Search

COVID-19, Aralık 2019’dan itibaren Çin’in Wuhan bölgesinden tüm dünyaya yayılarak pandemi oluşturan yeni tip koronavirustür. Gebe hastalarda diğer coronavirus enfeksiyonları (Middle East Respiratory Syndrome=MERS-CoV, Severe Acute Respiratory Syndrome=SARS-CoV) olumsuz sonuçlarla seyrettiğinden COVID-19 pozitif gebe hastalar endişeleri arttırmaktadır. Bu olgu sunumunda, kliniğimizin ilk COVID-19 pozitif hastası olan 36 haftalık gebenin sezaryen anestezisi yönetimi ele alınmıştır.

Objective: Congenital pes equinovarus (PEV) is the most common congenital deformity of the foot, characterized by plantar flexion with a frequency of 0.2-0.3%. It can be diagnosed from the 12th week of pregnancy. Non-isolated cases tend to be syndromic and complex. We aimed to evaluate the results of perinatally diagnosed isolated PEV. Materials and Methods: This was a retrospective cohort study conducted between March 2015-March 2020. Women who presented for fetal anomaly screening or were referred due to any suspected fetal anomaly were subjected to detailed fetal anomaly scans and checked for the presence of PEV. Karyotype analysis was discussed for patients with PEV. Pregnancy termination was recommended for those with chromosomal/life-threatening anomalies. The diagnosis was confirmed by postnatal examination/autopsy. Postnatal diagnosis was accepted as false-positive in those with no PEV. Results: One-hundred thirty-eight patients were found to have PEV, 41 (29.7%) of which were isolated. In the isolated group, the false-positive rate in the first trimester was significantly higher compared with the second trimester, 50%/15.3%, respectively (p

Objective To evaluate sacrococcygeal teratoma (SCT) cases according to associated cardiac, extracardiac, and chromosomal anomalies in the prenatal period, and to review their outcomes. Materials and methods Data of pregnancies with a prenatal diagnosis of SCT between 2009 and 2019 were retrospectively reviewed. Results One ongoing pregnancy was excluded. There were five medically terminated cases, three due to severe heart failure and the remaining two due to additional congenital defects. Two infants who had heart failure due to hyperdynamic flow died in the neonatal period. Nine infants are well and alive at the time of writing. Conclusion When a lesion is detected in the sacrococcygeal region during fetal sonography, the differential diagnosis should be made with an appropriate evaluation with emphasis on a possible diagnosis of fetal SCT. Tumor growth and heart failure should be monitored with serial scans when SCT has been diagnosed prenatally.

Purpose: The aim of this study was to evaluate the clinical and pathological characteristics of mixed endometrial carcinoma (MEC).Materials and Methods: The clinical and pathological records of the 29 MEC patients, who were operated on and regularly followed up in the clinic between January 2000 and December 2019, were reviewed. Clinic-pathologic features and survival in the MEC group (n=29) were compared to pure serous (n=42) and pure clear cell adenocarcinomas (n=13). Clinical features, operation characteristics, pathological findings, myometrial invasion degree (MI), lymph node involvement (LNI), lymphovascular space invasion (LVSI), adjuvant therapies, and follow-up data of the patients and their effects on survival were investigated. Results: Eighteen of the cases had endometrioid + serous, 7 had endometrioid + clear, 3 had endometrioid + serous, and 1 had clear + serous histopathology. Laparoscopic surgery was performed in 8 of the cases (27.6%) in the mixed group. Stage, the rate of LVSI, LNI, MI ≥50%, and omental metastasis were similar among the groups. There were no significant differences in the rates of receiving adjuvant therapy among the groups. Overall survive (OS) was similar among the groups. Conclusion: MECs are tumors that can be difficult to diagnose and manage. There was no difference between MEC and pure serous carcinoma (SC) and pure clear cell carcinoma (CC) in terms of clinicopathological features and prognosis. In addition to histopathological features, revealing and evaluating their molecular properties will help us to better understand this group of tumors., Amaç: Bu çalışmada miks endometrial karsinomun (MEK) klinik ve patolojik özelliklerini değerlendirilmesi amaçlanmıştır.Gereç ve Yöntem: Ocak 2000 - Aralık 2019 tarihleri arasında kliniğimizde ameliyat edilen ve düzenli takip edilen 29 MEK hastasının klinik ve patolojik kayıtları gözden geçirildi. MEK grubundaki (n = 29) klinik-patolojik özellikler ve sağkalım, saf seröz (n = 42) ve saf berrak hücreli adenokarsinomlar (n = 13) ile karşılaştırıldı. Hastaların klinik bulguları, operasyon özellikleri, patolojik bulguları, miyometriyal invazyon derecesi (MI), lenf nodu tutulumu (LNI), lenfovasküler alan invazyonu (LVSI), adjuvan tedaviler ve takip verileri ve sağkalıma etkileri araştırıldı.Bulgular: Olguların 18'inde endometrioid + seröz, 7'sinde endometrioid + berrak hücreli, 3'ünde endometrioid + seröz ve 1'inde berrak hücreli+ seröz histopatoloji vardı. Hastaların ortalama yaşı 63,2 ± 12,1 yıldı. Mikst gruptaki olguların 8'ine (% 27,6) laparoskopik cerrahi uygulandı. Evre, LVSI, LNI, MI ≥% 50 ve omental metastaz oranları gruplar arasında benzerdi. Adjuvan tedavi alma oranları için gruplar arasında önemli bir fark yoktu. Genel olarak hayatta kalma süresi gruplar arasında benzerdi.Sonuç: MEK'ler, teşhis edilmesi ve yönetilmesi zor olabilen tümörlerdir. Klinikopatolojik özellikler ve prognoz açısından MEK ile saf seröz karsinom ve saf berrak hücreli karsinom arasında fark yoktu. Histopatolojik özelliklerinin yanı sıra moleküler özelliklerinin ortaya çıkarılması ve değerlendirilmesi bu grup tümörleri daha iyi anlamamıza yardımcı olacaktır.

Purpose: The aim of this study was to show the effect of early and late onset intrauterine growth retardation (IUGR) on perinatal outcomes and the differences between themMaterials and Methods: Our study is a retrospective study. 334 patients who were followed up with the diagnosis of IUGR between January 1, 2015 and January 1, 2019 were divided into subgroups as early and late onset IUGR. The type of growth retardation, the gestational week at diagnosis, the estimated fetal weight (EFW), the presence of preeclampsia, doppler findings, the birth weight, the delivery type, the birth week, the 5th minute Apgar score, the neonatal intensive care need were recorded and the relationship of all these parameters with the negative consequences of the newborn was discussed.Results: The average of the gestational week at diagnosis was 30.9 ± 4.5 (min-max: 18-39). The average of the gestational week at delivery was 34.4 ± 4.5 (min-max: 22-41). The patients were examined in four groups as 37 weeks according to the diagnosis time. Perinatal outcomes deteriorate with the severity of Doppler findings. Having EFW, Amaç: Bu çalışmanın amacı erken ve geç başlangıçlı İntrauterin gelişme geriliği (İUGG) perinatal sonuçlara etkisini ve aradaki farkları gösterilmesidir.Gereç ve Yöntem: Çalışmamız retrospektif bir çalışmadır. Çalışmamızda 01 Ocak 2015- 01 Ocak 2019 tarihleri arasında İUGG tanısıyla takibe 334 hasta erken ve geç başlangıçlı IUGG olmak üzere alt gruplara ayrıldı. Gelişme geriliği tipi, tanı aldığı gebelik haftası, tahmini fetal ağırlığı (TFA), preeklampsi varlığı, Doppler bulguları, doğum kilosu, doğum şekli, doğum haftası, 5.dk Apgar skoru, yenidoğan yoğun bakım ihtiyacı kayıt edildi ve tüm bu parametrelerin yenidoğanın olumsuz sonuçlarıyla ilişkisi ele alındı.Bulgular: Tanı konulan gebelik haftası ortalaması 30,9±4,5 (min-maks:18-39)’dır. Hastaların doğum haftası ortalaması 34,4±4,5 (min-maks:22-41)’dır. Hastalar tanı aldıkları gebelik haftasına göre 37 hafta olarak dört grupta incelendi. Verilerimiz doppler bulgularının şiddeti ile perinatal sonuçların kötüleştiğini ortaya koymaktadır. Yine çalışmamız TFA

Amaç: Bu çalışmanın amacı agonist in-vitro fertilizasyon (IVF) / intrasitoplazmik sperm enjeksiyonu (ICSI) / embriyo transferi (ET) siklüslerinde, luteal faz desteği için progesterona ek olarak estrojen vermenin gebelik oranları üzerine etkisinin araştırılmasıdır. Gereç ve Yöntem: Bu çalışmaya toplamda IVF / ICSI endikasyonu olan 142 hasta çalışmaya alındı. Hastalar, oosit toplama işleminden (OPU) sonra luteal destek için progesteron (kontrol grubu n = 71) ve ek olarak transdermal östrojen (çalışma grubu n = 71) verilmek üzere randomize edildi. Östrojen seviyeleri, embriyonun transfer gününde ve transfer sonrası 12. günde ölçüldü. Çalışmanın esas sonucu devam eden gebelik oranıdır. Her iki grup indüksiyon özellikleri, östrojen seviyeleri, β-hCG pozitifliği ve düşük oranları açısından da karşılaştırıldı.Bulgular: Gruplar arasında yaş, infertilite süresi ve endikasyon açısından istatistiksel olarak anlamlı fark yoktu. Her iki grup indüksiyon özellikleri ve E2 düzeyleri açısından benzerdi. β-hCG pozitiflik oranı benzerdi ve devam eden gebelik oranı her iki grupta benzerdi. Biyokimyasal ve klinik abortus oranları açısından da her iki grup arasında anlamlı fark yoktu. 12. gün östrojen seviyesi gebelik elde edilen hastalarda, elde edilemeyenlere göre anlamlı düzeyde yüksekti.Sonuç: Çalışmamız; luteal destek amacı ile progesterona ek olarak östrojen eklenmesinin β-hCG pozitifliği, devam eden gebelik ve düşük oranları üzerinde olumlu bir etkisi olmadığını göstermiştir., Purpose: The aim of this study was to investigate the effect of transdermal estrogen on pregnancy rates in addition to progesterone for luteal phase support in agonist in-vitro fertilization (IVF) / intracytoplasmic sperm injection (ICSI) / embriyo transfer (ET) cycles. Material and Methods: This randomized controlled study (RCT) enrolled a total of 142 patients with an indication for IVF/ICSI. We randomized patients prospectively to administer either progesterone (control group n=71) and additionally transdermal estrogen patch (study group n=71) as luteal support after oocyte retrieval. The levels of estrogen was determined on the day of transfer of embryo and 12th day. The main outcome measure was the ongoing pregnancy rate. Both groups were also compared for the induction characteristics, estrogen levels, β-hCG positivity, and abortion rates. Results: There were no significant differences between the groups according to age, infertility time, and indications. Both groups were similar for induction characteristics and E2 levels. β-hCG positivity rate was similar and the ongoing pregnancy rate was similar in both groups. Biochemical and clinical abortion rates were also similar in both groups. On the 12th day, estrogen levels increased significantly in those who became pregnant group.Conclusion: Our study showed that adding supplementary estrogen to the progesterone has no positive effect on β-hCG positivity, ongoing pregnancy, and abortion rates.

Objectives Our primary aim was to evaluate the ability of various cerebroplacental ratio (CPR) reference values suggested by the Fetal Medicine Foundation to predict adverse neonatal outcomes in term fetuses exhibiting late-onset fetal growth restriction (LOFGR). Our secondary aim was to evaluate the effectiveness of other obstetric Doppler parameters used to assess fetal well-being in terms of predicting adverse neonatal outcomes. Methods This was a retrospective cohort study of 317 pregnant women diagnosed with LOFGR at 37–40 weeks of gestation between January 1, 2016, and September 1, 2019. Receiver operating characteristic (ROC) curves were drawn to determine the predictive performance of CPR 95th percentile in terms of predicting adverse neonatal outcomes. Results Pregnant women exhibiting LOFGR who gave birth in our clinic during the study period at a mean of 38 gestational weeks (minimum 37+0; maximum 40+6 weeks); the median CPR was 1.51 [interquartile range (IQR) 1.12–1.95] and median birthweight 2,350 g (IQR 2,125–2,575 g). The CPR Conclusions The CPR values below the 5th percentile better predicted adverse neonatal outcomes in pregnancies complicated by LOFGR than the UA PI and CPR

Background and objectives: Limited data are present on safety and efficiency of epinephrine for the prophylaxis and treatment of spinal-hypotension. This study was conducted to compare the effect of epinephrine with norepinephrine and phenylephrine on the treatment of spinal-hypotension and ephedrine requirement during cesarean delivery. Methods: One hundred and sixty parturients with uncomplicated pregnancies undergoing elective cesarean delivery under spinal anesthesia were recruited. They were allocated randomly to receive norepinephrine 5 µg.mL−1 (n = 40), epinephrine 5 µg.mL−1 (n = 40), phenylephrine 100 µg.mL−1 (n = 40) or 0.9% saline infusions (n = 40) immediately after induction of spinal anesthesia. Whenever systolic blood pressure drops to less than 80% of baseline, 5 mg of intravenous ephedrine was administered as rescue vasopressor. The incidence of hypotension, total number of hypotension episodes, the number of patients requiring ephedrine, the mean amount of ephedrine consumption and side effects were recorded. Results: There was no statistically significant difference in incidence of maternal hypotension between groups. The number of patients requiring ephedrine was significantly greater in group saline than in group phenylephrine (p< 0.001). However, it was similar between phenylephrine, norepinephrine, and epinephrine groups. The mean ephedrine consumption was significantly higher in group saline than in norepinephrine, epinephrine, phenylephrine groups (p= 0.001). Conclusion: There is no statistically significant difference in incidence of hypotension and ephedrine consumption during spinal anesthesia for cesarean delivery with the use of epinephrine when compared to norepinephrine or phenylephrine. Epinephrine can be considered an alternative agent for management of spinal hypotension. Resumo Justificativa e objetivos: Existem dados limitados sobre segurança e eficiência da epinefrina na profilaxia e tratamento da hipotensão arterial associada à raquianestesia. O presente estudo foi realizado para comparar o efeito da epinefrina com norepinefrina e fenilefrina no tratamento da hipotensão após raquianestesia e necessidade de efedrina durante o parto cesáreo. Método: Foram recrutadas 160 parturientes com gestações não complicadas, submetidas a cesariana eletiva sob raquianestesia. Elas foram alocadas aleatoriamente para receber norepinefrina 5 µg.mL-1 (n = 40), epinefrina 5 µg.mL-1 (n = 40), fenilefrina 100 µg.mL-1 (n = 40) ou infusão de solução fisiológica NaCl a 0,9% (n = 40) imediatamente após a indução da raquianestesia. Sempre que houvesse redução da pressão arterial sistólica para valor inferior a 80% da linha de base, 5 mg de efedrina iv eram administrados como vasopressor de resgate. A incidência de hipotensão, o número total de episódios de hipotensão, o número de pacientes que necessitaram de efedrina, o consumo médio de efedrina e os efeitos colaterais foram registrados. Resultados: Não houve diferença estatisticamente significante na incidência de hipotensão materna entre os grupos. O número de pacientes que necessitaram de efedrina foi significantemente maior no grupo solução fisiológica do que no grupo fenilefrina (p< 0,001). No entanto, foi semelhante entre os grupos fenilefrina, norepinefrina e epinefrina. O consumo médio de efedrina foi significantemente maior no grupo solução fisiológica do que nos grupos norepinefrina, epinefrina e fenilefrina (p = 0,001). Conclusão: Não houve diferença estatisticamente significante na incidência de hipotensão e consumo de efedrina durante raquianestesia para parto cesáreo com uso de epinefrina quando comparada à norepinefrina ou fenilefrina. A epinefrina pode ser considerada como agente alternativo para o tratamento da hipotensão após raquianestesia.

PubMedID: 28647444 Objective The predictive value of spot urine protein-to-creatinine ratio (PCR) for estimating total 24-hour proteinuria in severe preeclampsia is unclear. This study aimed to assess the diagnostic accuracy of spot urine PCR for ascertaining the magnitude of proteinuria in women with preeclampsia of varying severity. Methods A total of 205 patients with prediagnosed preeclampsia were included in this prospective cohort study. Patients were allocated into one of the three groups categorized by severity of disease, as follows: gestational hypertension, group 1 (n = 41); preeclampsia, group 2 (n = 88); and severe preeclampsia, group 3 (n = 76). We assessed the spot urine PCRs to determine significant proteinuria and the magnitude of proteinuria in these groups. Results The spot urine PCR was 0.53, with 81% sensitivity and 93% specificity to detect significant proteinuria. A significant correlation was found between PCR and 24-hour total proteinuria in group 1 (r = 0.473, P = 0.002). There were also significant correlations in group 2 (r = 0.814, P < 0.001) and group 3 (r = 0.912, P < 0.001). The established formula using spot urine PCR to estimate 24-hour total proteinuria in severe preeclampsia was Y = 832.02X + 378.74 mg (r 2 = 0.8304). Conclusion Although 24-hour urine collection remains a merely reliable test to determine the degree of total proteinuria, our findings suggest that it is likely to assess the magnitude of proteinuria by the spot urine PCR, especially in severe preeclampsia. Clinical trial registration www.clinicaltrials.gov NCT01623791 © 2017 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada

Purpose: The aim of the study is examine the effect of oral contraceptives on the serum levels of adhesion molecules and identify if the synthetic oestrogens provide protection against atherosclerosis.Materials and Methods: The interleukin 6 (IL-6), Tumor necrosis factor alfa (TNF Alfa), Vascular cell adhesion molecule 1 (VCAM-1), Intercellular Adhesion Molecule (ICAM-1), E selectin, P selectin, C selectin, C Reactive Protein (CRP) levels and erythrocyte sedimentation rate (ESH) of patients between 18-45, without additional illness, using oral contraceptives for contraception at least for three years were compared to healthy volunteers, aged between 18-45, having regular menstruation and without any additional diseases.Results: There has been no meaningful difference between the VCAM-1, ICAM-1, E selectin, P selectin, TNF alfa, IL 6, ESH levels of the two groups. Serum CRP levels are meaningfully higher in the group using oral contraceptives.Conclusion: Oral contraceptives change the serum levels of adhesion molecules. The change in the serum CRP levels might be due to the liver first pass effect., Amaç: Bu çalışmanın amacı, oral kontraseptiflerin adezyon moleküllerinin serum seviyelerine olan etkisini araştırarak, sentetik östrojenlerin ateroskleroza karşı koruyucu etkisi olup olmadığı saptamaktır.Gereç ve Yöntem: Ek hastalığı bulunmayan, kontrasepsiyon amaçlı en az 3 aydır oral kontraseptif kullanan, 18-45 yaş aralığında olan hastaların serum interlökin 6 (İL-6), tümör nekrozis faktör alfa (TNF alfa), damarsal hücre yapışma molekülü 1 (VCAM-1), hücreler arası adezyon molekülü (ICAM-1), E selektin, P selektin, c reaktif protein (CRP) seviyeleri ve eritrosit sedimentasyon hızları (ESH); ek hastalığı bulunmayan, düzenli adet gören, 18-45 yaş aralığında olan sağlıklı gönüllülerle karşılaştırıldı.Bulgular: Her iki grubun VCAM-1, ICAM-1, E selektin, P selektin, TNF alfa, İL 6, ESH seviyeleri arasında anlamlı fark saptanmadı. Oral kontraseptif kullanan grupta serum CRP seviyeleri anlamlı olarak daha yüksek saptandı.Sonuç: Oral kontraseptiflerin adezyon moleküllerinin serum seviyelerini değiştirdiği gösterilemiştir. Serum crp seviyelerinin değişimleri ise karaciğer ilk geçiş etkisine bağlanmaktadır.

Yapicioglu-Yildizdas H, Ece U, Sucu M, Yurdakul G, Simsek H, Ozlu F. Twin reversed arterial perfusion syndrome in a monochorionic monoamniotic twin pregnancy. Turk J Pediatr 2017; 59: 724-727. Twin reversed arterial perfusion syndrome is mostly seen in monochorionic diamniotic twin pregnancies with an estimated incidence of 1/9500-11000 pregnancies. One of the twins is acardiac with various abnormalities especially with upper part of the body, and mortality is 100%. The other twin functions as a pump twin and mostly has polyhydramnios and heart failure; and mortality rate is high due to prematurity and heart failure. Herein we report a TRAP syndrome and the prognosis of pump twin who was born at 30 weeks gestational age.

PubMedID: 29804024 Objective: Cancer-related inflammation is associated with poor long-term outcomes in various solid tumors. The aim of this study is to investigate the prognostic significance of pre-operative neutrophil lymphocyte ratio (NLR), monocyte count (MC), mean platelet volume (MPV), and platelet lymphocyte ratio (PLR) in endometrial cancer. Study Design: In this study, 763 patients with endometrial cancer were evaluated, who were followed between January 1996 and February 2016. Preoperative values of NLR, MC, MPV, and PLR were evaluated in terms of clinico-pathologic prognostic factors and overall survival (OS). Results: NLR, MC, and PLR were detected to be statistically significant with regard to advanced stage of the disease (p = 0.001, p = 0.02, and p = 0.001, respectively), but only MC was significant in terms of grade (p = 0.035). Higher NLR and PLR values were found to be associated with advanced stage of the disease, deep myometrial invasion, cervical involvement, lymphovascular space invasion (LVSI), and nodal involvement. When the cut-off value was considered as 3, sensitivity and specificity for NLR were found to be 68% and 69%, respectively, to predict lymph node metastasis. NLR was found as a prognostic factor for survival (p = 0.01). Age, the presence of comorbidity, stage, and cervical involvement were determined to be independent prognostic factors for OS in our cohort. Conclusion: NLR was detected to be a prognostic factor for survival. Moreover, NLR and PLR are a predictive value for lymph node involvement and also for cervical invasion in endometrial cancer. © 2018

Objective: Fetal structural malformations affect approximately 2-3% of all pregnancies. Only focusing on trisomy screening in first trimester and deferring the anatomic screening to second trimester may result with late detection of major anomalies that can be diagnosed earlier with careful examination. Material and Methods: This was a descriptive study of retrospective data that were obtained from all terminated single pregnancies due to ultrasonographic findings of major anomalies from 2011 to 2016 in our department. The study was based on a chart review and only abnormalities that were diagnosed before the 16th week were included. Results: Two hundred forty-four first trimester pregnancy terminations were performed. In total, 273 anomalies were detected in the 244 patients. Cranial NTD comprised 32% of all anomalies (n=89). Fifteen percent of anomalies (n=41) needed detailed anatomic scanning for early diagnosis. Conclusion: In this study, we presented the number and percentage of our early diagnosed anomalies by years, as well showed our diagnostic performance for specific anomalies such as atrioventricular septal defect during a 5-year period. The study provides valuable information for future studies in Turkey and shows the need for an anatomic scan protocol while performing aneuploidy screening during early gestation. © 2018 by the Turkish-German Gynecological Education and Research Foundation.

Amaç: Bu çalışmada, kliniğimizde son 5 yılda opere edilen bordeline overtümörlü vakaların değerlendirilmesi amaçlanmıştır.Gereç veYöntem: Çukurova Üniversitesi Tıp FakültesiJinekolojik Onkoloji biriminde son 5 yıl içerisinde opere edilen borderlineover tümörlü olguların, patoloji raporları ve birimin bilgisayar kayıtları ilearşiv dosyaları retrospektif bir şekilde tarandı. Toplam 41 vaka tespit edilipçalışmaya dahil edildi. Olguların demografik karakteristikleri, preoperatifmuayene bulguları, operasyon ve patoloji özellikleri değerlendirildi.Bulgular: Hastaların ortalama yaşı 41 idi ve %85’i premenopozal dönemde idi.Preoperatif dönemde bakılan ultrasonda, tümörün ortalama çapı 10 cm olarakölçüldü. Operasyon öncesi ortalama ca125 değeri 120 olarak tespit edildi. Totalhisterektomi + bilateral salpingooferektomi 12 hastaya uygulanırken, geri kalan29 hastaya unilateral salpingooferektomi uygulandı. Lenfadenektomi, hastaların%41.5’inde gerçekleştirildi. En sık seröz histopatolojik tip (%70.7) izlendi.Hastaların çoğunda (%90.2) tümör, evre I’de idi. Hiç bir olguda nüks tespitedilmedi.Sonuç: Borderline over tümörleri, iyi prognoza sahipolduğundan, fertilite arzusu olan hastalarda, unilateral salpingoferektomigüvenle önerilebilecek bir tedavi şeklidir., Purpose: The aim of this study was to evaluate the borderline ovarian tumor cases who were operated in our clinic. Material and Methods: The last 5 years’ pathology reports, computer records and archival files of the Çukurova University Medical Faculty Gynecologic Oncology Unit were retrospectively reviewed for the borderline ovarian tumor patients. A total of 41 cases were detected and included in the study. Patients’ demographic characteristics, preoperative assessments, operation and pathological features were evaluated.Results: Patients’ mean age was 41 and 85% of them were premenopausal. Average of the tumor diameter was found to be 10cm in the preoperative ultrasound examination. Mean of the preoperative ca125 value was 120. While total hysterectomy + bilateral salpingo-oophorectomy was applied to 12 cases, unilateral salpingo-oophorectomy was performed in the remaining 29 patients. Lymphadenectomy was carried out in 41.5% of the patients. Serous borderline was the most common histology (70.7%). Majority of the cases was with stage I disease (90.2%). No recurrences were determined among the study population.Conclusion: Borderline ovarian tumors have a favorable prognosis and therefore, unilateral salpingo-oophorectomy can be suggested to be a safely treatment approach for patients who desire to protect their fertility.

Pektus ekskavatum (PE) manubrium sterninin alt kısmının ve ksifoid çıkıntının içe doğru çöküntüsü olarak tanımlanır. PE'li hastaların esas problemi torasik boşluğun daralmasına bağlı gelişen kardiyopulmoner morbiditedir. Günümüze kadar bu deformitenin prenatal tanısı sadece bir kez ve Down sendromu ile ilişkili olarak bildirilmiştir. Biz, ikinci trimester fetal anatomik tarama sırasında tespit ettiğimiz bir diğer olguyu sunuyoruz. Pektus şiddeti indeksi, bu hastalar için postnatal dönemde kullanılan bir indekstir; fakat bunun prenatal döneme uyarlanması ilk kez bizim olgumuzda gerçekleştirildi. Pectus excavatum (PE) is the depression of the lower part of manubrium sterni and xiphoid process. The main problem of PE depends on the cardiopulmonary morbidity caused by the narrowing of the thoracic space. To date, prenatal diagnosis of this deformity has been reported only once and was associated with Down syndrome. We present another case which we diagnosed as PE during a second-trimester fetal anatomic scan. The pectus severity index is used for these patients in postnatal life; however, prenatal adaption of this index is reported for the first time in our case.

Amaç: Gebeliğin ilk üç ayında hemoglobinopatilerin prenatal tanısı için fetal aortik Doppler incelemesinin değerlendirilmesi amaçlanmıştır.Gereç ve Yöntemler: Ocak 2014 ve Kasım 2014 tarihleri arasında 108 hasta çalışmaya dahil edildi. Çiftler, Çukurova Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum Bölümü Prenatal Tanı Merkezi'ne alfa/beta talasemi, orak hücre anemisi veya bunların kombine taşıyıcısı olup başvuran kişilerden oluşmakta idi. Koryonik villüs örneklemesinden (KVÖ) bir saat önce fetal aortik Doppler incelemesi yapıldı. Pulsatilite indeksi, tepe sistolik hız, kalp hızı not edildi.Bulgular: Farklı KVÖ sonucu grupları sağlıklı kontrollerle karşılaştırıldıklarında Doppler indeksleri açısından istatistiksel olarak anlamlı fark bulunmamıştır.Sonuç: Fetal aortik Doppler incelemesi hemoglobinopatilerin prenatal tanısında etkin bulunmamıştır. Objective: To evaluate fetal aortic Doppler for the prenatal diagnosis of hemoglobinopathies in the first trimester of pregnancy.Materials and Methods: Between January and November 2014, a total of 108 patients were enrolled in the study. The couples were carriers of either alpha/beta thalassemia, sickle cell disease or combined carriers of these and were admitted to Çukurova University Faculty of Medicine, Department of Obstetrics and Gynecology Prenatal Diagnosis Center. One hour before the chorionic villus sampling (CVS), patients were evaluated using fetal aortic Doppler. Pulsatility index, peak systolic velocity, and heart rate were noted.Results: There were no statistically significant differences in Doppler indices between different groups of CVS results when compared with the healthy controls.Conclusion: Fetal aortic Doppler investigation was found to be ineffective for the prenatal diagnosis of hemoglobinopathies.

Human Immunodeficiency Virus (HIV) enfeksiyonunun yönetimi hızlı şekilde değişim göstermeye devam etmektedir. Gelişmiş ülkelerdeki perinatal geçiş oranları, antiretroviral tedavi (ART) ve sezaryen doğumun planlanmasıyla %20-30'lardan, %1-2'lere kadar düşürülmüştür. Perinatal geçişin azaltılması için yapılan girişimler HIV ile enfekte kadınlar için uygulanan prenatal bakımı daha kompleks hale getirmiştir. Standart bakımın çok hızlı değişmesi ve HIV enfeksiyonu yaygınlığının giderek artması nedeniyle gebe takibi yapan klinisyenlerin bu konudaki güncel bilgilere sahip olması önemlidir. Bu nedenle makalemizde, HIV enfeksiyonunun prenatal dönemdeki seyri, tedavisi ve perinatal geçişin önlenmesi için alınacak tedbirleri özetlemeyi amaçladık The management of Human Immunodeficiency Virus (HIV) infection is progressing rapidly. In developed countries, the perinatal transmission rates have decreased from 20-30% to 1-2% with the use of antiretroviral therapy and cesarean section. Interventions for the prevention of prenatal transmission has made the prenatal care of pregnant patients with HIV infection more complex. Rapid development of standard care and continuing increase in the distribution of HIV infection has required clinicians taking care of pregnants to have current information. Therefore, in our review we aimed to summarize the prenatal course, treatment and preventive methods for perinatal transmission of HIV