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25. The effect of maternal vitamin D levels on placental shear wave elastography findings in the first trimester.

Author

Artunc-Ulkumen, Burcu, Kirteke, Kenan, and Koyuncu, Faik Mumtaz

Subjects
SHEAR waves, VITAMIN D, FIRST trimester of pregnancy, VITAMIN D deficiency, FETAL growth retardation, RICKETS
Abstract

The aim of this study was to investigate the effect of maternal serum Vitamin D levels on the elasticity of placenta. Seventy-four spontaneously conceived singleton pregnancies in their first trimester were enrolled into this study. Fifty-one of them had Vitamin D deficiency (<20 ng/mL), while 23 pregnancies had Vitamin D levels ≥20 ng/mL. The placental elasticity was measured by the transabdominal Point Shear Wave Elastography (pSWE) method. In each case, the mean of 10 consecutive measurements was accepted as the mean placental elasticity value. The mean pSWE values did not significantly differ between the Vitamin D deficient group and the control group (p >.05). Placental elasticity was not found to be different in the pregnancies with Vitamin D deficiency during the first trimester. What is already known on this subject? The pSWE technique provides opportunity to determine the elasticity of any interested tissue. Placental elasticity has been found to be changed in inflammatory and fibrotic conditions such as in preeclampsia, intrauterine growth restriction or diabetes. On the other hand, Vitamin D deficiency is linked with several comorbidities such as autoimmune disorders, cancer and cardiovascular disorders. Vitamin D also plays a role in placental angiogenesis in the first trimester. Maternal Vitamin D levels are shown to be related with adverse pregnancy outcomes. What do the results of this study add? To the best of our knowledge, this study is the first assessing the association between Vitamin D levels and placental elasticity. Placental elasticity was not found to be changed by Vitamin D deficiency. What are the implications of these findings for clinical practice and/or further research? Our pilot study revealed that Vitamin D deficiency does not have any impact on placental elasticity in the first trimester. However, longitudinal studies concerning placental elasticity in subsequent trimesters are needed to support our findings. [ABSTRACT FROM AUTHOR]

Published
2021
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27. The relation between second-trimester placental elasticity and poor obstetric outcomes in low-risk pregnancies.

Author

Akbas, Murat, Koyuncu, Faik Mumtaz, Artunç-Ülkümen, Burcu, and Akbas, Gökce

Subjects
*MATERNAL health services, *ELASTICITY, *PREGNANT women, *PREGNANCY outcomes, *PLACENTA, *DESCRIPTIVE statistics, *BIRTH weight, *SECOND trimester of pregnancy, *LOGISTIC regression analysis
Abstract

Increased placental stiffness is associated with various pathological conditions. Our objective was to evaluate the relation between the second-trimester placental elasticity value in low-risk pregnant women and poor obstetric outcomes. A total of 143 pregnant women were enrolled. Placental elasticity values were measured using the transabdominal point shear wave elastography method. 10 random measurements were obtained from different areas of the placenta. The mean was accepted as the mean placental elasticity value. Logistic regression analyses were performed to identify independent variables associated with obstetric outcomes. Second-trimester placental elasticity value was significantly and positively associated with the poor obstetric outcomes (p=0.038). We could predict a poor outcome with 69.2% sensitivity and 60.7% specificity if we defined the placental elasticity cut-off as 3.19 kPa. Furthermore, in the multiple regression model, the placental elasticity value added significantly to the prediction of birth weight (p=0.043). Our results showed that the pregnancies with a stiffer placenta in the second trimester were associated with an increased likelihood of exhibiting poor obstetric outcomes. Also, placental elasticity was independently associated with birth weight. [ABSTRACT FROM AUTHOR]

Published
2021
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28. The impact of invasive prenatal testing on anxiety and sleep quality in pregnant women with a screen-positive result for aneuploidy.

Author

Akbas, Murat, Koyuncu, Faik Mumtaz, Bülbül, Yeşim, Artunc-Ulkumen, Burcu, and Çetin, Alptekin

Subjects
*TEST anxiety, *PREGNANT women, *PRENATAL diagnosis, *PRENATAL depression, *INVASIVE diagnosis, *ANEUPLOIDY
Abstract

Purpose: Prenatal anxiety has negative effects on pregnancy and neonate. Both screening tests and invasive diagnostic tests are associated with elevated anxiety level. But a normal fetal karyotype result could improve the anxiety level in high-risk patients. We hypothesized that patients who prefer follow-up without karyotyping may experience increased anxiety and sleep impairment until delivery. Our aim was to determine the effect of invasive diagnostic test decision on anxiety and sleep quality in women with a positive screening result.Methods: 132 women were included for the study and three groups were described. The invasive group consisted of women who underwent invasive procedure after a screen-positive test result, the follow-up group consisted of women who preferred non-invasive follow-up after a screen-positive result and the control group consisted of women with screen-negative test results. Participants were evaluated with the State-Trait Anxiety Inventory (STAI) and the Pittsburgh Sleep Quality Index (PSQI) after genetic counseling. They were asked for completing the same questionnaires in the third trimester to establish the course of anxiety and sleep quality throughout pregnancy.Results: STAI scores were significantly higher in both screen-positive groups than in the control group in the first evaluation (p < 0.001). STAI scores decreased in the invasive group and controls while PSQI scores did not significantly change during the course of the pregnancy. However, the anxiety level and sleep quality were worsened over time in the follow-up group.Conclusion: Screen-positive women who preferred to follow up had higher anxiety level and worse sleep quality in the later stages of pregnancy. We concluded that invasive prenatal diagnostic tests could improve anxiety and sleep quality in pregnant women with a screen-positive result for aneuploidy. [ABSTRACT FROM AUTHOR]

Published
2021
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29. Evaluation of maternal renal cortical elasticity in pregnancies with early- and late-onset preeclampsia.

Author

Akbas, Murat and Koyuncu, Faik Mumtaz

Subjects
*PREECLAMPSIA, *SYSTOLIC blood pressure, *BLOOD urea nitrogen, *ELASTICITY, *PREGNANT women, *SHEAR waves
Abstract

Objective: The current study aimed to investigate renal cortical elasticity (RCE) in early- and late-onset preeclampsia patients and compare the results with healthy controls. Materials and methods: The study consisted of 136 pregnant women. Three groups were identified as; the late-onset preeclampsia (LOP) group (n = 40), the early-onset preeclampsia (EOP) group (n = 32) and the control group (n = 64). RCE values were measured by point shear wave elastography (pSWE). Nine measurements were taken for each kidney and the mean of nine measurements was accepted as the mean RCE value for each kidney. The arithmetic mean of left and right RCE values was accepted as the overall RCE value of a subject. Groups were compared in terms of clinical and biochemical parameters, ultrasonography findings and pSWE values. Results: There was a statistically significant difference between groups in terms of overall RCE values (F[2,133] = 17.96, p <.001). Post hoc comparisons indicated that both preeclampsia groups exhibited significantly higher RCE values than the control group. However, overall RCE values were not significantly different between the EOP and LOP groups. Overall RCE values were significantly and positively correlated with systolic blood pressure (r = 0.363, p <.001), diastolic blood pressure (r = 0.347, p <.001), proteinuria (r = 0.343, p <.001), serum creatinine level (r = 0.181, p =.035), serum uric acid level (r = 0.243, p =.004) and blood urea nitrogen (r = 0.27, p =.001). Conclusion: Our study demonstrated that maternal renal cortical stiffness increased in women with preeclampsia. The increased RCE values may be indicative for the severity of preeclampsia due to positive correlations between renal cortical stiffness and systolic – diastolic blood pressure and serum creatinine level. [ABSTRACT FROM AUTHOR]

Published
2020
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30. Decreased maternal serum cortistatin levels in pregnancies with gestational diabetes mellitus.

Author

Akbas, Murat, Koltan, Semra Oruc, Koyuncu, Faik Mumtaz, Artunc Ulkumen, Burcu, Taneli, Fatma, and Ozdemir, Habib

Subjects
GESTATIONAL diabetes, ENZYME-linked immunosorbent assay, SERUM, MATERNAL age, GESTATIONAL age, NEUROPEPTIDES, BLOOD sugar, CASE-control method, INSULIN resistance
Abstract

Objective: To investigate serum cortistatin levels in women with gestational diabetes mellitus (GDM) and women with uncomplicated pregnancies.Material and methods: This case-control study consisted of 40 pregnancies with GDM and 41 healthy singleton pregnancies matched for maternal and gestational age. The maternal serum levels of cortistatin were measured with enzyme-linked immunosorbent assay and compared between groups.Results: Cortistatin levels were significantly lower in GDM group (48.85 ± 20.18 versus 65.84 ± 33.98 ng/ml, p = .008). There was a statistically significant difference in cortistatin levels between different treatment modalities and control group (χ2(2) = 8.828, p = .012). Pairwise comparisons showed that diet group had significantly lower CST levels than control group (p = .012). Serum cortistatin levels were negatively correlated with serum insulin and glucose levels and HOMA-IR (r = -0.358, p = .001; r = -0.303, p = .006; r = -0.444, p < .001, respectively).Conclusion: Cortistatin levels were significantly lower in GDM pregnancies and related to serum insulin and glucose levels and HOMA-IR in pregnancy. This may help to better clarify the mechanism of GDM pathogenesis. [ABSTRACT FROM AUTHOR]

Published
2020
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31. The effect of health policies on physicians’ decisions to perform caesarean sections:evaluation of a secondary health institution

Author

ESKİCİOĞLU, Fatma, HASDEMİR, Pınar Solmaz, ÇELİK, Hakan, and KOYUNCU, Faik Mümtaz

Subjects
Sezeryan oranı,endikasyon,vaginal doğum, cesarean section rate,indication,vaginal delivery
Abstract

Amaç: Sezaryan oranlarının Dünya Sağlık Örgütü’nün (WHO) önerdiği %15 düzeyine düşürülebilmesi için başta Sağlık Bakanlığı olmak üzere Türk Jinekoloji ve Obstetri Derneği (TJOD) gibi sivil toplum örgütleri yoğun çaba harcamaktadır. Bu uygulamaların ilimizde, doğum sayısı çok yüksek olan ikinci basamak sağlık kuruluşundaki etkilerini araştırmayı amaçladık. Gereç ve yöntem: Çalışma Manisa-Merkez Efendi Devlet Hastanesinde (eski adıyla Manisa Doğumevi) 2007- 2012 yılları arasında yapılan doğumları kapsamaktadır. Araştırma iki dönem olarak yapıldı; Grup-1; 2007-2008- 2009 yılları, Grup-2; 2010-2011-2012 yıllarını içermektedir. Bu dönemlerde olan doğum sayıları ve sezeryan değerlendirmeye alındı. İstatiksel analiz için X² testi kullanıldı. p, Purpose: The Ministry of Health and the Turkish Obstetrics and Gynaecology Association have been working hard to lower the rate of caesarean sections to %15 as recommended by the World Health Organization (WHO). In order to reach this target, the Ministry of Health introduced new policies. The aim of this research was to evaluate the effects of these policies on secondary health institutions with high birth rates in our region. Materials and methods: Our research included hospital records of deliveries made between 2007 and 2012 in Manisa Merkez Efendi State Hospital (formerly; Manisa Doğumevi). The research was carried out in two periods; Group-1 included 2007-2008-2009 years and Group-2 included 2010-2011-2012 years. The number of births and caesarean sections were evaluated during this period. X ² test was used for the statistical analysis and p value of

Published
2014

34. Hiperemezis Gravidarum’lu Gebelerin Hastalıkları Hakkında Düşünceleri Ve Gereksinimleri

Author

YANIKKEREM, Emre, ÇALIM, Selda İldan, GÖKER, Aslı, KOLTAN, Semra Oruç, and KOYUNCU, Faik M

Subjects
Hiperemezis Gravidarum,Kusma,Bulantı, Hyperemesis Gravidarum,Nausea,Vomiting
Abstract

The objective of this study is to describe the experiences and needs of women with Hyperemesis Gravidarum (HG), to explore severity of symptoms of the condition, to determine the psychological and social dimensions of the condition and to understand how Turkish women deal with nausea and vomiting during pregnancy. This descriptive study was carried out at Merkez Efendi Hospital and Celal Bayar University Faculty of medicine between the dates of January and December 2011 in women who were hospitalized for HG and agreed to participate in the study. The sample of the research is composed of 215 pregnant women. The data was collected by using a questionnaire which was prepared by the researchers. Data was gathered through a face to face interview with the women in their room. Statistical analyses were undertaken using SPSS version 17.0 and descriptive analysis was used for statistical evaluation. Nearly half of the women believed that nausea and vomiting was dangerous for themselves and their baby, respectively (52.6%, 47.4%) and 66.5% believed that they should be hospitalised. Pregnants who had nausea and vomitting symptoms preferred resting and eating something salty to reduce the symptoms. The majority (87.4%) stated that HG affected their daily activities, 55.3% the relations with their spouses and 67.9% were psychologically affected. When the problems during hospital stay were questioned 83.7% were tired, 82.8% had loss of appetite, 78.1% was bored and 59.1% had weight loss. HG is an important health problem that adversely affects the social and family life of women. Health care providers should recognize and validate the need for pregnant women to make changes in lifestyle that will enable them to achieve comfort., Bu çalışmanın amacı Hiperemezis gravidarum (HG) tanısı alan gebelerin yaşadıkları deneyimler ve gereksinimleri, yaşanan semptomların şiddeti, bu hastalığın fiziksel, psikolojik ve sosyal açıdan etkileri ve gebelerin bulantı ve kusma ile baş etme yöntemlerinin belirlenmesidir. Bu tanımlayıcı çalışma Merkez Efendi Hastanesi ve Celal Bayar Üniversitesi Tıp Fakültesinde Ocak ve Aralık 2011 tarihleri arasında HG tanısı ile hospitalize edilen ve çalışmaya katılmayı kabul eden gebelerde gerçekleştirilmiştir. Çalışma örneklemi 215 gebe kadından oluşmaktadır. Bu araştırmada literatür doğrultusunda araştırmacılar tarafından hazırlanan anket formu kullanılmıştır. Veriler yüz yüze görüşme tekniği ile kadınların odalarında toplanmıştır. İstatistiksel analizlerde SPSS 17.0 versiyonu kullanılarak ve tanımlayıcı analizler ile veriler değerlendirilmiştir. Gebelerin yaklaşık yarısı (%52.6) bulantı ve kusmanın sağlığı için, %47.4'ü bebek için tehlikeli olduğuna, gebelerin %66.5'i bulantı ve kusma yaşayan gebelerin hastaneye yatması gerektiğine inanmaktadır. HG olan gebelerin bulantı ve kusmayı azaltmak için istirahat etmeyi ve tuzlu bir şeyler yemeyi daha fazla tercih ettikleri belirlenmiştir. Gebelerin %87.4'ü kusma bulantının günlük yaşam aktivitelerini, %55.3'ü eşi ile olan ilişkilerini, %67.9'u psikolojik durumunu etkilediğini belirtmiştir. Gebelere hastanede yattığı süre boyunca yaşadıkları sorunlar sorulduğunda, %83.7'si yorgunluk, %82.8'i iştahta azalma, %78.1'i can sıkıntısı, %59.1'i kilo kaybı yaşadığını belirtmiştir. HG kadınların sosyal ve ailevi yaşantılarında olumsuz etkilere yol açan önemli bir sağlık sorunudur. Bu hastalara bakım verenlerin hastanın gereksinimlerinin farkında olmaları ve hastanın konforunu sağlayacak yaşam tarzı değişikliklerini sağlamaları son derece önemlidir.

Published
2014

35. EKTOPİK GEBELİK TEDAVİSİ: 74 OLGUNUN RETROSPEKTİF DEĞERLENDİRİLMESİ

Author

GÖKER TAMAY, Aslı, YILDIRIM, Yasemin, ORUÇ KOLTAN, Semra, ADIYEKE, Mehmet, and KOYUNCU, Faik

Subjects
Ektopik gebelik,metotreksat,β-HCG
Abstract

Amaç: Ektopik gebelik tedavisinde farklı olgularda farklı tedavi yaklaşımlarının ve etkinliğinin incelenmesi amacıyla retrospektif olarak olguların değerlendirilmesidir. Gereç ve yöntem: Kasım 2006 – Temmuz 2009 tarihleri arasında Celal Bayar Üniversitesi Hastanesi Kadın Hastalıkları ve Doğum Kliniğinde ektopik gebelik tanısı alan ve tedavi edilen 74 olgu retrospektif olarak incelendi. Bulgular: Kliniğimizde ektopik gebelik tanısı almış 44 hasta sistemik metotreksat tedavisi, 23 hasta cerrahi ve 7 hasta noninvazif nonmedikal bekleyici yaklaşım ile tedavi edilmiştir. Metotreksat tedavisine yanıt %90.9 olarak bulunmuştur. Cerrahi endikasyonları rüptür ve kornual gebelik olarak saptanmıştır. Sonuç: Ektopik gebeliğin erken ve doğru tanısı mortalite ve morbiditeyi önlemek için önemlidir. Tedavide metotreksat uygulaması, cerrahi girişim ve bekleyici yaklaşım doğru hastalarda uygulandığında başarı oranları komplikasyon gelişmeden yüksek olmaktadır.

Published
2011

42. BNecessity of Preoperative Endometrial Sampling for Hysterectomies With Benign Indications

Author

TAMAY, Aslı, Yıldırım, Yasemin, Buğday, Sultan, Koltan, Semra, GÜVENAL, Tevfik, Koyuncu, Faik, Altaş, İrem, and KANDİLOĞLU, Ali

Subjects
urogenital system, Histerektomi,endometriyal örnekleme,preoperative
Abstract

Aim. The purpose of this study is to investigate whether preoperative endometrial sampling is necessary for hysterectomies with benign indications. Material and Methods. Sixty-eight cases which had hysterectomy for benign indications at Celal Bayar University Department of Obstetrics and Gynecology between 2005 and 2008 were investigated retrospectively. All subjects had had D&C before the surgery. Data about age of subjects, hysterectomy indications, endometrial sampling results and endometrial findings of hysterectomy materials were collected from patient files and pathology reports. Preoperative and postoperative endometrial pathology results were compared. Results. The mean age of the patients was 47 (±8.0). Hysterectomy indications were myoma uteri in 50 cases, resistant bleeding in 12 cases, adnexial mass in 5 cases and retention of intrauterin device in 1 case. Preoperative endometrial samplings resulted in normal endometrium, proliferative endometrium, secretory endometrium, endometrial hyperplasia, endometrial polyp, chronic endometritis and insufficient material, none of the results was endometrial cancer. Postoperative pathologies of the endometrium were proliferative endometrium, secretory endometrium, endometrial hyperplasia, inactive endometrium, atrophic andometrium, basal endometrium, endometrial polyp and other diagnosis. Discussion: Preoperative endometrial sampling is not necessary for cases planned to undergo hysterectomy for benign indications., Aim. The purpose of this study is to investigate the necessity of preoperative endometrial sampling for hysterectomies with benign indications. Methods. Sixty-eight cases that had hysterectomy for benign indications at Celal Bayar University Department of Obstetrics and Gynecology between 2005 and 2008 were investigated retrospectively. All subjects had undergone dilatation and curettage ( D&C) under surface anesthesia before the surgery. Data about age of subjects, hysterectomy indications, endometrial sampling results and endometrial pathology findings of hysterectomy materials were collected from patient files and pathology reports. Preoperative and postoperative endometrial pathology results were compared. Results. The mean age of the patients was 47 (±8.0). Hysterectomy indications were myoma uteri in 50 cases, resistant bleeding in 12 cases, adnexal mass in 5 cases and retention of intrauterine device in 1 case. Preoperative endometrial samplings revealed proliferative endometrium, secretory endometrium, endometrial hyperplasia, endometrial polyp, chronic endometritis and insufficient material, but not endometrial cancer. Postoperative pathologies of the endometrium were proliferative endometrium, secretory endometrium, endometrial hyperplasia, inactive endometrium, atrophic endometrium, basal endometrium and endometrial polyp. Conclusion. Preoperative endometrial sampling is not necessary for cases planned to undergo hysterectomy for benign indications.Key words: Hysterectomy, endometrial sampling, preoperativeÖzetAmaç. Bu çalışmanın amacı benign nedenlerle histerektomi planlanan olgularda operasyon öncesi endometriyal örneklemenin gerekliliğini değerlendirmektir. Yöntem. 2005-2008 yılları arasında Celal Bayar Üniversitesi Kadın Hastalıkları ve Doğum Anabilim Dalı'nda benign nedenle histerektomi yapılan 68 olgu retrospektif olarak incelendi. Olguların hepsine operasyon öncesi yüzeyel anestezi ile dilatasyon ve küretaj (D&C) uygulanmıştı. Olguların yaşları, histerektomi endikasyonları, endometriyal örnekleme sonuçları ile histerektomi materyalindeki endometriyum bulguları verileri hasta dosyaları ve patoloji raporlarından elde edildi. Preoperatif ve postoperatif endometriyum bulguları karşılaştırıldı. Bulgular. Olguların yaş ortalamaları 47 (±8.0), histerektomi endikasyonları 50 olguda myoma uteri, 12 olguda tedaviye dirençli kanama, 5 olguda adneksiyel kitle ve 1 olguda rahim içi araç retansiyonu idi. Preoperatif endometriyal örnekleme bulguları proliferatif endometrium, sekretuar endometrium, endometrial hiperplazi, endometrial polip, kronik endometrit ve yetersiz materyal şeklinde olup endometriyal kanser saptanmadı. Postoperatif endometriyal bulgular proliferatif endometrium, sekretuar endometrium, endometriyal hiperplazi, inaktif endometrium, atrofik endometrium, bazal endometrium ve endometriyal polip şeklinde idi. Sonuç. Bu çalışmada benign nedenlerle histerektomi planlanan olgularda operasyon öncesi endometriumun örneklenmesinin gerekli olmadığı görülmüştür.Anahtar sözcükler: Histerektomi, endometriyal örnekleme, preoperative

Published
2010

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