Wos İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/11727/4807
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Item 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-1707-2020Objectives: 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.Item Early pregnancy after bariatric surgery: a single-institute preliminary experience(2020) Gunakan, Emre; Bulus, Hakan; Tohma, Yusuf Aytac; 0000-0001-9418-4733; 31840970; AAE-6482-2021Background/aim: Pregnancy after bariatric surgery is an issue of growing importance with increasing number of women undergoing bariatric surgery. Therefore, in this study we present patients who conceived after sleeve gastrectomy and evaluate the obstetric outcomes. Materials and methods: This retrospective case-control study includes 23 women who conceived after laparoscopic sleeve gastrectomy. Patients were evaluated in two groups according to the number of months between surgery and conception (group 1: <= 12 months; group 2: >12 months). Results: The mean body mass index of patients before surgery and at the time of conception was 46.6 kg/m(2) and 29.7 kg/m(2), respectively. Nine patients (39.1%) had a history of infertility. There was no statistical difference between groups 1 and 2 for haemoglobin, ferritin, and 25-OH Vit-D levels or maternofoetal complication rates and pregnancy outcomes. Enteral nutrition requirements and intravenous iron replacement needs were higher in group 1, although this difference was not statistically significant. Conclusion: Pregnancy in the first years after sleeve gastrectomy seems to have similar obstetric outcomes compared to pregnancies occurring later, but it remains a controversial issue. Although the results did not have statistical significance in our study, well-designed prospective series may determine the role of enteral nutrition and intravenous iron replacement in patient management.