Chorionic Villus Sampling: Results of 135 High Risk Cases

OBJECTIVE: To assess the data related to the first-trimester chorionic villus sampling performed in a single tertiary center. STUDY DESIGN: Transabdominal CVS perf ormed on 135 pregnant women, aged 18 to 38 y ears, at 11 to 14 weeks’ gestation, who sought prenatal diagnosis for v arious reasons, during the years 2000-2004. Procedure related f etal loss rate, the indications, results of cytogenetic analy sis and the clinical outcomes of patients was obtained retrospectiv ely. RESULTS: The indications f or prenatal diagnosis were enzymatic/DNA analysis f or single gene def ects (31.1%), adv anced positive screening test result (22.2%), advanced maternal age (17.8%), and maternal anxiety (11.9%). Kary oty ping was totally successful and chromosomal abnormality was detected in 3 women (2.2%). The procedure related f etal loss rate was 0.0%. CONCLUSION: CVS perf ormed 11-14 weeks of gestation by experienced operators is a quick, reliable, and saf e diagnostic method for prenatal diagnosis and the ov erall incidence of antenatal and neonatal complications is no greater than that expected f or a general population

The Applicability and Use of Doppler Ultrasonography in The First Trimester

In contemporary obstetrics, the idea of “the pathological processes which are apt to cause complications or diseases at the later stages of pregnancy or even at the postnatal period could be revealed in early pregnancy weeks is spreading. Most researchers are readily willing to use all available means of technology to detect the pathologies which could develop in the early weeks of pregnancy. Along with the first trimester screening tests, the importance and application fields of the first trimester doppler ultrasonography is frequently discussed. This review will discuss shortly the first trimester screening tests and then will focus on the advantages and applicability of the first trimester doppler ultrasound as mentioned in the current literature

Mid-trimester Genetic Amniocentesis: GATA Experience

OBJECTIVE: To ev aluate the data about amniocenteses those were perf ormed in our department and to compare indications, procedure related losses and pregnancy outcomes. STUDY DESIGN: The study was carried out at the Department of Obstetrics and Gy necology, Faculty of Medicine, Gülhane Military Medical Academy retrospectively. We studied amniocenteses for chromosomal analysis between 2002 and 2004. The data of the patients were obtained from their records. RESULTS: The mean (±SD) gestational age at amniocentesis was 17.9±1.3 weeks (range 16-22 weeks). The most common primary indications for amniocentesis were advanced maternal age (37.0%) and positiv e screening test result (36.5%). In 1452 of the procedures (99.7%), amniotic f luid was obtained by a single puncture. A chromosomal abnormality was detected in 47 women (3.2%) who pref erred termination of pregnancy. The total f etal loss rate was 0 in 1456 (0.0%) within two weeks f ollowing amniocentesis CONCLUSION: Amniocentesis is a saf e and reliable technique with low f etal loss rates in complicated and uncomplicated pregnancies in our study group

Aynı overin multipl matür rekürrent kistik teratomu: Vaka sunumu ve literatürün gözden geçirilmesi

In this case report, we emphasize the recurrence and multilocularity properties of mature cystic teratomas. A 26 year old G0 woman complaining of stomachache and abdominal distention attended to the gynecology outpatient clinic. Transvaginal ultrasound revealed a 9 cm right ovarian mass with echogenecities suggesting sebaceous material within multiple dermoid cyst loci. A diagnostic laparoscopy was planned; seven separate loci of the dermoid cysts ranging between 2 - 5 cm with a total diameter of approximately 9 cm, were located on the right ovary. The patient was discharged on the second day after the operation without any complication. This patient is the only case having the properties of both recurrence and multilocularity in the Medline database search. Especially, the regular follow-up of the young patients has a clinical importance in early detection of the recurrent masses and during the surgeries of the recurrent cases, the surgeon should be careful about the bilaterality or multilocularity of the tumor.Bu olgu sunumunda, olgun kistik teratomların nüks ve multilokülerite özelliklerini vurguladık. 26 yaşında G0 kadın mide ağrısı ve abdominal distansiyon yakınmalarıyla jinekoloji polikliniğine başvurdu. Transvaginal ultrasonda sağ overde mutipl dermoid kist lokusları içinde ekojenik yağ materyali düşündüren 9cm kitle gözlendi. Sağ overe yerleşmiş totalde yaklaşık 9cm çaplı 2 ile 5 cm arasında değişen dermoid kistin 7 ayrı lokasyonuna tanısal laparoskopi planlandı. Hasta 2. günde komplikasyonsuz bir operasyon sonrası taburcu edildi. Bu hasta, Medline veritabanında rekürren ve multiloküler özelliğe sahip tek olgudur. Özellikle genç hastaların düzenli izlemi tümörün multilokülaritesi ve bilateralitesi hakkında cerrahın dikkatli olmasında, nüks vakaların cerrahisinde ve nüks kitlelerin erken tespitinde klinik öneme sahiptir

Death of the Spouse During Pregnancy Giving the Bad News and the Management

Pregnancy is a vulnerable time for receiving bad news. Death may occur anytime, and some women will experience this during their pregnancy. In our practice we have seen the dispair of the pregnant women after the unexpected death of the spouse. The pregnant women in most cultures are accepted and treated as more vulnerable individuals. Some believe that the sudden emotional changes may influence the course of the pregnancy. Immediate adverse outcome to a pregnancy after hearing the bad news has not been mentioned on the literature. There seems to be no scientific evidence of doing a pregnancy check up on a normally progressing pregnancy before giving the bad news, as well as no acute measures to be taken to avoid an adverse outcome. We reviewed the unexpected death of the loved one during pregnancy, giving the bad news, understanding the needs and expectations of the pregnant women, and about the ways of professional help to ease the pai

Prenatal Diagnosis of Megacyst In Early Pregnancy: A Case Report

A case with an incidental ultrasonographic finding of a megacysty in the 14th week of pregnancy, leading to an early diagnosis of Trisomy 18 is presented. An 18-year-old primigravida attending to outpatient clinic for her routine antenatal check up at the 14th week of her pregnancy was observed to have a fetus with a 12 mm bladder. There were no other apperant major organ or system abnormalities. Under the guidance of current literature, the family was counseled by obstetrics and genetics departments, and a chorion villus sampling was adviced. The result of the CVS was reported as Trisomy 18. The family’s wish of termination of the pregnancy was evaluated and the medical abortion with misoprostol induction was achieved. When evaluating and screening an early pregnancy with ultrasound for fetal abnormalities, the size of the fetal bladder should be evaluated carefully and megacystic cases should be kept in mind with the possibility of chromosomal abnormalities