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Atalay A, Yetiskin FDY, Ocal FD, Besimoglu B, Kucuksahin O, Sahin D. First and second-trimester biochemical serum markers in maternal familial Mediterranean fever: The impact of colchicine use. J Gynecol Obstet Hum Reprod 2023; 52:102648. [PMID: 37611748 DOI: 10.1016/j.jogoh.2023.102648] [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: 04/30/2023] [Revised: 07/26/2023] [Accepted: 08/20/2023] [Indexed: 08/25/2023]
Abstract
INTRODUCTION We aimed to investigate the effects of colchicine use on first and second trimester screening markers in pregnancies complicated with familial Mediterranean fever (FMF) and to evaluate the overall impact of these effects on perinatal outcomes. METHODS A retrospective case-control study was conducted in pregnancies complicated with FMF using colchicine and healthy pregnancies as controls without any defined risk factors and medication use. Biochemical markers for the aneuploidy screening, including free ß-hCG and PAPP-A in the first trimester, and AFP, HCG, and unconjugated estriol (uE3) in the second trimester, were recorded, and MoM levels of these markers were compared between the FMF and control groups. Obstetric history and outcomes were also compared between groups. We used propensity score matching to form a cohort in which patients had similar baseline characteristics. RESULTS Among 93 eligible pregnant women, 31 women in FMF group and 31 in control group had similar propensity scores and were included in the analyses. Levels of serum-free ß-hCG, PAPP-A and AFP were similar between FMF and control groups (p = 0.671, p = 0.387 and p = 0.963, respectively). For the second-trimester markers, maternal serum uE3 MoM level were significantly lower in the FMF group using colchicine than in the controls (p = 0.045). We also compared these markers according to the daily colchicine dose between FMF subgroups. We did not detect significant difference between the different colchicine treatment modalities (0.5-1 mg/day vs. 1.5-2 mg/day, p > 0.05). CONCLUSION Maternal biochemical serum markers of an aneuploidy screening test in the second trimester may be affected by FMF with colchicine use, leading to misinterpretation of the risk level of tests. For these tests with decreased uE3 levels, FMF and colchicine use should be considered as a causative etiology after ruling out common etiologies and confounding factors before recommending invasive diagnostic testing.
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Affiliation(s)
- Aysegul Atalay
- Ankara City Hospital, Department of Obstetrics and Gynecology, Division of Perinatology, Ankara, Turkey.
| | | | - Fatma Doga Ocal
- Ankara City Hospital, Department of Obstetrics and Gynecology, Division of Perinatology, Ankara, Turkey
| | - Berhan Besimoglu
- Ankara City Hospital, Department of Obstetrics and Gynecology, Division of Perinatology, Ankara, Turkey
| | - Orhan Kucuksahin
- Ankara City Hospital, Department of Internal Medicine, Division of Rheumatology, Yıldırım Beyazıt University, Ankara, Turkey
| | - Dilek Sahin
- Ankara City Hospital, Department of Obstetrics and Gynecology, University of Health Sciences, Ankara, Turkey
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Halici-Ozturk F, Yucel Yetiskin FD, Gurlek B, Ocal FD, Yakut K, Engin-Ustun Y, Celen S, Sahin D. Longer anogenital distance in female fetus of diabetic and obese pregnant women. Taiwan J Obstet Gynecol 2023; 62:530-536. [PMID: 37407189 DOI: 10.1016/j.tjog.2023.02.005] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2023] [Indexed: 07/07/2023] Open
Abstract
OBJECTIVE Previous studies revealed that prenatal exposure to androgen excess such as polycystic ovary syndrome (PCOS) is associated with offspring's anogenital distance (AGD) length, and AGD is a biomarker of intrauterine androgen exposure. This study aims to investigate a possible relationship of fetal AGD with maternal diabetes and obesity, and to evaluate whether AGD predicts the fetal androgen exposure related to diabetes and obesity in female fetus. This study is the first to focus on the relationship between offspring's AGD and maternal diabetes and obesity. MATERIALS AND METHODS This is a prospective study investigating 218 pregnant women (125 in control group and 93 in study group). Fetal AGD was measured from the center of anus to the posterior convergence of the fourchette by ultrasound. Multivariate linear regression analysis was applied to assess the association of the fetal AGD length with maternal diabetes and obesity. RESULTS The control patients had significantly shorter fetal AGD (mean:10.7 mm, P < 0.001) compared to diabetic, obese and diabetic obese patients (mean: 12.6 mm, 12.8 mm and 12.9 mm, respectively). The results of regression analysis showed that both maternal diabetes and obesity were significantly correlated with longer AGD in female fetus. The results confirmed also that offspring's AGD measurement in utero by ultrasound is feasible and reliable. CONCLUSION The study findings suggest that both maternal diabetes and obesity are associated with intrauterine androgenic milieu during pregnancy, and fetal AGD may be used as a biomarker to predict this effect. This may provide important advantages in terms of early detection of reproductive system abnormalities related to prenatal androgen exposure.
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Affiliation(s)
- Filiz Halici-Ozturk
- Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, 06800, Ankara, Turkey.
| | - Fatma Didem Yucel Yetiskin
- Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, 06800, Ankara, Turkey
| | - Beril Gurlek
- Department of Obstetrics and Gynecology, Faculty of Medicine, Recep Tayyip Erdogan University, 53200, Rize, Turkey
| | - Fatma Doga Ocal
- Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, 06800, Ankara, Turkey
| | - Kadriye Yakut
- Etlik Zübeyde Hanım Women Health Care Training and Research Hospital, Obstetrics and Gynecology Department, 06010, Ankara, Turkey
| | - Yaprak Engin-Ustun
- Etlik Zübeyde Hanım Women Health Care Training and Research Hospital, Obstetrics and Gynecology Department, 06010, Ankara, Turkey
| | - Sevki Celen
- Etlik Zübeyde Hanım Women Health Care Training and Research Hospital, Obstetrics and Gynecology Department, 06010, Ankara, Turkey
| | - Dilek Sahin
- Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, 06800, Ankara, Turkey
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Laleli Koc B, Oluklu D, Hendem DU, Beser DM, Besimoglu B, Tanacan A, Ocal FD, Sahin D. Assessment of fetal cardiac functions in pregnant women with asthma. Echocardiography 2023. [PMID: 37138454 DOI: 10.1111/echo.15584] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 04/17/2023] [Indexed: 05/05/2023] Open
Abstract
AIM This study aims to investigate the effects of maternal asthma on fetal cardiac functions. METHODS The study was planned with 30 pregnant women who presented to a tertiary health center and were diagnosed with asthma and 60 healthy controls with similar gestational ages. The fetal echocardiographic assessment was assessed between 33 and 35 weeks of gestation with pulsed-wave Doppler (PW), M-mode, and tissue Doppler imaging (TDI). Fetal cardiac functions were compared between maternal asthma and the control group. Cardiac functions were assessed according to the duration of maternal asthma diagnosis, as well. RESULTS Early diastolic function parameters, tricuspid E wave (p = .001), and tricuspid E/A ratio (p = .005) were significantly lower in the group with maternal asthma. Tricuspid annular plane systolic excursion (TAPSE) and measurements of mitral annular plane systolic excursion (MAPSE) values were statistically lower in the study group than in the control group; p = .010 and p = .012, respectively. Parameters assessed with TDI (E', A', S', E/E', and MPI' of tricuspid valves) and global cardiac function parameters assessed with PW like myocardial performance index (MPI) and left cardiac output (LCO) were similar between groups (p > .05). Although, MPI did not change between groups, and the isovolumetric relaxation time (IVRT) value was prolonged in maternal asthma cases (p = .025). CONCLUSION We found that maternal asthma disease causes alteration in fetal diastolic and early systolic cardiac functions, but the global fetal cardiac function does not change. Diastolic heart function values also varied with the duration of maternal asthma. Prospective studies are needed to compare fetal cardiac functions with additional patient groups according to disease severity and type of medical treatment.
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Affiliation(s)
- Bergen Laleli Koc
- Department of Obstetrics and Gynecology, Division of Perinatology, Turkish Ministry of Health Ankara Bilkent City Hospital, Ankara, Turkey
| | - Deniz Oluklu
- Department of Obstetrics and Gynecology, Division of Perinatology, Turkish Ministry of Health Ankara Bilkent City Hospital, Ankara, Turkey
| | - Derya Uyan Hendem
- Department of Obstetrics and Gynecology, Division of Perinatology, Turkish Ministry of Health Ankara Bilkent City Hospital, Ankara, Turkey
| | - Dilek Menekse Beser
- Department of Obstetrics and Gynecology, Division of Perinatology, Turkish Ministry of Health Ankara Bilkent City Hospital, Ankara, Turkey
| | - Berchan Besimoglu
- Department of Obstetrics and Gynecology, Division of Perinatology, Turkish Ministry of Health Ankara Bilkent City Hospital, Ankara, Turkey
| | - Atakan Tanacan
- Department of Obstetrics and Gynecology, Division of Perinatology, Turkish Ministry of Health Ankara Bilkent City Hospital, Ankara, Turkey
| | - Fatma Doga Ocal
- Department of Obstetrics and Gynecology, Division of Perinatology, Turkish Ministry of Health Ankara Bilkent City Hospital, Ankara, Turkey
| | - Dilek Sahin
- Department of Obstetrics and Gynecology, Division of Perinatology, Ankara Bilkent City Hospital, Turkish Ministry of Health, University of Health Sciences, Ankara, Turkey
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Atalay A, Besimoglu B, Sinaci S, Kaya E, Ozkavak O, Ocal FD, Ozgu-Erdinc AS, Sahin D. The impact of covid-19 on thyroid function tests in pregnancy. Endocrine 2023; 79:502-511. [PMID: 36367674 PMCID: PMC9650657 DOI: 10.1007/s12020-022-03248-9] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 10/30/2022] [Indexed: 11/13/2022]
Abstract
PURPOSE To investigate the effects of laboratory-confirmed SARS-CoV-2 infection on thyroid function tests (TFTs) in pregnant women and to evaluate whether TFT changes are related to the severity and prognosis. METHODS Consecutive pregnant women tested for SARS-CoV-2 by RT-PCR at Ankara City Hospital were recruited between January 2021 and September 2021. Thyroid-stimulating hormone (TSH), free thyroxine (FT4) and free triiodothyronine (FT3), thyroid peroxidase antibody (anti-TPO), and thyroglobulin antibody (anti-TG) were measured on admission. RESULTS Among 747 eligible pregnant women with the same baseline characteristics, 369 RT-PCR-positive women in the patient group and 378 RT-PCR-negative women in the control group were included in the analyses. Pregnant women in the patient group had significantly lower TSH, FT4, FT3, Anti TPO, and Anti TG concentrations compared with those in the control group (p < 0.001). The proportion of patient groups with mild, moderate, severe, and critical diseases were 297 (80.4%), 40 (10.8%), 17 (4.6%), and 15 (4.2%), respectively, among which with the moderate, severe, and critical disease had significantly lower FT3 values (2.5 vs 2.19 pg/mL, p < 0.001) and higher nonthyroidal illness syndrome (NTIS) (29.2 vs. 8.4%, p < 0.001) than those with mild disease. Lower FT3 values increased the risk of ICU admission, NICU admission, and severe disease (p < 0.001). FT3 and TSH correlated positively with lymphocytes (p < 0.001) and negatively correlated with C-reactive protein (CRP) (p < 0.001, p = 0.005). CONCLUSION The SARS-CoV-2 infection seems to have an impact on the TFTs of pregnant women, and particularly FT3 level seems to be correlated with disease severity.
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Affiliation(s)
- Aysegul Atalay
- University of Health Sciences Ankara City Hospital, Department of Obstetrics and Gynecology, Division of Perinatology, Ankara, Turkey.
| | - Berhan Besimoglu
- University of Health Sciences Ankara City Hospital, Department of Obstetrics and Gynecology, Division of Perinatology, Ankara, Turkey
| | - Selcan Sinaci
- University of Health Sciences Ankara City Hospital, Department of Obstetrics and Gynecology, Division of Perinatology, Ankara, Turkey
| | - Ecem Kaya
- University of Health Sciences Ankara City Hospital, Department of Obstetrics and Gynecology, Division of Perinatology, Ankara, Turkey
| | - Onur Ozkavak
- University of Health Sciences Ankara City Hospital, Department of Obstetrics and Gynecology, Division of Perinatology, Ankara, Turkey
| | - Fatma Doga Ocal
- University of Health Sciences Ankara City Hospital, Department of Obstetrics and Gynecology, Division of Perinatology, Ankara, Turkey
| | - Ayse Seval Ozgu-Erdinc
- University of Health Sciences Ankara City Hospital, Department of Obstetrics and Gynecology, Division of Perinatology, Ankara, Turkey
| | - Dilek Sahin
- University of Health Sciences Ankara City Hospital, Department of Obstetrics and Gynecology, Division of Perinatology, Ankara, Turkey
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Uyan Hendem D, Ocal FD, Oluklu D, Besimoglu B, Sinaci S, Atalay A, Menekse Beser D, Tanacan A, Sahin D. Evaluation of fetal middle adrenal artery Doppler and fetal adrenal gland size in pregnancies with fetal growth restriction: a case-control study. J Perinat Med 2022; 51:492-499. [PMID: 36040753 DOI: 10.1515/jpm-2022-0270] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 07/05/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES This study aims to evaluate sonographic measurements of fetal adrenal gland size and middle adrenal artery Doppler in pregnancies with fetal growth restriction (FGR) and in a healthy control group. METHODS This prospective study included 107 singleton pregnancies with FGR between 24 and 42 weeks of gestation and 107 pregnancies with fetuses whose growth was appropriate for gestational age (AGA). Adrenal gland size and Doppler parameters of the adrenal artery were measured and the values and obstetric outcomes were compared between the study and control groups. RESULTS In the study group, the Z-scores of total adrenal width-length and height, fetal zone width-length and middle adrenal artery-peak systolic velocity (MAA-PSV) were significantly higher than those in the control group (p<0.05). The Z-scores of middle adrenal artery-pulsatility index (MAA-PI) were significantly lower in the study group than in the control group (p<0.05). The rate of neonatal intensive care unit admission in fetuses with high adrenal artery PI scores was higher in the FGR group (p<0.05). CONCLUSIONS In the present study, we observed decreased adrenal artery PI, increased adrenal blood flow, and increased fetal adrenal volume in fetuses diagnosed with fetal growth restriction, most likely in response to placental insufficiency and chronic hypoxia.
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Affiliation(s)
- Derya Uyan Hendem
- Department of Obstetrics and Gynecology, Division of Perinatology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Fatma Doga Ocal
- Department of Obstetrics and Gynecology, Division of Perinatology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Deniz Oluklu
- Department of Obstetrics and Gynecology, Division of Perinatology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Berhan Besimoglu
- Department of Obstetrics and Gynecology, Division of Perinatology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Selcan Sinaci
- Department of Obstetrics and Gynecology, Division of Perinatology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Aysegul Atalay
- Department of Obstetrics and Gynecology, Division of Perinatology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Dilek Menekse Beser
- Department of Obstetrics and Gynecology, Division of Perinatology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Atakan Tanacan
- Department of Obstetrics and Gynecology, Division of Perinatology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Dilek Sahin
- Department of Obstetrics and Gynecology, Division of Perinatology, University of Health Sciences, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
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Ocal O, Ocal FD, Sinaci S, Daglar Z, Secen AE, Divanlioglu D, Oguz EF, Erel O, Tayman C, Sahin D, Belen AD, Dalgic A. Maternal Serum and Fetal Cord Blood Concentrations of Thiol/ Disulfide and Ischemia-Modified Albumin as Predictors of Neural Tube Defects. Turk Neurosurg 2022; 33:134-139. [PMID: 36128919 DOI: 10.5137/1019-5149.jtn.40096-22.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
AIM To investigate the predictive role of thiol/ disulfide homeostasis and Ischemia-modified albumin (IMA) levels for NTDs. MATERIAL AND METHODS A total of 71 pregnant women (31 with NTD and 42 healthy controls) were enrolled in this study. This prospective case-control study included pregnant women with NTDs as the study group and randomly selected age-matched pregnant women with healthy fetuses as the control group. The two groups were compared on the basis of thiol/disulfide and IMA levels in the maternal and fetal samples. RESULTS No statistically significant difference in native thiol, total thiol, disulfide, and calculated ratios was observed between the groups. However, maternal IMA values were significantly higher in the study group. The IMA was proven to be a predictor with a sensitivity of 77.4% and specificity of 100% for NTDs at a cut-off value of 1.32. CONCLUSION The examination of the maternal levels of IMA may be useful in the detection of NTDs.
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Affiliation(s)
- Ozgur Ocal
- Ankara City Hospital, Department of Neurosurgery, Ankara, Turkey
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Halici-Ozturk F, Ocal FD, Aydin S, Tanacan A, Ayhan SG, Altinboga O, Dinc B, Moraloglu ÖT, Sahin D. Investigating the risk of maternal-fetal transmission of SARS-CoV-2 in early pregnancy. Placenta 2021; 106:25-29. [PMID: 33610934 PMCID: PMC7882222 DOI: 10.1016/j.placenta.2021.02.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 01/31/2021] [Accepted: 02/09/2021] [Indexed: 12/17/2022]
Abstract
Introduction The possibility of vertical transmission of SARS-CoV-2 from the mother to the fetus is one of the most crucial issues regarding the COVID-19 effects on pregnancy. In this study, we aimed to explore the risk of maternal-fetal transmission before 24 weeks of gestation, through analysis of abortion materials collected from PCR-positive women with pregnancy loss. To the best of our knowledge, apart from case reports, this study is the first prospective work on the vertical transmission of SARS-CoV-2 in early pregnancy. Methods The patients who had attended our clinic with the diagnosis of pregnancy loss before 24 weeks of gestation were screened for COVİD-19. Vertical transmission in PCR-positive women was assessed through the presence of SARS-CoV-2 RNA in fetal-placental tissues by rt-PCR test. Results 24 of 210 (%11,4) pregnant women participating in the study had positive rt-PCR results. Placenta and curettage material samples of these PCR-positive patients were analyzed and all valid test results (21 samples) were negative for SARS CoV-2 RNA. In three cases, the rt-PCR results were invalid due to failed internal controls. Discussion In the literature, the possibility of intrauterine vertical transmission of SARS-CoV-2 is still controversial. The findings of the present study did not reveal any evidence of vertical transmission of SARS-CoV-2 in early pregnancy.
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Affiliation(s)
- Filiz Halici-Ozturk
- Department of Obstetrics and Gynecology, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey.
| | - Fatma Doga Ocal
- Department of Obstetrics and Gynecology, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey.
| | - Selvi Aydin
- Department of Obstetrics and Gynecology, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey.
| | - Atakan Tanacan
- Department of Obstetrics and Gynecology, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey.
| | - Sule Göncü Ayhan
- Department of Obstetrics and Gynecology, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey.
| | - Orhan Altinboga
- Department of Obstetrics and Gynecology, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey.
| | - Bedia Dinc
- Department of Medical Microbiology, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey.
| | - Özlem Tekin Moraloglu
- Department of Obstetrics and Gynecology, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey; University of Health Sciences, Istanbul, Turkey.
| | - Dilek Sahin
- Department of Obstetrics and Gynecology, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey; University of Health Sciences, Istanbul, Turkey.
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Türkyılmaz E, Kılıc G, Ocal FD, Maralı S, Yavuz Avsar AF. Recurrent Scar Endometriosis Developing in the episiotomy. Medeni Med J 2017. [DOI: 10.5222/mmj.2017.1004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Turkyilmaz E, Kelestemur E, Karatas Eray İ, Ocal FD, Yavuz AF. Türk Populasyonundaki Gebelerin Glikoz Yükleme Testi Hakkındaki Bilgi Düzeyleri, Tutum ve Davranışları. Ankara Med J 2016. [DOI: 10.17098/amj.34510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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