Altay GEZER
Istanbul University-Cerrahpaşa, Obstetrics and Gynecology, Faculty Member
Placenta percreta is a rare and serious complication of pregnancy. A 35 years old pregnant woman with severe preeclampsia at 36 gestational weeks delivered a live small for gestational age (SGA) fetus by cesarean section. During the... more
Placenta percreta is a rare and serious complication of pregnancy. A 35 years old pregnant woman with severe preeclampsia at 36 gestational weeks delivered a live small for gestational age (SGA) fetus by cesarean section. During the operation, as the fetus had been delivered, the placenta was observed to be perforating the uterus at fundal region attaching to the omentum. This is a rare case of an intrauterine pregnancy with an extrauterine blood supply reaching almost term. Neither bleeding from placenta nor uterine rupture developed; and the infant was SGA and otherwise healthy.
Research Interests:
Research Interests:
Human Papillomavirus HPV infection is accepted as the cause of cervical cancer Besides HPV infection is a growing health problem Prophylactic HPV vaccines immunologically block the virus by increasing the neutralizing antibodies in... more
Human Papillomavirus HPV infection is accepted as the cause of cervical cancer Besides HPV infection is a growing health problem Prophylactic HPV vaccines immunologically block the virus by increasing the neutralizing antibodies in cervical secretions These vaccines aim to stop the development of cervical preinvasive lesions and cervical cancer The prospective studies proved that these vaccines were well tolerated; highly immunogenic resulting in high antibody titers decreasing persistent HPV infections and HPV related cervical disease It can be postulated that vaccination against HPV will be superior to current protection strategies Turk Arch Ped 2008; 43: 1 8 Key words: Cervical cancer HPV infection
Research Interests:
Lichen sclerosus is a chronic, skin disease. The involvement of the vagina is not a characteristic of lichen sclerosus. We report a rare case of vulvovaginal syndrome as a complication of lichen sclerosus with the diagnosis and the... more
Lichen sclerosus is a chronic, skin disease. The involvement of the vagina is not a characteristic of lichen sclerosus. We report a rare case of vulvovaginal syndrome as a complication of lichen sclerosus with the diagnosis and the management of vaginal synechia leading to intravaginal fluid accumulation mimicking pelvic mass. There were two interesting aspects of this case. First, the location of the synechia was behind the introitus, in the vagina. The second was the presence of a pelvic cyst in the lower pelvis. The surgical correction of the case was accomplished with vulvoperninoplasty but the difficulty of this procedure was the identification of the vaginal mucosa after dissection of the synechia. On the next step, the mucosa was attached to the vulvar skin with separate sutures. The postsurgical corticosteroid treatment and the regular dilatation of the introitus are essential to prevent the restenosis.
Research Interests:
OBJECTIVE: Evaluation of the assumption that elective cesarean section (CS) improved neonatal outcomes of ‘preterm fetuses in vertex presentation’. STUDY DESIGN: Birth records of a university hospital between 1999 and 2004 were reviewed.... more
OBJECTIVE: Evaluation of the assumption that elective cesarean section (CS) improved neonatal outcomes of ‘preterm fetuses in vertex presentation’. STUDY DESIGN: Birth records of a university hospital between 1999 and 2004 were reviewed. CS performed without a trial of labor before completion of 37 gestational weeks were included in the study group. Early neonatal and maternal outcomes were compared for the elective CS and vaginal birth groups. RESULTS: 61 elective CS and 117 preterm vaginal deliveries were eligible for the analysis. Neither the rate of NICU admission (38% v ersus 33%) nor the neonatal mortality rate (3.3% versus 4.3%) differed significantly. There were 2 cases of maternal morbidity in the CS group but none in the vaginal birth group. CONCLUSIONS: Data in this study did not demonstrate any beneficial effect of elective CS for the early neonatal outcome of preterm fetuses in vertex resentation despite the possible increase in maternal morbidity.
Research Interests:
Objective: To determine the factors indicating the accuracy of fetal weight estimation in the last prenatal ultrasonography before delivery in preterm newborns with normal amniotic fluid volume.Study Design: 371 singleton pregnancies with... more
Objective: To determine the factors indicating the accuracy of fetal weight estimation in the last prenatal ultrasonography before delivery in preterm newborns with normal amniotic fluid volume.Study Design: 371 singleton pregnancies with normal amniotic fluid volume and delivered at between 24+0 and 37+0 weeks of gestation were evaluated in a retrospective study. Maternal and fetal demographic and clinical data, ultrasonographic measurements and findings were recorded. Any possible associations between the absolute percentage errorof fetal weight estimations and the maternal and fetal data were examined.Results: In 135 of the 371 women (36%), the absolute percentage errorwas greater than 10%. The mean absolute percentage errorwas 8.7±7.5%. The mean absolute percentage errorswere 4.1±2.7% and 16.8±6.4% in the accurate and inaccurate estimation groups, respectively.There were no significant differences in age, body mass index (BMI), gestational age (GA) at delivery, estimated fetal w...
Research Interests:
Research Interests:
Research Interests:
Objective: To evaluate Clinical characteristics and perinatal outcomes of prenatally diagnosed diaphragmatic hernia cases. Material and Methods:We present a retrospective study of the 24 consecutive cases of congenital diaphragmatic... more
Objective: To evaluate Clinical characteristics and perinatal outcomes of prenatally diagnosed diaphragmatic hernia cases. Material and Methods:We present a retrospective study of the 24 consecutive cases of congenital diaphragmatic hernia diagnosed in utero during the period from 1998 to 2006 in our clinic. Gestational age at diagnosis and delivery, additional malformations and chromosomal anomalies, perinatal mortality and success rate of surgery were evaluated. Results: Gestational age at diagnosis was 28.8 ± 6.1 (19-37) weeks. Of the cases 14 (58.3%) were isolated and 10 (41.7%) were complex congenital diaphragmatic hernia. The defect was right-sided in 21% and liver herniation was present in 25% of the fetuses. The incidence of chromosomal abnormality was 8.3%. The perinatal mortality rate of the overall, complex and isolated groups was 91.6%, 100% and 85.7% respectively. Surgery could be performed in 4 fetuses with an isolated left-sided diaphragmatic hernia who born/live and ...
Research Interests:
To determine the effects of different hormone replacement therapy (HRT) regimens on thyroid function in surgical menopause. In a randomized, controlled study, 59 euthyroid women with surgical menopause were randomized to an estrogen-only... more
To determine the effects of different hormone replacement therapy (HRT) regimens on thyroid function in surgical menopause. In a randomized, controlled study, 59 euthyroid women with surgical menopause were randomized to an estrogen-only (n=20), tibolone (n=20) or calcium-only (n=19) group. On the 5th postoperative day and 4th and 12th weeks, serum E2, TSH, free T3 and free T4 levels were determined. Although the initial and week 4 serum E2, TSH, free T3 and free T4 levels were comparable, the week 12 serum E2 and TSH levels were different between the subjects on estrogen therapy and those receiving tibolone or calcium only (p=0.008 and 0.000, respectively). Serum E2 levels were higher and TSH levels lower in subjects receiving estrogen. Moreover, serum TSH levels correlated negatively with serum E2 levels in the 12th week of estrogen use (r=-0.354, p=0.006). TSH increased in the tibolone group as compared to the estrogen group but was still lower than in the calcium-only group; how...
Research Interests:
OBJECTIVE: To determine the factors indicating the accuracy of fetal weight estimation in the last prenatal ultrasonography before delivery in preterm newborns with normal amniotic fluid volume. STUDY DESIGN: Three hundred and seventy-one... more
OBJECTIVE: To determine the factors indicating the accuracy of fetal weight estimation in the last prenatal ultrasonography before delivery in preterm newborns with normal amniotic fluid volume. STUDY DESIGN: Three hundred and seventy-one singleton pregnancies with normal amniotic fluid volume and delivered at between 24+0 and 37+0 gestational weeks were evaluated in a retrospective study. Any possible associations between the absolute percentage error of fetal weight estimations and the maternal and fetal data were examined. RESULTS: In 135 of the 371 women (36%), the absolute percentage error was greater than 10%. The mean absolute percentage error was 8.7±7.5%. The mean absolute percentage errors were 4.1±2.7% and 16.8±6.4% in the accurate and inaccurate estimation groups, respectively. The rate of women examined during labor was significantly higher in the inaccurate estimation group compared to the accurate estimation group. There were no significant differences in age, body-ma...
Sum mary Aim: To investigate the neonatal morbidity and mortality results in PPROM. Material and Method: A review of 228 PPROM singleton pregnancies followed up in our clinic between 1996 and 2005 was performed. Results: The most common... more
Sum mary Aim: To investigate the neonatal morbidity and mortality results in PPROM. Material and Method: A review of 228 PPROM singleton pregnancies followed up in our clinic between 1996 and 2005 was performed. Results: The most common neonatal morbidities in PPROM cases are RDS, sepsis and IVH. The route of delivery does not affect NICU requirement, perinatal asphyxia, sepsis and IVH rates in PPROM cases. NICU and PPV requirement, RDS, sepsis and IVH rates increase if APGAR score is <5. Neonatal morbidity and mortality rates increase as latent period lenghtens. CRP on admission, final CRP, birthweight and the 5th minute APGAR score were found to be associated with NICU requirement; only the 5th minute APGAR score was found to be associated with RDS; final leukocyte count and maternal hemotacrit was found to be associated with sepsis and pneumonia, independently. Conclusions: In PPROM cases, CRP on admission, final CRP, birthweight, the 5th minute APGAR score, final leukocyte co...
The development of leiomyoma from the rudimentary buds in Rokitansky -Kuster- Hauser syndrome is extremely rare. Reviewing the literature, we detected only five cases that had been previously reported. We present a case of Rokitansky... more
The development of leiomyoma from the rudimentary buds in Rokitansky -Kuster- Hauser syndrome is extremely rare. Reviewing the literature, we detected only five cases that had been previously reported. We present a case of Rokitansky -Kuster- Hauser syndrome whom we diagnosed and treated a giant leiomyoma with a diameter of 25 cm. Key Words: Rokitansky-Kuster- Hauser syndrome, Leiomyoma
Research Interests:
Kad›n hastal›klar› prati¤inin önemli konular›ndan birisi çocukluk yafl grubunun (0-14 yafl) jinekolojik sorunlar›d›r. Bir kad›n›n yaflam› boyunca, kad›n olmaya iliflkin ilk deneyimleri bu dönemde edinilir. Bu deneyimin iyi ya da kötü... more
Kad›n hastal›klar› prati¤inin önemli konular›ndan birisi çocukluk yafl grubunun (0-14 yafl) jinekolojik sorunlar›d›r. Bir kad›n›n yaflam› boyunca, kad›n olmaya iliflkin ilk deneyimleri bu dönemde edinilir. Bu deneyimin iyi ya da kötü olmas› kad›n›n sonraki yaflam›n› etkileyecek sonuçlar do¤urabilir. Bu nedenle, bu dönemde yap›lacak muayenenin kendine özgü özellikleri oldu¤u unutulmamal›d›r. Di¤er taraftan, çocuk hastan›n de¤erlendirilmesinde fiziksel soruna odaklanman›n yan›s›ra döneme özgü fizyolojik de¤iflikliklerin de gözönünde bulundurulmas› gereklidir. Çocuklardaki jinekolojinin konusu, geçen yüzy›l içerisinde giderek genifllemifltir. Yenido¤an k›z çocu¤unun jinekolojik bak›m› do¤um salonunda bafllar. Do¤um sonras› yap›lan yenido¤an muayenesi s›ras›nda yap›lan d›fl genital organlar›n bak›lmas› (enspeksiyonu), ilk jinekolojik muayene say›labilir. D›fl genitalyan›n de¤erlendirilmesi sa¤lam çocuk muayenelerinin de bir parças›d›r. Böylelikle enfeksiyonlar, dudaklardaki yap›fl›kl›kl...
Research Interests:
Yaz›flmaAdresi/AddressforCorrespondence:Yasemin Kayadibi İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi, Radyoloji Anabilim Dalı, İstanbul, Türkiye GSM: +90 536 257 08 79 E-pos ta: yasemin.kurdoglu@istanbul.edu.tr... more
Yaz›flmaAdresi/AddressforCorrespondence:Yasemin Kayadibi İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi, Radyoloji Anabilim Dalı, İstanbul, Türkiye GSM: +90 536 257 08 79 E-pos ta: yasemin.kurdoglu@istanbul.edu.tr GeliflTarihi/Received:08 Temmuz 2013 KabulTarihi/Accepted:03 Eylül 2013 Haseki T›p Bülteni, Galenos Yay›nevi taraf›ndan bas›lm›flt›r. The Medical Bulletin of Haseki Training and Research Hospital, published by Galenos Publishing. DOI: 10.4274/Haseki.1278 Olgu Sunumu / Case Report
Research Interests:
OBJECTIVE: To investigate the accuracy of fetal weight estimation made by the last prenatal ultrasound measurement in low birth weight newborns (<2500 g). STUDY DESIGN: A total of 1082 women were evaluated in this retrospective cohort... more
OBJECTIVE: To investigate the accuracy of fetal weight estimation made by the last prenatal ultrasound measurement in low birth weight newborns (<2500 g). STUDY DESIGN: A total of 1082 women were evaluated in this retrospective cohort study. Demographic and clinical information of the mother and newborn and obstetric ultrasonography measurements and findings performed in the last week before birth were recorded. Accuracy of fetal weight estimation and parameters affecting it was investigated. RESULTS: Accurate estimation rates were lower in the term compared to the preterm delivery group; and in the SGA group compared to the AGA group (respectively, p=0.016, p=0.032). Accurate estimation rates (p=0.182) were comparable between the 500-1500 g and 1501-2500 g subgroups. The multiple linear regression analysis showed that gestational age at birth, birth weight, examination during labor, and duration between examination to delivery were statistically significant for the accurate esti...
OBJECTIVE Sirtuin3 (SIRT3) is a NAD+-dependent major mitochondrial deacetylase. In this study, we aimed to investigate SIRT3 levels and their target enzyme activities, including glutamate dehydrogenase (GDH), succinate dehydrogenase... more
OBJECTIVE Sirtuin3 (SIRT3) is a NAD+-dependent major mitochondrial deacetylase. In this study, we aimed to investigate SIRT3 levels and their target enzyme activities, including glutamate dehydrogenase (GDH), succinate dehydrogenase (SDH), and manganese superoxide dismutase (MnSOD), also to determine the antioxidant capacity and oxidative stress in tissue, mitochondria and serum samples in ovarian endometrioma patients. METHODS We collected serum and endometrioma tissue samples from 30 patients. In the control group, we collected serum and eutopic endometrial tissue samples from 26 women without endometriosis. RESULTS SIRT3 levels were significantly decreased in endometrioma tissue samples compared to the control group. There was no statistically significant difference in SIRT3 levels between patient and control serum samples. Furthermore, there was a decrease in GDH and SDH enzyme activities in both endometrioma tissue homogenate and mitochondria. MnSOD activity was decreased in tissue homogenate but increased in mitochondria and there was no difference in serum. While total SOD activity was decreased, CuZnSOD activity was increased in both tissue and serum samples. Besides these, total antioxidant capacity and advanced oxidation protein products (AOPP) levels were decreased in endometrioma tissue and mitochondria, but there was no difference in serum. CONCLUSIONS Our results suggested that decreased levels of SIRT3 in endometrioma may be an important factor in the weakening of mitochondrial energy metabolism and antioxidant defense in endometriosis. We think that SIRT3 deficiency may be an important factor underlying the pathogenesis of endometriosis. More detailed studies are needed to reveal the relationship between SIRT3 and metabolism and oxidative stress in ovarian endometrioma.
Research Interests:
The expressions of caveolin-1 have only been examined in the placental tissue of patients with preeclampsia and were reported to be low. Therefore, we decided to investigate the maternal serum levels of caveolin-1 in patients with... more
The expressions of caveolin-1 have only been examined in the placental tissue of patients with preeclampsia and were reported to be low. Therefore, we decided to investigate the maternal serum levels of caveolin-1 in patients with preeclampsia. This cross-sectional study was conducted including 87 pregnant women; 32 with normal pregnancy and 55 with preeclampsia. Maternal serum levels of caveolin-1 were measured by using enzyme-linked immunosorbent assay kit (ELISA). The mean serum caveolin-1 level was significantly lower in women with preeclampsia (PE) compared with the control group (11.48 ± 0.92 versus 12.94 ± 1.36 ng/ml) and being lowest in the early onset PE group (11.24 ± 0.74 ng/ml). Serum caveolin-1 concentrations did not correlate with maternal age and BMI. However, caveolin-1 concentrations were negatively correlated with systolic blood pressure (r = -0.467, p = .001) and diastolic blood pressure (r = -0.441, p = .001) as well as with umbilical artery resistance index (r =...
Research Interests:
We aimed to compare the serum autotaxin levels in early- and late- preeclamptic and healthy pregnant patients at a university hospital. A total of 55 singleton preeclamptic women who delivered at Cerrahpasa Medical Faculty were included... more
We aimed to compare the serum autotaxin levels in early- and late- preeclamptic and healthy pregnant patients at a university hospital. A total of 55 singleton preeclamptic women who delivered at Cerrahpasa Medical Faculty were included in the study. The patients were subdivided into two groups: early-onset preeclampsia (n = 31) and late-onset preeclampsia (n = 24). Demographic and clinical data were compared between early-onset and late-onset preeclamptic patients. The control group was composed of 32 healthy pregnant patients. The mean autotaxin levels were 1.16 ± 0.97 and 0.7 ± 0.35 ng/ml in the early- and late-onset preeclampsia groups, respectively. Autotaxin levels were significantly higher in early-onset preeclampsia group compared with late-onset preeclampsia group. Autotaxin levels were found to be significantly higher in preeclamptic patients compared with control group. Serum autotaxin levels showed a significant positive correlation with maternal systolic, diastolic bloo...
Research Interests:
The aim of this study is to investigate the maternal levels of collectrin in early-onset preeclampsia (EOPE) and late-onset preeclampsia (LOPE). To assess the correlation between serum collectrin levels and blood pressure in humans. This... more
The aim of this study is to investigate the maternal levels of collectrin in early-onset preeclampsia (EOPE) and late-onset preeclampsia (LOPE). To assess the correlation between serum collectrin levels and blood pressure in humans. This cross-sectional study was conducted including 79 pregnant women, 27 with normal pregnancy, 30 with EOPE and 22 with LOPE. Maternal serum levels of collectrin were measured by using enzyme-linked immunosorbent assay kits. The mean serum collectrin level was significantly lower in women with PE compared with the control group (8.49 ± 3.12 ng/ml (EOPE), 9.69 ± 3.01 ng/ml (LOPE) versus 11.51 ± 4.33 ng/ml) and was found to be the lowest in the EOPE group (8.49 ± 3.12 ng/ml). The mean serum urea and uric acid levels were significantly higher in the PE group than the control group. Serum collectrin concentrations did not correlate with maternal age, BMI and serum creatinine levels. However, collectrin concentrations were negatively correlated with systolic blood pressure (r = -0.284, p = .011) and diastolic blood pressure (r = -0.275, p = .014) as well as with maternal serum urea (r = -0.269, p = .017) and uric acid (r = -0.219, p = .049) concentrations. Maternal serum collectrin levels are significantly lower in patients with preeclampsia than in the control group. There is an inverse correlation between serum collectrin levels and blood pressure.
Research Interests:
This study aimed to investigate the role of telomerase activity in the development of endometriosis-related infertility by evaluation of the serum telomerase in eutopic and ectopic endometrial tissue. Eutopic endometrium, cystic... more
This study aimed to investigate the role of telomerase activity in the development of endometriosis-related infertility by evaluation of the serum telomerase in eutopic and ectopic endometrial tissue. Eutopic endometrium, cystic wall/ovarian cortex, and venous blood were assessed in forty-seven patients. The following groups of patients were identified: females with endometriosis requiring surgical intervention and healthy control females. Patients with histopathologically confirmed endometriosis were further subdivided in the infertile (n=14) and fertile (n=17) groups. Patients who underwent hysterectomy and oophorectomy for benign gynecological conditions were enrolled in the healthy control group (n=16). Telomerase activity was evaluated with three-group, endometriosis-based and fertility-based designs. Analyses were performed regardless the menstrual cycle phase (Phase G), in proliferative (Phase P) (n=22) and secretory phases (Phase S) (n=25). Telomeric Repeat Amplification Protocol PCR was applied for telomerase activity assessment. All statistical analyses were performed with STATA 14.2, GraphPad Prisma 7.01. In analyses of the eutopic endometrium, with three-group design, a significant difference was not found in Phase G and P (p=0.58 and p=0.33, respectively). However, a statistical difference was shown in Phase S (p=0.008). A significant difference was not established in Phase G, P and S of endometriosis-based design (p=0.35, p=1.0, p=0.13, respectively). No difference was detected in Phase G and P of fertility-based design (p=0.66 and p=0.14, respectively), whereas in secretory phase difference was approved (p=0,049). Telomerase activity was not established in ectopic endometrium and in serum assessment. Telomerase activity is useless as a biomarker in peripheric blood analysis. The absence of activity in cystic wall approves the high differentiation of endometriosis tissue, what is the possible reason of low malignancy risk. The high rate of telomerase activity in the eutopic endometrium of the infertile group may be considered as a cause of endometriosis-related infertility.
Research Interests:
Ozet Co¤ul gebeliklerde gebeli¤in ikinci trimesterinde, fetuslardan birinin do¤umunu takiben uygulanacak yaklafl›m›n tart›fl›lmas›. 16 gebelik haftas›nda ucuz gebeli¤i olan olgu erken membran rupturu ile baflvurdu. 18 gebelik haftas›nda onde... more
Ozet Co¤ul gebeliklerde gebeli¤in ikinci trimesterinde, fetuslardan birinin do¤umunu takiben uygulanacak yaklafl›m›n tart›fl›lmas›. 16 gebelik haftas›nda ucuz gebeli¤i olan olgu erken membran rupturu ile baflvurdu. 18 gebelik haftas›nda onde gelen fetus do- ¤urtuldu. ‹nfeksiyon bulgusu olmayan olguya tokolitik tedavi yap›larak 21 gebelik haftas›nda Shirodkar usulu servikal serklaj uy- guland›. 34 gebelik haftas›na kadar takip edilererek sezaryen ile do¤urtuldu. Ozellikle onde gelen fetusun do¤umu sonras› kalan fetus ya da fetuslar›n do¤umunun geciktirilmesi di¤er fetuslar›n sa¤kal›m›n› onemli olcude etkilemektedir. Bu nedenle di¤er fetus- lar›n gebelik suresinin uzat›lmas› amac›yla de¤iflik yaklafl›mlar denenebilir. Yatak istirahati, devaml› veya aral›kl› hastaneye yat›- r›lma, tokolitik tedavi, antibiyotik tedavisi, 26 gebelik haftas› ustunde kortikosteroid uygulanmas› ve serklaj uygulanmas› uygu- lanabilecek bafll›ca seceneklerdir. . Anahtar Kelimeler: Gecikmifl aral›kla do¤um, co¤ul gebelik, acil serklaj Cerrahpafla T›p Derg 2007; 38: 62 - 64 Delayed interval delivary in multiple gestation Abstract Triplet pregnancy at 16 weeks gestational age referred to outpatient clinic with the complaint of premature rupture of membranes. At 18 weeks of pregnancy, the presenting fetus was delivered vaginally and parenteral ritodrin tocolysis was initiated. At 21 weeks of gestation, cervical cerclage procedure (Shirodkar) was performed. Followed by parenteral tocolysis up to 34 weeks of pregnancy, the birth of remaining twins was accomplished by cesarean section. Delayed interval delivery certainly improves fetal well-being and outcome. Different therapy strategies could be utilized for this purpose. Bed rest, continuous or intermittent hospitalization, tocolysis, antibiotic therapy, corticosteroid administration over 26 weeks and cervical cerclage are the main alternatives in the management. KeyWords: Delayed interval delivery, multiple gestation, emergency cerclage Cerrahpasa J Med 2007; 38: 62 - 64
Research Interests:
To investigate the relationship of neonatal bilirubin levels to oxytocin infusion and the diluent used for oxytocin infusion. The study was carried out as a prospective, randomized study in Istanbul University Cerrahpasa School of... more
To investigate the relationship of neonatal bilirubin levels to oxytocin infusion and the diluent used for oxytocin infusion. The study was carried out as a prospective, randomized study in Istanbul University Cerrahpasa School of Medicine, Department of Obstetrics and Gynecology between January to December in 1995. A total of 80 patients managed with oxytocin during labor, enrolled to the study. These patients randomly divided into isotonic % 0.9 saline (Group 1) and 5% glucose solutions (Group 2) by a consecutive order using a balanced block randomization scheme. Forty multiparous patients delivering without oxytocin infusion formed the control group (Group 3). The details of maternal age, gestational age, labor duration, mode of delivery, birth weight of the babies, total volume of fluid administered until delivery and total oxytocin dose were noted in each case. Sodium and initial bilirubin levels were measured in the cord blood. Later on, capillary blood bilirubin and hematocrit concentrations were measured on day 1 and 2 in the newborn nursery. The groups were compared according to these parameters. The data of 29 patients in Group 1, 36 patients in Group 2 and 40 patients in Group 3 were suitable for analysis. The difference between study and control groups regarding the rate of hyponatremia, neonatal hyperbilirubinemia and neonatal jaundice was not statistically significant. Cord plasma sodium levels, cord plasma bilirubin levels and day 1 and 2 hematocrit and plasma bilirubin levels were not statistically different between the groups. irrespective of the diluent used, the cord plasma bilirubin levels and day 2 plasma bilirubin levels were significantly higher in the accelerated group. No significant effect of oxytocin infusion was revealed on neonatal hyperbilirubinemia unless oxytocin was for the augmentation of labor.
Research Interests:
Research Interests:
Amaç: Prenatal dönemde hafif fetal ventrikülomegali tanısı alan olguların klinik özelliklerinin ve prognozlarının değerlendirilmesi. Gereç ve Yöntemler: İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi Kadın Hastalıkları ve Doğum Anabilim... more
Amaç: Prenatal dönemde hafif fetal ventrikülomegali tanısı alan olguların klinik özelliklerinin ve prognozlarının değerlendirilmesi. Gereç ve Yöntemler: İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi Kadın Hastalıkları ve Doğum Anabilim Dalı'nda Ocak 2000 - Ocak 2009 tarihleri ...
Progestins are synthetic compounds that mimic the effects of progesteron. For over 50 years, oral progestins have been demonstrated to be effective in the treatment of endometriosis. They were reported to reduce or eliminate pain symptoms... more
Progestins are synthetic compounds that mimic the effects of progesteron. For over 50 years, oral progestins have been demonstrated to be effective in the treatment of endometriosis. They were reported to reduce or eliminate pain symptoms in approximately 90% of the patients. Progestins are available in many forms, including oral preparations, injections, subdermal implants and intrauterine systems. Continuous progestin use is an effective therapy for the treatment of painful symptoms associated with endometriosis but there had been no evidence of progestin use being superior to other types of treatment in endometriosis-related pain symptoms.
Research Interests:
Human Papillomavirus (HPV) infection is accepted as the cause of cervical cancer. Besides, HPV infection is a growing health problem. Prophylactic HPV vaccines immunologically block the virus by increasing the neutralizing antibodies in... more
Human Papillomavirus (HPV) infection is accepted as the cause of cervical cancer. Besides, HPV infection is a growing health problem. Prophylactic HPV vaccines immunologically block the virus by increasing the neutralizing antibodies in cervical secretions. These vaccines aim to stop the development of cervical preinvasive lesions and cervical cancer. The prospective studies proved that these vaccines were well tolerated; highly immunogenic, resulting in high antibody titers, decreasing persistent HPV infections and HPV related cervical disease. It can be postulated that vaccination against HPV will be superior to current protection strategies. (Turk Arch Ped 2008; 43: 1-8)
Research Interests:
Research Interests:
To determine the effects of different hormone replacement therapy (HRT) regimens on thyroid function in surgical menopause. In a randomized, controlled study, 59 euthyroid women with surgical menopause were randomized to an estrogen-only... more
To determine the effects of different hormone replacement therapy (HRT) regimens on thyroid function in surgical menopause. In a randomized, controlled study, 59 euthyroid women with surgical menopause were randomized to an estrogen-only (n=20), tibolone (n=20) or calcium-only (n=19) group. On the 5th postoperative day and 4th and 12th weeks, serum E2, TSH, free T3 and free T4 levels were determined. Although the initial and week 4 serum E2, TSH, free T3 and free T4 levels were comparable, the week 12 serum E2 and TSH levels were different between the subjects on estrogen therapy and those receiving tibolone or calcium only (p=0.008 and 0.000, respectively). Serum E2 levels were higher and TSH levels lower in subjects receiving estrogen. Moreover, serum TSH levels correlated negatively with serum E2 levels in the 12th week of estrogen use (r=-0.354, p=0.006). TSH increased in the tibolone group as compared to the estrogen group but was still lower than in the calcium-only group; how...
Research Interests:
Research Interests:
Research Interests:
Research Interests:
Research Interests:
Research Interests:
OBJECTIVE: To determine the effects of different hormone replacement therapy (HRT) regimens on thyroid function in surgical menopause. STUDY DESIGN: In a randomized, controlled study, 59 euthyroid women with surgical menopause were... more
OBJECTIVE: To determine the effects of different hormone replacement therapy (HRT) regimens on thyroid function in surgical menopause. STUDY DESIGN: In a randomized, controlled study, 59 euthyroid women with surgical menopause were randomized to an ...
Research Interests:
The aim of this study was to evaluate the incidence of associated structural anomalies and the outcome of fetuses with ventriculomegaly. We retrospectively collected 102 cases of antenatally diagnosed ventriculomegaly examined between... more
The aim of this study was to evaluate the incidence of associated structural anomalies and the outcome of fetuses with ventriculomegaly. We retrospectively collected 102 cases of antenatally diagnosed ventriculomegaly examined between 2000 and 2008. Ventricular width measurements were 10-12 mm, 12.1-14.9 mm and ≥ 15 mm in 24.5%, 20.6% and 54.9% of the cases, respectively. Associated structural malformations were detected in 77.4% of the fetuses. Mortality rate of fetuses with associated malformations and isolated ventriculomegaly was 86.1% and 55.7%, respectively (p &lt; 0.001). The mortality rate was significantly lower in mild (10-12 mm) than in moderate (12.1-14.9 mm) and severe (≥ 15 mm) cases (p &lt; 0.05). All of the fetuses with mild isolated ventriculomegaly were alive at &gt;12 months of age, without morbidity. Our results suggest that the prognosis of fetuses with ventriculomegaly mainly depends on the aetiology and on the presence of associated abnormalities. Fetuses with mild isolated ventriculomegaly have a favourable outcome.
Research Interests:
Preeclampsia is characterized by hypertension and proteinuria developing after 20 weeks of gestation. Increased vasoconstriction can be one of the major underlying pathophysiological event in this syndrome. We examined the role of... more
Preeclampsia is characterized by hypertension and proteinuria developing after 20 weeks of gestation. Increased vasoconstriction can be one of the major underlying pathophysiological event in this syndrome. We examined the role of vasoconstrictor prostanoid, prostaglandin F2α (PGF2α) in preeclamptic and normotensive human umbilical veins. Umbilical veins were set up in organ bath. The concentration-response curves of PGF2α (endogenous agonist of prostaglandin F receptor) and fluprostenol (prostaglandin F receptor selective agonist) were determined in normal and preeclamptic veins either in the absence or presence of BAY u3405 (thromboxane A2 receptor selective antagonist). PGF2α and its major metabolite concentrations were measured by enzyme immunoassay kit. The expression of vasoconstrictor prostanoid receptors was determined by western blot. The concentration-dependent contractions to PGF2α and fluprostenol were significantly increased in umbilical vein preparations derived from preeclamptic women compared with those of normotensives. Increased reactivity was related with enhanced sensitivity to these spasmogens in preeclamptic veins. BAY u3405 (10 μmol/l) did not modify the responsiveness to PGF2α in normal umbilical veins whereas moderately reduced the contractions in preeclamptic preparations. Serum concentrations of PGF2α and its major metabolite, 13,14-dihydro-15-keto-PGF2α, were comparable between preeclamptics and normotensives whereas the metabolite concentration was elevated in umbilical cord serum of preeclamptics. 13,14-dihydro-15-keto-PGF2α, release was also increased in umbilical vein preparations of preeclamptic women. An increased prostaglandin F receptor protein expression was determined whereas EP3 and thromboxane A2 protein expressions were unchanged in preeclamptic umbilical veins. Prostaglandin F and thromboxane A2 receptors activation by PGF2α could be involved in umbilical vasospasm observed in preeclampsia.