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Akdemir Y, Ayvaci H, Uludogan M. Effect of multiple thrombophilic gene mutations on uterine artery blood flow in nonpregnant recurrent pregnancy loss patients: are we searching enough? J Matern Fetal Neonatal Med 2019; 33:2466-2472. [PMID: 30704356 DOI: 10.1080/14767058.2019.1569618] [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: 10/27/2022]
Abstract
Objective: To investigate whether multiple thrombophilic mutations had a significant effect on uterine artery blood flow of nonpregnant recurrent pregnancy loss (RPL) patients.Materials and methods: Among 71 RPL patients, FV Leiden (FV), prothrombin G20210A (PTGM) and MTHFR mutations, deficiency of protein S, protein C and antithrombin III (AT3), association of Val34Leu polymorphism of the FXIII (FXIII), 4G/5G polymorphism of plasminogen activator inhibitor (PAI), -455-G/A polymorphism of β-fibrinogen (fibrinogen), and HPA-1 a/b L33P polymorphism of GPIIIa (GPIIIa) genes were investigated. Doppler flow measurements of RPL patients and healthy controls were performed at mid-luteal phase.Results: Twenty-two patients who had no thrombophilic gene mutations were grouped as unexplained RPL. Also, while 25 patients had multiple mutations, 24 patients had single mutation. In the multiple mutation RPL group, the most frequent mutations were PAI (22%), MTHFR C677T (20%), MTHFR A1298C (19%), and fibrinogen (11%). Only in the multiple mutation RPL group, mean PI and dominant PI values were significantly higher than the control group.Conclusions: Our data showed negative effects of multiple thrombophilic gene mutations on uterine artery blood flow and clarified the different effects of single and multiple thrombophilic factors on uterine artery vasculature. It is concluded that investigating more thrombophilic mutations could ameliorate prognostic factors of RPL and interactions to improve uterine artery blood flow could bring benefit to obstetric outcome.
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Affiliation(s)
- Yesim Akdemir
- Obstetrics and Gynecology Department, Bulent Ecevit University School of Medicine, Zonguldak, Turkey
| | - Habibe Ayvaci
- Perinatology Department, Zeynep Kamil Women and Children's Training and Research Hospital, Istanbul, Turkey
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Namazov A, Grin L, Karakus R, Uludogan M, Ayvaci H. An effect of maternal nifedipine therapy on fetoplacental blood flow: a prospective study. Arch Gynecol Obstet 2018; 298:685-688. [PMID: 29971560 DOI: 10.1007/s00404-018-4839-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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: 02/18/2018] [Accepted: 06/08/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE The aim of this study is to assess the effects of maternal nifedipine administration on placental and fetal blood flow. METHODS A total of 29 patients with preterm labor diagnosis admitted to the tertiary care center, Zeynep Kamil Hospital, were evaluated. Before and 24-48 h after administration of oral nifedipine, Doppler ultrasound scan was carried out to measure fetal middle cerebral artery, ductus venosus, umbilical artery, and maternal uterine artery blood flow. RESULTS After 24 and 48 h of therapy, there were no changes in mean PI and RI in the umbilical arteries and ductus venosus (p > 0.05). Fetal middle cerebral artery and maternal uterine artery PI and RI values showed a significant reduction 24-48 h after oral nifedipine therapy (p < 0.05). CONCLUSIONS Our study showed that 24 and 48 h after oral nifedipine therapy, there is a significant increase in fetal MCA and maternal uterine artery blood flow, while fetal umbilical artery and ductus venosus Doppler values do not change.
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Affiliation(s)
- Ahmet Namazov
- Department of Obstetrics and Gynecology, Barzilai University Medical Center, Ben-Gurion University of Negev, Faculty of Health Sciences, HaHistadrut street 2, Ashkelon, Israel.
| | - Leonti Grin
- Department of Obstetrics and Gynecology, Barzilai University Medical Center, Ben-Gurion University of Negev, Faculty of Health Sciences, HaHistadrut street 2, Ashkelon, Israel
| | - Resul Karakus
- Obstetrics and Gynecology Department, Zeynep Kamil Hospital, Istanbul, Turkey
| | - Mehmet Uludogan
- Obstetrics and Gynecology Department, Zeynep Kamil Hospital, Istanbul, Turkey
| | - Habibe Ayvaci
- Obstetrics and Gynecology Department, Zeynep Kamil Hospital, Istanbul, Turkey
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Ekiz A, Gul A, Uludogan M, Bornaun H. Prenatal diagnosis and postnatal outcome of persistent right ductus arteriosus: a report of three cases. J Med Ultrason (2001) 2015; 42:571-4. [PMID: 26576984 DOI: 10.1007/s10396-015-0644-2] [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: 02/06/2015] [Accepted: 06/08/2015] [Indexed: 10/23/2022]
Abstract
The ductus arteriosus is a fetal vascular connection between the main pulmonary artery and aorta that diverts blood away from the pulmonary bed. Left and right ductus arteriosi emerge from embryological aortic arches. In normal embryologic cardiac development, both right aortic and ductal arches regress and the left ones persist. Persistent right ductus arteriosus (rDA) is one of the congenital anomalies of the ductal arch. In this paper, we report three cases of persistent right ductus arteriosus with right aortic arch.
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Affiliation(s)
- Ali Ekiz
- Department of Maternal and Fetal Medicine, Kanuni Sultan Suleyman Education and Research Hospital, Fevzi Cakmak mah., Barbaros cd. 775 Sk, Validesuyu Konutlari, C2 blok, D:34 Gaziosmanpasa, Istanbul, Turkey.
| | | | | | - Helen Bornaun
- Department of Pediatric Cardiology, Kanuni Sultan Suleyman Education and Research Hospital, Istanbul, Turkey
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Sahinoglu Z, Yuksel A, Uludogan M, Bilgic R, Toksoy G. Left diaphragmatic eventration associated with ipsilateral pulmonary sequestration and intrathoracic kidney in a fetus: reviewing the prenatal diagnosis and etiopathogenesis. Fetal Pediatr Pathol 2011; 30:233-43. [PMID: 21434828 DOI: 10.3109/15513815.2011.555808] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [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: 11/13/2022]
Abstract
The prenatal diagnosis of congenital diaphragmatic eventration, pulmonary extralobar sequestration and intrathoracic ectopic kidney in a single fetus is not reported yet according to the pubmed. Congenital diaphragmatic eventration is an abnormal elevation of the diaphragm. Differential diagnosis from hernia is essential for the perinatal management. Extralobar sequestrations are usually asymptomatic and detected incidentally. Intrathoracic kidney is an extremely rare congenital anomaly. Genitourinary and cardiac anomalies should be searched as common co-existing malformations. Besides prenatal ultrasound, fetal magnetic resonance imaging has a substantial support in counselling the family, planning the follow-up of the pregnancy and decision-making for the perinatal management.
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Affiliation(s)
- Zeki Sahinoglu
- Department of Perinatology, Zeynep Kamil Women and Children Diseases Education and Research Hospital, Istanbul, Turkey.
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5
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Sahinoglu Z, Uludogan M, Arik H, Aydin A, Kucukbas M, Bilgic R, Toksoy G. Prenatal ultrasonographical features of limb body wall complex: a review of etiopathogenesis and a new classification. Fetal Pediatr Pathol 2007; 26:135-51. [PMID: 17886024 DOI: 10.1080/15513810701563728] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [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: 10/22/2022]
Abstract
Limb body wall complex is a spectrum of multiple severe anomalies. The etiopathogenesis and clinical classification are still under discussion. In our article, while reviewing previous etiopathogenetical hypothesis, we propose a new clinical classification regarding embryological theories and pheneotypical features. According to the Van Allen diagnostic criteria, the findings of 6 affected fetuses are presented. Prenatal diagnosis was performed in 5 of 6 cases. Craniofacial malformations were present in only 1 case. Thoracic defect and abdominoschisis (either infraumbilical or supraumbilical) associated with visceral eventration, placental-umbilical cord anomalies, and limb defects were detected in the other 5 cases. Aberrant development of each of the 4 embryonic folds (cephalic, 2 lateral abdominal, and caudal) associated with faulty umbilical ring development and placental formation were considered responsible for development of various malformations. In previous clinical classifications, existence or absence of the craniofacial malformation was utilized as an unique discriminating criterion while multiple anomalies exist. In this report, we propose a new clinical classification concerning almost all anomalies caused by defective placental attachment and maldevelopment of the 4 folds.
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Affiliation(s)
- Zeki Sahinoglu
- Division of Perinatology, Department of Obstetrics and Gynecology, Zeynep Kamil Women and Children Diseases Education and Research Hospital, Uskudar, Istanbul, Turkey.
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Sahinoglu Z, Uludogan M, Sayar C, Turkover B, Toksoy G. Second trimester choroid plexus cysts and trisomy 18. Int J Gynaecol Obstet 2003; 85:24-9. [PMID: 15050463 DOI: 10.1016/j.ijgo.2003.08.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [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: 05/02/2003] [Revised: 08/18/2003] [Accepted: 08/25/2003] [Indexed: 11/24/2022]
Abstract
OBJECTIVES In this study, the aims were to reveal the incidence of isolated choroid plexus cyst in our population, and to discuss the accuracy of distinguishing either an isolated or non-isolated choroid plexus cyst. METHODS The study population was consisted of 10594 pregnant women. The patients with choroid plexus cysts were classified into two groups: isolated and non-isolated. Detailed ultrasonographic examination and genetic counseling were performed and triple screening test was ordered. The incidence, sensitivity, specificity, false-positive rate and likelihood ratio of cases with isolated choroid plexus cyst for trisomy 18 were determined. RESULTS Choroid plexus cysts were identified in 109 patients (109/10594; 1.02%). In 102 patients isolated choroid plexus cysts, and in seven patients additional fetal anomalies supporting trisomy 18 were detected. Trisomy 18 was detected in four patients, and one of them had isolated choroid plexus cyst. The likelihood ratio in cases of isolated choroid plexus cysts for trisomy 18 was 9.51 (95% confidence interval, 0.2-41). CONCLUSIONS According to the study the individual risk for trisomy 18 in isolated choroid plexus cyst should be calculated by using the likelihood ratio. These data allows the physician to express the individual risk of trisomy 18 and permits more accurate genetic counseling.
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Affiliation(s)
- Z Sahinoglu
- Department of Perinatology, Zeynep Kamil Women and Children Hospital, Uskudar, Istanbul, Turkey.
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7
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Sahinoglu Z, Uludogan M, Gurbuz A, Karateke A. Prenatal diagnosis of thanatophoric dysplasia in the second trimester: ultrasonography and other diagnostic modalities. Arch Gynecol Obstet 2003; 269:57-61. [PMID: 14605823 DOI: 10.1007/s00404-002-0417-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [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: 04/24/2002] [Accepted: 08/13/2002] [Indexed: 11/30/2022]
Abstract
Thanatophoric dysplasia is the most common type of neonatal lethal osteochondrodysplasias, with an estimated frequency of nearly of 1 in 20,000 births. It is a disorder characterized by extremely short ribs, tubular bones and macrocephaly. The prenatal diagnosis of thanatophoric dysplasia has been well established by ultrasonography in the second trimester; however it is not always possible to differentiate the thanatophoric dysplasia fetuses from the others with skeletal dysplasias like fibrochondrogenesis or atelosteogenesis by ultrasonography. Recently, mutations in the fibroblast growth factor receptor 3 gene, located on the short arm of chromosome 4 have been identified as a cause of thanatophoric dysplasia. In this article we described the prenatal diagnosis of two fetuses with thanatophoric dysplasia at 18 and 24 weeks of gestation by ultrasonography. Postpartum radiological and histological analysis confirmed our prenatal diagnosis. Our purpose was to remind the differential prenatal diagnosis with other skeletal dysplasias and new prenatal diagnostic modalities.
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Affiliation(s)
- Zeki Sahinoglu
- Zeynep Kamil Women and Children Education and Research Hospital, Department of Perinatology, Uskudar, Istanbul, Turkey. zekisa @ixir.com
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8
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Abstract
Klippel-Trenaunay-Weber syndrome (KTW), also known as angio-osteohypertrophy syndrome, is a complex developmental disorder characterized by asymmetric hemi-hypertrophy of limbs and trunk due to bony and soft tissue overgrowth that may extend across the midline, varicose veins, and cutaneous hemangiomata. This rare syndrome has been previously described in the prenatal period by ultrasonography, and in literature, there are quite different presentation of cases. We describe a case suggested as a KTW syndrome by prenatal ultrasonography. The sonographic appearance of an unilateral leg hypertrophy associated with irregular echolucent cystic areas was consistent with KTW syndrome. A spheric, weak-echogenic mass without any active blood flow located in the umbilical cord revealed by color Doppler ultrasonography was an unexpected finding. The postpartum examination confirmed the prenatal diagnosis.
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MESH Headings
- Adolescent
- Blood Flow Velocity
- Diagnosis, Differential
- Fatal Outcome
- Female
- Humans
- Infant, Newborn
- Infant, Newborn, Diseases/diagnosis
- Infant, Newborn, Diseases/diagnostic imaging
- Infant, Newborn, Diseases/pathology
- Klippel-Trenaunay-Weber Syndrome/diagnosis
- Klippel-Trenaunay-Weber Syndrome/diagnostic imaging
- Klippel-Trenaunay-Weber Syndrome/pathology
- Leg/abnormalities
- Leg/diagnostic imaging
- Pregnancy
- Pregnancy Trimester, Second
- Ultrasonography, Doppler, Color
- Ultrasonography, Prenatal
- Umbilical Veins/physiology
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Affiliation(s)
- Zeki Sahinoglu
- Zeynep Kamil Women and Children's Hospital, Perinatology Department, Uskudar, Istanbul, Turkey
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Abstract
Several cases of enlarged cavum vergae have been reported, but prenatal diagnosis of this condition is very rare. We report 3 cases of dilated cavum vergae diagnosed prenatally using sonography. In 1 of the 3 fetuses, ventriculomegaly and lumbar meningomyelocele were additional sonographic findings. In 1 of the 3 infants, a stereotactic cyst-peritoneal shunt was placed at 6 months of age to relieve intracranial hypertension due to progressive enlargement of the cavum vergae. The infant who had a meningomyelocele required surgical repair of this defect shortly after birth; in the third infant, the dilated cavum vergae remained asymptomatic, and no surgery was necessary. When interhemispheric cystic lesions are identified prenatally, physicians must distinguish them from pathologic cysts and determine whether associated malformations are present. Sonography is useful for both the differential diagnosis and identification of associated anomalies.
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Affiliation(s)
- Zeki Sahinoglu
- Department of Perinatology, Zeynep Kamil Women and Children's Hospital, Uskudar, Istanbul, Turkey
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Demirci F, Kuyumcuoglu U, Uludogan M, Gorgen H, Sahinoglu Z, Delikara MN. Evaluation of urethrovesical junction mobility by perineal ultrasonography in stress urinary incontinence. J PAK MED ASSOC 1996; 46:2-5. [PMID: 8830164] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Perineal ultrasonographic measurements of the cephalocaudal and the ventrodorsal components of urethro-vesical junction (UVJ) movement at rest and stress was performed in 35 patients of stress urinary incontinence (SUI) and 20 continent controls. The cephalocaudal distance of UVJ from the pubis at rest position was almost similar in both continent and incontinent groups, but there was significant difference during stress. The cephalocaudal mobility and the ventrodorsal distance from the pubis was markedly different between the two groups, both at rest and during stress. However, the ventrodorsal mobility was similar in both groups. It is concluded that the UVJ mobility of SUI cases was higher on the cephalocaudal axis than the vetrodorsal axis. The distance between UVJ and the pubis was more on the ventrodorsal axis as compared to the control group and UVJ passed down the pubic symphysis in 63% of SUI cases during stress.
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Affiliation(s)
- F Demirci
- Department of Obstetric and Gynaecology, Zeynep Kamil Women and Children Hospital, Uskudar, Istanbul, Turkey
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Demirci F, Kuyumcuoglu U, Api M, Uludogan M. Longitudinal vaginal septum: an unusual cause of postpartum total uterine prolapse. J PAK MED ASSOC 1995; 45:221-2. [PMID: 8775495] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Longitudinal vaginal septum, a rare congenital fusion defect of mullarian ducts rarely causes dystosia of labour and total uterine prolapse. Several surgical techniques were developed for repair of prolapse but no consensus has been reached on one type of operation.
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Affiliation(s)
- F Demirci
- Department of Obstetric and Gynaecology, Zeynep Kamil Women and Children Hospital, Istanbul, Turkey
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