Browsing by Author "Uysal, Nihal Sahin"

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Application of the international classification of diseases-perinatal mortality (ICD-PM) system to stillbirths: A single center experience in a middle income country
(2022) Dagdeviren, Gulsah; Uysal, Nihal Sahin; Dilbaz, Kubra; Celen, Sevki; Caglar, Ali Turhan; 34890860
Objective: The present study is intended to investigate the causes of stillbirth and its relationship with maternal conditions using the International Classification of Diseases-Perinatal Mortality (ICD-PM) system.Material and methods: All early and late fetal deaths between 2015 and 2020 were analyzed. Time of death, fetal causes, and the maternal conditions involved were identified using the ICD-PM classification system.Results: During the study period, out of 74,102 births a total of 475 stillbirths were recorded (6.4 per 1000 births), of which 83.6% of the cases were antepartum and 11.8% were intrapartum fetal deaths, and the time of death could not be determined in 4.6% of the cases. Fetal developmental disorder was the most common cause of antepartum fetal death (24.2%). Intrapartum deaths were mostly due to extremely low birth weight (44.6%). The most common maternal conditions involved were complications of placenta, cord, and membranes (19.8%).Conclusion: The applicability of the ICD-PM classification system for stillbirths is easy. It was observed that fetal deaths mostly occurred in the antepartum period and the cause of death could not be identified in over half of these antepartum fetal deaths. In over half of the stillbirths, there is at least one maternal condition involved. The most common maternal conditions involved are complications of placenta, cord, and membranes. The most common maternal medical problem is hypertensive diseases of pregnancy. (c) 2021 Elsevier Masson SAS. All rights reserved.
How safe is pregnancy after liver transplantation? A large case series study at tertiary referral center in Turkey
(2020) Gulumser, Cagri; Kinap, Mahir; Yanik, Filiz Bilgin; Uysal, Nihal Sahin; Moray, Gokhan; Haberal, Mehmet; 0000-0002-3462-7632; 0000-0003-2498-7287; 0000-0001-5385-5502; 0000-0002-4066-9038; 30227751; AAJ-8097-2021; AAE-1041-2021; AAA-9475-2020; C-6543-2018
Objective: To investigate pregnancy outcomes and to define preventative measures against to risk factors and complications in pregnancy after liver transplantation. Secondary aim is to report postpartum allograft functions in these patients. Method: This is a case series study. All pregnant women with liver transplantations performed in our hospital were enrolled. Patients' hospital medical records, electronic records Neonatal Intensive Care Unit (NICU) records were used to collect data. Obstetric characteristics and antenatal complications, risk factors, pregnancy and neonatal outcomes, all aspects of liver transplant variables and allograft functions after pregnancy were studied. Results: A total of 11 patients were included in the study. All of them were singleton. Mean maternal age was 29.3 +/- 3.9 years. And mean gestational week of delivery was 37.2 +/- 2.2. 78% of the women were delivered at term (>37 weeks) only two babies were preterm and discharged from NICU without any complications. Birth weight (gr median +/- SD) was 2575 +/- 345. Five (45%) patients were nulliparous, majority of the cases (8/11, 72%) were conceived of pregnant with natural way. Live birth rate was 81% (9/11). Only one patient for each has suffered from fetal growth restriction, maternal anemia, maternal hyperthyroidism, and ulcerative colitis. Vaginal bleeding was seen in five women during the pregnancy. There was no maternal death, stillbirth or neonatal death. The mode of delivery for all live birth pregnancies was C-section. And none of them was emergency C-section. No complication of allograft function was seen after pregnancy. Conclusion: Pregnancy in women with liver transplantation is not associated with poor pregnancy outcomes and complications for both the mother and the neonates when these patients followed up at tertiary referral center with multidisciplinary approaches.
Increased nuchal translucency and pregnancy outcomes: experience of Baskent University Ankara Hospital
(2019) Uysal, Nihal Sahin; Gulumser, Cagri; Celik, Zerrin Yilmaz; Yanik, Filiz Bilgin; 0000-0001-5385-5502; 0000-0002-4066-9038; 31360583; AAA-9475-2020; C-6543-2018
Objective: First trimester nuchal translucency (NT) measurement is considered to be an important tool in antenatal follow-up. This study aimed to evaluate the outcomes of pregnancies with increased NT at Baskent University Ankara Hospital between 2004 and 2016. Materials and Methods: Patients with NT measurements >= 1.5 multiples of median (MoM) were divided into two groups; group I included increased NT cases without fetal anomalies (either abnormal fetal karyotype or congenital structural anomalies) or loss (intrauterine fetal death), and group II included increased NT cases with fetal anomalies or loss. The groups were compared with each other with respect to maternal demographic features and NT measurements. Results: Karyotype analyses were normal in 73.1% of cases with increased NT (57/78). Among those, 21.1% (12/57) had structural anomalies, and to specify, 9.6% (5/52 over 18 weeks) had cardiac anomalies. Although maternal demographic features did not differ significantly, NT measurements, both as millimeters and MoM, were significantly higher in group II (p<0.05). According to the receiver operating characteristic (ROC) curves, the optimal cutoff values for NT measurements for predicting fetal anomalies or loss were 3.05 mm and 2.02 MoM. NT measurement >7 millimeters or NT MoM >4.27 resulted in poor fetal outcomes without exception. Conclusion: Higher NT measurements indicate poorer pregnancy outcomes. Our study indicates that fetal echocardiography must be considered for all cases with increased NT.
Maternal and perinatal characteristics of small-for-gestational-age newborns: Ten-year experience of a single center
(2017) Gulumser, Cagri; Uysal, Nihal Sahin; Yanik, Filiz Bilgin; 0000-0001-5385-5502; 28490415; AAA-9475-2020
Objective: To analyze the maternal and perinatal characteristics of small-for-gestational-age (SGA) newborns compared with appropriate-for-gestational- age (AGA) newborns in singleton pregnancies managed at our hospital between January 2006 and December 2015. Material and Methods: The study (n=456) and control (n=4925) groups included pregnancies resulting in SGA and AGA newborns, respectively. Additionally, two SGA subgroups were defined according to abnormal (n=34) and normal (n=57) Doppler findings. Maternal demographic features; intracytoplasmic sperm injection (ICSI) pregnancies; gestational age at delivery; birth weight; major congenital anomalies, karyotype abnormalities, and genetic syndromes; maternal and obstetric problems such as hypertensive disorders, diabetes, oligohydramnios, preterm birth; admission to the neonatal intensive care unit (NICU), and perinatal mortality were recorded, and the two groups were compared with respect to these parameters. Results: Mean maternal age, parity, gestational age at delivery, and birthweight were significantly lower; the frequencies of ICSI pregnancies, hypertensive disorders, oligohydramnios, preterm delivery, major congenital anomalies, karyotype abnormalities and genetic syndromes, admission to the NICU and perinatal mortality were significantly higher in the study group (p<0.05). None of the study parameters were significantly different between the two SGA subgroups (p>0.05). Conclusion: The association of SGA with ICSI pregnancies, hypertensive disorders, oligohydramnios, preterm delivery, congenital/chromosomal anomalies, NICU admission and perinatal mortality may be important in perinatal care. Clinical suspicion of SGA necessitates appropriate monitorization and management. Although obstetric outcomes were not significantly different between the two SGA subgroups with abnormal and normal Doppler findings in this study, this finding must be evaluated with caution due to the small sizes.
Prenatal Evaluation and Postnatal Early Outcomes of Fetal Ventriculomegaly
(2014) Tugcu, Ali Ulas; Gulumser, Cagri; Ecevit, Ayse; Abbasoglu, Aslihan; Uysal, Nihal Sahin; Kupana, Ebru Sebnem; Yanik, Fatma Filiz; Tarcan, Aylin; https://orcid.org/0000-0002-2232-8117; https://orcid.org/0000-0001-5385-5502; 25135472; AAJ-4616-2021; AAA-9475-2020
Objective: This study aims to determine the incidence, etiology, diagnostic criteria and early outcomes of prenatally diagnosed fetal ventriculomegaly (VM). Methods: Diagnostic criteria for the fetal VM was atrial diameter of lateral ventricle measuring >= 10 mm, independent from gestational age. Results of our patients from ultrasonography (USG), karyotyping, congenital infections, and associated abnormalities were noted. Progress during pregnancy, postnatal USG results and neurobehavioral outcomes were recorded. Results: In our study, 40 subjects of fetal VM were recorded. 16 and 24 of those were bilateral (40%) and unilateral (60%) respectively. Female to male fetus ratio was 19/21 (0.9). Median gestational age at the diagnosis was 22 weeks (ranging between 16 and 34 weeks). While 21 VM subjects were isolated (52.5%) only 19 of the total were shown associated structural abnormalities in (47.5%) in addition to VM. Toxoplasmosis were diagnosed only in One subject (2.5%). Nineteen subjects had amniocentesis (47.5%) and 2 of them were showed abnormalities (10.5%) as follows; "inversion and duplication 8 (p11.2p23)" and "deletion 3". VM got back in to normal size during pregnancy in 24 subjects (24/40, 60%). Eight pregnancies were terminated (8/40) (20%). Five babies passed away during neonatal and postneonatal period. Some other structural abnormalities were diagnosed after the birth at six babies who classified as mild "isolated" VM. Conclusions: Our study revealed that amongst mild VM subjects, incidence of associated abnormalities and termination rate were higher. Although most of mild VM subjects are thought to be benign, associated abnormalities should be carefully evaluated and determined pre- and postnatally. (C) 2014 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.