Mehmet Baki Senturk

Can Platelet Count and Platelet Indices Predict the Risk and the Prognosis of Preeclampsia

Objective: To compare the hematocrit, platelet count (PC), mean platelet volume (MPV), platelet distribution width (PDW), PC to MPV ratio in the mild preeclamptic (mPE), severe preeclamptic (sPE) and healthy normotensive pregnant women to evaluate whether these parameters have a predictive and prognostic significance in determining the risk and the severity of preeclampsia (PE). Methods: A retrospective case-control study was designed including the patient population (N = 284) composed of 49 mPE, 70 sPE, 165 healthy normotensive pregnant women for controls. Preceding medical histories of all the cases were insignificant. Results: In comparison of the preeclamptic patients with controls; there was statistically significant difference in PC (p = 0.023; p < 0.05), MPV(p = 0.023; p < 0.05), PC/MPV ratio (p = 0.005; p < 0.01). But there was no difference between sPE and mPE. Cut-off value for MPV was calculated as 9 for the diagnosis of PE (p < 0.01), the odds ratio was 1.999. The cut off value for PC was 190, the odds ratio was 1.932. The cut off value was 19.9 for the PLT/MPV, the odds ratio was 2.42. Conclusion: We suggest that the increasing platelet turnover in PE causes a decrease in the PC, an increase of MPV value and especially a decrease in PC/MPV ratio pointing that these parameters may play an important role in predicting the risk of PE while they have no role on predicting the severity of PE. According to our findings we can suggest that the patients with these cut-off values of PC and platelet indices, should be carefully followed for the development of PE.

Factors associated with successful vaginal birth after cesarean section and outcomes in rural area of Anatolia.

Successful vaginal birth after cesarean section is more comfortable than repeat emergency or elective cesarean section. Antenatal examinations are important in selection for trial of labor, while birth management can be difficult when the patients present at emergency condition. But there is an increased chance of vaginal birth with advanced cervical dilation. This study attempts to evaluate factors associated with success of vaginal birth after cesarean section and to compare the maternal and perinatal outcomes between vaginal birth after cesarean section and intrapartum cesarean section in patients who were admitted to hospital during the active or second stage of labor. A retrospective evaluation was made from the results of 127 patients. Cesarean section was performed in 57 patients; 70 attempted trial of labor. The factors associated with success of vaginal birth after cesarean section were investigated. Maternal and neonatal outcomes were compared between the groups. Vaginal birth after cesarean section was successful in 55% of cases. Advanced cervical opening, effacement, gravidity, parity, and prior vaginal delivery were factors associated with successful vaginal birth. The vaginal birth group had more complications (P<0.01), but these were minor. The rate of blood transfusion and prevalence of changes in hemoglobin level were similar in both groups (P>0.05). In this study, cervical opening, effacement, gravidity, parity, and prior vaginal delivery were important factors for successful vaginal birth after cesarean section. The patients’ requests influenced outcome. Trial of labor should take into consideration the patient’s preference, together with the proper setting.

The relationship between hyperemesis gravidarum and maternal psychiatric well-being during and after pregnancy: controlled study

Abstract Objective: Psychiatric symptoms of varying degrees that accompany hyperemesis gravidarum (HG) may continue throughout the pregnancy or after, and these psychological problems may cause morbidity. In this study, we aimed to evaluate the relationship between the HG and psychiatric symptoms in the first trimester and postpartum depression. Methods: Two hundred and seven pregnant who were diagnosed as HG and 177 healthy pregnant women included in this prospective study. All cases were assessed with SCL-90-R in first trimester and with ED in postpartum period. Factors related to postpartum psychiatric symptoms were investigated with bivariate logistic regression analysis. Results: SCL-90-R and ED scores were statistically significant at HG group (p < 0.05). In cases who diagnosed as postpartum depression, the rates of HG and SCL-90-R results were higher (p< 0.05). In the bivariate analysis, the high rates of HG and high SCL-90-R scores were determined to be related to postpartum depression (p < 0.05). Conclusions: The results show that mental health is negatively affected by HG at pregnancy, and in this case, psychiatric symptoms may continue even after discontinuation HG.

Serum serotonin, leptin, and adiponectin changes in women with postpartum depression: controlled study

PurposePostpartum depression (PPD) affects nearly 10% of mothers after delivery and has many serious results. Although many factors associated with PPD, the etiology, and pathophysiology of PPD are not known completely. The relationship between serum serotonin concentration and depression is well known, but there are no enough data regarding the serum change of leptin and adiponectin. The aims of this study are to research the level of serum serotonin, leptin,s and adiponectin concentrations in women with PPD.Materials and methodsA controlled trial has been conducted in three centers. Two hundred and forty four women were evaluated at postpartum day 10 with the Edinburgh Postnatal Depression Scale (EPDD). Venous blood samples were collected and serotonin, and leptin and adiponectin levels were studied using human enzyme-linked immunosorbent assay. Mann–Whitney U test was used for comparison of serum levels of serotonin, leptin, and adiponectin between women with PPD and without. A p value of <0.05 was considered significant.ResultsPPD was detected in 70 postpartum women. The mean serum serotonin level was significantly lower in the group with PPD (p = 0.001), while mean serum adiponectin level was higher (p = 0.001). The mean serum leptin level was not different (p = 0.133).ConclusionsThe serum adiponectin and leptin levels were high in women with PPD. This could play important role in the pathophysiology of PPD. Elevation of serum levels also may play antidepressant role against PPD, especially the early postpartum period.

Does performing cesarean section after onset of labor has positive effect on neonatal respiratory disorders

Abstract Objective: The aim of this study is to evaluate whether neonatal respiratory disorders relate to the onset of labor or labor pain in patients with history of previous cesarean section. Methods: This prospective controlled study comprised 164 patients, grouped according to the presence of labor and related labor pain. All patients in both groups were applied cesarean section at 38 weeks gestational age or beyond due to previous cesarean section. The cord blood pH, Apgar scores and the need for the neonatal intensive care unit were compared. Results: There was a greater need for the neonatal intensive care unit in the control group and the cord blood pH values were higher in the study group (p < 0.05). No significant difference was determined between the groups in respect of Apgar scores (p > 0.05). Conclusion: The onset of labor and related labor pain provide a positive contribution to a reduction in neonatal respiratory disorders. Therefore, it can be considered reasonable to perform a cesarean section after the onset of labor or related pain.

A comparative study of conventional and liquid-based cervical cytology

OBJECTIVES The aim of our study is the comparison of the results of conventional smear (CC) technique and liquidbased cytology (LBC) technique used as cervical cancer screening methods. MATERIAL AND METHODS The results of 47954 patients submitted to smear screening in our gynecology clinic between January 2008 and December 2014 have been studied. The smear results have been divided into two groups CC and LBC according to the technique used. RESULTS When considering the distribution within CC group, the results were as follows: intraepithelial cell abnormalities 2,0% (n=619), insufficient sample for analysis 2,1% (n=660), Atypical squamous cells of undetermined significance (ASC-US) 1.8% (n=554), Low grade squamous intraepithelial lesion (LGSIL) 0.1% (n=35), High grade squamous intraepithelial lesion (HGSIL) 0.1% (n=16), Atypical squamous cells - cannot exclude HGSIL (ASC-H) 0.029% (n=9), Atypical glandular cells- not other wise specified (AGC-NOS) 0.012% (n=4), squamous carcinoma 0.003% (n=1). When considering the distribution in LBC group, the results were as follows: intraepithelial cell abnormalities2.1% (n=357), insufficient sample for analysis 0.9% (n=144), ASC-US 1.8% (n=296), LGSIL 0.2% (n=38), HGSIL 0.1% (n=8), ASC-H 0.1% (n=10), AGC-NOS 0.017% (n=3), squamous carcinoma 0.011% (n=2). CONCLUSIONS Although the rates of epithelial cell abnormalities are similar for both tests, LSIL results are more frequently observed in LBC technique. In LBC technique, the number of insufficient sample for analysis is quite low compared to CC group and thus constitutes an advantage.