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Köroğlu N, Tayyar A, Soydar A, Albayrak N, Aydın T, Çetin BA. Pre-delivery fibrinogen level is a predictor for severity of placental abruption. Eur J Obstet Gynecol Reprod Biol X 2023; 20:100264. [PMID: 38058588 PMCID: PMC10696460 DOI: 10.1016/j.eurox.2023.100264] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 11/05/2023] [Accepted: 11/24/2023] [Indexed: 12/08/2023] Open
Abstract
Objective To determine pre-delivery fibrinogen levels in predicting adverse maternal or neonatal outcomes in patients with placental abruption. Materials and method We conducted a retrospective study of all women admitted for placental abruption between January 2012 and May 2018. Postpartum hemorrhage (PPH), disseminated intravascular coagulation (DIC), massive blood transfusion and hospitalization in intensive care unit parameters were evaluated for maternal outcomes. For the neonatal outcomes, the 5th minute APGAR score, umbilical artery pH and stillbirth were evaluated. Results The mean predelivery fibrinogen levels were 221.3 ± 111.6 mg/dL. In multivariate logistic regression analysis, fibrinogen level was determined as an independent indicator for PPH, red cell concentrate (RCC) and fresh frozen plasma (FFP) transfusion. When fibrinogen levels decreased below 130 mg/dL, the risk of PPH increased and when fibrinogen levels decreased below 100 mg/dL, the risk of overt DİC and also the risk of red cell concentrate and fresh frozen plasma transfusion increased. In terms of the fetal results, there may be adverse neonatal outcomes when fibrinogen levels are below 250 mg/dL. Conclusion Predelivery fibrinogen levels are good indicators for predicting adverse maternal outcomes in placental abruption cases. In addition, fibrinogen levels might be a guide for management of placental abruption cases.
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Affiliation(s)
- Nadiye Köroğlu
- Acıbadem Mehmet Ali Aydınlar University, Faculty of Medicine, Department of Obstetrics and Gynecology, İstanbul, Turkey
| | - Ahmet Tayyar
- Acıbadem Mehmet Ali Aydınlar University, Faculty of Medicine, Department of Obstetrics and Gynecology, İstanbul, Turkey
| | - Ali Soydar
- Akhisar Mustafa Kirazoğlu State Hospital, Department of Obstetrics and Gynecology, Manisa, Turkey
| | - Nazli Albayrak
- Acıbadem Mehmet Ali Aydınlar University, Faculty of Medicine, Department of Obstetrics and Gynecology, İstanbul, Turkey
| | - Turgut Aydın
- Acıbadem Mehmet Ali Aydınlar University, Faculty of Medicine, Department of Obstetrics and Gynecology, İstanbul, Turkey
| | - Berna Aslan Çetin
- Başakşehir Çam ve Sakura City Hospital, Department of Obstetrics and Gynecology, İstanbul, Turkey
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Köroğlu N, Aydın T. Oocyte vitrification for oncological and social reasons. Turk J Obstet Gynecol 2023; 20:59-63. [PMID: 36908095 PMCID: PMC10013077 DOI: 10.4274/tjod.galenos.2022.59827] [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] [Indexed: 03/12/2023] Open
Abstract
The aim of this review is to present information related to oocyte cryopreservation, and particularly oocyte vitrification, performed to preserve fertility in oncologic and social indications. The success rates of oocyte cryopreservation have increased with the widespread use of the vitrification technique and are currently similar to those of in vitro fertilization performed with fresh oocytes. Vitrification is the most successful technique for oocyte cryopreservation. The most important factors that influence the success rate are the patient's age at the time of vitrification and the number of mature oocytes frozen. Thus, live birth rates differ for each age depending on the number of oocytes thawed and the freezing method. The American Society of Reproductive Medicine and the American Society of Clinical Oncology recommend presenting the option of oocyte cryopreservation for fertility preservation in cancer patients. Besides cancer patients, use of oocyte vitrification is increasing in women who wish to postpone pregnancy age and to have reproductive freedom with the development of the cryopreservation technique and the achievement of pregnancy rates similar to the use of fresh oocytes. Patients are provided consultancy service in terms of indication, the success rates by age, and the total number of oocytes frozen. It should be emphasized that this procedure is not a type of insurance policy for fertility, especially in elective oocyte cryopreservation.
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Affiliation(s)
- Nadiye Köroğlu
- Acıbadem Atakent Hospital, Clinic of Obstetrics and Gynecology, In Vitro Fertilization Unit, İstanbul, Turkey
| | - Turgut Aydın
- Acıbadem Mehmet Ali Aydınlar University, Atakent Hospital, Clinic of Obstetrics and Gynecology, In Vitro Fertilization Unit, İstanbul, Turkey
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Bakar RZ, Köroğlu N, Turkgeldi LS, Tola EN, Cetin BA, Gedikbasi A. Maternal serum procalcitonin levels in prediction of chorioamnionitis in women with preterm premature rupture of membranes. Arch Med Sci 2021; 17:694-699. [PMID: 34025839 PMCID: PMC8130487 DOI: 10.5114/aoms.2019.86191] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2018] [Accepted: 04/06/2018] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Chorioamnionitis is one of the most important maternal complications in the expectant management of patients with preterm premature rupture of membranes (PPROM). Procalcitonin (proCT), the precursor of the hormone calcitonin, is used to differentiate bacterial infections from non-bacterial ones. The objective of the study was to determine the efficacy of maternal serum procalcitonin levels in the early prediction of chorioamnionitis in women with PPROM. MATERIAL AND METHODS The study was conducted in 76 pregnant women hospitalized due to PPROM at the maternal-fetal medicine unit of a tertiary center in Istanbul. Patients were followed up with white blood cell (WBC), C-reactive protein (CRP) and proCT levels every 2 days. The values of investigated parameters were recorded at the diagnosis of PPROM and at the time of delivery. The maximum values during the follow-up period were also recorded. RESULTS Out of the 76 patients with PPROM, 15 (19.73%) developed clinical chorioamnionitis. No significant difference could be detected in the gravidity, parity, duration of hospitalization and gestational week at diagnosis between those patients who developed clinical chorioamnionitis and those who did not. The WBC at the time of hospital admittance and before delivery, and CRP levels before delivery were statistically higher in the chorioamnionitis group (p < 0.05). No difference in the proCT levels could be detected either at the time of hospital admittance or before delivery between the two groups. CONCLUSIONS Maternal proCT was not found to be predictive of chorioamnionitis. However, since there are reports in the literature that contradict these results, further studies are warranted to determine the true efficacy of proCT in the prediction of clinical chorioamnionitis.
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Affiliation(s)
- Rabia Zehra Bakar
- Department of Obstetrics and Gynecology, Erbaa State Hospital, Tokat, Turkey
| | - Nadiye Köroğlu
- Department of Obstetrics and Gynecology, University of Health Sciences, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey
| | | | - Esra N. Tola
- Department of Medicine, Suleyman Demirel University, Isparta, Turkey
| | - Berna Aslan Cetin
- Department of Obstetrics and Gynecology, University of Health Sciences, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey
| | - Ali Gedikbasi
- Department of Obstetrics and Gynecology, University of Health Sciences, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey
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Temel Yüksel İ, Acar D, Turhan U, Aslan Çetİn B, Köroğlu N, Şenol G, Tayyar A, Yüksel MA. Assessment of fetal right ventricular myocardial performance index changes following intrauterine transfusion. J Matern Fetal Neonatal Med 2019; 34:3046-3049. [PMID: 31608719 DOI: 10.1080/14767058.2019.1677595] [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] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Severe fetal anemia may cause cardiac ischemia, reduced contractility, and dysfunction. The purpose of our study is to evaluate right ventricular myocardial performance index (MPI) before and after intrauterine transfusion (IUT) in patients who underwent this procedure because of fetal anemia due to Rh-D alloimmunization. MATERIALS AND METHODS This prospective cohort study was conducted between January 2018 and June 2019 at Kanuni Sultan Suleyman Research and Training Hospital, Istanbul, Turkey. The pregnant women who were applied IUT because of fetal anemia due to Rh-D alloimmunization in our perinatology clinic were included in the study. Fetal right ventricular MPI before and 24 h after IUT were evaluated. RESULTS A total of 28 IUTs were performed in 17 pregnant women during the study period. The isovolumetric contraction time (ICT) and isovolumetric relaxation time (IRT) values measured before IUT, were found to be significantly longer compared to the ICT and IRT values measured after IUT. The MPI values measured after transfusion was found to be higher than before transfusion. CONCLUSIONS The fetal right ventricular MPI increases 24 h after IUT. This increase in the right ventricular MPI might be used as a marker for predicting adverse fetal outcomes following IUT.
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Affiliation(s)
- İlkbal Temel Yüksel
- Department of Obstetrics and Gynecology, Kanuni Sultan Suleyman Research and Training Hospital, Istanbul, Turkey
| | - Deniz Acar
- Department of Perinatology, Sadi Konuk Research and Training Hospital, Istanbul, Turkey
| | - Uğur Turhan
- Department of Perinatology, Samsun Research and Training Hospital, Samsun, Turkey
| | - Berna Aslan Çetİn
- Department of Obstetrics and Gynecology, Kanuni Sultan Suleyman Research and Training Hospital, Istanbul, Turkey
| | - Nadiye Köroğlu
- Department of Obstetrics and Gynecology, Kanuni Sultan Suleyman Research and Training Hospital, Istanbul, Turkey
| | - Gökalp Şenol
- Department of Obstetrics and Gynecology, Kanuni Sultan Suleyman Research and Training Hospital, Istanbul, Turkey
| | - Ahmet Tayyar
- Faculty of Medicine, Department of Perinatology, Medipol University, Istanbul, Turkey
| | - Mehmet Aytaç Yüksel
- Department of Obstetrics and Gynecology, Kanuni Sultan Suleyman Research and Training Hospital, Istanbul, Turkey
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Abstract
Intrahepatic cholestasis of pregnancy is a diagnosis of exclusion and presents with unexplained pruritus, abnormal liver function tests, and increased serum bile acid levels, particularly in the third trimester of pregnancy. Serum YKL-40 levels are increased in liver diseases and our aim was to investigate YKL-40 levels in pregnant women with ICP. 40 women with intrahepatic cholestasis of pregnancy and 40 healthy pregnant women were included in this cross-sectional study. Serum YKL-40 levels were measured in both groups and correlation analysis were performed between the YKL-40 and other liver function tests. Serum YKL-40 concentrations were higher in the intrahepatic cholestasis of pregnancy group than in the control group (103.46 ± 53.03 vs. 57.60 ± 30.30 ng/ml, p = .002). The cutoff YKL-40 serum concentration was 84.80 ng/ml for the diagnosis of intrahepatic cholestasis of pregnancy. There was no correlation between fasting bile acids and YKL-40 levels. However, there was a significant positive correlation between the YKL-40 levels and aspartate aminotransferase (r = 0.22, p = .04) and alanine aminotransferase (r = 0.24, p = .02). Raised YKL-40 levels might support the evidence on inflammatory processes in intrahepatic cholestasis of pregnancy.
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Affiliation(s)
- İlkbal Temel Yüksel
- a Obstetrics and Gynecology Department , Kanuni Sultan Süleyman Training and Research Hospital , İstanbul , Turkey
| | - Berna Aslan Çetin
- a Obstetrics and Gynecology Department , Kanuni Sultan Süleyman Training and Research Hospital , İstanbul , Turkey
| | - Nadiye Köroğlu
- a Obstetrics and Gynecology Department , Kanuni Sultan Süleyman Training and Research Hospital , İstanbul , Turkey
| | | | - Baki Erdem
- a Obstetrics and Gynecology Department , Kanuni Sultan Süleyman Training and Research Hospital , İstanbul , Turkey
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Aslan Çetin B, Aydoğan Mathyk B, Köroğlu N, Soydar A, Demirayak G, Çift T. Oxytocin infusion reduces bleeding during abdominal myomectomies: a randomized controlled trial. Arch Gynecol Obstet 2018; 299:151-157. [PMID: 30328494 DOI: 10.1007/s00404-018-4944-9] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 10/12/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE To evaluate the effectiveness of oxytocin infusion to reduce intraoperative bleeding during abdominal myomectomies. METHODS This randomized, parallel group, blinded study was conducted between October 2017 and May 2018. Patients undergoing abdominal myomectomies were randomized 1:1 either to the oxytocin group or to the control group (saline). In the oxytocin group, 10 IU oxytocin in 500 ml of saline at a rate of 120 ml/h was given during the course of the operation. The primary outcome of this study was to measure intraoperative blood loss between the study groups. Correlation and multiple regression analysis were performed to illustrate factors associated with intraoperative blood loss during the myomectomy. RESULTS The mean intraoperative blood loss during the surgery was 489.20 ± 239.72 ml in the oxytocin group and was 641.40 ± 288.21 ml in the control group. The hemoglobin decline was more evident in the control group than in the oxytocin group. Positive correlations were also observed between the intraoperative blood loss and number of fibroids removed during the surgery, largest fibroid removed and weight of fibroids removed. The use of oxytocin infusion during the myomectomy resulted in a reduction of bleeding in the regression model. CONCLUSION Intravenous oxytocin infusion is a safe and practical method to reduce intraoperative blood loss during the abdominal myomectomy.
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Affiliation(s)
- Berna Aslan Çetin
- Department of Obstetrics and Gynecology, İstanbul Kanuni Sultan Süleyman Training and Research Hospital, Altınşehir, 34303, Halkalı, Istanbul, Turkey.
| | | | - Nadiye Köroğlu
- Department of Obstetrics and Gynecology, İstanbul Kanuni Sultan Süleyman Training and Research Hospital, Altınşehir, 34303, Halkalı, Istanbul, Turkey
| | - Ali Soydar
- Department of Obstetrics and Gynecology, İstanbul Kanuni Sultan Süleyman Training and Research Hospital, Altınşehir, 34303, Halkalı, Istanbul, Turkey
| | - Gökhan Demirayak
- Obstetrics and Gynecology Department, İstanbul Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Tayfur Çift
- Obstetrics and Gynecology Department, Bursa Yüksek Ihtisas Training and Research Hospital, Bursa, Turkey
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Demirezen G, Aslan Çetin B, Aydoğan Mathyk B, Köroğlu N, Yildirim G. Efficiency of the Foley catheter versus the double balloon catheter during the induction of second trimester pregnancy terminations: a randomized controlled trial. Arch Gynecol Obstet 2018; 298:881-887. [PMID: 30167856 DOI: 10.1007/s00404-018-4882-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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: 05/20/2018] [Accepted: 08/22/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE To compare induction-to-delivery intervals of Foley catheters and double balloon catheters in second trimester pregnancy terminations. METHODS This randomized parallel study was conducted on women who underwent second trimester terminations between December 2016 and December 2017. Pregnant women in the second trimester with a Bishop score < 6 were included in the study. Participants were randomized into two groups, the first being the Foley catheter group and the second being the double balloon catheter group. The time frames from insertion of catheters to the delivery were recorded in each group. A multiple regression analysis was carried out to examine the contribution of factors to the induction-to-delivery interval. A survival analysis was conducted to compare the Foley method and the double balloon method. RESULTS A total of 91 pregnant women were included in the final analysis. The induction-to-delivery interval was shorter in the Foley catheter group than in the double balloon catheter group (38 h 54 min ± 21 h 6 min versus 58 h 17 min ± 25 h 56 min). We also found that women with intrauterine fetal death (IUFD) had a shorter time to delivery compared to women with live fetuses (39 h 12 min ± 18 h 46 min vs 51 h 30 min ± 26 h 42 min, p = 0.04). Women with a history of vaginal delivery also had a shorter induction-to-delivery time compared to women who never delivered vaginally before (38 h 12 min ± 17 h 42 min vs 53 h 54 min ± 27 h 18 min, p = 0.004). In the multiple regression analysis, the most significant contributor to the induction-to-delivery time was the method used for induction of labor and followed by other factors including the viability of the fetus (live/IUFD), history of vaginal delivery and PPROM. The survival analysis showed that the induction-to-delivery interval was significantly shorter in the Foley catheter group than in the double balloon catheter group (HR 2.51, 95% CI 1.57-4.00, p = 0.001). CONCLUSION During the termination of second trimester pregnancies time from induction of labor to delivery is shorter with the Foley catheter compared to double balloon catheter.
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Affiliation(s)
- Gözde Demirezen
- Obstetrics and Gynecology Department, Tekirdağ State Hospital, Tekirdağ, Turkey
| | - Berna Aslan Çetin
- Department of Obstetrics and Gynecology, İstanbul Kanuni Sultan Süleyman Training and Research Hospital, Altınşehir, Halkalı, 34303, Istanbul, Turkey.
| | - Begüm Aydoğan Mathyk
- Division of Reproductive Endocrinology and Infertility, Obstetrics and Gynecology Department, University of North Carolina, Chapel Hill, NC, USA
| | - Nadiye Köroğlu
- Department of Obstetrics and Gynecology, İstanbul Kanuni Sultan Süleyman Training and Research Hospital, Altınşehir, Halkalı, 34303, Istanbul, Turkey
| | - Gökhan Yildirim
- Department of Obstetrics and Gynecology, İstanbul Kanuni Sultan Süleyman Training and Research Hospital, Altınşehir, Halkalı, 34303, Istanbul, Turkey
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Abstract
BACKGROUND Oxidative stress has been proposed as a potential trigger in the etiopathogenesis of polycystic ovary syndrome-related infertility. Thiol/disulphide homeostasis, a recently identified oxidative stress marker, is one of the antioxidant mechanism in humans with critical roles in folliculogenesis and ovulation. AIMS To investigate follicular fluid thiol/disulphide homeostasis in the etiopathogenesis of polycystic ovary syndrome and to determine its association with in vitro fertilization outcome. The study procedures were approved by the local ethics committee. STUDY DESIGN Cross-sectional study. Methods Follicular fluid from 22 women with polycystic ovary syndrome and 20 ovulatory controls undergoing in vitro fertilization treatment was sampled. Thiol/disulphide homeostasis was analyzed via a novel spectrophotometric method. Results Follicular native thiol levels, as well as the native thiol/total thiol ratio, were lower in the polycystic ovary syndrome group than in the non-polycystic ovary syndrome group (p=0.041 and p<0.0001, respectively). Disulphide levels, disulphide/native thiol, and disulphide/total thiol ratios were increased in the polycystic ovary syndrome group (p<0.0001). A positive correlation between the fertilization rate and native thiol (p=0.01, r=0.53) and total thiol (p=0.01, r=0.052) among polycystic ovary syndrome patients was found. A positive predictive effect of native thiol level on the fertilization rate in the polycystic ovary syndrome group was also found (p=0.03, β=0.45, 95% CI= 0.031-0.643). Conclusion Deterioration of thiol/disulphide homeostasis, especially elevated disulphide levels, could be one of the etiopathogenetic mechanisms in polycystic ovary syndrome. Increased native thiol levels are related to the fertilization rate among polycystic ovary syndrome patients and are positive predictors of the fertilization rate among polycystic ovary syndrome patients. Improvement of thiol/disulphide homeostasis could be important in the treatment of polycystic ovary syndrome to increase in vitro fertilization success.
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Affiliation(s)
- Esra Nur Tola
- Department of Gynecology and Obstetrics, In Vitro Fertilization Unit, Süleyman Demirel University School of Medicine, Isparta, Turkey
| | - Nadiye Köroğlu
- Clinic of Gynecology and Obstetrics, University of Health Sciences, Kanuni Sultan Süleyman Training and Research Hospital, İstanbul, Turkey
| | - Merve Ergin
- Clinic of Biochemistry, Gaziantep 25 Aralık State Hospital, Gaziantep, Turkey
| | - Hilmi Baha Oral
- Department of Gynecology and Obstetrics, In Vitro Fertilization Unit, Süleyman Demirel University School of Medicine, Isparta, Turkey
| | - Abdülkadir Turgut
- Department of Gynecology and Obstetrics, Medeniyet University School of Medicine, İstanbul, Turkey
| | - Özcan Erel
- Department of Biochemistry, Yıldırım Beyazıt University School of Medicine, Ankara, Turkey
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Okmen Ozkan B, Köroğlu N, Turkgeldi LS, Cetin BA, Aslan H. Advanced maternal age and risk of non-chromosomal anomalies: data from a tertiary referral hospital in Turkey. J Matern Fetal Neonatal Med 2017; 32:749-752. [PMID: 28992718 DOI: 10.1080/14767058.2017.1390741] [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] [Indexed: 10/18/2022]
Abstract
PURPOSE The purpose of this study is to determine if there is a relationship between non-chromosomal fetal anomalies of various organ systems and advanced maternal age. MATERIALS AND METHOD This study was conducted in 387 women aged 20-53 years who underwent fetal karyotype testing due to positive prenatal test results or advanced maternal age at the Kanuni Sultan Süleyman Training and Research Hospital between September 2011 and March 2015. Fetuses with chromosomal anomalies were excluded from the study. The relationship between non-chromosomal anomalies and maternal age of women aged <35 or ≥35 years was studied. RESULTS More than 80% (81.7%) of non-chromosomal anomalies were detected in patients aged <35 years, and 18.3% were found in those ≥35 years. There were no statistically significant differences found between the incidence of non-chromosomal anomalies in women aged over 35 years and those under 35 years. When congenital major anomalies were evaluated with respect to various organ systems, the risk of musculo-skeletal system anomalies decreased with advancing maternal age. However, there was no statistically significant difference between the <35 and ≥35-year age groups in the incidence of central nervous system, craniofacial, cardiac, gastrointestinal system, urogenital, respiratory, and limb anomalies. CONCLUSION The incidence of non-chromosomal anomalies does not increase in fetuses of pregnant women aged over 35 years, in contrast to chromosomal anomalies.
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Affiliation(s)
- Berfin Okmen Ozkan
- a Department of Obstetrics and Gynecology , Sanlıurfa Gynecology and Obstetrics Hospital , SanliUrfa , Turkey
| | - Nadiye Köroğlu
- b Department of Obstetrics and Gynecology , Kanuni Sultan Suleyman Training and Research Hospital , Istanbul , Turkey
| | - Lale Susan Turkgeldi
- b Department of Obstetrics and Gynecology , Kanuni Sultan Suleyman Training and Research Hospital , Istanbul , Turkey
| | - Berna Aslan Cetin
- b Department of Obstetrics and Gynecology , Kanuni Sultan Suleyman Training and Research Hospital , Istanbul , Turkey
| | - Halil Aslan
- c Kanuni Sultan Suleyman Training and Research Hospital, Perinatology Clinic , Istanbul , Turkey
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Dikmen S, Aslan Çetin B, Gedikbaşı A, Kıyak H, Köroğlu N. The outcomes of extending uterine incision transversely or cephalocaudally in patients with previous cesarean section: a prospective randomized controlled study. Perinatal J 2017. [DOI: 10.2399/prn.17.0251001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Yetkin Yıldırım G, Orta Korkut A, Köroğlu N, Susan Türkgeldi L. The Relations Between HSG Proven Tubal Occlusion, Stimulated Intrauterine Insemination and Pregnancy Rate. Balkan Med J 2017; 34:60-63. [PMID: 28251025 PMCID: PMC5322513 DOI: 10.4274/balkanmedj.2016.0289] [Citation(s) in RCA: 2] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Accepted: 07/19/2016] [Indexed: 12/01/2022] Open
Abstract
Background: Tubal factor infertility is one of the main causes of female infertility. Although its sensitivity is low, hysterosalpingography (HSG) is remains the first-line method for evaluating tubal patency. Aims: To compare pregnancy rates in patients with HSG proven proximal or distal unilateral tubal occlusion, and unexplained infertility undergoing both controlled ovarian stimulation (COS) and intrauterine insemination (IUI). Study Design: Case control study. Methods: In total, 237 patients undergoing ovulation induction (OI) with gonadotropins and IUI were divided into two groups and evaluated. Study group consisted 59 patients with HSG proven unilateral tubal pathology, and 178 patients with unexplained infertility taken as control subjects. Cumulative pregnancy rate was the primary endpoint. Results: Cumulative pregnancy rates after three cycles of OI and IUI were 15.25% in study group and 20.79% in control group. Pregnancy rates between two groups were not statistically significant. Although, pregnancy rates in patients with proximal tubal occlusion (21.8%) were higher than in those with distal tubal occlusion (7.4%), the difference was not statistically significant. Conclusion: Our study data shows that, regardless of the HCG proven occlusion area, COS and IUI might be a preferred treatment modality in patient with unilateral tubal occlusion.
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Affiliation(s)
- Gonca Yetkin Yıldırım
- Department of Obstetrics and Gynaecology, Kanuni Sultan Süleyman Training and Research Hospital, İstanbul, Turkey
| | - Ahu Orta Korkut
- Department of Obstetrics and Gynaecology, Mardin Women and Children Hospital, Mardin, Turkey
| | - Nadiye Köroğlu
- Department of Obstetrics and Gynaecology, Kanuni Sultan Süleyman Training and Research Hospital, İstanbul, Turkey
| | - Lale Susan Türkgeldi
- Department of Obstetrics and Gynaecology, Kanuni Sultan Süleyman Training and Research Hospital, İstanbul, Turkey
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Başaranoğlu S, Deregözü A, Köroğlu N, Kalkan M, Şahin C, Kadanalı S. Early and Late Diagnosis of Iatrogenic Urinary Tract Injuries During Obstetric and Gynecological Operations. J Clin Exp Invest 2016. [DOI: 10.5799/jcei.328617] [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: 11/23/2022] Open
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13
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Dansuk R, Gonenc AI, Sudolmus S, Yucel O, Sevket O, Köroğlu N. Effect of GnRH antagonists on clinical pregnancy rates in ovulation induction protocols with gonadotropins and intrauterine insemination. Singapore Med J 2014; 56:353-6. [PMID: 25532515 DOI: 10.11622/smedj.2014192] [Citation(s) in RCA: 3] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Intrauterine insemination (IUI) after controlled ovarian hyperstimulation (COH) was applied to selected infertile patients to determine the effect of gonadotropin-releasing hormone (GnRH) antagonists in IUI cycles, in which recombinant follicle-stimulating hormone (rFSH) had been used for COH. METHODS This study was conducted between April 1, 2009 and June 10, 2009, and involved a total of 108 patients. These patients had primary or secondary infertility, which resulted in an indication for IUI, and they each received two cycles of ovarian stimulation treatment with clomiphene citrate. The patients were randomised into two groups--patients in group A received rFSH + GnRH antagonist (n = 45), while those in group B received only rFSH (n = 63). RESULTS The mean age of the patients was 31.84 ± 3.73 years and the mean body mass index (BMI) was 24.40 ± 1.88 kg/m(2). The mean age and BMI of the patients in groups A and B were not significantly different. There was no significant difference in the mean total rFSH dose administered (988.33 IU in group A and 871.83 IU in group B). When compared to group B, the mean number of follicles that were > 16 mm on the human chorionic gonadotropin (HCG) trigger day was significantly higher in group A (1.58 and 1.86, respectively; p < 0.05). When the two groups were compared, there were no statistically significant differences in the number of cancelled cycles due to premature luteinisation (none in group A vs. two in group B) and the rate of clinical pregnancy (8.9% in group A vs. 7.9% in group B). CONCLUSION No significant improvement in the clinical pregnancy rates was observed when GnRH antagonists were used in COH + IUI cycles, despite the significant increase in the number of follicles that were > 16 mm on HCG trigger day.
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Affiliation(s)
- Ramazan Dansuk
- Department of Obstetrics and Gynecology, Bezmialem Vakif University, School of Medicine, Istanbul, Turkey
| | | | - Sinem Sudolmus
- Department of Obstetrics and Gynecology, Bezmialem Vakif University, School of Medicine, Istanbul, Turkey
| | - Oguz Yucel
- Suleymaniye Women Health Training Hospital, Istanbul, Turkey
| | - Osman Sevket
- Department of Obstetrics and Gynecology, Bezmialem Vakif University, School of Medicine, Istanbul, Turkey
| | - Nadiye Köroğlu
- Department of Obstetrics and Gynecology, Bezmialem Vakif University, School of Medicine, Istanbul, Turkey
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