Aegean Journal of Obstetrics and Gynecology
Aegean Journal of Obstetrics and Gynecology (AEJOG) is open access and peer review journal which is published three times a year. AEJOG, publishing a broad range of original research articles, case reports, review articles and letters to the editor, about all aspects of obstetrics and gynecology and women's health including maternal-fetal medicine, gynecologic oncology and infertility/reproductive endocrinology.
AEJOG is an open-access journal which means that through the internet; freely accessible, readable, downloaded, copied, distributed, printed, scanned, linked to full texts, indexed, transferred to the software as data and used for any legal purpose, without financial, legal and technical obstacles. The only authority on reproduction and distribution and the sole copyright role in this field; has been given to authors therefore they can have control over the integrity of their work, so that they are properly recognized and cited. This is in accordance with the BOAI definition of open access. The content in Aegean Journal of Obstetrics and Gynecology (AEJOG) is protected by copyright. All copyrights of the submitted articles are transferred to the Aegean Journal of Obstetrics and Gynecology within the national and international regulations at the beginning of the evaluation process. Upon submission of their article, authors are requested to complete an assignment of copyright release form. Authors should acknowledge that they will not submit their manuscript to another journal, publish in any other language, or allow a third party to use the article without the written consent of the Aegean Journal of Obstetrics and Gynecology. When an article is published on AEJOG, it is read and reused for free as soon as it is published under a Creative Commons Attribution-NonCommercial 4.0 (CC BY NC 4.0) license. In case the article is rejected, all copyrights are given back to the authors. The content of the article and all legal proceedings against the journal, if any, are the responsibility of the author. In addition, all financial and legal liability for the copyright of the presented tables, figures and other visual materials protected by law belongs to the authors. It is the responsibility of the corresponding author to report authors scientific contributions and responsibilities regarding the article. In case of any conflict of interest, it is the responsibility of the authors to indicate the conflict of interest in the Disclosure part of the article. Author names will be published as they are listed on the submitted Title page.
The predictive effect of serum AMH and FSH levels alone or in combination on fertility outcome
Objective: To explore the roles of anti-mullerian hormone (AMH) and follicle stimulating hormone (FSH) in predicting clinical pregnancy. Materials and Methods: Forty patients who were decided on IVF/ICSI due to different infertility etiologies were included in the study. The patients were divided into two groups according to their AMH and FSH values as having a good prognosis or a poor prognosis. The clinical pregnancy and miscarriage rates of 33 cycles with good prognosis and 17 cycles with poor prognosis were compared. Results: In the good prognosis group, the FSH value was significantly lower than the poor prognosis group (5.98±1.04 mIU/mL vs. 13.6±3.07 mIU/mL, p<0.01), while the serum AMH level was significantly higher. (3.80±1.32 ng/mL vs 0.54±0.02 ng/mL, p<0.01). The rate of chemical pregnancy in the group with good prognosis was twice as high and significant compared to the group with poor prognosis (12 (36.3%) vs 5 (29.4%), p<0.02). In terms of clinical pregnancy rates, the group with good prognosis showed a higher frequency (33.3% vs. 23.5%, p<0.001), while miscarraige rates were higher in the group with poor prognosis (9.0% vs. 25%, p<0.003). Conclusions: Evaluation of AMH and FSH together is critical in determining clinical pregnancy rates.
Copyright (c) 2023 Zercan Kalı, Fatma Tanılır Çağıran https://creativecommons.org/licenses/by-nc/4.0
The Effect of an antioxidant agent-multivitamin complex food supplement on spermiogram in infertile men
giriiş Oxidative stress (OS) occurs due to overproduction of reactive oxygen radicals (ROS) or weakening of anti-oxidant mechanisms and may harm fertility. Our study aimed to investigate the effects of combined support therapy containing antioxidant agents and vitamin complexes on fertility. Material method In this retrospective case-control study, 300 randomly selected infertile men were included. For four months, the effect of daily intake of an antioxidant-multivitamin complex containing astaxhantin (5mg), Coenzyme Q10 (100mg), L-Arginine (250mg), L-Carnitine (250mg), Selenium (100mcg), Zinc (10mg), Folic acid (400mcg), Vitamin E (100mg) and Vitamin C (100mg) on spermiogram parameters was investigated. Results Semen hacminde (2.21 ml -3.05 ml; p=.004), sperm konsantrasyonunda (9.60 milyon/ml -14.10 milyon/ml; p=.000), ileri hareketli sperm sayısında (%16.50 -%26.65; p=.000) ), sperm canlılık oranında (%48 - %68; p=.001) beslenme desteği alan hastalarda istatistiksel olarak anlamlı artış bulundu. Ayrıca tedavinin anormal morfolojiye sahip hasta sayısında (Kruger kriterlerine göre normal morfolojiye ulaşamayan hastaların en az %4'ü) anlamlı azalma (%77 - %61; p=.002) sağladığı belirlendi. ). Çözüm Astaxhantin, KoQ10, L-arjinin, L-karnitin, selenyum, çinko, E ve C vitaminleri içeren antioksidan-multivitamin içerikli besin takviyelerinin semen hacmi, sperm morfolojisi, canlılık ve motilite üzerinde anlamlı iyileşme sağladığı belirlendi. Bu bağlamda antioksidan-multivitamin kompleksinin erkek kısırlığında destekleyici tedavi için gıda takviyesi olarak kullanılabileceğini öngörüyoruz.
Copyright (c) 2023 Pınar Tuğçe Özer https://creativecommons.org/licenses/by-nc/4.0
Evaluation of maternal and neonatal outcomes of emergency cesarean deliveries in cases of placenta previa uncomplicated with placenta acreata spectrum
Objective: The management and surgery of placenta previa describe a challenging process that requires experience. It is important to decide on the timing of planned cesarean section in women with placenta previa, taking into account the balance between possible maternal severe bleeding and possible neonatal morbidities. Material and methods: In the present study, the data of 349 singleton pregnant women with a diagnosis of placenta previa uncomplicated by placenta accreta spectrum were analyzed. Patients who underwent planned (68%, n=236) or emergency cesarean section (32%, n=113) were divided into two groups. In this study, maternal demographic and clinical information, surgical procedures and maternal/neonatal outcomes were studied. Results: The proportion of patients who underwent uterine compression suture and Bakri balloon was found to be significantly higher in the emergency cesarean section group compared to the planned cesarean deliveries group (p<0.001). The operation time, hospital stay, urinary tract infection rate, decrease in hemoglobin and need for blood transfusion were found to be significantly higher in the emergency cesarean section group compared to the planned cesarean section group (p<0.001, p<0.001, p<0.001, p<0.001, p<0.001, p<0.001, respectively). In addition, a significant association was detected between emergency cesarean section and prematurity, low birth weight, low APGAR score, increased neonatal intensive care unit hospitalization and neonatal mortality. Conclusion: Cases of placenta previa are at risk of emergency cesarean delivery, which can be complicated by poor maternal and neonatal outcomes. Equipped centers and experienced teams are of great importance in reducing fetomaternal morbidity and mortality caused by placenta previa.
Copyright (c) 2023 Mehmet Özer https://creativecommons.org/licenses/by-nc/4.0
Impact of the type of ductus venosus agenesis and the presence of associated anomalies on prognosis
Objective: The Ductus Venosus (DV) connects the umbilical vein to the inferior vena cava. With a portocaval pressure gradient, the well-oxygenated blood in the ductus venosus accelerates towards the left sidewall of the inferior vena cava, directing the blood preferentially towards cephalic and coronary circulation through the foramen ovale (1). DV serves as a shunt, expanding to protect the heart and brain in hypoxic conditions. Ductus Venosus Agenesis (DVA) is a rare congenital abnormality with a prevalence of 0.03-0.07%. The type of DVA, along with any additional anatomical or chromosomal anomalies in fetuses with DVA, significantly affects the postnatal prognosis. Some fetuses with DVA develop normally, while others may experience growth retardation, heart defects, or other complications. In this study, we aimed to evaluate the frequency of associated anomalies in DVA cases, examine the impact of each type of DVA (intrahepatic and extrahepatic venous drainage) on prognosis, and contribute to the literature on this rare disease. Materials and Methods: We conducted a retrospective study of all cases diagnosed prenatally with DVA at a tertiary center between 2016-2019. Our study reviewed obstetric data, associated anomalies, other systemic anomalies, type of DVA, chromosomal or genetic anomalies, and perinatal and postnatal outcomes. Postnatal infants were followed up to the 6th month. Results: We identified 16 cases with ductus venosus agenesis. The type of DVA (intrahepatic-extrahepatic shunt), presence of chromosomal anomalies, accompanying ultrasonographic findings, and perinatal outcomes were recorded. Generally, in 7 out of the 16 cases, the umbilical vein drained into the portal system (44% - intrahepatic), and in 9 cases, it drained into the systemic venous system. Conclusion: DVA is a rare congenital abnormality with potentially significant implications for affected fetuses and infants. Early diagnosis, careful monitoring, and appropriate management strategies are crucial to optimize outcomes for these patients. There's a need for future research to better understand the underlying etiology and pathophysiology of DVA and to develop more effective treatment options for affected individuals.
Copyright (c) 2023 Züat Acar, Yusuf Başkıran https://creativecommons.org/licenses/by-nc/4.0
The association between cervical HPV and female fertility
Objective: Genital human papillomavirus (HPV) infection is the most common sexually transmitted viral infection worldwide with a prevalence of 10-12% in the female population in the reproductive age; few studies addressed the effect of HPV infection on fertility. It is aimed to investigate the presence of HPV infection in infertile women in the present study. Materials and methods: In this retrospective cross-sectional study; the outpatient infertility clinic records between July 2020 and January 2023, were evaluated. Infertility examination and evaluation were performed following the guidelines. Infertile female individuals and control group’s HPV results were analyzed. Results: 234 infertile and 340 non-infertile females were included in the study, HPV positivity was found %11.5 for all infertile women. No significant relationship was found between and HPV (p=0.850). Conclusion: No significant association was found between female infertility and HPV. Still HPV may play a role in infertility with different genotypes. Further studies should include HPV genotypes.
Copyright (c) 2023 Alper İleri, İbrahim Karaca, Suna Yıldırım Karaca, Hande İleri, Can Ata, Mehmet Özer, Pınar Tuğçe Özer, Ahmet Demir https://creativecommons.org/licenses/by-nc/4.0
Hysteroscopic management of infected and partially discharged desidual cast in an adolescent: A case report and review of the literature in adolescents
Objective: Decidual cast in other words membranous dysmenorrhea is a rare entity. Hereby, we report the first infected case caused by drospirenon containing contraceptive use and managed successfully by hysteroscopy. Case presentation: A13 year-old girl started on drospirenon containing contraceptive theraphy since her menarche resulted in menorrhagia and anemia that requires transfusion. On follow up, she developed a partially discharged infected mass revealed to be a decidual cast on pathological review. Discussion: Membranous dysmenorrhea occurs more frequently in the adolescent and young adult population. All cases in this review were on hormonal theraphy except one occured spontaneously. Cast formation of the immature uterus after menarche is an exaggerated response to dose-independent increased progestin levels. Conclusion: We conclude that diagnosis of decidual cast/membranous dysmenorrhea should be kept in mind for colicky pain with bleeding of adolescents under hormonal contraceptive therapy and partially discharged cases may be managed successfully by hysteroscopy.
Copyright (c) 2023 Elcin Telli, Mehmet Surhan Arda https://creativecommons.org/licenses/by-nc/4.0
The effect of anti-phospholipid syndrome on pregnancy outcomes in patients with habitual abortus
Objective: The aim of this study was to research the pregnancy outcomes of women with anti-beta2 glycoprotein 1 and anti-cardiolipin antibody positivity and to determine the association with pregnancy morbidity. Materials and methods: This retrospective study contained pregnant women with anti-beta2 glycoprotein 1 and anti-cardiolipin antibody positivity and a control group without these antibodies. Totally 190 serum samples sent from Obstetrics and Gynecology clinics between January 2019 and January 2023 were analyzed in the medical microbiology laboratory of xx. Results: In a patient population separated into antibody-positive and antibody-negative groups, the gravida was found to be 3.8±0.1 and 3.5±0.3 respectively (p=0.333). Parity was 1.1±0.1 and 0.8±0.1 (p=0.071), abortion rates were 2.3±0.1 and 2.5±0.2 (p=0.659), and gestational age was 35.7±0.8 and 34±1.5 (p=0.047). Intrauterine fetal death was found to be higher in the antibody-positive group compared to the antibody-negative group (p=0.03). There was no noteworthy distinction noted between the two groups regarding additional pregnancy complications such as intrauterine growth restriction, oligohydramnios, gestational diabetes, and gestational hypertension (respectively p=0.623, 0.074, 0.312, 0.626). However, smoking was significantly higher in the antibody-positive group (p=0.049). Conclusion: Antiphospholipid syndrome adversely affects pregnancy outcomes. During the initial visit, a thorough patient history should be obtained, and in pregnant women with a history of poor obstetric outcomes or habitual abortions, this syndrome should be considered.
Copyright (c) 2023 Alper Togay, Duygu Tekin , Mehmet Özer, Özden Sıla Kılınç Gönüllü https://creativecommons.org/licenses/by-nc/4.0
The Results of karyotype analysis and 22q11.2 (DiGeorge Syndrome critical region) deletion investigation in fetal cardiac system anomalies
The results of karyotype analysis and 22q11.2 ( DiGeorge Syndrome critical region) deletion investigation in fetal cardiac system anomalies Objective: We aimed to determine the presence of accompanying chromosomal anomalies and 22q11.2 deletion in patients with cardiac system anomalies. Material and Methods: In our retrospective and cross-sectional study, 99 fetuses born with cardiac anomalies were evaluated in terms of chromosomal anomalies. 36 fetuses were evaluated for 22q11.2 deletion. Fetuses who were diagnosed with prenatal congenital heart defect and underwent invasive prenatal diagnostic tests for fetal karyotyping between 01.01.2010 and 30.06.2017 at a tertiary cancer center were included in the study. Results: Of 99 cases, 48 (48.4%) had only cardiac anomalies and 51 (51.5%) had non-cardiac anomalies. Chromosomal anomalies were found in 37 (37.4%) of the cases. Autosomal trisomy 18(43.2%) and autosomal trisomy 21(32.4%) were the most common chromosomal anomalies. The study results support the strong association of chromosomal changes and cardiac malformation, especially in septal defects, atrioventricular septal defects, and conotruncal malformations. Deletion was detected in one(2.8%) of 36 cases evaluated for 22q11.2 deletion. The fetus with this deletion had isolated tetralogy of fallot and had no extracardiac anomaly. Conclusion: In cases with cardiac anomalies, isolated or accompanied by extracardiac anomalies, investigations should be made in terms of underlying chromosomal diseases in the perinatal evaluation. In addition, the investigation of 22q11.2 deletion in fetuses with conotruncal cardiac anomalies should be included in prenatal genetic examination. Keywords: DiGeorge Syndrome, Fetal Anomalies, karyotype, trisomy, 22q11.2 Deletion Syndrome
Copyright (c) 2023 Zübeyde Emiralioğlu Çakır, Atalay Ekin, Altuğ Koç, Yaşar Bekir Kutbay, İlker Çakır, Muzaffer Sancı https://creativecommons.org/licenses/by-nc/4.0
Reasons for declining prenatal diagnostic tests and analysis of factors impacting the decision
Abstract Objective: To identify the factors impacting the decision of declining to have prenatal diagnostic tests and to determine the reasons for declining in cases with high trisomy risk in prenatal screening tests and those who refuse to undergo prenatal diagnostic tests. Materials and methods: Cases with positive test results in first and second trimester aneuploidy screening tests were included in the study. The patients were divided into two groups those who accepted prenatal diagnostic tests (Group 1) and those who refused prenatal diagnostic tests (Group 2). The patients that refused prenatal diagnostic tests were evaluated with a questionnaire to determine the reasons for refusal. Results: 204 cases were included in the study. 44 (21.6%) of these cases wanted to have prenatal diagnostic tests, while 160 (78.4%) refused to have prenatal diagnosis tests. A significant correlation was found between the decision to refuse the prenatal diagnostic test and the mother's educational status level (p=0.035), whereas no significant correlation was found between the personalized risk ratios and the number of abortions in previous pregnancies. Among the reasons for refusal of prenatal diagnosis test, the main reason was determined to be "Termination of pregnancy is not an option". Conclusion: Pregnant women should be offered all options, including not having a prenatal screening test or a prenatal diagnostic test, by providing accurate and understandable information about the purpose and potential outcomes of prenatal screening tests. Hence, pregnant women can be provided with the opportunity to make an informed choice.
Copyright (c) 2023 Fırat Ökmen, Huseyin Ekici, Erdoğan Koca, Osman Ökmen, Hicran ACAR SİRİNOGLU https://creativecommons.org/licenses/by-nc/4.0
Association between sexual dysfunction, self-esteem and sexual satisfaction in women
ABSTRACT Backround: The main purpose of this study is to investigate the relationships among female sexual dysfunction, self-esteem and sexual satisfaction. Method: The participants of the study were 321 women who applied for any sexual disorders to the Polyclinics of Gynecology of y Education and Research Hospital, x, Turkey. Their age ranged from 18 to 56. The participants completed a personal information form prepared by researcher, the Coopersmith Self-esteem Inventory developed by Stanley Coopersmith (1986) and the Golombok-Rust Inventory of Sexual Satisfaction validated by Tuğrul (1988). Results: The results indicated that female sexual dysfunction (FSD) and self-esteem were moderately negatively correlated (r= -.598, p<.01). FSD and sexual satisfaction were strongly positively correlated (r= .712, p<.01). Sexual satisfaction and self-esteem were moderately negatively correlated (r= -.472, p <.01). These findings reveal that the higher sexual dysfunction women have the less self-esteem they have and the less sexual satisfaction they experience. Conclusion: With the proper treatment of sexual dysfunction and interventions for improving the self-esteem, women can evaluate themselves in a more positive way and become more sexually satisfied. Thus, it is very significant to teach sexuality in a correct way and to increase sexual education and awareness among women.
Female sexuality, female sexual dysfunction, self-esteem, sexual satisfaction.
Copyright (c) 2023 Coc Avcı, Olgu Aygün, Dilek Güldal https://creativecommons.org/licenses/by-nc/4.0
Analyzing the quality and reliability of educational content in laparoscopic hysterectomy videos on Youtube
Objective: The aim of this study was to evaluate the quality, reliability, and usefulness of laparoscopıc hysterectomy videos on YouTube. Methods: A search was conducted on YouTube using the keyword " laparoscopıc hysterectomy". The search results were limited to the first 400 videos. 330 videos that met the inclusion criteria were examined. Viewer parameters such as likes and dislikes, total views, comments, and sources were evaluated. The educational content of the videos was evaluated using the Global Quality Score. Additionally, the popularity of the videos was evaluated using the Video Power Index. Upload sources were categorized as academic institutions and individual users. Results: Group 1 (low and medium quality videos) had 234 (70.9%) videos and group 2 (good and excellent quality videos) had 96 (20.1%) videos. The average views, likes, and comments in group 1 were 20589±23552 , 86±113 , and 28±31, respectively, while in group 2, they were 25571±24541 , 174±198 , and 49±42 , respectively. When the two groups were compared, no correlation was found between the length and quality of the videos.There was no difference between the groups in terms of the number of dislikes Additionally, the VPI values in group 2 were statistically higher than those in group 1 (p = 0.003). Conclusion: Only 20.1 % of laparoscopıc hysterectomy videos on YouTube are of good and excellent quality, indicating that a significant portion of videos providing laparoscopıc hysterectomy education are inadequate.
laparoscopic hysterectomy, educational videos, youtube
Copyright (c) 2023 Emine Öztürk https://creativecommons.org/licenses/by-nc/4.0
Women's health belief levels towards breast cancer: Example of three countries
Objective: This research aims to compare the health belief levels of women towards breast cancer by country. Material and Methods: This cross-sectional study was conducted with 431 women living in Turkey, Nigeria and India between December 2021 and April 2022 in order to examine the health belief levels of women towards breast cancer. Results: In our study, the mean score of Sensitivity Perception of individuals was 7.10±3.30, Caring/seriousness perception 17.02±5.91, Health motivation 21.09±3.65, BSE self-efficacy 31.28±12.34, BSE benefits 15.40±4.07, BSE barriers 21.38±6.40, Mammography benefits 18.76±4.62, and Mammography Barriers was 29.15±9.65. A significant difference was found in all sub-dimensions of the participants in the study, except for the mammography barriers, which are among the sub-dimensions of health beliefs about breast cancer (p<0.05). Conclusion: It was determined that all sub-dimensions of the participants in the study differed, except for the mammography barriers, which are among the sub-dimensions of health belief towards breast cancer.
Copyright (c) 2023 Metin Yıldız, Ayşe ELKOCA, Roseline Florence GOMES, Mehmet Salih YILDIRIM, Dursun Alper YILMAZ, Ebru SOLMAZ, Gökhan DEGE, Abraham Tanimowo, Mehmet Emin ATAY https://creativecommons.org/licenses/by-nc/4.0
The effect of oral iron supplementation on glucose metabolism in non-anemic pregnant women who are in the risk group for gestational diabetes mellitus
Aim: There are opinions about the negative effects of the increase in iron storages or plasma iron levels during pregnancy on glucose metabolism. We aimed to investigate the effects of oral iron supplementation on glucose metabolism in non-anemic pregnant women who are in the risk group for gestational diabetes mellitus. Material and methods: While oral iron supplementation of 40 mg/day was givento 41 pregnant women in the study group (Group I) for eight weeks, oral iron supplementation was not givento 35 pregnant women in the control group (Group II). 100 g oral glucose tolerance test (OGTT) was applied for the diagnosis of GDM in pregnant women whose 50 g OGTT results were positive. Analyzing the results between groups. Results:There was no significant difference between the two groups in terms of mean fasting plasma glucose (FPG) value (p: 0.185), GDM (p:0.292) and mean results of 50gr OGLT (p: 0.109).A total of 26 pregnant women with 50 gr OGLT positive were applied 100 gr OGTT for diagnostic purposes. Conclusion:It was concluded that 40 mg/day oral iron supplement used from the first trimester in pregnant women in the risk group for GDM did not have a significant negative effect on glucose metabolism and did not cause an increase in the risk of GDM.
Copyright (c) 2023 Onur Aldemir, Mehmet Rıfat Göklü, Mehmet Özer, Alper İleri, Pınar Tuğçe Özer, Özge Özdemir, Can Ata, Sefa Kurt https://creativecommons.org/licenses/by-nc/4.0
Ovarian mucinous cystadenoma recurred 2 years after laparoscopic surgery: A Case Report
Objective: Recurrence of ovarian mucinous cystadenomas is very rare. This report describes a case of ovarian mucous cystadenoma in a women that recurred 2 years after surgery. Case presentation: A 22-year-old patient, with a sizable ovarian tumor underwent laparoscopic-assisted cystectomy. On histopathology, the tumor was diagnosed to be an ovarian mucinous cystadenoma. The mucinous cystadenoma recurred 2 years after surgery and subsequently laparoscopic right adnexectomy was performed. Discussion: It has been reported that intraoperative cyst rupture and cystectomy instead of adnexectomy are risk factors for mucinous cystadenoma recurrence. Close follow-up is required for post-cystectomy patients because of the possibility of recurrence. Conclusion: The risk of recurrence and the preservation of fertility should be carefully considered when deciding on treatment in young patients with a mucinous cystadenoma. The follow-up is required for post-cystectomy patients because of the possibility of recurrence.
Copyright (c) 2023 Aykut Özcan https://creativecommons.org/licenses/by-nc/4.0
The effects of anti-mullerian hormone, antral follicle count, and follicle stimulating hormone values on pregnancy outcomes in a case with polycystic ovary syndrome
Objective: In this study, it was aimed to predict pregnancy by anti-mullerian hormone, follicle-stimulating hormone, and antral follicle count values of infertile patients with PCOS. Methods: This retrospective study has been conducted on 555 patients diagnosed with PCOS (polycystic ovary syndrome) according to the Rotterdam Criteria, referred for infertility in the IVF Clinic of Istanbul Training and Research Hospital in the 2010-2019 study. Clinical pregnancy results have been analyzed together with anti-mullerian hormone, antral follicle count, and follicle-stimulating hormone levels. Results: The age of the patients within the group of clinical pregnancy is significantly higher than the group without pregnancy (p ˂ 0.05). Follicle-stimulating hormone (iu/ml) and anti-mullerian hormone (ng/ml) values do not differ significantly (p 0.05) in the group with and without clinical pregnancy. For the group with clinical pregnancy, the antral follicle count value is found to be significantly higher (p ˂ 0.05) than the group without pregnancy. The age of the patients in the group with clinical pregnancy was found to be significantly higher than the group without pregnancy. (p ˂ 0.05). Follicle stimulating hormone (iu/ml) and anti-müllerian hormone (ng/ml) values did not differ significantly in the group with and without clinical pregnancy (p 0.05). Antral follicle count value was found to be significantly higher in the group with clinical pregnancy than in the group with out pregnancy (p ˂ 0.05). Although AFC was found to be significantly higher in the group with clinical pregnancy than in the non-pregnant group, it was examined diagnostically by ROC analysis, but the diagnostic capacity of this variable to distinguish between pregnant and non-pregnant women was not found to be sufficient. (AUC<0.70). Conclusion: We found that anti-mullerian hormone and follicle-stimulating hormone are not related to clinical pregnancy outcomes in the infertile patient group diagnosed with PCOS (polycystic ovary syndrome). Plus, although the AFC value in the group with pregnancy was significantly higher than the group without pregnancy, its diagnostic capacity was not found to be sufficient.
Copyright (c) 2023 CELAL AKDEMİR, Fatma Ferda Verit https://creativecommons.org/licenses/by-nc/4.0
Determining the level of superstition belief in pregnancy
Objective: This study was conducted to evaluate the superstitions of pregnant women. Method: This descriptive and correlational study was conducted with 278 pregnant women living in Agri between October 2021 and August 2022. Results: It was determined that the total mean score of the pregnant women on the Superstitious Belief Scale was 36.16±13.75. A statistically significant difference was found between the educational status, monthly income, perception of pregnancy and superstition levels of the pregnant women [p<0.05]. Conclusion: It was found that the total Superstitious Belief Scale scores of the pregnant women were moderate and unplanned pregnancy, income and education level affected the superstition score means.
Copyright (c) 2023 Metin Yıldız, Ela VAROL, Ahsen DEMİRHAN, Mehmet Salih YILDIRIM, Ebru SOLMAZ https://creativecommons.org/licenses/by-nc/4.0
Prediction Models of Endometriosis Stage Generated From Potential Hematological Biomarkers
Objective: The aim of the study assess efficacy of hematological biomarkers for predicting the stage of endometriosis. Materials and methods: Patients underwent surgery and diagnosed with endometriosis confirmed by pathology report between January 2015-December 2020 were included. Individuals were divided into two groups as stage 1-2-3 and stage 4 patients. Results: 91 patients with stage 1-2-3 and 105 with stage 4 endometriosis were identified. There was no significant relationship between endometriosis score and complete blood count parameters. However, endometriosis score revealed a significant correlation with serum CA125 level and the combined markers including CA125. The logarithm of the CA 125 was used to predict the endometriosis score. In order to quantify the relationship, a univariate linear model was performed to predict the endometriosis score with log (CA 125). It demonstrated for every increase in the level of log (CA 125), endometriosis score increased by 8.57 (β=8.57. R2=0.115. p<0.001). The p values of alternative parameters analyzed to predict the stage of endometriosis. p-values were 0.263 for neutrophile/lymphocyte; 0.457 for platelet/lymphocyte; 0.790 for red cell distribution width/lymphocyte and 0.842 for mean platelet volume/lymphocyte ratios. Conclusion: CA 125 alone was found substaintally efficient in predicting endometriosis stage preoperatively.
Copyright (c) 2023 Ayşe Rabia Şenkaya, Onur İnce , Alper İleri, Hakkı Aytaç, Suna Yıldırım Karaca https://creativecommons.org/licenses/by-nc/4.0
Comparison of laparoscopic cystectomy and fenestration/cauterization procedures in terms of pelvic pain and recurrence in patients with endometrioma
Abstract Introduction: Endometriosis is an estrogen-dependent, progressive inflammatory disease caused by the growth of endometrium-like tissue outside the uterine cavity. In women of reproductive age, it is a prevalent cause of pelvic pain. Surgical intervention may be required in the insufficiency of conservative treatments and laparoscopic procedures should be prioritized for surgery. The objective of our study was to compare the efficacy of laparoscopic fenestration-cauterization and cyst excision in patients with ovarian endometrioma on dysmenorrhea, non-menstrual pelvic pain, dyspareunia, and dyschezia symptoms. Materials and methods: The study comprised 112 patients with endometrioma who underwent laparoscopic surgery and whose data could be obtained. In 76.8% (n=86) of the patients, laparoscopic cystectomy was conducted, and in 23.2% (n=26) of the patients, laparoscopic fenestration+cauterization were performed. The patients' preoperative examination findings and VAS (Visual Analog Scale) pain levels were retrieved retrospectively. Patients were contacted again during the study, VAS pain scores were recalculated, and a gynecological ultrasound scan was performed to check for recurrence. The collected data were analyzed comparatively. Results: The mean age of the patients was 35.5 ± 6.8 years in the fenestration-cauterization group and 32.3 ± 5.9 years in the cystectomy group. 12.5% (n=14) of the cases were classified as stage I, 3.5% (n=4) as stage II, 32% (n=36) as stage III, and 52% (n=58) as stage IV. The operative time was significantly shorter in the fenestration+cauterization group compared to the cystectomy group (respectively/min 50.0±18.4 /61.3.±16.8, p=0.014). In both groups, the number of patients with dysmenorrhea, NMPP, dyspareunia, and dyschezia who had high VAS pain scores decreased significantly (p<0.005). In both procedures, there was no difference between recurrence rates (p=0.801). After surgical treatment, there was a significant decrease in the number of stage III-IV patients with dysmenorrhea and NMPP who had high VAS (p<0.005). Conclusion: We emphasize the significance of laparoscopy in the surgical treatment of endometriosis. Both laparoscopic fenestration + cauterization and laparoscopic cystectomy significantly reduced pain symptoms, especially in patients with advanced endometriosis. The efficacy and recurrence rates of both treatments were not significantly different. Keywords: Endometriosis, endometrioma, pelvic pain, laparoscopic surgery, recurrence
Copyright (c) 2022 Yasemin Göklü, Cüneyt Eftal Taner, Mehmet Rıfat Göklü, Alper ileri, Mehmet Özer https://creativecommons.org/licenses/by-nc/4.0
Acute appendicitis in pregnancy; A single center experience
Objective Appendicitis is the most common cause of extrauterine acute abdomen during pregnancy. There are scoring systems, such as Alvarado, based on physical examination and laboratory values developed for the diagnosis of appendicitis in the general population. However, when it comes to pregnant women, the effectiveness of the methods used in daily practice decreases considerably. In our study, we aimed to share the data of our patients who were diagnosed with acute appendicitis during pregnancy in our clinic. Material methods Pregnant women who were operated for acute appendicitis between April 2008 and May 2021 were included in the study. Demographic data of the patients, gestational week, physical examination and laboratory values at the time of admission, USG findings, type of surgery performed, surgical findings, pathology results and fetal-maternal complications that developed during postoperative follow -up were reviewed retrospectively through the hospital system. Results From the clinicopathological features of the patients, only re-operation due to appendiceal stump leakage (p:0.04) and drain placement during operation (p:0.046) were significantly associated with miscarriage. Although complications and abortion rates were higher in patients with perforation and periappendicular abscess, the difference was not statistically significant. Conclusion Detailed history and physical examination are key for the diagnosis of acute appendicitis in pregnant women. Any patient with right lower quadrant pain, nausea, vomiting and fever, who has tenderness and defensive rebound in the right lower quadrant on physical examination should be considered as appendicitis after obstetric causes are excluded, until proven otherwise.
Copyright (c) 2022 Emre Turgut, Ilker Cakir, Fatma Dikiser, Korhan Tuncer, Kenan Teker https://creativecommons.org/licenses/by-nc/4.0
Effective use of office hysteroscopy in virgin patients: A series of 22 cases
Aim: To investigate the efficacy of hysteroscopy in the diagnosis and treatment of patients with virginity. Materials and Methods: The prospective study included 22 virgin patients that underwent hysteroscopy due to various indications between January 2015 and January 2022. Results: Mean age was 35.4±12.6 years. Most common indication for hysteroscopy was heavy menstrual bleeding (n=13; 59.09%), followed by intermenstrual bleeding (n=4; 18.1%), vaginal bleeding (n=2; 9.09%), postmenopausal bleeding (n=2; 9.09%), and persistent vaginal discharge (n=1; 4.54%). Most of the patients (n=19; 86.36%) were in the premenopausal period and the remaining 3 (13.63%) patients were in the postmenopausal period. Maximum lesion diameter was 1.2±0.93 cm for endometrial polyps (n=20) and 1.8±0.9 cm for submucosal fibroids (n=4). Two patients had both endometrial polyp and submucous myoma. No patient had malignancy or endometrial hyperplasia. The procedure was completed successfully in all patients. No perioperative complications such as cervical trauma, uterine perforation or transurethral resection of prostate (TURP) syndrome were reported by any patient. Hymen integrity was preserved in all patients. Microscopically, no residual polyps and fibroids were identified and abnormal uterine bleeding (AUB) resolved. Conclusion: Hysteroscopy can be performed in virgin patients as well and is well tolerated when performed by experienced physicians. Accordingly, physicians should consider hysteroscopy together with the vaginoscopic approach to explore the genital tract and evaluate intrauterine lesions in this population.
Copyright (c) 2022 Yunus Cavus https://creativecommons.org/licenses/by-nc/4.0
How the nitric oxide and antioxidant enzymes work in the placental tissues of pregnant women with COVID 19 disease?
Objective: The aim of this study to examine the oxidative stress parameters in placental tissues and blood plasmas of pregnant women. Materials and Methods: The biochemical parameters were examined in 37 pregnant women with covid disease, 37 pregnant women who had covid, and 37 healthy pregnant women. The amounts of lipid peroxidation (LPO), glutathione (GSH), nitric oxide (NOx) and catalase (CAT), superoxide dismutase (SOD) enzyme activities were measured in each tissue and blood plasma. Results:The LPO levels increased in the pregnant woman who has had covid 19 compared with healthy pregnant. Likewise, the LPO levels increased in pregnant women who were negative at the time of delivery. While the amount of glutathione was high in healthy placental tissues, it was found to be quite low in covid 19 positive tissues. While the enzyme activities of SOD and NOx are quite high in placental tissues of healthy pregnant women, they are significantly low in covid positive and negative pregnant tissues. While the CAT enzymes activities, another antioxidant enzyme, was at a very low level in healthy placental tissues compared to SOD enzyme, it was significantly increased in positive pregnant placental tissues. Conclusion: The antioxidant enzyme activities and amounts show significant differences between groups in placental tissues. The changes in enzyme rates in placental tissues are proportional to blood plasma results.
Copyright (c) 2022 Ozlem Aydin Berktas, Sadettin Oguzhan Tutar, E. Gulceri Gulec Peker, Candan Kaya https://creativecommons.org/licenses/by-nc/4.0
The role of fetal adipose tissue thicknesses measured ultrasonographically in the prediction of gestational diabetes
AIM This study aims to investigate whether second-trimester fetal adipose tissue components reflect glycemic control in diabetic pregnancies and their role as an auxiliary method in predicting gestational diabetes. MATERIALS AND METHODS This study was designed prospectively, cross-sectionally in 300 pregnant women 24-28 weeks of gestation between April 2020 and July 2020. The adipose tissue thickness of the humerus, femur, scapula, and abdominal circumference was examined by transabdominal ultrasound. The age, body mass index, family history of diabetes, and diabetes history in previous pregnancies of the groups were questioned. RESULTS The anterior abdominal wall adipose tissue thickness of the fetuses we included in the study was 5 ± 0.8 mm, femur adipose tissue thickness was 4 ± 0.7 mm, humerus adipose tissue thickness was 3.7 ± 0.7 mm, scapula adipose tissue thickness was 4.1 ± 2,2 mm. The total adipose tissue thickness was 16.9 ± 2.9 mm. A statistically significant correlation was found between femoral adipose tissue thickness (p = 0.001) and humeral adipose tissue thickness (p = 0.023) in gestational diabetes groups. Patients with a diagnosis of Gestational Diabetes Mellitus (n = 60) constituted the first group, patients without GDM (n =240) constituted the second group. In our independent analysis of two groups, femur and humerus adipose tissue thickness were found to be statistically significantly different between both groups (p= 0.002, p = 0.043, respectively). Other parameters did not differ significantly between groups. Between three groups (healthy, impaired glucose tolerance, and gestational diabetes groups). Femoral adipose tissue thickness was statistically significant among the three groups (p = 0.005). As a result of binary logistic regression, if the femoral adipose tissue thickness was above 4.1 mm, the possibility of developing GDM was observed with 63.8% sensitivity and 65% specificity. CONCLUSION In the prediction of gestational diabetes, fetus femoral adipose tissue thickness may be significant
Copyright (c) 2022 Yasin Altekin, Emin Üstünyurt, Süleyman Serkan Karaşin, Ömür Keskin https://creativecommons.org/licenses/by-nc/4.0
Is lymphadenectomy necessary for low-risk endometrial cancer?
Objective: The aim of this study is to investigate the effect of lymphadenectomy on disease-free survival(DFS) and overall survival(OS) in low-risk endometrial cancer cases. Material and Methods: Patients who were operated for endometrial carcinoma with endometrioid type, The International Federation of Gynecology and Obstetrics (FIGO) stage 1A, grade 1 or 2 histology between 1994 and 2013 were included in this study. The patients were divided into two groups as those who underwent intraoperative lymphadenectomy(LA +, n=197) and those who did not(LA -, n=133). Each group was evaluated in terms of survival times and recurrences. Results: When the LA+ and LA - groups were compared in terms of survival, no significant difference was found between the two groups about DFS(p=0,955) and OS(p=0,937). The 5-year DFS rate was 95.1% in the LA - group and 94.9% in the LA+ group (P= 0.974). The 5-year OS rates in patients who did and did not undergo lymph node dissection were 96.8% and 97.0%, respectively, and no statistically significant difference was found between the groups (P= 0.551). Conclusion: Performing lymphadenectomy in patients with FIGO stage 1A, grade 1 or 2, endometrioid adenocarcinoma has no effect on DFS and OS. Key Words: Endometrial cancer, lymphadenectomy, survival
Copyright (c) 2022 İlker Çakır, mehmet özeren https://creativecommons.org/licenses/by-nc/4.0
Comparison of serum c-type natriuretic peptide levels in different genders: A pilot study
OBJECTIVE Firstly we aimed to compare serum C-type natriuretic peptide (CNP) levels in healthy male and female participants of similar age group and secondly to reveal the relationship between serum CNP values and ovarian function markers in women and sperm parameters in men. MATERIAL and METHODS In this prospective study, a total of 40 patients, who were admitted to the Department of Obstetrics and Gynecology at Near East University Hospital were included. Of these, 20 were female and 20 were male participants. Serum CNP levels of the patients were analyzed for all participants. Day 3 serum levels of follicle stimulating hormone (FSH), luteinizing hormone (LH) and estradiol (E2) for female participants and semen samples after 3-5 days of sexual abstinence for male participants were evaluated. RESULTS Serum CNP levels were similar in both genders. There was only a moderate, but statistically insignificant negative correlation between serum CNP and FSH in female group. In the correlation analysis performed in the male group, no significant correlation was observed between serum CNP level and any semen analysis parameter. CONCLUSION We showed that serum CNP levels were similar between healthy women and men. There was no relationship between levels of serum CNP and reproductive hormones in the early follicular phase of menstruation in women, and semen parameters in men.
Copyright (c) 2022 Yusuf Özay, Ali Cenk Özay, Oguzhan Edebel, Özlen Emekçi Özay, Yasemin Türkcan Çavdarlı, Namık Kemal Duru https://creativecommons.org/licenses/by-nc/4.0
Which technique is better for planning parametrial boost for cervical carcinoma? A dosimetric comparison study about new radiotherapy techniques vs classic method.
Aim: The idea of this study was based on the question of which technique should be used to plan parametrial boost in clinics that treat cervical carcinoma with external beam radio therapy (EBRT), but send their patients to other centers for brachytherapy, and who wishes to prepare all EBRT plan before brachytherapy. Material & method: Intensity Modulated Radiotherapy (IMRT), Volumetric Arc Therapy (Vmat) and Antero-Posterior (AP-PA) plans with Simultaneous Integrated Boost (SIB) or sequential boost of 10 patients target volume and organ at risk doses were evaluated. Forty-five Gy were administered for the pelvis and 54 Gy were administered for the parametrium. Result: The conformity and homogeneity indexes were found to be better in SIB for both the pelvis and the parametrial volumes. In the evaluation of V45and V54in the rectum and the bladder, it was observed that the SIB plain was statistically significantly lower (p=0.01, p<0.001, p=0.02, p<0.01 respectively), and for the V54AP-PA plan was higher than the others (p<0.01 for both rectum and bladder). Conclusion: SIB is considered to be a preferable method due to better CI, HI, dose coverage and lower normal tissue tolerance doses than the other techniques. Sequential boost can be applied in patients where a higher daily pelvic dose is desired.
Cervical carcinoma, radiotherapy, parametrial boost, simultaneous integrated boost, radiotherapy techniques.
Copyright (c) 2022 Zeliha Güzelöz, Ahmet Çalışır https://creativecommons.org/licenses/by-nc/4.0
The association of intravenous antispasmodics (hyoscine-N butyl bromide) injection with obstetric lacerations at vaginal delivery
Aim: To study whether hyoscine-N butyl bromide injection affects the incidence of obstetric lacerations at vaginal birth. Materials and methods: This retrospective cohort study consists of 15806 term pregnant women who undergone vaginal delivery, in Tepecik Training and Research Hospital, İzmir between January 2018 and December 2020. Patients who received intravenous injection of Hyoscine-N-butylbromide during the active period of labor were compared with those who did not in terms of the incidence of obstetric laceration. Results: The data of a total of 9216 deliveries meeting the study criteria were analyzed. Hyoscine-N-butylbromide was used in 4014 of these deliveries(HBD), and it was not used in 5202 of these deliveries. In both primigravid and multigravid patients in the HBD group, the first stage of delivery was found to be shorter than in patients who did not receive spasmolytics(p <0.001).There was no difference between the groups in terms of the second stage of labor. Intravenous injection of Hyoscine-N-butylbromide in the active phase of labor significantly reduced 1st and 2nd degree obstetric lacerations in primigravid patients, but had no effect on 3rd and 4th degree obstetric lacerations. Conclusion: Hyoscine-N-Butylbromide shortens the active phase of labor and reduces minor obstetric lacerations in primigravid women.
Copyright (c) 2022 Mehmet Adıyeke, Suna Yıldırım Karaca https://creativecommons.org/licenses/by-nc/4.0
Supervene of vesicovaginal fistula after open total hysterectomy with concurrently bladder repair in an outer unit: successful surgical management with robotic surgery and clinical follow-up
While vesicovaginal fistula (VVF) is not common in developed countries, it is a significant health problem in developing countries. In developed nations, these fistulas are usually unfortunate complications of gynecologic or other pelvic surgery and radiotherapy. Once a vesicovaginal fistula is suspected, a meticulous vaginal examination should be performed to identify its size, location, and relation to the trigone. Even though there is no consensus on which approaches are better, surgical and conservative are two options. In terms of the surgical option, there are numerous approaches such as abdominal, vaginal, and minimally invasive surgery (i.e., laparoscopic and robotic). The treatment algorithm depends on surgeons’ training and experience, facilities, anatomical localization. Recently, minimally invasive surgery is preferred to provide low morbidity and higher success rate. Therefore, if it is suitable, patientsshould be referred to the tertiary care center and the treatment process management with a multidisciplinary team including the department of urology, radiology, interval radiology, and urogynecology.
Copyright (c) 2022 Ozgen Nahya Ozdogar, Orcun Celik, İbrahim Egemen Ertas https://creativecommons.org/licenses/by-nc/4.0
Twin pregnancy with complete hydatidiform mole: A case report
Objective: The association of twin pregnancy and a hydatidiform mole is a rare clinical condition. With the development of ultrasonography devices, prenatal diagnosis becomes easier. Case Report: A 21-year-old patient with gravida 1 parity 0 applied to our clinic with the complaint of vaginal bleeding at the 16th week of her pregnancy according to her last menstrual period. A pregnancy termination option was offered to the patient who was diagnosed with twin pregnancy consisting of a complete hydatidiform mole and co-existent fetus as a result of the examination and tests. Emergency laparotomy was planned for the patient who did not accept the pregnancy termination option because of severe vaginal bleeding at the 21st week of pregnancy. Conclusion: Although live births are reported in the literature in cases where twin pregnancy and hydatidiform mole are seen together, pregnancy termination due to vaginal bleeding may be required in earlier weeks.
Copyright (c) 2022 Can Türkler, Pasa Uluğ, Kemine Uzel, Fatma Zehra Kurnuç, İlyas Sayar, Diren Vuslat Çağatay https://creativecommons.org/licenses/by-nc/4.0
Cerclage outcomes in singleton pregnancies at risk for preterm birth following assisted reproductive treatments
Objective: We aimed to evaluate the obstetric and neonatal outcomes of singleton pregnancies at risk for preterm birth (PTB) following assisted reproductive treatments and underwent cervical cerclage placement. Material and methods: A total of 42 women with singleton pregnancies following ART who underwent cerclage between 2009-2021 were included in this retrospective study. Indications of the cerclage procedure, gestational age at cerclage placement and delivery, neonatal birthweight, and requirement for admission to the neonatal unit of newborns were evaluated. Results: Of those cerclage placement performed in women with a history of second-trimester loss (19%), women with suspected cervical insufficiency according to pre-pregnancy evaluation (52.4%), women with the unicornuate uterus (4.8%), women with cervical shortening/or suspicious changes on ultrasonography (11.9%), and women with detection of cervical dilatation/shortening beyond 20 weeks of gestation (11.9%). Of the total group, 7.1% resulted in late miscarriages, while the remaining 92.9% ended with a live birth with mean gestational age at delivery of 37.0±2.5 weeks. Of those live births, 92.3% (36/39) delivered at >34 weeks and %74.4 (29/39) delivered at term. Except one neonatal death due to extremely PTB at 26th weeks, all infants were discharged from the hospital with well condition. Conclusion: ART pregnancies are evaluated as a special group as having a higher PTB risk at baseline. Cerclage may be considered in broader indications for suspected cervical insufficiency in these pregnancies. There is need for further studies on the effectiveness of cerclage in these ART pregnancies with suspected cervical insufficiency based on different criterions used.
Copyright (c) 2021 Gülnaz Şahin, Ferruh Acet, Ege Nazan Tavmergen Goker, Erol Tavmergen https://creativecommons.org/licenses/by-nc/4.0
International Congress of Hysterectomy in all Aspects, Oral & Poster Presentations Abstract Book
Copyright (c) 2021 Abdurrahman Hamdi inan; Ceren Gölbaşı, Hakan Gölbaşı, Sakine Rahimli Ocakoğlu, Seçil Karaca Kurtulmuş, Ömer Tammo, Zekiye Şahin, Gülnaz Şahin, Saliha Sağnıç, Evrim Kardelen, İlkan Kayar, Nahit Ata, Can Türkler, Mustafa Şengül, Ömer Demir, Meriç Balıkoğlu, Gülin Okay, Ahkam Göksel Kanmaz, Burcu Dinçgez, Özge Bal, Özgen Nahya Özdoğar, Sinan Serdar Ay, Uğur Şen, Doğay Özmüş, Hayriye Varnalı, Sercan Kantarcı, Mehmet Özer, Volkan Kolbaşı, Burak Bayraktar, Zübeyde Emiralioğlu Çakır, Alper İleri, Suna Yıldırım Karaca, Hande İleri, Can Ata, Sertaç Bulut, Hamit Çetin https://creativecommons.org/licenses/by-nc/4.0