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  • Küçük Resim
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    How does the type of delivery affect pelvic floor structure? Magnetic resonance imaging parameter-based anatomical study
    (Via Medica, 2023) Şenkaya, Ayşe Rabia; İsmailoğlu, Eren; Arı, Sabahattin Anıl; Karaca, İbrahim
    Objectives: The aim of this study is to examine the effects of delivery type and birth weight on pelvic floor structure using muscle defects, uterus-vagina angles and landmarks in pelvic magnetic resonance imaging (MRI). Material and methods: This is a retrospective study. Pelvic MR images of 38 vaginal deliveries and 62 cesarean section patients who met the study criteria were analyzed. Pubococcygeal line, H line, M line were marked on MR images, uterus cervix, cervix upper vagina, upper and middle vagina, middle and lower vagina angles, urogenital hiatus width, levator hiatus width, obturator internus muscle area, levator ani defect was measured. The urinary incontinence and pelvic organ prolapse examination findings were recorded. The patients' age, body mass index (BMI), parity, delivery type, maximum birth weight questions were asked. The data of both groups were compared. Results: Uterocervical angle and levator ani muscle defect was significantly higher in the vaginal delivery group (p < 0.001). In the vaginal delivery group, a significant positive correlation was found between the parity and the levator ani muscle defect (r = 0.552), (p = 0.000). A significant negative correlation was found between the parity and the uterocervical angle (r = -0.337), (p = 0.039). A significant negative correlation was found between maximum birth weight and cervix upper vagina angle (r = -0.365) (p = 0.024). In the vaginal delivery group, a negative significant correlation was found between birth weight and obturator internus muscle area (r = -0.378), (p = 0.019). Conclusions: These results show that cesarean section exposes the pelvic floor to less trauma and suggest that cesarean section may protect the pelvic floor.
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    Maternal and neonatal outcomes of couvelaire uterus
    (2021) Ileri, Alper; Karaca, Suna Yildirim; Öztekin, Deniz; Umut, Fethiye; Şenkaya, Ayşe Rabia; Aytaç, Hakkı
    Couvelaire uterus is a life-threatening condition in which placental abruption causes bleeding that penetrates the uterine myometrium. The objective of this study was to determine the risk factors of Couvelaire uterus and maternal and neonatal outcomes. Obstetrics emergency clinic data between January 2013 – December 2019 were screened and placental abruption patients confirmed by pathology or surgery note were recruited. Patients were divided into two groups; with or without Couvelaire uterus. Clinical features; such as maternal age, gravida, parity, gestational age at delivery, comorbidities, chief complaint, ultrasonography examination, placental pathology, degree of placental separation, DIC (disseminated intravascular coagulation), required hysterectomy and transfusion, maternal hemoglobin, maternal or fetal ICU (intensive care unit) admission, neonatal birth weight, APGAR 1’ and 5’ scores were compared. Age, gravida, and parity were significantly higher in patients with couvelaire uterus (p<0.001, p=0.017, p=0.034 respectively). The degree of placental separation was significantly larger and APGAR 1’ and 5’ scores significantly lower in the Couvelaire uterus group (p <0.001). Incident of Couvelaire uterus increases with higher age, gravida, and parity. Neonatal APGAR scores were lower and intrauterine fetal death rates were higher in Couvelaire uterus patients.
  • Küçük Resim
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    Perinatal trends and birth outcomes of Syrian refugee and turkish women
    (2022) Şenkaya, Ayşe Rabia; İleri, Alper; Karaca, Suna Yıldırım; İleri, Hande; Ata, Can
    Aim: The impact of migration on health is far-reaching, making migrant populations particularly vulnerable, fueling health inequalities and resulting in serious implications for global health. The aim of our study to assess antenatal care, pregnancy and neonatal outcomes of Syrian refugee women in Turkiye. Material and Methods: Syrian and Turkish pregnants who delivered between 2013-2019 were recruited and categorized into groups according to maternal age at delivery. First trimester combined test, second trimester triple test, preterm delivery, maternal anemia; neonatal stillbirth, APGAR scores, birth weight and breastfeeding status were assessed. Results: 4992 Syrian and 6846 Turkish pregnants were included. Maternal anemia was higher in Turkish patients in 20-34 and ?35 groups. First trimester combined test, APGAR scores and birth weights were lower in Syrian women. Preterm rates higher in Turkish patients in only 20-34 age group. Second-trimester triplet tests were only higher in Turkish women in ?35 age group. Low birth weight was higher in younger Syrian patients. Satisfying breastfeeding results were found in Syrian women. Conclusion: Our study stated that Syrian women are at risk of low birth weight in adolescent and 20-34 age groups and low rates in first trimester combined test in all age groups. However decreased risk of pregnancy complications such as maternal anemia, preterm delivery, cesarean delivery and satisfying breastfeeding results were found in Syrian patients.