Browsing by Author "Sahin, HG"

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Combined Bladder, Urethral and Uterine Rupture After a Normal, Spontaneous Vaginal Delivery at Home - a Case Report
(Sci Printers & Publ inc, 2005) Zeteroglu, S; Bayrakli, H; Yilmaz, Y; Sahin, HG
BACKGROUND: Uterine rupture and associated injury to the maternal bladder and urethra have been rarely reported. All those cases were associated with a scarred uterus or augmentation of labor. We report a case of simultaneous bladder, urethral and uterine rupture in an unscarred uterus following delivery at home. CASE: A 22-year-old woman was referred front a peripheral hospital to the emergency unit of the Medical Faculty, Yuzuncu Yil University, after delivering at home. On vaginal examination, the bladder neck and proximal one third of the urethra were ruptured. Intraoperatively it appeared that the posterior wall of the bladder and bladder base had ruptured and separated from the level of the interureteric ridge. An extensive rupture of the lower uterine segment to the left sidewall of the uterus was seen. CONCLUSION: To prevent these complications, uneducated, traditional birth attendants should be replaced by at least midwives, and the rate Of unsupervised home delivery should be reduced.
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
Outcome of Heterotopic Pregnancy Without Corpus Luteum
(Elsevier Science Bv, 2002) Sahin, HG; Sahin, HA; Gul, A; Ipeksoy, U; Kocar, M
Ovarian Hemangioma With Elevated Ca125 and Ascites Mimicking Ovarian Cancer
(I R O G Canada, inc, 2006) Erdemoglu, E; Kamaci, M; Özen, S; Sahin, HG; Kolusari, A
We report a case of a very rare tumor of the ovary with an unusual presentation; an ovarian hemangioma with massive ascites and elevated CA125. A 57-year-old woman presenting with elevated CA125, massive ascites and a left solid adnexal mass of 60 x 47 mm, with calcification and increased blood flow at Doppler examination, was submitted to laparotomy. Frozen section was inconclusive and a staging procedure which complicated the patient was performed. Pathologic examination revealed cavernous hemangioma which is an extremely rare tumor of the ovary. Although it is very unusual, an ovarian hemangioma may present with ascites and elevated CA125 and the differential diagnosis from ovarian cancer should be considered.
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.
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.