Sadettin Güngör

The effect of pre-eclampsia on complete blood count, platelet count and mean platelet volume

Pre-eclampsia is a condition observed during pregnancy and threatens the life of both mother and foetus. There are studies, which suggest platelets play a major role in the pathogenesis of pre-eclampsia. The aim of this study is to compare the complete blood count (CBC) parameters, especially platelet count and mean platelet volume (MPV), in pre-eclamptic and normal pregnant women and to evaluate whether these parameters have a prognostic significance in determining the severity of eclampsia. The study and control groups consist of 56 pre-eclamptic and 43 normal pregnant women, respectively. There was no statistically significant difference according to CBC, platelet count and MPV when pre-eclamptic and severely pre-eclamptic patients were compared with controls. As a result, we observed no prognostic significance of CBC, platelet count and MPV on the presence and/or severity of pre-eclamptic condition. There are conflicting results especially on the significance of MPV in the literature, and possibly this confliction is due to the difference between methods and/or equipments used for automated blood count.

Oronasopharyngeal Suction versus No Suction in Normal and Term Infants Delivered by Elective Cesarean Section: A Prospective Randomized Controlled Trial

Background/Aim: There are controversies about the routine use of oronasopharyngeal suction (ONPS) in healthy infants. This study aimed to compare the effects of oronasopharyngeal suction with those of no suction in normal, term infants delivered by cesarean section. Methods: 140 term, healthy newborns of uncomplicated pregnancies were prospectively randomized to one of two groups according to the use of ONPS procedure. Differences in oxygen saturation levels, heart rates, and Apgar scores were determined. Results: The mean SaO2 values through the 2nd and 6th min of life were significantly higher in the no suction group (p < 0.001). The maximum time to reach SaO2 of ≧92% (6 vs. 11 min) and ≧86% (5 vs. 8 min) saturation were shorter in the no suction group than in the ONPS group. The mean heart rates were consistently and significantly lower in the no suction group during the first 6 min except the second one. All neonates without suction had an Apgar score of 10 at the 5th min, while the mean ± SD for ONPS group was 9.34 ± 0.48 (p < 0.001). Conclusion: Although findings remained on statistical level and did not lead to clinically adverse outcomes, there is no statistical or physiological basis for oronasopharyngeal suction as a systematic procedure in healthy, term infants delivered by cesarean section.

Differences in prevalence of sexual dysfunction between primary and secondary infertile women

OBJECTIVE To examine the impact of type of infertility on female sexual function. DESIGN Comparison of female sexual function index and prevalence in primary infertile women and secondary infertile women. SETTING Hospital. PATIENT(S) One hundred twenty-two primary infertile and 51 secondary infertile women. INTERVENTION(S) Questionnaires (Female Sexual Function Index [FSFI] and Beck Depression Inventory). MAIN OUTCOME MEASURE(S) Prevalence of dysfunction in primary and secondary infertile women. RESULT(S) The prevalence of female sexual dysfunction was 64.8% (n = 79) and 76.5% (n = 39) in primary infertile and secondary infertile women, respectively. In analyses of mean overall and subgroup scores of FSFI, there were significant differences between primary and secondary infertile women in the mean scores of orgasm, satisfaction, and total FSFI. Backward logistic regression identified a model with four significant predictors of sexual dysfunction (group, age, income level, and educational level). Secondary infertile women had a 9.5-fold higher risk of sexual dysfunction than primary infertile women after adjustment for confounding factors. CONCLUSION(S) There was a higher prevalence of sexual dysfunction in secondary infertile women. Secondary infertile women have decreased sexual desire, orgasm, and satisfaction compared with primary infertile women.

Isolated torsion of fallopian tube in a premenarcheal 12‐year‐old girl

Isolated torsion of fallopian tubes should be considered even at premenarcheal ages in cases of acute pelvic pain, and prompt surgery can preserve the tube and thus fertility. It is an uncommon emergency event and a difficult condition to evaluate clinically. This report focuses on a 12‐year‐old premenarcheal girl who presented with acute pelvic pain of 2 days. Pelvic ultrasound showed an adnexal mass on the left side. Laparoscopy was performed and an isolated tubal torsion was discovered. The tube was necrotic and salpingectomy was performed. The appendix appeared to be hyperemic and erectile. Appendectomy was also performed to rule out appendicitis. Its our recommendation that in the differential diagnosis of acute lower abdominal pain of girls, isolated torsion of the fallopian tubes should be considered. Also, preservation of the tube and fertility should be possible with prompt surgical intervention.

Oronasopharyngeal suction versus no suction in normal, term and vaginally born infants: a prospective randomised controlled trial.

This prospective randomised controlled trial aimed to compare the effects of oronasopharyngeal suction with those of no suction in normal, term and vaginally born infants and was performed at a Turkish tertiary hospital from June 2003 to January 2004. A total of 140 newborns were enrolled in the trial (n = 70 per group). The no suction group showed lower mean heart rates through the 3rd and 6th minutes and higher SaO2 values through the first 6 mins of life (P < 0.001). The maximum time to reach SaO2 of ≥ 92% (6 vs. 11 min) and ≥ 86% (5 vs. 8 min) were shorter in the no suction group (P < 0.001).

Anticipated and perceived pain from midtrimester amniocentesis.

To evaluate the anticipated and perceived pain and determine the factors contributing to pain perception in women undergoing midtrimester amniocentesis.

Tension-Free Vaginal Tape for Surgical Relief of Intrinsic Sphincter Deficiency: Results of 5-year Follow-up

STUDY OBJECTIVE We evaluated effectiveness of tension-free vaginal tape application for surgical relief of intrinsic sphincter deficiency. DESIGN A prospective study (Canadian Task Force classification II-3). SETTING Tertiary center of medical faculty. PATIENTS We studied 47 patients. INTERVENTIONS Tension-free vaginal tape procedure, questionnaire form, stress test, cotton swab test, and functional bladder volume measurements. MEASUREMENTS AND MAIN RESULTS Patients were grouped as intrinsic sphincter deficiency according to American College of Obstetricians and Gynecologists criteria. Operative results were documented at 6, 12, 36, and 60 months after the procedure by using a questionnaire form and objective tests of stress test, cotton swab test, and mean bladder functional volume measurement. At first visit 6 months after procedure, 70% (n = 35) of patients were completely satisfied, 9 (18%) had improved urine control, and 5 (10%) had no change in urine control. Results were: 72% (n = 36), 12% (n = 6), and 14 (n = 7%) at the end of the first year, and 66% (n = 33), 20% (n = 10), and 14% (n = 7) at the end of the third year, respectively. The fifth years follow-up visit revealed 57.4% (n = 27 of 47) satisfaction, 17.02% (8 of 47) improved urine control, and 25.5% (12 of 47) no change in urine control. CONCLUSION Tension-free vaginal tape procedure is a safe and effective technique for patients who have exclusively intrinsic sphincter deficiency. Long-term results will clarify the value of this procedure in comparison with classic antistress surgical techniques.

Predictors of sexual function during pregnancy

The aim of the study was to evaluate sexual functions of pregnant women and to determine the factors affecting their sexual function. The cross-sectional study recruited 286 pregnant women from a hospital. To collect data, ‘Patient Information Form’, ‘State Anxiety Inventory’ and ‘Female Sexual Function Index’ were used. The mean age of women was 29.15 ± 4.85 and 77.6% of them presented with sexual dysfunction. Having partner at advanced age, a history of miscarriage, a history of health problem during previous pregnancy and a high level of anxiety were found to be factors negatively affecting sexual function. Health professionals should be aware of a number of risk factors that may contribute to sexual dysfunction in pregnant women.

A simple set for ıntrauterine fetal blood transfusion constructed by readily available materials in every clinic

Abstract Intrauterine fetal transfusion needs extensive experience and requires excellent eye–hand coordination, good equipment and experienced team workers to achieve success. While the needle is in the umbilical vein, an assistant withdraws and/or transfuses blood. The needle point should be kept still to prevent lacerations and dislodging. We propose a simple set for Intrauterine Fetal blood transfusion is constructed by readily available materials in every clinic to minimize needle tip movement and movements during syringe attachments and withdrawals during the intrauterine fetal transfusion. This makes possible to withdraw fetal blood sample, and to transfuse blood with minimal intervention.