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Gynecology Obstetrics & Reproductive Medicine     Open Access   (Followers: 1)
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Gynecology Obstetrics & Reproductive Medicine
Number of Followers: 1  

  This is an Open Access Journal Open Access journal
ISSN (Print) 1300-4751
Published by Medical Network Homepage  [1 journal]
  • The Effect of Adipose Tissue-Derived Mesenchymal Stem Cells on
           Regeneration of Uterine Scars

    • Authors: R. Ada Bender, Aykan Yücel, Volkan Noyan, Aylin Gürpınar, Pınar Atasoy, Faruk Comu
      Pages: 120 - 128
      Abstract: OBJECTIVE: The mesenchymal stem cell application to uterine healing scars may provide better tissue strength.
      STUDY DESIGN: Hysterectomy was performed on rats, and the wound recovery as a result of primary suturing was evaluated as tissue stretching and the positive histopathological effects. The mesenchymal stem cells originating from the adipose tissue were used during the healing period of the wound and would differentiate to mesenchyme-originated cells present in intact tissue for an optimum level of healing.
      RESULTS: The weights of non-incised uterine horns in the control group were found to be significantly higher than the weights of the incised uterine horns (z=2.52, p=0.012). In the experiment group, the weights of the incised uterine horns were found to be significantly higher than the non-incised uterine horns (z=2.527, p=0.012). In the control group, the non-incised uterine horns withstood the stretching test to a higher extent than the incised horns, and a significant difference was found between the stretching values (z=2.51, p=0.012). In the experiment group, the incised uterine horns withstood the stretching tests to a higher extent than the non-incised uterine horns; however, there was no significant difference between the stretching tests (z=1.540, p=0.123).
      CONCLUSION: Adipose tissue-originated mesenchyme stem cells were observed to increase the tissue stretching during wound healing.

      PubDate: 2017-12-05
      DOI: 10.21613/GORM.2016.654
      Issue No: Vol. 23, No. 3 (2017)
  • Prognostic Significance of Preterm Isolated Decreased Fetal Movement

    • Authors: Ertuğrul Karahanoğlu, Orhan Altınboğa, Funda Akpınar, Şafak Özdemirci, Emre Baser, Yıldız Aktaş, Serdar Yalvaç
      Pages: 129 - 132
      Abstract: Objective: Our aim is to evaluate the prognostic significance of isolated, preterm decreased fetal movement following normal initial full diagnostic workup.Study design: A retrospective observational study was conducted at a tertiary centre. The applied protocol was approved by the Medical Research Ethics Department of the hospital where the research was conducted. Obstetrics outcomes of preterm- and term-decreased fetal movement were compared following an initial, normal diagnostic work up. Evaluated outcomes were birth weight, mode of delivery, stillbirth rate, induction of labour, development of gestational hypertension, small for gestational age and oligohydramnios, polyhydramnios during the follow up period.Result: Obstetric complications related to placental insufficiency develops more frequently for decreased fetal movement in preterm cases with respect to that of in term cases. Following the diagnosis of decreased fetal movement, pregnancy hypertension occurred in 17% of preterm decreased fetal movement cases and in 4.7% of term decreased fetal movement cases. Fetal growth restriction developed in 6.6% of preterm decreased fetal movement and in 2.3% of term decreased fetal movement. Amniotic fluid abnormalities more frequently developed in preterm decreased fetal movement.Conclusion: Following an initial normal diagnostic workup, preterm decreased fetal movement convey a higher risk for the development of pregnancy complications associated with placental insufficiency. The patient should be monitored closely and management protocols must be developed for initial normal diagnostic workups in cases of preterm decreased fetal movement.
      PubDate: 2017-12-05
      DOI: 10.21613/GORM.2016.674
      Issue No: Vol. 23, No. 3 (2017)
  • Four or More Cesarean Sections, is it Still Safe'

    • Authors: Burak Yücel, Pınar Kadiroğulları, Onur Karahasan, Turgut Aydın, Kerem Doğa Seçkin, Ali Gedikbaşı
      Pages: 133 - 137
      Abstract: Objective: We aimed to compare the maternal and neonatal complications in women who had undergone fourth or more cesarean section with to women who had undergone second or third cesarean section.Study Design: 162 women who had four or more cesarean section (study group) and 228 women who had undergone second or third cesarean section (control group) were reviewed retrospectively. Demographic features, obstetric, intraoperative, postpartum and neonatal complications were determined in both groups. Results: The preoperative hematocrit values were lower in study group (35.63.6) than the control group (36.64.3), (p <0.001). Patients with four or more cesarean section had an increased rate (24.7%) of intra-abdominal dense adhesions compared with the controls (14.9%), (p<0.001). Blood transfusion rate was higher in the study group (8.6% to 3.5%, p=0.043). Except these; frequencies of obstetric, intraoperative, postpartum and neonatal complications were similar between groups.Conclusion: We found that multiple CSs (four or more) do not increase the risk of maternal or neonatal complications except the rate of maternal anemia, dense adhesions and need for blood transfusion according to the results of our study. Fourth or more cesarean section appears to be still a safe procedure.
      PubDate: 2017-12-05
      DOI: 10.21613/GORM.2017.677
      Issue No: Vol. 23, No. 3 (2017)
  • Does the Modification of Starting Gonadotropin Dose During ICSI Cycle Have
           Any Significant Impact on Cycle Outcome'

    • Authors: Enis Özkaya, Yavuz Şahin, Semra Kayatas Eser, Betul Albayrak, Oguzhan Bulduk, Ilhan Sanverdi, Tayfun Kutlu
      Pages: 138 - 142
      Abstract: OBJECTIVE: The aim of this study was to figure out the impact of gonadotropin dose alteration requirements due to high response or unresponsiveness on intracytoplasmic sperm injection cycle outcomes in a standard group of patients.STUDY DESIGN: One hundred cycles with same gonadotropin dosage along the stimulation were compared with 100 cycles in which gonadotropin dose alterations were needed due to high response or unresponsiveness. Groups were compared in terms of age, body mass index, serum follicle stimulating hormone and estradiol levels, antral follicle count, gonadotropin dosage, duration of stimulation, endometrial thickness at trigger day, number of total, mature and immature oocytes and finally the clinical pregnancy rates.RESULTS: There were significant differences between groups with regard to gonadotropin starting dose, total gonadotropin dose, duration of stimulation, estradiol level at trigger day, number of total oocytes and metaphase 1 oocyte number. Clinical pregnancy rates were similar between groups.CONCLUSION: Dose alteration requirement along intracytoplasmic sperm injection cycle result in high number of total and metaphase 1 oocyte yields, higher starting gonadotropin and total gonadotropin dose, duration of stimulation and estradiol level at trigger day, however clinical pregnancy rates were similar between groups.
      PubDate: 2017-12-05
      DOI: 10.21613/GORM.2016.651
      Issue No: Vol. 23, No. 3 (2017)
  • Urinary Tract Injury at Gynecological Surgery: Results from a
           Tertiary-Care Institution

    • Authors: Tayfun Toptaş, Aysel Uysal, Selim Karataş, Işın Üreyen, Onur Erol
      Pages: 143 - 147
      Abstract: Objective: To identify clinical features of urinary tract injuries detected during or after gynecologic surgeries, with a specific focus on incidence and role of surgeon and surgical route on urinary injury.Study design: The institutional database from January 2009 to January 2017 was reviewed with respect to gynecologic (non-obstetric) surgeries and urinary injuries.Results: A total of 8719 gynecologic surgeries were identified. Of these, 46 (0.52%) were found to be complicated with a bladder (N=34, 0.38%), ureteral (N=11, 0.12%) and/or urethral injury (N=1, 0.01%). Bladder injuries occurred mostly at the superior part of the bladder, while ureteric injuries at the most distal part of the ureter. Ureteric injuries were mostly delayed (81.8% vs. 5.9%, P<0.001) and were more related to thermal injury than bladder injuries (45.5% vs. 8.8%, P=0.029). Among all surgical procedures, radical hysterectomy had the highest incidence for the ureteric injury (8.53%), while Burch colposuspension via minimally invasive route had the highest incidence for the bladder injury (16.6%). Cumulative incidence of urinary injury significantly differed according to the surgical route preferred (P=0.032), with the vaginal surgeries were associated with the highest incidence (0.96%). However, there was no such a difference in injury rates between the low-volume (0.55%) and high-volume (0.52%) surgeons (P=0.328)Conclusion: Overall incidence of lower urinary tract injury at gynecologic surgeries is low, does not differ according to annual number of surgeries performed, but increases with the vaginal surgeries.
      PubDate: 2017-12-05
      DOI: 10.21613/GORM.2016.679
      Issue No: Vol. 23, No. 3 (2017)
  • Retrospective Analysis of Patients with Genitourinary Fistula

    • Authors: Serdar Başaranoğlu, Ayşegül Deregözü, Şafak Hatırnaz, Coşkun Şahin, Sedat Kadanalı
      Pages: 148 - 152
      Abstract: Objective: To present the outcomes of patients treated at a tertiary center for a diagnosis of genitourinary fistula secondary to gynecological and obstetric etiologies.Study Design: In this retrospective study, analysis was made of 18 patients with a diagnosis of genitourinary fistula in a tertiary center between January 2006 and June 2016. Patient data were taken from the archives and patient histories. A record was made of examinations, diagnostic methods such as cystoscopy and fistulography and appropriate medical treatments, demographic data, intraoperative and post-operative complications, duration of hospital stay, surgical operations and types, diameter and location of fistulas.Results: Of the 18 cases, 14 were secondary to obstetric trauma. In 10 of these 14 cases, fistula had developed after difficult vaginal delivery and in four cases, after caesarean section. Four of the 18 cases were secondary to gynecological surgeries, namely hysterectomy and cystocele repairs. Vesicovaginal fistulas were repaired transvaginally while vesicouterine fistulas and bilateral ureterovaginal fistulas were repaired transabdominally. The mean hospital stay was 3.8±1.5 days (2-7 days). Patients were followed up closely in the first 3 months and recurrence developed in only one case.Conclusion: Fistulas secondary to gynecological procedures are uncommon while fistulas secondary to inadequate perineal care, insufficient labor monitoring and difficulties in vaginal delivery techniques are more prevalent in Turkey. Thorough evaluation, using all diagnostic tools for complete diagnosis, understanding the pathophysiology and choosing the best surgical procedure are mandatory to obtain good outcomes after the surgical

      PubDate: 2017-12-05
      DOI: 10.21613/GORM.2016.637
      Issue No: Vol. 23, No. 3 (2017)
  • Factors Associated with Help Seeking Behavior of Turkish Women with
           Urinary Incontinence; A Single Center Cross-Sectional Study

    • Authors: Seyhan Sönmez, Ersen Eraydın, Yalçın Arıcan, Ferhan Sönmez
      Pages: 153 - 157
      Abstract: Objectives: The aim of this study was to determine the patient and UI-related factors affecting help seeking behavior of Turkish women with undiagnosed urinary incontinenceMethods: This cross-sectional study was conducted on 490 female patients aged > 18 years old and were seen in general gynecology outpatients’ clinic of Denizli State Hospital. According to referral complaint and results of UDI-6 questionnaire, the participants were classified into 3 groups: Group A: Help seeker patient, Group B: Non help seeker patient and Group C: Continent patient.Results: Overall UI prevelance was 24%. Nearly two thirds ( 67% ) of the UI patients do not complaint about their UI symptoms unless they were asked specifically about UI. Consultation rate increased with age, duration of incontinence, menopause and the severity of UI. After logistic regression analyses, only increasing age, UDI-6 score and severity (SSS) were found to be associated independently with help seeking behavior.Conclusions: This study showed that, older, more bothered and severe UI patients visit physician and seek medical help. Still nearly half of women who are suffering from clinically significant UI remain undiagnosed and untreated. Regardless the visiting reason if its asked specifically for UI symptoms by using simple questionnaires, we can reveal and diagnose this patients’ group that is suffering from UI but yet keeps it disguise .Keywords: Urinary incontinence, help seeking behavior, undiagnosed urinary incontinence
      PubDate: 2017-12-05
      DOI: 10.21613/GORM.2016.699
      Issue No: Vol. 23, No. 3 (2017)
  • The Relationship of Myometrial Invasion Between Other Prognostic
           Parameters in Endometrial Cancer

    • Authors: Mehmet Sait Bakır, Ali Emre Tahaoğlu, Emre Erdoğdu, Cem Dane
      Pages: 158 - 162
      Abstract: Objective: The aim of this study is to investigate the relationship between deep myometrial invasion and other prognostic factors in endometrial cancer. Recurrence rates, disease free survival and overall survival rates were evaluated in endometrial cancer patients with MI>50%.Sudy Design: A total of 132 patients with endometrial cancer who underwent surgical treatment between 2001 and 2011 were identified. Demographic, clinicopathological, surgical/adjuvant treatment and follow-up data were extracted.
      Results: Pelvic lymph node invasion ratio was 28,9% and para-aortic lymph node invasion ratio was 15,5% in patients with myometrial invasion is greater than 50%. Other prognostic factors especially lympho-vascular space invasion and pelvic/para-aortic lymph node metastasis were significantly higher when myometrial invasion is above 50% and also there was significant difference in recurrence rates, overall survival and disease free survival rates between patients with superficial and deep myometrial invasion (p<0.05).Conclusion: Myometrial invasion is an important prognostic parameter and can be determined intraoperatively to decide whether to perform pelvic and para-aortic lymph node dissection.
      PubDate: 2017-12-05
      DOI: 10.21613/GORM.2016.648
      Issue No: Vol. 23, No. 3 (2017)
  • Reference Ranges of Serum Blood Urea Nitrogen, Creatinine Concentration
           and Ultrasonographic Measurement of the Kidneys in Term Healthy Newborns
           in the Neonatal Period

    • Authors: Şebnem Kader, Mehmet Mutlu, Elif Bahat Özdoğan, Yakup Aslan, İlker Eyüpoğlu, Ayşegül Cansu, Mehmet Sarıaydın, Yüksel Ali Yazıcıoğlu
      Pages: 163 - 168
      Abstract: Objective: Acute kidney injury is an important problem in neonates. We conducted a cross-sectional prospective study to determine normal serum blood urea nitrogen, creatinine reference ranges and ranges of ultrasonographic measurement of kidneys in healthy term newborns.
      Study Design: Blood samples were collected from total 357 healthy newborns at birth (n=45), 1st (n=30), 3rd (n=61), 7th (n=34), 10th (n=132), 14th (n=36), and 28th (n=19) days of life. Renal ultrasonographic was performed by the same two radiologists on 81 newborns aged 10 days.
      Results: Serum blood urea nitrogen and creatinine concentrations have reached to the highest level at the first day of life and have returned to cord level at the third day of life. There were gradually decrease in serum blood urea nitrogen and creatinine levels after the first day of life. There were significant difference in both right and left renal length, width, and volumes in terms of gender and these parameters were statistically higher in boys than girls (p<0.05). Birth weight of the boys (3548±539g) was statistically higher than girls (3307±405 g) (p=0.028). There was a positive correlation between birth weight and right (r=0.38, p=0.000) and left kidney volumes (r=0.44, p=0.000).Conclusion: Our findings showed that measured blood urea nitrogen and creatinine levels changed in accordance with postnatal days and there was a positive correlation between kidney volume and birth weight of newborns. We concluded that these findings are important for evaluation of acute kidney injury and for screening of for urinary tract anomalies in neonates
      PubDate: 2017-12-05
      DOI: 10.21613/GORM.2017.693
      Issue No: Vol. 23, No. 3 (2017)
  • Pulmonary Embolism Associated with Hyperemesis Gravidarum Two Case Reports

    • Authors: Bekir Keskinkılıç, Dilek Uygur, Ayşe Özcan, Yaprak Engin Üstün, Hüseyin Levent Keskin, Selma Karaahmetoğlu, Meral Esen, İrfan Şencan, Sema Sanisoğlu
      Pages: 169 - 170
      Abstract: Pulmonary embolism is a major cause of death during pregnancy or the puerperium. The hemostatic changes in pregnancy creates a prothrombotic milieu. Hyperemesis gravidarum  is one of the recognised risk factors for venous tromboembolism.Two cases of maternal mortality were attributed to  PE associated with severe hyperemesis gravidarum in 2014 in Turkey. These two cases have been reported and discussed in the literature review. We aimed to alert clinicians that thromboprophylaxis should be considered when a pregnant woman suffers vomiting leading to clinical evidence of dehydration.
      PubDate: 2017-12-05
      DOI: 10.21613/GORM.2016.490
      Issue No: Vol. 23, No. 3 (2017)
  • Laparoscopic Management of Abdominal Pregnancy Replaced in the
           Vesicouterine Pouch and Sacrouterine Ligament

    • Authors: Cihan Kaya, Murat Ekin
      Pages: 171 - 173
      Abstract: AAbdominal pregnancies are rare and life threatening conditions with increased maternal mortality rate. A 37-year old woman admitted with acute abdominal pain. She had a history of dilatation and curettage due to anembryonic pregnancy five days ago. A pelvic X Ray confirmed an abdominally located IUCD. Her serum β-human chorionic gonadotropin level was 5531 mIU/ml.  A laparoscopy was performed and there was a round hemorrhagic mass in the vesicouterine pouch in exploration. The trophoblastic tissue was removed from the vesicouterine pouch and left sacrouterine ligament. The histopathology report revealed chorionic villi both of the excised specimens. The abdominal cavity should be explored carefully in suspicion of abdominal pregnancy and laparoscopic management is a feasible approach for this cases.
      PubDate: 2017-12-05
      DOI: 10.21613/GORM.2016.645
      Issue No: Vol. 23, No. 3 (2017)
School of Mathematical and Computer Sciences
Heriot-Watt University
Edinburgh, EH14 4AS, UK
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