Browsing by Author "Cetin, Orkun"

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Acoustic Radiation Force Impulse Elastosonography of Placenta in Maternal Red Blood Cell Alloimmunization: a Preliminary and Descriptive Study
(Soc Romana Ultrasonografe Medicina Biologie-srumb, 2017) Cetin, Orkun; Karaman, Erbil; Arslan, Harun; Akbudak, Ibrahim; Yildizhan, Recep; Kolusari, Ali
Aims: Maternal red blood cell alloimmunization is an important cause of fetal morbidity and mortality in the perinatal period, despite well-organized prophylaxis programs. The objective of the study was to evaluate placental elasticity by using Acoustic Radiation Force Impulse (ARFI) in Rhesus (Rh) alloimmunized pregnant women with hydropic and nonhydropic fetuses and to compare those with healthy pregnant women. Material and methods: This case-control and descriptive study comprised twenty-eight healthy pregnant women, 14 Rh alloimmunized pregnant women with nonhydropic fetuses, and 16 Rh alloimmunized pregnant women with hydropic fetuses in the third trimester of pregnancy. Placental elasticity measurements were performed by ARFI elastosonography at the day of delivery. The maternal characteristics and neonatal outcomes of the patients were also noted. Results: The highest mean placental ARFI scores were observed in Rh alloimmunized pregnant women with hydropic fetuses (1.13 m/s) (p= 0.001). Healthy controls and Rh alloimmunized pregnant women with nonhydropic fetuses had similar mean placenta ARFI scores (0.84 m/s, 0.88 m/s, respectively) (p< 0.05). Conclusions: Based on the present findings, the placenta becomes stiffer in Rh alloimmunized pregnancies complicated with hydrops fetalis. The increased placental ARFI scores may be a supplemental marker for adverse pregnancy outcomes, additional to Doppler evaluation of middle cerebral artery. This data should be confirmed with a large sample size and prospective studies by using serial measurements of ARFI elastosonography in maternal red blood cell alloimmunization.
Amniotic Fluid Oxidant-Antioxidant Status in Foetal Congenital Nervous System Anomalies
(Sage Publications Ltd, 2018) Cim, Numan; Tolunay, Harun Egemen; Karaman, Erbil; Boza, Baris; Bilici, Mustafa; Cetin, Orkun; Sahin, Hanim Guler
Objective This study aimed to evaluate the oxidant-antioxidant status of amniotic fluid in pregnant women with foetal congenital malformations of the central nervous system. Methods We studied pregnant women with foetal congenital nervous system anomalies at 16-22 weeks' gestation (n=36). The control group (n=30) consisted of pregnant women at the same gestational age who underwent amniocentesis, resulting in a normal karyotype. We analysed glutathione, catalase, and malondialdehyde levels in amniotic fluid. Enzyme activation was measured by spectrophotometry. Results The demographic features of the groups were similar in terms of age, parity, body mass index, and gestational weeks. We detected lower glutathione and catalase levels in the foetal congenital anomaly group than in the control group. We detected higher malondialdehyde levels in the foetal congenital anomaly group than in the control group. Conclusion In the organism, the rate of formation of free radicals and their rate of removal are balanced, and this is called oxidative balance. As long as oxidative stability is achieved, the organism is not affected by free radicals. This fact should be kept in mind to avoid any type of teratogenic agent that could lead to congenital disorders.
Chemerin Level in Pregnancies Complicated by Preeclampsia and Its Relation With Disease Severity and Neonatal Outcomes
(Taylor & Francis inc, 2017) Cetin, Orkun; Kurdoglu, Zehra; Kurdoglu, Mertihan; Sahin, H. Guler
The aims of this prospective study were to detect maternal serum chemerin level in patients with preeclampsia and investigate its association with disease severity and neonatal outcomes. Maternal serum chemerin levels were significantly elevated in severe preeclamptic women (394.72 +/- 100.01ng/ml) compared to mild preeclamptic women (322.11 +/- 37.60ng/ml) and healthy pregnant women (199.96 +/- 28.05ng/ml) (p=.001). Maternal serum chemerin levels were positively correlated with systolic and diastolic blood pressure, C-reactive protein levels, homeostasis model assessment of insulin resistance, proteinuria, AST, ALT, and duration of hospitalisation. Gestational week at delivery, birthweight, and APGAR scores at 1 and 5min were negatively correlated with maternal serum chemerin level. A maternal serum chemerin level of >252.0ng/ml indicated preeclampsia with 95.5% sensitivity and 95.7% specificity. There was a positive correlation between maternal serum chemerin level and severity of preeclampsia. Additionally, adverse neonatal outcomes were significantly associated with high maternal serum chemerin levels.
Clinical and Perinatal Outcomes in Eclamptic Women With Posterior Reversible Encephalopathy Syndrome
(Springer Heidelberg, 2015) Kurdoglu, Zehra; Cetin, Orkun; Sayin, Refah; Dirik, Deniz; Kurdoglu, Mertihan; Kolusari, Ali; Sahin, H. Guler
Purpose To compare the clinical and perinatal outcomes in eclamptic women with and without posterior reversible encephalopathy syndrome (PRES). Methods This single-center, retrospective, cohort study was conducted between 2008 and 2013. The clinical and perinatal outcomes of eclamptic patients were obtained from hospital records. Magnetic resonance imaging was used for the diagnosis of PRES. Eighty-one eclamptic women were divided into two groups: 45 and 36 patients were included in the PRES and non-PRES groups, respectively. Results In the PRES group, headache and visual impairment together (60.0 %) were the most common presenting symptoms. In the non-PRES group, only headache was the most common (50 %) presenting symptom. Occipital and parietal lobes were the most frequently affected areas in the PRES group. Women in the PRES group had a higher body mass index value (p = 0.005), longer hospitalization time (p = 0.001), and higher level of proteinuria (p = 0.012) than those in the non-PRES group. Women in the non-PRES group had higher Apgar scores (p = 0.002) than those in the PRES group. Conclusions This study indicates that PRES manifests predominantly with headache and visual impairment together. Adverse neonatal outcomes are also common in these patients.
Comparison of Placental Elasticity in Normal and Pre-Eclamptic Pregnant Women by Acoustic Radiation Force Impulse Elastosonography
(Wiley-blackwell, 2016) Karaman, Erbil; Arslan, Harun; Cetin, Orkun; Sahin, Hanim Guler; Bora, Aydin; Yavuz, Alparslan; Akbudak, Ibrahim
AimThe aim of this research was to study and compare placental elasticity with acoustic radiation force impulse (ARFI) elastography in pre-eclamptic and normal pregnancies. MethodsA total of 107 singleton pregnancies in the third trimester (38 healthy control subjects, 34 patients with gestational hypertension, and 35 pre-eclampsia patients) were included in the study. ARFI elastography was used to determine the placental elasticity in the three predetermined regions of the placenta (the fetal edge, maternal edge, and central part of the placenta). The obstetrical data regarding grayscale and Doppler ultrasonography and perinatal outcomes were reviewed. A mean placental shear wave velocity cut-off value that predicts the presence of pre-eclampsia was determined. ResultsThe shear wave elasticity values in the pre-eclampsia group in all three regions were significantly higher than in the gestational hypertension and healthy control groups (P=0.001). The most significant difference was found in the peripheral edge of the placenta from the fetal surface in the pre-eclampsia group (P=0.001). ConclusionThe stiffness of the placenta determined by the ARFI technique is significantly higher in pre-eclampsia patients. ARFI elastography of the placenta might be used as a non-invasive and easy method in the diagnosis and evaluation of pre-eclampsia as a supplement to the already existing methods.
Comparison of Topical Lidocaine Spray With Forced Coughing in Pain Relief During Colposcopic Biopsy Procedure: a Randomised Trial
(Taylor & Francis inc, 2019) Karaman, Erbil; Kolusari, Ali; Alkis, Ismet; Cetin, Orkun
Our objective was to compare the effectiveness of local lidocaine spray (LS) compared to forced coughing (FC) for relieving the pain during colposcopically guided cervical biopsies (CGBs). The study was a randomised study, which included patients with abnormal cervical cytologic results requiring a colposcopic biopsy procedure. The patients were randomly assigned to either the 10% LS or the FC groups before the biopsy procedure. As a primary outcome, the pain was assessed by using a 10cm visual analogue scale at the different steps during the procedure. Forty-four and 42 patients had CGBs using LS and FC, respectively. The age, parity, body mass index, history of previous curettage and vaginal delivery, smoking status and the number of biopsies were similar in both groups. The meanSD pain scores after the cervical biopsy were 3.251.4 and 4.41.3 in the LS and FC groups, respectively (p<.05). The operative time was longer in the LS than in the FC group (7.6 +/- 1.4 vs. 5.2 +/- 0.8, p: .004). No complication or adverse effect was observed in both groups. The present study showed that LS use can be recommended for pain relief during colposcopically directed cervical biopsy procedure with a superiority to the FC in the terms of pain and absence of any adverse reactions.Impact StatementWhat is already known on this subject? A colposcopic-guided cervical biopsy is a painful procedure and different techniques have been proposed to relieve this pain with conflicting results. Studies have demonstrated that a forced coughing is a good and easy method for relieving pain with some disadvantages. Local lidocaine spray (LS) is another option for pain relief during the biopsy procedure. However, no randomised study has compared these two methods yet.What the results of this study add? The results from this randomised study suggest that LS has superiority in terms of pain relief during the colposcopic biopsy procedure and has no adverse reactions.What the implications are of these findings for clinical practice and/or further research? The evidence from different studies showed some conflicting results regarding the pain relief methods during the colposcopic biopsy procedure. The local LS can be used in this procedure in routine clinical practice. However, further studies with larger samples and comparison of different methods are needed.
Conservative Treatment of a Placenta Accreta Case: Partial Segmental Uterine Resection
(Aras Part Medical int Press, 2016) Acar, Hicran; Verit, Fatma Ferda; Baydogan, Seyda; Cetin, Orkun; Kurdoglu, Mertihan
Introduction: Placenta accreta (PA) is defined as the penetration of trophoblastic tissue into the myometrium. We aimed to report a case of PA which was successfully managed with partial segmental resection of uterus. Case Presentation: A 23 years old women gravida 2, parity 1, referred to our hospital for placental retention after vaginal delivery. The intraoperative exploration showed that the placenta remained in the right part of the uterine. According to these findings, the initial diagnosis was PA. The placenta and the uterine wall were removed in one piece. The uterine wall was reconstructed by vicyrl no: 1 in a three layer closure. Bilateral uterine artery ligation was performed in order to prevent excess uterus bleeding. Then, modified b-lynch suture was performed for prophylaxis of atonia. Conclusion: Nowadays, conserving the uterus, avoiding the possibility of hemorrhage and making future pregnancies possible are the main objectives of conservative treatments in PA. Partial segmental uterine resection is an alternative, conservative and acceptable management option in selected cases of PA.
Does Bilateral Uterine Artery Ligation Have Negative Effects on Ovarian Reserve Markers and Ovarian Artery Blood Flow in Women With Postpartum Hemorrhage
(Korean Soc Reproductive Medicine, 2019) Verit, Fatma Ferda; Cetin, Orkun; Keskin, Seda; Akyol, Hurkan; Zebitay, Ali Galip
Objective: Bilateral uterine artery ligation (UAL) is a fertility-preserving procedure used in women experiencing postpartum hemorrhage (PPH). However, the long-term effects of this procedure on ovarian function remain unclear. The aim of this study was to investigate whether bilateral UAL compromised ovarian reserve and ovarian blood supply. Methods: This prospective study included 49 women aged between 21 and 36 years who had undergone a cesarean section for obstetric indications. Of these, 25 underwent uterine bilateral UAL to control intractable atonic PPH. The control group consisted of 24 women who had not undergone bilateral UAL. Standard clinical parameters, the results of color Doppler screening, and ovarian reserve markers were assessed in all participants at 6 months after surgery. The clinical parameters included age, parity, cycle history, body mass index, and previous medication and/or surgery. Color Doppler screening findings included the pulsatility index (PI) and resistance index (RI) for both the uterine and ovarian arteries. The ovarian reserve markers included day 3 follicle-stimulating hormone (FSH) levels, antral follicle count, and anti-Mullerian hormone (AMH) levels. Results: There were no significant differences in the ovarian reserve markers of day 3 FSH levels, antral follicle count, and AMH levels between the study and control groups (p>0.05 for all). In addition, no significant differences were observed in the PI and RI indices of the uterine and ovarian arteries (p>0.05 for all). Conclusion: In this study, we showed that bilateral UAL had no negative effects on ovarian reserve or ovarian blood supply, so this treatment should be used as a fertility preservation technique to avoid hysterectomy in patients experiencing PPH.
Early Prenatal Diagnosis of Conjoined Twins: Case Series
(Aras Part Medical int Press, 2015) Cetin, Orkun; Kurdoglu, Zehra; Cim, Numan; Yildizhan, Recep; Sahin, Guler; Kurdoglu, Mertihan
Introduction: Conjoined twins are complicated and unusual form of monozygotic twins. We present early prenatal diagnosis of three cases of conjoined twins by 2-dimensional (2D) ultrasound between 9-10 weeks of gestation. Case presentation: In the first case, we prenatally diagnosed parapagus dicephalus dibrachus dipus with 2-dimensional ultrasound at gestational age of 10 weeks 4 days. In the second case, we detected parapagus dicephalus at the 10 weeks 2 days gestation. In the third case, we diagnosed thoracopagus at the 9 weeks 6 days of gestation, using 2D ultrasound. After proper counselling, all of the patients opted early pregnancy termination due to the poor prognosis of conjoined twins. Conclusion: Early prenatal detection of conjoined twinning is important for the gestational course. Conjoined twinning could be identified in early first trimester with cautious and comprehensive view by experienced sonographers. Early and accurate prenatal diagnosis of conjoined twinning allows preferable counselling of the parents and gives a chance for early termination of pregnancy.
The Effect of Brucellosis on Women's Health and Reproduction
(Aras Part Medical int Press, 2015) Kurdoglu, Mertihan; Cetin, Orkun; Kurdoglu, Zehra; Akdeniz, Hayrettin
Due to its potential harmful effects on the general health and reproductive life of the women, in the light of available literature, it was aimed to review the effect of human brucellosis on women's health and reproduction. Data from 75 reports belonging to the years 1917 through 2015, obtained via a search on various internet sources by the words "Brucella", "brucellosis," "women's health," "human pregnancy," "human reproduction," "abortion," "preterm birth," "intrauterine fetal demise," and "intrauterine fetal death" were used to characterize basic microbiological features together with the risk factors, clinical presentations and complications of the human brucellosis related to various aspects of reproductive well-being. A high rate of spontaneous abortion was a more consistent finding rather than high rates of preterm delivery and intrauterine fetal death in pregnant women with brucellosis. The occurrence of abortion was not associated with the magnitude of serum agglutination titre or the clinical type of disease. The novel replication profiles of Brucella in human trophoblasts give insights into the pathogenesis of infectious abortion. Brucellosis is a risk factor for women's general health and reproduction as well as for many obstetric complications during pregnancy, of which spontaneous abortion is the mostly known. In order to prevent the disease and these complications, education of the women, especially the poor ones of childbearing age with low educational level is strongly advised. When the infected women present for medical care, an appropriate antimicrobial therapy should be started promptly.
Evaluation of Maternal Liver Elasticity by Acoustic Radiation Force Impulse Elastosonography in Hypertensive Disorders of Pregnancy: a Preliminary Descriptive Study
(Taylor & Francis Ltd, 2017) Cetin, Orkun; Karaman, Erbil; Arslan, Harun; Kolusari, Ali; Yildizhan, Recep; Ozgokce, Mesut; Akbudak, Ibrahim
Purpose: To compare maternal liver elasticity scores by Acoustic Radiation Force Impulse (ARFI) elastosonography in healthy and preeclamptic pregnancies and its association with the severity of the disease.Materials and methods: Forty-two healthy, 33 mild, 33 severe preeclamptic and 28 pregnant women with Hemolysis, Elevated Liver enzymes and Low Platelets (HELLP) syndrome were included into the study. Maternal liver elasticity was measured by ARFI elastosonography at the first day of puerperium. The maternal and neonatal outcomes of the patients were retrieved from the medical records.Results: The ARFI-Mean liver elastosonography scores of controls and mild preeclamptic women were lower than severe preeclamptic and HELLP syndrome women (p: 0.001). The mean ARFI elastosonography score >1.22 m/s indicated the effect of severe preeclampsia on maternal liver elasticity with 72.7% sensitivity and 74.7% specificity (Area under curve [AUC], 0.835, 95% confidence interval [CI], 0.757-0.913). The mean ARFI elastosonography score >1.31 m/s indicated the effect of HELLP syndrome on maternal liver elasticity with 78.6% sensitivity and 75.9% specificity (AUC, 0.794, 95% CI, 0.695-0.892).Conclusions: The maternal liver becomes stiffer in severe preeclampsia and HELLP syndrome measured by ARFI elastosonography. The increased maternal liver ARFI scores may alert the obstetrician about the possible maternal puerperal morbidity.
The Evaluation of Maternal Systemic Thiol/Disulphide Homeostasis for the Short-Term Prediction of Preterm Birth in Women With Threatened Preterm Labour: a Pilot Study
(Taylor & Francis inc, 2022) Cetin, Orkun; Karaman, Erbil; Alisik, Murat; Erel, Ozcan; Kolusari, Ali; Sahin, Hanim Guler
The aim of this study was to investigate maternal systemic thiol/disulphide homeostasis (TDH) for the short-term prediction of preterm birth in women with threatened preterm labour (TPL). This prospective study included 75 pregnant women whose pregnancies were complicated by TPL. Thirty-seven of them delivered within 7 days and 38 of them delivered beyond 7 days. Maternal serum samples were collected at the day of diagnosis and the TDH was measured. The maternal disulphide level was significantly higher in pregnant women who delivered within 7 days (25.0 +/- 9.8 mu mol/L vs 19.4 +/- 9.8 mu mol/L, p: .015). The threshold value of 22.1 mu mol/L for maternal disulphide level predicted delivery within 7 days with 62.2% sensitivity and 60.5% specificity (area under curve 0.651, confidence interval 0.53-0.78). The likelihood ratios for short cervix (<= 25 mm) and maternal disulphide level (>= 22 mu mol/L) to predict delivery within 7 days was found to be 8.7 and 7.3, respectively. The likelihood ratio of combining two tests to predict delivery within 7 days was found to be 11.4. The maternal TDH, which is an indicator of oxidative stress status in maternal compartment, is disturbed in TPL cases who delivered within 7 days. Elevated maternal disulphide level along with cervical length screening predicts a short latency period in pregnancies with TPL. IMPACT STATEMENT What is already known on this subject? Spontaneous preterm delivery is one of the major complication of pregnancy and the common cause of neonatal morbidity and mortality. Threatened preterm labour (TPL) is also a frequent complaint in obstetric emergency care units in all around the world. Triaging women with TPL is mandatory for planning further management therapies, since the most of them will eventually deliver at term. Only the measurement of cervical length in symptomatic women has moderate accuracy in predicting preterm delivery. Short cervix is described as an independent predictor of preterm delivery in women with TPL, its predictive accuracy as a single measurement is relatively limited. On this account, several potential markers like foetal fibronectin in the cervicovaginal fluid, salivary oestriol, prolactin in vaginal discharge, maternal serum calponin and interleukin-6 in the amniotic fluid were examined to predict preterm delivery in previous studies. However, none of them represented an excessive predictive accuracy like high sensitivity, PPV or NPV. What do the results of this study add? We report a method which has higher diagnostic and predictive performance to identifying TPL women with high risk of preterm delivery. According to the current literature, there are accumulated data about the correlation between oxidative stress (OS) and preterm delivery regardless of the amniotic membrane status. However, it is still debated whether OS is a trigger or a consequence of preterm delivery. Our study provides evidence for the first time that maternal serum thiol/disulphide homeostasis, which is an indicator of OS in maternal compartment, is disturbed in TPL cases who delivered within 7 days. The high disulphide level in maternal serum, along with cervical length measurement (short cervix) accurately predicts a short latency period in TPL cases. What are the implications of these findings for clinical practice and/or further research? This novel test combination (maternal serum disulphide level and cervical length measurement) could be used clinically to triage pregnant women presenting with TPL, avoiding overtreatment, unnecessary hospitalisations and increased medical costs. The future research would be addressed on reducing maternal OS by using new antioxidant treatment strategies to improve perinatal and long-term childhood outcomes.
Evaluation of Periodontal Status and Interleukin Levels in Pregnant Women With Hellp Syndrome
(Kerman Univ Medical Sciences, 2022) Aydinyurt, Hacer Sahin; Cetin, Orkun; Aydogdu, Hasan Murat; Karaman, Erbil; Taskin, Cem; Sahin, Hanim Guler; Alkhatib, Mohammed F. A.
BACKGROUND AND AIM: Hemolysis, elevated liver enzymes and low platelet (HELLP) syndrome is a pregnancy-specific disease that affects many systems of the body. Its etiopathogenesis has not been fully elucidated. HELLP syndrome is characterized by hemolysis, elevated liver enzymes, and low platelet counts. It has a prevalence of 0.2%-0.8% in pregnant women. This study aimed to compare periodontal status as well as interleukin (IL)-6 and IL-37 levels in gingival crevicular fluid (GCF) of healthy pregnant women and pregnant women with HELLP syndrome. METHODS: This study included 20 patients with HELLP and 20 healthy pregnant women. The clinical periodontal parameters [plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing depth (PD), clinical attachment level (CAL)] were recorded and GCF samples were collected. IL-6 and IL-37 levels were measured in GCF samples using the enzyme linked immunosorbent assay (ELISA) method. The data collected from healthy pregnant women and patients with HELLP were compared with statistical analysis. RESULTS: There was no statistically significant difference between healthy pregnant women and pregnant women with HELLP in terms of periodontal clinical parameters. There was a statistically significant difference in terms of IL-6 levels (P < 0.05); however, no statistically significant difference was determined in terms of IL-37 levels in GCF. CONCLUSION: This is the first study to evaluate periodontal status as well as IL-6 and IL-37 levels in GCF in pregnant women with HELLP syndrome. The results of the study showed that IL-6 levels were significantly higher in pregnant women with HELLP syndrome, but there was no significant difference in terms of other parameters. Further research is needed to evaluate the relationship between HELLP syndrome and periodontal disease.
The Impact of Low Molecular Weight Heparin on Obstetric Outcomes Among Unexplained Recurrent Miscarriages Complicated With Methylenetetrahydrofolate Reductase Gene Polymorphism
(Via Medica, 2017) Cetin, Orkun; Karaman, Erbil; Cim, Numan; Dirik, Deniz; Sahin, Hanim Guler; Kara, Erdal; Esen, Ramazan
Objectives: The association between methylenetetrahydrofolate reductase gene polymorphisms and unexplained recurrent miscarriage is elusive. The recommendations for improving pregnancy outcomes in these patients keep changing based on the available evidence. The aim of this study is to analyze the impact of low molecular weight heparin on obstetric outcomes of recurrent miscarriage patients complicated with methylenetetrahydrofolate reductase gene polymorphism. Material and methods: We reviewed medical records of 121 patients with a history of recurrent miscarriage complicated by methylenetetrahydrofolate reductase gene polymorphisms, retrospectively. From among them, 68 patients were treated only with folic acid and iron. The remaining 53 patients were treated with folic acid, iron and prophylactic doses of low molecular weight heparin. The subsequent pregnancy outcomes of these patients were noted. Results: The live birth rate was higher in patients with anticoagulant therapy than in patients without anticoagulant therapy (48.5% vs. 69.8%, respectively, p: 0.015) and the congenital anomaly rate was lower in anticoagulant therapy group (17.6% vs. 3.8%, respectively, p: 0.022). The other obstetric outcomes were found to be similar between the two groups. Conclusions: The current study demonstrated that low molecular weight heparin improved the live birth rates among unexplained recurrent miscarriage patients complicated with methylenetetrahydrofolate reductase gene polymorphisms. However, the routine use of low molecular weight heparin did not improve the late pregnancy complications in these selected patients in the eastern region of our country. Further studies are needed to discriminate the effect of anticoagulation on the live birth rate of each of methylenetetrahydrofolate reductase gene polymorphism type.
Impairment of Thiol-Disulfide Homeostasis in Preeclampsia
(Taylor & Francis Ltd, 2016) Korkmaz, Vakkas; Kurdoglu, Zehra; Alisik, Murat; Cetin, Orkun; Korkmaz, Hilal; Surer, Hatice; Erel, Ozcan
Aim: To investigate the effects of severity of preeclampsia on thiol-disulfide homeostasis (TDH).Material and methods: A total of 108 participants were divided into three groups: Group 1 was composed of pregnant women with no obstetric complications, Group 2 included pregnant women with mild preeclampsia, and Group 3 consisted of pregnant women with severe preeclampsia. TDH parameters were determined, and comparisons of clinical and routine laboratory test findings were made in all groups.Results: The serum native thiol level was 347.927.4 in the control group, 237.2 +/- 44.2 in the mild preeclampsia group, and 227.9 +/- 53.1 in the severe preeclampsia group (p<0.001). The serum total thiol level was 376.1 +/- 31.9 in the control group, 261.8 +/- 49.4 in the mild preeclampsia group, and 248.3 +/- 57.4 in the severe preeclampsia group (p<0.001). The disulfide level was 14.1 +/- 5.6 in the control group, 12.3 +/- 5.1 in the mild preeclampsia group, and 10.2 +/- 4.8 in the severe preeclampsia group (p=0.001). A significant correlation between impairment in degree of TDH and severity of preeclampsia was observed.Conclusion: TDH was impaired in women with preeclampsia, and this impairment increased with disease severity. Therefore, impaired TDH may have a role in the etiopathogenesis of the disease.
Intracranial Meningioma Diagnosed During Pregnancy Caused Maternal Death
(Hindawi Ltd, 2014) Kurdoglu, Zehra; Cetin, Orkun; Gulsen, Ismail; Dirik, Deniz; Bulut, M. Deniz
Brain tumors are rarely diagnosed during pregnancy. Accelerated growth of intracranialmeningiomas during pregnancy sometimes requires urgent surgical intervention. We describe a 41-year-old pregnant woman with severe neurological decompensation requiring immediate neurosurgery. Cesarean section resulted in maternal death. Meningioma diagnosed during a viable pregnancy should be managed according to the severity of maternal neurological symptoms and gestational age of pregnancy. Early intervention for intracranial tumors during pregnancy may save maternal and fetal lives.
Investigation of Maternal Psychopathological Symptoms, Dream Anxiety and Insomnia in Preeclampsia
(Taylor & Francis Ltd, 2017) Cetin, Orkun; Ozdemir, Pinar Guzel; Kurdoglu, Zehra; Sahin, Hanim Guler
Purpose: The aim of the current study was to investigate the psychopathological symptoms, psycho-emotional state, dream anxiety, and insomnia in healthy, mild and severe preeclamptic postpartum women and their relation to the severity of preeclampsia (PE).Materials and methods: This observational study included 45 healthy, 41 mild preeclamptic and 44 severe preeclamptic postpartum women. The 90-item Symptom Checklist Revised, Hospital Anxiety and Depression Scale, Insomnia Severity Index, and Van Dream Anxiety Scale (VDAS) were used to evaluate the psychopathological symptoms, psycho-emotional state, insomnia, and dream anxiety of the participants after delivery.Results: Severe preeclamptic women had higher VDAS scores than mild preeclamptic and healthy postpartum women (p: 0.001). The psychopathological symptoms were more frequent in preeclamptic women than in healthy controls (p: 0.001). Severe preeclamptic women had the highest scores in Hospital Anxiety-Depression Scale and Insomnia Severity Index (p: 0.001, p: 0.001, respectively).Conclusion: Preeclampsia negatively affects the psycho-emotional state, psychopathological symptoms and sleep patterns. Further, disturbed dreaming was more frequent in PE and also, all of these conditions became worse with the severity of PE. We speculated that the obstetricians should offer their preeclamptic patients an appropriate mental health care at bedside and postpartum period as needed.
Is Maternal Blood Procalcitonin Level a Reliable Predictor for Early Onset Neonatal Sepsis in Preterm Premature Rupture of Membranes
(Karger, 2017) Cetin, Orkun; Aydin, Zuhal Dilek; Verit, Fatma Ferda; Zebitay, Ali Galip; Karaman, Erbil; Elasan, Sadi; Yucel, Oguz
Background: This study is aimed at comparing the early diagnostic accuracy of maternal blood white blood cell (WBC) count, C-reactive protein (CRP) and procalcitonin in predicting early onset neonatal sepsis (EONS) among early preterm premature rupture of membrane (PPROM) pregnancies. Methods: A total of 57 consecutive pregnancies, complicated with PPROM, between 24 and 34 gestational weeks were recruited to the study at Suleymaniye Maternity Education and Research Hospital, Istanbul, Turkey between January 2012 and January 2013. All patients were hospitalized and followed up with expectant management. Maternal blood WBC count, CRP and procalcitonin levels were measured in the first 12 h of membrane rupture. EONS was diagnosed using clinical and laboratory findings, and obstetric and neonatal outcomes were noted. Results: The cutoff value for maternal blood CRP was >= 9.49 mg/dl. This value predicted EONS with 77.8% sensitivity, 80.0% specificity, 77.8% positive predictive value (PPV) and 80.0% negative predictive value (NPV). The cutoff value for maternal blood procalcitonin was 0.071 ng/ml. This value predicted EONS with 85.2% sensitivity, 86.7% specificity, 85.2% PPV and 86.7% NPV. Conclusion: Maternal blood procalcitonin levels were superior to maternal blood CRP and WBC count in predicting EONS. Consequently, the maternal blood procalcitonin level is a clinically useful, non-invasive and reliable biomarker in antenatal prediction of EONS. (C) 2016 S. Karger AG, Basel
The Levels of Knowledge of High School Students About Human Papilloma Virus Infection
(Aves Yayincilik, Ibrahim Kara, 2016) Cetin, Orkun; Verit, Fatma Ferda; Keskin, Seda
Local Resection May Be a Strong Alternative To Cesarean Hysterectomy in Conservative Surgical Management of Placenta Percreta: Experiences From a Tertiary Hospital
(Taylor & Francis Ltd, 2017) Karaman, Erbil; Kolusari, Ali; Cetin, Orkun; Cim, Numan; Alkis, Ismet; Yildizhan, Recep; Gul, Abdulaziz
Objective: To evaluate and describe a surgical approach for uterine preservation and management of postpartum hemorrhage in placenta percreta. Methods: We analyzed the data of patients who were diagnosed with placenta percreta prenatally and subsequently underwent cesarean section in which local resection technique was used to manage postpartum hemorrhage and uterine preservation at our tertiary care center between 2013 and 2016. The technique includes local resection of placental invasion site and suturing the new uterine edges. Results: The technique of local resection described above was successful in preserving the uterus and stopping the bleeding in 8 of 12 cases. The diagnosis of placenta percreta in all cases was confirmed intraoperatively and postoperatively by histological examinations. Four cases were resorted to hysterectomy. The mean number of transfused erythrocyte suspension was 4.82.6. One complication of bladder injury was encountered in which treated conservatively. Conclusion: Local resection of percreta site is an effective, safe and fertility preserving approach that can be applied to manage the postpartum hemorrhage and preservation of uterus in patients with placenta percreta.