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Öğe Bilateral hypogastric artery ligation: A tertiary center experience(Harran Üniversitesi Tıp Fakültesi, 2019) Peker, Nurullah; Yavuz, Mustafa; Aydın, Edip; Ege, Serhat; Bademkıran, Muhammet Hanifi; Turan, Gökçe; Karaçor, Talip; Gül, TalipBackground: The aim of this study was to evaluate the obstetric characteristics and maternal outcomes of patients undergoing bilateral hypogastric artery ligation (BHGAL) for primary postpartum hemorrhage (PPH). Materials and Methods: Digital records and hospital archives of patients who underwent BHGAL in the postpartum period after vaginal delivery (VD) or during or after cesarean section (C/S) in a tertiary center between May 2005 and May 2018 were reviewed retrospectively. Demographic characteristics, parity, gestational week, duration of operation, hospitalisation time, estimated blood loss, laboratory values, transfused blood volume, previous C/S history, and intensive care requirement of the patients were evaluated. The efficacy of BHGAL in controlling bleeding, indications, concomitant surgeries, and intraoperative and postoperative complications were evaluated. Results: There were 276.008 deliveries in our hospital in the specified period. Of the patients with PPH, 41 patients underwent BHGAL after VD and 19 patients underwent BHGAL during or after C/S. In 25 of 28 patients with PPH due to atony, bleeding was controlled by BHGAL, while 3 patients underwent hysterectomy together with BHGAL. While the effectiveness of BHGAL in uterine atony was 89.2%, the success rate was 33.3% when all cases were considered. The most common cause of indication for BHGAL was atony and disseminated intravascular coagulation (DIC) was the most common complication in patients undergoing BHGAL. Iliac vein injury was detected in one patient due to the procedure itself. Conclusions: BHGAL is more effective on controlling PPH due to atony compared to the control of other PPH causes. Most of the complications in these patients are not related to the procedure but are due to the complications of PPH. Therefore, BHGAL continues to be a life-saving method when applied by centers with adequate surgical knowledge and equipment.Öğe Effects of cerclage suture type on pregnancy and neonatal results: Mersilene suture & prolene suture(İnönü Üniversitesi Tıp Fakültesi, 2022) Değer, Uğur; Çavuş, Yunus; Turan, Gökçe; Peker, NurullahAim: The aim of this study is to compare pregnancy and neonatal results with regards to the thickness of the suture material used in the transvaginal cerclage operation. Materials and Methods: Patients who were subject to transvaginal cervical cerclage due to cervical insufficiency were evaluated in a secondary care center between 2103 and 2021 retrospectively. The demographic data, cerclage indications (ultrasound induced, prophylactic, or physical examination induced), number of pregnancy weeks at cerclage, type of cerclage suture (prolene, mersilene), type of cerclage (McDonald, Shirodkar), total pregnancy weeks, delivery method (cesarean (C/S), normal spontaneous vaginal delivery) of each patient were recorded. Additionally, birth weight, 1st and 5th minute APGAR scores, and neonatal intensive care unit (NICU) requirements were recorded as neonatal parameters. Patients were divided into two groups with regard to the type of cerclage suture (mersilene or prolene) and maternal, neonatal and pregnancy results were compared between these groups. Results: The study included 151 patients in total. Prolene sutures were used for 69 of the patients (45.7%) and mersilene sutures for 82 patients (54.3%) Cerclage was applied for 18 patients (11.9%) depending on the ultrasound findings, 121 patients (80.1%) depending on emergency and 12 patients (7.9%) depending on history. Gravida increased significantly in the prolene suture group (p=0.021). Pregnancy week was found to be significantly lower in the mersilene suture group [32.5 w (15-40)] compared to the prolene suture group [37.0 w (15-41)] [37.0 w (15-41)](p<0.001). Ratios of birthing below 34 weeks and 37 weeks for the mersilene suture group were found as 57.3% and 80.5%, and for the prolene suture group 11.6% and 40.6% respectively, and a statistically significant difference was observed (p<0.001). Fetal weight, 1st and 5th minute APGAR scores in the mersilene suture group were significantly lower (p<0.05). Ratios of newborn intensive care requirements and preterm premature rupture of membranes (PPROM) in the mersilene suture group were found to be significantly higher compared to the prolene suture group (p=0.016, p<0.001 respectively). Conclusion: Although mersilene suture is more preferred, its supply is not always possible in emergency situations. Therefore, the prolene suture should be kept in mind as an even stronger cerclage suture option.Öğe Evaluation of the effect of Birth Preparation Program on birth satisfaction with "Salmon's Item List" scale(Via Medica, 2021) Turan, Gökçe; Peker, Nurullah; Bağlı, İhsanObjectives: The aim of this study is to investigate the effects of a birth preparation program on birth satisfaction. Material and methods: This cross-sectional study was conducted with patients who applied to our hospital between January 2018 and January 2019. A total of 164 pregnant women (Study Group) who applied for the birth preparation program and completed all training in our hospital and 152 pregnant women who did not apply for the birth preparation program and who did not know about such training (Control Group) were included in the study. Demographical data and obstetric parameters of the groups were recorded. All patients were evaluated with the Visual Analog Scale and Salmon's Item List scale 48 hours after the delivery. The scores of both groups were compared. Results: There were no significant differences between the groups in terms of age, gravida, parity, gestational week of birth, the birth weight of infants, and 5th-minute APGAR scores. It was found that the Visual Analog Scale scores of the Control Group were significantly higher than in the Study Group. The Salmon's Item List scores of the Study Group were significantly higher than those of the patients in the Control Group (< 0.01). Conclusions: The birth preparation program increases satisfaction during labor and decreases the traumas that may occur in the following births and increase comfort in the postpartum period. For this reason, such programs must be applied commonly to ensure that women can face both the birth and postpartum processes comfortably.Öğe Gebelikteki çinko eksikliği ile kötü obstetrik sonuçlar arasında bir bağlantı var mı?(T.C. Sağlık Bakanlığı Ankara Şehir Hastanesi, 2022) Değer, Uğur; Turan, Gökçe; Peker, NurullahAmaç: Bu çalışmanın amacı gebelikteki çinko eksikliğinin maternal ve fetal sonuçları üzerindeki etkisini araştırmaktır. Yöntem: Bu çalışma Ocak 2020 ile Aralık 2020 tarihleri arasında ikinci basamak bir hastanede yapıldı. Tüm hastaların demografik verileri, doğum sırasındaki çinko, hemoglobin (Hb), hematokrit (Hct) düzeyleri, oligohidramnios, preterm doğum, preeklampsi, preterm prematür membran rüptürü (PPROM), intrauterin gelişme geriliği (IUGR) gibi kötü gebelik sonuçları kaydedildi. Maternal serum çinko değeriÖğe Tubal ektopik gebelik tanısında tam kan sayımı parametrelerinin değerlendirilmesi(Harran Üniversitesi Tıp Fakültesi, 2020) Turan, Gökçe; Çetin, Berna Aslan; Demirezen, Gözde; Peker, NurullahAmaç: Bu çalışmadaki amaç ektopik gebeliği (EG) olan hastalar ile sağlıklı intrauterin gebeliği olan hastaların hemogramparametrelerini karşılaştırmaktır.Materyal ve Metod: Ocak 2013 ile Ocak 2017 tarihleri arasında tersiyer bir merkezde tubal EG tanısı konan hastalar ileilk trimester intrauterin gebeliği olan hastaların demografik verileri ve tam kan sayımındaki beyaz küre (WBC),hemoglobin (Hgb), hematokrit (Hct), nötrofil, lenfosit, platelet (PLT), ortalama platelet hacmi (MPV), nötrofil-lenfosit oranı(NLO) ve platelet-lenfosit oranı (PLO) karşılaştırıldı.Bulgular: EG’i olan 718 hasta ile sağlıklı intrauterin gebeliği olan 937 hasta çalışmaya dahil edildi. Yaş, gravida, pariteve abortus EG grubunda (çalışma grubu) anlamlı olarak daha yüksek izlenirken (p<0,001), gestasyonel hafta ise kontrolgrubunda anlamlı olarak yüksek bulundu (p<0,001). Hgb, Hct ve MPV değerleri kontrol grubunda anlamlı olarak yüksekizlenirken (p<0,001), WBC, PLT, NLO ve PLO değerleri karşılaştırıldığında iki grup arasında anlamlı fark izlenmedi.Sonuç: Sonuç olarak EG’i öngörmede hemogram parametrelerinden sadece MPV değeri anlamlı bulundu. Bu çalışmadaNLO ve PLO değerleri EG tanısında anlamlı bulunmadı. EG tanı ve tedavi protokollerinde hemogram, NLO ve PLOdeğerleri daha olası ilişkileri araştırmak için daha geniş hasta gruplarının inceleneceği prospektif çalışmalara ihtiyaç vardır.
