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    A comparison of the clinical features of molar pregnancy in adolescents and adults
    (Professional Medical Publications, 2024) Ozer, Mehmet; Ozer, Pinar Tugce; Karaca, Ibrahim; Karaca, Suna; Ileri, Alper; Budak, Adnan
    Objective: To compare the age -specific clinical features of molar pregnancy and to describe the risk factors associated with this situation. Method : This retrospective case -control study was conducted at the Department of Obstetrics and Gynecology. Tepecik Education and Research Hospital, Izmir, Turkey. The participants included both adolescents (<= 19 years) and adults with histologically confirmed hydatidiform moles in our institution between January 2015 and January 2022. The interventions and main outcome measures of this study involved evaluating the clinical and ultrasonographic features, as well as the risk factors, associated with molar pregnancies in adolescents. Results : This study of 137 patients with molar pregnancy found that adults had a higher incidence of partial molar pregnancy (20 patients versus seven patients) and lower beta-hCG levels than adolescents (176.890.71 mIU/ml versus 253.734.47 mIU/ml). Adolescents had a higher likelihood of hyperthyroidism (25.4% versus 9.2%). bleeding on admission (4.2% versus 1.51%),. longer hospital stays (5.44 +/- 2.73 days versus 3.59 +/- 3.08 days). Higher rates of uterine enlargement and postoperative bleeding (15.5% versus 1.5%). Adolescents also required more analgesia (97% versus 89.4%). Conclusions: A dolescents with Gestational trophoblastic diseases (GTD) may present with more severe symptoms compared to adults, which can lead to delayed diagnosis and treatment. Further research is needed to better understand the underlying mechanisms and risk factors for GTDs in this population. Increased awareness and education can help improve recognition and management of GTDs in adolescents and improve their overall health outcomes.
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    The effect of progesterone supplementation in women with threatened miscarriage on fetal fraction in non-invasive prenatal testing: A matched case-control study
    (Elsevier Masson, Corp Off, 2023) Ileri, Alper; Karaca, Suna Yildirim; Ileri, Hande; Karaca, Ibrahim; Golbasi, Hakan; Ozer, Mehmet; Budak, Adnan
    Aim: To evaluate the effect of progesterone use on fetal fraction (FF) in non-invasive prenatal testing (NIPT) due to the threat of first trimester miscarriage.Methods: This case control study included the pregnant who were referred to our clinic for non-invasive prenatal testing. The patients were categorized into three groups: Pregnant women with vaginal bleeding and using progesterone, pregnant women with vaginal bleeding and not using progesterone, and pregnant women without bleeding. The groups were formed by matching gestational week. Women with multiple pregnancy, BMI (body mass index) >= 25, abnormal fetal karyotype, and chronic disease were excluded from the study. Maternal characteristics, FF of the NIPT were recruited from the computer based medical records.Results: A total of 10,275 NIPT tests were performed during the study period. 3% of the patients (n = 308) were found at risk of miscarriage. 100 patients with a vaginal bleeding and 50 control patients were matched. The median value of the fetal fraction ratio was found to be 6.55 in pregnant women without vaginal bleeding, 7.05 in pregnant women who had vaginal bleeding and using progesterone, and 7.3 in pregnant women who had vaginal bleeding and did not use progesterone. Although the fetal fraction ratio was found to be higher in pregnant women with vaginal bleeding and lower in progesterone users, this situation could not reach the level of statistical significance (p = 0.351).Conclusions: The fetal fraction rate in maternal blood is not affected in pregnant women who use progesterone due to vaginal bleeding in early gestational weeks.
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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.