İlhan Bahri Delibaş

Anthropometric, clinical and laboratory comparison of four phenotypes of polycystic ovary syndrome based on Rotterdam criteria

Aim:  To compare all phenotypes of polycystic ovary syndrome (PCOS) for anthropometrical, hormonal, and metabolic differences according to Rotterdam criteria.

Evaluation of 37,438 consecutive cervical smear results in the Turkish population.

Introduction Retrospective evaluation of cervical smear results of women who attended our gynecology policlinics with various symptoms and discussion of the results in the light of the literature. Material and methods We performed a retrospective investigation on 37,438 Pap smear results of women who attended our hospital between January 2011 and December 2012 with a variety of symptoms. Results Average patient age was 43 (18–83) years. Of the Pap smear results analyzed, in 21,503 (57.4%) findings were within normal limits, while 153 (0.41%) showed epithelial cell abnormalities and 15,358 (41%) showed inflammation. Four hundred and twenty-four (1.1%) cases were reported to have inadequate Pap smear samples for evaluation. Of the epithelial cell abnormalities, 136 (88.8%) were squamous cell abnormalities and 17 (11.1%) were glandular cell abnormalities. Atypical squamous cells of unknown significance (ASCUS) were reported for 117 (0.3%) Pap smears, while other epithelial abnormalities included atypical glandular cells of unknown significance (AGUS) in 17 (0.05%) cases, low-grade squamous intraepithelial lesion (LSIL) in 8 (0.02%) cases, atypical squamous cells with possible high grade lesion (ASC-H) in 8 (0.02%) cases and high-grade squamous intraepithelial lesion (HSIL) in 3 (0.008%) cases. Conclusions Public awareness should be raised on the importance of Pap smear testing repeated at appropriate intervals in the prevention and early diagnosis of cervical cancer. Health education should become more widespread, and the importance of screening programs and regular check-ups should be emphasized more often on this issue in the media.

Relationship between mean platelet volume and recurrent miscarriage: a preliminary study.

Introduction The aim of the study was to examine the relationship between mean platelet volume (MPV) and recurrent miscarriage in order to illuminate the etiopathogenesis of recurrent miscarriage. Material and methods We retrospectively investigated the data of 120 patients with unexplained recurrent miscarriage (group 1), and compared them with the data of 120 match-paired patients in the control group (group 2). The definition of recurrent miscarriage was accepted as two or more failed clinical pregnancies which were documented by ultrasonography or histopathologic examination. All patients in the recurrent miscarriage group were evaluated with diagnostic tests for the etiology of recurrent miscarriage. Total blood count parameters, including hemoglobin, mean corpuscular volume, red cell distribution width, white blood cells, platelets, and mean platelet volume, were compared. Results The average patient age at the time of examination was 29.07 ±2.81 years in group I and 28.53 ±3.5 years in group II (p > 0.05). Mean body mass index (BMI) was similar between group 1 and group 2, 22.54 ±3.17 and 22.99 ±2.38, respectively (p > 0.05). Mean hemoglobin, mean corpuscular volume, red cell distribution width, and white blood cell and platelet levels were similar in both groups (p > 0.05). Mean platelet volume levels were significantly higher in group I (9.45 ±1.09 fl) than in group II (7.63 ±0.52 fl) (p = 0.001). Conclusions Higher MPV values in the study group suggest and support the importance of thromboembolic events in the etiology of recurrent miscarriage.

Does reactive hypoglycemia during the 100 g oral glucose tolerance test adversely affect perinatal outcomes

OBJECTIVES To determine whether pregnant women who have reactive hypoglycemia during the 100 g oral glucose toler-ance test (OGTT) are at an increased risk of poor pregnancy outcomes. MATERIAL AND METHODS We retrospectively analyzed perinatal data from 413 women who underwent a 3 h OGTT at 24-28 weeks of gestation and gave birth in our clinics between January 2012 and December 2014. RESULTS According to OGTT results, the majority of the subjects were normoglycemic (n = 316, 76.5%), while 49 (11.9%) were diagnosed with gestational diabetes, and 33 (8.0%) had single high glucose values. Reactive hypoglycemia was de-tected in only 15 patients (3.6%). The mean age of the women in the reactive hypoglycemia group was significantly lower than that of the women in the gestational diabetes and single high glucose value groups (26.4 ± 4.4 years, 31.4 ± 5.4 years, and 31.8 ± 4.3 years, respectively; p < 0.05). The newborns of the women in the reactive hypoglycemia group had higher rates of APGAR scores < 7, increased admission to the neonatal intensive care unit (NICU), and lower birth weights compared with the other groups (p < 0.001, p < 0.001, and p = 0.009, respectively). CONCLUSION Reactive hypoglycemia during the 3 h 100 g OGTT is significantly associated with low APGAR scores, low birth weights, and prenatal admission to the NICU. Therefore, pregnant women who develop hypoglycemia during the 100 g OGTT performed at 24-28 weeks of gestation should receive attentive follow-up care to decrease the possibility of adverse perinatal outcomes.

Does antenatal betamethasone have negative effects on fetal activities and hemodynamics in cases of preeclampsia without severe features? A prospective, placebo-controlled, randomized study

Abstract Aim: To evaluate whether antenatal betamethasone affects the fetal biophysical profile (BPP) and Doppler indices of umbilical and middle cerebral arteries (MCAs) in cases of preeclampsia without severe features. Materials and methods: Forty singleton preeclamptic pregnancies without severe features at gestational ages of 28–34 weeks were randomly divided into two groups of 20 patients: betamethasone and control groups. Patients in the betamethasone group were administered two consecutive doses of 12 mg betamethasone intramuscularly, 24 h apart, and patients in the control group were administered the same volume of saline as a placebo. All participants were evaluated before (0 h) and at hours 24, 48, and 72 of betamethasone/placebo administration using BPP scoring and umbilical and MCA Doppler examinations. Results: Total BPP scores were significantly lower in the betamethasone group across the three time points during the follow-up period (p < 0.001). None of the Doppler indices differed significantly between the groups (p > 0.05). Conclusion: Antenatal betamethasone negatively affects fetal BPP score parameters, including the non-stress test, fetal body and breathing movements, without affecting vascular indices of umbilical arteries and MCAs. Clinician awareness of this transient drug-induced effect might be valuable for preventing iatrogenic preterm delivery for fetuses in preeclamptic pregnancies without severe features.

Do Urgent Caesarean Sections Have a Circadian Rhythm

OBJECTIVE The primary goal of the present study was to demonstrate the existence of a possible circadian variation in urgent operative deliveries. METHODS All urgent caesarean sections between 1 January 2014 and 1 January 2015 with known exact onset times of operation were included in this retrospective study. Cases that were previously scheduled for elective caesarean section were excluded. Information regarding age, delivery date, onset time of operation and type of anaesthesia was collected from the database. Analyses were completed using the Statistical Package for Social Sciences (SPSS Inc., Chicago, IL, USA) version 20.0 software. The statistical significance for all analyses was set at p<0.05. RESULTS A total of 285 urgent caesarean section deliveries were included in the study. There were 126 (44.2%) deliveries during the day shift and 159 (55.8%) during the night shift. 80 patients (28.1%) received general anaesthesia and 65 (22.8%) received spinal anaesthesia in the morning shift, whereas 54 patients (18.9%) received general anaesthesia and 86 (30.2%) received spinal anaesthesia during the night shift. CONCLUSION The present study suggested that urgent caesarean sections revealed a circadian rhythm during the day.

Can myometrial elasticity, as determined by elastography at 18–22 weeks of gestation, predict preterm delivery?

The aim of this study was to determine whether elastographic evaluation of uterine myometrium can predict preterm delivery.

17. gebelik haftasında nadir bir vaka: Hemoliz, yükselmiş karaciğer enzimleri, düşük platelet sayısı sendromu.

The HELLP syndrome is a condition characterized by Hemolysis, Elevated Liver enzymes and Low Platelet numbers. It occurs in 0.5-0.9% of all preg- nancies and 10-20% of patients with severe preeclampsia. It often occurs as part of severe preeclampsia after 27th week of gestation. We hereby present an unusual case of HELLP syndrome, which was diagnosed at 17 weeks of gestation. If definitive diagnosis of HELLP syndrome is made, prompt termination of pregnancy should be considered, particularly in preg- nancies, which are remote from term, to prevent potentially fatal complica- tions both for the mother and the fetus..

TOTAL PLASENTAL RETANSİYON, POSTPARTUM PLASENTA PERKRETA : OLGU SUNUMU

Plasenta perkreta ,plasenta akretanin en nadir ve en agir formudur. Gebelik sirasinda son derece nadir fakat potansiyel olarak olumcul bir olay olarak karsimiza cikar. Cunku siddetli kanama egilimi gosteren ve potansiyel olarak yasami tehdit eden bir durumdur. Plasenta akretadaki patofizyolojik sorun desidua basalisin kismi veya tam yoklugudur. Plasenta perkreta genellikle kendini postpartum hemoraji ile gosterir ve bu durum myometrium tabakasindan ayrilan plasentanin elle cekilmesi ile olusur. Risk faktorleri arasinda once- ki sezeryan operasyonu, uterin kuretaj, plasental anomaliler, plasenta previa, konjenital anomaliler, plasentanin kornual implantasyonu yer alir. Tani genellikle dogum esnasinda konulurken, dogum oncesi tani ultrason ve manyetik rezonans goruntuleme ile sagla- nabilir. Hasta klinigimize Kars’dan postpartum plasental retansiyon nedeniyle gonderildi. Uterin cerrahi oykusu yoktu. Ultrason ve manyetik rezonans goruntuleme sonrasi plasen- ta perkreata tanisi konuldu. Hemodinamik acidan stabil oldugu icin elektif histerektomi yapildi. Ameliyatta karaciger, dalak, bobrek ve yumurtalik gibi diger karin organlari, nor- mal gorunuyordu.

TOTAL PLASENTA PREVİALI GEBELERDE KISA SERVİKAL UZUNLUK VE ANTEPARTUM KANAMA RİSKİ

Objective: To evaluate the effectiveness of cervical length in predicting prepartum bleeding and emergency caesarean section in cases of complete placenta previa Materials and Methods: Between June 2009 and August 2011, cervical length was measured by transvaginal ultrasound in women with complete placenta previa persisting into the third trimester of pregnancy and correlated this to clinical outcome with regards to, emergency cesarean section due to massive hemorrhage Results: Overall, 65 women were included in the study group. The mean gestational age at ultrasound was 31.7 ± 2.9 weeks and the cervical length was 35.9 ±7.8 mm. Cesarean delivery was performed in all cases, at a mean gestational age of 34.5 ± 2.6 weeks. 26 (40 %) women presented prepartum bleeding and 12 (18,4 %) required an emergency cesarean section prior to 34 completed weeks due to massive haemorrhage. Cervical length was significantly shorter among patients who underwent emergency caesarean section <34 weeks due to massive hemorrhage compared with patients who underwent elective caesarean section (29.4 ± 5.7 mm , 36.1 ± 6.5 mm; p = 0.005). Conclusion: Transvaginal sonographic cervical length predicts the risk of emergency cesarean section <34 weeks in women with complete placenta previa.