Publications by authors named "Suleyman Cemil Oglak"

16 Publications

  • Page 1 of 1

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

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

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

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

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

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

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

Should isolated aberrant right subclavian artery be ignored in the antenatal period? A management dilemma

Turk J Obstet Gynecol 2021 06;18(2):103-108

Biruni University Faculty of Medicine, Department of Perinatology, İstanbul, Turkey

Objective: To investigate the frequency and types of chromosomal abnormalities in fetuses with the aberrant right subclavian artery (ARSA) and to evaluate its association with other ultrasonographic findings.

Materials And Methods: In all, 11,666 fetal anatomic surveys were performed between March 2014 and March 2020. The cases diagnosed as ARSA were examined. Accompanying ultrasound findings and chromosomal abnormalities were collected.

Results: ARSA was detected in 140 fetuses (1.2%). The ARSA appeared isolated in 47.1% (66/140) of cases and the remaining 52.9% (74/140) of cases were associated with cardiac or extracardiac malformations and soft markers. Chromosomal abnormalities were detected in 17.8% (25/140) of all cases. Trisomy 21 was the most common chromosomal anomaly with a prevalence of 11.4% (16/140). The corresponding rate was 3% (2/66) and 18.9% (14/74) for isolated and non-isolated ARSA, respectively. DiGeorge syndrome was detected in 3% (n=2) and Turner syndrome was in 3% (n=2) of the isolated group. ARSA was not an isolated finding in any of the 4 fetuses with trisomy 18.

Conclusion: Isolated ARSA may be the only antenatal predictor of trisomy 21 or other chromosomal anomalies, including DiGeorge or Turner syndrome. Hence, visualization of the right subclavian artery should be a part of the fetal anatomic survey and genetic analysis should be recommended even in the absence of associated findings.
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http://dx.doi.org/10.4274/tjod.galenos.2021.69749DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8191323PMC
June 2021

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

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

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

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

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

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

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

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

Circulating levels of Elabela in pregnant women complicated with intrauterine growth restriction.

J Gynecol Obstet Hum Reprod 2021 Mar 26;50(8):102127. Epub 2021 Mar 26.

Department of Biochemistry, Eyüpsultan Hospital, Istanbul, Turkey.

Objective: This study aimed to detect Elabela concentrations in the serum of normotensive pregnant women complicated with intrauterine growth restriction (IUGR) and compare them with the uncomplicated healthy pregnancies.

Material And Methods: This prospective case-control study was performed from May 1, 2020 to September 30, 2020. Of the 92 pregnant patients included in the study, we enrolled 49 normotensive patients complicated with IUGR as the study group, and 43 normotensive healthy gestational age-matched and body mass index (BMI)-matched patients without IUGR or additional pregnancy complication as the control group. Demographic and clinical characteristics, and maternal serum Elabela concentrations were recorded.

Results: Maternal serum Elabela levels were significantly lower in IUGR pregnancies (4.02±3.42 ng/mL) compared to healthy pregnant women (14.01±18.38 ng/mL, p<0.001). There was a positive intermediate correlation between maternal serum Elabela levels and the birth weight (r = 0.308, p = 0.004).

Conclusion: Maternal circulating levels of Elabela were significantly lower in IUGR pregnancies than in healthy pregnant women. Also, birth weight was positively correlated with maternal serum Elabela levels. We consider that Elabela might be a crucial biomarker of the pathophysiologic process in pregnancies complicated by IUGR.
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http://dx.doi.org/10.1016/j.jogoh.2021.102127DOI Listing
March 2021

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

Ginekol Pol 2021 Mar 23. Epub 2021 Mar 23.

Cukurova University, Adana, Turkey.

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

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

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

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

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

Ginekol Pol 2021 Mar 10. Epub 2021 Mar 10.

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

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

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

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

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

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

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

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

Letrozole is superior to clomiphene citrate in ovulation induction in patients with polycystic ovary syndrome.

Pak J Med Sci 2020 Nov-Dec;36(7):1460-1465

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

Objective: This study was aimed to compare the clinical outcomes of ovulation induction (OI) by timed intercourse with letrozole (LTZ) and clomiphene citrate (CC).

Methods: Three hundred and twenty-three patients with polycystic ovary syndrome (PCOS) who underwent OI with LTZ or CC between February 2017 and November 2018 were included in this retrospective study. The patients were divided into two groups as the CC group (n=148) and the LTZ group (n=175). Endometrial thickness, follicular development, ovulation, clinical pregnancy, abortion, and live birth rates of the groups were analyzed.

Results: The mean endometrium thickness of the CC group was 7.1±1.7 mm, and the LTZ group was 8.6±1.8 mm (p<0.001). The ovulation rate per cycle was higher in the LTZ group (93.1%) in comparison with the CC group (83.8%) (p=0.013). Clinical pregnancy rates were 52% in the LTZ group, and 41.2% in the CC group (p=0.047). LTZ with 44% of live birth rate was superior to CC with a 33% live birth rate (p=0.029).

Conclusions: LTZ is an effective OI agent in PCOS patients. LTZ is superior to CC in terms of pregnancy rates and live birth rates. As a result, we recommend that LTZ should be the first-line treatment agent in patients with PCOS.
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http://dx.doi.org/10.12669/pjms.36.7.3345DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7674913PMC
November 2020

Evaluation of BRD4 levels in patients with early-onset preeclampsia.

J Gynecol Obstet Hum Reprod 2021 Feb 28;50(2):101963. Epub 2020 Oct 28.

Department of Perinatology, Kocaeli University Hospital, Kocaeli, Turkey. Electronic address:

Objective: This study aimed to detect Bromodomain Containing Protein 4 (BRD4) concentrations in the serum of early-onset preeclamptic patients and compare them with the healthy control group.

Material And Methods: This prospective case-control study was performed from June 2019 to December 2019. Of the 80 pregnant patients included in the study, we enrolled 40 patients with early-onset preeclampsia as the study group, and 40 normotensive healthy gestational age- and gravidity-matched patients with normal blood pressure without proteinuria as the control group. Demographic characteristics, amount of proteinuria, and serum BRD4 concentrations were recorded.

Results: Maternal serum BRD4 concentrations were significantly higher in patients with preeclampsia (39.10 ± 42.14 ng/mL) compared to the participants in the control group (13.64 ± 7.24 ng/mL, p < 0.001). There was a positive intermediate correlation between serum BRD4 levels and the amount of proteinuria (r = 0.447, p = 0.006).

Conclusion: Maternal serum BRD4 levels were significantly higher in preeclamptic patients compared to healthy pregnant women. Also, the amount of proteinuria was positively correlated with serum BRD4 levels. Although this preliminary study shows increased BRD4 levels in preeclampsia, its utility as a biomarker must be clarified.
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http://dx.doi.org/10.1016/j.jogoh.2020.101963DOI Listing
February 2021

Are neutrophil to lymphocyte ratio and platelet to lymphocyte ratio clinically useful for the prediction of early pregnancy loss?

Ginekol Pol 2020;91(9):524-527

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

Objectives: Red cell distribution width (RDW), mean platelet volume (MPV), plateletcrit (PCT), platelet distribution width (PDW), neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) have all been identified as systemic inflammatory markers. The aim of this study to investigate whether the use of systemic inflammatory markers can predict early pregnancy loss.

Material And Methods: A total of 137 patients with early pregnancy loss was compared with 148 participants in the control group who had given birth at term. In the study group, CBC values were included in the study at the time of referral to the hospital for routine follow-up, while patients did not experience early pregnancy loss. In the control group, CBC values of the patient before the seventh week of pregnancy were included in the study.

Results: There was no significant difference between the two groups in terms of RDW, MPV, PCT and PDW values. The NLR and PLR values were significantly higher in the early pregnancy loss group than the control group (p < 0.05).

Conclusion: Our findings suggest that high NLR and PLR values are potent markers for the prediction of early pregnancy loss.
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http://dx.doi.org/10.5603/GP.a2020.0082DOI Listing
January 2020

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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