PubMed İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/11727/4810
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Item Does high estrogen level negatively affect pregnancy success in frozen embryo transfer?(2022) Ozdemir, Ayse; Karli, Pervin; Gulumser, Cagri; 35591836Introduction: High estrogen levels could reduce pregnancy rates by disrupting the implantation of the embryo into the endometrium in patients treated with fresh cycles of in vitro fertilization. The aim of the present study was to investigate the effect of estrogen levels on the pregnancy and abortion rate in autologous frozen embryo transfer with hormone replacement therapy (HRT). Material and methods: A historical cohort study was conducted in an academic setting to investigate the effect of estrogen levels on the pregnancy and abortion rates for all autologous artificial frozen embryo transfer cycles performed from January 2016 to January 2018. Serum estradiol levels recorded on day 2 or 3 of the cycle were stated as e1, and levels recorded on the day of progesterone were indicated as e2. Human chorionic gonadotropin (beta-hCG) positivity, which was examined 14 days after the transfer, was used to evaluate biochemical pregnancy. Abortion was defined as the termination of pregnancy before the 20th gestational week. Results: There were 130 patients with unexplained infertility, 20 patients with poor ovarian reserve, and 54 patients with male factor. Of the patients with unexplained infertility, poor ovarian reserve, and male factor, 58, 4, and 27 of them were pregnant, respectively. No statistically significant difference was found between the e1 and e2 levels of the pregnant and non-pregnant groups (p = 0.273, p = 0.219). In addition, there was no statistically significant difference between e2 levels in terms of the abortion rate (p = 0.722). Conclusions: In autologous frozen embryo transfer with HRT, estrogen levels did not have a significant effect on the pregnancy or abortion rate. Therefore, estrogen levels do not need to be monitored in frozen embryo transfer with HRT.Item Outcome of ICSI pregnancies with spontaneous loss of a co-twin compared with singleton ICSI pregnancies: Single center experience(2020) Uysal, Nihal S.; Gulumser, Cagri; Yanik, Fiiz F. Bilgin; Onalan, Goegsen; Zeyneloglu, Hulusi B.; 0000-0001-5385-5502; 0000-0002-0289-2642; 31922328; AAA-9475-2020; B-6487-2009Aim To compare the outcome of intracytoplasmic sperm injection (ICSI) pregnancies complicated by spontaneous loss of a dichorionic co-twin with that of singleton ICSI pregnancies. Methods The study group included dichorionic ICSI pregnancies with co-twin loss (n = 33) and the control group included ICSI pregnancies with a singleton from the beginning (n = 327). Primary outcome measures were obstetric complications, including preterm delivery, newborn small for gestational age, gestational diabetes, gestational hypertensive disorders and abruptio placenta; admission to neonatal intensive care unit (NICU) and perinatal mortality observed in the study and control groups. Statistical analysis was performed using spss for Windows, version 22.0. Results In the study group, there were 26 cases of first trimester (early) and 7 cases of second or third trimester (late) co-twin losses. Mean gestational age at delivery and mean birth weight were significantly lower in the whole study group compared to control (P < 0.05). Preterm delivery and NICU admission rates were significantly higher in the whole study group, compared to control (39.3% vs 14.6% and 36.36% vs 11.69% respectively, P < 0.05), but did not show significant difference between early loss subgroup and control (P > 0.05). Preterm delivery rate was significantly higher in the late loss subgroup compared to the early loss subgroup (85.71% vs 26.92% P < 0.05). Conclusion Loss of a co-twin in dichorionic ICSI pregnancies is associated with increased risk of preterm birth. This risk is significantly higher in cases with late loss compared to the early loss cases.Item 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-6543-2018Objective: 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.Item 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-6543-2018Objective: 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.Item The risk factors, consequences, treatment, and importance of gestational depression(2015) Yilmaz, Elif Akkas; Gulumser, Cagri; 28913052Nowadays, mental problems have become an important health issue, the most frequent of which in pregnancy is depression. Gestational depression is known to increase gestational complications and negatively affect maternal and fetal health. The frequency of gestational depression and depressive symptoms are 10-30%. Risk factors vary according to genetic, psychologic, environmental, social, and biologic factors. Maternal morbidity and mortality rates increase in pregnant women who do not receive treatment, obstetric complications and negative fetal consequences are seen, and the incidence of postpartum depression increases. Due to all these important consequences, healthcare providers who manage pregnant women should be informed about the frequency, symptoms, and screening methods of postpartum depression, the significance of the consequences of undiagnosed and untreated depression on the health of mother and baby, and the importance of early diagnosis. Pregnant women who are at risk should be screened and detected, and directed to related centers. In this review, we briefly review the definition of gestational depression, its frequency, risk factors, complications, screening, treatments, and the procedures that need to be performed the diagnostic process.Item Decrease in middle ear resonance frequency during pregnancy(2016) Dag, Emine Kutlu; Gulumser, Cagri; Erbek, Seyra; 27588163Many physiological changes occur during pregnancy The aim of the study was to reveal whether there is a change in middle ear resonance frequency during pregnancy. A prospective case-control study was designed at a tertiary referral center. The study included 46 pregnant women at the third trimester (27-40 weeks) and 43 nonpregnant voluntary women. All the study subjects underwent pure-tone audiometry and multifrequency tympanometry Pure-tone hearing levels at frequencies of 250 to 8000 Hz and resonance frequency values were corn pared between pregnant and nonpregnant women. Impact of age, side of the tested ear, and weight gained in pregnancy on resonance frequency were evaluated. Air conduction threshold values at frequencies of 250 Hz and 500 Hz were significantly higher in pregnant women than in the control group (P<0.001). Middle ear resonance frequency values of both ears in pregnant women were found to be significantly lower than those in control group (P<0.001). There was no statistically significant relation of middle ear resonance frequency values to age or side of the tested ear in both groups (P>0.05). A negative correlation between weight gained in pregnancy and middle ear resonance fre- quency values was determined for the left ear (correlation coefficient for left ears: 0.348, P=0.018). The results of this study suggest that resonance frequency may be decreased during the pregnancy. More comprehensive studies in which many pregnant women followed regularly before and after pregnancy are needed to have more certain links.Item 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-9475-2020Objective: 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.