Hulusi Gürel

Pelvic relaxation and associated risk factors, The results of logistic regression analysis

BACKGROUND To determine the possible risk factors in our population. METHODS From 250 patients attending our clinic 28 patients with pelvic relaxation were the study group and the rest, 222 in all, were the control group. RESULTS Age, marriage period, parity and number of abortus in pelvic relaxation group are found to be significantly higher with univariate analysis. With logistic regression analysis menopause, grandmultiparity, abortus (two or more), home deliveries, history of macrosomic infant (4500 gr. or more), deliveries without episiotomy and laceration of uterine cervix are found to be risk factors for pelvic relaxation. CONCLUSIONS Good family planning programs to reduce grandmultiparity and unnecessary curettage for undesired pregnancies, preventing harmful home deliveries by inexperienced people, and fearless usage of episiotomy in difficult deliveries are necessary to prevent pelvic relaxation.

The evaluation of determinants of early postpartum low mood: the importance of parity and inter-pregnancy interval

OBJECTIVES The aim of this study is to determine the extent of early postpartum low mood and possible relevant variables in our population. STUDY DESIGN Depressive symptoms were examined in a sample of 85 women in the first week of postpartum period using Beck Depression Inventory (BDI). The relevant sociodemographic variables were tested by multiple logistic regression analysis. RESULTS The rate of postpartum low mood (BDI score >10) was found 35.2%. High parity, long marriage period and low education level were all significantly associated with low mood in the postpartum first week. When logistic regression analysis was used to eliminate confounding effect of the parameters; grandmultiparity, short inter-pregnancy interval and low educational level were found to have important effect on postpartum low mood. CONCLUSION Pregnant women with risk factors for postpartum low mood such as grandmultiparity, short inter-pregnancy interval and low educational level should be identified early during antenatal period. Educational and social support should be given to those in such a risk. We believe that effective family planning programs and improvement of womens educational level are important preventive factors for postpartum low mood and subsequently developing depression.

Urethral syndrome and associated risk factors related to obstetrics and gynecology

OBJECTIVE To evaluate the risk factors related to gynecology and obstetrics, and the incidence of urethral syndrome in our gynecological practice. STUDY DESIGN The study comprised 35 patients without urinary tract infection who admitted to our department of gynecology with the complaints of recurrent urinary irritation symptoms, sensation of incomplete emptying and burning sensation during urination after sexual intercourse. A total of 200 women served as controls. RESULTS We found urethral syndrome in 15% of patients. The incidence of grandmultiparity and the delivery without episiotomy were significantly higher in the study group than controls using univariate analysis. Considering logistic regression analysis, we found that grandmultiparity, two or more abortus, hospital delivery, delivery without episiotomy and pelvic relaxation were risk factors for the urethral syndrome. CONCLUSION Although urethral syndrome is often detected in gynecological practice, it has not yet been reached utmost importance. Grandmultiparity and delivery without episiotomy are the major risk factors accompanying urethral syndrome.

Dyspareunia, back pain and chronic pelvic pain : The importance of this pain complex in gynecological practice and its relation with grandmultiparity and pelvic relaxation

The aim of this study was to evaluate the correlation between severe dyspareunia, back pain, dysmenorrhea and chronic pelvic pain (CPP), and the relationship of each pain type with various sociodemographic factors, pelvic relaxation and high parity. Two hundred thirty-five premenstrual individuals were included. The prevalences of CPP, deep dyspareunia, dysmenorrhea and back pain were found to be 80.4, 30.6, 57.0 and 57.4%, respectively. Marriage duration was longer (p < 0.01) and also parity was higher (p < 0.0001) in CPP cases than controls. However, none of the demographic factors had a significant correlation with dyspareunia, back pain and dysmenorrhea. CPP was correlated with both back pain (r = 0.18, p < 0.005) and dyspareunia (r = 0.19, p < 0.004). However, there was no correlation between back pain and dyspareunia. On the other hand, dysmenorrhea did not show a correlation with any pain types. While grandmultiparity had a significant effect on CPP (p < 0.0001), it did not have a significant effect on other pain types in a MANOVA model. CPP is very often seen in our population and it often makes a pain complex with dyspareunia and back pain. The prevention of grandmultiparity is important to decrease the incidence of CPP.

FIGO Committee for the Ethical Aspects of Human Reproduction and Women’s Health

The FIGO Committee for the Ethical Aspects of Human Reproduction and Women’s Health considers the ethical aspects of issues that impact the discipline of Obstetrics, Gynecology and Women’s Health. The following documents represent the result of that carefully researched and considered discussion. This material is not intended to reflect an official position of FIGO, but to provide material for consideration and debate about these ethical aspects of our discipline for member organizations and their constituent membership. Definition of Pregnancy

Early development of HELLP syndrome associated with eclampsia: a case report.

The syndrome of haemolysis, elevated liver enzymes and low platelet count during pregnancy (HELLP syndrome) is recognized as a serious, multisystem disease and diagnosed generally after thirtieth week of pregnancy. In this report, a case who developed eclampsia with HELLP syndrome was discussed.

A large yolk sac may be important in the early diagnosis of gestational trophoblastic disease: a case report

A large yolk sac in a deformed shape gestational sac was detected by ultrasonography in an 8 week pregnant woman. The disappearance of the yolk sac and the gestational sac, enlargement of the uterine cavity and a heterogeneous appearance similar to early gestational trophoblastic disease were recognized when ultrasonographic examination was performed 2 weeks later. After uterine evacuation, partial hydatidiform mole was diagnosed by histopathological evaluation of the curettage material. In our study, the role of the large yolk sac in predicting trophoblastic disease is discussed.