Levonorgestrel-releasing intrauterine device versus oral progesterone for treatment of simple endometrial hyperplasia without atypia

The aim of this study was to compare the efficacy and effect on the menstrual pattern of the levonorgestrel releasing intrauterine device versus oral progesterone for treatment in patient having simple endometrial hyperplasia (EH) without atypia. Patients who underwent endometrial sampling with abnormal uterine bleeding history and received simple EH without atypia were included in this study between 1 December 2015 and 31 March 2016, retrospectively. Twenty-two patients were treated with the levonorgestrel-releasing intrauterine device (LNG-IUD) and 47 with oral progesterone. Primary outcome measures were regression of hyperplasia after 3 months of therapy. Secondary outcome measures were effect on menstruel pattern during treatment, or rates of hysterectomy and recurrence within a 12 month period. After 3 months of treatment, regression of EH occurred in all of women in LNG-IUD group versus 93% of women in the oral progesterone group (p=0.226). Hb values were increased at the 3th month measurement in both of groups. Endometrial thickness was significantly decreased at the end of the 3th month (p< 0.001). Amenorrhea was more common in the LNG-IUD group (p [Med-Science 2018; 7(1.000): 21-24

Comparing neonatal respiratory morbidity in neonates delivered after 34 weeks of gestation with and without antenatal corticosteroid

Objective: To investigate the effect of antenatal corticosteroid prophylaxis on neonatal respiratory morbidity between 34 and 37 weeks of gestation

Comparing neonatal respiratory morbidity in neonates delivered after 34 weeks of gestation with and without antenatal corticosteroid

Objective: To investigate the effect of antenatal corticosteroid prophylaxis on neonatal respiratory morbidity between 34 and 37 weeks of gestation

To evaluate the effect of pre-pregnancy body mass index on maternal and perinatal outcomes among adolescent pregnant women

Objective: To evaluate the effect of pre-pregnancy body mass index on maternal and perinatal outcomes among adolescent pregnant women

Fasting and post-prandial plasma glucose screening for gestational diabetes mellitus

Background: Gestational diabetes mellitus (GDM) is defined as impaired glucose tolerance with onset during the second or third trimester of pregnancy

The Importance of CD56 and CD98 Levels in Patients with Recurrent Implantation Failure

Aim: Despite major advances in assisted reproductive techniques, clinical pregnancy rates remain around 31% with fresh embryo transfer and around 41% with oocyte donations. We also know that the implantation process itself and the window period defined as the "implantation phase'' are significantly important for successful in-vitro fertilization (IVF) cycles. With this study we have tried to determine any differences in immunohistochemical staining for CD56 and CD98 within the implantation phase endometrium of patients with recurrent implantation failure and of a control group that eventually had a successful IVF cycle. Material and Method: This study was retrospectively performed on a total of 36 patients selected out of a database of 6260 patients who received their IVF cycles from 2004 to 2010. Patients were defined as implantation failure if they did not have a positive result for b-HCG testing following at least 3 IVF cycles with a total of at least 8 embryo transfers. The control group was formed with patients who had success (positive b-HCG testing) on their first IVF treatment. Results: Comparison of means for CD 56 staining percentages, CD 98 staining percentages, CD 98 staining power, and CD 98 staining score showed significant difference between the control group and the study group (p<.001). The endometrium of patients without recurrent implantation failure is significantly more stainable by CD 98 than that of patients with recurrent implantation failure. Discussion: We suggest that CD 56 and CD 98 staining for endometrium tissue can be a part of diagnostic testing for patients who are candidates for IVF treatments. We need further studies to determine the correlation between the overall chance for pregnancy and these types of immunohistochemical staining for patients receiving IVF treatment

Maternal serum advanced glycation end products level as an early marker for predicting preterm labor/PPROM: a prospective preliminary study

Objective: To evaluate the value of maternal serum advanced glycation end products (AGEs) level at 11-13 weeks' gestation for the prediction of preterm labor and or preterm premature rupture of membranes (PPROM). Materials and methods: This prospective cross-sectional study is performed in a university-affiliated hospital between February and April 2016. The participants of this study are low-risk pregnant women. Blood samples for maternal AGEs level were collected in the first trimester of pregnancy and all women completed their antenatal follow-up and delivered in our center. During the follow-up 21 women developed preterm labor/PPROM. The first trimester maternal AGEs levels of preterm labor/PPROM cases were compared with uncomplicated cases (n = 25) matched for age-parity and BMI. The predictive value of AGEs levels for preterm labor/PPROM was also assessed. Results: First-trimester AGEs levels were significantly higher in cases complicated with preterm labor/PPROM (1832 (415-6682) versus 1276 (466-6445) ng/L, p = .001 and 1722 (804-6682) versus 1343 (466-6445) ng/L, p = .025). According to receiver-operating characteristic curve analysis, the calculated cut off value of AGEs was 1538 ng/L with the sensitivity 91.7%, specificity 73.8%; and the negative and positive predictive values were 91.6% and 29.5%, respectively. Conclusions: For the prediction of preterm labor/PPROM, the relatively high AGEs levels in the first trimester might be a useful marker

Second-trimester urinary neutrophil gelatinase-associated lipocalin levels in gestational diabetes: preliminary results

Objective: The objective of this study is to investigate the urinary neutrophil gelatinase-associated lipocalin (uNGAL) levels in the second trimester of pregnant patients at the time of gestational diabetes mellitus (GDM) screening.Materials and methods: Urinary samples from 88 pregnant women who underwent gestational diabetes screening test were collected in late second trimester (24-28 weeks) prospectively. After an overnight fasting, 75g GTT was performed. The blood samples were drawn for measurement of glucose, insulin, and HbA1c. The urinary and blood parameters were compared for pregnant women with or without gestational diabetes.Results: uNGAL levels were significantly elevated in pregnant women with gesting compared with the control groups (p<.014). There was a positive correlation between uNGAL and HbA1c levels (p=.001).Conclusions: In the second trimester, at the time of GDM screening, high levels of uNGAL indicate tubular injury in GDM cases which seems to be a result of hyperglycemia. uNGAL may correlate with an inflammatory renal involvement in GDM

Malignancy Risk of Endometrial Polyps Among Geriatric Women

Summary: Background: The population of elderly women is increasing worldwide. Here we investigated the prevalence of malignant endometrial polyps in a population of geriatric women. Methods: This retrospective study was conducted at the gynaecology clinic of Zekai Tahir Burak Education and Research Hospital. Women who were aged >65 years and who were pathologically diagnosed with endometrial polyps between 2007 and 2016 were included. All patients with endometrial polyps underwent hysteroscopic resection. Patient characteristics, complaints and imaging and surgical findings were obtained from their medical records. Statistical data analysis was performed using SPSS software. Results: In total, 133 geriatric female patients were included. They had a mean age of 68.96 ± 4.20 (65–83) years. Among them, 114 (85.7%) patients had benign endometrial polyps, 7 (5.2%) had endometrial hyperplasia and 12 (9%) had endometrial cancer. Forty-eight women had been admitted because of postmenopausal bleeding. Eighty-five women presented with either non-specific symptoms, such as abdominal pain, dysuria and urinary incontinence, or had no symptoms and received incidental diagnosis via ultrasound scanning. The mean endometrial thickness was 9.3 ± 6.39 mm in benign cases and 16.44 ± 8.64 mm in premalignant/malignant cases. In multivariate Cox regression analysis, uterine bleeding and endometrial thickness were significantly and independently associated with premalignant or malignant polyps.All malignant polyps were found to be endometrioid adenocarcinoma. Conclusion: In our study, we detected an prevalence of endometrial cancer among 9% of geriatric women with endometrial polyps. Hence, it is important to conduct a pathological evaluation of endometrial polyps in such patients. Keywords: geriatrics, postmenopausal period, polyps, neoplasm

Female Sterilization by Tubal Ligation During C-Section in Women with a History of 2 or More C-Section

Objective: The aim of this study is to determine bilateral tubal ligation incidence performed during C-section in women with a history of 2 or more C-section and the factors affecting sterilization demand. Study Design: Patients who were admitted to Zekai Tahir Burak Woman's Health, Education and Research Hospital between February 2017 and June 2017 and who had a history of 2 or more C-section between week 37 and 41 were included in this prospective cross-sectional study. These subjects were separated into 2 groups according to whether they wanted bilateral tubal ligation during C-section. Bilateral tubal ligation was performed by means of modified Pomeroy technique. Both groups were compared in terms of age, gravida, number of children living at home, education level and income status. Patients who did not want bilateral tubal ligation were asked to fill a questionnaire involving reasons for not asking for bilateral tubal ligation. Results: The number of patients who wanted bilateral tubal ligation was 51 (43%) while those who did not want bilateral tubal ligation was 67 (57%). Compared with patients who did not want bilateral tubal ligation, patients who wanted bilateral tubal ligation had more number of children at home and a higher number of previous C-section (p<0.001). Reasons for not wanting bilateral tubal ligation consisted of religious beliefs (26.8%), desire for protection with a reversible contraceptive method (17.9%), partner who does not want bilateral tubal ligation (17.9%), incompletely family size (13.4%), respectively according to their frequency. Conclusion: bilateral tubal ligation for contraception during C-section was performed forty-three percent of women who had had a history of 2 or more C-section. In one fourth of the cases, pregnant women did not want bilateral tubal ligation due to religious beliefs