Browsing by Author "Dur, Riza"

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    Comparison of Emergency and Elective Cesarean Sections in the Breech Presentation: A Case-Control Study
    (2020) Coskun, Bugra; Pay, Ramazan Erda; Coskun, Bora; Simsir, Coskun; Dur, Riza; Colak, Eser; Karasahin, Kazim Emre
    Objective: In this study, we aimed to compare the characteristics and outcomes between the patients who underwent emergency or elective cesarean section (CS) with the indication of breech presentation (BP). Method: All the patients who underwent cesarean delivery with the indication of BP between January 2016-December 2018 were included in this retrospective study. BP Patients with any other indication for CS were excluded from the study. Group I; consisting of patients with BP who underwent emergency CS due to progression of cervical dilation and/or effacement, pain or membrane rupture, presence of = 3 contractions at regular intervals over 25 mmHg within 10 minutes, and Group II; consisting of term pregnant patients without any additional problem who underwent elective CS following 38. gestational weeks between 08:00 AM to 05:00 PM were compared statistically. Also, subgroups were compared according to BP subtypes and cervical opening measurements. Results: APGAR scores at the 1st / 5th minutes and postoperative hemoglobin values were significantly lower in the emergency CS group than the elective CS group. Also we found that the decreases in hemoglobin values before and after the cesarean section, and APGAR scores at 1., and 5. min, were significantly higher, the operation time was significantly longer in the emergency CS group. Also, the median value of the week of emergency cesarean section was 37 gestational weeks, and we found that when the cervical dilation was 2 cm and above before operation, the drop in hemoglobin value, need for blood transfusion and neonatal intensive care increased significantly. No significant difference was found between BP subtypes. Conclusion: Postoperative parameters may tend to be unfavourable in patients with BP who underwent emergency CS due to pain or progression of cervical dilation. Therefore, clinicians who prefer cesarean delivery in patients with BP, should be very cautious against possible emergency operation until the time of the elective operation and also avoid iatrogenic preterm labor.
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    The role of anti-Mullerian hormone in predicting the response to clomiphene citrate in unexplained infertility
    (2018) Coskun, Bora; Dilbaz, Berna; Karadag, Burak; Coskun, Bugra; Tohma, Yusuf Aytac; Dur, Riza; Akkurt, Mehmet Ozgur; 30342657
    Objective: To determine the role of anti-Mullerian hormone (AMH) levels in predicting the response to clomiphene citrate (CC) therapy for ovulation induction in women with unexplained infertility. Materials and methods: For this retrospective study, fifty consecutive patients who responded to CC were taken as Group 1, while fifty consecutive patients who failed to show adequate ovulatory response with CC were taken as Group 2. We compared the AMH levels of the two groups and receiver operating characteristic (ROC) curve was used to determine the threshold for AMH in predicting the ovulatory response to CC therapy. Results: Mean age, body mass index, luteinizing hormone, prolactin, and thyroid-stimulating hormone values were similar in the two groups. AMH and antral follicle count (AFC) values were higher in Group 1 than in Group 2 (p = 0.001 and p = 0.001, respectively). There was a statistically significant negative correlation between FSH and AFC (r = -0.339, p = 0.001), while AFC and AMH displayed a statistically significant positive correlation (r = 0.713 and p = 0.001). AMH values and AFC were found to be predictors of the adequate ovulatory response to CC. The area under the ROC curve was 0.86 vs 0.80, respectively. At an AFC cutoff value of 14, the sensitivity and specificity for prediction of ovulation were 68% and 80%, respectively. Conclusion: The AMH and AFC cut-off values for the prediction of positive ovarian response to CC in patients with unexplained infertility were 2.78 ng/mL and 14, respectively. If further prospective and randomized studies confirm our results, these thresholds may be useful to predict successful ovulation induction and reduce the unresponsive cycles. (C) 2018 Taiwan Association of Obstetrics & Gynecology. Publishing services by Elsevier B.V.