The effects of pregnancy on the sexual life of Turkish women

Aim: To investigate the effects of pregnancy on the sexual life of Turkish women Materials and Methods: One thousand twenty six pregnant women were included in the study. The Libido Scoring System, which is a questionnaire consisting of four questions about the frequency of intercourse, the partner initiating the intercourse, orgasm and masturbation status of the pregnant women, was completed by all patients. Both pre-pregnancy and pregnancy sexuality was evaluated independently using this scale. Results: The frequency of sexual intercourse during pregnancy significantly decreased from 3.07/week to 2.40/week (p<0.05). The masturbation rate during pregnancy was significantly lower than the pre-pregnancy period (3.6% vs 4.9 %, p<0.001). The percentage of pregnant women who never had an orgasm was significantly higher compared to the pre-pregnant period (21.7 % vs 10.8 %, p<0.01). The rates of initiation of sexual intercourse in the pre-pregnancy period by men and by women were 94.5% (970/1026) and 5.3% (54/1026) respectively. In pregnancy period the rates of initiation of sexual intercourse by man and woman were 93.4% (904/968) and 6.6% (64/968) respectively (p=0.0001). The mean libido scores during pregnancy were statistically lower than the pre-pregnancy period (6.38±0.04 vs 7.31±0.04, p<0.001). Conclusion: Pregnancy has a negative effect on the sexual life of women, but more prospective studies are required to clarify the mechanisms

The role of multiple high-risk human papillomavirus infections for cervical biopsies and findings in colposcopic procedures

Objective: The clinical outcome of high-risk HPV (hr-HPV) infection varies according to genotype(s). Patients may harbor either one single hr-HPV (s-HPV) or multiple HPV (m-HPV) genotypes. Recently, the relationship between m-HPV infections and high-grade dysplasia has been investigated, and controversial results have been obtained. Therefore, the clinical significance of m-HPV is not clear. This study aimed to evaluate which group is associated with higher grade dysplasia by analyzing colposcopic punch biopsies. Material and Methods: A total of 690 patients who were scheduled for a diagnostic excisional procedure between April 2016 and January 2019 due to the detection of high-grade cervical intraepithelial neoplasia (CIN 2/3) in colposcopy were included. Patients who were not scheduled for colposcopic examination or cervical punch biopsy, or who were scheduled for an excisional procedure due to smear-biopsy incompatibility or persistent low-grade dysplasia were excluded. Patients with a negative HPV test and an unknown HPV genotype were also excluded. Results: Among the patients scheduled for excision (n=404), 74.5% had a s-HPV and 25.5% had a m-HPV infection. The proportion of CIN 1, 2 and 3 per patient in the m-HPV group was significantly higher than the s-HPV group (p=0.017). When this analysis was made for the number of CIN 2+3 per patient in the s-HPV and m-HPV groups, it was 1.29 (389/301) and 1.36 (140/103), respectively, and no difference was found (p=0.491). Conclusion: Patients in the m-HPV group, who underwent more colposcopic cervical biopsies, had higher numbers of CIN lesions, regardless of age and cytology results

Persistent ectopic pregnancy after milking procedure: Case report

Ectopic pregnancy is the settlement of the pregnancy product at any site other than the endometrium. The incidence of ectopic pregnancy have increased in the last 20 years. Increased frequency and early diagnosis has led to conservative treatment methods to become more favorable. Follow-up, medical management and surgical managements are considered as conservative methods. As salpingostomy is the most common conservative surgical method, milking is considered as an alternative conservative surgical method. The most important complication of the conservative surgery is the persistence of ectopic pregnancy because of the residual trophoblastic tissue. Since the prediction of the persistent ectopic pregnancy is difficult after the conservative surgery, β-HCG follow up is so important for early diagnosis. In this case report we have discussed the case of the patient who admitted to our clinic with persistent ectopic pregnancy with acute abdomen, after the treatment with milking procedure whom than treated by salpingectomy procedure

Comparison of the effectiveness of topical silicone gel and corticosteroid cream on the pfannenstiel scar prevention — a randomized controlled trial

  Objectives: To compare the effects of topical silicone gel and corticosteroid cream for preventing hypertrophic scar and keloid formation following Pfannenstiel incisions. Material and methods: Fifty patients operated for benign gynecological diseases through primary Pfannenstiel incision were included. The wounds were randomly allocated to the treatment and control arms. In the treatment arm, the wounds were divided into two halves; one was treated with silicone gel and the other with methylprednisolone cream. No treat­ment was administered to the control group. Scars using the modified Vancouver Scar Scale (MVSS), patient satisfaction, and side effects were evaluated before and after (3rd month when treatment discontinued and 6th month) the treatment. Results: Thirty-nine patients (21 patients in the treatment group and 18 patients in the control group) completed the stu­dy. Intragroup comparisons of the 3rd month and 6th month scores of the MVSS revealed that the scores of all parameters (height, pigmentation, vascularity, pliability, and total MVSS score) significantly decreased at the 6th month evaluation as compared with the 3rd month evaluation in all groups (control, silicone, and methylprednisolone groups). Multiple group comparisons at the 6th month revealed that the most prominent improvements occurred in the methylprednisolone group in all MVSS parameters as compared with the control group and in the height, vascularity, and pigmentation parameters as compared with the silicone group. No side effects were experienced by the patients with either treatment and patient satisfaction was higher in the methylprednisolone group. Conclusion: The use of topical methylprednisolone cream in fresh wounds at the postoperative early period appears to be promising

COVID-19 during pregnancy and its impacts on perinatal health

n this review, we reviewed current literature on COVID-19 infection during pregnancy and provided up-to-date information and community/society recommendations. Although it has previous examples such as SARS and MERS and the infection findings appeared at an earlier period and have become known in China, the infection could not be limited and spread worldwide. Until June 8, 2020, a total of 6.8 million cases were reported and 397,000 cases died. As of the same date, the total case number in Turkey is 171,000 and total number of death is 4711. COVID-19 virus spread by droplets and its incubation period varies between 2 and 14 days. The rate of asymptomatic cases is 42% in non-pregnant patients while it is 44–89% in pregnant women. The disease progresses with mild-medium severity in about 80% of the patients, and it recovers by itself. A total of 17 maternal death cases has been reported. Although vertical transmission risk is very low according to a study investigating 265 pregnant women, there are cases showing fetal vertical transmission and we reviewed such cases in detail in this review

Examination of the Ovarian Reserve after Generation of Unilateral Rudimentary Uterine Horns in Rats

Objective. The purpose of this experimental rat model study is to evaluate the changes in the ovarian environment after excision of the rudimentary horn. Methods. Ten female Wistar albino rats were used in this study. One cm of right uterine horn length was excised in the first operation. Two months after the first operation, all animals were sacrificed to obtain ovaries for histological examination. Mann-Whitney U test and Student's t-test were used for statistical analysis purposes. Statistical significance was defined as P<0.005. Results. The number of primordial follicles (P=0.415), primary follicles (P=0.959), preantral follicles (P=0.645), antral follicles (P=0.328), and Graafian follicles (P=0.721) was decreased and the number of atretic follicles (P=0.374) increased in the right ovarian side. Howeve,r this difference was not found to be statistically significant. Conclusion. The results of this experimental rat model study suggest that the excision of rudimentary horn could have negative effects on ipsilateral ovarian functions

Ooferektomize sıçan modelinde levonorgestrel salgılayan intrauterin aracın östrojen replasman tedavisi sonrası endometrium üzerine olan etkilerinin ışık mikroskopisi ve transmisyon elektron mikroskopisi düzeyinde araştırılması

ÖZETOOFEREKTOMİZE SIÇAN MODELİNDE LEVONORGESTREL SALGILAYAN İNTRAUTERİN ARACIN ÖSTROJEN REPLASMAN TEDAVİSİ SONRASI ENDOMETRİUM ÜZERİNE OLAN ETKİLERİNİN IŞIK MİKROSKOPİSİ VE TRANSMİSYON ELEKTRON MİKROSKOPİSİ DÜZEYİNDE ARAŞTIRILMASIPostmenopozal dönemdeki kadınlar gerekli östrojen yerine koyma tedavisi görürken endometriumlarını korumak için progesteron kullanmaktadırlar. Kullanılan bu progesteronların değişik sistemik yan etkileri mevcuttur. Bu yan etkileri en aza indirebilmek için gestagenlerin rahim içi araç yoluyla verilmesi iyi bir seçenek olarak düşünülmektedir. Ancak bu yöntemin endometrium üzerindeki etkinliği yeterince araştırılmamış bir konudur. Bu amaçla ooferektomize sıçan modelinde gestagenlerin sistemik yan etkilerinden kaçınmak için lokal intrauterin uygulamanın endometriuma olan etkileri, ışık ve transmisyon elektron mikroskopi düzeyinde araştırıldı.Yirmidört sıçan altışarlı eşit gruplara bölündü. Birinci gruba operasyonla rahim içi levonorgestrel salgılayan araç yerleştirildi ve bir ay süreyle östrojen replasman tedavisi uygulandı. İkinci gruba operasyonla rahim içi levonorgestrel salgılayan araç yerleştirildi ve bir ay süreyle plasebo tedavisi uygulandı. Üçüncü gruba operasyonla salgısı olmayan rahim içi araç yerleştirildi ve bir ay süreyle östrojen replasman tedavisi uygulandı. Dördüncü gruba operasyonla salgısı olmayan rahim içi araç yerleştirildi ve bir ay süreyle plasebo replasman tedavisi uygulandı. Tüm sıçanların bir ay sonraki ikinci operasyonlarında endometrial doku örnekleri ışık ve elektron mikroskopi takibi için ve sağ femur kemikleri mineral dansitesi ölçümü için alındı. Elde edilen bulgular istatistiksel olarak değerlendirildi.Tüm sıçanların endometriumlarında görülen morfolojik bulgular 11 değişik histopatolojik başlık altında toplandı. Lökosit infiltrasyonu en sık birinci grupta görülürken ödem ve epitelde vakuolleşme en sık ikinci grupta, keratinize skuamöz metaplazi ve myometrial hiperplazi üçüncü grupta ve atrofi bulguları dördüncü grupta izlendi. Transmisyon elektron mikroskopisinde de paralel bulgular elde edildi. Kemik mineral yoğunlukları istatistiksel olarak anlamsız düzeyde değişiklikler gösterdi.Sadece östrojen tedavisi uygulanan üçüncü grupta görülen keratinize skuamöz metaplazi ve myometrial hiperplazi bulguları sıçanlarda östrojenin tek başına olumsuz etkisi olarak yorumlandı. Bu etkinin birinci grupta lokal gestajen etkisi ile önlendiği gözlendi. Işık mikroskopisi ve elektron mikroskopisi düzeyinde yapılan bu incelemeler sonucunda; postmenopozal rahmi alınmamış kadınların gestagenlerin sistemik yan etkilerinden korunmak ve endometriumlarında etkin ve güvenilir korumayı sağlamak için sistemik estrojen replasman tedavisi alırken lokal etkili levonorgestel salgılayan rahim içi araç takılarak daha güvenli ve yararlı bir hormon replasman tedavisi almaları sağlanabileceği görüşüne varıldı. SUMMARYLIGHT AND TRANSMISSION ELECTRON MICROSCOPICAL INVESTIGATIONS ON THE EFFECT OF LEVONORGESTREL RELEASING INTRAUTERINE DEVICE ON THE ENDOMETRIUM OF OVARIECTOMIZED RATS UNDER ESTROGEN REPLACEMENT THERAPY Postmenapausal women should use progesteron in order to protect their endometrium, while taking estrogen replacement therapy. The progesterons in use have variable systemic adverse effects. In order to minimize these adverse effects the local use of gestagens by the help of intrauterine device seems to be a logical option. Nevertheless the efficacy of these usage is not properly investigated. For this purpose, the endometrial effects of local intrauterine use in the ovariectomized rats -in order to get away from the systemic adverse effects- have been investigated at the light and transmission electron microscopic levels. Twenty-four rats have been subdivided into four groups containing six rats in each. In the first group an intrauterine device -releasing levonorgestrel- has been applicated by an operation and estrogen replacement therapy has been given for a period of one month. In the second group, an intrauterine device-releasing levonorgestrel- has been applicated by an operation and placebo treatment has been given for a period of one month. In the third group, an intrauterine device -releasing nothing- has been applicated by an operation and estrogen replecament therapy has been given for one month long. In the fourth group, an intrauterine device -releasing nothing- has been applicated by an operation and placebo treatment has been given for one month long. At the end of one month by the second operation, endometrial tissue samples have been collected for light and transmission electron microscopic investigation and right femurs have been extracted for bone mineral densitometric measurements. The revealed data have been statistically analysed. All morphologic findings in the endometrial samples of all groups have been grouped under eleven different histopathological criteria. The leukocyte infiltration has been seen at most in the first group whereas edema and vacuolisation in the epithelium have been observed most commonly in the second group, keratinized squamous metaplasia and myometrial hyperplasia most commonly in the third group and atrophy most commonly in the fourth group. The parallel findings have been revealed also in the transmission electron microscopical investigation. The bone mineral densities have been evaluated as having no statistically significant variabilities.Light and electron microscopical investigations suggest that it is possible to supply a safe and benificial hormone replacement therapy to postmenopausal non-hysterectomized women; taking systemic esterogen replacement therapy by the use of locally active levonorgestrel releasing intrauterine device in order to protect them from the systemic adverse effects of gestagens and to supply the efficient and safe protection in their endometrium

Association between FVL G1691A, FII G20210A, and MTHFR C677T and A1298C polymorphisms and Turkish women with recurrent pregnancy loss

Aim Recurrent pregnancy loss (RPL) poses a challenge in reproductive medicine because the etiology is often unknown. Here we investigated the frequency of mutations in the Factor V Leiden (FVL), prothrombin (FII), and methylene tetrahydrofolate reductase (MTHFR) genes in women with RPL and healthy women. Methods Blood samples were obtained from patients with ≥2 consecutive pregnancy losses and no identifiable etiology before 12 weeks of pregnancy (n=145). The control group comprised 105 age-matched women with ≥2 live births. Results The frequency of homozygotes for FVL 1691AA was 15 (10.3%) in patients and three (2.86%) in controls (p=0.073), while for FII 20210AA it was eight (5.5%) and one (0.9%), respectively (p=0.055). For two polymorphisms in MTHFR, genotype frequencies of 89 (61.4%) were found in patients and 55 (52.4%) in controls for 677TT (p=0.322), and 89 (61.4%) and 62 (59%) for 1298CC, respectively (p=0.810). Conclusion Despite a trend towards significance for FII G20210A, no significant differences in genotype frequencies of these polymorphisms between patients and controls was found. No evidence of the role of FVL G1691A, MTHFR C677T, and MTHFR A1298C in RPL in our Turkish cohort was found; however, further investigation of FII as a culprit gene in RPL is warranted