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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]
  • Evaluation of Fetuses Diagnosed with Megacystis During Prenatal Period

    • Authors: Kemal Sarsmaz, Busra Kanyildiz, Gokcen Orgul, Gokhan Karakoc, Hasan Eroglu, Dilek Sahin, Aykan Yucel
      Pages: 190 - 194
      Abstract: Objectives: Fetal megacystis is very rare; however this problem may be associated with other structural or chromosomal abnormalities leading to morbidity and mortality. Due to renal injury and pulmonary hypoplasia, prognosis is poor especially in fetuses with early onset oligohydramnios. In this study, we evaluated the management strategies and outcomes of fetal megacystis in our hospital.Study Design: The data of cases who were prenatally diagnosed with megacystis between 1 January 2017 and 31 December 2019 were analyzed. Ultrasonography findings and antennal interventions were withdrawn from computerized database. Information about postpartum status was also received. The data were analyzed in terms of diagnostic methods, fetal interventions (vesicosynthesis (VS), vesicoamniotic shunt (VAS)), potential prognostic markers and short/long-term prognostic results.Results: A total of 15 megacystis patients were detected. One of the fetuses was female and the remaining cases were male. Six of the patients were isolated. Ten patients underwent invasive procedures for prenatal aneuploidy diagnosis and one of them diagnosed with trisomy 18. Totally, 4 patients underwent VS; however no VAS was recorded. Four fetuses were terminated and intrauterine fetal demise occurred in 2 fetuses. Four patients were lost during follow up. Survival rate was 33.3%.Conclusion: Fetal megacystis is an important ultrasonographic finding which may be a component of chromosomal / genetic anomalies. This problem may also be isolated in some cases. Because of the poor outcome, parents should be well informed and all interventions should be offered to families.
      PubDate: 2021-12-15
      DOI: 10.21613/GORM.2019.971
      Issue No: Vol. 27, No. 3 (2021)
       
  • Community-Based Study of Abortion Complications and Care Sought by Rural
           Tribal Women of an Extremely Low Resource Setting

    • Authors: Shakuntala Chhabra, Akanksha Suman
      Pages: 195 - 201
      Abstract: OBJECTIVE: Knowing about complications, care sought by women is essential for understanding the risks, services, programs, and policies for abortion care. This study aimed to know the magnitude of abortion complications and to define the care sought by rural tribal women. STUDY DESIGN: Rural community-based cross-sectional study was carried out in villages near Sewagram Wardha and Melghat, Amravati, Maharashtra, India. RESULTS: Spontaneous abortions rate was 3.30% in villages around Sewagram and 0.32% in villages of Melghat. The reported complications rate for induced abortions was 1% in Sewagram villages and 0.1%in Melghat villages. In Sewagram villages, among 24 (4.3%) women who had complications with spontaneous abortions, the reported complications were: vaginal bleeding in 33.3% (1.4% of all spontaneous abortions), abdominal pain in 33.3%, weakness in 29.16% (1.2% all spontaneous abortions), backache in16.6% (0.7%of spontaneous abortions), fever in 12.5%(0.5% of spontaneous abortions), excessive vaginal discharge in 8.33% (0.3% of spontaneous abortions), and other complications in 8.33% (0.36% of spontaneous abortions) women. Among 7 women (3.9% of all 177), who reported complications after induced abortions, 57.1% (2.2% of all induced abortions) reported, vaginal bleeding and 28.5% (1.1% of induced abortions) reported abdominal pain. In Melghat villages only 4 women reported complications with spontaneous abortions (0.32% spontaneous abortions): two (0.16% spontaneous abortions) reported abdominal pain, one (0.08% spontaneous abortions) reported vaginal bleeding, and one (0.08% of spontaneous abortions) reported backache. In villages of Melghat 2 women (3.7%) out of 27 induced abortions cases had complications: one had vaginal bleeding, discharge, pain, weakness, another only vaginal bleeding. In villages of Melghat 2 of the total 6 sought health facility care, however, no one reported to specialists despite complications. Nevertheless, there was neither abortion-related mortality nor near-miss morbidity or severe morbidity during the same duration. CONCLUSION: Research is needed about traditional therapies, reverse pharmacology, socio-behavioral issues in addition to creating awareness in women about abortion complications, long-term squeal, and the necessity of care-seeking.
      PubDate: 2021-12-15
      DOI: 10.21613/GORM.2021.1139
      Issue No: Vol. 27, No. 3 (2021)
       
  • Psychological Reactions in Women with Pregnancy Termination Due to Fetal
           Anomaly

    • Authors: Gurcan Turkyilmaz, Yavuz Selim Atan, Emircan Erturk, Sebnem Turkyilmaz
      Pages: 202 - 206
      Abstract: OBJECTIVE: We aimed to determine and compare grief, depression, and post-traumatic stress scores in women who underwent termination of pregnancy due to fetal anomaly in the first vs. second-trimester of pregnancy. STUDY DESIGN: Forty-three women who underwent termination of pregnancy for fetal anomaly were subdivided into two categories in this prospective-cohort study: First-trimester group, which was defined as termination of pregnancy performed <14 weeks of gestation, and Second-trimester termination of pregnancy who underwent termination of pregnancy between 20 and 28 weeks of pregnancy. Eight weeks after the termination of pregnancy, the Beck Depression Inventory, Perinatal Grief Scale-short version, and Impact of Event Scale-Revised were performed with face-to-face interviews. RESULTS: Twenty-four women in the first-trimester group and 19 women in the second-trimester group were enrolled. The mean Beck Depression Inventory score was 7.3±4.2 in the first-trimester group and 11.1±4.6 in the second-trimester group (p=0.033). The mean Perinatal Grief Scale-short scores were 86.3±17.2 and 101.4±29.2 in the first and second-trimester groups, respectively (p=0.014). Impact of Event Scale-Revised scores of the first trimester and second-trimester groups were 22.5±8.6 and 35.3±17.1, respectively (p=0.022). Depression was detected in 29.1% of women in the first-trimester group and 57.8% in the second-trimester group (p=0.023). Perinatal grief was significantly higher in the second-trimester group (45.8% vs. 84.2% p<0.01). Post-traumatic stress was significantly higher in the second-trimester group (41.6% vs. 73.6%, p=0.031). CONCLUSION: Our study indicates that termination of pregnancy for fetal anomaly causes severe psychiatric problems in most women. Depression, grief, and post-traumatic stress are more prominent in women who underwent termination of pregnancy in the second trimester of pregnancy than in the first trimester.
      PubDate: 2021-12-15
      DOI: 10.21613/GORM.2021.1145
      Issue No: Vol. 27, No. 3 (2021)
       
  • The Relationship Between First-Trimester Aneuploidy Markers and Birth
           Weight

    • Authors: Cenk Soysal, Hatice Sari, Ozlem Erten, Ismail Biyik, Onur Ince, Yasemin Tasci, Nadi Keskin
      Pages: 207 - 212
      Abstract: OBJECTIVE: We aimed to determine the relationship between the first-trimester aneuploidy screeningma and the predicted weight at birth: Small for gestational age and large for gestational age. STUDY DESIGN: 594 low-risk pregnant women with a singleton pregnancy, who underwent first-trimester aneuploidy screening by measuring nuchal translucency, maternal serum free beta-human chorionic gonadotropin, and pregnancy-associated plasma protein-A were included in the study. Those weighing above the 3rd percentile and below the 10th percentile were defined as small for gestational age, and those over the 90th percentile were defined as large for gestational age. RESULTS: A total of 594 pregnant women were enrolled. The mean maternal age of the studied group was 28.8±5.5 years. Low maternal serum pregnancy-associated plasma protein-A levels and decreased nuchal translucency measurements were associated with the small for gestational age newborn (p<0.001 and p=0.001, respectively). There is a significant correlation with large for gestational age for newborns only with an increase in maternal serum pregnancy-associated plasma protein-A levels (p=0.001). beta-human chorionic gonadotropin levels were not associated with the birth weight (p=0.735). CONCLUSION: Maternal serum pregnancy-associated plasma protein-A levels, one of the markers in first-trimester aneuploidy screening, can be used in the prediction of small for gestational age and large for gestational age However, due to its low correlation, it is not a suitable screening test for clinical practice.
      PubDate: 2021-12-15
      DOI: 10.21613/GORM.2021.1215
      Issue No: Vol. 27, No. 3 (2021)
       
  • Evaluation of Factors Affecting Perinatal Mortality in Patients with HELLP
           Syndrome

    • Authors: Reyhan Gunduz, Senem Yaman Tunc, Mehmet Sait Icen, Sabahattin Ertugrul, Talip Gul
      Pages: 213 - 220
      Abstract: OBJECTIVE: To determine the perinatal mortality rate in patients with HELLP syndrome in our clinic and to investigate the factors affecting perinatal mortality. It also makes recommendations to reduce perinatal mortality and contributes to the literature. STUDY DESIGN: Three-hundred-and-eighty-three patients were retrospectively evaluated in this cohort study. The patients' demographic, clinical data, laboratory results, gestational week at delivery, method of delivery, neonatal birth weight, fetal gender, 1- and 5-minute APGAR scores, place of delivery, maternal morbidity, mortality rates, and perinatal mortality rates were recorded. The relationship of these factors with perinatal mortality was investigated. RESULTS: The rate of perinatal mortality was determined as 6%. Patients with HELLP syndrome who experienced perinatal mortality showed significantly lower birth weight, gestational age at delivery, and 1- and 5-minute APGAR score values (p<0.05). With respect to methods of delivery, we determined that vaginal delivery was linked to a significantly higher rate of perinatal mortality (p<0.001). Gestational age at delivery, birth weight, 1- and 5-minute APGAR scores were negatively correlated with perinatal mortality. Logistic regression revealed the APGAR score at 5 minutes as the most reliable independent predictive finding for perinatal mortality. CONCLUSION: We think that to decrease perinatal mortality rates, maternal and fetal well-being in patients with HELLP syndrome should be closely monitored and delivery and follow-up should take place at tertiary health institutions after maternal and neonatal intensive care arrangements are made. Particularly, neonates with low 5-minute APGAR scores in the postpartum evaluation of neonatal condition are recommended to be followed-up at the neonatal intensive care unit.
      PubDate: 2021-12-15
      DOI: 10.21613/GORM.2021.1144
      Issue No: Vol. 27, No. 3 (2021)
       
  • Clinical Course of Untreated and Treated Chronic Hepatitis B in Pregnant
           Patients: A Prospective Study

    • Authors: Yasemin Nadir, Ayse Batirel, Ayse Yasemin Karsidag, Fatma Kaya Narter, Ahmet Nadir
      Pages: 221 - 227
      Abstract: OBJECTIVE: Implementation of strategies to prevent vertical transmission is highly important steps in reducing the global burden of chronic hepatitis B. We conducted this prospective study to observe the clinical course and outcomes of untreated and treated HBV in pregnant.STUDY DESIGN: HBsAg-positive pregnants were prospectively enrolled from 2013 to 2016 and antiviral therapy was administered to eligible patients. Pregnancy and neonatal outcomes were determined in the treated (n=29) and untreated group (n=136). Active-passive immunoprophylaxis was administered to infants and they were tested for HBsAg.RESULTS: The risk factors for transmission (HBeAg positivity, history of previously-born HBsAg-positive child) were significantly higher in the treated group. All participants under treatment had sufficient viral suppression. Half of the pregnant women for whom the treatment was withheld at the postpartum period, experienced increased viral load. The treated group had significantly higher pre- and postpartum alanine aminotransferase levels more than the untreated group, although there were no significant differences in other biochemical parameters. There were no significant differences regarding fetal outcomes between the two groups. All infants were HBsAg-negative at seven months postpartum.CONCLUSION: While the untreated group included inactive carriers, there were more patients at risk for transmission of HBV to their offsprings in the treated group. Half of the pregnant women for whom the treatment was withheld at the postpartum period, experienced increased viral load. Antiviral therapy did not adversely affect the outcomes of infants. As a result, we successfully prevented perinatal HBV transmission by close monitoring of participant pregnant women and starting antiviral therapy when needed.
      PubDate: 2021-12-15
      DOI: 10.21613/GORM.2020.1084
      Issue No: Vol. 27, No. 3 (2021)
       
  • Evaluation of Prevalence and Risk Factors for Postpartum Depression Using
           the Edinburgh Postpartum Depression Scale: A Cross-Sectional Analytic
           Study

    • Authors: Gaye Kahveci, Bekir Kahveci, Hamza Aslanhan, Pakize Gamze Erten Bucaktepe
      Pages: 227 - 233
      Abstract: Objective: To evaluate the prevalence and associated risk factors for postpartum depression (PPD) using the Edinburgh Postpartum Depression Scale (EPDS). Study design: The population of this cross-sectional analytic study consisted of 311 women who were admitted to our hospital at 4-6 weeks after birth. The data were collected between April-June 2018 by applying a sociodemographic data form consisting of 44 questions and the EPDS consisting of 10 questions. We used the EPDS in postpartum period to divide parturients into those with (n=47) and without (n=264) PPD using a cut-off score of ³ 13. The primary outcome is the prevalence of PPD, while the secondary outcomes are associated risk factors.Results: The PPD prevalence was 15.1% (n=47). In the PPD group, the difference was highly significant in terms of abortion, antenatal depression, inadequate care for the baby and health problem in the newborn [0.6±0.9 vs. 0.2±0.6, 13 (37.1%) vs. 27 (10.5%), 9 (56.3%) vs. 38 (12.9%), 12 (36.4%) vs. 35 (12.6%), respectively] (p<0.001). The logistic regression analysis revealed that abortion increased PPD by 1.64 fold (1.13-2.37% at 95% CI), antenatal depression by 5.04 fold (2.38-10.68% at 95% CI), inadequate care for the baby by 6.28 fold (1.89-20.86% at 95% CI), and health problem in the newborn increased PPD by 3.59 fold (1.43-8.99% at 95% CI).Conclusion: PPD is a health problem that can affect primarily mother and child. Therefore, it is important to determine highly predictable risk factors using a scale (e.g. EPDS) for early diagnosis and timely treatment of symptoms.
      PubDate: 2021-12-15
      DOI: 10.21613/GORM.2020.1109
      Issue No: Vol. 27, No. 3 (2021)
       
  • Does the Apoptosis Value of Cumulus Cells Play a Role in Rescue Oocyte in
           Vitro Maturation'

    • Authors: Tulay Irez, Sinem Ercan Dogan, Enver Ciraci, Saadet Busra Aksoyer, Muhammet Sait Toprak, Nurten Dayioglu, Onur Guralp
      Pages: 234 - 241
      Abstract: OBJECTIVE: In this study, we aimed to investigate the role of the cumulus cell’s apoptosis parameter in the maturation of immature rescue oocytes. STUDY DESIGN: In this experimental study, donated immature germinal vesicle oocytes were cultured for, in vitro maturation, embryo development in matured germinal vesicle oocytes were compared with apoptotic properties of cumulus cells. RESULTS: In all of the immature oocytes after oocyte in vitro maturation, the maturation rate has been observed as 56.1% and 2PN rate as 63.0%. Afterin vitro maturation of germinal vesicle oocytes, there was no difference in apoptosis rates of the cumulus cells between mature and immature oocytes (p> 0.05). The ratio of 2PN in matured germinal vesicle oocytes showing embryo development was 35.4%. A positive correlation was found between luteinizing hormone values on day 3 and E2 values during HCG days during oocyte maturation and embryo development (p=0.021, p=0.020). In addition, it has been observed that the germinal vesicle oocytes, which have completed their maturation and developed into embryos, have high E2 values during HCG days (p=0.020).CONCLUSION: In our study, it has been demonstrated that in vitro maturation in rescue oocytes from stimulated cycles, embryo development potential could not be explained by the apoptosis parameter.
      PubDate: 2021-12-15
      DOI: 10.21613/GORM.2020.1087
      Issue No: Vol. 27, No. 3 (2021)
       
  • The Expression Pattern of Prostaglandin-Endoperoxide Synthase-2 in
           Immature Oocytes and Surrounding Cumulus Cells May Explain A Disrupted
           Oocyte Maturation Process

    • Authors: Goktan Kuspinar, Berrin Avcı
      Pages: 242 - 247
      Abstract: Objective: To evaluate the correlation between the gene expression of prostaglandin-endoperoxide synthase-2 in the cumulus-oocyte complex with the level of prostaglandin-endoperoxide synthase-2 in follicular fluid and follicle diameter, oocyte maturation, and fertilization capacity.Study Design: As the study group, 26 cumulus-oocyte complexes and 26 follicular fluids obtained from immature (n=10) or unfertilized mature oocytes (n=16) and as the control group, 26 cumulus complexes and 26 follicular fluids surrounding mature and fertilized oocytes were retrieved one by one totally from 32 patients in 32 intracytoplasmic sperm injection cycles. Results: There was no significant efficacy of prostaglandin-endoperoxide synthase-2 gene expressions in cumulus complexes and the level of prostaglandin-endoperoxide synthase-2 in follicular fluids in terms of oocyte maturation stage. The level of prostaglandin-endoperoxide synthase-2 in follicular fluids and follicle diameters showed a significantly positive correlation in the mature and fertilized oocyte group (r=0.414; p=0.035). Conclusions: Although the prostaglandin-endoperoxide synthase-2 gene expressions in immature oocytes and their cumulus cells were similar to those in oocytes that have completed their nuclear and cytoplasmic maturation, the level of prostaglandin-endoperoxide synthases-2 in the follicular fluid and follicle diameter correlation may lead to new clinical approaches in cases of premature follicular rupture before oocyte maturation is completed.
      PubDate: 2021-12-15
      DOI: 10.21613/GORM.2020.1069
      Issue No: Vol. 27, No. 3 (2021)
       
  • Oocyte Cryopreservation: Retrospective Analysis of 5 Years Experience

    • Authors: Halime Goktepe, Esengul Turkyilmaz, Gulsen Dogan Durdag, Murat Sonmezer, Cem Atabekoglu, Batuhan Ozmen
      Pages: 248 - 253
      Abstract: OBJECTIVE: To analyze demographic and clinical data of patients who resorted to oocyte freezing between January 2014 and December 2018. STUDY DESIGN: Patients who applied to the Reproductive Endocrinology and Infertility Unit of Ankara University School of Medicine between January 2014 and December 2018 with the request of oocyte freezing were included in this study. The files and computer records of the patients were analyzed retrospectively and sociodemographic, clinical and laboratory data were evaluated. RESULTS: A total of 46 cycles were recorded in 40 patients over a 5-year period. The main indications were low ovarian reserve and/or advanced age (68.3%) and malignancy diagnosis (31.7%). There was a significant difference between elective fertility preservation and oncofertility preservation (Onco-FP) groups in terms of the age (38.4±4.7 vs 28.4±6.1; p=0.001). There was a significant difference between two groups in favor of oncofertility group in terms of anti-Mullerian hormone level, basal follicle-stimulating hormone level, antral follicle count, trigger day estradiol (E2) level, number of obtained oocytes, MII oocytes, and frozen oocytesCONCLUSION: According to our study, the most prominent oocyte cryopreservation indication was advanced age and/or low ovarian reserve. The number of oocytes collected from patients in the Onco-FP group and thus the number of frozen oocytes was significantly higher than in the elective fertility preservation group, due to younger ages and better ovarian reserve in the Onco-FP group. Abdominal administration of the technique is particularly important for virgin patients in our country. Oocyte freezing is a fertility protection method available in a wide range of indications for reproductive-aged women.
      PubDate: 2021-12-15
      DOI: 10.21613/GORM.2019.1014
      Issue No: Vol. 27, No. 3 (2021)
       
  • Comparison of Cycle Outcomes among Women with Endometrioma or
           Non-Functional Cysts Versus Control

    • Authors: Enis Ozkaya, Ebru Cogendez, Elif Tozkir, Saadet Unsal, Ahmet Yavuz, Gulden Tunali, Ozgur Uzun, Evrim Bostancı Ergen, Semra Kayatas Eser
      Pages: 254 - 259
      Abstract: OBJECTIVE: This study aimed to compare cycle outcomes among women with endometrioma or non-functional cysts versus control. STUDY DESIGN: Women under 35 years of age with unexplained infertility underwent in vitro fertilization cycle. Two hundred and ninety-nine women were included in this study. Study groups consist of women with endometrioma (n=82) or non-functional ovarian cysts (n=100) and control group (n=117). Women in each group were selected consecutively. Groups were matched for age and ovarian reserve and compared in terms of in vitro fertilization cycle outcome. RESULTS: There were no significant differences among groups in terms of mean age, early follicular phase Follicle-Stimulating Hormone, and anti-müllerian hormone levels (p>0.05). Baseline total antral follicle counts were similar among groups (p>0.05). There were significant differences among groups in terms of mean starting and total gonadotropin dose, peak estradiol level, total oocyte number, and mature oocyte numbers (p<0.05). Clinical pregnancy rates were 10.7%, 17.3%, and 31.6% in groups with non-functional cyst, endometrioma and control group respectively (p<0.05). The presence of a non-functional cystic mass of ovary on the starting day of stimulation was a risk factor for poor cycle outcome in terms of clinical pregnancy rates [OR=0.5 (95 % CI; 0.2-0.9, p=0.03)]. CONCLUSION: Our data showed that the presence of any kind of cystic mass of the ovary especially the non-functional cysts on the starting day of stimulation was a risk factor for poor cycle outcomes in terms of clinical pregnancy rates.
      PubDate: 2021-12-15
      DOI: 10.21613/GORM.2020.1110
      Issue No: Vol. 27, No. 3 (2021)
       
  • Impact of Obesity Visceral Adiposity and Metabolic Syndrome on Male
           Fertility

    • Authors: Esra Bahar Gur, Ebru Sahin Gulec, Sadik Ince, Mehmet Zeynel Keskin, Ahmet Demir, Baris Sengul, Mehmet Serkan Gur
      Pages: 260 - 267
      Abstract: OBJECTIVE: The study aimed to assess the association between the separate anthropometric indexes including visceral adiposity and metabolic syndrome on male fertility. STUDY DESIGN: In a cross-sectional study, the visceral and subcutaneous fat thickness of 162 participants were measured by ultrasonography. Participants' body mass index, waist circumference, and waist/hip ratio were determined. Participants' biochemical metabolic parameters and reproductive hormones were measured and semen parameters were recorded. Participants were divided into groups according to body mass index and different percentiles of the visceral fat thickness. Differences between groups were investigated by One-way ANOVA, Kruskal-Wallis H, and Pearson Chi-Square test. The relationship between anthropometric measurements and sperm parameters was evaluated by Pearson and Spearman’s rank correlation test. The effect of anthropometric indexes on sperm parameters was evaluated using multivariate regression analysis. RESULTS: It was seen that only total testosterone of sex hormones decreased significantly in the obesity group (p=0.003). There was a significant and reverse association between visceral fat thickness with sperm morphology (rho=–0.2, p=0.01). There was no significant correlation between semen parameters and other anthropometric measurements. In multiple regression analysis, the effect of anthropometric measurements, including visceral fat thickness, on semen parameters was not found, but only smoking was found to be a factor affecting sperm concentration, progressive motility, and morphology (p=0.03, p=0.03, and p=0.01). CONCLUSION: In this study, it was shown that increased obesity was associated with low testosterone levels and increased visceral fat was associated with abnormal sperm morphology. More extensive studies are required on this subject.
      PubDate: 2021-12-15
      DOI: 10.21613/GORM.2021.1156
      Issue No: Vol. 27, No. 3 (2021)
       
  • Type-Specific Persistence/Clearance Results in Human Papillomavirus
           Infections in Turkish Women

    • Authors: Haci Ozturk Sahin, Beril Gurlek, Bulent Demir, Fatma Silan
      Pages: 268 - 272
      Abstract: OBJECTIVE: The persistence of high-risk human papillomavirus infections, most of which are known to be transient is of critical importance for the development of precursor lesions and cancer in the cervix. The aim of the present study is to investigate the persistence and clearance of genotype-based human papillomavirus infections and also some cofactors that could be effective in persistence. STUDY DESIGN: Data of 115 patients whose human papillomavirus and genotype detection was made with multiplex Polymerase chain reaction, and capillary electrophoresis were categorized as low-risk human papillomavirus/high risk human papillomavirus and single/multiple human papillomavirus infections, and clearance/persistence data of two years were investigated. RESULTS: While 82 (71.3%) out of 115 patients (mean age 40.1 years) had a single human papillomavirus infection, the remaining had two or more human papillomavirus infections. Of all human papillomavirus infections, 81.5% (128/157) were high risk-human papillomavirus. Clearance rates of human papillomavirus infections during the first two years was 85.4% (134/157), persistence was 14.6% (23/157). The most frequently persisted high risk-human papillomavirus genotypes were 31, 52, 68, 16, and 35, respectively. A statistically significant difference was not found in human papillomavirus persistence with regard to the infection’s being single/multiple or low-ris/high risk. A significant difference was not found between age groups and persistence. CONCLUSIONS: Of human papillomavirus infections, 85.4% are cleared during the first two years while the most frequently persisted high risk-human papillomavirus genotypes were 31, 52, 68, 16, and 35, respectively. Being aware of population-based clearance/persistence results of type-specific infections may specify screening strategies.
      PubDate: 2021-12-15
      DOI: 10.21613/GORM.2020.1070
      Issue No: Vol. 27, No. 3 (2021)
       
  • Evaluation of the Frequency and Pathological Diagnosis of Vulvar Lesions
           Is it Associated with Vulvar Pruritus - If So, How Closely'

    • Authors: Omer Demir, Mirac Ozalp, Turhan Aran, Mehmet Armagan Osmanagaoğlu
      Pages: 273 - 278
      Abstract: OBJECTIVE: Vulvar lesions are not well known to gynecologists and often cause difficulties in the differential diagnosis. In this study; we aimed to show the frequency of pathologic diagnosis of vulvar lesions and their relationship with vulvar pruritus. STUDY DESIGN: The pathological results of the patients who underwent vulvar biopsy between 2015 and 2019 were examined. The frequency of vulvar lesions was determined and classified under certain headings for gynecologists. The pathological diagnoses were correlated with the severity of pruritus. RESULTS: A total of 220 patients underwent a vulvar biopsy between the dates indicated in the study. The mean age of these patients was 47.9±16.7. The most common concomitant lesion was vulvar pruritus with a rate of 62.7% in cases who were referred to the outpatient clinic and referred for vulvar biopsy. According to biopsy results, the three most common pathological diagnoses were proliferative lesions, infection, and dermatoses. Dermatoses were the most common pathologic diagnosis in patients with severe pruritus. CONCLUSION: Thanks to the clear classification of vulvar lesions for gynecologists; pathological diagnoses will not be overlooked and differential diagnoses will be more effective. In vulvar lesions accompanied by pruritus, making the differential diagnosis according to the severity of pruritus and bringing the possible diagnosis to mind first will speed up the treatment.
      PubDate: 2021-12-15
      DOI: 10.21613/GORM.2020.1152
      Issue No: Vol. 27, No. 3 (2021)
       
  • Primary Fallopian Tube Carcinoma: Results of a Single-Institutional
           Retrospective Analysis of 17 Patients with Evaluation of Staging and
           Prognostic Factors

    • Authors: Neserine Tounsi, Hanen Bouazize, Ikram Margheli, Nadia Boujelbene, Hechiche Monia, Maher Slimane, Khaled Rahel
      Pages: 279 - 282
      Abstract: OBJECTIVE: Primary carcinoma of the fallopian tubes is one of the less common gynecological cancers. It constitutes (0.14-0.18%) of gynecological malignancies. Our study aimed to review the managing process of primary carcinoma of the fallopian tubes in the mono-center institute and to identify prognostic factors impacting survival. STUDY DESIGN: A retrospective cohort study regarding patients with fallopian tube carcinoma treated between July 1991 and December 2005 was identified at the Tunisian anticancer institute “Salah Azaiez”. During this period, we have identified 17 patients. Data such as age, gravidity and parity, menopausal condition, symptoms reported by the patient on presentation, adjuvant therapy, stage of illness, surgical intervention, pathological findings, tumor recurrence, and previous surgical procedures were obtained from the patients’ reports. RESULTS: The average age at the time of diagnosis was 58 years. Fourteen of the included patients were postmenopausal. Surgery was the initial therapy for 15 patients. Optimal cytoreductive surgery was achievable in seven patients with no residual tumors. Histologic examination revealed that serous adenocarcinoma type was the predominant type. Two were in stage I and, four were in stage II; seven were in stage III and four in stage IV. The median follow-up time was 24 months. At the time of the final analysis, 11 patients died of disease. 5-year OS, DFS was 21% and 37% respectively. In our study, only the residual tumor was a significant prognostic factor predicting survival. CONCLUSION: Complete optimal surgery with no residual tumor was the main goal of the surgeon to improved survival in primary fallopian tube carcinoma.
      PubDate: 2021-12-15
      DOI: 10.21613/GORM.2021.1075
      Issue No: Vol. 27, No. 3 (2021)
       
  • Mature Cystic Teratoma of the Ovary; Clinicopathological Evaluation of 143
           Cases in our Series, 5 Years Experience

    • Authors: Ferah Kazanci, Betul Ogut, Dilek Yapar, Ozlem Erdem, M. Anil Onan
      Pages: 283 - 288
      Abstract: OBJECTIVE: Mature cystic teratoma, also known as a dermoid cyst, is the most common germ cell tumor of the ovary. In this retrospective study, it is aimed to evaluate clinicopathological findings of the patients who were operated on due to the preliminary diagnosis of dermoid cyst. STUDY DESIGN: Between May 2013 and May 2018, the findings of a total of 143 patients who were operated on with a preliminary diagnosis of dermoid cyst in our institution were analyzed retrospectively. In addition to demographic characteristics such as age, parity number and tumor size, lateralization, preoperative tumor markers, surgical procedure, presence of other pathological findings, and the rate of malignant transformation were analyzed. RESULTS: The median age of patients was 35.4 years and the ratio of nulliparous, primiparous, and multiparous patients was 46.9%, 25.2%, and 28%, respectively. The median tumor diameter was 6.7 cm, 50.3% of which were right-sided, 46.9% were left-sided and the remaining 2.8% were bilateral. Intraoperative torsion was found in 15 (10.5%) cases. The treatment consisted of 60.1% cystectomy by laparoscopy, 3.5% unilateral salpingo-oophorectomy by laparoscopy, 9.8% unilateral salpingo-oophorectomy by laparotomy, while the rate of 16.1% cases underwent hysterectomy with bilateral salpingo-oophorectomy by laparotomy, 10.5% of the cases, cysts were excised during cesarean section. As the final pathology report revealed, of 143 patients, immature teratoma was observed in five cases (3.5%), in one of them (0.7%) mixed germ cell tumor and in three of them (2.1%) borderline mucinous cancer, squamous cell carcinoma, and carcinoid tumor on mature cystic teratoma base were observed. CONCLUSION: Torsion is the most common complication with mature cystic teratoma. The size of the tumor is an important prognostic factor in terms of the malignant transformation of teratoma. Fertility sparing surgery with a minimally invasive surgical approach is available for fertility patients diagnosed with Mature cystic teratoma.
      PubDate: 2021-12-15
      DOI: 10.21613/GORM.2021.1189
      Issue No: Vol. 27, No. 3 (2021)
       
  • Neonatal Bacterial Meningitis: Single Reference Center Experience and
           Review of Current Literature: A Retrospective Cohort Study

    • Authors: Alper Aykanat, Hasan Tolga Celik, Gulsen Hazirolan, Sule Yigit, Murat Yurdakok
      Pages: 289 - 293
      Abstract: OBJECTIVE: Despite improvements in neonatal care, neonatal bacterial meningitis is still an emerging problem worldwide with high rates of mortality. The present study evaluates data on suspected- and culture-proven neonatal bacterial meningitis in the light of a single tertiary reference center experience in Turkey in comparison with the globe. STUDY DESIGN: In this retrospective cohort study newborns admitted to Hacettepe University Ihsan Dogramaci Children’s Hospital Neonatal Intensive Care Unit during a 5-year-period between April 2014-May 2019 and who underwent atraumatic lumbar puncture were included. RESULTS: Two hundred sixty-four patients fulfilled the inclusion criteria. Most common symptoms in all patients raised suspicion in favor of NBM and resulted in lumbar puncture were fever (34.5%, n=91), respiratory distress (31.1%, n=82), lethargy (31.1%, n=82), and apnea (26.1%, n=69). The incidence of culture-proven NBM among suspected patients was 5.7% (n=15/264); while the incidence is 3.1 per 1000 (15/4574) at all Neonatal Intensive Care Unit admissions. Respiratory distress (60.0%, n=9/15) and apnea (40.0%, n=6/15) were the most common symptoms in patients with NBM; which may be due to the predominance of premature newborns in the NBM group. The most common microorganisms in CSF cultures were coagulase-negative Staphylococci with Methicillin-resistant Staphylococcus epidermidis being most common among all. CONCLUSIONS: The present study underlines high rates of culture-proven neonatal bacterial meningitis among suspected newborns despite improvements in modern health care, which raises attention to careful evaluation of these patients and early administration of properly-selected antibiotics. Our incidence rates are in keeping with studies from the developed world.
      PubDate: 2021-12-15
      DOI: 10.21613/GORM.2021.1142
      Issue No: Vol. 27, No. 3 (2021)
       
  • COVID-19 Positive Woman Presented with Preterm Labor: Case Report

    • Authors: Ibrahim A. Abdelazim, Mohannad AbuFaza, Sulaiman Al-Munaifi
      Pages: 294 - 296
      Abstract: The novel coronavirus disease-19 (COVID-19) considered a global health problem. Pregnant women are considered a COVID-19 high-risk group.
      A 26-years old woman, G2 P1+0, previous cesarean section, 31 weeks`+4 days, admitted with preterm labor, without fever, cough, and/or respiratory symptoms on admission. She presented to the emergency department with fever, and cough, 27 days before the current admission, she was referred to the Ministry of Health, and her COVID-19 PCR swab at Ministry of Health was positive.
      She delivered by cesarean section, and the PCR swab of the studied woman taken on admission came positive for COVID-19. The delivered girl was admitted to the neonatal intensive care unit for 16 days. The PCR swab of the delivered girl came negative for COVID-19. This report highlights that the COVID-19 infection during pregnancy may increase the rates of preterm labor and cesarean section. There is no strong evidence of vertical COVID-19 transmission when the infection manifests during the 3rd trimester of pregnancy.
      PubDate: 2021-12-15
      DOI: 10.21613/GORM.2021.1170
      Issue No: Vol. 27, No. 3 (2021)
       
  • Genetic Polymorphism in Peripartum Cardiomyopathy

    • Authors: Ivana Purnama Dewi, Johanes Nugroho
      Pages: 297 - 301
      Abstract: Peripartum cardiomyopathy (PPCM) is a rare type of cardiomyopathy. PPCM is a potentially life-threatening pregnancy-associated disease that typically arises in peripartum period and is marked with left ventricular (LV) dysfunction and heart failure. The cause of PPCM remain unclear, but several mechanisms have been proposed ehich indices a potentially multi-factorial etiology. Early case reports identified overlap between familial dilated cardiomyopathy (DCM) and PPCM, although the degree of overlap is largely unknown. Many evidence supporting a contribution from gene mutations in PPCM includes genome-wide association studies, familial occurrence, variable prevalence among different regions and ethnicities, and more recent investigations of panels of genes for mutations among women with PPCM. Although the true incidence of genetic cardiomyopathy is not yet known among women with PPCM, there is substantial evidence demonstrating that genetic contribution to their condition.
      PubDate: 2021-12-15
      DOI: 10.21613/GORM.2021.1072
      Issue No: Vol. 27, No. 3 (2021)
       
  • Author’s Keywords Index

    • Authors: Gynecology Obstetrics; Reproductive Medicine
      Pages: 302 - 307
      PubDate: 2021-12-16
      Issue No: Vol. 27, No. 3 (2021)
       
 
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