Publications by authors named "Z Asli Oskovi-Kaplan"

21 Publications

Do fetuin-A/apha2-Heremans Schmid-glycoprotein levels have an association with recurrent pregnancy loss?

J Matern Fetal Neonatal Med 2021 May 23:1-4. Epub 2021 May 23.

Department of Obstetrics and Gynecology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey.

Objective: Fetuin-A is a hepatokine which is previously found related to fertility and pregnancy outcomes. We aimed to investigate if recurrent pregnancy loss (RPL) is associated with increased fetuin-A levels.

Materials And Methods: Serum fetuin-A concentrations were measured and compared in 30 non-pregnant women with a history of unexplained recurrent miscarriage, 29 women who had a history of unexplained recurrent miscarriage and were admitted to our clinic due to miscarriage during the study period and 30 fertile women who have no history of miscarriage or any other pregnancy complications with at least two previous healthy children.

Results: The median serum fetuin-A levels of group I, II, and III were 59.45, 62.73, and 44.52, respectively (=.065). Serum fetuin-A levels significantly increased in group II compared to group III (=.011). No significant differences in the levels of fetuin-A of group I compared to either group II (=.433) or group III (=.268).

Conclusions: The etiology of RPL is still a subject that is not clarified. Fetuin-A levels may have a relationship with RPL.
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http://dx.doi.org/10.1080/14767058.2021.1931675DOI Listing
May 2021

The effect of the birth method on changes of the prepartum and postpartum dimensions of perineal body.

Eur J Obstet Gynecol Reprod Biol 2021 May 5;262:36-39. Epub 2021 May 5.

Ministry of Health Ankara City Hospital, Department of Obstetrics and Gynecology, Turkey.

Objective: The perineal body is critical for maintaining the integrity of the pelvic floor, especially in females as it can be injured during vaginal delivery. This study aimed to evaluate the effect of childbirth on perineal body dimensions by using a transperineal 2D ultrasound.

Study Design: This prospective cohort study was performed in a tertiary obstetric care center. A total of 172 term pregnant women who delivered either by cesarean section or vaginal delivery were enrolled in the study. All demographic data and information were collected prospectively. The perineal body was measured in length, height, perimeter, and area. Mode of delivery was classified into four categories, including prelabor cesarean section, cesarean section during the first stage of labor, the first vaginal delivery, and more than one previously vaginal delivery. A postpartum evaluation was performed after 6 weeks.

Results: Among the 172 women, 40 (23.3 %) had a history of cesarean section (CS) and they delivered with scheduled CS, 40 (23.3 %) women delivered by primary CS during active labor, 48 (27.9 %) women had the first vaginal delivery, 44 (25.6 %) women who delivered vaginally had a history of at least one vaginal delivery. The postpartum perineal body measurements were significantly lower in terms of length, perimeter, and area in all pregnancy groups.

Conclusion: Pregnancy and delivery change perineal body dimensions, significantly. Cesarean section does not completely protect against changes in perineal body morphology.
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http://dx.doi.org/10.1016/j.ejogrb.2021.04.044DOI Listing
May 2021

Copper and levonorgestrel containing intrauterine devices: comparison of their effect on oxidative stress markers.

Gynecol Endocrinol 2021 Apr 17;37(4):320-323. Epub 2021 Feb 17.

Department of Obstetrics and Gynecology, Etlik Zübeyde Hanim Women's Health Training and Research Hospital, Ankara, Turkey.

Objective: We aimed to evaluate the oxidative stress by measuring the thiol-disulfide balance in women who use either T380A or LNG-IUD as a contraceptive method. The study included two groups; 30 women with LNG-IUD and 30 women with copper-IUD. Thiol-disulfide homeostasis as a marker of oxidative stress was analyzed before the IUD insertion and on the 6 month after insertion. The LNG-IUD group had similar native thiol levels with Cu-IUD (293.1 ± 43.5 µmol/l vs. 290.4 ± 42.4 µmol/l respectively,  = 819). In the copper-IUD group total thiol levels were higher than LNG-IUD group (345.5 ± 58.2 µmol/l vs. 319.5 ± 52.4 µmol/l,  = .031). A significant increase was observed after 6 months in LNG-IUD patients in terms of disulfide/native thiol (7.9 ± 4.4% vs. 11.2 ± 2.6%,  = .006), disulfide/total thiol (6.2 ± 1.8% vs. 8.7 ± 1.9%,  = .004) and Native thiol/total thiol (87.1 ± 12.1% vs. 82.3 ± 8.2%,  = .004) levels. After 6 months in copper-IUD patients, disulfide (22.3 ± 7.3 µmol/l vs. 27.5 ± 6.9 µmol/l respectively,  = .006), disulfide/native thiol (7.7 ± 3.8% vs. 9.8 ± 2.4% respectively,  = .007), disulfide/total thiol (6.4 ± 2.03% vs. 8.2 ± 1.8% respectively,  = .007) and native thiol/total thiol (86.3 ± 9.4% vs. 83.8 ± 10.6% respectively,  = .007) levels were increased. An increase in oxidative stress markers were observed in both groups. Studies evaluating the long term subclinical risks of IUD's are needed to understand the outcomes of the increased oxidative stress.
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http://dx.doi.org/10.1080/09513590.2021.1878132DOI Listing
April 2021

Identifying the risk factors and incidence of Asherman Syndrome in women with post-abortion uterine curettage.

J Obstet Gynaecol Res 2021 Apr 18;47(4):1549-1555. Epub 2021 Jan 18.

Department of Obstetrics and Gynecology, Memorial Ankara Hospital, Ankara, Turkey.

Aim: To evaluate the risk factors and incidence of Asherman Syndrome in women with post-abortion uterine evacuation and curettage.

Methods: A total of 2546 patients who had surgical abortion (uterine evacuation and curettage) before the 20th gestational week with indications of missed abortion, anembryonic pregnancy, incomplete abortion, and elective curettage in a tertiary antenatal care center were recruited. The patients were called and surveyed for their symptoms; including infertility, oligo-amenorrhea and recurrent pregnancy loss, preterm birth and intrauterine growth retardation and abnormal placentation as criteria of Asherman Syndrome. Diagnostic (office) hysteroscopy was performed for 177 who had one of those complaints.

Results: The incidence of Asherman Syndrome was 1.6% (n = 43/2546). History of ≥3 abortions was the main factor that increased the risk of Asherman Syndrome for by 4.6 times. Use of vacuum aspiration or sharp curettage, premedication for cervical priming, and having a pregnancy >10th gestational weeks were not risk factors for Asherman Syndrome.

Conclusion: When the diagnosis was based on presence of symptoms who underwent uterine instrumentation, the incidence of Asherman Syndrome was found to be 1.6%. Repeated abortions were the main risk factor for Asherman Syndrome and avoiding from repeated uterine instrumentations may have a role in prevention.
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http://dx.doi.org/10.1111/jog.14667DOI Listing
April 2021

Echogenic particles in the amniotic fluid of term low-risk pregnant women: does it have a clinical significance?

J Obstet Gynaecol 2021 Jan 11:1-5. Epub 2021 Jan 11.

Department of Obstetrics and Gynecology, Ankara Zekai Tahir Burak Education and Research Hospital, Ankara, Turkey.

In this study, we aimed to analyse the clinical features of the third-trimester pregnant women, with echogenic amniotic fluid and to compare their obstetric and neonatal outcomes with pregnant women with normal amniotic fluid echogenicity. This case-control study was conducted in a tertiary antenatal care centre. A total of 560 term (37-42 weeks of gestation) singleton women; 280 with echogenic particles in amniotic fluid and 280 with clear amniotic fluid, who delivered within 24 h after the ultrasound scan were evaluated. The women in the two groups were similar in terms of age, parity, body mass index, foetal birth weight, and gestational age. More patients in the particulate amnion group had lower Apgar scores (<7) in 1st and 5th minutes than controls ( = .006,  = .031 respectively) however the rate of admission to neonatal intensive care was similar. Vernix stained amniotic fluid was more common in the study group (48.8%,  = .031), the rate of meconium-stained amniotic fluid was similar in the study and control groups (9.6-9.2%,  = .881). The primary caesarean section rate was higher in women with particulate amnion (18.4%,  = .037). Echogenic particles in the amniotic fluid in the third trimester could not be attributed to meconium, however, higher rates of primary caesarean section may require further attention.IMPACT STATEMENT Previous studies showed that high-density intra-amniotic particles were possibly related to vernix caseosa, intra-amniotic bleeding, and meconium. The number of study groups in these studies was also limited. Additional to other previous studies, we found an increased rate of intra-amniotic echogenic particles in male foetuses. The presence of echogenic particles on ultrasound was not related to increased risk for the presence of meconium. Significantly more neonates born to mothers with intra-amniotic echogenic particles tended to have lower Apgar scores (<7), however, this significant difference did not affect the need for NICU admission. The presence of echogenic particles in the amniotic fluid of the third-trimester pregnant women could not be attributed to meconium and adverse perinatal outcomes, however, the higher rates of primary caesarean section may require further attention.
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http://dx.doi.org/10.1080/01443615.2020.1834520DOI Listing
January 2021