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Gunkaya OS, Tekin AB, Bestel A, Arslan O, Şahin F, Taymur BD, Tuğ N. Is polycystic ovary syndrome a risk factor for depression and anxiety?: a cross-sectional study. Rev Assoc Med Bras (1992) 2024; 70:e20230918. [PMID: 38655994 DOI: 10.1590/1806-9282.20230918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 11/03/2023] [Indexed: 04/26/2024]
Abstract
OBJECTIVE The objective of this study was to learn more about the prevalence and pathophysiology of depression and anxiety that may be caused by polycystic ovary syndrome and to make plans for taking necessary precautions for this vulnerable group. METHODS This case-control study was conducted between January 2022 and October 2022. A total of 120 women with polycystic ovary syndrome and 143 controls were included in the study. All healthy volunteers and women with polycystic ovary syndrome were evaluated using self-administered questionnaires and physical examination. Anthropometric data such as weight and height and laboratory value were documented. RESULTS There was no significant difference between the groups in terms of demographic characteristics. When the Hospital Anxiety and Depression Scale scores of both groups were compared, both depression and anxiety scores were found to be significantly higher in women with polycystic ovary syndrome compared with the control group (OR: 3.319, 95%CI, 1.563-7.047, p<0.001 and OR: 3.238, 95%CI, 1.659-6.315, p<0.001). In the Hospital Anxiety and Depression Scale questionnaire, the rate of irregular menstruation and Ferriman-Gallwey score were statistically significant in women with polycystic ovary syndrome with high depression and anxiety scores. While serum LH levels and LH/FSH ratios were significantly different in women with polycystic ovary syndrome with high depression scores, serum LH, LH:FSH ratios, and serum total testosterone levels were found significant in women with polycystic ovary syndrome with high anxiety scores. CONCLUSION It is clear that depression and anxiety are more common in patients with polycystic ovary syndrome than in healthy women. Our findings support previous recommendations regarding routine screening for depression and anxiety in this population.
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Affiliation(s)
- Osman Samet Gunkaya
- University of Health Sciences Turkey, Sehit Prof. Dr. Ilhan Varank Sancaktepe Training and Research Hospital, Department of Obstetrics and Gynecology - İstanbul, Turkey
| | - Arzu Bilge Tekin
- University of Health Sciences Turkey, Sehit Prof. Dr. Ilhan Varank Sancaktepe Training and Research Hospital, Department of Obstetrics and Gynecology - İstanbul, Turkey
| | - Ayşegül Bestel
- University of Health Sciences Turkey, Kanuni Sultan Suleyman Training and Research Hospital, Clinic of Obstetrics and Gynecology - İstanbul, Turkey
| | - Oguz Arslan
- University of Health Sciences Turkey, Sehit Prof. Dr. Ilhan Varank Sancaktepe Training and Research Hospital, Department of Obstetrics and Gynecology - İstanbul, Turkey
| | - Fatih Şahin
- University of Health Sciences Turkey, Istanbul Prof. Dr. Cemil Taşcioğlu City Hospital, Department of Obstetrics and Gynecology - İstanbul, Turkey
| | - Bilge Dogan Taymur
- University of Health Sciences Turkey, Sehit Prof. Dr. Ilhan Varank Sancaktepe Training and Research Hospital, Department of Obstetrics and Gynecology - İstanbul, Turkey
| | - Niyazi Tuğ
- University of Health Sciences Turkey, Sehit Prof. Dr. Ilhan Varank Sancaktepe Training and Research Hospital, Department of Obstetrics and Gynecology - İstanbul, Turkey
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Birol Ilter P, Yassa M, Timur H, Dogan O, Tekin AB, Haydar A, Gulumser C, Tug N, Malvasi A, Tinelli A. Intrapartum ultrasound for fetal head asynclitism: Is it possible to establish a degree of asynclitism to correlate to delivery outcome? Int J Gynaecol Obstet 2023; 163:271-276. [PMID: 37118912 DOI: 10.1002/ijgo.14814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 03/30/2023] [Accepted: 04/11/2023] [Indexed: 04/30/2023]
Abstract
OBJECTIVE To investigate the role of intrapartum ultrasound (IU) in the diagnosis of asynclitism and the importance of asynclitism degree in labor outcomes. METHOD This prospective cohort study included 41 low-risk pregnant women with fetus in singleton-vertex. The IU assessment to diagnose asynclitism was performed during labor at two specific steps, including the suspicion and/or diagnosis of labor arrest. The "four-chamber view" and "squint sign without nose" were classified as marked/severe asynclitism. The "midline deviation" and "squint sign with nose" findings were classified as moderate asynclitism. Obstetric outcomes and maternal-fetal complications were compared with the degree of asynclitism. RESULTS Severe and moderate asynclitism was seen in 17 (41.7%), 10 (58.8%) and seven (41.2%) women, respectively. All pregnant women diagnosed with asynclitism delivered by vacuum extraction (VE) or cesarean section (CS). CS was performed in nine patients with asynclitism (52.9%). The difference between asynclitism type and VE/CS ratios was statistically significant (P = 0.039). Four fetuses with squint sign without nose delivered by VE. A significant correlation was seen between the presence of squint without nose sign and second-/third-degree perineal injury. CONCLUSION Severe asynclitism is associated with increasing operative birth and maternal-fetal complications. Detection of asynclitism degree by IU could be useful, alerting the obstetrics team to possible perinatal problems during delivery.
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Affiliation(s)
- Pinar Birol Ilter
- Şehit Prof. Dr. İlhan Varank Sancaktepe Training and Research Hospital, Clinic of Obstetrics and Gynecology, University of Health Sciences Turkey, İstanbul, Turkey
- Department of Obstetrics and Gynecology, Kartal Dr. Lutfi Kirdar Research and Training Hospital, University of Health Sciences Turkey, Istanbul, Turkey
| | - Murat Yassa
- Şehit Prof. Dr. İlhan Varank Sancaktepe Training and Research Hospital, Clinic of Obstetrics and Gynecology, University of Health Sciences Turkey, İstanbul, Turkey
- Bahçeşehir University, VM Medical Park Maltepe Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey
| | - Hakan Timur
- Department of Obstetrics and Gynecology, Ordu University Training and Research Hospital, Ordu, Turkey
| | | | - Arzu Bilge Tekin
- Şehit Prof. Dr. İlhan Varank Sancaktepe Training and Research Hospital, Clinic of Obstetrics and Gynecology, University of Health Sciences Turkey, İstanbul, Turkey
| | - Ahmad Haydar
- Department of Obstetrics and Gynecology, Clinique Générale-Beaulieu, Geneva, Switzerland
| | - Cagri Gulumser
- Department of Obstetrics and Gynecology, Yuksek Ihtisas University, Ankara, Turkey
| | - Niyazi Tug
- Şehit Prof. Dr. İlhan Varank Sancaktepe Training and Research Hospital, Clinic of Obstetrics and Gynecology, University of Health Sciences Turkey, İstanbul, Turkey
| | - Antonio Malvasi
- Unit of Obstetrics and Gynecology, D.I.M.O Unıversity, Bari, Italy
| | - Andrea Tinelli
- Department of Obstetrics and Gynecology and CERICSAL (CEntro di RIcerca Clinico Salentino), Veris delli Ponti Hospital, Lecce, Italy
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Gunkaya OS, Tekin AB, Yassa M, Arslan O, Karakoç K, Demirtaş N, Usta C, Künt İşgüder Ç, Tuğ N. Pregnant women's knowledge about and beliefs toward COVID-19 vaccine: a cross-sectional study. Clin Exp Vaccine Res 2023; 12:134-142. [PMID: 37214145 PMCID: PMC10193106 DOI: 10.7774/cevr.2023.12.2.134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 01/31/2023] [Accepted: 02/05/2023] [Indexed: 05/24/2023] Open
Abstract
Purpose The aim of this study was to determine the scope of knowledge, attitudes, and behaviors of pregnant women about the coronavirus disease 2019 (COVID-19) vaccine. Materials and Methods A total of 886 pregnant women were recruited for the study. A cross-sectional questionnaire was conducted on these selected participants. Data about past infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), SARS-CoV-2 infection of closely related people, and deaths due to COVID-19 among their relatives were questioned. Results The rate of vaccination was higher (64.1%) in pregnant women with higher education levels. Informing about the vaccine, especially by health professionals, showed that the rates of vaccination (25%) increased (p<0.001). In addition, a significant increase was observed in vaccination rates with increasing age and financial income (p<0.001). Conclusion The main limitation of our study is that the vaccine, which was approved for "emergency use", was just started to be administered to pregnant women during the study. Our findings show that our target audience, low-income, low-education, younger pregnant women should be given more attention than those who apply to the doctor for routine follow-up.
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Affiliation(s)
- Osman Samet Gunkaya
- Department of Obstetrics and Gynecology, Sehit Prof. Dr. Ilhan Varank Sancaktepe Training and Research Hospital, University of Health Sciences Turkey, Istanbul, Turkey
| | - Arzu Bilge Tekin
- Department of Obstetrics and Gynecology, Sehit Prof. Dr. Ilhan Varank Sancaktepe Training and Research Hospital, University of Health Sciences Turkey, Istanbul, Turkey
| | - Murat Yassa
- Clinic of Obstetrics and Gynecology, VM Medical Park Maltepe Hospital, Istanbul, Turkey
| | - Oguz Arslan
- Department of Obstetrics and Gynecology, Sehit Prof. Dr. Ilhan Varank Sancaktepe Training and Research Hospital, University of Health Sciences Turkey, Istanbul, Turkey
| | - Kübra Karakoç
- Department of Obstetrics and Gynecology, Sehit Prof. Dr. Ilhan Varank Sancaktepe Training and Research Hospital, University of Health Sciences Turkey, Istanbul, Turkey
| | - Nesibe Demirtaş
- Department of Obstetrics and Gynecology, Sehit Prof. Dr. Ilhan Varank Sancaktepe Training and Research Hospital, University of Health Sciences Turkey, Istanbul, Turkey
| | - Canberk Usta
- Department of Obstetrics and Gynecology, Sehit Prof. Dr. Ilhan Varank Sancaktepe Training and Research Hospital, University of Health Sciences Turkey, Istanbul, Turkey
| | - Çiğdem Künt İşgüder
- Department of Obstetrics and Gynecology, Sehit Prof. Dr. Ilhan Varank Sancaktepe Training and Research Hospital, University of Health Sciences Turkey, Istanbul, Turkey
| | - Niyazi Tuğ
- Department of Obstetrics and Gynecology, Sehit Prof. Dr. Ilhan Varank Sancaktepe Training and Research Hospital, University of Health Sciences Turkey, Istanbul, Turkey
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Tekin AB, Yassa M, Kaya C, Budak D, Ilter PB, Mutlu MA, Usta C, Gunkaya OS, Yavuz E, Tug N. Implementing the transvaginal natural orifice transluminal endoscopic surgery (vNOTES) "first" strategy in benign gynecological surgeries. Arch Gynecol Obstet 2023; 307:1007-1013. [PMID: 36445449 DOI: 10.1007/s00404-022-06859-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 11/14/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE The use of transvaginal natural orifice transluminal endoscopic surgery (vNOTES) as the first choice of surgical route for patients scheduled to undergo conventional laparoscopy is still being debated. We aimed to evaluate and compare the outcomes of the "vNOTES first" strategy in benign gynecological cases. METHODS All benign gynecological surgeries were initiated using vNOTES during the study period, regardless of the difficulty. Surgical outcomes, short-term patient satisfaction and sexual pain were compared between hysterectomies, adnexal and diagnostic procedures. Visual Analog Score (VAS), Patients Global Impressions of Improvements scale (PGI-I) and Female Sexual Function Index (FSFI) were used to assess the postoperative pain, satisfaction and sexual pain, respectively. RESULTS A total of 105 vNOTES procedures were performed during the study period: 63 (60.58%) adnexal procedures, 36 (34.62%) hysterectomies, 5 (4.81%) diagnostic procedures and one (0.96%) myomectomy. The median 24th hour VAS scores for adnexal, hysterectomy, and diagnostic procedures were 1.29 ± 1.41, 2.06 ± 2.08, and 2.6 ± 2.41, respectively. The satisfaction rate was 96.19% at the 1st postoperative week and 97.14% at the first month. There was either no change or a slight improvement in the patients' total score on the FSFI/pain domain before and after surgery. There were two conversions (1.9%) from vNOTES to laparoscopy and laparotomy, and two (5.56%) bladder injuries in hysterectomy cases. CONCLUSION Implementing the vNOTES technique as an initial approach for all benign gynecological surgeries seems feasible, safe and satisfactory, even in those with a non-prolapsed or enlarged uterus and those that have previously undergone abdominal surgery. The pain scores were found to be low and patients stated a high satisfaction with no or better change in their sexual life.
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Affiliation(s)
- Arzu Bilge Tekin
- Department of Obstetrics and Gynecology, Sehit Prof Dr Ilhan Varank Sancaktepe Training and Research Hospital, University of Health Sciences, Emek Mahallesi, Namık Kemal Caddesi, No: 54, Sancaktepe, 34785, Istanbul, Turkey.
| | - Murat Yassa
- Department of Obstetrics and Gynecology, VM Medical Park Maltepe Hospital, Bahcesehir University, Istanbul, Turkey
| | - Cihan Kaya
- Department of Obstetrics and Gynecology, Acibadem Bakirkoy Hospital, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | - Dogus Budak
- Department of Obstetrics and Gynecology, Sehit Prof Dr Ilhan Varank Sancaktepe Training and Research Hospital, University of Health Sciences, Emek Mahallesi, Namık Kemal Caddesi, No: 54, Sancaktepe, 34785, Istanbul, Turkey
| | - Pinar Birol Ilter
- Department of Obstetrics and Gynecology, Sehit Prof Dr Ilhan Varank Sancaktepe Training and Research Hospital, University of Health Sciences, Emek Mahallesi, Namık Kemal Caddesi, No: 54, Sancaktepe, 34785, Istanbul, Turkey
| | - Memis Ali Mutlu
- Department of Obstetrics and Gynecology, Sehit Prof Dr Ilhan Varank Sancaktepe Training and Research Hospital, University of Health Sciences, Emek Mahallesi, Namık Kemal Caddesi, No: 54, Sancaktepe, 34785, Istanbul, Turkey
| | - Canberk Usta
- Department of Obstetrics and Gynecology, Sehit Prof Dr Ilhan Varank Sancaktepe Training and Research Hospital, University of Health Sciences, Emek Mahallesi, Namık Kemal Caddesi, No: 54, Sancaktepe, 34785, Istanbul, Turkey
| | - Osman Samet Gunkaya
- Department of Obstetrics and Gynecology, Sehit Prof Dr Ilhan Varank Sancaktepe Training and Research Hospital, University of Health Sciences, Emek Mahallesi, Namık Kemal Caddesi, No: 54, Sancaktepe, 34785, Istanbul, Turkey
| | - Emre Yavuz
- Department of Obstetrics and Gynecology, Sehit Prof Dr Ilhan Varank Sancaktepe Training and Research Hospital, University of Health Sciences, Emek Mahallesi, Namık Kemal Caddesi, No: 54, Sancaktepe, 34785, Istanbul, Turkey
| | - Niyazi Tug
- Department of Obstetrics and Gynecology, Sehit Prof Dr Ilhan Varank Sancaktepe Training and Research Hospital, University of Health Sciences, Emek Mahallesi, Namık Kemal Caddesi, No: 54, Sancaktepe, 34785, Istanbul, Turkey
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Tekin AB, Yassa M, Kaya C, Birol Ilter P, Mutlu MA, Kalkan U, Tug N. Vaginal birth following diagnostic vNOTES and appendectomy in a pregnant woman: a case report. J OBSTET GYNAECOL 2022; 42:3387-3389. [PMID: 36018048 DOI: 10.1080/01443615.2022.2114330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- Arzu Bilge Tekin
- Department of Obstetrics and Gynecology, Sehit Prof Dr Ilhan Varank Sancaktepe Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Murat Yassa
- Department of Obstetrics and Gynecology, VM Medical Park Maltepe Hospital, Bahcesehir University, Istanbul, Turkey
| | - Cihan Kaya
- Department of Obstetrics and Gynecology, Acibadem Bakirkoy Hospital, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | - Pinar Birol Ilter
- Department of Obstetrics and Gynecology, Sehit Prof Dr Ilhan Varank Sancaktepe Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Memis Ali Mutlu
- Department of Obstetrics and Gynecology, Sehit Prof Dr Ilhan Varank Sancaktepe Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Uzeyir Kalkan
- Department of Obstetrics and Gynecology, Koc University, Istanbul, Turkey
| | - Niyazi Tug
- Department of Obstetrics and Gynecology, Sehit Prof Dr Ilhan Varank Sancaktepe Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
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Tekin AB, Yassa M, Birol İlter P, Yavuz E, Önden B, Usta C, Budak D, Günkaya OS, Çavuşoğlu G, Taymur BD, Tuğ N. COVID-19 related maternal mortality cases in associated with Delta and Omicron waves and the role of lung ultrasound. Turk J Obstet Gynecol 2022; 19:88-97. [PMID: 35770508 PMCID: PMC9249361 DOI: 10.4274/tjod.galenos.2022.36937] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Objective: To present coronavirus disease-2019 (COVID-19) related maternal mortality in relation to Delta and Omicron waves and to investigate the role of lung ultrasound (LUS) in estimating mortality. Materials and Methods: This retrospective cohort study was conducted in the obstetrics and gynecology clinic of a tertiary pandemic hospital between March 2020 and January 2022. The hospitalized pregnant women with COVID-19 diagnosis and maternal deaths were studied in relation with Delta and Omicron waves. The relationship between LUS scores of hospitalized patients and maternal mortality was explored. Results: Thousand and sixty-five pregnant women were hospitalized because of COVID-19 infection. Fifty-one (4.79%) of these patients had critical sickness, 96 (9.01%) of them had severe illness, 62 (5.82%) of them were admitted to the intensive care unit and 28 (2.63%) of all hospitalized pregnant women had died. Of the 1.065 patients, 783 (73.5%) were hospitalized before the Delta wave and the maternal mortality rate was 1.28% (10/783), 243 (22.8%) were hospitalized during the Delta wave and the maternal mortality rate was 7% (17/243) [relative risk (RR)=5.478, 95% confidence interval (CI) (2.54-11.8), z=4.342, p<0.001]. During the Omicron wave 39 (3.66%) patients were hospitalized and the maternal mortality rate was 2.56% (1/39). Maternal mortality rates, according to LUS scores, were 0.37% (1/273) for LUS 0, 0.72% (2/277) for LUS 1, 2.58% (10/387) for LUS 2 and 11.72% (15/128) for LUS 3 respectively (LUS 3 vs. others; maternal mortality: RR=8.447, 95% CI (4.11-17.34), z=5.814, p<0.0001). There were no vaccinated patients in the study cohort. Conclusion: The maternal mortality rate was relatively high, particularly during the Delta wave at our referral center. The Delta wave, delayed vaccination and vaccine hesitancy of pregnant women might have important roles in maternal mortality. Higher LUS scores should warn clinicians of an increased risk of maternal death.
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Affiliation(s)
- Arzu Bilge Tekin
- University of Health Sciences Turkey, Şehit Prof. Dr. İlhan Varank Sancaktepe Training and Research Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey
| | - Murat Yassa
- Bahçeşehir University, VM Medical Park Maltepe Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey
| | - Pınar Birol İlter
- University of Health Sciences Turkey, Şehit Prof. Dr. İlhan Varank Sancaktepe Training and Research Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey
| | - Emre Yavuz
- University of Health Sciences Turkey, Şehit Prof. Dr. İlhan Varank Sancaktepe Training and Research Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey
| | - Betül Önden
- University of Health Sciences Turkey, Şehit Prof. Dr. İlhan Varank Sancaktepe Training and Research Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey
| | - Canberk Usta
- University of Health Sciences Turkey, Şehit Prof. Dr. İlhan Varank Sancaktepe Training and Research Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey
| | - Doğuş Budak
- University of Health Sciences Turkey, Şehit Prof. Dr. İlhan Varank Sancaktepe Training and Research Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey
| | - Osman Samet Günkaya
- University of Health Sciences Turkey, Şehit Prof. Dr. İlhan Varank Sancaktepe Training and Research Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey
| | - Gül Çavuşoğlu
- University of Health Sciences Turkey, Şehit Prof. Dr. İlhan Varank Sancaktepe Training and Research Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey
| | - Bilge Doğan Taymur
- University of Health Sciences Turkey, Şehit Prof. Dr. İlhan Varank Sancaktepe Training and Research Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey
| | - Niyazi Tuğ
- University of Health Sciences Turkey, Şehit Prof. Dr. İlhan Varank Sancaktepe Training and Research Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey
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Kalafat E, Prasad S, Birol P, Tekin AB, Kunt A, Di Fabrizio C, Alatas C, Celik E, Bagci H, Binder J, Le Doare K, Magee LA, Mutlu MA, Yassa M, Tug N, Sahin O, Krokos P, O’brien P, von Dadelszen P, Palmrich P, Papaioannou G, Ayaz R, Ladhani SN, Kalantaridou S, Mihmanli V, Khalil A. An internally validated prediction model for critical COVID-19 infection and intensive care unit admission in symptomatic pregnant women. Am J Obstet Gynecol 2022; 226:403.e1-403.e13. [PMID: 34582796 PMCID: PMC8463298 DOI: 10.1016/j.ajog.2021.09.024] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 09/12/2021] [Accepted: 09/21/2021] [Indexed: 12/15/2022]
Abstract
Background Pregnant women are at an increased risk of mortality and morbidity owing to COVID-19. Many studies have reported on the association of COVID-19 with pregnancy-specific adverse outcomes, but prediction models utilizing large cohorts of pregnant women are still lacking for estimating the risk of maternal morbidity and other adverse events. Objective The main aim of this study was to develop a prediction model to quantify the risk of progression to critical COVID-19 and intensive care unit admission in pregnant women with symptomatic infection. Study Design This was a multicenter retrospective cohort study including 8 hospitals from 4 countries (the United Kingdom, Austria, Greece, and Turkey). The data extraction was from February 2020 until May 2021. Included were consecutive pregnant and early postpartum women (within 10 days of birth); reverse transcriptase polymerase chain reaction confirmed SARS-CoV-2 infection. The primary outcome was progression to critical illness requiring intensive care. The secondary outcomes included maternal death, preeclampsia, and stillbirth. The association between the primary outcome and 12 candidate predictors having a known association with severe COVID-19 in pregnancy was analyzed with log-binomial mixed-effects regression and reported as adjusted risk ratios. All the potential predictors were evaluated in 1 model and only the baseline factors in another. The predictive accuracy was assessed by the area under the receiver operating characteristic curves. Results Of the 793 pregnant women who were positive for SARS-CoV-2 and were symptomatic, 44 (5.5%) were admitted to intensive care, of whom 10 died (1.3%). The ‘mini-COvid Maternal Intensive Therapy’ model included the following demographic and clinical variables available at disease onset: maternal age (adjusted risk ratio, 1.45; 95% confidence interval, 1.07–1.95; P=.015); body mass index (adjusted risk ratio, 1.34; 95% confidence interval, 1.06–1.66; P=.010); and diagnosis in the third trimester of pregnancy (adjusted risk ratio, 3.64; 95% confidence interval, 1.78–8.46; P=.001). The optimism-adjusted area under the receiver operating characteristic curve was 0.73. The ‘full-COvid Maternal Intensive Therapy’ model included body mass index (adjusted risk ratio, 1.39; 95% confidence interval, 1.07–1.95; P=.015), lower respiratory symptoms (adjusted risk ratio, 5.11; 95% confidence interval, 1.81–21.4; P=.007), neutrophil to lymphocyte ratio (adjusted risk ratio, 1.62; 95% confidence interval, 1.36–1.89; P<.001); and serum C-reactive protein (adjusted risk ratio, 1.30; 95% confidence interval, 1.15–1.44; P<.001), with an optimism-adjusted area under the receiver operating characteristic curve of 0.85. Neither model showed signs of a poor fit. Categorization as high-risk by either model was associated with a shorter diagnosis to intensive care unit admission interval (log-rank test P<.001, both), higher maternal death (5.2% vs 0.2%; P<.001), and preeclampsia (5.7% vs 1.0%; P<.001). A spreadsheet calculator is available for risk estimation. Conclusion At presentation with symptomatic COVID-19, pregnant and recently postpartum women can be stratified into high- and low-risk for progression to critical disease, even where resources are limited. This can support the nature and place of care. These models also highlight the independent risk for severe disease associated with obesity and should further emphasize that even in the absence of other comorbidities, vaccination is particularly important for these women. Finally, the model also provides useful information for policy makers when prioritizing national vaccination programs to quickly protect those at the highest risk of critical and fatal COVID-19.
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Annac G, Tekin AB. Echogenicities in the fetal gallbladder: Prevalence, sonographic findings, and postnatal outcomes. J Clin Ultrasound 2022; 50:74-79. [PMID: 34871456 DOI: 10.1002/jcu.23092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 10/05/2021] [Accepted: 10/12/2021] [Indexed: 06/13/2023]
Abstract
PURPOSE To investigate the prevalence of echogenicity in the fetal gallbladder (EFG) and to present prenatal sonographic findings and their postnatal outcomes. MATERIALS AND METHODS We performed a retrospective study within 17420 pregnant women during a 66-month period. Fetuses with an incidental finding of EFG in their 2nd or 3rd trimester of pregnancy were followed until birth per two weeks with sonographic examinations. RESULTS Out of 5977 fetuses, 44 fetuses were found to have EFG with a prevalence of 0.74%. Nine (20%) of 44 fetuses had single echogenicity, 25 (56%) had multiple echogenicities, 10 (22%) had sludge-like echogenicities. In Doppler sonography, 28 fetuses with EFG exhibited twinkling artifacts; however, none of the echogenicities had obvious acoustic shadowing. All of the cases were resolved either in utero or after birth before 10 months of age. CONCLUSION EFG is a late third-trimester phenomenon with a prevalence of 0.74%. Most EFGs presented as twinkling artifacts, suggesting they had a cholesterol component.
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Affiliation(s)
- Gokce Annac
- Specialist, Department of Radiology, Bartin State Hospital, Bartin, Turkey
| | - Arzu Bilge Tekin
- Specialist, Department of Obstetric and Gynecology, Şehit Prof. Dr. Ilhan Varank Training and Research Hospital, Istanbul, Turkey
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Tekin AB, Yassa M, Birol P, Unlu SN, Sahin T, Buran AM, Ayanoglu E, Tug N. Vitamin D status is not associated with clinical severity of COVID-19 in pregnant women. Eur J Nutr 2021; 61:1035-1041. [PMID: 34713327 PMCID: PMC8553286 DOI: 10.1007/s00394-021-02709-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 10/13/2021] [Indexed: 01/06/2023]
Abstract
Purpose To investigate the association between vitamin D status and the clinical severity of COVID-19 in pregnant women. Methods This prospective case–control study included 147 pregnant women with COVID-19 and 300 matched controls. Serum 25-hydroxyvitamin (25(OH)D) concentrations were measured on admission. Patients with mild-to-moderate disease (n = 114, 77.6%) and severe-to-critical disease (n = 33, 22.4%) were classified as symptomatic patients who did not require oxygen support and those who received oxygen support, respectively. SARS-CoV-2 positivity rates, clinical severity of COVID-19, and pulmonary involvement were compared according to vitamin D status. Results Serum 25(OH)D concentrations were found to be 36.6 ± 26.8 and 31.3 ± 20.7 nmol/L in pregnant women infected with SARS-CoV-2 and healthy controls, respectively (p = 0.001). The clinical severity of pregnant women with COVID-19 did not differ concerning vitamin D deficiency (RR = 0.568, 95% CI [0.311–1.036]; p = 0.065), even after excluding patients on vitamin supplementation (RR = 0.625, 95% CI [0.275–1.419]; p = 0.261). Testing positive for SARS-CoV-2 was not related to vitamin D status in the overall cohort of pregnant women (RR = 0.767, 95% CI [0.570–1.030]; p = 0.078). Pulmonary involvement of COVID-19 was found to be similar between patients with vitamin D deficiency and adequate vitamin D levels (RR = 0.954; 95% CI [0.863–1.055]; p = 0.357). Conclusion The clinical severity and pulmonary involvement of COVID-19 may not be associated with vitamin D status in pregnant women. Vitamin D deficiency/adequacy rates were comparable in pregnant women infected with SARS-CoV-2 and healthy pregnant women.
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Affiliation(s)
- Arzu Bilge Tekin
- Department of Obstetrics and Gynecology, Sancaktepe Sehit Prof. Dr. Ilhan Varank Training and Research Hospital, Health Sciences University, Emek Mahallesi, Namık Kemal Caddesi, No: 54, Sancaktepe, 34785 Istanbul, Turkey
| | - Murat Yassa
- Department of Obstetrics and Gynecology, Sancaktepe Sehit Prof. Dr. Ilhan Varank Training and Research Hospital, Health Sciences University, Emek Mahallesi, Namık Kemal Caddesi, No: 54, Sancaktepe, 34785 Istanbul, Turkey
| | - Pınar Birol
- Department of Obstetrics and Gynecology, Sancaktepe Sehit Prof. Dr. Ilhan Varank Training and Research Hospital, Health Sciences University, Emek Mahallesi, Namık Kemal Caddesi, No: 54, Sancaktepe, 34785 Istanbul, Turkey
| | - Sakine Nisa Unlu
- Department of Obstetrics and Gynecology, Sancaktepe Sehit Prof. Dr. Ilhan Varank Training and Research Hospital, Health Sciences University, Emek Mahallesi, Namık Kemal Caddesi, No: 54, Sancaktepe, 34785 Istanbul, Turkey
| | - Turan Sahin
- Department of Obstetrics and Gynecology, Sancaktepe Sehit Prof. Dr. Ilhan Varank Training and Research Hospital, Health Sciences University, Emek Mahallesi, Namık Kemal Caddesi, No: 54, Sancaktepe, 34785 Istanbul, Turkey
| | - Ayca Miray Buran
- Department of Obstetrics and Gynecology, Sancaktepe Sehit Prof. Dr. Ilhan Varank Training and Research Hospital, Health Sciences University, Emek Mahallesi, Namık Kemal Caddesi, No: 54, Sancaktepe, 34785 Istanbul, Turkey
| | - Esra Ayanoglu
- Department of Obstetrics and Gynecology, Sancaktepe Sehit Prof. Dr. Ilhan Varank Training and Research Hospital, Health Sciences University, Emek Mahallesi, Namık Kemal Caddesi, No: 54, Sancaktepe, 34785 Istanbul, Turkey
| | - Niyazi Tug
- Department of Obstetrics and Gynecology, Sancaktepe Sehit Prof. Dr. Ilhan Varank Training and Research Hospital, Health Sciences University, Emek Mahallesi, Namık Kemal Caddesi, No: 54, Sancaktepe, 34785 Istanbul, Turkey
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Yassa M, Kaya C, Kalafat E, Tekin AB, Karakas S, Mutlu MA, Birol P, Tug N. The Comparison of Transvaginal Natural Orifice Transluminal Endoscopic Surgery and Conventional Laparoscopy in Opportunistic Bilateral Salpingectomy for Permanent Female Sterilization. J Minim Invasive Gynecol 2021; 29:257-264.e1. [PMID: 34411729 DOI: 10.1016/j.jmig.2021.08.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/09/2021] [Accepted: 08/11/2021] [Indexed: 01/11/2023]
Abstract
STUDY OBJECTIVE To compare the transvaginal natural orifice transluminal endoscopic surgery (vNOTES) approach with conventional laparoscopy (CL) in opportunistic bilateral salpingectomy (BS) alone for permanent female sterilization as an opportunistic cancer prevention strategy. DESIGN Prospective cohort study. SETTING Two-centered tertiary hospitals. PATIENTS Ninety-six women with a nonprolapsed uterus seeking definitive surgical permanent contraception. INTERVENTIONS Patients were scheduled for BS and assigned to a study arm in a 2:1 fashion (CL:vNOTES allocation ratio) concerning patient's choice. MEASUREMENTS AND MAIN RESULTS Patients were followed at their postoperative first week and first month. The visual analog score (VAS), Patient Global Impression of Improvement, and Female Sexual Function Index scales were used to assess the pain, patient satisfaction, and discomfort/pain after vaginal penetration, respectively. Patients who underwent to vNOTES had a significantly higher number of previous abdominal surgery (median difference, 1.97; 95% confidence interval [CI], 1.12-3.48; p = .016). Compared with CL, vNOTES was associated with lower 6-hour (rate ratio [RR], 0.63; 95% CI, 0.50-0.77) and 24-hour (RR, 0.33; 95% CI, 0.23-0.46) postoperative VAS scores and less amount of postoperative analgesics (RR, 0.54; 95% CI, 0.36-0.78). The slope of change in postoperative VAS scores was in a shorter time in the vNOTES group (RR, 0.47; 95% CI, 0.36-0.60). The rate of postoperative improvement was higher in the vNOTES group than the CL group at the postoperative first week (87.5% vs 68.2%, χ2 = 4.232, p = .032) and first month (96.9% vs 87.9%, χ2 = 2.091, p = .140). The rate of patients reporting postoperative decline in Female Sexual Function Index /pain scores (RR, 0.97; 95% CI, 0.47-1.96) was found to be similar in both of the study groups, and no postoperative complication was observed in either group. CONCLUSION Women seeking permanent sterilization and who underwent BS for ovarian cancer risk reduction purposes had higher satisfaction, less postoperative pain, lower analgesic requirement, and similar surgical outcomes in the vNOTES group than the CL group, even in patients with previous surgeries and a nonprolapsed uterus. vNOTES approach could be the preferred method for the opportunistic BS in female sterilization.
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Affiliation(s)
- Murat Yassa
- Department of Obstetrics and Gynecology, Sehit Prof Dr Ilhan Varank Sancaktepe Training and Research Hospital, University of Health Sciences (Drs. Yassa, Tekin, Mutlu, Birol, and Tug).
| | - Cihan Kaya
- Department of Obstetrics and Gynecology, Acibadem Bakirkoy Hospital, Acibadem Mehmet Ali Aydinlar University (Dr. Kaya)
| | - Erkan Kalafat
- Department of Obstetrics and Gynecology, Koc University (Dr. Kalafat)
| | - Arzu Bilge Tekin
- Department of Obstetrics and Gynecology, Sehit Prof Dr Ilhan Varank Sancaktepe Training and Research Hospital, University of Health Sciences (Drs. Yassa, Tekin, Mutlu, Birol, and Tug)
| | - Sema Karakas
- Department of Obstetrics and Gynecology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, University of Health Sciences (Dr. Karakas), Istanbul, Turkey
| | - Memis Ali Mutlu
- Department of Obstetrics and Gynecology, Sehit Prof Dr Ilhan Varank Sancaktepe Training and Research Hospital, University of Health Sciences (Drs. Yassa, Tekin, Mutlu, Birol, and Tug)
| | - Pinar Birol
- Department of Obstetrics and Gynecology, Sehit Prof Dr Ilhan Varank Sancaktepe Training and Research Hospital, University of Health Sciences (Drs. Yassa, Tekin, Mutlu, Birol, and Tug)
| | - Niyazi Tug
- Department of Obstetrics and Gynecology, Sehit Prof Dr Ilhan Varank Sancaktepe Training and Research Hospital, University of Health Sciences (Drs. Yassa, Tekin, Mutlu, Birol, and Tug)
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Tekin AB, Yassa M. Implementation of lung ultrasound in the triage of pregnant women during the SARS-CoV-2 pandemics. Artif Intell Med Imaging 2021; 2:56-63. [DOI: 10.35711/aimi.v2.i3.56] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 05/06/2021] [Accepted: 06/04/2021] [Indexed: 02/06/2023] Open
Abstract
Lung ultrasound (US) has been shown that it is able to detect interstitial lung disease, subpleural consolidations and acute respiratory distress syndrome in clinical and physical studies that assess its role in upper respiratory infections. It is used worldwide in the coronavirus disease 2019 (COVID-19) outbreak and the effectiveness has been assessed in several studies. Fast diagnosis of COVID-19 is essential in deciding for patient isolation, clinical care and reducing transmission. Imaging the lung and pleura by ultrasound is efficient, cost-effective, and safe and it is recognized as rapid, repeatable, and reliable. Obstetricians are already using the US and are quite proficient in doing so. During the pandemic, performing lung US (LUS) right after the fetal assessment until reverse transcription polymerase chain reaction results are obtained, particularly in settings that have a centralized testing center, was found feasible for the prediction of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The use of LUS is efficient in the triage and monitoring of pregnant women. Clinicians dealing with pregnant women should consider LUS as the first-line diagnostic tool in pregnant women during the SARS-CoV-2 pandemic.
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Affiliation(s)
- Arzu Bilge Tekin
- Department of Obstetrics and Gynecology, Sancaktepe Sehit Prof. Dr. Ilhan Varank Training and Research Hospital, Istanbul 34785, Sancaktepe, Turkey
| | - Murat Yassa
- Department of Obstetrics and Gynecology, Sancaktepe Sehit Prof. Dr. Ilhan Varank Training and Research Hospital, Istanbul 34785, Sancaktepe, Turkey
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Tekin AB, Zanapalioglu U, Gulmez S, Akarsu I, Yassa M, Tug N. Guillain Barre Syndrome following delivery in a pregnant woman infected with SARS-CoV-2. J Clin Neurosci 2021; 86:190-192. [PMID: 33775326 PMCID: PMC7993757 DOI: 10.1016/j.jocn.2021.01.028] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 01/16/2021] [Indexed: 01/27/2023]
Abstract
Effects of SARS-CoV-2 on the neurological system have been investigated. Evidence of Guillain-Barre Syndrome (GBS) cases associated with SARS-CoV-2 infection have recently been reported. A 34-year-old multiparous woman with COVID-19 infection at her 37th (4/7) gestational week was presented here. She was diagnosed with Guillain Barre Syndrome at postpartum. As we know recently this was the first case mentioned in the literature. The clinical course of GBS with COVID-19 after childbirth may be similar to GBS patients not infected with COVID-19.
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Affiliation(s)
- Arzu Bilge Tekin
- Department of Obstetrics and Gynecology, Sehit Prof. Dr. Ilhan Varank Training and Research Hospital, Istanbul, Turkey.
| | - Umit Zanapalioglu
- Department of Neurology, Sehit Prof Dr Ilhan Varank Sancaktepe Training and Research Hospital, Health Sciences University, Istanbul, Turkey
| | - Selcen Gulmez
- Department of Obstetrics and Gynecology, Sehit Prof. Dr. Ilhan Varank Training and Research Hospital, Istanbul, Turkey
| | - Ilkyaz Akarsu
- Department of Obstetrics and Gynecology, Sehit Prof. Dr. Ilhan Varank Training and Research Hospital, Istanbul, Turkey
| | - Murat Yassa
- Department of Obstetrics and Gynecology, Sehit Prof. Dr. Ilhan Varank Training and Research Hospital, Istanbul, Turkey
| | - Niyazi Tug
- Department of Obstetrics and Gynecology, Sehit Prof. Dr. Ilhan Varank Training and Research Hospital, Istanbul, Turkey
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Yassa M, Birol P, Mutlu AM, Tekin AB, Sandal K, Tug N. Lung Ultrasound Can Influence the Clinical Treatment of Pregnant Women With COVID-19. J Ultrasound Med 2021; 40:191-203. [PMID: 32478445 PMCID: PMC7300952 DOI: 10.1002/jum.15367] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 05/18/2020] [Accepted: 05/20/2020] [Indexed: 05/07/2023]
Abstract
Lung ultrasound (LUS) is an effective tool to detect and monitor patients infected with 2019 coronavirus disease (COVID-19). The use of LUS on pregnant women is an emerging trend, considering its effectiveness during the outbreak. Eight pregnant women with a diagnosis of COVID-19 confirmed by nasal/throat real-time reverse transcription polymerase chain reaction testing who underwent point-of-care LUS examinations after routine obstetric ultrasound are described. A routinely performed LUS examination revealed serious lung involvement in 7 cases: 2 were initially asymptomatic; 3 have chest computed tomography; 1 had initial negative real-time reverse transcription polymerase chain reaction results; and 1 had initial negative computed tomographic findings. Treatment for COVID-19 was either commenced or changed in 87.5% of the patients (n = 7 of 8) on LUS findings. Among patients with abnormal LUS findings, treatment was commenced in 5 patients (71.5%) and changed in 2 patients (28.5%). One normal and 7 abnormal LUS cases indicate the impact of routine LUS on the clinical outcome and treatment of pregnant women.
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Affiliation(s)
- Murat Yassa
- Department of Obstetrics and GynecologySehit Prof Dr Ilhan Varank Sancaktepe Training and Research HospitalIstanbulTurkey
| | - Pinar Birol
- Department of Obstetrics and GynecologySehit Prof Dr Ilhan Varank Sancaktepe Training and Research HospitalIstanbulTurkey
| | - Ali Memis Mutlu
- Department of Obstetrics and GynecologySehit Prof Dr Ilhan Varank Sancaktepe Training and Research HospitalIstanbulTurkey
| | - Arzu Bilge Tekin
- Department of Obstetrics and GynecologySehit Prof Dr Ilhan Varank Sancaktepe Training and Research HospitalIstanbulTurkey
| | - Kemal Sandal
- Department of Obstetrics and GynecologySehit Prof Dr Ilhan Varank Sancaktepe Training and Research HospitalIstanbulTurkey
| | - Niyazi Tug
- Department of Obstetrics and GynecologySehit Prof Dr Ilhan Varank Sancaktepe Training and Research HospitalIstanbulTurkey
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Yassa M, Yassa A, Yirmibeş C, Birol P, Ünlü UG, Tekin AB, Sandal K, Mutlu MA, Çavuşoğlu G, Tug N. Anxiety levels and obsessive compulsion symptoms of pregnant women during the COVID-19 pandemic. Turk J Obstet Gynecol 2020; 17:155-160. [PMID: 33072418 PMCID: PMC7538825 DOI: 10.4274/tjod.galenos.2020.91455] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 08/24/2020] [Indexed: 02/07/2023] Open
Abstract
Objective Reliable data regarding maternal mental well-being during the Severe Acute Respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic are scarce. This study aimed to assess the state/trait anxiety and obsessive-compulsive symptoms of pregnant women and compare those with the non-pregnant population using patient-reported validated outcome measures. Materials and Methods This prospective case-control study was conducted at a tertiary 'Coronavirus Pandemic Hospital' in İstanbul, Turkey in April, 2020. Pregnant and non-pregnant women were consecutively allocated to two groups regardless of gestational age. The primary outcome was to identify the anxiety levels and obsessive-compulsive symptoms of pregnant women during the SARS-CoV-2 pandemic using the State-Trait Anxiety inventory (STAI) and Maudsley Obsessive-Compulsive inventory (MOCI), respectively. Results Two hundred three pregnant women and 101 non-pregnant women were included. The mean STAI-S questionnaire score of pregnant and nonpregnant women was 41.96±9.15 and 46.62±12, respectively (p=0.001). The overall incidence of STAI >40 in pregnant and non-pregnant women was 62.6% and 73.3%, respectively. The mean total score of MOCI was 17.9±6.7 and 15±6.6 in pregnant and non-pregnant women, respectively. The overall incidence of 30-item-MOCI ≥13.1 in pregnant and non-pregnant women was 61.6% (125/203) and 30.7% (31/103), respectively (p<0.001). Conclusion State anxiety and obsessive-compulsive symptoms in pregnant women were found increased during the current SARS-CoV-2 pandemic. Pregnant women showed more favourable anxiety levels compared with non-pregnant women. These findings can be used to improve the coping skills of pregnant women during the pandemic, to prepare for the post-pandemic period, and to deal with the long-term mental health impact of COVID-19.
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Affiliation(s)
- Murat Yassa
- University of Health Sciences Turkey, Şehit Prof. Dr. İlhan Varank Sancaktepe Training and Research Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey
| | - Ahmet Yassa
- Tuzla State Hospital, Clinic of Psychiatry, İstanbul, Turkey
| | - Cihangir Yirmibeş
- University of Health Sciences Turkey, Şehit Prof. Dr. İlhan Varank Sancaktepe Training and Research Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey
| | - Pınar Birol
- University of Health Sciences Turkey, Şehit Prof. Dr. İlhan Varank Sancaktepe Training and Research Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey
| | - Umur Göktuğ Ünlü
- University of Health Sciences Turkey, Şehit Prof. Dr. İlhan Varank Sancaktepe Training and Research Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey
| | - Arzu Bilge Tekin
- University of Health Sciences Turkey, Şehit Prof. Dr. İlhan Varank Sancaktepe Training and Research Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey
| | - Kemal Sandal
- University of Health Sciences Turkey, Şehit Prof. Dr. İlhan Varank Sancaktepe Training and Research Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey
| | - Memiş Ali Mutlu
- University of Health Sciences Turkey, Şehit Prof. Dr. İlhan Varank Sancaktepe Training and Research Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey
| | - Gül Çavuşoğlu
- University of Health Sciences Turkey, Şehit Prof. Dr. İlhan Varank Sancaktepe Training and Research Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey
| | - Niyazi Tug
- University of Health Sciences Turkey, Şehit Prof. Dr. İlhan Varank Sancaktepe Training and Research Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey
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Yassa M, Mutlu MA, Kalafat E, Birol P, Yirmibeş C, Tekin AB, Sandal K, Ayanoğlu E, Yassa M, Kılınç C, Tug N. How to perform and interpret the lung ultrasound by the obstetricians in pregnant women during the SARS-CoV-2 pandemic. Turk J Obstet Gynecol 2020; 17:225-232. [PMID: 33072428 PMCID: PMC7538823 DOI: 10.4274/tjod.galenos.2020.93902] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 08/04/2020] [Indexed: 02/06/2023] Open
Abstract
Objective: Evidence for the use of lung ultrasound scan (LUS) examinations in coronavirus 2019 pneumonia is rapidly growing. The safe and non-ionizing nature of LUS drew attention, particularly for pregnant women. This study aimed to contribute to the interpretation of LUS findings in pregnant women for the obstetricians. Materials and Methods: LUS was performed to pregnant women suspected of or diagnosed as having Severe Acute Respiratory syndrome coronavirus-2 (SARS-CoV-2) in the first 24 hours of admission. Fourteen areas (3 posterior, 2 lateral, and 2 anterior) were scanned per patient for at least 10 seconds along the indicated anatomical landmarks. The scan was performed in supine, right-sided and left-sided positions, respectively. Each area was given a score between 0 and 3 according to the specific pattern. Results: In this study, 21 still images and 21 videoclips that enabled dynamic and real-time evaluation were provided. Pleural line assessment, physiologic A-lines, pathologic B-lines, light beam pattern, white lung pattern, and specific patterns for quick recognition and evaluation are described. Conclusion: The potential advantages and limitations of LUS and its areas of use for obstetricians are discussed. LUS is a promising supplementary imaging tool during the SARS-CoV-2 pandemic. It is easy to perform and may be feasible in the hands of obstetricians after a brief didactic course. It may be a firstline imaging modality for pregnant women.
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Affiliation(s)
- Murat Yassa
- University of Health Sciences Turkey, Şehit Prof. Dr. İlhan Varank Sancaktepe Training and Research Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey
| | - Memiş Ali Mutlu
- University of Health Sciences Turkey, Şehit Prof. Dr. İlhan Varank Sancaktepe Training and Research Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey
| | - Erkan Kalafat
- Ankara University Faculty of Medicine, Department of Obstetrics and Gynecology, Ankara, Turkey
| | - Pınar Birol
- University of Health Sciences Turkey, Şehit Prof. Dr. İlhan Varank Sancaktepe Training and Research Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey
| | - Cihangir Yirmibeş
- University of Health Sciences Turkey, Şehit Prof. Dr. İlhan Varank Sancaktepe Training and Research Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey
| | - Arzu Bilge Tekin
- University of Health Sciences Turkey, Şehit Prof. Dr. İlhan Varank Sancaktepe Training and Research Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey
| | - Kemal Sandal
- University of Health Sciences Turkey, Şehit Prof. Dr. İlhan Varank Sancaktepe Training and Research Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey
| | - Esra Ayanoğlu
- Ankara University Faculty of Medicine, Department of Obstetrics and Gynecology, Ankara, Turkey
| | - Mahmut Yassa
- Selahaddin Eyyubi State Hospital, Clinic of Obstetrics and Gynecology, Diyarbakır, Turkey
| | - Ceyhun Kılınç
- University of Health Sciences Turkey, Şehit Prof. Dr. İlhan Varank Sancaktepe Training and Research Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey
| | - Niyazi Tug
- University of Health Sciences Turkey, Şehit Prof. Dr. İlhan Varank Sancaktepe Training and Research Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey
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Yassa M, Birol P, Yirmibes C, Usta C, Haydar A, Yassa A, Sandal K, Tekin AB, Tug N. Near-term pregnant women's attitude toward, concern about and knowledge of the COVID-19 pandemic. J Matern Fetal Neonatal Med 2020; 33:3827-3834. [PMID: 32429780 DOI: 10.1080/14767058.2020.1763947] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Background: COVID-19 is a novel type of the coronavirus family with an incompletely described clinical course. Little is known about the psychological aspects, particularly for vulnerable populations including pregnant women.Objectives: To understand the attitude, concerns, and knowledge of the non-infected pregnant women toward the COVID-19 outbreak in order to constitute base data for detailed counseling and to develop targeted messages.Patients and methods: This cross-sectional survey research presented analysis of prospectively collected data yielded at a single tertiary "Coronavirus Pandemic Hospital" referral center for a ten days period following the first confirmed death due to the COVID-19 pandemic in Turkey. Non-infected women with a confirmed pregnancy over 30th gestational week were consecutively included. A patient-reported non-validated questionnaire formed by the expert committee that includes 15 specific questions was used. Non-infected, pregnant women over 30th gestational week who applied to the outpatient clinic were consecutively included. A total of 213 women were enrolled, 37 were excluded: 7 for being in the first trimester, 3 were illiterate, and 27 were Syrian refugees having difficulties in translation.Results: A total of 172 pregnant women were included. Overall, four women refused to participate to the survey (1.9%). The mean age was 27.5 ± 5.3 years. Median gestational week and parity were 35 ± 11 weeks and 1 ± 2, respectively. Pregnant women were observed to trust the authorities (65%) and the healthcare staff (92.4%), and their respect was increased (82.5%) during the outbreak. Majority of the women (87.2%) comply with the self-quarantine rules. Half of the women (52%) reported that they felt vulnerable and predominantly were concerned (80%). Approximately one-third of the women constantly keep thinking that they may get infected (35.5%) or they might get infected during/following the delivery or their baby might get infected after being born (42%). Half of the women (50%) were reported that they either had no idea about or think the breastfeeding is not safe during the outbreak. About 45% of the women were confused or had doubts about if the mode of delivery may be affected by the pandemic. Greater part of the participants does not know if COVID-19 might cause birth defects (76%) or preterm birth (64.5%). Counseling flow keys helping pregnant women to overcome misleads, regarding the COVID-19 outbreak is proposed.Conclusions: Non-infected pregnant women with a viable pregnancy at near term were observed to have positive attitude and compliance toward the COVID-19 outbreak and frontline healthcare staff; increased concern and vulnerability; and restricted knowledge about the pregnancy-related outcomes. While the clinical evidence was growing rapidly, this data may guide obstetricians and midwives to perceive what accurate information should be provided to the pregnant women.
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Affiliation(s)
- Murat Yassa
- Department of Obstetrics and Gynecology, Ilhan Varank Sancaktepe Training and Research Hospital, Istanbul, Turkey
| | - Pinar Birol
- Department of Obstetrics and Gynecology, Ilhan Varank Sancaktepe Training and Research Hospital, Istanbul, Turkey
| | - Cihangir Yirmibes
- Department of Obstetrics and Gynecology, Ilhan Varank Sancaktepe Training and Research Hospital, Istanbul, Turkey
| | - Canberk Usta
- Department of Obstetrics and Gynecology, Ilhan Varank Sancaktepe Training and Research Hospital, Istanbul, Turkey
| | - Ahmad Haydar
- Department of Obstetrics and Gynecology, Hôpitaux Universitaires de Genève, Geneve, Switzerland
| | - Ahmet Yassa
- Department of Psychiatry, Tuzla State Hospital, Istanbul, Turkey
| | - Kemal Sandal
- Department of Obstetrics and Gynecology, Ilhan Varank Sancaktepe Training and Research Hospital, Istanbul, Turkey
| | - Arzu Bilge Tekin
- Department of Obstetrics and Gynecology, Ilhan Varank Sancaktepe Training and Research Hospital, Istanbul, Turkey
| | - Niyazi Tug
- Department of Obstetrics and Gynecology, Ilhan Varank Sancaktepe Training and Research Hospital, Istanbul, Turkey
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