Browsing by Author "Esin, Sertac"

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Are There Any Predictors of Endometrial Premalignancy/Malignancy within Endometrial Polyps in Infertile Patients?
(2019) Tohma, Yusuf Aytac; Onalan, Gogsen; Esin, Sertac; Sahin, Hanifi; Aysun, Dide; Kuscu, Esra; Haberal, Ali; Zeyneloglu, Hulusi Bulent; 0000-0001-9418-4733; 31311015
Background: In the literature, there is no detailed analysis on the prediction factors for premalignancy/malignancy within endometrial polyps (EPs) in infertile patients. In this study, we aimed to determine the frequency of endometrial premalignancy/malignancy within EPs in infertile patients undergoing office hysteroscopic polypectomy and identify the factors that can potentially predict an endometrial premalignancy/malignancy within EPs. Method: A total of 957 infertile patients undergoing office hysteroscopy were diagnosed with EPs between February 2011 and August 2018. Patients were divided into 2 groups according to the pathological examination of EPs as benign (Group 1; n = 939) and premalignant/malignant (Group 2; n = 18). The medical records of all patients included in the study were reviewed retrospectively. Results: In this cohort, prevalence of endometrial premalignancy/malignancy within EPs was 18/957 (1.88%). On univariate analysis, age, polyp size, diabetes, hypertension, and causes of infertility did not differ between the 2 groups. On multivariate analysis, diffuse polypoid appearance of the endometrial cavity on office hysteroscopy (hazard ratio [HR] 4.1; 95% CI 1.576-10.785), duration of infertility, (HR 4; 95% CI 1.279-12.562), and body mass index (HR 7.9; 95% CI 2.591-24.258) were found to be independent predictors of endometrial premalignancy/malignancy within polyps in infertile patients. Conclusion: When diffuse polypoid appearance of the endometrial cavity is detected in an infertile patient during office hysteroscopy, hysteroscopy-guided resection and endometrial curettage should be performed. The pathological specimen should be sent for histopathological evaluation to diagnose possible endometrial premalignancy/malignancy within polyps.
Associations between IL-1 alpha, IL-1 beta, TNF alpha, and IL-6 variations, and susceptibility to transposition of the great arteries
(2022) Atasoy Karakas, Latife; Tugrul, Duygu; Sahin Uysal, Nihal; Esin, Sertac; Tokel, Niyazi Kursat; Terzi, Yunus Kasim; 35590253; AEY-5060-2022
Background: To evaluate the relationship between IL-1 alpha-889UT (rs1800587), IL-1 beta -511 C >T (rs16944), TNF alpha-308G > A (rs1800629), TNF alpha-238G > A (rs361525), IL-6 -174G> C (rs1800795), and IL-6 -572G > C (rs1800796) polymorphisms and the susceptibility to transposition of the great arteries (TGA). Methods: A prospective analysis was performed on mothers whose newborns were diagnosed as having TGA. For each case of TGA, a mother who gave birth to a healthy neonate in the same period was randomly selected for the control group. The sample size was calculated before planning the study with 80% power and 5% alpha. Results: Twenty-seven mothers whose newborn had TGA anomalies (group 1) and 27 mothers whose newborn had no TGA (group 2) were included in the study. There were no significant differences between the groups in terms of maternal age, pregestational body mass index, gestational age at birth and infant sex (p> 0.05). The genotype and allele distributions of IL-1 alpha -889C/T (rs1800587), IL-1 beta -511C >T (rs16944), TNF alpha -308G >A (rs1800629), TNF alpha -238G > A (rs361525), IL-6 -174G> C (rs1800795) and IL-6 -572G > C (rs1800796) gene variants were not different between the two groups (p> 0.05). Conclusions: There was no relation between IL-1 alpha, IL-1 beta, IL-6, and TNF alpha promoter gene polymorphisms and TGA occurrence in our study group.
Clinical management of coronavirus disease 2019 (COVID-19) in pregnancy: recommendations of WAPM-World Association of Perinatal Medicine
(2020) Api, Olus; Sen, Cihat; Debska, Marzena; Saccone, Gabriele; D'Antonio, Francesco; Volpe, Nicola; Yayla, Murat; Esin, Sertac; Turan, Sifa; Kurjak, Asim; Chervenak, Frank; 0000-0001-9577-4946; 32692708; AAI-8810-2021
These guidelines follow the mission of the World Association of Perinatal Medicine, which brings together groups and individuals throughout the world with the goal of improving outcomes of maternal, fetal and neonatal (perinatal) patients. Guidelines for auditing, evaluation, and clinical care in perinatal medicine enable physicians diagnose, treat and follow-up of COVID-19-exposed pregnant women. These guidelines are based on quality evidence in the peer review literature as well as the experience of perinatal expert throughout the world. Physicians are advised to apply these guidelines to the local realities which they face. We plan to update these guidelines as new evidence become available.
Comparison of placental alpha microglobulin-1 protein assay (Amnisure) with speculum examination for the diagnosis of premature preterm rupture of membranes (PPROM): a clinical evaluation
(2021) Esin, Sertac; Tohma, Yusuf Aytac; Alay, Ismail; Guden, Mahmut; Colak, Eser; Demirel, Nihal; Bas, Ahmet Yagmur; Serdar Yalvac, Ethem; Kandemir, Omer; 0000-0001-9577-4946; 32835549; AAI-8810-2021
In this study, we aimed to compare the clinical outcomes of Premature Preterm Rupture of Membranes (PPROM) cases diagnosed by classical speculum examination and by placental alpha microglobulin-1 protein (PAMG-1) assay. The medical records of all patients with singleton pregnancies that were diagnosed with PPROM were retrospectively reviewed. Singleton pregnancies with PPROM diagnosis that was confirmed either by direct visualisation of amniotic fluid leaking through the cervix or by placental alpha microglobulin-1 protein (PAMG-1) assay if no amniotic fluid leakage was documented were included in the study. Demographics, prenatal and postnatal characteristics were reviewed from the medical charts and were recorded. The study included 138 pregnancies with PPROM; 111 patients in clinical speculum examination group and 27 in PAMG-1 assay group. There were no significant differences in maternal and pregnancy characteristics between the clinical speculum examination and PAMG-1 assay groups. Foetal outcomes were comparable between clinical speculum examination and PAMG-1 assay groups. In the clinical speculum examination group, there were nine (8.1%) chorioamnionitis cases, however, there were no chorioamnionitis cases in the PAMG-1 assay group during the latency period (p = .21).Impact statement What is already known on this subject?Placental alpha microglobulin-1 protein assay uses immunochromatography method to detect trace amount of placental alpha microglobulin-1 protein in vaginal fluids and has high sensitivity and specificity for ROM diagnosis. However, to the best of our knowledge, the clinical outcome of ROM cases detected by classical speculum examination and by placental alpha microglobulin-1 protein assay has not been compared in the literature previously. What do the results of this study add?Although statistically insignificant, cases diagnosed by PAMG-1 assay had lower risk of chorioamnionitis during latency period. What are the implications of these findings for clinical practice and/or further research?Whether cases diagnosed by PAMG-1 assay represent a milder form of rupture of membranes than cases diagnosed by classical speculum examination group warrants further research.
Complete Fetal Atrioventricular Block Associated with Maternal Autoinflammatory Diseases: Case Report and Literature Review
(2020) Tugcu, Ali Ulas; Ince, Deniz Anuk; Esin, Sertac; Turan, Ozden; Erdogan, Ilkay; Ecevit, Ayse; 0000-0002-2232-8117; 0000-0002-7707-1881; 0000-0001-9577-4946; 0000-0002-4369-2110; 31903011; AAJ-4616-2021; AAJ-2333-2021; AAJ-2305-2021; AAI-8810-2021; I-6746-2016
Gut dysbiosis may be associated with hyperemesis gravidarum
(2020) Balci, Serdar; Tohma, Yusuf Aytac; Esin, Sertac; Onalan, Gogsen; Tekindal, Mustafa Agah; Zeyneloglu, Hulusi Bulent; 0000-0001-9418-4733; 0000-0002-0289-2642; 0000-0002-1782-7325; 0000-0001-9577-4946; 32519907; AAE-6482-2021; B-6487-2009; AAJ-1097-2021; AAI-8810-2021
Purpose:In this study, we aimed to determine the frequency of different intestinal microorganisms of patients with normal pregnancies and HG and to compare these frequencies between the two groups. Materials and methods:This case-control study was carried out in Baskent University Department of Obstetrics and Gynecology and included 20 patients; 10 of whom had normal pregnancies and 10 of whom had HG. A stool flora scan was routinely planned for all patients. Transient and continuous fecal bacteria and fungal flora were analyzed. All data were evaluated statistically and their relationships with clinical condition were discussed. Results:The study group consisted of 20 pregnant women with a mean age of 31.5 years. All patients were nonsmokers and free of chronic diseases and of any medications. Aerobic and anaerobic bacteria groups, fungal colonies, and parasites were examined and bowel pH values were measured separately for each patient. Bacterial and fungal species outside the reference ranges were recorded for each patient. There was a statistically significant increase inClostridiumspp. (p:.01) andCandidaspp. (p:.033) and a statistically significant decrease inBifidobacteriumspp.(p:.008) in patients with HG compared to women with normal pregnancies. There was a significant difference between the group with HG and the group with normal pregnancies in terms of flora dysbiosis (p:.001). Conclusion:Our results suggest that gut dysbiosis may be a factor in HG. The effect of the severity of gut dysbiosis on the disease may be the subject of future studies.
Management of a Patient in the State of Total Occlusion of Aorta Due to Takayasu Arteritis in Preconceptional and Pregnancy Period
(2021) Gunakan, Emre; Akay, Tankut; Esin, Sertac; 0000-0001-8854-8190; ABI-1707-2020
Objectives: Total aortic occlusion is a severe complication of Takayasu arteritis (TAK). Pregnancy follow-up in the state of total aortic occlusion due to TAK has not been reported before. Case presentation: A 35 year-old nulliparous woman with total aortic occlusion in the distal aorta due to TAK, admitted with pregnancy desire. She had developed a collateral vessel system which has maintained the lower body circulation. She was informed about the potential risks after an evaluation and she admitted to our clinic at the seventh week of pregnancy, and acetylsalicylic acid was prescribed. At 20th gestational week anomaly screening was in normal limits although the uterine artery Doppler had lower S/D, PI and RI values. She was followed-up regularly in every two weeks. Vascular examination was performed by using an ankle brachial index (ABI) by duplex ultrasound. At 20th gestational week ankle brachial index score was 0.8-0.9 which indicates mild disease. Around 28th gestational week her claudication got worse again and ABI was in moderate level (0.5-0.8) and low molecular weight heparin was started. Until 37th gestational week her disease was stable, ABI was above 0.5, her blood pressure was in normal limits, no vascular complication occurred and the baby's growth percentile was at 25th centile. At 37th gestational week a 2,640 g baby was delivered. Patient was discharged without any complications at third post-operative day. Conclusions: Complicated TAK patients may have good obstetric outcomes with a multidisciplinary approach in experienced tertiary centers.
Multi-center results on the clinical use of KANET
(2019) Kurjak, Asim; Barisic, Lara Spalldi; Stanojevic, Milan; Antsaklis, Panagiotis; Panchal, Sonal; Honemeyer, Ulrich; Neto, Raul Moreira; Tinjic, Suada; Vladareanu, Radu; Esin, Sertac; Bomba-Opon, Dorota; Mededovic, Edin; Hata, Toshyuki; 31677378
An extensive review of the literature on the diagnostic and clinical accuracy of Kurjak's antenatal neurodevelopmental test (KANET) and the summarized results of the multi-center study involving 10 centers revealed that four-dimensional ultrasonography (4D US) has become a powerful tool and KANET a valuable test that empowers the clinicians worldwide to evaluate the fetal behavior in a systematic way and contribute to the detection of fetuses that might be at high risk for neurological impairments and in particular cerebral palsy (CP). After 10 years of clinical use, many published papers and multi-center studies, hundreds of trained physicians and numerous tests performed all over the world, KANET has proven its value and has been showing encouraging results so far. The aim of this paper is to show the results from the studies done so far and to reveal the clinical value of the KANET. We expect that data from the larger ongoing collaborative study, the short- and long-term postnatal follow-up will continue to improve our knowledge. Ultimately, we all strive to prevent the CP disorders, autism spectrum disorder (ASD) and other neurological impairments and we are convinced that KANET might be helpful in the realization of this important aim.
A Novel Technique for Prediction of Preterm Birth: Fetal Nasal Flow Doppler
(2021) Esin, Sertac; Okuyan, Erhan; Gunakan, Emre; Zengin, Hatice Yagmur; Hayran, Mutlu; Tohma, Yusuf Aytac; 0000-0001-8854-8190; 0000-0002-9855-2449; 0000-0001-9418-4733; 33180051; ABI-1707-2020; ABA-3224-2021; AAE-6482-2021
Objectives: Absence of fetal breathing movements (FBM) has been found to be a good predictor of preterm delivery in symptomatic patients. However, analysis of FBM patterns and Doppler measurement of them for preterm birth prediction have not been performed before. In this study, we aimed to investigate and analyze FBM patterns in symptomatic preterm labor patients by fetal ultrasonography and nasal Doppler. Methods: This was a multicenter, prospective cohort study. Singleton pregnant patients between 24 and 37 gestational weeks diagnosed with preterm labor were included in the study. Patients were evaluated in three groups: no FBM (Group 1), regular FBM (Group 2), irregular FBM (Group3). Results: Seventy-three patients were available for the final analysis after exclusion. Preterm delivery rate in 24 h in groups were 91.7, 32.7 and 100%, respectively. The absence of FBM (Group 1) was statistically significant for preterm delivery in for both 24 (91.7 vs. 42.6%, p=0.002) and 48 h (91.7 vs. 49.2%, p=0.006) when compared with fetal breathing positive Group 2 and 3. In fetal nasal Doppler analyses in Group 2, the inspiration/expiration number rate was significantly lower in the patients who delivered in 24 h (0 .98 +/- 0.2 vs. 1.25 +/- 0.57, p=0.015). By using fetal nasal Doppler, combination of absence of FBM or irregular FBM or regular FBM with inspiration number/expiration number (I/E) <1.25 detects 94.6% of patients who will eventually deliver in the first 24 h after admission. Conclusions: Examining FBM patterns and using nasal Doppler may help the clinician to differentiate those who will deliver preterm and may be an invaluable tool for managing preterm labor patients.
Risk factors for sexual dysfunction in pregnant women during the COVID-19 pandemic
(2020) Karakas, Latife A.; Azemi, Asli; Simsek, Seda Y.; Akilli, Huseyin; Esin, Sertac; 0000-0001-9577-4946; 0000-0001-7369-5470; 33141928; AAI-8810-2021; AAI-8793-2021
Objective To evaluate the level of sexual function during the COVID-19 pandemic in pregnant women followed up in Baskent University Faculty of Medicine, Turkey, using the Female Sexual Function Index (FSFI). Methods An observational analysis was performed on pregnant women who were not infected with COVID-19. A total of 135 pregnant women (group 1), 45 of whom were in the first trimester, 45 in the second trimester, and 45 in the third trimester, and 45 healthy women who were not pregnant (group 2), were included in the study. The FSFI was used to assess sexual dysfunction status. Results A total of 118 (87.4%) pregnant participants and 31 (68.9%) non-pregnant participants were diagnosed as having sexual dysfunction according to the FSFI. When comparing groups 1 and 2, FSFI scores were significantly lower in group 1 (p = 0.002). It was also found that women who had university degrees, were multiparous, and in the third trimester were more likely to develop sexual dysfunction (p = 0.030, p = 0.029, and p = 0.001, respectively). FSFI scores were found to be significantly higher in planned pregnancies than in unplanned pregnancies (p = 0.001). Conclusion The sexual function of uninfected pregnant women decreased during the COVID-19 pandemic, negatively influenced by restrictive social distancing measures.
sRepeated Dose of Prostaglandin E2 Vaginal Insert When the First Dose Fails
(2021) Karadag, Ceyda; Esin, Sertac; Tohma, Yusuf Aytac; Yalvac, Ethem Serdar; Basar, Tugrul; Karadag, Burak; 0000-0001-9418-4733; 33715333; AAE-6482-2021
Objective: To compare the obstetric and neonatal outcomes of patients treated with repeated-dose prostaglandin E2 (dinoprostone) vaginal insert when the first dose fails. Materials and Methods: This retrospective study included 1.043 pregnant women who received dinoprostone for labor induction between November 2012 and August 2015. Pregnant women were divided into two groups according to the number of dinoprostone administrations: group 1, single-dose dinoprostone (n=1.000), and group 2, repeated-dose dinoprostone (n=43). Intrapartum, postpartum, and neonatal outcomes of the pregnant women were compared. Results: Vaginal delivery rate was 65% in group 1 and 30.2% in group 2 (p=0.001). The need for the neonatal intensive care unit was found in 44 pregnant women (4.4%) in group 1 and 6 pregnant women (13.6%) in group 2 (p=0.006). Conclusion: When obstetric and neonatal data were evaluated in our study, we observed that dinoprostone administration was associated with increased cesarean rates and adverse neonatal outcomes with repeated-dose dinoprostone when the first dose failed.
Vitamin D receptor gene TaqI single nucleotide polymorphism is not associated with lead levels in maternal and umbilical cord blood
(2019) Tohma, Yusuf Aytac; Akad, Selin; Colak, Eser; Kulaksizoglu, Sevsen; Akyol, Mesut; Terzi, Yunus Kasim; Ozcimen, Emel Ebru; Esin, Sertac; Sahin, Feride Iffet; 0000-0001-5612-9696; 0000-0001-7308-9673; 0000-0002-3808-7004; 0000-0001-9418-4733; 0000-0002-8184-7531; 29463156; AAC-8356-2020; B-4372-2018; AAC-7232-2020
Purpose: We aimed to investigate the association of vitamin D receptor (VDR) gene TaqI single nucleotide polymorphism (SNPs) with serum lead (Pb) levels in maternal and umbilical cord blood. Materials and methods: Eighty-one patients who lived in Konya, Turkey for the last 3 years and had delivery at Baskent University Konya Hospital in 2016 were included in this study. Venous blood samples were drawn from each volunteer immediately before giving birth to determine the maternal Pb levels and VDR SNPs. Additionally, umbilical cord blood samples were collected from the umbilical vein into tube with EDTA as an anticoagulant immediately after birth to determine Pb levels of the fetus. Results: The median level of Pb in the maternal blood was 29.00 (Interquartile Range (IQR) = 16.35) mu g/L and the median Pb level in the cord blood was 22.50 (IQR = 9.75) mu g/L. Blood Pb level of women living in the urban area was significantly higher than in those living in the rural area (Z = 2.118; p = .034). There was a very strong positive correlation between the Pb levels in the maternal blood and in the umbilical cord blood (rho = 0.825, p < .001, respectively). Regarding VDR SNPs, "TT", "TC", and "CC" VDR TaqI genotypes were observed in 28 (34.6%), 45 (55.5%), and eight samples (9.9%), respectively. Pb levels in maternal and cord blood were higher in women with the "CC" VDR TaqI genotype; however, there was no statistically significant difference (p > .05). Conclusions: Although women with the "CC" VDR TaqI genotype had higher maternal and cord blood Pb levels, this was statistically insignificant and therefore, VDR TaqI SNPs did not significantly affect maternal and umbilical cord blood Pb levels.