Publications by authors named "Fatma Ferda Verit Atmaca"

5 Publications

  • Page 1 of 1

Preliminary evaluation of foetal liver volume by three-dimensional ultrasound in women with gestational diabetes mellitus.

J Obstet Gynaecol 2018 Oct 19;38(7):922-926. Epub 2018 Mar 19.

a Department of Obstetrics and Gynecology , Health Sciences University, Süleymaniye Women and Children's Health Training and Research Hospital , İstanbul , Turkey.

The aim of the study was to assess the standard foetal biometric measurements and foetal liver volume (FLV) in pregnancies complicated by gestational diabetes mellitus (GDM) at the time of GDM screening and to compare the results with foetuses in normal pregnancies. Ninety-seven pregnant women with normal singleton uncomplicated pregnancies between 24 and 28 weeks of gestation were allocated into GDM (+) (n: 33) and GDM (-) (n: 64) groups based on their 75 g oral glucose tolerance test results. Foetal biometric measurements and FLV measurements of the groups were compared. Although there were no significant differences in the standard biometric measurements between the two groups, FLV was significantly higher in the women with GDM (p < .01). The ROC analysis implied that with a cut-off value of FLV of 32.72 cm for GDM prediction, the sensitivity was 78.8% and specificity was 56.3%. We suggest that FLV measurements during the second-trimester ultrasound scanning may be a tool for the prediction of GDM in the obstetric population. Impact statement What is already known on this subject? GDM is an important pregnancy disease, because of its possible foetal and maternal complications. Besides the standard biometric measurements, some other foetal body dimensions such as the anterior abdominal wall thickness, skinfold thickness, adipose tissue thickness, Wharton's jelly thickness, foetal liver length and foetal liver volume (FLV) have been evaluated as ultrasound parameters of glycaemic control. While the evaluation of foetal liver dimensions has a role in identifying foetal growth acceleration, previous studies addressed patients with insulin-dependent diabetes mellitus rather than gestational diabetes mellitus, utilised two-dimensional ultrasound and did not argue the diagnostic value of these findings. What do the results of this study add? In our study, besides the standard biometric measurements, the FLV measurements were evaluated by a three-dimensional ultrasound. Although there were no significant differences in the standard biometric measurements between the GDM (+) and GDM (-) groups, the FLV was significantly higher in women with GDM. The FLV was found to be a potential predictive factor for GDM. The ROC analysis implied that as a cut-off value of FLV of 32.72 cm for GDM prediction, the sensitivity was 78.8% and the specificity was 56.3%. What are the implications of these findings for clinical practise and/or further research? Screening for GDM with oral glucose tolerance test within the limited weeks of gestation may not always be feasible. On the other hand, the mid-trimester ultrasound scanning is done almost in all pregnancies. Accordingly, FLV measurement might be an alternative method for the GDM diagnosis.
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October 2018

Evaluation of Neutrophil-Lymphocyte Ratio, Platelet-Lymphocyte Ratio and Red Blood Cell Distribution Width-Platelet Ratio for Diagnosis of Premature Ovarian Insufficiency.

J Family Reprod Health 2016 Dec;10(4):211-216

Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Adnan Menderes University, Aydın, Turkey.

To evaluate whether systemic inflammatory markers (neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR) and red blood cell distribution width (RDW) to platelet ratio (RPR)) can be used as reliable markers for the diagnosis of premature ovarian insufficiency (POI) and to determine if there is a relationship between these markers and follicle stimulating hormone (FSH), Anti-Müllerian Hormone (AMH) levels. Written and electronic medical records were reviewed using searches for diagnoses with the terms of 'premature ovarian failure', 'premature ovarian insufficiency'. Patients younger than the age of 40 were diagnosed to have premature ovarian insufficiency based on their menstrual history and sonographic examination and they were compared with healthy females. Complete blood counts, day-3 hormone profiles, AMH levels of all subjects were analyzed. NLR was statistically higher in POI group compared with controls (p < 0.05). NLR had a positive correlation between FSH (r = 0.23, p = 0.045) and a negative association with AMH (r = - 0.27, p = 0.018). The area under ROC curve for NLR in POI was 0.66, with a threshold value 1.5 and sensitivity = 75.7 % and specificity = 46.0 %. NLR can be a marker for the diagnosis of POI. There is a close relationship between NLR and ovarian reserve markers such as FSH and AMH.
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December 2016

Cervical Conization and the Risk of Preterm Birth: A Population-Based Multicentric Trial of Turkish Cohort.

J Clin Diagn Res 2017 Mar 1;11(3):QC21-QC24. Epub 2017 Mar 1.

Consultant, Department of Obstetrics and Gynaecology, Haseki Research and Education Hospital, Istanbul, Turkey.

Introduction: Cold Knife Conization (CKC) is one of the most effective methods for the treatment of Cervical Intraepithelial Neoplasia (CIN). Some studies showed a relation between preterm birth and the treatment of CIN; on the other hand, other studies do not show such a relationship.

Aim: The present study was conducted with the aim to investigate the pregnancy outcomes of Turkish women regarding demographic characteristics, obstetric history, removed tissue, and residual cervical length after CKC and to determine the effect of removed cervical tissue volume and height on preterm birth.

Materials And Methods: This study was a population-based, multicenter trial that was conducted on singleton pregnancies between January 2007 and December 2013. The control group comprised of 38,892 patients who gave birth during this period. On the other hand, patients who conceived after CKC during this period were invited to the hospital and included in the case group (n=20). The course of pregnancy following CKC was studied. Preterm birth rates, risk factors for preterm birth, conisation age, cervical smear and colposcopic biopsy results and the volume and height of the removed cervical tissue of those patients were evaluated.

Results: There was no statistically significant difference in preterm birth rates between the case and the control groups. None of our cases had any identified preterm birth risk factor except for one case. The average height of removed cervical tissue was 12.6±5.4 mm and the average length of the residual cervix after birth was 28.7±4.3 mm.

Conclusion: Removal of cervical tissue of 12.6±5.4 mm in height and 2.35±2.27 cm in volume will not increase the risk of preterm birth of women who do not have any other preterm birth risk factors. If there is no other preterm birth risk factors, term birth is most probably possible after conisation.
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March 2017

Risk factors and microbiology of wound infections following cesarean delivery: Experience of a single institution.

J Infect Chemother 2016 Oct 3;22(10):667-70. Epub 2016 Aug 3.

Suleymaniye Research and Education Hospital, Microbiology, Istanbul, Turkey. Electronic address:

Aims: To determine the prevalence of wound infection following cesarean delivery, risk factors, common bacterial pathogens and their antibiotic sensitivity.

Material-method: The study population consisted of 5787 cesarean deliveries. All of the patients received 2 g doses of cephazolin perioperatively for antibiotic prophylaxis. Patients with wound infection who had two doses of 1 g cephazolin postoperatively and who were continued on oral preparations of 500 mg of cephuroxime twice daily for 5 days after hospital discharge were included in Group A. Patients with wound infection whose postoperative antibiotics and antibiotics after discharge were omitted were included in Group B. Patient related variables, gestational age, co-morbidities, cesarean section indications, neonatal intensive care requirements were assessed. Risk factors were evaluated according to the type of the procedure (elective or emergent) and administered antibiotic protocol.

Results: The incidence of wound infection following cesarean section was 0,37% in elective operations and 5,4% in emergency cases. On the other hand, wound infection rate was found to be 1,35% in antibiotic receiving group (Group A) and 1,12% in the group not receiving antibiotics (Group B).

Conclusion: Increased rate of wound infections were remarkable in emergency cases and postoperative antibiotics did not have a major impact in reducing the rate of wound infection following cesarean section.
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October 2016

What is Turkish women's opinion about vaginal delivery?

Turk J Obstet Gynecol 2015 Jun 15;12(2):75-78. Epub 2015 Jun 15.

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

Objective: To determine Turkish women's opinion about vaginal birth.

Materials And Methods: This prospective cohort study was conducted in Department of Obstetrics and Gynecology of Süleymaniye Maternity Research and Training Hospital in İstanbul, Turkey, between February 2015 and April 2015. The participants of this study were 100 primiparous pregnant women who had vaginal deliveries. The women were interviewed face-to-face after the birth. Data were collected through a socio-demographic and clinical questionnaire.

Results: Ninety percent of the women reported vaginal birth as the ideal mode of delivery route; a minority of the women (10%) had decided on cesarean birth before having a vaginal birth. Anxiety of pain was the major factor that influenced choice of delivery type before giving birth. After vaginal birth, 84% of women were satisfied with vaginal birth and reported that they would prefer vaginal birth for their next pregnancy. However, 16% reported that they would prefer cesarean birth for their next pregnancy due to pain of labor, pain of episiotomy, anxiety, and prolonged duration of labor.

Conclusion: The results suggest the majority of women prefer to give birth vaginally and reported vaginal birth as the ideal choice.
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June 2015