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Öğe Comparison of The Efficacy of Letrozole and Gonadotropin Combination Versus Gonadotropin Alone In Intrauterine Insemination Cycles In Patients With Unexplained Infertility(2020) Oğlak, Süleyman Cemil; Ege, Serhat; Otçu, Serap Mutlu Özçelik; Obut, Mehmet; Kahveci, Bekir; Yıldız, İsmail; Sakar, Mehmet NafiThis study aimed to determine the outcomes of combined treatment of letrozole (LTZ) with recombinant follicle -stimulating hormone (rFSH) in comparison with rFSH alone in intrauterine insemination (IUI) cycles.This study consisted of 86 patients who experienced 106 IUI cycle s. Patients were classified into two treatment groups:group I underwent a combination of LTZ plus rFSH, and group II received rFSH alone. Ovulation was triggered withhuman chorionic gonadotropin (hCG), and IUI performed 36 hours later. The number of follicles ?18 mm, endometrialthickness, required dose of FSH, duration of ovulation induction (OI), clinical pregnancy rates, multiple pregnancy rates,spontaneous abortion rates, and live birth rates were evaluated.The total required rFSH dose during the OI was significantly lower in the LTZ-rFSH combination group than the rFSHalone group (401.2±177.1 IU and 770.1±345.8 IU, respectively, p<0.001). The days of stimulation with rFSH were alsolower in the LTZ co-treatment group than the rFSH-alone group (5.2±1.3 days and 10.1±3.0 days, respectively, p<0.001).Clinical pregnancy rate was 17.0% in LTZ-rFSH group, and 15.2% in rFSH group (p>0.05).The combined use of LTZ with rFSH resulted in a lower required dose of rFSH, a similar and ac ceptable endometrialthickness at the day of hCG administration, and comparable pregnancy rate compared with rFSH aloneÖğe Differential Diagnosis of Amniotic Band and Intrauterine Synechiae in Second Trimester Pregnancy: Case Report(2020) Kahveci, Gaye; Doğan, Yasemin Pekin; Bademkıran, Muhammet Hanifi; Kahveci, BekirAmniotic band sequence describes highly variable spectrum of congenital anomalies that occur in as-sociation with amniotic bands. İntrauterine synechiae is a condition in which scar tissue develops within the uterine cavity. We aim to present a case of amniotic band sequence and a case of intrauterine synechiae and compare their ultrasonographic findings. Ultrasonography revealed contraction ring in the right groin area of the first fetus but second fetus was healthy. The diagnosis of amniotic band sequence is based upon the presence of characteristic structural findings on prenatal ultrasound or postnatal phys-ical examination. The diagnosis of intrauterine adhesions is based upon visualization of intrauterine ad-hesions either directly by hysteroscopy or indirectly by other imaging studies. The floor of the intrauter-ine adhesions is widely and lateral of the uterine cavity and occurs from four layers while the amniotic band is a thin layer and forms fluctuations in the amniotic fluid. Amniotic bands may cause variable spec-trum of congenital anomalies whereas intrauterine adhesions do not increase the probability of fetal anomaly because it is out of the amniotic cavity.Öğe Diyarbakır ilindeki gebe kadınlarda Toksoplazma, Rubella ve Sitomegalovirus seroprevalansı(Dicle Üniversitesi Tıp Fakültesi, 2019) Obut, Mehmet; Doğan, Yasemin; Bademkıran, Muhammed Hanifi; Akgöl, Sedat; Kahveci, Bekir; Peker, Nurullah; Uzundere, Osman; Kaçar, Cem Kıvılcım; Özbek, Erdal; Gül, TalipAmaç: Bu çalışmada; gebelerde, Toxoplasma gondii, Rubella virüs ve Cytomegalovirus infeksiyonlarının bölgemizdeki seroprevalanslarının belirlemesi amaçlanmıştır. Yöntemler: Bu çalışmada hastanemize Eylül 2016 ile Haziran 2018 tarihleri arasında kadın hastalıkları ve doğum polikliniklerine ilk prenatal vizite gelen 18-45 yaş arası gebeler dahil edildi. Bu hastalardan Toxoplasma gondii, Rubella ve Cytomegalovirus virüs serolojisi çalışılanların test sonuçları retrospektif olarak incelendi. Bulgular: Toxoplasma gondii antikorları açısından 8175 hastanın 2853’ inde (%34,9) anti toksoplazma gondii IgG antikorları, 91’ inde (%1,1) anti Toxoplasma gondii IgM antikorları pozitif olarak saptandı. Cytomegalovirus antikorları açısından 2797 hastanın 2775’ inde (%99,2) anti Cytomegalovirus IgG, 20’ sinde (%0,7) anti Cytomegalovirus IgM pozitif olarak saptandı. Rubella virüs antikorları açısından 8158 hastanın 7677’ sinde (%94,1) anti Rubellavirus IgG, 5’ inde (%0,1) anti Rubellavirus IgM pozitif olarak saptandı. Sonuç: Bu çalışmada hastanemize başvuran gebelerin çoğunun toksoplazma seronegatif (%65,1) olduğu tespit edildi. Rubella seroprevalansı (%94,1) Türkiye verileri ile uyumludur. Gebelerin Cytomegalovirus seroprevalansı için seropozitiflik oranı (%99,2) dünya verileri ile uyumludur.Öğe Evaluation and Management of Patients with Hematoma After Gynecologic and Obstetric Surgery(2021) Uzundere, Osman; Ege, Serhat; Kahveci, Bekir; Budak, Mehmet Sukru; Kahveci, Gaye; Peker, Nurullah; Sucu, MeteOBJECTIVE: Postoperative hematoma following abdominal surgery is relatively rare and mainly depends on the type of surgery. Specific treatment including surgery or interventional radiology is sometimes necessary. The aim of this study is to evaluate the cases of postoperative hematoma after gynecologic and obstetric surgery.STUDY DESIGN: This is a retrospective cohort study of 30 patients with hematoma developed after gynecologic and obstetric surgery. We included the patients who hospitalized with the diagnosis of a postoperative hematoma between June 2017 and April 2019 at Gazi Yasargil Training and ResearchHospital of Health Sciences University. Hematomas occurring after endoscopic surgery and episiotomywere not included. The diagnosed cases were divided into three groups as wound hematoma, rectussheath hematoma and intra-abdominal hematoma (intraperitoneal and retroperitoneal). All cases wereassessed by patient demographics and clinical findings, hematoma of characteristics, treatment methods and results.RESULTS: A total of 30 patients were included in the study with a mean age of 33.0±8.6 years.Incidence of hematoma account for 0.2%. The mean c-reactive protein was 37.9±47.4 mg/dL at admission and 14.6±25.8 mg/dL at discharge, respectively. The decrease was statistically significant (p <0.001). The mean hemoglobin was 10.6±2.1 g/dL at admission and 10.7±1.5 g/dL at discharge. Feverwas detected in 7 (23.3%) patients. Only 12 patients (40%) were followed up by observation and symptom management. In 10 (33.3%) patients, antibiotics were included in the treatment due to infection. Inaddition, 4 patients (13.3%) had relaparotomy, 5 patients (16.7%) underwent percutaneous radiologicaldrainage and 8 (26.7%) received blood transfusion. The mean time of resorption of the hematoma was4.6 ± 2.0 days. The evaluation of the hematoma locations revealed that 14 patients (46.7%) had woundhematoma, 7 patients (23.3%) had rectus sheath hematoma (Type I: 2 cases, type II: 3 cases, type III:2 cases), 8 patients (26.7%) had pelvic hematoma and 2 patients (6.7%) had a retroperitonealhematoma. The mean hematoma size was 68.1±15.18 mm.CONCLUSIONS: In cases of hematoma resistant to antibiotic treatment and non-resorbable hematoma,we can consider percutaneous catheter drainage as an alternative to surgical interventionÖğe Evaluation of catalase, myeloperoxidase and ferroxidase values in pregnant women with hyperemesis gravidarum(Via Medica, 2019) Ege, Serhat; Bademkıran, Muhammed Hanifi; Peker, Nurullah; Erdem, Selami; Bağlı, İhsan; Köçeroǧlu, Ruşen; Kahveci, Bekir; Yıldızhan, Recep; Erel, Özcan; Araç, EşrefObjectives: To investigate maternal serum catalase, myeloperoxidase and ferroxidase levels in pregnant women with Hyperemesis Gravidarum and to compare the results with healthy pregnancies. Material and methods: In this study, 60 female patients admitted to the Health Sciences University, Gazi Yasargil Training and Research Hospital, Gynecology and Obstetrics Department were evaluated. The patients were divided into two groups: Group 1 included 30 pregnant women with hyperemesis gravidarum; Group 2 included 30 healthy pregnant women. Pregnancies over 14 weeks were excluded from the study. Results: The laboratory and laboratory characteristics of both groups are shown in Table 1. No significant differences were found between the groups in terms of the maternal age, gestational age, gravidity, parity, fasting glucose level, and BMI. The maternal blood CAT levels were significantly higher in the HG group (219.6 ± 111.3 kU/L) when compared to the control group (71.5 ± 52.5 kU/L) (p < 0.001). The maternal blood MPO levels were lower in the control group (121.5 ± 36.3 U/L) than in the study group (90.9 ± 56.4 U/L) (p = 0.016). However, the ferroxidase levels were similar between the two groups. The independent variables BMI, age, parity, gravidity and gestational week effects were adjusted according to the logistic regression method with groups. Significant differences were observed between the two groups in the levels of CAT (0.001), MPO (0.005) values. Conclusions: This study suggests that antioxidants in response to oxidative stress gave different reactions with different mechanisms; Also, we believe that insufficient food intake suppresses the immune system and this has an important role on antioxidants.Öğe Evaluation of Prevalence and Risk Factors for Postpartum Depression Using the Edinburgh Postpartum Depression Scale: A Cross-Sectional Analytic Study(2021) Kahveci, Gaye; Kahveci, Bekir; Bucaktepe, Pakize Gamze ErtenOBJECTIVE: To evaluate the prevalence and associated risk factors for postpartum depression using the Edinburgh Postpartum Depression Scale. STUDY DESIGN: The population of this cross-sectional analytic study consisted of 311 women who were admitted to our hospital at 4-6 weeks after birth. The data were collected between April-June 2018 by applying a sociodemographic data form consisting of 44 questions and the Edinburgh Postpartum Depression Scale consisting of 10 questions. We used the Edinburgh Postpartum Depression Scale in the postpartum period to divide parturients into those with (n=47) and without (n=264) postpartum depression using a cut-off score of ? 13. The primary outcome is the prevalence of postpartum depression, while the secondary outcomes are associated-risk factors. RESULTS: The postpartum depression prevalence was 15.1% (n=47). In the postpartum depression group, the difference was highly significant in terms of abortion, antenatal depression, inadequate care for the baby, and health problem in the newborn ?0.6±0.9 vs. 0.2±0.6, 13 (37.1%) vs. 27 (10.5%), 9 (56.3%) vs. 38 (12.9%), 12 (36.4%) vs. 35 (12.6%), respectively? (p<0.001). The Logistic regression analysis revealed that abortion by 1.64 fold (1.13-2.37% at 95% CI), antenatal depression by 5.04 fold (2.38-10.68% at 95% CI), inadequate baby care by 6.28 fold (1.89-20.86% at 95% CI), and health problem in the newborn by 3.59 fold (1.43-8.99% at 95% CI) increased postpartum depression. CONCLUSION: postpartum depression is a health problem that can affect primarily mother and child. Therefore, it is important to determine highly predictable risk factors using a scale (e.g. Edinburgh Postpartum Depression Scale) for early diagnosis and timely treatment of symptoms.Öğe Mevsimsel Sıcaklık Değişikliklerinin Gestasyonel Diabetes Mellitus Prevalansı Üzerine Etkisi(2021) Obut, Mehmet; Kahramanoğlu, Özge; Budak, Mehmet Sukru; Andan, Cengiz; Akgöl, Sedat; Kahveci, Bekir; Kahramanoğlu, İlkerAmaç: Bu çalışmada, ortam sıcaklığındaki mevsimsel değişikliklerin gestasyonel diabetes mellitus (GDM) prevalansı üzerine etkisinin araştırılmasıamaçlanmıştır.Gereç ve Yöntem: Ocak 2017-Aralık 2017 tarihleri arasında, yazları sıcak ve kurak, kışın soğuk ve yağışlı bir şehir olan Diyarbakır’da Sağlık BilimleriÜniversitesi, Gazi Yaşargil Eğitim ve Araştırma Hastanesi’nde GDM taraması yapılan 24.-28. haftalarında olan gebelerin sonuçları retrospektif olarak değerlendirildi. GDM taraması yapılan hamile kadınlar mevsimlere göre dört gruba ayrıldı. Farklı mevsimlerde GDM tanısı konulan gebelerde GDM prevalansı açısından bir karşılaştırma yapıldı.Bulgular: Taranan 3.618 gebe arasından %7,5’i (n=272) GDM tanısı aldı. GDM olgularının mevsimsel dağılımı kışın %6,4 (n=54), ilkbaharda %8,3 (n=78), yaz aylarında %9,2 (n=84) ve sonbaharda %6,1 (n=56) olmuştur. Mevsimsel dağılım açısından anlamlı bir fark gözlendi (p<0,05).Sonuç: Bu çalışmanın sonuçları, mevsimsel sıcaklık değişimlerinin GDM prevalansı üzerinde anlamlı bir etkisi olduğunu göstermiştir. Ancak, bu ilişkiyi daha iyi göstermek için daha fazla çalışmaya ihtiyaç vardırÖğe Ovarian Hyperstimulation Syndrome Continuing with Very High C Reactivity Protein Level without Infection: A Case Report and Review of the Literature(2020) Vardar, Mehmet; Kahveci, Bekir; Budak, Mehmet SukruOvarian hyperstimulation syndrome is an iatrogenic complication of supraphysiologic ovarian stimulation. The syndrome is al-most exclusively associated with exogenous gonadotropin stimulation and is only rarely observed after clomiphene citrate treatment or spon-taneous ovulation. C-reactive protein, an acute phase protein produced by the hepatocytes, is a marker of systemic inflammation, tissue damage, and/or infection. While the increased C-reactive protein level in the ovarian hyperstimulation syndrome made us think that there is an infection, for making this diagnosis, other infection indicators must be researched on these patients. Although the use of C-reactive pro-tein for infection in ovarian hyperstimulation syndrome is recommended, the level of C-reactive protein may increase without infection. We aimed to identify ovarian hyperstimulation syndrome with very high C-reactive protein level without infection.Öğe PALM-COEIN classification system of FIGO vs the classic terminology in patients with abnormal uterine bleeding(Via Medica, 2021) Kahveci, Bekir; Budak, Mehmet Şükrü; Ege, Serhat; Obut, Mehmet; Bağlı, İhsan; Oğlak, Süleyman Cemil; Vardar, Mehmet AliObjectives: To evaluate the FIGO's novel classification system versus the classic terminology in patients with abnormal uterine bleeding. Material and methods: A retrospective study was carried out between August 2015 and September 2019 in the Health Sciences University Gazi Yasargil Training and Research Hospital. The pathology reports of the patients were classified according to the PALM-COEIN method and were compared with classical terminology. The operated patients with fibroids reported in the pathology results were classified as subgroups of fibroids. Results: Evaluation was made of a total of 515 women with abnormal uterine bleeding. According to the classical terminology, 137 (26.6%) patients were defined with hypermenorrhea, 74 (14.4%) with menorrhagia, 57 (11.1%) with metrorrhagia, and 246 (47.8%) with menometrorrhagia. In the PALM-COEIN classification system, polyps were determined in 84 (16.3%) cases, adenomyosis in 228 [diffuse adenomyosis:196 (38.1%), local adenomyosis:32 (6.2%)], leiomyoma in 386 [submucous:161 (31.1%), other types: 225 (43.9%)], and malignancy and hyperplasia in 47 (9.1%). Conclusions: The classical terminology for abnormal uterine bleeding is insufficient in terms of etiological pathologies in non-pregnant women of reproductive age. The widespread use of this novel system for the abnormal uterine bleeding classification will provide a more useful communication between physicians and researchers.Öğe Unscarred uterine rupture and subsequent pregnancy outcome-a tertiary centre experience(Via Medica, 2020) Peker, Nurullah; Aydın, Edip; Evsen, Mehmet Sıddık; Hançer, Fatma Nur; Bademkıran, Muhammed Hanifi; Ege, Serhat; Kahveci, Bekir; Karaçor, Talip; Gül, TalipObjectives: The aim of this study was to investigate the incidence, etiology and obstetric outcomes of rupture in unscarred uterine rupture and in those with a history of uterine rupture Material and methods: The hospital records of women who had delivered between May 2005 and May 2017 at a tertiary center were examined retrospectively. Data on patients with unscarred uterine rupture in pregnancy who had undergone fertility-preserving surgery were evaluated. Results: During the study period, 185,609 deliveries occurred. Of those, unscarred uterine rupture has occurred in 67 women. There were no ruptures reported in nulliparous women. The rupture was observed in the isthmic region in 60 (89.6%) patients and in the fundus in 7 (10.4%) patients. Thirty-eight (56.7%) patients had undergone a total or subtotal hysterectomy, and 29 (43.3%) patients had received primary repair. Ten patients had reconceived after the repair. Of these, eight patients who had a history of isthmic rupture, successfully delivered by elective C-section at 36-37 wk. of gestation, and two experienced recurrent rupture at 33 and 34 wk. of gestation, respectively. Both patients had a history of fundal rupture, and their inter-pregnancy interval was 9 and 11 mo., respectively. Conclusions: The incidence of rupture in unscarred pregnant uteri was found to be one per 2,770 deliveries. Owing to the high morbidity, regarding more than half of the cases with rupture eventuated in hysterectomy, clinicians should be prudent in induction of labour for multiparous women since it was the main cause of rupture in this series. Short inter-pregnancy intervals and history of fundal rupture may confer a risk for rupture recurrence. Those risk factors for recurrence should be validated in another studies.
