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Recurrent pregnancy loss (RPL) is defined by two or more failed pregnancies. The relation between RPL and inherited thrombophilia requires anticoagulant therapy during pregnancy. However the obstetric outcomes have not been well defined in these RPL patients diagnosed with inherited thrombophilia, who have been given anticoagulant therapy. To investigate the obstetric outcomes in pregnant women with RPL who are given low molecular weight heparin (LMWH) and low-dose aspirin due to diagnosis of inherited thrombophilia. A hundred and eight RPL women were diagnosed with inherited thrombophilia, and 98 women were diagnosed with unexplained RPL. The patients with inherited thrombophilia were given LMWH and low-dose aspirin. Unexplained RPL patients were not given any medicine. The obstetric outcomes of participants were noted. In thrombophilic group, the live-birth levels were significantly higher [90 (83%) vs 67 (68%) p

Background: Young maternal age is variously defined in studies of its effect on obstetrics and perinatal outcomes. Also, pregnancy has been reported as the leading cause of death in adolescent girls in low- and middle-income countries. Aims: The aim of the study was to evaluate whether young maternal age was associated with an increased risk of obstetrics and perinatal adverse outcomes. Study Design: Case-control study. Methods: This case-control study was derived from a database of the medical records between January 2008 and December 2012. In the present study, 1374 teenage pregnancy and 1294 adult pregnancy cases were included. After restriction of analyses to singleton primiparous women, 1282 teenage pregnancy and 735 adult pregnancy cases were analyzed. Maternal age was separated into three groups: 15 and less, 16-19, and 20-34 years. Adjusted odds ratios (ORs) were derived through logistic regression models for the potential confounding factors. Results: Adolescents aged 15 years and younger had higher risks of preterm delivery, early preterm delivery, intrauterine fetal death and neonatal death compared with women aged 20 to 34 years after adjustment for confounding factors. In addition, both groups of adolescents had higher risks for anemia and episiotomy and lower risk of cesarean delivery. The rates of preeclampsia, gestational diabetes, chronic diseases, intrauterine growth restriction (IUGR) were higher in the adult group. Conclusion: Younger maternal age was correlated with increased risks of preterm delivery, fetal and neonatal death and anemia.

Objective To evaluate the possible effects of prenatal steroid administration on Doppler parameters of the umbilical artery, uterine artery, middle cerebral artery, and ductus venosus, the cerebroplacental ratio, and the amniotic fluid index in preterm fetuses. Methods The present prospective observational study was performed at the Perinatology Department of Trakya University, Edirne, Turkey, between June 1, 2015, and September 1, 2016. It included patients with healthy singleton pregnancies who had received betamethasone at 24-34 weeks of pregnancy. Doppler parameters were measured before (0 hours) and 24, 48, and 72 hours after the administration of betamethasone (two intramuscular doses of 12 mg each, administered 24 hours apart). Results There were 68 patients included. Pairwise comparisons demonstrated that, at 72 hours after betamethasone administration, the umbilical artery resistance index (P=0.038), the middle cerebral artery systolic/diastolic velocity ratio (P=0.007), and the amniotic fluid index (P=0.017) were reduced, whereas the end-diastolic velocity of the middle cerebral artery was increased (P=0.012), compared with baseline values. Conclusion Betamethasone had favorable effects on fetal cerebral circulation, with increased end-diastolic velocity in the middle cerebral artery; this could represent a positive effect on cerebral blood circulation and decreased flow resistance in the umbilical artery.

Background: Ovarian cancer is one of the highest mortality cancers in gynaecology. Discrimination of benign masses from malignant ones may sometimes become a challenge for the clinician since there is not a reliable tumour marker, thus some unnecessary, highly morbid operations can be performed. Aims: To explore the efficacy of human epididymis 4 (HE 4) and cancer antigen 125 (CA 125) markers in differentiating malignant and benign pelvic masses of ovarian origin and to identify the cut-off points for those markers. Study Design: Prospective study. Methods: Fifty-one patients who were diagnosed and planned to undergo surgery for ovarian mass between June 2008 and December 2008 were enrolled into this study. Preoperative venous blood samples were taken and frozen for marker investigation and final diagnoses were concluded by histopathological examination. After recruitment of all cases CA 125 and HE 4 levels were evaluated. Results: The statistical analysis did not indicate any statistically significant difference between the CA 125 levels of the patients with malignant and benign adnexal masses (p=0.105). The HE 4 levels of the patients with malignant adnexal masses were higher at a statistically significant level compared to the patients with benign adnexal masses (p=0.002). For HE 4 tumour marker and at the cut-off point of >25 pM, sensitivity was 1, specificity 0.40, positive cut-off value 0.19, negative cut-off value 1, accuracy 0.47 and positive likelihood ratio 1.65. Conclusion: Human epididymis 4 is a better diagnostic tool than CA 125 in benign-malignant discrimination of adnexal masses. The cut-off value of 25 pmol/L for human epididymis 4 will contribute to providing proper guidance to patients with adnexal masses and applying the proper treatment method.

Background: Pelvic organ prolapse is an important problem for women. To overcome this issue, different operational technics are in use, such as abdominal sacrocolpopexy, sacrospinous fixation, and the total Prolift procedure. Aims: This study assessed perioperative complications in abdominal sacrocolpopexy, sacrospinous fixation, and the total Prolift procedure. Study Design: Retrospective comparative study. Methods: Perioperative complications were defined as any complication occurring during surgery or the first 6 weeks postoperatively. Forty-five patients underwent abdominal procedures, 60 patients underwent sacrospinous fixation, and 43 patients underwent the total Prolift procedure. Results: In the abdominal group, one bladder injury, four hemorrhages, and three wound dehiscences occurred. In the sacrospinous group, one rectal injury and one postoperative vault infection occurred. In the Prolift group, one bladder injury and one hemorrhage occurred. Minor complications were more frequent in the abdominal group than the others. The operating time and hospital stay of the abdominal group were significantly longer than the others. The Prolift procedure had less operating time and hospital stay than other procedures. Conclusion: The total Prolift may be a novel alternative for apical prolapse with low perioperative morbidities and complications.

Amaç: Buçalışmada kliniğimizde benign hastalıklar nedeniyle total abdominalhisterektomi olmuş hastaların operasyon endikasyonları ve operasyonmateryallerinin histopatolojik inceleme sonuçlarını değerlendirmeyi amaçladık.Materyal ve Metod:2010-2015 yılları arasında benign endikasyonlarla yapılmış toplam 184 totalabdominal histerektomi vakası operasyon endikasyonları ve ameliyat sonrasıpiyeslerin histopatolojik inceleme sonuçları retrospektif olarakdeğerlendirilmiştir.Bulgular: Ensık histerektomi endikasyonu myomauteri idi (n=120, %65,21). Sonrasırasıyla endometrial hiperplazi (n=19, %10,32), servikal intraepitelyal neoplazi(n=15, %8,15) ve ovarian kistik kitleler (n=9, %4,89) izlenmekteydi.Histopatolojik inceleme sonunda, endikasyonlarla uyumlu olarak en sık tanımyoma uteri (n=68, %35,95) ve diğer tanılar da sırasıyla myoma uteri veadenomyozis birlikteliği (n=19, %10,32), myoma uteri ve endometrial patolojiler(n=19, %10,32), servikal intraepitelyal neoplazi (n=15,%8,15) ve adenomyozis(n=11, n=5,97) olarak bulundu.Sonuç: Kliniğimizdeyapılan histerektomiler arasında en sık endikasyon tek başına myoma uteri iken,histopatolojik inceleme sonuçları değerlendirildiğinde myoma uteri tek başınave diğer benign jinekolojik hastalık tanılarıyla birlikteliği en sık olan tanıdır., Aim: To evaluate the indications andfinal pathologic diagnosis of benign abdominal hysterectomies performed at ourclinic.Material and Methods: Data werecollected from 184 patient charts who had hysterectomy between 2010 and 2015 atXXXX Medicine Faculty, Department ofGynecology for benign indications.Results: The mostcommon preoperative indication for hysterectomy was myoma uteri (n=120,%65,21). Endometrial hyperplasia (n=19,%10,32), cervical intraepithelial neoplasia (n=15, %8,15) and ovarian cysticmasses (n=9, %4,89) were the following most common indications. Thehystopathologic diagnosis revealed a similar most common indication by myomauteri (n=68, %35,95) followed by the combinations of myoma uteri andadenomyosis (n=19, %10,32), myoma uteri and endometrial pathologies (n=19,%10,32), cervical intraepithelial neoplasia (n=15,%8,15) and adenomyosis (n=11,n=5,97).Conclusion: Myoma uteri has the highestindication in both preoperative and postoperative diagnosis solely or as acombination indication.

OBJECTIVE To document the neonatal outcomes of preterm birth in twin pregnancies and to investigate whether perinatal and obstetric parameters are associated with clinical outcomes. METHODS This retrospective trial was conducted on data gathered from 176 preterm twins delivered in the obstetrics and gynecology department of our tertiary care center. Data extracted from medical files of 88 pregnant women who gave preterm birth (at 26(0/7) to 36(6/7) gestational weeks) to twins were analyzed. Maternal/fetal descriptive and obstetric parameters, sonographic data, route of delivery, indication for cesarean section, birth weight, Apgar scores, head circumference, umbilical cord length and placental weight were noted. RESULTS The average age of the pregnant women was 28.8±6.4 years and ultrasonographic gestational age was 31.9±2.6 weeks. Apgar scores at 1(st) minute were affected significantly by fetal body weight (p=0.001), gestational age (p=0.001), height (p=0.004) and head circumference (p=0.011). None of these variables exhibited a noteworthy effect on Apgar scores at 5(th) minute. CONCLUSION Efforts must be made to achieve advancement of gestational age until delivery in the follow-up preterm of twins. A well-established algorithm with special emphasis to risk factors is necessary to standardize and popularize the appropriate management strategy.

Objectives: The aim of this study was to determine gestational diabetes mellitus (GDM) frequency and age related frequency with GDM screening tests in patients whom referred to our hospital’s antepartum clinic for routine follow-up.Materials and methods: Totally, 2617 pregnant women who did not have any risk factors for GDM and attended to our antepartum clinic for routine follow-up between August 2009 and March 2011 enrolled in this study. A 50-g glucose challenge test (GCT) applied at 24-28 weeks’ gestation. The patients who had a value of blood glucose ≥ 140 mg/dl undergone 100-g oral glucose tolerance test (OGTT). Patients who had a value of ≥200 mg/dl blood glucose in GCT or one value of ≥200 mg/dl in OGTT or had two values exceeded normal ranges in OGTT were accepted as GDM. Age related GDM frequency was also determined.Results: Of the 2617 pregnant women 110 patients diagnosed as GDM (4.2%). For the age related frequency, there was a tendency towards GDM after the age of 33. The age 44 was the most risky with a 33% ratio of GDM occurrence rate.Conclusion: In this study the GDM frequency in our hospital’s routine follow-up clinic was found as compatible with the 1% to 6% frequency reported in the literature. The higher frequency of GDM was found in advanced age pregnancies.

Objective Recurrent pregnancy loss is often defined as three or more consecutive pregnancy losses but there are no strict criteria for initiation of investigations after a miscarriage. We compared the frequency of uterine anomalies diagnosed by hysteroscopy following one, two and three or more miscarriages. Study design In our study 151 patients underwent diagnostic hysteroscopy following a missed or an incomplete abortion. Uterine septum, subseptum, arcuate uterus, and uterine hypoplasia are classified as congenital uterine anomalies and polyps, synechia, and submucous myomas are classified as acquired uterine abnormalities. Results 151 Patients were enrolled in the study. The pregnancy numbers of the patients varied between 1 and 12. Sixty nine (46%) of the patients had one miscarriage, 42 (28%) had two miscarriages and 40 (26%) had three or more miscarriages. Diagnostic hysteroscopy revealed normal uterine cavity in 61.1% of the patients, congenital uterine anomalies in 20.4% and acquired uterine pathologies in 18.5%. Among the congenital anomalies, 14 (9.3%) were uterine septum, 10 (6.6%) were subseptate uterus, 4 (2.6%) were arcuate uterus and 3 (1.9%) were uterine hypoplasia. Among acquired abnormalities 14 (9.3%) were uterine synechia, 12 (7.9%) were endometrial polyps, and 2 (1.3%) were submucous myoma. Among patients who had one miscarriage 64.1% had a normal uterine cavity, 18.2% had congenital abnormalities and 17.7% had acquired uterine pathologies. Of patients with two miscarriages, 52% had a normal uterine cavity, 21.9% had congenital anomalies and 26.1% had acquired uterine pathology. In the three or more miscarriage group, 58.4% had normal uterine cavity, 25.3% had congenital anomalies, and 16.3% had acquired uterine pathology. We did not find any statistically significant difference between the number of miscarriages and pathologic diagnostic hysteroscopy findings. Conclusions Post-abortion office hysteroscopy is a simple and efficient tool in the early diagnosis of congenital and acquired uterine pathologies. Diagnostic hysteroscopy can be performed after the first miscarriage in order to determine congenital and acquired uterine pathologies, with regard to the patient's age and anxiety level.

Background: The aim of this study was to investigate the effect of estrogen and progesterone on central corneal thickness, corneal curvature, and the development of dry eye in postmenopausal women.Methods: This is a case-control study including 54 premenopausal and 54 postmenopausal women. The two groups were compared in terms of follicle stimulating hormone, estradiol, progesterone, and horizontal and vertical curvatures, astigmatism, central corneal thickness, Schirmer I test scores, and dry eye scores of both eyes.Results: In the postmenopausal women, central corneal thickness was significantly thinner in both eyes (p=0.017) and the Schirmer test scores were significantly lower both for the right (p=0.001) and the left eye (p=0.003). Estradiol levels were positively correlated with central corneal thickness (p=0.003-0.006) and Schirmer test scores (p=0.004-0.002) whereas progesterone levels showed a positive correlation only with Schirmer test scores (p=0.036-0.044). Although a significant positive correlation was found between estradiol levels and dry eye scores (p=0,009), no significant correlation was found between progesterone levels and dry eye scores (p=0,118).Conclusions: Age-related hormonal abnormalities lead to central corneal thinning, increased dry eye symptoms, and decreased tear flow, particularly in the postmenopausal term. Decreased estrogen levels are associated with central corneal thickness and dry-eye symptoms, decreased estrogen and progesterone levels correlates well with diminished tear production but progesterone levels does not effect dry-eye symptoms.