The associtation between aberrant right subclavian artery and trisomy 21 in a tertiary center in Turkey

Objectives: We hoped to reveal the frequency of Aberrant Right Subclavian Artery (ARSA) and to find the relationship of isolated/non-isolated ARSA with chromosomal defects and other fetal congenital heart diseases (FCHD) in a heterogeneous population. Material and methods: This was a retrospective cohort study conducted between December 2015 to September 2018. Women admitted for routine ultrasound examination or referred to our hospital for a suspected fetal anomaly were underwent detailed fetal anomaly ultrasonography scan and tested for the presence of ARSA. Results: ARSA was detected in 27 patients and an isolated finding in 13 (48%) cases. Among 13 cases with isolated ARSA, trisomy 21 was diagnosed in 1 case. In the non-isolated group (n: 14, 52%), five cases presented with trisomy 21. There was no significant difference of trisomy 21 frequency between isolated and non-isolated groups (7.6% vs 35.7%, p = 0.08). In 3 patients, FCHD was diagnosed and 2 of them had trisomy 21. Conclusions: Our study shows that ARSA can be the only marker in trisomy 21. The examination of the subclavian artery must be a part of the fetal anomaly ultrasonography. Detecting an ARSA should increase the attentiveness of the sonographer to investigate for the other markers of trisomy 21. In the existence of other findings, invasive diagnostic procedures should be offered to the patients, whereas in cases that arsa is the only finding, other risk factors should be investigated to offer karyotyping or cell-free DNA analysis

Molecular investigation of mechanisms considered to cause preterm premature membrane rupture

Purpose: The aim of this study was to investigate the mRNA expression level of p16, CDK4, CDK6, Cyclin D, RB1, and E2F genes in preterm premature rupture of membrane (PPROM) cases and their roles in etiopathogenesis of PPROM.Materials and Methods: Twenty-one pregnancies with PPROM before 34th gestational weeks (study group) were compared with twenty pregnancies with no complication, who gave birth after 37th gestational-week (control group). Both groups chorioamniotic membranes were compared for mRNA expression of p16, cyclin D, CDK4, CDK6, RB1 and E2F genes.Results: The mRNA expression levels of p16, cyclin D, CDK4, CDK6, RB1and E2F genes decreased in the PPROM group compared to control group at a statistically significant level.Conclusion: Our findings have shown that oxidative stress may not act on the p16 pathway in these cases. In order to understand the molecular mechanism of PPROM, biomarkers of oxidative stress and aging should be evaluated together with other pathways related to aging and oxidative stress in future studies.Amaç: Bu çalışmanın amacı, preterm erken membran rüptürü (PEMR) vakalarında, p16 ile CDK4, CDK6, siklin D, RB1, E2F genlerinin mRNA ekspresyon seviyelerini ve bu genlerin etiyopatogenezdeki rollerini saptamaktır. Gereç ve Yöntem: Çalışmamızda 34. gebelik haftasından önce membran rüptürü olan 21 gebe (çalışma grubu) ile herhangi bir durumla komplike olmamış ve 37. gebelik haftasından sonra doğum yapmış 20 gebenin (kontrol) doğum sonu koryoamniyotik membranları incelendi ve bu iki grubun koryoamniyotik membran örnekleri p16, siklin D, CDK4, CDK6, RB1 ve E2F genlerinin mRNA ekspresyon seviyeleri açısından karşılaştırıldı. Bulgular: Çalışmamızda, kontrol grubu ile kıyaslandığında p16, siklin D, CDK4, CDK6, RB1 ve E2F genlerinin ekspresyon seviyelerinin PEMR grubunda anlamlı derecede azaldığı saptandı. Sonuç: Bulgularımız bu vakalarda oksidatif stresin p16 yolağı üzerinden etki etmeyebileceğini göstermiştir. PEMR’nin moleküler mekanizmasını anlamak için, gelecekteki çalışmalarda oksidatif stres ve yaşlanma biyobelirteçleri ile yaşlanma ve oksidatif streste görevli diğer yolaklar birlikte değerlendirilmelidir.Cukurova Universit

Placenta accreta spectrum surgery with the Joel Cohen incision for abdominal access: a single-center experience

Objectives: Placenta accreta spectrum (PAS) is usually treated by hysterectomy performed through a midline incision. We hypothesize that PAS surgery can be performed through a Joel-Cohen incision with adequate sight and safety. Material and methods: The data on women having a hysterectomy due to PAS between 2013–2021 was collected retrospectively. Operation length, baby’s pre-delivery general anesthesia exposure time, transfusion rates, complication rates, postoperative admission to the intensive care unit (ICU), postoperative hospital stay, and neonatal outcomes were collected. In addition, the data investigated whether the operation was performed under emergent conditions and in the early (2013–2016) or late (2017–2021) years. Results: 161 patients met the inclusion criteria. The median gestational age at delivery was 34 weeks (27–39). The mean operation length was 150 minutes (75–420), and the anesthesia–to–delivery interval was 32 minutes (5–95). Twenty-three (14%) patients did not receive any blood product, 73 (45%) received less than three packs of erythrocyte, and only seven (4%) had a massive transfusion. Bladder injuries occurred in 24 (15%). Preoperative anemia, hypogastric artery ligation, transfusion, ICU admission, and maternal and neonatal complications were more frequent in emergent cases. Comparison between the early and late groups showed a decrease in the rate of anemia, maternal ICU admission, hypogastric artery ligation, and neonatal complications. In addition, infectious complications were relatively rare in all groups. Conclusions: The Joel-Cohen incision and bladder dissection before the baby's delivery reduce transfusion rates and avoid midline incision, which is prone to complications and unpleasant cosmetic appearance while performing a hysterectomy for PAS surgery

Perinatal outcomes of the antenatally diagnosed omphalocele cases: a single tertiary center experience

Objectives: To evaluate the perinatal outcomes of antenatally diagnosed omphalocele cases. Material and methods: This was a retrospective study conducted between July 2014 and February 2020 at the prenatal diagnosis center of a university clinic. Gestational week of diagnosis, associated anomalies, karyotype analysis results, complications during pregnancy, termination/delivery characteristics, and postnatal results were evaluated. Results: The analysis was performed on 58 patients. The median diagnosis time was 14.5 weeks of gestation. Thirty-three cases (57%) were defined in the first trimester. 33 (57%) of 58 patients had one or more concomitant anomalies, while 25 patients (43%) had isolated omphalocele. The most common associated anomaly was a cardiac anomaly which was observed in 17 fetuses (30% of all omphalocele cases). Karyotype analysis was performed in forty-five patients (41 in the prenatal period, 4 in the postnatal period). A normal karyotype was detected in 27 cases (60%). Trisomy 18 was the most common chromosomal anomaly (n = 15, 33.3%). Thirty of 58 patients (52%) requested termination of pregnancy (TOP) in the early pregnancy period. Thirteen of the cases died in-utero (22%). Fifteen pregnancies resulted in live births (26%), of those eight were lost in the first year of life (six of them had additional anomalies, while two of them had isolated omphalocele but the omphalocele pouch was containing the liver in those two babies). Conclusions: Most of the cases with an omphalocele can be diagnosed in the first trimester. Cardiac anomalies were the most common associated anomalies, while trisomy 18 is the most common chromosomal anomaly. Thus, earlier and effective counseling can be made about the prognosis of pregnancy

Jinekoloji ve obstetrik'te preoperatif laboratuvar testleri ile postoperatif komplikasyonların ilişkisi: rutin preoperatif tetkikler gereklimidir?

TEZ1642Tez (Uzmanlık) -- Çukurova Üniversitesi, Adana, 1994.Kaynakça (s. 77-81) var.81 s. ; 30 cm.

Gestational Diabetes Screening During Pregnancy

Gestational diabetes is a type of diabetes that is diagnosed during pregnancy in patients who do not have pregestational diabetes. Unless diagnosed and treated on time, it may cause various maternal, fetal and neonatal complications like macrosomia, polyhydramniosis, preterm labor, in utero ex fetus, infections, neonatal metabolic complications. The diagnosis of gestational diabetes stands on single-step or two-step screening/diagnosis strategies. These screening and diagnosis tests should be well known by physicians who are taking care of pregnants. [Archives Medical Review Journal 2015; 24(3.000): 348-354

Vajinal makat doğumlar: Son 30 yıldaki eğilim

Vajinal makat doğumların sıklığı gün geçtikçe azalmaktadır. Tüm dünyada olduğu gibi ülkemizde de bu eğilim vardır. J Turk Soc Obstet Gynecol 2014;4:252Vaginal breech delivery incidence is progressively decreasing. This trend exists in our country like other countries around the world. J Turk Soc Obstet Gynecol 2014;4:25

Gebelikte renal anjiomyolipom: Olgu sunumu ve literatürün gözden geçirilmesi

Renal anjiomyolipom, nadir bir tümördür. Sporadik olabileceği gibi, tüberoz skleroz veya pulmoner lenfanjioleiomyomatozis ile birlikteliği de olabilir. Bu tümörler, hormon duyarlıdır, bu yüzden de gebelikte büyüme eğilimi gösterirler. Bu tümörlerin esas komplikasyonu rüptür riskidir. Optimal yönetimi hala netleşmemiştir, çünkü literatürde bununla ilgili çok az sayıda olgu sunumu vardır. Bu olguların çoğunda da gebelikte rüptür gelişmiş ve hastalar sezaryan ile doğurtulmuştur. Olgumuzun, rüptür olmadan 36. gebelik haftasında vajinal yoldan doğurtularak ve kesin tedavi (nefrektomi) bunu takiben gerçekleştirildiğinden dolayı bu tümörlerin gebelikteki yönetimi konusundaki bilgimizi daha da arttıracağını ummaktayız. J Turk Soc Obstet Gynecol 2015;2:118-21Renal angiomyolipoma is a rare tumor that can be either sporadic or found together with tuberous sclerosis or pulmonary lymphangioleiomyomatosis. These tumors are hormone sensitive and therefore tend to grow during pregnancy and their main complication is the risk of rupture. Optimal management is still controversial because there are very few cases reported in the literature. We expect that the case of our patient, who delivered her baby vaginally at 36 weeks of gestation and underwent definitive treatment (nephrectomy) thereafter, to further enhance the knowledge about the management of these rare tumors during pregnancy. J Turk Soc Obstet Gynecol 2015;2:118-2