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Şahin N, Genc M, Turan GA, Kasap E, Güçlü S. A comparison of 2 cesarean section methods, modified Misgav-Ladach and Pfannenstiel-Kerr: A randomized controlled study. ADV CLIN EXP MED 2018. [PMID: 29533540 DOI: 10.17219/acem/66215] [Citation(s) in RCA: 3] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND The modified Misgav-Ladach method (MML) is a minimally invasive cesarean section procedure compared with the classic Pfannenstiel-Kerr (PK) method. OBJECTIVES The aim of the study was to compare the MML method and the PK method in terms of intraoperative and short-term postoperative outcomes. MATERIAL AND METHODS This prospective, randomized controlled trial involved 252 pregnant women scheduled for primary emergency or elective cesarean section between October, 2014 and July, 2015. The primary outcome measures were the duration of surgery, extraction time, Apgar score, blood loss, wound complications, and number of sutures used. Secondary outcome measures were the wound infection, time of bowel restitution, visual analogue scale (VAS) scores at 6 h and 24 h after the operation, limitations in movement, and analgesic requirements. At 6 weeks after surgery, the patients were evaluated regarding late complications. RESULTS There was a significant reduction in total operating and extraction time in the MML group (p < 0.001). Limitations in movement were lower at 24 h after the MML operation, and less analgesic was required in the MML group. There was no difference between the 2 groups in terms of febrile morbidity or the duration of hospitalization. At 6 weeks after the operation, no complaints and no additional complications from the surgery were noted. CONCLUSIONS The MML method is a minimally invasive cesarean section. In the future, as surgeons' experience increases, MML will likely be chosen more often than the classic PK method.
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Affiliation(s)
- Nur Şahin
- Department of Obstetrics and Gynecology, Sifa University, Izmir, Turkey
| | - Mine Genc
- Department of Obstetrics and Gynecology, Sifa University, Izmir, Turkey
| | | | - Esin Kasap
- Department of Obstetrics and Gynecology, Karatas Hospital, Izmir, Turkey
| | - Serkan Güçlü
- Department of Obstetrics and Gynecology, Kent Hospital, Izmir, Turkey
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Kasap E, Genc M, Turan GA, Eskicioglu F, Saklamaz A, Sahin N, Guclu S. The association of impaired gestational glucose tolerance with maternal and fetal outcomes. CLIN EXP OBSTET GYN 2016; 43:755-758. [PMID: 30074333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The aim of the present study was to examine the associations of gestational diabetes mellitus (GDM) and impaired glucose tolerance (IGT) with maternal and fetal outcomes.A total of 200 pregnant women were included in this cross-sectional study. A 50-gram oral glucose challenge test (GCT) was performed between 24 and 28 weeks of gestation, followed by glucose tolerance test (OGTT) with 100 grams of oral glucose in those with an abnormal one-hour test result. The following were not significantly different between groups. Preterm labour (PL), pregnancy induced hypertension(PIH), pre-eclampsia, polyhydramnios, and macrosomia. However, a significant increase was noted in the fetal birth weight as well as in number of cesarean deliveries among GDM subjects. Neonatal outcomes were also similar between the two groups. In conclusion, the present results suggest that single high glucose readings in OGTT may be as important as a diagnosis of GDM in terms of fetomaternal complication risk.
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Şahin N, Apaydın N, Töz E, Sivrikoz ON, Genç M, Turan GA, Cengiz H, Eskicioğlu F. Comparison of the effects of letrozole and cabergoline on vascular permeability, ovarian diameter, ovarian tissue VEGF levels, and blood PEDF levels, in a rat model of ovarian hyperstimulation syndrome. Arch Gynecol Obstet 2015; 293:1101-6. [PMID: 26690356 DOI: 10.1007/s00404-015-3987-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [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: 08/03/2015] [Accepted: 12/08/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To evaluate the effects of letrozole and cabergoline in a rat model of ovarian hyperstimulation syndrome (OHSS). STUDY DESIGN In this prospective, controlled experimental study, the 28 female Wistar rats were divided into four subgroups (one non-stimulated control and three OHSS-positive groups: placebo, letrozole, and cabergoline). To induce OHSS, rats were injected with 10 IU of pregnant mare serum gonadotropin from day 29 to day 32 of life, followed by subcutaneous injection of 30 IU hCG on day 33. Letrozole rats received with a single dose of 0.1 mg/kg letrozole via oral gavage, on the hCG day. Cabergoline rats received with a single dose of 100 µg/kg cabergoline via oral gavage, on the hCG day. All animals were compared in terms of body weight, vascular permeability (VP), ovarian diameter, ovarian tissue VEGF expression (assessed via immunohistochemical staining), and blood pigment epithelium-derived growth factor (PEDF) levels. RESULTS The OHSS-positive placebo group (group 2) exhibited the highest VP, ovarian diameter, extent of VEGF staining, and lowest PEDF level, as expected. No significant difference was evident between the letrozole and cabergoline groups in terms of any of body weight; VP; PEDF level; ovarian diameter; or the staining intensity of, or percentage staining for, VEGF in ovarian tissues. CONCLUSIONS Letrozole and cabergoline were equally effective to prevent OHSS, reducing the ovarian diameter, VP, and PEDF and VEGF levels to similar extents.
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Affiliation(s)
- Nur Şahin
- Department of Obstetrics and Gynecology, Sifa University Medicine School, Sanayi cad. No: 7 Bornova, Izmir, Turkey.
| | - Nesin Apaydın
- Department of Obstetrics and Gynecology, M.H. Tepecik Research and Education Hospital, Izmir, Turkey
| | - Emrah Töz
- Department of Obstetrics and Gynecology, M.H. Tepecik Research and Education Hospital, Izmir, Turkey
| | | | - Mine Genç
- Department of Obstetrics and Gynecology, Sifa University Medicine School, Sanayi cad. No: 7 Bornova, Izmir, Turkey
| | - Gülüzar Arzu Turan
- Department of Obstetrics and Gynecology, Sifa University Medicine School, Sanayi cad. No: 7 Bornova, Izmir, Turkey
| | - Hakan Cengiz
- Department of Biostatistics and Medical Informatics, Sifa University Medicine School, Izmir, Turkey
| | - Fatma Eskicioğlu
- Department of Obstetrics and Gynecology, M.H. Manisa Public Hospital, Manisa, Turkey
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Eskicioğlu F, Özdemir AT, Özdemir RB, Turan GA, Akan Z, Hasdemir SP. The association of HLA-G and immune markers in recurrent miscarriages. J Matern Fetal Neonatal Med 2015; 29:3056-60. [DOI: 10.3109/14767058.2015.1114085] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Fatma Eskicioğlu
- Department of Obstetrics and Gynecology, School of Medicine, Celal Bayar University, Manisa, Turkey,
| | - Alper Tunga Özdemir
- Department of Stem Cell, Institute of Health Sciences, Ege University, Izmir, Turkey,
| | - Rabia Bilge Özdemir
- Department of Immunology and Allergy, School of Medicine, Celal Bayar University, Manisa, Turkey,
| | - Gülüzar Arzu Turan
- Department of Obstetrics and Gynecology, School of Medicine, Şifa University, Izmir, Turkey, and
| | - Zafer Akan
- Department of Biophysics, School of Medicine, Celal Bayar University, Manisa, Turkey
| | - Solmaz Pınar Hasdemir
- Department of Obstetrics and Gynecology, School of Medicine, Celal Bayar University, Manisa, Turkey,
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Gur EB, Turan GA, Ince O, Karadeniz M, Tatar S, Kasap E, Sahin N, Guclu S. Effect of Ramadan fasting on metabolic markers, dietary intake and abdominal fat distribution in pregnancy. Hippokratia 2015; 19:298-303. [PMID: 27688692 PMCID: PMC5033138] [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] [Indexed: 06/06/2023]
Abstract
BACKGROUND The aim of this study is to evaluate the effect of Ramadan intermittent fasting on metabolic markers, dietary intake, anthropometric measurements, and abdominal visceral fat thickness (VFT) in pregnancy. METHODS Seventy-eight healthy pregnant subjects who had fasted for at least 15 days during the month of Ramadan in 2012 and 2013 and 78 controls were included in this study. Metabolic markers, dietary intake, anthropometric measurements, and ultrasonographic VFT were calculated for each subject before and after Ramadan fasting. RESULTS When before and after Ramadan values in the fasting group were compared, we found that daily protein intake was increased (p <0.001), but fat and carbohydrate intake remained unchanged. A significant reduction was observed in liquid consumption while the frequency of asymptomatic bacteriuria was increased. High-density lipoprotein significantly increased, and glycated hemoglobin, insulin, and homeostasis model index significantly decreased (p =0.005, p =0.01, p <0.001, and p =0.03, respectively). A significant increase in ferritin was found (p =0.02). No change was observed in subcutaneous fat thickness, while VFT significantly decreased (p =0.08, p =0.005). However, in the control group, only ferritin level increased. CONCLUSION A combined change in the number and timing of meals and the portioning of the entire daily intake into only two meals per day may have beneficial metabolic effects and reduction in VFT during pregnancy. Hippokratia 2015; 19 (4): 298-303.
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Affiliation(s)
- E B Gur
- Department of Obstetrics and Gynecology, Faculty of Medicine, Katip Celebi University, Izmir, Turkey
| | - G A Turan
- Department of Obstetrics and Gynecology, Faculty of Medicine, Sifa University, Izmir, Turkey
| | - O Ince
- Department of Radiology, Faculty of Medicine, Sifa University, Izmir, Turkey
| | - M Karadeniz
- Department of Endocrinology, Faculty of Medicine, Sifa University, Izmir, Turkey
| | - S Tatar
- Department of Obstetrics and Gynecology, Faculty of Medicine, Sifa University, Izmir, Turkey
| | - E Kasap
- Department of Obstetrics and Gynecology, Faculty of Medicine, Sifa University, Izmir, Turkey
| | - N Sahin
- Department of Obstetrics and Gynecology, Faculty of Medicine, Sifa University, Izmir, Turkey
| | - S Guclu
- Department of Obstetrics and Gynecology, Faculty of Medicine, Sifa University, Izmir, Turkey
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Abstract
OBJECTIVE The aim of this study was to determine the rate of unexpected uterine pathology in postmenopausal women admitted to a gynecology clinic with symptoms other than vaginal bleeding and who were scheduled to undergo hysterectomy. MATERIALS AND METHODS We reviewed retrospectively the medical records of 283 postmenopausal patients who had gynecological surgery between September 2007 and January 2014. We reviewed their presenting symptoms on admission, the indications for surgery, and their transvaginal ultrasonographic findings. Postoperative histopathological results based on uterine specimens were also recorded. The results were analyzed statistically. RESULTS Of 283 patients who had surgery, 209 had no vaginal bleeding at the time of admission. From this group, 75.6% were found to have unsuspected pathology, including endometrial hyperplasia, endometrial polyps, uterine fibroids, adenomyosis, and one case of endometrial carcinoma (0.5%). The remaining 74 patients had experienced postmenopausal bleeding and in 87.8% there were pathological findings including 13 cases (17.6%) of endometrial cancer (p = 0.0001). CONCLUSION Vaginal bleeding in postmenopausal women is indicative of a wide array of gynecological pathologies, including endometrial carcinoma. However, uterine fibroids, pelvic masses, or even endometrial cancer may develop without co-morbid vaginal bleeding. Therefore we advocate that postmenopausal women should undergo yearly screening and consultation, without waiting for an episode of vaginal bleeding.
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Affiliation(s)
- M Genc
- Departments of Obstetrics and Gynecology, Sifa University , İzmir , Turkey
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Gür EB, Turan GA, Tatar S, Gökduman A, Karadeniz M, Celik G, Genç M, Güçlü S. The effect of place of residence and lifestyle on vitamin D deficiency in pregnancy: Comparison of eastern and western parts of Turkey. J Turk Ger Gynecol Assoc 2014; 15:149-55. [PMID: 25317042 DOI: 10.5152/jtgga.2014.13048] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [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: 04/15/2014] [Accepted: 07/09/2014] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE The aim of this study was to determine the prevalence and the predictive factors of vitamin D deficiency in pregnancy and the compliance with "The National Vitamin D Support Program" at Turkey's easternmost and westernmost provinces. MATERIAL AND METHODS Lifestyles of women at 24-28 weeks of pregnancy were assessed using a questionnaire form, and serum 25-hydroxyvitamin D3 (25(OH)D3) levels were measured. RESULTS Vitamin D deficiency (≤20 ng/mL) in pregnant women had a prevalence of 27.8% in İzmir and 76.3% in Erzurum. The compliance of "The National Vitamin D Support Program" was 8% in İzmir and 32.6% in Erzurum. Clothing style, fish consumption, seaside holiday duration, and 1200 IU/day vitamin D replacement had an effect on 25(OH)D3 levels in pregnant subjects in İzmir, whereas only holiday duration and 1200 IU/day vitamin D replacement affected 25(OH)D3 levels in Erzurum. However, when a threshold for 25(OH)D3 level was considered ≥32 ng/mL, lifestyles did not affect 25(OH)D3 level. CONCLUSION The effect of lifestyle on 25(OH)D3 level in pregnancy is limited, especially in cold regions. We recommended increasing the compliance with "The National Vitamin D Support Program" at the follow-up of all pregnant women, irrespective of region and season.
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Affiliation(s)
- Esra Bahar Gür
- Department of Obstetrics and Gynecology, Şifa University Faculty of Medicine, İzmir, Turkey
| | - Gülüzar Arzu Turan
- Department of Obstetrics and Gynecology, Şifa University Faculty of Medicine, İzmir, Turkey
| | - Sümeyra Tatar
- Department of Obstetrics and Gynecology, Şifa University Faculty of Medicine, İzmir, Turkey
| | - Ayşe Gökduman
- Department of Biochemistry, Şifa University Faculty of Medicine, İzmir, Turkey
| | - Muammer Karadeniz
- Department of Endocrinology, Şifa University Faculty of Medicine, İzmir, Turkey
| | - Gülnaz Celik
- Depertment of Biochemistry, Şifa Hospital, Erzurum, Turkey
| | - Mine Genç
- Department of Obstetrics and Gynecology, Şifa University Faculty of Medicine, İzmir, Turkey
| | - Serkan Güçlü
- Department of Obstetrics and Gynecology, Şifa University Faculty of Medicine, İzmir, Turkey
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