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Amaç: Menstrüel siklusun luteal faz sırasında ortaya çıkıp, menstruasyonun başlamasıyla hızla düzelen somatik, bilişsel, duygusal ve davranışsal bozuklukları tanımlamak için premenstrual sendrom (PMS) tanımı kullanılmaktadır. COVID-19 pandemisi ise tıbbi, psikolojik ve sosyal-ekonomik yönleriyle küresel halk sağlığı sorununa neden olan bir kriz durumudur. Bu çalışmada pandemi döneminde kısıtlamalara bağlı olarak psikososyal yönden hassas olan kadınların PMS semptomlarının araştırılması amaçlanmıştır.Yöntem: Haziran 2021 ile Ağustos 2021 tarihleri arasında Turhal Devlet Hastanesi Kadın Hastalıkları ve Doğum Polikliniği’ne; 18-50 yaş aralığında olan 187 kadın çalışmaya dahil edildi. Kadınlar son 6 ay içerisinde COVID-19 hastalığı geçiren ve iyileşen 66 kadın ile COVID-19 hastalığı geçirmeyen 121 kadın olmak üzere iki ayrı gruba ayrıldı. Gruplar; yaş, gravida, parite, medeni hal, vücut kitle endeksi (vki), sigara kullanımı, hirsutizm varlığı, oral kontraseptif (oks) kullanımı, emzirme durumu, rahim içi araç (ria) kullanımı, menstrüel düzen ve dismenore varlığı açısından PMS Ölçeği (PMSÖ) kullanılarak karşılaştırıldı.Bulgular: COVID-19 pandemisi ile birlikte iştah değişikliği (p=0.004), depresif duygulanım (p=0.002), depresif düşünceler (p=0.001), yorgunluk (p=0,001), anksiyete (p=0.036) ve uyku değişiklikleri (p=0,002) şikayetlerinin COVID-19 hastalığı geçiren grupta, COVID-19 hastalığı geçirmeyen gruba göre belirgin olarak daha yüksek oranda saptandı. Ayrıca menstrüel düzen hali COVID-19 geçirmeyen kadınlarda COVID-19 geçiren kadınlara göre daha yüksek oranda görüldü (p=0,003).Sonuç: PMS şikayetleri arasında yer alan iştah değişikliği, depresif duygulanım, depresif düşünceler, yorgunluk, uyku değişiklikleri ve menstrüel düzensizlik şikayetlerinin COVID-19 geçirenlerde daha yoğun yaşanmaktadır. Bu nedenle COVID-19 pandemisinde kadınların PMS şikayetleri dikkatle dinlenmeli ve bunların geçirilmiş COVID-19 hastalığı ile daha belirgin olabileceği göz önünde bulundurulmalıdır., Aim: The term premenstrual syndrome (PMS) is used to define somatic, cognitive, emotional, andbehavioural disorders that emerge during the luteal phase of the menstrual cycle and rapidly recoverwith the onset of menstruation. The aim of this study was to investigate PMS symptoms in women whowere sensitive psychosocially because of pandemic restrictions.Material and Methods: The study included a total of 187 women aged 18-50 years who presented atthe Gynaecology and Obstetrics Department of Turhal State Hospital between June 2021 and August2021. The women were separated into two groups as 66 who had contracted and recovered fromCOVID-19 infection within the previous 6 months and 121 who had not had COVID-19 infection. ThePMS Scale was applied to all the patients.Results: The rates of complaints of changes in appetite (p=0.004), depressive mood (p=0.002),depressive thoughts (p=0.001), fatigue (p=0.001), changes in sleep (p=0.002), anxiety (p=0.036) andmenstrual irregularity (p=0.003) were determined to be statistically significantly higher in the COVID-19group compared to the group that had not had COVID-19.Conclusion: The PMS complaints of changes in appetite, depressive mood, depressive thoughts,fatigue, changes in sleep, anxiety and menstrual irregularity were experienced more in the women whohad had COVID-19. Therefore, the PMS complaints of women during the COVID-19 pandemic shouldbe listened to carefully and it must be taken into consideration that these can be more significant inpatients who have contracted COVID-19 infection. .

The purpose of this review is to update readers on recent surgical treatment modalities of ectopic pregnancies (EP) and their advantages vs disadvantages. EP was generally managed with surgical treatment, and of the available applications, methotrexate (MTX) may be preferred for selected patients. “Wait-and-see” can be another treatment method, depending on preference or need. Surgical treatment indications are haemodynamic instability, suspected or risk of rupture, contraindications for MTX, or failure of medical treatment. Salpingostomy or salpingectomy is generally the first surgical choice in tubal EPs. The selection of salpingostomy or salpingectomy is based on several factors and the decision should be made by the surgeon and patient together. For women who have completed fertility, bilateral salpingectomy can be applied for permanent sterilisation. The sterilisation method of salpingectomy has the additional potential benefit of reducing the risk of tubal neoplasia and ovarian cancer. The advantage of salpingostomy is the potential to preserve the tube to meet the patient’s wishes for potential future fertility. The selection of surgical approach (laparoscopy vs laparotomy) should be made by the surgeon in consultation with the anaesthetist and taking the clinical condition of the patient into account.

Lysyl oxidase like protein 2 (LOXL-2) is an enzyme that is involved in the development of hepatic fibrosis and bile duct epithelial injury in hepatic cholestasis. Our aim was to investigate maternal serum levels of LOXL-2 and their relationship with fasting total bile acid (FTBA) levels in patients with intrahepatic cholestasis of pregnancy (ICP).Thirty-five pregnant women with ICP and 35 healthy women with uncomplicated pregnancies as the control group, were included in this cross-sectional study. Maternal serum LOXL-2, FTBA and other liver function test levels were compared between the two groups. The predictive cutoff value for LOXL-2 level in ICP was specified.Serum LOXL-2 levels were found to be higher in the ICP group compared to the control group (225.699 ± 142.453 vs. 127.731 ± 63.419 pg/mL,Maternal serum LOXL-2 levels were significantly higher in women with ICP. LOXL-2 may be both an initiating factor in the pathophysiology of ICP and a marker in the prediction. It may also be a target in terms of preventing strategies in ICP.

Aim: To analyse the cervical biopsies and colopscopic examinations made of women who presented at our clinic with abnormal pap-smear and/or human papilloma virus (HPV) positivity. Material and Method: A retrospective examination was made of the colopscopy findings, number of punch biopsies and final histo-pathological results of patients who presented at the gynaecology polyclinic between January 2018 and January 2020 with a smear result showing atypical squamous cells of undetermined significance (ASCUS), low-grade squamous intraepithelial lesions (LGSIL), high-grade squamous intraepithelial lesions (HGSIL), and atypical squamous cells cannot exclude high-grade squamous intraepithelial lesion (ASC-H), and/or HPV test was 16, 18 and other types of positivity. The Chi-square test was applied in the comparisons of the findings. Results: Evaluation was made of 214 patients with a mean age of 46.54±10.76 years. The pap-smear results were recorded as ASCUS in 71 (33.2%) patients, ASC-H in 2 (0.9%), LGSIL in 23 (10.7%), HGSIL in 8 (3.7%) and normal or showing inflammation in 110 (51.4%). HPV 16 positivity was determined in 58 (27.1%) patients, HPV 18 positivity in 12 (5.6%), other high-risk type HPV positivity in 84 (39.3%) and other type HPV positivity in 53 (24.8%). The colposcopy findings were recorded as leukoplakia in 60 (28%) patients, a punctuation appearance in 40 (18.7%), mosaic appearance in 26 (12.1%), and atypical vascularisation in 24(11.2%). A single punch biopsy was taken from 53 (24.8%) patients, and multiple biopsies were taken from 161 (75.2%). The histo-pathological results were reported as LGSIL in 45 (21%) patients, HGSIL in 15 (7%) and carcinoma in 1 (0.5%). No correlation was determined between the colopscopic examination findings and the number of punch biopsies (p=0.655). As the number of punch biopsies increased, so the probability of LGSIL, HGSIL, and carcinoma increased (p=0.006). Conclusion: While the colposcopy examination findings did not affect the number of punch biopsies, it was seen that as the number of punch biopsies increased so did the probability of capturing cervical premalignant and malignant lesions. When no lesion is seen in the colposcopy examination, the number of cervical punch biopsies should be increased., Amaç: Kliniğimize anormal pap-smear ve/veya pozitif HPV (human papilloma virüs) sonuçları ile başvuran kadınlara yaptığımız kolposkopik incelemelerin ve aldığımız servikal biyopsilerin sonuçlarını analiz etmek.Gereç ve yöntem: Ocak 2018 ve Ocak 2020 tarihleri arasında jinekoloji polikliniklerimize başvurmuş smear sonucu: atipik skuamoz hücreler (ASCUS), düşük dereceli servikal intraepitelyal lezyon (LGSIL), yüksek dereceli servikal intraepitelyal lezyon (HGSIL) ve atipik skuamoz hücreler-yüksek dereceli lezyonun ekarte edilemediği (ASC-H) olan ve/veya HPV testi:16, 18, ve diğer tipleri pozitif olan kadınların yapılmış kolposkopik muayene bulguları, punch biyopsi sayıları ve en nihai histopatolojik sonuçları retrospektif olarak incelendi. Bulguların karşılaştırılmasında Ki-kare testi kullanıldı.Bulgular: Çalışmaya dahil edilen 214 hastanın yaş ortalaması 46.54 ± 10.765 idi. Pap-smear sonuçları sırasıyla; 71 (%33.2) hastanın ASCUS, 2 (%0.9) hastanın ASC-H, 23 (%10.7) hastanın LGSIL, 8 (%3.7) hastanın HGSIL ve 110 (%51.4) hastanın normal veya inflamasyon şeklinde idi. HPV 16 pozitifliği 58 (%27.1), HPV 18 pozitifliği 12 (%5.6), diğer yüksek risk tip HPV pozitifliği 84 (%39.3), diğer tip HPV pozitifliği ise 53 (%24.8) kadında mevcuttu. Kolposkopi bulgusu olarak 60 (%28) kadında lökoplaki, 40 (%18.7) kadında beneklenme, 26 (%12.1) kadında mozaik görünüm ve 24 (%11.2) kadında atipik damarlanma mevcuttu. 53 (%24.8) kadından tek punch biyopsi alınmışken, 161 (%75.2) kadından çoklu punch biyopsi alınmıştı. Histopatolojik sonuçlar 45 (%21) kadında LGSIL, 15 (%7) kadında HGSIL ve 1 (%0.5) kadında karsinom olarak raporlanmıştı. Kolposkopik muayene bulguları ile punch biyopsi alma sayısı arasında ilişki izlenmedi (p=0.655). Ancak, punch biyopsi sayısı arttıkça LGSIL, HGSIL ve karsinom olasılığı da artmaktaydı (p=0.006).Sonuç: Kolposkopik muayene bulgularının özelliklerine göre punch biyopsi alma sayısı değişmezken, biyopsi sayısı arttıkça servikal premalign ve malign lezyon yakalama olasılığı artmaktadır. Kolposkopik incelemede lezyonun görülemediği durumda servikal punch biyopsi sayısının artırılması gerektiği kanaatindeyiz.

Aim: To investigate the effects on delivery and neonatal outcomes of vaginal douching, which can be performed before the application of dinoprostone pessary in the vagina for labour induction. Materials and method: In this prospective study 240 women with singleton, term pregnancy who underwent labour induction, were randomized into two groups. Application of dinoprostone pessary intra-vaginally with vaginal douching group (n=103) and it without vaginal douching group (n=116) were compared firstly for duration of dinoprostone application intra-vaginally secondly for duration from the beginning of dinoprostone application intra-vaginally to the active phase of labor, duration from the beginning of dinoprostone application intra-vaginally to total cervical dilatation, induction need, route of delivery (vaginal/cesarean), and uterine hyperstimulation. The birth weight, 1 and 5-minute Apgar scores, intubation need, NICU admission, presence of meconium, and fetal infection were compared between the newborns of the two groups. Data were statistically compared using the Student’s-t test, Mann-Whitney U test and Pearson Chi-square test. Results: Intra-vaginal dinoprostone pessary application with vaginal douching compared it without douching had shorter duration of dinoprostone application (p=0.001), duration from the beginning of dinoprostone application to the active phase of labor (p=0.001) and duration from the beginning of dinoprostone application to total cervical dilatation (p=0.001). Route of delivery was not statistically different between the groups (p=0.414). Uterine hyperstimulation was more frequent in the vaginal douche group however it did not reach the statistical significance (p=0.058). Neonatal mean birth weight and 5-minute Apgar scores were higher in the vaginal douching group (p=0.660, 0.091) while intubation need, presence of meconium, and fetal infection rates were lower with statistical significance (p=0.007, 0.018, 0.011, respectively). Conclusion: As a safe, easy to perform and cheap procedure, vaginal douching prior to dinoprostone pessary application intra-vaginally can augment the induction of labour in women without increasing maternal or fetal adverse outcomes.

Objective The second trimester triple test although declared inadequate for the screening of aneuploidies by the International Society for Prenatal Diagnosis remains a widely employed test. We aim to investigate the associations between the biochemical parameters of the triple test and the severity of intrahepatic cholestasis of pregnancy (ICP). Material and Methods The triple test parameters of 102 healthy pregnant women and 100 pregnant women with ICP were evaluated retrospectively. Serum bile acid level of ≥ 40 μmol/L was categorized as severe ICP. Serum α-fetoprotein (AFP), β-human chorionic gonadotropin (β-hCG), and unconjugated estriol (uE3) multiple of the median (MoM) values and the perinatal outcomes were recorded. The Student’s t-test, Mann–Whitney U test, Kruskal–Wallis test, and receiver operating characteristic curve analysis were used to compare the data. Results The AFP, β-hCG, and uE3 MoM values were higher in the severe ICP group when compared to those with mild ICP and those without ICP (p < 0.01). The sensitivity and specificity values for ICP were 80.95% and 73.42%, respectively, with AFP values ≥ 1.26 MoM, 76.19% and 88.61%, respectively, with β-hCG values ≥ 1.78 MoM, and 61.90% and 94.94%, respectively, with uE3 values ≥ 1.58 MoM [95% confidence interval; area under the curve (AUC) ± standard error (SE) = 0.810 ± 0.049, AUC ± SE: 0.790 ± 0.065, and AUC ± SE: 0.797 ± 0.065, respectively]. Conclusion An increase in the AFP, β-hCG, and uE3 MoM values in the triple test can predict the risk of developing severe ICP.

Amaç: Vajinal prostaglandin E2 (PGE2) ile indüklenen multipar kadınlarda gebeliğin intrahepatik kolestazına (ICP) bağlı artan serum safra asit konsantrasyonları ile doğumun ilk evresi arasındaki ilişkiyi belirlemek.Gereç ve Yöntemler: Bu retrospektif vaka-kontrol çalışmasında 283 ICP’li ve 283 sağlıklı multipar gebe doğum indüksiyonu için kabul edildi, vajinal olarak PGE2 (10 mg dinoproston) yerleştirildi. Hafif, orta ve şiddetli ICP’li gruplar, PGE2’nin vajinal yerleştirilmesinin başlangıcından doğumun aktif evresine kadar geçen süreler, PGE2’nin vajinal yerleştirilmesinin başlangıcından serviksin tamamen dilatasyonuna kadar geçen süreler ve fetal sonuçlar açısından kontrol grubu ile karşılaştırıldı.Bulgular: Hafif, orta ve şiddetli ICP gruplarında PGE2’nin yerleştirilmesinin başlangıcından aktif evreye kadar geçen süre ICP olmayan gruptakine göre daha kısaydı; sırasıyla, 3,19±0,32, 7,26±0,34, 8,71±0,35 saat (p, Aim: To determine the relationship between increased serum bile acid concentrations and the first stage of labor in multiparous women induced by vaginal prostaglandin E2 (PGE2) with intrahepatic cholestasis of pregnancy (ICP).Material and Methods: In this retrospective case-control study 283 multiparous women with ICP and 283 healthy multiparous pregnant women were admitted for induction of delivery, were inserted PGE2 (10 mg dinoprostone) vaginally. The groups with mild, moderate and severe ICP were compared with control group in terms of the time from beginning of PGE2 vaginal insertion to active phase of labor, the time from beginning of PGE2 vaginal insertion to complete dilatation of cervix and fetal outcomes.Results: The time from beginning of PGE2 insertion to active phase in the mild, moderate and severe ICP groups were shorter than in the non-ICP group; 3.19±0.32, 7.26±0.34, 8.71±0.35 hours, respectively (p

Tinelli, Andrea/0000-0001-8426-8490; erol, onur/0000-0002-7411-1200; GULER, OGUZ/0000-0001-7756-4267 WOS: 000514513400001 PubMed: 32064967 Objective: This multi-center study aims to determine the efficiency and safety of endometrial myomectomy (EM) for the removal of uterine fibroids during cesarean section (CS). Methods: Retrospective review of 360 women diagnosed for fibroids during pregnancy. They all delivered by CS between 2014 and 2019. The study groups included 118 women who only underwent EM, 120 women who only had subserosal myomectomy by traditional technique and 122 women with fibroids who decided to avoid cesarean myomectomy, as control group. They were analyzed and compared the surgical outcomes. Results: The EM, subserosal myomectomy and control groups were statistically (p > 0.05) similar for to age, body mass index (BMI), gravidity, parity, gestational age at delivery, indications for CS, number of excised fibroids, size of the largest myoma. Postoperative hemoglobin values and ? (?) hemoglobin concentrations were lower in SM group (10.39gr/dl vs 9.98 gr/dl vs 10.19 - 1.44 gr/dl vs 1.90 gr/dl vs 1.35; p = 0.047, p = 0.021; respectively) Hybrid fibroids were significantly more frequent in the EM group than subserosal myomectomy and control groups (respectively, 33.1% vs 23.3% vs 27.0%, p = 0.002). Surgery time was significantly longer in the subserosal myomectomy group than EM and control groups (respectively, 46.53 min vs 37.88 min vs 33.86 min, p = 0.001). Myomectomy took significantly longer time in the subserosal myomectomy than EM group (13.75 min vs 8.17 min, p = 0.001). Conclusions: Endometrial myomectomy is a feasible choice for treatment of fibroids during CS, and, basing on our results could be an alternative to traditional cesarean subserosal myomectomy.

We investigated the serum anti-Mullerian hormone (AMH), oestrogen and progesterone levels in spontaneously conceiving pregnant women, diagnosed for hyperemesis gravidarum (HG), in the first trimester. Pregnant women admitted at Hospital between 5 and 12 gestational weeks and treated for HG were compared, in this prospective case-control study, to a control group. The serum AMH, oestradiol, and progesterone values of both groups were evaluated and compared, and potential correlations were calculated. The serum AMH values were significantly higher in the HG group than the control group (3.15 ± 1.51 ng/mL vs. 2.27 ± 1.20 ng/mL

The possible correlation between nausea and vomiting during pregnancy (NVP) with obsessive-compulsive disorder (OCD) and alexithymia were examined in this cross-sectional study. A cohort of pregnant women at the first trimester of pregnancy experiencing NVP were divided into three groups, according to severity (mild, moderate and severe) with the Pregnancy Unique Quantification of Emesis and Nausea (PUQE) test. The Maudsley Obsessive Compulsive Disorder Scale (MOCQ) and the Toronto Alexithymia Scale (TAS-20) were applied. Scores of scales were compared in all three groups, and the relationship between NVP severity and OCD and alexithymia was evaluated. On the 110 enrolled pregnant women, 42 had mild, 36 had moderate and 32 had severe NVP. Pregnant women with mild NVP had lower MOCQ scores than those with severe NVP (p = .010). Total scores of TAS-20 were higher among subjects with greater NVP severity (p

Amaç: İntrauterininseminasyon (IUI), infertil çiftlerin gebelik şansını artırmak için yaygınolarak kullanılan bir işlemdir. hCG (human koryonik gonadotropin) uygulamasısonrası planlanan IUI zamanlaması pratikte 36. Saat olarak belirlenmiştir.Ancak klinik yoğunluk sebebi ile bu zamanlamada gecikmeler yaşanabilmektedir.Biz de çalışmamızda IUI’ları 36. Saate ve 42. Saate yapılan hastaların kliniksonuçlarını karşılaştırmayı amaçladık.Yöntem:Samsun Eğitim ve Araştırma Hastanesine açıklanamayan infertilite sebebi ilebaşvurmuş ve gonadotropin tedavisi sonrası IUI yapılmış 450 hastanın kayıtlarıgeriye dönük incelendi. Klinikteki yoğunluk sebebi ile hCG uygulaması sonrasıIUI zamanlaması 6 saat gecikmiş (42. Saat) olan hastalar ile zamanında (36.Saat) yapılmış hastaların demografik bilgileri, hormon düzeyleri, endometriumkalınlıkları, toplam folikül sayıları, β-hCG test pozitiflikleri, canlı doğumoranları ve spontan abort oranları değerlendirildi. Gruplar arasıkarşılaştırmalarda Student t test ve Ki-kare testi uygulandı.Bulgular:Hastaların 348’ine IUI prosedürü hCG uygulaması sonrasında 36. Saatteuygulanmışken 102’sine 42. Saatte uygulanmıştı. Gruplar arasında yaş,infertilite süresi, bazal hormon düzeyleri ve endometrial kalınlıklar açısındanfark izlenmedi (p, Aim: Intrauterine insemination (IUI) is acommonly used procedure to increase the chance of pregnancy in infertilecouples. The planned IUI timing after hCG (human chorionic gonadotropin)trigger was practically determined as at 36th hour. However, this timing may bedelayed due to clinical traffic. In our study, we aimed to compare the clinicalresults of patients who underwent IUIs at 36th hour versus at 42nd hour.Method: The records of 450 patients whowere admitted to Samsun Training and Research Hospital due to unexplainedinfertility and were performed IUI after gonadotropin treatment, wereretrospectively analyzed. Demographic information, hormone levels, endometrialthickness, total follicle numbers, β-hCG test positivity, live birth rates, andspontaneous abortion rates of patients with 6 hours delay (42 hours) in IUItiming after hCG trigger due to the traffic in the clinic, and patients with onthe time (36 hours) IUI performation were evaluated. Student's t-test andChi-square test were used for comparisons between groups.Results: IUI procedures were applied to 348patients at the 36th hour and 102 patients at the 42nd hour after the hCGtriggers. No difference was observed between the groups in terms of ages,infertility durations, basal hormone levels and endometrial thicknesses (p

Background/Aim: There is a lack of data about male contribution to idiopathic recurrent pregnancy loss (IRPL). The study aimed to investigate the factors associated with males, including Vitamin D, semen parameters, fertility hormones, and some demographical features in IRPL.Methods: In this cross-sectional study, the data of 41 men whose partners were diagnosed with recurrent pregnancy loss between February 2014 to February 2015 were collected. Female partners were examined fully, including thrombophilia factors, and no cause was detected. The karyotypes of both partners were normal. Men’s 25-hydroxy-vitamin D (25-OH-VD) levels, semen parameters (ejaculate volume, total sperm count per ejaculate, sperm concentration, sperm progressive motility, and sperm morphology), and fertility hormones (follicle-stimulating hormone, luteinizing hormone, total testosterone, estradiol, and prolactin) were assessed. Results: Mean 25-OH-VD was lower (18.4 (9.6) ng/ml) than the normal range. We found that testosterone was significantly lower in the group with 25-OH-VD ≤19 ng/dl when compared to the group with 25-OH-VD ≥20 ng/ml. There is a positive correlation between 25-OH-VD and testosterone levels. Although it was not statistically significant, there was a tendency for decreased sperm morphology.Conclusion: Serum testosterone levels of men whose partners were diagnosed with IRPL decreased with lower 25-OH-VD levels. In addition to standard female factors, male factors should also be taken into consideration when evaluating the risk of IRPL.

Objective To evaluate whether placental protein-13 (PP-13) measured in the serum of pregnant women could predict abnormal invasive placentation (AIP) detected by color Doppler ultrasound (US) and magnetic resonance imaging scan in addition to the routine US scan during the third trimester. Materials and methods The prospective case-control study included patients subdivided in 2 groups: 42 pregnant women with a singleton pregnancy at 28–32 weeks of gestation with only suspected AIP, and 32 healthy pregnant women. The serum PP-13 levels were measured in both groups using an enzyme-linked immunosorbent assay (ELISA) method and statistically compared. The cases of AIP were confirmed by placental histopathological examination and/or the uterus removed by hysterectomy after elective caesarean section. Results Serum PP-13 levels of pregnant women with AIP were significantly higher (p Conclusion Maternal serum PP-13 may have a role in the pathophysiology of AIP owing to its high serum value in the AIP group. The maternal serum dosage of PP-13 levels could improve pregnancy management in those patients suspected of having AIP.

The aim of the study was to evaluate the demographic data, clinical findings, ectopic pregnancy (EP) localization (left or right-sided), and treatments versus clinical presentation of tubal pregnancies (TP) with or without acute abdomen.Pregnants with a diagnosis of TP, selected for acute abdomen or not, were evaluated and compared, concerning EP local-ization (right/left), age, parity, symptoms (menstrual delay, vaginal bleeding, and groin pain), initial β-hCG value, endometrial thickness, presence of rupture, and treatment type (methotrexate and surgery).On a total of 122 pregnants with TP, 32 showed acute abdomen, 45 had a TP located in the right tube and 32 in the left tube. In the acute abdomen group, parity, initial β-hCG level, and endometrial thickness were greater than non-acute abdomen group. In addition to this, the frequency of bleeding complaints, right-sided TP, rupture, and need for surgery were higher, than to the non-acute abdomen group. The frequency of the previous EP and methotrexate treatment was higher in those with the left-sided TP compared to those with the right-sided TP.EP rate, in patients with TP who applied to the emergency department with acute abdominal symptoms, was mostly located in the right tube with greater frequency of salpingectomy in open surgery.

Midregional pro-adrenomedullin (MR-proADM) and matrix metalloproteinase-2 (MMP-2) are such proteins, that decreased levels are demonstrated in defective placental functions, as preeclampsia. The aim of the study is to compare maternal serum MR-proADM and MMP-2 levels across pregnancies with intrauterine growth restriction (IUGR), small for gestational age (SGA) and appropriate for gestational age (AGA), to biochemical screen the difference between SGA and IUGR.180 pregnant women were enrolled in a cross-sectional study: sixty pregnancies diagnosed for IUGR were included in group 1 (IUGR group), sixty pregnancies with SGA were in Group 2 (SGA group) and sixty pregnancies diagnosed for AGA, as control group. Maternal venous blood samples were collected at the time of enrollment, to assess serum MR-proADM and MMP-2 levels, by enzyme-linked immunosorbent assay (ELISA).The mean maternal serum MR-proADM and MMP-2 levels were lower in the IUGR group than in the SGA and AGA groups (Maternal serum MR-proADM and MMP-2 levels were significantly lower in pregnancies with IUGR. Maternal serum MR-proADM and MMP-2 measurements could be used to distinguish IUGR pregnancies from SGA pregnancies.

Objective: The aim of this study is to investigate the level of anxiety and distress among pregnant women during the outbreak of Covid-19. Material and Methods: A 30-item questionnaire was applied on-line to a total of 240 pregnant women from all the cities of Turkey between 18-24 May 2020. With this questionnaire, demographic data of the participants, their knowledge and concerns about Covid-19, general measures they took against Covid-19, pregnancy follow-ups and their delivery preferences were evaluated. In addition, the State-trait Anxiety Inventory (STAI) adapted to Turkish was applied to each participant. Personal and obstetric information were grouped and compared with the anxiety scale. Anxiety levels of the groups were calculated.Results: The STAI score means of 240 pregnant women who filled our questionnaire was 46.39±12.36 and the Cronbach Alpha value was calculated as 0.93. It was found that 125 pregnant women received help by contacting their doctor over the phone during the Covid-19 outbreak. It was also found that 106 pregnant women wanted to give birth at home. It was again found that 47.9% of pregnant women received information about Covid-19 from television. The STAI scores of pregnant women whose one or more family members’ Covid-19 test were positive was 59.60 ± 5.63. The anxiety scores of pregnant women who were healthcare workers was 48.30 ± 12.27.Conclusions: Necessary clinical and psychological counseling services should be provided by local and national health institutions via television, telephone and internet for pregnant women, whose anxiety level increased during the Covid-19 outbreak, to be in full physical and mental well-being.

Amaç: Menopozal başlangıç kadınların hayat kalitesini belirleyen önemli faktörlerden biridir. Bu çalışmanın amacı postmenopozalkadınlarda doğal veya cerrahi menopozlu olmanın, menopozal sürenin ve serum gonadotropin düzeylerinin pre-diyabet (pre-DM) vediyabet (DM) gelişimi üzerine etkisini incelemektir.Gereç ve Yöntemler: Bu retrospektif olgu kontrol çalışmasına 140 pre-DM, 148 DM postmenopozal kadın ile 265 sağlıklı postmenopozalkadın dâhil edildi. Grupların menapoz tipi, süresi ve serum folikül stimüle edici hormon (FSH), luteinize edici hormon (LH) ve östradiol(E2) serum düzeyleri karşılaştırıldı. İstatistiksel değerlendirmede ANOVA ve Kruskal Wallis Testi kullanıldı.Bulgular: Doğal ya da cerrahi menopozlu olmanın pre-DM veya DM gelişimleri üzerine etkisi bulunmadı (p=0,393). Artmış menopozsüresi en fazla DM’li kadınlarda görüldü ve kontrollere göre farklılık istatistiksel olarak anlamlı bulundu (p=0,019). DM grubundadüşük serum FSH ve LH düzeyleri ile yüksek serum E2 düzeyleri gözlendi ve aradaki fark kontrol grubuna göre anlamlıydı (sırasıyla,p=0,001, p=0,001ve p=0,012).Sonuç: Cerrahi veya doğal yolla menopoza başlangıç yapmak kadınlarda gelişebilecek pre-DM ve DM oluşumunu etkilememektedir.DM’li kadınların menapozal süresi daha uzundur. DM öncesi ve DM’li kadınlar daha düşük serum FSH ve LH ve daha yüksek serumE2 düzeylerine sahiptir. Bu durum kısmen adiposite ve insulin direnci ile açıklanabilir., Aim: The onset of menopause is an important factor determining quality of life in females. The aim of this study was to evaluate theeffect of natural or surgical menopause, the duration of the menopausal period, and serum gonadotropin levels on the development ofpre-diabetes mellitus (pre-DM) and diabetes mellitus (DM) in postmenopausal women.Material and Methods: This retrospective study included 140 postmenopausal women with pre-DM, 148 postmenopausal women withDM and 265 healthy postmenopausal women. The groups were compared in respect of menopause type, the duration of the menopausalperiod, and serum follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2) levels. Statistical evaluations weremade.Results: There was found to be no significant effect of natural or surgical menopause on the development of pre-DM or DM (p=0.393).Increased duration of menopause was mostly seen in women with DM and the difference was statistically significant compared to thecontrols (p=0.019). Serum decreased FSH and LH levels and increased E2 level were observed in the DM group and the difference wassignificant compared to the control group (respectively, p=0.001, p=0.001 and p=0.012).Conclusion: The onset of natural or surgical menopause does not affect the development of pre-DM and DM. Women with DM havea longer menopausal period. Women with pre-DM and DM have lower serum FSH and LH levels and higher serum E2 levels. This canbe explained in part by adiposity and insulin resistance.

Hiperekojen barsak; USG’de barsağın çevresindeki kemiklerle (krista iliakave vertebra dansitesi ile) benzer veya daha fazla ekojenitede olması şeklindetanımlanır. Bazı kaynaklar da akciğer veya karaciğer ekojenitesine görekarşılaştırma önermektedir. 20. gebelik haftasından önce görülen izole hiperekojen barsak genelliklegeçicidir, ilerleyen haftalardaki seri ultrasonografilerde gözdenkaybolmaktadır. Bu durum çoğu infantta normal barsak fonksiyonuylasonuçlanmaktadır. 3. Trimestırde persiste eden hiperekojenik ince barsak dahaçok altta yatan patolojiyi yansıtsa da normal bir sonuçla dakarşılanabilinmektedir. Normalin bir varyantı olabileceği gibi, primer gastrointestinal patoloji,konjenital viral enfeksiyonlar, kistik fibrozis, anöploidi ve intra abdominalhemorajilerde de hiperekojen barsak karşımıza çıkabilmektedir. Hiperekojen barsak nedenleri arasında anal atrezi olguları nadir görülmesinerağmen akla gelmelidir. Biz bu çalışmamızda anne karnında hiperekojenik barsağıolan fetusun doğum sonrasında anal atrezi tanısı da konulan olgu sunumunuişleyeceğiz., Hyperechogenic bowel; is defined as the presence of echogenicity similar toor superior than the bones around the intestine (with density of iliac crystaand vertebra). Some resources also recommend comparison with lung or liverechogenicity. The isolated hyperechogenic bowel present before the 20th gestational week isusually transient and disappears from the eye in serial ultrasonography in thefollowing weeks. This results in most infantile normal bowel function. 3.Thymester-persistent hyperechogenic small intestine is more likely to be metwith a normal result even if it reflects the underlying pathology. As well as hyperechogenic bowel may be a variant of normality, it may also beencountered with primary gastrointestinal pathology, congenital viral infections,cystic fibrosis, aneuploidy and intraabdominal hemorrhage. Among the causes of hyperechogenic bowel, cases of anal atresia should beconsidered, although rare. In this study, we present a case report, a fetuswhich had hyperechogenic intestines intra-uterine and diagnosed anal atresiaafter delivery.

Amac: Isthmosel, dunyada gittikce yayginlasan sezaryen operasyonunun uzun donem bir komplikasyonudur. Ancak sezaryen skar defektli kadinlarin(SSD=Isthmosel) tamaminda semptom gorulmez. Biz calismamizda isthmosel prevalansi, gelisimi icin risk faktorleri ve en yaygin semptomlarini arastirmak istedik. Yontemler: Bu calismaya 6 aydan daha uzun bir sure once sezaryen operasyonu olan, 2017 Ocak 2017 Nisan tarihleri arasinda gebe olmayan, jinekoloji poliklinigine herhangi bir nedenle basvuran kadinlar dahil edildi. Menapoz doneminde ki hastalar calisma disi birakilma kriteri olarak alindi. Sezaryen olan 115 kadinin verileri yasi, vucut kitle indexi, sezaryen sonrasi gecen sure ve gecirilmis sezaryen sayisini icerecek sekilde kayit altina alindi. Standardize edilen skar parametreleri (residual myometrial kalinlik (RMK), triangular hipoekoik nishe’in genislik ve derinligi olcumu) transvajinal ultrasonografi (TVUSG) ile yapildi. Isthmosel semptomlari asemptomatik, postmenstrual spotting tarzi kanama, menoraji, kronik pelvik agri, dismenore ve infertilite olarak kategorize edildi. Isthmosel ve menstruel komplikasyonlar arasindaki iliski arastirildi. Isthmosel gelisimi ve sezaryen sebebleri arasindaki iliskiler degerlendirildi. Bulgular: Hastalarin TVUSG ile degerlendirmesinde 17 tanesinde (%14,78) isthmosel tespit edildi. Birden fazla sezaryen olan hastalar tek sezaryen olan hastalara gore daha fazla isthmosel gelistirme egilimindeydiler. Ortalama isthmosel capi 6,006 ± 0,7970 mm’di. Isthmoselli kadinlarin 6 tanesi (%35,3) elektif alinan sezaryen vakalarinda gelismis iken, 11 tanesi (%64,7) dogum eylemi basladiktan sonar yapilmisti. Isthmosel olan hastalarin cogunlugu semptomatikti ve daha cok spotting tarzda kanama goruluyordu. Isthmosel gorulen kadinlarin RMK degerleri isthmosel gorulemyenlerden belirgin olarak dusuktu (5,57 ± 0,60 mm vs 8,78 ± 0,22 mm). Sonuc: SSD prevalans ve insidansi kadin dogum hekimlerinin tahmin ettiginden cok daha fazladir. Isthmosel bir sezaryen sonrasi bile gelisebilir ve o kadinlarda uzun vadeli yasamlari boyunca morbidite sebebi olarak gorulur. Sezaryen oranlarinin azaltilmasi isthmosel prevalansini azaltmada cok etkili olacaktir.

Myomas are commonly seen benign tumors of the uterus; they may cause a great variety of symptoms depending on the location. Herein, we presented an unusual case of giant cervical myoma with associated actinomycosis resulting in bilateral hydronephrosis and uremia. A 42-year-old woman was admitted to emergency service with anuria and confusion. She had an intra-abdominal mass extending 4-5 cm above the level of umbilicus. The hemoglobin level was 5.1 g/dl and creatinine level was 5.2 mg/dl. Magnetic resonance imaging revealed enlarged uterus with intrauterine device which was displaced up above the level of umbilicus due to a large cervical mass measuring 16.5x11.5x12 cm, tortuous hydroureters on both sites and left tuba ovarian abscess. A huge cervical lobulated mass which was pressing both ureters and filling the lower abdomen, and left tuba ovarian abscess with dense adhesions which was created by actinomycotic infection were detected on explorative laparotomy. Uremia was normalized gradually following hysterectomy, and the patient was discharged with penicillin treatment. Although myomas are the benign tumors, they may mimic the genital malignancy, and may cause life-threatening complications such as renal failure and uremia.

Mature cystic teratomas are benign tumours of the ovary (Pins et al. 1996). They may rarely contain tissues such as adrenal, pituitary, kidney, lung, breast, retina, pancreas and prostatic elements...

Müllerian adenosarkom daha çok postmenapozal dönemdeki kadınları etkileyen nadir bir tümördür. Patolojik olarak düşük gradeli endometrial stromal sarkom ve çoğunlukla benign, ama bazen de atipik glandüler epitelden oluşur. Hastalar çoğunlukla karın ağrısı, huzursuzluk ve uterin kanama şikayetiyle başvururlar. Bu yazıda abse formasyonuyla komplike olan ve postoperatif dönemde sepsis gelişen bir Müllerian adenosarkom olgusunu sunmayı amaçladık. Müllerian adenosarkomlar rölatif olarak iyi prognoza sahip nadir görülen tümörler olmakla birlikte klinik tablo nekroza sekonder gelişen enfeksiyon, abse gelişimi ve postoperatif sepsisle komplike olabilmektedir

Factor VII (F VII) deficiency is a rare coagulation disorder inherited autosomal recessively. According to our literature search, it shows a wide clinical spectrum and can be diagnosed in advanced ages. Depending on the F VII levels, patients can admit with different kind of bleeding disorders or face to bleeding in postoperative period. Although the association between F VII levels and severity bleeding problems is not clear cut, recombinant F VII product infusion was advised before major surgery. In this paper, we aimed to present a late diagnosed F VII deficiency during preoperative investigation for elevated International Normalize Ratio (INR) levels in a 27 years old woman with an uncomplicated cesarean section history. Copyright © 2015 by Türkiye Klinikleri.