Murat Muhcu

Longitudinal study of platelet size changes in gestation and predictive power of elevated MPV in development of pre-eclampsia

The aim of this cohort is to investigate whether any haematologic changes detectable by simple complete blood count (CBC) precede pre‐eclampsia development and the diagnostic value of these markers in clinical practice for prediction of pre‐eclampsia.

Evaluation of neonatal outcomes in elective repeat cesarean delivery at term according to weeks of gestation

Aim:  Our aim is to evaluate the association between gestational age at delivery and neonatal outcomes in elective cesarean delivery.

Could mean platelet volume be a predictive marker for gestational diabetes mellitus

Abstract Background: Gestational diabetes mellitus is defined as any degree of glucose intolerance with onset or first recognition during pregnancy. Early diagnosis of this complication and appropriate treatment aimed at tight control over maternal glucose levels may positively influence the perinatal outcome. There are studies, which suggest platelets play a role in the pathogenesis of gestational diabetes mellitus. Aim: The aim of this study is to compare the platelet count and other platelet parameters in gestational diabetic and normal pregnant women and to investigate whether these parameters have a predictive significance in gestational diabetes mellitus. Materials and methods: Thirty four women with gestational diabetes mellitus and 45 normal pregnant women were enrolled into the study. Results: Women with gestational diabetes mellitus had lower platelet counts and higher mean platelet volume (MPV) values which were statistically significant (p <0·006 and p <0·0001), respectively. Conclusion: Our results indicate that platelet count and MPV play an important predictive role in gestational diabetes mellitus.

Prenatal diagnosis of vertebral deformities associated with pentalogy of Cantrell: The role of three-dimensional sonography?

Pentalogy of Cantrell was diagnosed in a fetus at 14 weeks of gestation, on routine two‐dimensional sonographic examination with Doppler imaging, which revealed a midline supraumbilical abdominal wall defect including herniated liver, an ectopia cordis without intracardiac anomalies, and a large omphalocele containing intestines. Although left unilateral club foot deformity was also detected as an associated anomaly in the same examination, severe lumbar lordoscoliosis was only detected by using three‐dimensional sonography because of the spatial configuration of the deformity. After termination of the pregnancy, postnatal inspection of the fetus confirmed the diagnosis of pentalogy of Cantrell associated with skeletal deformities and revealed low implant ears as an additional finding. Although two‐dimensional sonography with Doppler imaging is sufficient to diagnose pentalogy of Cantrell, it may fail to show the complex vertebral deformities and three‐dimensional sonography may assist in visualizing the defect accurately.

The outcome of adding peripheral neuromodulation (stoller afferent neuro-stimulation) to anti-muscarinic therapy in women with severe overactive bladder

Objective. Anti-muscarinic treatment alone and peripheral neuromodulation with concomitant anti-muscarinic treatment were compared in patients with severe overactive bladder. Methods. In this prospective study, 40 women with severe overactive bladder according to the 7-day voiding diary without any prior treatment completed the Incontinence Impact Questionnaire (IIQ-7) and were randomised into anti-muscarinic-alone and combination treatment groups. Twenty women received daily 4 mgs of tolterodine orally and in 20 women Stoller afferent neuro-stimulation (SANS) therapy was performed concomitantly for 12 weeks to the same anti-muscarinic regimen. After 12 weeks of therapy, two of the patients drop out of the study and remaining patients filled out the IIQ-7 questionnaire and the 7-day voiding diary again. Pretreatment and post-treatment QoL scores and the 7-day voiding diaries were compared. Mann–Whitney U, Wilcoxon and two sided significance tests were used. Results. Thirty-eight women fulfilling the criteria were included in the study. Severity of overactive bladder symptoms decreased significantly in both treatment groups. However, the decrease in combination treatment group was more significant than the anti-muscarinic-alone group. Adverse events were similar between the two groups. Conclusion. Combining SANS and anti-muscarinic therapy resulted in significantly better clinical outcomes and IIQ-7 scores as compared with anti-muscarinic treatment alone in patients with severe overactive bladder.

Second trimester amniotic fluid annexin A5 levels and subsequent development of intrauterine growth restriction

The purpose of this study was to investigate the levels of annexin A5 in second trimester amniotic fluid, and evaluate its correlation with subsequent development of intrauterine growth restriction (IUGR).

First trimester screening for Down syndrome in rhesus negative women.

To explore the effect of maternal rhesus status on first‐trimester screening markers for Down syndrome.

Effect of an Amniotic Sheet on Pregnancy Outcomes

OBJECTIVES Our aim was to evaluate whether the presence of an amniotic sheet affects obstetric and neonatal outcomes. METHODS All singleton pregnant women with and without a sonographic diagnosis of an amniotic sheet between the 16th and 24th weeks of pregnancy were retrospectively identified. Two women without an amniotic sheet were randomly selected from the similar stratified periods as a control group for each case. The demographic characteristics and obstetric and perinatal outcomes were compared between the groups. Multivariable logistic regression was also performed for potential confounding factors. In addition, the subsequent pregnancies of 12 women with an amniotic sheet were followed during the antenatal and postnatal periods. RESULTS The prevalence of an amniotic sheet was 1.13%. The risk factors for an amniotic sheet were primiparity, previous normal vaginal delivery, previous dilation and curettage, and previous abortions. When the groups were compared in terms of maternal and neonatal outcomes, the rates of a nuchal cord at birth, breech birth, birth weight of less than 2500 g, preterm delivery (<37 weeks), and neonatal intensive care unit admission were higher in the amniotic sheet group than the control group. There were 2 intrauterine deaths in the amniotic sheet group. In addition, an amniotic sheet was not observed again in any of the subsequent pregnancies of the 12 cases from the amniotic sheet group, and these pregnancies eventuated uneventfully. CONCLUSIONS An amniotic sheet is associated with an increase in poor obstetric outcomes. Therefore, close monitoring of pregnancies after diagnosis is required.

Is prenatal volumetric evaluation of aneurysm of the vein of Galen important in the prediction of adverse fetal outcome

Aneurysm of the vein of Galen is a rare congenital vascular malformation of the central nervous system. There are controversies in the literature regarding the possible prognostic value of aneurysmal volume estimation with 3‐dimensional US for the prediction of fetal outcome. In this report, we present a case of prenatally diagnosed large aneurysm of the vein of Galen complicated by heart failure in a fetus. The volume of the malformation was calculated as 17.8 cm3 and the fetal outcome was poor.

Long-term impacts of vaginal birth with mediolateral episiotomy on sexual and pelvic dysfunction and perineal pain

Abstract Objective: To investigate whether spontaneous vaginal birth with mediolateral episiotomy has any long-term impact on urinary and/or fecal incontinence, sexual dysfunction and perineal pain in primiparous women. Methods: This matched case-control study included 150 women between 25 and 35 years old who had a singleton childbirth at least five years previously. Patients were grouped as; women who had a spontaneous vaginal delivery with mediolateral episiotomy (Group 1), an elective cesarean delivery (Group 2), and who had no delivery (Group 3). Controls were matched for age and delivery time. Urinary/fecal incontinence were questioned and Female Sexual Function Index (FSFI) questionnaire was completed. Total FSFI and domain scores were compared. Statistical evaluation was performed using One-way ANOVA test or χ2 test. Statistical significance was defined as p < 0.05. Results: No women had urinary/fecal incontinence nor sexual dysfunction. Mean total FSFI points in Group 1 were significantly lower than in Groups 2 and 3 (p = 0.001). There were significant differences in sexual desire between groups 1 and 3 (p = 0.005), in arousal and in orgasm between both groups 1 and 2 (p = 0.001 and p = 0.038, respectively) and groups 1 and 3 (p = 0.001 and p = 0.001, respectively). There was no significant difference between groups 2 and 3 in any parameters or total points. Conclusions: Vaginal delivery with mediolateral episiotomy is not associated with urinary and/or fecal incontinence and sexual dysfunction but associated with a decreased sexual functioning as well as sexual desire, arousal and orgasm within postpartum five years.