Publications by authors named "Sibel Sak"

29 Publications

  • Page 1 of 1

Recurrent pregnancy loss and metabolic syndrome.

Ginekol Pol 2020;91(6):320-323

Sanliurfa Eyyubiye Government Hospital, Sanliurfa, Turkey.

Objectives: The aim of this study was to evaluate the frequency of metabolic syndrome (MetS) and its components in patients with unexplained recurrent pregnancy loss (RPL).

Material And Methods: A cross-sectional study was held including 115 patients with unexplained RPL who were referred to a tertiary center between December 2018 and December 2019. In the study, MetS was classified according to The National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III) criteria on the basis of metabolic risk factors. Frequency of MetS in the patients with unexplained RPL was investigated. The relationship between miscarriage rate and metabolic risk factors was also evaluated.

Results: According to our study the percentage of MetS in patients with unexplained RPL was 24.4%. When evaluated according to different age groups, it was 18.4% in patients aged 20-29 years, and it was 27.8% in patients aged 30-39 years. At least having one of its components were high (82.6%) in all patients with unexplained RPL.

Conclusions: The percentage of MetS or of at least having one of its components were high in patients with unexplained RPL. Increased number of having MetS components were associated with increased miscarriage rate.
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http://dx.doi.org/10.5603/GP.a2020.0063DOI Listing
January 2020

Impact of timing on wound dressing removal after caesarean delivery: a multicentre, randomised controlled trial.

J Obstet Gynaecol 2021 Apr 21;41(3):348-352. Epub 2020 Apr 21.

Office of Biostatistics, Preventive Medicine and Community Health, The University of Texas Medical Branch at Galveston, TX, USA.

We compared wound dressing removal at 24 hours 48 hours following low-risk caesarean deliveries. This multicentre, randomised, controlled study included patients 18-44 years of age with low-risk term, singleton pregnancies. The randomisation was done weekly. Scheduled caesarean deliveries without labour were included. For comparison, the dditional treatment, erous discharge, rythema, urulent exudate, eparation of deep tissues, solation of bacteria, tay in hospital > 14 days (ASEPSIS) score for wound healing assessment was modified. The absolute scores were obtained based on a one-day reading rather than the five-day reading used in ASEPSIS. Zero ("0") was assigned as a complete healing. Higher scores were associated with more severe disruption of healing. The patients were enrolled between March 2015 and February 2017. The demographics were not statistically different. The wound scoring was similar in the groups at discharge and first-week evaluation. At the six weeks post-surgery, the wound scoring was significantly less in the 48-hour (3.9%) the 24-hour group (9%;  .002). Dressing removal at 48 hours had a lower scoring in the low-risk population with scheduled caesarean deliveries.IMPACT STATEMENT Surgical dressings are used to provide suitable conditions to heal caesarean incisions. There has been a limited number of studies on the evaluation of ideal timing on wound dressing removal after a caesarean delivery. These studies concluded there are no increased wound complications with removal at six hours 24 hours or within or beyond 48 hours after surgery. The postoperative removal of the wound dressing at 48 hours had a lower wound score at six weeks than the removal at 24 hours for women with uncomplicated scheduled caesarean deliveries. Early discharge after caesarean delivery is becoming more common. Dressing removal at 24 hours 48 hours becomes more crucial and needs to be clarified. Besides, high-risk populations, different skin closure techniques, and patients in labour should be addressed separately.
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http://dx.doi.org/10.1080/01443615.2020.1736015DOI Listing
April 2021

Minor variant of AHSG gene 767C>G polymorphism may decrease the risk of gestational diabetes mellitus.

J Obstet Gynaecol 2020 Apr 24;40(3):303-307. Epub 2019 Jul 24.

Department of Medical Biology, Faculty of Medicine, Harran University, Sanliurfa, Turkey.

Insulin resistance plays a central role in the development of gestational diabetes mellitus (GDM). The fetuin A molecule, of which serum level increases during pregnancy, is an inhibitor of insulin receptor tyrosine kinase and it is associated with insulin resistance. The aim of this study is to research the relationship of -843A>T (rs2248690) and 767C>G (rs4918) polymorphisms in the alpha-2-Heremans Schmid glycoprotein (AHSG) gene which is responsible for the synthesis of fetuin A and its association with (GDM). In this study, 83 pregnant women with GDM who applied to the Obstetrics and Gynaecology Clinics and 100 normal pregnants enrolled as the control group. Genotyping of AHSG gene polymorphisms was performed by using the TaqMan allelic discrimination kit with real time PCR device. In our study, homozygous GG genotype which was polymorphic in the 767C>G polymorphism of AHSG gene was found significantly low in the patient group ( < .05). Genotype distribution of AHSG gene -843A>T polymorphism was not statistically significant between the patient and control groups ( > .05). Our results showed that homozygous GG variant of AHSG gene 767C>G polymorphism may have protective effect against the development of GDM.Impact statement Insulin resistance has a central role in the development of gestational diabetes mellitus (GDM). The fetuin A molecule is an inhibitor of insulin receptor tyrosine kinase and it is associated with insulin resistance. The -843T>A and 767G>C polymorphisms of AHSG gene encoding fetuin A are affects serum fetuin A level. In a single study investigating the relationship between GDM and AHSG gene 767G>C polymorphism, there was no significant difference in genotype distribution but it was reported that the frequency of G allele increased in GDM group and this increase provided a weak risk or predisposition. The present study revealed that homozygous GG variant of AHSG gene 767C>G polymorphism may decrease the risk of GDM. Protective effect of homozygous GG variant of AHSG gene 767C>G polymorphism, can be used as a molecular biomarker to predict the development of GDM. These results should be supported by further research in larger sample sizes.
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http://dx.doi.org/10.1080/01443615.2019.1621810DOI Listing
April 2020

Acupuncture Enhances Chances of Pregnancy in Unexplained Infertile Patients Who Undergo A Blastocyst Transfer in A Fresh-Cycle.

Chin J Integr Med 2019 Apr 25;25(4):298-302. Epub 2019 Jun 25.

Bahcesehir University, Department of Obstetrics and Gynecology, Istanbul, Turkey.

Objective: To analyze the effects of acupuncture on in vitro fertilization patients with unexplained infertility.

Methods: We retrospectively analyzed the charts of a total of 302 cycles performed in 273 patients attending Assisted Reproductive Technology (ART) Centre from August 2013 to August 2016. During the study period, embryo transfer with acupuncture (Acupuncture group, 46 cases) and without acupuncture (Control group, 42 cases) were applied. Prior to embryo transfer, the following points were used in the acupuncture group: Neiguan (CX 6), Diji (SP 8), Taichong (Liv 3), Baihui (Gv 20), and Guilai (S 29). These sessions were carried out two times before and after embryo transfer in a single day. In addition, auricular acupuncture was also performed at ear points, including ear point 55 (Shenmen), ear point 58 (Zhigong), ear point 22 (Neifenmi) and ear point 34 (Naodian). The biochemical pregnancy rate and clinical pregnancy rate after transplantation were compared between two groups.

Results: The clinical pregnancy rate in the acupuncture group was higher than that in the control group [60.9% (28/46) vs. 33.3% (14/42), respectively, P<0.05]. Likewise, the live birth rate in the acupuncture group was also higher than that in the control group [71.7% (33/46) vs. 31.0% (12/42), P<0.01).

Conclusion: Administration of acupuncture on the day of embryo transfer dramatically improved fertility results in women who underwent in vitro fertilization/intra-cytoplasm sperm injection for reproduction.
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http://dx.doi.org/10.1007/s11655-018-2918-6DOI Listing
April 2019

The parameters affecting the success of uterus-sparing surgery in cases of placenta adhesion spectrum disorder.

J Matern Fetal Neonatal Med 2021 Apr 10;34(7):1091-1098. Epub 2019 Jun 10.

Department of Obstetrics and Gynecology, Harran University School of Medicine, Şanlıurfa, Turkey.

Objective: This study aimed to evaluate the parameters affecting the treatment success of conservative surgery in cases with placental invasion anomaly.

Methods: Archive files and digital image records of 67 patients with placental invasion anomaly were studied. The patients were divided into two groups, a conservative surgery group and a cesarean hysterectomy group. Demographic data, cervical length, placental localization, placental surface area adhering to previous cesarean section line, preoperative and postoperative hematocrit values, transfused blood products, and surgical complications were compared between the two groups.

Results: In the conservative surgery group, the cervical length was longer ( < .001) and the surface area of the placenta in the previous cesarean scar line was smaller ( < .001). For cervical length, the sensitivity and specificity values were 97 and 81%, respectively, when the cut-off value was 35.5 mm. When the cut-off value for the placental surface area in the previous cesarean scar line was 85.5 cm, the sensitivity and specificity values were 68 and 72%, respectively. In the caesarean hysterectomy group, the preoperative and postoperative hematocrit values were lower ( < .001,  = .003, respectively), and the amount of transfused erythrocyte suspension and fresh frozen plasma were higher ( < .001,  = .001, respectively).

Conclusion: In this study, it was concluded that the presence of the nondestructive intact cervical tissue, in the cases with placental invasion anomaly and/or the small size of the placental surface area adhering to the previous cesarean scar line, increase the feasibility of conservative surgery.
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http://dx.doi.org/10.1080/14767058.2019.1624719DOI Listing
April 2021

Cytogenetic screening in couples with Habitual Abortions.

J Gynecol Obstet Hum Reprod 2019 Mar 6;48(3):155-158. Epub 2018 Nov 6.

Harran University, Faculty of Medicine, Department of Obstetrics and Gynecology, Sanliurfa, Turkey.

Objective: Habitual abortion (HA) is defined at least three consecutive pregnancy losses. One of the etiologic causes is parental chromosomal anomalies. In this study, we aimed to that investigate the effect of parental chromosomal abnormalities on HA.

Methods: The cytogenetic results of patients with at least three abortions referred to our university hospital between January 2010 - March 2017 were evaluated. A total of 1154 couples with HA were analysed. Peripheral lymphocyte cultures incubated for 72 h were used for karyotype analysis via the Giemsa banding technique.

Results: Of a total 1154 couples (2308 patients) 37 female (3.2%) and 17 male (1.47%) had abnormal karyotypes. Reciprocal translocation carriage (n = 26; 1.12%) was the most commonly detected structural anomaly, followed by X chromosome mosaicism (n = 16; 0.69%),Robertsoniantranslocation (n = 9; 0.38%), Chromosomal inversion (n = 6; 0.26%). Chromosomal polymorphisms, which are considered minor chromosomal changes, were detected in 221 (9.57%) individuals.

Conclusion: Our study exhibits that chromosomal analysis in patient with HA is an appropriate approach to elucidate the aetiology of HA. Data from cytogenetic screening can be used in guiding couples planning future pregnancies and in prenatal diagnosis of chromosomal anomalies in the foetus.
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http://dx.doi.org/10.1016/j.jogoh.2018.10.021DOI Listing
March 2019

Associations of serum fetuin-A and oxidative stress parameters with polycystic ovary syndrome.

Clin Exp Reprod Med 2018 Sep 3;45(3):116-121. Epub 2018 Sep 3.

Department of Obstetrics and Gynaecology, Faculty of Medicine, Harran University, Sanliurfa, Turkey.

Objective: The aim of this study was to compare serum fetuin-A levels and oxidative stress markers, as indicators of insulin resistance, in women with polycystic ovary syndrome (PCOS) and in healthy controls.

Methods: This prospective case-control study included 46 patients with PCOS and 48 age- and body mass index-matched control women. Levels of serum hormones, fetuin-A, and oxidative stress markers were measured in blood samples taken during the early follicular period from each participant.

Results: Follicle-stimulating hormone (FSH), luteinising hormone (LH), total testosterone levels, and the LH/FSH ratio were found to be significantly higher in women with PCOS than in controls. Serum total antioxidant status, total oxidant status, and oxidative stress index parameters all indicated significantly higher levels of oxidative stress in PCOS patients than in controls. Serum fetuin-A levels, which were analyzed as an indicator of insulin resistance, were higher in the PCOS group than in the control group (210.26±65.06 µg/mL and 182.68±51.20 µg/mL, respectively; =0.024).

Conclusion: The data obtained from the present study suggest that higher levels of both serum fetuin-A and oxidative stress markers might be related with PCOS.
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http://dx.doi.org/10.5653/cerm.2018.45.3.116DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6125147PMC
September 2018

Evaluation of Sexual Function in Women with Hypogonadotropic Hypogonadism Using the Female Sexual Function Index (FSFI) and the Beck Depression Inventory (BDI).

Med Sci Monit 2018 Aug 12;24:5610-5618. Epub 2018 Aug 12.

Department of Obstetrics and Gynecology, Hera Center, Istanbul, Turkey.

BACKGROUND Hypogonadotropic hypogonadism (HH), or secondary hypogonadism, results from reduced secretion of gonadotropins, including follicle-stimulating hormone (FSH) and luteinizing hormone (LH), by the pituitary gland, resulting in lack of production of sex steroids. The aim of this study was to evaluate self-reported sexual function in sexually active women with and without HH using two evaluation methods, the Female Sexual Function Index (FSFI) and the Beck Depression Inventory (BDI). MATERIAL AND METHODS The study recruited 88 women who attended an outpatient in vitro fertilization (IVF) clinic in Turkey for primary infertility, between August 2013 and August 2016. All patients were sexually active with an age that ranged from 20-41 years. Following an initial examination, including measurement of FSH and LH levels, all study participants were asked to complete the FSFI and BDI self-reporting questionnaires. Patients were divided into Group 1 (with HH) (N=42) and Group 2 (the control group) (N=46). RESULTS Analysis of the patient responses to questions regarding their sexual function in the FSFI and BDI showed that of the 42 patients in Group 1 (the HH group), 27 patients (64.28%) reported sexual dysfunction; of the 46 patients in Group 2 (the control group) 14 patients (30.34%) reported sexual dysfunction. Analysis of the FSFI lubrication scores and orgasm scores showed a statistically significant difference between the two groups (both, p<0.01). CONCLUSIONS Women with HH require both physical and psychological support to improve their sexual function, self-esteem, mental health, and quality of life.
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http://dx.doi.org/10.12659/MSM.910304DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6104546PMC
August 2018

Thrombophilia and Recurrent Pregnancy Loss: The Enigma Continues.

Med Sci Monit 2018 Jun 22;24:4288-4294. Epub 2018 Jun 22.

Department of Obstetric and Gynecology, Diyarlife IVF Center, Diyarbakır, Turkey.

BACKGROUND Thrombophilic gene polymorphism is known to be a risk factor for recurrent pregnancy loss (RPL), but few studies have confirmed a possible role of thrombophilic genes polymorphism in RPL risk. This study was conducted to understand the relationship of the mutations of some thrombophilia-associated gene polymorphism (heterozygous/homozygous) with RPL. We compared patients with 2 abortions to patients with 3 or more abortions among Turkish women. MATERIAL AND METHODS In this study, patients previously diagnosed with habitual abortus at Obstetrics and Gynecology outpatient clinics in Turkey between 2012 and 2016 were included. In their peripheral blood, we detected factor V Leiden H1299R, prothrombin G20210A, MTHFR C677T, MTHFR A1298C, PAI-1 4G/5G, and PAI-1 4G/4G gene mutations. RESULTS In this study, we have observed statistically meaningful data (P<0.01) related to the relationship between RPL and thrombophilia-associated gene polymorphisms such as heterozygous factor V Leiden H1299R, heterozygous prothrombin G20210A, PAI-1 4G/5G, and PAI-1 4G/4G. CONCLUSIONS We found that diagnosis of thrombophilic genes polymorphism is useful to determine the causes of RPL, recognizing that this multifactorial disease can also be influenced by various acquired factors, including reproduction-associated risk factors and prolonged immobilization.
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http://dx.doi.org/10.12659/MSM.908832DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6045916PMC
June 2018

Copper and ceruloplasmin levels are closely related to the severity of preeclampsia.

J Matern Fetal Neonatal Med 2020 Jan 18;33(1):96-102. Epub 2018 Jul 18.

Harran University School of Medicine, Sanliurfa, Turkey.

The aim of this study was to investigate the maternal serum concentrations of copper (Cu) and ceruloplasmin (CP) in patients with mild preeclampsia, severe preeclampsia, hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome, and to determine their association with the severity of the disease. This study was carried out at the largest tertiary care health center in the southeast region in Turkey and Department of Obstetrics and Gynecology, Dicle University Hospital. A total of 179 pregnant women, including 58 healthy pregnant women and 71 mild preeclampsia, 26 severe preeclampsia, and 24 HELLP syndrome cases classified according to the American College of Obstetricians and Gynecologists' 2013 guidelines were included in this prospective study. Blood samples were taken from all the pregnant women to evaluate the serum Cu and CP levels. The Cu level was determined atomic absorption/emission spectroscopy, while the serum CP level was assessed with a nephelometric assay using an automatic image analyzer. Spearman's rank correlation tests were used to determine the correlations between the serum levels of the antioxidative markers and the preeclampsia severity. The mean ± SD of the Cu was 81.2 ± 11.84 µg/dl in the mild preeclampsia cases and 160.2 ± 20.89 µg/dl in the severe preeclampsia cases ( < .001). The mean ± SD of the CP was 33.0 ± 4.81 mg/dl in the mild preeclampsia cases and 65.3 ± 9.17 mg/dl in the severe preeclampsia cases ( < .001). The Cu and CP levels were significantly higher in the patients with HELLP syndrome, which is an advanced and more severe form of severe preeclampsia, than in the mild and severe preeclampsia patients ( < .001 and  < .001, respectively). Therefore, the serum Cu and CP levels were correlated with the severity of preeclampsia ( = 859,  < .001 and  = 786,  < .001, respectively). In addition, there was a positive correlation between the serum Cu and CP levels and the systolic and diastolic blood pressure values and aspartate amino transferase levels (AST), and a negative correlation between the serum Cu and CP levels and the platelet count. This was the first study in which the ceruloplasmin and Cu levels were investigated in HELLP syndrome patients. When considering the results obtained in the present study, there were significant relationships between the Cu, CP levels which are the markers of oxidative stress and the preeclampsia severity.
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http://dx.doi.org/10.1080/14767058.2018.1487934DOI Listing
January 2020

Serum ischemia modified albumin level and its relationship with the thiol/disulfide balance in placenta percreta patients.

J Obstet Gynaecol 2018 Nov 8;38(8):1073-1077. Epub 2018 Jun 8.

d Department of Clinical Biochemistry, Faculty of Medicine , Harran University , Sanliurfa , Turkey.

The pathogenesis of placenta percreta (PP) is not very well known. This study was designed to analyse the oxidative stress (OS), the thiol/disulphide balance, and ischaemia-modified albumin (IMA) the women with PP. The study included 38 pregnant women with PP and 40 similarly aged healthy pregnant women in their third trimester of gestation. We measured the IMA, native and total thiols, and disulphide concentrations in the maternal sera of all of the participating women. The IMA levels were higher and the native and total thiols were lower in the PP group than in the control group. However, there was no statistical significance with respect to the thiol/disulphide balance between the two groups. The results of this study suggest that an increase in the ischaemia and OS and a decrease in the antioxidant status may contribute to the pathogenesis of PP. Impact statement What is already known on this subject? Placenta percreta (PP) is a serious complication of pregnancy. Although there are several studies investigating the pathophysiological mechanism of PP, whether the pathology results from a lack of decidua or from the over-invasiveness of trophoblasts remains controversial. The pathology of PP is poorly understood. What do the results of this study add? This prospective study has shown an increased ischaemia modified albumin (IMA) and a decreased antioxidant capacity in the patients with placenta percreta. The results from 38 women with PP suggest that the serum concentrations of IMA and the oxidative stress parameters may be able to predict PP in cases of uncertainty. What are the implications of these findings for clinical practice and/or further research? The implication of these findings shed light on understanding the pathogenesis of PP for further research.
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http://dx.doi.org/10.1080/01443615.2018.1450369DOI Listing
November 2018

Human Papilloma Viruses and Their Genotype Distribution in Women with High Socioeconomic Status in Central Anatolia, Turkey: A Pilot Study.

Med Sci Monit 2018 Jan 4;24:58-66. Epub 2018 Jan 4.

Department of Obstetrics and Gynecology, Health Research System In Vitro Fertilization (HRS IVF) Center, Ankara, Turkey.

BACKGROUND In the present study we retrospectively evaluated the results of outpatients who had an HPV analysis, and present objective evidence for the administration of preventive inoculation in our area. MATERIAL AND METHODS We retrospectively reviewed 532 outpatients who visited a single center between 2012 and 2016 and had an HPV infection analysis. The criteria for inclusion of patients with unhealthy cervix in the study were: erosion, chronic cervicitis, healed lacerations, hypertrophied cervix, and abnormal discharges from the cervix. RESULTS We found that 122 out of 532 patients were infected with HPV, and the rate of multiple infections was 59.0% (72/122). HR-HPV (group 1 carcinogens HPV-16 (18.9%, 23/122), HPV-18 (13.1%, 16/122), HPV- 31 (4.9%, 6/122), HPV-33 (3.3%, 4/122), HPV-35 (7.4.9%/122), HPV-39 (5.7%, 7/122), HPV-45 (5.7%, 7/122), HPV-51 (11.5%, 15/122); Group 3 LR-HPV; HPV-6 (31.1%, 38/122), HPV-11 (26.2%, 32/122), HPV-42 (9.0%, 11/122) and HPV-43 (4.9%, 6/122). In terms of linear-by-linear association test, no significant statistical difference was identified between years. The P value for HPV infection rate on year basis was P>0.05. CONCLUSIONS In this hospital-based retrospective analysis, HPV types were found to be similar to HPV types reported in developed countries. We firmly suggest that patients should be informed about the risk of HPV infection at early ages.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5764117PMC
http://dx.doi.org/10.12659/msm.906652DOI Listing
January 2018

Comparison of sVCAM-1 and sICAM-1 levels in maternal serum and vaginal secretion between pregnant women with preterm prelabour ruptures of membranes and healthy pregnant women.

J Matern Fetal Neonatal Med 2019 Mar 2;32(6):910-915. Epub 2017 Nov 2.

a Department of Obstetrics and Gynecology , Harran University School of Medicine , Sanliurfa , Turkey.

Objective: The study aims to evaluate the maternal serum and the vaginal fluid levels of soluble vascular cell adhesion molecule-1 (sVCAM-1) and soluble intercellular adhesion molecular (sICAM-1) in pregnant women complicated by preterm prelabour ruptures of membranes (PPROM).

Materials And Methods: The prospective case control study included 34 pregnant women with PPROM and 34 healthy pregnant women. Patients with additional diseases, a smoking habit and vaginal bleeding, as well as those using antibiotics, during the study period were not included in the study. Cervicovaginal fluid and serum samples were taken during the patients' admission. The demographic data, maternal serum and vaginal fluid sVCAM-1 and sICAM-1, C reactive protein (CRP) and leukocyte counts were noted for all pregnant women included in the study. The sVCAM-1 and sICAM-1 levels were measured by enzyme-linked immunosorbent assay kits.

Results: In pregnant women with PPROM, the serum leukocyte (mean ± SD =11.41 ± 1.067 versus 9.18 ± 1.56, p < .0001), serum sVCAM-1 (median 771.20 versus 704.60 ng/ml, p < .001), sICAM-1 (mean ± SD 213.10 ± 35.59 ng/ml versus 188.11 ± 37.35 ng/ml, p = .06), vaginal sVCAM-1 (median 208.00 versus 140.20 ng/ml, p = .014) and sICAM-1 (mean ± SD 32.32 ± 6.49 ng/ml versus 24.87 ± 6.79 ng/ml, p < .001) values were found to be significantly higher in pregnant women with PPROM than in healthy pregnant women. A positive and significant correlation was observed between the leukocyte count and the vaginal sVCAM-1 level (r = 0.850; p < .001).

Conclusion: To the best of our knowledge, this is the first study evaluating the levels of sICAM-1 in maternal serum in pregnant women with PPROM. The maternal serum and vaginal fluid sVCAM-1 and sICAM-1 levels can be used as biochemical markers supporting the PPROM diagnosis because of the increase in both maternal serum and vaginal fluid sVCAM-1 and sICAM-1 levels in pregnant women with PPROM.
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http://dx.doi.org/10.1080/14767058.2017.1395016DOI Listing
March 2019

Management of peripartum hysterectomies performed on patients with placenta percreta in a tertiary central hospital.

J Matern Fetal Neonatal Med 2019 Mar 2;32(6):883-888. Epub 2017 Nov 2.

a Harran University School of Medicine , Department of Obstetrics and Gynecology , Sanliurfa , Turkey.

Objective: The main objective of this study is to analyse the circumstances and management of peripartum hysterectomies performed on patients with placenta percreta.

Methods: This study included 37 patients who were diagnosed with placenta percreta, a condition in which the placenta invades the uterine wall, and who therefore underwent a peripartum hysterectomy. Their demographic characteristics, history of past caesareans, uterine surgery and curettage, duration of hospitalization, admission to an intensive care unit, neonatal outcomes, skin and uterus incision type, hypogastric artery ligation (HAL), complications, quantities of transfused ES (erythrocyte suspensions), and FFP (fresh frozen plasma), maternal morbidity and mortality and postoperative pathology results were retrospectively reviewed.

Results: All pregnant patients who underwent a caesarean hysterectomy due to placenta percreta had a history of caesarean section and also of placenta praevia totalis. Bilateral HAL was performed in two patients (5.4%), owing to uncontrollable bleeding during the bladder dissection. The complications most frequently observed were bladder injury (13.5%), followed by infection (8.1%) and relaparotomy (5.4%). There was no mortality. Twenty-three (62.2%) of the patients had ES and 11 patients (29.7%) had FFP transfusions. According to the histopathology findings, 33 of the 37 patients (89.1%) reportedly had placenta percreta, three patients had placenta increta, and one patient had placenta accreta. Analysis of the neonatal status at birth showed that the gestational age was, on average, the 35th week. The birth weight was normal in relation to the gestational week, but the first and fifth minute Apgar score, which measures the physical condition of an infant, was found to be lower than the normal range.

Conclusions: If a pregnant patient undergoes uterine surgery or has a history of a caesarean with placenta praevia, she is likely to have placenta percreta. In placenta percreta cases with bladder invasion; careful suturing of the high-volume vessels on the posterior wall of the bladder, through the bladder serosa is important in reducing the amount of bleeding and preventing future fistula formation.
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http://dx.doi.org/10.1080/14767058.2017.1394289DOI Listing
March 2019

Serum Angiogenic and Anti-angiogenic Markers in Pregnant Women with Placenta Percreta.

Balkan Med J 2018 01 13;35(1):55-60. Epub 2017 Sep 13.

Department of Obstetrics and Gynecology, Harran University School of Medicine, Şanlıurfa, Turkey.

Background: Placenta percreta is the morbidly adherent form of all the placental invasion abnormalities. The pathology that underlies placenta percreta is poorly understood.

Aims: To compare the levels of circulating vascular endothelial growth factor, placental growth factor and soluble fms-like tyrosine kinase 1 in pregnant women with placenta percreta to a control group.

Study Design: Case-control study.

Methods: Twenty-two women who underwent caesarean section due to placenta percreta and 22 women who underwent caesarean section for other obstetric reasons were included in this study. The diagnosis of placenta percreta was defined as extreme trophoblastic invasion involving serosa of the uterus. Venous blood samples were collected for biochemical comparison of circulating vascular endothelial growth factor, placental growth factor and soluble fms-like tyrosine kinase 1 from all pregnant women.

Results: Women with placenta percreta were significantly older, had higher gravidity, received more frequent antenatal steroids and blood transfusions and delivered at an earlier gestational age when compared to the control group. In women with placenta percreta, preoperative circulating levels of vascular endothelial growth factor, placental growth factor and soluble fms-like tyrosine kinase 1 were lower than the controls (p<0.001, p<0.001 and p<0.05, respectively). While the postoperative levels of vascular endothelial growth factorand soluble fms-like tyrosine kinase 1 levels were higher in placenta percreta (p=0.001 and p<0.001, respectively), placental growth factor levels were similar in both groups.

Conclusion: The findings of this study suggest that a decrease in vascular endothelial growth factor, placental growth factor and soluble fms-like tyrosine kinase 1 levels may be related to placenta percreta etiopathogenesis.
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http://dx.doi.org/10.4274/balkanmedj.2016.1890DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5820448PMC
January 2018

Assessment of oxidative stress markers in cord blood of newborns to patients with oxytocin-induced labor.

J Obstet Gynaecol Res 2017 May;43(5):860-865

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

Aim: We aimed to measure the extent of oxidative stress experienced during labor by the neonates of pregnant women undergoing induced or spontaneous birth and to compare the effects of induced labor on fetal well-being.

Methods: Sixty-four healthy pregnant women referring to the Department of Gynecology and Obstetrics, Dicle University Medical Faculty between October 2010 and May 2011 were included in this comparative study. Pregnant women undergoing induced labor by oxytocin were group 1 and those without labor induction were group 2. Post-partum Apgar score was calculated at 1 and 5 min and measurements of weight and height of the neonates were carried out. After the fetal cord was clamped, 5 cm blood was drawn into a plain tube without anticoagulant. The samples were centrifuged at 5000 r.p.m. for 5 min. Separated sera were transferred to Eppendorf tubes and were stored at -80 C° until the analysis time.

Results: The complete blood counts and biochemistry results indicated that there were no statistically significant differences in regards to diseases between the two groups. Nitric oxide and asymmetrical dimethylarginine values of the two groups were not significantly different; however, there were statistically significant differences in the malondialdehyde, paraoxonase, total antioxidative status, and total oxidative status values of the two groups (respectively, P = 0.005, P = 0.006, P = 0.008, and P = 0.007).

Conclusion: We observed that oxytocin-induced labor increases stress markers but does not affect Apgar scores. Oxidative stress in pregnant women may trigger antioxidative mechanisms. Prospective studies in larger cohorts are needed to better understand the impact of oxytocin-induced labor on pregnant women and neonates.
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http://dx.doi.org/10.1111/jog.13263DOI Listing
May 2017

Does apoptotic activity have a role in the development of the placental abruption?

J Matern Fetal Neonatal Med 2017 Dec 6;30(23):2871-2875. Epub 2017 Feb 6.

a Department of Gynecology and Obstetrics, Faculty of Medicine , Harran University , Sanliurfa , Turkey.

Objective: The purpose of the present study is to analyses the role of apoptotic activity in placental abruption (PA) development by evaluating the level of plasma M30-M65.

Methods: The study group included 46 pregnant women who underwent caesarean sections (CS) because of PA, and the control group included 48 pregnant women who underwent CS because of obstetric causes. Venous blood samples were received from all expectants before starting the CS for the purpose of evaluating the M30-M65 levels, which are indicators of apoptotic activity in maternal plasma.

Results: The plasma M30-M65 levels were determined to be statistically significantly higher in with PA group. The sensitivity and specificity of the test were determined to be 71.7% and 64.6%, respectively in identifying the expectants with PA when the cut-off value was taken as 163.50 U/L for the plasma M30 value. The sensitivity and specificity of the test were determined to be 76.1% and 66.7%, respectively in identifying the PA when the cut-off value was taken as 295.50 U/L for the M65 value.

Conclusions: The increase of apoptotic activity induced by thrombin resulting from decidual bleeding may have a role in the development of PA.
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http://dx.doi.org/10.1080/14767058.2016.1265936DOI Listing
December 2017

Amniotic fluid paraoxonase-1 activity, thyroid hormone concentration and oxidant status in neural tube defects.

J Obstet Gynaecol Res 2016 Sep 21;42(9):1080-5. Epub 2016 Jun 21.

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

Aim: The aim of this study was to investigate the potential association between neural tube defects and paraoxonase-1 activity in amniotic fluid. We studied total oxidant status, total antioxidant capacity, paraoxonase-1 activity and thyroid hormone amniotic fluid concentration in fetuses with neural tube defects.

Methods: The present study was performed at the Department of Obstetrics and Gynaecology and the Department of Clinical Biochemistry of Dicle University between September 2011 and June 2013. The study group included 37 amniotic fluid samples from pregnant women (16-20 weeks of gestation) with fetuses affected by neural tube defects. The control group consisted of 36 pregnant women who were diagnosed with a high-risk pregnancy according to first or second trimester aneuploidy screening and were later confirmed on amniocentesis to have genetically normal fetuses.

Results: Amniotic fluid paraoxonase-1 activity and total oxidant status were significantly higher (P = 0.023, P = 0.029, respectively) whereas free T4 was significantly lower (P = 0.022) in fetuses with neural tube defects compared with control subjects. In fetuses with neural tube defects, amniotic fluid paraoxonase-1 activity correlated positively with total oxidant status (r = 0.424**, P = 0.010), and amniotic fluid total antioxidant capacity correlated positively with free t4 (r = 0.381*, P = 0.022).

Conclusion: This is the first study in the literature to show an association between paraoxonase-1 activity and thyroid hormone concentration and neural tube defects.
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http://dx.doi.org/10.1111/jog.13026DOI Listing
September 2016

Multiple repeat caesarean deliveries: do they increase maternal and neonatal morbidity?

J Matern Fetal Neonatal Med 2017 Mar 20;30(6):739-744. Epub 2016 May 20.

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

Objective: The aim of the present study is to evaluate the effects of the increased number of caesarean deliveries (CDs) in cases of multiple repeat caesarean deliveries (MRCDs) on maternal and neonatal morbidity.

Methods: MRCDs admitted to our hospital between January 2013 and September 2014 were analysed retrospectively. A total number of 1133 women were included in the study and were divided into 4 groups. Group 1: second CDs (n = 329); Group 2: third CDs (n = 225); Group 3: fourth CDs (n = 447); Group 4: fifth CDs (n = 132). The clinical, demographic, intraoperative and postoperative data of the patients were registered upon the review of patient files.

Results: The differences among the groups were found to be statistically significant in terms of mean maternal age, gravida, APGAR (Activity, Pulse, Grimace, Appearance, Respiration) scores, hospital stay and operation time. In addition, the difference was also statistically significant for severe adhesion, bladder injury and premature birth. No statistically significant difference was observed among the groups with respect to placenta previa, placenta accreta, caesarean hysterectomy, uterine scar rupture.

Conclusions: According to our findings, MRCDs seem to increasing the maternal and neonatal morbidity even though they are not life-threatening.
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http://dx.doi.org/10.1080/14767058.2016.1183638DOI Listing
March 2017

Are multiple repeated cesarean sections really as safe?

J Matern Fetal Neonatal Med 2017 Feb 5;30(4):482-485. Epub 2016 May 5.

a Department of Obstetrics and Gynecology , Medical Faculty, Harran University , Sanliurfa , Turkey.

Aim: Surgical complications were compared between patients with three or less prior cesarean deliveries and four or more prior cesarean deliveries.

Materials And Methods: Records of 120 patients who had undergone cesarean sections (CSs) in our Department of Obstetrics and Gynecology, between August and November 2015, were retrospectively studied. Cases were reviewed on the basis of age, type of operation, type of anesthesia, number of CSs, time of hospitalization, and intra-operative and post-operative complications.

Results: Cesarean sections had been performed on 62 (51.7%) patients whose cesarean number was three or less, while 58 (48.3%) patients had multiple CSs four or more. Patients with four or more prior cesareans had an increased rate of intra-abdominal adhesions, compared with the other group. There was no significant difference in the gestational weeks, neonatal admission rate, incidence of cesarean hysterectomy, uterine scar rupture, placenta previa with placental invasion anomalies, bladder and bowel injuries, incidence of peripartum hemorrhage and blood transfusion rate between the two groups.

Conclusion: There is no greater risk of maternal complications in patients with four or more prior cesareans, excepting intra-abdominal adhesions.
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http://dx.doi.org/10.1080/14767058.2016.1175426DOI Listing
February 2017

Should we add unilateral sacrospinous ligament fixation to vaginal hysterectomy in management of stage 3 and stage 4 pelvic organ prolapse?

Turk J Obstet Gynecol 2015 Sep 15;12(3):144-150. Epub 2015 Sep 15.

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

Objective: To compare ''vaginal hysterectomy alone'' with ''vaginal hysterectomy with prophylactic unilateral sacrospinous ligament fixation'' in terms of intraoperative complications and 1-year anatomic outcomes and symptoms in patients aged over 50 years who presented with stage 3 or 4 pelvic organ prolapse (POP).

Materials And Methods: Thirty-five patients underwent vaginal hysterectomy alone and 32 patients underwent vaginal hysterectomy with unilateral sacrospinous ligament fixation because of benign pathology between January 2012, and June 2014, were retrospectively analyzed in this study. The patients' demographic data and preoperative and intraoperative findings were obtained from the hospital records and noted. The patients were invited by phone to a follow-up visit to assess their 1-year anatomic outcomes and symptoms.

Results: There was no significant demographic difference between the patients who underwent vaginal hysterectomy alone and those who had a vaginal hysterectomy with sacrospinous ligament fixation. Both length of operation and hospital stay were significantly longer in the patients who underwent vaginal hysterectomy with sacrospinous ligament fixation (p<0.001); intraoperative complications requiring blood transfusion were also significantly more frequent in these patients compared with the patients who underwent vaginal hysterectomy only (p=0.048). Recurrence of vaginal vault prolapse was significantly more frequent in the patients with vaginal hysterectomy alone compared with those who had both vaginal hysterectomy and sacrospinous ligament fixation (p=0.035).

Conclusion: Unilateral sacrospinous ligament fixation might be added to vaginal hysterectomy in patients with stage 3 or 4 POP who are predicted to have long survival times. However, further studies with a larger sample size are needed in this area of research.
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http://dx.doi.org/10.4274/tjod.93546DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5558388PMC
September 2015

Levels of Neopterin and other Inflammatory Markers in Obese and Non-Obese Patients with Polycystic Ovary Syndrome.

Med Sci Monit 2015 Aug 20;21:2446-55. Epub 2015 Aug 20.

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

Background: We aimed to measure the levels of inflammatory markers and neopterin in obese and non-obese patients with PCOS by using 2 separate control groups with matching body mass index (BMI).

Material And Methods: A total of 60 women of reproductive age with (n=30) and without (n=30) PCOS were included in this study. Based on their BMI, patients with PCOS were divided into 2 groups as obese (n=15) and non-obese (n=15) PCOS groups. In addition, 2 BMI-matched control groups were formed. Neopterin, tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (N/L ratio), and vitamin B12 were assessed by complete blood count.

Results: No significant difference was found between patients with PCOS and control subjects in neopterin, IL-6, TNF-α, and CRP levels. However, N/L ratio levels were significantly higher (p 0.045) and vitamin B12 levels were significantly lower (p 0.033) in patients with PCOS compared to control subjects. No statistically significant difference was found between obese and non-obese patients with PCOS and control subjects in neopterin, IL-6, TNF-α, and N/L ratio levels. However, CRP levels were significantly higher in obese patients with PCOS compared to obese control subjects (p 0.007).

Conclusions: It can be concluded that inflammatory activity is increased in patients with PCOS, can lead to an increased risk for atherosclerosis, and this increase is not caused by obesity but rather by the polycystic ovary syndrome itself. However, studies with larger sample sizes are needed in this area.
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http://dx.doi.org/10.12659/MSM.894368DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4548699PMC
August 2015

The protective effect of curcumin on ischemia-reperfusion injury in rat ovary.

Int J Surg 2013 21;11(9):967-70. Epub 2013 Jun 21.

Dicle University, School of Medicine, Department of Obstetrics and Gynecology, Diyarbakır 21280, Turkey. Electronic address:

Background: To evaluate the protective effects of curcumin in experimental ischemia and ischemia/reperfusion (I/R) injury of rat ovaries.

Methods: Forty-eight female adult Wistar Albino rats were used. Rats divided into six groups and designed: Sham, Torsion, Detorsion, Sham + Curcumin, Torsion + Curcumin, and Detorsion + Curcumin. Except for the Sham and Sham + Curcumin group, all groups were performed to bilateral adnexal torsion for 3 h. Bilateral adnexal detorsion was implemented in the Detorsion and Detorsion + Curcumin groups. The injection of curcumin was intraperitoneally achieved 30 min before the sham, torsion and detorsion.

Results: Total oxidant status levels (TOS), oxidative stress index (OSI) and histologic scores values of ovarian tissue were higher in the torsion and detorsion groups than the sham group (p < 0.05). There was a strong correlation between the total histologic scores of I/R injury and the OSI (r = 0.809, p < 0.001). By the use of curcumin, a significant decrease was established in the mean levels of oxidant markers and histopathologic scores of the ovarian tissues.

Conclusions: Administration of curcumin is effective in reversing tissue damage induced by ischemia-reperfusion injury in ovarian torsion.
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http://dx.doi.org/10.1016/j.ijsu.2013.06.007DOI Listing
July 2014

Translocated intrauterine contraceptive device: experiences of two medical centers with risk factors and the need for surgical treatment.

J Reprod Med 2013 May-Jun;58(5-6):234-40

Department of Gynecology and Obstetrics, Dicle University School of Medicine, 21280 Diyarbakir, Turkey.

Objective: To present experiences of 21 patients with a translocated intrauterine contraceptive device (IUD) who required surgical treatment and to discuss the diagnosis, surgical management, and complications of such cases.

Study Design: The cases of 21 patients who were hospitalized with the diagnosis of translocated IUD and had surgical treatment were analyzed retrospectively.

Results: The mean age of the patients was 25.7 (range, 20-35). Of the 21 patients, 17 (81%) were in puerperium. IUDs were inserted by trained midwife nurses in 17 cases (81%). Severe lower abdominal pain was reported by 16 patients (76%) during the insertion procedure. At the time of diagnosis, 13 patients (62%) presented with lower abdominal pain. Surgical treatments included laparoscopic surgery (67%), laparotomy, colpotomy, and hysteroscopy. All of the removed IUDs were TCu-380A models. The most frequent complication due to translocation of the IUD was pelvic abscess (38%).

Conclusion: The incidence of IUD translocations was significantly high in the puerperal period and for insertions performed by educated midwife nurses. Uterine perforation must be taken into consideration when there are complaints of unusually severe abdominal pain during the insertion procedure. Surgical treatment is necessary because of the potential complications of extracavitary IUDs.
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July 2013

Imperforate hymen with elevated serum CA 125 and CA 19-9 levels.

J Reprod Med 2013 Jan-Feb;58(1-2):47-50

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

Objective: To report the clinical characteristics of 14 patients with imperforate hymen and their levels of tumor markers (CA 19-9 and CA 125).

Study Design: Fourteen patients with imperforate hymen who followed-up between September 2006 and September 2010 in the Department of Obstetrics and Gynecology, Dicle University School of Medicine, Diyarbakir, Turkey, were evaluated retrospectively. The clinical features and the management of the patients are discussed.

Results: The mean age of the patients was 13.8 years. All patients had primary amenorrhea and pelvic pain. The most common clinical symptoms were cryptomenorrhea in 14 patients, pelvic pain in 11, palpable abdominal mass in 6, voiding difficulties in 7, and defecation problems in 2. In 6 patients with palpable pelvic mass, the mean + standard deviation values of tumor markers were as follows: CA 125, 84.0 +/- 23.7 and CA 19-9, 162 +/- 189. One week after surgery we measured CA 125 and CA 19-9 levels once again. The postoperative mean CA 125 level was 13.8 +/- 3.6, and the mean postoperative CA 19-9 level was 17.5 +/- 3.5. Preoperative levels of CA 125 and CA 19-9 were significantly higher than those of the postoperative period (p < 0.001 for both comparisons). Six patients were treated by T-shaped incision and 8 patients by a central surgical incision through the hymenal membrane.

Conclusion: Diagnosis of imperforate hymen is very important before undergoing surgery in a different clinic. Many patients have seen several doctors before receiving a clear diagnosis and have had tumor markers evaluated because the presence of pelvic mass in patients suggests the possibility of a gynecologic malignancy. Imperforate hymen is one of the benign conditions that increase serum CA 125 and CA 19-9 levels and which is not listed in the classical medical textbooks. These markers are not needed for the diagnosis.
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April 2013

Diploid karyotype partial mole coexisting with live term fetus--case report and review of the world literature.

Ginekol Pol 2012 Oct;83(10):789-91

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

A partial molar pregnancy of diploid karyotype coexisting with live term fetus is a rare entity Most instances of partial mole are triploid and only a few eases of diploid partial moles with term delivery have been reported. Here, we report a case of partial mole concomitant with a 37-week live fetus. Postpartum karyotype of the placenta and the fetus revealed both as 46XX. Histological examination of the placenta showed a partial hydatidiform mole. We discuss the diagnosis based on presenting clinical picture and proper management of signs and symptoms of partial molar pregnancy coexisting with live term fetus and diploid karyotype, coupled with a review of the literature.
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October 2012

Internal iliac artery ligation for severe postpartum hemorrhage.

Ginekol Pol 2012 Sep;83(9):665-8

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

Objective: To evaluate the outcomes of bilateral internal iliac artery ligation (IIAL) in severe postpartum hemorrhage (PPH).

Design: Multi-center retrospective study.

Methods: The study was performed from January 2005 to December 2010, at the Obstetrics and Gynecology Clinic, Dicle University Medical Faculty and Maternity Hospital, Diyarbakir, Turkey. Life-threatening cases of severe postpartum hemorrhage, which could not be controlled with conservative medical and surgical treatments and finally managed with IIAL, were retrospectively evaluated.

Results: Totally 53 patients who underwent IIAL procedures were included in the study. All patients were hemodynamically unstable. The mean shock index and transfused units of blood were 1.17 +/- 0.46, 5.49 +/- 3.04, respectively. Uterine atony was the leading cause of severe postpartum hemorrhage and the need for IIAL. Coagulopathy developed in 26 (49.1%) patients during the postoperative follow-up period. Uterus was preserved in 17 (32.0%) cases. Three patients died of complications and/or morbidity associated with hemorrhage.

Conclusion: Serious PPH is most frequently associated with uterine atony and IIAL should be considered in cases with severe PPH unresponsive to other treatment modalities. If, in the antenatal period, patients have risk factors of postpartum hemorrhage, they must be transferred to appropriate centers to prevent a possibly fatal outcome.
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September 2012

Relaparotomy after initial surgery in obstetric and gynecologic operations: analysis of 113 cases.

Ginekol Pol 2012 Jun;83(6):429-32

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

Condensation: Even though relaparotomy is unavoidable in some cases, several measures such as careful surgical technique, meticulous hemostasis and aseptic conditions must be undertaken to prevent unnecessary interventions in obstetrics and gynecology

Objective: To assess the indications, procedures, risk factors and outcome for relaparotomy after obstetric and gynecological operations.

Study Design: A retrospective observational study during a four-year period in a tertiary care center was performed. Demographics such as age, parity and indications for relaparotomy as well as outcome measures in terms of complications and mortality rates were assessed in 113 patients who had undergone a relaparotomy after the initial obstetric or gynecological surgery

Results: The overall incidence of mortality after relaparotomy was 3.5%. Leading indications for the initial operation included placental abruption in 10 cases (8.8%), followed by the HELLP syndrome and previous cesarean section both in 5 cases (4.4%), and postpartum atonia in 4 (3.5%). The most common operations performed initially were cesarean section in 78 cases (69.0%) and 31 hysterectomies (27.5%). Principal indications for relaparotomy were bleeding and hematoma in 80 cases (70.8%) and abscess in 10 cases (8.8%). The most frequently performed procedures at relaparotomy were drainage and resuturing of hematomas (n = 42, 37.1%), hypogastric artery ligation (n = 32, 28.3%), hysterectomy (n = 31, 27.5%), and drainage of abscess (n = 7, 6.2%). A second relaparotomy was performed in 4 cases (3.5%). Complications were encountered in 4 patients and 4 cases ended up with mortality

Conclusion: Hemorrhagic and infectious complications were the main indications for relaparotomy after obstetric and gynecologic surgeries. Cases with a history of placental abruption, HELLP Syndrome and previous cesarean section were under risk for relaparotomy. Despite favourable outcome, preventive measures such as careful surgical technique, meticulous hemostasis and aseptic conditions should be undertaken.
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June 2012

Platelet profile in patients with gestational diabetes: a retrospective study.

J Turk Ger Gynecol Assoc 2012 1;13(4):223-6. Epub 2012 Dec 1.

Dicle University, School of Medicine, Department of Obstetrics And Gynecology, Diyarbakır, Turkey.

Objective: To assess and compare alterations in the morphology and function of platelets occurring in gestational diabetes and healthy pregnancies.

Material And Methods: A retrospective study was performed of 77 pregnant women: 42 cases with gestational diabetes and 35 healthy controls. The two groups were compared in terms of demographics and platelet parameters derived from complete blood counts.

Results: The mean platelet volume (p=0.001) and HbA1c (p<0.001) were significantly increased in the patients with gestational diabetes. The mean platelet volume was well correlated with the platelet distribution width (rs=0.404, p<0.001) and the platelet count (rs=0.355, p=0.002).

Conclusion: The mean platelet volume and other platelet parameters may significantly aid the identification of diabetic pregnants at risk for vascular complications. The role and possible clinical relevance of these changes during diabetic pregnancy need to be investigated in further studies.
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http://dx.doi.org/10.5152/jtgga.2012.34DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3881706PMC
March 2014
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