Browsing by Author "Tolunay, Harun Egemen"

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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.
Covıd-19 ve Düşük Ürik Asit Seviyeleri
(2021) Dülger, Ahmet Cumhur; Aydın, Mesut; Dirik, Yaren; Tolunay, Harun Egemen; Gül, Alev
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Epilepsinin Gebelik Sonuçları Üzerine Etkisi
(2018) Çim, Numan; Alkis, İsmet; Yildizhan, Recep; Aksin, Şerif; Tolunay, Harun Egemen; Boza, Barış; Karaman, Erbil
Amaç: Epilepsili olguların yaklaşık %25’i reprodüktifçağdadır. Günümüzdeki anti-epileptik ilaçlarla nöbetlerkontrol altına alınmakta ve bu olgularda artmış orandagebelik tercihi olmaktadır. Bu çalışmada epilepsili gebeolguların gebelik sonuçlarının incelenmesi amaçlandı.Gereç ve Yöntem: Bu çalışma epilepsi tanısı olangebelerin dosya kayıtları üzerinden retrospektif olarakyapıldı. Ocak 2009- Nisan 2014 tarihleri arasında toplam43 epilepsi tanısı olan gebe kaydına ulaşıldı. Aynı tariharalığında başvuran, sistemik hastalığı ve ilaç kullanımıolmayan, tekiz canlı gebeliği olan, benzer yaş ve gebelikhaftadaki dosya kaydı tam olan 87 olgu ise kontrolgrubunu oluşturdu. Her iki grup demografik özellikler,gebelik haftası, doğum şekli, bebek 1. ve 5. dk Apgarskoru, doğum kilosu, epilepsi tanı süresi, nöbet sıklığı,kullandığı anti-epileptik ilaç, maternal komplikasyon,gebelik komplikasyonu yönünden istatistiksel olarakkarşılaştırıldı.Bulgular: Demografik yönden ve perinatal sonuçlaryönünden gruplar arasında fark yoktu (p>0,05), fakatabortus sayısı epilepsi tanılı gebe grubunda sağlıklı gebegrubuna göre anlamlı olarak daha yüksekti (p:0,035).Gruplar gebelik komplikasyonları bakımındankarşılaştırıldığında, epileptik grupta oligohidroamnioz,preterm eylem, preeklampsi ve eklampsi oranları kontrolgrubuna göre daha yüksekti (p:0,001). Her iki gruptasezaryen ile doğum oranı yüksekti (% 68,4 ve %62,4).Epilepsili gebe olgularda en sık geçirilen nöbet türüjeneralize tonik-klonik nöbetti (%81,6). Epileptik nöbetsayısı arttıkça 5. dk Apgar skoru düşmekteydi. Olguların%26,3’ü ilaç kullanmazken, % 55,3’ü monoterapi,%18,4’ü ise politerapi almaktaydı.Sonuç: Epilepsili gebelerde gebelikle ilişkilikomplikasyonlar ve kötü perinatal sonuçlar dahayüksektir. Gebelikteki nöbet sayısı arttıkça, gebeliksonuçları olumsuz olarak etkilenmektedir. Bu olgularagebelik öncesi iyi bir danışmanlık verilmeli ve nöbetsizdönemde gebelik önerilmelidir.
Helicobacter Pylori Infection in Amniotic Fluid May Cause Hyperemesis Gravidarum
(Yale J Biology Medicine, inc, 2020) Aydin, Mesut; Tolunay, Harun Egemen; Varli, Erol Nadi; Boza, Baris; Sahin, Ozgur; Ozer, Serhat; Dulger, Ahmet Cumhur
Objectives: Limited data are available from recent trials involving pregnant women to guide Helicobacter pylori infection diagnosis. There are no data about the presence of H. pylori in the amniotic fluid as well. Furthermore, the relation between amniotic fluid H. pylori and hyperemesis gravidarum (HG) has not been characterized yet. Materials and Methods: This is a prospective study conducted after obtaining approval from the Ethics Committee. Pregnant women undergoing amniocentesis were enrolled in the study. The stool antigen test assessed the presence of H. pylori in amniotic fluid. A perinatologist independently performed an amniocentesis. The obtained amniotic liquid was sent to the laboratory to evaluate H. pylori infection by stool H. pylori antigen assay. We determined the rate of H. pylori in amniotic fluid and assessed relations between H. pylori infection and pregnancy outcome, including HG. Results: Between May and September 2017, we enrolled 48 pregnant women who underwent amniocentesis to detect possible fetal malformations. Patients were divided into two groups regarding the HG status. There were significant differences between the groups in terms of H. pylori infection presence. Among them, 28 (58.3%) were found to have a positive H. pylori test in their amniotic fluid. The rate of HG was significantly higher (71.4%) in patients who tested positive for H. pylori in amniocentesis than the H. pylori-negative group (20%), (p<0.001). Conclusions: The study's main new finding is that presence of H. pylori in the amniotic fluid is possible. Our data suggest that H. pylori-infected amniotic fluid is associated with the experience of past HG. The current study may have important implications for HG detection and help identify patients who would benefit from future preventive strategies.
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 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.
Retrospective Evaluation of Hydatid Cyst Cases During Pregnancy
(Yale J Biology Medicine, inc, 2021) Sahin, Ozgur; Tolunay, Harun Egemen; Varli, Erol Nadi; Arat, Ozgur; Aydin, Mesut
Aim: Zoonotic parasite infections affect many pregnant people around the world. Hydatid cystic disease is also a zoonotic disease caused by Echinococcus sp. This study aims to present the maternal-fetal results and clinical treatment of pregnant women diagnosed with liver hydatid cyst (CH). This zoonotic disease is discussed again in the light of current literature. Materials and Methods: Pregnant women with hydatid cyst monitored in a tertiary health center between 2018 and 2020 were evaluated. Seven cases were included in this study. We retrospectively collected and analyzed clinical data, which did not interfere with medical treatment. Results: Albendazole was started as medical therapy in six patients, and percutaneous drainage was applied to one patient. Three of our six patients who started medical treatment had to undergo surgery due to maternal complications that developed despite medical treatment. Two of our patients were delivered with a cesarean section due to the obstetric indications. Discussion: Hydatid cysts are most commonly caused by Echinococcus granulosus infection and most common in the liver. The diagnosis of liver hydatid cysts is not difficult, but pregnant women's treatment methods have some problems. Although both medical and surgical treatments are available, there is no consensus. We would also like to underscore that echinococcal disease of the liver should be kept in mind in the differential diagnosis of abdominal pain, jaundice, and/or fever, especially in endemic regions. We think that when we increase awareness about this disease, we can improve fetal and maternal outcomes by making an early diagnosis and management.
Serklajın Servikal Değişikliklerde Gebelik Sonuçlarına Etkisi
(2017) Karaman, Erbil; Çim, Numan; Tolunay, Harun Egemen; Alkis, İsmet; Yildizhan, Recep; Kolusarı, Ali; Şahin, Hanım Güler
Giriş: Yüksek neonatal morbidite ve mortalite ile sonuçlanan preterm doğumları engellemek için yapılan servikal serklajın sonuçlarını göstermeyi amaçladık. Gereç ve Yöntem: ACOG (The American College of Obstetrics and Gynecology) kriterlerine uygun McDonald yöntemi ile serklaj yapılan 56 olgunun retrospektif olarak sonuçları incelendi. Birinci grup ikinci trimestrde servikal kısalma olup dilatasyonun olmadığı 32 olgu, ikinci grup ise servikal kısalma ile birlikte 3 cm'den daha az servikal dilatasyonu olan 24 olgudan oluştu. Bulgular: Olguların servikal serklaj sonuçları karşılaştırıldığında birinci grup olguların ikinci gruba oranla daha geç haftada doğum yaptıkları (p:0,002), serklaj uygulanan hafta ile doğum arasında geçen sürenin daha uzun olduğu (p:0,001) ve bebeklerin doğum kilosunun daha fazla olduğu (p:0,002) saptandı. Sonuç: Servikal yetmezlik tanısı alan olgularda tekrarlayan gebelik kaybı ve preterm doğumu azaltmak için servikal serklaj uygulaması iyi bir seçenektir.
Shear-Wave Elastography - Virtual Touch Tissue Quantification of Fetal Placentas With a Single Umbilical Artery
(Taylor & Francis Ltd, 2019) Arslan, Harun; Tolunay, Harun Egemen; Cim, Numan; Boza, Baris; Yavuz, Alpaslan; Ilik, Ibrahim; Yildizhan, Recep
Objective: In this study, we aimed to evaluate the elasticities of fetal placentas with a single umbilical artery using the Virtual Touch Tissue Quantification (VTTQ) technique. Materials and methods: Pregnant women with fetuses with a single umbilical artery (SUA) and pregnant women with fetuses having three vessel cord (3VC) at 18-22 weeks of gestation were enrolled in the research. The placentas were evaluated and divided into three equal parts as the inner 1/3 of the placenta (fetal edge), the outer 1/3 of the placenta (maternal edge) and the central 1/3 of the placenta (central part). Shear-wave velocity (SWV) measurements were used in the elastographic evaluation of placentas by VTTQ. Results: Forty pregnant women were included in the study (n = 20 SUA, n = 20 three vessel cord pregnant women). The placental Acoustic Radiation Force Impulse (VTTQ) of the placenta regarding SWV measurement values of the fetal edge of the placenta in the fetuses with SUA and the control group were 0.876 and 0.957 m/sec, respectively. A significant statistical difference was found between the groups regarding the measurement of the stiffness of fetal placenta (p = 0.021). There was no significant difference between the measured stiffness values of the central or outer region of the placentas. Conclusions: In this study, we found lower SWV scores for the fetal edge of the placenta with SUA. This finding may reflect tissue elasticity level, and we hope that the use of the VTTQ technique may contribute to predicting the pregnancy-related morbidities of fetuses with SUA in the future.
Use of Arfi Elastography in the Prediction of Placental Invasion Anomaly Via a New Virtual Touch Quantification Technique
(Taylor & Francis inc, 2018) Cim, Numan; Tolunay, Harun Egemen; Boza, Baris; Arslan, Harun; Ates, Can; Ilik, Ibrahim; Yavuz, Alpaslan
We aimed to evaluate the efficiency of placental elasticity in predicting a placental invasion anomaly with the Virtual Touch Quantification (VTQ) technique. Pregnant women in the third trimester with suspected placental invasion anomaly were enrolled into the research (n = 58). The placenta was evaluated and divided into three equal parts as foetal edge (inner 1/3 of placenta), maternal edge (outer 1/3 of placenta) and the central part (central 1/3 of placenta). Shear wave velocity (SWV) measurements were used in the elastographic evaluation of placentas by VTQ. We performed the measurements at the different regions of placenta for sampling the variety areas of the placenta. Acoustic Radiation Force Impulse (ARFI) Elastography scores were significantly higher in the group in which an invasion was detected during the surgery of patients with preoperative placental invasion suspicion. A significant difference in the measurements of the inner, central and outer third of the placenta between the groups was found (p < .001). In this study, we have shown higher SWV scores of placental measurements of the patients with preoperative suspected anomalies and an invasion detected during their surgery. These findings may reflect an event at the tissue elasticity level and we hope that the use of the VTQ technique may contribute to an early prediction of placental invasions before surgery in the future via new research.