Bulat Aytek Şık

Retrospective analysis of factors that affect the success of single-dose methotrexate treatment in ectopic pregnancy

Objective: Detection of factors that affect the success of single-dose methotrexate treatment in ectopic pregnancy. Materials and Methods: We investigated 99 patients who had been treated with single-dose methotrexate for ectopic pregnancy in our clinic between January 2009 and June 2014. Demographic, clinical, and laboratory results of possible factors that affect treatment success were retrospectively analyzed. Successfully and unsuccessfully treated patients were compared based on their pre-treatment results. Results: The success rate of single-dose methotrexate treatment was found to be 70.7%. No significant difference was found between succesfully and unsuccessfully treated patients before treatment in terms of factors such as gestational weeks, mass size, presence of yolk sac, and presence of free fluid (p=0.224, p=0.201, p=0.200, p=0.200). Serum β-hCG values in patients whose treatment was unsuccessful was found to be higher compared with the successfully treated group (mean β-hCG value of unsuccessful group: 4412±3501 mIU/mL; mean β-hCG value of successful group: 1079±942 mIU/mL; p<0.001). Conclusion: Single-dose methotrexate treatment is an effective and reliable method in the treatment of ectopic pregnancy. Elevation of serum β-hCG value stands as the main prognostic factor that affects the success of single-dose methotrexate treatment.

EFFECTIVENESS OF UMBILICAL ARTERY DOPPLER EXAMINATION, CARDIOTOCOGRAPHY AND AMNIOTIC FLUID INDEX APPLIED IN EARLY INTRAPARTUM PERIOD IN DIAGNOSIS OF FETAL DISTRESS

The present study aims to find an alternative solution to continuous monitoring with Cardiotocography (CTG) during intrapartum management process of pregnant women with no previous antenatal follow-up, and to diagnose low-risk pregnancies and avoid the financial burden and discomfort to the pregnant woman resulting from continuous monitoring. Randomly selected 114 term pregnant women with expected vaginal delivery, singleton pregnancies and no major fetal abnormalities were included in the study. Routine obstetric ultrasonography (USG) and uterine artery (UA) doppler measurements were administered. The pregnant women included in the study had an average gestation period of 38.3 ± 1.3, average age of 26.1 ± 5.3, average parity of 2.1 ± 1.5 and average infant birth weight of 3280 ± 442 g. 13 pregnant women were considered to have fetal distress following continuous monitoring with cardiotocography. Furthermore, decreased amniotic fluid index was detected in 9 of them. 10 cases were assessed to be pathological as a result of Uterine Artery Doppler examination. In two cases deemed pathological, fetal distress developed and found to be statistically insignificant. No statistically significant difference was found between decreased amniotic fluid index cases and non-decreased amniotic fluid index cases in terms of C-section application due to fetal distress. In our study, Cardiotocography + Amniotic Fluid Index measurement was determined to be the most valuable combination as the delivery room admission test.

Does preparation for childbirth training reduce the cesarean rate

Purpose: This study was conducted as experimental and prospective to determine the effect of birth preparation training on the birth route preparations of pregnant individuals. Methods: The study was conducted in three state hospitals which operate under Kocaeli State Hospitals Community. The study group included 110 pregnant individuals who attended the hospitals’ birth preparation training classes between 1 January – 30 June 2015 and the control group included 90 pregnant individuals from Kocaeli Maternity Hospital. The chisquared test was used to measure the differences between groups in classified variables, and the t-test was used for parametric variables. P <0.05 was considered to be

Evaluation of the efficiency of antibiotic prophylaxis in cesarean cases

Background: In recent years the rate of cesarean section has significantly increased.To determine the efficacy of prophylactic antibiotics in reducing infectious morbidity after cesarean section. Objectives: In our study, we aimed to evaluate the efficiency of prophylactic antibiotic administration by comparing three groups using single, multiple and no prophylactic antibiotic therapy. Materials and Methods: Our study is a prospective, randomized controlled study including emergent cases, that developed cesarean indication while in active labor, and elective cesarean cases. A total of 90 patients were included in the study, including 30 patients who underwent cesarean delivery and did not undergo an antibiotic prophylaxis (Group 1), 30 patients who underwent a single dose antibiotic prophylaxis (Group II) and 30 patients who underwent multiple dose antibiotic prophylaxis (Group III). Results: The incidence of wound infection was significantly higher in cases that were not using antibiotics at postoperative days 3, 5 and 7 compared to the cases using single and multiple antibiotics. There was not a significant difference between groups in terms of endometritis. Conclusion: Administration of prophylactic antibiotics prevent wound infection but does not prevent development of endometritis.

Evaluation of the efficacy of transobturator tape surgery in the treatment of stress urinary incontinence using urodynamics and questionnaires

Objective: To measure the efficiency of transobturator tape (TOT) surgery using urodynamics and questionnaires in stress urinary incontinence. Materials and Methods: Ninety-two patients with stress and mixed urinary incontinency who underwent TOT surgery were selected for the study. We retrospectively examined the patients’ urodynamics, ultrasonography, demographic characteristics, incontinency surveys, life quality scores [incontinence impact questionnaire, (IQ-7) and urinary distress inventory (UDI-6)], diagnostic findings, Q-type test, surgical records, and complications. Patients treatment adherence, life quality scores, and urodynamics were evaluated as per the findings and complications following discharge of the patients between 12 and 36 months. Patients with a surgical history as the result of incontinence were excluded from the study. Results: Prior to surgery, 57 (61%, 95) patients had stress urinary incontinence (SUI), and 35 (38%, 05) patients had mixed urinary incontinence (MUI). During surgery, 45 (48%, 91) patients underwent extra pelvic surgical intervention. The mean follow-up time was 22.17±7.55 months. Our subjective success rate was 91%, 3 and the objective success rate was 78%, 3. In the life quality evaluation, a statistically significant improvement was found between IIQ-7 and UDI-6 scores. Parity over 4 was an important failure reason. Two (2%, 17) patients developed vaginal erosion, 2 (2%, 17) of the patients developed temporary urine retention, and 1 (1%, 08) patient developed nova urge incontinence. Conclusion: Our study demonstrates that TOT surgery provides high objective and subjective success and has a positive impact on life quality. The ease of application and lower complication rate makes TOT a valuable alternative for other treatment approaches in the surgical treatment of SUI.