Browsing by Author "Cim, Numan"

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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.
Analysis of Factors Affecting Outcomes of Pregnancy Complicated by Echinococcus: an Algorithm for Approach and Management
(Springer Heidelberg, 2018) Celik, Sebahattin; Okyay, Ozan; Karaman, Erbil; Sert, Ozlem Z.; Cim, Numan; Okyay, Tuba Y.
The management of hydatid disease (HD) co-occurring with pregnancy remains a challenge for physicians. We aimed to determine factors that were related to fetal and maternal outcomes in HD complicated pregnancies and then develop an approach/treatment algorithm. All patients at the participating hospitals were first analyzed to determine whether they had HD. Only patients diagnosed with HD during the course of their pregnancy were included. Certain cyst-related factors (diameter, localization, increase in size, and viability) and certain pregnancy-related factors (treatments, gestational week, maternal co-morbidities, and delivery type) were investigated. Nonlinear principal component analysis (NPCA) was performed to determine the relationships between the categories of variables. Out of 12,926 pregnancies, 27 cases were diagnosed with HD. In 13 cases, each developed at least one fetal problem. Using Albendazol in first trimester, presence of an active cyst, increased diameter by more than 1 cm during pregnancy and a cyst diagnosed in the second trimester were associated with at least one fetal problem. According to the NPCA results, cyst diameter when first diagnosed was related to fetal outcomes; a cyst greater than 10 cm was associated with "at least one fetal problem". Cysts 5-10 cm in diameter were in a neutral position, while 2-5 cm in diameter were in the "no problems" group. HD mostly affects fetus. If cyst-related and pregnancy-related variables are optimal, close follow-up on a monthly is the best course of action. However, in high-risk conditions, percutaneous interventions or surgery should be considered.
An Analysis on the Roles of Angiogenesis-Related Factors Including Serum Vitamin D, Soluble Endoglin (Seng), Soluble Fms-Like Tyrosine Kinase 1 (Sflt1), and Vascular Endothelial Growth Factor (Vegf) in the Diagnosis and Severity of Late-Onset Preeclampsia
(Taylor & Francis Ltd, 2017) Cim, Numan; Kurdoglu, Mertihan; Ege, Serhat; Yoruk, Ibrahim; Yaman, Gorkem; Yildizhan, Recep
Aim: The aim of this study was to evaluate the roles of proangiogenic factors including serum vitamin D and vascular endothelial growth factor (VEGF) and anti-angiogenic factors including soluble endoglin (sEng) and soluble fms-like tyrosine kinase 1 (sFlt1) in the diagnosis and severity of late-onset preeclampsia. Materials and methods: The study was conducted at Yuzuncu Yil University Research and Education Hospital Department of Gynecology and Obstetrics. The study included a patient group of 40 women with late-onset preeclampsia who were pregnant at >= 32 weeks of gestation according to the last menstrual period (LMP) or ultrasonographic fetal biometric measurement and a control group of 40 healthy pregnant women who presented to our clinic for routine pregnancy examination and were at the same age and gestational period with those in the patient group. The two groups were compared in terms of maternal age, gravida, parity, week of gestation, systolic/diastolic blood pressure, total protein in spot urine sample, 24-h urine protein, white blood cell (WBC), hemoglobin (Hgb), platelet count, urea, creatinine, liver function tests (AST, ALT, LDH), vitamin D-3, 25(OH) vitamin D-3, 1,25(OH) vitamin D-3, sEng, sFlt1, and VEGF levels, mode of delivery, the infant APGAR score at 1 and 5 min after delivery, and infant weight at delivery. Results: The groups were similar in terms of age, gravida, parity, week of gestation, serum vitamin D-3, 25(OH) vitamin D-3, 1,25(OH)(2) vitamin D-3 and VEGF levels, and infant weight at delivery (p > 0.05). Systolic/diastolic blood pressure, total protein in spot urine sample, 24-h urine protein, WBC, Hgb, serum urea, creatine, AST, ALT, and LDH were significantly higher in the preeclamptic group compared to the healthy group (p < 0.05). However, thrombocyte level and the APGAR score at 1 and 5 min after delivery were significantly lower in the preeclamptic group compared to the healthy group (p < 0.05). No significant correlation was found between serum sEng, sFlt1, VEGF, vitamin D-3, 25(OH) vitamin D-3, and 1,25(OH)(2) vitamin D-3 levels. The sEng level was higher in the women with severe preeclampsia compared to the women with mild preeclampsia (p < 0.05) and no significant difference was observed in serum sFlt1, VEGF, vitamin D-3, 25(OH) vitamin D-3, and 1,25(OH)(2) vitamin D-3 levels between the subgroups of preeclampsia (p > 0.05). Conclusion: Both sEng and sFlt1 levels are remarkably high in patients with late-onset preeclampsia; however, only sEng may be a useful tool in the determination of the severity of preeclampsia.
Angiogenic Factors and Evaluation of Vascular Status in Preeclampsia
(Bayrakol Medical Publisher, 2021) Aksin, Serif; Cim, Numan; Sahin, Hanim Guler; Balsak, Deniz
Aim: The aim of this study was to measure serum levels of the angiogenic factors nitric oxide (NO), soluble endoglin (s Eng), soluble fms-like tyrosine kinase-1 (s Flt-1), placental-derived growth factor (PIGF) and vascular endothelial growth factor (VEGF) and to measure uterine and umbilical arterial blood flow using Doppler ultrasonography to investigate the physiopathology of preeclampsia and endovascular dysfunction by comparing brachial artery dilatation and the thickness of the carotid artery with normal pregnant women. Material and Methods: Forty pregnant women with preeclampsia and 40 healthy pregnant women (control group) were recruited for the study in April 2011 and October 2011 at Van Yuzuncu Yil University. Systolic and diastolic blood pressure, urinary protein in spot urine samples, complete blood counts, aspartate transaminase (AST), alanine aminotransferase (ALT) levels of sEng, sFlt-1, VEGF, PIGF and NO, and APGAR scores at one and five minutes after birth were recorded and compared in all patients. Intima-media thickness of the carotid artery, brachial artery dilatation and umbilical artery Doppler parameters of all pregnant women were assessed and recorded. Results: When compared to the control group, systolic and diastolic blood pressures urinary protein in spot and 24-hour urine collection, levels of AST, ALT and sFlt-1, and uterine artery Doppler parameters were significantly higher, whereas VEGF, platelet count and APGAR scores at one and five minutes after birth were lower in the preeclampsia group (p<0.001). Brachial artery dilatation before obstruction was found to be insignificant in both groups, while post obstructive dilatation was found to be significantly higher in the control group. Discussion: Uterine artery Doppler evaluation, assessment of brachial artery dilatation and measurement of VEGF and sFlt-1 levels seem to be useful in preeclampsia.
Are the Skin Scar Characteristics and Closure of the Parietal Peritoneum Associated With Pelvic Adhesions
(Galenos Yayincilik, 2018) Cim, Numan; Elci, Erkan; Elci, Gulhan Gunes; Almah, Necat; Yildizhan, Recep
Objective: To assess whether the abdominal scar characteristics and closure of the peritoneum were associated with pelvic adhesions. Materials and Methods: Patients who had undergone cesarean section between December 2015 and February 2016 were assessed prospectively in terms of age, gravida, body mass index, number of living children, number of cesarean sections, time passed since the last cesarean section, closure status of the peritoneum in the last cesarean section, presence of other diseases, smoking status, location of incision in the abdomen (medial, pfannenstiel) scar dimensions (length, width), scar status with respect to skin (hypertrophic, flat, depressive), scar color [color change/no color change (hyperpigmented/hypopigmented)], adhesion of bowel-omentum-uterus, omentum-anterior abdominal wall, uterus-anterior abdominal wall, uterus-bladder, bladder-anterior abdominal wall, fixed uterus, and uterus-omentum-anterior abdominal wall in abdominal exploration. Results: One hundred five pregnant women who had undergone previous ceserean section surgery by the same physician, were at least in their 30th gestational week, had surgery notes about their previous operation, and had no chronic diseases were included in the study. Age, gravida, body mass index, number of children, number of cesarean sections, time passed since the previous cesarean section, closure/non-closure of peritoneum in the previous cesarean section, and smoking status had no effect on pelvic adhesions. Intraabdominal adhesion was not found to be associated with scar length [odds ratio (OR): 1.54, 95% confidence interval (CI): 1.1-2.2; p= 0.02], depressive scar (OR: 9.3, 95% CI: 3.2-27.2; p< 0.001), or hypopigmented scar [OR: 0.01, 95% CI: 0.003-0.11; p< 0.001]. Conclusion: Adhesions following surgical operations are of great importance due to complications for the patient, complications in relaparotomy, and high costs. Depressive and hypopigmented abdominal scars may be associated with pelvic adhesions. We believe that closure or non-closure of the parietal peritoneum is not associated with pelvic adhesions.
Comparison of the Effects of Chlormadinone Acetate Versus Drospirenone Containing Oral Contraceptives on Metabolic and Hormonal Parameters in Women With Pcos for a Period of Two-Year Follow-Up
(Taylor & Francis Ltd, 2015) Yildizhan, Recep; Gokce, Anik Ilhan; Yildizhan, Begum; Cim, Numan
Objective: A randomized trial to compare the effects of two oral contraceptive pills containing either chlormadinone acetate or drospirenone as the progestogen, in women with PCOS for a period of two-year follow-up. Methods: Group A received ethinyl-estradiol 0.03 mg + drospirenone 3 mg (EE+DRSP; n=56) and Group B received ethinyl-estradiol 0.03 mg + chlormadinone acetate 2 mg (EE+CMA; n=50). Clinical, hormonal and biochemical parameters were compared at baseline, 6 months, 12 months and 24 months. Results: The increase in total cholesterol and hsCRP levels was statistically significantly higher at 6, 12 and 24 months in Group B when compared with Group A. The change in the high-density lipoprotein cholesterol level at the 24 months of treatment was statistically significantly higher in Group A. Group A has a significantly higher reduction in FAI at 6 and 24 months, in FGS at 6, 12 and 24 months and in HOMA-IR index at 12 and 24 months when compared with Group B. Conclusions: Drospirenone containing combined oral contraceptive (COC) is found to have more favorable effects on lipid profiles, hsCRP levels, insulin resistance and hyperandrogenism when compared with the CMA containing COC and appears to be more beneficial for the long-term cardiovascular and metabolic aspects of PCOS.
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.
Energy Drinks May Affect the Ovarian Reserve and Serum Anti-Mullerian Hormone Levels in a Rat Model
(Galenos Yayincilik, 2021) Elci, Erkan; Elci, Gulhan Gunes; Cim, Numan; Aras, Ibrahim; Sayan, Sena; Yildizhan, Recep
Objective: Energy drinks have an impact on concentration levels, physical performance, speed of reaction, and focus, but these drinks cause many adverse effects and intoxication symptoms. The main goal of this study was to determine the effect of energy drink consumption on ovarian reserve and serum anti-mullerian hormone (AMH) levels. Materials and Methods: Female Wistar albino rats (n=16) were included and randomized into two groups (n=8). Serum AMH levels were checked before and after energy drinks were given. Eight weeks later, the ovaries and uteruses of the rats were analyzed histopathologically. The number of follicles in the ovaries was counted. Results: The total number of the preantral plus small antral follicles, which show the ovarian reserve, was decreased at the end of eight weeks in both the control group and the energy drink group. There was a statistical difference between them (p=0.021). Also, there was a statistically significant difference in the initial/final AMH (ng/mL) reduction levels between the control group and the energy drink group (p=0.002). AMH levels were decreased more in the energy drink group. Conclusion: The consumption of energy drinks can lead to a decrease in ovarian reserve and AMH values and may cause weight gain.
Evaluation of Cardiac Risk Marker Levels in Obese and Non-Obese Patients With Polycystic Ovaries
(Taylor & Francis Ltd, 2017) Elci, Erkan; Kaya, Cihan; Cim, Numan; Yildizhan, Recep; Elci, Gulhan Gunes
Objective: To compare cardiac risk markers such as asymmetric dimethyl arginine (ADMA), C-reactive protein (CRP), homocystein (Hcy), plasminogen activator inhibitor-1 (PAI-1), vascular endothelial growth factor (VEGF), angiopoietin-related growth factor 6 (ANGPTL6) in obese and non-obese patients with polycystic ovary syndrome (PCOS). Study design: Thirty obese (BMI>30kg/m(2)) and 30 non-obese (BMI<30kg/m(2)) patients diagnosed with PCOS and 30 age-matched healthy controls were included in the study. The ages of subjects were varying between 18 and 30 years. Serum ADMA, CRP, Hcy, PAI-1, VEGF and ANGPTL6 levels were analyzed for each subject. Results: Serum ADMA, CRP, Hcy, PAI-1, VEGF and ANGPTL6 levels were significantly elevated in obese and non-obese women with PCOS in comparison to control subjects (p<0.05). This elevation was more obvious in the obese PCOS group than in the other group. Conclusions: Cardiovascular risk markers such as ADMA, CRP, Hcy, PAI-1, VEGF and ANGPTL6 levels are elevated in women with PCOS.
Evaluation of Mean Platelet Volume in Unruptured Ectopic Pregnancy: a Retrospective Analysis
(Taylor & Francis inc, 2016) Karaman, Erbil; Cim, Numan; Alkis, Ismet; Yildizhan, Recep; Elci, Gulhan
We aimed to investigate and compare the mean platelet volume (MPV) levels in ectopic and viable intrauterine pregnancy (IUP). The medical records of 78 unruptured tubal ectopic pregnancy patients (TEP, Group 1) and 150 patients with viable IUP (Group 2) served as control group between May 2014 and February 2015 in our clinic were retrospectively analysed. The demographic characteristics including age, parity, gravida, abortus, haemoglobin levels and leucocyte counts showed no statistically difference between two groups. The mean MPV level was significantly lower in TEP group compared to IUP group (8.69 +/- 1.14 and 10.06 +/- 1.46, p<0.001). The platelet (PLT) distribution width was higher in TEP group, however, there was no statistical difference between the two groups (p=0.078). The early diagnosis of TEP is crucial in order to prevent maternal morbidity and mortality. Our results showed that MPV is lower in TEP than IUP and it seems to be related with the possible inflammation at implantation site of tuba uterina. However, there is need for further studies for employing PLT indices in the diagnosis of TEP.
A Five-Year Audit of Cases With Ectopic Pregnancy in Our Clinic
(Galenos Yayincilik, 2010) Adali, Ertan; Kurdoglu, Mertihan; Kolusari, Ali; Yildizhan, Recep; Cim, Numan; Sahin, Hanim Guler; Kamaci, Mansur
Objective: The aim of this study was to review the ectopic pregnancy cases that were administered to our clinic in the last five years. Materials and methods: According to the dermographic features, risk factors, clinical signs and treatment approaches, ninetyone cases with ectopic pregnancies were evaluated retrospectively between 2004-2009. For statistical analysis, SPSS was used. Results: The average age of the patients were 28,38 +/- 6,47 years and ectopic pregnancies were mostly seen between the ages of 26-35. The mean gravida and parity were 3,86 +/- 2,55 and 2,34 +/- 2,16, respectively. The mean serum beta-hCG level of the patients on admission to our clinic was 3085,41 +/- 6346,84 mIU/L. The risk factors in the order of frequencies were previous abdomino-pelvic surgery (16 %), the use of intrauterine device (12 %), previous ectopic pregnancies (7 %) and previous pelvic inflammatory disease (2 %). The most common complaint on admission were abdominal pain (40 %) and following that in the order of frequencies were vaginal bleeding with pain (38 %) and only vaginal bleeding (15 %). As a treatment option, surgery, methotrexate and expectant management were applied to 66 %, 20% and 10% of the patients respectively. Conclusion: Ectopic pregnancies are important health problems since they may interfere with fertility capability of the patient in her future life and may even cause maternal mortality. Especially, women who had abdomino-pelvic surgery before are at risk. Early diagnosis enables conservative management approaches.
Ghrelin Does Not Change in Hyperemesis Gravidarum
(Via Medica, 2019) Ege, Serhat; Kolusari, Ali; Bugdayci, Guler; Cim, Numan; Bademkiran, Muhammet Hanifi; Peker, Nurullah; Yildizhan, Recep
Objectives: Ghrelin levels can play an important role in maintaining the energy balance of pregnant women. Therefore, we investigated the relationship between HG and Ghrelin. Material and methods: 50 female patients admitted to the VAN Yuzuncu Yil University, Gynecology and Obstetrics Department were evaluated. The patients were divided into two groups: Group 1 included 25 pregnant women with HG, Group 2 included 25 healthy pregnant women. Results:The two groups showed similarities in terms of age, gravidity, B-HCG and gestational age.There was no statistically significant difference between the two groups in terms of the Ghrelin levels (p = 0.867). Conclusions: This study shows that there is no difference between Ghrelin levels and HG during pregnancy. Increased Ghrelin in previous studies was attributed to low oral intake. Another study reported lower Ghrelin levels are not the result of, but are rather the cause of, reduced oral intake during. The balancing of these two conditions does not lead to a change in the level of Ghrelin.
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.
Isolated Tubal Torsion: Case Report and Review of the Literature
(derman Medical Publ, 2015) Kavak, Ebru Celik; Baykus, Yakup; Cim, Numan; Kavak, Salih Burcin; Ilhan, Rasit
Isolated tubal torsion is a rare clinical entity causing acute pelvic pain. Preoperative diagnosis is difficult since it doesn't have any pathognomonic symptom, clinical sign, imaging or laboratory sign. It is mostly seen in women of reproductive age and mostly diagnosed during surgery done to find the etiology of acute abdomen. Since delay in diagnosis and treated can cause problems in fertility, it must be remembered in mind in differential diagnosis of acute abdomen especially in nulliparous women and in those who didn't complete their fertility.
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.
Maternal and Fetal Outcomes After Laparoscopic Vs. Open Appendectomy in Pregnant Women: Data From Two Tertiary Referral Centers
(Studio K, 2016) Karaman, Erbil; Aras, Abbas; Cim, Numan; Kolusari, Ali; Kiziltan, Remzi; Celik, Sebahattin; Anule, Turgut
Objectives: Appendectomy is the most common cause of non-obstetric surgery in pregnant women. Our aim was to compare the clinical characteristics, pert-and post-operative data of pregnant women undergoing either laparoscopic appendectomy (LA) or open appendectomy (OA). Material and methods: This was a retrospective study of medical records of all pregnant women diagnosed and treated surgically for acute appendicitis at two referral centers of Yuzuncu Yil University Medical Faculty and Kafkas University Medical Faculty, from January 2010 to January 2015. Results: The study included 48 patients, divided to two groups (12 - LA and 36 - OA). There were no significant differences in demographic characteristics of the studied population, including age, BMI, gestational age at operation, gravidity, parity, and history of cesarean sections. A far as obstetric and fetal outcomes are concerned, no significant differences were found in terms of preterm delivery, fetal loss, delivery mode, birth weight, APGAR score, and maternal death between the two investigated groups. One perioperative complication of intra-abdominal abscess was noted in the OA group. However, the LA group had shorter hospital stay (3.25 +/- 2.45 vs. 4.28 +/- 3.31, p=0.004), earlier mobilization time (8.1 +/- 2.2 vs. 10.1 +/- 1.6, p=0.025), and shorter time to first flatus (2.3 +/- 0.3 vs. 4.0 +/- 1.6, p=0.032) as compared to the OA group. The OA group had statistically shorter operation time than the LA group (38.61 +/- 11.5 vs. 49.42 +/- 11.38, p=0.007). Conclusion: LA is related to shorter hospital stay, faster return to daily activities, and shorter time to first flatus. LA appears to be as safe and effective as OA in pregnant patients without increasing adverse perinatal outcomes.
Maternal and Fetal Outcomes of Pregnant Women With Hepatic Cirrhosis
(Hindawi Ltd, 2020) Tolunay, Harun Egemen; Aydin, Mesut; Cim, Numan; Boza, Baris; Dulger, Ahmet Cumhur; Yildizhan, Recep
Aim. The reproductive hormone levels and systemic physiology of women with hepatic cirrhosis are altered. Existing data have indicated the adverse effects of cirrhosis on both the mother and the fetus. Pregnancy is successful in most of the patients with chronic liver disease. But maternal and fetal complication rates are still high for decompensated hepatic cirrhosis. In this study, we aimed to evaluate the clinical features, etiological factors, medications, morbidity, mortality, and obstetric outcomes of pregnant women with hepatic cirrhosis. Methods. Pregnant women, who were diagnosed with maternal hepatic cirrhosis and followed up in our clinic between 2014 and 2017, were retrospectively evaluated. The pregnant women that had been followed up for hepatic cirrhosis were classified as compensated disease and decompensated disease. Eleven cases were included in this period. Results. The mean age of cases was 33.5 +/- 5.5 years. The mean gravida number was 3.2 +/- 1.1, and the mean parity number was 1.7 +/- 1. Six cases were in the compensated cirrhosis stage, and 5 cases were in the decompensated cirrhosis stage. A pregnancy with decompensated cirrhosis was terminated after the fetal heart sound was negative in the 9th week of pregnancy. Spontaneous abortus occurred in one case (<20 weeks). The mean gestational week of the 9 cases was 33.3 +/- 6.2. Two of the 9 cases delivered birth vaginally. Seven cases delivered by cesarean section. The mean first- and fifth-minute APGAR scores were 6.6 +/- 1.41 and 8.2 +/- 1.56, respectively. The mean birth weight was 2303 +/- 981 g. Among 9 cases with live birth, 6 had compensated cirrhosis and 3 had decompensated cirrhosis. In the second trimester, upper gastrointestinal endoscopy was performed to all patients in terms of esophageal varices. Endoscopic band ligation was performed in 3 cases with upper gastrointestinal bleeding. The postpartum mortality did not occur. Discussion. Pregnancy is not recommended for patients with hepatic cirrhosis due to high maternal and fetal morbidity and mortality. The pregnancy course of cases with cirrhosis changes according to the stage of liver injury and severity of disease. Although the delivery method is controversial, delivery by cesarean section is recommended for patients with esophageal varices by the reason of bleeding from varices after pushing during labor. The bleeding risk must be kept in mind as coagulopathy is common in hepatic diseases. The maternal-fetal morbidity and mortality rates have been decreased by the current developments in hepatology, prevention of bleeding from varices with drugs and/or band ligation, improvement in liver transplantation, and increasing experience in this issue.
Maternal Serum Calponin 1 Level as a Biomarker for the Short-Term Prediction of Preterm Birth in Women With Threatened Preterm Labor
(Taylor & Francis Ltd, 2018) Cetin, Orkun; Karaman, Erbil; Boza, Baris; Cim, Numan; Sahin, Hanim Guler
Purpose: To assess the utility of maternal serum calponin 1 level in the prediction of delivery within 7 days among pregnancies complicated with threatened preterm labor.Materials and methods: Eligible women who presented at 24-34 weeks of gestation with threatened preterm labor underwent sampling for serum calponin 1 level and cervical length measurement. They were followed up until delivery prospectively and the perinatal outcomes of the patients were recorded.Results: Of 73 women included in the study, 36 women delivered within 7 days and 37 women delivered beyond 7 days after admission. The maternal serum calponin 1 level was significantly high in women who delivered within 7 days (p: 0.031). The threshold value of 2ng/mL for maternal serum calponin 1 predicted delivery within 7 days with 61.1% sensitivity and 62.2 specificity (area under curve, 0.658, confidence interval 0.53-0.79). The general accuracy values for maternal cervical length measurement (25mm), serum calponin 1 level (>2ng/mL) and the combination of two tests to predict delivery within 7 days was found to be 64.4%, 61.6% and 72.1%, respectively.Conclusions: The maternal serum calponin 1 level may be a useful biomarker in short-term prediction of preterm birth among pregnancies complicated with threatened preterm labor, in addition to cervical length measurement.
Maternal Serum Ischemia-Modified Albumin as an Oxidative Stress Biomarker in Preterm Pre-Labor Rupture of Membranes
(Via Medica, 2024) Cetin, Orkun; Karaman, Erbil; Tolunay, Harun Egemen; Boza, Baris; Cim, Numan; Alisik, Murat; Sahin, Hanim Gueler
Objectives: To evaluate the maternal serum ischemia-modified albumin (IMA) concentration as an oxidative stress biomarker in pregnancies complicated by preterm pre-labor rupture of membranes (PPROM) without maternal clinical infection and compare these results with healthy pregnancies. Material and methods: The present cohort study included 40 pregnancies complicated by PPROM and 49 similar gestational age healthy pregnancies in the third trimester of gestation. Maternal venous blood specimens were obtained at the day of first diagnosis. Maternal serum IMA level was assayed with an Albumin Cobalt Binding test. The subjects were followed up until delivery and perinatal outcomes were recorded. Results: The maternal serum IMA concentrations were significantly higher in the study group (0.56 +/- 0.05 absorbance units) as compared to controls (0.54 +/- 0.03 absorbance units) (p = 0.020). The maternal serum IMA concentrations were not significantly correlated with the initial maternal white blood cell count (r: 0.118, p = 0.269) and C-reactive protein levels (r: 0.066, p = 0.541). The maternal serum IMA concentrations were negatively correlated with gestational age at delivery (r: -0.248, p = 0.019), birthweight (r: -0.247, p = 0.020) and Apgar scores (r: -0.200, p = 0.049; r: -0.245, p = 0.020). The threshold value of maternal serum IMA concentration above 0.55 absorbance units indicated the pregnancy complicated by PPROM by 57.5% sensitivity and 57.1% specificity (Area under curve 0.613, confidence interval 0.50-0.73). Conclusions: The current study supported for the first time that there is an association between increased maternal serum IMA levels and the development of PPROM in the third trimester of gestation without maternal clinical infection. Elevated maternal serum IMA levels may alert the obstetrician about poor ongoing perinatal outcomes in the early phase of PPROM before increased maternal C-reactive protein and white blood cell count.
Maternal Serum Thiol/Disulfide Homeostasis in Pregnancies Complicated by Neural Tube Defects: Report of a Preliminary Study
(Taylor & Francis Ltd, 2017) Karaman, Erbil; Cetin, Orkun; Boza, Baris; Alisik, Murat; Erel, Ozcan; Cim, Numan; Sahin, Hanim Guler
Objective: To determine and evaluate the maternal serum thiol/disulfide homeostasis in pregnancies complicated by neural tube defects (NTD) via a novel method.Methods: Seventy-three pregnant women with NTD (study group) and seventy-one healthy control pregnant women (control group) were included in the study. A new and fully automated method was used to measure plasma native thiol, total thiol and disulfide levels, based on the reduction of dynamic disulfide bonds to functional thiol groups by sodium borohydrate.Results: The study and control groups were gestational age-matched. There were no statistical differences in demographic variables regarding age, gravidity, parity and body mass index. The serum native thiol levels (-SH) were 360.550.3 and 353.3 +/- 31.0mol/l in study and control groups, respectively, which was not statistically different (p=0.308). The native thiol/total thiol, disulfide/native thiol and disulfide/total thiol ratios were not statistically significantly different (p>0.05).Conclusion: Our preliminary results show that maternal serum thiol/disulfide homeostatis does not change in pregnancies complicated by NTD. Larger further studies are required to evaluate the relation of oxidative stress and development of NTD.