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Aim: Our aim is to evaluate the effect of nifedipine on fetoplacental hemodynamic parameters. Methods: A retrospective study was conducted at a tertiary center with 30 patients for whom nifedipine treatment was used as a tocolytic therapy for preterm labor. Initiation of this treatment was at 31.6±2.5 weeks of gestation. We combined the pulse Doppler imaging parameters with grayscale imaging via the Bernoulli theorem, which is called the "continuity equation", to get the fetoplacental perfusion (FPP). Evaluated parameters were the resistance index (RI), the pulsatility index (PI), systole/diastole ratios (S/D), the velocity-time integral of the umbilical artery (VTI), the radius of the umbilical artery, the peak systolic velocity and the mean pressure gradient in the umbilical artery. From these parameters, the FPP was acquired. Results: We found that the RI, the PI and the S/D ratio did not change after treatment with nifedipine. The mean pressure gradient, the VTI and the peak systolic velocity increased after treatment with nifedipine. Nifedipine increases FPP from 166±73.81 beat.cm3/min to 220±83.3 beat.cm3/min. Discussion: Although nifedipine had no effect on the PI, the RI or the S/D, it increased the mean pressure gradient, the VTI and FPP. [ABSTRACT FROM AUTHOR]

Aim Our aim was to evaluate the obstetric outcomes of isolated oligohydramnios during the early-term, full-term, and late-term periods, and to determine the optimal timing of delivery. Methods A retrospective study was performed at a tertiary center. Isolated oligohydramnios cases were divided into early-term, full-term, and late-term groups. Evaluated outcomes were fetal birthweight, 5-min Apgar score < 7, meconium-stained amniotic fluid, neonatal intensive care unit admission, transient tachypnea of newborn (TTN), requirement of ventilator, newborn jaundice, mode of delivery, induction of labor, and undiagnosed small-for-gestational-age fetus before delivery. Composite outcome was defined as perinatal outcomes taken together (neonatal intensive care unit admission, TTN, requirement of ventilator, and newborn jaundice). Results The study period included 1213 cases of term isolated oligohydramnios. Within this cohort there were 347 early-term, 781 full-term and 85 late-term patients. The cesarean rate and the rate of newborn jaundice were higher in early-term cases (37.8% and 3.5%, respectively) than in full-term cases (30.1% and 0.9%, respectively). Meconium-stained amniotic fluid was higher in late-term than full-term cases. Timing of delivery did not affect occurrence of TTN, 5-min Apgar score < 7, ventilator requirement, or composite outcome. In total, 15-17% of isolated oligohydramnios cases involved undetected small-for-gestational-age fetuses. Conclusion As this study was not a randomized controlled trial, a decisive conclusion may not be possible. However, until well-designed controlled studies are conducted, expectant management may be appropriate up to the full-term period and induction of labor may be appropriate management when the full-term period is reached. [ABSTRACT FROM AUTHOR]

This paper investigates the effect of idiopathic polyhydramnios on the intrapartum and postpartum characteristics of labour and early neonatal outcomes. In this study, intrapartum and early neonatal outcomes of 207 women with idiopathic polyhydramnios and 336 matched healthy pregnant patients were evaluated. In the case of idiopathic polyhydramnios, the active phase of labour became longer when compared to the control group (5.76 ± 3.56 h vs. 4.38 ± 2.8 h, p: 001). The risk of preterm birth (OR 5.23; 95% CI: 2.04-13.42) and caesarean section (OR 2.26; 95% CI: 1.56-3.28) was higher in women with IP. Patients with IP had a higher rate of transcient tachypnoea of the newborn (TTN), newborn resuscitation, admission to neonatal intensive care unit (NICU), ventilator requirement, newborn jaundice, newborn hypoglycaemia and structural anomalies. IP did not cause any appreciable maternal risk during the intrapartum or postpartum periods. However, neonatal morbidity and post-natal anomaly rates were higher in the case of IP. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to evaluate the risk factors for clavicle fracture concurrent with brachial plexus injuries.Methods: A retrospective study was conducted at a tertiary centre. The hospital records of 62,288 vaginal deliveries were evaluated retrospectively. There were 35 cases of brachial plexus injury. Of these patients, nine had brachial plexus injuries with clavicle fracture and 26 without clavicle fracture. The analysed risk factors for clavicle fracture concurrent with brachial plexus injury were gestational diabetes, labour induction and augmentation, prolonged second stage of labour, estimated foetal weight above 4000 g, birth weight above 4000 g, risky working hours, and the requirement of manoeuvres to free the impacted shoulder from behind the symphysis pubis.Results: Labour augmentation with oxytocin increased the risk of clavicle fracture in cases of brachial plexus injury (OR 6.67; 95% CI 1.26-35.03). A birth weight higher than 4000 g also increased the risk of clavicle fracture. Risky working hours, gestational diabetes, estimated foetal weight higher than 4000 g, and requirement of shoulder dystocia manoeuvres did not increase the risk of clavicle fracture.Conclusions: Labour augmentation and actual birth weight higher than 4000 g were identified as risk factors for clavicle fracture in cases of brachial plexus injury. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the influence of threatened miscarriage on obstetric complications during pregnancy and early postpartum period. Methods: In this case–control study, hospital records of 12 050 first-trimester patients between January 2011 and December 2012 at the Research and Educational Hospital in Ankara, Turkey, were used. Of the 12 050 patients, 481 threatened miscarriage patients were evaluated. The control group was formed by age- and body mass index-matched cases without first trimester bleeding. Abortion, intrauterine foetal demise, preterm birth, preeclampsia, antenatal haematoma, uterine atony placental abruption and low birth-weights were compared between the study and the control group. Results: When compared with the control group, the risk of having a preterm birth (p = 0.014; OR: 1.95; 95% CI: 1.15–3.24), low-birth-weight infant (p = 0.001; OR: 2.33; 95% CI: 1.45–3.83) and abortion (p = 0.00; OR: 2.55; 95% CI: 1.62–3.91) increased in cases of threatened miscarriage. However, the risk of uterine atony was decreased (p = 0.006; OR: 0.09; 95% CI: 0.12–0.7) in the threatened miscarriage group when compared with the control group. Threatened miscarriage did not increase the risk of placenta praevia, placental abruption or intrauterine foetal demise. Conclusion: Increased complications after threatened miscarriage is probably due to the persistence of a triggering mechanism. As preterm birth and abortion rate increased, whilst uterine atony rate decreased, one of the mechanisms causing threatened miscarriage might be increased uterine contractility. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to analyze the experience of a tertiary health center about the management of adnexal masses that have been diagnosed during pregnancy or detected accidentally during cesarean delivery. Methods: This is a retrospective review of 160 women who underwent concurrent surgery for adnexal mass during cesarean section, 24 women who delivered vaginally and subsequently had surgery due to the prenatal diagnosis of adnexal mass and 10 women who underwent surgery for adnexal mass during pregnancy. Corresponding to the delivery and surgery times, 200 women who had no diagnosis of pregnancy-associated adnexal mass served as controls. Results: The women in the control group and study groups had statistically similar gestational age at delivery, birth weight and preterm delivery (p > 0.05 for all). Miscarriage was significantly more frequent in women undergoing surgery for adnexal mass during pregnancy (p = 0.001). The women who had surgery for adnexal mass during pregnancy, at the time of cesarean section and following delivery were statistically similar with respect to surgery type and histopathological diagnosis (p > 0.05 for both). Malignancy was detected in none of the patients who underwent surgery for adnexal mass during pregnancy. Acute abdomen was the indication for the emergency surgery in six patients (3.5%) who had surgery for adnexal mass during pregnancy. Four patients (2.4%) had surgery for adnexal mass during pregnancy due to the high index of suspicion for malignancy. Conclusion: The risk of malignancy was relatively lower in this cohort of adnexal masses detected during pregnancy and cesarean delivery. Surgical management of adnexal masses should be postponed to postpartum period as such management leads to an increased risk of miscarriage. Unless there is a need for emergent surgery or cancer staging, vaginal delivery should be encouraged in women diagnosed with adnexal mass during pregnancy. [ABSTRACT FROM AUTHOR]

Objective: Polyhdramnios is seen nearly 0.4%-%1.7 of the obstetric population after 24th week. About 45% of these cases etiology can not be defined. Nearly 5% of the idiopathic polyhdramios post natal structural anomaly is detected. Gastro intestinsl system, urinar system and cardiovascular system anomalies are the most seen ones. Risk of having aneuploidy is higher in idiopathic polyhdramnios. Stuides have showed that early neonatal outcomes is not well when compared with healthy one. In this study post natal anaomlies and early neonatal outcomes of idiopathic polyhdramnios were analyzed. Methods: A case control study was conducted at Etlik Zubeyde Hanım Women's Health Research and Training Hospital. 207 idiopathic polhydramios cases and 336 control group pregnant are included in the study. With postnatal anomaly early neonatal outcomes are also investigated. Early neonatal outcomes are defined as 5 minute apgar score, NICU admission, ventilator requirement, TTS, newborn hypoglycemia. Results: Rate of post natal structural anomaly is higher in idiopathic polyhdramnios group when compared with control group (%5.3 vs %0.6, p=0.001). Patients with I.P. have increased rate of TTN(%1.9 vs %0.0, p=0.021), new born ressutation, (%3.4 vs %0.3, p=0.007), need for NICU (%6.8 vs %0.3, p=0.00), need for ventilator (%2.9 vs %0.0, p=0.03), new born jaundice (%6.3 vs %0.9, p=0.00) and new born hypoglycemia (%5 vs %1.2, p=0.006). Conclusion: In idiopathic polhydramnios, although antenatal follow up do not show any abnormality postnatally, there is higher rate of having structural anomalous fetus. In our study we found that higher rate of structural anomaly at postpartum period. Although prior studies did not find higher rate of early neonatal complication, in our study we found that higher. [ABSTRACT FROM AUTHOR]

In developing countries, failing to conceive is a life crisis with effects on an individual's social life, including stigmatization, loss of social status, marital instability and even conflicts of gender. The aim of this study was to evaluate the relationship between female infertility and intimate partner violence (IPV) in Turkey. This was a cross-sectional study including women with primary infertility who were admitted to University of Health Sciences Ankara Etlik Zubeyde Hanim Health Practice Research Center Hospital between August 2014 and February 2015. IPV was assessed using an Abuse Assessment Screen. Of the 142 participants, 68 (47.9%) confirmed the presence of IPV in their lives. The most common type of violence was psychological, with a prevalence of 76.5% (n = 52), followed by physical, sexual and both physical and sexual abuse, with 17.6% (n = 12), 4.4% (n = 3) and 1.5% (n = 1) prevalence, respectively. Women of low educational and economic level and women living in a compound family were found to be at greater risk for IPV. This high prevalence indicates that Turkey requires new policy for IPV immediately. [ABSTRACT FROM AUTHOR]

Objective: One of the importatnt aspect of PPROM is subclincal infection and metabolic response of fetus to this infection. Response of fetus to this subclinical infection is know as FIRS (Fetal Inflammatory Response Syndrome). As a result of FIRS there is detoriation in the cardiac function in fetus. In the case of pprom there is also detoriation in umblical and splenic artery Doppler indices. It has been shown that after amnioinfusion there has been improvement in umblical artery Doppler indices. As a result of subclical infection and mechanical effect of fetus to amniotic vasculature there might be new vascular adaptaion and organization in umblical artery. In our study we examine effect of pprom on umbilical artery doppler indices. Methods: This was a case control study that was designed in Etlik Zubeyde Hanı m Women's Health and Tranining Research Hospital between January 2013 and July 2013. Cases were formed from the 42 patient that have the diagnosis of PPROM and control group formed from 58 pregnancy week matched healthy pregnant. Study group were formed from the pprom patient under 34 week of pregnancy without any know intrauterine growth restriction, clinical chorioamnionitis, olygohydramnios. Umbilical arter resistance and A/B indices were collected from the last measurement before the birth. Results: When the effect of duration of PPROM on umbilical artery Doppler indices evaluated, PPROM patient divided in to two group according to median value of pprom duration. The duration of PPROM have no effect on umbilical artery Doppler indices Conclusion: Preterm premature rupture of membranes have no effect on umbilical artery hemodynamic indices. Resistance indices and systole/diastole ratio did not diifer between study and control group. Yuce at al showed that in the cases of histological chorioamnionitis umbilical artery resistance increased. In our study we did not do subgroup analysis that compares subclinic chorioamnionitis with control group. In the case of subclinical chorioamnionitis this finding could be changed. There is need to be RCT trail to show exact effect of pprom on hemodynamic parameters of fetal circulation. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effects of surgical anatomical correction on lower urinary tract symptoms (LUTS) in patients with a pelvic anterior compartment defect (PACD). Methods: This prospective study was carried out on 30 women who had stage II‐IV PACD. The women were questioned regarding LUTS symptoms such as urgency, urge incontinence, frequency, hesitancy, abnormal emptying, nocturia and dysuria pre and postoperatively. After a 7‐month follow up, the comparison of LUTS symptoms with respect to their healing, existence or de novo appearance was performed using the McNemar and Bowner and Wilcoxon signed‐rank tests. Results: For the repair of ACD, 15, 8 and 7 women were operated on using site‐specific surgery, transvaginal mesh placement and anterior colporrhaphy, respectively. Surgery has significantly improved the LUTS: urgency (100 vs 26.7%, urge incontinence (70 vs 16.7%), frequency (76.7 vs 13.3%), abnormal emptying (56.7 vs 10%), hesitancy (30 vs 6.7%), nocturia (83.3 vs 60%) and dysuria (30 vs 6.7%). The differences were statistically significant (P < 0.05). Conclusions: The correctional surgery on anterior compartment defects not only maintains the anatomy but also significantly heals the LUTS. [ABSTRACT FROM AUTHOR]

One hundred and seventy-two twin-pregnant patients were enrolled. The estimated foetal weight was calculated using 19 different formulas. Ong's formula (0.954 (95%CI = 0.938/0.966)), which was designed specifically for twins, produced the highest Cronbach's alpha value followed by Hadlock II (0.952 (95%CI = 0.935/0.965)), Hadlock I (0.952 (95%CI = 0.935/0.964)), Hadlock III (0.952 (95%CI = 0.935/0.964)), Hadlock IV (0.952 (95%CI = 0.935/0.964)) and our formula (0.952 (95%CI = 0.935/0.964)), which produced the same Cronbach's alpha values for twin A. For twin B, our formula produced the highest Cronbach's alpha value (0.961 (95%CI = 0.948/0.972) followed by Hadlock II (0.960 (95%CI = 0.946/0.971)), Hadlock I (0.960 (95%CI = 0.946/0.970)), Hadlock III (0.960 (95%CI = 0.946/0.970)) and Hadlock IV (0.960 (95%CI = 0.946/0.970)). In conclusion, our formula (AC, FL) performed well in predicting the foetal weights in twin pregnancies (>24 weeks) in our study. However, it should be tested in other populations. Hadlock II (AC, FL) produced a comparable performance to Hadlock I (BPD, HC, AC, FL), Hadlock III (BPD, AC, FL) and Hadlock IV (HC, AC, FL). Hadlock II may be preferable in twin pregnancies since it is based on AC and FL only. [ABSTRACT FROM AUTHOR]