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Sclerosing stromal tumor (SST) is an extremely rare and distinctive sex cord stromal tumor, which occurs predominantly in the second and third decades of life. SSTs make up 2-6% of ovarian sex-cord stromal tumors. Due to the solid and distinct vascular structure of the tumor, it can be mistaken as a number of malignant ovarian tumors. As this specific neoplasm is very rare, it is not always possible to diagnose the tumor preoperatively with clinical and ultrasonographic findings. Furthermore, histopathological and immunohistochemical analysis does not always confirm the diagnosis. In this case report, clinical findings, histopathological features, and macroscopic appearance during laparoscopy of an SST are presented in a 20-year-old woman with pelvic pain. SST should be considered among the differential diagnosis of women with adnexal masses. 35263835

Objectives: Crohn's disease (CD) is a repeating bowel disease characterized by remission and exacerbation periods. The disease mostly affects adults of reproductive age. Women with desires to conceive are concerned about the effects of CD on their fertility. To demonstrate the relationship between ovarian reserve and CD anti-Mullerian hormone (AMH) levels, antral follicle count (AFC) and ovarian volume were evaluated. Material and methods: The prospective case-controlled study was conducted at a tertiary referral center in Istanbul between March-August 2019. Ovarian functions were evaluated in 50 patients with CD and in 95 healthy women. Serum gonadotropin and AMH levels were determined. AFCs and ovarian volumes were calculated for all subjects. Results: AMH levels were significantly lower in CD patients (2.1 +/- 0.8) compared to the control group (3.3 +/- 0.9) (P = 0.001). Serum AMH levels were significantly lower in patients with active CD (2.1 +/- 0.6) than the CD patients in remission (2.6 +/- 0.8) (p = 0.002). Ovarian volumes and AFC values were significantly lower in both ovaries in CD patients compared to the controls (p < 0.05). Conclusions: AMH levels, ovarian volume and AFC counts, and thus ovarian reserve was shown to be decreased in CD patients of reproductive age compared to healthy control subjects. Because possible effects of inflammatory damage may be seen in newly diagnosed female CD patients who desire to have a child, we believe that CD patients should be comprehensively assessed for ovarian reserve.

Objective: We aimed to investigate the effect of acupuncture performed as an adjuvant therapy to in vitro fertilization, on pregnancy rates by performing acupuncture on the day of embryo transfer, one hour before the procedure and one hour after the procedure.Study Design: In this open-label randomized prospective controlled study, 60 unexplained infertility patients enrolled for in vitro fertilization treatment were randomized by a computer-based number generator for acupuncture performance and no-treatment. All patients received rFSH (Gonal-F®) for ovulation induction and the antagonist Cetrorelix (Cetrotide®) to prevent premature ovulation. Ovulation was triggered by using hCG (Ovitrelle®) and egg collection was done after 36-48 hours. In the study group, acupuncture was performed by intradermal needling, bilaterally with a sterile needle, both one hour before and one hour after the embryo transfer. Acupuncture was not performed on the control group. The results of the treatment were evaluated 12 days after embryo transfer.Results: Thirty patients were randomized into the study group and 30 patients were randomly placed in the control group. Although there was no statistically significant difference between groups in terms of β-hCG positivity, it was 43.3% in the study group and 36.7% in the control group (p>0.05).Conclusion: The success rate of in vitro fertilization was higher in terms of pregnancy rate in the patient group who received acupuncture procedure as well, but the difference was not statistically significant. This may be due to the type of acupuncture procedure selected or insufficient sample size. As a result, further studies involving larger numbers of participants and using different acupuncture techniques are needed.

Bulut, Berk (isu author) Removal of uterus during laparoscopic hysterectomy (LH) is occasionally challenging and therefore sometimes requires morcellation. Morcellation techniques for hysterectomy can spread the cancer cells which were presumed benign preoperatively in to the abdomen or pelvis. Probability of an undetected malignity should not be disregarded and accordingly must be shared with the patient prior to LH. The present study aimed to identify the demographic and the clinical factors associated with the need for morcellation in patients undergoing LH. A total of 153 patients who underwent LH for presumed benign causes were enrolled in this retrospective study. Subjects were divided into two groups according to the need for the morcellation during the LH: Morcellation group and intact vaginal removal (IVR) group (it was possible to deliver the uterine specimen vaginally). The two groups were compared with respect to demographic and clinical characteristics, indications for LH, preoperative ultrasonographic findings and postoperative complications. The frequency of the postmenopausal women was significantly higher in the morcellation group than the IVR group (p = 0.005). Preoperative uterus width (p < 0.001) and postoperative Uterus weight (p < 0.001) were significantly higher in the morcellation group compared to that of the IVR group. There were no significant differences between the groups regarding the complication rate. Uterine weight (OR: 1.020, 95% CI: 1.008-1.031, p = 0.001) and menopause (OR: 2.571, 95% CI: 1.328-4.980, p < 0.001) were predictive for the need of morcellation. A cut-off value of 287.5 gram was able to predict the need for morcellation with 87% sensitivity and 71% specificity. The present study demonstrates that uterine weight and presence of the menopause are predictive for the need of morcellation at the time of the total LH. These factors should be considered in preoperative planning and used to further guide surgeons in providing LH. © 2020, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.

This video will demonstrate a minimally invasive technique, in which the Manchester procedure was combined with laparoscopic sacrohysteropexy by retroperitoneal tunneling in patients with uterine prolapse and cervical elongation who wished to preserve the uterus. The principle steps and techniques to complete the operation are dictated in the video. The prolapse surgery was performed uneventfully, and the uterus was restored to its anatomical position. During the two years of follow-up, there were no complications from the prolapse or mesh-related events. No prolapse recurrence was observed. This technique facilitates uterine-sparing surgery, results in less bleeding and shorter operative time, and we believe that it may reduce the recurrence of prolapse due to the elongation of the cervix. (J Turk Ger Gynecol Assoc 2022

Objective To demonstrate the laparoscopic excision technique of a juvenile cystic adenomyoma and show how the decidualization of ectopic endometrial tissue can lead to the misdiagnosis of a focus of ectopic pregnancy. Design Description and step-by-step demonstration of the surgical procedure using a video recording (Canadian Task Force Classification 3). Setting Teaching and research hospital. Patient(s) A 27-year-old gravida 2 parity 1 patient with one previous caesarean delivery presented to the emergency department with symptoms of pelvic pain and delayed menses. Her beta-human chorionic gonadotropin level was 2,161 mIU/mL. On transvaginal ultrasonography the uterine cavity appeared empty without any signs of a gestational sac, and a 42×45 mm heterogeneous mass was observed on the right cornual area. An 18×21 mm cystic area was observed within the mass. A diagnosis of cornual pregnancy was made and two doses of systemic methotrexate treatment were administered. On the 12th day following medical treatment, the patient reported increasing abdominal pain and free fluid was observed in the pouch of Douglas on ultrasonography. The decision to perform laparoscopic cornual excision was made. Main Outcomes and Measure(s) On laparoscopic exploration a tubal ectopic pregnancy was observed within the left fallopian tube. The presence of two simultaneous ectopic pregnancies, located in the left fallopian tube and the right cornual area, was suspected. However, upon careful inspection, the right fallopian tube appeared normal and the mass initially thought to be a right cornual pregnancy appeared more like a degenerated fibroid. A left salpingectomy was performed and the excision of the mass in the right cornual area was planned. An incision was made over the mass and the cystic inner area containing chocolate-brown colored fluid was drained. As there was no pseudo capsule surrounding the mass, the diagnosis of focal adenomyosis instead of degenerated fibroid was made. No endometriotic foci were observed within the pelvis. Different from the enucleation of a fibroid, the mass was dissected from the middle into two halves until healthy myometrium was reached on the floor of the mass. The two halves of the mass were resected totally by dissecting the adenomyotic tissue from the myometrium starting from the caudal end towards the cranial end. The first layer of the remaining myometrial defect was sutured extracorporeally with No.1 polyglactan sutures. The second and third layers were sutured intracorporeally with V-loc sutures. The resected left fallopian tube containing the ectopic pregnancy and the adenomyotic mass were externalized through a posterior colpotomy incision. Result(s) The patient was discharged 24 hours postoperatively without any complications. A diagnosis of juvenile cystic adenoma was made upon histopathological examination. The patient reported subsiding of her dysmenorrhea on the postoperative third month. Conclusion(s) Juvenile cystic adenomyosis (JCA), is a rare form of focal adenomyosis which is usually located in close proximity to the uterine insertion of the round ligament, contains a cystic inner area larger than 1 cm and is encountered before the age of 30 years. Some authors reported JCA to be an accessory and cavitated uterine mass (ACUM) anomaly developing as a result of gubernaculum dysfunction. The only difference between the two conditions is reported to be the presence of a denser area of adenomyosis surrounding the cystic area lined with endometrium in JCA than in ACUM. This case has shown that decidual changes observed in ectopic endometrial tissue within an adenomyotic area may be misdiagnosed as a focus of ectopic pregnancy. Atypical endometriomas demonstrating decidual changes may also be misdiagnosed as ovarian malignancies. In non-emergency situations, waiting for the decidualization effect of ectopic endometrium to subside can help in the definitive diagnosis of such cases. Our technique for JCA excision is different from enucleation of a fibroid and may aid in the total resection and dissection of the adenomyotic tissue from healthy myometrium.

Objective The aim of this study was to evaluate the diagnostic accuracy of hysteroscopic chromopertubation (HCT) in the assessment of tubal patency by comparing its results with laparoscopic chromopertubation (LCT). Study Design The population of this prospective cohort study consisted of both fertile and infertile women. Sixty-four women were included to the study. HCT was assessed by the observation of the transport of highly concentrated methylene blue from uterine cavity to tubal ostia. The results of HCT were compared with the results of LCT as a gold standard. The accuracy of HCT, sensitivity, specificity, positive and negative predictive values in diagnosing tubal patency were calculated. Results The results of HCT and LCT were evaluated for right and left tubes, separately. One hundred and twenty-eight tubes were determined. Sensitivity, specificity, positive and negative predictive values for HCT were; 85.85%, 59.09%, 91% and 46.43%, respectively. Conclusion This study’s result showed that HCT had high sensitivity and moderate specificity values in the assessment of tubal patency. HCT during office hysteroscopy could give the chance to practitioners to assess tubal patency without subjecting the patient to multiple procedures.

Objective: We aimed to compare the maternal and neonatal complications in women who had undergone fourth or more cesarean section with to women who had undergone second or third cesarean section.Study Design: 162 women who had four or more cesarean section (study group) and 228 women who had undergone second or third cesarean section (control group) were reviewed retrospectively. Demographic features, obstetric, intraoperative, postpartum and neonatal complications were determined in both groups. Results: The preoperative hematocrit values were lower in study group (35.63.6) than the control group (36.64.3), (p

Aim: To investigate whether endometrial polyps are associated with obesity and incidence of diabetes mellitus or hypertension in women who admitted with abnormal uterin bleeding in reproductive ages. Material and Method: We included 557 patients who had endometrial sampling due to the abnormal uterine bleeding. Patients with postmenopausal bleeding, endometrial hyperplasia or cancer and concomitant uterine pathology were excluded (n=117). Finally, endometrial polyp group consisted of 120 patients and control group consisted of 320 patients. Results: Mean body mass index was statistically significantly higher in endometrial polyp group (30.1±2.94) compared to control group (28.2±1.92; p, Amaç: Anormal uterin kanama ile başvuran reprodüktif çağdaki kadınlarda, endometrial polip tanısının obezite, diyabet veya hipertansiyon sıklığı ile ilişkisi olup olmadığını araştırmak.Materyal ve Metot: Anormal uterin kanama nedeni ile endometrial örnekleme yapılan 557 hasta çalışmaya dahil edildi. Postmenopozal kanaması olan, patoloji sonucunda endometrial hiperplazi veya kanser sapta-nan, eşlik eden uterin patolojisi bulunan hastalar çalışmadan dışlandı (n=117). Sonuç olarak endometrial polip grubu 120 hastadan oluşuyordu, kontrol grubu ise endometrial polip tanı- sı almamış 320 hastadan oluşturuldu. Bulgular: Ortalama vücut kitle indeksi, endometrial polip grubunda (30,1±2,94), kontrol grubu (28,2±1,92) ile karşılaştırıldığında istatistiksel olarak anlamlı yüksekti (p

Objectives: To compare the ‘strictly’ active management protocol in women with low risk of postpartum hemorrhage using the expectant management protocol with respect to changes in hematologic parameters, uterotonics, blood transfusions, or additional interventions. Material and methods: A randomized controlled prospective trial in which 934 singleton parturients enrolled; 654 were randomly assigned to the active and mixed management groups. The primary outcome parameter was the reduction in hemoglobin concentrations due to delivery, and the secondary outcome parameters were changes in hemoglobin of more than 3 g/dL (ΔHb ≥ 3 g/dL), durations of the third stage of labor, need for additional uterotonic agents, blood transfusions, manual removal of the placenta, and surgical evacuation of retained products of conception. Results: The mean postpartum hemoglobin concentration was significantly higher (P = 0.04) in the active management group with a significantly lower reduction (P = 0.03). Falls of hemoglobin levels of more than 3 g/dL (ΔHb ≥ 3g/dL) were less common in the active management group though not significantly (P = 0.32). The mean duration of the third stage of labor was significantly (P < 0.001) shorter in the active management group. There was no significant difference between the two groups with regard to the need for additional uterotonic agents, uterine atony, blood transfusion, manual removal of the placenta, surgical evacuation of retained products of conception, and prolonged third stage of labor. Conclusions: Although active management of the third stage of labor was associated with higher postpartum hemoglobin levels, it did not influence the risk of ‘severe postpartum hemorrhage’ in women with low risk of postpartum hemorrhage.

Aim: To investigate the effect of melatonin on ischemia–reperfusion (I/R) injury in rat ovary. Material and Method: A total of 24 Wistar rats were divided into four groups. The rats were first numbered randomly and then randomly divided into four equal groups: sham, torsion, detorsion and melatonin groups. In group I (n = 6) sham, as well as in group II ovary torsion was not performed and no drug was administered. In group III, 1 hour of ischemia and 2 hours of reperfusion were performed and no drug was given. In group IV, melatonin was dissolved in 1% ethanol just before use. Melatonin was injected 1 hour before torsion to the torsion plus melatonin group. Right ovaries were surgically removed in all groups. Result: Malondialdehyde (MDA) levels were measured. We suggested that administration of melatonin would be in treating ovaries from torsion/detorsion induced damage in humans. The histopathological changes such as vascular congestion, edema, hemorrhage, and follicular degeneration were found to be decreased in the melatonin + ischemia-reperfusion group. Ischemia-reperfusion group: PECAM-I expression is positive in vessel of the stromal area. The follicles and interfolicular area infiltrated with CD68 positive cells were increased in a time of ischemia-reperfusion exposure dependent manner. Conclusions: Melatonin after ischemia-reperfusion CD31 and CD68 expressions is weak, due to the reduction of the inflammatory effects and hemorrhage is thought that melatonin is effective.

Amaç: Bu çalışmanın amacı maternal serum D-dimer ve fibrinojen düzeylerinin bir marker olarak intra uterin büyüme geriliğini (İUGG) saptamadaki etkinliğini araştırmaktır. Gereç ve Yöntemler: Bu çalışmaya Ocak 2011-Aralık 2011 tarihleri arasında gebelik takiplerini ve doğumlarını 3. basamak bir hastanede gerçekleştiren toplam 234 gebe dahil edildi. Gebeler iki gruba ayrıldı; grup 1: İUGG tanısı almış 117 gebe ve grup 2: kontrol grubu olarak İUGG bulunmayan 117 sağlıklı gebe. Tüm gebelerin serum D-dimer ve fibrinojen düzeyleri gebeliğin üçüncü trimesterinde ölçüldü. İki grup serum D-dimer ve fibrinojen düzeyleri açısından karşılaştırıldı. Bulgular: Yaş, gebelik öncesi vücut kitle indeksi, sigara kullanımı ve gebelik haftası için gruplar arasında istatistiksel olarak anlamlı bir farklılık bulunmadı (p>0,05). Gravida, parite, yaşayan çocuk sayısı ile maternal kanda bakılan fibrinojen seviyesinde ise istatistiksel olarak anlamlı bir farklılık tespit edildi (p0.05). Gravidity, parity, number of children and maternal serum fibrinogen level were detected significantly different between the groups (p

The purpose of this study was to investigate the impact of parity on perinatal outcomes in pregnancies complicated by advanced maternal age.A total of 11 587 pregnancies were reviewed retrospectively from patient medical records. Singleton pregnancies greater than 24 weeks of gestation were included. The study group consisted of women ≥40 years old at the time of delivery, and the control group consisted of women aged between 20 and 30 years old. Data regarding age, parity, gestational age, mode of delivery, and obstetric and neonatal complications were collected. Firstly, pregnancies ≥40 years and the younger control group were compared altogether with respect to the obstetric and neonatal complications. Secondly, both groups were divided into subgroups according to parity, and a second comparison was made with controls.Mean maternal age in the study and control groups was 43±2.2 and 24±2.8 years, respectively. In women ≥40 years old, all of the investigated obstetric and neonatal complications except postpartum haemorrhage and foetal malformations were higher when compared to younger controls (p0.05). In the nulliparous ≥40 year old group, the most significant complications were preterm delivery (45.3%), low 5-minute Apgar score (15.2%), and neonatal intensive care unit admission (15.2%). On the other hand, in the multiparous group, preeclampsia (16.6%), abruptio placentae (5.1%), foetal demise (7.2%), and macrosomia (9.6%) were found to be significantly higher when compared to controls.The study suggests that pregnancies of maternal age ≥40 years carry increased risks for both neonatal and obstetric complications, and these risks seem to be effected by parity.Bu çalışmanın amacı, paritenin ileri maternal yaş ile komplike olmuş gebeliklerde perinatal sonuçlara olan etkisinin incelenmesidir.Toplam 11 587 gebeliğe ait takip dosyası retrospektif olarak incelendi. Çalışmaya 24 hafta üzeri tekiz gebelikler dahil edildi. Çalışma grubu doğum sırasında 40 yaş ve üzeri olan gebe kadınlardan, kontrol grubu ise 20–30 yaş arası gebe kadınlardan oluşturuldu. Hastaların yaş, parite, gestasyonel yaş, doğum şekli, obstetrik ve neonatal komplikasyonlara ait verileri toplandı. İlk olarak 40 yaş üzeri gebelerle genç kontrol grubunun tamamı obstetrik ve neonatal komplikasyonlar açısından karşılaştırıldı. Sonrasında, her iki grup da pariteye göre ayrılarak (nullipar ve multipar), ikinci bir karşılaştırma yapıldı.Çalışma ve kontrol grubunda ortalama maternal yaşlar sırasıyla 43±2.2 ve 24±2.8 yıl idi. Kırk yaş üzeri kadınlarda, postpartum kanama ve fetal malformasyonlar dışında incelenen tüm obstetrik ve neonatal komplikasyonlar kontrollere göre daha sıktı (p0.05). Nullipar 40 yaş üstü gebelerde kontrollere göre anlamlı olarak daha sık gözlenen en sık komplikasyonlar preterm doğum (%45.3), düşük 5.dakika APGAR skoru (%15.2), ve neonatal yoğun bakım ünitesine yatış (%15.2) idi. Diğer taraftan multipar grupta preeklampsi (%16.6), ablasyo plasenta (%5.1), fetal kayıp (%7.2) ve makrozomi (%9.6) kontrol grubuna göre daha sıktı (p0.05).Bu çalışmada, maternal yaşın 40’ın üzerinde olduğu gebeliklerde neonatal ve obstetrik komplikasyonlarda artış olduğu, ve bu risklerin pariteden etkilendiği sonucuna varılmıştır.

Objective: To determine the optimal cone size to achieve a reliable sensitivity and specificity for clear surgical margins after cold knife conization (CKC). Material and Methods: The medical reports of patients who had high-grade cervical intraepithelial lesions, carcinoma in situ, or stage 1A1 microinvasive carcinoma in their CKC specimens between June 2008 and January 2015 were reviewed retrospectively. Results: In total, 315 women fulfilled the inclusion criteria. The mean age of the patients was 40.7 years. The conization results were microinvasive carcinoma and high-grade squamous lesion (HSIL) for 8 and 307 patients, respectively. Ninety-nine patients had positive surgical margins. Eighty-one patients with positive cone margins underwent the repeat excisional procedure and 35 of them showed residual disease. In the univariate analyses, the patient age, menopausal status, and mean cone height parameters showed statistically significant differences between the patients with positive and negative margins. Also, residual disease was associated with the menopausal status and age of the patients. Conclusion: There is no optimal cone depth that is applicable for all patients. The most important predictors for positive margins are the menopausal status of the patient and that more than two quadrants are involved. However, the menopausal status and age of the patients were still predictors for residual disease. © 2016 by the Turkish-German Gynecological Education and Research Foundation.

OBJECTIVE: The aim of the study was to determine whether it is possible to differentiate submucosal fibroids before interventional procedures based on mean platelet volume (MPV), in reproductive-age patients presenting with endometrial thickening and abnormal uterine bleeding.STUDY DESIGN: This study included 581 reproductive-age women who underwent diagnostic procedures (curettage or operative hysteroscopy) and were subsequently divided into two groups based on clinico-pathological findings. The first group included those with benign endometrial pathology (control group, n=438), and the second group consisted of those with submucosal leiomyomas (n=143). The demographic characteristics and complete blood count (CBC) data of these patients were collected retrospectively, and comparisons were made between groups.RESULTS: No statistically significant difference was found between the groups according to demographic features and CBC parameters such as hemoglobin levels and white blood count (p>0,05). Platelet counts were significantly higher and MPV values were significantly lower in submucosal leiomyoma patients compared with the control subjects (p

Background: Hydronephrosis is frequently encountered in advanced stage cervical cancers, and may be associated with mortality. In the present study, we aimed to demonstrate the effect of hydronephrosis on survival in patients with inoperable advanced stage cervical cancer. Materials and Methods: The study data were acquired by retrospective analysis of the patient records belonging to 165 women with FIGO (International Federation of Gynecology and Obstetrics) stage-IIIB or more advanced cervical cancer, which were not surgical candidates. Parameters including patient age, pathological diagnosis, disease stage, pelvic sidewall extension, presence of hydronephrosis and administration of chemoradiation were analyzed. Further, the effects of these variables on survival were assessed. P values less than 0.05 were considered statistically significant. Results: The distribution of the study patients according to disease stage was as follows: 131 (79.4%) had stage-IIIB, 18 (10.9%) had stage-IVB and 16 (% 9.7) patients had stage-IVA disease. Hydronephrosis was not evident in 91 (55.2%) of these patients, whereas 41 (24.8%) had unilateral and 33 (20%) patients had bilateral hydronephrosis. When compared to mean survival in patients who did not have hydronephrosis, survival was significantly shortened in patients who had bilateral and unilateral hydronephrosis (p < 0.05). There was no significant survival difference between patients with unilateral and bilateral hydronephrosis (p>0.05). Although patient age, pathological type, pelvic involvement, and chemotherapy treatment rates were similar (p>0.05), radiotherapy requirement rate and disease stage were significantly different among the study groups (p

The present study aimed to investigate the utility and importance of the various parameters of complete blood count panel for benign-malignant differentiation of adnexal masses.This retrospective study involved 316 patients with documented benign and 253 patients with malignant adnexal masses who underwent primary surgical treatment at a tertiary referral center. Prior to the study, all benign and malignant cases were compared within their own groups and then the benign and malignant cases were compared to each other. For all cases, cut-off, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated for the neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), neutrophil, lymphocyte, platelet and CA-125 parameters, and the results were compared in regards to the groups.NLR, PLR, neutrophil, CA-125, and platelet values were higher in the malignant compared to the benign cases (p0.01). The lymphocyte value was lower in the malignant cases (p0.01). No significant differences were found for basophils and eosinophils (p0.05). For CA-125, the sensitivity, specificity, PPV and NPV for all cases were 78%, 62%, 62% and 78%, respectively. For NLR, they were 65.6%, 72.1%, 65.3%, and 72.3%, and for PLR, 48%, 81%, 67%, and 66%. Additionally, the sensitivity and specificity were 55% and 77% for CA-125, 66% and 58% for NLR, and 61% and 58% for PLR in early malignant cases.NLR and PLR appear to be useful methods that can be applied together with CA-125 due to the relatively high sensitivity values for the malign-benign differentiation of ovarian masses. Although the specificity of these parameters is lower than CA-125, especially in cases with early malignant ovarian pathology, their sensitivity being higher is promising for the early diagnosis of ovarian cancer. It can be used to detect ovarian malignancies in the early stages, and it will increase the treatment options and improve survival rates.

To determine whether inherited thrombophilia affects components of second trimester combined aneuploidy screening test.A case-control study was performed between 1 December 2010 and 1 February 2012, at a tertiary referral hospital. Singleton pregnancies with inherited thrombophilia that underwent second trimester (16-19(+6) week) combined aneuploidy screening test were included in the study. Maternal serum alfa fetoprotein, unconjugated estriol, human chorionic gonadotropin levels and multiple of median (MoM) levels were compared between the study group and controls.Within the study period, 18,943 women with singleton pregnancies had a combined second trimester aneuploidy screening test at our institution. Among these, 26 women met the criteria of thrombophilia. A control group that comprised 275 women with similar gestational age was generated, using a 1:1 ratio. Unconjugated estriol MoM levels were significantly lower in women with inherited thrombophilia (p = 0.02). But there was no statistically significant difference for unconjugated estriol levels, human chorionic gonadotropin, alfa fetoprotein and their MoM levels.Our study suggest that in patients with hereditary thrombophilia a new correction factor should be used, when calculating unconjugated estriol MoM value, which is one of the markers of second trimester aneuploidy screening test.

seckin, kerem doga/0000-0002-9668-2063; karsli, mehmet fatih/0000-0001-8524-2428; WOS: 000339139500006 PubMed: 24792406 Objective: To investigate the effects of long-lasting maternal fasting on fetal biometry, amniotic fluid volume, fetal Doppler parameters, and neonatal outcomes. Methods: The present study, conducted at Solhan State Hospital, Bingol, Turkey, between July and August 2013 recruited 82 healthy and otherwise normal pregnant women with a gestational age of 29 weeks or more who were fasting for at least 20 days. The control group comprised 87 healthy non-fasting women matched for maternal age, parity, gestational age. Fetal parameters were measured at the beginning and the end of the fasting month. Perinatal outcomes were compared between the groups. Results: There were no significant differences between the groups in fetal biometry, fetal Doppler parameters, or neonatal outcomes. In the fasting group, however, there was a significantly greater decrease in amniotic fluid index during the fasting period (P < 0.001). The number of women who initially had a normal amniotic fluid measurement and subsequently developed oligohydramnios was also significantly higher in the religious fasting group (P < 0.05). Conclusion: Fetal development, Doppler parameters, and neonatal outcomes were not significantly affected in healthy fasting women; however, there was a significant association between fasting and amniotic fluid index. These findings mandate more frequent follow-up visits for this group of women. (C) 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Background/aim: To investigate the risk of de novo stress urinary incontinence SUI occurrence in women who were treated for pelvic organ prolapse POP with sacrospinous ligament fixation SSLF in addition to vaginal hysterectomy VAH and antero-posterior colporrhaphy CAP over a 24-month follow-up period. Materials and methods: A prospective randomized study was designed. Women without occult or obvious SUI were randomized into either one of the study groups: Group 1: VAH + CAP, and Group 2: VAH + CAP + SSLF. Postoperatively, the patients were reevaluated for de novo SUI occurrence. Results: A total of 150 women were analyzed [G1 = VAH + CAP n: 77 and G2 = VAH + CAP + SSLF n: 73 ]. Mean age, parity, body mass index, menopausal status, and preoperative POP degree, grade 1 and grade 2-3 cystocele and rectocele frequencies were similar between the 2 groups. During follow-up period, de novo SUI developed in 7 patients 9.1% of Group 1, and in 6 patients 8.2% of Group 2 P > 0.05 . In Groups 1 and 2, POP recurrence occurred in 5 6.4% vs. 1 1.3% cases,respectively P < 0.05 . Conclusion: In patients undergoing surgery for POP, the addition of SSLF did not result in an increased rate of de novo SUI. Careful patient selection, and informing the patients about the risks and benefits of the planned surgical procedure are essential steps in each case of POP.