Publications by authors named "Salim Sezer"

11 Publications

  • Page 1 of 1

Blake's pouch cyst: Prenatal diagnosis and management.

Turk J Obstet Gynecol 2021 Mar;18(1):44-49

University of Health Sciences Turkey, Kanuni Sultan Süleyman Training and Research Hospital, Clinic of Perinatology, İstanbul, Turkey.

Objective: This study aimed to present the characteristic features of 19 patients who were diagnosed as having Blake's pouch cyst (BPC) at our center.

Materials And Methods: Nineteen patients diagnosed as BPC between 2015 and 2019 were included in this retrospective study. Follow-up examinations were performed using ultrasonography (US) every three weeks up to 35 weeks of gestation. Prenatal magnetic resonance imaging (MRI) was performed at the time of diagnosis or during follow-up in 13 patients. MRI or transfontanellar US was performed to confirm the diagnosis of BPC after delivery. Karyotype results of eight patients were recorded.

Results: Isolated BPC was observed in 9 (47%) patients, and associated anomalies were detected in 10 (53%) patients, including seven (36%) with the central nervous system and four (21%) with cardiac anomalies. Two fetuses had abnormal karyotype analysis as trisomy 21 and 13. The MRI report of eight patients was "differential diagnosis required for Dandy-Walker complex" and only in five (26%) patients, it was reported to be compatible with BPC. Spontaneous resolution was seen in four patients. Postnatal MRI was performed in five patients, and transfontanellar US in two patients, and all MRI and US results were consistent with BPC. During the neonatal period, abnormal neurologic development was observed in four (21%) patients, and one (5%) died.

Conclusion: Although the prognosis of isolated BPC is very good with healthy neurologic development until advanced ages, death in the early neonatal period and abnormal neurologic development may be observed depending on the condition of the associated anomalies.
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http://dx.doi.org/10.4274/tjod.galenos.2020.21703DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7962159PMC
March 2021

Fetal cardiac tumors: prenatal diagnosis, management and prognosis in 18 cases

J Turk Ger Gynecol Assoc 2020 12;21(4):255-259

Clinic of Perinatology, University of Health Sciences Turkey, Kanuni Sultan Süleyman Training and Research Hospital, İstanbul, Turkey

Objective: To evaluate the long-term follow-up of patients with fetal cardiac tumors (FCTs), and to review the literature regarding advances in diagnosis and management of FCTs in the last decade.

Material And Methods: In this retrospective study, pregnant women referred to a single center maternal-fetal medicine unit between 2013 and 2018 for advanced ultrasonography, were reviewed. Pediatric cardiology counseling was offered to women whose fetuses had FCTs. All patients were evaluated according to revised diagnostic criteria for tuberous sclerosis complex (TSC). Medical treatment was administered to patients with FCTs ≥30 mm or if they were symptomatic. Everolimus therapy at a dose of 2x0.25 mg twice a week for three months was started in the postnatal period.

Results: Out of the 75,312 patients referred 18 (0.024%) were diagnosed with FCTs. Six were referred with fetal arrhythmias and the others were diagnosed with FCTs during routine follow-up. Ten patients (55%) with FCTs were diagnosed with TSC. All tumors were assessed to be rhabdomyoma. Mean tumor diameter in fetuses with TSC was significantly larger than those without TSC (29.8±14.1 mm versus 9.3±4.8 mm, respectively; p=0.004). All patients (n=2) who received medical therapy had a diagnosis of TSC and multiple FCTs and a reduction in tumor size occurred. Tumor size decreased in eight patients spontaneously during follow-up, but increased in one patient who had multiple locations but no TCS. No change in size was observed in the remaining seven cases. None of the fetuses died during the 1-5 year follow-up period.

Conclusion: Rhabdomyoma are usually multiple and associated with TSC. Rhabdomyomas with TSC are larger, but most regress spontaneously or respond well to medical treatment after birth, and have an excellent long-term prognosis.
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http://dx.doi.org/10.4274/jtgga.galenos.2020.2019.0180DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7726467PMC
December 2020

The assessment of cardiac function with tissue Doppler imaging in fetuses with congenital diaphragmatic hernia.

J Matern Fetal Neonatal Med 2020 Apr 6;33(7):1233-1238. Epub 2019 Oct 6.

Department of Maternal Fetal Medicine, Akdeniz University, Antalya, Turkey.

This study aimed to evaluate the cardiac function of fetuses with congenital diaphragmatic hernia by conventional echocardiography and spectral tissue Doppler imaging (s-TDI) and to evaluate the relationship between cardiac function and the severity of pulmonary hypoplasia. We also aimed to investigate the effect of diaphragmatic hernia side on fetal cardiac function. Fetal cardiac function were evaluated in 28 fetuses (20 with left-sided and 8 with right-sided) complicated with isolated congenital diaphragmatic hernia (CDH) and 56 gestational age matched control in this single center prospective study. s-TDI measurements were obtained at the right atrioventricular valve annulus. The annular peak velocities and their ratios, the time periods of cardiac cycle and myocardial performance index were calculated. In comparison to controls, significantly prolonged isovolumetric contraction time (ICT') and isovolumetric relaxation time (IRT') and, significantly shortened ejection time (ET') were observed in fetuses with CDH by s-TDI. Fetuses with CDH also had higher myocardial performance index (MPI') z-scores compared to controls. There were no significant differences in terms of s-TDI cardiac function parameters between fetuses with right- and left-sided CDH. In correlation analysis, a significant positive correlation was found between ET' value and o/e LHR. The signs of both systolic and diastolic altered function were observed in fetuses with CDH with s-TDI independent of the side of the hernia, and a significant positive correlation was observed between fetal cardiac systolic function and the severity of pulmonary hypoplasia.
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http://dx.doi.org/10.1080/14767058.2019.1674806DOI Listing
April 2020

Maternal serum galectin-1 and galectin-3 levels in pregnancies complicated with preterm prelabor rupture of membranes.

J Matern Fetal Neonatal Med 2020 Mar 7;33(5):861-868. Epub 2019 Jul 7.

Department of Maternal-Fetal Medicine, İstanbul Medipol University Hospital, İstanbul, Turkey.

To investigate maternal serum galectin-1 and galectin-3 levels in pregnancies complicated with preterm prelabor rupture of membranes (PPROM) and to compare with pregnancies delivered at term. In this cross-sectional study, 40 women with singleton pregnancies complicated with PPROM between 24 and 34 weeks of gestation were compared with gestational age-matched 40 pregnant women with no obstetrics complications, who delivered at term. The maternal serum galectin-1 and galectin-3 levels were measured. Patients complicated with PPROM had significantly higher levels of galectin-1 ( = .001) and galectin-3 ( = .003) than the control group. Maternal serum galectin-3 levels were found significantly negatively correlated with the gestational age at delivery and birth weight. Maternal serum galectin-1 and galectin-3 levels were significantly higher in pregnancies complicated with PPROM. Galectin-1 and galectin-3, with their regulatory effects in key biological processes, may be both an initiating factor in the pathophysiology of PPROM, a marker in the prediction, and a target of preventing strategies of PPROM.
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http://dx.doi.org/10.1080/14767058.2019.1637409DOI Listing
March 2020

Prenatal diagnosis of left pulmonary artery sling and review of literature.

Echocardiography 2019 May 9;36(5):1001-1004. Epub 2019 Apr 9.

Department of Maternal Fetal Medicine, Kanuni Sultan Süleyman Education and Research Hospital, İstanbul, Turkey.

Left pulmonary artery sling (LPAS) is a very rare cause of large airway compression. In LPAS, the left pulmonary artery (LPA) arises from the proximal right pulmonary artery, coursing over the right mainstem bronchus, posterior to the trachea and anterior to the esophagus prior to reaching the left hilum. The aberrant course of the LPA results in anatomical obstruction of the right mainstem bronchus, the trachea, or both. Only a few reports present the prenatal features of LPAS. In this report, we present the prenatal diagnosis of a case of LPAS in one of a set of identical twins in which the only feature was that of an abnormal course of the LPA on 3-vessel tracheal view. The cross-sectional view at the level of three vessels which includes both pulmonary artery branches is useful to detect this abnormality. Color and power Doppler may be helpful as well.
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http://dx.doi.org/10.1111/echo.14325DOI Listing
May 2019

Prenatal diagnosis of aortopulmonary window by foetal echocardiography: 'U or reversed U sign'.

J Obstet Gynaecol 2019 Jul 11;39(5):712-713. Epub 2019 Mar 11.

a Department of Maternal Fetal Medicine , Kanuni Sultan Süleyman Education and Research Hospital , İstanbul , Turkey.

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http://dx.doi.org/10.1080/01443615.2018.1534817DOI Listing
July 2019

Maternal serum TXNDC5 levels and thiol/disulfide homeostasis in preeclamptic pregnancies.

J Matern Fetal Neonatal Med 2020 Feb 20;33(4):671-676. Epub 2018 Dec 20.

Department of Clinical Biochemistry, Yıldırım Beyazıt University, Ankara, Turkey.

To investigate thiol/disulfide homeostasis (TDH) and thioredoxin domain-containing 5 (TXNDC5) level in early and late-onset preeclampsia. In this cross-sectional study, 24 pregnant women with early-onset preeclampsia and 26 pregnant women with late-onset preeclampsia were compared with 30 pregnant women with no obstetric complications. The serum TXNDC5 levels and thiol/disulfide homeostasis were measured. Serum TXNDC5 levels were significantly higher in the early-onset and late-onset preeclampsia groups compared with the control group ( < .05). Native thiol and total thiol levels were significantly lower in the early-onset and late-onset preeclampsia groups than control group. The disulfide levels were found as significantly high in early preeclamptic patients compared to control group ( < .05). The highest levels of TXNDC5 and the lowest levels of native thiol and total thiol were found in early-onset preeclampsia group. No significant difference was found between the patients with early onset and late onset preeclampsia regarding TXNDC5 levels and thiol/disulfide homeostasis ( > .05). Serum TXNDC5 levels were significantly higher in patients with early-onset and late-onset preeclampsia. The dynamic thiol/disulfide homeostasis was impaired in favor of the oxidized state in patients with preeclampsia.
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http://dx.doi.org/10.1080/14767058.2018.1557140DOI Listing
February 2020

Prenatal Diagnosis of Persistent Hyperplastic Primary Vitreous: Report of 2 Cases and Review of the Literature.

J Ultrasound Med 2016 Oct 31;35(10):2285-91. Epub 2016 Aug 31.

Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey.

Persistent hyperplastic primary vitreous is a spectrum of congenital ocular abnormalities characterized by leukocoria, microphthalmia, cataracts, extensive intravitreal hemorrhage, persistence of the hyaloid artery, glaucoma, and retinal detachment. It might be isolated or associated with congenital syndromes such as trisomy 13, Walker-Warburg syndrome, and Norrie disease. We present 2 cases of persistent hyperplastic primary vitreous diagnosed by prenatal sonography in the early third trimester. Bilateral hyperechoic lenses and retinal nonattachment were detected in the sonographic examination of the first case, whereas irregular echogenic bands between the lenses and posterior walls of the eyes were prominent in the second case. In both of the cases, ocular findings were accompanied by intracranial findings, including severe hydrocephalus, an abnormal gyral pattern, and cerebellar hypoplasia, suggesting the diagnosis of Walker-Warburg syndrome. We also present a review of the literature regarding the prenatal diagnosis of this malformation.
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http://dx.doi.org/10.7863/ultra.15.11040DOI Listing
October 2016

How necessary is to analyze PTPN11 gene in fetuses with first trimester cystic hygroma and normal karyotype?

J Matern Fetal Neonatal Med 2017 Apr 8;30(8):938-941. Epub 2016 Jun 8.

b Department of Maternal Fetal Medicine , Kanuni Sultan Suleyman Training and Research Hospital , Istanbul , Turkey.

Cystic hygroma (CH) is a vascular-lymphatic malformation and can occur either as an isolated finding or as a part of a syndrome. The incidence of CH is about 1:1000-1:6000 births. Ultrasonographic diagnosis of CH is usually obtained in the first trimester, and the lesion can appear in septated or non-septated forms. Increased nuchal translucency and CH have been associated with a wide range of structural and genetic abnormalities. Most of CHs are associated with a number of chromosomal abnormalities especially Trisomy 21, 13, 18 and Turner syndrome. Besides, the associations between CH and non-chromosomal syndromes were also reported and Noonan Syndrome (NS) is one of the leading causes. Approximately 50% of NS cases are caused by mutations in the PTPN11 gene. A novel PTPN11 mutation defined in two separate fetuses with CH and associated with NS phenotype is being reported here.
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http://dx.doi.org/10.1080/14767058.2016.1191463DOI Listing
April 2017

Sonographic features and management options of uterine arteriovenous malformation. A case report.

Med Ultrason 2015 Dec;17(4):561-3

Department of Obstetrics and Gynecology, Kanuni Sultan Suleyman Education and Research Hospital, Istanbul, Turkey.

Uterine arteriovenous malformation (AVM), an extremely rare condition, is defined as an abnormal connection between artery and vein. Although the pelvis is a common site for AVM, the uterus is involved occasionally and the true incidence is unknown. The objective of this study was to discuss diagnostic features and management options of AVMs. In this paper six cases of AVMs have been reported with a review of diagnosis and management options.
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http://dx.doi.org/10.11152/mu.2013.2066.174.sghDOI Listing
December 2015

Prenatal diagnosis of congenital high airway obstruction syndrome (CHAOS). Five case report.

Med Ultrason 2015 Mar;17(1):115-8

Department of Maternal Fetal Medicine, Kanuni Sultan Suleyman Education and Research Hospital, Istanbul, Turkey.

Congenital high airway obstruction syndrome (CHAOS) is an extremely rare life-threatening condition. Laryngeal atresia appears to be the most frequent cause. Generally the diagnosis is made with severely enlarged and highly echogenic lungs and additional ultrasound findings. The prognosis of the affected infants is often poor. Five cases are reported here that were diagnosed in a tertiary center between 2008 and 2014.
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http://dx.doi.org/10.11152/mu.2013.2066.171.haekDOI Listing
March 2015