Publications by authors named "Sema Süzen Çaypınar"

14 Publications

  • Page 1 of 1

Maternal serum IL-22 concentrations are significantly upregulated in patients with preterm premature rupture of membranes.

Ginekol Pol 2021 Apr 12. Epub 2021 Apr 12.

Department of Biochemistry, Eyüpsultan State Hospital, Istanbul, Turkey.

Objectives: This study aimed to compare the serum IL-22 levels between preterm premature rupture of membranes (PPROM) patients and the control group with intact membranes. We also hypothesized whether serum IL-22 upregulation might contribute to defense against inflammatory responses and improve the pregnancy outcomes.

Material And Methods: We performed this prospective case-control study between 24-34 weeks of pregnancy. We enrolled 40 singleton pregnant patients with PPROM and 40 healthy gestational age- and gravidity-matched patients without PPROM. The degree of association between variables and IL-22 were calculated by Spearman correlation coefficients where appropriate. Scatter plots were given for statistically significant correlations. ROC curve was constructed to illustrate the sensitivity and specificity performance characteristics of IL-22, and a cutoff value was estimated by using the index of Youden.

Results: Maternal serum IL-22 levels were significantly higher in PPROM patients (60.34 ± 139.81 pg/mL) compared to the participants in the control group (20.71 ± 4.36 pg/mL, p < 0.001). When we analyze the area under the ROC curve (AUC), the IL-22 value can be considered a statistically significant parameter for diagnosing PPROM. According to the Youden index, a 23.86 pg/mL cut-off value of IL-22 can be used to diagnosing PPROM with 72% sensitivity and 61.5% specificity. There was no positive correlation between serum IL-22 levels and maternal C-reactive protein (CRP) value, procalcitonin value, latency period, birth week, birth weight, and umbilical cord blood pH value.

Conclusions: Maternal serum IL-22 levels were significantly higher in PPROM patients than healthy pregnant women with an intact membrane. We suggest that IL-22 might be a crucial biomarker of the inflammatory process in PPROM.
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http://dx.doi.org/10.5603/GP.a2021.0036DOI Listing
April 2021

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

Prenatal Diagnosis of Double Aortic Arch: Associated Findings and Postnatal Clinical Outcomes.

J Ultrasound Med 2021 Mar 3. Epub 2021 Mar 3.

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

Objectives: The aim of this study is to share our experience in the prenatal diagnosis and characteristics of double aortic arc and neonatal consequences.

Methods: We retrospectively analyzed 2153 fetal echocardiography reports between 2014 and 2019 years. Records of 14 fetuses with double aortic arc were examined. Prenatal and postnatal medical records, sonographic images, genetic reports, associated cardiac and extracardiac anomalies, and neonatal clinical results of affected fetuses were reviewed retrospectively.

Results: DAA was isolated in 9 of 14 (64.2%) cases, while the other five cases had cardiac or extracardiac accompanying ultrasound findings. Three of cases (21.4%) were associated with other heart pathologies, including ventricular septal defect, double outlet right ventricle, and persistent left superior vena cava. In 10 cases (71.43%), the right aortic arch diameter was dominant. The left aortic arc was dominant in two cases and both arcs were symmetrical in the remaining two cases. 22q11 microdeletion was the only chromosomal abnormality and was detected in two of nine patients who accepted genetic analysis. Intrauterine fetal death occurred in two of the cases. After birth, in 58.3% (7/12) of the live born cases various degrees of symptoms. Surgical repair was performed with the division of the aorta to all symptomatic cases at different times according to severity of the complaints.

Conclusions: Since it can cause severe respiratory distress in the postnatal period and may accompany chromosomal anomalies, it is important to provide antenatal diagnosis of double aortic arc and adequate counseling to the family.
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http://dx.doi.org/10.1002/jum.15669DOI Listing
March 2021

What is the main factor in predicting the morbidity and mortality in patients with Gastroschisis: Delivery time, delivery mode, closure method, or the type of Gastroschisis (simple or complex)?

Turk J Med Sci 2021 Feb 8. Epub 2021 Feb 8.

Background/aim: There are numerous debates in the management of Gastroschisis (GS). The current study aimed to evaluate perinatal outcomes, surgical and clinical characteristics among Gastroschisis (GS) patients based on their type of GS, abdominal wall closure method, and delivery timing.

Materials And Methods: This study was a retrospective analysis of prospectively collected data of 29 fetuses with GS that were prenatally diagnosed, delivered, and managed between June 2015 and December 2019 at the Obstetrics and Pediatric Surgery Clinics of Kanuni Sultan Süleyman Training and Research Hospital.

Results: Twenty-three of the patients were simple GS, and six of them were complex GS. The reoperation requirement, number of operations, duration of mechanical ventilation, time to initiate feeding, time to full enteral feeding, total parenteral nutrition (TPN) duration, TPN-associated cholestasis, wound infection, sepsis, and necrotizing enterocolitis were significantly lower in the simple GS group than the complex GS group. The mean hospital length of stay was 3.5 times longer in the complex GS group (121.50±24.42 days) than that of the simple GS group (33.91±4.13 days, p=0.009). There were no cases of death in the simple GS group. However, two deaths occurred in the complex GS group.

Conclusion: This study indicated that simple GS, compared with complex GS, was associated with improved neonatal outcomes. We suggest that the main factor affecting the patients? outcomes is whether the patient is a simple or complex GS rather than the abdominal wall closure method.
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http://dx.doi.org/10.3906/sag-2011-166DOI Listing
February 2021

Effect of metformin and detorsion treatment on serum anti-Müllerian hormonelevels and ovarian histopathology in a rat ovarian torsion model

Turk J Med Sci 2020 04 9;50(2):455-463. Epub 2020 Apr 9.

Department of Obstetrics and Gynecology, University of Health Sciences,Bakirköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey

Background/aim: Adnexal torsion is a common gynaecological emergency, and considered to be a problem mostly in reproductive-age women. To evaluatethe effect of metformin and detorsion treatment on reducing ovarian reserve in an ovarian torsion model.

Materials And Methods: Twenty-four nonpregnant, Wistar Hannover rats were included in the study. Animals were divided into 3 groups: the control group, the detorsion only group, and the metformin + detorsion group. The first group received only laparotomy. In the second group, ovaries were fixed to the abdominal wall after performing 360° ovarian torsion, followed by detorsion after a 3-h period of ischemia. The third group underwent the same torsion and detorsion procedures as the second group, and received 50 mg/kg metformin by gavage for 14 days. Ovarian damage scores, follicle counts, and AMH levels were evaluated.

Results: The total damage score was significantly increased in the detorsion only group compared to the metformin+detorsion and control groups. Pre-operative/post-operative AMH decreases were statistically significant in negative direction in the detorsion only group when compared to the metformin+detorsion and control groups (P = 0.001).

Conclusion: Metformin+detorsion treatment may be effective in protecting the ovarian reserve after ovarian torsion.
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http://dx.doi.org/10.3906/sag-1803-196DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7164755PMC
April 2020

Perinatal outcomes of intrauterine transfusion for foetal anaemia due to red blood cell alloimmunisation.

J Obstet Gynaecol 2020 Jul 29;40(5):649-653. Epub 2019 Aug 29.

Department of Perinatology, Kanuni Sultan Suleyman Research and Training Hospital, Istanbul, Turkey.

The aim of this study was to evaluate the maternal and neonatal outcomes of patients who underwent intrauterine transfusion (IUT) for foetal anaemia due to red blood cell alloimmunisation and to determine the factors that affected the outcomes. All pregnancies that were treated with IUT due to Rh immunisation between January 2015 and June 2018 in the Kanuni Sultan Süleyman Training and Research Hospital, Department of Obstetrics and Gynaecology, were evaluated retrospectively. IUT due to non-Rh alloimmunisation, parvovirus B19 infection, chronic fetomaternal haemorrhage and foetal anaemia due to homozygous alpha-thalassemia were not included in the study. The perinatal and neonatal outcomes of the patients were retrospectively analysed. The gestational age, ultrasonography findings before and after IUT, laboratory results, complications related to IUT, and data on the newborns were recorded. The cases were divided into two groups, those with complication and those without complications, and their perinatal outcomes were compared. A total of 110 IUTs were performed in 42 foetuses. The survival rate after transfusion was 80.95%. Procedure-related complications were found in 12.7% of cases. There were no significant differences between the demographic and clinical characteristics of the patients with and without complications. The survival rate was lower and perinatal mortality was higher in foetuses with hydrops fetalis. IUT is a safe and effective procedure that can be used in the treatment of foetal anaemia in experienced centres. Survival rates can be increased by referring patients to experienced perinatology centres, by improving the IUT technique, and by reducing technique-related complications.Impact statement The predominant use of IUT is to treat foetal anaemia due to red blood cell alloimmunisation. Despite the decrease after anti-D immune globulin prophylaxis, Rh immunisation is still a major cause of foetal anaemia. However, foetal survival rates have increased with the use of IUT. The survival rates were increased after the development of a high-resolution ultrasound. Because foetal monitoring can be performed by ultrasonography, cord accidents and overload findings can be detected during transfusion, which allows for early interventions and increases survival rates.? The IUT procedure can be used in the treatment of foetal anaemia in experienced centres. After the technique was improved, the complication rates related to the procedure were decreased and foetal survival rates were increased. Further studies on the use of different IUT techniques will extend our findings.
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http://dx.doi.org/10.1080/01443615.2019.1647521DOI Listing
July 2020

The relationship between menopausal symptoms and metabolic syndrome in postmenopausal women.

J Obstet Gynaecol 2019 May 11;39(4):529-533. Epub 2019 Feb 11.

a Department of Obstetrics and Gynecology , University of Health Sciences Bakirkoy Dr. Sadi Konuk Teaching and Research Hospital , Istanbul , Turkey.

The most common symptoms during menopausal transition and menopause are vasomotor symptoms. We aimed to investigate the relationship between menopausal symptoms and metabolic syndrome (MetS) in postmenopausal women. Two hundred and fifty-four and 317 postmenopausal women were in the MetS and non-MetS groups, respectively. The total menopause rating scale and psychological subscale scores were higher in the MetS group than the non-MetS group, and the differences were significant (p < .05). A positive correlation was found between the abdominal circumferences, systolic-diastolic blood pressures, triglycerides and total MRS scores. However, a significant positive correlation was found between the abdominal circumference and total urogenital scores (p = .008). Impact statement What is already known on this subject? MetS and its dominant component (abdominal obesity) significantly increase the prevalence and severity of menopausal symptoms. Data regarding the relationship between metabolic syndrome (MetS) and vasomotor symptoms remain limited. What do the results of this study add? We showed that sleeping problems, depressive symptoms and bladder problems were more frequently encountered in the MetS group than in the non-MetS group (p<0.05). What are the implications of these findings for clinical practice and/or further research? There is a need for more randomised controlled studies to demonstrate the relationship between MetS and the severity of menopausal symptoms.
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http://dx.doi.org/10.1080/01443615.2018.1534812DOI Listing
May 2019

Comparative cosmetic outcome of surgical incisions created by the PEAK Plasma Blade and a scalpel after cesarean section by Patient and Observer Assessment Scale (POSAS): A randomized double blind study.

Taiwan J Obstet Gynecol 2018 Feb;57(1):68-70

Department of Obstetrics and Gynecology, Bakirkoy Dr. Sadi Konuk Teaching and Research Center, University of Health Sciences, Istanbul, Turkey.

Objective: To compare the cosmetic result of the PEAK Plasma Blade with traditional scalpel in patients who had primary cesarean delivery by using POSAS (Patient and Observer Assessment Scale).

Material And Methods: Fourty women between 20 and 40 years, who were planning to have primary cesarean delivery, were randomized for skin incision with PEAK Plasma Blade (n:20) and with scalpel (n:20) were blinded to their group allocation. At six months, the cosmetic outcome of the cesarean scar was assessed using the POSAS. Subjective scar rating was performed using the patient component of the POSAS. Objective scar assessment was performed by an observer dermatologist blinded to the patient's group allocation.

Results: The observer scores (p = 0,003), patient scores (p = 0,001) and the total scores (p = 0,001) of the POSAS scale were significantly lower in favor of the Peak Plasma Blade group with respect to the scalpel group.

Conclusion: The PEAK Plasma Blade has superior cosmetic outcome compared to traditional scalpel skin incision at cesarean section.
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http://dx.doi.org/10.1016/j.tjog.2017.12.011DOI Listing
February 2018

Salvage therapy in acute life-threatening vaginal bleeding of cervical cancer: Hypogastric artery embolization.

Taiwan J Obstet Gynecol 2016 Aug;55(4):607-8

Department of Gynecology and Obstetrics, Bakirkoy Dr. Sadi Konuk Teaching and Research Hospital, Istanbul, Turkey.

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http://dx.doi.org/10.1016/j.tjog.2015.01.005DOI Listing
August 2016

Differentiated therapy in pre- and postmenopausal adnexal torsion based on malignancy rates: A retrospective multicentre study over five years.

Int J Surg 2016 May 19;29:95-100. Epub 2016 Mar 19.

Department of Obstetrics and Gynecology, Hacettepe University School of Medicine, Ankara, Turkey.

Introduction: The purpose of this study was to investigate the clinical presentation, intra and postoperative outcomes in pre and postmenopausal women who underwent operations for adnexal torsion, and to define our experience diagnosing and managing postmenopausal women with adnexal torsion.

Methods: One hundred and fifty-seven patients who underwent operation with a diagnosis of adnexal torsion were analyzed according to demographic characteristics, menopausal status, preoperative signs and symptoms, surgical findings and applied surgical procedures, and pathological results in four tertiary centers.

Results: The main indication for surgery for the postmenopausal women was pelvic mass (58% vs. 40%), while for premenopausal women the main indication was suspicion of torsion (55% vs. 24%), (each p < 0.001). The duration of time between being admitted to the hospital and entering operating room as well as the duration of surgery and postoperative hospitalization were statistically longer in the postmenopausal group (each p < 0.001). While extensive surgeries were performed for 68% of the postmenopausal group, this was required for only 3% of the premenopausal group. Functional cysts were the most common pathologic finding in premenopausal women, and only 2 cases of malignancy (1.6%) were seen as opposed to the postmenopausal group, where malignancy was diagnosed in 16% of cases (p < 0.001).

Discussion: Adnexal torsion in postmenopausal women is an uncommon event. Malignancy risk should be considered before operation.

Conclusion: The malignancy rate was 16% in postmenopausal women with adnexal torsion. Thus, extensive surgeries are more common in postmenopausal women with adnexal torsion.
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http://dx.doi.org/10.1016/j.ijsu.2016.03.042DOI Listing
May 2016

Intramuscular versus intravenous prophylactic oxytocin for postpartum hemorrhage after vaginal delivery: a randomized controlled study.

Arch Gynecol Obstet 2016 11 15;294(5):911-916. Epub 2016 Mar 15.

Department of Obstetrics and Gynaecology, Bakirkoy Dr. Sadi Konuk Teaching and Research Hospital, Tevfik Saglam Street, No: 11, Zuhuratbaba, Bakirkoy, Istanbul, Turkey.

Purpose: Prevention of postpartum haemorrhage (PPH) is essential in the pursuit of improved health care for women. Oxytocin, the most commonly used uterotonic agent to prevent PPH, has no established the route of administration. In this study we aimed to compare whether the mode of oxytocin administration, i.e., intravenous and intramuscular administration, has an effect on the potential benefits and side effects.

Materials And Methods: A total of 256 women were randomised into two groups: intramuscular group (128) or intravenous group (128).

Results: Estimated blood loss during the third stage of labour was similar between the two groups (p = 0.572). Further there were no statistically significant difference was noted between the two groups in terms of the mean duration of labor, duration of the third stage of labor, manual removal of the placenta, need for instrumental delivery, need for blood transfusion, PPH ≥500 mL, PPH ≥1000 mL, or length of hospital stay.

Conclusion: Using oxytocin by intravenous and intramuscular route has a similar efficacy and adverse effects.
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http://dx.doi.org/10.1007/s00404-016-4060-7DOI Listing
November 2016

Ischemia-modified albumin as an oxidative stress biomarker in early pregnancy loss.

J Matern Fetal Neonatal Med 2016 2;29(11):1754-7. Epub 2015 Jul 2.

a Department of Obstetrics and Gynaecology , Bakirkoy Dr. Sadi Konuk Teaching and Research Hospital , Istanbul , Turkey.

Background/aims: This study aimed to determine the association between early pregnancy loss and serum ischemia-modified albumin (IMA) concentrations.

Methods: Serum samples of 180 women that included healthy pregnant women, women admitted for termination of pregnancy due to the absence of fetal cardiac activity or absence of fetal pole on ultrasonographic examination, and healthy non-pregnant women attending for gynecological examination. Each group included 60 patients. Serum concentrations of IMA were compared among the groups, and the correlations with patients' age, gravidity, BMI, gestational age and total serum albumin concentrations were calculated.

Results: When the groups were compared with respect to IMA concentrations, the group with early pregnancy loss was found to have significantly higher IMA concentrations (p < 0.001). An IMA threshold of >163 ng/mL had a sensitivity of 75%, specificity of 55% to discriminate between healthy pregnant patients and patients with early pregnancy loss in first trimester.

Conclusion: Our findings support the theory that possible oxidative stress, a more hypoxic environment and defective placentation lead to increased serum IMA concentrations. These findings may help to shed light on the complicated pathogenesis of early pregnancy loss.
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http://dx.doi.org/10.3109/14767058.2015.1061494DOI Listing
January 2017

Plasma serotonin levels are elevated in pregnant women with hyperemesis gravidarum.

Arch Gynecol Obstet 2015 Jun 13;291(6):1271-6. Epub 2014 Dec 13.

Bakirkoy Dr. Sadi Konuk Teaching and Research Hospital, Tevfik Saglam Street, No: 11, Zuhuratbaba, Istanbul, Bakirkoy, Turkey,

Purpose: This study aimed to determine the association between serotonin and hyperemesis gravidarum.

Materials And Methods: Plasma samples of 87 women in their first trimester pregnancies with HG (n = 28), morning sickness of pregnancy (n = 30) and control (n = 29) groups were obtained. Plasma levels of serotonin were compared between the groups, and the correlations with severity of symptoms using modified PUQE (Pregnancy Unique Quantification of Emesis) scoring, BMI, E2, hCG and TSH were calculated.

Results: When the groups were compared with respect to serotonin levels, the group with hyperemesis gravidarum was found to have significantly higher serotonin levels (p = 0.001). A significant positive correlation was found between the serotonin level and the PUQE score in all study subjects (r = 0.578, p = 0.0001). A serotonin threshold of >277.58 ng/mL had a sensitivity of 75%, specificity of 86.4%, positive predictive value of 72.4%, negative predictive value of 87.9%, and a likelihood ratio of 5.53 (p = 0.0001).

Conclusions: Our findings support the possible role of serotonin in the pathogenesis of hyperemesis gravidarum.
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http://dx.doi.org/10.1007/s00404-014-3572-2DOI Listing
June 2015

Comparing the efficacy of intrauterine lidocaine and paracervical block in decreasing the pain associated with endometrial biopsy: a randomised trial.

Arch Gynecol Obstet 2014 Mar 27;289(3):609-14. Epub 2013 Sep 27.

Bakirkoy Dr. Sadi Konuk Teaching and Research Hospital, Tevfik Saglam Street, No. 11, Zuhuratbaba, Bakirkoy, Istanbul, Turkey,

Purpose: Almost 50% of the patients experience moderate-to-severe pain during endometrial biopsy. The study aimed to examine the effectiveness of intrauterine lidocaine for relieving pain during endometrial biopsy.

Methods: A randomised trial was conducted in 120 patients undergoing endometrial biopsy. Sixty-seven women were assigned to the paracervical block group and 53 were assigned to the intrauterine lidocaine group. The main outcome measure was pain intensity, measured using the visual analogue scale, during and after the procedure.

Results: The groups were similar with regard to age, body mass index, gravidity, total number of previous vaginal deliveries, menopausal status, and uterine depth. The pain scores immediately after the procedure were similar in the groups (p = 0.079). However, the pain scores 30 min after the procedure were significantly lower in the intrauterine group than in the paracervical group (p = 0.0001).

Conclusions: Compared to paracervical block, intrauterine lidocaine may be the preferred anaesthesia for endometrial biopsy, and it does not cause any serious complications.
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http://dx.doi.org/10.1007/s00404-013-3036-0DOI Listing
March 2014