Evaluation of Maternal and Fetal Outcomes in the Adolescents Pregnancy

Objective: In this study, our aim is to compare discussing maternal and fetal problems non-adolescent pregnancy with maternal and fetal problems in adolescent pregnancy that seen in hospital. Methods: 15-19 years of age (50 patients) and 20-23 years (96 patients) who gave birth at the Gynaecologi­cal and Obstetric Clinic under the Faculty of Medicine of Dicle University between January 2015-October 2015 were retrospectively evaluated. Age at birth, parity, blood pressure, pulse, gestational age, complications at birth, cesarean section indications, maternal biochemical pa­rameters, patients with preeclampsia and preterm birth, maternal and fetal complications were recorded. Results: Total number of births between January 2015- October 2015 were 1715 patients in our clinic. 62 of them (3.6%) were observed in the adolescent group. Maternal blood transfusion needs were found to be significantly higher in the adolescent group (p=0.004). Fetal abnor­malities and fetal intensive care needs were found to be significantly higher in the adolescent group (p=0.014, p=0.018). Conclusion: Adolescent pregnancies were high-risk pregnancies in terms of maternal anemia and blood transfusion requirements and because of adverse perina­tal outcomes. Therefore, to reduce the adolescent preg­nancy and to minimize perinatal complications should be done more extensive studies

Emergency Peripartum Hysterectomy: 16-year Experience of a Medical Hospital

We conducted this retrospective study to evaluate the outcomes and indications of emergency peripartum hysterectomy (EPH) as a life-saving procedure. Methods: We analyzed a series of 140 cases of EPH, between January 1993 and December 2008 in our clinic, retrospectively. The data were collected from the patients' files. The incidence, demographic characteristics, risk factors, indications and outcomes of hysterectomy, peripartum complications, the operation types, maternal morbidity and mortality and fetal mortality were evaluated. Results: A total of 26,015 of women were delivered. The incidence of EPH was 5.38 per 1,000 deliveries. The mean age was 34.19 ± 6.04 years (range, 21-49 years), gravidity was 6.84 ± 3.38 (1-17) and parity was 5.58 ± 3.04 (0-15). Of the 140 cases, 90 were delivered by cesarean section [29 (20.71%) of these had had a previous cesarean section] and 50 were vaginally delivered. One hundred and five cases had subtotal hysterectomy and 35 had total abdominal hysterectomy. The most common indications for EPH were uterine atony followed by uterine rupture and abnormal placentation. Mean operation time was 142.23 ± 43.70 minutes. The average blood transfusion was 4.79 ± 3.36 (1-14) units. Relaparotomy was performed in 23 cases. Maternal mortality was seen in 13 cases. Seventy-nine of the cases delivered at an outside center and were referred to our clinic for the intensive care unit. Sixty-one of the cases delivered at our clinic and 31 had stillbirths. Conclusion: This study suggests that the most common indications for EPH are uterine atony, uterine rupture and abnormal placentation. This is probably due to the advanced age of pregnancies and multiparity in our region. Therefore, we believe that the risk of EPH may be decreased with appropriate and closer prenatal care as well as education of the pregnant women

Chronic Myeloid Leukemia In a Pregnant Woman: A Case Report

Chronic myeloid leukemia (CML) is a rare disease in pregnancy. Our aim is to present a 37 weeks of pregnant woman with chronic myelogenous leukemia. A 27 Years in multigravi (gravida 5, parity: 4), at 37 weeks gestation was admitted with the diagnosis of painful pregnancy and CML. Physical examination findings were normal, complete blood count and peripheral blood smear results were consistent with CML. The patient was diagnosed CML in the 30th week of pregnancy and were treated with hydroxyurea and interferon. Treatment depends on the mother and the fetus did not develop any side effects. Our patient with CML is interesting due to lack of perinatal effects and take the diagnosis at an early age. CML diagnosed during pregnancy requires a multidisciplinary approach and hydroxyurea and interferon treatment on the mother and fetus are at low risk of inducing adverse effects. [Cukurova Med J 2015; 40(4.000): 811-813