Aslı Somunkiran

Comparison of colour Doppler indices of pelvic arteries in women with bilateral hypogastric artery ligation and controls.

The aim of this study is to compare the blood flows of bilateral uterine, ovarian and arcuate arteries in patients who underwent bilateral hypogastric ligation (BHL), with the controls having similar characteristics. The S/D, the RI and the PI were measured on uterine, arcuate and ovarian arteries in 7 women with BHL and compared with 10 controls. There were not significant differences between the Doppler indices of the two groups. In conclusion, our study suggests that BHL preserves pelvic function and fertility.

Effects of tibolone on blood flow resistance and intima-media thickness of the carotid arteries: effect of time since menopause.

Objective The aim of this prospective study was to evaluate the effects of tibolone on carotid atherosclerosis in healthy postmenopausal women. Methods Twenty-five healthy postmenopausal women were included in the study. Patients received tibolone 2.5 mg daily for 6 months. Resistance indices of the common carotid artery (CCA), internal carotid artery (ICA), external carotid artery (ECA) and vertebral arteries, and intima-media thickness of the CCA were measured both at baseline and at the end of the study with ultrasonography. Results No significant differences were observed in the resistance indices of the CCA, ICA, ECA and vertebral arteries, as well as intima-media thickness of CCA at 6 months in comparison with baseline. Tibolone significantly improved the intima-media thickness of the CCA of women who were less than 18 months since menopause. Conclusion Overall, these results demonstrate no significant effects of tibolone on either intima-media thickness or blood flow resistance in the carotid arteries in postmenopausal women. However, the results suggest that tibolone may have a positive effect on the vascular system if commenced within 18 months since menopause; this warrants further investigation.

Perioperative Complications in Abdominal Sacrocolpopexy, Sacrospinous Ligament Fixation and Prolift Procedures

BACKGROUND Pelvic organ prolapse is an important problem for women. To overcome this issue, different operational technics are in use, such as abdominal sacrocolpopexy, sacrospinous fixation, and the total Prolift procedure. AIMS This study assessed perioperative complications in abdominal sacrocolpopexy, sacrospinous fixation, and the total Prolift procedure. STUDY DESIGN Retrospective comparative study. METHODS Perioperative complications were defined as any complication occurring during surgery or the first 6 weeks postoperatively. Forty-five patients underwent abdominal procedures, 60 patients underwent sacrospinous fixation, and 43 patients underwent the total Prolift procedure. RESULTS In the abdominal group, one bladder injury, four hemorrhages, and three wound dehiscences occurred. In the sacrospinous group, one rectal injury and one postoperative vault infection occurred. In the Prolift group, one bladder injury and one hemorrhage occurred. Minor complications were more frequent in the abdominal group than the others. The operating time and hospital stay of the abdominal group were significantly longer than the others. The Pro-lift procedure had less operating time and hospital stay than other procedures. CONCLUSION The total Prolift may be a novel alternative for apical prolapse with low perioperative morbidities and complications.

Does postoperative misoprostol use induce intestinal motility? A prospective randomised double-blind trial.

Background:  Misoprostol has been shown to increase colonic activity and decrease colonic transit time in chronic constipation patients.

B-Lynch suture after the failure of hypogastric artery ligation to control post-partum hemorrhage due to placenta increta in a patient with the factor V Leiden mutation

Post‐partum hemorrhage may be a life‐threatening condition. A case of a patient receiving antithrombotic therapy for the factor V Leiden mutation, in whom post‐partum hemorrhage had occurred due to placenta increta, is described. In this case, the post‐partum hemorrhage did not respond to bilateral hypogastric artery ligation, while the B‐Lynch surgical technique was successful in obtaining hemostasis.

İndüksiyon öncesi transperineal ultrasonografik servikal uzunluk ve Biskop skorunun indüksiyon-doğum süresine etkisi

Objective: We aimed to evaluate the effect of preinduction cervical length and Bishop score for induction-to-delivery interval in nulliparae and multiparae. Materials and Methods: A total of 97 pregnant women (55 nulliparae, 42 multiparae) between 35 and 44 weeks of gestation were included in the study. Misoprostol 50 g tablet was used as labour induction agent intravaginally. Cervical length measurement was obtained by transperineal ultrasonographic approach and Bishop score was determined with digital examination. While Mann-Whitney U test, Pearson correlation, spearman correlation and multiple linear regressions were used for continuous variables, chi-square test was used for categorical variables. Receiver Operating Characteristics Curve was used for bishop score and cervical length. Results: All vaginal deliveries were occurred within 24 hours. Eighth patients (8.2%) had nausea, 1 had (1%) vomiting, 9 had (9.3%) tachysystoly and 5 had (5.1%) hiperstimulation. Eight pregnant women (8.2%) were delivered with caesarean section. In nulliparous and multiparous women, Bishop score and cervical length showed correlation (r=0.752, p=0.000; r=0.691, p=0.000; respectively). Cervical length (r=0.490, p=0.000) and Bishop score (r=0.455, p=0.01) were correlated in nulliparae whereas only Bishop score (r=0.441, p=0.04) were correlated in multiparae. To determine the induction-to-delivery time using multiple linear regression, the cervical length for multiparae (t=3.850, p=0.000) and the Bishop Score for multiparae (t=11.222, p=0.000) were the only independent variables. Receiver operating characteristics for induction-to-delivery time curve showed that cervix length was better than Bishop score in nulliparae whereas the Bishop Score was better than cervical length in multiparae. Conclusion: Fifty g misoprostol intravaginally was found successful in induction of delivery. To determine induction-to-delivery time in pregnancies, cervical length in nulliparae and Bishop score in multiparae was found more suitable.