Browsing by Author "Karaaslan, O."

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Amniocentesis Results of Van and Surrounding Provinces Between 2018 and 2020: a Tertiary Center Experience
(Yuzuncu Yil Universitesi Tip Fakultesi, 2021) Küçükbaş, G.N.; Dirik, D.; Karaaslan, O.; Karaman, E.; Kolusari, A.; Aymelek, H.S.; Şahin, H.G.
Amniocentesis is one of the safest procedures of prenatal diagnosis. This study aimed to show amniocentesis indications, rate of successful amniocyte culture, complications and outcomes of these pregnancies undergoing prenatal diagnosis in eastern part of Turkey, especially Van province and its nearby. Between 2018 and 2020, 253 patients were referred to our center for amniocentesis and 120 patients giving consent were enrolled from Van and its surrounding provinces. The most frequent indication was high risk in prenatal screening tests whereas the highest chromosomal abnormality was found in fetuses with abnormal ultrasonographic findings. Overall, 11.6% of fetuses had chromosomal anomaly. The most abundant chromosomal abnormality was Trisomy 21, followed by trisomy 18 and 13. Except one case with amniotic leakage no complications were found. Eleven pregnancies were terminated whereas one fetus was born with Turner syndrome and two pregnancies resulted with stillbirth. In conclusion, fetuses with abnormal ultrasound screening had higher chromosome anomaly diagnosed by amniocentesis and compatible with the literature, amniocentesis is a safe and successful method of prenatal diagnosis of chromosomal abnormalities. Van and its surrounding provinces showed a high rate of chromosomal anomaly when prenatal diagnosis was done. © 2021, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Does Cervical Length Predict the Successful Labor Induction in Term Nulliparous Women Who Had Unfavorable Cervix
(Yuzuncu Yil Universitesi Tip Fakultesi, 2020) Türkyılmaz, G.; Karaaslan, O.; Turkyilmaz, Ş.; Ertürk, E.
The aim of this study was to determine the predictive value of cervical length (CL) measurement in the result of labor induction in term nulliparous women who had a strict cervix. A total of 78 pregnancies were evaluated prospectively. Dinoprostone ovule was used for the induction of labor in all cases. Low dose oxytocin was administered for augmentation of the labor. Statistical analyses were performed using SPSS Version 24. A p-value <0.05 was determined as to be statistically significant. Dinoprostone's indication for labor induction was seen in 57.7% of cases at post-term pregnancy and unsafe fetal wellbeing observed in the remaining 42.3% of the patients. 59% of patients delivered their babies vaginally, and we performed a cesarean section in 41% of patients. The most cesarean indication was fetal distress (40.6%). The arrest of labor was considered in 31.2% of the patients and failed labor induction was observed in 28.1% of the patients. A significant correlation was found between CL and successful labor induction. The Area Under the Curve (AUC) for CL was: 0.6975 (95% CI: 0.5816-0.8134). The sensitivity and specificity of CL≤ 20 mm were 94% and 45%, respectively, while the positive and negative predictive values associated with it were 57% and 90%. Sensitivity was 23%, and specificity was 84% at the CL≥ 30 mm cut-off point. There was no significant difference between umbilical cord pH and the route of delivery (p: 0.185). Our study indicates that CL measurement is a highly effective method to predict labor induced, particularly in nulliparous and having unfavorable cervix. © 2020, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
The Effectiveness of Rescue Cervical Cerclage: a Retrospective Observational Study
(Yuzuncu Yil Universitesi Tip Fakultesi, 2020) Türkyılmaz, G.; Karaaslan, O.
We purposed to determine the outcome of emergency cervical cerclage (ECC) in pregnancies who had cervical dilatation in clinical examination. We evaluated 20 women between 18-25 weeks and performed ECC with the McDonald technique. We collected data included: prolongation of pregnancy, gestational age at delivery, neonatal survival rate, and perioperative complications. The mean gestational week of pregnancy was 21±1,6 at cerclage operation, and mean cervical dilatation was 2,5±1,1 mm. The mean prolongation of pregnancy and the mean gestational age at delivery were 47,3±37,1, and 27,8±5,3 were respectively. The mean birth weight was 1184±866 g. A perioperative complication occurred in 1 (5%) case. 15 of 20 (75%) neonates admitted to NICU and neonatal survival was 65%. Half of the cases delivered after 28 weeks of gestation, and there was no perinatal mortality in this group. ECC is a beneficial procedure to prolong pregnancy and to improve perinatal outcomes. © 2020, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Epidemiology and Clinical Features of Preeclampsia
(Nova Science Publishers, Inc., 2020) Karaman, E.; Dirik, D.; Karaaslan, O.; Rapisarda, A.M.C.; Fichera, M.; Karaman, Y.
Preeclampsia is one of most important hypertensive disorders of pregnancy. It is characterized by the new onset of hypertension and proteinuria, or of hypertension and significant end-organ dysfunction with or without proteinuria, in the last half of gestation or postpartum. It complicates about 2-8% of gestations and it is a well-known cause of maternal-perinatal morbidity and mortality. The risk factors for development of preeclampsia include genetic factors, sperm exposure, maternal smoking, pre-existing medical conditions (such as hypertension, diabetes mellitus, chronic kidney disease and anti-phospholipid syndrome), and miscellaneous ones such as nulliparity, older maternal age and obesity. The clinical presentation of preeclampsia is varied. The main symptoms are headache, visual symptoms (including blindness), epigastric pain or nausea and vomiting. Preeclampsia is classified as mild and severe based on the degree of hypertension, laboratory and clinical findings. The most severe form is the development of eclampsia and HELLP syndrome. © 2020 by Nova Science Publishers, Inc. All rights reserved.
Evaluation of Fetal Central Nervous System Anomalies Diagnosed Prenatally: Prenatal and Postnatal Outcomes
(Yuzuncu Yil Universitesi Tip Fakultesi, 2024) Bağcı, M.; Uçkan, K.; Şahin, H.G.; Karaaslan, O.; Karaman, E.; Başkıran, Y.
Introduction: The aim of this study is to examine the diagnosis types and rates of patients with central nervous system (CNS) anomalies detected in the prenatal period between 2021-2022 in our perinatology clinic and to contribute to the literature. Materials and Methods: Our study included 191 patients with CNS anomaly and whose pregnancy results were reached. Demographic characteristics of the patients, additional detected anomalies, fetal Magnetic Resonance Imaging (MRI) and genetic results, o bstetric and neonatal results were evaluated if requested. Results: Neural tube defects (NTD) were found most frequently at 75.3%, and among these, acrania was found most frequently at 27.2%. While 74.3% of the detected CNS anomalies were isolated anomalies, it was found that 5.2% were accompanied by additional CNS anomalies and 21.9% were accompanied by additional extracranial anomalies. Abnormal karyotype was obtained in 12.1% of the pa tients who wanted to have a prenatal diagnosis test. It was found that 11% of the patients requested fetal MRI and ventriculomegaly was the most common fetal MRI indication. While the pregnancies of 56.5% of the patients were terminated, 37.7% of them gave live bir ths. The rate of surgical intervention in live-born babies with CNS anomalies was found to be 56.9%. A total mortality rate of 43% was found in live-born babies. Conclusion: Since CNS anomalies are associated with serious morbidity and mortality; Prenatal diagnosis is very important so that families can be offered a pregnancy termination option and those who will continue to be pregnant should be informed about the treatment and rehabilitation processes of their babies. © 2024, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Evaluation of Peripartum Hysterectomy; Ten Years of Experience of a Tertiary Center
(Yuzuncu Yil Universitesi Tip Fakultesi, 2021) Dirik, D.; Karaman, E.; Okyay, T.Y.; Kucukbas, G.N.; Karaaslan, O.; Alkiş, I.; Kolusari, A.
The objective of this study is to assess the 10-year incidence of peripartum hysterectomy that was performed in the province of Van, Turkey, as well as its clinical results. In this study, we retrospectively examined all patients who underwent peripartum hysterectomy, which was performed at Van Yuzuncu Yil University Dursun Odabas Medical Center between 2010 and 2020. 99 patients who underwent hysterectomy due to severe bleeding, which could not be stopped despite conservative tre atments within 24 hours following the delivery, were included in the study. The overall rate of peripartum hysterectomy was 99 of 22242 or 4.4 per 1,000 deliveries. The mean maternal age was 31.98 ± 5.41 years. The most common indications for peripartum hysterectomy are placental adhesion disorders (70.7%), uterine atony (25.2%), and uterine rupture (4%). Ultimately, the most common indication for peripartum hysterectomy is placental adhesion disorders. The rise in the number of cesarean section might have increased the incidence of placental adhesion disorders. Thus, patients should be provided with healthcare in centers that have adequate equipment and staff. © 2021, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Extraperitoneal Cesarean, Is It Safe and Comfortable
(Yuzuncu Yil Universitesi Tip Fakultesi, 2020) Karaaslan, O.; Türkyılmaz, G.; Şimşek, E.
We aimed to show that extraperitoneal cesarean delivery (EPCD) is more advantageous than trans peritoneal cesarean delivery (TPCD). Sixty cases analyzed either EPCD or TPCD were included in this study. Patients with suspected placental invasion anomalies (placenta accreta, increta or percreta), placenta previa, a history of midline uterine incision, multiple pregnanci es, previous cesarean section, previous major abdominal surgery, delivery before 34 weeks of gestation or fetal macrosomia (estimated fetal weight >4500 g) were excluded. The endpoints were the duration of the operation, nausea and vomiting during the operation, postoperative nausea and vomiting, the number of an algesic medications, postoperative shoulder pain, postoperative gas/stool discharge time, complete blood count (CBC), urinary dysfunction, and neonatal outcomes . Results TPCD patients suffered significantly more intraoperative nausea (10% vs. 33.3%, p:0.03) and postoperative vomiting (0% vs. 13.3%, p: 0.04) compared to TPCD group. There was no significant difference in intraoperative vomiting and postoperative nausea rates between the two groups (p:0,282).The duration of the operation was shorter in TPCD than EPCD groups (25,5 minutes vs. 28,7 minutes, p=0.01). After the operation, significantly fewer analgesic drugs were used in the EPCD than the TPCD groups (p: 0.01). The duration between defecation and operation was significantly shorter in the EPCD group compared to TPCD group (p: 0,042). Postoperative shoulder pain and flatulating time were similar between the two groups. There was no significant difference in urinary symptoms after six weeks of the operation between the two groups (p:0,690). No significant difference was found for neonatal outcomes between each groups. EPCD reduces postoperative pain, analgesic requirement, nausea, vomiting, and bowel dysfunction in cesarean patients without an increase in significant complications. © 2020, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Maternal Serum Xenin-25 Levels in Gestational Diabetes Mellitus
(Verduci Editore s.r.l, 2023) Kucukbas, G.N.; Komuroglu, A.U.; Dirik, D.; Korpe, B.; Kose, C.; Karaaslan, O.; Sahin, H.G.
OBJECTIVE: Xenin-25 is a polypeptide having an insulinotropic effect via increasing the insulin-releasing action of glucose-dependent insulinotropic polypeptide (GIP) and promoting beta cell survival and proliferation. We aimed to assess serum xenin-25 levels in euglycemic pregnancies vs. pregnancies complicated with gestational diabetes mellitus (GDM). PATIENTS AND METHODS: Forty pregnancies complicated with GDM and 40 healthy pregnancies with gestational age between 24 and 28 weeks were included. Following eight hours of fasting, blood samples were drawn from the participants, and subsequently, 75 g of glucose was administered orally. Blood was drawn again 120 minutes after the glucose challenge. Serum xenin-25 levels were detected by ELISA. Statistical analysis was performed, and p<0.05 was considered statistically significant. RESULTS: There was no significant difference in maternal age, gestational age, BMI, fasting glucose, and insulin levels between the groups. Both fasting and 120th-minute xenin-25 levels were significantly higher in the GDM group when compared to the control group (p<0.05). Both the fasting and 120th-minute serum xenin-25 levels were significantly higher in women with GDM compared to healthy pregnant women. CONCLUSIONS: High levels of xenin-25 were associated with gestational diabetes, and xenin-25 might be a potential marker for detecting GDM in the future. © 2023 Verduci Editore s.r.l. All rights reserved.
Ovarian Torsion During Pregnancy: a Case of Malignant Ovarian Cancer
(Yuzuncu Yil Universitesi Tip Fakultesi, 2020) Hacıoğlu, L.; Karaman, E.; Dirik, D.; Karaaslan, O.; Kolusarı, A.; Şahin, H.G.; Gül, A.
Ovarian torsion is an acute and emergency condition during pregnancy. It is caused mainly by the benign cystic mass in the ovary. However, ovarian cancer may be seen as a cause which is very rare during pregnancy. Here, we aim to present a case of pregnant women with ovarian torsion and diagnosed with malignant ovarian tumor. © 2020, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Pathogenesis of Placenta Accreta Spectrum
(Springer International Publishing, 2022) Karaman, E.; Dirik, D.; Karaaslan, O.
This chapter covers the underlying mechanisms and pathological processes that leads to the development of placenta accreta. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2023.
Prenatal Diagnosis and Associated Anomalies of Congenital Hand Malformations
(Kare Publishing, 2025) Türkyilmaz, G.; Bütün, Z.; Karaaslan, O.
Objective: Congenital hand malformations (CHM) are prevalent congenital anomalies in the prenatal period. We aimed to assess the prenatal features of CHM, associated genetic syndromes, and postnatal prognosis. Material and Methods: Ultrasound findings, associated anomalies, genetic results, and postnatal course were evaluated in ten cases with CHM in two centers over three years. Results: The mean gestational age at diagnosis was 22.8±2.7 weeks. CHM was isolated in four cases and accompanied by associated anomalies in six fetuses. It was bilateral in six cases. Polydactyly was the most common type of hand malformation. Termination of pregnancy was performed in four fetuses. There was no genetic etiology in isolated cases, and the postnatal course was favorable. Hand malformations with associated anomalies and a genetic syndrome carried a high risk, and the prognosis was poor. Conclusion: Prenatal diagnosis of CHM should prompt a detailed anatomical scan and a comprehensive genetic work-up. In isolated cases, the likelihood of a genetic cause is relatively low. In fetuses with multiple congenital anomalies, genetic etiology is common, and the prognosis is poor. © 2025 Kare Publishing. All rights reserved.
Preoperative Factors Associated With the Need for the Morcellation in Total Laparoscopic Hysterectomy
(Yuzuncu Yil Universitesi Tip Fakultesi, 2020) Kiyak, H.; Karaaslan, O.; Doga Seckin, K.; Karacan, T.; Ozyurek, E.S.; Yilmaz, G.; Bulut, B.
Removal of uterus during laparoscopic hysterectomy (LH) is occasionally challenging and therefore sometimes requires morcellation. Morcellation techniques for hysterectomy can spread the cancer cells which were presumed benign preoperatively in to the abdomen or pelvis. Probability of an undetected malignity should not be disregarded and accordingly must be shared with the patient prior to LH. The present study aimed to identify the demographic and the clinical factors associated with the need for morcellation in patients undergoing LH. A total of 153 patients who underwent LH for presumed benign causes were enrolled in this retrospective study. Subjects were divided into two groups according to the need for the morcellation during the LH: Morcellation group and intact vaginal removal (IVR) group (it was possible to deliver the uterine specimen vaginally). The two groups were compared with respect to demographic and clinical characteristics, indications for LH, preoperative ultrasonographic findings and postoperative complications. The frequency of the postmenopausal women was significantly higher in the morcellation group than the IVR group (p = 0.005). Preoperative uterus width (p < 0.001) and postoperative Uterus weight (p < 0.001) were significantly higher in the morcellation group compared to that of the IVR group. There were no significant differences between the groups regarding the complication rate. Uterine weight (OR: 1.020, 95% CI: 1.008-1.031, p = 0.001) and menopause (OR: 2.571, 95% CI: 1.328-4.980, p < 0.001) were predictive for the need of morcellation. A cut-off value of 287.5 gram was able to predict the need for morcellation with 87% sensitivity and 71% specificity. The present study demonstrates that uterine weight and presence of the menopause are predictive for the need of morcellation at the time of the total LH. These factors should be considered in preoperative planning and used to further guide surgeons in providing LH. © 2020, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Primary Gestational Choriocarcinoma of the Uterine Cervix and Fallopian Tube: the Diagnosis of Ectopic Pregnancy Is Not Always a Benign Condition
(Bmj Publishing Group, 2019) Karaman, E.; Kolusan, A.; Alkis, I.; Karaaslan, O.; Sahin, H. G.; Gul, A.
A Rare Case of Uterine Rupture Diagnosed in the Late Postpartum Period
(Yuzuncu Yil Universitesi Tip Fakultesi, 2021) Karaaslan, O.; Kolusari, A.; Kolusari, P.; Dirik, D.; Sakinci, M.; Karaman, E.
Obstetric hemorrhages are still the most common cause of maternal mortality worldwide (1). Uterine rupture, which could be included among the causes of postpartum bleeding, results in serious mortality and morbidity. Although scarless uterine rupture is extremely rare, it might be seen with an approximate frequency of 1/5700-1/20000 in pregnancies (2-5). In general, it is diagnosed and treated in the early postpartum period as it usually presents symptoms at this very stage. A case of uterine rupture that was diagnosed and treated on the 28th postpartum day was discussed in this case. © 2021, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
A Rare Case; Isolated Tubal Torsion
(Yuzuncu Yil Universitesi Tip Fakultesi, 2020) Karaaslan, O.; Yildirim, D.; Şimşek, E.; Hacıoğlu, L.
Although isolated torsion of the tuba is very rare, it should be kept in mind especially in women of reproductive age who present with abdominal pain, as it causes fertility problems especially in late diagnosed cases. Pre-operative diagnosis is difficult because there is no pathognomonic symptom or specific clinical, imaging and laboratory findings. Therefore, it should be considered in reproductive age women presenting with undiagnosed abdominal pain. © 2020, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Spinal Anesthesia Is Associated With Postoperative Urinary Retention in Women Undergoing Urogynecologic Surgery
(Yuzuncu Yil Universitesi Tip Fakultesi, 2020) Yilmaz, G.; Akça, A.; Kiyak, H.; Karaaslan, O.; Salihoğlu, Z.
We hypothesized that spinal anesthesia could lead to impairment in bladder function and consequently, to postoperative urinary retention (POUR), particularly in patients undergoing urogynecologic surgery. This study was aimed to compare the rate of the POUR between the subjects receiving spinal and general anesthesia who underwent urogynecologic surgery. One hundred and eighty subjects who underwent urogynecologic surgery between June 2016 and May 2019 were retrospectively analyzed to evaluate the risk of POUR after general versus spinal anesthesia. All subjects underwent a standardized voiding trial subsequent to surgery, which was performed by backfilling the bladder with 300 ml of saline. The presence of > 100 ml volume in the post-void bladder scan was defined as POUR. The primary outcome was to compare rates of POUR between spinal and general anesthesia. Identifying the risk factors for POUR was the secondary outcome of this study. Spinal anesthesia group included 80, and the general anesthesia group consisted of 100 patients. The overall rate of the POUR was %22.8. The proportion of the patients with POUR was significantly higher in the spinal anesthesia group compared to that of the subjects in the general anesthesia group (%33.8vs%14, P=0.002). Multivariate logistic regression analysis revealed that the adoption of spinal anesthesia (Odds ratio: 3.172, 95%CI: 1.383-7.275, P=0.006) and presence of diabetes (Odds ratio: 5.840, 95% CI:2.325-14.666, P< 0.001) were independent predictors for the development of POUR. The rate of the POUR is significantly higher in patients receiving spinal anesthesia than those receiving general anesthesia among women undergoing urogynecologic surgery. © 2020, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved.
Ultrasound Anatomy of the Uterus at Term
(Springer, 2021) Kalafat, E.; Karaaslan, O.
The evaluation of uterine anatomy at term is challenging. The grown fetus usually obstructs the view of the posterior elements of the uterus. The evaluation of adnexa and ovaries is also often not possible as the structures are high up in the abdominal cavity and out of the scanning depth. Luckily, pathologies requiring the assessment of adnexa are relatively rare at term pregnancies. The focus of anatomic ultrasound at term is the evaluation of the lower uterine segment, the placenta, the cervix, and the bladder. These structures have clinical relevance due to conditions such as placenta previa, placenta accrete spectrum (PAS), and risk assessment for a trial of labor after cesarean. The uterus undergoes significant changes throughout pregnancy and at term; the fully developed lower uterine segment (LUS) is present by 37 weeks' gestation. We will discuss the formation of LUS and its surgical relevance later on in this chapter. © Springer Nature Switzerland AG 2021.