Yavuz Aydin

Hematological abnormalities in adolescent menorrhagia.

Background: The purpose of this study is to determine the frequency of underlying hematological disorders as the cause of acute adolescent menorrhagia. Methods: The records of 25 patients that were hospitalized with acute adolescent menorrhagia in the Obstetrics and Gynecology Department of Cerrahpa¸sa Medical School of ˙Istanbul University between 1988 and 1995 were analyzed. Results: The mean age of the patients was 13.9±1.6 (SD) years. A hematological abnormality that caused bleeding diathesis and acute menorrhagia was diagnosed in 7 of the 25 patients (28%). There were four cases of immune thrombocytopenic purpura, two cases of Van Willebrand disease and one case of acute promyelocytic leukemia. All seven patients with a coagulation disorder required blood transfusions and the mean hemoglobin level at presentation was 6.2 g/dl.

Elevated serum levels of anti-Müllerian hormone can be introduced as a new diagnostic marker for polycystic ovary syndrome

To determine the possible role of anti‐Müllerian hormone (AMH) in the diagnosis of polycystic ovary syndrome (PCOS) with a larger population of women and to evaluate its role as a new diagnostic marker.

Symptomatic Treatment of Premenstrual Mastalgia in Premenopausal Women with Lisuride Maleate: A Double-Blind Placebo-Controlled Randomized Study

OBJECTIVE To determine the therapeutic effect of lisuride maleate on premenstrual mastalgia in premenopausal women. DESIGN Double-blind randomized prospective study. SETTING Department of obstetrics and gynecology at a university hospital. PATIENT(S) Sixty women with premenstrual mastalgia were included in the study. Study and control groups consisted of 30 women each. INTERVENTION(S) Women enrolled in the study and control group were given one tablet daily (0.2 mg) of lisuride maleate or placebo orally for 2 months. Severity of mastalgia was evaluated using the visual analog scale. MAIN OUTCOME MEASURE(S) Severity of mastalgia and side effects of the drug administered. RESULT(S) Mastalgia subsided significantly in women receiving lisuride maleate compared with controls. There were no significant side effects from lisuride maleate. Prolactin levels decreased significantly in the group receiving lisuride, which correlated well with pain resolution. CONCLUSION(S) Lisuride maleate may be useful for the symptomatic treatment of premenstrual mastalgia.

Cabergoline versus bromocriptine for symptomatic treatment of premenstrual mastalgia: a randomised, open-label study

OBJECTIVE To compare the effectiveness and side effects of cabergoline with bromocriptine for the symptomatic treatment of cyclic mastalgia as a part of the premenstrual syndrome. STUDY DESIGN 140 women with premenstrual mastalgia were enrolled in this randomised, open-label trial. Two groups were created (bromocriptine and cabergoline) and consisted of 61 and 67 patients respectively at the end of trial. Bromocriptine was administered 5 mg daily during second half of the menstrual cycle. Cabergoline was administered 0.5 mg weekly during the second half of the cycle. Relief of pain was evaluated using a visual analog scale (VAS). The mean percentage decrease in score for all patients in each group was calculated. A 50% or greater decrease at the end of the third month from the basal VAS score was accepted as a positive response to drug therapy. Data regarding side effects were collected systematically with review of a symptom diary. RESULTS The positive response rates to treatment were similar (bromocriptine 66.6% and cabergoline 68.4%). The pain reduction rates for each month were also similar. Moreover, the pain reduction rate was maximum in the second month of treatment for both groups. Vomiting (28%), nausea (39%) and headaches (23%) recorded in the bromocriptine group were significantly more frequent than vomiting (4.5%), nausea (20.9%) and headache (6%) recorded in the cabergoline group (p=0.023, p=0.001, p=0.006 respectively). A difference in the rate of dizziness was not statistically significant (26.4% vs. 14.9%). There was no correlation between the baseline breast pain score and prolactin level but post-treatment pain reduction was well correlated with prolactin level. CONCLUSIONS Cabergoline is as effective as bromocriptine for the treatment of cyclic mastalgia but has minimal side effects compared to bromocriptine.

Serum levels of epidermal growth factor, transforming growth factor, and c-erbB2 in ovarian cancer.

Objective This study aimed to investigate serum levels of epidermal growth factor (EGF), transforming growth factor α (TGF-α), and c-erbB2 in patients with ovarian cancer. Materials and Methods In this retrospective cohort study, the study and control groups were composed of 43 women with a prediagnosis of ovarian cancer and 43 healthy women, respectively. Blood samples from all women were obtained and studied by enzyme-linked immunosorbent assay kits for EGF, TGF-α, and c-erbB2. After surgery of the study group, ovarian cancer was confirmed and compared with control group. Stage, grade, and histological types were defined after histopathologic examination, and subgroups were constructed and compared. Results Serum EGF, TGF-α, and c-erbB2 levels were significantly increased in study group compared with those in the control group (P < 0.001). There were no differences in serum levels of EGF, TGF-α, and c-erbB2 among all stages, grades, and histological types of ovarian cancer. If 47.90 pg/mL was selected as the cutoff value, EGF has an 80% sensitivity and a 65% specificity for detecting ovarian cancer. The cutoff value of 41,095.00 pg/mL for TGF-α has a 90% sensitivity and a 72% specificity for detecting ovarian cancer. The c-erbB2 level of 4.63 pg/mL as the cutoff value has an 83% sensitivity and a 76% specificity for predicting ovarian cancer. Conclusions Serum levels of EGF, TGF-α, and c-erbB2 may be used for diagnosing ovarian cancer.

Hereditary Thrombophilia, Anti‐Beta2 Glycoprotein 1 IgM, and Anti‐Annexin V Antibodies in Recurrent Pregnancy Loss

Citation Karata S, Aydin Y, Ocer F, Buyru A, Balci H. Hereditary Thrombophilia, anti‐beta2 glycoprotein 1 IgM, and anti‐annexin V antibodies in recurrent pregnancy loss. Am J Reprod Immunol 2012; 67: 251–255

Association of cervical infection of Chlamydia trachomatis, Ureaplasma urealyticum and Mycoplasma hominis with peritoneum colonisation in pregnancy

This study investigated the prevalence of Chlamydia trachomatis, Ureaplasma urealyticum and Mycoplasma hominis infections in the cervices and peritoneum of pregnant women and compared them with non-pregnant controls. A total of 96 pregnant women who planned to deliver by caesarean section, and 124 non-pregnant women were screened for cervical Chlamydia trachomatis, Ureaplasma urealyticum and Mycoplasma hominis infections by polymerase chain reaction analysis. If cervical infection was present, peritoneal infection was searched from the Pouch of Douglas during caesarean section in the pregnant group and was searched by culdocentesis in the control group. Chlamydia trachomatis infection was present in 7.3% of pregnant women and 2.4% of the non-pregnant controls. Ureaplasma urealyticum infection was present in 26% of pregnant women and 15.3% of the non-pregnant controls. The incidence of Chlamydia trachomatis and Ureaplasma urealyticum infection was significantly higher in pregnancy. Mycoplasma hominis infection was present less frequently compared with Chlamydia trachomatis and Ureaplasma urealyticum in both groups. Intraperitoneal colonisation by Chlamydia trachomatis was present in only one pregnant woman and in one non-pregnant control. No intraperitoneal infection was detected for Ureaplasma urealyticum and Mycoplasma hominis. Cervical Ureaplasma urealyticum and Chlamydia trachomatis infections were more frequently seen in pregnant Turkish women.

Hyperreactio luteinalis with preeclampsia

Hyperreactio luteinalis (HL) is a condition associated with bilateral and, in rare cases, unilateral ovarian enlargement due to theca lutein cysts. HL is a benign condition, usually found incidentally at cesarean section, which can appear anaplastic and lead to unnecessary ovarian resection. A 24-year-old woman with 35 weeks of gestation attended with bilaterally enlarged ovaries. She had preeclampsia and preterm contractions. Due to breech presentation of baby and nulliparity and possible severe preeclampsia, she delivered by cesarean section. The ovaries had an anaplastic appearance and a biopsy was taken during cesarean section. Pathology revealed multiple benign theca lutein cysts. There are 51 reported cases of HL associated with a normal pregnancy in the literature. It is estimated that approximately 60% of the cases of HL is not associated with trophoblastic disease and occurs with normal singleton pregnancy. Only three of them were found to be associated with preeclampsia and this is the fourth case. HL may help explain the underlying cause of preeclampsia in these cases. There are multiple benign ovarian lesions in HL, which can mimic ovarian neoplasms. Accordingly, it is important to exclude these from the differential diagnosis via a wedge biopsy and frozen section to avoid unnecessary surgical excision.

Factors affecting the accuracy of ultrasonographical fetal weight estimation in twin pregnancies

Objective. To determine the factors affecting the accuracy of ultrasonographic weight estimation in twins. Methods. 152 sets of twins delivered vaginally, were included. Effects of fetal weights, inter-twin weight discordance, chorionicity, early rupture of membranes, intrauterine growth restriction, and presentations of twins on errors of estimated fetal weights were evaluated. The primary measures of estimated fetal weight accuracy compared were mean-percentage-error and the standart deviation (SD) of percentage errors. Results. Mean percentage errors for the first fetus (8.13 ± 6.82) and the second fetus (8.07 ± 6.88) were similar (p = 0.64). Random errors of both fetuses were also similar (p = 0.78). If one of the fetuses had IUGR, the percentage error and also the random error of that fetus would increase significantly. Different presentations and fetal gender combinations were similar for both types of errors of fetal weight estimation. A weak negative lineer relationship was found between the weight of the first fetus and its percentage error (r = −0.27, p = 0.04). A similar relation was present between the weight and percentage error of the second fetus (r = −0.29, p = 0.03). Percentage errors and also random errors of both fetuses were significantly higher if severe discordance was present between twins (p = 0.01 and p = 0.02, respectively). Conclusions. IUGR, fetal weights, and inter-twin discordence are the factors affecting the accuracy of weight estimation by ultrasonography.

Relation of antimullerian hormone with the clinical signs of hyperandrogenism and polycystic ovary morphology

Abstract The relation of antimullerian hormone (AMH) levels with the clinical and biochemical markers of polycystic ovary syndrome (PCOS) could be different. A total of 463 PCOS patients were evaluated in this cross-sectional study. Groups were constructed according to polycystic ovarian morphology (PCOM) and menstrual cycle-length. The relation of serum AMH with androgenic hormones, menstrual cycle-length and clinical signs of PCOS were investigated. A powerful positive relation was found between the PCOM and AMH levels (odds ratio = 2.49). There was a negative correlation between age and AMH level (p < 0.001, r[correlation coefficent] = −0.155). Positive correlations were found between luteinizing hormone (LH) and AMH (p < 0.001, r = 0.25) and also between cycle length and AMH (p < 0.01, r = 0.27). We found a negative week correlation between AMH and follicle-stimulating hormone (FSH) (p = 0.01, r = −0.19). After controlling main androgenic hormones, AMH was found to be correlated with the Ferriman–Gallway score (p = 0.03, r = 0.18). There was a positive relationship between hirsutism and AMH (odds ratio = 1.43), but no correlation between AMH and other parameters of clinical hyperandrogenism like hair-loss, acne and seborrhea were identified. The strongest relation was presented between the AMH levels and PCOM. Also, cycle-length correlated well with the AMH levels. The relationship between hirsutism and AMH is found to be independent from androgenic hormones.