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Yilmaz G, Neselioglu S, Aydogdu FE, Erel O, Uzunlar O, Moraloglu Tekin O. The effect of slow-release vaginal dinoprostone on maternal and fetal oxidative stress in term pregnancies complicated by oligohydramnios: Prospective cohort study. J Chin Med Assoc 2024; 87:410-413. [PMID: 38376193 DOI: 10.1097/jcma.0000000000001072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND To evaluate changes in oxidant status using thiol/disulfide homeostasis in mothers and fetuses after induction of labor with slow-release vaginal dinoprostone inserts. METHODS A total of 70 pregnant women were divided into two groups. Thirty-five women in whom labor was induced with slow-release vaginal dinoprostone inserts (10 mg of prostaglandin E2, group A) were compared before and after the administration. The other 35 women, who were followed up spontaneously during labor (group B), were included as a control group. Both groups were diagnosed with isolated oligohydramnios without signs of placental insufficiency. The thiol/disulfide homeostasis parameters were calculated before medical induction and after removal of the insert at the beginning of the active phase of labor. Maternal and cord blood values were measured in both groups. RESULTS Although the balance shifted to the antioxidant side after the slow-release vaginal dinoprostone insert was applied, there was no significant difference in maternal oxidative load compared to the pre-application status (5.32 ± 014/5.16 ± 0.15, p = 0.491). Despite the shift toward the antioxidant side, maternal antioxidants were still significantly lower in the group that received slow-release vaginal dinoprostone at the beginning of the active phase of labor than in the control group (295.98 ± 13.03/346.47 ± 12.04, respectively, p = 0.009). There was no statistically significant difference in terms of oxidative balance or newborn Apgar score ( p > 0.05). CONCLUSION Induction of labor with slow-release vaginal dinoprostone inserts in pregnancies with isolated oligohydramnios does not cause further oxidative stress and is safe for both mothers and neonates in terms of oxidant load by thiol/disulfide homeostasis.
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Affiliation(s)
- Gamze Yilmaz
- Department of Obstetrics and Gynecology, Republic of Turkey Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Salim Neselioglu
- Department of Medical Biochemistry, University of Health Sciences, Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Fatma Ece Aydogdu
- Department of Obstetrics and Gynecology, Republic of Turkey Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Ozcan Erel
- Department of Medical Biochemistry, University of Health Sciences, Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Ozlem Uzunlar
- Department of Obstetrics and Gynecology, Republic of Turkey Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Ozlem Moraloglu Tekin
- Department of Obstetrics and Gynecology, Republic of Turkey Ministry of Health Ankara City Hospital, Ankara, Turkey
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Tokalioglu AA, Oktar O, Sahin M, Ozturk C, Erdogan O, Yildirim HEK, Ucar Y, Kilic F, Ersak B, Yalcin N, Ozmen F, Alci A, Bas S, Gorgulu G, Selcuk I, Ucar G, Kocak O, Cakir C, Kilic C, Comert GK, Ureyen I, Toptas T, Narin MA, Tasci T, Taskin S, Boran N, Ozdal B, Sanci M, Uncu D, Korkmaz V, Tekin OM, Ustun Y, Ortac F, Turan T. Defining the relationship between ovarian adult granulosa cell tumors and synchronous endometrial pathology: Does ovarian tumor size correlate with endometrial cancer? J Obstet Gynaecol Res 2024; 50:655-662. [PMID: 38304973 DOI: 10.1111/jog.15896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 01/17/2024] [Indexed: 02/03/2024]
Abstract
OBJECTIVE The main feature of adult granulosa cell tumors (AGCT) is their capacity to secrete hormones, with nearly all of them capable of synthesizing oestradiol. The primary goal of this study is to identify synchronized endometrial pathologies, particularly endometrial cancer, in AGCT patients who had undergone a hysterectomy. MATERIALS AND METHODS The study cohort comprised retrospectively of 316 AGCT patients from 10 tertiary gynecological oncology centers. AGCT surgery consisted of bilateral salpingo-oophorectomy, hysterectomy, peritoneal cytology, omentectomy, and the excision of any suspicious lesion. The median tumor size value was used to define the relationship between tumor size and endometrial cancer. The relationship between each value and endometrial cancer was evaluated. RESULTS Endometrial intraepithelial neoplasia, or hyperplasia with complex atypia, was detected in 7.3% of patients, and endometrial cancer in 3.1% of patients. Age, menopausal status, tumor size, International Federation of Gynecology and Obstetrics stage, ascites, and CA-125 level were not statistically significant factors to predict endometrial cancer. There was no endometrial cancer under the age of 40, and 97.8% of women diagnosed with endometrial hyperplasia were over the age of 40. During the menopausal period, the endometrial cancer risk was 4.5%. Developing endometrial cancer increased to 12.1% from 3.2% when the size of the tumor was >150 mm in menopausal patients (p = 0.036). CONCLUSION Endometrial hyperplasia, or cancer, occurs in approximately 30% of AGCT patients. Patients diagnosed with AGCT, especially those older than 40 years, should be evaluated for endometrial pathologies. There may be a relationship between tumor size and endometrial cancer, especially in menopausal patients.
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Affiliation(s)
- Abdurrahman Alp Tokalioglu
- Department of Gynecologic Oncology, Ankara Bilkent City Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Okan Oktar
- Department of Gynecologic Oncology, Ankara Etlik City Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Mustafa Sahin
- Department of Gynecologic Oncology, Ankara Bilkent City Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Cagatayhan Ozturk
- Department of Gynecologic Oncology, Ankara University, Faculty of Medicine, Ankara, Turkey
| | - Ozgur Erdogan
- Department of Gynecologic Oncology, Tepecik Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Izmir, Turkey
| | - Hande Esra Koca Yildirim
- Department of Gynecologic Oncology, Ankara Etlik City Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Yesim Ucar
- Department of Gynecologic Oncology, Ankara Bilkent City Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Fatih Kilic
- Department of Gynecologic Oncology, Ankara Bilkent City Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Burak Ersak
- Department of Gynecologic Oncology, Ankara Etlik City Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Necim Yalcin
- Department of Gynecologic Oncology, Antalya Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Antalya, Turkey
| | - Fatma Ozmen
- Department of Gynecologic Oncology, Adana City Hospital, Faculty of Medicine, University of Health Sciences, Adana, Turkey
| | - Aysun Alci
- Department of Gynecologic Oncology, Antalya Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Antalya, Turkey
| | - Sevda Bas
- Department of Gynecologic Oncology, Adana City Hospital, Faculty of Medicine, University of Health Sciences, Adana, Turkey
| | - Goksen Gorgulu
- Department of Gynecologic Oncology, Tepecik Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Izmir, Turkey
| | - Ilker Selcuk
- Department of Gynecologic Oncology, Zekai Tahir Burak Women's Health Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Gokhan Ucar
- Department of Medical Oncology, Ankara Bilkent City Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Ozgur Kocak
- Department of Gynecologic Oncology, Hitit University, Faculty of Medicine, Corum, Turkey
| | - Caner Cakir
- Department of Gynecologic Oncology, Ankara Etlik City Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Cigdem Kilic
- Department of Gynecologic Oncology, Hitit University, Faculty of Medicine, Corum, Turkey
| | - Gunsu Kimyon Comert
- Department of Gynecologic Oncology, Ankara Bilkent City Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Isin Ureyen
- Department of Gynecologic Oncology, Antalya Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Antalya, Turkey
| | - Tayfun Toptas
- Department of Gynecologic Oncology, Antalya Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Antalya, Turkey
| | - Mehmet Ali Narin
- Department of Gynecologic Oncology, Adana City Hospital, Faculty of Medicine, University of Health Sciences, Adana, Turkey
| | - Tolga Tasci
- Department of Gynecologic Oncology, Bahcesehir University, Faculty of Medicine, Istanbul, Turkey
| | - Salih Taskin
- Department of Gynecologic Oncology, Ankara University, Faculty of Medicine, Ankara, Turkey
| | - Nurettin Boran
- Department of Gynecologic Oncology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Bulent Ozdal
- Department of Gynecologic Oncology, Zekai Tahir Burak Women's Health Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Muzaffer Sanci
- Department of Gynecologic Oncology, Tepecik Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Izmir, Turkey
| | - Dogan Uncu
- Department of Medical Oncology, Ankara Bilkent City Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Vakkas Korkmaz
- Department of Gynecologic Oncology, Ankara Etlik City Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Ozlem Moraloglu Tekin
- Department of Obstetrics and Gynecology, Ankara City Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Yaprak Ustun
- Department of Obstetrics and Gynecology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Fırat Ortac
- Department of Gynecologic Oncology, Ankara University, Faculty of Medicine, Ankara, Turkey
| | - Taner Turan
- Department of Gynecologic Oncology, Ankara Bilkent City Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
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Kilic F, Ersak B, Cakir C, Yuksel D, Kilic C, Korkmaz V, Tokgozoglu N, Toptas T, Boran N, Kimyon Comert G, Ureyen I, Tasci T, Moraloglu Tekin O, Ustun Y, Turan T. Assessment of the differences in oncologic outcomes between patients with high-grade serous ovarian carcinoma and uterine serous carcinoma. J Obstet Gynaecol Res 2024; 50:86-94. [PMID: 37854000 DOI: 10.1111/jog.15814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 10/08/2023] [Indexed: 10/20/2023]
Abstract
AIM To evaluate whether the recurrence rates, recurrence patterns, and survival outcomes differed according to the primary site of the tumor in patients with high-grade serous ovarian carcinoma (HGSOC) and uterine serous carcinoma (USC). METHODS The population of this multicenter retrospective study consisted of patients who had USC or HGSOC. Progression-free survival (PFS) and disease-specific survival (DSS) estimates were determined using the Kaplan-Meier method. Survival curves were compared using the log-rank test. RESULTS The study cohort consisted of 247 patients with HGSOC and 34 with USC. Recurrence developed in 118 (51.1%) in the HGSOC group and 14 (42.4%) in the USC group (p = 0.352). The median time to recurrence was 23.5 (range, 4-144) and 17 (range, 4-43) months in the HGSOC and USC groups, respectively (p = 0.055). The 3-year PFS was 52% in the HGSOC group and 47% in the USC group (p = 0.450). Additionally, 3-year DSS was 92% and 82% in the HGSOC and USC groups, respectively (p = 0.060). CONCLUSIONS HGSOC and USC are aggressive tumors with high recurrence and mortality rates in advanced stages. These two carcinomas, which are similar in molecular features and clinical management, may also have similar recurrence patterns, disease failure, and survival rates.
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Affiliation(s)
- Fatih Kilic
- Department of Gynecologic Oncology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Burak Ersak
- Department of Gynecologic Oncology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Caner Cakir
- Department of Gynecologic Oncology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Dilek Yuksel
- Department of Gynecologic Oncology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Cigdem Kilic
- Department of Gynecologic Oncology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Vakkas Korkmaz
- Department of Gynecologic Oncology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Nedim Tokgozoglu
- Department of Gynecologic Oncology, Okmeydani Training and Research Hospital, Istanbul, Turkey
| | - Tayfun Toptas
- Department of Gynecologic Oncology, Antalya Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Antalya, Turkey
| | - Nurettin Boran
- Department of Gynecologic Oncology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Gunsu Kimyon Comert
- Department of Gynecologic Oncology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Isin Ureyen
- Department of Gynecologic Oncology, Antalya Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Antalya, Turkey
| | - Tolga Tasci
- Department of Gynecologic Oncology, Okmeydani Training and Research Hospital, Istanbul, Turkey
| | - Ozlem Moraloglu Tekin
- Department of Gynecologic Oncology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Yaprak Ustun
- Department of Gynecologic Oncology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Taner Turan
- Department of Gynecologic Oncology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
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Unsal M, Kilic C, Cakir C, Kilic F, Ersak B, Karakas S, Tokgozoglu N, Varli B, Oktar O, Kimyon Comert G, Ozdemir IA, Boran N, Toptas T, Ureyen I, Korkmaz V, Taskin S, Moraloglu Tekin O, Ustun Y, Tasci T, Ortac F, Turan T. Neoadjuvant chemotherapy in patients with stage IVB uterine serous carcinoma: a Turkish multicentric study. J OBSTET GYNAECOL 2023; 43:2151355. [PMID: 36503383 DOI: 10.1080/01443615.2022.2151355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The aim of this study was to evaluate the prognostic factors for and determine the effect of neoadjuvant chemotherapy (NACT) on oncologic outcome in stage IVB pure serous endometrial carcinoma patients who received taxane and platinum. Forty-two patients with 2009 International Federation of Gynecology and Obstetrics (FIGO) stage IVB uterine serous carcinoma were enrolled from six gynecologic oncology centers and a study group was created. The study group had a 2-year disease-free survival (DFS) of 32% and 2-year disease-specific survival (DSS) of 73%. On univariate analysis; lymphadenectomy (not performed vs. performed), paraaortic lymph node metastasis (positive vs. negative) and number of metastatic lymph node count (≤5 vs. >5) were found to have statistical significance for DFS (p < 0.001, p = 0.026 and p = 0.044, respectively). Adnexal metastasis (positive vs. negative) and type of cytoreductive surgery (maximal vs. optimal and suboptimal) had statistical significance for DSS (p = 0.041 and p = 0.015, respectively). Receiving NACT did not affect DFS and DSS in stage IVB uterine serous carcinoma patients. As our sample size was small, precise conclusions could not be made for suggesting the use of NACT in advanced stage uterine serous carcinoma. For more accurate results, more randomized controlled studies are needed in this patient group.IMPACT STATEMENTWhat is already known on this subject? Endometrial carcinoma is the most common type of gynecologic tract malignancies and usually it is diagnosed at early stages. Although the favorable prognosis, uterine serous carcinoma (USC), one of the rarest subtypes, has a poorer prognosis when compared to other histological subtypes. USC has a propensity to spread beyond pelvis. Due to this aggressive behavior, surgical intervention could not be feasible in advanced stage disease.What do the results of this study add? Our study evaluated the prognostic factors that affect survival in advanced stage USC patients. Also we investigated that neoadjuvant chemotherapy (NACT) could improve oncologic outcomes. Performing lymphadenectomy, presence of paraaortic lymph node and adnexal metastasis, number of metastatic lymph nodes and type of cytoreductive surgery improved survival in advanced stage USC patients. However, NACT did not have a statistical significance as a predictor for disease-specific survival (DSS) and disease-free survival (DFS).What are the implications of these findings for clinical practice and/or further research? Maximal surgical effort should be performed in advanced stage USC according to our results. On the other hand, NACT had no impact on DSS and DFS rates. For this reason, we could not be able to suggest the routine use of NACT in advanced stage USC. But more randomized controlled trials are warranted for confirmation of our results.
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Affiliation(s)
- Mehmet Unsal
- Department of Gynecologic Oncology, Ankara City Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Cigdem Kilic
- Department of Gynecologic Oncology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Caner Cakir
- Department of Gynecologic Oncology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Fatih Kilic
- Department of Gynecologic Oncology, Ankara City Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Burak Ersak
- Department of Gynecologic Oncology, Ankara City Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Sema Karakas
- Department of Gynecologic Oncology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Istanbul, Turkey
| | - Nedim Tokgozoglu
- Department of Gynecologic Oncology, Okmeydani Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Istanbul, Turkey
| | - Bulut Varli
- Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Okan Oktar
- Department of Gynecologic Oncology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Gunsu Kimyon Comert
- Department of Gynecologic Oncology, Ankara City Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Isa Aykut Ozdemir
- Department of Gynecologic Oncology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Istanbul, Turkey
| | - Nurettin Boran
- Department of Gynecologic Oncology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Tayfun Toptas
- Department of Gynecologic Oncology, Antalya Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Antalya, Turkey
| | - Isin Ureyen
- Department of Gynecologic Oncology, Antalya Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Antalya, Turkey
| | - Vakkas Korkmaz
- Department of Gynecologic Oncology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Salih Taskin
- Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Ozlem Moraloglu Tekin
- Department of Gynecologic Oncology, Ankara City Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Yaprak Ustun
- Department of Gynecologic Oncology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Tolga Tasci
- Department of Gynecologic Oncology, Okmeydani Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Istanbul, Turkey
| | - Firat Ortac
- Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Taner Turan
- Department of Gynecologic Oncology, Ankara City Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
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Beser DM, Hendem DU, Oluklu D, Turgut E, Hancerliogullari N, Ayhan SG, Tekin OM, Sahin D. Factors Related to Low COVID-19 Vaccination Rate in Pregnant and Postpartum Women with and without COVID-19. Rev Bras Ginecol Obstet 2023; 45:e638-e645. [PMID: 38029765 PMCID: PMC10686763 DOI: 10.1055/s-0043-1772589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 04/27/2023] [Indexed: 12/01/2023] Open
Abstract
OBJECTIVE This study focused on pregnant and postpartum women during the COVID-19 pandemic, aiming to determine the attitudes and behaviors of vaccinated and unvaccinated groups, and the vaccination behaviors in the groups with and without the disease. The reasons for refusing the vaccine were also questioned. METHODS This cross-sectional study was performed from September 2021 to October 2021. The study data were collected using a face-to-face questionnaire. The participants were pregnant women who applied to the hospital for routine antenatal care and were hospitalized, and women in the postpartum period. Additionally, pregnant and postpartum patients who were diagnosed with COVID-19 at the time of admission and were hospitalized and admitted to the intensive care unit due to this disease were also included in the study. RESULTS A total of 1,146 pregnant and postpartum women who completed the questionnaire were included in our study. Only 43 (3.8%) of the participants were vaccinated; 154 (13.4%) of the participants had comorbidities. The number of COVID-19-positive patients was 153. The lack of sufficient information about the safety of the COVID-19 vaccine is the most common reason for the refusal. CONCLUSION Vaccine refusal can significantly delay or hinder herd immunity, resulting in higher morbidity and mortality. Considering the adverse effects of COVID-19 on pregnancy, it is essential to understand pregnant and postpartum women's perceptions toward vaccination to end the pandemic.
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Affiliation(s)
- Dilek Menekse Beser
- Division of Perinatology, Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey.
| | - Derya Uyan Hendem
- Division of Perinatology, Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey.
| | - Deniz Oluklu
- Division of Perinatology, Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey.
| | - Ezgi Turgut
- Division of Perinatology, Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey.
| | - Necati Hancerliogullari
- Department of Obstetrics and Gynecology, University of Health Sciences, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey.
| | - Sule Goncu Ayhan
- Division of Perinatology, Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey.
| | - Ozlem Moraloglu Tekin
- Department of Obstetrics and Gynecology, University of Health Sciences, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey.
| | - Dilek Sahin
- Division of Perinatology, Department of Obstetrics and Gynecology, University of Health Sciences, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey.
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Mert SA, Dilbaz B, Akpinar F, Diktas EG, Kinay T, Ensari T, Tekin OM. Evaluation of the Success of Hysteroscopic Uterine Septum Resection. Gynecol Minim Invasive Ther 2023; 12:230-235. [PMID: 38034112 PMCID: PMC10683958 DOI: 10.4103/gmit.gmit_131_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 04/10/2023] [Accepted: 04/24/2023] [Indexed: 12/02/2023] Open
Abstract
Objectives The aim is to use three-dimensional transvaginal ultrasonography (3-D TVUS) to evaluate the success of hysteroscopic metroplasty for the uterine septum and to compare the pregnancy outcomes. Materials and Methods Thirty-eight patients with uterine septum who had hysteroscopic uterine septum resection were recruited. Preoperative 3-D TVUS measurements of the septal apex to the uterine fundus (s1), septal apex to internal os distance (s2), and intercornual distance (s3) were compared with the postoperative values. The pregnancies of the patients were followed up for a year postoperative period. Results Out of the 38 patients, thirty-five had partial uterine septum (class U2a), while 3 patients had complete uterine septum (class U2b). Eighteen (47.36%) of the patients who underwent uterine septum resection achieved pregnancy, and thirteen of these pregnancies were (72.2%) term pregnancies, and all term pregnancies resulted in a live birth. Natural conception was achieved in 77.7% (14 of 18) of the patients. Term pregnancy occurred in 68.7% (11 of 16) of the patients with a partial septum and in 66.6% (2 of 3) of the patients with a complete uterine septum. A comparison of the 3-D TVUS measurements of the uterus pre- and postoperatively showed a decrease in s1 and an increase in s2 (P < 0.05). The uterine cavity length of pregnant patients was found to be higher than nonpregnant patients (P < 0.05). Conclusion Reproductive results of hysteroscopic metroplasty were favorable in achieving live and term birth. three-dimensional TVUS can be preferred as a noninvasive effective method in objective evaluation of the success of the hysteroscopic surgery.
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Affiliation(s)
- Sule Atalay Mert
- Department of Reproductive Endocrinology, Etlik Zübeyde Hanim Women’s Health Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Berna Dilbaz
- Department of Reproductive Endocrinology, Etlik Zübeyde Hanim Women’s Health Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Funda Akpinar
- Gynecology and Obstetrics Clinic, Ankara Training and Research Hospital, Ankara, Turkey
| | - Elif Gulsah Diktas
- Department of Reproductive Endocrinology, Etlik Zübeyde Hanim Women’s Health Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Tugba Kinay
- Department of Reproductive Endocrinology, Etlik Zübeyde Hanim Women’s Health Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Tugba Ensari
- Gynecology and Obstetrics Clinic, Ankara City Hospital, Ankara, Turkey
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7
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Sinaci S, Tanacan A, Besimoglu B, Menekse Beser D, Uyan Hendem D, Tugrul Ersak D, Atalay A, Kaya E, Ozden Tokalioglu E, Cankar Dal H, Ocal DF, Erdem D, Izdes S, Moraloglu Tekin O, Ates İ, Turan S, Sahin D. Adverse outcomes and maternal complications in pregnant women with severe-critical COVID-19: a tertiary center experience. J Perinat Med 2023; 51:874-885. [PMID: 37134274 DOI: 10.1515/jpm-2022-0564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 01/19/2023] [Indexed: 05/05/2023]
Abstract
OBJECTIVES This study aimed to present perinatal outcomes, clinical challenges, and basic ICU management in pregnant women with severe-critical COVID-19 at our tertiary referral center. METHODS In this prospective cohort study, patients were divided into two groups, whether they survived or not. Clinical characteristics, obstetric and neonatal outcomes, initial laboratory test results and radiologic imaging findings, arterial blood gas parameters at ICU admission, and ICU complications and interventions were compared between groups. RESULTS 157 of the patients survived, and 34 of the patients died. Asthma was the leading health problem among the non-survivors. Fifty-eight patients were intubated, and 24 of them were weaned off and discharged healthfully. Of the 10 patients who underwent ECMO, only 1 survived (p<0.001). Preterm labor was the most common pregnancy complication. Maternal deterioration was the most common indication for a cesarean section. Higher neutrophil-to-lymphocyte-ratio (NLR) values, the need for prone positioning, and the occurrence of an ICU complication were important parameters that influenced maternal mortality (p<0.05). CONCLUSIONS Overweight pregnant women and pregnant women with comorbidities, especially asthma, may have a higher risk of mortality related to COVID-19. A worsening maternal health condition can lead to increased rates of cesarean delivery and iatrogenic prematurity.
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Affiliation(s)
- Selcan Sinaci
- Clinic of Perinatology, Department of Obstetrics and Gynaecology, Ministry of Health, Ankara City Hospital, Ankara, Türkiye
| | - Atakan Tanacan
- Clinic of Perinatology, Department of Obstetrics and Gynaecology, Ministry of Health, Ankara City Hospital, Ankara, Türkiye
| | - Berhan Besimoglu
- Clinic of Perinatology, Department of Obstetrics and Gynaecology, Ministry of Health, Ankara City Hospital, Ankara, Türkiye
| | - Dilek Menekse Beser
- Clinic of Perinatology, Department of Obstetrics and Gynaecology, Ministry of Health, Ankara City Hospital, Ankara, Türkiye
| | - Derya Uyan Hendem
- Clinic of Perinatology, Department of Obstetrics and Gynaecology, Ministry of Health, Ankara City Hospital, Ankara, Türkiye
| | - Duygu Tugrul Ersak
- Clinic of Perinatology, Department of Obstetrics and Gynaecology, Ministry of Health, Ankara City Hospital, Ankara, Türkiye
| | - Aysegul Atalay
- Clinic of Perinatology, Department of Obstetrics and Gynaecology, Ministry of Health, Ankara City Hospital, Ankara, Türkiye
| | - Ecem Kaya
- Clinic of Perinatology, Department of Obstetrics and Gynaecology, Ministry of Health, Ankara City Hospital, Ankara, Türkiye
| | - Eda Ozden Tokalioglu
- Clinic of Perinatology, Department of Obstetrics and Gynaecology, Ministry of Health, Ankara City Hospital, Ankara, Türkiye
| | - Hayriye Cankar Dal
- Clinic of Anaesthesiology and Reanimation, Department of Intensive Care, Ministry of Health, Ankara City Hospital, Ankara, Türkiye
| | - Doga Fatma Ocal
- Clinic of Perinatology, Department of Obstetrics and Gynaecology, Ministry of Health, Ankara City Hospital, Ankara, Türkiye
| | - Deniz Erdem
- Clinic of Anaesthesiology and Reanimation, Department of Intensive Care, Ministry of Health, Ankara City Hospital, Ankara, Türkiye
- University of Health Sciences, Ankara City Hospital, Istanbul, Türkiye
| | - Seval Izdes
- Clinic of Anaesthesiology and Reanimation, Department of Intensive Care, Ministry of Health, Ankara City Hospital, Ankara, Türkiye
- University of Health Sciences, Ankara City Hospital, Istanbul, Türkiye
| | - Ozlem Moraloglu Tekin
- Clinic of Perinatology, Department of Obstetrics and Gynaecology, Ministry of Health, Ankara City Hospital, Ankara, Türkiye
- General Internal Medicine, Ministry of Health, Ankara City Hospital, Ankara, Türkiye
| | - İhsan Ates
- General Internal Medicine, Ministry of Health, Ankara City Hospital, Ankara, Türkiye
- University of Health Sciences, Ankara City Hospital, Istanbul, Türkiye
| | - Sema Turan
- Clinic of Anaesthesiology and Reanimation, Department of Intensive Care, Ministry of Health, Ankara City Hospital, Ankara, Türkiye
- University of Health Sciences, Ankara City Hospital, Istanbul, Türkiye
| | - Dilek Sahin
- Clinic of Perinatology, Department of Obstetrics and Gynaecology, Ministry of Health, Ankara City Hospital, Ankara, Türkiye
- University of Health Sciences, Ankara City Hospital, Istanbul, Türkiye
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8
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Ulubasoglu H, Hancerliogullari N, Tokmak A, Keskin LH, Candar T, Moraloglu Tekin O. Low sirtuin-1 levels are associated with gestational diabetes mellitus. Minerva Endocrinol (Torino) 2023; 48:282-287. [PMID: 36285745 DOI: 10.23736/s2724-6507.22.03868-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND The aim of this study was to determine whether sirtuin-1 (SIRT1), which has a regulatory role in glucose and lipid metabolism with its deacetylase activity, has a decisive role in predicting gestational diabetes (GDM). METHODS This study was performed at the antenatal outpatient clinic of Ankara City Hospital between January 2021 and May 2021. A total of 525 women with low-risk pregnancy underwent the 75 g oral glucose tolerance test (OGTT) between 24th-28th weeks of pregnancy during the study period. Fasting serum SIRT1 levels of patients diagnosed with GDM according to OGTT results were compared some of those without GDM. RESULTS Of the 525 pregnant women who underwent 75 g OGTT, 50 (9.6%) were diagnosed with GDM. The data of pregnant women with GDM were compared with age and Body Mass Index matched 122 controls. While serum SIRT1 levels were 22.0 (19.9-24.3) ng/mL in the GDM group, it was 34.7 (28.8-54.6) ng/mL in the control group (P<0.001). ROC curve analysis showed that a threshold level for serum SIRT1 equal to or greater than 27.3 ng/mL may predict GDM with a sensitivity of 86% and specificity of 80%. CONCLUSIONS Second-trimester low serum SIRT1 levels are associated with GDM. It may be a diagnostic marker for GDM.
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Affiliation(s)
- Hasan Ulubasoglu
- Department of Obstetrics and Gynecology, Ankara Bilkent City Hospital, Ankara, Türkiye
| | | | - Aytekin Tokmak
- Department of Obstetrics and Gynecology, Ankara Bilkent City Hospital, Ankara, Türkiye
| | - Levent H Keskin
- Department of Obstetrics and Gynecology, Ankara Bilkent City Hospital, Ankara, Türkiye
| | - Tuba Candar
- Department of Medical Biochemistry, Ufuk University, Ankara, Türkiye
| | - Ozlem Moraloglu Tekin
- Department of Obstetrics and Gynecology, Ankara Bilkent City Hospital, Ankara, Türkiye
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9
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Gündüz Ö, Seven B, Ozgu-Erdınc AS, Ayhan SG, Sahin D, Tekin OM, Keskin HL. Correlation of systemic inflammation biomarkers and disease severity in pregnant women with COVID-19. Rev Assoc Med Bras (1992) 2023; 69:e20221614. [PMID: 37377284 DOI: 10.1590/1806-9282.20221614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 03/16/2023] [Indexed: 06/29/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate the prognostic value of whole blood parameters, systemic inflammatory indices, and systemic inflammatory markers in pregnant women with COVID-19. METHODS In this cross-sectional study, the demographic, clinical, and laboratory data (i.e., whole blood parameters, C-reactive protein, procalcitonin, ferritin, and D-dimer) of 464 pregnant women with COVID-19 who attended a tertiary hospital between January and April 2021 were reviewed. Systemic inflammatory indices (i.e., neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, platelet/neutrophil ratio, and systemic immune inflammation index) were calculated. Asymptomatic and mildly symptomatic pregnant women were classified as Group 1 (n=413), and those with severe disease were classified as Group 2 (n=51). RESULTS Lymphocyte count and lymphocyte percentage in whole blood parameters were significantly lower (p<0.05), and C-reactive protein, ferritin, and procalcitonin values were higher in Group 2 (p<0.05). Systemic inflammatory indices [neutrophil/lymphocyte ratio (4.7±2.9 (1.1-21.2) vs 7.5±4.7 (2.13-23.2)), platelet/lymphocyte ratio (191.1±104.3 (53.0-807.1) vs 269.5±118.9 (105.0-756.0)), systemic immune inflammation index (1,000±663 (209-5,231) vs 1,630±1,314 (345-7,006))] were found statistically significantly higher in severe disease group (p<0.001). CONCLUSION Evidence in this study indicates that neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, and systemic immune inflammation index at first admission are simple, rapid, and inexpensive indices in predicting the prognosis of COVID-19 in pregnant women.
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Affiliation(s)
- Özlem Gündüz
- Ankara City Hospital, Ministry of Health, Department of Obstetrics and Gynecology - Ankara, Turkey
| | - Banu Seven
- Ankara City Hospital, Ministry of Health, Department of Obstetrics and Gynecology - Ankara, Turkey
| | - A Seval Ozgu-Erdınc
- University of Health Sciences, Ankara City Hospital, Ministry of Health, Department of Obstetrics and Gynecology - Ankara, Turkey
| | - Sule Goncu Ayhan
- Ankara City Hospital, Ministry of Health, Department of Obstetrics and Gynecology - Ankara, Turkey
| | - Dilek Sahin
- University of Health Sciences, Ankara City Hospital, Ministry of Health, Department of Obstetrics and Gynecology - Ankara, Turkey
| | - Ozlem Moraloglu Tekin
- University of Health Sciences, Ankara City Hospital, Ministry of Health, Department of Obstetrics and Gynecology - Ankara, Turkey
| | - Huseyin Levent Keskin
- University of Health Sciences, Ankara City Hospital, Ministry of Health, Department of Obstetrics and Gynecology - Ankara, Turkey
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10
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Erdogan O, Kilic C, Cakir C, Kilic F, Oktar O, Ersak B, Sahin M, Tokalioglu A, Kocak O, Ozturk C, Gorgulu G, Gokkaya M, Selcuk I, Korkmaz V, Comert GK, Toptas T, Ureyen I, Ucar G, Taskin S, Tasci T, Uncu D, Narin MA, Boran N, Ozdal B, Tekin OM, Ustun Y, Sancı M, Ortac F, Turan T. Is adjuvant chemotherapy necessary for 2014 FIGO stage IC adult granulosa cell tumor?: Multicentric Turkish study. Asia Pac J Clin Oncol 2023. [PMID: 37096294 DOI: 10.1111/ajco.13942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 01/10/2023] [Accepted: 01/11/2023] [Indexed: 04/26/2023]
Abstract
AIM The aim of our study is to examine the clinical, surgical, and pathological factors of stage 1C adult granulosa cell tumor (AGCT) patients and to investigate the effects of adjuvant therapy on recurrence and survival rates in this patient group. METHODS Out of a total of 415 AGCT patients treated by 10 tertiary oncology centers participating in the study, 63 (15.2%) patients with 2014 FIGO stage IC constituted the study group. The FIGO 2014 system was used for staging. Patient group who received adjuvant chemotherapy was compared with patient group who did not receive adjuvant chemotherapy in terms of disease-free survival (DFS), and disease-specific survival. RESULTS The 5-year DFS of the study cohort was 89%, and the 10-year DFS was 85%. Those who received adjuvant chemotherapy and those who did not were similar in terms of clinical, surgical and pathological factors, except for peritoneal cytology. In the univariate analysis, none of the clinical, surgical or pathological factors were significant for DFS. Adjuvant chemotherapy and type of treatment protocol had no impact on DFS. CONCLUSION Adjuvant chemotherapy was not associated with improved DFS and overall survival in stage IC AGCT. Multicentric and randomized controlled studies are needed for early stage AGCT in order to confirm these results and reach accurate conclusions.
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Affiliation(s)
- Ozgur Erdogan
- Department of Gynecologic Oncology, Tepecik Training and Research Hospital, Izmir, Turkey
| | - Cigdem Kilic
- Department of Gynecologic Oncology, Hitit University, Corum, Turkey
| | - Caner Cakir
- Department of Gynecologic Oncology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Fatih Kilic
- Department of Gynecologic Oncology, Ankara City Hospital, Ankara, Turkey
| | - Okan Oktar
- Department of Gynecologic Oncology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Burak Ersak
- Department of Gynecologic Oncology, Ankara City Hospital, Ankara, Turkey
| | - Mustafa Sahin
- Department of Gynecologic Oncology, Ankara City Hospital, Ankara, Turkey
| | - Alp Tokalioglu
- Department of Gynecologic Oncology, Ankara City Hospital, Ankara, Turkey
| | - Ozgur Kocak
- Department of Gynecologic Oncology, Hitit University, Corum, Turkey
| | | | - Goksen Gorgulu
- Department of Gynecologic Oncology, Tepecik Training and Research Hospital, Izmir, Turkey
| | - Mustafa Gokkaya
- Department of Gynecologic Oncology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Ilker Selcuk
- Department of Gynecologic Oncology, Zekai Tahir Burak Training and Research Hospital, Ankara, Turkey
| | - Vakkas Korkmaz
- Department of Gynecologic Oncology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | | | - Tayfun Toptas
- Department of Gynecologic Oncology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Isin Ureyen
- Department of Gynecologic Oncology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Gokhan Ucar
- Department of Medical Oncology, Ankara City Hospital, Ankara, Turkey
| | - Salih Taskin
- Ankara University, Faculty of Medicine, Ankara, Turkey
| | - Tolga Tasci
- Department of Gynecologic Oncology, Bahcesehir University, Istanbul, Turkey
| | - Dogan Uncu
- Department of Medical Oncology, Ankara City Hospital, Ankara, Turkey
| | - Mehmet Ali Narin
- Department of Gynecologic Oncology, Adana City Hospital, Adana, Turkey
| | - Nurettin Boran
- Department of Gynecologic Oncology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Bulent Ozdal
- Department of Gynecologic Oncology, Zekai Tahir Burak Training and Research Hospital, Ankara, Turkey
| | | | - Yaprak Ustun
- Department of Gynecologic Oncology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Muzaffer Sancı
- Department of Gynecologic Oncology, Tepecik Training and Research Hospital, Izmir, Turkey
| | - Firat Ortac
- Ankara University, Faculty of Medicine, Ankara, Turkey
| | - Taner Turan
- Department of Gynecologic Oncology, Ankara City Hospital, Ankara, Turkey
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11
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Tanacan A, Oluklu D, Laleli Koc B, Sinaci S, Menekse Beser D, Uyan Hendem D, Yildirim M, Sakcak B, Besimoglu B, Tugrul Ersak D, Akgun Aktas B, Gulen Yildiz E, Unlu S, Kara O, Alyamac Dizdar E, Canpolat FE, Ates İ, Moraloglu Tekin O, Sahin D. The utility of systemic immune-inflammation index and systemic immune-response index in the prediction of adverse outcomes in pregnant women with coronavirus disease 2019: Analysis of 2649 cases. J Obstet Gynaecol Res 2023; 49:912-919. [PMID: 36582132 DOI: 10.1111/jog.15533] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 12/19/2022] [Indexed: 12/31/2022]
Abstract
AIM To investigate the association of systemic immune-inflammation index (SII) and systemic immune-response index (SIRI) with adverse perinatal outcomes in pregnant women with coronavirus disease 2019 (COVID-19). METHODS The cases were divided into (1) the Mild-moderate COVID-19 group (n = 2437) and (2) the Severe-critical COVID-19 group (n = 212). Clinical characteristics, perinatal outcomes, SII (neutrophilXplatelet/lymphocyte), and SIRI (neutrophilXmonocyte/lymphocyte) were compared between the groups. Afterward, SII and SIRI values were compared between subgroups based on pregnancy complications, neonatal intensive care unit (NICU) admission, and maternal mortality. A receiver operator characteristic analysis was performed for the determination of optimal cutoff values for SII and SIRI in the prediction of COVID-19 severity, pregnancy complications, NICU admission, and maternal mortality. RESULTS Both SII and SIRI were significantly higher in complicated cases (p < 0.05). Cutoff values in the prediction of severe-critical COVID-19 were 1309.8 for SII, and 2.3 for SIRI. For pregnancy complications, optimal cutoff values were 973.2 and 1.6. Cutoff values of 1045.4 and 1.8 were calculated for the prediction of NICU admission. Finally, cut-off values of 1224.2 and 2.4 were found in the prediction of maternal mortality. CONCLUSION SII and SIRI might be used in combination with other clinical findings in the prediction of poor perinatal outcomes.
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Affiliation(s)
- Atakan Tanacan
- Perinatology Clinic, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Deniz Oluklu
- Perinatology Clinic, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Bergen Laleli Koc
- Perinatology Clinic, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Selcan Sinaci
- Perinatology Clinic, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Dilek Menekse Beser
- Perinatology Clinic, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Derya Uyan Hendem
- Perinatology Clinic, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Muradiye Yildirim
- Perinatology Clinic, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Bedri Sakcak
- Perinatology Clinic, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Berhan Besimoglu
- Perinatology Clinic, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Duygu Tugrul Ersak
- Perinatology Clinic, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Betul Akgun Aktas
- Perinatology Clinic, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Esra Gulen Yildiz
- Perinatology Clinic, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Serpil Unlu
- Department of Infectious Diseases, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Ozgur Kara
- Perinatology Clinic, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Evrim Alyamac Dizdar
- Neonatal Intensive Care Unit, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Fuat Emre Canpolat
- Neonatal Intensive Care Unit, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - İhsan Ates
- Department of Internal Medicine, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Ozlem Moraloglu Tekin
- Department of Obstetrics and Gynecology, University of Health Sciences, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Dilek Sahin
- Department of Obstetrics and Gynecology, University of Health Sciences, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
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12
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Aytekin O, Cakir C, Unsal M, Celik F, Tokalioglu AA, Kilic F, Ersak B, Codal B, Kahraman A, Gokkaya M, Ayhan S, Akar S, Cesur N, Erdogan F, Ozdal B, Oktar O, Koc S, Boran N, Comert GK, Ureyen I, Toptas T, Korkmaz V, Ustun Y, Tekin OM, Turkmen O, Turan T. Clinicopathological features of atypical glandular cells, not otherwise specified, on cervicovaginal pap smears. Cytopathology 2023; 34:130-137. [PMID: 36571109 DOI: 10.1111/cyt.13204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 11/30/2022] [Accepted: 12/14/2022] [Indexed: 12/27/2022]
Abstract
OBJECTIVE The Papanicolaou (Pap) smear test is a standard screening test that detects cervical lesions and cancers. In this multicentric study, we performed a retrospective analysis of cytological results associated with atypical glandular cells, not otherwise specified (AGC-NOS). METHODS We retrospectively reviewed Pap smear tests that resulted as AGC-NOS. A total of 254 women who underwent colposcopy due to a Pap smear result of AGC-NOS were included the study between 2003 and 2021. The ages, Pap smear results, HPV results if any, colposcopic biopsy results, endocervical and endometrial pathology results, and management of these patients were analysed. RESULTS Two hundred fifty-four patients with AGC-NOS Pap smear results were included in the study. A total of 70 (27.6%) patients had cervical and endometrial premalignant or malignant lesions. Malignancy was observed in 17 (6.7%) patients (endometrium, n = 11 [4.3%]; cervix, n = 6 [2.4%]). Isolated premalignant or malignant lesions of the cervix and endometrium were detected in 57 (22.4%) and 12 (4.7%) patients, respectively. CONCLUSIONS Patients diagnosed with AGC-NOS should undergo a careful evaluation with all clinicopathological features. Because cancer of the cervix and endometrium is not rare in patients diagnosed with AGC-NOS, colposcopic examination with endocervical sampling should be a priority based on a cervicovaginal smear. Endometrial sampling is also required according to the patient's clinic, age, and examination characteristics.
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Affiliation(s)
- Okan Aytekin
- Department of Gynecologic Oncology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Caner Cakir
- Department of Gynecologic Oncology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Mehmet Unsal
- Department of Gynecologic Oncology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Fatih Celik
- Department of Gynecologic Oncology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | | | - Fatih Kilic
- Department of Gynecologic Oncology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Burak Ersak
- Department of Gynecologic Oncology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Bahadır Codal
- Department of Gynecologic Oncology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Alper Kahraman
- Department of Gynecologic Oncology, Antalya Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Antalya, Turkey
| | - Mustafa Gokkaya
- Department of Gynecologic Oncology, Antalya Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Antalya, Turkey
| | - Sevgi Ayhan
- Department of Gynecologic Oncology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Serra Akar
- Department of Gynecologic Oncology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Nesibe Cesur
- Department of Pathology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Fazli Erdogan
- Department of Pathology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Bulent Ozdal
- Department of Gynecologic Oncology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Okan Oktar
- Department of Gynecologic Oncology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Sevgi Koc
- Department of Gynecologic Oncology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Nurettin Boran
- Department of Gynecologic Oncology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Gunsu Kimyon Comert
- Department of Gynecologic Oncology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Isin Ureyen
- Department of Gynecologic Oncology, Antalya Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Antalya, Turkey
| | - Tayfun Toptas
- Department of Gynecologic Oncology, Antalya Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Antalya, Turkey
| | - Vakkas Korkmaz
- Department of Gynecologic Oncology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Yaprak Ustun
- Department of Gynecologic Oncology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Ankara, Turkey
| | - Ozlem Moraloglu Tekin
- Department of Gynecologic Oncology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Osman Turkmen
- Department of Gynecologic Oncology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Taner Turan
- Department of Gynecologic Oncology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
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13
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Unal S, Demirel N, Tokgoz-Cuni B, İyigün F, Moraloglu Tekin O, Baş AY. In-Hospital Newborn Falls and Near Miss Events: A Need to Report. Am J Perinatol 2023. [PMID: 36848934 DOI: 10.1055/s-0043-1764209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
OBJECTIVE This study aimed to evaluate the clinical characteristics of the neonates who fell in the maternity ward and identify the incidence of near miss events during the immediate postpartum period. STUDY DESIGN The study consisted of two steps. The retrospective part included the evaluation of admissions due to the in-hospital newborn fall for 6 years. The prospective part included the assessment of the near miss events (any probability of falling of the newborn; either cosleeping or an incident with a possible consequence of falling of the newborn) in the postpartum clinic (<72 hours after delivery) for a period of 4 weeks. The details of the events and clinical outcomes were recorded. A questionnaire about fatigue was administered to mothers who experienced near miss event. RESULTS Seventeen in-hospital newborn falls were recorded: 1.8 to 2.4/10,000 live births. The median age of the neonates when the fall occurred was 22 (16-34) postnatal hours. Fourteen events (82%) occurred between 10 p.m. and 6 a.m. All neonates who experienced a fall were discharged without any known adverse outcomes. Twelve mothers (71%) had experienced a near miss event before. In the prospective arm of the study, 67 out of 804 mothers (8.3%) were found to experience a near miss event (44/1,000 days of postpartum hospitalization). Thirty-two events (49%) occurred in the first postpartum day. Fifty-two events (78%) occurred between 10 p.m. and 6 a.m. Fifty-eight mothers (86%) had no companion. Sixty-three percent of the mothers expressed intense fatigue after delivery. CONCLUSION In-hospital newborn fall may occur in the postpartum period, and near miss events should warn clinicians for a probable fall event. The nighttime shift requires more attention regarding the prevention of both the fall and the near miss events. Immediate postpartum mothers are needed to be observed carefully. KEY POINTS · In-hospital newborn falls occurred mainly during the night shift.. · Nearly two-third of the mothers whose newborn was fallen experienced a previous near miss event.. · Any near miss event in the hospital was detected in 8.3% of mothers..
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Affiliation(s)
- Sezin Unal
- Department of Neonatology, Etlik Zubeyde Hanım Women's Health Teaching and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Nihal Demirel
- Division of Neonatology, Department of Pediatrics, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Betül Tokgoz-Cuni
- Department of Neonatology, Etlik Zubeyde Hanım Women's Health Teaching and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Fatma İyigün
- Department of Neonatology, Etlik Zubeyde Hanım Women's Health Teaching and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Ozlem Moraloglu Tekin
- Department of Gynecology, Etlik Zubeyde Hanım Women's Health Teaching and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Ahmet Y Baş
- Division of Neonatology, Department of Pediatrics, Ankara Yildirim Beyazit University, Ankara, Turkey
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Ulubasoglu H, Bedir Fındık R, Keskin HL, Özcan D, Tekin OM, Karakaya J. The effect of sacral massage on meconium-stained amniotic fluid and the duration of fetal descent in labor: A randomized controlled trial. J Obstet Gynaecol Res 2023; 49:201-208. [PMID: 36268587 DOI: 10.1111/jog.15460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 08/30/2022] [Accepted: 09/28/2022] [Indexed: 01/19/2023]
Abstract
OBJECTIVE The aim of this study was to investigate the effect of sacral massage on the presence of meconium-stained amniotic fluid and the duration of fetal descent during labor in pregnant women. METHODS A total of 220 nulliparous women with singleton low-risk pregnancies in the vertex position at term were recruited. Eligible women were randomly assigned to either massage group or a control group. The massages were performed with friction and tapotement protocol. The massage was applied for 10 min each time by a midwife who is also an expert in the field, at the onset of contractions during the intrapartum period, when cervical dilatation reached 10 cm. The Wong-Baker faces pain rating scale was evaluated. RESULTS No significant difference was found between the length of the first stage of labor and the total length of delivery (p = 0.097 and 0.434), respectively. There was a significant difference between the two groups in terms of perineal injuries. Perineal injury was lower in the massaged group (p = 0.005). There was a low percentage of meconium-stained amniotic fluid in the massaged group. The difference between the groups was statistically significant. The duration of fetal descent was shorter in the massaged group (p < 0.001). A significant difference was found in Wong-Baker FACES pain rating scale scores. Lower scores were detected in the massaged group (p < 0.001). CONCLUSION Sacral massage has beneficial effects on mothers and babies in obstetric practice. In addition, applying massage during labor plays a significant role in reducing the presence of meconium-stained amniotic fluid and the duration of fetal descent.
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Affiliation(s)
- Hasan Ulubasoglu
- Department of Obstetrics and Gynecology, Health Sciences University, Ankara City Hospital, Ankara, Turkey
| | - Rahime Bedir Fındık
- Department of Obstetrics and Gynecology, Health Sciences University, Ankara City Hospital, Ankara, Turkey
| | - Hüseyin Levent Keskin
- Department of Obstetrics and Gynecology, Health Sciences University, Ankara City Hospital, Ankara, Turkey
| | - Damla Özcan
- Department of Obstetrics and Gynecology, Health Sciences University, Ankara City Hospital, Ankara, Turkey
| | - Ozlem Moraloglu Tekin
- Department of Obstetrics and Gynecology, Health Sciences University, Ankara City Hospital, Ankara, Turkey
| | - Jale Karakaya
- Department of Biostatistics, Hacettepe University, Medical Faculty, Ankara, Turkey
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Elmas B, Ercan N, Ersak DT, Ozdemir EU, Çelik IH, Tapisiz OL, Akay A, Yucel E, Armangil M, Tekin OM. Risk factors for brachial plexus injury and permanent sequelae due to shoulder dystocia. Niger J Clin Pract 2022; 25:2016-2023. [PMID: 36537460 DOI: 10.4103/njcp.njcp_464_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
AIM The primary aim of this study was to determine the risk factors for the occurrence of brachial plexus injury in cases of shoulder dystocia. Secondly, it was aimed to determine the factors affecting the occurrence of permanent sequelae in cases with brachial plexus injury. SUBJECTS AND METHODS ICD-10 codes were scanned from the records of patients who gave birth between 2012 and 2018, and the records of patients with brachial plexus injury and shoulder dystocia were reached. Shoulder dystocia cases with brachial plexus damage were accepted as the study group, and shoulder dystocia cases without brachial plexus damage were considered the control group. Shoulder dystocia patients with brachial plexus injury and without injury were compared for 2-year orthopedics clinic follow-up reports, surgical intervention, permanent sequelae status as well as birth data, maternal characteristics, and maneuvers applied to the management of shoulder dystocia. RESULTS Five hundred sixty births with shoulder dystocia were detected. Brachial plexus injury was observed in 88 of them, and permanent sequelae were detected in 12 of these patients. Maneuvers other than McRobert's (advanced maneuvers) were used more and clavicle fracture was seen more in the group with plexus injury (P < 0.05, P < 0.05, respectively). Logistic regression analysis was performed to determine the risk factors of brachial plexus injury. Brachial plexus injury was observed 4.746 times more in infants who were delivered with advanced maneuvers and 3.58 times more in infants with clavicle fractures at birth. CONCLUSION In patients with shoulder dystocia, the risk of brachial plexus injury increased in deliveries in which advanced maneuvers were used and clavicle fracture occurred.
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Affiliation(s)
- B Elmas
- Department of Gynecology and Obstetrics, University of Health Sciences Ankara City Hospital, Ankara, Nigeria
| | - N Ercan
- Department of Orthopedics and Traumatology, Ankara Training and Research Hospital, Ankara, Nigeria
| | - D T Ersak
- Department of Gynecology and Obstetrics, University of Health Sciences Ankara City Hospital, Ankara, Nigeria
| | - E U Ozdemir
- Department of Gynecology and Obstetrics, University of Health Sciences Ankara City Hospital, Ankara, Nigeria
| | - I H Çelik
- Department of Neonatology, University of Health Sciences Etlik Zübeyde Hanım Women's Health Training and Research Hospital, Ankara, Turkey
| | - O L Tapisiz
- Gynecology and Obstetrics Clinic, Private Güven Hospital, Ankara, Turkey
| | - A Akay
- Department of Gynecology and Obstetrics, University of Health Sciences Etlik Zübeyde Hanım Women's Health Training and Research Hospital, Ankara, Turkey
| | - E Yucel
- Department of Gynecology and Obstetrics, University of Health Sciences Etlik Zübeyde Hanım Women's Health Training and Research Hospital, Ankara, Turkey
| | - M Armangil
- Department of Orthopedics and Traumatology, Division of Hand Surgery, Ankara University Faculty of Medicine, Ankara, Turkey
| | - O M Tekin
- Department of Gynecology and Obstetrics, University of Health Sciences Ankara City Hospital, Ankara, Nigeria
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Kahyaoglu S, Ozaksit MG, Kahyaoglu I, Filiz AA, Pekcan MK, Atalay E, Tekin OM. Does Coronavirus Disease-19 Infection Affect Ovarian Reserve in Infertile Women? A Retrospective Study. J Hum Reprod Sci 2022; 15:357-361. [PMID: 37033136 PMCID: PMC10077751 DOI: 10.4103/jhrs.jhrs_121_22] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 09/26/2022] [Accepted: 11/22/2022] [Indexed: 04/11/2023] Open
Abstract
Background Previous studies have revealed menstrual changes following coronavirus disease-19 (COVID-19) disease. The potential impact of COVID-19 on female reproductive organs, ovary in particular, has not been investigated thoroughly. Aims The aim of this study was to evaluate changes in serum levels of follicle-stimulating hormone (FSH), luteinising hormone (LH) and oestradiol (E2) following COVID-19 disease as a surrogate for the detection of ovarian vulnerability to SARS-CoV-2 infection. Settings and Design In this retrospective study, hospital records of unexplained infertile women between 21 and 40 years old who have attended our institution's reproductive medicine unit for evaluation and/or treatment of infertility have been evaluated. Materials and Methods Menstrual cycle day 2-5 serum follicle-stimulating hormone, luteinising hormone and E2 levels of 28 infertile women have been studied both before and after the COVID-19 disease to evaluate ovarian reserve before the ovulation induction treatment cycle. Statistical Analysis Used The demographic characteristics and hormonal results of these 28 unexplained infertile women have been compared. The Shapiro-Wilk test has been used to evaluate the normal distribution of variables. Comparison of ovarian reserve markers which were established before and after COVID-19 infection has been performed using paired samples t-test. Results All patients except one have shown mild COVID-19 symptoms and their infection courses have resulted in uneventful recovery. Serum FSH, LH and E2 levels of 24 (85%) and serum anti-Müllerian hormone (AMH) levels of 4 (15%) patients have been evaluated before and after COVID-19 disease is statistically similar. Conclusion COVID-19 disease or inflammatory response of the infection itself does not seem to affect pituitary gonadotropins and ovarian hormones in infertile women based on menstrual cycle day 2-5 serum FSH, LH, E2 and AMH levels. Further studies including higher patient numbers are urgently needed to clarify the potential effects of COVID-19 disease on the gonadal function of women.
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Affiliation(s)
- Serkan Kahyaoglu
- Department of Reproductive Endocrinology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Muzeyyen Gulnur Ozaksit
- Department of Reproductive Endocrinology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Inci Kahyaoglu
- Department of Reproductive Endocrinology, Etlik Zubeyde Hanim Women's Health and Education Hospital, University of Health Sciences, Ankara, Turkey
| | - Ahmet Arif Filiz
- Department of Reproductive Endocrinology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Meryem Kuru Pekcan
- Department of Reproductive Endocrinology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Ece Atalay
- Department of Reproductive Endocrinology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Ozlem Moraloglu Tekin
- Department of Reproductive Endocrinology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
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17
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Goncu Ayhan S, Turgut E, Ozden Tokalioglu E, Oluklu D, Sakcak B, Uyan Hendem D, Tanacan A, Moraloglu Tekin O, Sahin D. Post-COVID-19 fetal cardiac evaluation in moderate infection group of pregnant women. J Clin Ultrasound 2022; 50:630-635. [PMID: 35524502 PMCID: PMC9348261 DOI: 10.1002/jcu.23220] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 03/31/2022] [Accepted: 03/31/2022] [Indexed: 06/14/2023]
Abstract
PURPOSE To determine the long-term fetal cardiac effects of the SARS-CoV-2 infection in pregnant women recovered from moderate COVID-19 with fetal echocardiography (ECHO). METHODS Forty-five pregnant women that recovered from moderate COVID-19 (CRG) 4 weeks after the infection confirmation, were compared with 45 gestational and maternal age-matched control groups (CG) in terms of demographic features fetal cardiac morphological (sphericity index, cardiothoracic ratio), and functional (myocardial performance index, mitral E/A, tricuspid E/A, mitral and tricuspid annular plane systolic excursion) parameters. RESULTS There was no difference in demographic features between the groups. Fetal cardiac morphologic parameters were found to be similar between the two groups. When the fetal cardiac functional assessment of the two groups was compared, only mitral E/A ratio results were found to be statistically significantly lower in the CRG than in the control group (p = 0.030). CONCLUSION The fetal heart does not seem to be negatively affected by COVID-19 after recovery from moderate infection. These results about the fetal effect of SARS-CoV-2 may improve our limited knowledge of the utility of fetal ECHO in pregnant women who recovered from COVID-19.
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Affiliation(s)
- Sule Goncu Ayhan
- Department of Obstetrics and GynecologyMinistry of Health Ankara City HospitalAnkaraTurkey
| | - Ezgi Turgut
- Department of Obstetrics and GynecologyMinistry of Health Ankara City HospitalAnkaraTurkey
| | - Eda Ozden Tokalioglu
- Department of Obstetrics and GynecologyMinistry of Health Ankara City HospitalAnkaraTurkey
| | - Deniz Oluklu
- Department of Obstetrics and GynecologyMinistry of Health Ankara City HospitalAnkaraTurkey
| | - Bedri Sakcak
- Department of Obstetrics and GynecologyMinistry of Health Ankara City HospitalAnkaraTurkey
| | - Derya Uyan Hendem
- Department of Obstetrics and GynecologyMinistry of Health Ankara City HospitalAnkaraTurkey
| | - Atakan Tanacan
- Department of Obstetrics and GynecologyMinistry of Health Ankara City HospitalAnkaraTurkey
| | - Ozlem Moraloglu Tekin
- Department of Obstetrics and GynecologyMinistry of Health Ankara City HospitalAnkaraTurkey
- Department of Obstetrics and GynecologyUniversity of Health SciencesIstanbulTurkey
| | - Dilek Sahin
- Department of Obstetrics and GynecologyMinistry of Health Ankara City HospitalAnkaraTurkey
- Department of Obstetrics and GynecologyUniversity of Health SciencesIstanbulTurkey
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18
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Sahin D, Tanacan A, Erol SA, Anuk AT, Ozden Tokalioglu E, Yucel Yetiskin FD, Besimoglu B, Oguz Y, Goncu Ayhan S, Altinboga O, Unlu S, Ozcan N, Keskin HL, Moraloglu Tekin O. Experience of a tertiary pandemic centre on the labour and delivery of 337 pregnant women with COVID-19: a prospective cohort study from Turkey. J OBSTET GYNAECOL 2022; 42:1803-1810. [DOI: 10.1080/01443615.2022.2039907] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Dilek Sahin
- Department of Obstetrics and Gynecology, University of Health Sciences, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Atakan Tanacan
- Department of Obstetrics and Gynecology, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Seyit Ahmet Erol
- Department of Obstetrics and Gynecology, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Ali Taner Anuk
- Department of Obstetrics and Gynecology, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Eda Ozden Tokalioglu
- Department of Obstetrics and Gynecology, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Fatma Didem Yucel Yetiskin
- Department of Obstetrics and Gynecology, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Berhan Besimoglu
- Department of Obstetrics and Gynecology, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Yuksel Oguz
- Department of Obstetrics and Gynecology, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Sule Goncu Ayhan
- Department of Obstetrics and Gynecology, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Orhan Altinboga
- Department of Obstetrics and Gynecology, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Serpil Unlu
- Department of Infectious Diseases, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Namik Ozcan
- Department of Anesthesiology and Reanimation, University of Health Sciences, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Huseyin Levent Keskin
- Department of Obstetrics and Gynecology, University of Health Sciences, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Ozlem Moraloglu Tekin
- Department of Obstetrics and Gynecology, University of Health Sciences, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
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Sahin D, Tanacan A, Anuk AT, Sinaci S, Besimoglu B, Oluklu D, Hendem DU, Beser DM, Yildirim M, Sakcak B, Erol SA, Colakoglu Y, Ayhan SG, Turgut E, Unlu S, Canpolat FE, Izdes S, Turan S, Surel AA, Tekin OM. Comparison of clinical features and perinatal outcomes between pre-variant and post-variant periods in pregnant women with SARS-CoV-2: analysis of 1935 cases. Arch Gynecol Obstet 2022; 306:1939-1948. [PMID: 35257193 PMCID: PMC8901098 DOI: 10.1007/s00404-022-06493-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 02/25/2022] [Indexed: 12/20/2022]
Abstract
Purpose To compare the clinical features and perinatal outcomes of pregnant women with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the pre-variant and post-variant periods. Methods This prospective cohort study includes pregnant women with SARS-CoV-2 who were followed-up at Ankara City Hospital between 11, March 2020 and 15, September 2021. Demographic features, clinical characteristics and pregnancy outcomes were compared between the pre-variant (n = 1416) and post-variant (n = 519) groups. Results The rates of severe and critical cases significantly increased in the post-variant group (9.7% vs 2%, p < 0.001). The rates of respiratory support (26.8% vs 7.3%, p < 0.001), ICU admission (12.9% vs 1.8%, p < 0.001) and maternal mortality (2.9% vs 0.4%, p < 0.001) were significantly higher in the post-variant group. A significant increase was observed for pregnancy complications in the post-variant group (45.6% vs 18.8%, p = 0.007). The rates of preterm delivery (26.4% vs 4.4%, p < 0.001) and NICU admission (34% vs 18.8%, p < 0.001) were significantly higher in the post-variant group. Positive, weak, statistically significant correlations were observed between the post-variant period, disease severity and maternal mortality (r = 0.19, r = 0.12 and p < 0.001). Conclusion Post-variant COVID-19 period was associated with a severe course of the disease and increased rates of adverse obstetric outcomes in pregnant patients.
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Affiliation(s)
- Dilek Sahin
- Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Atakan Tanacan
- Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, 06800, Ankara, Turkey.
| | - Ali Taner Anuk
- Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, 06800, Ankara, Turkey
| | - Selcan Sinaci
- Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, 06800, Ankara, Turkey
| | - Berhan Besimoglu
- Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, 06800, Ankara, Turkey
| | - Deniz Oluklu
- Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, 06800, Ankara, Turkey
| | - Derya Uyan Hendem
- Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, 06800, Ankara, Turkey
| | - Dilek Menekse Beser
- Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, 06800, Ankara, Turkey
| | - Muradiye Yildirim
- Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, 06800, Ankara, Turkey
| | - Bedri Sakcak
- Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, 06800, Ankara, Turkey
| | - Seyit Ahmet Erol
- Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, 06800, Ankara, Turkey
| | - Yeliz Colakoglu
- Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, 06800, Ankara, Turkey
| | - Sule Goncu Ayhan
- Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, 06800, Ankara, Turkey
| | - Ezgi Turgut
- Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, 06800, Ankara, Turkey
| | - Serpil Unlu
- Department of Infectious Diseases, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Fuat Emre Canpolat
- Division of Neonatology, Department of Pediatrics, Head of Center for Clinical Research, Turkish Ministry of Health Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Seval Izdes
- Intensive Care Clinic, Turkish Ministry of Health Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Sema Turan
- Intensive Care Clinic, Ankara Yildirim Beyazit University, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Aziz Ahmet Surel
- Coordinator Head Physician of Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Ozlem Moraloglu Tekin
- Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, University of Health Sciences, Ankara, Turkey
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Tanacan A, Erol SA, Anuk AT, Yetiskin FDY, Tokalioglu EO, Sahin S, Unlu S, Keskin HL, Surel AA, Tekin OM, Sahin D. The Association of Serum Electrolytes with Disease Severity and Obstetric Complications in Pregnant Women with COVID-19: a Prospective Cohort Study from a Tertiary Reference
Center. Geburtshilfe Frauenheilkd 2022; 82:326-332. [PMID: 35250381 PMCID: PMC8893987 DOI: 10.1055/a-1577-3249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 08/01/2021] [Indexed: 11/03/2022] Open
Abstract
Abstract
Introduction To evaluate the association of serum electrolytes with disease severity and obstetric complications in pregnant women with Coronavirus disease 2019 (COVID-19).
Materials and Methods This prospective cohort study was conducted on pregnant women with confirmed COVID-19. Study population was divided into two groups: 1) Mild COVID-19 group
(n = 811) and 2) Moderate/severe COVID-19 group (n = 52). Demographic features, clinical characteristics, obstetric complications, and serum electrolytes were compared between the groups.
Afterward, a correlation analysis was performed to investigate the association between serum electrolyte disturbances with COVID-19 severity and obstetric complications.
Results Highest serum sodium, hypernatremia, potassium replacement, hypopotassemia, hyperchloremia, initial serum magnesium, hypermagnesemia, and hypocalcemia were significantly
higher in the moderate/severe COVID-19 group. The lowest serum sodium, lowest serum potassium, and initial serum calcium were significantly higher in the mild COVID-19 group (p < 0.05).
Statistically significant positive weak correlations were found between hypernatremia, hypopotassemia, hyperchloremia, hypermagnesemia, hypocalcemia and COVID-19 severity (r values were
0.27, 0.20, 0.12, 0.18 and 0.12, p values were < 0.001, < 0.001, 0.02, 0.03 and 0.03, respectively). Furthermore, statistically significant positive weak correlations were found
between hypopotassemia, hypochloremia, hypermagnesemia, and obstetric complications (r values were 0.10, 0.10, and 0.28, p values were 0.004, 0.03, and 0.001, respectively). A statistically
significant negative weak correlation was found between hypomagnesemia and obstetric complications (r = − 0.23 and p = 0.01, respectively).
Conclusion Electrolyte disturbances in pregnant women with COVID-19 seem to be associated with disease severity and obstetric complications.
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Affiliation(s)
- Atakan Tanacan
- Department of Obstetrics and Gynecology, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Seyit Ahmet Erol
- Department of Obstetrics and Gynecology, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Ali Taner Anuk
- Department of Obstetrics and Gynecology, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Fatma Didem Yucel Yetiskin
- Department of Obstetrics and Gynecology, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Eda Ozden Tokalioglu
- Department of Obstetrics and Gynecology, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Selin Sahin
- Department of Obstetrics and Gynecology, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Serpil Unlu
- Department of Infectious Diseases, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Huseyin Levent Keskin
- Department of Obstetrics and Gynecology, Turkish Ministry of Health, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Aziz Ahmet Surel
- Coordinator Head Physician of Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Ozlem Moraloglu Tekin
- Department of Obstetrics and Gynecology, Turkish Ministry of Health, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Dilek Sahin
- Department of Obstetrics and Gynecology, Turkish Ministry of Health, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
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21
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Goncu Ayhan S, Turgut E, Oluklu D, Ozden Tokalioglu E, Menekse Beser D, Moraloglu Tekin O, Sahin D. Influence of Covid-19 infection on fetal thymus size after recovery. J Perinat Med 2022; 50:139-143. [PMID: 34881540 DOI: 10.1515/jpm-2021-0322] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 10/20/2021] [Indexed: 01/02/2023]
Abstract
OBJECTIVES To investigate the long-term effects of the SARS-CoV-2 infection on the fetal immune system by fetal thymus size measurements with ultrasound (USG). METHODS This prospective study was conducted in the Turkish Ministry of Health Ankara City Hospital between November 1, 2020 and April 1, 2021, with recovered, pregnant women, four weeks after they had been confirmed for the SARS-CoV-2 infection by real-time polymerase-chain-reaction (RT-PCR). COVID-19 recovered (CR) pregnant women compared with age-matched pregnant controls in terms of demographic features, fetal thymic-thoracic ratio (TTR), and laboratory parameters. RESULTS There was no difference in demographic features between the two groups. TTR found significantly lower in the CR group than the control group (p=0.001). The fetal TTR showed a significant and moderate correlation with maternal monocyte counts, monocyte to lymphocyte ratio (MLR), and red cell distribution width (RDW); while it did not correlate with lymphocyte counts, c-reactive protein (CRP), and procalcitonin levels. CONCLUSIONS The 2019 novel coronavirus disease (COVID-19) reduces fetal thymus size in pregnant women with mild or moderate symptoms after recovery from the infection.
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Affiliation(s)
- Sule Goncu Ayhan
- Department of Obstetrics and Gynecology, Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Ezgi Turgut
- Department of Obstetrics and Gynecology, Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Deniz Oluklu
- Department of Obstetrics and Gynecology, Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Eda Ozden Tokalioglu
- Department of Obstetrics and Gynecology, Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Dilek Menekse Beser
- Department of Obstetrics and Gynecology, Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Ozlem Moraloglu Tekin
- Department of Obstetrics and Gynecology, Ministry of Health Ankara City Hospital, Ankara, Turkey
- University of Health Sciences, Istanbul, Turkey
| | - Dilek Sahin
- Department of Obstetrics and Gynecology, Ministry of Health Ankara City Hospital, Ankara, Turkey
- University of Health Sciences, Istanbul, Turkey
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22
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Sinaci S, Moraloglu Tekin O, Sahin D. Response to the concern that the baseline change in CTG traces does not reflect the impact of maternal COVID-19. J Perinat Med 2022; 50:231. [PMID: 34826369 DOI: 10.1515/jpm-2021-0583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 11/11/2021] [Indexed: 11/15/2022]
Affiliation(s)
- Selcan Sinaci
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Ozlem Moraloglu Tekin
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
- University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Dilek Sahin
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
- University of Health Sciences, Ankara City Hospital, Ankara, Turkey
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23
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Ozgu-Erdinc AS, Sert UY, Kansu-Celik H, Moraloglu Tekin O, Engin-Ustun Y. Prediction of gestational diabetes mellitus in the first trimester by fasting plasma glucose which cutoff is better? Arch Physiol Biochem 2022; 128:195-199. [PMID: 31573373 DOI: 10.1080/13813455.2019.1671457] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVE We aimed to predict subsequent gestational diabetes mellitus (GDM) by fasting plasma glucose (FPG) in the first trimester. METHODS Healthy pregnant women who were screened for GDM at 24-28 gestational weeks and had FPG levels calculated during their first antenatal visit and less than 14 gestational weeks were included in this study. RESULTS Of the 2605 women who were recruited for the study, 245 (9.4%) were diagnosed with GDM at weeks 24-28. The diagnostic accuracy for FPG predicting GDM was 66.5, 78.4, and 88.2 for the cutoff values of 87.5 mg/dl, 92 mg/dl, and 99.5 mg/dl, respectively. CONCLUSIONS FPG values which are within the normoglycaemic range constitute an independent risk factor for the development of GDM. The threshold for gestational diabetes diagnosis must be revised.
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Affiliation(s)
- A Seval Ozgu-Erdinc
- Dr. Zekai Tahir Burak Women's Health Care, Education and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Umit Yasemin Sert
- Dr. Zekai Tahir Burak Women's Health Care, Education and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Hatice Kansu-Celik
- Dr. Zekai Tahir Burak Women's Health Care, Education and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Ozlem Moraloglu Tekin
- Dr. Zekai Tahir Burak Women's Health Care, Education and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Yaprak Engin-Ustun
- Dr. Zekai Tahir Burak Women's Health Care, Education and Research Hospital, University of Health Sciences, Ankara, Turkey
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24
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Sinaci S, Ocal DF, Ozden Tokalioglu E, Halici Ozturk F, Aydin Senel S, Keskin LH, Moraloglu Tekin O, Sahin D. Cardiotocographic features in COVID-19 infected pregnant women. J Perinat Med 2022; 50:46-55. [PMID: 34411469 DOI: 10.1515/jpm-2021-0132] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 07/22/2021] [Indexed: 12/27/2022]
Abstract
OBJECTIVES We aimed to evaluate the cardiotocograph (CTG) traces of 224 women infected with novel coronavirus 2019 (COVID-19) and analyze whether changes in the CTG traces are related to the severity of COVID-19. METHODS We designed a prospective cohort study. Two-hundred and twenty-four women who had a single pregnancy of 32 weeks or more, and tested positive for SARS-CoV-2 were included. Clinical diagnosis and classifications were made according to the Chinese management guideline for COVID-19 (version 6.0). Patients were classified into categories as mild, moderate, severe and the CTG traces were observed comparing the hospital admission with the third day of positivity. RESULTS There was no statistically significant relationship between COVID-19 severity and CTG category, variability, tachycardia, bradycardia, acceleration, deceleration, and uterine contractility, Apgar 1st and 5th min. CONCLUSIONS Maternal COVID-19 infection can cause changes that can be observed in CTG. Regardless of the severity of the disease, COVID-19 infection is associated with changes in CTG. The increase in the baseline is the most obvious change.
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Affiliation(s)
- Selcan Sinaci
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Doga Fatma Ocal
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Eda Ozden Tokalioglu
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Filiz Halici Ozturk
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Selvi Aydin Senel
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Levent Huseyin Keskin
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey.,University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Ozlem Moraloglu Tekin
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey.,University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Dilek Sahin
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey.,University of Health Sciences, Ankara City Hospital, Ankara, Turkey
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25
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Baser E, Aydogan Kirmizi D, Ozelci R, Aldemir O, Dilbaz B, Dilbaz S, Moraloglu Tekin O. Neutrophil:lymphocyte and estradiol:progesterone ratios as predictive markers for ovarian hyperstimulation syndrome (OHSS). Reprod Fertil Dev 2021; 34:343-349. [PMID: 34914886 DOI: 10.1071/rd21182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Accepted: 11/18/2021] [Indexed: 11/23/2022] Open
Abstract
This study was based on the pathophysiology of the disease and aimed at predicting ovarian hyperstimulation syndrome (OHSS) by determining the importance of ratios obtained from the inflammatory process associated with oestradiol and progesterone in recent years. Out of 242 infertile women who underwent assisted reproductive therapy, 59 patients who developed OHSS were taken as the study group, while the remaining 122 normo-responder (NR) and 61 hyper-responder (HR) patients constituted the control group. The neutrophil to lymphocyte (NLR) and oestradiol/progesterone (EPR) ratios were found to be statistically significantly higher in the OHSS group (P<0.001). A multivariate logistic regression analysis revealed that the NLR (OR=2.410, P=0.001) and EPR (OR=1.701, P=0.028) were independent predictors for the development of OHSS. In conclusion, in OHSS inadequate progesterone levels may inhibit suppression of the exaggerated inflammatory process caused by high E2 levels, and NLR and EPR can be used to predict the development of OHSS in patients undergoing controlled ovarian hyperstimulation during in vitro fertilisation cycles.
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Affiliation(s)
- Emre Baser
- Department of Obstetrics and Gynecology, Faculty of Medicine, Yozgat Bozok University, Yozgat, Turkey
| | - Demet Aydogan Kirmizi
- Department of Obstetrics and Gynecology, Faculty of Medicine, Yozgat Bozok University, Yozgat, Turkey
| | - Runa Ozelci
- Department of Obstetrics and Gynecology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Ankara, Turkey
| | - Oya Aldemir
- Department of Obstetrics and Gynecology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Ankara, Turkey
| | - Berna Dilbaz
- Department of Obstetrics and Gynecology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Ankara, Turkey
| | - Serdar Dilbaz
- Department of Obstetrics and Gynecology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Ankara, Turkey
| | - Ozlem Moraloglu Tekin
- Department of Obstetrics and Gynecology, Turkish Ministry of Health, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
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26
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Sahin D, Tanacan A, Erol SA, Yucel Yetiskin FD, Besimoglu B, Ozden Tokalioglu E, Anuk AT, Turgut E, Goncu Ayhan S, Turgay B, Unlu S, Kanmaz G, Dinc B, Ozgu-Erdinc AS, Keskin HL, Surel AA, Moraloglu Tekin O. Management of pregnant women with COVID-19: A tertiary pandemic center experience on 1416 cases. J Med Virol 2021; 94:1074-1084. [PMID: 34713913 PMCID: PMC8662099 DOI: 10.1002/jmv.27423] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 10/25/2021] [Accepted: 10/26/2021] [Indexed: 12/19/2022]
Abstract
The aim of this study is to share the comprehensive experience of a tertiary pandemic center on pregnant women with COVID-19 and to compare clinical outcomes between pregnancy trimesters. The present prospective cohort study consisted of pregnant women with COVID-19 who were followed up at Ankara City Hospital between March 11, 2020 and February 20, 2021. Clinical characteristics and perinatal outcomes were compared between the pregnancy trimesters. A total of 1416 pregnant women (1400 singletons and 16 twins) with COVID-19 were evaluated. Twenty-six (1.8%) patients were admitted to the intensive care unit (ICU) and maternal mortality was observed in six (0.4%) cases. Pregnancy complications were present in 227 (16.1%) cases and preterm labor was the most common one (n = 42, 2.9%). There were 311, 433, and 672 patients in the first, second, and third trimesters of pregnancy, respectively. Rates of mild and severe/critic COVID-19 were highest in the first and second trimesters, respectively. The hospitalization rate was highest in the third trimester. Pregnancy complications, maternal mortality, and NICU admission rates were similar between the groups. The course of the disease and obstetric outcomes may be different among pregnancy trimesters. A worse course of the disease may be observed even in pregnant women without any coexisting health problems.
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Affiliation(s)
- Dilek Sahin
- Department of Obstetrics and Gynecology, University of Health Sciences, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Atakan Tanacan
- Department of Obstetrics and Gynecology, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Seyit Ahmet Erol
- Department of Obstetrics and Gynecology, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Fatma Didem Yucel Yetiskin
- Department of Obstetrics and Gynecology, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Berhan Besimoglu
- Department of Obstetrics and Gynecology, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Eda Ozden Tokalioglu
- Department of Obstetrics and Gynecology, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Ali Taner Anuk
- Department of Obstetrics and Gynecology, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Ezgi Turgut
- Department of Obstetrics and Gynecology, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Sule Goncu Ayhan
- Department of Obstetrics and Gynecology, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Batuhan Turgay
- Department of Obstetrics and Gynecology, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey.,Department of Obstetrics and Gynecology, Yıldırım Beyazıt University, Ankara, Turkey
| | - Serpil Unlu
- Department of Infectious Diseases, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Gozde Kanmaz
- Department of Pediatrics, Division of Neonatology, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Bedia Dinc
- Department of Clinical Microbiology, Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - A Seval Ozgu-Erdinc
- Department of Obstetrics and Gynecology, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Huseyin Levent Keskin
- Department of Obstetrics and Gynecology, University of Health Sciences, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Aziz Ahmet Surel
- Department of General Surgery, Coordinator Head Physician of Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Ozlem Moraloglu Tekin
- Department of Obstetrics and Gynecology, University of Health Sciences, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
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27
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Sinaci S, Ocal DF, Yucel Yetiskin DF, Uyan Hendem D, Buyuk GN, Goncu Ayhan S, Tanacan A, Ozgu-Erdinc AS, Moraloglu Tekin O, Sahin D. Impact of vitamin D on the course of COVID-19 during pregnancy: A case control study. J Steroid Biochem Mol Biol 2021; 213:105964. [PMID: 34390830 PMCID: PMC8356729 DOI: 10.1016/j.jsbmb.2021.105964] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 08/04/2021] [Accepted: 08/09/2021] [Indexed: 12/27/2022]
Abstract
OBJECTIVE We aimed to evaluate the vitamin D status of pregnant women with COVID-19, and the association between vitamin D level and severity of COVID-19. METHODS In this case control study, 159 women with a single pregnancy and tested positive for SARS-CoV-2, and randomly selected 332 healthy pregnant women with similar gestational ages were included. COVID-19 patients were classified as mild, moderate, and severe. Vitamin D deficiency was defined as 25-hydroxycholecalciferol <20 ng/mL (50 nmol/L), and 25-OH D vitamin <10 ng/mL was defined as severe vitamin D deficiency, also 25-OH D vitamin level between 20-29 ng/mL (525-725 nmol/L) was defined as vitamin D insufficiency. RESULTS Vitamin D levels of the pregnant women in the COVID-19 group (12.46) were lower than the control group (18.76). 25-OH D vitamin levels of those in the mild COVID-19 category (13.69) were significantly higher than those in the moderate/severe category (9.06). In terms of taking vitamin D supplementation, there was no statistically significant difference between the groups. However, it was observed that all of those who had severe COVID-19 were the patients who did not take vitamin D supplementation. CONCLUSION The vitamin D levels are low in pregnant women with COVID-19. Also, there is a significant difference regarding to vitamin D level and COVID-19 severity in pregnant women. Maintenance of adequate vitamin D level can be useful as an approach for the prevention of an aggressive course of the inflammation induced by this novel coronavirus in pregnant women.
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Affiliation(s)
- Selcan Sinaci
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey.
| | - Doga Fatma Ocal
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | | | - Derya Uyan Hendem
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Gul Nihal Buyuk
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Sule Goncu Ayhan
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Atakan Tanacan
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - A Seval Ozgu-Erdinc
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Ozlem Moraloglu Tekin
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey; University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Dilek Sahin
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey; University of Health Sciences, Ankara City Hospital, Ankara, Turkey
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28
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Anuk AT, Polat N, Akdas S, Erol SA, Tanacan A, Biriken D, Keskin HL, Moraloglu Tekin O, Yazihan N, Sahin D. The Relation Between Trace Element Status (Zinc, Copper, Magnesium) and Clinical Outcomes in COVID-19 Infection During Pregnancy. Biol Trace Elem Res 2021; 199:3608-3617. [PMID: 33236293 PMCID: PMC7685187 DOI: 10.1007/s12011-020-02496-y] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 11/15/2020] [Indexed: 11/26/2022]
Abstract
SARS CoV-2 is a novel coronavirus which has caused many deaths in the recent pandemic. This study aimed to determine zinc, copper and magnesium status on pregnant women with COVID-19. 100 healthy (33/32/35) and 100 SARS-CoV-2 positive (34/33/33) pregnant women were included in the study according to their trimesters. Blood samples were obtained from the patients along with the initial laboratory tests for clinical outcomes upon their first admission to hospital. In the first and third trimesters serum zinc level was lower (p:0,004 and p:0,02), serum copper level was higher (p:0,006 and p:0,008), the Zn / Cu ratio decreased(p < 0.0001 and p < 0.0001) and the serum magnesium level was higher(p < 0.0001 and p < 0.0001) in the COVID-19 group.In the second trimester COVID-19 patients had lower serum zinc (p:0,05) and copper levels (p:0,0003) compared to controls. Disease severity correlated with zinc/copper ratio in COVID19 patients (p:0.018, r:-0.243). Serum zinc and Zn/Cu ratio levels had a negative relationship with acute phase markers such as IL-6, Erythrocyte Sedimentation Rate, procalcitonin and C-reactive Protein. Also, increased serum magnesium level may play a role in decreased white blood cell, neutrophil, lymphocyte cell count and increased CRP levels in the third trimester. This study indicated that trace element status changed in pregnant women with COVID-19. The effect of trace elements on pregnant women diagnosed with COVID-19 infection was investigated in comparison with healthy pregnant women for the first time. This effect will be revealed better in more comprehensive studies to be planned in the future.
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Affiliation(s)
- Ali Taner Anuk
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Naci Polat
- Department of Pathophysiology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Sevginur Akdas
- Institute of Health, Interdisciplinary Food, Metabolism and Clinical Nutrition Department, Ankara University, Ankara, Turkey
| | - Seyit Ahmet Erol
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Atakan Tanacan
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Derya Biriken
- Department of Microbiology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Huseyin Levent Keskin
- Department of Obstetrics and Gynecology, University of Health Sciences, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Ozlem Moraloglu Tekin
- Department of Obstetrics and Gynecology, University of Health Sciences, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Nuray Yazihan
- Department of Pathophysiology, Ankara University Faculty of Medicine, Ankara, Turkey.
- Institute of Health, Interdisciplinary Food, Metabolism and Clinical Nutrition Department, Ankara University, Ankara, Turkey.
| | - Dilek Sahin
- Department of Obstetrics and Gynecology, University of Health Sciences, Ministry of Health, Ankara City Hospital, Ankara, Turkey
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29
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Sarsmaz K, Kulah BB, Orgul G, Tonyalı NV, Yucel A, Tekin OM. Effectiveness of Moxibustion for Breech Presentation: A Prospective Study. Z Geburtshilfe Neonatol 2021; 226:112-120. [PMID: 34528235 DOI: 10.1055/a-1579-1436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To evaluate the moxibustion for turning fetuses from breech to vertex presentation. MATERIALS AND METHODS This was a single-center prospective study. All pregnant women carrying a fetus in breech presentation between the 32 and 35 gestational weeks were offered moxibustion application. The primary outcomes were vertex presentation at 37 weeks of gestation, vertex presentation at birth, and vaginal birth rates. A secondary analysis was performed to understand the effect of parity, type of breech presentation, body mass index (BMI), placental location, gender, and fetal birth weight on the presentation at birth. RESULTS There were 63 cases in the study group and 245 cases in the control group. The rate of vertex presentation at term was found to be higher in the moxibustion group compared to controls (66.7 vs. 48.2%, p=0.022). There were 45 (71.4%) and 131 (53.5%) fetuses with vertex presentation at birth in the study and control groups, respectively (p=0.020). Overall, vaginal delivery rate was higher in the study group (50.8 vs. 37.1%, p=0.048). Multiparity and higher birth weight were associated with increased rates of vertex presentation in the moxibustion and control groups. CONCLUSION Moxibustion application increased the rate of vertex presentation at birth and also vaginal delivery rate compared with expectant management. Offering moxibustion between the 32nd and 36th week of gestation may provide women with a singleton fetus in breech presentation an opportunity for a vaginal birth.
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Affiliation(s)
- Kemal Sarsmaz
- Division of Perinatology, Department of Obstetrics and Gynecology, Etlik Zubeyde Hanim Women's Health Care, Training and Research Hospital, Ankara, Turkey
| | - Belkiz Berna Kulah
- Department of Anesthesiology, Etlik Zubeyde Hanim Women's Health Care, Training and Research Hospital, Ankara, Turkey
| | - Gokcen Orgul
- Division of Perinatology, Department of Obstetrics and Gynecology, Etlik Zubeyde Hanim Women's Health Care, Training and Research Hospital, Ankara, Turkey
| | - Nazan Vanlı Tonyalı
- Division of Perinatology, Department of Obstetrics and Gynecology, Etlik Zubeyde Hanim Women's Health Care, Training and Research Hospital, Ankara, Turkey
| | - Aykan Yucel
- Division of Perinatology, Department of Obstetrics and Gynecology, Turkish Ministry of Health, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Ozlem Moraloglu Tekin
- Department of Obstetrics and Gynecology, Turkish Ministry of Health, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
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30
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Turgut E, Ayhan SG, Oluklu D, Tokalioglu EO, Tekin OM, Sahin D. Fetal pulmonary artery Doppler evaluation in pregnant women after recovery from COVID-19. Int J Gynaecol Obstet 2021; 155:450-454. [PMID: 34499751 PMCID: PMC9087611 DOI: 10.1002/ijgo.13916] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 09/06/2021] [Indexed: 12/02/2022]
Abstract
Objective To evaluate fetal lung development using pulmonary artery Doppler in pregnant women who had recovered from COVID‐19. Methods The prospective case–control study included 41 pregnant women who had recovered from COVID‐19 and 43 healthy pregnant women (control group). All the women in the study group had been diagnosed with COVID‐19 and had completed a quarantine period. Results The demographic data of patients were similar in the groups (P > 0.05). Main pulmonary artery peak systolic velocity was higher and pulsatility indices were lower in pregnant women who recovered from COVID‐19 compared to the controls (P < 0.001, P = 0.001). Acceleration time, ejection time, and acceleration/ejection time ratio (PATET) of the fetal MPA Doppler were significantly decreased in pregnant women who recovered from COVID‐19 (P < 0.001, P = 0.036, and P = 0.002, respectively). The patients who had recovered from COVID‐19 were divided into two groups: those treated with expectant management and those treated in hospital. The pulmonary artery acceleration time and PATET ratio were significantly lower in the group treated in the hospital (P = 0.023 and P = 0.045, respectively). Conclusion Detailed Doppler evaluations of the pulmonary artery may help in evaluating the fetal adverse effects of COVID‐19 disease. Detailed Doppler evaluations of the pulmonary artery may help in evaluating the fetal adverse effects of COVID‐19 disease.
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Affiliation(s)
- Ezgi Turgut
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Sule Goncu Ayhan
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Deniz Oluklu
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Eda Ozden Tokalioglu
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Ozlem Moraloglu Tekin
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Dilek Sahin
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
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Unlubilgin E, Tetik S, Aksoy I, Yuksel D, Tekin OM. Relationship Between Adult Separation Anxiety and Attachment Styles and Vaginismus. J Sex Med 2021; 18:1752-1758. [PMID: 37057497 DOI: 10.1016/j.jsxm.2021.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 05/30/2021] [Accepted: 07/08/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Vaginismus has an unknown etiology, is comorbid with anxiety, and is the most common sexual dysfunction in sexual dysfunction outpatient clinics in Turkey. AIM This study aimed to determine the frequency of adult separation anxiety disorder (ASAD) and styles of attachment in patients with vaginismus and to investigate its relationship with female sexual dysfunction. METHODS Sixty women with vaginismus and 60 healthy controls were compared using the Relationship Scales Questionnaire, Female Sexual Function Index (FSFI), and Adult Separation Anxiety Questionnaire (ASA-27). OUTCOMES We report the results of the questionnaires with their implication on the etiology of vaginismus. RESULTS Separation anxiety and fearful and dismissive avoidance attachment style in the vaginismus group were significantly higher than in the control group. Both total FSFI scores and arousal, pain, and satisfaction subscale scores were higher in the control group. CLINICAL IMPLICATIONS ASAD should be evaluated and addressed separately, when necessary, in the treatment of vaginismus. STRENGTHS & LIMITATIONS The relationship between ASAD and vaginismus has been shown for the first time. Study limitations included the assessment of factors influencing the study results based on self-reporting and possible recall bias. CONCLUSION Attachment and comorbidity research in vaginismus needs to shift from just reporting disturbances, to identify various clinical variables, such as the severity of the vaginismus, response to therapy, and differences in therapeutic modalities, in terms of outcome. Unlubilgin E, Tetik S, Aksoy I, et al. Relationship Between Adult Separation Anxiety and Attachment Styles and Vaginismus. J Sex Med 2021;18:1752-1758.
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Affiliation(s)
- Eylem Unlubilgin
- Etlik Zubeyde Hanim Gynecology Training and Research Hospital, University of Health Sciences, Ankara, Turkey.
| | - Sinan Tetik
- Etlik Zubeyde Hanim Gynecology Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Ihsan Aksoy
- Bolu Abant İzzet Baysal University, Bolu, Turkey
| | - Dilek Yuksel
- Etlik Zubeyde Hanim Gynecology Training and Research Hospital, University of Health Sciences, Ankara, Turkey
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Ayhan SG, Tanacan A, Atalay A, Sinaci S, Tokalioglu EO, Sahin D, Tekin OM. Assessment of fetal Doppler parameters in pregnant women with COVID-19 infection: a prospective case-control study. J Perinat Med 2021; 49:697-701. [PMID: 33660492 DOI: 10.1515/jpm-2020-0512] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 02/08/2021] [Indexed: 01/02/2023]
Abstract
OBJECTIVES To investigate the effect of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on fetal Doppler parameters. METHODS This was a prospective case-control study conducted in Ankara City Hospital with confirmed SARS-CoV-2 infected pregnants between August 1, 2020 and October 1, 2020. There were 54 COVID-19 confirmed pregnant women and 97 age-matched pregnant women as a control group between 28 and 39 weeks. Infection was confirmed based on positive real-time polymerase-chain reaction results. Demographic features, uterine artery (right, left), umblical artery, middle cerebral artery, ductus venosus, cerebro-placental ratio, and cerebral-placental-uterine ratio Doppler parameters were investigated in both groups. RESULTS Two groups were similar in terms of demographic features and no difference was found for fetal Doppler parameters. CONCLUSIONS COVID-19 seems to have no adverse effect on fetoplacental circulation in mild and moderate patients during the acute phase of the infection.
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Affiliation(s)
- Sule Goncu Ayhan
- Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Atakan Tanacan
- Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Aysegul Atalay
- Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Selcan Sinaci
- Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Eda Ozden Tokalioglu
- Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Dilek Sahin
- Department of Obstetrics and Gynecology, University of Health Sciences, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Ozlem Moraloglu Tekin
- Department of Obstetrics and Gynecology, University of Health Sciences, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
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Sinaci S, Ocal DF, Seven B, Anuk AT, Besimoglu B, Keven MC, Goncu Ayhan S, Akin MS, Tayman C, Keskin HL, Yapar Eyi EG, Dinc B, Moraloglu Tekin O, Sahin D. Vertical transmission of SARS-CoV-2: A prospective cross-sectional study from a tertiary center. J Med Virol 2021; 93:5864-5872. [PMID: 34081331 PMCID: PMC8242620 DOI: 10.1002/jmv.27128] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 06/01/2021] [Indexed: 12/22/2022]
Abstract
The aim was to investigate the association of the delivery mode and vertical transmission of severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2) through the samples of vaginal secretions, placenta, cord blood, or amniotic fluid as well as the neonatal outcomes. This cross‐sectional study presents an analysis of prospectively gathered data collected at a single tertiary hospital. Sixty‐three pregnant women with confirmed coronavirus disease 2019 (COVID‐19) participated in the study. Vertical transmission of SARS‐CoV‐2 was analyzed with reverse transcriptase‐polymerase chain reaction (RT‐PCR) tests and blood tests for immunoglobulin G (IgG)–immunoglobulin M (IgM) antibodies. All patients were in the mild or moderate category for COVID‐19. Only one placental sample and two of the vaginal secretion samples were positive for SARS‐CoV‐2. Except for one, all positive samples were obtained from patients who gave birth by cesarean. All cord blood and amniotic fluid samples were negative for SARS‐CoV‐2. Two newborns were screened positive for COVID‐19 IgG–IgM within 24 h after delivery, but the RT‐PCR tests were negative. A positive RT‐PCR result was detected in a neof a mother whose placenta, cord blood, amniotic fluid, and vaginal secretions samples were negative. He died due to pulmonary hemorrhage on the 11th day of life. In conclusion, we demonstrated that SARS‐CoV‐2 can be detectable in the placenta or vaginal secretions of pregnant women. Detection of the virus in the placenta or vaginal secretions may not be associated with neonatal infection. Vaginal delivery may not increase the incidence of neonatal infection, and cesarean may not prevent vertical transmission. The decision regarding the mode of delivery should be based on obstetric indications and COVID‐19 severity.
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Affiliation(s)
- Selcan Sinaci
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Doga F Ocal
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Banu Seven
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Ali T Anuk
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Berhan Besimoglu
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Mehmet C Keven
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Sule Goncu Ayhan
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Mustafa S Akin
- Division of Neonatology, Department of Pediatrics, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Cuneyt Tayman
- Division of Neonatology, Department of Pediatrics, Ministry of Health, Ankara City Hospital, Ankara, Turkey.,Ankara City Hospital, University of Health Sciences, Istanbul, Turkey
| | - Huseyin L Keskin
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey.,Ankara City Hospital, University of Health Sciences, Istanbul, Turkey
| | - Elif G Yapar Eyi
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Bedia Dinc
- Ankara City Hospital, University of Health Sciences, Istanbul, Turkey.,Department of Medical Microbiology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Ozlem Moraloglu Tekin
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey.,Ankara City Hospital, University of Health Sciences, Istanbul, Turkey
| | - Dilek Sahin
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey.,Ankara City Hospital, University of Health Sciences, Istanbul, Turkey
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Goncu Ayhan S, Oluklu D, Atalay A, Menekse Beser D, Tanacan A, Moraloglu Tekin O, Sahin D. COVID-19 vaccine acceptance in pregnant women. Int J Gynaecol Obstet 2021; 154:291-296. [PMID: 33872386 PMCID: PMC9087778 DOI: 10.1002/ijgo.13713] [Citation(s) in RCA: 161] [Impact Index Per Article: 53.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 04/16/2021] [Indexed: 12/11/2022]
Abstract
Objective To determine vaccine acceptance and hesitancy attitudes toward coronavirus disease 2019 (COVID‐19) vaccines in pregnant women. Methods Three hundred pregnant women were surveyed face to face with 40 questions. Sociodemographic characteristics, vaccination history, perception of risk for the COVID‐19 pandemic, the impact of the COVID‐19 pandemic, and acceptance of and attitude toward future COVID‐19 vaccination were prospectively evaluated. Results Among all participants, 111 (37%) stated their intent to receive the vaccine if it were recommended for pregnant women. Most common refusal reasons were lack of data about COVID‐19 vaccine safety in pregnant populations and possibility of harm to the fetus. There was a weak positive correlation between COVID‐19 vaccine acceptancy and number of school‐age children. Pregnant women in the first trimester expressed higher acceptance of COVID‐19 vaccination than those in the second and third trimesters. Conclusion The present study reported low acceptance of COVID‐19 vaccination in a sample of pregnant women. Concern about vaccine safety was the major reason for hesitancy. Identifying attitudes among priority groups will be useful for creating vaccination strategies that increase uptake during the current pandemic. Identifying attitudes among priority groups like pregnant women will be useful to create vaccination strategies in the prevention and control of COVID‐19.
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Affiliation(s)
- Sule Goncu Ayhan
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Deniz Oluklu
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Aysegul Atalay
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Dilek Menekse Beser
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Atakan Tanacan
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Ozlem Moraloglu Tekin
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Dilek Sahin
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
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Yenigül NN, Dilbaz S, Dilbaz B, Kaplanoğlu İ, Güçel F, Aldemir O, Baser E, Ozelci R, Moraloglu Tekin O. The effect of plastic bottled water consumption on outcomes of ICSI cycles undertaken for unexplained infertility. Reprod Biomed Online 2021; 43:91-99. [PMID: 34001442 DOI: 10.1016/j.rbmo.2021.04.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 04/03/2021] [Accepted: 04/12/2021] [Indexed: 10/21/2022]
Abstract
RESEARCH QUESTION Do bisphenol A (BPA) levels in maternal urine, serum and follicular fluid affect embryo quality and intracytoplasmic sperm hinjection (ICSI) cycle outcomes in women with unexplained infertility? DESIGN Prospective study conducted between 1 April 2019 and 30 September 2019. The study cohort consisted of 82 women aged between 23 and 33 years who underwent intracytoplasmic sperm injection owing to unexplained infertility and provided urine, blood and follicular fluid samples on the day of oocyte retrieval. Consumption of drinking water from plastic carboys or bottles at home were considered as chronic BPA exposure. Demographic features and IVF outcomes of the patients were collected. RESULTS Among the 82 women with unexplained infertility, clinical pregnancy was achieved in 22 (26.8%) patients after the IVF and embryo transfer cycle. The patients who consumed tap water had statistically significantly lower BPA values in three body fluids compared with patients who consumed plastic bottled water (all P < 0.001). Women who had grade 1 embryos transferred had lower serum BPA values than women who had grade 2 embryos transferred (10.8 ± 5.2 versus 26.9 ± 22 ng/ml, P = 0.003). Serum and follicular fluid BPA levels were statistically significantly higher in women who failed to achieve clinical pregnancy (P < 0.001, P = 0.006, respectively) and obtain a live birth (both P = 0.007). CONCLUSIONS A negative relationship was found between serum and follicular fluid BPA levels and embryo quality, clinical pregnancy and live birth in these women. In addition, the BPA levels of women who consume tap water at home were lower than those who use plastic bottled water.
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Affiliation(s)
- Nefise Nazlı Yenigül
- IVF Clinic of the University of Health Sciences School of Medicine, Etlik Zubeyde Hanım Research and Training Hospital, Ankara, Turkey.
| | - Serdar Dilbaz
- IVF Clinic of the University of Health Sciences School of Medicine, Etlik Zubeyde Hanım Research and Training Hospital, Ankara, Turkey
| | - Berna Dilbaz
- IVF Clinic of the University of Health Sciences School of Medicine, Etlik Zubeyde Hanım Research and Training Hospital, Ankara, Turkey
| | - İskender Kaplanoğlu
- IVF Clinic of the University of Health Sciences School of Medicine, Etlik Zubeyde Hanım Research and Training Hospital, Ankara, Turkey
| | - Funda Güçel
- IVF Clinic of the University of Health Sciences School of Medicine, Etlik Zubeyde Hanım Research and Training Hospital, Ankara, Turkey
| | - Oya Aldemir
- IVF Clinic of the University of Health Sciences School of Medicine, Etlik Zubeyde Hanım Research and Training Hospital, Ankara, Turkey
| | - Emre Baser
- Yozgat Bozok University Faculty of Medicine, Department of Obstetrics and Gynecology Yozgat, Turkey
| | - Runa Ozelci
- IVF Clinic of the University of Health Sciences School of Medicine, Etlik Zubeyde Hanım Research and Training Hospital, Ankara, Turkey
| | - Ozlem Moraloglu Tekin
- IVF Clinic of the University of Health Sciences School of Medicine, Etlik Zubeyde Hanım Research and Training Hospital, Ankara, Turkey
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Kilic C, Kimyon Comert G, Cakir C, Yuksel D, Codal B, Kilic F, Turkmen O, Karalok A, Moraloglu Tekin O, Boran N, Turan T. Recurrence pattern and prognostic factors for survival in cervical cancer with lymph node metastasis. J Obstet Gynaecol Res 2021; 47:2175-2184. [PMID: 33765693 DOI: 10.1111/jog.14762] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 02/16/2021] [Accepted: 03/09/2021] [Indexed: 11/29/2022]
Abstract
AIM The aim of this study is to evaluate the recurrence pattern and oncological outcomes in cervical cancer (CC) patients with lymph node metastasis. METHODS This study included 224 International Federation of Gynecology and Obstetrics (FIGO) 2009 stage IB1-IIIB CC patients with pathologically proven lymph node metastasis. Surgical intervention was grouped as hysterectomy performed/not performed. Adjuvant therapy decision was made by the tumor board. Radiotherapy was applied to all patients with lymph node metastasis. RESULTS Only paraaortic lymph node metastasis was determined as an independent prognostic factor for recurrence. Presence of paraaortic lymph node metastasis increased the risk of recurrence more than two times (odds ratio: 2.129; 95% confidence interval: 1.011-4.485; p = 0.047). An independent prognostic factor for death because of disease was age only. Risk of death was nearly doubled with younger age (odds ratio: 2.693; 95% confidence interval: 1.064-6.184; p = 0.037). CONCLUSION The most of recurrences were located at distant sites and multiple regions. Paraaortic lymph node metastasis was the only independent prognostic factor for recurrence, in spite of that age was an independent predictor for risk of death in patients with early stage or locally advanced CC and also with surgically proven metastatic lymph nodes. Furthermore, the presence of the paraaortic lymph node metastasis was significantly associated with distant recurrence. Therefore, more appropriate and individualized therapy strategy focusing on intenser systemic chemotherapy options in addition to radiotherapy should be taken into consideration according to paraaortic lymph node metastasis and age.
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Affiliation(s)
- Cigdem Kilic
- Health Sciences University Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Gynecologic Oncology Surgery Department, Ankara, Turkey
| | - Gunsu Kimyon Comert
- Health Sciences University Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Gynecologic Oncology Surgery Department, Ankara, Turkey
| | - Caner Cakir
- Health Sciences University Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Gynecologic Oncology Surgery Department, Ankara, Turkey
| | - Dilek Yuksel
- Health Sciences University Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Gynecologic Oncology Surgery Department, Ankara, Turkey
| | - Bahadır Codal
- Health Sciences University Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Gynecologic Oncology Surgery Department, Ankara, Turkey
| | - Fatih Kilic
- Health Sciences University Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Gynecologic Oncology Surgery Department, Ankara, Turkey
| | - Osman Turkmen
- Health Sciences University Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Gynecologic Oncology Surgery Department, Ankara, Turkey
| | - Alper Karalok
- Health Sciences University Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Gynecologic Oncology Surgery Department, Ankara, Turkey
| | - Ozlem Moraloglu Tekin
- Health Sciences University Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Gynecologic Oncology Surgery Department, Ankara, Turkey
| | - Nurettin Boran
- Health Sciences University Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Gynecologic Oncology Surgery Department, Ankara, Turkey
| | - Taner Turan
- Health Sciences University Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Gynecologic Oncology Surgery Department, Ankara, Turkey
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Tanacan A, Anuk AT, Erol SA, Keskin HL, Altinboga O, Yakistiran B, Aydogan S, Unlu S, Eyi EGY, Tayman C, Dinc B, Sahin D, Moraloglu Tekin O. The effect of real-time polymerase chain reaction cycle threshold values on perinatal outcomes of pregnant women with COVID-19. J Matern Fetal Neonatal Med 2021; 34:3601-3608. [PMID: 33706649 DOI: 10.1080/14767058.2021.1900105] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To evaluate the effect of cycle threshold (Ct) values on the pregnancy outcomes of women with coronavirus disease 2019 (COVID-19). MATERIALS AND METHODS This prospective cohort study was conducted on pregnant women with COVID-19. A real-time polymerase chain reaction (RT-PCR) assay of a nasopharyngeal and oropharyngeal specimen was used for the diagnosis. Initial Ct values for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RT-PCR tests were recorded. 22.9 was the 50th percentile Ct value of the study population. The study population was divided into two groups based on their Ct values: (1) Cases with Higher Ct values (Ct > 22.9)(n = 50) and (2) Cases with lower Ct values (Ct ≤ 22.9)(n = 55). Demographic features, clinical characteristics, disease progression, laboratory test results and pregnancy outcomes were compared between the groups. A receiver operating characteristic (ROC) curve was used to assess the performance of Ct values in predicting obstetric complications. RESULTS Obstetric complication rate was significantly higher in cases with lower Ct values (p < .001). A significantly lower lymphocyte count together with higher ESR, procalcitonin and IL-6 values were observed in the cases with lower Ct values (p > .05). Additionally, a significantly higher NICU admission rate and longer hospital stays were present in the cases with lower Ct values (p > .05). The value in ROC curves with the best balance of sensitivity/specificity was 22.5 (85.7% sensitivity, 63.6% specificity). CONCLUSION Lower Ct values may be associated with an increased rate of obstetric complications in pregnant women with COVID-19. Physicians should be cautious in the management of cases with Ct levels below 22.5.
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Affiliation(s)
- Atakan Tanacan
- Department of Obstetrics and Gynecology, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Ali Taner Anuk
- Department of Obstetrics and Gynecology, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Seyit Ahmet Erol
- Department of Obstetrics and Gynecology, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Huseyin Levent Keskin
- Department of Obstetrics and Gynecology, University of Health Sciences, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Orhan Altinboga
- Department of Obstetrics and Gynecology, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Betul Yakistiran
- Department of Obstetrics and Gynecology, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Sibel Aydogan
- Department of Medical Microbiology, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Serpil Unlu
- Department of Infectious Diseases, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Elif Gul Yapar Eyi
- Department of Obstetrics and Gynecology, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Cuneyt Tayman
- Division of Neonatology, Department of Pediatrics, University of Health Sciences, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Bedia Dinc
- Department of Medical Microbiology, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Dilek Sahin
- Department of Obstetrics and Gynecology, University of Health Sciences, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Ozlem Moraloglu Tekin
- Department of Obstetrics and Gynecology, University of Health Sciences, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
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Kinay T, Akgul MA, Kiykac Altinbas S, Tapisiz OL, Kayikcioglu F, Moraloglu Tekin O. Diagnostic value of the neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios in adnexal torsion cases. J Obstet Gynaecol Res 2021; 47:1846-1853. [PMID: 33650213 DOI: 10.1111/jog.14715] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 12/26/2020] [Accepted: 01/29/2021] [Indexed: 11/28/2022]
Abstract
AIM To evaluate if the neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR) could be used to diagnose adnexal torsion. METHODS A retrospective study reviewed medical records of women who underwent surgery due to an adnexal mass between January 2012 and December 2017 at a tertiary referral center in Turkey. According to the surgical findings, the women were divided into a torsion group and a control group. NLR and PLR were compared between women who had adnexal torsion and those who did not. RESULTS A total of 201 women were included in the study: 67 in the torsion group and 134 in the control group. Mean WBC count (9584.0 ± 3080.8 vs. 6678.2 ± 1886.1 h/mm3 ), mean NLR (5.9 ± 4.3 vs. 2.1 ± 0.8), and mean PLR (210.5 ± 132.7 vs. 147.9 ± 48.7) were higher in the torsion group than in the control group (p < 0.001). According to the ROC curve analyses, the optimal cut-off value for NLR and PLR were 2.51 (sensitivity, 72%; specificity, 78%) and 154.4 (sensitivity, 61%; specificity, 64%) in the diagnosis of adnexal torsion, respectively. CONCLUSION NLR and PLR have been found useful hematological markers for the diagnosis of adnexal torsion. NLR and PLR could be helpful in cases, which is difficult to make a definitive diagnosis with patients' symptom and the ultrasonographic examination.
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Affiliation(s)
- Tugba Kinay
- Department of Obstetrics and Gynaecology, University of Health Sciences Turkey, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Ankara, Turkey
| | - Mehmet A Akgul
- Department of Obstetrics and Gynaecology, University of Health Sciences Turkey, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Ankara, Turkey
| | - Sadiman Kiykac Altinbas
- Department of Obstetrics and Gynaecology, University of Health Sciences Turkey, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Ankara, Turkey
| | - Omer L Tapisiz
- Department of Obstetrics and Gynaecology, University of Health Sciences Turkey, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Ankara, Turkey
| | - Fulya Kayikcioglu
- Department of Obstetrics and Gynaecology, University of Health Sciences Turkey, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Ankara, Turkey
| | - Ozlem Moraloglu Tekin
- Department of Obstetrics and Gynaecology, Ministry of Health Ankara City Hospital, Ankara, Turkey
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Yapar Eyi EG, Moraloglu Tekin O, Buglagil A, Sahin D, Yucel A, Tanacan A, Halici Ozturk F, Yakistiran B, Yucel Yetiskin D, Unlu S, Gokcinar D. Perinatology clinic in the coronavirus disease-2019 pandemic: what harms, often teaches. J Matern Fetal Neonatal Med 2021; 34:3591-3600. [PMID: 33645392 DOI: 10.1080/14767058.2021.1875440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Compartmental models simplify the mathematical modeling of infectious diseases based on reported cases. In the absence of precautions, personal protective equipment, quarantine and social distancing, a Susceptible-Exposed-Infectious-Recovered (SuEIR) model with Unscented Kalman Filter for coronavirus disease-19 (COVID-19) Forecasts in Turkey has revealed 174 641 infected people on August 15, 2020, whilst the reported case was 12 216. Through numerical experiments, the effects of quarantine, social distancing, and COVID-19 testing on the dynamics of the outbreak varies. We herein present the documentation of the work in a perinatology clinic during COVID-19 pandemic to find the reflection in a pandemic hospital as even in the pandemic, pregnancy complications and fetal diagnosis/therapy are time-sensitive and cannot be delayed. During the prevention of the horizontal transmission to the health-care workers (HCWs), testing all pregnant women with nasopharyngeal/oropharyngeal swabs for severe acute respiratory syndrome coronavirus (SARS-COV-2) undergoing birth, ultrasound examinations, invasive procedures appear to be the gold standard so that appropriate precautions can be taken if the screen is positive. Though it is logical, it may be incompatible with a busy obstetric practise as a pending polymerase chain reaction (PCR) result should never delay any emergent procedure. OBJECTIVE We aim to describe the development of COVID-19 disease of 408 HCW out of 1462 by the exposure to pregnant women while providing obstetric care in a single tertiary perinatology unit under strict clinical triage, recommended precautions and wearing personal protective equipment and compare the maternal and perinatal outcome with those of the preceding three months. STUDY DESIGN A prospective cohort study involving the pregnant women and the HCW with positive PCR for SARS-COV-2 were carried out to correlate with the horizontal transmission while documenting the perinatal work. RESULTS 25 HCW, including nurses/midwives: 11, doctors: 7 and health technicians: 3 and support staff: 4 developed positive PCR for SARS-COV-2 while providing healthcare to 162 cases: mild-moderate (n = 146), severe (n = 12) and critical (n = 1) and asymptomatic (n = 3) in obstetric population. 22 out of 25 HCW were working in the perinatology unit. COVID-19 clinic was asymptomatic (n = 8), mild-moderate (13) or severe (n = 2) in HCW. However, "Exposed" group in the SuEIR model, both the pregnant women and the HCW that have already been infected and have not been tested, which have been also capable of infecting the "Susceptible" group could not be determined. Some of the HCW and the pregnant women in the "Exposed" group were tested and transferred to the "Infectious" group (which were reported to be PCR positive), while the rest of them who recovered, transitted to the so-called "Unreported Recovered" group. The ratio of the women with severe pre-eclampsia admitted to intensive care unit increased significantly during the lockdown (p = .01). CONCLUSIONS In a nonstop pandemic perinatology clinic, exposure to 162 PCR positive pregnant women may be correlated with a 5.4% (22/408) documented horizontal transmission in the frontline HCW despite clinical triage and personal protective equipment.
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Affiliation(s)
| | | | - Arda Buglagil
- Department of Electrical and Electronics Engineering, Bilkent University, Bilkent, Ankara, Turkey
| | - Dilek Sahin
- Ministry of Health Ankara City Hospital, Bilkent, Ankara, Turkey
| | - Aykan Yucel
- Ministry of Health Ankara City Hospital, Bilkent, Ankara, Turkey
| | - Atakan Tanacan
- Ministry of Health Ankara City Hospital, Bilkent, Ankara, Turkey
| | | | - Betul Yakistiran
- Ministry of Health Ankara City Hospital, Bilkent, Ankara, Turkey
| | | | - Serpil Unlu
- Ministry of Health Ankara City Hospital, Bilkent, Ankara, Turkey
| | - Derya Gokcinar
- Ministry of Health Ankara City Hospital, Bilkent, Ankara, Turkey
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Baser E, Kirmizi DA, Unlubilgin E, Caltekin MD, Meriç NB, Tekin OM. Effect of psychiatric symptoms and male sexual function of couples on the success of treatment for vaginismus. Sex Health 2021; 17:453-461. [PMID: 33497600 DOI: 10.1071/sh20116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 09/14/2020] [Indexed: 11/23/2022]
Abstract
Background This study evaluated psychiatric factors and sexual functions of women with vaginismus and their partners during the treatment process. METHODS The study was performed on 110 women diagnosed with vaginismus and their partners. The women underwent cognitive behavioural therapy (CBT), and couples were divided into two groups: successful and unsuccessful therapy. Sexual function in couples was evaluated using the Golombok Rust Index of Sexual Satisfaction (GRISS) in men and the Female Sexual Function Index in women. The psychopathological symptoms of participants were evaluated using the Symptom Check List-90-Revised (SCL-90-R). RESULTS Of the 110 women in this study, 98 completed CBT and treatment was successful for 59 (60.2%). GRISS scores pertaining to the subscales of infrequency (66.7% and 39.0%), non-communication (56.4% and 22.0%), avoidance (76.9% and 52.5%), impotence (56.4% and 33.9%) and premature ejaculation (64.1% and 32.2%) before treatment were significantly lower in the successful than unsuccessful treatment group (P < 0.05). Furthermore, there was a positive correlation between complaints of impotence and premature ejaculation in men and symptoms of depression and anxiety in men. In the successful treatment group, pretreatment values were lower for the SCL-90-R subscales of anxiety and depression in men and anxiety, depression, phobic anxiety and obsessive compulsiveness in women than in the unsuccessful treatment group. CONCLUSIONS The psychiatric symptoms and sexual functions of couples were found to affect the success of treatment for vaginismus. As such, treatments should be administered in accordance with other symptoms present in couples.
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Affiliation(s)
- Emre Baser
- Department of Obstetrics and Gynecology, Faculty of Medicine, Yozgat Bozok University, Yozgat 66100, Turkey; and Corresponding author.
| | - Demet Aydogan Kirmizi
- Department of Obstetrics and Gynecology, Faculty of Medicine, Yozgat Bozok University, Yozgat 66100, Turkey
| | - Eylem Unlubilgin
- Department of Obstetrics and Gynecology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Yeni Etlik Caddesi, Etlik/Ankara 06010, Turkey
| | - Melike Demir Caltekin
- Department of Obstetrics and Gynecology, Faculty of Medicine, Yozgat Bozok University, Yozgat 66100, Turkey
| | - Nurhan Bolat Meriç
- Department of Psychology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Ankara, Turkey
| | - Ozlem Moraloglu Tekin
- Department of Obstetrics and Gynecology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Yeni Etlik Caddesi, Etlik/Ankara 06010, Turkey
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Tanacan A, Yazihan N, Erol SA, Anuk AT, Yucel Yetiskin FD, Biriken D, Ozgu-Erdinc AS, Keskin HL, Moraloglu Tekin O, Sahin D. The impact of COVID-19 infection on the cytokine profile of pregnant women: A prospective case-control study. Cytokine 2021; 140:155431. [PMID: 33503581 PMCID: PMC7810028 DOI: 10.1016/j.cyto.2021.155431] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 12/08/2020] [Accepted: 01/02/2021] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To compare the levels of various cytokines between pregnant women with confirmed coronavirus disease (COVID-19) infection and pregnant women without any defined risk factor. MATERIALS AND METHODS Pregnant women with confirmed COVID-19 infection (study group)(n = 90) were prospectively compared to a gestational age-matched control group of pregnant women without any defined risk factors (n = 90). Demographic features, clinical characteristics, laboratory parameters, interferon-gamma (IFN γ), interleukin (IL-2), IL-6, IL-10, and IL-17 levels were compared between the groups. Additionally, a correlation analysis was performed in the study group for the assessment of IFN γ, IL-2, IL-6, IL-10, and IL-17 levels with disease severity and CRP levels. RESULTS Study group had significantly higher pregnancy complication rate, erythrocyte sedimentation rate, C-reactive protein, procalcitonin, ferritin, D-dimer, lactate dehydrogenase, IFN γ, and IL-6 values (p < 0.05). On the other hand, the control group had significantly higher hemoglobin, leukocyte, platelet, lymphocyte, IL-2, IL-10, and IL-17 values (p < 0.05). Statistically significant differences were found between the groups for IFN γ, IL-2, IL-10, and IL-17 values between the trimesters (p < 0.05). Statistically significant positive correlations were found for IFN γ and IL-6 with disease severity (r = 0.41 and p < 0.001 for IFN γ and r = 0.58 and p < 0.001 for IL-6). On the other hand, a moderate negative correlation for IL-2 and a weak negative correlation for IL-10 were present (r = -0.62 and p < 0.001 for IL-2 and r = -0.19 and p = 0.01 for IL-10). A statistically significant positive moderate correlation was found between IL-6 and CRP (r = 0.40 and p < 0.001) CONCLUSION: COVID-19 infection seems to have an impact on the cytokine profile of pregnant women varying according to pregnancy trimesters and cytokine levels seem to be correlated with disease severity.
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Affiliation(s)
- Atakan Tanacan
- Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey.
| | - Nuray Yazihan
- Ankara University, Faculty of Medicine, Internal Medicine, Pathophysiology Department, Ankara University, Institute of Health Sciences, Interdisciplinary Food, Metabolism and Clinical Nutrition Department, Ankara, Turkey
| | - Seyit Ahmet Erol
- Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Ali Taner Anuk
- Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Fatma Didem Yucel Yetiskin
- Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Derya Biriken
- Department of Microbiology, Ankara University, Ankara, Turkey
| | - A Seval Ozgu-Erdinc
- Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Huseyin Levent Keskin
- University of Health Sciences, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Ozlem Moraloglu Tekin
- University of Health Sciences, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Dilek Sahin
- University of Health Sciences, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
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Sahin D, Tanacan A, Moraloglu Tekin O. Response to concerns about the use of delivery table shield in the vaginal delivery of the pregnant women with suspected/diagnosed COVID-19. Am J Obstet Gynecol 2020; 223:778-779. [PMID: 32681827 PMCID: PMC7362804 DOI: 10.1016/j.ajog.2020.07.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 07/14/2020] [Indexed: 01/22/2023]
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Sinaci S, Ozden Tokalioglu E, Ocal D, Atalay A, Yilmaz G, Keskin HL, Erdinc SO, Sahin D, Moraloglu Tekin O. Does having a high-risk pregnancy influence anxiety level during the COVID-19 pandemic? Eur J Obstet Gynecol Reprod Biol 2020; 255:190-196. [PMID: 33147531 PMCID: PMC7585497 DOI: 10.1016/j.ejogrb.2020.10.055] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 10/20/2020] [Accepted: 10/23/2020] [Indexed: 01/18/2023]
Abstract
Objective We aimed to analyze the changing level of anxiety during COVID-19 pandemic in pregnant women, with and without high-risk indicators separately, in a tertiary care center serving also for COVID-19 patients, in the capital of Turkey. Study design We designed a case-control and cross-sectional study using surveys. The Spielberger State-Trait Anxiety Scale questionnaire (STAI-T) and Beck Anxiety Inventory (BAI) which were validated in Turkish were given to outpatient women with high-risk pregnancies as study group and normal pregnancies as control group. A total of 446 women were recruited. Results There was a statistically significant difference between those with and without high-risk pregnancy in terms of Trait-State Anxiety scores with COVID-19 pandemic (p < 0.05). We found an increased prevalence of anxiety during COVID-19 pandemic in high-risk pregnant women comparing to pregnancies with no risk factors (p < 0.05). There was a statistically significant difference between the education level in high-risk pregnant women in terms of anxiety scores (p < 0.05), Beck Anxiety score was highest in high school graduates (42.75). While the level of Trait Anxiety was the highest with pandemic in those with high-risk pregnancy with threatened preterm labor and preterm ruptures of membranes (58.0), those with thrombophilia were the lowest (50.88). The State Anxiety level and Beck Anxiety Score of those with maternal systemic disease were the highest (53.32 and 45.53), while those with thrombophilia were the lowest (46.96 and 40.08). The scores of Trait Anxiety (56.38), State Anxiety (52.14), Beck Anxiety (43.94) were statistically higher during the pandemic in those hospitalized at least once (p < 0.05). Conclusion High-risk pregnant women require routine anxiety and depression screening and psychosocial support during the COVID-19 pandemic. High-risk pregnancy patients have comorbid conditions most of the time, hence they not only at more risk for getting infected, but also have higher anxiety scores because of the stress caused by COVID-19 pandemic.
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Affiliation(s)
- Selcan Sinaci
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey.
| | - Eda Ozden Tokalioglu
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Doga Ocal
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Aysegul Atalay
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Gamze Yilmaz
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Huseyin Levent Keskin
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Seval Ozgu Erdinc
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Dilek Sahin
- University of Health Sciences, Ankara City Hospital, Ankara, Turkey; Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Ozlem Moraloglu Tekin
- University of Health Sciences, Ankara City Hospital, Ankara, Turkey; Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, Turkey
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Sivas MC, Tapisiz OL, Ayik RT, Kahraman D, Kiykac Altinbas S, Moraloglu Tekin O. Effects of melatonin on uterine hypertrophy/hyperplasia: A preliminary experimental rat study. Heliyon 2020; 6:e05142. [PMID: 33072913 PMCID: PMC7548983 DOI: 10.1016/j.heliyon.2020.e05142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 09/23/2020] [Accepted: 09/29/2020] [Indexed: 12/12/2022] Open
Abstract
Endometrial hyperplasia is a process of endometrial proliferation that results in a thickening of the endometrial tissue. Melatonin might be able to change the pathophysiological process and prognosis into a positive way that might prevent and heal endometrial hyperplasia, which is the first stage of endometrial cancer. For this perspective, we tried to investigate the effect of melatonin on uterine hypertrophy/hyperplasia in an experimental rat model. Forty Wistar-Albino rats were undergone bilateral oophorectomy and randomized into four groups. To create a model of uterine hypertrophy/hyperplasia in all groups, except the control group [C] (n = 10), 4 mg/kg/day estradiol hemihydrate were given for 14 days. The uterine hypertrophy/hyperplasia was evaluated histopathologically in the left uterine horns, then the groups were treated for 14 days as follows; melatonin (10 mg/kg/day/po) [M] (n = 10), melatonin + estradiol hemihydrate (10 mg/kg/day/po and 4 mg/kg/day/po) [M + E] (n = 10), and dark environment [D] (n = 10). Finally, the effects of the melatonin were examined histopathologically in the right uterine horns. An uterine hypertrophy/hyperplasia model was established in all groups compared to the control group (p < 0.05). In the [M] and [M + E] groups, epithelial cell height and luminal epithelial cell height significantly decreased (41μm vs 12μm, p = 0.005; 14μm vs 10μm, p = 0.005, respectively for [M] group) and (32μm vs 14μm, p = 0.012; 17μm vs 10μm, p = 0.017, respectively for [M + E] group). The [D] group exhibited a significant decrease in epithelial cell height (33μm vs 20μm, p = 0.017). With or without estrogen exposure, melatonin-treated and physiologically melatonin-released rats experienced a significant uterine hypertrophy/hyperplasia recovery. Melatonin may have protective effects on endometrial hyperplasia.
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Affiliation(s)
- Mustafa Can Sivas
- Department of Obstetrics and Gynecology, University of Health Sciences, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Ankara, Turkey
| | - Omer Lutfi Tapisiz
- Department of Obstetrics and Gynecology, University of Health Sciences, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Ankara, Turkey
| | - Rasit Tan Ayik
- Department of Obstetrics and Gynecology, University of Health Sciences, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Ankara, Turkey
| | - Devrim Kahraman
- Department of Pathology, School of Medicine, The Union of Chambers and Commodity Exchanges of Turkey, University of Economics and Technology (TOBB ETU), Ankara, Turkey
| | - Sadiman Kiykac Altinbas
- Department of Obstetrics and Gynecology, University of Health Sciences, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Ankara, Turkey
| | - Ozlem Moraloglu Tekin
- Department of Obstetrics and Gynecology, University of Health Sciences, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Ankara, Turkey
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Sahin D, Ahmet Erol S, Tanacan A, Ozcan N, Keskin HL, Moraloglu Tekin O. Protective equipment to use in the vaginal delivery of the pregnant woman with suspected or diagnosed coronavirus disease 2019: delivery table shield. Am J Obstet Gynecol 2020; 223:599-601. [PMID: 32553912 PMCID: PMC7294272 DOI: 10.1016/j.ajog.2020.06.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 05/27/2020] [Accepted: 06/10/2020] [Indexed: 11/22/2022]
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Aldemir O, Ozelci R, Baser E, Kaplanoglu I, Dilbaz S, Dilbaz B, Tekin OM. Impact of Transferring a Poor Quality Embryo Along with a Good Quality Embryo on Pregnancy Outcomes in IVF/ICSI Cycles: a Retrospective Study. Geburtshilfe Frauenheilkd 2020; 80:844-850. [PMID: 32817991 PMCID: PMC7428370 DOI: 10.1055/a-1213-9164] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Accepted: 07/07/2020] [Indexed: 11/03/2022] Open
Abstract
Background The number and the quality of embryos transferred are important predictors of success in in vitro fertilization (IVF) cycles. In the presence of more than one good quality embryo on the transfer day, double-embryo transfer (DET) can be performed with these embryos, but generally, different quality embryos are present in the available transfer cohort. We aimed to investigate the effect of transferring a poor quality embryo along with a good quality embryo on IVF outcomes. Methods In this study, 2298 fresh IVF/intracytoplasmic sperm injection (ICSI) cycles with two good quality embryos (group A), one good and one poor quality embryo (group B), and single good quality embryo (group C) transfers were examined. All groups were divided into two subgroups according to the transfer day as cleavage or blastocyst stage. Clinical pregnancy and live birth rates were the primary outcomes. Results In the cleavage stage transfer subgroups, the clinical pregnancy rates were lower in the single-embryo transfer (SET) subgroup compared with DET subgroups, but the difference was not statistically significant compared with DET with mixed quality embryos. The live birth rates were comparable between the three groups. In the blastocyst transfer subgroups, the clinical pregnancy and live birth rates were significantly higher in DET with two good quality embryos than DET with mixed quality embryos and SET groups. Multiple pregnancy rates were higher in both DET groups in terms of transfer day (p = 0.001). Conclusion DET with mixed quality embryos results with lower clinical pregnancy and live birth rates compared with DET with two good quality embryos at the blastocyst stage. At cleavage stage transfer, there is no difference in live birth rates between the two groups.
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Affiliation(s)
- Oya Aldemir
- Department of Assisted Reproductive Technology, Ankara Etlik Zubeyde Hanım Women's Health Training and Research Hospital, Ankara, Turkey
| | - Runa Ozelci
- Department of Assisted Reproductive Technology, Ankara Etlik Zubeyde Hanım Women's Health Training and Research Hospital, Ankara, Turkey
| | - Emre Baser
- Department of Obstetrics and Gynaecology, Bozok University Medical Faculty, Yozgat, Turkey
| | - Iskender Kaplanoglu
- Department of Assisted Reproductive Technology, Ankara Etlik Zubeyde Hanım Women's Health Training and Research Hospital, Ankara, Turkey
| | - Serdar Dilbaz
- Department of Assisted Reproductive Technology, Ankara Etlik Zubeyde Hanım Women's Health Training and Research Hospital, Ankara, Turkey
| | - Berna Dilbaz
- Department of Assisted Reproductive Technology, Ankara Etlik Zubeyde Hanım Women's Health Training and Research Hospital, Ankara, Turkey
| | - Ozlem Moraloglu Tekin
- Department of Assisted Reproductive Technology, Ankara Etlik Zubeyde Hanım Women's Health Training and Research Hospital, Ankara, Turkey
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Tanacan A, Erol SA, Turgay B, Anuk AT, Secen EI, Yegin GF, Ozyer S, Kirca F, Dinc B, Unlu S, Yapar Eyi EG, Keskin HL, Sahin D, Surel AA, Tekin OM. The rate of SARS-CoV-2 positivity in asymptomatic pregnant women admitted to hospital for delivery: Experience of a pandemic center in Turkey. Eur J Obstet Gynecol Reprod Biol 2020; 253:31-34. [PMID: 32763728 PMCID: PMC7390745 DOI: 10.1016/j.ejogrb.2020.07.051] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 07/22/2020] [Accepted: 07/27/2020] [Indexed: 01/14/2023]
Abstract
Objective To investigate the rate of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positivity in asymptomatic pregnant women admitted to hospital for delivery in a Turkish pandemic center. Study Design This prospective cohort study was conducted in Ankara City Hospital between April, 15, 2020 and June, 5, 2020. A total of 206 asymptomatic pregnant women (103 low-risk pregnant women without any defined risk factor and 103 high-risk pregnant women) were screened for SARS-CoV-2 positivity upon admission to hospital for delivery. Detection of SARS-CoV2 in nasopharyngeal and oropharyngeal samples was performed by Real Time Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) method targeting RdRp (RNA dependent RNA polymerase) gene. Two groups were compared in terms of demographic features, clinical characteristics and SARS-CoV-2 positivity. Results Three of the 206 pregnant women participating in the study had positive RT-PCR tests (1.4 %) and all positive cases were in the high-risk pregnancy group. Although, one case in the high-risk pregnancy group had developed symptoms highly suspicious for COVID-19, two repeated RT-PCR tests were negative. SARS-CoV-2 RT-PCR positivity rate was significantly higher in the high-risk pregnancy group (2.9 % vs 0%, p = 0.04). Conclusion Healthcare professionals should be cautious in the labor and delivery of high-risk pregnant women during the pandemic period and universal testing for COVID-19 may be considered in selected populations.
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Affiliation(s)
- Atakan Tanacan
- Department of Obstetrics and Gynecology, Ministry of Health Ankara City Hospital, Ankara, Turkey.
| | - Seyit Ahmet Erol
- Department of Obstetrics and Gynecology, Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Batuhan Turgay
- Department of Obstetrics and Gynecology, Ministry of Health Ankara City Hospital, Ankara, Turkey; Yıldırım Beyazıt University, Ankara, Turkey
| | - Ali Taner Anuk
- Department of Obstetrics and Gynecology, Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Elcin Islek Secen
- Department of Obstetrics and Gynecology, Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Gulin Feykan Yegin
- Department of Obstetrics and Gynecology, Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Sebnem Ozyer
- Department of Obstetrics and Gynecology, Ministry of Health Ankara City Hospital, Ankara, Turkey; University of Health Sciences, Istanbul, Turkey
| | - Fisun Kirca
- Department of Clinical Microbiology, Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Bedia Dinc
- Department of Clinical Microbiology, Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Serpil Unlu
- Department of Infectious Diseases, Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Elif Gul Yapar Eyi
- Department of Obstetrics and Gynecology, Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Huseyin Levent Keskin
- Department of Obstetrics and Gynecology, Ministry of Health Ankara City Hospital, Ankara, Turkey; University of Health Sciences, Istanbul, Turkey
| | - Dilek Sahin
- Department of Obstetrics and Gynecology, Ministry of Health Ankara City Hospital, Ankara, Turkey; University of Health Sciences, Istanbul, Turkey
| | - Aziz Ahmet Surel
- Coordinator Head Physician of Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Ozlem Moraloglu Tekin
- Department of Obstetrics and Gynecology, Ministry of Health Ankara City Hospital, Ankara, Turkey; University of Health Sciences, Istanbul, Turkey; Head Physician of Maternity Hospital of Ankara City Hospital, Ankara, Turkey
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Baser E, Aydogan Kirmizi D, Ulubas Isik D, Ozdemirci S, Onat T, Serdar Yalvac E, Demirel N, Moraloglu Tekin O. The effects of latency period in PPROM cases managed expectantly. J Matern Fetal Neonatal Med 2020; 33:2274-2283. [PMID: 32089027 DOI: 10.1080/14767058.2020.1731465] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objective: Preterm premature rupture of membranes (PPROM), associated with prematurity, is an important obstetric complication that may cause neonatal mortality and morbidity. The optimal delivery time is controversial in cases with the expectant approach. The fetal effects of long-term exposure to PPROM are unknown. This study aimed to evaluate the maternal and fetal outcomes of expectantly-managed PPROM cases with different latency periods at 240/7-346/7 weeks of gestation.Material and method: The study group consisted of 206 patients at 240/7-346/7 weeks of gestation who met the inclusion criteria. Patients were divided into three groups according to their weeks of PPROM diagnosis as 240/7-286/7, 290/7-316/7, and 320/7-346/7. The period from membrane rupture to delivery was defined as the latency period and divided into three subgroups as 3-7 days, 8-13 days and ≥14 days. In addition to the demographic characteristics of the patients, maternal and obstetric complications, primary and secondary neonatal outcomes were compared between the groups. Primary neonatal outcomes were determined in terms of pathological Apgar scores (<5 at minute 1, <7 at minute 5), requiring resuscitation, admission to Neonatal Intensive Care Unit (NICU) and NICU length of stay. Secondary neonatal outcomes were determined in terms of respiratory distress syndrome, bronchopulmonary dysplasia, intraventricular hemorrhage, retinopathy of prematurity, necrotizing enterocolitis, patent ductus arteriosus, periventricular leukomalacia, and neonatal sepsis. In addition, for the prediction of morbidity and mortality, newborns were evaluated by SNAPPE II (Score for Neonatal Acute Physiology with Perinatal extension-II) consisting of the combination of biochemical and physiological parameters, using the parameters including mean blood pressure (mm/Hg), corporal temperature (°C), PO2/FiO2 ratio, lowest serum pH, multiple seizures, urine output (ml/kg/hr), Apgar score, birth weight, and small for gestational age. The higher the score of SNAPPE II, the higher the morbidity and mortality risk of neonates. For the statistical analysis, the Kruskal Wallis and one-way ANOVA tests were utilized for the numerical data. Categorical data were compared using the chi-square test. The receiver operating characteristic (ROC) test was used to determine the threshold value of the data affecting neonatal morbidity.Results: The mean PPROM week was found to be 29.7 ± 3.0 weeks and the mean delivery week was 31.8 ± 2.5 weeks. The mean latency period for all the patients was 15.1 ± 13.8 days. Clinic chorioamnionitis was observed in 17% of the cases. The lowest chorioamnionitis rate (8.6%) was in the 3-7-day latency period group. Total complications were significantly lower in the 290/7-316/7 week PPROM group in which the latency period was ≥14 days, compared to those in 3-7 days and 8-13 days (p = .001). Total complications were lower in the < 32 weeks PPROM groups in which the latency period was ≥14 days compared to those obtained in 3-7 days and 8-13 days. There was no significant difference between the latency period and total complications after 32 weeks (p = .422). The best discriminative cutoff value of SNAPPE-II for neonatal morbidity was 11.0 (sensitivity 82%, specificity 80%). In the present study, the optimal latency period for the best neonatal outcomes was found to be 34.5 days (sensitivity 70% and specificity 84%) between weeks 240/7-286/7, and 11.0 days between weeks 290/7-316/7 (sensitivity 68% and specificity 85%).Conclusions: Our findings indicated that a long latency period did not increase neonatal morbidity and there was no increase in neonatal complications after 32 weeks of the gestational period compared to those obtained before 32 weeks.
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Affiliation(s)
- Emre Baser
- Department of Obstetrics and Gynecology, Faculty of Medicine, Yozgat Bozok University, Yozgat, Turkey
| | - Demet Aydogan Kirmizi
- Department of Obstetrics and Gynecology, Faculty of Medicine, Yozgat Bozok University, Yozgat, Turkey
| | - Dilek Ulubas Isik
- Department of Neonatology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Health Science University, Ankara, Turkey
| | - Safak Ozdemirci
- Department of Obstetrics and Gynecology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Health Science University, Ankara, Turkey
| | - Taylan Onat
- Department of Obstetrics and Gynecology, Faculty of Medicine, Yozgat Bozok University, Yozgat, Turkey
| | - Ethem Serdar Yalvac
- Department of Obstetrics and Gynecology, Faculty of Medicine, Yozgat Bozok University, Yozgat, Turkey
| | - Nihal Demirel
- Department of Neonatology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Health Science University, Ankara, Turkey
| | - Ozlem Moraloglu Tekin
- Department of Obstetrics and Gynecology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Health Science University, Ankara, Turkey
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Kilic C, Yuksel D, Cakir C, Karalok A, Boyraz G, Moraloglu Tekin O, Turan T. Pulmonary recurrence after radical hysterectomy for uterine cervical carcinoma. J OBSTET GYNAECOL 2020; 40:1155-1159. [PMID: 32027187 DOI: 10.1080/01443615.2019.1706158] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Pulmonary spread from carcinoma of the uterine cervix, though uncommon, has been reported in 2.2-9.1% of all cervical cancers. The aim of this study was to evaluate the surgical, clinical, pathological factors and clinical outcomes of cervical cancer patients with pulmonary recurrence (PR).This study included 17 cervical cancer patients with PR after radical hysterectomy. The entire cohort consisted of 413 patients whose surgeries (type III radical hysterectomy + pelvic ± para-aortic lymphadenectomy) had been performed in our Gynaecologic Oncology Clinic between 1993 and 2018. Tumour size, lymph node metastasis and receiving adjuvant therapy were found to be effective for PR on univariate analyses in the main cohort (p = .042, p < .001 and p = .001, respectively). Therefore, performing adjuvant therapy to reduce the PR must be assessed properly with the information of lymph node status and tumour size obtained from the final pathology reports.Impact StatementWhat is already known on this subject? Pulmonary spread from carcinoma of the uterine cervix has been reported in 2.2-9.1% of all cervical cancers. Data related to clinico-pathological features of patients with pulmonary recurrence (PR) is limited. Diagnosis of a PR is considered to worsen the prognosis.What do the results of this study add? Tumour size, lymph node metastasis and receiving adjuvant therapy were found to be effective for PR on univariate analyses.What are the implications of these findings for clinical practice and/or further research? Performing adjuvant therapy to reduce the PR must be assessed properly with the information of lymph node status and tumour size obtained from the final pathology reports in patients with uterine cervical carcinoma.
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Affiliation(s)
- Cigdem Kilic
- Gynecologic Oncology Surgery Department, Health Sciences University Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Ankara, Turkey
| | - Dilek Yuksel
- Gynecologic Oncology Surgery Department, Health Sciences University Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Ankara, Turkey
| | - Caner Cakir
- Gynecologic Oncology Surgery Department, Health Sciences University Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Ankara, Turkey
| | - Alper Karalok
- Gynecologic Oncology Surgery Department, Health Sciences University Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Ankara, Turkey
| | - Gokhan Boyraz
- Gynecologic Oncology Surgery Department, Health Sciences University Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Ankara, Turkey
| | - Ozlem Moraloglu Tekin
- Gynecologic Oncology Surgery Department, Health Sciences University Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Ankara, Turkey
| | - Taner Turan
- Gynecologic Oncology Surgery Department, Health Sciences University Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Ankara, Turkey
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50
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Kilic C, Cakir C, Yuksel D, Tokgozoglu N, Comert GK, Karalok A, Ureyen I, Turkmen O, Boyraz G, Tasci T, Tekin OM, Turan T. Which factors predict parametrial involvement in early stage cervical cancer? A Turkish multicenter study. Eur J Obstet Gynecol Reprod Biol 2019; 243:63-66. [PMID: 31675631 DOI: 10.1016/j.ejogrb.2019.10.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 09/24/2019] [Accepted: 10/17/2019] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To evaluate the clinical and pathological factors for predicting the parametrial involvement (PI) in early stage cervical cancer. STUDY DESIGN This study included 406 patients with type III radical hysterectomy + pelvic ± para-aortic lymphadenectomy and FIGO stage I and II cervical adenocarcinoma, squamous type, and adenosquamous type cervical cancer. RESULTS The entire cohort of patients had lymphadenectomy performed. Early stage cervical cancer patients were evaluated. FIGO 2014 stage, uterine invasion, LVSI, surgical border involvement, vaginal metastasis, stromal invasion and lymph node metastasis were found to be effective for PI on univariate analyses. However; age, tumor type and tumor size did not determine the parametrial invasion. LVSI (HR: 4.438, 95%CI: 1.771-11.121; p = 0.001), lymph node metastases (HR: 2.418, 95%CI: 1.207-4.847; p = 0.013) and vaginal involvement (HR: 4.109, 95%CI: 1.674-10.087; p = 0.02) are independent prognostic factors on multivariate analysis. CONCLUSION Lymph node metastases, LVSI and surgical border involvement are independent prognostic factors for PI in early stage cervical cancer patients. Therefore, less radical surgical approaches for early stage tumors with no nodal spread, negative LVSI and no surgical border involvement are applicable.
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Affiliation(s)
- Cigdem Kilic
- Health Sciences University, Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Gynecologic Oncology Surgery Department, Ankara, Turkey.
| | - Caner Cakir
- Health Sciences University, Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Gynecologic Oncology Surgery Department, Ankara, Turkey
| | - Dilek Yuksel
- Health Sciences University, Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Gynecologic Oncology Surgery Department, Ankara, Turkey
| | | | - Gunsu Kimyon Comert
- Health Sciences University, Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Gynecologic Oncology Surgery Department, Ankara, Turkey
| | - Alper Karalok
- Health Sciences University, Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Gynecologic Oncology Surgery Department, Ankara, Turkey
| | - Isin Ureyen
- Antalya Training and Research Hospital, Antalya, Turkey
| | - Osman Turkmen
- Health Sciences University, Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Gynecologic Oncology Surgery Department, Ankara, Turkey
| | - Gokhan Boyraz
- Health Sciences University, Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Gynecologic Oncology Surgery Department, Ankara, Turkey
| | - Tolga Tasci
- Okmeydanı Training and Research Hospital, Istanbul, Turkey
| | - Ozlem Moraloglu Tekin
- Health Sciences University, Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Gynecologic Oncology Surgery Department, Ankara, Turkey
| | - Taner Turan
- Health Sciences University, Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Gynecologic Oncology Surgery Department, Ankara, Turkey
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