Urinary tract infection in pregnant population, which empirical antimicrobial agent should be specified in each of the three trimesters?

Objective: We aimed to investigate the bacterial profile and the adequacy of antimicrobial treatment in pregnant women with urinary tract infection. Material and Methods: This retrospective observational study was conducted with 753 pregnant women who needed hospitalization because of UTI in each of the three trimesters. Midstream urine culture and antimicrobial susceptibility tests were evaluated. Results: E.Coli was the most frequently isolated bacterial agent (82.2%), followed by Klebsiella spp. (11.2%). In each of the three trimesters, E.Coli remained the most frequently isolated bacterium (86%, 82.2%, 79.5%, respectively), followed by Klebsiella spp. (9%, 11.6%, 12.2%, respectively). Enterococcus spp. were isolated as a third microbial agent, with 43 patients (5.7%) in the three trimesters. The bacteria were found to be highly sensitive to fosfomycin, with 98-99% sensitivity for E.Coli and 88-89% for Klebsiella spp. and for Enterococcus spp. 93-100% nitrofurantoin sensitivity for each of the three trimesters. Conclusions: We demonstrated that E.Coli and Klebsiella spp. are the most common bacterial agents isolated from urine culture of pregnant women with UTI in each of the three trimesters. We consider fosfomycin to be the most adequate first-line treatment regimen due to high sensitivity to the drug, ease of use and safety for use in pregnancy

Utjecaj obiteljske mediteranske vrućice na ishod izvantjelesne oplodnje: retrospektivna analiza niza slučajeva

Although the in vitro fertilization-intra-cytoplasmic sperm injection (IVF-ICSI) has been utilized widely, the management in patients with an autoimmune disease is still a challenge. The aim of this study was to demonstrate IVF-ICSI outcomes in infertile women with familial Mediterranean fever (FMF). Patient data were collected from the cases registered from January 2006 until January 2014. A total of 6152 assisted reproductive technology (ART) cycles were analyzed retrospectively in the Ankara Zekai Tahir Burak Women’s Health Education and Research Hospital. Ten infertile women with FMF were included in the study. Baseline clinical and laboratory characteristics were collected and perinatal outcomes evaluated. The mean age (years), duration of infertility (years) and body mass index (kg/m2) were 29.9±5.3, 5.7±5.3 and 27.9±5.7, respectively. The mean baseline follicle-stimulating hormone (FSH; IU/L), estradiol (E2; pg/mL) and antral follicle count were 7.0±2.4, 48.1±15.8 and 7.9±2.9, respectively. The distribution of ovarian response was heterogeneous. Fourteen cycles in ten patients were evaluated. Embryo transfer could be achieved in only ten cycles. Three out of ten patients became pregnant. No adverse perinatal outcome was observed. Our findings indicate that FMF might have no impact on ART cycles.Iako je metoda oplodnje in vitro i intracitoplazmatskog injektiranja sperme (in vitro fertilization-intra-cytoplasmic sperm injection, IVF-ICSI) danas široko rasprostranjena u čitavom svijetu, njezina primjena u bolesnica s autoimunim bolestima još uvijek predstavlja velik izazov. Cilj ovoga istraživanja bio je pokazati ishode IVF-ICSI kod neplodnih žena s obiteljskom mediteranskom groznicom (familial Mediterranean fever, FMF). Podaci bolesnica prikupljeni su iz registriranih slučajeva od siječnja 2006. do siječnja 2014. godine. Retrospektivna analiza provedena u Zekai Tahir Burak Women’s Health Education and Research Hospital u Ankari obuhvatila je 6152 ciklusa potpomognute oplodnje (assisted reproductive technology, ART). U istraživanje je bilo uključeno deset neplodnih žena s FMF. Uzeti su bazalni podaci o kliničkim i laboratorijskim značajkama uključenih žena, kao i perinatalnim ishodima. Srednje vrijednosti dobi (godine), trajanja neplodnosti (godine) i indeksa tjelesne mase (kg/m2) bile su 29,9±5,3; 5,7±5,3 odnosno 27,9±5,7. Srednje vrijednosti folikul-stimulirajućeg hormona (FSH; IU/L), estradiola (E2; pg/mL) i broja antralnih folikula bile su 7,0±2,4; 48,1±15,8 odnosno 7,9±2,9. Raspodjela ovarijskog odgovora bila je heterogena. Procijenjeno je 14 ciklusa u deset žena. Transfer embrija bio je moguć u samo deset ciklusa, a trudnoća je postignuta u tri od deset žena. Nije zabilježen nikakav štetni perinatalni ishod. Naši nalazi ukazuju na to da FMF možda nema nikakvog utjecaja na cikluse ART

Major problems, current characteristics and future career plans of obstetrics and gynecology residents in Turkey

Objective: To evaluate the current problems and future career plans of obstetrics and gynecology residents in Turkey

The Effect of Adenomyosis in Myometrial Invasion and Overall Survival in Endometrial Cancer

Aim The aim of this study was to evaluate whether adenomyosis had an effect on myometrial tumor invasion, stage of the disease, and survival in endometrial cancer

Factors affecting pregnancy rates in infertile women performed abdominal myomectomy

Purpose:To evaluate pregnancy outcomes in infertile women performed abdominal myomectomy at our clinic. Patients and Methods:This retrospective study included 76 infertile women underwent abdominal myomectomy. The cases were divided into two groups according to postoperative pregnancy (Group 1, n=22), and cases with no postoperative pregnancy (Group 2, n=54). Risk factors recorded were; age, parity, size of the fibroids, body mass index (BMI), tumor markers and serum blood values. Results:A total of 76 infertile women underwent abdominal myomectomy during the study period. Of all cases 22 (28.94 %) became pregnant. There was statically significant difference between the groups in terms of age, BMI, diameter of the fibroids (p<0.05) (Table 2). The receiver operator curve (ROC) analyses showed that diameter of the fibroid may be a prognostic factor in order to assess the probability of pregnancy following abdominal myomectomy in infertile women. Conclusion:We think that in infertile women with intramural fibroids >5 cm the treatment modality should be abdominal myomectomy to increase the chance of postoperative pregnancy. [Cukurova Med J 2014; 39(4.000): 801-806

Effect of familial mediterranean fever on ivf outcome: a retrospective case series

Although the in vitro fertilization-intra-cytoplasmic sperm injection (IVF-ICSI) has been utilized widely, the management in patients with an autoimmune disease is still a challenge. The aim of this study was to demonstrate IVF-ICSI outcomes in infertile women with familial Mediterranean fever (FMF). Patient data were collected from the cases registered from January 2006 until January 2014. A total of 6152 assisted reproductive technology (ART) cycles were analyzed retrospectively in the Ankara Zekai Tahir Burak Women’s Health Education and Research Hospital. Ten infertile women with FMF were included in the study. Baseline clinical and laboratory characteristics were collected and perinatal outcomes evaluated. The mean age (years), duration of infertility (years) and body mass index (kg/m2) were 29.9±5.3, 5.7±5.3 and 27.9±5.7, respectively. The mean baseline follicle-stimulating hormone (FSH; IU/L), estradiol (E2; pg/mL) and antral follicle count were 7.0±2.4, 48.1±15.8 and 7.9±2.9, respectively. The distribution of ovarian response was heterogeneous. Fourteen cycles in ten patients were evaluated. Embryo transfer could be achieved in only ten cycles. Three out of ten patients became pregnant. No adverse perinatal outcome was observed. Our findings indicate that FMF might have no impact on ART cycles

Comparison of the morphokinetic parameters of embryos according to ovarian reserve in IVF cycles

The aim of this study is to evaluate the impact of ovarian reserve and age of women on early morphokinetic parameters of embryos with a time-lapse monitoring system. In total, 197 infertile couples with poor ovarian reserve (Group 1, n = 41), normal ovarian reserve (Group 2, n = 59), or polycystic ovaries (Group 3, n = 97) were included. The time from insemination to the following events were analyzed: pronuclear fading (Pnf) and cleavage to 2, 3, 4 and 5 cells. The optimal ranges for morphokinetic parameters of t5, s2 and cc2 in each group were also evaluated. In total, 1144 embryos were evaluated. Morphokinetic parameters did not differ statistically between the groups. Data were analyzed according to different age groups (20-30, 30-40, >40). The morphokinetic parameters did not differ statistically in Group 1 and 3. In Group 2, the times from insemination to tPnf, t2, t3, t4 were significantly shorter in the younger age group than the older age group (p < 0.05). The percentages of optimal embryos, according to t5, s2 and cc2, did not differ statistically between the groups. In conclusion, ovarian reserve did not seem to affect the morphokinetic parameters of embryos

A prospective case control questionnaire study for restless leg syndrome on 600 pregnant women

Aim: To evaluate the clinical characteristics of pregnant women with restless leg syndrome (RLS)

When Should the Labor Induction be Started For Late-term Pregnancies, in the Morning or in the Evening?

Aim: We aimed to investigate the labor outcomes of late-term pregnancies underwent intravenous oxytocin induction starting in the morning compared with starting in the evening. Material and Method: 266 women with a singleton pregnancy in cephalic presentation, at gestational age of 41 0/7 through 41 6/7 weeks were enrolled in this retrospective study. Labor inductions with intravenous oxytocin were started in the morning hours (08.00-12.00) or in the evening hours (16.00-20.00). Labor outcomes and night-time (20.00-08.00) deliveries were recorded. Results: In primiparae group, labor duration and active phase length of labor were significantly shorter in the evening group than in the morning group. In multiparae women, the ratio of night-time delivery was significantly higher in evening group as compared to morning group. And also night-time delivery was found as a significant risk factor for neonatal intensive care unit admission. Discussion: Induction of labour with intravenous oxytocin starting in the evening shortens labor duration in primiparae women, but not in multiparae women. Night-time delivery may be a risk for poor perinatal outcome. As the labor induction is planned, parity, start time of induction and estimated delivery time should be taken into account to reduce the risk of poor neonatal outcome in late-term pregnancies

Association between adverse perinatal outcomes and amino acid levels measured with nutrient questionnaire in adolescent pregnancies

Background: To evaluate the maternal serum amino acid levels in first trimester adolescent pregnancies by using a new developed dietary questionnaire. Methods: A group of 169 pregnant women in the first trimester of their pregnancy were asked to complete the dietary questionnaire. Among all the women, 39 were adolescent pregnancies. The results of the questionnaire were evaluated by a nutrient database program (BeBiS software program) designed to evaluate Turkish traditional foods and commercial processed foods. Results: There was no statistically significant difference between the groups in terms of body mass index and educational and socio-economic status. The mean age and gravidity was statistically significantly lower in adolescent pregnancies. The mean isoleucine, leucine, lysine, methionine, phenylalanine, tyrosine, threonine, valine, arginine, and proline levels were statistically significantly lower in adolescent pregnancies. Receiver operating characteristic (ROC) curve analysis showed the cut-off values of these amino acids. Of these amino acids; lower values of histidine, serine, and alanine were associated with lower birth weight, and lower values of histidine and alanine were associated with preterm delivery. Conclusion: To the best of our knowledge, this is the first study evaluating the amino acid levels in adolescent pregnancies. According to this study, some amino acid levels were lower in adolescent pregnancies and associated with adverse perinatal outcomes. Further studies with maternal and perinatal outcomes are needed to demonstrate the effects of these amino acids in such pregnancies