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Aim: To evaluate the usefulness, diagnostic accuracy, and cost-effectiveness of transvaginal hydrolaparoscopy (THL) in infertile women with abnormal hysterosalpingogram (HSG) results without obvious pelvic pathology. Material and methods: Thirty infertile women (age: 20–40 years) who had tubal pathology in HSG were enrolled in the study. All patients underwent THL instead of standard laparoscopy. A cost analysis was performed comparing HSG and THL methods. Results: In comparison of the HSG of cases by considering the chromopertubation results by THL, the sensitivity and specificity of HSG were 85.1% and 56%, respectively. The reasons for preferring standard laparoscopy rather than THL were: failure in accessing of Douglas (n = 3), insufficient monitoring of pelvis (n = 1), hydrosalpinx (n = 1), and intense peritubal adhesion (n = 1), which were 10%, 3%, 3%, and 3%, respectively. The complication rate was 3.8%. Cost analysis of the procedures showed that the total cost of the THL group was 34.8% lower than the HSG group. Conclusions: In the elective patients group, THL is more feasible than HSG. Transvaginal hydrolaparoscopy is effective, simple and safe, avoiding the cost, possible complications, time and postoperative patient discomfort compared to conventional laparoscopy.

Introduction : Pre-eclampsia is a common and potentially dangerous disorder of human pregnancy. The maternal syndrome of hypertension and proteinuria is part of a severe systemic inflammatory response that includes leukocyte and endothelial cell activation. PCT is a polypeptide consisting of 116 aminoacids and is the precursor of calcitonin. Over the last decade, PCT has become increasingly popular as a novel marker of infection in the intensive care unit setting. The aim of our study was to evaluate changes in serum levels of PCT in pregnancies complicated with mild pre-eclampsia or severe pre-eclampsia and further investigate the correlation with CRP. Methods : Throughout the study period, 80 pregnant women complicated with mild preeclampsia, 80 pregnant women complicated with severe preeclampsia and 80 healthy pregnant women as a control group, giving a total of 240 pregnant women were enrolled into study. Results : Both severe pre-eclampsia and mild pre-eclampsia groups showed significantly higher PCT values when compared with control healthy group (p

Anal inkontinans, gaz ve dışkının istem dışı kaçırılması-dır. Fekal inkontinans vajinal doğumun çok korkulan bir komplikasyonudur. Bu durum sfinkter yırtılması, pudental sinir hasarlanması ya da her ikisi ile birlikte olabilmektedir. Anal inkontinans prevelansı araştırılan topluluğa göre farklılık göstermektedir. Genel olarak 30-90 yaş arası kadınlar incelendiğinde, en az bir aylık sürede katı veya sıvı dışkı tutamama prevalansı %7.7dir. Vajinal doğum veya sezaryen doğumdan 6 ay sonra anal inkontinans %13-25 arası olmakta fakat bu 12 aylık bir sürede %1-6 aralığına düşmektedir. Anal inkontinans yaşam kalitesi üzerinde önemli bir etkisi vardır. Kadınlarda en önemli neden doğum travmasıdır. Anal sfinkter defekti ile birlikte perine yırtılması %1-9 arasında değişmektedir. Tanımlanmamış sfinker hasarı %18-35 olarak yüksek bir değerdedir. Pudental nöropati doğumunun ikinci evresinde ıkınma ile birlikte sinirin gerilmesi ve fetal başın inmesi ile oluşmaktadır. Hatta bazen doğumun birinci evresinde bile olmaktadır. Sfinkter hasarı ve pu-dental nöropati risk faktörleri forsepsli doğum, büyük fetüs ölçüsü ve uzamış ikinci doğum evresidir. Özellikle ilk doğum süresince fekal inkontinans riski göz önünde bulundurulmalıdır. Rutin epizyotomi sfinker hasarını engellememekte hatta sebebiyet verebilmektedir. Anal inkontinanslı kadınların tedavi yaklaşımı altta yatan etyoloji temelli olmalıdır. Başlangıç tedavisi olarak önerilen tıbbi yaklaşım nadiren etkilidir. Prmer anal sfinkter cerrahisi yapılan hastaların yarısı kısa ve uzun dönemde kontinans problemi ile karşılaşabilmektedirler. Bu çalışmada obstetrik yaralanmaya bağlı olarak ortaya çıkan ve ‘Anterior Overlapping Sfinkteroplasti’ yöntemiyle başarı bir şekilde tedavi edilen anal inkontinanslı bir olguyu sunuyoruz. Anal incontinence means inability to control the release of flatus or stool. Fecal incontinence is one of the most feared complications of vaginal delivery. It may be the consequence of sphincter tears, of pudendal neuropat-hy, or of a combination of the two. The prevalence of fecal incontinence varies depending on the population studied. In one population-based, age-stratified postal survey of women aged 30 to 90 years, the prevalence of fecal incontinence (defined as at least monthly loss of liquid or solid stool) was 7.7 percent. At three to six months after vaginal or cesarean delivery, as many as 13 to 25 percent of women report fecal incontinence. However, the prevalence falls to 1 to 6 percent by 12 months. Fecal incontinence has a significant impact on quality of life. Most important cause of incontinence is obstetric trauma in women. The incidence of perineal tear with anal sphincteric defect varies from 1-9% and the incidence of unrecognized sphincter injury may be as high as 18-35%. Pudendal neuropathy is caused by nerve stretch during pushing in the second stage of labor and descent of the fetal head; it may occur even with the first delivery. Risk factors for sphincter injury and pudendal neuropathy include forceps delivery, lar-ge neonatal size, and prolonged second stage of labor. The risk of fecal incontinence must be considered even during the first pregnancy. Routine episiotomy does not prevent sphincter injury and may even predispose to it. Therapeutic management of the women with anal incontinence should be based on underlying etiology. Medical treatment, recommended as initial approach, is rarely effective. Half the women who undergo primary anal sphincter repair have short or long term continen-ce problems. In this study we present a case of anal in-continence due to obstetric injury who was successfully treated using ‘anterior overlapping sphincteroplasty’

Objective: To investigate the efficacy of laparoscopic uterine nerve ethanol neurolysis (LUNEN) for pain management in patients with chronic pelvic pain (CPP). Methods: LUNEN, as a chemical neurolysis procedure, was performed on 22 subjects, and these were compared with 20 controls that had a diagnostic laparoscopy alone. Pre-treatment and postoperative 6th month Visual Analogue Scale (VAS) scores were estimated and a subjective pain evaluation questioning patients’ satisfaction about pain relief in the 6th month after surgery was also performed. Results: A total of 31 (73.8%) out of 42 CPP patients had a laparoscopic pelvic pathology. Preoperative VAS scores were similar in the groups; however, the mean postoperative VAS score was significantly lower in the LUNEN group than in the control group (3.18 ± 2.88 vs. 5.35 ± 3.09; p=0.02). In the LUNEN group, the number of patients who stated that their pain was relieved partially or completely was also significantly higher than in the control group (82% vs. 40%, p=0.019). Conclusion: LUNEN is a feasible, safe and effective surgical alternative to traditional surgical methods in patients suffering from CPP. J Clin Exp Invest 2016; 7 (1): 7-13 Key words: Chronic pelvic pain, uterine nerve neurolysis, laparoscopy, ethanol

Objective: To investigate the role of ultrasound guidance in intrauterine insemination (IUI). Materials and Methods: A retrospective study was conducted. The data was collected from the records of 197 couples with unexplained infertility who underwent IUI with a total of 267 IUI cycles in the in vitro fertilization center of our hospital between January 2009 and December 2010. Results: Of the 267 IUI cycles, 145 were carried out as US-guided, while 122 cycles IUI were performed with a blind procedure. In the US-guided IUI and blinded IUI groups, the pregnancy rates were 23.4 and 13.9%, respectively. The difference between the groups was statistically significant (p = 0.049), thereby indicating that US guidance improves pregnancy rates. In the US-guided IUI group, 9.7% of the cases were difficult, while in the blinded IUI group, 26.2% were difficult and the difference between the groups was also statistically significant (p < 0.001). Conclusion: US guidance in IUI improves pregnancy rates and reduces the frequency of difficult IUI.

Intrauterine device (IUD) is one of the most commonly used methods of contraception in Turkey. In the course of insertion of IUD which is simple method to application, uterine perforation can occur during it as an undesired complication. At %15 of uterin perforation cases related dislocated IUD, neighbour organs especially small bowel is affected from this. Asymptomatic intestinal perforation related IUD is uncommon. In this study, the case whose IUD is dislocated in abdomen which perfored ileum after uterin perforation and has no symptom and which is recognized after complicated with pregnancy was discussed. She wanted to termination of pregnant and after this application she was treated by operating with minilaparotomy and removing dislocated IUD with ileal enterotomy and primary reperation. Asymptomatic intestinal perforation related IUD is hard to identify. Abdominal X-ray and pelvic ultrasound can show dislocated IUD but most cases are recognized on laparotomy or laparoscopy which is used for removing IUD. When intraabdominal IUD is localized well, minilaparotomy is suitable for removing IUD. Asymptomatic intestinal IUD can usually be treated without any intestinal resection.

Objective. The purpose of this study was to evaluate the role of a slow embryonic heart rate in embryos before 7 weeks’ gestation as a marker in screening for chromosomal abnormalities. Methods. Fifty-seven embryos before 7 weeks’ gestation with slow heart rates were compared with 1156 embryos of the same gestational period with normal heart rates. Embryos that showed an increased risk of chromosomal abnormalities in the screening blood tests underwent invasive analysis for abnormal karyotype detection. Results. The rates of first-trimester death were 15.8% for pregnancies with slow embryonic heart rates (9 of 57) and 2.5% for those with normal heart rates (29 of 1156). Because of the increased risk of chromosomal abnormalities, amniocentesis was performed on 6 with slow embryonic heart rates and 61 with normal embryonic heart rates. After karyotype analysis, there were 2 fetuses with trisomy 21 in each group, which represented significantly higher percentage of embryos with trisomy 21 in the slow–heart rate group compared with the normal–heart rate group (P < .05). Conclusions. When a slow embryonic heart rate is detected before 7 weeks’ gestation, there is a higher likelihood of chromosomal abnormalities. Key words: embryo; fetus; first trimester; heart rate.

To determine whether the use of the subdermal contraceptive implant releasing etonogestrel (Implanon) affects serum hormonal and biochemical indices.Seventy women with a mean age of 28.5+/-3.4 years were enrolled into this prospective observational study. After placement of an Implanon rod, they were followed-up for three years. Baseline and end-of-study values of serum low-density lipoprotein (LDL), high-density lipoprotein (HDL), cholesterol, triglycerides, fasting glucose, blood urea nitrogen (BUN), creatinine, SGOT, SGPT, follicle stimulating hormone (FSH), luteinizing hormone (LH), oestradiol, free 3,5,3'-tri-iodothyronine (fT3), free thyroxine (fT4), thyroid stimulating hormone (TSH), and prolactine (PRL) were compared using Student's t-test.There was no failure of contraception during the three year period. No statistically significant differences were observed between the initial and final levels of fasting blood glucose, BUN, SGOT, SGPT, LDL, HDL, E2, FSH, LH, fT3, fT4 and TSH (p0.05), but the increase in PRL, cholesterol and triglycerides, and the decrease in creatinine levels at the end of three years were statistically significant (p0.05) although the values were still within normal ranges.Our findings confirm data from the literature according to which Implanon does not affect meaningfully reproductive hormonal parameters, thyroid function, hepatic and renal functions, and glucose metabolism. However, further studies are needed to elucidate lipid metabolism changes.

The aim of this study was to compare the accuracy of hysteroscopy and hysterosalpingography (HSG) in evaluating the uterine cavity in patients with recurrent pregnancy loss (RPL). One hundred and twenty consecutive patients with a history of RPL were enrolled into this prospective-observational study in the reproductive endocrinology and infertility clinic of a tertiary referral center. Diagnostic office hysteroscopy without anesthesia or sedation, HSG, and diagnostic laparoscopy when indicated were performed in each case. Eighty-five of 120 (70.83%) hysteroscopic studies performed for RPL demonstrated an acquired (55 cases: 64.7%) or congenital (30 cases: 35.3%) intrauterine lesion. Furthermore, several other etiologic factors were also identified in RPL patients with intrauterine lesions. HSG accurately diagnosed an intrauterine defect in only 56 of 85 (65.88%) cases, based on hysteroscopic confirmation. Fifty percent of the cases with incomplete uterine septum were overlooked during HSG. The sensitivity, specificity, positive predictive value, and negative predictive value of HSG were 74.6%, 79.5%, 90.4%, and 54.7%, respectively. There was a single complication (0.83%) due to hysteroscopy. Hysteroscopy is more accurate than HSG in evaluating the uterine cavity in patients with RPL. We recommend it as a routine procedure instead of HSG.

Twenty-eight renal transplantation patients, aged 19-35 years, and 30 healthy women of reproductive age were enrolled into the study. Analyses revealed significant differences between study and control groups' midluteal serum P levels and between study and control groups' serum PRL levels. Although most renal transplantation patients have plasma estrogen and gonadotropin levels similar to those in healthy women, several problems, such as luteal phase defect, might affect transplant recipients.

We tried to evaluate the demographic characteristics, treatment modalities and survival chances of the choriocarcinoma cases diagnosed in our hospital retrospectively. Eleven patients diagnosed with choriocarcinoma and treated in our department between January 1994 and December 2001 were used in this study. Seven cases (63.6%) had pulmonary metastasis when diagnosed and one case (9.1%) had additional vaginal metastasis. First-line chemotherapy was given to nine patients (81.9%) and adjuvant chemotherapy was given to two (18.1%), after primary hysterectomy. Interval hysterectomy was applied after four cures of chemotherapy (Methotrexate 0.4 mg/kg 5 days) to two out of the nine cases who had first-line chemotherapy (18.1%). Two hundred and seventy-four (12.7%) of 2155 genital tumors followed-up in the SSK Aegean Maternity Hospital Oncology Department were gestational trophoblastic diseases (GTD). Eleven cases (18.6%) out of 59 (21.5%) who had been given chemotherapy because of differentiation from GTD to ge...

Objective: The aim of the study was to evaluate the voiding symptoms of pregnant women and to compare the symptoms amongst trimesters and controls by means of the International Prostate Symptom Score (IPSS). Materials and Methods: Voiding symptoms of 256 pregnant and 230 non-pregnant healthy women hospitalized for other reasons were evaluated. Subjects who had a history of urological and neurological problems or previous pelvic surgery associated with urinary symptoms and those who had urinary tract infection were excluded from the study. The pregnant group was then subdivided into subgroups as to the trimesters of pregnancy. The IPSS assesses seven symptoms on a scale of 0 (no symptoms) to 5 (symptom always present) and was administered as a self-administered questionnaire with the assistance of a trained nurse. Symptom scores of each group and subgroup and the distribution of scores were assessed. Results: The mean scores for all questions in the pregnant group were significantly higher than controls. The comparison of mean scores according to trimesters showed a significant difference for the questions of frequency, intermittency, urgency, weak stream, nocturia, quality of life and for the total scores. The distribution of the scores for each question showed that frequency and nocturia were the most prominent symptoms in pregnancy. The percentage of the respondents with an IPSS score of >7 was 47.6% and the percentage of a quality of life score of ≧4 (mostly dissatisfied) was 48.4%. Conclusions: Voiding symptoms during pregnancy are highly prevalent. These symptoms worsen as the pregnancy progresses.

Aim: To compare the continence results and complications of the tension-free vaginal tape (TVT) and transobturator tape (TOT) procedures. Material and Method: Sixty two urinary incontinence patients; (37 were stress urinary incontinence and 25 were mixed incontinence) underwent TVT or TOT. The clinic-pathologic parameters of the patients, perioperative and postoperative complications and outcome in terms of continence and quality of life were compared. Results: TOT and TVT were performed on % 50 of the patients respectively. An objective cure rate in patients who underwent TOT was observed in 74% of cases, an objective improvement in 26% of cases. 11 of the patients had dysuria, 10 of them had suprapubic pain. An objective cure rate in patients who underwent TVT was observed in 90% of cases, an objective improvement in 8% of cases. A de novo urge incontinence presented in 2 patients. The quality of life improved in 93,5% of cases. In terms of continence results and quality of life, there was no significant difference between the procedures. The complication rate was higher with the TVT procedure when compared to that of the TOT procedure. Discussion: TOT procedure in short terms, performs similar operational success with the TVT procedure. Operational time; in consideration of the cystoscopy time, can be an advantage compared to the TVT procedure. If the operation includes anterior colporrhaphy, the success of both procedures reduces.

The authors report a case of holoprosencephaly with cyclopia, diagnosed prenatally at a gestational age of 19 weeks. The patient’s clinical history was normal, except for aspirin usage for her headache. The sonographic diagnosis was based on the intracranial finding of fused thalami with no visible midline structures and facial abnormalities, including cyclopia, proboscis, and absence of the nose. These findings are characteristic of alobar holoprosencephaly. With the informed consent of the patient, the pregnancy was terminated by induction after proper counseling. Postmortem examination of the abortus material confirmed the presence of cyclopia and a proboscis.

The aim of the study was to determine the detection rate of structural abnormalities at the 11-14 week ultrasound examination as a part of two-stage screening process in low-risk pregnancies.A total of 1085 consecutive low-risk pregnant women participated in screening by two-stage ultrasonography for the estimation of the sensitivity of the first and second trimester ultrasound scans in the detection of major anomalies as a part of routine screening.Of 1085 pregnancies, 21 (1.93%) fetuses had at least one major structural defect considered detectable by routine ultrasound screening; 14 (1.29%) were identified at early screening and an additional 5 (0.47%) at late screening. Two abnormalities were not detected prenatally, and data were obtained from the patients after delivery.The majority of fetal structural abnormalities can be detected by sonographic screening at 11-14 weeks, but detailed fetal anatomic survey performed at 18-22 weeks should not be abandoned.

Intrahepatic cholestasis of pregnancy (ICP) is associated with significant perinatal morbidity and mortality. ICP-related prenatal complications include increased premature delivery, fetal distress, perinatal asphyxia, and intrauterine fetal loss. Levels of serum total bile acids (TBA) are typically elevated from 10- to 100-fold and may be used as a diagnostic criterion for ICP. An association between ICP and respiratory distress syndrome has been reported, and it has been suggested that scoring systems that include TBA level and exposure time may be useful to predict respiratory distress syndrome in neonates. This retrospective study investigated biochemical parameters that could be useful as potential predictors of fetal asphyxia in patients with ICP. The study was conducted between 2004 and 2008 at a tertiary care maternity center. A total of 187 cholestatic pregnancies in both primiparous (43; 23%) and multiparous (144; 77%) women were included in the study. Fetal asphyxia was defined as a mean 5 Apgar score of less than 7. A binary multivariate logistic regression model was used to identify independent variables that may help predict fetal asphyxia in ICP. Of the 187 cholestatic pregnancies, 36 (19.2%) resulted in asphyctic newborns at delivery. There were statistically significant differences between the asphyxiated and nonasphyxiated group in levels of TBA (42.4 ± 15.2 vs. 33.8 ± 12.9 μmol/L, P < 0.01), total cholesterol (279.0 ± 51.4 vs. 257.7 ± 51.6, P = 0.02), high-density lipoprotein (54.2 ± 15.9 vs. 61.3 ± 12.2, P = 0.01), and triacylglycerol (299.4 ± 94.6 vs. 260.4 ± 118.7, P = 0.03). In the multivariate model, independent variables that significantly predicted fetal asphyxia in ICP were TBA levels (odds ratio, 1.04; 95% confidence interval, 1.01-1.08, P = 0.03) and exposure time (odds ratio, 1.11; 95% confidence interval, 1.05-1.17, P < 0.01). These findings suggest that the most important predictive factors for fetal asphyxia in ICP are levels of TBA and exposure time.

WOS: 000259030900006, PubMed ID: 18446039, Background/Aims: Quantitative fluorescent polymerase chain reaction (QF-PCR) is a successful prenatal diagnostic method which has been regularly used for the diagnosis of common chromosomal abnormalities in recent years. This method provides diagnosis of common aneuploidies in a few hours after sampling with a high throughput, very low error rates and low cost. Methods: In this study, 576 amniotic fluid samples were analyzed for trisomies 13, 18, and 21 and sex chromosome aneuploidies using different commercial QF-PCR kits (ChromoQuant (TM) version 1, Aneufast (TM), ChromoQuant (TM) version 2). Test results were compared with those obtained by conventional cytogenetic analyses. Results: Nine cases of trisomy 21 (1.6%), 1 case of trisomy 13 (0.17%), 3 cases of trisomy 18 (0.52%), 1 case of Turner syndrome (0.17%), 2 cases of Klinefelter's syndrome (0.34%), 2 cases of triploidy (0.34%) and 1 case of XXX (0.17%) were detected by QF-PCR. The results obtained by QF-PCR were consistent with the results of cytogenetic studies (except for 2 samples which had structural chromosomal abnormalities which could not be detected by QF-PCR). Conclusion: The QF-PCR method is an appropriate choice for rapid aneuploidy testing in our as well as in other populations. Copyright (C) 2008 S. Karger AG, Basel.

Pentalogy of Cantrell is a rarely seen syndrome that, in full form, includes a midline supraumbilical abdominal defect, defect of the lower sternum, deficiency of the diaphragmatic pericardium, deficiency of the anterior diaphragm, and congenital cardiac anomalies. Cases not fulfilling these criteria but including various combinations of them, provided that they include at least either a sternal defect or intracardiac and ventral abdominal wall abnormalities, are regarded as variants of the classic form. A case of a variant of Cantrell's pentalogy detected by sonography at 21 weeks' gestation is presented. Clinical examination of the aborted fetus confirmed the sonographic findings. Because of the poor prognosis of the condition, early antenatal sonographic diagnosis is important because it may allow for elective abortion before viability.

Gestational diabetes mellitus (GDM)-carbohydrate intolerance that begins or is first recognized during pregnancy-carries increased risk for the mother, fetus, and newborn infant. Both impaired insulin secretion and increased resistance to insulin have been described in GDM. Short-term exogenous corticosteroids can derange glucose metabolism when given alone or with beta-adrenergic drugs, but little is known about whether long-term steroid treatment adversely affects glucose tolerance during pregnancy. This case-control study compared 25 pregnant women with idiopathic thrombocytopenic purpura (ITP) who received steroids (5-10 mg daily of prednisone) for longer than 4 weeks with 108 pregnant women who had not received steroids. Women having pregestational diabetes were excluded. The two groups were similar with regard to age and body mass index. Steroids had been given to the ITP group for nearly 10 weeks on average, and the duration of treatment correlated positively with the risk of the development of GDM which was diagnosed in 24% of steroid-treated women, and in 3% of control women. Subsequent diabetes also was more prevalent in steroid-treated women. With one exception, GDM was diagnosed by screening at 16 weeks' gestation. Five of six affected study patients but none of three control women with GDM required insulin. Target blood glucose levels were achieved in all diabetic women and there were no acute metabolic complications. All the ITP pregnancies resulted in a live birth. Only one infant developed severe thrombocytopenia. No bleeding complications were observed, and no infant in either group had such GDM-related complications as polyhydramnios, macrosomia, neonatal hypoglycemia, or respiratory distress syndrome. Because long-term corticosteroid treatment may promote the development of diabetes in pregnant women, glucose tolerance testing should be done early in the course of pregnancy in steroid-treated women.

Objective To evaluate reproductive and obstetric characteristics of adolescent pregnancies in Turkish population. Design Retrospective study. Setting Social Security Agency (SSK) Aegean Obstetrics and Gynecology Teaching Hospital (tertiary referral center). Patients One thousand and eight hundred adolescent pregnant women who referred to our center, between January 12, 2002 and March 15, 2003. The adolescent age group was defined as young women between the ages of 13 and 19. Interventions None. Outcome Measures Socio-demographic characteristics, contraceptive histories, sexually transmitted infections (STI), and obstetric outcomes of the patients. Results Mean age was 17.3 (range 13–19) years. Among all adolescent pregnancies 1368 (76%) cases were planned, and 1512 (84%) cases were married. Approximately 70% of the patients with a non-planned pregnancy were not using any contraceptive methods. Although there were no patients with HIV infection, there were a considerable percentage of patients with positive cervical screening tests for Human Papilloma Virus (8.05%). A majority of adolescent mothers (77%) lacked prenatal care; mean gestational week at the first prenatal visit of the patients taking prenatal care was 28.2 (range 6–39) weeks. There were 249 (13.83%) abortions. Mean gestational age at delivery was 36±2 (range 25–41) weeks. The most common obstetric complication was low birth weight (28.72%). Conclusions Adolescent pregnancy rate in Turkey is similar to those in developed countries. However, there are considerable differences which possible reflect ethnic and socio-cultural differences, in between two populations. Our major problems seem to be the low rate of previous effective contraceptive use for unintended adolescent pregnant women and the high rate of inadequate prenatal care for adolescent pregnant women, even if their pregnancies are intended.

Background: Thrombophilic predisposition may be one of the underlying causes of recurrent miscariage (RM). The purpose of this study was to evaluate the Prothrombin G20210A mutation in cases with history of RM. Material and methods: A total of 104 cases, 55 with diagnosis of RM and 49 control cases, were included in this controlled study. In all cases, in addition to full examination tests, Prothrombin 20210A mutation analysis was carried out by means of Polymerase Chain Reaction (PCR). Results: Mean number of the abortion was 3.51±0.74 in the RM group and 0.08±0.27 in the control group (p

Necrotizing fasciitis, a severe soft tissue infection, was first described 80 years ago. It occurs rarely in obstetric and gynecology practice. We reviewed medical records of 2,894 women who had underwent an abdominal hysterectomy at the Social Security Agency Aegean Obstetrics and Gynecology Teaching Hospital between 2001 and 2005, and identified 5 (0.17%) cases of necrotizing fasciitis, which are described.

Adenosarcomas of the uterus are very rarely observed and diagnosed. In this report, we present a case of a uterine adenosarcoma that was diagnosed in February 2002.

The aim of this study was to investigate the DNA of Chlamydia trachomatis by polymerase chain reaction (PCR) in the first-void urine samples of patients with mucopurulent genital discharge and to compare the results with the urethral/endocervical swab culture method. First-void urine samples from 56 patients (46 female, 14 male) and urethral swab samples from 14 male patients were tested by PCR. Additionally, shell-vial culture method was performed for the urethral/endocervical swab samples which were collected from 46 female and 14 male patients. Four (2 females, 2 males) of the patients (7.1%) showed positive results by both of the methods. In five (8.9%) of the urine samples, internal control tests were found negative, indicating the presence of amplification inhibitors, and the culture results of these patients were also negative. Since the PCR method (Cobas Amplicor CT, Roche Diagnostic Systems, NJ, USA) which was used in the study included internal control programme to identify inhibitors in urine, the sensitivity was improved. As a result, the perfect (100%) correlation between culture and PCR methods, lead to the conclusion that PCR is a rapid and reliable method for the detection of C. trachomatis in urine samples, however more detailed studies are necessary related to the sensitivity and specificity of PCR method.

Objective: To compare the clinical, hormonal, biochemical and hemotological effects of flutamide versus flutamide plus an oral contraceptive (OC) in the treatment of hirsutism. Patients: Eighty-four women with hirsutism were equally randomized to receive either flutamide or flutamide plus OC. Design: Eighty-four women with hirsutism were recruited from patients presenting to our hospital. Each patient underwent a complete medical and gynecological examination as well as blood cell counts, biochemical and endocrine profiles. Hirsutism scores and laboratory tests were done during the 1st, 3rd and 6th months of therapy. Thirty-seven women in the flutamide group (taking 250 mg flutamide per day) and 32 women in the flutamide plus OC group (taking 250 mg flutamide plus 35 µg ethinyl estradiol and 2 mg cyproterone acetate per day) regularly followed the therapy regimens. Results: There were no significant differences in Ferriman-Gallway scores at the beginning and at the end of the therapies between the two groups (p > 0.05). At the 6th month, the decreases in Ferriman-Gallway scores were significant in both flutamide (from 18.95 ± 4.44 to 14.46 ± 5.02; p < 0.05) and flutamide plus OC groups (from 19.94 ± 4.31 to 15.58 ± 4.28; p < 0.05). In the first group, 2 of 6 oligomenorrheic women had regular cycles at the end of the therapy. Oligomenorrhea in 8 women was all changed to regular cycles in the flutamide plus OC group. Regarding the hormonal profile, only in the second group were prolactin, free testosterone and dehydroepiandrosterone sulfate levels significantly decreased (p < 0.05). Hepatic function tests were significantly increased in both groups, but they were all within normal ranges. Conclusion: These data suggest that both therapies were similarly effective and safe in the treatment of hirsutism. In women with oligomenorrhea and/or needing contraception, adding an OC shows better results than flutamide treatment alone in providing regular cycles.