PubMed Açık Erişimli Yayınlar
Permanent URI for this collectionhttps://hdl.handle.net/11727/10763
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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.Item Pregnancy of patients with idiopathic thrombocytopenic purpura: maternal and neonatal outcomes(2020) Kalayci, Hakan; Durdag, Gulsen Dogan; Baran, Safak Yilmaz; Simsek, Seda Yuksel; Alemdaroglu, Songul; Ozdogan, Serdinc; Kilicdag, Esra Bulgan; 0000-0003-4335-6659; 0000-0002-0942-9108; 0000-0002-5064-5267; 0000-0001-5874-7324; 0000-0002-1767-1527; 31397144; AAK-7016-2021; AAI-8400-2021; ABF-6439-2020; AAK-8872-2021; AAI-9594-2021Objective: Thrombocytopenia occurs in 7% of pregnant women. Along with other causes, idiopathic thrombocytopenic purpura (ITP), which is an autoimmune disease with autoantibodies causing platelet destruction, must be considered in the differential diagnosis. Antiplatelet antibodies can cross the placenta and cause thrombocytopenia in the newborn. The aim of our study was to assess the management of ITP in pregnancy, and to investigate neonatal outcomes. Material and Methods: This retrospective study was conducted in a tertiary center including 89 pregnant patients with ITP followed between October 2011 and January 2018. Patients were evaluated in two groups according to diagnoses of ITP and chronic ITP. Age, obstetric history, ITP diagnosis, and follow-up period, presence of splenectomy, platelet count during pregnancy and after birth, treatment during pregnancy, route of delivery, weight and platelet count of newborn, sign of hemorrhage, and fetal congenital anomaly were assessed. Results: Considering the ITP and chronic ITP groups, no significant difference was seen with respect to parity, timing of delivery, preoperative and postoperative platelet counts, and hemoglobin values. Route of delivery, birth weight, APGAR scores, newborn platelet count, and congenital anomaly rates were also similar. The timing of treatment was different because patients whose diagnoses were established during pregnancy were mostly treated for preparation of delivery. Treatment modalities were similar. Conclusion: Probability of severe thrombocytopenia at delivery is higher in patients with ITP who are diagnosed during pregnancy when compared with patients who received prepregnancy diagnoses. ITP is an important disease for both the mother and newborn. Patients should be followed closely in cooperation with the hematology department.Item Translation, cultural adaptation, and validation and reliability of assessment of pelvic floor disorders and their risk factors during pregnancy and postpartum questionnaire in Turkish population(2020) Koyuncu, Kazibe; Sakin, Onder; Akalin, Emine Eda; Akalin, Munip; Angin, Ali Dogukan; Aboalhasan, Yasemin; Sonmezer, Emel; 32779160Objectives: This study was conducted in order to produce translation, cultural adaptation, and validation of Assessment of Pelvic Floor Disorders and Their Risk Factors During Pregnancy and Postpartum Questionnaire (APFDQ) to Turkish in pregnant and postpartum population. Material and methods: The study included 80 pregnant women. Internal consistency was tested using Cronbach's alpha. Questionnaires were applied three different times in order to assess for sensitivity. Patients were asked to complete the questionnaire first in the third trimester, secondly in postpartum 6th week and finally in postpartum 6th month after birth. For translation process content, face/content validity, reliability, construct validity and reactivity studies were done. All women had undergone pelvic examination and prolapse was assessed by using Pelvic organ Prolapse Quantification System (POP-Q). Urinary symptoms were also evaluated with Urinary Distress Inventory (UDI-6) questionnaire. Results: The mean age of patients was 27.7 +/- 5.5 years. Forty-one (51.25%) of the patients had vaginal delivery and 39 (48.75%) had a cesarean section. Above 96% of the patients had completed the questionnaires. POP-Q assessments and UDI-6 results were used to evaluate construct validity. Cronbach's alpha results were found to be 0.7 for all the subscales of the questionnaire: bladder: 0.702, bowel: 0.744, prolapse: 0.701, sexual function: 0.706 respectively, indicating adequate reliability. The test/retest reliability was studied and Pabak values showed moderate reliability in the bowel, prolapse and sexuality, and good reliability for bladder subscale. The results of the patients were compared between pregnancy and postpartum to assess reactivity and shown to be reactive to changes. Also risk factors of the patients were assessed including, family predisposition, maternal age over 35 years, BMI > 25, nicotine use, subjective inability to contract pelvic floor and sense of postpartum wound pain. Conclusions: The Turkish version of APFDQ is a reliable and valid tool. It can be used for assessing the risk factors, incidence, assessing degree of PFDs and evaluating the impact on quality of life in pregnant and postpartum women.Item 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-8810-2021These 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.Item Prostaglandin F receptor expression in intrauterine tissues of pregnant rats(2014) Anadol, Elvan; Kanca, Halit; Yar, Atiye Seda; Helvacioglu, Fatma; Menevse, Sevda; Calguner, Engin; Erdogan, DenizIn this investigation, we studied the expression and localization of rat prostaglandin F (FP) receptor in uterine tissues of rats on gestational Days 10, 15, 18, 20, 21, 21.5 and postpartal Days 1 and 3 using Western blotting analysis, real-time PCR, and immunohistochemistry. A high level of immunoreactivity was observed on gestational Days 20, 21, and 21.5 with the most significant signals found on Day 20. FP receptor protein was expressed starting on gestational Day 15, and a fluctuating unsteady increase was observed until delivery. Uterine FP receptor mRNA levels were low between Days 10 and 18 of gestation (p < 0.05). The transcript level increased significantly on Day 20 and peaked on Day 21.5 just before labor (p < 0.05). There was a positive correlation between FP receptor mRNA expression and serum estradiol levels (rs = 0.78; p < 0.01) along with serum estradiol/progesterone ratios (rs = 0.79; p < 0.01). In summary, we observed an increase FP receptor expression in rat uterus with advancing gestation, a marked elevation of expression at term, and a concominant decrease during the postpartum period. These findings indicate a role for uterine FP receptors in the mediation of uterine contractility at term.Item The impact of sweeping the membranes on cervical length and labor: a randomize clinical trial(2014) Parlakgumus, Huriye A.; Yalcinkaya, Cem; Haydardedeoglu, Bulent; Tarim, Ebru; 25322540Objectives: The aim of the study was to investigate to what extent sweeping of the membranes contributes to cervical shortening and if cervical shortening is related to the time to onset of labor and duration of the active phase of labor. Methods: This prospective randomized clinical trial was performed at Baskent University between February and March 2011. Women were randomly assigned to receive membrane sweeping (Sweeping Group) (n=69) or no membrane sweeping (Control Group) (n=71). Cervical length was measured (cervix 1) in both groups by examiner 1 and the Bishap Score was determined in the control group and sweeping was performed in the sweeping group by examiner 2. Two days later the patients had another cervical length measurement (cervix 2) by examiner 1, blinded to the group and results of the examiner 2. t test, Mann-Whitney U test and Chi-square test were used for statistical analyses. Results: Cervix 1 was 27.4 +/- 8.4 mm and 29.6 +/- 8.9 mm (p = 0.14), cervix 2 was 23.3 +/- 8.8 mm and 23.8 +/- 8.5mm (p = 0.28) and cervical shortening was 5 +/- 4 mm and 5 +/- 4mm (p = 0.446), time to onset of labor was 6.3 +/- 4.6 and 5.7 +/- 4.1 (p = 0.38) and duration of labor was 5.8 +/- 2.89 and 5.7 +/- 2.4 (p = 0.82) for the sweeping and the control groups, respectively. Conclusions: Sweeping of the membranes does not reduce cervical length and does not shorten time to onset of labor and duration of the active phase of labor.