Search

Amaç: Üçüncü basamak bir doğum hastanesinde bir yılda gerçekleşen sezaryen doğumların Robson On Gruplu Sınıflandırma Sistemi kullanılarak analiz edilmesi amaçlanmıştır. Gereç ve Yöntem: 1 Ocak 2019 - 31 Aralık 2019 tarihleri arasında hastanemiz doğum salonuna kabul edilip, hastanemizde doğum yapmış olan ve herhangi bir obstetrik risk faktö rü olmayan gebeler çalışmaya dahil edilmiştir. Çalışmamız retrospektif olarak dizayn edilmiştir. Bulgular: Çalışmada 10781 doğuma ait veriler incelendi. Bu doğumların 4391’i sezaryen doğum ile gerçekleşmiştir. Tüm doğumlar içerisinde sezaryen doğum oranı %40,7’dir. Sezaryen doğum yapan gebelerin %9,3’lük kısmı Robson sınıflandırmasına göre birinci grupta, %13,6’sı Robson sınıflandırılmasına göre ikinci grupta yer almıştır. Sezaryen doğum yapan gebelerin %12,1’lik kısmı Robson sınıflandırmasına göre üçüncü grupta, %10,8’i dördüncü gruptadır. Grup 5, grup 6 ve grup 7’nin tüm sezaryen doğumlardaki oranları sırasıyla % 47,7, %2,5 ve %2,6’dır. Robson sınıflandırmasına göre Grup 9 ’un tüm sezaryen doğumlar arasındaki oranı ise %1,4’tür. Sonuç: Sonuç olarak, hastanelerin yıllık Robson On Gruplu Sınıflandırma Sistemi Formundaki yüzdelere gö re sezaryen doğumlarının izlenmesi ve değerlendirilmesi, kendi sezaryen eylem planlarını hazırlamaları ve belirledikleri sezaryen hedefine gö re kalite notlarının değerlendirilmesi de sezaryen oranının azaltılması hedefine katkı sağlayacaktır.

Aims:To evaluate the clinical characteristics that distinguish the leiomyoma variants from the ordinary ones, as well as the recurrence risk and patterns of these tumors.Methods:This retrospective, case-control study included women diagnosed with uterine leiomyoma between 2009 and 2019 at a tertiary referral center in Turkey. The clinical characteristics of patients diagnosed with cellular leiomyoma (CL), leiomyoma with bizarre nuclei (LBN), mitotically active leiomyoma (MAL), and ordinary leiomyoma (OL) were examined. Disease recurrence and patterns of variants were evaluated.Results:Among the 1,581 women with uterine leiomyoma, the incidence of CL, LBN, and MAL were 2.9%, 1.2%, and 1.3%, respectively. The occurrence for a single mass (63% in CL, 78.9% in LBN, 61.9% in MAL, 38.8% in OL; p=0.001) was more common, and the diagnosis of intramural leiomyoma (67.4% in CL, 73.7% in LBN, 71.4% in MAL, 90.8% in OL; p=0.002) was less frequent in the leiomyoma variant groups compared with the OL group. Recurrent leiomyosarcoma was observed in one woman with MAL.Conclusions:This study showed that single mass rate was higher and intramural leiomyoma rate was lower in leiomyoma variants than in ordinary variants. Although rare, leiomyoma variants carry a risk of malignant recurrence after hysterectomy, suggesting the need for long-term follow-up.

Endometrial hyperplasia is a process of endometrial proliferation that results in a thickening of the endometrial tissue. Melatonin might be able to change the pathophysiological process and prognosis into a positive way that might prevent and heal endometrial hyperplasia, which is the first stage of endometrial cancer.For this perspective, we tried to investigate the effect of melatonin on uterine hypertrophy/hyperplasia in an experimental rat model. Forty Wistar-Albino rats were undergone bilateral oophorectomy and randomized into four groups. To create a model of uterine hypertrophy/hyperplasia in all groups, except the control group [C] (n = 10), 4 mg/kg/day estradiol hemihydrate were given for 14 days. The uterine hypertrophy/hyperplasia was evaluated histopathologically in the left uterine horns, then the groups were treated for 14 days as follows; melatonin (10 mg/kg/day/po) [M] (n = 10), melatonin + estradiol hemihydrate (10 mg/kg/day/po and 4 mg/kg/day/po) [M + E] (n = 10), and dark environment [D] (n = 10). Finally, the effects of the melatonin were examined histopathologically in the right uterine horns.An uterine hypertrophy/hyperplasia model was established in all groups compared to the control group (p < 0.05). In the [M] and [M + E] groups, epithelial cell height and luminal epithelial cell height significantly decreased (41μm vs 12μm, p = 0.005; 14μm vs 10μm, p = 0.005, respectively for [M] group) and (32μm vs 14μm, p = 0.012; 17μm vs 10μm, p = 0.017, respectively for [M + E] group). The [D] group exhibited a significant decrease in epithelial cell height (33μm vs 20μm, p = 0.017).With or without estrogen exposure, melatonin-treated and physiologically melatonin-released rats experienced a significant uterine hypertrophy/hyperplasia recovery. Melatonin may have protective effects on endometrial hyperplasia.

Retinal detachment is the separation of the neurosensory retina from the underlying retinal pigment epithelium. In pregnancy with hypertensive disorders, it is a very rare complication and usually seen bilaterally. Here, a case of bilateral serous retinal detachment and uterine atony in association with preeclampsia seen in the postpartum period of a term pregnant woman with no history of prior hypertension is presented.

Objective: Endometriosis is a chronic inflammatory disease pathologically defined as the presence of endometrial-like tissue outside the uterine cavity. It is one of the most important diseases affecting women of reproductive age. The process of endometriotic implant growth is mediated by many complex interactions of immunologic, hormonal, genetic, and environmental mediators. Vitamin C (ascorbic acid), besides playing a role in preventing invasion and metastasis, is an antioxidant having anti-inflammatory and -angiogenic effects. In this study, we aimed to investigate the effect of vitamin C on the prevention and regression of endometriotic implants in a rat model of endometriosis. Materials and Methods: This was a prospective, comparative, experimental animal study. After endometriotic implants were induced simultaneously, rats were divided into three groups. Group A was given 500 mg/kg of intravenous vitamin C every 2 days, starting immediately after implantation (n = 11). All rats had a second operation 21 days after the initial one and had the lesion volumes measured. Group B was given 500 mg/kg of intravenous vitamin C every 2 days, starting 21 days after this operation (n = 11). All rats were sacrificed 21 days after the third operation. Implant volume, weight measurements, and histopathological evaluation of the lesions were carried out. Group A received vitamin C throughout the study, while Group C (n = 11) was not given any medication. The findings in the three groups were compared. Results: At the second laparotomy after the induction, Group A had the smallest implant volume with a statistically significant difference compared to Group B (p = 0.012). The end-of-study volumes of endometriotic implants of group B were significantly smaller than the first volumes (p

ObjectiveTo investigate the correlation between sonographic, hysteroscopic, and pathological findings in postmenopausal asymptomatic patients with sonographically thickened endometrium.MethodsThe records of postmenopausal patients who attended the Menopause Outpatient Clinic of a tertiary women's hospital in Ankara, Turkey between January 1, 2012 and December 15, 2013 were retrieved. A total of 266 postmenopausal women without vaginal bleeding underwent hysteroscopic evaluation and endometrial sampling. Patients whose pathological records indicated an endometrial thickness equal to or greater than 6 mm (double layer) on transvaginal ultrasonography without any symptoms were included in the study.ResultsThe most frequently detected focal intrauterine lesions in asymptomatic women were endometrial polyps, which were diagnosed in 168 (63.1%) cases. Twenty-four (9%) patients were diagnosed as having simple hyperplasia, 4 (1%) atypical hyperplasia, and 8 (3%) endometrial adenocarcinoma. Two of the patients with adenocarcinoma were diagnosed based on endometrial polyps, and 6 cases showed endometrial hyperplasia on hysteroscopy, while histological examination showed endometrial carcinoma.ConclusionWe suggest 10.5 mm as the cutoff value for endometrial thickness and recommend hysteroscopy following dilatation and curettage to increase diagnostic efficacy and provide definitive treatment in asymptomatic postmenopausal women with thickened endometrium.

A 13-year-old patient with a complaint of worsening lower abdominal pain during the past 4 months was admitted to the emergency department. An abdominopelvic ultrasound scan revealed a distended uterocervical cavity suggestive of hematometrocolpos. Imperforate hymen was observed on examination of the external genitalia. MRI scan revealed an air-fluid level representing pyometrocolpos within a distended vagina. Posterior vaginal extraperitoneal leakage as the sign of a fistula between the vagina and the rectovaginal space was detected. Although laparoscopic approach was planned, malodorous pus expelled after the insertion of the Veress needle, it was decided to proceed to laparotomy. Pus with peritoneal microabscess formations was observed at laparotomy. The imperforate hymen and TVS were excised vaginally. A more complex anomaly should be suspected in cases with hematometra and concomitant imperforated hymen without any bulging and thorough evaluation using radiological imaging techniques should be performed before surgical approach.