Browsing by Author "Sahin, HA"

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Induction of Labor in Great Grandmultipara With Misoprostol
(Elsevier Ireland Ltd, 2006) Zeteroglu, S; Sahin, HG; Sahin, HA
Objective: To compare the efficacy and complications of intravaginal misoprostol application with oxytocin infusion for induction of labor in great grandmultiparous pregnancies with a Bishop score of <6. Study design: Sixty-four great grandmultiparous (delivering the tenth, or greater, infant) pregnant patients with a Bishop score of <6 were randomized in two groups with 32 patients receiving 50 mu g intravaginal misoprostol four times with 4 It intervals, and 32 patients receiving oxytocin infusion for induction of labor starting from 2 mIU/min, increasing it every 30 min with 2 mIU/min increments up to maximum of 40 mIU/min. The time from induction to delivery, the route of delivery, fetal outcome and maternal complications were recorded. Statistical analyses were performed using Mann-Whitney U-test, Chi-Square test and hypothesis test about differences for two proportions (t-test) to determine differences between the two groups. P <= 0.05 was considered significant. Result: The mean time from induction to delivery was 9.91 +/- 4.30 and 10.88 +/- 4.72 h in the misoprostol and oxytocin administered group, respectively, with no significant difference between the groups. The rate of vaginal delivery was 84.4 and 87.5% in the misoprostol and oxytocin administered group, respectively, with no significant difference between the groups (P = 0.72). The rates of placental abruption and postpartum hemorrhage were similar in both groups and no case of uterine rupture occurred. The 1 and 5 min mean Apgar scores were 6.91 +/- 1.57-8.88 +/- 1.39 and 7.22 +/- 1.24-9.06 +/- 0.84 in the misoprostol and oxytocin administered group with no significant differences between the groups (P = 0.38 and 0.51). No case of asphyxia was present. The rate of admission to neonatal intensive care unit was higher in the misoprostol administered group, but the difference was not significant. Conclusion: Intravaginal misoprostol is an alternative method to oxytocin in induction of labor in great grandmultiparous pregnant women with low Bishop scores, as it is effective, cheap and easy to use. Safety about rare complications and neonatal morbidity needs clarifications with further studies. (C) 2005 Elsevier Ireland Ltd. All rights reserved.
Induction of Labor in Toxemia With Misoprostol
(Blackwell Munksgaard, 2002) Sahin, HG; Sahin, HA; Kocer, M
Background To compare the efficacy and complications of intravaginal misoprostol application with oxytocin infusion for induction of labor in toxemia of pregnancy with a modified Bishop score of less than or equal to4. Methods. A hundred preeclamptic women with a modified Bishop score of :54 were randomized into two groups of 50 patients one group receiving 50 mug intravaginal misoprostol 4 times at 4 hour intervals, the second group receiving oxytocin infusion for induction of labor starting from 1 mIU/per minute, increasing it every 30 minutes with 2 mIU/per minute increments up to maximum of 30 mIU/per minute. Modified Bishop scores 12 hours after induction, the time from induction to delivery, the route of delivery, fetal outcome and maternal complications were recorded. Statistical analyses were performed using Mann Whitney-U, Chi-Square and hypothesis tests about differences for two proportions (t test) to determine differences between the two groups. p less than or equal to 0.05 was considered significant. Results. Misoprostol was significantly superior for induction of labor in toxemia of pregnancy with modified Bishop score of less than or equal to4. After 12 hours median modified Bishop scores of misoprostol administered group and oxytocin administered group were 7 and 4 respectively. Misoprostol administered group I was significantly better than oxytocin administered group 2 (p = 0.027). The rate of patients who were in labor after 12 hours were 94% and 80% in group I and 2 respectively and the difference showed significant difference (p < 0.05). The median time from induction to delivery was 14 hours and 16 hours in the misoprostol and oxytocin administered group respectively with significant difference between the groups (p = 0.003). The rate of vaginal delivery was significantly higher in the misoprostol administered group 1 (82%) when compared with the oxytocin administered group 2 (66%) (p < 0.05). The I and 5 minutes median Apgar scores were 5-7 and 6-7.5 in group 1 and 2, respectively with no significant differences between the groups (p = 0.96, p = 0.64). The rate of admission to neonatal intensive care unit was similar in both groups. The complication rates were similar in all groups and no significant detrimental effects were noted. Conclusion. Intravaginal misoprostol is an efficacious, cheap and safe method of induction of labor in toxemia of pregnancy with modified Bishop score of less than or equal to4.
Induction of Labor With Misoprostol in Grand Multiparous Patients
(Elsevier Sci Ireland Ltd, 2004) Zeteroglu, S; Sahin, HG; Sahin, HA
Knowledge and Attitudes Towards Emergency Contraception of Healthcare Providers in a Region With a High Birth Rate
(Parthenon Publishing Group, 2004) Zeteroglu, S; Sahin, G; Sahin, HA; Bolluk, G
Objective To assess the knowledge of, attitude towards and practices of emergency contraception among health-care providers at a university hospital located in a region with a high birth rate. Methods The survey was conducted among 214 health-care providers working at a university hospital located in eastern Turkey. Results Two hundred participants completed the questionnaire. Of the respondents, 26.0% said that they did not know anything about emergency contraception, while the remaining 74.0% said that they knew about at least one of the methods of emergency contraception. But among these, the knowledge of 38.5% of the participants about emergency contraception was accurate and that of 61.5% was inaccurate. Thirty-four percent of the respondents stated that they had previously required personally to use emergency contraceptive methods. The most commonly used emergency contraceptive methods were oral contraceptives (69.1%) and intrauterine device (14.7%). None of the respondents knew anything about mifepristone and levonorgestrel. Conclusion There is a knowledge deficit among health-care providers who play a significant role in the dissemination of the information about emergency contraception.
Outcome of Heterotopic Pregnancy Without Corpus Luteum
(Elsevier Science Bv, 2002) Sahin, HG; Sahin, HA; Gul, A; Ipeksoy, U; Kocar, M
Randomized Outpatient Clinical Trial of Medical Evacuation and Surgical Curettage in Incomplete Miscarriage
(Parthenon Publishing Group, 2001) Sahin, HG; Sahin, HA; Kocer, M
Objective To compare the efficacy and safety of misoprostol in outpatient medical evacuation with surgical curettage in uncomplicated incomplete spontaneous miscarriage. Methods Eighty women with a history of vaginal bleeding, and passage of some products of the conceptus were randomized into two groups. Forty patients in Group I received 200 mug misoprostol q.i.d. after the application of 200 mug intravaginal misoprostol for 5 days; 40 patients in Group 2 had a surgical curettage performed. All of the patients were re-evaluated after 10 days. The success rates, mean number of days of bleeding, mean decreases in hemoglobin levels, the complications and the rates of patient dissatisfaction in the two groups were compared. Results The success rate in the misoprostol-administered group was 93.33%. Although the mean number of days of bleeding was significantly higher in the misoprostol-administered group, the mean decreases in hemoglobin values in the two groups were not significantly different. The patient dissatisfaction rate was 2.5% in the misoprostol group, compared to 35% in the control group. The difference between the two groups was significant. Conclusions The use of misoprostol in the outpatient treatment of uncomplicated incomplete spontaneous miscarriage is safe and effective and can be an alternative to surgical evacuation and expectant management.
Reasons for Not Using Family Planning Methods in Eastern Turkey
(Parthenon Publishing Group, 2003) Sahin, HA; Sahin, HG
Objective The reasons for not using family planning methods among women aged 15-45 years were investigated in the Eastern region of Turkey. Methods A total of 518 randomly selected women were interviewed with a questionnaire. Information was collected on women's fertility behavior and intentions, sources of knowledge and practice of contraception and sociodemographic characteristics. Results The rate of women who were not using any form of family planning was 45.2%. The reasons for not using any form of family planning were: not having the approval of the husband or family leaders (38%); believing that it was a sin to use a family planning method (32.5%); believing that it could cause abnormal bleeding (14.1%); believing that it could cause infertility (7.3%); believing that it could cause cancer (4.7%); and believing that it could cause pelvic pain (3.4%). Conclusion Efforts should be directed towards education of family members and religious leaders to increase the usage of family planning methods.
Recurrent Impetigo Herpetiformis in a Pregnant Adolescent: Case Report
(Elsevier Sci Ireland Ltd, 2002) Sahin, HG; Sahin, HA; Metin, A; Zeteroglu, S; Ugras, S
Impedigo Herpetiformis is a rare pustular dermatosis that typically occurs in pregnant women with unknown ethiology. A 17 year old patient who developed Impedigo Herpetiformis for the second time in the 27th week of her 2nd pregnancy is presented. The patient improved with corticosteroids treatment but the lesions did not clear completely and had flare ups during stressful periods which brings us to conclusion that Impedigo Herpetiformis at least has a common pathway with Generalized Pustular Psoriasis in the pathogenesis as stress provoked exacerbations. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.
Renal Involvement in Brucellosis
(Oxford Univ Press, 2005) Sahin, I; Arabaci, F; Eminbeyli, L; Ilhan, M; Onbasi, K; Sahin, HA
Sociodemographic Factors in Organophosphate Poisonings: a Prospective Study
(Sage Publications Ltd, 2003) Sahin, HA; Sahin, I; Arabaci, F
The sociodemographic features of organophosphate poisonings (OPPs) in the east Anatolian region of Turkey were investigated in this study. All OPPs admitted to the Emergency Department of Yuzuncu Yil University Medical Faculty Hospital in Turkey from 1 April 1999 to 31 August 2001 were prospectively studied. Data collected included age, gender, education, employment and marital status, socioeconomic levels, time and route of exposure of the toxic agents, treatment before admission, duration of hospitalization and complications. The proportion of OPPs was 15.1% among 564 poisonings. Fifty-seven (67.1%) patients were female, 28 (32.9%) were male. Fifty-six (65.9%) cases were attempted suicides and 29 cases (34.1%) were due to accidental events. Mean age was 22.1 +/- 9.2 years in the suicidal cases and 43 (76.8%) of them were less than 24 years ( P = 0.001). Among the suicide attempts, 29 (51.8%) patients were unmarried and 43 ( 76.8%) patients were female. The attempted suicide proportion was 46.4% in men and 75.4% in women ( P = 0.008). Eighty per cent of cases had a primary education level or were illiterate and 78.8% of the patients were in the lower socioeconomic status. The patients' mean arrival time to the hospital after poisoning was 4.4 +/- 3.7 (1-15) hours and mean hospitalization duration was 4.9 +/- 4.1 (1-32) days. Exposure routes were gastrointestinal in 75 (88.2%), respiratory in five (5.9%), dermal in four (4.7%) and both dermal and respiratory in one case (1.2%). Seventeen patients (23.5%) were admitted to the ICU and four ( 4.7%) of them died. In conclusion, OPPs especially affected young unmarried females, and most of them were due to attempted suicide. As OPP is the important cause of morbidity and mortality in the region, therapy should be started as early as possible so undesirable consequences can be avoided.
A Study of Intravaginal Misoprostol for Induction of Labor in Toxemia of Pregnancy
(Elsevier Sci Ireland Ltd, 2001) Sahin, HG; Sahin, HA; Surucu, R; Guvercinci, M
Objective: To compare the efficacy and complications of intravaginal misoprostol for induction of labor in patients with and without toxemia of pregnancy. Methods: Forty-two patients with toxemia of pregnancy (group 1) and 59 women at term without toxemia (group 2) with Bishop scores of less than or equal to 6 were treated with 50 mug intravaginal misoprostol given four times at 4-h intervals. Labor and neonatal outcomes, and any complications, were recorded. Mann-Whitney U-, Student's t- and chi (2)-tests were used for statistical analyses. P less than or equal to 0.05 was considered significant. Results: The rates of vaginal delivery were 73.8% and 84.6%, oxytocin augmentation were 4.8% and 5.1% and the mean insertion to delivery times were 12.5 and 13.8 h in group 1 and 2, respectively, with no significant differences between the groups. Neonatal outcomes, rates of uterine contraction abnormalities and gastrointestinal symptoms were similar in both groups. Conclusions: Intravaginal misoprostol is an equally effective and safe method of induction of labor in patients with toxemia of pregnancy and in normal pregnant women. (C) 2001 International Federation of Gynecology and Obstetrics. All rights reserved.
An Unaddressed Issue: Domestic Violence and Unplanned Pregnancies Among Pregnant Women in Turkey
(Taylor & Francis Ltd, 2003) Sahin, HA; Sahin, HG
Objective The aim of this study was to estimate the prevalence and type of domestic violence during pregnancy in Turkey and to compare socioeconomic background factors. Methods A survey was carried out among a representative sample of 475 pregnant women. Data were collected on the incidence and the nature of domestic violence perpetrated by the woman's spouse or other family members during her current pregnancy and before. Sociodemographic characteristics such as age, duration of marriage, number of children, monthly income, education, occupation of the husband, domestic violence towards children, contribution to family decisions, smoking habits, sexual relations and whether the pregnancy was planned or not, were also recorded. Results Of the 475 women screened for domestic violence during pregnancy, 158 (33.3%) reported physical or sexual abuse since they had become pregnant. The source of the domestic violence was mainly the husband in 105 (66.5%) women. Types of abuse were psychological in 71 (44.9%) and physical in 87 (55.1%) women. The rate of women's satisfaction with their sexual life among abused women was 43.67% compared to 61.2% among non-abused women. Abused pregnant women were less educated, had lower income, had more children, had a longer duration of marriage, were applying violence towards their children, were not contributing to family decisions, were less satisfied with their sexual life and were more likely to have unplanned pregnancies when compared to non-abused women. Conclusion Antenatal care protocols should be modified to address domestic violence and contributing factors during pregnancy so that identified women can be counseled appropriately and attempts can be made to intervene to prevent further episodes of domestic violence in primary care settings.