Publications by authors named "Mehmet Obut"

18 Publications

  • Page 1 of 1

A prospective cohort study of shock index as a reliable marker to predict the patient's need for blood transfusion due to postpartum hemorrhage.

Pak J Med Sci 2021 May-Jun;37(3):863-868

Ihsan Bagli, Department of Obstetrics and Gynecology, Health Sciences University, Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey.

Objective: This study was aimed to compare the shock index (SI) values between patients who required blood transfusion due to postpartum hemorrhage (PPH) and patients who received no blood transfusion.

Methods: We conducted this cross-sectional study at a tertiary center between January 2019 and June 2019. A total of 2534 patients who underwent vaginal delivery were included in this study. We measured SI values upon admission, 30 minutes, 1-hour, and 2-hours after delivery. We identified women who required blood transfusion as the study group. Control patients who delivered in the same period and received no blood transfusion were identified in the medical record system and randomly selected. Age, parity, BMI, and SI values at each one prepartum and three postpartum periods of the groups were analyzed.

Results: A total of 2534 patients were included in the study. A varying amount of blood transfusion was performed in 54 patients (2.13%). When we compared with patients who did not receive blood transfusion after delivery, patients who received any amount of blood transfusion after vaginal delivery had significantly higher SI values 30 minutes after delivery (0.99±0.20, and 085±0.11, p=0.0001), at 1-hour (1.00±0.18, and 0.85±0.11, p=0.0001), and 2-hours (1.09±0.16, and 0.87±0.11, p=0.0001).

Conclusion: SI value could be a reliable and consistent marker to predict the requirement for any amount of blood transfusion due to PPH.
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http://dx.doi.org/10.12669/pjms.37.3.3444DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8155416PMC
June 2021

Comparison of the Quality of Life and Female Sexual Function Following Laparoscopic Pectopexy and Laparoscopic Sacrohysteropexy in Apical Prolapse Patients.

Gynecol Minim Invasive Ther 2021 Apr-Jun;10(2):96-103. Epub 2021 Apr 14.

Department of Obstetrics and Gynecology, Health Sciences University, Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Turkey.

Objectives: We sought to compare the surgical outcomes, safety, effectiveness, and mid-term outcomes in patients who had undergone laparoscopic hysterosacropexy and laparoscopic pectopexy due to apical prolapse.

Materials And Methods: This prospective randomized study was conducted on a total of 62 women who underwent apical prolapse surgery (32 undergoing a pectopexy and 30 undergoing a sacrohysteropexy) between June 2015 and June 2017. Patients with symptomatic uterine or vaginal vault prolapse with stage 2 or worse were included in the sudy. Before and after the operation, we used the Pelvic Organ Prolapse Quantification System (POP-Q) and questionnaires, which are the Prolapse Quality of Life Questionnaire (P-QOL) and Female Sexual Function Index (FSFI), to evaluated cases. Baseline characteristics, perioperative and postoperative complications, and follow-up results at 12 months were also evaluated.

Results: All domains of POP-Q, P-QOL, and FSFI scores improved significantly after surgery both in pectopexy and sacrohysteropexy group. The postoperative complications of both procedures were similar except for constipation after surgery (3.2% in the pectopexy group and 20% in the hysterosacropexy group [ = 0.036]).

Conclusion: Both sacrohysteropexy and pectopexy are effective surgical options for apical prolapse patients. The pectopexy is an acceptable alternative to laparoscopic sacrohysteropexy because of its less complexity and not reducing pelvic space for the rectum to exist. We suggest that the laparoscopic pectopexy may be widely used in clinical routine.
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http://dx.doi.org/10.4103/GMIT.GMIT_67_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8140535PMC
April 2021

Outcomes of pregnancies diagnosed with circumvallate placenta, and use of uterine artery pulsatility index and maternal serum alpha-fetoprotein for prediction of adverse outcomes.

Eur J Obstet Gynecol Reprod Biol 2021 May 7;262:57-61. Epub 2021 May 7.

Sağlık Bilimleri Üniversitesi Etlik Zübeyde Hanım Kadın Hastalıkları Eğitim ve Araştırma Hastanesi, Ankara, Turkey.

Objectives: To evaluate the outcomes, and predictive value of uterine artery pulsatility index (UtA-PI) and second-trimester maternal serum alpha-fetoprotein (MSAFP) for adverse obstetric outcomes in cases with morphologically confirmed circumvallate placenta by comparison with normal pregnancies.

Study Design: This prospective study was conducted in a tertiary referral hospital between January 2017 and December 2019. During the study period, 77 patients with a circumvallate placenta and 77 patients without any placental or feto-maternal diseases or abnormalities were evaluated. The final diagnosis was made based on macroscopic examination of the placenta soon after birth. Demographic characteristics, MSAFP, obstetric complications, haemoglobin after delivery, gestational week of birth, fetal sex, 1- and 5-min Apgar scores, postnatal complications and type of delivery were retrieved from hospital records. Bilateral mean transabdominal UtA-PI and MSAFP were evaluated for the prediction of adverse outcomes. SPSS Version 21.0 for Windows was used for statistical analysis, and receiver operating characteristic (ROC) curves were used for the prediction model of adverse outcomes.

Results: Smoking rate, MSAFP, preterm birth and intrauterine growth restriction (IUGR) were higher in the patients with a circumvallate placenta (p = 0.005, 0.00, 0.025 and 0.027, respectively). The cut-off value of MSAFP was 1.41 (0.60-3.32) and the cut-off value of UtA-PI was 1.2 using the ROC curves, and had sensitivity of 73.7 % and specificity of 71.9 %, and sensitivity of 73.7 % and specificity of 76.3 %, respectively (p < 0.05).

Conclusions: Circumvallate placenta was associated with a higher rate of IUGR, preterm birth and bleeding at the time of delivery. In patients with a circumvallate placenta, UtA-PI and MSAFP may be valuable as predictors of IUGR.
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http://dx.doi.org/10.1016/j.ejogrb.2021.05.008DOI Listing
May 2021

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

Maternal near-miss patients and maternal mortality cases in a Turkish tertiary referral hospital.

Ginekol Pol 2021 Mar 10. Epub 2021 Mar 10.

Department of Obstetrics and Gynecology, Dicle Memorial Hospital, Diyarbakır, Turkey, Turkey.

Objectives: This study aimed to estimate the incidence of maternal near-miss (MNM) morbidity in a tertiary hospital setting in Turkey.

Material And Methods: In this retrospective study, we concluded 125 MNM patients who delivered between January 2017 and December 2017 and fulfilled the WHO management-based criteria and severe pre-eclamptic and HELLP patients which is the top three highest mortality rates due to pregnancy. Two maternal death cases were also included. The indicators to monitor the quality of obstetric care using MNM patients and maternal deaths were calculated. Demographic characteristics of the patients, the primary diagnoses causing MNM and maternal deaths, clinical and surgical interventions in MNM patients, shock index (SI) value of the patients with obstetric hemorrhage and maternal death cases were evaluated.

Results: The MNM ratio was 5.06 patients per 1000 live births. Maternal mortality (MM) ratio was 8.1 maternal deaths per 100 000 live births. SMOR was 5.14 per 1000 live births. The MI was 1.57%, and the MNM/maternal death ratio was 62.4:1. The SI of MNM patients with obstetric hemorrhage was 1.36 ± 0.43, and the SI of the patient who died due to PPH was 1.74.

Conclusion: The MNM rates and MM rates in our hospital were higher than high-income countries but were lower than in low- and middle-income countries. Hypertensive disorders and obstetric hemorrhage were the leading conditions related to MNM and MM. However, the MIs for these causes were low, reflecting the good quality of maternal care and well-resourced units. Adopting the MNM concept into the health system and use as an indicator for evaluating maternal health facilities is crucial to prevent MM.
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http://dx.doi.org/10.5603/GP.a2020.0187DOI Listing
March 2021

First-trimester aspartate aminotransferase to platelet ratio index in predicting intrahepatic cholestasis in pregnancy and its relationship with bile acids: A pilot study.

Eur J Obstet Gynecol Reprod Biol 2021 Jan 11;256:114-117. Epub 2020 Nov 11.

Etlik Zübeyde Hanım Maternity and Women's Health Teaching and Research Hospital, Ankara, Turkey.

Objective: To evaluate the predictive value of the first-trimester aspartate aminotransferase (AST)/platelet count ratio [AST to platelet ratio index (APRI) score] for intrahepatic cholestasis in pregnancy (ICP).

Methods: This study consisted of a patient group diagnosed with ICP (n = 37) and a control group (n = 66) who presented to the hospital perinatology clinic between 2018 and 2020. Laboratory tests of both groups were analysed retrospectively. Age, gravida, parity, body mass index, third-trimester laboratory tests and first-trimester APRI scores were compared between the two groups. A receiver operating characteristic (ROC) analysis of the study was performed to determine the cut-off value for APRI score that is predictive of ICP.

Results: Patients with ICP had significantly higher first-trimester APRI scores compared with controls (p < 0.001). In the ROC analysis, the cut-off value for APRI score was 0.57, with 86.5 % sensitivity and 77.3 % specificity. Spearman's correlation indicated that there was a significant positive association between first-trimester APRI score and third-trimester fasting bile acid level (r = 0.641, p < 0.001). The demographic characteristics of patients in the third trimester did not differ, except for AST and alanine transferase values.

Conclusions: The APRI score calculated in the first trimester of pregnancy seems to be predictive of the development of ICP in the third trimester.
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http://dx.doi.org/10.1016/j.ejogrb.2020.11.014DOI Listing
January 2021

Can placental elasticity predict the time of delivery in cases of threatened preterm labor?

J Obstet Gynaecol Res 2021 Feb 16;47(2):606-612. Epub 2020 Nov 16.

Department of Perinatology, Etlik Zübeyde Hanım Maternity and Women's Health Teaching and Research Hospital, Ankara, Turkey.

Aim: We aimed to evaluate placental elasticity for the short-time prediction of delivery in cases of threatened preterm labor (TPL).

Methods: We performed a prospective study with consented pregnant women diagnosed with TPL (24th to 34th gestational week). According to the birth time, the patients were grouped into two groups, whether the delivery happened in the following first week or not. We compared the placental strain ratio (PSR) values between these two groups.

Results: A total of 108 pregnant women divided into two groups according to the delivery time were enrolled in our study. The pregnant women who had a delivery in 1 week after hospitalization have increased PSR values when compared to those who have not delivered within 1 week (P < 0.001). Multivariate logistic regression analysis showed that cervical length and PSR were significantly associated with delivery in 1 week after hospitalization. When the cervical length was entered as a covariate (control) variable, PSR was significantly associated with delivery time (B = 0.504, odds ratio: 1.655, 95% confidence interval: 1.339-2.045, P < 0.001). A PSR value of 4.04 had a sensitivity of 77.78% and a specificity of 87.04% in terms of short-time prediction of the delivery time, in the receiver-operator curves analysis to determine the cut-off point PSR value.

Conclusion: Elastography may contribute to predict the delivery time in high-risk pregnants with TPL.
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http://dx.doi.org/10.1111/jog.14570DOI Listing
February 2021

The effect of vaginal disinfection on reducing post-caesarean endometritis: A prospective, randomised controlled trial.

J Gynecol Obstet Hum Reprod 2021 Mar 10;50(3):101981. Epub 2020 Nov 10.

University of Health Sciences Diyarbakir Gazi Yasargil Research and Training Hospital, Department of Obstetrics and Gynecology, Diyarbakır, Turkey.

Purpose: We aimed to evaluate the efficacy of vaginal disinfection using 10 % povidone-iodine on rates of endometritis from post-caesarean infectious diseases before elective caesarean section (CS).

Methods: A total of 270 pregnant women who chose to undergo elective CS were recruited for this prospective randomised controlled study. The experimental group comprised 130 patients who had preoperatively undergone vaginal disinfection with 10 % povidone-iodine for 30 s. The control group consisted of 140 patients who had not undergone any vaginal implication before CS. The primary outcome measure was the rate of postpartum endometritis for each group. Intraoperatively, all patients who had closed uterine cervical canals underwent a digital opening of the internal and external cervical canal to equalise the groups. All of the participants were checked for endometritis one week after CS at the hospital. Additionally, for the week before and after surgery, C-reactive protein (CRP) and white blood cell (WBC) values were assessed for both groups. Ethics committee approval number: 339. Statistical analysis was performed using R version 3.5.1 (R statistical Software, Institute for Statistics and Mathematics, Vienna, Austria).

Results: The groups were balanced in terms of the patients' demographic characteristics. There were no significant differences between the two groups according to endometritis rates: 4.6 % in the study group versus 6.4 % in the control group (p > 0.05). The CRP and WBC values before CS were similar in both groups. In the study group, the CRPand WBC values after CS were lower, whereas they were higher in the control group after CS; these differences were significant (p = 0.01 for CRP and p = 0.001 for WBC).

Conclusion: Vaginal disinfection with povidone-iodine solution 10 % before elective CS does not significantly reduce post-caesarean endometritis rates; however, it does significantly reduce inflammatory markers such as CRP and WBC.
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http://dx.doi.org/10.1016/j.jogoh.2020.101981DOI Listing
March 2021

Explanatory variables and nomogram of a clinical prediction model to estimate the risk of caesarean section after term induction.

J Obstet Gynaecol 2021 Apr 15;41(3):367-373. Epub 2020 Oct 15.

Department of Neonatology, Health Sciences University Gaziyaşargil Education and Research Hospital, Diyarbakır, Turkey.

The aims of this study were to identify the explanatory variables associated with failure of induction of labour (IOL) and to designate nomograms that predict probability. This retrospective study included 1328 singleton term pregnant women (37-42 weeks). The penalised maximum likelihood estimation (PMLE) method was used instead of traditional logistic regression. Of the 25,678 deliveries that occurred during the study period, 1328 (5.1%) women underwent term delivery. Of those, 1125 (84.7%) had successful vaginal deliveries and 203 (15.3%) had failed vaginal deliveries following use of a dinoprostone slow-release vaginal insert. Explanatory variables were discovered that were associated with delivery failure in term pregnancy undergoing induction of labour with an unfavourable cervix, and a nomogram that predicted probability was developed.IMPACT STATEMENT The caesarean rate has continued to climb worldwide over the past decade. Most caesarean sections are performed because of suspected foetal distress or failure to progress. In absolute numbers, most caesarean deliveries are performed in women with a term pregnancy with a foetus in cephalic presentation. Despite these numbers, predicting the mode of delivery by which these women will deliver remains a challenge. Five explanatory variables were strongly associated with failure of dinoprostone delivery of term pregnancies: nulliparity, induction time, premature rupture of membranes, Bishop score and foetal gender The developed nomograms enable fast and easy implementation in clinical practice. After external validation and proof of generalisability, the present model could be used in obstetric clinical management.
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http://dx.doi.org/10.1080/01443615.2020.1798902DOI Listing
April 2021

Expression of CD44 and IL-10 in normotensive and preeclamptic placental tissue.

Ginekol Pol 2020;91(6):334-341

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

Objectives: We aimed to demonstrate cell-cell adhesion and apoptotic changes in preeclamptic placentas by examining the expression of CD44 and IL-10.

Material And Methods: Placenta samples of 15 preeclamptic and 15 healthy 35-38th week-pregnant women were involved in the study. Tissue samples were taken only from the maternal side of the placenta and fixed in 10% formaldehyde, then blocked in paraffin wax and 5 μm-thick sections were cut and stained with Masson Trichrome. Antigen retrieval was performed for sections, incubated with CD44 antibody and anti-IL-10 antibody. After the application of streptavidin peroxidase followed by AEC chromogen solution, sections were counterstained with Mayer hematoxylin.

Results: In the preeclampsia group, increased CD44 positive expression was observed in maternal decidua cells and fibroblast cells close to root villi. CD44 was positively expressed in muscle cells around the blood vessels, mucosal connective tissue areas, syncytial nodes, and syncytial bridges. In the preeclampsia group, significant increased IL-10 expression was seen in subendothelial layers of the medium-sized vessels in the maternal region. IL-10 was also positively expressed in decidua cells outside the vessels, and inflamed connective tissue areas, chorionic villus cells with intense inflammation in intervillous spaces.

Conclusions: CD44 was found to be an essential molecule in the regulation of vascular permeability, inflammatory response, activation of the cells, cell-to-cell interaction, and the signaling pathways to which they are associated. Since IL-10 regulates appropriate pregnancy outcomes and contributes to the balance of anti-inflammatory signals via both paracrine and autocrine regulators of trophoblast activity, we proposed that it might be a key to elucidate the etiology of preeclampsia with CD44 receptor.
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http://dx.doi.org/10.5603/GP.2020.0058DOI Listing
January 2020

Predictor variables in the success of slow-release dinoprostone used for cervical ripening in intrauterine growth restriction pregnancies.

J Gynecol Obstet Hum Reprod 2020 Jun 3;49(6):101739. Epub 2020 Apr 3.

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

Objective: This study aims to evaluate the consequences of a trigger by vaginal Dinoprotone on outcome of pregnancies with Intrauterine growth restriction (IUGR).

Materials And Methods: This retrospective study included 161 induced IUGR fetuses (35-39 weeks). Consecutive patients who were evaluated formed the basis of the clinical outcomes. The penalized maximum likelihood estimation (PMLE) method was used instead of traditional logistic regression in order to reduce the risk of overfitting.

Results: Of the 25,678 deliveries that occurred during the study period, 161 (0.6%) women underwent IUGR delivery; of these, 117 (73%) succeeded and 44 (27%) failed to achieve cervical ripening using the dinoprostone slow-release vaginal insert. Two predictors were associated with dinoprostone vaginal delivery success: Parity (OR:1.4([0.89-2.3]), and Bishop score (OR:1.54[1.23-1.94]). The PMLE model correctly classified 78% participants (c-index: 0.78).

Conclusion: Basic parameters such as parity and Bishop score can be used to predict successful vaginal birth following dinoprostone slow-release vaginal insert administration.
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http://dx.doi.org/10.1016/j.jogoh.2020.101739DOI Listing
June 2020

The potential of serum fetal DNA for early diagnosis of gestational trophoblastic disease.

Turk J Obstet Gynecol 2019 Dec 28;16(4):249-254. Epub 2020 Feb 28.

Private Practise, Clinic of Obstetrics and Gynecology, Gaziantep, Turkey.

Objective: To study cell-free DNA (cfDNA) levels in patients with gestational trophoblastic disease (GTD) in order to test the hypothesis that cfDNA circulating in maternal plasma could provide early detection of GTD.

Materials And Methods: This study included 32 patients with GTD (complete mole and partial mole) and 30 non-GTD patients in the first trimester of pregnancy with no other medical problems. cfDNA levels in maternal serum were measured using polymerase chain reaction analysis on Y-chromosome-specific sequences.

Results: cfDNA was found as 327±367 pg on average in the control group and 600±535 pg in the GTD group. Within the GTD group, the partial mole group had an cfDNA average of 636±549 pg, and the complete mole group had an cfDNA average of 563±536 pg. Although there was a statistically significant difference between the GTD group and the control group in terms of cfDNA (p=0.02), there was no statistically significant difference between the complete mole group and the partial mole group (p=0.76).

Conclusion: Non-parametric analysis of covariance in terms of cfDNA in GTD was performed, thereby increasing its power and revealing a significant difference compared with the control group. This indicates that maternal peripheral bloodstream cfDNA monitoring might be significant in the early diagnosis of GTD.
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http://dx.doi.org/10.4274/tjod.galenos.2019.54815DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7090260PMC
December 2019

The effect of transobturator tape operation on sexual functions of a patient with stress urinary incontinence and patient's spouse.

Low Urin Tract Symptoms 2020 Sep 12;12(3):218-222. Epub 2020 Mar 12.

Department of Obstetrics and Gynecology, Etlik Zübeyde Hanım Training and Research Hospital, Ankara, Turkey.

Purpose: This prospective study aimed to investigate the effects of transobturator tape (TOT) procedure on patients with stress urinary incontinence (SUI) and their spouses' sexual function.

Material And Methods: A total of 157 patients with SUI who underwent TOT operation between January 2017 and May 2019 and their spouses were included. All patients enrolled filled out the Incontinence Impact Questionnaire (IIQ-7), the Urogenital Distress Inventory (UDI-6), the Female Sexual Function Index (FSFI), and patients' spouses filled out International Index of Erectile Function (IIEF-5) before surgery and 6 months after the surgery.

Results: The mean value of IIQ-7 and UDI-6 questionnaires in the sixth month after the TOT surgery was lower than the mean scores of these questionnaires before surgery (P < .001). The mean value of the FSFI score was 21.84 ± 1.76 before the surgery and 25.43 ± 1.84 in the sixth month after the surgery (P < .001). There was a significant improvement in desire, arousal, lubrication, orgasm, satisfaction, and pain scores on the FSFI domains (P < .001, <.001, <.001, <.001, <.001 and <.05, respectively). The mean value of the IIEF-5 score of patients' spouses was 48.31 ± 5.23 before surgery and 57.87 ± 7.22 in the sixth month after the surgery (P < .001). Significant improvement was observed in IIEF-5 score regarding sexual desire, intercourse satisfaction, and overall satisfaction domains (P = .012, .002, and .006, respectively).

Conclusion: TOT surgery significantly improves the sexual functions of both patients and their spouses.
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http://dx.doi.org/10.1111/luts.12307DOI Listing
September 2020

A New Technique of Oophoropexy: Folding and Fixating of Utero-Ovarian Ligament to Round Ligament in a Patient with Reccurrent Ovarian Torsion.

Case Rep Obstet Gynecol 2019 21;2019:7647091. Epub 2019 Nov 21.

Department of Obstetrics and Gynecology, Dicle Memorial Hospital, Diyarbakır, Turkey.

Introduction: Most cases of ovarian torsion occur in the reproductive age and many are related to ovarian and paraovarian masses. If it occurs without any subtle anatomic etiology or ovarian and paraovarian masses, recurrence of ovarian torsion is more likely. Recurrent left ovarian torsion is much less common than recurrent right ovarian torsion. The authors describe a rare case with their new ovarian fixation technique.

Case And Method: A 21-year-old female patient with polycystic ovarian syndrome had a 7th recurrence of left ovarian torsion. Although ovarian fixation was performed in addition to detorsion at the 5th and the 6th laparoscopic surgeries, it had failed. Due to recurrence ovarian torsion after ovarian fixation, the authors performed a different technique:folding the utero-ovarian ligament which folded on itself. The distal part of the utero-ovarian ligament with the ovary was both fixed to the proximal part of the round ligament which was adjacent to the uterus.

Conclusion: Although a wide range of oophoropexy methods have been described in the literature, the best method remains a matter for debate. This technique can be performed even when the ovarian tissue is necrotic. Because of this, we think that this technique is useful and effective technique.
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http://dx.doi.org/10.1155/2019/7647091DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6906817PMC
November 2019

Can clomiphene citrate resistance be predicted by RDW-CV levels in infertile women with PCOS?

Niger J Clin Pract 2019 Nov;22(11):1463-1466

Department of Obstetrics and Gynecology, Dicle University, Faculty of Medicine, Diyarbakir, Turkey.

Objective: To identify whether red blood cell distribution width coefficient of variation (RDW-CV) and mean platelet volume (MPV) levels can predict clomiphene citrate resistance (CC-R) in infertile, anovulatory females with polycystic ovarian syndrome (PCOS).

Methods: A total of 89 infertile patients who were admitted to a tertiary center diagnosed with non-obese PCOS were included in this study. The patients were divided into two groups: the first group comprised 53 non-obese patients with PCOS and CC-R, and the second group included 36 non-obese patients with PCOS and CC-S. RDW-CV, RDW-SD, and MPV values, along with routine whole blood count parameters were compared between the groups.

Results: RDW-CV values were found to be significantly higher in the patients with CC-R compared to those with CC-S (P < 0.05). The sensitivity, specificity, positive, and negative predictive values were found to be 69%, 58.1%, 34.5%, and 12.5%, respectively, at an RDW-CV level of 12.85. The odds ratio was calculated as 3.077 (95% CI 1.245-7.603) in terms of the cut-off point.

Conclusion: We think that RDW-CV which is a marker of inflammation is a simple, cheap, and accessible marker for the prediction of CC resistance.
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http://dx.doi.org/10.4103/njcp.njcp_666_18DOI Listing
November 2019

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

Retrospective analysis of placenta accreta: management strategies--evaluation of 41 cases.

Ginekol Pol 2012 Jul;83(7):501-4

Dicle University, School of Medicine, Department of Obstetrics and Gynecology, Diyarbakir, Turkey.

Objective: The aim of the study was to evaluate maternal characteristics, surgical treatment options, and morbidity of patients with placenta accreta.

Methods: We retrospectively reviewed the medical records of placenta accreta patients who were diagnosed and hospitalized between 2006 and 2010 at the Obstetrics and Gynecology Clinics of the Dicle University Hospital (Center A) and Maternity Hospital (Center B) in Diyarbakir Turkey The data were retrieved from medical charts of both hospitals. Maternal demographic features, clinical outcomes, type of surgical intervention, and complications were evaluated.

Results: The incidence of placenta accreta was 1/426 deliveries in Center A and 1/7573 deliveries in Center B over a 5-year period. Thirty-nine (95.1%) patients had placenta previa, and 32 (78.0%) patients had at least one previous cesarean delivery Hysterectomy was performed in 28 (68.3%) of 41 women with placenta accreta and uterine preservation was achieved in 13 (31.7%) of them. One (2.4%) maternal death occurred. Estimated blood loss was >2 liters and all patients required blood products transfusion.

Conclusion: Placenta accreta is highly associated with the existence of placenta previa, especially in cases with previous cesarean delivery When placenta accreta is diagnosed or suspected, the patient should be referred to a tertiary center for optimum care, where the obstetrical team should include experienced pelvic surgeons who are capable of performing emergent hysterectomy internal iliac artery ligation, and uterine devascularization procedures.
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July 2012