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Objective: To determine the maternal deaths and the factors affecting them in our city. Methods: The maternal deaths occurred in our city between January 2015 and June 2020 were reviewed retrospectively. The review was conducted by checking “Maternal Death Registry Forms” of the Provincial Directorate of Health. In cases where additional data related with the cause of death were required, the relatives of the cases, associated family practitioner, The Council of Forensic Medicine or local authorities were contacted. The data of the cases including age, gravida, parity, abortion, delivery type, week of gestation during delivery, period of death and maternal deaths due to direct, indirect and incidental causes were recorded. Based on total live births and maternal deaths within 6.5 years, maternal mortality rate was found as the maternal death number per 100,000 live births. Descriptive statistics were used for the statistical analysis of the data. Results: A total of 46.618 live births occurred between 2015 and 2020 in Elazığ. The number of maternal deaths due to direct and indirect causes is 7, and maternal mortality rate was found 15.01/100,000. Hypertensive diseases during pregnancy (n=3, 42.8%), pulmonary embolism (n=1, 14.3%) and cerebral thrombosis (n=1, 14.3%) were among the natural causes of maternal deaths. Indirect cause for maternal death was cardiac diseases (n=2, 28.6%). When they were categorized according to the Three Delays Model, there were 3 death cases in the first delay model and 2 death cases in the third delay model, but there was no maternal death in the second delay model. Conclusion: Maternal death is an significant public health issue which develops due to the generally preventable causes and maintains its importance. The factors contributing to death should be paid attention in order to decrease maternal death rates.

Objective: Twin pregnancies constitute 1–2% of all pregnancies. With the recent developments in assisted reproductive technologies, the incidence of multiple pregnancy has increased. Preterm labor is held responsible for the poor neonatal outcomes primarily. In our study, we aimed to assess fetal-maternal outcomes of twin pregnancies seen in our clinic. Methods: One hundred and thirty twin pregnancy cases out of 4241 pregnant women who delivered in our clinic between 01.01.2017 and 01.01.2020 were included in the study. The labor records of the patients were reviewed retrospectively and their data for age, week of gestation, delivery type, birth weight, fetal sex, chorionicity characteristics and laboratory parameters were recorded. Definitive statistics and SPSS 21.0 for statistical analyses were used to evaluate the data obtained from the study. The data were presented as mean ± SD (standard deviation). Results: The incidence of twin pregnancy was found 3%. In the ultrasonographic imaging evaluated during diagnosis, 27.7% of the cases were monochorionic and 72% of them were dichorionic. Of the pregnant women, 12.3% were at term and 87.7% were at preterm period. When the preterm fetuses were evaluated, 37.7% of 114 preterm fetuses were delivered at late preterm period, 29.2% of them at mid-preterm period and 20.8% at premature preterm period. The rates of treatment pregnancy (pregnancy provided by ovulation induction and assisted reproductive technologies) and spontaneous twin pregnancy were 20% and 80%, respectively. Mean maternal age was found 31.3. When evaluated in terms of maternal morbidity, preterm labor and premature rupture of membrane were the most common problems. Mean newborn weight was 1832g and 59.3% of the newborns had low birth weight and 21.8% of them had very low birth weight. While one fetus had transverse presentation in 12.5% of the patients, at least one fetus had breech presentation in 53.1% of the cases and 34.4% of the cases had head-head presentation. Conclusion: Twin pregnancies are characterized by the increased feto-maternal risks. Therefore, both antenatal and intrapartum management should be maintained diligently.

Objective To investigate the incidence and concomitant findings of persistent right umbilical vein (PRUV). Methods The study was conducted by retrospective review of the data of 1856 patients who admitted to the Clinic of Obstetrics and Gynecology of Fırat University between December 2018 and December 2019 for the gestational examination between 14 and 28 weeks of gestation. The obstetric characteristics of the patients such as age, number of pregnancy, abortion, parity and body mass index were recorded. The diagnosis of PRUV was established in the conditions where portal vein reaches to stomach abnormally (roughly, course towards stomach instead of parallel course), fetal gall bladder locates in the medial of umbilical vein or umbilical vein connects to right portal vein abnormally instead of left portal vein. In the cases diagnosed with PRUV, the isolated persistent right umbilical vein or its association with other anomalies was recorded. Ultrasonography findings (minor markers) were also recorded in these cases. Results During the study period, 1856 pregnant women were evaluated for gestational examination. Five cases were established with the diagnosis of PRUV. Accordingly, PRUV prevalence was 0.27%. The PRUV incidence in the study population was 1/370 in the study population. No chromosomal anomaly was found in PRUV cases, but one case had echogenic intracardiac focus, one case had echogenic intestine, and one case had short nasal bone. When organ systems were evaluated, renal cyst was found in one case. No additional finding was found in one case. Conclusion PRUV is the most common form among fetal venous system anomalies. If detected, fetal examination is required in terms of the anomalies that may accompany. Chromosome analysis is not necessary if it is isolated, and it should be evaluated as a variant of normal anatomy.

Copyright of Istanbul Gelisim University Journal of Health Sciences / İstanbul Gelişim Üniversitesi Sağlık Bilimleri Dergisi is the property of Istanbul Gelisim Universitesi Saglik Bilimleri Yuksekokulu and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Twin pregnancies constitute 1-2% of all pregnancies. With the recent developments in assisted reproductive technologies, the incidence of multiple pregnancy has increased. Preterm labor is held responsible for the poor neonatal outcomes primarily. In our study, we aimed to assess fetal-maternal outcomes of twin pregnancies seen in our clinic. Methods: One hundred and thirty twin pregnancy cases out of4241 pregnant women who delivered in our clinic between 01.01.2017 and 01.01.2020 were included in the study. The labor records of the patients were reviewed retrospectively and their data for age, week of gestation, delivery type, birth weight, fetal sex, chorionicity characteristics and laboratory parameters were recorded. Definitive statistics and SPSS 21.0 for statistical analyses were used to evaluate the data obtained from the study. The data were presented as mean ± SD (standard deviation). Results: The incidence of twin pregnancy was found 3%. In the ultrasonographic imaging evaluated during diagnosis, 27.7% of the cases were monochorionic and 72% of them were dichorionic. Of the pregnant women, 12.3% were at term and 87.7% were at preterm period. When the preterm fetuses were evaluated, 37.7% of 114 preterm fetuses were delivered at late preterm period, 29.2% of them at mid-preterm period and 20.8% at premature preterm period. The rates of treatment pregnancy (pregnancy provided by ovulation induction and assisted reproductive technologies) and spontaneous twin pregnancy were 20% and 80%, respectively. Mean maternal age was found 31.3. When evaluated in terms of maternal morbidity, preterm labor and premature rupture of membrane were the most common problems. Mean newborn weight was 1832g and 59.3% of the newborns had low birth weight and 21.8% of them had very low birth weight. While one fetus had transverse presentation in 12.5% of the patients, at least one fetus had breech presentation in 53.1% of the cases and 34.4% of the cases had head-head presentation. Conclusion: Twin pregnancies are characterized by the increased feto-maternal risks. Therefore, both antenatal and intrapartum management should be maintained diligently. [ABSTRACT FROM AUTHOR]

Objective: To determine the maternal deaths and the factors affecting them in our city. Methods: The maternal deaths occurred in our city between January 2015 and June 2020 were reviewed retrospectively. The review was conducted by checking "Maternal Death Registry Forms" of the Provincial Directorate of Health. In cases where additional data related with the cause of death were required, the relatives of the cases, associated family practitioner, The Council of Forensic Medicine or local authorities were contacted. The data of the cases including age, gravida, parity, abortion, delivery type, week of gestation during delivery, period of death and maternal deaths due to direct, indirect and incidental causes were recorded. Based on total live births and maternal deaths within 6.5 years, maternal mortality rate was found as the maternal death number per 100,000 live births. Descriptive statistics were used for the statistical analysis of the data. Results: A total of 46.618 live births occurred between 2015 and 2020 in Elazığ. The number of maternal deaths due to direct and indirect causes is 7, and maternal mortality rate was found 15.01/100,000. Hypertensive diseases during pregnancy (n=3, 42.8%), pulmonary embolism (n=1, 14.3%) and cerebral thrombosis (n=1, 14.3%) were among the natural causes of maternal deaths. Indirect cause for maternal death was cardiac diseases (n=2, 28.6%). When they were categorized according to the Three Delays Model, there were 3 death cases in the first delay model and 2 death cases in the third delay model, but there was no maternal death in the second delay model. Conclusion: Maternal death is an significant public health issue which develops due to the generally preventable causes and maintains its importance. The factors contributing to death should be paid attention in order to decrease maternal death rates. [ABSTRACT FROM AUTHOR]

Objective: To investigate the incidence and concomitant findings of persistent right umbilical vein (PRUV). Methods: The study was conducted by retrospective review of the data of 1856 patients who admitted to the Clinic of Obstetrics and Gynecology of Fırat University between December 2018 and December 2019 for the gestational examination between 14 and 28 weeks of gestation. The obstetric characteristics of the patients such as age, number of pregnane)/, abortion, parity and body mass index were recorded. The diagnosis of PRUV was established in the conditions where portal vein reaches to stomach abnormally (roughly, course towards stomach instead of parallel course), fetal gall bladder locates in the medial of umbilical vein or umbilical vein connects to right portal vein abnormally instead of left portal vein. In the cases diagnosed with PRUV, the isolated persistent right umbilical vein or its association with other anomalies was recorded. Ultrasonography findings (minor markers) were also recorded in these cases, Results: During the study period, 1856 pregnant women were evaluated for gestational examination, Five cases were established with the diagnosis of PRUV, Accordingly, PRUV prevalence was 0,27%. The PRUV incidence in the study population was 1/370 in the study population. No chromosomal anomaly was found in PRUV cases, but one case had echogenic intracardiac focus, one case had echogenic intestine, and one case had short nasal bone. When organ systems were evaluated, renal cyst was found in one case. No additional finding was found in one case. Conclusion: PRUV-7 is the most common form among fetal venous system anomalies. If detected, fetal examination is required in terms of the anomalies that may accompany. Chromosome analysis is not necessary if it is isolated, and it should be evaluated as a variant of normal anatomy. [ABSTRACT FROM AUTHOR]

We aimed to investigate myoinositol effect on contractility of rat uterus in vitro and its mechanism of action. In a standard organ bath spontaneous contractions were recorded. After the cessation of spontaneous contractions, 5μM, 50 μM and 500 μM of myoinositol and 20μM folic acid were applied to each 7 strips and contractions were again enrolled. Same procedures were also repeated in calcium free solution. Real Time Polymerase Chain Reaction (RT -PCR) analysis of ion channels were done only for 50 μM myoinositol which corresponds to the treatment dose. It is demonstrated that in all doses increase in frequency and amplitude of contractions were statistically significant. Any contraction was not observed in calcium free solution which demonstrated us that myoinositol uses extracellular calcium for contraction. It is also demonstrated that folic acid does not cause contraction in non pregnant rat uterine smooth muscle cells. Expression of Transient receptor potential cation channel, subfamily M, member 2 (TRPM2) and Transi ent receptor potential cation channel, subfamily V, member 1 (TRPV1) channels significantly decreased after application of myoinositol (p=0.0 1, for both) whereas expression of Transient receptor potential cation channel, subfamily M, member 7 (TRPM7) and Calcium channel, voltage-dependent, N type, alpha 1B subunit (CACNA1B) channels did not change significantly when compared to control (for both). We demonstrated for the first time that myoinositol causes contraction in myometrium of nonpregnant rat uterus and it uses the extracellular calcium for contraction. [ABSTRACT FROM AUTHOR]

Objective: Although anemia is a quite common problem in all age groups and sexes in the world, it is particularly important in pregnant women as it may lead to poor maternal and perinatal outcomes. In this study, we aimed to determine anemia prevalence, the impact of parity on anemia prevalence and the severity of anemia in term pregnancies in our region. Methods: A total of 426 pregnant women who admitted to Obstetrics and Gynecology Department of Fırat University between June 1, 2016 and December 31, 2016 and who were at 37 weeks of gestation and above without any additional pathologies such as preeclampsia, HELLP syndrome and placental abruption were included in the study. The demographic characteristics and hemoglobin values of pregnant women were evaluated retrospectively. Results: The anemia prevalence was 18.7% in nulliparous patients and 21.9% in those with parity between 1 and 4, and it was 46.2% in grand multiparous patients. The severities of all diagnosed anemia cases were mild to moderate. Severe and very severe anemia was not found in any patient. Conclusion: When compared to nulliparous patients, the prevalence of anemia is higher in multiparous and grand multiparous patients. Iron deficiency anemia is seen at a high rate despite preventive medicine activities. [ABSTRACT FROM AUTHOR]

The present study aimed to report a case of primary frontoethmoidal encephalocele diagnosed at 24 weeks of gestation. Encephalocele is one of the most commonly observed neural tube defects; the other two are anencephaly and spina bifida. No associated abnormality was observed in the present case, which only had a mass lesion in the glabellar region of the face. Frontoethmoidal encephalocele was diagnosed after physical examination and radiologic evaluation of the case. Frontoethmoidal encephaloceles are rare cases and can be diagnosed in the antenatal period. All masses at the nasal region must be accepted as an encephalocele until proven otherwise. [ABSTRACT FROM AUTHOR]

Copyright of Firat Tip Dergisi is the property of Firat University, Faculty of Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

To show the efficacy of double-balloon cervical ripening catheter in the management of postpartum hemorrhage originating from the lower segment of the uterus or the upper parts of the vagina. Methods: Patients with intractable bleeding from the lower segment of the uterus and the upper parts of the vagina after Cesarean or vaginal deliveries were treated by double-balloon cervical ripening catheter. Results: Double-balloon catheter was used in seven patients, and it was properly placed in all of them. No other intervention was needed to control bleeding. Two patients were delivered vaginally, and five patients were delivered by Cesarean section. Length of hospitalization was longer in the vaginal delivery patients (average hospitalization was 12 days in the vaginal delivery patients and 5 days in the Cesarean section patients). The need for blood and blood products transfusion (average of blood and blood products transfusion was 30 U in the vaginal delivery patients and 6 U in the Cesarean patients) was also higher in the vaginal delivery patients. Conclusion: Although double-balloon cervical ripening catheter is designed for the induction of labor, it can successfully control intractable bleedings from the lower segment of the uterus and the upper parts of the vagina. This procedure can save patients from undergoing more morbid procedures. [ABSTRACT FROM AUTHOR]

Copyright of Firat Tip Dergisi is the property of Firat University, Faculty of Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: The incidence of cervical ectopic pregnancy varies between 1/2,500 and 1/10,000. Cervical ectopic pregnancy is life-threatening, and one of the rarest forms of ectopic pregnancy. Sonographic diagnosis of cervical pregnancy has several challenges. The relationship between endometrial cavity and gestational sac should be considered carefully. Since it is seen rarely and one of the most significant reasons of mortality, we aimed to present a case of a cervical ectopic pregnancy diagnosed at 23 weeks of gestation. Case: Twenty-nine-year-old case with second pregnancy had no remarkable history except a previous cesarean delivery. The case who regularly visited external center for follow-up during current pregnancy admitted to our clinic with the pre-diagnosis of 22W2D pregnancy oligohydramnios and diastolic flow loss. The case who had 22W2D pregnancy according to early USGs had fetus competible to 19 weeks of gestational age in the USG performed. The case was followed up weekly with the diagnosis of oligohydramnios + IUGR (AC: 18W, FL: 20W) and diastolic flow loss. Placenta was low-lying and no clear relationship with cervix was established. The patient had normal results for first trimester combined test in her history, no rupture of membrane was described and there was no remarkable characteristic in the TORCH panel. The patient who refused vaginal examination was called for control. The patient came one week later and fetal cardiac activity was not seen in the ultrasonography. Fetal abdominal circumference was compatible with 18W4D. She was diagnosed with 23W1D oligohydramnios, intrauterine fetal death, transverse presentation, and previous 1 C/S. In the USG, fundus was observed as empty and in postpartum appearance. Fetus was observed around isthmic area. So it was suspected of servical ectopic pregnancy. The patient was hospitalized and applied laparotomy after preoperative evaluation. The abdomen was entered by epigastric and hypogastric incisions. The diagnosis of cervical ectopic pregnancy was confirmed by the laparotomy. In order to prevent possible severe bleeding, it was decided to apply Infrarenal Aorta occlusion. The aorta was suspended from Aorta bifurcation level by the consultant cardiovascular surgery physician. Double J catheters were placed on both ureters together with cystoscopy by consultant urologist. Also tourniquet was applied by Penrose over isthmic region. 1 cc heparin was administered and the aorta was clamped 2 minutes later. First the bladder was dissected. Just below the isthmus on the front side of uterus, fetus and its attachments were delivered by opening 3 cm transverse incision. Fetus was 240 g, 20 cm and male. Placenta and its attachments were cleaned. Intracervical foley condom was placed. It was inflated by 300 cc SF. Aorta clamp was opened. The procedure took about 25 minutes. One foley drain was placed into Douglas. Bleeding was checked. The case was taken to her bed in the unit with stable findings. Conclusion: The diagnosis of servical ectopic pregnancy is generally limited with the first trimester cases in the literature. In cases referring at advanced weeks of gestation, prioritized evaluation of uterine fundus and fetus localization is essential to prevent delays in diagnosis. [ABSTRACT FROM AUTHOR]

Objectives: The aim of our study is to examine maternal serum Elabela levels in pregnancy with intrauterine growth retardation (IUGR). IUGR is one of the most important causes of perinatal mortality and morbidity. IUGR is also related future comorobidities such as diabetes mellitus, hyperlipidemia, hypertension and coronary artery disease., Material and Methods: Fifty pregnancies diagnosed as IUGR (Group 1) and fifty healthy pregnancies (Group 2) enrolled into the study. Obstetric and demographic characteristics of the patients, serum elabela levels, ultrasound parameters, cord pH value and APGAR scores of the newborns were recorded. In the study, which was planned as a prospective case-control study, an independent t test was used for the evaluation of continuous data and the Mann Whitney U test was used for the statistical evaluation of ordinal data. p < 0.05 was considered significant., Results: The mean gestational age of the cases at delivery was 36.35 ± 1.29 in Group 1 and 38.16 ± 0.94 weeks in Group 2 (p < 0.05). Mean serum Elabela levels were 15.05 ± 9.03 in Group 1 and 8.96 ± 4.33 ng/mL in Group 2 (p < 0.0001). Mean newborn weights were 2498.20 ± 465.92 in Group 1 and 3179.44 ± 387.99 gr. in Group 2 (p < 0.0001). Systolic and diastolic blood pressure measurements taken on the day of delivery were higher in Group 1, and diastolic blood pressure was 77.0 ± 9.53 in Group 1 and 72.60 ± 13.37 mmHg in Group 2 (p < 0.05). Bilateral uterine artery Pulsatile Index (PI) and umbilical artery PI value were significantly higher in Group 1 (p < 0.05), and middle cerebral artery PI and cerebroplacental ratio were significantly lower in Group 1 compared to Group 2 (p < 0.05). Although the cord pH value, 1st and 5th minute APGAR scores were lower in Group 1 compared to Group 2, no statistically significant difference was found (p > 0.05)., Conlusions: In our study, it was found that serum Elabela levels increased significantly in pregnancies complicated by IUGR compared to the control group.

Objective: To examine the effects of low-to-high doses of tamoxifen on ovarian histopathology, serum VEGF, and endothelin 1 levels in ovarian hyperstimulation syndrome (OHSS) in an experimental setting., Materials and Methods: A total of 20 female Wistar albino rats, 22 days of age, were randomly divided into four groups. Follicle-stimulating hormone 10 IU was administered subcutaneously in 15 rats on 4 consecutive days, with OHSS induction on day 5 by 30 IU of human chorionic gonadotropin. Group 1 (n=5) comprised 35-day-old control rats, group 2 (n=5) 35-day-old OHSS rats, group 3 (n=5) 27-day-old OHSS rats receiving 1 mg/kg of oral tamoxifen for 7 days, group 4 (n=5) 27-day-old OHSS rats receiving 3 mg/kg of oral tamoxifen for 7 days. All rats were decapitated on day 35. Serum VEGF, endothelin 1, and ovarian follicular reserve were assessed in all rats. Kruskal-Wallis variance analysis and the Mann-Whitney U-test were used for statistical comparisons. A Bonferroni correction was performed to control the inflation of significance, with a significance level set at a P-value of less than 0.025., Results: Despite higher serum VEGF, endothelin 1, follicular reserve, and angiogenesis and fibrosis of the corpus luteum in the OHSS group compared to controls, these differences were not significant (P>0.025, Mann-Whitney U-test). There was a significant reduction in the ovarian follicular reserve in tamoxifen groups compared to controls (P<0.025, Mann-Whitney U-test), while angiogenesis of the corpus luteum, number of atretic follicles, fibrosis, and serum VEGF were significantly higher in rats receiving tamoxifen (P<0.025, Mann-Whitney U-test). Also, significantly lower follicular reserve and fibrosis were observed among rats in the low-dose tamoxifen group in comparison with rats in the high-dose tamoxifen group (P<0.025, Mann-Whitney U-test). No groups had a significant change in endothelin 1 levels (P>0.025, Mann-Whitney U-test)., Conclusion: Tamoxifen 1 g and 3 g resulted in a dose-dependent increase in VEGF and endothelin 1 levels, and ovarian follicle reserves were significantly reduced in our experimental model.