Publications by authors named "Mehmet Şükrü Budak"

10 Publications

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PALM-COEIN classification system of FIGO vs the classic terminology in patients with abnormal uterine bleeding.

Ginekol Pol 2021 Mar 23. Epub 2021 Mar 23.

Cukurova University, Adana, Turkey.

Objectives: To evaluate the FIGO's novel classification system versus the classic terminology in patients with abnormal uterine bleeding.

Material And Methods: A retrospective study was carried out between August 2015 and September 2019 in the Health Sciences University Gazi Yaşargil Training and Research Hospital. The pathology reports of the patients were classified according to the PALM-COEIN method and were compared with classical terminology. The operated patients with fibroids reported in the pathology results were classified as subgroups of fibroids.

Results: Evaluation was made of a total of 515 women with abnormal uterine bleeding. According to the classical terminology, 137 (26.6%) patients were defined with hypermenorrhea, 74 (14.4%) with menorrhagia, 57 (11.1%) with metrorrhagia, and 246 (47.8%) with menometrorrhagia. In the PALM-COEIN classification system, polyps were determined in 84 (16.3%) cases, adenomyosis in 228 [diffuse adenomyosis: 196 (38.1%), local adenomyosis: 32 (6.2%)], leiomyoma in 386 [submu-cous: 161 (31.1%), other types: 225 (43.9%)], and malignancy and hyperplasia in 47 (9.1%).

Conclusions: The classical terminology for abnormal uterine bleeding is insufficient in terms of etiological pathologies in non-pregnant women of reproductive age. The widespread use of this novel system for the abnormal uterine bleeding classification will provide a more useful communication between physicians and researchers.
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http://dx.doi.org/10.5603/GP.a2021.0011DOI Listing
March 2021

The effect of obesity on the onset of spontaneous labor and scheduled delivery rates in term pregnancies.

Taiwan J Obstet Gynecol 2020 Jan;59(1):34-38

Department of Obstetrics and Gynecology, Health Sciences University Diyarbakır Gazi Yaşargil Education and Research Hospital, Diyarbakır, Turkey.

Objective: To determine the effect of obesity on the onset of spontaneous labor, scheduled delivery rates and perinatal outcomes in term pregnancies.

Material And Methods: 242 obese and 244 non-obese pregnant women ≥37 gestational weeks were compared in terms of the onset of spontaneous labor, scheduled delivery rates and perinatal outcomes.

Results: Obese pregnant women had statistically significantly lower onset of spontaneous labor and higher rates of scheduled delivery. No difference was determined in respect of the type of delivery, 1st and 5th minutes APGAR scores and the need for intensive care. Higher values of birth weight, large for gestational age, macrosomia, gestational diabetes mellitus and preeclampsia were determined in obese women.

Conclusion: The onset of spontaneous labor rates in term obese pregnancies were lower and scheduled delivery rates were higher than in the non-obese pregnancies. However, more extensive studies are needed to better understand this relationship.
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http://dx.doi.org/10.1016/j.tjog.2019.10.002DOI Listing
January 2020

Maternal abdominal subcutaneous fat thickness as a simple predictor for gestational diabetes mellitus.

J Perinat Med 2019 Aug;47(6):605-610

Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy.

Background To date, only a limited number of studies have evaluated the importance of abdominal subcutaneous fat thickness (ASFT) on gestational diabetes mellitus (GDM) screening. The aim of this study was to investigate the effectiveness of ASFT measurement during routine obstetric ultrasound performed between 24 and 28 weeks of gestation in predicting cases with GDM. Methods This prospective comparative study was conducted on 50 cases with GDM and 50 cases without GDM in the GDM screening program at 24-28 gestational weeks between January 2018 and May 2018. The most accurate ASFT cut-off point values were determined for the prediction of cases with GDM by performing receiver operator characteristic (ROC) curve analysis. Results The ASFT was higher in those with GDM compared to those without GDM (P < 0.05). For an ASFT cut-off point value of 18.1 mm for the prediction of cases with GDM, the sensitivity, specificity, negative and positive predictive values were 72.0%, 60.0%, 64.2% and 68.1%, respectively. The risk of GDM increased 3.86-fold in those with ASFT level >18.1 mm (P = 0.001). Conclusion The ASFT value measured by routine obstetric ultrasound performed at 24-28 weeks of gestation was found to be significantly higher in patients with GDM in comparison to those without GDM. However, further multi-centered and comprehensive prospective studies are required to better demonstrate this relationship.
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http://dx.doi.org/10.1515/jpm-2018-0431DOI Listing
August 2019

An investigation of the effect of placental growth factor on intrapartum fetal compromise prediction in terminduced high risk pregnancies.

Ginekol Pol 2018 ;89(12):700-704

Department of Obstetrics and Gynecology, Health Sciences University Diyarbakır Gazi Yaşargil Education and Research Hospital, Diyarbakır, Turkey.

Objectives: To date, there is no available test to predict the risk of intrapartum fetal compromise (IFC) during labor, either starting spontaneously or induced due to obstetrics indications. The aim of this study was to examine the effectiveness of placental growth factor (PIGF) in identifying cases that develop intrapartum fetal compromise (IFC) in term high-risk pregnancies induced for labor.

Material And Methods: This prospective cross-sectional study was conducted on 40 IFC+ cases and 40 IFC- cases with high-risk term pregnancy and labor induction started in the Health Sciences University Gazi Yaşargil Training and Research Hospital, between January 2018 and April 2018. Comparisons were made between the groups in respect of placental growth factor (PIGF) levels, and obstetric and neonatal outcomes.

Results: The PIGF level was found to be statistically significantly lower in the IFC+ cases compared to the IFC- cases. For a PIGF cutoff value of 32 pg/mL for the prediction of IFC+ cases, sensitivity was 74.4%, specificity 73.2%, NPV 75% and PPV 72.5%, with a statistically significant difference determined between the groups. The IFC+ development risk increased 7.91-fold in patients with PIGF ≤ 32 pg/mL.

Conclusions: The PIGF levels in cases of IFC+ high risk pregnancies were found to be statistically significantly lower than those of IFC- cases. However, further, large-scale randomized controlled research is necessary to demonstrate this relationship better.
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http://dx.doi.org/10.5603/GP.a2018.0118DOI Listing
August 2019

A national measure to reduce primary cesarean rates in Turkey.

J Matern Fetal Neonatal Med 2020 May 10;33(10):1643-1646. Epub 2018 Oct 10.

Department of Obstetrics and Gynecology, Bursa Yüksek İhtisas Training and Research Hospital, Education and Research Hospital, Sağlık bilimleri University, Bursa, Turkey.

To examine the influence of the "Physician Unit Performance Coefficient" (PUPC) regulation, taken into force by the TR Ministry of Health in January 2013 in our country, based on the cesarean rates in our clinic. The pregnant women who gave birth at the Diyarbakır Maternity and Pediatrics Hospital within a period of three years before the PUPC has been taken into force and the pregnant women who have birth within a period of three years after January 2013, when the regulation has been taken into force, have been divided into two groups as Group 1 and Group 2, respectively. Comparisons have been made between the two groups with respect to primary cesarean, total cesarean, neonatal mortality, and maternal mortality rates. From the 125,816 pregnant women who gave birth between February 2010 and January 2016, 58,856 (46.7%) are included in Group 1 and the remaining 66,960 (53.3%) are in Group 2. The total Cesarean Rate is 27% in Group 2 and 24.8% in Group 1. The primary Cesarean Rate is 11.3% in Group 2 and 13.5% in Group 1. The neonatal mortality rate is 7.81‰ in Group 2 and 10‰ in Group 1. The differences in the total cesarean rates, primary cesarean rates and neonatal mortality rates have been found statistically significant. Maternal mortality rates have been found to be 5.1 in 100,000 in Group one and 4.48 in 100,000 in Group 2 and the difference between the two groups has not been found as statistically significant. A meaningful reduction has been achieved in the primary cesarean rates without increasing maternal and neonatal mortality rates after the PUPC, implemented by the TR Ministry of Health, has been taken into force.
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http://dx.doi.org/10.1080/14767058.2018.1526901DOI Listing
May 2020

Maternal hypoglycaemia on the 50 g oral glucose challenge test - evaluation of obstetric and neonatal outcomes.

Ginekol Pol 2018 ;89(7):370-374

University of Health Sciences Diyarbakır Gazi Yaşargil Training and Research Hospital Department of Obstetrics and Gynecology, TR 21500 Diyarbakır, Turkey.

Objectives: To discuss obstetric and neonatal outcomes of maternal hypoglycaemia observed after the 50 g oral glucose challenge test.

Material And Methods: A retrospective evaluation was made of the results of patients at 24-28 weeks gestation of a live singleton pregnancy who underwent a 50 g OGCT at the Health Sciences University Gazi Yaşargil Training and Research Hos-pital, between September 2016 and August 2017. In the 50 g OGCT, 1-hour blood glucose results were divided into Low OGCT (< 90 mg/dL) and Normal OGCT (90-139 mg/dL). The groups were compared in respect of obstetrics and neonatal outcomes.

Results: Of 2623 pregnant patients applied with the 50 g OGCT, blood glucose was < 140 mg/dL in 77.16% (n = 2024), with 11.9% (n = 312) in the Low OGCT group, and the remaining 65.26% (n = 1712) in the Normal OGCT group. Based on the comparison of the groups, the SGA rate was 7% in the Low OGCT group and 4% in the Normal OGCT group; the 5th minute APGAR score was < 7 in 2% of the Low OGCT group and in 1% of the Normal OGCT group, while caesarean section rates were 25% and 32% respectively (p < 0.05).

Conclusions: The results of the study showed a significant association between maternal hypoglycaemia and increased SGA rate, decreased 5-minute APGAR scores and reduced caesarean section rates, and this relationship should be confirmed with further comprehensive studies.
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http://dx.doi.org/10.5603/GP.a2018.0063DOI Listing
October 2018

Postpartum urinary retention: Evaluation of risk factors.

Turk J Obstet Gynecol 2018 Jun 21;15(2):70-74. Epub 2018 Jun 21.

University of Health Sciences, Diyarbakır Gazi Yaşargil Training and Research Hospital, Clinic of Obstetrics and Gynecology, Diyarbakır Turkey.

Objective: Postpartum urinary retention means the absence of spontaneous micturition more than 6 hours after birth or when residual volume after urination is less than 150 cc. If neglected, postpartum urinary retention may result in bladder denervation and detrusor muscle weakness requiring intermittent catheterization or permanent micturition dysfunction. Our goal was to identify the possible risk factors for postpartum urinary retention.

Materials And Methods: Five hundred sixty female subjects were included in this retrospective study. All data obtained including variables such as age, parity, body mass index, duration of labor, prepartum bladder catheterization were compared between female subjects with and without postpartum urinary retention.

Results: Among the 560 patients recruited to our study, 124 (22.1%) had postpartum urinary retention. Third stage duration, time from birth to the first void, and number of peripartum micturitions were found to be potential risk factors for postpartum urinary retention. Different than other studies, our study revealed a correlation between peripartum catheterization and postpartum urinary retention. There were no statistically significant differences between patients with and without postpartum urinary retention in terms of other variables.

Conclusion: In this study, a correlation between peripartum catheterization and postpartum urinary retention was found. There are studies that reported the possible risk factors related to the occurrence of postpartum urinary retention. More studies should be conducted to investigate long-term results with larger populations.
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http://dx.doi.org/10.4274/tjod.43931DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6022424PMC
June 2018

Serum serotonin, leptin, and adiponectin changes in women with postpartum depression: controlled study.

Arch Gynecol Obstet 2017 Apr 21;295(4):853-858. Epub 2017 Feb 21.

Department of Obstetrics and Gynecology, Zeynep Kamil Gynecologic and Pediatric Training and Research Hospital, Opr. Dr. Burhanettin Ustunel street, No: 10, 34668, Uskudar, Istanbul, Turkey.

Purpose: Postpartum depression (PPD) affects nearly 10% of mothers after delivery and has many serious results. Although many factors associated with PPD, the etiology, and pathophysiology of PPD are not known completely. The relationship between serum serotonin concentration and depression is well known, but there are no enough data regarding the serum change of leptin and adiponectin. The aims of this study are to research the level of serum serotonin, leptin,s and adiponectin concentrations in women with PPD.

Materials And Methods: A controlled trial has been conducted in three centers. Two hundred and forty four women were evaluated at postpartum day 10 with the Edinburgh Postnatal Depression Scale (EPDD). Venous blood samples were collected and serotonin, and leptin and adiponectin levels were studied using human enzyme-linked immunosorbent assay. Mann-Whitney U test was used for comparison of serum levels of serotonin, leptin, and adiponectin between women with PPD and without. A p value of <0.05 was considered significant.

Results: PPD was detected in 70 postpartum women. The mean serum serotonin level was significantly lower in the group with PPD (p = 0.001), while mean serum adiponectin level was higher (p = 0.001). The mean serum leptin level was not different (p = 0.133).

Conclusions: The serum adiponectin and leptin levels were high in women with PPD. This could play important role in the pathophysiology of PPD. Elevation of serum levels also may play antidepressant role against PPD, especially the early postpartum period.
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http://dx.doi.org/10.1007/s00404-017-4313-0DOI Listing
April 2017

A comparative study of conventional and liquid-based cervical cytology.

Ginekol Pol 2016 ;87(3):190-3

Objectives: The aim of our study is the comparison of the results of conventional smear (CC) technique and liquidbased cytology (LBC) technique used as cervical cancer screening methods.

Material And Methods: The results of 47954 patients submitted to smear screening in our gynecology clinic between January 2008 and December 2014 have been studied. The smear results have been divided into two groups CC and LBC according to the technique used.

Results: When considering the distribution within CC group, the results were as follows: intraepithelial cell abnormalities 2,0% (n=619), insufficient sample for analysis 2,1% (n=660), Atypical squamous cells of undetermined significance (ASC-US) 1.8% (n=554), Low grade squamous intraepithelial lesion (LGSIL) 0.1% (n=35), High grade squamous intraepithelial lesion (HGSIL) 0.1% (n=16), Atypical squamous cells - cannot exclude HGSIL (ASC-H) 0.029% (n=9), Atypical glandular cells- not other wise specified (AGC-NOS) 0.012% (n=4), squamous carcinoma 0.003% (n=1). When considering the distribution in LBC group, the results were as follows: intraepithelial cell abnormalities2.1% (n=357), insufficient sample for analysis 0.9% (n=144), ASC-US 1.8% (n=296), LGSIL 0.2% (n=38), HGSIL 0.1% (n=8), ASC-H 0.1% (n=10), AGC-NOS 0.017% (n=3), squamous carcinoma 0.011% (n=2).

Conclusions: Although the rates of epithelial cell abnormalities are similar for both tests, LSIL results are more frequently observed in LBC technique. In LBC technique, the number of insufficient sample for analysis is quite low compared to CC group and thus constitutes an advantage.
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http://dx.doi.org/10.17772/gp/60980DOI Listing
July 2018

Factors associated with successful vaginal birth after cesarean section and outcomes in rural area of Anatolia.

Int J Womens Health 2015 10;7:693-7. Epub 2015 Jul 10.

Department of Obstetrics and Gynecology, Diyarbakir Research Hospital, Diyarbakir, Turkey.

Successful vaginal birth after cesarean section is more comfortable than repeat emergency or elective cesarean section. Antenatal examinations are important in selection for trial of labor, while birth management can be difficult when the patients present at emergency condition. But there is an increased chance of vaginal birth with advanced cervical dilation. This study attempts to evaluate factors associated with success of vaginal birth after cesarean section and to compare the maternal and perinatal outcomes between vaginal birth after cesarean section and intrapartum cesarean section in patients who were admitted to hospital during the active or second stage of labor. A retrospective evaluation was made from the results of 127 patients. Cesarean section was performed in 57 patients; 70 attempted trial of labor. The factors associated with success of vaginal birth after cesarean section were investigated. Maternal and neonatal outcomes were compared between the groups. Vaginal birth after cesarean section was successful in 55% of cases. Advanced cervical opening, effacement, gravidity, parity, and prior vaginal delivery were factors associated with successful vaginal birth. The vaginal birth group had more complications (P<0.01), but these were minor. The rate of blood transfusion and prevalence of changes in hemoglobin level were similar in both groups (P>0.05). In this study, cervical opening, effacement, gravidity, parity, and prior vaginal delivery were important factors for successful vaginal birth after cesarean section. The patients' requests influenced outcome. Trial of labor should take into consideration the patient's preference, together with the proper setting.
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http://dx.doi.org/10.2147/IJWH.S83800DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4506034PMC
July 2015