, respectively. The mean duration of infertility treatment in the study group was 5.48±5.023 months. SCS scores were significantly lower, and HADS scores (both depression and anxiety) were significantly higher in the study group, compared to the control group. There was a negative correlation between SCS and HADS scores (p < 0.001), indicating that lower self-compassion levels are associated with increased depression and anxiety. Duration of infertility treatment was not correlated with SCS and HADS scores (p > 0.05).Conclusion: It is crucial to screen infertile women for psychiatric symptoms, especially anxiety and depression. Patients with these symptoms should be referred to a mental health professional. Interventions targeting psychological well-being of infertile women are fundamental. Self-compassion is an influential factor in maintaining psychological well-being and preventing anxiety and depressive symptoms in infertile women.

Purpose: The use of a drain during a laparoscopic bilateral tubal sterilization (L/S BTS) operation is not a routine procedure, but enables close follow up of a patient when there is suspected bleeding. The aim of this study was to investigate the potential benefits of drain placement during L/S BTS operation in respect of the gastrointestinal system postoperatively. Materials and methods: A retrospective evaluation was made of patients applied with L/S BTS at Turhal State Hospital between June 2019 and March 2021. The study included a total of 64 women; 22 applied with a drain during L/S BTS operation and 42 women not applied with a drain. The two groups of patients were compared in respect of age, time to postoperative gas-faeces output, abdominal pain, the formation of intra-abdominal abscess-hematoma, wound site infection, operation time, and time of hospital discharge.Results: In the comparison of the patients with and without a drain, there was seen to be earlier gas and faeces output in the patients where a drain was used (p=0.003, p=0.018). Greater abdominal pain was felt in the first 12 hours (p=0.029), and a higher rate of wound site infection was observed (p=0.008) in the patients with a drain. Conclusion: Perioperative placement of a drain in patients applied with L/S BTS was seen to result in earlier gas-faeces output but greater abdominal pain. Drain application in the early postoperative period can be considered to have a positive effect on the bowel movements evacuating laparoscopy gas., Amaç: Laparoskopik bilateral tubal sterilizasyon (L/S BTS) operasyonu sırasında dren kullanımı rutin bir uygulama olmayıp kanama şüphesi durumunda hastanın yakın takibini mümkün kılar. Bu çalışma ile L/S BTS operasyonu sırasında dren uygulamasının postoperatif dönemde gastrointestinal sistem açısından olası faydalarını araştırmak amaçlanmıştır. Gereç ve yöntem: Turhal Devlet Hastanesi’nde Haziran 2019 ile Mart 2021 arasında L/S BTS uygulanmış hastaların dosya verileri retrospektif olarak tarandı. Çalışmaya L/S BTS operasyonu sırasında dren uygulanmış 22 hasta kadın ile L/S BTS operasyonu sırasında dren uygulanmamış olan 42 hasta kadın olmak üzere toplamda 64 hasta kadın dahil edildi. Gruplar; yaş, ameliyat sonrası gaz-feçes çıkışına kadar geçen süre, karın ağrısı, karın içi apse-hematom oluşumu, yara yeri enfeksiyonu, ameliyat süresi ve hastaneden taburcu olma süresi açısından karşılaştırıldı. Bulgular: Dren kullanılan hastalar ile dren kullanılmayan hastalar karşılaştırdıklarında; dren kullanılan hastalarda gaz ve gaita çıkış saatlerinin daha erken olduğu bulundu (p=0,003 ve p=0,018). Ancak dren kullanılan hastalar ilk 12 saatte daha fazla abdominal ağrı hissetmekteydiler (p=0,029). Yine dren konulan hastalarda daha fazla yara yeri infeksiyonu oluştuğu gözlendi (p=0,008). Sonuç: L/S BTS yapılan hastalara peroperatif dren uygulanması ile postoperatif dönemde gaz-gaita çıkışı daha erken saatte olmakta ancak abdominal ağrı hissi daha fazla olmaktaydı. Dren uygulaması ile postoperatif erken dönemde boşalan laparoskopi gazının bağırsak hareketlerini olumlu yönde etkilediği kanaatindeyiz.

Background/Aim: It is known that pregnancy success in IUI cycles performed in couples with unexplained infertility is below 20% even under the best conditions. Predicting the success in IUI cycles and directing patients to appropriate assisted reproductive treatment is essential for the time and budget. In this context, we aimed to investigate the use of uterine artery Doppler velocimetry values to predict pregnancy in intrauterine insemination (IUI) cycles in couples with unexplained infertility.Methods: In this prospective cohort study, couples with unexplained infertility were randomly assigned to two groups: clomiphene citrate (CC) and gonadotropin. The CC group used 50-150 mg CC daily between the 5th and 9th days of the menstrual period, while the gonadotropin group used 37.5-75 IU of recFSH daily from the 3rd day of the menstrual period until the dominant follicle developed. Ovulation was triggered by recHcg when at least one dominant follicle of 17 mm or larger was detected. Intrauterine insemination was performed 36 hours after the trigger. Uterine artery flow pulsatility index (PI), resistance index (RI)and the systolic-diastolic ratio (S/D) were measured in all patients by Doppler ultrasound on the 3rd day of menstruation and trigger day. Uterine artery Doppler values of the group that achieved pregnancy and those who could not conceive were compared as the main outcome of the study.Results: The study was designed over 143 IUI cycles, 89 cycles in the gonadotropin group and 54 cycles in the CC group. In 143 IUI cycles, 24 (16%) pregnancies were obtained, seven (12%) in the CC group and 17 (12%) in the gonadotropin group. In both CC and gonadotropin cycles, mean age, BMI, duration of infertility, hormone levels on the third day of menstruation, endometrial thickness on 3rd day of menstruation and on the trigger day, dominant follicle number and mean follicle diameter were similar in the pregnant and non-pregnant groups (P

Aim: The aim of this study is to evaluate pregnant women admitted to the outpatient clinic in terms of sleep apnea risk and sleep quality.Materials and Method: 31 women were included in this retrospective descriptive study which were conducted at Obstetrics and Gynecology Outpatient Clinic of the Hospital, between January 2016 and January 2017. Demographic characteristics, results of sleep questionnaires, pulmonary function test values, and information about delivery of the patients were obtained retrospectively for the 8th week and last trimester.Results: The mean sleep time was 7.9±1.3 hours at 8th week and 7.3±2.0 hours at last trimester; with no significant difference in two periods (p=0.077). According to sleep questionnaires there was no statistically significant difference between 8th week and the last trimester (p>0.05), except Stanford Sleepiness Scale score (p=0.047). There was no significant difference according to pulmonary function test values between 8th week and last trimester (p>0.05), there was a statistical difference between two periods only in terms of FEV1% (p=0.047). No significant difference was found between the mean birth weight of babies of 13 pregnant women with poor sleep quality and mean birth weight of babies of 18 pregnant women with good sleep quality (p=0.565).Conclusion: As a result, in our study, nearly half of the pregnant women had impaired sleep quality in the last trimester according to the Pittsburg Sleep Quality Index, but birth weight was not affected in pregnant women with poor sleep quality. Sleep quality, the presence of OSAS in pregnancy and its relationship with pregnancy and postpartum complications are not clear, OSAS pregnancy studies should be performed especially involving complicated pregnancies., Amaç: Bu çalışmanın amacı polikliniğe başvuran gebelerin uyku apnesi riski ve uyku kalitesi açısından değerlendirilmesidir.Gereç ve Yöntem: Hastanenin Kadın Hastalıkları ve Doğum Polikliniği'nde Ocak 2016-Ocak 2017 tarihleri arasında yapılan retrospektif tanımlayıcı çalışmaya 31 kadın dahil edildi. Hastaların demografik özellikleri, uyku anket sonuçları, solunum fonksiyon testi değerleri ve doğum bilgileri 8. hafta ve son trimester için geriye dönük olarak elde edildi.Bulgular: Ortalama uyku süresi 8. haftada 7.9±1.3 saat ve son trimesterde 7.3±2.0 saat idi; iki periyotta anlamlı fark yoktu (p=0.077). Uyku anketlerine göre 8. hafta ile son trimester arasında Stanford Uykululuk Skalası skoru (p=0.047) dışında istatistiksel olarak anlamlı fark yoktu (p>0.05). 8. hafta ile son trimester arasında solunum fonksiyon testi değerleri bakımından anlamlı fark yoktu (p>0.05), iki dönem arasında sadece FEV1 açısından istatistiksel fark vardı (p=0.047). Uyku kalitesi kötü olan 13 gebenin bebeklerinin ortalama doğum ağırlıkları ile uyku kalitesi iyi olan 18 gebenin bebeklerinin ortalama doğum ağırlıkları arasında anlamlı fark bulunmadı (p=0.565).Sonuç: Sonuç olarak, çalışmamızda Pittsburg Uyku Kalitesi İndeksi'ne göre son trimesterde gebelerin yaklaşık yarısının uyku kalitesi bozulurken, uyku kalitesi kötü olan gebelerde doğum ağırlığı etkilenmedi. Uyku kalitesi, gebelikte OUAS varlığı, gebelik ve doğum sonu komplikasyonlarla ilişkisi net değildir, özellikle komplike gebeliklerde OUAS gebelik çalışmaları yapılmalıdır.

Objectives: To examine the relationship between upper extremity problems and the performance of abdominal sonography to provide an understanding of the prevalence of upper extremity pain among perinatologist. Methods: This study was conducted as a prospective trial between June-August 2020. The online questionnaire prepared by the researchers was completed by volunteer perinatologists. It included topics such as age, gender, years of perinatology specialist experience, average number of patients per week, minutes each patient’s examination lasted and other demographic data is performed. Perinatologists with upper extremity pain were assigned to group 1. Group 2 comprised those who had no upper extremity pain. Patients in group 1 were divided into two subgroups according to pain intensity. All data were compared between groups. Results: Overall, 115 perinatologists participated in this research. Of all participants, 82 (71.3%) had upper extremity pain, and 33 (28.7%) had no upper extremity pain. No significant relationship was observed for age, gender, average number of ultrasound examinations per day, or time allotted for each patient's examination between group 1 and 2. Providers performed perinatology services for 5 years (range: 1-23 years) in subgroup 1A and for 7 years (range: 1-23 years) in subgroup 1B (p = 0.02). Conclusions: Upper extremity pain caused by intensive ultrasound use is common in perinatologists; as the years in the profession increase, the frequency and severity of these pains may increase.