Fakülteler / Faculties
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Item Investigation of Sexual Distress in Pregnant Women: A Turkish Multi-center Study(SEXUALITY RESEARCH AND SOCIAL POLICY, 2024) Koc, Emine; Baltaci, Nazli; Yuksekol, Ozlem Dogan; Gurel, Reyyan; Ulucan, MihribanIntroduction: During pregnancy, sexual distress is common, but its prevalence and underlying factors require elucidation. This study was performed to investigate sexual distress in pregnant women. Methods:This research was designed as a descriptive and multi-center study. The study included 2365 pregnant women from 6 geographical regions of Turkey between April 1, 2022, and February 1, 2023. Data was collected using the "Pregnant Information Form" and "Female Sexual Distress Scale-Revised (FDS-R)." Descriptive statistics, independent sample t-test, analysis of variance, and the Pearson correlation test were used for data analysis. Results:Herein, 46.1% of pregnant women experienced sexual distress, and the mean FDS-R score of the study participants was 14.49. Participants who were dissatisfied with their sexual life before and during pregnancy (p < 0.001), those who did not have sexual intercourse during pregnancy (p < 0.001), those who experienced decreased sexual desire during pregnancy (p < 0.001), those who did not receive sexual education during pregnancy (p < 0.001), and those who experienced problems when engaging in sexual intercourse during pregnancy (p < 0.001) experienced more sexual distress. Sexual distress increased when the mean age and the number of pregnancies and children increased, whereas it decreased when the gestational week increased. Conclusions: Approximately half of the pregnant women included in the study experienced sexual distress. The findings highlight the importance of midwives and nurses encouraging pregnant women to discuss their sexuality. Policy implications:The findings of this study show that sexual distress during pregnancy is common and affected by some factors related to personal and sexual life during pregnancy. This result provides evidence of the need to develop culturally appropriate interventions and policies that include sexual partners in the context of improving pregnant women's sexual distress, sexual health, good family relationships and mental health.Item Plasma GDF-15 Levels and Their Association with Hormonal and Metabolic Status in Women with Polycystic Ovary Syndrome Aged 25-35(2014) Berberoglu, Z.; Aktas, A.; Fidan, Y.; Yazici, A. Canan; Aral, Y.; https://orcid.org/0000-0002-3132-242X; 24736483; AAS-6810-2021Aim. We aimed to determine plasma levels of growth differentiation factor (GDF)-15 and their possible association with hormonal and metabolic status, as well as echocardiographic profiles and carotid artery intima-media thickness (CAIMT) measurements in patients with polycystic ovary syndrome (PCOS). Methods. Forty-two obese PCOS women aged 25-35 years, 23 women with idiopathic hirsutism and 20 healthy controls matched for age and body mass index were enrolled. Anthropometric, metabolic and hormonal patterns, plasma GDF-15 concentrations, CAIMT, and conventional echocardiographic parameters were measured. Results. Metabolic/lipid profiles as well as GDF-15 levels were similar across the three groups. CAIMT tended to be higher in PCOS group but did not reach statistical significance. No between-group differences were found in the conventional echocardiographic parameters. Analysis of PCOS patients showed a significant correlation of GDF-15 concentrations with age and homeostasis model assessment (HOMA) index (r=0.319, P<0.05, and r=0.312, P<0.05, respectively). In multiple linear regression analyses, GDF-15 was significantly associated with age (r(2)=0.102, P<0.05), and HOMA index (r(2)=0.10, P<0.05). Conclusion. Plasma GDF-15 levels, CAIMT and conventional echocardiographic parameters in obese subjects with PCOS (25-35 yrs old) were comparable to those in either subjects with idiopathic hirsutism or healthy controls with similar anthropometric and metabolic profiles, suggesting that PCOS alone could not impart an early and higher risk independent of associated risk factors. GDF-15 might provide a link between future diabetes and cardiovascular risk in PCOS women.Item Knowledge, Attitudes and Behaviors of Physicians Towards Thyroid Disorders and Iodine Requirements in Pregnancy(2015) Kut, A.; Kalli, H.; Anil, C.; Mousa, U.; Gursoy, A.; 0000-0003-0776-8349; 0000-0002-8078-9376; 0000-0003-3802-9733; 25833359; A-2550-2015; I-1735-2018Purpose Thyroid disorders including iodine deficiency during pregnancy are important health problems worldwide. However, considering real life, assessment of knowledge, attitudes, and practice of physicians is lacking. We aim to evaluate knowledge, attitudes and behaviors of physicians towards thyroid disorders and requirements of iodine during pregnancy on a nationwide basis. Methods Clinicians from different medical disciplines most likely to encounter pregnant women in daily practice (i.e., obstetricians, endocrinologists, and family physicians) were included. Family physicians were selected from primary care centers; endocrinologists and gynecologists were selected from state hospitals. Randomly selected 322 physicians from seven geographical regions of Turkey were included. Subjects filled a questionnaire which consisted of three sections about knowledge, attitudes and behaviors towards thyroid disorders and iodine requirements during pregnancy. Results Physicians had insufficient and/ or erroneous knowledge about thyroid disorders during pregnancy. 73.1 % of endocrinologists, 32.7 % of family physicians, and 17.8 % of obstetricians knew the correct level of TSH during pregnancy (p < 0.001). 67.1 % of physicians thought it is unnecessary to offer iodine supplementation to pregnant women. Endocrinologists achieved the highest scores in each section, and also had the highest total scores (p < 0.001). Family physicians achieved higher scores than obstetricians. Conclusions Physicians who encounter pregnant women in Turkey do not have sufficient information about management of thyroid disorders and providing iodine support during pregnancy and lactation.Item Pregnancy and Sickle Cell Disease: A Review of the Current Literature(2016) Boga, Can; Ozdogu, Hakan; https://orcid.org/0000-0002-8902-1283; 26672916; AAD-6222-2021; AAD-5542-2021Sickle cell disease (SCD) is the most common hereditary disease worldwide, presenting with anemia and intermittent severe pain. Pregnancy in a patient with SCD is associated with high levels of maternal and fetal morbidity and mortality; the maternal and fetal death rates during pregnancy can attain 11.4% and 20%, respectively. Patient care has improved over time. However, certain management issues remain unresolved; these include the optimum policy in terms of prophylactic blood transfusion, and the use of antiplatelet drugs. Such issues are attributable to the heterogeneous nature of clinical SCD features, and the limitations of uncontrolled and prospective trials. In this review, we seek to facilitate a better understanding of relevant issues via creation of a comparative data profile extracted from current studies. This report may also encourage the drafting of standard operating procedure for management of pregnancy in SCD patients. (C) 2015 Elsevier Ireland Ltd. All rights reserved.Item Comparison between the use of vitamin d supplement by 20-49 year old women and their nutrition and depression status(2021) Soykurt, Seniha Cukurovali; Tayfur, Muhittin; Celen, Emine UlucamObjective: Aim of this study is to determine the possible relation between the nutritional status, food choices, eating habits, and Vitamin D supplement use of pregnant women between 20-49 years of age, and depression. Methods: The study was conducted between December 2018 and January 2019, on a total of 150 pregnant women between the ages of 20 and 49, who were admitted to Ankara Ataturk Training and Research Hospital Obstetrics and Gynaecology Policlinic. A questionnaire was used in order to identify personal data of the individuals, levels of serum Vitamin D, depression status, physical changes and other information regarding the changes in food consumption. Dietary habits and food consumption records of the individuals were obtained through face-to-face interviews. Results: A total of 75 individuals participating in the study used Vitamin D, while the other 75 did not. Of the individuals participating in the study, beck depression score median of those who used Vitamin D was found as 9.00 (IQR =6), while it was 33.00 (IQR =13) for those who did not. When the scores were analyzed based on Vitamin D use, it was found that there were statistically significant differences. Conclusions: There is evidence from epidemiological studies that show that vitamin D deficiency or insufficiency is associated with depression. Therefore, it is appropriate to recommend taking vitamin D supplements to prevent or treat depression in risk groups. Larger studies are needed to examine this situation in detail.Item The effect of ultraviolet index measurements on levels of vitamin D and inflammatory markers in pregnant women(2021) Balci, SerdarBackground: Hypovitaminosis D is a risk factor for infertility and several adverse pregnancy outcomes. These negative effects of vitamin D deficiency may be due to inflammatory processes. T lymphocytes play a key role in the formation of immune response by producing some cytokines. Vitamin D is known to have significant effects on T lymphocytes and T regulator cells. The most significant determinant of vitamin Din the human body is sun exposure. The most important indicator determining the sun exposure in a region is the ultraviolet index (UVi). We tried to determine the effect of UV changes on vitamin D values during pregnancy and possible effects on inflammatory markers in a single region. Methods: The vitamin D serum values and blood count values of pregnant patients at the time of first admission were recorded in the months of April to September (AS) and October to March (OM). The daily UVi values of the Izmir region were obtained. These daily values were averaged according to the two groups. As inflammatory markers, the Neutrophil-Lymphocyte ratio (NLR), Platelet-Lymphocyte ratio (PLR), Monocyte-Lymphocyte ratio (MLR), mean platelet volume (MPV) and erythrocyte volume distribution (RDW) values were calculated from the blood count. Results: The UVi mean value was found to be 8 for AS and 3 for OM. There was a significant difference in the mean vitamin D values for the AS (42 patients) and OM (40 patients) periods. A predisposition to inflammatory processes was determined for the OM period in terms of the inflammation markers examined between the two groups. Our study showed lower levels of RDW and MPV and similar values for NLR, PLR and MLR according to the UVi values. Discussion: Vitamin D plays role in many systems as a hormone, a vitamin or an immunomodulator after activation in the skin tissue. Besides its known benefits to the musculoskeletal system, adequate serum vitamin D values reduce the risk of certain types of cancer, mental disorders, infectious diseases, cardiovascular diseases, type 2 diabetes mellitus, autoimmune disorders and adverse pregnancy outcomes. Additionally, lower UVi may be associated with lower vitamin D values in pregnant women and increased inflammatory markers in complete blood count. As a result, in order to avoid adverse pregnancy outcomes, the UVi values of regions may be useful for determining replacement of vitamin D during or before pregnancy.Item 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-8793-2021Objective 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.Item Gastrointestinal endoscopy in pregnancy(2014) Savas, Nurten; 25386072Gastrointestinal endoscopy has a major diagnostic and therapeutic role in most gastrointestinal disorders; however, limited information is available about clinical efficacy and safety in pregnant patients. The major risks of endoscopy during pregnancy include potential harm to the fetus because of hypoxia, premature labor, trauma and teratogenesis. In some cases, endoscopic procedures may be postponed until after delivery. When emergency or urgent indications are present, endoscopic procedures may be considered with some precautions. United States Food and Drug Administration category B drugs may be used in low doses. Endoscopic procedures during pregnancy may include upper gastrointestinal endoscopy, percutaneous endoscopic gastrostomy, sigmoidoscopy, colonoscopy, enteroscopy of the small bowel or video capsule endoscopy, endoscopic retrograde cholangiopancreatography and endoscopic ultrasonography. All gastrointestinal endoscopic procedures in pregnant patients should be performed in hospitals by expert endoscopists and an obstetrician should be informed about all endoscopic procedures. The endoscopy and flexible sigmoidoscopy may be safe for the fetus and pregnant patient, and may be performed during pregnancy when strong indications are present. Colonoscopy for pregnant patients may be considered for strong indications during the second trimester. Although therapeutic endoscopic retrograde cholangiopancreatography may be considered during pregnancy, this procedure should be performed only for strong indications and attempts should be made to minimize radiation exposure. (C) 2014 Baishideng Publishing Group Inc. All rights reserved.Item Giant Fibroadenoma Growing Rapidly During Pregnancy(2014) Karagulle, Erdal; Turk, Emin; Erinanc, Ozgur Hilal; Moray, Gokhan; 25389498Introduction: Giant fibroadenoma is a rare disease with unknown etiology During pregnancy fibroadenomas increase in size and may show lactational histologic changes. High concentrations of estrogen, progesterone, and prolactin promote the ductal growth and formation of tubuloalveolar structures.This may be a reason for the significant enlargement in this period. Case Presentation: We presented a case of giant fibroadenoma, first detected at the onset of pregnancy, which grew rapidly and was excised surgically two months after the birth. There was no marked deformity in the breast nor a need to reconstruct it, despite the giant mass was excised and the mother was lactating. Discussion: We presented a rare case of giant fibroadenoma in a lactating woman. A progressively growing mass in breast can lead to structural damages. The current management approach for giant fibroadenomas is still surgical excision.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.