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Güralp O, Kaya B, Daglar K, Soliman A, Malik E. Bilaterale Ligatur der A. iliaca interna als alleinige Therapie oder in Kombination mit anderen uteruserhaltenden Techniken bei Therapie resistenter postpartaler Blutung. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- O Güralp
- Universitätsklinik für Gynäkologie und Geburtshilfe, Klinikum Oldenburg AöR, Fakultät für Medizin und Gesundheitswissenschaften, Universität Oldenburg, Gynäkologie und Geburtshilfe, Oldenburg, Deutschland
| | - B Kaya
- Near East University, Gynäkologie und Geburtshilfe, Mersin, Türkei
- Gaziantep Geburtsklinik, Gynäkologie und Geburtshilfe, Gaziantep, Türkei
| | - K Daglar
- Gaziantep Geburtsklinik, Gynäkologie und Geburtshilfe, Gaziantep, Türkei
- Zekai Tahir Burak Lehrkrankenhaus, Gynäkologie und Geburtshilfe, Ankara, Deutschland
| | - A Soliman
- Universitätsklinik für Gynäkologie und Geburtshilfe, Klinikum Oldenburg AöR, Fakultät für Medizin und Gesundheitswissenschaften, Universität Oldenburg, Gynäkologie und Geburtshilfe, Oldenburg, Deutschland
| | - E Malik
- Universitätsklinik für Gynäkologie und Geburtshilfe, Klinikum Oldenburg AöR, Fakultät für Medizin und Gesundheitswissenschaften, Universität Oldenburg, Gynäkologie und Geburtshilfe, Oldenburg, Deutschland
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Vural Yilmaz Z, Gencosmanoglu Turkmen G, Daglar K, Yılmaz E, Kara O, Uygur D. Elevated red blood cell distribution width is associated with intrahepatic cholestasis of pregnancy. Ginekol Pol 2018; 88:75-80. [PMID: 28326516 DOI: 10.5603/gp.a2017.0015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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: 08/18/2016] [Revised: 11/08/2016] [Accepted: 01/08/2017] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES Intrahepatic cholestasis of pregnancy is the most common pregnancy specific liver disease and related with adverse maternal and perinatal outcome. Red blood cell distribution width, an anisocytosis marker in a complete blood count, has been used as an inflammation marker in various diseases. However the association of red blood cell distribution width with intrahepatic cholestasis of pregnancy is unknown. We aimed to evaluate the relationship between red blood cell distribution width and intrahepatic cholestasis of pregnancy. MATERIAL AND METHODS Ninety pregnant women with intrahepatic cholestasis of pregnancy and ninety healthy pregnant women were included in the study. Their clinical and laboratory characteristics including red blood cell distribution width, liver function tests, fasting and postprandial bile acid concentrations were analyzed. RESULTS Serum red blood cell distribution width cell levels were significantly higher in pregnants with intrahepatic cholestasis of pregnancy than healthy pregnants. We also demonstrated that red blood cell distribution Width levels were higher in severe disease than mild disease and was significantly correlated with fasting and postprandial bile acid concentration in intrahepatic cholestasis of pregnancy group. CONCLUSIONS Our study showed that red blood cell distribution width, an easy and inexpensive marker; were associated with intrahepatic cholestasis of pregnancy and can be used as a diagnostic and prognostic marker in intrahepatic cholestasis of pregnancy.
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Affiliation(s)
- Zehra Vural Yilmaz
- Zekai Tahir Burak Women's Health Care, Training and Research Hospital, Ankara, Turkey.
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Kara Ö, Kirbas A, Yakut K, Daglar K, Timur H, Ozturk İnal Z, Engin-Ustun Y. Assessment of circulating betatrophin levels in intrahepatic cholestasis of pregnancy. J Matern Fetal Neonatal Med 2018; 32:4067-4072. [PMID: 29890866 DOI: 10.1080/14767058.2018.1481382] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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
Objective: To investigate maternal serum levels of betatrophin and their relationship with total bile acid (TBA) levels in patients with intrahepatic cholestasis of pregnancy (ICP).Materials and methods: Fifty-nine pregnant women with ICP (31 patients with severe and 28 patients with mild disease classifications) and 23 healthy women with uncomplicated pregnancies as the control group included the study. The maternal betatrophin, fasting blood glucose, fasting insulin (FI), and homeostatic model assessment of insulin resistance (HOMA-IR) levels of the groups were compared.Results: Serum betatrophin levels were significantly higher in the ICP groups than in the control group (p = .04 and p < .001, respectively). The FI levels and HOMA-IR values were significantly higher in the severe ICP group than in the control group (p = .006 and p = .001, respectively). While a significant positive correlation was found between betatrophin levels and fasting and postprandial TBA levels, there was no significant correlation among betatrophin and HOMA-IR or FI levels.Conclusions: Betatrophin levels were shown to correlate with TBA levels, it provides a model for future studies to understand the physiopathology of ICP, a complex metabolic disease. Changes in betatrophin levels may shed light on the pathogenesis of ICP.
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Affiliation(s)
- Özgür Kara
- Department of Maternal-Fetal Medicine Unit, University of Health Sciences, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey
| | - Ayşe Kirbas
- Department of Maternal-Fetal Medicine Unit, University of Health Sciences, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey
| | - Kadriye Yakut
- Department of Maternal-Fetal Medicine Unit, University of Health Sciences, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey
| | - Korkut Daglar
- Department of Maternal-Fetal Medicine Unit, University of Health Sciences, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey
| | - Hakan Timur
- Department of Maternal-Fetal Medicine Unit, University of Health Sciences, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey
| | - Zeynep Ozturk İnal
- Department of Obstetrics and Gynecology, Konya Education and Research Hospital, Konya, Turkey
| | - Yaprak Engin-Ustun
- Department of Maternal-Fetal Medicine Unit, University of Health Sciences, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey
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Kaya B, Balci BK, Daglar K, Polat M, Tuten A, Sahin H, Soliman A, Guralp O. Surgical treatment of uterine atony: an assessment of final year obstetrics and gynecology residents in Turkey with a questionnaire. CLIN EXP OBSTET GYN 2017. [DOI: 10.12891/ceog3878.2017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Daglar K, Tokmak A, Kirbas A, Kara O, Biberoglu E, Uygur D, Danisman N. Anterior placenta previa is associated with increased umbilical cord blood hematocrit concenrations. J Neonatal Perinatal Med 2017; 9:279-84. [PMID: 27589555 DOI: 10.3233/npm-16915145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE We aimed to evaluate the umbilical cord blood (CB) hematocrit (Hct) levels in women with anterior located placenta previa (PP). METHODS This is a prospective case-control study performed in a tertiary level maternity hospital. Thirty seven pregnant women diagnosed with anterior PP (study group) and 37 women without PP (control group) included into the study. Groups were matched with regard to age, gestational age, and fetal gender. All women underwent Cesarean section. Umbilical CB Hct levels of the newborns were measured. Demographics, operative features, and neonatal outcomes were recorded. RESULTS Umbilical CB Hct levels were statistically significantly higher in the PP patients compared with controls (p: 52.6±5.0 vs. 47.5±5.0, p < 0.001). Preoperative maternal hemoglobin (Hgb) and Hct levels were similar in the two groups. However, postoperative Hb and Hct levels were significantly lower in the study group (p: 0.003, p < 0.001, respectively). Intraoperative complication rates were higher in this group. Neonatal Apgar scores were lower and neonatal intensive care unit admission was more common in the PP group when compared with controls. CONCLUSION We think that anterior PP is associated with increased umbilical CB Hct levels. Neonatologists should consider this condition in the infants born to mothers with anterior PP.
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Türkmen GG, Timur H, Yilmaz Z, Kirbas A, Daglar K, Tokmak A, Uygur D, Danişman N. Effect of intrahepatic cholestasis of pregnancy on maternal serum screening tests. J Neonatal Perinatal Med 2017; 9:411-415. [PMID: 28009332 DOI: 10.3233/npm-161618] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE In this study, we aimed to evaluate whether the changes in the first and second trimester maternal serum biochemical markers used for prenatal screening are associated with euploid pregnancies complicated by intrahepatic cholestasis of pregnancy (ICP). METHODS A total of 94 pregnant women were included in this retrospective comparative study. Thirty-seven women whose pregnancy was complicated with ICP constituted the study group whereas 57 of them constituted the control group. All hospital records were examined in terms of combined first trimester screening test and second trimester triple test parameters. Perinatal outcomes were also recorded. RESULTS No significant difference was observed between the two groups in term of age, BMI, and obstetric history (all p > 0.05). Mean serum aspartate aminotransferase (AST), alanine aminotransferase (ALT) and serum bile acid concentrations in the study group were significantly higher than in the controls (p < 0.001). There were no significant differences between the two groups in terms of first and second trimester serum biochemical markers. Newborn gender, route of birth, and NICU admission rates were also similar in the two groups. Mean birth weight of the control group was statistically significantly higher than the ICP group (p = 0.012). CONCLUSION We report no significant differences between pregnancies complicated by ICP and healthy pregnancies in terms of first and second trimester maternal serum screening test results.
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Sanhal CY, Daglar K, Kara O, Yılmaz ZV, Turkmen GG, Erel O, Uygur D, Yucel A. An alternative method for measuring oxidative stress in intrahepatic cholestasis of pregnancy: thiol/disulphide homeostasis. J Matern Fetal Neonatal Med 2017; 31:1477-1482. [DOI: 10.1080/14767058.2017.1319922] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Cem Yasar Sanhal
- Department of Perinatology, Zekai Tahir Burak Women's Health Care, Training and Research Hospital, Ankara, Turkey
| | - Korkut Daglar
- Department of Perinatology, Zekai Tahir Burak Women's Health Care, Training and Research Hospital, Ankara, Turkey
| | - Ozgur Kara
- Department of Perinatology, Zekai Tahir Burak Women's Health Care, Training and Research Hospital, Ankara, Turkey
| | - Zehra Vural Yılmaz
- Department of Perinatology, Zekai Tahir Burak Women's Health Care, Training and Research Hospital, Ankara, Turkey
| | | | - Ozcan Erel
- Department of Clinical Biochemistry, Faculty of Medicine, Yildirim Beyazit University, Ankara, Turkey
| | - Dilek Uygur
- Department of Perinatology, Zekai Tahir Burak Women's Health Care, Training and Research Hospital, Ankara, Turkey
| | - Aykan Yucel
- Department of Perinatology, Zekai Tahir Burak Women's Health Care, Training and Research Hospital, Ankara, Turkey
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Daglar K, Kara O, Türkmen GG, Kırbas A, Biberoğlu EH, Sanhal CY, Danisman N. Clinical significance of fasting plasma glucose in patients with normal 50-g glucose challenge test in pregnancy: Is 100 bigger than 92? J OBSTET GYNAECOL 2016; 36:957-961. [PMID: 27565573 DOI: 10.1080/01443615.2016.1174836] [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: 10/21/2022]
Abstract
The present study aimed to analyse the perinatal outcomes in patients with normal 50-g Glucose Challenge Test but who are considered retrospectively to have gestational diabetes mellitus based on elevated fasting plasma glucose (FPG) levels according to recent criteria. The study was conducted between January 2010 and December 2014 to identify patients with FPG values >92 mg/dl and GCT values <130 mg/dl. The patients were divided into two groups: those with FPG values between 92 and 99 mg/dl (Group 1) and those with FPG values >99 mg/dl (Group 2). The rate of obstetric complications was similar in the three groups, except for a higher rate of preeclampsia in Group 2 than in the control group (8.3% versus 3.1%; p = 0.031). The rate of large for gestational age neonates in Group 2 was 15%, which was higher than the rate in Group 1 (5.5%) and control group (7.4%) (p = 0.046 and p = 0.047, respectively). The rate of neonatal intensive care unit admissions in Group 2 was 11.7%, which was higher than the rate in Group 1 (3.1%) and in the control group (2.4%). Our findings indicate that there is a clinically recognisable difference in perinatal outcomes when a threshold of 100 mg/dl is used for FPG instead of 92 mg/dl.
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Affiliation(s)
- Korkut Daglar
- a Department of Perinatology, Zekai Tahir Burak Research and Training Hospital , Ankara , Turkey
| | - Ozgür Kara
- a Department of Perinatology, Zekai Tahir Burak Research and Training Hospital , Ankara , Turkey
| | | | - Ayse Kırbas
- a Department of Perinatology, Zekai Tahir Burak Research and Training Hospital , Ankara , Turkey
| | - Ebru Hacer Biberoğlu
- a Department of Perinatology, Zekai Tahir Burak Research and Training Hospital , Ankara , Turkey
| | - Cem Yasar Sanhal
- a Department of Perinatology, Zekai Tahir Burak Research and Training Hospital , Ankara , Turkey
| | - Nuri Danisman
- a Department of Perinatology, Zekai Tahir Burak Research and Training Hospital , Ankara , Turkey
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Kaya B, Damarer Z, Daglar K, Unal O, Soliman A, Guralp O. Is there yet a role for internal iliac artery ligation in obstetric hemorrhage with the current gain in popularity of other uterus sparing techniques? J Matern Fetal Neonatal Med 2016; 30:1325-1332. [DOI: 10.1080/14767058.2016.1212333] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Kirbas A, Daglar K, Kirbas O, Koseoglu C, Kara O, Biberoglu E, Kurmus O, Yayla C, Danisman N. P wave and QT dispersion in familial mediterranean fever. Eur Rev Med Pharmacol Sci 2016; 20:3427-3433. [PMID: 27608902] [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] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE Familial mediterranean fever (FMF) is the most common auto-inflammatory disease that is characterized by recurrent, self-limited attacks of fever and serous membrane inflammation. Patients with inflammatory rheumatic diseases are considered to have a raised cardiovascular diseases risk. The aim of this study was to investigate; by means of P wave dispersion (Pd) and QT dispersion (QTd) parameters detected by simple standard electrocardiogram (ECG), atrial and ventricular repolarization changes in pregnant women with and without FMF. PATIENTS AND METHODS In this case-control study including 37 pregnant women with FMF who already put on colchicine treatment and 40 healthy, uncomplicated pregnancy cases, were prospectively assessed using 12-lead ECG and echocardiography. RESULTS No differences in Pd and corrected QT values were found between the groups. Epicardial fat thickness values were significantly higher in the FMF group compared with the control group (p = 0.015). A positive correlation was found between FMF duration and epicardial fat thickness (r = 0.350, p = 0.042). CONCLUSIONS Pd, a non-invasive marker of potential atrial arrhythmia and QT-d, a non-invasive marker of potentially lethal ventricular tachyarrhythmia, constitute a recent contribution to the field of noninvasive electrocardiology. Pd and QT-d values were not altered in pregnant women with FMF who already put on colchicine treatment, with no increased risk of atrial or ventricular arrhythmias indicated. Colchicine may have a cardio-protective effect beyond the effect mediated through suppression of inflammation.
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Affiliation(s)
- A Kirbas
- Department of Perinatology, Zekai Tahir Burak Women Health Care, Education and Research Hospital, Ankara, Turkey.
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Kaya B, Guralp O, Daglar K, Tuten A, Demirol A, Yayci E, Atacag T, Dogan A. Extra-abdominal removal of placenta during cesarean section: a prospective randomized controlled trial of a novel technique. J Perinat Med 2016; 44:557-65. [PMID: 26854288 DOI: 10.1515/jpm-2015-0330] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2015] [Accepted: 12/22/2015] [Indexed: 11/15/2022]
Abstract
AIM To evaluate intraoperative and early postoperative outcomes of a novel placenta delivery technique; extra-abdominal removal vs. intra-abdominal removal of the placenta during cesarean section (CS). METHODS A total of 210 women delivering by CS at term in a tertiary university hospital between March 2014 and January 2015 were randomized to extra-abdominal removal vs. intra-abdominal removal of the placenta. The women were randomly allocated to the extra- (group 1) or intra-abdominal removal group (group 2) according to random sampling method, where women with even and odd numbers were allocated to intra- and extra-abdominal groups, respectively. The amount of intra-abdominal hemorrhagic fluid accumulation, the duration of operation and estimated blood loss during operation were the primary outcomes. The secondary outcomes included the mean difference between pre- and post-operative hemoglobin and hematocrit levels, the mean postoperative pain score, any additional need of analgesia, postoperative bowel function, postoperative endometritis and wound infections. RESULTS The amount of aspirated hemorrhagic fluid was significantly higher in the intra-abdominal group compared to the extra-abdominal group (34.6±22.2 mL vs. 9.4±4.8 mL, P<0.001). Mean duration of the operation, intraoperative blood loss, postoperative requirement of additional analgesia, postoperative pain scores, postoperative endometritis or wound infection, and length of hospital stay were not significantly different between the intra- and extra-abdominal placental removal groups. CONCLUSION By extra-abdominal removal of the placenta, the accumulation of bloody fluid in the abdominal cavity is significantly less compared to the intra-abdominal removal method, which, in turn, provides avoidance of excessive mounted-gauze use, intra-abdominal manipulations, or iatrogenic trauma.
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Kirbas A, Daglar K, Kara O, Sucak A, Caglar T. Non-puerperal uterine inversion due to submucous myoma in a woman: a case report. J Exp Ther Oncol 2016; 11:221-223. [PMID: 28471130] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2015] [Revised: 12/15/2015] [Accepted: 12/18/2015] [Indexed: 06/07/2023]
Abstract
Uterine leiomyomas are the most common benign tumor of the female reproductive tract. Their incidence during pregnancy is approximately 2 percent and they are associated with some complications such as preterm labor, placental abruption, fetal malpresentation, obstructed labor, cesarean delivery, and postpartum hemorrhage. They may develop anywhere within the muscular wall of the uterus, including submucosal, intramural, or subserosal areas. Some of the submucous myomas may be pedunculated and eventually may protrude through the cervical canal to the vagina. They later become necrotic and sometimes infected. Vaginal myomectomy is recommended as the initial treatment of choice for a prolapsed, pedunculated myoma except when other indications require an abdominal procedure. Inversion is a condition in which the uterus turns inside out with prolapse of the fundus through the cervix. It is seen in acute and chronic forms. Chronic inversion may follow an incomplete obstetric inversion unnoticed or left uncared. Herein, we present, a case of infected non-puerperal uterine inversion due to submucous leiomyoma that was originating from fundus and the diagnostic dilemma it presents in the after puerperal stage.
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Affiliation(s)
- Ayse Kirbas
- Department of Perinatology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey
| | - Korkut Daglar
- Department of Perinatology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey
| | - Ozgur Kara
- Department of Perinatology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey
| | - Ayhan Sucak
- Department of Perinatology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey
| | - Turhan Caglar
- Department of Perinatology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey
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Turkmen GG, Timur H, Tokmak A, Yilmaz Z, Kirbas A, Daglar K, Sanhal CY, Uygur D. Levels of serum vitamin D and calcium in pregnancies complicated with fetal congenital diaphragmatic hernia and normal pregnancies. J Matern Fetal Neonatal Med 2016; 30:990-994. [DOI: 10.1080/14767058.2016.1196662] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Abstract
OBJECTIVE To investigate the presence of oxidative stress (OS) in pregnant women with Familial Mediterranean fever (FMF) in the first trimester by evaluating thiol/disulphide homeostasis. STUDY DESIGN A total of 31 pregnant women with a diagnosis of FMF, between 11(0) and 13(6) weeks of gestation, were compared with 51 healthy pregnant controls at the same gestational weeks. A recently defined method was used to measure plasma native thiol, total thiol and disulphide levels. RESULTS There were no differences between groups in terms of maternal age, body mass index and numbers of gravida and parity. Antenatal complications (45.2% vs. 9.8%, P = 0.001) and primary caesarean section (22.6% vs. 5.9%, P = 0.037) were higher in the FMF group. Pregnant women with FMF had significantly lower first trimester serum levels of native thiol (297.5 μmol/l (153.2-441.8) vs. 366.1 μmol/l (288.7-432.4), P = 0.000), total thiol (327.2 μmol/l (171.0-471.0) vs. 389.9 μmol/l (317.1-449.8), P = 0.000) and higher levels of disulphide (14.2 ± 4.5 μmol/l vs. 12.4 ± 3.4 μmol/l, P = 0.045). No differences were found in these parameters among FMF patients with and without antenatal complications. CONCLUSIONS The main outcome demonstrates a relation between OS and pregnant women with FMF in the first trimester of gestation. OS in the first trimester may be a major aetiological factor of unfavourable pregancy outcomes in this group of patients.
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Affiliation(s)
- Aykan Yucel
- a Department of Perinatology , Zekai Tahir Burak Women's Health Care, Training and Research Hospital , Ankara , Turkey
| | - Cem Yasar Sanhal
- a Department of Perinatology , Zekai Tahir Burak Women's Health Care, Training and Research Hospital , Ankara , Turkey
| | - Korkut Daglar
- a Department of Perinatology , Zekai Tahir Burak Women's Health Care, Training and Research Hospital , Ankara , Turkey
| | - Ozgur Kara
- a Department of Perinatology , Zekai Tahir Burak Women's Health Care, Training and Research Hospital , Ankara , Turkey
| | - Dilek Uygur
- a Department of Perinatology , Zekai Tahir Burak Women's Health Care, Training and Research Hospital , Ankara , Turkey
| | - Ozcan Erel
- b Department of Clinical Biochemistry, Faculty of Medicine , Yildirim Beyazit University , Ankara , Turkey
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Daglar K, Kirbas A, Timur H, Ozturk Inal Z, Danisman N. Placental levels of total oxidative and anti-oxidative status, ADAMTS-12 and decorin in early- and late-onset severe preeclampsia. J Matern Fetal Neonatal Med 2016; 29:4059-64. [PMID: 26953866 DOI: 10.3109/14767058.2016.1154942] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [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
OBJECTIVE Preeclampsia (PE), can be classified according to the timing of disease onset: early-onset PE occurs before the 34th gestational week and late-onset PE occurs in the 34th gestational week or later. The aim of this study was to determine whether total antioxidant status (TAS), and total oxidant status (TOS), ADAMTS-12 and decorin levels differ among early-onset severe PE (EOS-PE), late-onset severe PE (LOS-PE) and uncomplicated pregnancies. METHODS In this case-control study, placental samples obtained from 25 pregnant patients with EOS-PE, 26 pregnant patients with LOS-PE and 28 healthy patients with uncomplicated pregnancies (control group). RESULTS Placenta levels of decorin and TOS were significantly higher and TAS was significantly lower in the EOS-PE and LOS-PE groups than in the control group. These alterations were more prominent in patients with EOS-PE than in patients with LOS-PE. There were no significant differences in the ADAMTS-12 levels of the groups. CONCLUSION The distinctly higher rate of negative perinatal outcomes in both EOS-PE and LOS-PE patients is well evidenced. However, the main questions that need to be answered are whether the only difference between these two diseases is the time of their onset and whether the only difference between them with respect to fetal morbidity and mortality is prematurity.
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Affiliation(s)
- Korkut Daglar
- a Department of Perinatology , Zekai Tahir Burak Women's Health Education and Research Hospital , Ankara , Turkey and
| | - Ayse Kirbas
- a Department of Perinatology , Zekai Tahir Burak Women's Health Education and Research Hospital , Ankara , Turkey and
| | - Hakan Timur
- a Department of Perinatology , Zekai Tahir Burak Women's Health Education and Research Hospital , Ankara , Turkey and
| | - Zeynep Ozturk Inal
- b Department of Obstetrics and Gynecology , Konya Education and Research Hospital , Konya , Turkey
| | - Nuri Danisman
- a Department of Perinatology , Zekai Tahir Burak Women's Health Education and Research Hospital , Ankara , Turkey and
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Biberoglu E, Kirbas A, Daglar K, Biberoglu K, Timur H, Demirtas C, Karabulut E, Danisman N. Serum angiogenic profile in abnormal placentation. J Matern Fetal Neonatal Med 2016; 29:3193-7. [DOI: 10.3109/14767058.2015.1118044] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Ebru Biberoglu
- Department of Perinatology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey,
| | - Ayse Kirbas
- Department of Perinatology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey,
| | - Korkut Daglar
- Department of Perinatology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey,
| | - Kutay Biberoglu
- Department of Obstetrics and Gynecology, Gazi University Medical School, Ankara, Turkey,
| | - Hakan Timur
- Department of Perinatology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey,
| | - Canan Demirtas
- Department of Biochemistry, Gazi University Medical School, Ankara, Turkey, and
| | - Erdem Karabulut
- Department of Biostatistics, Hacettepe University Medical School, Ankara, Turkey
| | - Nuri Danisman
- Department of Perinatology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey,
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Kirbas A, Kirbas O, Daglar K, Inal HA, Kurmus O, Kara O, Timur H, Gencosmanoglu G, Danisman N. Novel indexes of arrhythmogenesis in preeclampsia: QT dispersion, Tp-e interval, and Tp-e/QT ratio. Pregnancy Hypertens 2016; 6:38-41. [PMID: 26955770 DOI: 10.1016/j.preghy.2016.01.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [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: 11/23/2015] [Accepted: 01/19/2016] [Indexed: 01/13/2023]
Abstract
OBJECTIVE There is increasing evidence that preeclampsia (PE) may also be a risk factor for future cardiovascular diseases (CVDs), including arrhythmia. In this study we aimed to evaluate the association between PE and ventricular repolarization using novel electrocardiogram markers: QT interval duration, Tp-e interval, and Tp-e/QT ratio. MATERIALS AND METHODS In this controlled cross-sectional study sixty-four pregnant women with PE (31 with mild and 33 with severe disease) and 32 healthy women with uncomplicated pregnancies in the third trimester were compared by measuring QT parameters, Tp-e interval, and Tp-e/QT ratio. RESULTS Tp-e interval and Tp-e/QT ratio values were significantly higher in both the mild and severe PE groups compared to the healthy pregnant group. CONCLUSION Prevention of CVD requires that patients be aware of their risk factors, be educated about their risk, and perhaps most importantly perceive them to be at risk. In this study, we documented that PE has a significant effect on ventricular repolarization. This alteration could, in part, explain the increased cardiovascular risk in women with a history of PE. This important association can be used to screen women for increased risk in order to better target counseling regarding lifestyle modifications and to follow up and manage women with a history of hypertensive disease of pregnancy more closely.
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Affiliation(s)
- Ayse Kirbas
- Department of Perinatology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey.
| | - Ozgur Kirbas
- Department of Cardiology, Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey.
| | - Korkut Daglar
- Department of Perinatology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey.
| | - Hasan Ali Inal
- Department of Obstetrics and Gynecology, Konya Education and Research Hospital, Konya, Turkey.
| | - Ozge Kurmus
- Department of Cardiology, Mersin State Hospital, Mersin, Turkey.
| | - Ozgur Kara
- Department of Perinatology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey.
| | - Hakan Timur
- Department of Perinatology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey.
| | - Gulenay Gencosmanoglu
- Department of Perinatology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey.
| | - Nuri Danisman
- Department of Perinatology, Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey.
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Biberoglu E, Kirbas A, Daglar K, Kara O, Karabulut E, Yakut HI, Danisman N. Role of inflammation in intrahepatic cholestasis of pregnancy. J Obstet Gynaecol Res 2016; 42:252-7. [DOI: 10.1111/jog.12902] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 10/04/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Ebru Biberoglu
- Department of Perinatology; Zekai Tahir Burak Women's Health Education and Research Hospital; Ankara Turkey
| | - Ayse Kirbas
- Department of Perinatology; Zekai Tahir Burak Women's Health Education and Research Hospital; Ankara Turkey
| | - Korkut Daglar
- Department of Perinatology; Zekai Tahir Burak Women's Health Education and Research Hospital; Ankara Turkey
| | - Ozgur Kara
- Department of Perinatology; Zekai Tahir Burak Women's Health Education and Research Hospital; Ankara Turkey
| | - Erdem Karabulut
- Department of Biostatistics; Hacettepe University Faculty of Medicine; Ankara Turkey
| | - Halil Ibrahim Yakut
- Department of Perinatology; Zekai Tahir Burak Women's Health Education and Research Hospital; Ankara Turkey
| | - Nuri Danisman
- Department of Perinatology; Zekai Tahir Burak Women's Health Education and Research Hospital; Ankara Turkey
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Kirbas A, Daglar K, Timur H, Yilmaz Z, Gencosmanoglu G, Danisman N. Circulating ADAMTS-12 levels in early- and late-onset severe preeclampsia. Med-Science 2016. [DOI: 10.5455/medscience.2016.05.8433] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Kirbas A, Daglar K, Timur H, Biberoglu E, Inal HA, Kara O, Yilmaz Z, Turkmen G, Danisman N. Maternal circulating levels of irisin in intrahepatic cholestasis of pregnancy. J Matern Fetal Neonatal Med 2015; 29:3483-7. [DOI: 10.3109/14767058.2015.1132694] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Biberoglu E, Biberoglu K, Kirbas A, Daglar K, Genc M, Avci A, Danisman N. Circulating and myometrial markers of oxidative stress in pregnant women with fetal growth restriction. J Obstet Gynaecol Res 2015; 42:29-35. [PMID: 26555027 DOI: 10.1111/jog.12857] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [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: 06/08/2015] [Accepted: 08/09/2015] [Indexed: 11/28/2022]
Abstract
AIM The objective of this study was to identify the relationship between fetal growth restriction (FGR) and oxidative stress. The mechanisms that protect against oxidative stress in the local microenvironment were investigated by comparing the activities of the markers, both in the circulation and myometrium. MATERIALS AND METHODS Myometrial tissue and serum levels of malondialdehyde (MDA), xanthine oxidase (XO), catalase (CAT) and superoxide dismutase (SOD) markers were measured in 20 FGR and 20 healthy pregnancies. RESULTS The mean duration of gestation at delivery was shorter (P = 0003) and the mean birthweight was lower P < 0001) in the FGR study group compared with the control group, as expected. While MDA and CAT concentrations were higher in the serum (P < 0.02 and P < 0.01, respectively), but lower in the myometrial samples (P < 0.01) in the FGR versus the control group, XO and myometrial SOD values were comparable in both groups. CONCLUSIONS Although our data demonstrated that FGR is associated with oxidative stress, the exact role and mechanism of the oxidant and antioxidant imbalance is obscure. We speculate that despite limited local synthesis of CAT, effective and efficient removal of MDA in the uterine environment explains high MDA and CAT serum concentrations in women with FGR. Alternatively, a well-functioning myometrial system could rescue the fetus from reactive oxygen species, as demonstrated by lowered MDA and depleted CAT resulting from hyperconsumption. Elevated serum MDA and CAT levels in the serum may reflect the 'spillover' of these markers from the uterus to the circulation.
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Affiliation(s)
- Ebru Biberoglu
- Department of Perinatology, Zekai Tahir Burak Women Health Care, Education and Research Hospital, Ankara, Turkey
| | - Kutay Biberoglu
- Department of Obstetrics and Gynecology, Gazi University Medical School, Ankara, Turkey
| | - Ayse Kirbas
- Department of Perinatology, Zekai Tahir Burak Women Health Care, Education and Research Hospital, Ankara, Turkey
| | - Korkut Daglar
- Department of Perinatology, Zekai Tahir Burak Women Health Care, Education and Research Hospital, Ankara, Turkey
| | - Metin Genc
- Department of Biochemistry, Ankara University Medical Faculty, Ankara, Turkey
| | - Aslihan Avci
- Department of Biochemistry, Ankara University Medical Faculty, Ankara, Turkey
| | - Nuri Danisman
- Department of Perinatology, Zekai Tahir Burak Women Health Care, Education and Research Hospital, Ankara, Turkey
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Kirbas A, Ersoy AO, Daglar K, Dikici T, Biberoglu EH, Kirbas O, Danisman N. Prediction of Preeclampsia by First Trimester Combined Test and Simple Complete Blood Count Parameters. J Clin Diagn Res 2015; 9:QC20-3. [PMID: 26674673 DOI: 10.7860/jcdr/2015/15397.6833] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [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: 06/27/2015] [Accepted: 09/10/2015] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Preeclampsia is a serious disease which may result in maternal and neonatal mortality and morbidity. Improving the outcome for preeclampsia necessitates early prediction of the disease to identify women at high risk. Measuring blood cell subtype ratios, such as the neutrophil to lymphocyte (NLR) and platelet to lymphocyte (PLR) ratios, might provide prognostic and diagnostic clues to diseases. AIM To investigate hematological changes in early pregnancy, using simple complete blood count (CBC) and blood concentrations of beta-human chorionic gonadotropin (β-hCG) and pregnancy-associated plasma protein-A (PAPP-A) to determine whether these measures are of any value in the prediction and early diagnosis of preeclampsia. MATERIALS AND METHODS Six hundred fourteen consecutive pregnant women with preeclampsia (288 with mild disease and 326 with severe disease) and 320 uncomplicated pregnant women were included in the study. Blood samples for routine CBC and first trimester screen, which combines PAPP-A and free β-hCG blood concentrations, were analyzed. RESULTS The NLR values were significantly higher in the severe preeclampsia group compared with the control group (p<0.001). We also confirmed that levels of PAPP-A were lower in patients who developed preeclampsia. CONCLUSION Because measuring CBC parameters, particularly NLR, is fast and easily applicable, they may be used to predict preeclampsia.
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Affiliation(s)
- Ayse Kirbas
- Faculty, Department of Perinatology, Zekai Tahir Burak Women's Health Education and Research Hospital , Ankara, Turkey
| | - Ali Ozgur Ersoy
- Faculty, Department of Perinatology, Zekai Tahir Burak Women's Health Education and Research Hospital , Ankara, Turkey
| | - Korkut Daglar
- Faculty, Department of Perinatology, Zekai Tahir Burak Women's Health Education and Research Hospital , Ankara, Turkey
| | - Turkan Dikici
- Faculty, Deparment of Obstetric and Gynecology, Hilal Hospital , Kirikkale, Turkey
| | - Ebru Hacer Biberoglu
- Faculty, Department of Perinatology, Zekai Tahir Burak Women's Health Education and Research Hospital , Ankara, Turkey
| | - Ozgur Kirbas
- Faculty, Department of Cardiology, Yuksek Ihtisas Education and Research Hospital , Ankara, Turkey
| | - Nuri Danisman
- Assistant Professor, Department of Perinatology, Zekai Tahir Burak Women's Health Education and Research Hospital , Ankara, Turkey
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Daglar K, Biberoglu E, Kirbas A, Dirican AO, Genc M, Avci A, Biberoglu K. The cellular immunity and oxidative stress markers in early pregnancy loss. J Matern Fetal Neonatal Med 2015; 29:1840-3. [PMID: 26135767 DOI: 10.3109/14767058.2015.1064886] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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: 11/13/2022]
Abstract
OBJECTIVE We investigated whether changes in cellular immunity and oxidative stress in pregnancy have any association with spontaneous miscarriage. MATERIAL AND METHODS Circulating adenosine deaminase (ADA) activity as a marker of cellular immunity and malondialdehyde (MDA) and catalase (CAT), glutathione peroxidase (GPx) as markers of T lymphocyte activation and parameters of oxidative stress and antioxidant defense were compared between 40 women with early pregnancy loss and another 40 women with ungoing healthy pregnancy. RESULTS Women with miscarriage had higher serum ADA and GPx levels when compared with women with normal pregnancy (p = 0.034 and p < 0.001, respectively). Although serum MDA level was slightly higher in women with miscarriage, the difference was not significant (p = 0.083). CAT levels were alike in both groups. CONCLUSION We have demonstrated an increased cellular immunity and perhaps a compensated oxidative stress related to increased antioxidant activation in women with early spontaneous pregnancy loss.
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Affiliation(s)
- Korkut Daglar
- a Department of Perinatology , Zekai Tahir Burak Women Health Care, Education and Research Hospital , Ankara , Turkey
| | - Ebru Biberoglu
- a Department of Perinatology , Zekai Tahir Burak Women Health Care, Education and Research Hospital , Ankara , Turkey
| | - Ayse Kirbas
- a Department of Perinatology , Zekai Tahir Burak Women Health Care, Education and Research Hospital , Ankara , Turkey
| | - Aylin Onder Dirican
- a Department of Perinatology , Zekai Tahir Burak Women Health Care, Education and Research Hospital , Ankara , Turkey
| | - Metin Genc
- b Department of Biochemistry , Ankara University Faculty of Medicine , Ankara , Turkey , and
| | - Aslihan Avci
- b Department of Biochemistry , Ankara University Faculty of Medicine , Ankara , Turkey , and
| | - Kutay Biberoglu
- c Department of Obstetrics and Gynecology , Gazi University Medical School , Ankara , Turkey
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Biberoglu EH, Kirbas A, Daglar K, Danisman N. Prenatal Diagnosis of A Case with Frontoethmoidal Encephalocele and the Neonatal Outcome. J Clin Diagn Res 2015; 9:QD05-7. [PMID: 26393172 DOI: 10.7860/jcdr/2015/13746.6166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 02/27/2015] [Accepted: 05/29/2015] [Indexed: 11/24/2022]
Abstract
Encephalocele is a rare congenital defect characterized by a sac-like protrusion of the neural tissue and/or meninges through a defect in the skull. We reported a case with a naso-frontal anterior encephalocele which was diagnosed by prenatally and confirmed by postnatal evaluation and complications such as hypoadrenalism, diabetes insipidus and arterial thrombosis in the lower limbs were diagnosed in the neonatal period.
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Affiliation(s)
- Ebru Hacer Biberoglu
- Faculty, Department of Perinatology, Zekai Tahir Burak Women's Health Education and Research Hospital , Ankara, Turkey
| | - Ayse Kirbas
- Faculty, Department of Perinatology, Zekai Tahir Burak Women's Health Education and Research Hospital , Ankara, Turkey
| | - Korkut Daglar
- Faculty, Department of Perinatology, Zekai Tahir Burak Women's Health Education and Research Hospital , Ankara, Turkey
| | - Nuri Danisman
- Assistant Professor, Department of Perinatology, Zekai Tahir Burak Women's Health Education and Research Hospital , Ankara, Turkey
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Kirbas O, Biberoglu EH, Kirbas A, Daglar K, Kurmus O, Danisman N, Biberoglu K. Evaluation of ventricular repolarization in pregnant women with intrahepatic cholestasis. Int J Cardiol 2015; 189:25-9. [PMID: 25885869 DOI: 10.1016/j.ijcard.2015.04.001] [Citation(s) in RCA: 9] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Revised: 03/06/2015] [Accepted: 04/01/2015] [Indexed: 12/15/2022]
Abstract
BACKGROUND Bile acids can induce arrhythmia by altering cardiomyocyte contractility or electrical conduction. The aim of this study was to investigate, by means of QT dispersion parameter detected by simple standard electrocardiogram (ECG), ventricular repolarization changes in pregnant women with and without intrahepatic cholestasis of pregnancy (ICP). METHODS In this case-control study including 75 pregnant women with cholestasis and 35 healthy, uncomplicated pregnancy cases, electrocardiographic QT interval durations and QT dispersion (QT-disp) parameters, corrected for the patients' heart rate using the Hodges formula, were investigated. RESULTS Maximum corrected QT interval values were significantly higher in the severe ICP group than in the control group (p < 0.001) and significantly higher in the severe ICP group than in the mild ICP group (p = 0.01). The values of the mild ICP and control groups were similar. Corrected QT-disp values were also significantly higher in both ICP groups than in the control group and significantly higher in the severe ICP group than in the mild ICP group. CONCLUSION Cholestatic diseases predispose patients to cardiovascular complications. Our data clearly demonstrated that QT-disp values were significantly altered in pregnant women with cholestasis when compared to the normal ones. This simple ECG parameter can be used to screen high-risk women, in order to better target counseling regarding lifestyle modifications and to conduct closer follow up and management of women with a history of ICP.
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Affiliation(s)
- Ozgur Kirbas
- Department of Cardiology, Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey.
| | - Ebru Hacer Biberoglu
- Department of Perinatology, Zekai Tahir Burak Women Health Care, Education and Research Hospital, Ankara, Turkey.
| | - Ayse Kirbas
- Department of Perinatology, Zekai Tahir Burak Women Health Care, Education and Research Hospital, Ankara, Turkey.
| | - Korkut Daglar
- Department of Perinatology, Zekai Tahir Burak Women Health Care, Education and Research Hospital, Ankara, Turkey.
| | - Ozge Kurmus
- Department of Cardiology, Ataturk Education and Research Hospital, Ankara, Turkey.
| | - Nuri Danisman
- Department of Perinatology, Zekai Tahir Burak Women Health Care, Education and Research Hospital, Ankara, Turkey.
| | - Kutay Biberoglu
- Gazi University Medical School, Department of Obstetrics and Gynecology, Ankara, Turkey.
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Daglar K, Tokmak A, Kirbas A, Guzel AI, Erkenekli K, Yucel A, Uygur D. Maternal serum vitamin D levels in pregnancies complicated by neural tube defects. J Matern Fetal Neonatal Med 2014; 29:298-302. [DOI: 10.3109/14767058.2014.999037] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Korkut Daglar
- Dr. Zekai Tahir Burak Women’s Health Research and Education Hospital, Ankara, Turkey
| | - Aytekin Tokmak
- Dr. Zekai Tahir Burak Women’s Health Research and Education Hospital, Ankara, Turkey
| | - Ayse Kirbas
- Dr. Zekai Tahir Burak Women’s Health Research and Education Hospital, Ankara, Turkey
| | - Ali Irfan Guzel
- Dr. Zekai Tahir Burak Women’s Health Research and Education Hospital, Ankara, Turkey
| | - Kudret Erkenekli
- Dr. Zekai Tahir Burak Women’s Health Research and Education Hospital, Ankara, Turkey
| | - Aykan Yucel
- Dr. Zekai Tahir Burak Women’s Health Research and Education Hospital, Ankara, Turkey
| | - Dilek Uygur
- Dr. Zekai Tahir Burak Women’s Health Research and Education Hospital, Ankara, Turkey
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Kaya B, Tuten A, Daglar K, Misirlioglu M, Polat M, Yildirim Y, Unal O, Kilic GS, Guralp O. Balloon tamponade for the management of postpartum uterine hemorrhage. J Perinat Med 2014; 42:745-53. [PMID: 24663227 DOI: 10.1515/jpm-2013-0336] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Accepted: 02/27/2014] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To evaluate the use of the Bakri balloon in postpartum hemorrhage (PPH) resistant to medical treatment. METHODS The Bakri balloon was applied to 45 women with PPH after failure of initial management. Bilateral internal iliac artery ligation (BIIAL) and hysterectomy were performed if necessary. RESULTS The Bakri balloon was applied in 45 women; an additional BIIAL was required in nine women. The mean inflation volume of the Bakri balloon was 571±264 mL (range: 240-1300 mL). Hemostasis was achieved in 34 (75.5%) women with the Bakri balloon alone, and in six women with an additional BIIAL. The Bakri balloon was effective with additional procedures overall in 40 of 45 (88.8%) women. In 34 women with uterine atony, the Bakri balloon was successful alone in 27 (79.4%) and with an additional BIIAL in 30 (88.2%) women. An inflation volume of >500 mL was necessary in 18 women with uterine atony. CONCLUSION The Bakri balloon may be performed as a first line of treatment for PPH resistant to uterotonic agents, and can be used not only in tertiary centers but also in limited-resource centers. The inflation volume of the Bakri balloon should be adjusted according to the type of PPH; a volume exceeding 500 mL may be necessary in uterine atony.
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Kirbas A, Biberoglu E, Daglar K, İskender C, Erkaya S, Dede H, Uygur D, Danisman N. Neutrophil-to-lymphocyte ratio as a diagnostic marker of intrahepatic cholestasis of pregnancy. Eur J Obstet Gynecol Reprod Biol 2014; 180:12-5. [DOI: 10.1016/j.ejogrb.2014.05.042] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Revised: 05/23/2014] [Accepted: 05/28/2014] [Indexed: 02/07/2023]
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