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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, İbrahim; 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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    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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    Pelvic floor imaging in women with hemorrhoidal disease: An anatomical feasibility study
    (Royal College Surgeons Edinburgh, 2024) Kebapçı, Eyüp; Karaca, İbrahim; Şenkaya, Ayşe Rabia; Hacıoğlu, Ali Doruk
    Objective: To compare pelvic floor muscle and organ structures in women with and without hemorrhoidal disease (HD) using magnetic resonance imaging (MRI). Material and methods: Pelvic MRI measurements and computer-based medical records of women diagnosed with HD between January 2018 and March 2021 were analyzed. Parameters including pubococcygeal distance, puborectal distance, posterior anorectal angle, obturator internus muscle area, presence of levator ani muscle defect, genital hiatus length, vaginal length, uterocervical angle, cervix-upper vagina angle, and cervix-middle vagina angle were evaluated. The control group consisted of women without HD, matched for age and body mass index. Results: Puborectal hiatus distance was higher in the HD group (59.2 +/- 8.7 mm vs. 55.5 +/- 7.1 mm, p = 0.03). Similarly, the distance to the M line was greater in the HD group (18.3 +/- 4.8 mm vs. 16 +/- 4.6 mm, p = 0.04). Obturator internus muscle area was found to be lower in the HD group compared to the non-HD group (1721 +/- 291.4 mm(2) vs. 1897.5 +/- 352.5 mm(2), p = 0.02). Additionally, the presence of unilateral levator ani muscle defect was higher in HD patients (p = 0.03). There was a negative correlation between birthweight and obturator internus muscle area (r = -0.388, p = 0.02), and a positive correlation with M line distance (r = 0.344, p = 0.04). Conclusion: Levator ani muscle defects and obturator internus muscle area, indicators of pelvic floor dysfunction, are more common in patients with hemorrhoidal disease.
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    Sociocultural Determinants in Adolescent Pregnancies: Evaluation of Contraception, Breastfeeding and Birth Outcomes
    (Mümin POLAT, 2023) Şenkaya, Ayşe Rabia; Arı, Sabahattin Anıl; Karaca, İbrahim
    Introduction: Adolescent pregnancies are expressed as pregnancies occurring in this age group. We evaluated the sociocultural characteristics, obstetric outcomes, contraception and breastfeeding status of early-middle and late adolescent pregnant women. Methods: The research was carried out by retrospective research of electronic and printed medical patient records. All patient files who gave birth in our clinic in Turkey, between 2017-2022 were examined. Inclusion criteria for the study were defined as being 19 years of age and younger and having a vaginal or cesarean delivery. Exclusion criteria from the study were defined as missing or inaccessible medical records. 10-16 years of age were considered as early-middle adolescent and 17-19 years of age as late adolescent. A total of 206 adolescent pregnant women were included in the study. The patients were divided into two groups as early and late adolescents. Their sociodemographic characteristics, obstetric outcomes, contraception and breastfeeding status were compared. Results: Marriage rate was higher in the late adolescent group (p
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    Uterine isthmus contractions during pregnancy
    (Mosby-Elsevier, 2024) Yavuz, Onur; Karaca, İbrahim
    [No abstract available]