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Objective: The current study assesss programmed death-1 (PD-1) receptor expression and CD3, CD4, and CD8 tumor-infiltrating lymphocytes (TILs) in high-grade serous ovarian cancer (HGSOC) and to associate our results with neoadjuvant chemotherapy history and disease prognosis. Materials and Methods: We included cases diagnosed with primary HGSOC with biopsy or surgical resection materials in this study. The immunoreactivity of CD3, CD4, CD8, and PD1 was assessed immunohistochemically in tumor tissue. We analyzed TILs in two predetermined groups of high and low TIL. The relationships between clinical characteristics, PD-1, and TIL were assessed. by the χ(2) test or Fisher’s Exact test. We used Kaplan-Meier survival analysis and Cox proportional hazards regression model to the connection between survival and the amounts of TIL, and PD1. Results: Univariate analysis demonstrated that optimal debulking (p

This study aimed to investigate the effectiveness of abdominal subcutaneous fat thickness (ASFT) in predicting antenatal insulin therapy (AIT) in patients with gestational diabetes mellitus (GDM).A prospective study was conducted on patients with regulated blood sugar levels (n = 50) and those with unregulated blood sugar (n = 50) although medical nutrition therapy (MNT) was initiated and then AIT was applied. Using receiver operator characteristic (ROC) curve analysis, appropriate ASFT cut-off point values were found for the prediction of cases that required AIT after MNT in GDM pregnancies.Patients with GDM who needed AIT had a significantly higher ASFT value compared to those with GDM who did not need AIT. The optimal ASFT cutoff was 21.7 mm in predicting cases that required AIT after MNT (sensitivity, specificity, negative, and positive predictive values were 68.0%, 64.0%, 65.8%, and 66.6%, respectively). The risk of AIT increased 3.77-fold in those with ASFT 21.7 mm in GDM pregnancies (p = 0.001).The ASFT value was significantly higher in cases with GDM, with blood glucose levels not regulated despite MNT and AIT being then needed, compared to patients with blood glucose levels regulated by MNT, and who did not need AIT. Also, patients requiring AIT can be determined with moderate to high sensitivity and specificity using a cut-off value of ASFT 21.7 mm. The ASFT 21.7 mm cut-off point was seen to be more effective than BMI ≥ 30 kg/m

Objective Based on the SUCCOR study database, our primary objective was to identify the independent clinical pathological variables associated with the risk of relapse in patients with stage IB1 cervical cancer who underwent a radical hysterectomy. Our secondary goal was to design and validate a risk predictive index (RPI) for classifying patients depending on the risk of recurrence. Methods Overall, 1116 women were included from January 2013 to December 2014. We randomly divided our sample into two cohorts: discovery and validation cohorts. The test group was used to identify the independent variables associated with relapse, and with these variables, we designed our RPI. The index was applied to calculate a relapse risk score for each participant in the validation group. Results A previous cone biopsy was the most significant independent variable that lowered the rate of relapse (odds ratio [OR] 0.31, 95% confidence interval [CI] 0.17–0.60). Additionally, patients with a tumor diameter >2 cm on preoperative imaging assessment (OR 2.15, 95% CI 1.33–3.5) and operated by the minimally invasive approach (OR 1.61, 95% CI 1.00–2.57) were more likely to have a recurrence. Based on these findings, patients in the validation cohort were classified according to the RPI of low, medium, or high risk of relapse, with rates of 3.4%, 9.8%, and 21.3% observed in each group, respectively. With a median follow-up of 58 months, the 5-year disease-free survival rates were 97.2% for the low-risk group, 88.0% for the medium-risk group, and 80.5% for the high-risk group (p < 0.001). Conclusion Previous conization to radical hysterectomy was the most powerful protective variable of relapse. Our risk predictor index was validated to identify patients at risk of recurrence.

Objective: The aim of this study was to evaluate the frequency of postpartum depression (PPD), accompanying risk factors, and obstetrics and neonatal outcomes in adolescent pregnancies.Study Design: This prospective study was conducted on adolescent and adult pregnant patients giving birth in Diyarbakır Gazi Yaşargil Training and Research Hospital of Health Sciences University between January 01 and 31, 2018. Groups were compared in terms of PPD rates and PPD-related factors were also determined in both groups.Results: The frequency of PPD was higher in adolescent patients than in adult patients but the difference was not considered statistically significant (p> 0.05). In adolescent and adult patients, the following factors were found to increase PPD risk: illiteracy, living in an urban area, divorced parents, having fewer than 4 siblings, anemia and caesarean delivery.Conclusion: The study results showed no significant difference in PPD rates between adolescent and adult pregnant patients. In both groups, the factors of illiteracy, living in an urban area, divorced parents, anemia, fewer than 4 siblings, and caesarean delivery were found to increase the risk of development of PPD.

Objective: Lymph node metastasis (LNM) is the most important factor affecting survival in early-stage cervical cancer (CC). International Federation of Gynecology and Obstetrics revised the staging of CC in 2018 and reported LNM as a staging criterion. We investigated the preoperatively assessable risk factors associated with LNM in surgically treated stage IB1-IIA2 CC patients. Materials and Methods: This was a retrospective cohort study of women who underwent radical hysterectomy and pelvic lymphadenectomy with or without para-aortic lymphadenectomy for CC stage IB1-IIA2 from 2004 to 2019. All patients included in this study were examined with speculum inspection, parametrial assessment by rectovaginal palpation under general anesthesia, transvaginal ultrasonography, magnetic resonance imaging (MRI), and chest radiography. Clinical staging was done according to the preoperative findings. MRI was used to measure tumor and lymph node dimensions. Results: Out of the 149 women included in the study, 29 (19.4%) had LNM. Univariate analysis revealed that larger tumor size (≥30 mm), lymphovascular space invasion (LVSI) detected with diagnostic biopsy, parametrial involvement, and deep stromal invasion status were significantly different between the group with LNM and the group without LNM. In multivariate analysis, specific preoperative risk factors such as MRI based tumor diameter ≥30 mm and LVSI (+) on the diagnostic biopsy were found to be independent risk factors for LNM in the multivariate analysis. Conclusion: The rate of LNM is high in patients with CC with a tumor size ≥30 mm and preoperative biopsy LVSI status even if they are clinically in early stages. Surgeons can take this into account while deciding between primary surgery and chemoradiotherapy in the treatment of CC. WOS:000908434300015 36412408 Q4

Objective: To evaluate the 8-day methotrexate (MTX)/folinic acid (FA) as a first-line chemotherapy regimen treatment in terms of complete regression of disease in women with low-risk gestational trophoblastic neoplasia (GTN). Material and Methods: All patients with low-risk GTN treated with an 8-day MTX/FA regimen were retrospectively included in the study. International Federation of Obstetrics and Gynecology and the modified World Health Organization Prognostic Scoring System were used to classify the risk of GTN. All women received diagnostic imaging evaluation before starting the treatment. The same MTX/FA regime was used repeating as a two-week cycle until normalization of the beta-human chorionic gonadotropin (ß-HCG), thus monthly ß-HCG follow-up was scheduled for up to 1 year. Results: Successful treatment was achieved in 56/66 (84.8%) patients. Nine (13.6%) women had resistance and 1 (1.6%) toxicity. The resistance patients were successfully treated with EMA-CO (etoposide, methotrexate, actinomycin D, cyclophosphamide, vincristine) protocol, whereas the patient who showed toxicity to the MTX/FA regime was successfully treated with actinomycin-D. Conclusion: Eight-day MTX/FA regime could be useful in low-risk GTN patients with good security margins. The toxicity rates in this protocol were determined as quite low. All resistance was treated successfully with the EMA-CO protocol.

Objective: To evaluate the outcomes of patients who were followed up and treated for serous epithelial ovarian tumor. Materials and Methods: This retrospective study included 260 patients who were diagnosed with serous epithelial ovarian cancer, treated and followed up at Kanuni Sultan Suleyman Training and Research Hospital between January 2002 and December 2019. Results: The mean age of the patients participated in the study was 53.4±11.6 years. Of the patients, 79.7% had advance stage and 82.4% had grade 3 tumors. The rate of complete or optimal surgery was 88.2%, while the rate of suboptimal surgery was 11.2%. While 82% of the patients received adjuvant chemotherapy, 15.7% received neoadjuvant chemotherapy. Of the patients, 80.2% had a Ca 125 value higher than 35. Despite primary cytoreductive surgery and platinum-based adjuvant chemotherapy, the recurrence rate was 66.2%, and the PFS and OS rates were 34.7±41.0 and 50.5±40.0 months, respectively. Conclusion: The majority of serous epithelial ovarian cancers are diagnosed at an advanced stage. Despite primary situ reductive surgery and subsequent platinum-based chemotherapy, the recurrence rates are quite high.

Objective: The aim of this study was to evaluate obstetric and neonatal outcomes of pregnancies with mild gestational hyperglycemia diagnosed at gestational diabetes mellitus screening.Study design: Between September 2016 and August 2017, the pregnant women diagnosed as normal glycaemia or mild gestational hyperglycemia according to the results of gestational diabetes mellitus screening with 50 g oral glucose challenge test, and 100 g oral glucose tolerance test were compared [Normal glycaemia: Blood glucose value

Purpose:The aim of this study was to research the relationship between types of birth and congenital nasolacrimal duct obstruction.Method:The study enrolled 665 infantile patients with prediagnosis of congenital nasolacrimal duct obstruction due to associated ophthalmic symptoms. Age, gender, family history, delivery type, and patient medical records were investigated. Patients were grouped and compared according to their birth type and whether it was the first birth.Results:The number of the infants with and without congenital nasolacrimal duct obstruction was 227 (34.1%) and 438 (65.9%), respectively. Comparison of the congenital nasolacrimal duct obstruction and non-congenital nasolacrimal duct obstruction groups according to the first births showed that ratio of cesarean section was significantly higher in the congenital nasolacrimal duct obstruction group than the non- congenital nasolacrimal duct obstruction group (58.7% and 20.7%, respectively). Number with positive family history also was significantly higher in the congenital nasolacrimal duct obstruction group.Conclusion:Cesarean section in first birth and positive family history of congenital nasolacrimal duct obstruction appear to be important risk factors in the etiopathogenesis of congenital nasolacrimal duct obstruction.

Objectives: The aim of this study was to compare the obstetric and neonatal outcomes of pregnant women who were screened with one or two-step screening programs for diagnosis of gestational diabetes mellitus.Study Design: A retrospective evaluation was made of pregnant women who were screened with one step [75 g oral glucose tolerance test] or two-step screening programs [50 g oral glucose challenge test and 100 g oral glucose tolerance test] depending on the preference of the physician between September 2016 and August 2017.Results: The one-step screening program was applied to 34.1% (n:1358) of the pregnancies and the remaining 65.9% (n=2623) were screened using the two-step program. The following results were obtained for the pregnant women applied with the one and two-step screening programs, respectively; mean age: 29.37±7.6 years and 28.1 ± 6.2 years, gestational diabetes mellitus: 8.8% and 4.8%, pre-term birth:5.2% and 6.9%, term birth: 89.8% and 85.5%, post-term birth: 5% and 7.6%, vaginal delivery: 74.8% and 67.5%, caesarean section delivery: 25.2% and 32.5%, birth weight: 3389±432 gr and 3234.1 ± 415.9 gr, and mean 5-minute APGAR score: 9.1 ± 0.4 and 9.2 ± 0.7. Comparisons showed statistically significant differences between the groups.Conclusion: The study results showed a significantly higher rate of gestational diabetes mellitus diagnosis for the pregnant women screened with the one-step screening program than the two-step screening program. Although the mean maternal age was significantly higher in the pregnant women screened with the one-step screening program, these pregnancies were observed to have better outcomes (low rates of preterm birth, post-term birth, caesarean delivery and high rates of term birth, vaginal delivery). These results can be attributed to the early referral to a treatment program and follow-up, even though more cases of gestational diabetes mellitus were diagnosed with the one-step screening program.

Amaç: Bu çalışmada; gebelerde, Toxoplasma gondii, Rubella virüs ve Cytomegalovirus infeksiyonlarının bölgemizdeki seroprevalanslarının belirlemesi amaçlanmıştır. Yöntemler: Bu çalışmada hastanemize Eylül 2016 ile Haziran 2018 tarihleri arasında kadın hastalıkları ve doğum polikliniklerine ilk prenatal vizite gelen 18-45 yaş arası gebeler dahil edildi. Bu hastalardan Toxoplasma gondii, Rubella ve Cytomegalovirus virüs serolojisi çalışılanların test sonuçları retrospektif olarak incelendi. Bulgular: Toxoplasma gondii antikorları açısından 8175 hastanın 2853’ inde (%34,9) anti toksoplazma gondii IgG antikorları, 91’ inde (%1,1) anti Toxoplasma gondii IgM antikorları pozitif olarak saptandı. Cytomegalovirus antikorları açısından 2797 hastanın 2775’ inde (%99,2) anti Cytomegalovirus IgG, 20’ sinde (%0,7) anti Cytomegalovirus IgM pozitif olarak saptandı.Rubella virüs antikorları açısından 8158 hastanın 7677’ sinde (%94,1) anti Rubellavirus IgG, 5’ inde (%0,1) anti Rubellavirus IgM pozitif olarak saptandı. Sonuç: Bu çalışmada hastanemize başvuran gebelerin çoğunun toksoplazma seronegatif (%65,1) olduğu tespit edildi.Rubella seroprevalansı (%94,1) Türkiye verileri ile uyumludur. Gebelerin Cytomegalovirus seroprevalansı için seropozitiflik oranı (%99,2) dünya verileri ile uyumludur.

Objectives: This study aimed to compare the serum IL-22 levels between preterm premature rupture of membranes (PPROM) patients and the control group with intact membranes. We also hypothesized whether serum IL-22 upregulation might contribute to defense against inflammatory responses and improve the pregnancy outcomes. Material and methods: We performed this prospective case-control study between 24–34 weeks of pregnancy. We enrolled 40 singleton pregnant patients with PPROM and 40 healthy gestational age- and gravidity-matched patients without PPROM. The degree of association between variables and IL-22 were calculated by Spearman correlation coefficients where appropriate. Scatter plots were given for statistically significant correlations. ROC curve was constructed to illustrate the sensitivity and specificity performance characteristics of IL-22, and a cutoff value was estimated by using the index of Youden. Results: Maternal serum IL-22 levels were significantly higher in PPROM patients (60.34 ± 139.81 pg/mL) compared to the participants in the control group (20.71 ± 4.36 pg/mL, p < 0.001). When we analyze the area under the ROC curve (AUC), the IL-22 value can be considered a statistically significant parameter for diagnosing PPROM. According to the Youden index, a 23.86 pg/mL cut-off value of IL-22 can be used to diagnosing PPROM with 72% sensitivity and 61.5% specificity. There was no positive correlation between serum IL-22 levels and maternal C-reactive protein (CRP) value, procalcitonin value, latency period, birth week, birth weight, and umbilical cord blood pH value. Conclusions: Maternal serum IL-22 levels were significantly higher in PPROM patients than healthy pregnant women with an intact membrane. We suggest that IL-22 might be a crucial biomarker of the inflammatory process in PPROM.

Objective: The aim of the study is to objectively evaluate the effects of Loop Electrosurgical Excision Procedure (LEEP) on women’s sexual function using a validated questionnaire. Methods: This pre-post survey design study was conducted at a tertiary referral hospital gynecological oncology clinic. 80 sexually active patients who had undergone LEEP because of abnormal cervical cytology results between October 2018 and December 2018 were included. Participating patients answered the Female Sexual Function Index (FSFI) questionnaire before undergoing LEEP and at 3 and 6 months after the procedure. The FSFI questionnaire consists of 19 multiple choice questions and it evaluates the following six aspects of female sexuality: arousal, lubrication, desire, orgasm, satisfaction, and pain. 9 patients were excluded for not coming to the follow-up appointments. Patients who had any systemic or psychological disease were excluded in order to avoid any additional variables that could affect sexual function. Results: Arousal, lubrication, desire, orgasm, satisfaction, and pain were evaluated in 71 patients. There was no statistical difference in sexual desire, lubrication, sexual satisfaction, and pain in between follow-up results and the baseline scores. However, there was a significant decrease in patients’ orgasm scores and degree of arousal in the follow-up results compared to the baseline scores. Conclusion: Parameters such as orgasm and the degree of arousal, which are strongly connected with a patient’s physical and psychological well-being, are affected by the procedure. We believe detailed information, psychological support, and even psychiatric consultation can have a beneficial effect on patients. Further studies with a larger sample and a control group and a longer follow-up interval should be performed to assess the effect of psychological precautions and to avoid sexual function disorders resulting from LEEP.

Objective: The aim of this study was to evaluate the risk factors and outcomes of umbilical cord prolapseStudy Design: In this descriptive retrospective study, 94 cases of umbilical cord prolapse between January 2013 and December 2014 in our department were analyzed.Results: 45.166 births occurred in our hospital during the study period, and the prevalence of umbilical cord prolapse was 2.08 (n=94) per 1000 live births, and the perinatal mortality rate was 1.1%. In all pregnant women, the delivery had been performed by emergent caesarean section. The average age, gravida, parity and gestational week of pregnant women were 29.11±6.17, 3.69±2.48, 2.69±2.48 and 37.61±3.17, respectively. Singleton pregnancies were 95.7% (n=90) of all pregnancies and twin pregnancies were 4.3% (n=4). Presentation of the cases were vertex, breech or transverse at 75.5% (n=71), 16% (n=15) and 8.5% (n=8) of all cases respectively. Polyhydramnios complicated 13.8% (n=13) of all cases and average birth weight was 3138.62±759.89 grams. 16% (n=15) of the cases had a birthweight lesser than 2500 gr. 1st and 5th minute APGAR scores were 6.89±2.05 and 8.69±1.39, respectively. The time period between the diagnosis and delivery was demonstrated as 8.24±1.22 minutes.Conclusion: Breech presentation, polyhydramnios, multiple pregnancies and low birth weight are risk factors for umbilical cord prolapse. Shortening the time interval between diagnosis and delivery significantly reduces perinatal mortality. It can be provided at clinics that presenting the appropriate infrastructures for rapid intervention.

SUCCOR study: an international European cohort observational study comparing minimally invasive surgery versus open abdominal radical hysterectomy in patients with stage IB1 cervical cancer FREE http://orcid.org/0000-0002-1908-3251Luis Chiva1, Vanna Zanagnolo2, Denis Querleu3, Nerea Martin- Calvo4, Juan Arévalo-Serrano5, Mihai Emil Căpîlna6, Anna Fagotti7, Ali Kucukmetin8, Constantijne Mom9, Galina Chakalova10, Shamistan Aliyev11, Mario Malzoni12, http://orcid.org/0000- 0001-5809-3535Fabrice Narducci13, Octavio Arencibia14, Francesco Raspagliesi15, Tayfun Toptas16, David Cibula17, Dilyara Kaidarova18, http://orcid.org/0000-0001-6763-9720Mehmet Mutlu Meydanli19, Mariana Tavares20, Dmytro Golub21, http://orcid.org/0000-0003-3140-4772Anna Myriam Perrone22, Robert Poka23, Dimitrios Tsolakidis24, Goran Vujić25, http://orcid.org/0000-0001-8935- 0311Marcin A Jedryka26, Petra L M Zusterzeel27, Jogchum Jan Beltman28, Frederic Goffin29, Dimitrios Haidopoulos30, Herman Haller31, Robert Jach32, Iryna Yezhova33, Igor Berlev34, Margarida Bernardino35, Rasiah Bharathan36, Maximilian Lanner37, Minna M Maenpaa38, http://orcid.org/0000-0002-4403-3707Vladyslav Sukhin39, Jean-Guillaume Feron40, Robert Fruscio41, 42, Kersti Kukk43, Jordi Ponce44, Jose Angel Minguez45, http://orcid.org/0000-0002-9618- 5606Daniel Vázquez-Vicente45, Teresa Castellanos45, Enrique Chacon46 and http://orcid.org/0000-0002-9700-0853Juan Luis Alcazar47 On behalf of the SUCCOR study Group Author affiliations Abstract Background Minimally invasive surgery in cervical cancer has demonstrated in recent publications worse outcomes than open surgery. The primary objective of the SUCCOR study, a European, multicenter, retrospective, observational cohort study was to evaluate disease-free survival in patients with stage IB1 (FIGO 2009) cervical cancer undergoing open vs minimally invasive radical hysterectomy. As a secondary objective, we aimed to investigate the association between protective surgical maneuvers and the risk of relapse. Methods We obtained data from 1272 patients that underwent a radical hysterectomy by open or minimally invasive surgery for stage IB1 cervical cancer (FIGO 2009) from January 2013 to December 2014. After applying all the inclusion-exclusion criteria, we used an inverse probability weighting to construct a weighted cohort of 693 patients to compare outcomes (minimally invasive surgery vs open). The first endpoint compared disease-free survival at 4.5 years in both groups. Secondary endpoints compared overall survival among groups and the impact of the use of a uterine manipulator and protective closure of the colpotomy over the tumor in the minimally invasive surgery group. Results Mean age was 48.3 years (range ; 23–83) while the mean BMI was 25.7 kg/m2 (range ; 15–49). The risk of recurrence for patients who underwent minimally invasive surgery was twice as high as that in the open surgery group (HR, 2.07 ; 95% CI, 1.35 to 3.15 ; P=0.001). Similarly, the risk of death was 2.42-times higher than in the open surgery group (HR, 2.45 ; 95% CI, 1.30 to 4.60, P=0.005). Patients that underwent minimally invasive surgery using a uterine manipulator had a 2.76-times higher hazard of relapse (HR, 2.76 ; 95% CI, 1.75 to 4.33 ; P

Introduction/Background The aim of this study was to analyze the survival outcomes of stage IIIC ovarian high-grade serous carcinoma (HGSC) patients with both peritoneal and lymphatic dissemination (IP(+)/RP(+)) who had undergone maximal or optimal cytoreduction followed by intravenous carboplatin/paclitaxel chemotherapy to those women with stage IIIC ovarian HGSC who have only peritoneal involvement (IP(+)/RP(-)) treated similarly. Methodology We performed aretrospective, multicenter study by participation of five gynecologic cancer centers. At first, stage IIIC ovarian HGSC patients were classified asoptimally or maximally debulked cohorts. Then in each cohort, patients were divided into two groups: The IP(+)/RP(–) group included women with transcoelomic spread outside the pelvis with no nodal disease, The IP(+)/RP(+) group included patients with transcoelomic dissemination outside the pelvis in addition to positive nodal status. Survival outcomes were compared between the two groups in each cohort. Results A total of 405 ovarian HGSC patients were analyzed. In the optimally debulked cohort (n=257), the median progression-free survival (PFS) and overall survival (OS) for the IP(+)/RP(-) group (n=69) was 24 and 57 months, respectively compared to 21 and 58 months in the IP(+)/RP(+) group (n=188) (p=0.78, and p=0.40; respectively). In the maximally debulked cohort (n=148), the median PFS and OS for the IP(+)/RP(-) group (n=55) was 35 and 63 months, respectively compared to 25 and 51 months in the IP(+)/RP(+) group (n=93) (p=0.49, and p=0.31; respectively). Conclusion Our findings indicated no survival difference between the IP(+)/RP(-) and the IP(+)/RP(+) groups after maximal or optimal cytoreduction. Disclosure Nothing to disclose.

Introduction/Background The purpose of this study was to investigate prognostic factors associated with overall survival (OS) in endometrioid endometrial cancer (EC). Methodology A multicenter, retrospective department database review was performed to identify patients with endometrioid EC at seven high-volume gynecologic oncology centers in Turkey. A total of 4993 women who had undergone primary surgery between 1999 and 2018 were included. Women were staged according to the 2009 FIGO staging system. Kaplan-Meier method was used to generate survival data. Factors predictive of outcome were analyzed using Cox proportional hazards models. Results Three thousand two hundred and nineteen women (64.5%) were classified as stage IA, 1034 (20.7%) as IB, 286 (5.7%) as II, 72 (1.4%) as IIIA, 15 (0.3%) as IIIB, 173 (3.55) as IIIC1, 128 (2.6%) as IIIC2, and 66 (1.3%) as stage IV. The median age at surgery was 58 years (range, 21–94 years), and the median duration of follow-up was 47 months (range, 3–227 months). For the entire cohort, the 5-year disease-free survival was 75.1% whereas the 5-year OS was 82.2%. Age ≥60 years (Hazard ratio [HR]: 1.21, 95% confidence interval [CI]:1.06–1.40; p=0.005), myometrial invasion (MMI) ≥1/2 (HR: 1.19, 95% CI:1.02–1.41; p=0.02), lymphovascular space invasion (LVSI) (HR: 1.29, 95% CI:1.05–1.58; p=0.01), and baseline serum CA 125 ≥35 U/ml (HR: 1.29, 95% CI:1.08-1.55; p=0.005) were identified as independent prognostic factors for decreased OS. Conclusion Age ≥60 years, MMI ≥1/2, LVSI, and baseline serum CA 125≥35 U/ml seem to be independent prognostic factors for decreased OS in Turkish endometrioid EC population. Disclosure Nothing to disclose.

Objective: To determine the effect of obesity on the onset of spontaneous labor, scheduled delivery rates and perinatal outcomes in term pregnancies. Material and methods: 242 obese and 244 non-obese pregnant women ≥37 gestational weeks were compared in terms of the onset of spontaneous labor, scheduled delivery rates and perinatal outcomes. Results: Obese pregnant women had statistically significantly lower onset of spontaneous labor and higher rates of scheduled delivery. No difference was determined in respect of the type of delivery, 1st and 5th minutes APGAR scores and the need for intensive care. Higher values of birth weight, large for gestational age, macrosomia, gestational diabetes mellitus and preeclampsia were determined in obese women. Conclusion: The onset of spontaneous labor rates in term obese pregnancies were lower and scheduled delivery rates were higher than in the non-obese pregnancies. However, more extensive studies are needed to better understand this relationship. Keywords: Pregnancy, Obesity, Delivery, Labor, Pregnancy outcomes

Aim The aim of this study was to analyze the survival outcomes of stage IIIC ovarian high-grade serous carcinoma (HGSC) patients with both peritoneal and lymphatic dissemination (IP+/RP+) who had undergone maximal or optimal cytoreduction followed by intravenous carboplatin/paclitaxel chemotherapy compared to those women with stage IIIC ovarian HGSC with only peritoneal involvement (IP+/RP-) who were treated similarly. Methods We performed a retrospective, multicenter study with the participation of five gynecological cancer centers. First, the stage IIIC ovarian HGSC patients were classified into optimally or maximally debulked cohorts. Then, in each cohort, the patients were divided into two groups; the IP+/RP- group included those women with transcoelomic spreading outside the pelvis with no nodal disease, and the IP+/RP+ group included those patients with transcoelomic dissemination outside the pelvis in addition to a positive nodal status. The survival outcomes were compared between the two groups in each cohort. Results A total of 405 ovarian HGSC patients were analyzed. In the optimally debulked cohort (n = 257), the progression-free survival (PFS) and overall survival (OS) medians for the IP+/RP- group (n = 69) were 24 and 57 months, respectively, compared to 21 and 58 months, respectively, for the IP+/RP+ group (n = 188) (P = 0.78 and P = 0.40, respectively). In the maximally debulked cohort (n = 148), the PFS and OS medians for the IP+/RP- group (n = 55) were 35 and 63 months, respectively, compared to 25 and 51 months, respectively, for the IP+/RP+ group (n = 93) (P = 0.49 and P = 0.31, respectively). Conclusion Our findings indicated no survival differences between the IP+/RP- and the IP+/RP+ groups.

Background To date, only a limited number of studies have evaluated the importance of abdominal subcutaneous fat thickness (ASFT) on gestational diabetes mellitus (GDM) screening. The aim of this study was to investigate the effectiveness of ASFT measurement during routine obstetric ultrasound performed between 24 and 28 weeks of gestation in predicting cases with GDM. Methods This prospective comparative study was conducted on 50 cases with GDM and 50 cases without GDM in the GDM screening program at 24–28 gestational weeks between January 2018 and May 2018. The most accurate ASFT cut-off point values were determined for the prediction of cases with GDM by performing receiver operator characteristic (ROC) curve analysis. Results The ASFT was higher in those with GDM compared to those without GDM (P < 0.05). For an ASFT cut-off point value of 18.1 mm for the prediction of cases with GDM, the sensitivity, specificity, negative and positive predictive values were 72.0%, 60.0%, 64.2% and 68.1%, respectively. The risk of GDM increased 3.86-fold in those with ASFT level >18.1 mm (P = 0.001). Conclusion The ASFT value measured by routine obstetric ultrasound performed at 24–28 weeks of gestation was found to be significantly higher in patients with GDM in comparison to those without GDM. However, further multi-centered and comprehensive prospective studies are required to better demonstrate this relationship.

Objectives: To date, there is no available test to predict the risk of intrapartum fetal compromise (IFC) during labor, either starting spontaneously or induced due to obstetrics indications. The aim of this study was to examine the effectiveness of placental growth factor (PIGF) in identifying cases that develop intrapartum fetal compromise (IFC) in term high-risk pregnancies induced for labor. Material and methods: This prospective cross-sectional study was conducted on 40 IFC+ cases and 40 IFC- cases with high-risk term pregnancy and labor induction started in the Health Sciences University Gazi Yasargil Training and Research Hospital, between January 2018 and April 2018. Comparisons were made between the groups in respect of placental growth factor (PIGF) levels, and obstetric and neonatal outcomes. Results: The PIGF level was found to be statistically significantly lower in the IFC+ cases compared to the IFC- cases. For a PIGF cutoff value of 32 pg/mL for the prediction of IFC+ cases, sensitivity was 74.4%, specificity 73.2%, NPV 75% and PPV 72.5%, with a statistically significant difference determined between the groups. The IFC+ development risk increased 7.91-fold in patients with PIGF ≤ 32 pg/mL. Conclusions: The PIGF levels in cases of IFC+ high risk pregnancies were found to be statistically significantly lower than those of IFC- cases. However, further, large-scale randomized controlled research is necessary to demonstrate this relationship better.

Objectives: The aim of our study is the comparison of the results of conventional smear (CC) technique and liquidbased cytology (LBC) technique used as cervical cancer screening methods. Material and methods: The results of 47954 patients submitted to smear screening in our gynecology clinic between January 2008 and December 2014 have been studied. The smear results have been divided into two groups CC and LBC according to the technique used. Results: When considering the distribution within CC group, the results were as follows: intraepithelial cell abnormalities 2,0% (n=619), insufficient sample for analysis 2,1% (n=660), Atypical squamous cells of undetermined significance (ASC-US) 1.8% (n=554), Low grade squamous intraepithelial lesion (LGSIL) 0.1% (n=35), High grade squamous intraepithelial lesion (HGSIL) 0.1% (n=16), Atypical squamous cells – cannot exclude HGSIL (ASC-H) 0.029% (n=9), Atypical glandular cells- not other wise specified (AGC-NOS) 0.012% (n=4), squamous carcinoma 0.003% (n=1). When considering the distribution in LBC group, the results were as follows: intraepithelial cell abnormalities2.1% (n=357), insufficient sample for analysis 0.9% (n=144), ASC-US 1.8% (n=296), LGSIL 0.2% (n=38), HGSIL 0.1% (n=8), ASC-H 0.1% (n=10), AGC-NOS 0.017% (n=3), squamous carcinoma 0.011% (n=2). Conclusions: Although the rates of epithelial cell abnormalities are similar for both tests, LSIL results are more frequently observed in LBC technique. In LBC technique, the number of insufficient sample for analysis is quite low compared to CC group and thus constitutes an advantage.

Objective: The present study aims to make an epidemiological analysis of stillbirths which occurred during a 24-month-long period at a tertiary health center located in the biggest city of Southeastern Anatolia Region. Materials and Methods: This is a retrospective analysis of 472 stillbirths which occurred at Diyarbakır Maternity Hospital between 1 January 2012 and 1 January 2014. Results: Stillbirth rates were computed as 0.14%for 2012 and 0.11%for 2013. The mothers were housewives in 93%of stillbirths. The mothers had social insurance in 83%of them and they had chronic diseases in 17%of stillbirths. About 57%of stillbirths received antenatal care at family health centers, 17%of them were due to consanguineous marriages. Only 41 stillbirths (8.7%) occurred during third trimester of pregnancy and 15 of these third trimester stillbirths (36.6%) were related with intrapartum causes. Preeclampsia (41.9%), abruptio placenta (28.4%) and fetal anomaly (13.5%) were the most frequently associated clinical conditions for stillbirths. Conclusion: The stillbirth rate in geographical regions with low socioeconomical status can be significantly decreased by certain precautions. These precautions include the fortification of antenatal care centers, maintenance of prenatal care at home facilities in collaboration with parents, prevention and treatment of perinatal infections, effective labor induction after 41st gestational week, delivery by experienced midwives/doctors working at hospitals and easy access to emergent obstetric care, Amaç: Güneydoğu Anadolu Bölgesi’nin en büyük ilinde yer alan bir üçüncü sağlık merkezinde son 24 ayda meydana gelen ölü doğumların epidemiyolojik bakımdan değerlendirilmesi amaçlanmaktadır. Gereç ve Yöntem: Bu çalışmada, 1 Ocak 2012 ve 1 Ocak 2014 tarihleri arasında Diyarbakır Kadın Doğum ve Çocuk Hastalıkları Hastanesi’nde meydana gelen 472 ölü doğum geriye dönük olarak incelenmiştir.Bulgular: Ölü doğum hızı 2012 ve 2013 yılları için sırasıyla %0.14 ve %0.11 olarak hesaplanmıştır. Ölü doğum olgularının %93’ünde annenin ev hanımı olduğu, %83’ünde akraba evliliği bulunduğu, %57’sinde gebelik takibinin aile sağlığı merkezinde gerçekleştirildiği, %17’sinde kronik bir hastalık bulunmadığı ve %17’sinin sosyal güvenceye sahip olmadığı belirlenmiştir. Yalnızca 41 ölü doğum (%8.7) gebeliğin son üç ayında meydana geldiği ve 15 ölü doğumun (%36.6) gebeliğin son üç ayında intrapartum nedenlere bağlı olduğu kaydedilmiştir. Preeklampsi (%41.9), ablasyo plasenta (%28.4) ve fetal anomali (%13.5), ölü doğumlarla ilişkili olan klinik durumların başında gelmektedir. Sonuç: Sosyoekonomik bakımdan gelişmemiş olan ve ölü doğum açısından yüksek risk taşıyan coğrafi bölgelerde; antenatal bakım hizmeti sunan merkezlerin güçlendirilmesi, ebeveynler ile işbirliği yapılarak gebelik

research Amaç: Aile planlaması polikliniğine başvurup isteğe bağlı kürtaj yapan kadınların gebe kalırken kullandıkları kontraseptif yöntemler ve kürtaj nedenleri açısından değerlendirilmesi. Gereç ve Yöntemler: Diyarbakır kadın doğum ve çocuk hastalıkları hastanesine 01/01/2014-31/03/2014 tarihleri arasında aile planlaması polikliniğine başvurup isteğe bağlı kürtaj yaptıran ve çalışmaya katılmayı kabul eden 84 hasta değerlendirmeye alınmıştır. Veriler katılımcılar ile yüz yüze görüşülerek alınmıştır. Bulgular: Çalışmaya katılan kadınların yaş ortalaması 34.18±6.62 yıl, paritesi 4.73±2.75, yaşayan çocuk sayısı 4.21±2.26 ve daha önce isteğe bağlı kürtaj sayısı 0.44±0.84’ dır. Katılımcıların gebe kalırken %58.3’ü kontraseptif yöntem kullanmaktaydı. Kullanılan kontraseptif yöntemler içinde en sık kullanılanı % 53 ile geri çekme yöntemi olarak saptandı. İkinci ve üçüncü sırada ise kondom % 28.5, OKS % 14.2 olduğu saptandı. Kadınların kürtaj nedenleri açısından bakıldığında geçim sıkıntısı %44 ve çocuk istememe %22.4 olarak saptandı. Sonuç: Düşük sosyoekonomik düzey ve düşük eğitim düzeyleri istenmeyen gebeliklerin başlıca nedenlerini oluşturmaktadır. Aile planlaması eğitimleri düzenli ve devamlı bir şekilde yapılmalıdır. Aim: To investigate contraception methods and cause of legal abortion of the pregnant women who consult family planning clinic in our institution. Material and Methods: In this study, 84 pregnant women who consult family planing clinic between January 2014 and March 2014 were observed. The patients were asked for education levels, working status, number of pregnancies, contraception methods, cause of legal abortion. Results: The patient’s age ranged between 20 and 48 ( mean±SD : 34.18±6.62), parity of the patients was 4.73±2.75, number of children was 4.21±2.26, number of previous curettage was 0.44±0.84. Fourty-nine patient used a contraception method (%58,3). The most used contraception method was coitus interruptus. Conclusion: Low socioeconomic and education level are major causes of unwanted pregnancies. Family planning education should continously be given to these groups.

Amaç: Güneydoğu Anadolu Bölgesi’nin en büyük ilinde yer alan bir üçüncü sağlık merkezinde son 24 ayda meydana gelen ölü doğumların epidemiyolojik bakımdan değerlendirilmesi amaçlanmaktadır. Gereç ve Yöntem: Bu çalışmada, 1 Ocak 2012 ve 1 Ocak 2014 tarihleri arasında Diyarbakır Kadın Doğum ve Çocuk Hastalıkları Hastanesi’nde meydana gelen 472 ölü doğum geriye dönük olarak incelenmiştir. Bulgular: Ölü doğum hızı 2012 ve 2013 yılları için sırasıyla %0.14 ve %0.11 olarak hesaplanmıştır. Ölü doğum olgularının %93’ünde annenin ev hanımı olduğu, %83’ünde akraba evliliği bulunduğu, %57’sinde gebelik takibinin aile sağlığı merkezinde gerçekleştirildiği, %17’sinde kronik bir hastalık bulunmadığı ve %17’sinin sosyal güvenceye sahip olmadığı belirlenmiştir. Yalnızca 41 ölü doğum (%8.7) gebeliğin son üç ayında meydana geldiği ve 15 ölü doğumun (%36.6) gebeliğin son üç ayında intrapartum nedenlere bağlı olduğu kaydedilmiştir. Preeklampsi (%41.9), ablasyo plasenta (%28.4) ve fetal anomali (%13.5), ölü doğumlarla ilişkili olan klinik durumların başında gelmektedir. Sonuç: Sosyoekonomik bakımdan gelişmemiş olan ve ölü doğum açısından yüksek risk taşıyan coğrafi bölgelerde; antenatal bakım hizmeti sunan merkezlerin güçlendirilmesi, ebeveynler ile işbirliği yapılarak gebelik bakımı ve izlemi hizmetlerinin evde de sürdürülmesi, perinatal enfeksiyonların önlenmesi ve tedavisi, gebeliğin 41. haftasından sonra doğum eyleminin etkin indüksiyonu, deneyimli ebelerin/hekimlerin hastane koşullarında doğum yaptırması ve kolaylıkla acil obstetrik bakıma ulaşılması ile belirgin bir iyileşme sağlanabilir. Objective: The present study aims to make an epidemiological analysis of stillbirths which occurred during a 24-month-long period at a tertiary health center located in the biggest city of Southeastern Anatolia Region. Materials and Methods: This is a retrospective analysis of 472 stillbirths which occurred at Diyarbakır Maternity Hospital between 1 January 2012 and 1 January 2014. Results: Stillbirth rates were computed as 0.14%for 2012 and 0.11%for 2013. The mothers were housewives in 93%of stillbirths. The mothers had social insurance in 83%of them and they had chronic diseases in 17%of stillbirths. About 57%of stillbirths received antenatal care at family health centers, 17%of them were due to consanguineous marriages. Only 41 stillbirths (8.7%) occurred during third trimester of pregnancy and 15 of these third trimester stillbirths (36.6%) were related with intrapartum causes. Preeclampsia (41.9%), abruptio placenta (28.4%) and fetal anomaly (13.5%) were the most frequently associated clinical conditions for stillbirths. Conclusion: The stillbirth rate in geographical regions with low socioeconomical status can be significantly decreased by certain precautions. These precautions include the fortification of antenatal care centers, maintenance of prenatal care at home facilities in collaboration with parents, prevention and treatment of perinatal infections, effective labor induction after 41st gestational week, delivery by experienced midwives/doctors working at hospitals and easy access to emergent obstetric care.