The effects of threatened abortions on pregnancy outcomes

Objectives: The effects of first trimester threatened abortions on prenatal and postnatal pregnancy outcomes.  Material and methods: Data from 24.835 pregnant women were retrospectively analysed. The pregnant women were divided into two groups according to whether they had a first trimester threatened abortion or not. The demographic data and prenatal, postnatal and labour outcomes were compared for the two groups. Those cases with miscarriages during their follow-up, pregnant women with systemic diseases, multiple pregnancies and patients who were diagnosed with cervical erosion and cervical polypoid formation during vaginal bleeding examinations were all excluded.  Results: The age (p < 0.001), ART pregnancy rate (p = 0.03) and nulliparity rate (p = 0.013) in those with the risk of miscar- riage were statistically significantly higher than those without the risk. The gestational weeks (p < 0.001) and birth weights (p < 0.001) were significantly lower for the miscarriage group than in the control group. Hyperemesis gravidarum (p < 0.001), gestational diabetes mellitus (GDM) (p < 0.001) and placenta previa (p = 0.018) rates were statistically significantly and more frequent in the pregnancies with the threatened abortion group than in the control group. The rates of caesarean delivery were statistically significantly higher in the threatened abortion group (p < 0.001).  Conclusions: Threatened abortion between 6- and 14-weeks gestational age is a complication that may cause anxiety in the early weeks of pregnancy. But the treatment, follow-up and cause of threatened abortion all remain unclear.

The prognostic significance of serum CA125 levels with ER, PR, P53 and Ki-67 expression in endometrial carcinomas

Objectives: The present study evaluates the relationship between the expression levels of hormone receptors (HRs), Ki-67, p53 and serum cancer antigen 125 (CA125) levels in endometrial cancer and clinicopathological risk factors, and determines their prognostic values. Material and methods: This retrospective study included 49 patients with endometrial cancer whose estrogen receptor (ER) and progesterone receptor (PR) Ki-67 and p53 expression levels were determined through immunohistochemical methods, and whose preoperative serum CA125 levels were measured. These factors relationship with various clinicopathological factors, progression-free survival (PFS) and overall survival (OS) was investigated. Results: The study included 49 patients with EC with a mean age of 61 ± 10 years. The rate of HR positivity was significantly higher in the endometrioid histology group than in the non-endometroid histology group (p = 0.026). A high level of Ki- 67 expression was found to be associated with a non-endometroid histology (p = 0.016), and a high tumor grade (p < 0.001) and a high p53 expression were found to be associated with advanced disease stage (p = 0.026). A positive correlation was found between p53 and Ki-67, a negative correlation was found between p53 and Ki-67 and the presence of HR. Significant relationship was not found between HR status, p53, Ki-67, CA125 and either other clinicopathological risk factors or survival. Conclusions: While HR positivity indicates favorable clinicopathological prognostic factors, high Ki-67 and high p53 expression indicate unfavorable ones. However, no direct effect of these factors on prognosis was found in this study

Isolated pulmonary metastases in patients with cervical cancer and the factors affecting survival after recurrence

Objectives: The aim of this study was to assess the treatment options and survival of uterine cervical cancer (UCC) patients who develop isolated pulmonary metastases (IPM) and to establish risk factors for IPM.Material and Methods: Data from patients diagnosed with UCC between June 1991 and January 2017 at the Gynecological Oncology Department, Tepecik Training and Research Hospital, were investigated. In total, 43 cases with IPM were evaluated retrospectively. Additionally, 172 control patients diagnosed with UCC without recurrence were matched according to the International Federation of Gynecology and Obstetrics (FIGO) 2009 stage when the tumor was diagnosed. They wereselected using a dependent random sampling method.Results: Of the 890 patients with UCC, 43 (4.8%) had IPM. The presence of lymphovascular space invasion (LVSI) anda mid-corpuscular volume (MCV) < 80 fL were statistically significant prognostic factors for IPM development in UCC patientsaccording to univariate regression analyses, and the presence of LVSI, a hemoglobin level < 12 g/dL, and an MCV < 80 fLwere statistically significant according to the multivariate regression analyses. We were unable to assess the role of lymph node status (involvement or reactive) as a prognostic factor in the development of IPM, because only seven patients (16.2%) in the case group underwent lymph node dissection.Conclusions: IPM typically develops within the first 3 years after the diagnosis of UCC, and survival is generally poor. AnMCV < 80 fL and the presence of LVSI are significant risk factors for IPM development

Development and management of ovarian hyperstimulation syndrome in spontaneous singleton pregnancy

Ovarian hyperstimulation syndrome (OHSS) is one of the most life-threatening complications of ovulation induction. However, rarely, OHSS can develop spontaneously during pregnancy without induction of ovulation. It has been shown in the literature that some diseases such as polycystic ovary syndrome (PCOS), hypothyroidism, and pituitary adenoma may accompany spontaneous OHSS. Spontaneous OHSS should be included in the differential diagnosis in first-trimester pregnancies with nausea, vomiting, and acute abdomen. The focus should be on preventing possible complications and initiating early treatment immediately after diagnosis

Stage IB1 cervical cancer treated with modified radical or radical hysterectomy: does size determine risk factors?

Objectives: This study was performed to investigate prognostic factors status at smaller tumors in patients with stageIB1 cervical cancer (CC) who underwent modified radical or radical hysterectomy.Matherial and metods: Data from patients diagnosed with CC between January 1995 and January 2017 at the GynecologicalOncology Department, Tepecik Training and Research Hospital and Bakirkoy Dr. Sadi Konuk Training and Research Hospital,Istanbul, Turkey, were investigated. A total of 182 stage IB1 CC cases were evaluated retrospectively.Results: Patients were divided into two groups according to tumor size (< 2 cm and ≥ 2 cm). There were no complicationsassociated with the operation in patients with a tumor size < 2 cm. Among patients with a tumor size ≥ 2 cm, however, 0.9% (n = 1) developed bladder laceration, 0.9% (n = 1) rectum laceration, and 0.9% (n = 1) pulmonary emboli (P = 0.583). The rates of intermediate risk factors (depth of stromal invasion and lymphovascular space invasion) were significantly higher and lymph node involvement significantly more frequent in patients with a tumor size ≥ 2 cm. However, there were no significant differences in parametrial invasion or vaginal margin involvement between the two groups.Conclusions: Intermediate risk factors and lymph node metastasis were significantly less frequent in patients with smalltumors measuring < 2 cm. However, although parametrial involvement and vaginal margin involvement were less common in patients with small tumors compared with large tumors (≥ 2 cm), the differences were not significant

Intra-operative diagnosis of an adult ureterocele complicated by hydronephrosis: a case report

Ureterocele is a cystic dilatation of the terminal ureter. Hydronephrosis is less commonly reported in individuals with ureterocele. We report a unique case of an incidental ureterocele with hydronephrosis in a 47-year-old woman; diagnosed with intraoperative control cystoscopy while performing total laparoscopic hysterectomy and bilateral salpingo- oophorectomy

Various BhCG monitoring protocols for predicting the success of single-dose methotrexate in the treatment of ectopic pregnancy

We investigated various monitoring protocols on the success of methotrexate therapy in patients with tubal ectopic pregnancy. The data from patients who received single-dose methotrexate therapy as their first-line treatment was reviewed. The Beta-human chorionic gonadotropin (BhCG) days 1–4 and days 1–7 follow-up protocols were compared with the BhCG day 4–7 follow-up protocol, in terms of the treatment. Cut-off values were determined for the reduction of BhCG between the days 1–4 and days 1–7. There were no significant differences between the groups in terms of the demographic data, except for BhCG fourth- and seventh-day values. There was a 21% decrease in BhCG between days 1 and 4 and a 32% decrease for BhCG between days 1 and 7 as good predictors for treatment success. These follow-up protocols allow earlier and more cost-effective methods than the protocol based on a 15% reduction in BhCG levels between days 4 and 7.Impact statement What is already known on this subject? A decrease of 15% BhCG levels between days 4 and 7 is a common protocol for predicting the success of a single-dose methotrexate therapy of an ectopic pregnancy. What do the results of this study add? This clinical study offers the cut-off values for the various BhCG follow-up protocols recently found in the literature for single-dose methotrexate therapy for the treatment of ectopic pregnancy. What are the implications of these findings for clinical practice and/or further research? We identified the importance of fourth-day BhCG for measuring the success of single-dose methotrexate therapy. Therefore, after randomised, multicentre, prospective clinical trials, the most common follow-up protocol can be changed to a single-dose methotrexate therapy for ectopic pregnancy

Obstetric Outcomes of Syrian Refugees and Turkish Citizens

inan, Abdurrahman Hamdi/0000-0003-4782-3955; Beyan, Emrah/0000-0002-1662-5051; Ozgur, Su/0000-0002-8993-674XWOS: 000488286000001PubMed: 31679368Background: To present the differences in prenatal, labor and neonatal outcomes for Syrian refugees and Turkish citizens. Methods: Between January 2013 and December 2016, all patients in our hospital were screened retrospectively. Totally, 17 000 pregnant women included in the study were divided into three groups: group 1: 4802 pregnant in Syrian refugees group; group 2: 6752 pregnant in the low-income Turkish citizens (LI groups); and group 3: 5446 women in high-income Turkish citizens (HI groups). the groups were compared for demographic parameters, prenatal, labor and postnatal results. Results: Age, gestational week, birth weights, antenatal follow-up, antenatal iron supplementation and prenatal hemoglobin (Hb) values were significantly lower in the Syrian refugee group (P < 0.001). Only moderate preterm delivery and moderate low birth weight were higher in the refugee group (P = 0.023 and P = 0.001). Stillbirth rates were similar in all three groups (P = 0.203), but all other neonatal complications were higher in the Turkish citizens group. Conclusion: in comparison to non-refugee control patients, adverse perinatal outcomes were not observed in pregnant refugees. the refugee health policies of the Republic of Turkey seem to be working. However, further larger multicenter studies may provide more convincing data about obstetric outcomes and health results in the Syrian refugee population

Effect of advanced maternal age on pregnancy outcomes: a single-centre data from a tertiary healthcare hospital

The aim of this study was to assess the effect of advanced maternal age on pregnancy and neonatal outcomes in patients attending a tertiary centre hospital. Between January 2013 and December 2016, the records of all patients who were referred for pregnancy follow-ups and delivery were retrospectively reviewed and were divided according to their parity and age. Patients over 35 years old were categorised as advanced maternal age; (1) 35–40 years old. (2) 40–45 years old. (3) 45 years and over. Most of the prenatal complications were found to increase in the advanced maternal age group. The caesarian section rate was found to be higher in all advanced maternal age groups. There was no significant relationship between 5 Minute Apgar scores of <7 and perinatal mortality and post-term pregnancy and parity. Globally, advanced maternal age pregnancy shows an increase as a result pregnancy complication will increase. It is important to make a appropriate follow-up for pregnancies of advance maternal age mothers. Impact statement What is already known on this subject? Advanced maternal age is a poor prognostic factor for pregnancy outcomes. But there remains no consensus opinion or a plan for the management of pregnancy in this particular risk group. What do the results of this study add? This clinical study makes a contribution to the literature for advanced maternal age and pregnancy complications. This study is one of the few studies emphasising the importance of parity in advanced maternal age and the relationship between first trimester pregnancy complications and advanced maternal age. What are the implications of these findings for clinical practice and/or further research? After the ART pregnancies increasing all around the world not only advanced age but the parity become an important role. Due to an increase in advanced maternal age pregnancies in all around the world, we think that better understanding and management of the complications to be encountered in advanced maternal age and parity pregnancies will be appropriate