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Objectives: Apigenin and parthenolide as natural products have potent antioxidant and anti-inflammatory outcomes that could make them a perfect option for endometriosis therapy. This study aimed to determine the effects of apigenin and parthenolide on created endometrial implants in a rat model of endometriosis. Methods: Thirty-nine mature, female Sprague-Dawley rats were assigned randomly to six experimental groups four weeks after endometriosis induction. Group 1 (n = 5): Control (CTRL) that opened and closed the abdomen; Group 2 (n = 6): Peritoneal and ovarian endometriosis (POE) + drug-free; Group 3 (n = 7): POE+ Apigenin (APG) (50 mg/kg); Group 4 (n = 7): POE+ Parthenolide (PTL) (10 mg/kg); Group 5 (n = 7): POE+ Apigenin (APG) (50 mg/kg) + Parthenolide (PTL) (10 mg/kg); Group 6 (n = 7): POE+ DMSO. An endometriosis model was created, and histopathological analysis and biochemical evaluation were performed. Serum and peritoneal levels of pro-and-anti-inflammatory cytokine, and oxidative stress of implant tissue were measured. Results: Serum IL-37 levels decreased significantly in the APG-treated group compared to the drug-free group (p = 0.016). The peritoneum and ovary endometriosis histopathologic scores were significantly lower in APG-treated (p = 0.001) and PTL-treated (p = 0.001) groups in comparison to the drug-free group. The oxidative stress index (OSI) values were increased statistically significantly in ovary endometriosis tissue in the drug-free group, (p = 0.001). However, compared to the drug-free group, OSI values decreased statistically significantly in the APG-treated group (p = 0.003). Conclusions: The application of apigenin caused a decrease in oxidative stress and an improvement in histopathological grade. Apigenin may be a novel therapeutic agent for the treatment of endometriosis.

Malignant melanomas, often appearing on the skin, rarely metastasize to internal organs and the ovaries are the least affected site. A 45-year-old female patient presenting with a skin lesion on the right side of the neck and diagnosed with malignant melanoma through excision biopsy also appeared to have lung metastasis and a nonspecific ovarian cystic mass of 6 cm after PET-CT scan was performed. Examination revealed a mass with the widest diameter of 9 cm and a surgical decision was made due to the rapid growth pattern. Tumor markers appeared to be within the normal range. Laparoscopic right salpingoopherectomy was performed and frozen section biopsy was obtained. The result was found to be malignant and complementary surgery was performed. Pathological examination of the cystic mass, which was detected to have only nonspecific findings on radiological exam, revealed tiny solid areas in its capsule. The patient was started on postoperative Dabrafenib + Trametinib treatment by oncology and was followed up without recurrence until the 24th postoperative month. At month 24, the brain metastasis with no response to radiotherapy occurred and the patient was lost on the 15th day after decompression surgery. It is important to send adnexal masses to the frozen even if they appear to have a benign character. In patients with a known history of primary cancer, the possibility of the metastasis from the primary tumor site to the ovary should be considered in those whose peroperative frozen section result is in favor of malignancy. Our case is the first case of ovarian malignant melanoma metastasis with a completely cystic and septa-free character in the literature.

Amaç: Endometrium kanseri; Türkiye, Amerika ve Avrupa'da kadınlarda en sık görülen jinekolojik malignensidir. Genel olarak kadınlar yaşamları boyunca endomertium kanserine yakalanma riski %3-4’tür. Tedavi ve evrelemesi cerrahi olarak yapılan endometrium kanserinde cerrahi olarak seçilen genel yöntem açık cerrahidir. Çalışma; endometrium kanserinin evreleme ve tedavisinde laparotomi ile laparoskopiyi karşılaştırmayı amaçlamaktadır.Gereç ve Yöntemler: Endometrium kanseri nedeniyle evreleme cerrahisi yapılan 57 hastanın 29’unda cerrahi laparoskopik olarak, 28’inde cerrahi laparotomik olarak gerçekleştirildi. Laparoskopi grubu ile laparotomi grubunun; yaş, vücut kitle indeksi, perioperatif ve postoperatif komplikasyonları, çıkarılan lenf nodu sayıları, operasyon süresi ve hastanede kalış süresi, cerrahiye giriş ve çıkış hemoglobin değerleri karşılaştırıldı. Bulgular: Gruplar, demografik, maternal ve antropometrik açıdan değerlendirildiğinde homojen yapıda oldukları izlendi. Yalnızca laparotomik grupta parite laparoskopik gruba göre istatiksel olarak anlamlı derecede fazlaydı, gravidalar arasında fark yoktu. Operasyon süreleri, tahmini kan kayıpları, preoperatif, postoperatif hemoglobin düzeyleri, intraoperatif, ve postoperatif komplikasyonlar açısından laparoskopi ve laparotomi arasında fark saptanmadı. Laparoskopi grubunda hastanede kalış süresi anlamlı olarak kısa saptandı. Lenf nodu disseksiyonunda çıkarılan lenf bezi sayısı laparotomik cerrahide daha fazlaydı.Sonuç: Laparoskopik cerrahi endometrium kanserinde güvenilir ve uygulanabilir bir cerrahi yöntemidir. Hastanede kalış süresini azaltması, günlük yaşama çabuk dönüş avantajı olarak gözükmektedir. Buna karşı daha agresif lenf nodu disseksiyonu gerektiren ileri evre, yüksek grade, agresif tip kanserlerde, daha az lenf nodu çıkarılması dezavantaj olabilir., Aim: Endometrial carcinoma is the most frequent gynecologic malignancy in Turkey, among United States and Europe. Life time risk of a patient to have endometrial carcinoma is 3-4%. Endometrial carcinoma is staged surgically and the mostly preferred surgical method is open surgery. Aim of this study is to compare open surgery and laparoscopic surgery for treatment and surgical staging of endometrial carcinoma.Materials and Method: We included a total number of 57 patients with the diagnosis of endometrial carcinoma, including 29 operated with laparoscopic surgery and 28 cases operated with open surgery. In this study, we compared the groups in terms of age, body mass index, perioperative and postoperative complications, total lymph node number, operation time, length of hospital stay, pre and post-operative hemoglobin values.Results: There were no significant differences between the two groups among demographic and anthropometric measures. Parity was higher among the open surgery arm and this was statistically significant. There were no significant differences between the two groups in terms of operation time, blood loss, pre and post-operative hemoglobin values, intra and post operative complications. Length of hospital stay was significantly shorter in the laparoscopically managed cases than the open surgery arm. However, total number of lymph nodes dissected were significantly higher in the open surgery group.Conclusion: Laparoscopic surgery is a reliable and a feasible surgical technique in cases with the diagnosis of endometrial carcinoma. Shorter stay at hospital seems to be advantageous in terms of quality of life. Despite that, laparoscopy seems to be disadvantageous for cases with high stage, high grade, agressive type disease, becaouse of lower numbers of dissected lymph nodes.Buna karşı daha agresif lenf nodu disseksiyonu gerektiren ileri evre, yüksek grade, agresif tip kanserlerde, daha az lenf nodu çıkarılması dezavantaj olabilir.

Objective: The effect of Ulipristal Acetate on endometriosis foci created in rats was investigated. Methods: The study was conducted with 12-week-old rats weighing approximately 280 grams. After creating an autologous endometriosis model, the group that did not receive ulipristal acetate negative was administered with oral saline daily, and the group given ulipristal acetate positive was administered with 0.5 mg/kg (0.125 mg/rat/day) orally for 4 weeks. Ectopic endometrial tissues were removed for histopathological and immunohistochemical evaluations. Staining was performed with Hematoxylin Eosin, Ki-67, and Cyclooxygenase-2.Results: The Hematoxylin-Eosin Staining score of the ectopic endometrium surface epithelium was found to be 2.5 points in the ulipristal acetate negative group, and 0.5 points in the ulipristal acetate positive group. In the immunohistochemical evaluation, Ki-67 positivity of the ectopic endometrial surface epithelium was found to be 71.2% in the ulipristal acetate negative group vs. 31.7% in the ulipristal acetate positive group. Cyclooxygenase-2 positivity was detected as 67% in the ulipristal acetate negative group vs. 27% in the ulipristal acetate positive group.Conclusions: Hematoxylin-Eosin staining revealed that ulipristal acetate negative group was 2.5 (well-moderately preserved epithelium), and the ulipristal acetate positive group was 0.5 (epithelium was rarely present or absent). It was found that the percentage of Ki-67 and Cyclooxygenase-2 immunohistochemical positivity was decreased in the ulipristal acetate positive group compared to the ulipristal acetate negative group at a statistically significant level. More literature data are needed on this subject., Amaç: Ulipristal Asetat'ın ratlarda oluşturulan endometriozis odakları üzerindeki etkisinin araştırılması hedeflendi. Gereç ve Yöntem: Çalışma, yaklaşık 280 gram ağırlığında 12 haftalık ratlarla yürütüldü. Otolog endometriozis modeli oluşturulduktan sonra, ulipristal asetat almayan gruba günlük oral salin, ulipristal asetat verilen gruba ise 4 hafta süreyle 0.5 mg/kg (0.125 mg/rat/gün) oral yolla verildi. Histopatolojik ve immünohistokimyasal değerlendirmeler için ektopik endometriyal dokular çıkarıldı. Boyama Hematoksilen-Eozin, Ki-67 ve Siklooksijenaz-2 ile yapıldı.Bulgular: Ektopik endometrium yüzey epitelinin Hematoksilen-Eozin Boyama skoru ulipristal asetat negatif grubunda 2,5 puan, ulipristal asetat pozitif grubunda 0,5 puan olarak bulundu. İmmünhistokimyasal değerlendirmede ektopik endometriyal yüzey epitelinin Ki-67 pozitifliği ulipristal asetat negatif grubunda %71.2, ulipristal asetat pozitif grubunda ise %31,7 olarak bulundu. Siklooksijenaz-2 pozitifliği ulipristal asetat negatif grubunda %67, ulipristal asetat pozitif grubunda ise %27 olarak tespit edildi.Sonuçlar: Hematoksilen-Eozin boyaması, ulipristal asetat negatif grubunun 2.5 (iyi-orta derecede korunmuş epitel) ve ulipristal asetat pozitif grubunun 0.5 (epitel nadiren var veya yok) olduğunu ortaya koydu. Ulipristal asetat pozitif grubunda Ki-67 ve Siklooksijenaz-2 immünohistokimyasal pozitiflik yüzdesinin ulipristal asetat negatif grubuna göre istatistiksel olarak anlamlı düzeyde azaldığı bulundu. Bu konuda daha fazla literatür verisine ihtiyaç vardır.

Aim: To investigate and review retrospective and prospective randomized controlled trials about balloon catheter application for mechanical dilatation in vaginal birth after caesarian in studies published between 2011-2021 and to systematically examine the data. Instrument and Methods: Pubmed database was used and 116 randomized controlled trials were reached. All of the studies were examined and 10 studies that met the inclusion criteria were included in the review. The studies that were reached were systematised in regards to their methods and findings.Findings: When the studies were examined, it was seen that a single-balloon catheter was mostly used for mechanical dilation in vaginal delivery after cesarean section and the balloon fluid volume was 30-50 ml on average. It was determined that there was an increase in the cervical Bishop Score in the first 24 hours with the use of foley balloon catheter, and the vaginal delivery rate was 57% and the cesarean delivery rate was 43%. It has been stated that low-dose oxytocin support may be needed for the continuation of the action after cervical ripening was achieved. Compared to medical induction, no increased maternal and fetal complications were reported.Conclusion: Foley-balloon catheter is a safe and effective method for induction of vaginal birth after cesarean section. Clinicians should be encouraged to expand the use of foley-balloon catheters to reduce the inreasing rate of caesarean delivery. Cervix must be evaluated in the choice of catheter types.Key words: Vaginal birth after cesarean, previous cesarean, balloon catheter, foley, cervical ripening., Amaç: Sezaryen sonrası vajinal doğumda mekanik dilatasyon amacıyla balon kateter kullanımına yönelik 2011-2021 tarihleri arasında yayınlanmış randomize kontrollü retrospektif ve prospektif deneysel çalışmaları gözden geçirmek ve elde edilen verileri sistematik biçimde incelemektir.Gereç-Yöntem: Konu ile ilgili ‘’Pubmed’’ veri tabanı kullanılarak 116 çalışmaya ulaşıldı. Çalışmaların tümü gözden geçirilerek dahil edilme kriterlerini karşılayan 10 yayın çalışma kapsamına alındı. Ulaşılan çalışmalar, yöntemleri ve bulguları açısından sistematize edildi.Bulgular: Çalışmalar incelendiğinde sezaryen sonrası vajinal doğumda mekanik dilatasyon amacıyla yoğunlukla tek balonlu kateter uygulandığı ve sıvı volümünün ortalama 30-50 ml olduğu görülmüştür. Foley balon kateter kullanımı ile ilk 24 saatte servikal Bishop Skoru’nda artış olduğu ve vajinal doğum oranının %57, sezaryen doğum oranının %43 olduğu belirlenmiştir. Servikal olgunlaşma sağlandıktan sonra eylemin devamlılığı için düşük doz oksitosin desteğine ihtiyaç olabileceği belirtilmiştir. Medikal indüksiyona kıyasla artmış maternal ve fetal komplikasyon görülmemektedir.Sonuç: Sezaryen sonrası vajinal doğum indüksiyonunda foley-balon kateter kullanımı güvenli ve etkili bir yöntemdir. Artış eğiliminde olan sezaryen oranlarını azaltmak için foley-balon kateter kullanımının yaygınlaştırılması konusunda klinisyenler teşvik edilmelidir. Kateter seçimi için serviks mutlaka değerlendirilmelidir.Anahtar Sözcükler: Sezaryen sonrası vajinal doğum, önceki sezaryen, balon kateter, foley, servikal olgunlaşma.

Amaç: Bu çalışma kalıcı mesane kateteri olmadan sezaryen doğumun (SD) güvenliğini değerlendirmeyi amaçlamıştır. Ayrıca bu çalışmada üriner kateteri olan ve olmayan hastaların SD sonrası klinik ve idrar boşaltım özellikleri arasındaki farklılıkların karşılaştırılması da amaçlanmıştır.Gereç ve yöntemler: Bu vaka-kontrol çalışması Gazi Üniversitesi Tıp Fakültesi Hastanesi'nde Nisan ile Eylül 2021 tarihleri arasında retrospektif olarak yürütüldü. Elektif sezaryen olan toplam 40 hasta incelendi. Bu hastalardan idrar sondası kullanımına göre iki grup incelendi: idrar sondası olmayan hastalar (Grup 1 / Çalışma) ve idrar sondası olan hastalar (Grup 2 / Kontol). Sonuç ölçütleri postoperatif idrara çıkma, postoperatif mobilizasyon ve hastaların taburcu olma süresi idi.Bulgular: Grup 1'de sezaryen süresi anlamlı olarak daha uzun iken, grup 2'de postoperatif idrara çıkma, postoperatif mobilizasyon ve hastaneden çıkış süreleri anlamlı olarak daha uzundu (p, Aim: This study aimed to evaluate the safety of cesarean section (CS) without an indwelling bladder catheter. We also aimed to compare the differences of clinical and voiding characteristics in patients with or without the urinary catheter after CS.Materials and Methods: This case-control study was conducted retrospectively in Gazi University Faculty of Medicine Hospital between April and September 2021. A total of 40 patients having an elective CS were reviewed. Among these patients, two groups were analyzed according to urinary catheter use: Patients without the urinary catheter (Group 1 / Study) and patients with the urinary catheter (Group 2 / Control). Outcome measures were postoperative urination, postoperative mobilization, and the discharge time of the patients. Results: While cesarean duration was significantly longer in group 1, postoperative urination, postoperative mobilization, and the hospital discharge times were significantly longer in group 2 (p

Aim: The purpose of this article is to analyze the maternal, fetal, and obstetric outcomes of pregnancies diagnosed with coronavirus 2019 disease in the first trimester.Methods: A prospective analysis of patients diagnosed with COVID-19 during the first trimester of pregnancy and hospitalized was performed. Obstetric complications, delivery, and neonatal outcomes were reported in the following weeks of pregnancy.Results: We included seventy-five patients in the study. The mean age of pregnant women, Covid-19 positive, was 28.2 years, and the mean gestational week was 9.9 weeks. The mean delivery week was 31.65±9.47. Twenty-seven of the patients had preterm delivery. There was no neonatal Sars Cov-2 positivity among all the cases in any babies. Fifteen of twenty-nine patients with severe Covid-19 resulted in preterm delivery.Conclusion: Pregnant women with severe Covid-19 in their first trimester are at higher risk of premature birth, intrauterine fetal death, and perinatal complications, Amaç: Bu makalenin amacı, ilk trimesterde koronavirüs 2019 hastalığı tanısı alan gebeliklerin maternal, fetal ve obstetrik sonuçlarını analiz etmektir.Yöntemler: Gebeliğin ilk üç ayında COVID-19 tanısı konan ve hastaneye yatırılan hastaların prospektif analizi yapıldı. Gebeliğin sonraki haftalarında obstetrik komplikasyonlar, doğum ve neonatal sonuçlar rapor edildi.Bulgular: Yetmiş beş hastayı çalışmaya dahil ettik. Kovid-19 pozitif olan gebelerin ortalama yaşı 28.2 yıl, ortalama gebelik haftası 9.9 hafta idi. Ortalama doğum haftası 31,65±9,47 idi. Hastaların 27'si erken doğum yaptı. Hiçbir bebekte tüm olgular arasında neonatal Sars Cov-2 pozitifliği yoktu. Şiddetli Covid-19 hastası olan 29 hastanın 15'i erken doğumla sonuçlandı.Sonuç: İlk trimesterinde ağır Covid-19 olan hamile kadınlar, erken doğum, intrauterin fetal ölüm ve perinatal komplikasyon açısından daha yüksek risk altındadır.

Objective: It was aimed to investigate histopathological changes of rat uterus in experimental hyperthyroidism. Methods: 16 new adult Wistar albino female rats weighing 200-220 g were used. Group 1 (Control group) were given 3 ml distilled water for 25 days, Group 2 was given 100 µg/day of L-thyroxine dissolved in 3 mL distilled water by oral gavage for 25 days. In the uterine tissue sections, incubation was performed with the Caspase 3 primary antibody to detect apoptotic cell death and LC3B primary antibody to detect autophagic cell death. Immunositivities were evaluated and histological examination was performed.Results: In terms of apoptotic cell death, no immunopositivity was observed in both group. Differences were found between the groups in terms of autophagic cell death. It was observed that there is hyperplasia in some places in epithelial cells and the cells undergo degenerative changes. In the endometrium, edematous areas and mononuclear inflammatory cell infiltrations were noted.Conclusion: We have observed that hyperthyroidism causes edematous and inflammatory changes in the endometrium of adult rats, increases autophagy. We believe that the increase in autophagy is due to the effect of increased inflammation and impaired homeostasis. Detailed molecular studies are needed to investigate the effects of hyperthyroidism at the tissue level., Amaç: Bu çalışmada deneysel olarak dişi ratlarda oluşturulan hipertiroidinin uterus üzerinde meydana getirdiği histopatolojik değişikliklerin incelenmesi amaçlanmıştır.Yöntem: Ağırlıkları 200-220 gr olan yeni erişkin 16 adet Wistar albino dişi rat kullanıldı. Grup 1’e (Kontrol grubu) 25 gün boyunca 3 mL distile su oral yolla verildi, Grup 2’ye 25 gün boyunca 3 mL distile su içinde çözülmüş 100 μg/gün L-thyroxine oral gavaj yoluyla verildi. Uterus dokusu kesitlerinde apoptotik hücre ölümünü tespit etmek için Caspase 3 primer antikoru ile otofajik hücre ölümünü tespit etmek için ise LC3B primer antikoru ile inkübasyon uygulandı. İmmünpozitiflikler değerlendirildi ve histolojik inceleme yapıldı. Bulgular: Apoptotik hücre ölümü açısından her iki grupta da herhangi bir immunpozitiflik görülmedi. Otofajik hücre ölümü açısından gruplar arasında farklılıklara rastlandı. Epitel hücrelerinde bazı yerlerde hiperplazinin olduğu, hücrelerin dejeneratif değişimlere uğradığı gözlendi. Endometriumda ödematöz alanlara ve mononükleer inflamatuar hücre infiltrasyonlarına rastlandı.Sonuç: Hipertiroidinin erişkin rat endometriyumunda ödematöz ve inflamatuar değişikliklere sebep olduğunu, otofajiyi artırdığını gözlemledik. Otofajideki artışın artan inflamasyonun ve bozulan homeostazisin etkisinden kaynaklandığını düşünmekteyiz. Hipertiroidinin doku düzeyindeki etkilerinin araştırıldığı detaylı moleküler çalışmalara ihtiyaç vardır.

Giriş ve Amaç: Çalışmamızın amacı, gestasyonel trofoblastik hastalık (GTH) tanısı alan hastalarımızın insidansını, demografik özelliklerini, komplikasyonlarını, takip ve tedavi yaklaşımlarını güncel literatür bilgileriyle tartışılmasıdır.Gereç ve Yöntemler: Kliniğimizde 2005- 2020 tarihleri arasında histopatolojik olarak GTH tanısı alan 134 hasta geriye dönük olarak çalışmaya alındı. Bu hastaların başvuru şikâyetleri, demografik verileri, laboratuvar tahlilleri, uygulanan tedaviler, eşlik eden diğer hastalıkların varlığı, GTH histolojik alt tipi, transfüzyon ve kemoterapi ihtiyaçları değerlendirildi. Parsiyel ve komplet mol hidatiform gebelikler birbirleriyle karşılaştırıldı.Bulgular: Hastalarda ortalama yaş 29,9±7,49 olarak bulundu. Histopatolojik sonuçlara göre parsiyel mol tanılı 91 hasta (%67,9), komplet mol tanılı 37 hasta (%27,6) bulundu. İnvaziv mol bir hastada (%0,7), koryokarsinom bir hastada (%0,7), plasental yerleşimli trofoblastik tümör (PSTT) bir hastada (%0.7) tespit edildi. GTH tanısı ortalama 8. haftada konuldu. GTH hastalarında en çok A Rh (+) kan grubu, en az B Rh (-) ve AB Rh (-) kan grupları izlendi.Sonuç: Bölgesel olarak farklı insidans gösteren GTH’de erken teşhis ve uygun takip-tedavinin yapılması bu hastalıkla ilişkili morbidite ve mortalitenin önlenmesinde önemli rol oynamaktadır., Objective: The aim of our study is to discuss the incidence, demographic characteristics, complications, follow-up and treatment approaches of our patients diagnosed with gestational trophoblastic disease (GTH) with current literature.Materials and Methods: 134 patients who were diagnosed with GTD histopathologically in our clinic between 2005 and 2020 were included in the study retrospectively. Application complaints, demographic data, laboratory tests, treatments, presence of other comorbidities, histological subtype of GTD, transfusion and chemotherapy needs of these patients were evaluated. Partial and complete molar hydatiform pregnancies were compared with each other.Results: The mean age of the patients was 29.9±7.49 years. According to the histopathological results, 91 patients (67.9%) with partial mole and 37 (27.6%) patients with complete mole were found. Invasive mole was detected in one patient (0.7%), choriocarcinoma in one patient (0.7%), and placental trophoblastic tumor (PSTT) in one patient (0.7%). The diagnosis of GTD was made at an average of 8 weeks. In GTD patients, A Rh (+) blood group was the most, B Rh (-) and AB Rh (-) blood groups were the least.Conclusion: Early diagnosis and appropriate follow-up-treatment in GTD, which has a regionally different incidence, play an important role in preventing the morbidity and mortality associated with this disease.

In many countries, women’s requests for termination of pregnancy are possible within the law. Generally, this demand is met until the fetus is viable when it is born. In few countries, uterine evacuation is legally possible after the viability limit. Uterine evacuation continues to be discussed ethically and legally due to life-compatible fetus diseases and disabilities. The legislation and practice based on uterine evacuation in England and our country will be compared, the medical and other problems encountered will be evaluated., Pek çok ülkede kadınların gebeliği sonlandırma talepleri yasalar çerçevesinde mümkün olmaktadır. Genelde fetüsün doğduğunda yaşayabilir (viable) olmasına kadar bu talep karşılanır. Birkaç ülkede ise viabilite sınırı sonrasında da rahim tahliyesi yasal olarak mümkündür. Yaşamla bağdaşan fetüs hastalık ve sakatlıkları nedeniyle rahim tahliyesi yapılması etik ve yasal olarak tartışılmaya devam etmektedir. İngiltere ve ülkemizde yapılan rahim tahliyesinin dayandığı mevzuat ve uygulama karşılaştırılıp karşılaşılan tıbbi ve diğer sorunlar değerlendirilecektir.

Objectives: This study aimed to investigate the postoperative quality-of-life of patients with placental adhesion disorder undergoing a cesarean hysterectomy and partial uterine resection. Methods: This was a prospective study performed on 40 patients aged from 25 to 35 years. The subjects were divided into two groups based on whether the uterus was preserved or not following a cesarean hysterectomy and on partial uterine resection. The Turkish version of SF-36 Quality-of-life Scale consisting of 36 items and 8 subscales was applied to the patients. Results: The participants had a mean age of 31.3 ± 3.2 years. The mean parity, number of cesarean sections and body mass index was 3.45, 3.22 and 29.1 ± 2.9, respectively. The mean physical function score was 83.4 ± 11.61 in the cesarean hysterectomy group and 93.67 ± 8.55 in the partial uterine resection group. A significant difference was found between the cesarean hysterectomy and partial uterine resection groups in terms of their health-related quality-of-life (p = 0.005). Conclusions: Patients who underwent partial uterine resection had improved health-related quality-of-life compared to patients who had a cesarean hysterectomy. Choosing uterus-preserving surgery in suitable patients by evaluating the degree of placental adhesion and adhesion size may have a positive effect on the quality-of-life after surgery.

Objectives: To examine the differences in sexual functions between women using copper intrauterine device (Cu-IUD) and levonorgestrel intrauterine system (LND-IUS). Methods: A total of 125 women between the ages of 20 and 40 were included in the study. The demographic data of all participants were recorded. Female Sexual Function Index (FSFI) was performed to all participants. Study participants were divided into 3 groups; 42 Cu-IUD users, 42 LND-IUS users, and 41 control (not use contraceptive) group, then compared. Women with a total score lower than ≤ 26.5 were considered as having sexual dysfunction. Results: The prevalence of female sexual dysfunction (FSD) was 56.8% among the participants. The total FSFI scores of Cu-IUD and LNG-IUS groups were similar. Moreover, the FSFI score of both IUD users was lower than the control group, and the difference was statistically significant (p < 0.001). The presence of Cu-IUD affected arousal more than pain, satisfaction, lubrication and orgasm scores (p = 0.016). Pain score was similar among IUD groups and significantly lower than controls (p < 0.001). Moreover, orgasm and satisfaction scores were found to be significantly higher in the control group than in the both IUD groups (p < 0.001). All of three groups were also similar about desire and lubrication domains of FSFI. Conclusions: In conclusion, this study found that Cu-IUD and LNG-IUS users did not differ in terms of sexual function according to scores calculated by FSFI.

Joubert sendromu (JS), ilk olarak Marie Joubert tarafından tanımlanmıştır. Siliyopatiye ait genlerin nedensel mutasyonu ile karakterize, otozomal resesif geçişli kalıtımsal bir hastalıktır. 27 yaşında bir kadın, prenatal yapılan ultrasonografide renal kist saptanması üzerine ileri araştırma için kliniğimize sevk edildi. Ayrıntılı ultrasonografik incelemede fetal polikistik böbrek gözlendi. Korion villus örneklemesinde INPP5E mutasyonu mevcuttu.Gebeliğin 23. haftasında yapılan ultrasonografide vermis hipoplazisi, polikistik böbrek ve molar diş bulgusu mevcuttu. Bu bulguların başta joubert sendromu olmak üzere sendromik bir durum olduğu düşünüldü. MRI incelemesindeki vermis hipoplazisi, posterior fossa genişlemesi ve bilateral polikistik böbrek gözlendi ve radyolog bu durumu Dandy-Walker'a bağlı olduğu bildirildi, fakat molar diş bulgusuna dikkat etmediği anlaşıldı ve tekrar konsülte edildi. Aileye prognoz hakkında bilgi verildi ve terminasyon seçeneği sunuldu. JS'nin en yaygın karakteristik beyin görüntüsü eksenel düzlemdeki molar diş işareti (MTS), serebellar vermis (CV) hipoplazisi ve derinleşmiş interpedunküler fossadır. MTS, bu hastalık için anahtar tanısal özelliktir. Şimdiye kadar, JSRD'nin çeşitli alt tipleri için 30'dan fazla nedensel gen bulundu.Bunlardan biri INPP5E. Ekstra sinir sistemi kusurları arasında polikistik böbrek hastalığı, retina dejenerasyonu, iskelet kusurları (polidaktili gibi) ve karaciğer bozukluğu yer alır.Joubert Sendromu prenatal dönemde teşhis edilebilir. MTS prenatal dönemde ultrasonografi ile rahatlıkla görülebilir. Vermian hipoplazisi ve ek organ anomalileri olması akıla JS getirmeli ve molar diş bulgusu araştırılmalıdır., Joubert syndrome(JS), was first discovered by Marie Joubert, which is a rare autosomal recessive inherited disease belonging to ciliopathy with the causative mutation of genes. A 27-years-old woman was referred to our clinic for advanced research over the detection of fetal renal cyst.We observed policycstic kidney in detailed examination.INPP5E mutation was detected on chorion villus sampling.We were thought may be this findings will be associated with the syndrome, primarily joubert syndorme (JS),upon detection the vermis hypoplasia, policyctic kidney and molar teeth sign was observed on USG in the 23rd week of pregnancy.The vermis hypoplasia, posterior fossa expansion and bilateral polycystic kidney was seen on MRI and radiologist was reported as Dandy-Walker depend on this findings.They did not pay attention to the molar tooth finding.We were explanied prognosis and suggeted termination to the family.The family was accepted and fetus was terminated. The most common characteristic brain image of JS is the molar tooth sign(MTS) on the axial plane, cerebellar vermis (CV) hypoplasia, and a deepened interpeduncular fossa.The MTS is the key diagnostic feature for this disease. So far, more than 30 causative genes have been found for the various subtypes of JSRD.One of them is INPP5E. Defects of additional extra-nervous systems involve polycystic kidney disease, retinal degeneration, skeletal defects (such as polydactyly), and liver disorder.Joubert Syndrome can be diagnosed in prenatally period.MTS can be seen easily with usg during prenatal period.The vermian hypoplasia and additional organ anomalies must be brought to mind JS and MTS should be searched.

Cysts can occur in all body tissues, but cysts in organs other than the ovaries present symptoms more rapidly due to the resulting dysfunction. Ovarian cysts often do not cause complaints because they are not in contact with other organs and are typically detected during routine checks. Although cysts of various sizes are encountered, giant ovarian cysts are extremely rare. This report presents the case of a 36-year-old female patient admitted to our clinic with complaints of inguinal pain, abdominal swelling, and constipation. In the ultrasonographic examination, a giant cystic mass thought to originate from the left adnexal area, was observed. A decision to perform surgical operation for the left ovarian mass was made. The cystic mass, 15 × 20 cm in size and originating from the mesoileum, was excised with its wall after peroperative aspiration with a mini-phannensteil incision. Considering this case, we aimed to demonstrate that giant ovarian cysts can be confused with mesenteric cysts and that giant benign cysts can be excised with a mini-phannensteil incision., Tüm vücut dokularında kistler oluşabilir, ancak overler dışındaki organlarda oluşan kistler, disfonksiyon oluşturmaları nedeniyle semptomları daha hızlı gösterir. Over kistleri diğer organlarla temas halinde olmadıkları ve tipik olarak rutin kontroller sırasında tespit edildikleri için sıklıkla şikayete neden olmazlar. Çeşitli boyutlarda kistlerle karşılaşılsa da dev over kistleri son derece nadirdir. Bu olgu ile kliniğimize kasık ağrısı, karın şişliği ve kabızlık şikayetleri ile başvuran 36 yaşında kadın hasta sunulmaktadır. Ultrasonografik muayenede sol adneksiyel alandan kaynaklandığı düşünülen dev bir kistik kitle izlendi. Sol over kitlesi için cerrahi operasyon yapılmasına karar verildi. Mezoileumdan kaynaklanan 15 × 20 cm boyutlarında kistik kitle mini-phannensteil insizyon ile peroperatif aspirasyon sonrası, duvarı ile birlikte eksize edildi. Bu olgudan yola çıkarak dev over kistlerinin mezenterik kistlerle karıştırılabileceğini ve dev benign kistlerin mini-phannensteil insizyon ile eksize edilebileceğini göstermeyi amaçladık.

Aim: The aim of this study is to evaluate the change in the pre- and post-education knowledge levels of pregnant women who received online education during the Covid 19 pandemic period and to compare it with the antenatal classes in the pre-pandemic period.Material method: Study group consisted of pregnant women who attended the online antenatal education in pandemic period and control group consisted of pregnant women who attended antenatal classes before the pandemic. The pregnant women who completed the pre- and post-evaluation test were included to the study. In order to evaluate the effectiveness of online education, the evaluation test results of the antenatal classses were compared with the evaluation test results of the online education.Results: When the pre-evaluation and post-evaluation test results of both groups were compared, the post-evaluation test scores of both groups were found to be statistically significantly higher (p>0.01). The difference between the mean post-evaluation test results and the mean pre-evaluation test results of both groups were compared and no statistically significant difference was found between groups(p=0.148). Conclusion: It was seen that the online education was effective and the number of participants was higher., Amaç: Covid 19 pandemisi döneminde online olarak eğitim alan gebelerin eğitim öncesi ve eğitim sonrası bilgi düzey durumlarındaki değişimi değerlendirmek ve pandemi öncesi dönemdeki gebe bilgilendirme sınıfında verilen eğitimle karşılaştırmaktır.Gereçler ve Yöntem: Çalışma grubu pandemi döneminde online gebe bilgilendirme eğitimine katılan gebelerden, kontrol grubu ise pandemi öncesinde gebe bilgilendirme sınıflarına katılan gebelerden oluşmaktadır. Ön ve son değerlendirme testini tamamlayan gebeler çalışmaya dahil edildi. Online eğitimin etkinliğini değerlendirmek için gebe bilgilendirme sınıflarında yapılan eğitimin değerlendirme test sonuçları, online yapılan eğitimin değerlendirme test sonuçları ile karşılaştırıldı.Bulgular: Her 2 grubun ön değerlendirme ve son değerlendirme testi sonuçları karşılaştırıldığında, her iki grubun da son değerlendirme testi puanları istatiksel anlamlı olarak daha yüksek bulundu (p>0,01) . Her iki grubun ortalama son değerlendirme test sonuçları ile ortalama ön değerlendirme test sonuçları arasındaki fark karşılaştırıldı ve gruplar arasında istatiksel olarak anlamlı fark bulunmadı (p=0.148).Sonuç: Online gebe bilgilendirme eğitiminin etkili olduğu ve katılımcı sayısının daha fazla olduğu görüldü.

Aim: In this study, it was aimed to present a tertiary center data by examining the current risk factors, management of cases and perinatal outcomes of shoulder dystocia cases that occurred over a 5-year period.Materials and methods: Among 44522 patients who delivered vaginally between 2013 and 2018, 479 patients with shoulder dystocia at birth were evaluated. Cases were reached retrospectively using the “follow-up form in infants with shoulder dystocia” available in the birth files. In addition to sociodemographic features, ultrasonographic features, features of delivery, approaches applied in dystocia management, and postnatal features and sequelae of babies were evaluated together with their 2-year orthopedic follow-up.Results: The mean age of the women was 28.17, the mean gestational week according to LMP was 38.29, and the mean gravida was 2.34. In the 5-year evaluation of our clinic, the rate of shoulder dystocia was found to be 1.07%. In 5.1% of the cases, maternal complications were found, 14.6% had brachial plexus damage, 9.6% had clavicle fracture and 1.3% had sequelae. It was concluded that brachial plexus damage was observed in 33% of those who underwent Mc Robert's + Suprapubic compression maneuver, and the incidence of clavicle fracture was higher in posterior shoulder delivery and Mc Robert's and Rubin maneuvers.Conclusion: Sonographic measurements made by experienced obstetricians before birth are also informative in terms of maternal and neonatal morbidities. In addition, when performing maneuvers in cases with shoulder dystocia, choosing the safest maneuvers and applying them correctly may contribute to minimizing maternal and fetal complication rates., Amaç: Bu çalışmada 5 yıllık süre içerisinde gerçekleşen omuz distosisi vakalarının mevcut risk faktörlerini, vakaların yönetimini ve perinatal sonuçlarını inceleyerek bir tersiyer merkez verisi sunmak hedeflenmiştir.Gereçler ve yöntem: 2013-2018 yılları arası vajinal doğum yapan 44522 hasta arasından, doğumunda omuz distosi yaşanan 479 hasta değerlendirilmiştir. Vakalara doğum dosyalarında mevcut bulunan “omuz distosisi olan bebeklerde izlem formu” kullanılarak retrospektif olarak ulaşılmıştır. Sosyodemografik özelliklerin yanısıra ultrasonografik özellikler , doğuma dair özellikler, distosi yönetiminde uygulanan yaklaşımlarla birlikte bebeklerin doğum sonrası özellikleri ve sekel durumları 2 yıllık ortopedik takipleriyle birlikte değerlendirilmiştir.Bulgular: Kadınların yaş ortalaması 28.17, SAT’a göre gebelik haftası ortalaması 38.29 hafta, gravida ortalaması 2.34’tür. Kliniğimizin 5 yıllık değerlendirmesinde omuz distosisi oranı %1,07 olarak bulunmuştur. Vakaların %5.1’inde maternal komplikasyon görülmüş olup, %14.6’sında brakiyal pleksus hasarı bulunmakta, %9.6’sının klavikula kırığı bulunmakta, %1.3’ünün sekeli ise bulunmaktadır. Mc Robert’s + Suprapubik bası manevrası uygulananların %33’ünde brakiyal pleksus hasarı izlendiği ve arka omuz doğrultulması, Mc Robert’s ve Rubin manevralarında ise klaviküla kırığı görülme oranı diğerlerinden yüksek olduğu sonuçlarına ulaşılmıştır.Sonuç: Doğum öncesi tecrübeli obstetrisyenler tarafından yapılan sonografik ölçümler de maternal ve neonatal morbiditeler açısından fikir vericidir. Ayrıca omuz distosisiyle karşılaşılan vakalarda manevralar uygulanırken en güvenli manevraların seçilip doğru şekilde uygulanması maternal ve fetal komplikasyon oranlarını en aza indirmeye katkı sağlayabilir.

Aim: It was aimed to determine whether neutrophil/lymphocyte ratio, platelet/lymphocyte ratio and mean platelet volume are predictors of cardiovaskular risk in postmenopausal women.Material and Method: Postmenopausal patients without cardiovascular disease were included in our study. Body mass indexes were calculated by measuring height and weight, hemogram and lipid profile analyzes were made and carotid intima thickness was measured. According to these values, it was analyzed whether there was a significant difference between the group with high cardiovascular risk and the group with low risk in terms of neutrophil/lymphocyte ratio, platelet/lymphocyte ratio and mean platelet volume values.Results: 158 female patients were included in our study. Total cholesterol, triglyceride, low density lipoprotein and lymphocyte levels as well as bilateral carotid intima thicknesses were found to be significantly higher in the group with a body mass index of ≥30. While there was no significant difference between the two groups in terms of neutrophil count, platelet count, mean platelet volume, neutrophil/lymphocyte ratio and high-density lipoprotein levels, the platelet/lymphocyte ratio was found to be lower in the group with BMI ≥30.Conclusion: In our study postmenopausal patients without cardiovascular disease were divided into two groups as high and low risk for the development of cardiovascular disease and compared. The result of the study showed that these inflammatory markers are not significant markers in predicting risk in patients who have not yet manifested the disease., Amaç: Postmenopozal dönemindeki kadınlarda nötrofil/lenfosit oranı, trombosit/lenfosit oranı ve ortalama trombosit hacminin kardiyovasküler riski öngören birer belirteç olup olmadıklarının tespit edilmesi hedeflenmiştir.Gereç ve Yöntem: Kardiyovasküler hastalığı olmayan, postmenapozal dönemindeki hastalar çalışmamıza dahil edilmiştir. Boy ve kilo ölçümleri yapılarak vücut kitle indeksleri hesaplanmış, hemogram ve lipid profili analizleri yapılmış ve karotis intima kalınlıkları ölçülmüştür. Bu değerlere göre kardiyovasküler riski yüksek olan grup ve düşük olan grup arasında nötrofil/lenfosit oranı, trombosit/lenfosit oranı ve ortalama trombosit hacmi değerleri açısından anlamlı farklılık olup olmadığı analiz edilmiştir. Bulgular: Çalışmamıza 158 kadın hasta dahil edilmiştir. Vücut kitle indexi ≥30 olan grubun total kolesterol, trigliserid, düşük yoğunluklu lipoprotein ve lenfosit düzeyi ve ayrıca bilateral karotis intima kalınlıkları anlamlı olarak daha yüksek bulunmuştur. İki grup arasında nötrofil sayısı, trombosit sayısı, ortalama trombosit hacmi, nötrofil/lenfosit oranı ve yüksek dansiteli lipoprotein düzeyleri açısından anlamlı farklılık tespit edilemezken, trombosit/lenfosit oranı VKİ ≥30 olan grupta daha düşük bulunmuştur.Sonuç: Çalışmamızda kardiyovasküler hastalığı olmayan postmenopozal dönemdeki hastalar kardiyovasküler hastalık gelişimi açısından yüksek ve düşük riskli olarak ikiye ayrılarak kıyaslanmıştır. Çalışmanın sonucu bu inflamatuar belirteçlerin henüz hastalık tablosu ortaya çıkmamış hastalarda risk öngörmede anlamlı belirteçler olmadığını göstermiştir.

Background/Aim: No consensus on the optimal stimulation protocol for increasing in vitro fertilization (IVF) treatment's success rate in patients with diminished ovarian reserve is available. This study aimed to compare IVF outcomes in patients with diminished ovarian reserve (DOR) stimulated with a luteal phase estradiol (E2) priming protocol versus the standard antagonist protocol.Methods: This retrospective cohort study included 603 patients who underwent intracytoplasmic sperm injection cycles (ICSI) after the diagnosis of DOR and who were stimulated with the luteal E2 priming protocol (E2 priming group; n = 181) or the standard antagonist protocol (antagonist group; n = 422). Groups were compared in terms of demographic characteristics, ovarian stimulation results, ICSI cycle outcomes, clinical pregnancy, and live birth rates per embryo transfer. Results: The duration of ovarian stimulation was longer, and the total gonadotropin dose used was significantly higher (P = 0.001) in the E2 priming group than in the antagonist group. The number of embryos transferred was higher in the antagonist group when compared with E2 priming group (0.87 (0.75) versus 0.64 (0.49); P = 0.01), but no statistically significant difference in terms of embryo quality between groups was found (P > 0.05). The cycle cancellation rate, clinical pregnancy, and live birth rates per embryo transfer were similar in both groups.Conclusions: No difference between IVF outcomes in the patients diagnosed with DOR who were stimulated with the antagonist protocol and the luteal E2 priming protocol was detected. The antagonist protocol might be considered more advantageous because of the shorter treatment duration and lower doses of gonadotropin. This protocol also allows more embryos to be transferred. Additional randomized controlled trials are needed to verify these findings.

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.

The aim of this study was to assess the effect of continued smoking before and during pregnancy on mid-trimester fetal head development. A total of 250 pregnant women enrolled in the study. All participants were confirmed to be smokers or non-smokers by verifying breath carbon monoxide readings. Biparietal diameter (BPD), head circumference (HC), lateral ventricle (LV), and cisterna magna (CM) were evaluated by ultrasound between 20-22 weeks of pregnancy. Gender and gestational age-adjusted BPD z- scores were not statistically different between smokers and non-smokers (-0.75 ± 1.6 vs -0.51 ± 1, p = .3). HC measurements and z- scores were significantly lower in the smoking group than in the non-smoking groups (183.38 ± 14.56 vs. 189.28 ± 12.53, p = .003, 0.18 ± 1.39 multiple of median (MoM) vs. 0.56 ± 0.92, respectively, p = .023). At linear regression analysis, maternal smoking was the only independent factor associated with fetal HC z score (p = .041). In conclusion, continued smoking during pregnancy reduces fetal HC and has no effect on BPD, LV, or CM measurements at mid-gestation.IMPACT STATEMENTWhat is already known on this subject? Smoking during pregnancy is one of the most common environmental factors affecting fetal and neonatal growth and well-being. Despite the well-known effects of smoking on somatic growth, current studies have shown that it selectively affects some parts of the fetal brain, even in appropriately growing fetuses.What do the results of this study add? Continued smoking during pregnancy reduces fetal HC and has no effect on BPD, LV or CM measurements at mid-gestation. Since smoking is well known for its early and late childhood behavioral and neurological consequences, smaller mid-trimester fetal HC measurements should bring maternal smoking to mind as one of the potentially reversible causes.What are the implications of these findings for clinical practice and/or further research? The harmful effects of smoking start before the third trimester and antenatal counseling should be started early in the gestation. Every effort should be made to quit smoking before or early in pregnancy.

A 25-year-old female patient applied to our clinic with a complaint of a growing mass in external genitalia. Patient’s complaint began 10 years ago as a small papillomatous lesion in the right labia majora, which increased in size progressively reaching to present size of 20-30 cm in 2-3 years after the first symptom. The mass was prediagnosed as vulvar soft fibroma, and surgical excision was decided. The histopathological findings were compatible with fibroepithelial polyp .The patient had no postoperative complication, and there was no residue or recurrence at the last assessment on postoperative 3rd month., 25 yaşında kadın hasta kliniğimize dış genital bölgede büyüyen kitle şikayeti ile başvurdu. Hastanın şikayeti 10 yıl önce sağ labia majorada küçük bir papillomatöz lezyon olarak başlamış ve ilk semptomdan 2-3 yıl sonra giderek artan şekilde 20-30 cm olarak günümüz büyüklüğüne ulaşmıştır. Kitleye vulvar soft fibrom ön tanı konuldu ve cerrahi eksizyona karar verildi. Histopatolojik bulgular fibroepitelyal polip ile uyumluydu. Hastanın postoperatif komplikasyonu yoktu ve postoperatif 3. ayda yapılan son değerlendirmede rezidü veya rekürrens yoktu.

Endometrial stromal sarkom (ESS), genellikle perimenopozal kadınlarda görülen uterusun nadir bir malign tümörüdür. Bu olguda akut ağır vajinal kanama ve şiddetli anemi ile başvuran 42 yaşında jinekolojik muayeneyi ve endometriyal örneklemeyi reddeden bir kadın hastayı ele aldık. Transabdominal ultrasonografik değerlendirmede uterusun fundal bölgesinde 9x6 cm boyutlarında intramural submuköz kitle tespit edildi. ESS tanısı, ameliyat öncesi leiomyom olduğu düşünülen tümörün frozen kesiti ile tesadüfen konuldu. Jinekolojik Onkoloji Bölümü ile intraoperatif konsültasyon sonrası total histerektomi ve bilateral salpenjektomi yapıldı. Nihai patolojik raporun ardından hastaya tedavinin sonlandırılması için bilateral ooferektomi önerildi., Endometrial stromal sarcoma (ESS) is a rare malignant tumour of the uterus that usually occurs in perimenopausal women. Such a case was a hospitalized 42-year-old woman with acute heavy vaginal bleeding and severe anaemia. The patient refused to have a gynaecological examination and endometrial sampling. However, during the transabdominal ultrasonographic evaluation, an intramural submucous mass of 9 cm × 6 cm was detected in the fundal area of the uterus. The diagnosis of ESS was discovered unexpectedly by examining a frozen section of the tumour that was thought to be leiomyoma preoperatively. After intraoperative consultation with the Gynaecologic Oncology Department, total hysterectomy and bilateral salpingectomy were performed. Once the final pathological report was presented, the patient was recommended to have bilateral oophorectomy in order to proceed with the treatment.

Amaç: Üreme çağındaki kadınlarda en sık karşılaşılan jinekolojik problemlerden biri de primer dismenoredir. Dismenore, kadınlarda fizyolojik ve psikolojik etkilerinin yanı sıra günlük yaşam aktiviteleri ve yaşam kalitesi üzerine de olumsuz etkileri olan jinekolojik bir sorundur. Bu nedenle bu çalışmanın amacı primer dismenore semptomlarıyla baş edebilmek için kullanılan tamamlayıcı ve destekleyici yöntemlere ilişkin kanıta dayalı uygulamaların sistematik analizini yapmaktır.Gereç ve Yöntemler: Bu sistematik derleme PRISMA (2009) sistematik derleme yöntemi kullanılarak, Cochrane, Pubmed, Medline, ScienceDirect, CiteSeerx, EBSCOhost, Scopus, CINAHL ve ULAKBİM veri tabanlarının incelenmesiyle oluşturuldu. Derlemeye 2010-2020 yılları arasında, yayın dili Türkçe ve İngilizce olan, orijinal, tam metni bulunan ve PDF formatındaki randomize kontrollü deneysel 32 araştırma dahil edildi. Literatür tarama sonucu 2944 çalışmaya ulaşıldı. Tarama 16 anahtar sözcük kullanılarak gerçekleştirildi. Bulgular: Literatür taraması sonucunda primer dismenore ile baş etmede kullanılan tamamlayıcı ve destekleyici yöntemlere ilişkin çalışmaların en fazla İran'da olduğu ve en çok da zencefil ve aromaterapi uygulamalarının primer dismenoreye olan etkilerinin araştırıldığı bulundu. Ayrıca aeorobik egzersiz, aromaterapi, yoga, akupressur, lokal ısı uygulaması, transkutanöz elektriksel sinir stimülasyonu, balık yağı, D vitamini ve E vitamini kullanımının en fazla kullanılan ve kanıt düzeyi yüksek olan tamamlayıcı ve destekleyici yöntemler olduğu; esneme egzersizi, akupunktor, zencefil, hipnoz, refleksoloji uygulamalarına ilişkin daha fazla randomize kontrollü deneysel çalışmalara ihtiyaç olduğu bulunmuştur. Sonuç: Primer dismenoresi olan kadınların, dismenore semptomları ile baş edilebilmeleri ve analjezik kullanımının azaltılabilmesi için farmakolojik yöntemlere göre yan etkileri daha az olan hem ucuz hem de güvenilir tamamlayıcı ve destekleyici yöntemlere ilişkin geniş örneklem üzerinde çalışılmış daha fazla randomize kontrollü deneysel çalışmalara ihtiyaç vardır., Aim: Primary dysmenorrhea is the most common gynecological problems among women of reproductive age. Dysmenorrhea is a gynecological problem with negative effects on daily life activities and quality of life as well as physiological and psychological effects in women. Therefore, the aim of this study is to systematically analyze the evidence-based practices regarding complementary and supportive methods used to cope with symptoms of primary dysmenorrhea.Materials and Methods: This systematic review was created using the PRISMA (2009) systematic review method.The study was conducted by scanning Cochrane, Pubmed, Medline, ScienceDirect, CiteSeerx, EBSCOhost, Scopus, CINAHL ve ULAKBİM databases. In this systematic review, was included between 2010-2020 in Turkish and English languages, original, with full texts and in PDF format 32 randomized controlled experimental studies . A total of 2944 articles were reached. The scanning was carried out using 16 key words.Results: As a result of the literature search, it has been found that the majority of studies on complementary and supportive methods used in coping with primary dysmenorrhea are in Iran and mostly, the effects of ginger and aromatherapy applications were investigated on primary dysmenorrheaIn the study has been found that aerobic exercise, aromatherapy, yoga, acupressure, local heat application, transcutaneous electrical nerve stimulation, fish oil, vitamin D and vitamin E are used the most and the level of evidence is high.In addition, it has been determined that there is a need on randomized controlled experimental studies in stretching exercises, acupunctor, ginger, hypnosis and reflexology applications.Conclusion: Women with primary dysmenorrhea in order to cope with the symptoms of dysmenorrhea and reduce the use of analgesics , there is a need for randomized controlled experimental studies that have been studied with a larger number of samples intended for complementary and supportive methods on both cheap and reliable.

Aim: It has been shown that fasting serum bile acid (SBA) levels above 40 µmol/L are better in predicting adverse perinatal outcomes in women with a diagnosis of intrahepatic cholestasis of pregnancy (ICP) in many studies in the literature. We aimed to measure the relationship between disease severity and adverse perinatal outcomes between groups according to serum SBA levels (10-40 and >40 mmol/L) in patients diagnosed with ICP in our study.Materials and Method: 120 patients diagnosed with ICP were included in this retrospective study conducted in our hospital between September 1, 2019 and December 31, 2020. Obstetric outcomes, maternal and fetal complications were analyzed.Results: 88 cases with fasting SBA levels in the range of 10-40 umol/L and 32 cases with fasting SBA levels above 40 umol/L were compared. Maternal and fetal complication rates were significantly increased in the group with fasting bile acid level >40 umol/L (p40 umol/L, 1st minute and 5th minute Apgar scores were found to be statistically significantly lower, and the need for neonatal intensive care unit (NICU) increased significantly (p 40 umol/L. In particular, the significant increase in adverse pregnancy outcomes above certain SBA levels may guide clinicians to achieve better clinical outcomes in the management of pregnancies complicated by ICP., Amaç: Literatürde birçok çalışmada intrahepatik gebelik kolestazı (İGK) tanılı kadınlarda serum açlık safra asidi (ASA) düzeylerinin 40 umol/L üzerinde iken olumsuz perinatal sonuçları öngörmede daha iyi olduğu gösterilmiştir. Çalışmamızda, İGK tanısı alan hastalarda, serum ASA düzeylerine göre (10-40 ve >40 mmol/L) oluşturulan gruplar arasında hastalık şiddeti ile olumsuz perinatal sonuçlar arasındaki ilişkiyi ölçmeyi amaçladık.Gereç ve Yöntemler: 1 Eylül 2019 - 31 Aralık 2020 tarihleri arasında hastanemizde yapılan bu retrospektif çalışmaya İGK tanısı alan 120 hasta dahil edildi. Obstetrik sonuçlar, maternal ve fetal komplikasyonlar analiz edildi.Bulgular: Serum ASA düzeyleri 10-40 umol/L aralığında olan 88 olgu ile 40 umol/L’nin üzerinde olan 32 olgu karşılaştırıldı. Maternal ve fetal komplikasyon oranları, açlık safra asidi düzeyi >40 umol/L olan grupta anlamlı olarak artmış saptandı (p40 umol/L olan grupta 1. dk ve 5.dk Apgar skorları istatistiksel olarak anlamlı oranda düşük saptanmış olup, yenidoğan yoğun bakım (YDYB) ihtiyacı da anlamlı olarak artmış bulundu (p 40 umol/L olan İGK tanılı olgularda preterm doğum, mekonyumlu amniyon, neonatal respiratuar distres sendromu (RDS), YDYB ihtiyacı ve neonatal ölümü içeren gebelik olumsuz sonuçları istatistiksel olarak anlamlı düzeyde yüksek saptandı. Özellikle olumsuz gebelik sonuçlarının belirli ASA değerlerinin üzerinde anlamlı olarak yükselmesi, klinisyenleri İGK ile komplike olan gebeliklerin yönetiminde daha iyi klinik sonuçlar elde etmek açısından yönlendirebilir.

Amaç: Bu çalışma, COVID-19 şüphesi olan veya doğrulanmış kadınların vajinal doğumlarının ikinci aşaması sırasında kullanımı için tasarladığımız doğum masası siperliğine (DTS) ilişkin doktorların, ebelerin ve hastaların algılarını değerlendirmeyi amaçladı.Yöntemler: Bu kesitsel çift merkezli çalışmada, ikinci evrede DTS kullanımı deneyimi olan doktorlara/ebelere (n = 224) ve COVID-19 şüphesi olan veya doğrulanmış COVID-19 hastalarına (n = 154) yarı yapılandırılmış anketler uygulandı. . Tüm istatistiksel analizler, kategorik değişkenleri karşılaştırmak için ki-kare testi kullanılarak yapıldı ve ikili karşılaştırmalar ki-kare testi ile yapıldı. p değeri < 0.05 istatistiksel olarak anlamlı kabul edildi.Bulgular: Örneklemdeki sağlık hizmeti sunucularından 180'i (%80,4) DTS ile güvende hissettiğini belirtti; 204 (%91,1)'ü DTS kullanımında herhangi bir sorunla karşılaşmadığını; 171 (%76.3) DTS'nin herhangi bir obstetrik aciliyette müdahaleyi karmaşıklaştırmadığını düşündüğünü bildirdi. Hastaların 131'i (%85) kendilerini güvende hissettiklerini ve herhangi bir sorun yaşamadıklarını; 141 (%91,6)'i DTS'nin anne-bebek bağını etkilemediğini belirtmiş ve anne adaylarına DTS ile vajinal doğumu önermişlerdir.Sonuç: Çalışma, COVID-19 şüphesi olan veya doğrulanan kadınların vajinal doğumlarının ikinci evresinde DTS kullanımının, optimal doğum koşullarından ödün vermeden kadın doğum uzmanları ve ebeler için avantajlı olduğunu desteklemiştir., Objective: This study aimed to evaluate perceptions of doctors, midwives, and patients regarding our designed delivery table shield (DTS) during second stage of vaginal deliveries of women with suspected or confirmed COVID-19.Methods: In this cross-sectional double-center study, semi-structured questionnaires were administered to doctors/midwives (n = 224) and patients with suspected or confirmed COVID-19 (n = 154) with experience on use of DTS during second stage. All statistical analyses were performed using the chi-square test to compare the categorical variables and pair-wise comparisons were performed via the chi-square test. A p-value < 0.05 were considered statistically significant.Results: Of the sample healthcare providers, 180 (80.4%) stated being safe with DTS; 204 (91.1%) stated not encountering any problem using the shield; 171 (76.3 %) thought the DTS does not complicate the intervention in any obstetric urgency. 131 (85%) of patients stated feeling safe and not having any problem; 141 (91.6%) stated that DTS did not affect mother-baby bonding and suggested vaginal delivery with DTS to expectant mothers. Conclusion: The study supported that using DTS during second stage of vaginal delivery of women with suspected or confirmed COVID-19, is advantageous for obstetricians and midwives without compromising optimal labor conditions.

Aim: Second to fourth digit (2D:4D) ratio is used as an indicator of androgen exposure in fetal life. It is known that the differentiation of urogenital tract and finger length are both controlled by Homeobox genes (HoxA and HoxD). Therefore, factors that are connected with anthropometric characteristics of fingers are expected to be in relation with urogenital anatomy, depending on genetic and hormonal basis. Aim of the study is to evaluate the correlation between 2D:4D ratio and urethrovaginal space measurements.Materials and methods: In this prospective cohort study, digital anthropometric measurements of hands and ultrasonographic measurements of urethrovaginal space were evaluated and the correlation between these parameters were assessed in a sample of women in reproductive period.Results: A significant negative correlation was detected between both right and left hand 2D: 4D ratio and length of urethrovaginal space (p=0.007 and p=0.003, respectively). The thickness of urethrovaginal space at proximal, middle and distal segment was also correlated negatively with 2D:4D ratio for both hands. Conclusion: The findings of the current study have shown a correlation between 2D: 4D ratio and urethrovaginal space measurements. The insights gained from these data will serve as a base for future research about the relationship between 2D:4D and female genital anatomy. The present study has also provided additional evidence with respect to anatomical features of UVS., Amaç: İkinci- dördüncü parmak uzunlukları oranı (2D:4D), fetal yaşamda androjen maruziyetinin bir göstergesi olarak kullanılır. Ürogenital sistem ve parmak uzunluğunun farklılaşmasının Homeobox genleri (HoxA ve HoxD) tarafından kontrol edildiği bilinmektedir. Bu nedenle parmakların antropometrik özellikleri ile bağlantılı faktörlerin genetik ve hormonal temele bağlı olarak ürogenital anatomi ile ilişkili olması beklenir. Bu çalışmanın amacı 2D:4D oranı ile üretrovajinal aralık ölçümleri arasındaki korelasyonun değerlendirilmesidir.Materyal ve yöntem: Bu prospektif kohort çalışmada üreme dönemindeki otuz bir kadının sonuçları değerlendirilmiştir. Ellerin dijital antropometrik ölçümler ve üretrovajinal aralığın ultrasonografik ölçümleri yapılmış, bu parametreler arasındaki korelasyon değerlendirildi.Bulgular: Sağ ve sol el 2D:4D oranı ile üretrovajinal boşluk uzunluğu arasında anlamlı negatif korelasyon saptandı (sırasıyla p=0,007 ve p=0,003). Proksimal, orta ve distal segmentteki üretrovajinal boşluğun kalınlığı da her iki el için 2D:4D oranı ile negatif korelasyon gösterdi.Sonuç: Mevcut çalışmanın bulguları 2D:4D oranı ile üretrovajinal boşluk ölçümleri arasında bir ilişki olduğunu göstermiştir. Bu verilerden elde edilen içgörüler, 2D:4D ve kadın genital anatomisi arasındaki ilişki hakkında gelecekteki araştırmalar için bir temel teşkil edecektir. Bu çalışma ayrıca UVS' nin anatomik özelliklerine ilişkin ek kanıtlar sağlamıştır.

Amaç: Gebelik süreci kadının kendini algılayışını etkilemektedir. Bunun yanında gebenin üriner inkontinans sorunu yaşaması gebeye ek zorluklar getirmektedir. Gebelerin üriner inkontinansa bağlı olarak yaşadığı sorunların gebelik deneyimlerini etkileyebileceği düşünülmektedir. Bu çalışmada son trimesterdeki gebelerin inkontinans yaşama durumları ve gebelik deneyimlerinin incelenmesi amaçlanmıştır.Yöntemler: Prospektif tanımlayıcı nitelikteki bu araştırma Türkiye’nin güneydoğusunda yer alan bir ilde, Kadın Hastalıkları ve Çocuk Hastanesi Kadın Doğum Polikliniği’ne antenatal takip için başvuran gebeler üzerinde yapılmıştır. Araştırmaya 30-39. gebelik haftasında olan ve araştırmaya katılmayı kabul eden 143 gebe dahil edilmiştir. Araştırmada veri toplama araçları olarak, “Gebe Tanıtım Formu”, “Aşırı Aktif Mesane Değerlendirme Formu”, “Gebelik Deneyimleri Ölçeği” ve “İnkontinans Etki Anketi” kullanılmıştır. Araştırmaya ait veriler IBM SPSS 26.00 paket programı ile değerlendirilmiştir. İstatistiksel anlamlılık düzeyi p, Objective: Pregnancy affects the self-perception of women. Besides, having problems such as incontinence brings additional difficulties to the pregnant woman. It is thought that the problems regarding incontinence experience may affect the pregnancy experience of pregnant women. In this research, it is aimed to investigate the pregnancy experiences and urinary incontinence experiences of pregnant women who were in the third trimester.Methods: This prospective descriptive study was conducted in the obstetrics and gynecology department of a Women’s and Children's Health Hospital in a city in the southeast of Turkey. Totally 143 pregnant women were recruited who were in 30-39th gestational age and voluntary to participate in this study. “Pregnant Women Introduction Form”, “Pregnancy Experience Scale”, “Overactive Bladder Assessment Tool” and “The Incontinence Impact Questionnaire” were used as data collection tools. Research data were analyzed by using the IBM SPSS packet program. A

Aim: We aim to evaluate fetal cardiac output in intrahepatic cholestasis of pregnancy (ICP).Material and Method: Thirty-two patients with ICP and 42 healthy pregnant women were included in the study. The diagnosis of ICP was made by detecting fasting bile acid value >10 µmol/L in symptomatic pregnant women. Fetal echocardiographic evaluations were performed >34 weeks of gestation. Demographic data, fetal cardiac output, and perinatal outcomes of the patients were compared between the groups.Results: In the ICP group aspartate aminotransferase (AST), and alanine aminotransferase (ALT) were higher than the control group (p, Amaç: Gebeliğin intrahepatik kolestazında (ICP) fetal kalp debisini değerlendirmeyi amaçlıyoruz.Gereçler ve yöntem: Çalışmaya 32 ICP izlenen hasta ve 42 sağlıklı gebe dahil edildi. Semptomatik gebelerde açlık safra asidi değeri >10 µmol/L saptanması ile ICP tanısı konuldu. Fetal ekokardiyografik değerlendirmeler >34 gebelik haftasında yapıldı. Gruplar arasında hastaların demografik verileri, fetal kalp debisi ve perinatal sonuçları karşılaştırıldı.Bulgular: ICP grubunda aspartat aminotransferaz (AST) ve alanin aminotransferaz (ALT) kontrol grubuna göre daha yüksekti (p

Objectives: Aim of this study is to find out the clinical relevance of estimating paraoxonase activity of PON1 enzyme, triglyceride (TG), total cholesterol, HDL, and LDL levels in maternal serum and umbilical cord blood according to birth weight. Methods: Venous blood samples were taken from mothers just before birth. Babies were divided into four groups: normal-weight babies, premature babies, low birth weight babies, and postmature babies. The weight of the newborns was measured and cord blood was taken. The samples were looked at HDL, LDL, total cholesterol, triglyceride levels and PON1 activities. We have investigated the paraoxonase activity of the PON1 enzyme. Enzyme activity assay was obtained spectrophotometrically measurement of p‐nitrophenol at 412 nm. Results: Maternal PON1 paraoxonase activity levels in Pre-Term show a significant decrease in cases as compared to other groups. Baby PON1 paraoxonase activity levels are also found to be significantly decreased in cases concerning the Term and Post-Term groups. There was a significant difference in all values the such as baby's weight, TG, Total cholesterol, HDL, LDL and PON1.belonging to babies (p < 0.05). Conclusions: Decreased paraoxonase activity in maternal serum may be considered as an additional risk factor for the development of low birth weight. It appears that PON1 activity plays an important role in infant development and affects birth weight. We think that the paraoxonase activity of the PON1 enzyme in mothers may be a marker in predicting the babies who are at risk in terms of birth weight.

Background/Aim: Not only because of the deterioration of the general condition of pregnant women, but also considering the extra burden of long hospitalizations, in patients with hyperemesis alternative treatments become even more important. The aim of this study was to determine whether medical hypnosis is an effective and tolerated treatment for nausea and vomiting of pregnancy thus can be a good alternative to medical therapy for pregnant women with severe hyperemesis that would require hospitalization.Methods: A cross sectional study was conducted with 40 pregnant women who were hospitalized for hyperemesis gravidarum between 6-20 weeks of pregnancy. The PUQE test was performed in a face-to-face interview to determine nausea and vomiting severity. All patients were given the same medical treatment and hypnosis was performed with alternate patients after stabilization, by the same trained hypnotist. After the day of hypnosis all patients were again given the PUQE test. The groups were compared according to PUQE test results, the length of hospital stay and the time of first enteral feeding.Results: The groups were similar in terms of socio-demographic characteristics. The median PUQE scores were lower and the median hospitalization time was significantly shorter in the hypnosis group (P

Introduction: Skin to skin contact is applied in vaginal and cesarean section and many of its positive effects are already known. In this study we aimed to investigate the effects of skin to skin contact on birth hormones and expulsion time of the placenta in spontaneous vaginal deliveries. Methods: The study comprised 40 women who applied to the Department of Obstetrics and Gynecology of XXX. The study group experienced continuous SSC and the control group received standart care with separation of the newborn. Expulsion time of the placenta was noted and blood samples pre- and postpartum were withdrawn for levels of oxytocin, β-endorphine and catecholamine. Results: The mean age of mothers in the case group was 28.55±5.97, the mean age of mothers in the control group was 26.75±6.58. The seperation time of the placenta was statistically significant shorter in the study group when compared to the control group. Levels of oxytocin and catecholamine were similar both pre-and postpartum between study and control groups. β-endorphine levels were similar postpartum but significantly higher in the prepartum period in the study group.Discussion and Conclusion: Skin to skin contact at birth is a factor affecting the separation time of the placenta without disturbing the balance between birth hormones. Health professionals should be informed and awareness about skin to skin contact should be increased in the early postpartum period. Health care providers working in the delivery room, namely midwives, nurses and doctors should be aware of the many advantages of skin to skin contact immediately after birth in low risk deliveries. Additional advantage of rapid detachment of the placenta without changing equilibrium of birth hormones should be kept in mind as well., Giriş ve Amaç: Ten tene temas vajinal ve sezaryen doğumlarda tercih edilen ve pek çok olumlu etkisi bilinen bir uygulamadır. Bu çalışmada vajinal doğum sonrasında ten tene temasın plasenta ayrılma süresi ve doğum hormonları üzerine olan etkisini araştırnayı planladık. Yöntem ve gereçler: Çalışmaya XXXX kadın hastalıkları ve doğum kliniğine başvuran 40 gebe dahil edildiç çalışma grubunda doğum sonrası kesintisiz ten tene temas uygulandı, control grubunda anne ve bebek ayrıldı.Plasentanın ayrılma süresi not edildi ve doğum öncesi doğum sonrası kan örneklerinde oksitoain, β-endorfin ve katekolamin düzeyleri ölçüldü. Bulgular: Kadınların ortalam yaşı çalışma grubunda 28.55±5.97, control grubunda 26.75±6.58 idi. Plasentanın ayrılma süresi çalışma grubunda istatistiksel olarak anlamlı biçimde daha kısa bulundu. Oksitosin ve katekolamin seviyeleri hem çalışma hem control grubunda pre ve postpartum dönemde benzerdi. β-endorfin seviyeleri postpartum dönemde iki grup arasında benzerdi ancak prepartum dönemde çalışma grubunda istatistiksel olarak anlamlı biçimde daha yüksektir. Tartışma ve Sonuç: Doğum sonrası uygulanan ten tene temas doğum hormonları arasındaki dengeyi bozmadan plasenta ayrılma süresini kısaltmaktadır. Sağlık çalışanları ten tene temasın önemi hakkında bilgilendirilmeli ve uygulama erken postpartum dönemde yaygınlaştırılmalıdır. Doğum salonunda çalışanlar yani ebe, hemşire ve doktorlar ten tene temasın pek çok avantajının yanısıra plasenta yarılma süresini kısaltması ve doğum hormonlarına etki etmemesi konusunda da bilgilendirilmelidir.

Research question: Can cannabidiol (CBD) be used in the treatment of endometriosis for its anti-inflammatory, antioxidative and antiangiogenic effects? Design: Endometrial implants were surgically induced in 36 female Wistar albino rats. After confirmation of endometriotic foci, the rats were randomized into four groups. In the leuprolide acetate group, rats were given a single 1 mg/kg s.c. leuprolide acetate injection. The other groups were 5 mg/kg CBD (CBD5), saline solution and 20 mg/kg CBD (CBD20); daily i.p. injections were administered for 7 days. After 21 days, the rats were euthanised, and total antioxidant status (TAS), total oxidant status (TOS), oxidative stress index (OSI), interleukin-6 (IL-6) and tumour necrosis factor-alpha (TNF-a) measurements in blood and peritoneal fluid samples, and immunohistochemical staining for TNF-a, IL-6 and vascular endothelial growth factor (VEGF) of endometriotic tissues were evaluated. Results: Significant reductions in the endometriotic implant surface area (P = 0.0213), serum TOS (P = 0.0491), OSI (P = 0.0056), IL-6 (P = 0.0236), TNF-a (P = 0.0083) and peritoneal fluid OSI (P = 0.0401), IL-6 (P = 0.0205) and TNF-a (P = 0.0045) concentrations were observed in the CBD5 group when compared with the saline solution group. Compared with the saline solution group, increased TAS concentrations in serum (P = 0.0012) and peritoneal fluid (P = 0.0145) were found in the CBD5 group. The CBD5 and leuprolide acetate groups were similar regarding inflammatory and oxidative stress parameters of serum and peritoneal fluid samples. The CBD5 group showed significantly lower mean intensity in both surface epithelium and stromal cells for VEGF (both P = 0.002) and only in surface epithelium cells for IL-6 (P = 0.0108), when compared with the leuprolide acetate group. Conclusion: Due to its anti-inflammatory, antioxidative and antiangiogenic effects, CBD might be a therapeutic agent candidate for endometriosis. Department of Biostatistics ; Reakiro Company ; Bezmialem Vakif University

Purpose: In this study, it is aimed to reveal the output, trends and important developments of researches globally by bibliometric analysis of joint publications on Human Papilloma Virus (HPV) vaccine and cervical cancer. Methods: It is a bibliometric visualized study using the Web of Science (WoS) database. A search query was made with keywords. As a result of the search, 158 out of 923 articles were excluded because they did not meet the specified criteria. 771 articles were analyzed. VOSviewer 1.6.12 was used to visualize bibliometric analyzes and network analysis was performed. Calculated values were presented as frequency (n) and percentage (%). Results: It was found that the most common publications on HPV vaccine and cervical cancer were in 2021 (n=94). In the countries with the highest number of research articles, the USA is in the first place with 281 research articles, followed by the UK and Australia. Our country, Turkey, had 16 publications in this field. The first magazine “Vaccine” and “PLOS one” published about 11% of its articles. The three most frequently used keywords were “cervical cancer”, “human papillomavirus” and “HPV”. Conclusion: In recent years, the number of studies focusing on HPV vaccine and cervical cancer has increased. It is seen that developed countries have done the most studies on the subject. To improve the global output of research in this area, it would be beneficial to establish strong research cooperation between developing and developed countries.

AMAÇ: Gebelikte anatomik, fonksiyonel ve immun değişiklikler idrar yolu enfeksiyonu riskini artırmaktadır. Gebelik göreceli olarak immun yetersizlik durumu ortaya çıkarır. İmmun sistemin düzgün işlemesinde elzem olan çinko elementinin eksikliği beraberinde daha fazla genitoüriner enfeksiyon riskini de getirir. Bu araştırma gebelikte ilk trimester çinko değerleri ile idrar yolu enfeksiyonu arasındaki ilişkiyi değerlendirmek amacıyla yapılmıştır.GEREÇLER VE YÖNTEM: Ekim 2019 ve Ekim 2020 tarihleri arasında Özel Etlik Lokman Hekim hastanesine gebelik takibi amacıyla başvuran 184 hasta üzerinde retrospektif olarak yapılan bu çalışmada hastalardan gebeliğin ilk trimesterinde bakılan serum çinko seviyesi değerlendirildi. Çinko seviyesine göre hastalar düşük ve normal değere sahip olmak üzere iki gruba ayrıldı. İdrar yolu enfeksiyonu ile çinko seviyesi arasındaki ilişki incelendi. BULGULAR: Çalışmaya dahil gebe populasyonunda ilk trimesterde çinko eksiklik oranı %35,9 olarak bulunmuştur. İdrar yolu enfeksiyonu ile serum çinko seviyesi arasındaki ilişki istatistiksel olarak anlamlı değildir (p=0,562). Çinko içeren multivitamin kullanımı hastaların serum çinko seviyesinde istatistiksel olarak anlamlı değişiklikler oluşturmasına rağmen (p=0,039) multivitamin kullanımı ile idrar yolu enfeksiyonu arasındaki ilişki anlamlı değildir (p=0,073). Hasta yaşı artıkça idrar yolu enfeksiyonu riskinin azaldığı izlenmiştir (p=0,041).SONUÇ: Çalışma yaptığımız popülasyonda hastaların %35,9’unda ilk trimester çinko seviyesi normal değerin altındadır. Ancak çinko seviyesi ile idrar yolu enfeksiyonu arasında istatistiksel olarak anlamlı bir ilişki yoktur. Çinko içeren multivitamin kullanımı idrar yolu enfeksiyonu riskini azaltmamıştır. Ancak multivitamin kullanmayan hastalarda çinko seviyesi kullanan gruptan daha düşüktür., AIM: The risk of urinary tract infection increases in pregnancy due to anatomical, functional and immune changes. Pregnancy causes relatively immune deficiency. The deficiency of the zinc element, which is essential for the proper functioning of the immune system, brings with it more risk of genitourinary infections. This study was conducted to evaluate the relationship between the first trimester zinc values and urinary tract infection. .MATERIALS AND METHOD: In this retrospective study conducted on 184 patients who were admitted to the Private Etlik Lokman Hekim Hospital for pregnancy follow-up between October 2019 and October 2020, the serum zinc level of the patients in the first trimester of pregnancy was evaluated. The patients were divided into two groups according to the zinc level as low and normal values. The relationship between urinary tract infection and zinc level was analyzed.RESULTS: The first trimester zinc level is below the normal value in 35.9% of the patients in the population we studied. The relationship between urinary tract infection and serum zinc level is not statistically significant (p=0.562). Although the use of a zinc-containing multivitamin creates statistically significant changes in the serum zinc level of the patients (p=0.039), the relationship between multivitamin use and urinary tract infection is not significant (p=0.073). It was observed that the risk of urinary tract infection decreased as the age of the patient increased (p=0.041).CONCLUSION: In the population we studied, 35.9% of the patients had first trimester zinc levels below the normal value. There is no statistically significant relationship between zinc level and urinary tract infection. The use of a zinc-containing multivitamin did not reduce the risk of urinary tract infections. However, in patients who do not take a multivitamin, the zinc level is lower than the group taking it.

Amaç: Bu çalışmanın amacı stres üriner inkontinansın cerrahi tedavisinde uygulanan trans obturatuar tape (TOT) ve Burchoperasyonlarını postoperatif rezidüel volüm, seksüel fonksiyon ve inkontinans skorları açısından karşılaştırmaktır.Gereç ve Yöntem: Çalışma prospektif gözlemsel olarak dizayn edildi. Eylül 2014- Ocak 2018 tarihleri arasında ürinerinkontinans cerrahisi uygulanan olgular dahil edildi. Trans obturatuar tape ve Burch uygulanan hastalar postoperatifrezidü miktarı, Arizona Sexual Experiences Scale (ASEX) ve International Incontinence Questionnaire-Incontinence ShortForm (ICIQ-SF) açısından karşılaştırıldı. İstatistiksel analiz için student t, mann-whitney u, wilcoxon testleri uygulandı.P, Aim: Aim: This study aims to compare trans obturator tape (TOT) and Burch operations performed for the surgical treatmentof stress urinary incontinence in terms of postoperative residual volume, sexual function and incontinence scores.Material and Method: The study was designed as prospective observational. Cases who underwent urinary incontinencesurgery between September 2014 and January 2018 were included. Patients who underwent trans obturatory tape andBurch were compared in terms of postoperative residue, Arizona Sexual Experiences Scale (ASEX) and InternationalIncontinence Questionnaire-Incontinence Short Form (ICIQ-SF). Student t, Mann-Whitney u, Wilcoxon tests were usedfor statistical analysis. P

Amaç: Doğum şekli ve parite sayısının pelvik organ prolapsusu (POP) ve üriner inkontinans (UI) gelişimine etkisini araştırmak.Gereç ve yöntem: 2007-2012 yılları arasında POP ve UI ameliyatı geçiren 1500 kadın geriye dönük olarak değerlendirildi. Dışlama kriterlerinden sonra 875 kadın dahil edildi. POP ameliyatı öyküsü olan 353 kadın, POP ameliyatı olmayan 129 kontrol ile karşılaştırıldı ve anti-inkontinans ameliyatı öyküsü olan 201 hasta, böyle bir ameliyatı olmayan 192 kontrol ile karşılaştırıldı. Olası faktörlerin POP ve UI gelişimi üzerindeki çoklu etkisi lojistik regresyon ile belirlendi.Bulgular: POP grubu ve kontroller ile anti inkontinans cerrahisi grubu ve kontrollerin özellikleri parite sayısı dışında benzerdi. Parite sayısı arttıkça POP ameliyatı olma riski daha yüksekti. En yüksek risk, 5 ve daha fazla doğum öyküsü olan kadınlarda bulundu. UI için multiparite bir risk faktörü olarak göründü, ancak inkontinans cerrahisine girme riski artan parite sayısı ile artmadı. Doğum şekli, hem POP hem de anti-inkontinans grubu için bir risk faktörü değildi.Sonuç: Parite sayısı arttıkça POP riski artar ve multiparite de UI için bir risk faktörüdür. Birden fazla doğum planlayan kadınlar bu durumdan haberdar edilmelidir. Doğum modunun etkisi net olarak gösterilmediğinden, pelvik taban disfonksiyon insidansının uygun obstetrik bakım ile azaltılabileceğine inanıyoruz., Aim: To investigate the effect of delivery mode and parity number on development of pelvic organ prolapse (POP) and urinary incontinence (UI).Materials and methods: 1500 women who had undergone surgery for POP and UI between 2007-2012 were retrospectively evaluated. After exclusion criteria, 875 women were included. 353 women with history of POP surgery were compared with 129 controls who had no POP and 201 patients with history of anti-incontinence surgery were compared with 192 controls who had no such surgery. Multiple effect of possible factors on the development of POP and UI was determined by logistic regression.Results: The characteristics of POP group and the controls, as well as anti incontinence surgery group and controls were similar, except parity number. The risk of having a POP surgery was higher with increasing number of parity. The highest risk was found in women with a history of 5 and more deliveries. For UI, multiparity seemed as a risk factor, however the risk of undergoing incontinence surgery did not increase with increasing number of parity. Delivery mode was not a risk factor for either POP or anti-incontinence group.Conclusion: The risk of POP increases with increasing number of parity, and also multiparity is a risk factor for UI. Women planning more than one delivery should be informed about this concern. Since the impact of delivery mode has not been shown clearly, we believe the incidence of pelvic floor dysfunction can be decreased with proper obstetric

Amaç: Bu çalışmanın amacı doğum sonu dönemde annelerin yaşadığı stresin emzirme öz-yeterliliğe etkisini belirlemektir.Gereç ve Yöntem: Araştırma analitik ve kesitsel tiptedir. Araştırmanın verileri bir devlet hastanesinin çocuk polikliniklerinde anket formu kullanılarak toplanmıştır. Çalışma 148 anne ile tamamlanmıştır. Verilerin analizinde tanımlayıcı istatistiksel metodları, Student t Test, Pearson Ki-Kare testi ve Korelasyon t testi kullanılmıştır.Bulgular: Katılımcıların Doğum Sonu Stres Ölçeği puan ortalamaları 21-34 yaş aralığında, üniversite mezunu olan, çalışıp şuan ücretsiz izinde olan, gelir düzeyi iyi olan, çekirdek ailede yaşayan, eşi üniversite mezunu olan ve eşi çalışmayan kadınlarda daha yüksektir. Emzirme Öz-yeterlilik Ölçeği puan ortalamalarına bakıldığında ise, primigravidalarda, abortusu olanlarda ve 3 ve üzeri yaşayan çocuğu olan, gebeliği planlı olmayan, normal doğum yapan ve bebeği 36 hafta ve altında doğan kadınların puanları daha yüksek saptandı (p, Aim: The aim of this study is to determine the effect of stress experienced by mothers in the postpartum period on breastfeeding self-efficacy.Materials and Method: The research is of analytical and cross-sectional types. The data of the study were collected by using a questionnaire in the pediatric outpatient clinics of a state hospital. The study was completed with 148 mothers. Descriptive statistical methods, Student t Test, Pearson Chi-Square test and Correlation t test were used in the analysis of the data.Results: Participants’ Postpartum Stress mean score is higher for women who are between the ages of 21-34, who are university graduates, who are working but are currently on unpaid leave, have a good income, live in a nuclear family, whose spouse is university graduate and whose spouse is not working. When the mean scores of the Breastfeeding Self-Efficacy Scale were examined, it was found that the scores of primigravidas, those with abortion and those with 3 or more living children, who had no planned pregnancy, had a vaginal delivery, and whose babies were born at 36 weeks or less were higher (p

Background/Aim: Preterm labor is one of the main obstetric problems and the leading cause of neonatal mortality and morbidity. Some pregnant women at risk of preterm labor receive tocolytic therapy, but the agents used can affect maternal blood parameters and enzyme levels. Physiological changes that occur during pregnancy may cause changes in enzymatic activities. Maternal amylase, lipase, lactate dehydrogenase (LDH), and creatine kinase (CK) levels should be followed throughout pregnancy to assess any increase. This study aimed to examine maternal amylase, lipase, creatine kinase, and lactate dehydrogenase levels in pregnant women who gave term and preterm birth and determine the physiological changes that may occur with gestational age and tocolysis. Methods: The records of patients over their 24th gestational week who gave birth at the Gynecology and Obstetrics Department of Okmeydani Training and Research Hospital between July-December 2018 were reviewed in this retrospective cohort study. Their clinical findings, maternal and obstetric outcomes were noted. A total of 548 pregnant women were included in the study, who were divided into three groups: Group 1- Preterm delivery without tocolysis, Group 2- Preterm delivery with tocolysis, Group 3- Term deliveryResults: The maternal age, gravidity, history of abortion, fetal gender, amylase, and lipase values were similar between the groups (p>0.05 for all), while delivery types and cesarean section indications significantly differed (p=0.009, and p

Background/Aim: Postpartum hemorrhage (PPH) is an important cause of maternal death and morbidity worldwide. Its incidence is still increasing in some countries. This study aimed to evaluate the incidence, indications, risk factors, complications, maternal and fetal outcomes, mortality rates and management strategies of emergency peripartum hysterectomy (EPH) in women with life-threatening postpartum hemorrhage.Methods: This retrospective cohort study included 94 cases of EPH performed at tertiary obstetric center between January 2016-January 2021. The demographic data, current pregnancy and delivery mode, hysterectomy indications, operative complications, postoperative conditions, and maternal and fetal outcomes were analyzed. EPH was performed for hemorrhage which cannot be controlled with other conventional treatments within 24 hours of delivery.Results: The incidence of EPH was 1.71 per 1000 deliveries. In our study, the indications of hysterectomy were placenta previa in 47 cases (50%), placental insertion anomalies in 23 cases (24.5%), uterine atony in 22 cases (23.4%), and uterine rupture in 2 cases (2.1%). Hysterectomy was performed after vaginal delivery in 7 patients (7.4%) and during cesarean section in 87 cases (92.6%). Total and subtotal hysterectomy were performed in 88 (93.6%) and 6 cases (6.4%), respectively. Major complications occurred in 40 patients (42.6%). In total, 97.9% of the patients required a transfusion of blood and blood products. The mean postoperative hospital stay was 8.1 (6.1) days. There were two (2.2 %) maternal deaths due to pulmonary embolism and coagulopathy.Conclusion: EPH operation has high maternal morbidity and mortality but is lifesaving when performed at the appropriate time. The most common indication for EPH was placental abnormality (74.5%), followed by uterine atony (23.4%). Together with a significant increase in cesarean rates, significant increases in the frequency of placental abnormalities are remarkable. Limiting the number of cesarean deliveries will have a significant impact on reducing the risk of EPH.

Background/Aim: Serious side effects, depending on the length of the hormone-free interval and the estrogen dose, cause the discontinuation of combined oral contraceptives (COCs). Therefore, it is important to identify COCs with minimal side effects which provide effective contraception. This study aimed to compare the effects of two different drospirenone-containing oral contraceptives (COCs) on ovarian suppression, cycle control, premenstrual symptoms, pain, acne, and the incidence of side-effects.Methods: This prospective randomized controlled study was conducted with eighty women aged between 17-40 years. Patients were randomized to either 3mg drospirenone/30mcg ethinylestradiol (21/7 tablets) (Group 1) or 3mg drospirenone/20mcg ethinylestradiol (24/4 tablets) (Group 2) COCs. On Day-3 of the pre-treatment cycle, menstrual cycle patterns, serum hormone and lipid levels, menstrual complaints were recorded, followed by an evaluation of Day-21 progesterone levels, sonographic evaluation of endometrial thickness and the ovaries. Same assessment was repeated after pill use and the findings of the two cycles were compared.Results: Both COC formulations suppressed serum hormone levels, decreased endometrial thickness and reduced incidence of dysmenorrhea-dyspareunia, and acne while serum HDL-cholesterol level was increased. Progesterone, FSH and endometrial thickness were lower, and serum cholesterol level was higher in Group 2 (P=0.007, P=0.044, P

PURPOSE: Infertility is a stressful condition for couples and can affect patients\" circadian rhythm and sleep quality. The goal of this study is to assess differences in chronotype and sleep quality between infertile and fertile people. METHODS: A cross-sectional study was conducted. The infertile patient population consisted study group. Primiparous patients without any known gynecological disease who presented for routine cervical cancer screening follow-up were included in the control group. The Turkish version of the Morningness-Eveningness Questionnaire (MEQ) and Pittsburg Sleep Quality Index (PSQI) scores were evaluated between groups. RESULTS: A total of 227 patients were assessed. There were 110 patients in the study (infertile) group and 117 patients in the control (fertile) group. The evening chronotype proportion (23.6 vs. 0.9%, p < 0.001) was higher in the infertile group. The median of MEQ score was significantly higher in the fertile patients (50, IQR = 43 - 55 vs. 56, IQR = 51 - 59; p < 0.001), and the median of PSQI score was significantly higher in the infertile patients (5, IQR = 4 - 6, vs. 4, IQR = 3 - 5; p < 0.001). CONCLUSIONS: In this study, we found significantly worse sleep quality, and more evening chronotype in the patients with infertility.

Amaç: Postmenopozal osteoporozu olan ve olmayan hastalar arasında inflamatuar biyobelirteç değerlerinin ve kemik mineral yoğunluğu (KMY) ile ilişkisinin incelenmesidir.Gereç ve Yöntem: Retrospektif gözlemsel çalışmamıza Sağlık Bilimleri Üniversitesi Etlik Zübeyde Hanım Kadın Hastalıkları Eğitim Araştırma Hastanesi’ne Mayıs 2021 ve Ocak 2022 tarihleri arasında rutin kontrol için başvuran ve KMY istenen 93 hasta dahil edildi. ‘Dual Enerji X ray Absorbsiyometri (DEXA) ile yapılan KMY sonuçlarından ortalama lumbal KMY T-skoru değerine göre; T-skoru 0,05). T-skoru ile NLR, PLR ve SII değerleri arasında korelasyon izlenmedi (p>0,05).Sonuç: Çalışmamızda, postmenopozal osteoporozlu kadınlarda inflamatuar biyobelirteçler ve kemik mineral yoğunluğu arasında ilişki izlenmemiştir. Çok merkezli ve daha çok hasta sayılı çalışmalara ihtiyaç olmakla beraber, literatürdeki çalışmalar hemogram parametrelerinden elde edilen inflamatuar biyobelirteçlerin postmenopozal osteoporozun taranması ve önlenmesinde önemli bir rol oynayabileceğini göstermektedir., Objective: The aim of this study is to examine the relationship between inflammatory biomarker values and bone mineral density (BMD) in patients with and without postmenopausal osteoporosis.Material and Methods: This retrospective observational study includes 93 patients who applied to Health Sciences University Etlik Zübeyde Hanım Gynecology Training and Research Hospital for routine control and required to have BMD between May 2021 and January 2022. According to the mean lumbar BMD T-score value from the BMD results performed with Dual Energy X-Ray Absorbsiometry (DEXA); T-score 0.05). No correlation was observed between NLR, PLR and SII values and T score (p>0.05).Conclusion: In our study, no relationship was observed between inflammatory biomarkers and bone mineral density in postmenopausal women with osteoporosis. Although multicenter studies with larger numbers of patients are needed, studies in the literature show that inflammatory biomarkers obtained from hemogram parameters can play an important role in the screening and prevention of postmenopausal osteoporosis.

Gebelik ve doğum sonrası dönem, kadınlarda kilo alımının arttığı bir dönemdir. Bu dönemde alınan kilo, kadında aşırı kilolu olma veya obezite gelişimine yol açabilmekte, anne ve bebek sağlığı üzerinde uzun vadeli olumsuz sonuçlara neden olabilmektedir. Doğum sonu süreçte, lohusa eski vücut ağırlığına dönmesine yardımcı mekanizmaları kullanma konusunda, ebeler ve diğer sağlık profesyonelleri tarafından desteklenmelidir. Bu yardımcı mekanizmalardan birisi de emzirme olarak kabul edilmektedir. Postpartum sürecin getirmiş olduğu doğal bir fonksiyon olan emzirme, lohusanın önceki vücut ağırlığına dönmesi ve obezitenin önlenmesinde önemli bir aktivite olarak görülmektedir. Kilo kontrolünde emzirmenin; egzersiz ve kalori alımının kısıtlanması gibi yöntemlerle desteklenmesi, süresinin uzatılması kilo kontrolündeki başarıyı arttırmaktadır. Bu nedenle anne ve bebek sağlığına getirdiği diğer olumlu katkıların yanı sıra kadınlarda obezite oluşumunun önlenmesi için emzirmenin başlatılması ve sürdürülmesi ebeler tarafından desteklenmelidir., The pregnancy and postpartum period is a period of increased weight gain in women. The weight gained during this period may lead to the development of overweight or obesity in women and may cause long-term negative consequences on maternal and infant health. In the postpartum period, the puerpera should be supported by midwives and other health professionals to use mechanisms that help her return to her old bodyweight. One of these auxiliary mechanisms is considered to be breastfeeding. Breastfeeding, which is a natural function brought by the postpartum period, is seen as an important activity in returning the puerpera to her previous body weight and preventing obesity. Supporting breastfeeding in weight control with methods such as exercise and restriction of calorie intake and prolonging the breastfeeding period increase the success in weight control. For this reason, midwives should support the initiation and maintenance of breastfeeding in order to prevent obesity in women, as well as other positive contributions to maternal and infant health.

Purpose: An accurate assessment of a potential lymph node metastasis (LNM) is an important issue for the individual treatment of cervical cancer. The goal of the current retrospective study was to identify predictive factors of LNM in patients with cervical cancer.Materials and Methods: In this retrospective study, from 2007 to 2019, patients with cervical cancer of the International Federation of Gynecology and Obstetrics (FIGO) stage IB1-IIA2 were included. Incidences of LNM were described, and the predictive value of the risk factors for pelvic and paraaortic LNM were determined in univariate and multivariate models.Results: Among 212 patients, the number of patients with pelvic LNM was 81(38.2%), the number of patients with paraaortic LNM was 17(8%). Multivariate analysis revealed that the parametrial involvement (hazard ratio [HR]: 2.75, 95% confidence interval [CI], 1.18-6.40, p=0.019) and LVSI ([HR]: 3.83, 95% [CI], 1.76-8.38, p=0.001) were independent risk factors for pelvic LNM with cervical cancer patients. For paraaortic LNM parametrial involvement was independent risk factor on multivariate analysis ([HR]: 3.62, 95% [CI], 1.20-10.98, p=0.023). Conclusion: The predictive factors of pelvic LNM in cervical cancer patients were parametrial involvement and LVSI and for paraaortic LNM was parametrial involvement., Amaç: Serviks kanseri hastalarında lenf nodu metastazının (LNM) değerlendirmesi tedavinin bireyselleştirilmesi için önemli bir konudur. Çalışmamızın amacı, serviks kanserli hastalarda LNM'nin prediktif faktörlerini belirlemektir.Gereç ve Yöntem: Bu retrospektif çalışmaya, 2007'den 2019'a kadar Uluslararası Jinekoloji ve Obstetrik Federasyonu (FIGO) evre IB1-IIA2'nin serviks kanseri hastaları dahil edildi. LNM insidanslarıyla beraber tek ve çok değişkenli modellerde pelvik ve paraaortik LNM için risk faktörlerinin prediktif değeri belirlendi.Bulgular: Çalışmaya dahil edilen 212 hastadan pelvik LNM olan hasta sayısı 81(%38.2), paraaortik LNM'li hasta sayısı 17(%8) idi. Serviks kanseri hastalarında multivariyant analize göre parametriyal tutulum (hazard ratio [HR]: 2.75, 95% confidence interval [CI], 1.18-6.40, p=0.019) ve lenfovasküler tutulum ([HR]: 3.83, 95% [CI], 1.76-8.38, p=0.001) pelvik LNM için bağımsız risk faktörleriydi iken paraaortik LNM için parametriyal tutulum bağımsız risk faktörüydü ([HR]: 3.62, 95% [CI], 1.20-10.98, p=0.023).Sonuç: Serviks kanseri hastalarında pelvik LNM'nin prediktif faktörleri parametrial tutulum ve LVSI iken paraaortik LNM için prediktif risk faktörü parametrial tutulumdu.

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)