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  • Küçük Resim
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    Could laparoscopic cystectomy improve intrauterine insemination with controlled ovarian hyperstimulation outcomes in women with endometrioma?
    (Via Medica, 2022) Güleç, Ebru Şahin; Öztekin, Deniz; Karaca, Suna Yıldırım
    Objectives: To clarify the effects of laparoscopic cystectomy of endometriomas on intrauterine insemination with controlled ovarian hyperstimulation (COH + IUI) success in women with the disease. Material and methods: We performed a retrospective study with endometrioma patients having at least one patent fallopian tube. The study group consisted of 57 infertile patients with a history of laparoscopic cystectomy who underwent 83 COH + IUI cycles. The control group consisted of 88 patients with endometrioma who underwent 161 COH + IUI cycles without surgery.Results: The total number of antral follicles was significantly lower in the study group than in the control group (10.1 +/- 5.1 vs 11.9 +/- 5.0; p = 0.008). No significant difference was observed in the clinical pregnancy and live birth rates per cycle [(9.6% vs 7.6%; p=0.7175 OR: 1.195% CI: 0.6-2.1) and (7.2% vs 6.2%; p = 0.9544 OR: 1.1 95% CI: 0.5-2.1], respectively) between the operated and non-operated groups. Conclusions: The results of the study show that the presence of an endometrioma with at least one patent fallopian tube does not require any cystectomy before COH+IUI treatment because no improvement was observed in the treatment outcomes of the patients who underwent preceding surgery. We conclude that an operation may be taken into consideration when malignancy cannot be ruled out or severe pelvic pain related to endometrioma cannot be relieved.
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    The effect of maternal anxiety during delivery on birth outcomes
    (2021) Abacı, Hüseyin; Karabulut, Alaattin; İleri, Alper; Aytaç, Hakkı; Öztekin, Deniz Can; Senkaya, Ayse Rabia; Karaca, Suna Yıldırım
    Birth anxiety can be defined as the fear of direct pain, the fear of the birth process. The aim of this study is to investigate the effect of anxiety level at the time of birth on the birth process and maternal and neonatal outcomes. Materials and Methods: Anxiety scores of the patients were recorded. Demographic data of the patients, cervical examination findings, place of residence, education level, type of delivery, APGAR score, presence of episiotomy or dehiscence in normal deliveries, 1st, 2nd and 3rd stages of labor, analgesia needs, prenatal and postnatal hemoglobin variability were recorded. The patients were divided into two groups as those with low (n=76) and moderate/high (n=24) anxiety levels, and the effect of anxiety level on birth outcomes was compared. Results: 53.9% (n=41) of pregnant women with low level of anxiety were nulliparous, and 91.7% (n=22) of patients with moderate/high level of anxiety were nulliparous (p=0.001). Postpartum hemoglobin change in pregnants with low level of anxiety, was higher than the pregnant women with moderate/high level of anxiety (p=0.00). A statistically significant relationship was found between age and anxiety level, the anxiety score of younger pregnant women was significantly higher (p=0.001). Conclusion: Although we did not find a statistically significant relationship between prepartum anxiety level and fetal and neonatal outcomes in our study, the amount of bleeding was less in pregnant women with low anxiety. We also concluded that previous birth experience and maternal age affect the anxiety score.
  • Küçük Resim
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    Gebelikte ilaç maruziyetinin prenatal ve postnatal sonuçları
    (2022) Özer, Mehmet; Çakır, Zübeyde Emiralioğlu; Demir, Ömer; Ömeroğlu, İbrahim; Ekin, Atalay; Sever, Barış; Karaca, Suna Yıldırım; Gölbaşı, Hakan
    Amaç: Hastanemize başvuran ve perinatoloji konseyimizde değerlendirdiğimiz gebelerden ilaç kullanım öyküsü olanların demografik özelliklerini ve maruz kalınan ilaçların Yapısal Tedavi Edici Kimyasallar Sınıflaması (ATC) sistemine göre dağılımlarını belirlemektir. Yöntem: Bu araştırma retrospektif kohort bir çalışma olarak tasarlanmıştır. Hastane veri tabanından elde edilen veriler, literatür ışığında değerlendirilmiştir. Gebeliğinde ilaç kullanımı tespit edilen gebelerin sıklıkla hangi ilaçları kullandıkları ATC sistemine göre kategorize edildi. Aynı zamanda gebelerin demografik verileri, eğitim durumları, gelir seviyeleri, alkol sigara kullanımları, obstetrik sonuçları incelendi. Bulgular: Çalışmamıza İzmir Tepecik Eğitim ve Araştırma Hastanesi, Perinatoloji Bölümü Konseyi’nde değerlendirilen 99 gebe dahil edildi. Gebelerde ortalama yaş 31,70 [18-47, standart sapma (SS)=5,880], ortalama gravida 2,81 (1-8, SS=1,452), ortalama parite 1,4 (0-5, SS=0,988) ve başvuru sırasındaki ortalama gebelik haftası 11,27 (5-30, SS=4,692) olarak hesaplandı. Ortalama ilaç kullanım süresinin ortalama 66,56 gün olduğu tespit edildi. Çalışmamızda %29,33 oranıyla en sık sinir sistemini ilgilendirilen ilaçların kullanıldığı bunu %15,03 oranıyla sindirim sistemini ilgilendiren ilaçların takip ettiği gözlendi. İlaca maruz kalan 100 gebenin sadece 5’inde doğumsal anomali gözlemlenmiştir. Sonuç: Gebelerin demografik verileri, maruz kaldıkları ilaçların dağılımları literatür ile benzer şekildedir. Ancak daha önceki çalışmalardan farklı olarak isteğe bağlı küretaj tercihi daha düşük orandadır. Bununla birlikte doğumsal anomali görülme durumu da beklenenden yüksek değildir.
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    Öğe
    Hemoglobin A1c Level is Associated with Lymphovascular Space Invasion in Diabetic Endometrial Cancer Patients
    (2024) Şenkaya, Ayşe Rabia; Kantarcı, Sercan; Karaca, Suna Yıldırım; Sanci, Muzaffer
    OBJECTIVE: Our aim in this study is to examine the relationship of hemoglobin A1c (HbA1c) and fast- ing glucose with the stage, grade, and histological type of cancer and its value in predicting the prog- nosis of endometrial cancer in diabetic endometrial cancer patients. STUDY DESIGN: The data of 138 endometrial cancer patients with diabetes who met the study criteria were analyzed. Hemoglobin A1c levels and fasting glucose were compared with cancer stage, grade, histological type, lymphovascular invasion, chemotherapy, and radiotherapy data. RESULTS: A statistically significant difference was found between the groups in terms of HbA1c values only according to the lymphovascular invasion ( p=0.02). While there was no significant correlation be- tween endometrial thickness and HbA1c, a low positive correlation was found between the fasting glu- cose value (r=0.191, p=0.025) CONCLUSIONS: The higher rate of lymphovascular invasion in patients with high HbA1c values alone is insufficient in determining the prognosis when other parameters are considered.
  • 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.