Publications by authors named "Fatma Ferda Verit"

57 Publications

Can Short Anogenital Distance Cause Chronic Prostatitis?

Urol J 2021 Apr 18. Epub 2021 Apr 18.

Univ. of Health Sciences, Istanbul Hospital, Dept. of Obstet. and Gyn. Istanbul, Turkey.

Chronic prostatitis/Chronic pelvic pain syndromes (CP/CPPS) are a widespread pathology with unknown etiology without a proved treatment algorithm. Neurologic, endocrine and immune systems, and oxidative stress, infections are ranked in the physiopathology. Anogenital distance (AGD) as a marker for the degree of antenatal exposure of androgens that link to some disorders of androgen-sensitive tissues especially of urogenital system. In this study, we aimed a construct a hypothesis that improper development of perineum and pelvic bottom due to the insufficient embryologic androgen exposure, which can be detected by reduced AGD, can form histologic/clinic CP in adulthood through the physical forces that resulted in stretched prostate via chronic hypoxia induced oxidative stress and failed immune mechanisms. AGD, unlike the previous published ones, suggested as a real physical scale to detect narrowed pelvic bottom other than an endocrine related biomarker.
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http://dx.doi.org/10.22037/uj.v18i.6687DOI Listing
April 2021

Are women with small endometriomas who undergo intracytoplasmic sperm injection at an elevated risk for adverse pregnancy, obstetric, and neonatal outcomes?

Clin Exp Reprod Med 2021 Mar 18;48(1):80-84. Epub 2021 Feb 18.

Department of Obstetrics and Gynecology, Bezmialem Foundation University, Istanbul, Turkey.

Objective: The aim of the study was to investigate pregnancy, obstetric, and neonatal outcomes in women with small (<4 cm) unilateral endometriomas.

Methods: This retrospective study included 177 patients: 91 patients with small endometriomas and 86 controls with unexplained or tubal factor infertility who were treated at the Süleymaniye Gynecology and Maternity Training and Research Hospital Infertility Unit between January 2010 and July 2015. The groups were matched with regards to demographic characteristics such as age, body mass index, and infertility duration. All of the women in this study conceived via intracytoplasmic sperm injection. We compared pregnancy, obstetric, and neonatal outcomes between these groups.

Results: Women with endometriomas had a higher biochemical pregnancy rate, but lower clinical pregnancy and live birth rates than women with unexplained and tubal factor infertility (p<0.05 for all). However no significant differences were found in terms of obstetric and neonatal complications between the two groups (p>0.05 for all).

Conclusion: In this study, we found that women with endometriomas less than 4 cm were more prone to early pregnancy complications. We also showed that this group did not have any increased risks of late pregnancy, obstetric, and neonatal complications.
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http://dx.doi.org/10.5653/cerm.2020.03776DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7943352PMC
March 2021

The efficacy of onion extract in the management of subsequent abdominal hypertrophic scar formation.

J Wound Care 2020 Oct;29(10):612-616

Süleymaniye Maternity Research and Training Hospital, Obstetrics and Gynecology Clinic, Zeytinburnu, Istanbul, Turkey.

Objective: Development of postoperative scars is often a problem. This study aimed to evaluate the efficacy of gel containing extract, allantoin and heparin (Contractubex, Merz Pharmaceuticals GmbH, Frankfurt, Germany) in reducing scarring after a caesarean section by comparing it with a control group, and also intra-individually, using the Vancouver Scar Scale (VSS).

Method: A total of 120 patients who underwent a second elective caesarean delivery and who presented with hypertrophic scar development after their first caesarean section were included in the study. A scar revision was performed for all patients during the second caesarean operation. Patients in the study group (n=60) were advised to apply the topical scar gel postoperatively for a period of 6 months. The control group (n=60) received no treatment.

Results: Significant reductions were observed in the vascularity, pigmentation and height subgroups of the VSS for those in the group who continued the treatment to 24 weeks. An intra-individual analysis showed that the gel effectively reduced scarring after the second caesarean section.

Conclusion: The prophylactic use of the gel to reduce scar development offers better results for vascularity, pigmentation and height subscales of the VSS after surgical removal of the primary caesarean scar during the second caesarean section. The results were better both intra-individually, and also in comparison with the control group and support the use of a gel containing extract, allantoin and heparin to reduce scarring after a caesarean section.
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http://dx.doi.org/10.12968/jowc.2020.29.10.612DOI Listing
October 2020

The phallus of the greatest archeological finding of the new millenia: an untold story of Gobeklitepe dated back 12 milleniums.

Int J Impot Res 2020 May 11. Epub 2020 May 11.

University of Health Sciences, Medical Faculty, Istanbul Samatya Hospital Dept. of Obstet. & Gyn, Istanbul, Turkey.

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http://dx.doi.org/10.1038/s41443-020-0300-2DOI Listing
May 2020

Does bilateral uterine artery ligation have negative effects on ovarian reserve markers and ovarian artery blood flow in women with postpartum hemorrhage?

Clin Exp Reprod Med 2019 Mar 1;46(1):30-35. Epub 2019 Mar 1.

Department of Obstetrics and Gynecology, Suleymaniye Maternity, Research and Training Hospital, University of Health Sciences, Istanbul, Turkey.

Objective: Bilateral uterine artery ligation (UAL) is a fertility-preserving procedure used in women experiencing postpartum hemorrhage (PPH). However, the long-term effects of this procedure on ovarian function remain unclear. The aim of this study was to investigate whether bilateral UAL compromised ovarian reserve and ovarian blood supply.

Methods: This prospective study included 49 women aged between 21 and 36 years who had undergone a cesarean section for obstetric indications. Of these, 25 underwent uterine bilateral UAL to control intractable atonic PPH. The control group consisted of 24 women who had not undergone bilateral UAL. Standard clinical parameters, the results of color Doppler screening, and ovarian reserve markers were assessed in all participants at 6 months after surgery. The clinical parameters included age, parity, cycle history, body mass index, and previous medication and/or surgery. Color Doppler screening findings included the pulsatility index (PI) and resistance index (RI) for both the uterine and ovarian arteries. The ovarian reserve markers included day 3 follicle-stimulating hormone (FSH) levels, antral follicle count, and anti-Müllerian hormone (AMH) levels.

Results: There were no significant differences in the ovarian reserve markers of day 3 FSH levels, antral follicle count, and AMH levels between the study and control groups (p>0.05 for all). In addition, no significant differences were observed in the PI and RI indices of the uterine and ovarian arteries (p>0.05 for all).

Conclusion: In this study, we showed that bilateral UAL had no negative effects on ovarian reserve or ovarian blood supply, so this treatment should be used as a fertility preservation technique to avoid hysterectomy in patients experiencing PPH.
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http://dx.doi.org/10.5653/cerm.2019.46.1.30DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6436468PMC
March 2019

Effect of intrauterine insemination treatment on sexual function and quality of life for infertile women.

Pak J Med Sci 2018 Jul-Aug;34(4):891-896

Prof. Dr. Fatma Ferda Verit, Suleymaniye Maternity Research and Training Hospital, Department of Obstetrics and Gynecology, Istanbul, Turkey.

Objectives: To evaluate the effect of intrauterine insemination (IUI) on sexual functioning, quality of life and psychological well-being.

Methods: One hundred and thirty four infertile women going to IUI treatment as study group and 134 women who do not report any infertility complaint attending to gynecology clinic for routine control as control group were enrolled. Demographic data of the patients were collected. Patients were asked to complete Female Sexual Functioning Index (FSFI), Beck Depression Inventory (BDI) and SF 36 form.

Results: Total FSFI score (mean±SD) for study group was 23.4±4.1 and 24.8±3.4 for control group (p<0.05). This means a lower sexual function for patients going to IUI. There were also statistically significant differences according to subscales of FSFI scores for sexual desire, arousal and satisfaction. Mean±SD scores for Beck Depression Inventory analysis was 18.6±9.8 for study group and 18.5±7.1 for control group. According to SF-36 scores, there were statistically significant differences between the groups for four subscales: Role physical,bodily pain,general health and vitality.

Conclusions: Going to an IUI treatment has negative effects on FSFI scores and some of SF 36 scores but we did not find a significant negative effect on BDI scores.
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http://dx.doi.org/10.12669/pjms.344.14789DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6115572PMC
September 2018

Do Syrian refugees have increased risk for worser pregnancy outcomes? Results of a tertiary center in İstanbul.

Turk J Obstet Gynecol 2018 Mar 29;15(1):23-27. Epub 2018 Mar 29.

Süleymaniye Maternity Research and Training Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey.

Objective: To compare obstetric and perinatal outcomes of Syrian refugee pregnants and Turkish counterparts who gave birth at a tertiary center in İstanbul.

Materials And Methods: A retrospective study including the birth records of 704 Syrian refugees and 744 Turkish pregnant women between January 2016 and May 2017 were analyzed. Demographic data, obstetric and neonatal outcomes were compared. The primary aims of this study were to evaluate the pregnancy outcomes and cesarean rates between the groups. The secondary outcomes were the use of antenatal vitamin supplementation, hemoglobin-hematocrit values, and maternal complications.

Results: Our results showed that the use of folic acid and iron supplementation rates during pregnancy were similar between the groups (folic acid supplementation 8.1% vs 6.5%, p=0.264; iron supplementation 20.7% vs 19.6%, p=0.125; respectively for Turkish women and Syrian refugees). Cesarean rates were significantly higher for Turkish patients than in Syrian refugees (42.7% vs 32.7%; p<0.05). Gestational age at delivery was significantly higher among Turkish women when compared with Syrian refugees (37.7±2.3 vs 36.4±2.3 weeks, p<0.05), but there was no significant difference regarding the birtweights' of the newborns (3134 g vs 3066 g for Turkish women and Syrian refugees, respectively, p=0.105). Although obstetric complications were seen more often in Syrian refugees, it did not reach statistical difference (9.7% vs 8.1%, respectively, p=0.285).

Conclusion: Syrian refugees use antenatal vitamin supplementations at similar rates to Turkish citizens and obstetric and perinatal outcomes are similar between the groups.
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http://dx.doi.org/10.4274/tjod.64022DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5894532PMC
March 2018

What influences women's contraceptive choice? A cross-sectional study from Turkey.

Ginekol Pol 2017 ;88(12):639-646

Objectives: In our study, we tried to investigate the determinants of women's choices about contraception with the aim of discovering whether or not there is a difference in their preferences before and after consultation with a gynaecologist.

Material And Methods: A total of 1058 women were enrolled. They were given detailed information regarding contraception and contraceptive methods. Subsequently, a survey which was made of 21 questions was administered.

Results: Contraceptive counselling significantly changed the contraceptive choice of women. However, influences from social media and friends, their partners and religious belief affected their contraceptive choices. Significant differences in contraceptive choice were observed when women were categorized according to their marital status, education level, household income, age, and number of children.

Conclusions: Although contraceptive counselling influenced Turkish women's choices, there were still other determinants like social media and input from outside sources such as clerics and husbands, which should be overcome.
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http://dx.doi.org/10.5603/GP.a2017.0115DOI Listing
July 2018

Psychologic and sexual dysfunction in primary and secondary infertile male patients.

Arch Ital Urol Androl 2017 Jun 30;89(2):120-124. Epub 2017 Jun 30.

Fatih Sultan Mehmet Research & Training Hospital, Department of Urology, Istanbul.

Objective: The aim of this study was to compare depression and sexual dysfunctions observed in primary and secondary infertile patients.

Material And Method: The study was performed in 39 primary and 31 secondary infertile male patients. Male sexual health was evaluated using the International Index of Erectile Function (IIEF) score and depression with Beck Depression Inventory (BDI).

Results: Mean age of the participants and their partners were 31.54 ± 5.37 (range, 24-48 yrs), and 28.16 ± 5.58 (range, 20- 46 yrs) years, respectively. Mean duration of their marriage ranged between 1 and 17 years (mean, 5.06 ± 4.15 yrs). A statistically significant intergroup difference was detected between groups as for BDI scores (p = 0.015; p < 0. 05). BDI scores of the primary group were significantly lower than those of the secondary group. A statistically and extremely significant difference was detected between IIEF scores of the groups (p = 0.006; p < 0.01). IIEF scores of the primary infertile group were higher than those of the secondary group.

Conclusion: Our study, frequency of the depression and erectile dysfunction seen in the patients with secondary infertility was seen significantly higher than the patients with primary infertility.
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http://dx.doi.org/10.4081/aiua.2017.2.120DOI Listing
June 2017

Effect of Betamethasone on Fetal Pulmonary and Umbilical Artery Doppler Velocimetry and Relationship With Respiratory Distress Syndrome Development.

J Ultrasound Med 2017 Dec 19;36(12):2441-2445. Epub 2017 Jun 19.

Gynecology and Obstetrics Clinic, Süleymaniye Maternity Research and Education Hospital, Istanbul, Turkey.

Objectives: Respiratory distress syndrome (RDS) is a major cause of neonatal morbidity and mortality. It is primarily a disease of premature neonates. The aim of this study was to evaluate the impact of maternal betamethasone administration on the fetal pulmonary arteries (PAs) and umbilical arteries (UAs) and the correlation between RDS development and PA Doppler results.

Methods: Forty singleton pregnancies between 24 and 34 gestational weeks with a diagnosis of preterm birth were included prospectively. They received corticosteroids to enhance fetal lung maturity. Fetal PA and UA Doppler parameters were evaluated before and 48 to 72 hours after steroid administration. Maternal records were matched to neonatal charts, and demographic and outcome data were abstracted.

Results: There were no differences between groups for maternal age, body mass index, mode of delivery, and mean GA at steroid administration. Apgar scores at 1 and 5 minutes were significantly lower for neonates who developed RDS (P < .05). There were no statistically significant differences in PA Doppler results between fetuses who developed RDS and those who did not, and there were no significant differences in PA Doppler results before and after steroid administration for both groups. The UA pulsatility and resistive indices were significantly lower after steroid administration for the neonates who developed RDS (P < .05).

Conclusions: There were no significant differences in PA Doppler indices for fetuses with or without RDS after steroid administration.
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http://dx.doi.org/10.1002/jum.14280DOI Listing
December 2017

Cardiovascular risk may be increased in women with unexplained infertility.

Clin Exp Reprod Med 2017 Mar 31;44(1):28-32. Epub 2017 Mar 31.

Department of Obstetrics and Gynecology, Suleymaniye Maternity, Research, and Training Hospital, Istanbul, Turkey.

Objective: Growing evidence suggests that increased cardiovascular disease (CVD) risk is associated with female infertility caused by conditions such as polycystic ovarian disease, obesity, thyroid dysfunction, and endometriosis. The aim of this study was to evaluate whether any relationship exists between CVD and unexplained infertility.

Methods: Sixty-five women with unexplained infertility and 65 fertile controls were enrolled in the study. CVD risk markers such as low-density lipoprotein (LDL), high-density lipoprotein (HDL), total cholesterol (TC), triglycerides (TG), insulin resistance (defined by the homeostasis model assessment ratio), and high-sensitivity C-reactive protein (hs-CRP) were assessed.

Results: TG, TC, LDL, and hs-CRP levels were higher and HDL levels were lower in patients with unexplained infertility than in fertile controls (<0.05 for all). Positive associations were found between unexplained infertility and TG, TC, LDL, and hs-CRP levels, and a negative correlation was found for HDL (<0.05 for all). Multivariate logistic regression analysis showed that TG, HDL, and hs-CRP were independent variables associated with unexplained infertility.

Conclusion: Our study showed that women with unexplained infertility had an atherogenic lipid profile and elevated hs-CRP levels, suggesting a higher risk of developing CVD in the future. Further studies with larger groups are needed to investigate the nature of this link.
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http://dx.doi.org/10.5653/cerm.2017.44.1.28DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5395549PMC
March 2017

The impact of mode of delivery on the sexual function of primiparous women: a prospective study.

Arch Gynecol Obstet 2017 Apr 6;295(4):907-916. Epub 2017 Feb 6.

Department of Obstetrics and Gynecology, Suleymaniye Women's Health Training and Research Hospital, Istanbul, Turkey.

Aim: The purpose of this study was to evaluate the impact of mode of delivery on the sexual function of women using the Female Sexual Function Index (FSFI).

Methods: This was a prospective study of 452 nulliparous women, comparing their sexual function before and after birth. A Turkish version of the FSFI questionnaire was administered within the first 8 weeks of pregnancy, at 3 and 6 months postpartum in a face-to-face manner and subsequently at the 12th month and 24th month over the telephone.

Results: Age, BMI, education level, house income, duration of marriage, birthweight, and feeding at each time point were similar between group 1 [vaginal birth and mediolateral episiotomy (MLE)] and group 2 [caesarean section (CS)]. In the postpartum period, there were 265 and 138 participants at 3rd month, 216 and 121 participants at 6th month, 189 and 111 participants at 12th month, and 133 and 85 participants at 24th month in group 1 and 2, respectively. The FSFI total scores decreased at 3 and 6 months postpartum in both groups (27.3 to 23.1 in group 1 and 27.5 to 25 in group 2; p < 0.05 for both). Desire, arousal, lubrication, satisfaction and pain scores were significantly decreased at 3 months postpartum in group (1) In group 1, desire, arousal and pain scores remained decreased at the 6th month compared to initial scores. Group 2 had significantly lower desire, lubrication, satisfaction and pain scores at 3 months postpartum compared to their initial scores. Decline in desire and lubrication domains persisted at the 6th month for group (2) None of the FSFI domain scores differed after 6th months when compared to pre-delivery scores in both groups. Compared with the caesarean group, the vaginal birth with MLE group had lower satisfaction and higher pain levels at 3 months postpartum (p < 0.0001, for both). None of the FSFI domains differed at the 6th, 12th or the 24th month between the groups.

Conclusion: Our study revealed that caesarean section is not superior to vaginal birth in terms of preservation of normal sexual function, regardless of short-term postpartum effects. Women should be informed that, irrespective of their type of delivery, sexual function 6 months after childbirth is similar to that in pre-pregnancy.
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http://dx.doi.org/10.1007/s00404-017-4299-7DOI Listing
April 2017

Comparison of two different antibiotic regimens for the prophylaxisis of cases with preterm premature rupture of membranes: a randomized clinical trial.

Ginekol Pol 2016 ;87(10):701-705

Department of Obstetrics and Gynecology, Cerrahpasa Medical Faculty, Istanbul University.

Objectives: The aim of the study was to assess the effect of 1 g ampicillin prophylactic dosage whether it is as effective as the dosage of 2 g to prevent maternal and neonatal morbidity in a randomized manner.

Materials And Methods: One hundred and fourty eight singleton pregnant women with preterm premature rupture of membranes between 21 and 33 weeks of gestation were followed-up during the study period in our institution. We com-pared the efficacy of two different different dosages of ampicillin. The study population was randomized into 2 groups. In the group 1, 1 g of intravenous ampicillin was given every 6 hours. In the group 2, 2 g of intravenous ampicillin was given every 6 hours.

Results: There was no significant difference between groups interms of fetal complications (RDS, icterus, mortality, sepsis, transient tachypnea of newborn and the pneumonia), rate of intensive care unit admission, fetal gender, fever, rate of clinical chorioamnionitis, high white blood cell count and the CRP, rate of cases < 30 weeks (p > 0.05). There was a significant differ-ence between the groups for the rate of previous preterm premature rupture of membranes history, steroid administration and the need for tocolysis (p < 0.05).

Conclusions: Although antibiotics seems to be innocent, several side effects have been introduced. It is reasonable to use the lowest dosages in shortest period in order to minimize these unwanted effects.
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http://dx.doi.org/10.5603/GP.2016.0071DOI Listing
July 2018

Surgery for Benign Gynecological Disorders Improve Endometrium Receptivity.

Reprod Sci 2017 02 27;24(2):174-192. Epub 2016 Sep 27.

9 Department of Obstetrics and Gynecology, Bahcesehir University School of Medicine, Kocaeli, Turkey.

Regardless of the anatomical locations, some benign gynecological disorders (BGDs) such as peritoneal endometriosis, ovarian endometrioma, adenomyosis, uterine leiomyomas, endometrial polyps, uterine septum, and hydrosalpinges may lead to implantation failure. Despite progress in medical therapies, surgery remains a mainstay of BGDs treatment. Although our knowledge of endometrial receptivity after BGDs surgery is limited, it has allowed for significant improvement in the treatment of female subfertility. Many researchers studied on pregnancy outcome following BGDs surgery, but they did not investigate the possible impact of surgery on endometrial receptivity. They, therefore, concluded that pregnancy rates improved after BGDs surgery based on clinical observations. Many of these clinicians believe that surgical resection of BGDs leads to removal of local mechanical effect over the endometrium. Moreover, they accept that BGDs surgery may inhibit the detrimental signaling and secretion of some molecules from the BGDSs into the endometrium that may lead to favorable effect on the endometrium. However, so far, data from randomized controlled trials or systematic review or meta-analyses to answer the question whether surgical treatment of BGDs can improve endometrial receptivity are lacking. The purpose of this systematic review was to evaluate the results of available publications dealing with the impact of reproductive surgery for BGDs on endometrial receptivity.
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http://dx.doi.org/10.1177/1933719116654993DOI Listing
February 2017

Is there any role of prolidase enzyme activity in the etiology of preeclampsia?

J Matern Fetal Neonatal Med 2017 May 11;30(9):1108-1113. Epub 2016 Jul 11.

c Department of Obstetrics and Gynecology , Bursa Yüksek İhtisas Training and Research Hospital , Bursa , Turkey.

Objective: To evaluate a relationship between preeclampsia and prolidase enzyme activity.

Methods: A prospective cohort study of 41 pregnant women diagnosed with preeclampsia and 31 healthy pregnant women as control group was selected at Harran University Hospital Department of Obstetrics and Gynecology. The prolidase enzyme activity was analyzed in maternal and umbilical cord plasma, amniotic fluid and placental and umbilical cord tissues by Chinard method in addition to maternal serum levels of lactate dehydrogenase (LDH), serum glutamate pyruvate transaminase (SGPT) and serum glutamate oxaloacetate transaminase (SGOT).

Results: A significant relationship was found between plasma prolidase activity (635 ± 83 U/L) (p  = 0.007), umbilical cord plasma prolidase activity (610 ± 90 U/L) (p = 0.013), amniotic fluid prolidase activity (558 ± 100 U/L) (p  = 0.001), umbilical cord tissue prolidase activity (4248 ± 1675 U/gr protein) (p  = 0.013) and placental tissue prolidase activity (2116 ± 601 U/gr protein) (p  = 0.001) in preeclamptic group when compared to healthy pregnant women.

Conclusion: There is a strong correlation between prolidase enzyme activity and preeclampsia. Prolidase enzyme activity may play a role in preeclampsia.
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http://dx.doi.org/10.1080/14767058.2016.1205023DOI Listing
May 2017

Is Maternal Blood Procalcitonin Level a Reliable Predictor for Early Onset Neonatal Sepsis in Preterm Premature Rupture of Membranes?

Gynecol Obstet Invest 2017 15;82(2):163-169. Epub 2016 Jun 15.

Department of Obstetrics and Gynecology, Yuzuncu Yil University, Faculty of Medicine, Van, Turkey.

Background: This study is aimed at comparing the early diagnostic accuracy of maternal blood white blood cell (WBC) count, C-reactive protein (CRP) and procalcitonin in predicting early onset neonatal sepsis (EONS) among early preterm premature rupture of membrane (PPROM) pregnancies.

Methods: A total of 57 consecutive pregnancies, complicated with PPROM, between 24 and 34 gestational weeks were recruited to the study at Suleymaniye Maternity Education and Research Hospital, Istanbul, Turkey between January 2012 and January 2013. All patients were hospitalized and followed up with expectant management. Maternal blood WBC count, CRP and procalcitonin levels were measured in the first 12 h of membrane rupture. EONS was diagnosed using clinical and laboratory findings, and obstetric and neonatal outcomes were noted.

Results: The cutoff value for maternal blood CRP was ≥9.49 mg/dl. This value predicted EONS with 77.8% sensitivity, 80.0% specificity, 77.8% positive predictive value (PPV) and 80.0% negative predictive value (NPV). The cutoff value for maternal blood procalcitonin was 0.071 ng/ml. This value predicted EONS with 85.2% sensitivity, 86.7% specificity, 85.2% PPV and 86.7% NPV.

Conclusion: Maternal blood procalcitonin levels were superior to maternal blood CRP and WBC count in predicting EONS. Consequently, the maternal blood procalcitonin level is a clinically useful, non-invasive and reliable biomarker in antenatal prediction of EONS.
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http://dx.doi.org/10.1159/000446949DOI Listing
July 2017

Low antimullerian hormone levels may be associated with cardiovascular risk markers in women with diminished ovarian reserve.

Gynecol Endocrinol 2016 27;32(4):302-5. Epub 2015 Nov 27.

b Department of Obstetrics & Gynecology , Diyarbakir Gazi Yasargil Training and Research Hospital , Diyarbakir , Turkey.

There is growing evidence that diminished ovarian reserve (DOR) may be associated with cardiovascular disease (CVD). The aim of the study was to investigate whether there was any relationship between antimullerian hormone (AMH) and CVD risk markers in the study. Ninety women with DOR and 90 women with normal ovarian reserve (NOR) attending the infertility unit at XXXX, were enrolled in the study. CVD risk markers such as insulin resistance [defined by the homeostasis model assessment ratio (HOMA-IR)], C-reactive protein (CRP), low density lipoprotein (LDL), high-density lipoprotein (HDL), total cholesterol (TC), and triglyceride (TG) were assessed. HOMA-IR, CRP, TG, LDL levels were higher and HDL and AMH were lower among patients with DOR compared with controls (p < 0.05, for all). There were positive associations between low AMH and HOMA-IR, CRP, TG, LDL levels and a negative correlation with HDL (p < 0.05, for all). However, multivariate logistic regression analysis showed that HOMA-IR, CRP, TG and HDL were independent variables that were associated with low AMH. There was a close relationship between low AMH and CVD risk markers in the study. Further studies with larger groups are needed to investigate the nature of this link in these patients.
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http://dx.doi.org/10.3109/09513590.2015.1116065DOI Listing
January 2017

Neither early nor late for becoming pregnant: Comparison of the perinatal outcomes of adolescent, reproductive age, and advanced maternal age pregnancies.

Turk J Obstet Gynecol 2015 Sep 15;12(3):151-157. Epub 2015 Sep 15.

Adana Numune Education and Research Hospital, Clinic of Obstetrics and Gynecology, Adana, Turkey.

Objective: To compare perinatal and short-term neonatal outcomes of adolescent, reproductive age, and advanced maternal age (AMA) pregnancies in a low-income region of İstanbul.

Materials And Methods: Three hundred six adolescents, 301 reproductive age, and 303 AMA pregnant women who delivered in Süleymaniye Education and Research Hospital between January 1 2007, and January 31 2015, were recruited to the study population. The clinical, obstetric and short-term neonatal outcomes of the women were analyzed retrospectively.

Results: Adolescent and AMA pregnancies were associated with severe adverse perinatal and short-term neonatal outcomes compared with reproductive-age women. Adolescent and AMA pregnancies had quite similar risks in obstetric outcomes. Adolescent pregnancies were related with severe adverse short-term neonatal outcomes when compared with advanced maternal age pregnancies.

Conclusion: Adolescent and AMA pregnancies should be defined as high-risk pregnancies. Our research indicated that healthcare providers such as obstetricians, midwives, and family physicians should be alert in these populations.
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http://dx.doi.org/10.4274/tjod.94758DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5558389PMC
September 2015

Knowledge levels of adolescent girls about human papilloma virus and its vaccine.

Turk Pediatri Ars 2014 Jun 1;49(2):142-7. Epub 2014 Jun 1.

Department of Gynecology and Obstetrics, Süleymaniye Maternity Training and Research Hospital, İstanbul, Turkey.

Aim: The aim of our study was to evaluate the level of knowledge of the adolescent girls who presented to our clinic about human papilloma virus (HPV) infection and HPV vaccine.

Material And Methods: Five hundred and one adolescent girls aged between 13 and 18 years who presented to the gynecology outpatient clinic between March 2012 and March 2013 were asked to answer the questions of the questionnaire about HPV and HPV vaccine. The "Participant Information Form" and "HPV Information Assessment Form" were used by examination of the related literature by the investigators. The data obtained were entered into the computer using the SPSS 16.5 program and evaluated. Descriptive statistics were shown with mean, standard deviation, number and percentage values.

Results: The mean age of 501 subjects who were included into the study was 15.92 years. 390 subjects (77.8%) who were included in the study had no information about HPV. 111 subjects (22.2%) stated that they heard of HPV before or had information about HPV. The mean age of the subjects who had information about human papilloma virus was found to be 16.52 years. The mean age of 390 subjects (77.8%) who had no information about human papilloma virus was 15.75 years. It was found that only one of the subjects (0.9%) was vaccinated with HPV vaccine. When the subjects who did not wish to be vaccinated were asked for the reason, 40.9% stated that the reason was inadequate information, 26.4% stated that the reason was high cost, 16.4% stated that the reason was the fact that they did not consider themselves at risk and 16.4% stated that the reason was the fact that they were afraid of side effects.

Conclusions: In our study, it was found that the adolescent girls who constituted our study group had insufficient information about HPV and HPV vaccine. Verbal, written and visual communication tools and internet should be used intensively and efficiently for the objective of introducing HPV vaccine and teaching the precautions related with prevention of cervix cancer in terms of public health. Primarily pediatrician and gynecologists and family physicians who give service for the adolescence age group should be supported to develop appropriate attitudes and behaviors related with HPV vaccine and infection.
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http://dx.doi.org/10.5152/tpa.2014.1545DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4462274PMC
June 2014

Association of endothelial nitric oxide synthase gene G894T polymorphism and serum nitric oxide levels in patients with preeclampsia and gestational hypertension.

J Matern Fetal Neonatal Med 2015 Nov 20;28(16):1907-11. Epub 2014 Oct 20.

a Department of Obstetrics and Gynecology , Suleymaniye Maternity Education and Research Hospital , Istanbul , Turkey .

Objective: Pregnancy-induced hypertension is one of the most important cause of maternal-fetal morbidity and mortality. Pregnancy-related hypertensive disorders are usually associated with diminished nitric oxide (NO) levels. We aimed to evaluate the role of serum NO levels and eNOS gene G894T polymorphism on hypertensive disorders of pregnancy.

Methods: Eighty patients with gestational hypertension or preeclampsia, and 80 healthy pregnants were enrolled to analyze serum NO levels and G894T polymorphism of the eNOS gene. NO level was analyzed by high-performance liquid chromatography (HPLC) method. The G894T polymorphism of the eNOS gene was determined by polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP).

Results: There was no significant difference between groups in terms of G894T/eNOS genotype and allele frequencies (p > 0.05). Serum NO levels were significantly lower in the patients group. In the control group, subjects with thymine-thymine (TT) genotype had significantly lower NO levels when compared to subjects with guanine-guanine (GG) or guanine-thymine (GT) genotype (p < 0.05).

Conclusions: We failed to demonstrate an association between eNOS gene G894T polymorphism and serum NO levels in patients with pregnancy-induced hypertensive disorders. We established a relation between pregnancy-induced hypertension and low NO levels.
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http://dx.doi.org/10.3109/14767058.2014.971748DOI Listing
November 2015

Serial ultrasonographic examination of the fetal thymus in the prediction of early neonatal sepsis in preterm premature rupture of membranes.

Gynecol Obstet Invest 2014 9;78(3):201-7. Epub 2014 Sep 9.

Maternal and Fetal Medicine, Obstetrics and Gynecology, Yuzuncu Yuzyil University, Van, Turkey.

Background/aims: To evaluate the diagnostic accuracy of fetal thymus transverse diameter (FTTD) in predicting fetal infection in preterm premature rupture of membranes (PPROM) and compare its accuracy with cord blood tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6).

Methods: Forty consecutive pregnancies complicated with PPROM between 26(1/7) and 36(6/7) gestational weeks were evaluated prospectively. Serial fetal ultrasonography follow-ups with 3-day intervals were performed beginning on the admission day. The FTTD was recorded on every ultrasonographic examination. Cord blood TNF-α and IL-6 values were measured after delivery.

Results: FTTD was decreased below 5% according to nomograms compared to the initial measurement in 45% of all PPROM cases. Decreased FTTD had a sensitivity of 100%, specificity of 73%, positive predictive value of 55%, and negative predictive value of 100% in predicting early neonatal sepsis. Cord blood TNF-α had a sensitivity of 80% and specificity of 90%, whereas IL-6 had a sensitivity of 90% and specificity of 63.3% in predicting early neonatal sepsis.

Conclusions: Assessment of the decrease in FTTD by serial ultrasonographic examinations is a promising 'prenatal' method for the early detection of early neonatal sepsis.
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http://dx.doi.org/10.1159/000364871DOI Listing
June 2015

Is there any relationship between cardiovascular risk markers and young women with diminished ovarian reserve?

Gynecol Endocrinol 2014 Oct 10;30(10):697-700. Epub 2014 Jun 10.

Department of Obstetrics & Gynecology, Infertility Research & Treatment Center, Suleymaniye Maternity, Research & Training Hospital , Istanbul , Turkey and.

Objective: It has been widely known that cardiovascular disease (CVD) risk is increased in menopause. The aim of the study was to evaluate whether this risk was elevated in young women with diminished ovarian reserve (DOR).

Methods: A hundred women with DOR and 100 women with normal ovarian reserve (NOR) attending the infertility unit at Suleymaniye Maternity, Research &Training Hospital, were enrolled in the study. CVD risk markers such as insulin resistance (defined by the homeostasis model assessment ratio [HOMA-IR]), C-reactive protein (CRP), low-density lipoprotein (LDL), high-density lipoprotein (HDL), total cholesterol (TC), and triglyceride (TG) were assessed.

Results: HOMA-IR, CRP, TG, LDL levels were higher and HDL was lower among patients with DOR compared to the controls (p < 0.05 for all). There were positive associations between DOR and HOMA-IR, CRP, TG, LDL levels and a negative correlation with HDL (p < 0.05 for all). However, multivariate logistic regression analysis showed that HOMA-IR, CRP, TG, and HDL were independent variables that were associated with DOR.

Conclusions: CVD risk markers were increased in women with DOR. Further studies with larger groups are needed to investigate the nature of the link in these patients.
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http://dx.doi.org/10.3109/09513590.2014.922948DOI Listing
October 2014

Is there any effect of insulin resistance on male reproductive system?

Arch Ital Urol Androl 2014 Mar 28;86(1):5-8. Epub 2014 Mar 28.

Fatih Sultan Mehmet Research & Training Hospital, Dept. of Urology, Istanbul.

Objectives: To investigate the possible effect of insulin resistance (IR) on male reproductive system via evaluation of semen analysis, male sex hormones and serum lipid profiles, and testicular volumes.

Methods: After the exclusions, a total of 80 male patients were enrolled in this prospective study. Body Mass Index (BMI), Testicular volume, semen samples, serum hormone/lipid profiles, high sensitive C-Reactive Protein (hsCRP) were obtained from all the subjects.

Results: The patients were divided into two groups as study and control according to the presence of IR. There were no statistical differences in terms of age, marriage period, testicular volume, serum levels of hormone and lipid profiles and BMI between the groups. There were no relationship between homeostasis model assessment of insulin resistance (HOMA-IR) and semen volume (r = -0.10, p = 0.37), total sperm count (r = -0.09, p = 0.39), motility (r = -0.15, p = 0.16) and morphology (r = -0.14, p = 0.19). However, HOMA-IR was closely associated with hsCRP levels (r = 0.94, p < 0.0001).

Conclusions: Despite of the documented strong inverse relationships between Diabetes Mellitus (DM) and male/female fertility, and also between IR and female infertility via ovarian functions as in polycystic ovary syndrome, to our knowledge, there is no report about any influence of IR on male fertility. DM and metabolic syndrome (MetS) have negative influence on fertility. Thus, IR may be accused of causing detrimental effect on male infertility due to hyperinsulinemic state and being one of the components for MetS. Interestingly, due to our preliminary results, we do not found any inverse correlation between IR and male reproductive functions.
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http://dx.doi.org/10.4081/aiua.2014.1.5DOI Listing
March 2014

Endometriosis, leiomyoma and adenomyosis: the risk of gynecologic malignancy.

Asian Pac J Cancer Prev 2013 ;14(10):5589-97

Department of Obstetrics and Gynecology, Research and Training Hospital, Infertility Research and Treatment Center, Suleymaniye Maternity, Istanbul, Turkey E-mail :

The aim of this review article was to evaluate the relationship and the possible etiological mechanisms between endometriosis, leiomyoma (LM) and adenomyosis and gynecological cancers, such as ovarian and endometrial cancer and leiomyosarcoma (LMS). MEDLINE was searched for all articles written in the English literature from July 1966 to May 2013. Reports were collected systematically and all the references were also reviewed. Malignant transformation of gynecologic benign diseases such as endometriosis, adenomyosis and LM to ovarian and endometrial cancer remains unclear. Hormonal factors, inflammation, familial predisposition, genetic alterations, growth factors, diet, altered immune system, environmental factors and oxidative stress may be causative factors in carcinogenesis. Early menarche, low parity, late menopause and infertility have also been implicated in the pathogenesis of these cancers. Ovarian cancers and endometriosis have been shown to have common genetic alterations such as loss of heterozygosity (LOH), PTEN, p53, ARID1A mutations. MicroRNAs have also been implicated in malignant transformation. Inflammation releases proinflammatory cytokines, and activates tumor associated macrophages (TAMS) and nuclear factor kappa b (NF-KB) signaling pathways that promote genetic mutations and carcinogenesis. MED12 mutations in LM and smooth muscle tumors of undetermined malignant potential (STUMP) may contribute to malignant transformation to LMS. A hyperestrogenic state may be shared in common with pathogenesis of adenomyosis, LM and endometrial cancer. However, the effect of these benign gynecologic diseases on endometrial cancer should be studied in detail. This review study indicates that endometriosis, LM, adenomyosis may be associated with increased risk of gynecological cancers such as endometrial and ovarian cancers. The patients who have these gynecological benign diseases should be counseled about the future risks of developing cancer. Further studies are needed to investigate the relationship between STUMPs, LMS and LM and characteristics and outcome endometrial carcinoma in adenomyotic patients.
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http://dx.doi.org/10.7314/apjcp.2013.14.10.5589DOI Listing
January 2015

Biomarkers of endometriosis.

Fertil Steril 2013 Oct 15;100(4):e19. Epub 2013 Aug 15.

Suleymaniye Maternity, Research, and Training Hospital, Department of Obstetrics and Gynecology, Infertility Research and Treatment Center, Istanbul, Turkey.

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http://dx.doi.org/10.1016/j.fertnstert.2013.07.009DOI Listing
October 2013

Klinefelter syndrome: an argument for early aggressive hormonal and fertility management.

Fertil Steril 2012 Nov 8;98(5):e25; author reply e26. Epub 2012 Sep 8.

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http://dx.doi.org/10.1016/j.fertnstert.2012.08.031DOI Listing
November 2012

The prevalence of metabolic syndrome in clomiphene citrate resistant polycystic ovary syndrome.

Gynecol Endocrinol 2012 May 12;28(5):365-9. Epub 2012 Mar 12.

Department of Obstetrics and Gynecology, Harran University Faculty of Medicine, Sanliurfa Turkey.

Objective: To investigate the prevalence of metabolic syndrome in clomiphene citrate (CC) resistant polycystic ovary syndrome (PCOS) patients.

Methods: 58 CC resistant PCOS patients, 52 CC responders, 53 fertile PCOS and 53 age and body mass index-matched normoandrogenic ovulatory fertile women were evaluated for metabolic syndrome.

Results: Metabolic syndrome prevalence was 41.4% in CC resistants, in 23.1% of CC responders, in 11.3% of PCOS fertiles and 0% of controls (p < 0.0001). Waist circumference (WC) > 88 cm was 44.8%, systolic blood pressure (BP) ≥ 130 mmHg and diastolic BP ≥85 mmHg were 27.6%, TG (triglyceride) ≥150 mg/dL was 36.2%, HDL(high density lipoprotein) < 50 mg/dL was 63.8%, fasting glucose levels ≥ 100 mg/dL was 20.7% in CC resistant PCOS women. There were positive associations between CC resistance and WC >88 cm, BP ≥ 130 ≥ 85 mmHg, TG ≥ 150 mg/dL, HDL < 50 mg/dL, fasting glucose ≥ 100 mg/dL, and presence of metabolic syndrome (p < 0.05, for all). Moreover, WC > 88 cm, and HDL < 50 mg/dL were independent variables that were associated by CC resistance by multivariate regression analysis.

Conclusions: CC resistant PCOS patients have high prevalence of metabolic syndrome. These women have an increased risk of future cardiovascular disease.
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http://dx.doi.org/10.3109/09513590.2011.593931DOI Listing
May 2012

How effective is in vitro fertilization, and how can it be improved?

Fertil Steril 2011 Jun 3;95(7):e27; author reply e28. Epub 2011 Apr 3.

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http://dx.doi.org/10.1016/j.fertnstert.2011.03.016DOI Listing
June 2011

Increased insulin resistance and C-reactive protein in women with complete hydatidiform mole.

Gynecol Endocrinol 2011 Oct 4;27(10):840-3. Epub 2011 Jan 4.

Department of Obstetrics and Gynecology, Harran University Faculty of Medicine, Sanliurfa, Turkey.

Objective: To evaluate (i) insulin resistance and C-reactive protein (CRP) levels in women with complete hydatidiform mole (CHM) and (ii) whether there were any correlations between these parameters and CHM.

Methods: Thirty-two women with CHM and 30 healthy pregnant women were enrolled in the study. Fasting serum glucose and insulin levels, low-density lipoprotein (LDL), high-density lipoprotein (HDL), total cholesterol (TC), and triglyceride (TG) and C-reactive protein (CRP) were measured. Insulin resistance was calculated by the homeostasis model assessment ratio (HOMA-IR).

Results: Fasting glucose, insulin, HOMA-IR, CRP, and TG levels were higher, and HDL was lower among patients with CHM compared with healthy pregnant group (p < 0.05 for all). There were positive associations between CHM status and glucose, insulin, HOMA-IR, CRP, TG levels and had a negative correlation with HDL (p < 0.05 for all). The receiver operating characteristic curve (ROC) analysis value for HOMA-IR in CHM was 0.96 (95% confidence interval (CI) = 0.92-1.00), sensitivity = 94%, and specificity = 87%. The area under ROC curve value for CRP was 0.72 (95% confidence interval (CI) = 0.58-0.84), sensitivity = 82%, and specificity = 60% in CHM.

Conclusions: Insulin resistance and CRP were found to be higher among patients with CHM. These parameters were also closely associated with CHM. Further studies are needed to investigate the nature of this link in this group.
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http://dx.doi.org/10.3109/09513590.2010.538096DOI Listing
October 2011