Murat Api - Academia.edu (original) (raw)
Papers by Murat Api
AYDIN SAĞLIK DERGİSİ, 2015
We aimed to report a case of conservatively managed recurrent bilateral theca lutein cysts associ... more We aimed to report a case of conservatively managed recurrent bilateral theca lutein cysts associated with a singleton pregnancy after taking informed consent. A 31-year-old woman with a singleton pregnancy, bilaterally multicystic adnexal mass and within the normal beta-hCG range was referred at 13.week pregnancy. She had a history of bilaterally enlarged ovaries up to 18 cm in her first pregnancy. Magnetic resonance imaging showed 112x142x136 mm right ovary and 197x118x242 mm left ovary at 21-week pregnancy. The right multicystic ovary resolved spontaneously during the third trimester. Thinwalled multicystic left ovarian cyst with clear serous fluid content without a solid component measured about 25x15x20 cm in size during cesarean section. Left ovarian cystectomy was performed. At the final pathology, normal morphological findings were detected in the left ovarian cyst. The followup could be a reasonable choice in women with enlarged multicystic ovaries without malignant signs such as papillary, complex and/or solid structure.
Amaç: A¤›r preeklamptik ve sa¤l›kl› gebelerde serum IGF-1, insulin de¤erleri ve HOMA-IR indeksler... more Amaç: A¤›r preeklamptik ve sa¤l›kl› gebelerde serum IGF-1, insulin de¤erleri ve HOMA-IR indekslerini karfl›laflt›rmak. Materyal ve Metod: Dr. Lütfi K›rdar Kartal E¤itim ve Araflt›rma Hastahanesi Kad›n Hastal›klar› ve Do¤um Klini¤ine 01.10.2003-01.03.2004 tarihleri aras›nda baflvuran a¤›r preeklamptik/eklamptik 20 gebe ile sa¤l›kl› 20 gebe çal›flma grubuna dahil edildi. Açl›k kan flekeri (AKfi), ‹nsülin, AKfi/insülin oran›, IGF-1, Ürik Asit, SGOT, SGPT, Üre, Kreatinin, Total Protein, Albumin, LDH çal›fl›lan parametrelerdi. Çal›flan parametrelerin ortalama/ortanca de¤erlerinin karfl›laflt›r›lmas›nda, gruplar aras›ndaki fark›n anlaml›l›¤› Mann-Whitney U test ile de¤erlendirildi. Parametreler aras›nda yap›lan korelasyon analizinde, Spearman korelasyon katsay›s› kullan›ld›. ‹statistiksel anlaml›l›k düzeyi (p) 0.05 olarak kabul edildi. Bulgular: ‹ki grup aras›nda istatistiksel olarak yafl, gravida, parite aç›s›ndan fark bulunamam›fl olup; gebelik haftas› aç›s›ndan anlaml› fark bulunmufltu...
Gynecology Obstetrics and Reproductive Medicine, 2007
OBJECTIVE: The aim of this study was to evaluate the correlation of dual-energy X-ray absorbtiome... more OBJECTIVE: The aim of this study was to evaluate the correlation of dual-energy X-ray absorbtiometry measurements between the spine and femoral neck to predict bone mineral density (BMD) as defined according to the WHO classification in Turkish population. STUDY DESIGN: Five hundred and ninety-two postmenopausal women aged 39-74 years were investigated. There was significant and strong correlation between BMD measurements, with r:0,69-0,74 p<0,05. RESULTS: The cut off values of the femoral neck and ward triangle BMD that allow the identification with 95% sensivity of postmenopausal women with either lumbal spines T-score< -1, correspond to a T score -0,4 (femoral neck) and +0,05 ( ward triangle). CONCLUSION: However, this study highlights the difficulties in using a unique T-score that could be applied to different sites to diagnose osteoporosis.
SUMMARY A 22-year-old, primigravida, at 18 weeksi gestation presented with an acute onset of abdo... more SUMMARY A 22-year-old, primigravida, at 18 weeksi gestation presented with an acute onset of abdominal pain, severe hypotension and tachycardia. It has been revealed in her previous medical history that she had been operated with a presumptive diagnosis of ectopic pregnancy and due to the intraoperative misdiagnosis of uterus bicornis, the intact right uterine pregnancy in the rudimentary horn was left in place to continue in another hospital. After the operation, prophylactic cerclage was performed. She was urgently brought to a private hospital and emergency laparotomy was performed for the presumptive diagnosis of intraperitoneal hemorrhage. A significant hemoperitoneum was encountered with the fetus floating freely with the placenta in the peritoneal cavity. The right rudimentary uterine horn had a fundal rupture that necessitated performing a rudimentary uterine and ipsilateral tubal excision. The patient recovered uneventfully.
Objective: The objective of the present study is to evaluate the efficacy of guaiazulene ointment... more Objective: The objective of the present study is to evaluate the efficacy of guaiazulene ointment versus breast milk application in the prevention of cracked nipples during breastfeeding. Material and Methods: This prospective, randomized, double-blind trial was conducted in mother-infant care wards in a tertiary care training and research hospital. Two hundred postpartum puerperal women with normal nipples who were breastfeeding after a vaginal delivery at 37 or more weeks of gestation were included in the study. Participants were assigned randomly to one of the two treatment groups with 0.05% guaiazulene ointment or her own breast milk application. Participants applied the treatments after each breastfeeding, from postpartum day 1 to 30. Rate of occurrences of nipple cracks at day 30, nipple pain measured with visual analogue score at day 15 and 30 were the primary endpoints of the trial. Results: Forty-seven women have either not fulfilled the final criteria for statistical analy...
Ginekologia Polska, 2017
Objectives: To compare the effects of topical silicone gel and corticosteroid cream for preventin... more Objectives: To compare the effects of topical silicone gel and corticosteroid cream for preventing hypertrophic scar and keloid formation following Pfannenstiel incisions. Material and methods: Fifty patients operated for benign gynecological diseases through primary Pfannenstiel incision were included. The wounds were randomly allocated to the treatment and control arms. In the treatment arm, the wounds were divided into two halves; one was treated with silicone gel and the other with methylprednisolone cream. No treatment was administered to the control group. Scars using the modified Vancouver Scar Scale (MVSS), patient satisfaction, and side effects were evaluated before and after (3 rd month when treatment discontinued and 6 th month) the treatment. Results: Thirty-nine patients (21 patients in the treatment group and 18 patients in the control group) completed the study. Intragroup comparisons of the 3 rd month and 6 th month scores of the MVSS revealed that the scores of all parameters (height, pigmentation, vascularity, pliability, and total MVSS score) significantly decreased at the 6 th month evaluation as compared with the 3 rd month evaluation in all groups (control, silicone, and methylprednisolone groups). Multiple group comparisons at the 6 th month revealed that the most prominent improvements occurred in the methylprednisolone group in all MVSS parameters as compared with the control group and in the height, vascularity, and pigmentation parameters as compared with the silicone group. No side effects were experienced by the patients with either treatment and patient satisfaction was higher in the methylprednisolone group. Conclusion: The use of topical methylprednisolone cream in fresh wounds at the postoperative early period appears to be promising.
Journal of the Turkish-German Gynecological Association, 2019
Objective: The objective of this study was to assess maternal and perinatal outcomes of twin preg... more Objective: The objective of this study was to assess maternal and perinatal outcomes of twin pregnancies with single fetal demise in terms of chorionicity and fetal death time. Material and Methods: All deliveries between January 2008 and July 2015 were reviewed retrospectively and 85 twin pregnancies with single fetal demise were included. These cases were grouped according to chorionicity and fetal death time. Results: The incidence of single fetal demise was 4.7%. The mean delivery week was later in the dichorionic group (34.16±4.65) than in the monochorionic group (31.1±3.83). The ratios of deliveries before the 34 th gestational week were 71.4% in monochorionics and 35% in dichorionics. Monochorionics had a 13 times greater risk for having delivery before the 37 th gestational week and a 4 times greater risk for having delivery before the 34 th gestational week compared with dichorionics. Furthermore, monochorionics had a 7 times greater risk for having abruptio placenta compared with dichorionics. The newborn intensive care unit admission ratios were 61.3% in dichorionics and 85.7% in monochorionics. Also, monochorionics had a 3.7 times greater risk for admission to newborn intensive care unit compared with dichorionics. Conclusion: We recommend follow-up of twin pregnancies with single fetal demise in terms of premature birth, regardless of chorionicity. Also, close monitoring is recommended for monochorionic twin pregnancies with single fetal demise in terms of premature birth before 34 weeks of gestation, abruptio placenta, the need for neonatal intensive care, and respiratory distress syndrome.
Journal of Turkish Society of Obstetric and Gynecology, 2017
Kadından erkeğe cinsiyet değiştiren kişilerin uterus donörü olmaya uygunluklarını histolojik, cer... more Kadından erkeğe cinsiyet değiştiren kişilerin uterus donörü olmaya uygunluklarını histolojik, cerrahi ve sosyal açıdan değerlendirmektir. Gereç ve Yöntemler: Bu prospektif kohort çalışmada, 31 kişiye kadından erkeğe cinsiyet değişimi için laparoskopik histerektomi ve bilateral salpingoooferektomi uygulandı. Bu kişilerin pelvik viserası ve çıkarılan uterusların histolojileri üreme potansiyeli açısından değerlendirildi. Operasyon sonrası uterus donörü olmaya dair tutumlarına dair bir anket uygulandı. Bulgular: Kişilerin ortalama ± standart sapma yaşı 28,5±5 yıldır. Ortalama testosteron desteği alma süresi 2,4 yıl iken destek süresince hastaların tümünün menstrüel periyotları düzensizdi. Herhangi bir kronik hastalık veya geçirilmiş abdominal cerrahileri yoktu. Çıkarılan uterus volümlerinin ortalaması 138±48 cm 3 'tür. Herhangi bir adenomyozis, endometriozis, polip, adezyon veya uterus anomalisi gözlemlenmedi veya raporlanmadı. Endometrial histolojileri proliferatif (%58), atrofik (%29) ve sekretuar (%13) paternde rapor edildi. Otuz bir kişinin 30'u (%96,7) uterus donörü olma yönünde pozitif bir tutum bildirirken, bir kişi herhangi bir fikri olmadığını söyledi. Nakil için uterusun alınması operasyonu ile ilgili ayrıntılı bilgi verildikten sonra 26 (%84) kişi hala donasyon için gönüllü iken, 4 (%12) kişi kararını değiştirerek negatif tutum beyan etti (p=0,12, McNemar testi). Sonuç: Kadından erkeğe cinsiyet değiştiren kişilerin uterus donörü olması daha önce denenmemiş hipotetik bir modeldir. Bu çalışma ile kadından erkeğe cinsiyet değiştiren kişilerin sosyal, hukuki ve biyolojik açıdan donör olmaya uygun adaylar olduğu düşünülebilir.
Proceedings in Obstetrics and Gynecology, 2014
Aim: To investigate the effects of pregnancy on the sexual life of Turkish women Materials and Me... more Aim: To investigate the effects of pregnancy on the sexual life of Turkish women Materials and Methods: One thousand twenty six pregnant women were included in the study. The Libido Scoring System, which is a questionnaire consisting of four questions about the frequency of intercourse, the partner initiating the intercourse, orgasm and masturbation status of the pregnant women, was completed by all patients. Both prepregnancy and pregnancy sexuality was evaluated independently using this scale. Results: The frequency of sexual intercourse during pregnancy significantly decreased from 3.07/week to 2.40/week (p<0.05). The masturbation rate during pregnancy was significantly lower than the pre-pregnancy period (3.6% vs 4.9 %, p<0.001). The percentage of pregnant women who never had an orgasm was significantly higher compared to the pre-pregnant period (21.7 % vs 10.8 %, p<0.01). The rates of initiation of sexual intercourse in the pre-pregnancy period by men and by women were 94.5% (970/1026) and 5.3% (54/1026) respectively. In pregnancy period the rates of initiation of sexual intercourse by man and woman were 93.4% (904/968) and 6.6% (64/968) respectively (p=0.0001). The mean libido scores during pregnancy were statistically lower than the prepregnancy period (6.38±0.04 vs 7.31±0.04, p<0.001). Conclusion: Pregnancy has a negative effect on the sexual life of women, but more prospective studies are required to clarify the mechanisms.
Journal of Clinical Gynecology and Obstetrics, 2014
ABSTRACT Pregnancy in women with advanced maternal age following ovum donation is associated with... more ABSTRACT Pregnancy in women with advanced maternal age following ovum donation is associated with significant maternal and fetal complications which lead to increased risks of prematurity and lower birth weight. A 57-year-old postmenopausal, nulliparous woman with dichorionic pregnancy who had conceived with ovum donation, presented with preterm labor at 26 weeks and 5 days of gestation. Following rupture of the membrane of the protruding sac and delivery of the first twin, an emergency cerclage with tocolytics, antibiotics and corticosteroid therapy was initiated in order to improve the perinatal outcome of the second twin. The cerclage suture was removed after 4 days due to increasing serum C-reactive protein levels and maternal moderate respiratory distress. Both of the neonates survived following hospitalization for 6 weeks in the neonatal intensive care unit. The management described in this case report suggest that delayed interval delivery may be safe for the mother and salvative for the fetus; but both parents and doctors must be realized about its benefits and risks.
Iranian journal of medical sciences, 2016
Cesarean scar pregnancy (CSP) is a rare, but life-threatening type of ectopic pregnancy. An exact... more Cesarean scar pregnancy (CSP) is a rare, but life-threatening type of ectopic pregnancy. An exact and early diagnosis of CSP is very important for prognosis. The aim of the present study was to describe 4 women with CSP and discuss their clinical presentations, diagnoses, and various management options along with the published literature. Four women with a suspicion of CSP or cervical pregnancy were referred to our hospital between August 2013 and January 2014. All the patients were counseled about medical management options. After the treatment, serum beta human chorionic gonadotropin (ß-hCG) levels were followed weekly until they reached <5 mIU/mL. All the patients were diagnosed at the first trimester, with the average gestational age of 6.4±0.9 weeks. Treatment was systemic methotrexate (MTX) treatment in 3 of the 4 women, requiring no further intervention. The remaining 1 woman was treated with an intragestational administration of MTX. The mean time passed until ß-hCG reach...
Asian Pacific Journal of Cancer Prevention, 2014
Background: To evaluate the incidence, diagnosis and management of GTN among 28 centers in Turkey... more Background: To evaluate the incidence, diagnosis and management of GTN among 28 centers in Turkey. Materials and Methods: A retrospective study was designed to include GTN patients attending 28 centers in the 10-year period between January 2003 and May 2013. Demographical characteristics of the patients, histopathological diagnosis, the International Federation of Gynecology and Obstetrics (FIGO) anatomical and prognostic scores, use of single-agent and multi-agent chemotherapy, surgical interventions and prognosis were evaluated. Results: From 2003-2013, there were 1,173,235 deliveries and 456 GTN cases at the 28 centers. The incidence was calculated to be 0.38 per 1,000 deliveries. According to the evaluated data of 364 patients, the median age at diagnosis was 31 years (range, 15-59 years). A histopathological diagnosis was present for 45.1% of the patients, and invasive mole, choriocarcinoma and PSTTs were diagnosed in 22.3% (n=81), 18.1% (n=66) and 4.7% (n=17) of the patients, respectively. Regarding final prognosis, 352 (96.7%) of the patients had remission, and 7 (1.9%) had persistence, whereas the disease was mortal for 5 (1.4%) of the patients. Conclusions: Because of the differences between countries, it is important to provide national registration systems and special clinics for the accurate diagnosis and treatment of GTN.
Turkiye Klinikleri Journal of Gynecology and Obstetrics, 1999
Turkiye Klinikleri Jinekoloji Obstetrik Dergisi, 2010
International journal of clinical and experimental medicine, 2015
To compare and evaluate the influences of expectant and aggressive management of severe preeclamp... more To compare and evaluate the influences of expectant and aggressive management of severe preeclampsia on the first year neurologic development of the infants in pregnancies between 27 and 34 weeks of pregnancy. Seventy women with severe preeclampsia between 27 and 34 weeks of gestation were included in the study. 37 patients were managed aggressively (Group 1) and 33 patients were managed expectantly (Group 2). Glucocorticoids, magnesium sulfate infusion and antihypertensive drugs were administered to each group. After glucocorticoid administration was completed Group 1 was delivered either by cesarean section or vaginal delivery. In Group 2 magnesium sulfate infusion was stopped after glucocorticoid administration was completed. Antihypertensive drugs were given, bed rest and intensive fetal monitorization were continued in this group. The average weeks of gestation, one minute and five minute apgar scores and hospitalization time in intensive care unit were similar in both groups (...
Turkiye Klinikleri Journal of Endocrinology Special Topics, 2013
İstanbul Tıp Fakültesi Dergisi, 2015
Ectopic pregnancy continues to be one of the important reasons for maternal mortality. With the w... more Ectopic pregnancy continues to be one of the important reasons for maternal mortality. With the widespread and frequent use of Assisted Reproductive Techniques (ART), the frequency of abnormally located pregnancies also rises. In this article, we presented a case of an ectopic pregnancy occurring in the right tubal stump after an intracytoplasmic sperm injectionembryo transfer performed on a 39 year-old patient with secondary infertility and bilateral salphingectomy. Although a bilateral salphingectomy was performed in IVF cycles for an early diagnosis in order to decrease maternal morbidity and mortality, an ectopic pregnancy in the stump should be definitely taken into consideration in cases where no intrauterine pregnancy is observed.
Background: The aim of this study was to determine the factors associated with the need for insul... more Background: The aim of this study was to determine the factors associated with the need for insulin therapy in patients with gestational diyabetes (GDM). Material and Methods: This study is a retrospective study that was included 40 patients hospitalized with a diagnosis of GDM between January 2009 and December 2010 in Adana Numune Education and Research Hospital Clinic of Obstetrics and Gynecology. These patients were divided into two groups: only diet modification (Group 1) and diet + insulin therapy (Group 2). These two groups were compared in terms of demographic characteristics, 100 g OGTT results and the percentage of glycosylated hemoglobin (HbA1c) values. Results: According to the results of our study, regulation of glucose was achieved on 22 (55%) patients with only dietary modification and 18 patients (45%) received diet + insulin treatment for the regulation of glucose. From the demographic characteristics, age and body mass index (BMI) were found to be significantly high...
JPMA. The Journal of the Pakistan Medical Association, 1995
Longitudinal vaginal septum, a rare congenital fusion defect of mullarian ducts rarely causes dys... more Longitudinal vaginal septum, a rare congenital fusion defect of mullarian ducts rarely causes dystosia of labour and total uterine prolapse. Several surgical techniques were developed for repair of prolapse but no consensus has been reached on one type of operation.
Zeynep Kamil Tıp Bülteni, 2014
Amac: Bu calismada, preoperatif donemde salin infuzyon sonografisi (SIS) ile tani konulan hastala... more Amac: Bu calismada, preoperatif donemde salin infuzyon sonografisi (SIS) ile tani konulan hastalarin histeroskopik tanilarinin karsilastirilmasi ve histeroskopinin etkinlik ve guvenilirliginin belirlenmesi amaclanmistir. Gerec ve Yontem: Bu calisma Egitim ve Arastirma Hastanesi kadin hastaliklari ve dogum kliniginde Ekim 2011- Aralik 2012 tarihleri arasinda histeroskopi yapilan 95 hasta ile yapilmisir. Farkli nedenlerden dolayi histeroskopi planlanan tum hastalara preoperatif SIS yapildi. Daha sonra bu iki yontemin tanisal degerleri karsilastirildi. Bulgular: Histolojik tani altin standart olarak kabul edildiginde polip tanisinda SIS’in %90.62 sensitivite, %90.48 spesifite, myom tanisinda %84.21 sensitivite, %100 spesifiteye sahip oldugu izlenmistir. Histeroskopinin polip tanisinda %96.87 sensitivite, %90.48 spesifite, myom tanisinda ise %84.21 sensitivite, %100 spesifiteye sahip oldugu saptanmistir. Sonuc: SIS fokal lezyonlarin tanisinda oldukca doyurucu etkinlige sahip olsa da histeroskopinin endomatrial kavite patolojilerinde giderek yayginlasan ve vazgecilmez bir tani ve tedavi yontemi haline geldigini gormekteyiz. Anahtar Kelimeler: Salin infuzyon sonografi, histeroskopi, endometrial patoloji
AYDIN SAĞLIK DERGİSİ, 2015
We aimed to report a case of conservatively managed recurrent bilateral theca lutein cysts associ... more We aimed to report a case of conservatively managed recurrent bilateral theca lutein cysts associated with a singleton pregnancy after taking informed consent. A 31-year-old woman with a singleton pregnancy, bilaterally multicystic adnexal mass and within the normal beta-hCG range was referred at 13.week pregnancy. She had a history of bilaterally enlarged ovaries up to 18 cm in her first pregnancy. Magnetic resonance imaging showed 112x142x136 mm right ovary and 197x118x242 mm left ovary at 21-week pregnancy. The right multicystic ovary resolved spontaneously during the third trimester. Thinwalled multicystic left ovarian cyst with clear serous fluid content without a solid component measured about 25x15x20 cm in size during cesarean section. Left ovarian cystectomy was performed. At the final pathology, normal morphological findings were detected in the left ovarian cyst. The followup could be a reasonable choice in women with enlarged multicystic ovaries without malignant signs such as papillary, complex and/or solid structure.
Amaç: A¤›r preeklamptik ve sa¤l›kl› gebelerde serum IGF-1, insulin de¤erleri ve HOMA-IR indeksler... more Amaç: A¤›r preeklamptik ve sa¤l›kl› gebelerde serum IGF-1, insulin de¤erleri ve HOMA-IR indekslerini karfl›laflt›rmak. Materyal ve Metod: Dr. Lütfi K›rdar Kartal E¤itim ve Araflt›rma Hastahanesi Kad›n Hastal›klar› ve Do¤um Klini¤ine 01.10.2003-01.03.2004 tarihleri aras›nda baflvuran a¤›r preeklamptik/eklamptik 20 gebe ile sa¤l›kl› 20 gebe çal›flma grubuna dahil edildi. Açl›k kan flekeri (AKfi), ‹nsülin, AKfi/insülin oran›, IGF-1, Ürik Asit, SGOT, SGPT, Üre, Kreatinin, Total Protein, Albumin, LDH çal›fl›lan parametrelerdi. Çal›flan parametrelerin ortalama/ortanca de¤erlerinin karfl›laflt›r›lmas›nda, gruplar aras›ndaki fark›n anlaml›l›¤› Mann-Whitney U test ile de¤erlendirildi. Parametreler aras›nda yap›lan korelasyon analizinde, Spearman korelasyon katsay›s› kullan›ld›. ‹statistiksel anlaml›l›k düzeyi (p) 0.05 olarak kabul edildi. Bulgular: ‹ki grup aras›nda istatistiksel olarak yafl, gravida, parite aç›s›ndan fark bulunamam›fl olup; gebelik haftas› aç›s›ndan anlaml› fark bulunmufltu...
Gynecology Obstetrics and Reproductive Medicine, 2007
OBJECTIVE: The aim of this study was to evaluate the correlation of dual-energy X-ray absorbtiome... more OBJECTIVE: The aim of this study was to evaluate the correlation of dual-energy X-ray absorbtiometry measurements between the spine and femoral neck to predict bone mineral density (BMD) as defined according to the WHO classification in Turkish population. STUDY DESIGN: Five hundred and ninety-two postmenopausal women aged 39-74 years were investigated. There was significant and strong correlation between BMD measurements, with r:0,69-0,74 p<0,05. RESULTS: The cut off values of the femoral neck and ward triangle BMD that allow the identification with 95% sensivity of postmenopausal women with either lumbal spines T-score< -1, correspond to a T score -0,4 (femoral neck) and +0,05 ( ward triangle). CONCLUSION: However, this study highlights the difficulties in using a unique T-score that could be applied to different sites to diagnose osteoporosis.
SUMMARY A 22-year-old, primigravida, at 18 weeksi gestation presented with an acute onset of abdo... more SUMMARY A 22-year-old, primigravida, at 18 weeksi gestation presented with an acute onset of abdominal pain, severe hypotension and tachycardia. It has been revealed in her previous medical history that she had been operated with a presumptive diagnosis of ectopic pregnancy and due to the intraoperative misdiagnosis of uterus bicornis, the intact right uterine pregnancy in the rudimentary horn was left in place to continue in another hospital. After the operation, prophylactic cerclage was performed. She was urgently brought to a private hospital and emergency laparotomy was performed for the presumptive diagnosis of intraperitoneal hemorrhage. A significant hemoperitoneum was encountered with the fetus floating freely with the placenta in the peritoneal cavity. The right rudimentary uterine horn had a fundal rupture that necessitated performing a rudimentary uterine and ipsilateral tubal excision. The patient recovered uneventfully.
Objective: The objective of the present study is to evaluate the efficacy of guaiazulene ointment... more Objective: The objective of the present study is to evaluate the efficacy of guaiazulene ointment versus breast milk application in the prevention of cracked nipples during breastfeeding. Material and Methods: This prospective, randomized, double-blind trial was conducted in mother-infant care wards in a tertiary care training and research hospital. Two hundred postpartum puerperal women with normal nipples who were breastfeeding after a vaginal delivery at 37 or more weeks of gestation were included in the study. Participants were assigned randomly to one of the two treatment groups with 0.05% guaiazulene ointment or her own breast milk application. Participants applied the treatments after each breastfeeding, from postpartum day 1 to 30. Rate of occurrences of nipple cracks at day 30, nipple pain measured with visual analogue score at day 15 and 30 were the primary endpoints of the trial. Results: Forty-seven women have either not fulfilled the final criteria for statistical analy...
Ginekologia Polska, 2017
Objectives: To compare the effects of topical silicone gel and corticosteroid cream for preventin... more Objectives: To compare the effects of topical silicone gel and corticosteroid cream for preventing hypertrophic scar and keloid formation following Pfannenstiel incisions. Material and methods: Fifty patients operated for benign gynecological diseases through primary Pfannenstiel incision were included. The wounds were randomly allocated to the treatment and control arms. In the treatment arm, the wounds were divided into two halves; one was treated with silicone gel and the other with methylprednisolone cream. No treatment was administered to the control group. Scars using the modified Vancouver Scar Scale (MVSS), patient satisfaction, and side effects were evaluated before and after (3 rd month when treatment discontinued and 6 th month) the treatment. Results: Thirty-nine patients (21 patients in the treatment group and 18 patients in the control group) completed the study. Intragroup comparisons of the 3 rd month and 6 th month scores of the MVSS revealed that the scores of all parameters (height, pigmentation, vascularity, pliability, and total MVSS score) significantly decreased at the 6 th month evaluation as compared with the 3 rd month evaluation in all groups (control, silicone, and methylprednisolone groups). Multiple group comparisons at the 6 th month revealed that the most prominent improvements occurred in the methylprednisolone group in all MVSS parameters as compared with the control group and in the height, vascularity, and pigmentation parameters as compared with the silicone group. No side effects were experienced by the patients with either treatment and patient satisfaction was higher in the methylprednisolone group. Conclusion: The use of topical methylprednisolone cream in fresh wounds at the postoperative early period appears to be promising.
Journal of the Turkish-German Gynecological Association, 2019
Objective: The objective of this study was to assess maternal and perinatal outcomes of twin preg... more Objective: The objective of this study was to assess maternal and perinatal outcomes of twin pregnancies with single fetal demise in terms of chorionicity and fetal death time. Material and Methods: All deliveries between January 2008 and July 2015 were reviewed retrospectively and 85 twin pregnancies with single fetal demise were included. These cases were grouped according to chorionicity and fetal death time. Results: The incidence of single fetal demise was 4.7%. The mean delivery week was later in the dichorionic group (34.16±4.65) than in the monochorionic group (31.1±3.83). The ratios of deliveries before the 34 th gestational week were 71.4% in monochorionics and 35% in dichorionics. Monochorionics had a 13 times greater risk for having delivery before the 37 th gestational week and a 4 times greater risk for having delivery before the 34 th gestational week compared with dichorionics. Furthermore, monochorionics had a 7 times greater risk for having abruptio placenta compared with dichorionics. The newborn intensive care unit admission ratios were 61.3% in dichorionics and 85.7% in monochorionics. Also, monochorionics had a 3.7 times greater risk for admission to newborn intensive care unit compared with dichorionics. Conclusion: We recommend follow-up of twin pregnancies with single fetal demise in terms of premature birth, regardless of chorionicity. Also, close monitoring is recommended for monochorionic twin pregnancies with single fetal demise in terms of premature birth before 34 weeks of gestation, abruptio placenta, the need for neonatal intensive care, and respiratory distress syndrome.
Journal of Turkish Society of Obstetric and Gynecology, 2017
Kadından erkeğe cinsiyet değiştiren kişilerin uterus donörü olmaya uygunluklarını histolojik, cer... more Kadından erkeğe cinsiyet değiştiren kişilerin uterus donörü olmaya uygunluklarını histolojik, cerrahi ve sosyal açıdan değerlendirmektir. Gereç ve Yöntemler: Bu prospektif kohort çalışmada, 31 kişiye kadından erkeğe cinsiyet değişimi için laparoskopik histerektomi ve bilateral salpingoooferektomi uygulandı. Bu kişilerin pelvik viserası ve çıkarılan uterusların histolojileri üreme potansiyeli açısından değerlendirildi. Operasyon sonrası uterus donörü olmaya dair tutumlarına dair bir anket uygulandı. Bulgular: Kişilerin ortalama ± standart sapma yaşı 28,5±5 yıldır. Ortalama testosteron desteği alma süresi 2,4 yıl iken destek süresince hastaların tümünün menstrüel periyotları düzensizdi. Herhangi bir kronik hastalık veya geçirilmiş abdominal cerrahileri yoktu. Çıkarılan uterus volümlerinin ortalaması 138±48 cm 3 'tür. Herhangi bir adenomyozis, endometriozis, polip, adezyon veya uterus anomalisi gözlemlenmedi veya raporlanmadı. Endometrial histolojileri proliferatif (%58), atrofik (%29) ve sekretuar (%13) paternde rapor edildi. Otuz bir kişinin 30'u (%96,7) uterus donörü olma yönünde pozitif bir tutum bildirirken, bir kişi herhangi bir fikri olmadığını söyledi. Nakil için uterusun alınması operasyonu ile ilgili ayrıntılı bilgi verildikten sonra 26 (%84) kişi hala donasyon için gönüllü iken, 4 (%12) kişi kararını değiştirerek negatif tutum beyan etti (p=0,12, McNemar testi). Sonuç: Kadından erkeğe cinsiyet değiştiren kişilerin uterus donörü olması daha önce denenmemiş hipotetik bir modeldir. Bu çalışma ile kadından erkeğe cinsiyet değiştiren kişilerin sosyal, hukuki ve biyolojik açıdan donör olmaya uygun adaylar olduğu düşünülebilir.
Proceedings in Obstetrics and Gynecology, 2014
Aim: To investigate the effects of pregnancy on the sexual life of Turkish women Materials and Me... more Aim: To investigate the effects of pregnancy on the sexual life of Turkish women Materials and Methods: One thousand twenty six pregnant women were included in the study. The Libido Scoring System, which is a questionnaire consisting of four questions about the frequency of intercourse, the partner initiating the intercourse, orgasm and masturbation status of the pregnant women, was completed by all patients. Both prepregnancy and pregnancy sexuality was evaluated independently using this scale. Results: The frequency of sexual intercourse during pregnancy significantly decreased from 3.07/week to 2.40/week (p<0.05). The masturbation rate during pregnancy was significantly lower than the pre-pregnancy period (3.6% vs 4.9 %, p<0.001). The percentage of pregnant women who never had an orgasm was significantly higher compared to the pre-pregnant period (21.7 % vs 10.8 %, p<0.01). The rates of initiation of sexual intercourse in the pre-pregnancy period by men and by women were 94.5% (970/1026) and 5.3% (54/1026) respectively. In pregnancy period the rates of initiation of sexual intercourse by man and woman were 93.4% (904/968) and 6.6% (64/968) respectively (p=0.0001). The mean libido scores during pregnancy were statistically lower than the prepregnancy period (6.38±0.04 vs 7.31±0.04, p<0.001). Conclusion: Pregnancy has a negative effect on the sexual life of women, but more prospective studies are required to clarify the mechanisms.
Journal of Clinical Gynecology and Obstetrics, 2014
ABSTRACT Pregnancy in women with advanced maternal age following ovum donation is associated with... more ABSTRACT Pregnancy in women with advanced maternal age following ovum donation is associated with significant maternal and fetal complications which lead to increased risks of prematurity and lower birth weight. A 57-year-old postmenopausal, nulliparous woman with dichorionic pregnancy who had conceived with ovum donation, presented with preterm labor at 26 weeks and 5 days of gestation. Following rupture of the membrane of the protruding sac and delivery of the first twin, an emergency cerclage with tocolytics, antibiotics and corticosteroid therapy was initiated in order to improve the perinatal outcome of the second twin. The cerclage suture was removed after 4 days due to increasing serum C-reactive protein levels and maternal moderate respiratory distress. Both of the neonates survived following hospitalization for 6 weeks in the neonatal intensive care unit. The management described in this case report suggest that delayed interval delivery may be safe for the mother and salvative for the fetus; but both parents and doctors must be realized about its benefits and risks.
Iranian journal of medical sciences, 2016
Cesarean scar pregnancy (CSP) is a rare, but life-threatening type of ectopic pregnancy. An exact... more Cesarean scar pregnancy (CSP) is a rare, but life-threatening type of ectopic pregnancy. An exact and early diagnosis of CSP is very important for prognosis. The aim of the present study was to describe 4 women with CSP and discuss their clinical presentations, diagnoses, and various management options along with the published literature. Four women with a suspicion of CSP or cervical pregnancy were referred to our hospital between August 2013 and January 2014. All the patients were counseled about medical management options. After the treatment, serum beta human chorionic gonadotropin (ß-hCG) levels were followed weekly until they reached <5 mIU/mL. All the patients were diagnosed at the first trimester, with the average gestational age of 6.4±0.9 weeks. Treatment was systemic methotrexate (MTX) treatment in 3 of the 4 women, requiring no further intervention. The remaining 1 woman was treated with an intragestational administration of MTX. The mean time passed until ß-hCG reach...
Asian Pacific Journal of Cancer Prevention, 2014
Background: To evaluate the incidence, diagnosis and management of GTN among 28 centers in Turkey... more Background: To evaluate the incidence, diagnosis and management of GTN among 28 centers in Turkey. Materials and Methods: A retrospective study was designed to include GTN patients attending 28 centers in the 10-year period between January 2003 and May 2013. Demographical characteristics of the patients, histopathological diagnosis, the International Federation of Gynecology and Obstetrics (FIGO) anatomical and prognostic scores, use of single-agent and multi-agent chemotherapy, surgical interventions and prognosis were evaluated. Results: From 2003-2013, there were 1,173,235 deliveries and 456 GTN cases at the 28 centers. The incidence was calculated to be 0.38 per 1,000 deliveries. According to the evaluated data of 364 patients, the median age at diagnosis was 31 years (range, 15-59 years). A histopathological diagnosis was present for 45.1% of the patients, and invasive mole, choriocarcinoma and PSTTs were diagnosed in 22.3% (n=81), 18.1% (n=66) and 4.7% (n=17) of the patients, respectively. Regarding final prognosis, 352 (96.7%) of the patients had remission, and 7 (1.9%) had persistence, whereas the disease was mortal for 5 (1.4%) of the patients. Conclusions: Because of the differences between countries, it is important to provide national registration systems and special clinics for the accurate diagnosis and treatment of GTN.
Turkiye Klinikleri Journal of Gynecology and Obstetrics, 1999
Turkiye Klinikleri Jinekoloji Obstetrik Dergisi, 2010
International journal of clinical and experimental medicine, 2015
To compare and evaluate the influences of expectant and aggressive management of severe preeclamp... more To compare and evaluate the influences of expectant and aggressive management of severe preeclampsia on the first year neurologic development of the infants in pregnancies between 27 and 34 weeks of pregnancy. Seventy women with severe preeclampsia between 27 and 34 weeks of gestation were included in the study. 37 patients were managed aggressively (Group 1) and 33 patients were managed expectantly (Group 2). Glucocorticoids, magnesium sulfate infusion and antihypertensive drugs were administered to each group. After glucocorticoid administration was completed Group 1 was delivered either by cesarean section or vaginal delivery. In Group 2 magnesium sulfate infusion was stopped after glucocorticoid administration was completed. Antihypertensive drugs were given, bed rest and intensive fetal monitorization were continued in this group. The average weeks of gestation, one minute and five minute apgar scores and hospitalization time in intensive care unit were similar in both groups (...
Turkiye Klinikleri Journal of Endocrinology Special Topics, 2013
İstanbul Tıp Fakültesi Dergisi, 2015
Ectopic pregnancy continues to be one of the important reasons for maternal mortality. With the w... more Ectopic pregnancy continues to be one of the important reasons for maternal mortality. With the widespread and frequent use of Assisted Reproductive Techniques (ART), the frequency of abnormally located pregnancies also rises. In this article, we presented a case of an ectopic pregnancy occurring in the right tubal stump after an intracytoplasmic sperm injectionembryo transfer performed on a 39 year-old patient with secondary infertility and bilateral salphingectomy. Although a bilateral salphingectomy was performed in IVF cycles for an early diagnosis in order to decrease maternal morbidity and mortality, an ectopic pregnancy in the stump should be definitely taken into consideration in cases where no intrauterine pregnancy is observed.
Background: The aim of this study was to determine the factors associated with the need for insul... more Background: The aim of this study was to determine the factors associated with the need for insulin therapy in patients with gestational diyabetes (GDM). Material and Methods: This study is a retrospective study that was included 40 patients hospitalized with a diagnosis of GDM between January 2009 and December 2010 in Adana Numune Education and Research Hospital Clinic of Obstetrics and Gynecology. These patients were divided into two groups: only diet modification (Group 1) and diet + insulin therapy (Group 2). These two groups were compared in terms of demographic characteristics, 100 g OGTT results and the percentage of glycosylated hemoglobin (HbA1c) values. Results: According to the results of our study, regulation of glucose was achieved on 22 (55%) patients with only dietary modification and 18 patients (45%) received diet + insulin treatment for the regulation of glucose. From the demographic characteristics, age and body mass index (BMI) were found to be significantly high...
JPMA. The Journal of the Pakistan Medical Association, 1995
Longitudinal vaginal septum, a rare congenital fusion defect of mullarian ducts rarely causes dys... more Longitudinal vaginal septum, a rare congenital fusion defect of mullarian ducts rarely causes dystosia of labour and total uterine prolapse. Several surgical techniques were developed for repair of prolapse but no consensus has been reached on one type of operation.
Zeynep Kamil Tıp Bülteni, 2014
Amac: Bu calismada, preoperatif donemde salin infuzyon sonografisi (SIS) ile tani konulan hastala... more Amac: Bu calismada, preoperatif donemde salin infuzyon sonografisi (SIS) ile tani konulan hastalarin histeroskopik tanilarinin karsilastirilmasi ve histeroskopinin etkinlik ve guvenilirliginin belirlenmesi amaclanmistir. Gerec ve Yontem: Bu calisma Egitim ve Arastirma Hastanesi kadin hastaliklari ve dogum kliniginde Ekim 2011- Aralik 2012 tarihleri arasinda histeroskopi yapilan 95 hasta ile yapilmisir. Farkli nedenlerden dolayi histeroskopi planlanan tum hastalara preoperatif SIS yapildi. Daha sonra bu iki yontemin tanisal degerleri karsilastirildi. Bulgular: Histolojik tani altin standart olarak kabul edildiginde polip tanisinda SIS’in %90.62 sensitivite, %90.48 spesifite, myom tanisinda %84.21 sensitivite, %100 spesifiteye sahip oldugu izlenmistir. Histeroskopinin polip tanisinda %96.87 sensitivite, %90.48 spesifite, myom tanisinda ise %84.21 sensitivite, %100 spesifiteye sahip oldugu saptanmistir. Sonuc: SIS fokal lezyonlarin tanisinda oldukca doyurucu etkinlige sahip olsa da histeroskopinin endomatrial kavite patolojilerinde giderek yayginlasan ve vazgecilmez bir tani ve tedavi yontemi haline geldigini gormekteyiz. Anahtar Kelimeler: Salin infuzyon sonografi, histeroskopi, endometrial patoloji