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Öğe Comparison of serum and salivary alpha-fetoprotein levels in pregnancies complicated with neural tube defects(Yerküre Tanıtım & Yayıncılık Hizmetleri A.Ş., 2020) Karaçor, Talip; Bülbül, Mehmet; Nacar, Mehmet Can; Kırıcı, Pınar; Önderci, Muhittin; Peker, Nurullah; Sak, SibelObjective: To compare the serum and salivary values of alpha-fetoprotein (AFP) used in screening neural tube defects (NTD) during pregnancy. To investigate whether saliva can be used instead of serum in NTD screening. Method: The study was conducted between May 2018 - November 2019 at Adıyaman University. The study included 41 pregnant women complicated by NTD and 44 healthy pregnant women. Three ml venous blood and 2 ml saliva samples were taken from both groups. Serum and saliva samples were not diluted. AFP concentration was measured at 450 nm by using commercially available enzyme-linked immunoassay. The intra‐ , and inter- test assay coefficients (CVs) of the kit were <8% and <10%, respectively. SPSS 21 program was used for data analysis. Mann-Whitney Test was used for the analysis of continuously changing parameters. The correlation coefficient was calculated by Spearman test. A p value of less than 0.05 was accepted for statistical significance. Results: When serum and salivary AFP values were compared between the two groups, the AFP values were found to be higher in both NTD group samples (p<0.001, p<0.001). In both groups, correlation analysis for serum and salivary AFP values showed a strong positive correlation (r=0.730, p<0.001). When the cut-off value for serum AFP is taken as 0.26, NTD can be determined with 100% sensitivity and 90% specificity (AUC: 0.932, p<0.001). When the cut-off value for salivary AFP is taken as 0.034, it can detect NTD with 95% sensitivity and 92% specificity (AUC: 1.00, p<0.001). Conclusion: Salivary and serum AFP values showed strong positive correlation between themselves. We believe that saliva can be used in NTD screening performed by AFP measurement.Öğe The effect of surgical procedure on surgical outcomes in patients undergoing emergency peripartum hysterectomy: a retrospective(Taylor & Francis, 2021) Bülbül, Mehmet; Karaçor, Talip; Peker, Nurullah; Nacar, Mehmet Can; Okutucu, GülcanObjective To investigate the effect of surgical procedure on the operation's results in patients undergoing emergency peripartum hysterectomy (EPH). Methods The records of patients who underwent EPH due to postpartum hemorrhage between 2010 and 2020 in two tertiary centers with a high crude delivery rate were retrospectively analyzed. Surgical data were compared according to the EPH type. Results During the study period, 115,709 births occurred in these two centers. EPH was administered for 181 (1.6%) of these patients. Sixty-seven (37%) of the EPH cases involved subtotal EPH (SEPH), and 114 (63%) were total EPH (TEPH). Surgical time (107.3 +/- 17.6 vs. 134.2 +/- 32.3 min, p < 0.001), erythrocyte transfusion count (2.6 +/- 1.3 vs. 4.3 +/- 6.2, p < 0.001), ureter injury (0.0 vs. 7.9%), bladder injury (1.5 vs. 28.1%), disseminated intravascular coagulation (1.5 vs. 9.6%), need for relaparotomy (4.5 vs. 14%), and intensive care unit admission (19.4 vs. 52.6%) were found to be higher in the TEPH group compared to the SEPH group (p < 0.05). In addition, the total length of hospitalization was longer in the TEPH group (4.5 +/- 2.3 vs. 6.1 +/- 4.6 day, p = 0.011). Conclusion According to the results, if the bleeding in peripartum hemorrhage requiring EPH can be controlled with SEPH, attempting to remove the cervix completely may be associated with increased surgical time, blood transfusion need, and surgical complications.Öğe The effect of vaginal bleeding and non-spesific pelvic pain on pregnancy outcomes in subchorionichematomas cases(Via Medica, 2019) Karaçor, Talip; Bülbül, Mehmet; Nacar, Mehmet Can; Kırıcı, Pınar; Peker, Nurullah; Ağaçayak, Elifbjectives: To determine the clinical differences and factors affecting early pregnancy outcome in the first and early second trimester subchorionic hematoma cases. Material and methods: This study involved with the retrospective analysis and evaluation of 81 cases diagnosed with subchorionic hematoma. The patients were grouped according to the gestational periods, symptoms at the time of admission, ratio of surrounding hematoma to the gestational sac, and whether there was a pregnancy loss. The groups were compared according to the clinical features and pregnancy outcomes. Results: The ratio of surrounding hematoma to the gestational sac in the group with pregnancy loss was significantly higher (p = 0.002). When the cut-off value was 35.5%, it could determine the possibility of a complication in pregnancy with 70% sensitivity and 75% specificity. Nonspecific pelvic pain were significantly higher in the pregnancy loss group than in the other group. Logistic regression analysis was performed to determine the effect of these two parameters on the pregnancy outcome. Although the presence of non-specific pelvic pain is more in the group with pregnancy loss; there was no effect of on pregnancy outcome (p = 0.141). The risk of pregnancy loss increased 4.5 fold if the ratio of ScH to gestational sac was above 35% (p = 0.027). Conclusions: In the cases of subchorionic hematoma, we concluded that when the ratio of surrounding hematoma to the gestational sac increased and when it was accompanied by nonspecific pelvic pain, the hospitalization period of the patients increased and the ratio of pregnancy loss was higher.Öğe Evaluation of specific heavy metal levels of pregnant women complicated by neural tube defects(İnönü Üniversitesi Tıp Fakültesi, 2020) Karaçor, Talip; Kırıcı, Pınar; Nacar, Mehmet Can; Bülbül, Mehmet; Önderci, Muhittin; Peker, NurullahAim: The etiology of neural tube defect (NTD) is still not clear enough. In our study, we aimed to evaluate plasma heavy metal levels of pregnant women with NTD and to determine whether there is a relationship between heavy metal levels and NTD severity. Material and Methods: TThis study was conducted in Adıyaman University, Department of Gynaecology and Obstetrics. The study included 38 pregnant women with NTD and 42 pregnant women with healthy infants. Pregnant women who have NTD were divided into two groups as NTD Type 1 and NTD Type 2 according to the anomaly type. Levels of heavy metals such as Mercury (Hg), Cadmium (Cd), Cobalt (Co), Lead (Pb), Manganese (Mn) and Arsenic (As) were compared between groups. Results: Plasma Hg, Co, Cd and Pb levels were higher in NTD group than control group. (p values, respectively; p <0.001, p = 0.001, p <0.001, p <0.001). As and Mn levels were not statistically different between the two groups (p values; p = .519, p = .819, respectively). In the NTD group, Hg was found to be higher in NTD Type 1 than NTD Type 2 (p <0.001). Conclusion: It is obvious that some histomorphological changes are formed in the cardinal ligaments of patients with uterine prolapse due to pressure on the uterus. We believe that the increase in the number of extravasated erythrocytes and the thickness of the vascular wall and peripheral nerve should be supported by further studies.
