Mehmet Cengiz Colakoglu

Serum TNF-α, IL-6, lupus anticoagulant and anticardiolipin antibody in women with and without a past history of recurrent miscarriage

ObjectiveThe aim of the this study was to investigate Lupus Anticoagulan (LA), Anticardiolipin Antibody (ACA), Tumor Necrosis Factor-α (TNF-α) and Interleukin-6 (IL-6) serum levels in 40 pregnant and 20 nonpregnant.Materials and methodsThe women were divided into three groups. The first group consisted of 20 pregnant women of less than 20 gestational weeks and a past history of habitual abortion . The second group consisted of 20 non pregnant patients with a past history of habitual abortion. The third group consisted of 20 healthy non pregnant women. RESULT: LA was found in only one patient in the Group 2. ACA Ig G positivity were found 1 patient in the Group 1, 3 patients Group 2 and 1 patient in Group 3. Mean ACA IgG was highest in the Group 2. High serum TNF-α levels were found in the 12 (60%), 6(30%) and 2 (10%) women in the Groups 1, 2, and 3, respectively. Significant difference were found for TNF-α among the groups (P<0.05). The highest level of TNF-α was found in the Group 1 and the lowest in the Group 3. There were statistically significant differences for IL-6 among the three groups (P>0.05).ConclusionWe propose that cytokines especially TNF-α was found to be related to the pregnancy loss.

The treatment of 65 women with imperforate hymen by a central incision and application of Foley catheter.

Objective  To determine the surgical outcome of 65 women with imperforate hymen treated with a central surgical incision and insertion of a Foley catheter.

Management and outcomes of adnexal masses during pregnancy: A 6-year experience

Aim:  To demonstrate adnexal masses detected during gestations in a 6‐year period.

The Effect of Antenatal Steroids on Fetal Lung Maturation between the 34th and 36th Week of Pregnancy

Aim: To evaluate the effect of antenatal treatment with a single dose of betamethasone between the 34th and the 36th week of pregnancy on the maturation of fetal lung. Methods: To study 100 pregnant women in their 34th–36th week of pregnancy who were diagnosed as susceptible to have preterm delivery. Fifty patients did not receive betamethasone (group 1). The other 50 patients were administered 12 mg betamethasone in a single dose (group 2). Patients who delivered at least 24 h after the administration of betamethasone were included in this study. After delivery, the Apgar score and the development of respiratory distress syndrome (RDS) in the neonates were compared. Results: Group 2 babies had better Apgar scores when compared to group 1, and the difference was statistically significant. Sixteen (32%) neonates of group 1 and 7 (14%) neonates of group 2 required resuscitation, and the difference was statistically significant (p = 0.032; OR = 0.34, 95% CI 0.12–0.93). RDS was detected in 8 newborns of group 1 and 2 of group 2. The difference was statistically significant (p = 0.046; OR = 0.21, 95% CI 0.04–1.08). Conclusion: The administration of a single dose of betamethasone to pregnant women in their 34th–36th week of pregnancy who are likely to have preterm delivery reduces RDS development. There is a need for larger studies to confirm these results.

Contraceptive efficacy and side effects of Implanon

Objective To determine the efficacy and side effects of Implanon® used for long-term contraception. Material and method Prospective study of 80 patients who used Implanon® for long-term contraception between January 2004 and January 2006. Side effects, efficacy and removals were recorded. Results Amenorrhoea, infrequent bleeding and frequent bleeding were reported by 33 (41.25%), 19 (23.75%) and 14 patients (17.5%), respectively. Non-menstrual side effects comprised breast tenderness in 15 patients (18.75%), acne in eight (10%), headache and dizziness in three (3.75%); depressive mood disorders, pelvic pain and loss of libido were mentioned each by two of the women (2.5%). During the study period, Implanon® was removed from 20 participants. No problem was encountered during its placement or removal. Conclusion Patients considering use of Implanon® must be carefully selected and informed about its expected side effects before placement.

Effect of pre-amniocentesis counseling on maternal pain and anxiety.

Aim:  The aim of this study was to evaluate the levels of anticipated and perceived pain and anxiety in expectant mothers at the times of pre‐counseling, post‐counseling, and post‐amniocentesis and to investigate the effect of pre‐amniocentesis counseling on the level of pain and anxiety.

Comparison of induction of labor with vaginal misoprostol plus oxytocin versus oxytocin alone in term primigravidae

Objective. To compare the efficacy and complications of intravaginal misoprostol application before starting oxytocin infusion with oxytocin infusion alone for labor induction in term primigravidae pregnancies with low-Bishop score. Methods. This randomized study included 101 primigravidae women with singleton pregnancies >38 weeks and a Bishop score of <6. Group 1 (50 patients) received a 50-μg dose of intravaginal misoprostol, with an oxytocin infusion started 3 h later. Group 2 (51 patients) received only an oxytocin infusion for labor induction. The time from induction to delivery, the route of delivery and complications were analyzed. Results. The mean time from induction to delivery was 10.4 ± 2.1 h in Group 1 and 13.7 ± 3.4 in Group 2 (p < 0.001). The rates of vaginal delivery, Apgar scores at 1st and 5th min, placental abruption, and postpartum hemorrhage were similar between the two groups. Conclusion. Intravaginal application of 50-μg misoprostol before starting oxytocin infusion is a more effective method of labor induction than oxytocin infusion alone in term primigravidae pregnant women with low-Bishop scores.

The efficacy of multiple-dose methotrexate treatment for unruptured tubal ectopic pregnancy and conversion rate to surgery: a study on 294 cases

In this prospective study 294 patients diagnosed with ectopic pregnancy (EP) were treated with multiple-dose methotrexate (MTX) to determine the conversion rate to surgery. We concluded that multiple-dose MTX treatment had a low success rate, and the success rate was not related to initial b-hCG value; it was more related to the size of gestational mass before treatment.

Removal of intra-abdominal mislocated intrauterine devices by laparoscopy

This retrospective study was carried out on 15 patients who underwent laparoscopy for the removal of a mislocated IUD from 2003 to 2009. The mean duration of usage of an IUD was 16.1 months. The IUD was found in the Pouch of Douglas in six patients; in the posterior wall of the uterus in three patients; in the adnexa in three patients; in the omentum in two patients and it was embedded in the rectal serosa in one patient. The types of the IUDs were TCu-380A (n = 13) and Mirena® (n = 2). The mean laparoscopic operation time was 25 min. No major complications occurred. A second ancillary port was required in three patients. All patients were discharged within 24 h. Laparoscopic removal of the intra-abdominal IUD must be the first choice of therapy. If possible, a single ancillary port should be preferred for the removal of mislocated IUDs. We advise that surgical removal and surgical risk should be discussed with the patients, even if asymptomatic.

Comparison of Modified Biophysical Profile and Doppler Ultrasound in Predicting the Perinatal Outcome at or over 36 Weeks of Gestation

Aims: In this study, modified biophysical profile (MBP) and uterine and umbilical artery Doppler ultrasonographic (USG) analysis were compared in predicting the perinatal outcome of pregnancies at ≧36 weeks. Methods: Three hundred and fifteen pregnant women were included in this study. Following routine examination, amniotic fluid index, uterine and umbilical artery Doppler indices were evaluated. Nonstress test (NST) was done and MBP was generated. Non-reassuring fetal status (NRFS), perinatal mortality, 5-min APGAR score and umbilical artery pH results were used in evaluating the perinatal outcome. Results: In groups with abnormal MBP and Doppler analysis the results of all parameters were bad. The statistical difference between the groups of normal and abnormal MBP and Doppler analysis was significant. In predicting the NRFS, MBP sensitivity was 60%, umbilical artery Doppler was 50% and uterine artery Doppler was 30%. In case of combination of findings of MBP and umbilical artery Doppler, the sensitivity rose to 70%. Conclusion: MBP was proved to be more significant than Doppler analysis in prediction of NRFS and perinatal results, but the sensitivity was increased when both were combined, so combination of MBP and Doppler analysis instead of MBP alone is more significant in antenatal assessment.