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5. Maternal and Fetal Outcomes in Disseminated Intravascular Coagulation Cases Associated with Pregnancy Complications.

Author

Oguz, Yuksel, Dagdeviren, Gulsah, Aksoy, Münevver, Keleş, Ayşe, Çelik, Özge Y., Yucel, Kadriye Y., and Çağlar, Ali T.

Subjects
PREGNANCY complications, DISSEMINATED intravascular coagulation, PREGNANCY, PREECLAMPSIA, ABRUPTIO placentae, HELLP syndrome, PROGNOSIS
Abstract

Background: The relationship between the pregnancy modified DIC score, which is applied in obstetric conditions where the risk of disseminated intravascular coagulation is high, and underlying disease, as well as its effect on the prognosis, was investigated. Methods: Those with a DIC score ≥ 26 from obstetric conditions, such as obstetric bleeding, placental abruption, or preeclampsia/HELLP syndrome, which are at high risk of developing DIC, were included in the study. These patients were compared in terms of laboratory results, maternal morbidity/mortality, and neonatal outcomes, according to the underlying disease. Results: The DIC score was ≥ 26 in 224 of 154,233 deliveries in our center, and the incidence was 0.14%. In the preeclampsia/HELLP syndrome group, the platelet count and prothrombin time were lower, and the fibrinogen level was higher than those of the obstetric hemorrhage and placental abruption groups. In addition, the rates of blood transfusion and hysterectomy were lower in women who developed DIC due to pre-eclampsia/HELLP syndrome than in those with obstetric hemorrhage. Conclusions: Considering the underlying disease is an important factor in predicting prognosis, when using the new pregnancy modified diagnostic scores for DIC diagnosis. [ABSTRACT FROM AUTHOR]

Published
2024
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6. Assessing the Relationship Between Intrahepatic Cholestasis of Pregnancy and Exogenous Progesterone Intake.

Author

CENDEK, BUSRA DEMİR, DAGDEVİREN, GULSAH, CELEN, SEVKİ, and CAGLAR, ALİTURHAN

Subjects
*PROGESTERONE, *FARNESOID X receptor, *CHOLESTASIS, *MATERNAL age, *PREGNANCY, *LIVER function tests, *BODY mass index, *URSODEOXYCHOLIC acid, *GESTATIONAL diabetes
Abstract

Aim: Progesterone metabolites are known to be elevated in the serum of patients with intrahepatic cholestasis of pregnancy (ICP), and exogenous progesterone supplementation in early pregnancy may cause an increase in progesterone metabolites. The aim of this study is to investigate the relationship between ICP and exogenous progesterone intake. Materials and Methods: This study is a retrospective case-control study conducted between January 2015 and November 2023. The groups liver function tests, total bile acids, maternal age, body mass index, parity, history of cholestasis, history of progesterone use, gestational week in which pruritus symptoms occurred, gestational week, in which ICP was diagnosed, history of ursodeoxycholic acid intake, obstetric pathology, maternal comorbidities, week of delivery, delivery method, birth weight, APGAR scores were obtained from the database of our hospital and compared. Results: A total of 379 pregnant women including 79 with ICP and 300 control were included in the study. Nulliparity, history of cholestasis, and history of progesterone intake were significantly higher in the ICP group than in the control group (p<0.005, for all). Conclusion: Intake of exogenous progesterone in early pregnancy may lead to ICP and have adverse effects on the fetus. Further studies are needed to investigate the role of progesterone in the development of ICP. [ABSTRACT FROM AUTHOR]

Published
2024
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12. Plasenta previalı gebelerde acil müdahalenin risk faktörleri ve sonuçları: gözlemsel bir çalışma

Author

KELEŞ, Ayşe, AYDOĞMUŞ, Süheyla, YUCEL CELİK, Ozge, DAGDEVİREN, Gulsah, OBUT, Mehmet, ÇELEN, Şevki, and ÇAĞLAR, Ali

Subjects
antepartum hemorrhage, emergency intervention, maternal and neonatal outcomes, placenta previa, Medicine, acil müdahale, antepartum kanama, maternal ve neonatal sonuçlar, plasenta previa, Tıp
Abstract

Aim: To investigate the risk factors and outcomes of emergency intervention in pregnant women with placenta previa (PP). Material and method: This retrospective study was conducted between June 2015 and January 2021. Pregnant women with PP were divided into emergency and planned intervention groups according to surgical planning. The groups were compared in terms of demographic characteristics, presence of antepartum hemorrhage (APH), operation characteristics, and maternal and neonatal outcomes. Results: A total of 434 patients with PP were analyzed. The frequency of PP was 0.52%. The emergency intervention was performed in 168 (38.7%) pregnant women, whereas planned intervention was performed in 266 (61.3%). APH was present in 208 (47.9%) patients; the presence of APH was associated with increased risk of emergency intervention by 3.026 [95% confidence interval (CI), 1.990–4.603; p = 0.000]-fold. The weight gained during pregnancy was associated with reduced risk of emergency intervention by 0.932 (95% CI, 0.887–0.978; p = 0.004)-fold. In the emergency intervention group, more additional surgical procedures and massive transfusion were performed during the operation (p = 0.000 and p = 0.000) Emergency intervention resulted in an increase in adverse maternal and fetal outcomes by 3.064 (95% CI, 1.571–5.975) and 7.5 (95% CI, 4.841–11.620)-fold, respectively.Conclusion: The frequency of an emergency intervention is high in those with PP and is associated with increased adverse maternal and neonatal outcomes.The most effective factor in the prediction of emergency intervention is APH., Amaç: Plasenta previalı (PP) gebelerde acil müdahalenin risk faktörlerini ve sonuçlarını araştırmak. Gereç ve yöntem: Bu retrospektif çalışma Haziran 2015 ile Ocak 2021 tarihleri arasında yapıldı. PP'li gebeler cerrahi planlamaya göre acil ve planlı müdahale gruplarına ayrıldı. Gruplar demografik özellikler, antepartum kanama (AK) varlığı, operasyon özellikleri, anne ve yenidoğan sonuçları açısından karşılaştırıldı. Bulgular: PP'li toplam 434 hasta analiz edildi. Çalışma süresince PP sıklığı %0,52 idi. 168 (%38,7) gebeye acil müdahale yapılırken, 266 (%61,3) gebeye planlı müdahale yapıldı. PP’lı gebelerin 208 (%47,9)’sinde AK öyküsü vardı. Gebelerde AK öyküsünün olması acil müdahale riskinin 3.026 kat artmasıyla ilişkiliydi [%95 güven aralığı (GA), 1.990–4.603; p = 0.000]. Gebelikte kilo alımı acil müdahale riskinin 0,932 (%95 GA, 0,887–0,987; p = 0,004) kat azalmasıyla ilişkilendirildi. Acil müdahale grubunda, operasyon sırasında daha fazla ek cerrahi prosedür gerekti ve daha fazla masif transfüzyon yapıldı (p = 0.000 ve p = 0.000). Acil müdahale, olumsuz maternal sonuçlarda 3.064 (% 95 GA, 1.571-5.975) kat ve olumsuz fetal sonuçlarda 7.5 (%95 GA, 4.841–11.620) kat artışa neden oldu. Sonuç: PP'li gebelerde doğumda acil müdahale sıklığı yüksektir ve bu durum artan olumsuz maternal ve neonatal sonuçlarla ilişkilidir. Acil müdahalenin öngörülmesinde en etkili faktör AK'dir.

Published
2022

14. THE EFFECT OF CELIAC DISEASE ON PREGNANCY OUTCOME

Author

KELEŞ, Ayşe, DAGDEVİREN, Gulsah, YUCEL CELİK, Ozge, ÖZGEN, Gül, İSKENDER, Cantekin, and ÇELEN, Şevki

Subjects
Adverse outcome, celiac disease, pregnancy, Surgery, Çölyak hastalığı, gebelik, olumsuz sonuç, Cerrahi
Abstract

AmaçGenetik olarak yatkın kişilerde glutene bağlı otoimmunenteropati olarak tanımlanan Çölyak Hastalığının (ÇH)olumsuz gebelik ve yenidoğan sonuçları ile ilişkisiniaraştırmak ve glütensiz beslenmenin bu sonuçlar üzerindekietkisini incelemektir.Gereç ve YöntemRetrospektif olarak tasarlanan bu çalışma, 2017-2022yılları arasında hastanemizde doğum yapan ÇH olangebeler ile aynı dönemde doğum yapan sağlıklı gebelerarasında gerçekleştirildi. Hastaların demografik verileri,gebelik komplikasyonları, doğum haftası, doğumkilosu ve yenidoğan yoğun bakım ihtiyacı analiz edildi.BulgularÇalışma süresince 30 ÇH olan gebe tespit edildi. Kontrolgrubu 90 sağlıklı gebeden oluşturuldu. ÇH olan gebelerdematernal yaş daha yüksekti (p= 0,020). Gravide,parite, abortus ve fertilite tedavisi açısından gruplararsında farklılık saptanmadı. ÇH grubunda çoğul gebelikve plasenta previa olguları fazla görüldü (p=0,034ve p=0,003). Erken doğum ÇH grubunda anlamlı derecedefazla bulundu (p=0,000). Diğer gebelik komplikasyonlarıaçısından fark saptanmadı. Glutensiz beslenme,ÇH varlığında gebelik ve yenidoğan sonuçlarınıiyileştirmekle birlikte erken doğum kontrol grubundanhala fazla tespit edildi (p=0,006).SonuçÇH, gebelikte erken doğum ve olumsuz yenidoğansonuçları ile ilişkilidir. Glutensiz beslenme olumsuz sonuçlardaazalma yapmakla birlikte ÇH’nın varlığı erkendoğum açısından risk teşkil etmektedir., ObjectiveTo investigate the association between celiacdisease (CD), defined as gluten-induced autoimmuneenteropathy in genetically susceptible individuals, andadverse pregnancy and neonatal outcomes and toinvestigate the effects of a gluten-free diet on theseoutcomes.Material and MethodThis retrospective study was conducted betweenpregnant women with CD, who delivered in ourhospital between 2017-2022, and healthy pregnantwomen who delivered during the same period.Patient demographic characteristics, pregnancycomplications, gestational age at delivery, birth weight,and neonatal intensive care needs were analyzed.ResultsDuring the study period, 30 pregnant women withCD were identified. The control group was formedby 90 healthy pregnant women. Maternal age washigher in pregnant women with CD (p=0.020). Therewas no difference between groups in gravidity, parity,abortion, and fertility treatment. Multiple pregnanciesand placenta previa occurred more frequently inthe CD group (p=0.034 and p=0.003, respectively).Preterm births were significantly more common inthe CD group (p=0.000). There were no differencesbetween groups in other pregnancy complications.The gluten-free diet improved pregnancy and neonataloutcomes in the CD group. However, the increase inpreterm birth rate remained compared to the controlgroup (p=0.006).ConclusionCD is associated with preterm birth in pregnancy andadverse neonatal outcomes. Although a gluten-freediet reduces adverse outcomes, the presence of CDcontinues to pose a risk for preterm birth.

Published
2022

15. Can Inflammatory Indices be Used to Predict Adverse Pregnancy Outcomes in Pregnant Women with Recurrent Urinary Tract Infection?

Author

KELEŞ, Ayşe, DAGDEVİREN, Gulsah, YUCEL CELİK, Ozge, ÖZTÜRK, Azize Cemre, OBUT, Mehmet, ÇELEN, Şevki, and ÇAĞLAR, Ali

Subjects
Adverse pregnancy outcomes, inflammatory indices, recurrent urinary tract infections, tekrarlayan idrar yolu enfeksiyonları, Medicine, inflamatuar indeksler, olumsuz gebelik sonuçları, İnflamatuar indeksler, recurrent urinary tract infections Olumsuz gebelik sonuçları, Tıp
Abstract

Aim: This study aimed to investigate the utility of inflammatory indices in predicting adverse maternal and neonatal outcomes in pregnant women with recurrent urinary tract infections.Material and Methods: This retrospective study was conducted on pregnant women treated for symptomatic urinary tract infection (UTI) between 2017 and 2021. Pregnant women with two or more episodes of symptomatic UTI were included in the study group. Pregnant women with one UTI were included in the control group. The study group consisted of 91 (46.9%) patients and the control group consisted of 103 (53.1%) patients. The groups were compared in terms of clinical characteristics, adverse outcomes, and inflammatory indices.Results: It was found that more adverse maternal and neonatal outcomes occurred in the study group compared to the control group (p=0.021, and p, Amaç: Bu çalışmanın amacı tekrarlayan idrar yolu enfeksiyonu olan hamile kadınlarda inflamatuar indekslerin olumsuz maternal ve neonatal sonuçları tahmin etmedeki yararını araştırmaktır.Gereç ve Yöntemler: Bu geriye dönük çalışma, 2017 ve 2021 yılları arasında semptomatik idrar yolu enfeksiyonu (İYE) nedeniyle tedavi edilen gebeler üzerinde yapılmıştır. İki veya daha fazla semptomatik İYE atağı olan gebeler çalışma grubuna dahil edilmiştir. Kontrol grubuna tek İYE geçiren gebeler dahil edilmiştir. Çalışma grubu 91 (%46,9) hastadan ve kontrol grubu ise 103 (%53,1) hastadan oluşmuştur. Gruplar klinik özellikler, olumsuz sonuçlar ve inflamatuar indeksler açısından karşılaştırıldı.Bulgular: Kontrol grubu ile karşılaştırıldığında, çalışma grubunda daha fazla olumsuz maternal ve neonatal sonuçların meydana geldiği bulundu (sırasıyla p=0,021 ve p

Published
2022

18. Fetal intracranial hemorrhage: prenatal imaging findings and postnatal clinical outcome

Author

DAGDEVİREN, Gulsah, ERGÜN, Elif, KELEŞ, Ayşe, YUCEL CELİK, Ozge, YÜCEL, Aykan, and SAHİN, Dilek

Subjects
Fetal intrakraniyal kanama,fetal manyetik rezonans görüntüleme,intraventriküler kanama,prenatal tanı,ultrasonografi, Fetal intracranial hemorrhage,fetal magnetic resonance imaging,intraventricular hemorrhage,prenatal diagnosis,ultrasonography, Obstetrics and Gynecology, Kadın Hastalıkları ve Doğum
Abstract

Amaç: Fetal intrakraniyal kanamanın görüntüleme bulgularını ve postnatal klinik özelliklerini araştırmak.Gereçler ve Yöntem: Çalışmaya kurumumuzda 2018-2020 yılları arasında ultrasonografi ve manyetik rezonans görüntüleme ile tanı konulan fetal intrakranial kanama olguları dahil edildi. Maternal özellikler, ultrason ve manyetik rezonans görüntüleme bulguları ile postnatal sonuçlar hasta kayıtlarından elde edildi.Bulgular: Tanı anında gestasyonel yaşı 21-35 hafta olan toplam 10 olgu tespit edildi. Sekiz fetusta intraventriküler kanama, bir fetusta serebellar kanama ve birinde hem intraventriküler hem de subdural kanama vardı. Olguların %60'ında tanımlanabilir bir risk faktörü saptandı. Ultrasonografi ile yedi fetusta intrakranial kanama tanısı konurken, üç fetusta diğer endikasyonlar için yapılan manyetik rezonans görüntüleme ile fetal intrakranial kanama saptandı. İki olguda gebelik sonlandırıldı, bir adet intrauterin fetal ölüm meydana geldi ve canlı doğan yedi olgu postnatal dönemde en az altı ay süreyle izlendi. Bunların %66,6'sında nörolojik bozukluk görüldü.Sonuç: Manyetik rezonans görüntüleme fetal intrakranial kanamanın tanı ve karakterizasyonunda önemli bir rol oynar ve ultrasonografiyi tamamlayıcıdır. Bu nedenle prenatal tanıda ultrason ve manyetik rezonans görüntüleme birlikte kullanılmalıdır., Aim: To investigate imaging findings and postnatal clinical features of fetal intracranial hemorrhage.Materials and Method: Fetal intracranial hemorrhage cases detected in our institution between 2018 and 2020 by ultrasonography and magnetic resonance imaging were included. Maternal characteristics, ultrasonography and magnetic resonance imaging findings, and postnatal outcomes were noted.Results: A total of 10 cases with a gestational age of 21-35 weeks at the time of diagnosis were detected. Eight cases had an intraventricular hemorrhage, one case had a cerebellar hemorrhage, and one case had both intraventricular and subdural hemorrhage. An identifiable risk factor was detected in 60% of the cases. While intracranial hemorrhage was diagnosed by ultrasonography in seven cases, in 3 cases it was detected by magnetic resonance imaging that was performed for indications other than intracranial hemorrhage. In two cases pregnancy was terminated, one intrauterine fetal death occurred and seven cases born alive were followed up for at least six months in the postnatal period. Among these, the neurological disorder was observed in 66.6%.Conclusion: Fetal magnetic resonance imaging plays an important role in the diagnosis and characterization of intracranial hemorrhage and is complementary to ultrasonography. Hence we recommend using ultrasonography and magnetic resonance imaging together in its diagnosis.

Published
2021

21. Prenatal diagnosis of the persistent right umbilical vein, incidence and clinical significance.

Author

Dagdeviren, Gulsah, Keles, Ayse, Yücel Celik, Ozge, Yucel, Aykan, and Sahin, Dilek

Subjects
*UMBILICAL veins, *PRENATAL diagnosis, *INVASIVE diagnosis, *CARDIOVASCULAR system, *CONGENITAL heart disease
Abstract

Prenatal diagnosis of persistent right umbilical vein (PRUV) is important due to accompanying malformations. Pregnant women diagnosed with PRUV were analysed retrospectively. Intrahepatic PRUV was seen in 12 of 10.743 foetuses and its incidence was found to be 0.11%. The gestational week at the time of diagnosis was between 20 and 35 weeks. Six of the cases had additional abnormal sonographic findings (50%) and six cases (50%) were isolated. Major congenital malformations were seen in four (33.3%) foetuses, 75% of which were congenital heart disease (CHD). Genitourinary system anomaly accompanied in two cases (16.6%). Invasive diagnostic tests were applied to three pregnant women and the results were reported as normal karyotype. In PRUV cases, a detailed sonographic examination should be performed, especially the cardiovascular system. Although PRUV cases do not appear to be associated with chromosomal abnormalities, invasive diagnostic tests should be recommended in the presence of concomitant anomalies. What is already known on this subject? The persistent right umbilical vein (PRUV) is a pathological vascular anomaly, in which the left umbilical vein regresses and the right umbilical vein remains open. PRUV can occur in an isolated form that represents its normal variant or be associated with other major or minor anomalies. What do the results of this study add? Additional abnormal sonographic findings were accompanied in 50% of PRUV, major anomaly was detected in 33.3% of them and cardiovascular abnormalities constituted 75% of foetuses with major anomalies. What are the implications of these findings for clinical practice and/or further research? The presence of concomitant anomalies in PRUV cases is not rare and detailed anatomy screening should be done. The most common accompanying abnormality is seen in the cardiovascular system, so foetuses with PRUV should be evaluated by foetal echocardiography. [ABSTRACT FROM AUTHOR]

Published
2022
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22. Pregnancy Outcomes of Patients Diagnosed As Having Cleft Lip Or/and Cleft Palate In Antenatal Screening.

Author

Celik, Ozge Yucel, Obut, Mehmet, Dagdeviren, Gulsah, Keles, Ayse, Kahraman, Neval Cayonu, Yıldız, Gulsah Aynaoglu, Arat, Ozgur, and Iskender, Cantekin

Subjects
PREGNANCY outcomes, CLEFT palate, CLEFT lip, POLYHYDRAMNIOS, NEONATAL intensive care units, MEDICAL screening
Abstract

To evaluate the obstetric outcomes of extra ultrasonographic anomalies in patients with cleft lip or/and cleft (CL±P) palate. This retrospective study was conducted in a tertiary referral hospital between December 2017 and March 2021. The patients were analyzed under three groups as follows: isolated CL±P (group 1), CL±P with ultrasonographic anomalies with mild fetal and neonatal consequences (group 2), and CL±P with ultrasonographic anomalies with severe fetal and neonatal consequences (group 3). Fourty cases were analyzed. The abnormal karyotype result (16.7%) were 46,x,t (t15;16)(q26;24), monosomy 18, trisomy 13, 46, XX, 21ps +. In the central cleft, ultrasonographic anomalies were seen in nine patients, which was statistically significantly higher than in isolated CL±P (p=0.004). Seven patients with extra ultrasonographic anomalies underwent termination, one patient with anencephaly died in utero. Preterm birth was the most common obstetric complication in all groups (n=9, 27.2%). In group 3, polyhydramnios was observed statistically significantly more frequently than in group 2 (p=0.033), and the first minute APGAR score was statist ically significantly lower than in group 1 and 2 (p=0.003). The fifth minute APGAR score was statistically significantly lower and the need for the neonatal intensive care unit was statistically significantly higher than group 1 only (p=0.004 and p=0.007, respectively). Polyhydramnios is not found in isolated cases, but only in cases with additional anomalies. Patients with CL±P with either major or minor additional ultrasonographic anomalies have worse fifth minute Apgar results and a greater need for the NICU. [ABSTRACT FROM AUTHOR]

Published
2022
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23. Fetal intracranial hemorrhage: prenatal imaging findings and postnatal clinical outcome.

Author

DAGDEVİREN, Gulsah, ERGÜN, Elif, KELEŞ, Ayşe, YUCEL CELİK, Ozge, YÜCEL, Aykan, and SAHİN, Dilek

Subjects
*INTRACRANIAL hemorrhage, *ULTRASONIC imaging, *MAGNETIC resonance imaging, *PUERPERIUM, *CEREBRAL hemorrhage
Abstract

Aim: To investigate imaging findings and postnatal clinical features of fetal intracranial hemorrhage. Materials and Method: Fetal intracranial hemorrhage cases detected in our institution between 2018 and 2020 by ultrasonography and magnetic resonance imaging were included. Maternal characteristics, ultrasonography and magnetic resonance imaging findings, and postnatal outcomes were noted. Results: A total of 10 cases with a gestational age of 21-35 weeks at the time of diagnosis were detected. Eight cases had an intraventricular hemorrhage, one case had a cerebellar hemorrhage, and one case had both intraventricular and subdural hemorrhage. An identifiable risk factor was detected in 60% of the cases. While intracranial hemorrhage was diagnosed by ultrasonography in seven cases, in 3 cases it was detected by magnetic resonance imaging that was performed for indications other than intracranial hemorrhage. In two cases pregnancy was terminated, one intrauterine fetal death occurred and seven cases born alive were followed up for at least six months in the postnatal period. Among these, the neurological disorder was observed in 66.6%. Conclusion: Fetal magnetic resonance imaging plays an important role in the diagnosis and characterization of intracranial hemorrhage and is complementary to ultrasonography. Hence we recommend using ultrasonography and magnetic resonance imaging together in its diagnosis. [ABSTRACT FROM AUTHOR]

Published
2022
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24. Application of the International Classification of Diseases-Perinatal Mortality (ICD-PM) system to stillbirths:a single center experience in a middle income country

Author

Dagdeviren, Gulsah, Uysal, Nihal Sahin, Dilbaz, Kubra, Celen, Sevki, and Caglar, Ali Turhan

Abstract

The present study is intended to investigate the causes of stillbirth and its relationship with maternal conditions using the International Classification of Diseases-Perinatal Mortality (ICD-PM) system.

Published
2021
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