Evaluation of the effect of Birth Preparation Program on birth satisfaction with „Salmon’s Item List” scale

Objectives: The aim of this study is to investigate the effects of a birth preparation program on birth satisfaction. Material and methods: This cross-sectional study was conducted with patients who applied to our hospital between January 2018 and January 2019. A total of 164 pregnant women (Study Group) who applied for the birth preparation program and completed all training in our hospital and 152 pregnant women who did not apply for the birth preparation program and who did not know about such training (Control Group) were included in the study. Demographical data and obstetric parameters of the groups were recorded. All patients were evaluated with the Visual Analog Scale and Salmon’s Item List scale 48 hours after the delivery. The scores of both groups were compared. Results: There were no significant differences between the groups in terms of age, gravida, parity, gestational week of birth, the birth weight of infants, and 5th-minute APGAR scores. It was found that the Visual Analog Scale scores of the Control Group were significantly higher than in the Study Group. The Salmon’s Item List scores of the Study Group were significantly higher than those of the patients in the Control Group (< 0.01). Conclusions: The birth preparation program increases satisfaction during labor and decreases the traumas that may occur in the following births and increase comfort in the postpartum period. For this reason, such programs must be applied commonly to ensure that women can face both the birth and postpartum processes comfortably

The effect of vaginal bleeding and non-spesific pelvic pain on pregnancy outcomes in subchorionic hematomas cases

Objectives: To determine the clinical differences and factors affecting early pregnancy outcome in the first and early second trimester subchorionic hematoma cases.  Material and methods: This study involved with the retrospective analysis and evaluation of 81 cases diagnosed with subchorionic hematoma. The patients were grouped according to the gestational periods, symptoms at the time of admission, ratio of surrounding hematoma to the gestational sac, and whether there was a pregnancy loss. The groups were compared according to the clinical features and pregnancy outcomes.  Results: The ratio of surrounding hematoma to the gestational sac in the group with pregnancy loss was significantly higher (p = 0.002). When the cut-off value was 35.5%, it could determine the possibility of a complication in pregnancy with 70% sensitivity and 75% specificity. Nonspecific pelvic pain were significantly higher in the pregnancy loss group than in the other group. Logistic regression analysis was performed to determine the effect of these two parameters on the pregnancy outcome. Although the presence of non-specific pelvic pain is more in the group with pregnancy loss; there was no effect of on pregnancy outcome (p = 0.141). The risk of pregnancy loss increased 4.5 fold if the ratio of ScH to gestational sac was above 35% (p = 0.027).  Conclusions: In the cases of subchorionic hematoma, we concluded that when the ratio of surrounding hematoma to the gestational sac increased and when it was accompanied by nonspecific pelvic pain, the hospitalization period of the patients increased and the ratio of pregnancy loss was higher

Rudimentary horn pregnancy — ten years of experience

Objectives: This study aimed to evaluate data on early diagnosis and therapeutic management of rudimentary hornpregnancy (RHP).Material and methods: Patients diagnosed with RHP at a tertiary center between for two periods of 2008–2012 and2013–2018 were analysed retrospectively. We obtained information of patients from hospital electronic archive registrationsystem. Data on demographic characteristics, clinical presentation, gestational age at presentation, presenting symptoms,diagnostic methods, and therapeutic management were noted and analysed by descriptive statistical method. Demographicdatas, the complaint of patient’s admission to hospital, history of cesarean section, preliminary diagnosis and intraoperativediagnosis were compared between periods of 2008–2012 and 2013–2018.Results: A total of 14 RHP patients were included. Eight (57.1%) of these patients were diagnosed between 2008–2012 (Group1), whereas six patients (42.9%) were diagnosed between 2013–2018 (Group 2). Rudimentary horn was non-communicatingin 13 patients (92.8%). Communicated form was observed in 1 patient in group 1. RHP was diagnosed on the left side in ninepatients (64.2%). Six of these patients were observed in group 1 and 3 were in group 2. The pre-rupture diagnosis was madein 10 (71.4%) patients. Six (100%) of 10 patients were in group 2. In addition, in group 1, four patients (50%) experiencedintraoperative RHP rupture. RHP was diagnosed before rupture in 2 (33.3%) patients in group 2.Conclusions: It is an indication of advanced ultrasonographic technology as well as increased carefulness on the physicianside and raised alertness on the patient side that today both RHP and preoperative rupture of RHP are less frequent.Still, further awareness is required among physicians of the necessity of excision of a rudimentary horn that is detectedat the time of C-section

Factors associated with complications of vaginal hysterectomy in patients with pelvic organ prolapse — a single centre’s experience

Objectives: The study aimed to examine the predisposing factors that play a role in the development of complications in patients undergoing vaginal hysterectomy. Material and methods: This retrospective analysis was performed on data provided from 239 patients who underwent vaginal hysterectomy due to uterine prolapse at a single centre between January 2008 and August 2018. Complications were defined according to Clavien-Dindo classification of complications. The patients were divided into two groups: with and without complications. We built a model using multivariable logistic regression to examine the relationships between complications and five candidate predictors. Results: Intra/postoperative complications developed in 30 patients, and the complication rate was found to be 12.5%. 87.2% of the reported complications were classified as Grade ≤ 2 according to Clavien-Dindo system. It was found that complications were associated with factors such as intraoperative concurrent salpingo-oophorectomy [Odds ratio (OR): 1.24 (1.1–1.4)], low preoperative haemoglobin [OR: 0.96 (0.94–0.98)], uterine weight [OR: 2.69 (2.62–2.76)], and long operation time [OR: 1.04 (1.02–1.07)]. History of pelvic surgery was not found to increase complication rate [OR: 1.11 (0.96–1.27), p = 0.13]. Our multiple logistic regression model correctly classified 74% of participants within the Receiver Operating Characteristic (ROC) curve. Conclusions: Preoperative anaemia, large uterus and concomitant adnexectomy were found to be factors associated with complications during and after vaginal hysterectomy for pelvic organ prolapse

The thiol/disulfide balance in ketone positive and ketone negative pregnant women with nausea and vomiting — a prospective study in a tertiary center

Objectives: We aimed to investigate the thiol/disulfide balance in ketone positive (hyperemesis gravidarum) and ketonenegative pregnant women with nausea and vomiting.Material and methods: A total of 60 patients under the 14th week of pregnancy were included in this study, and they weredivided into two groups. Group 1 included 30 pregnant women with ketone positive, group 2 included 30 ketone negativepregnant women with nausea, and vomiting.Results: The native thiol, disulfide, and total thiol concentrations were measured using an automated method and comparedamong the two groups. There were also three indexes that are derived from disulfide, native and total thiol (Index1 = 100 × disulfide/native thiol); (Index 2 = 100 × disulfide/total thiol); (Index 3 = 100 × native thiol/total thiol). Whencompared with Group 1 and Group 2, total thiol was high, native thiol was low but not statistically significant. Disulphide(p = 0.046), index 1 (p = 0.036) and index 3 (p = 0.034) were statistically significant.Conclusions: Patients with ketone positive are shifting to OS direction due to lack of nutrients and electrolytes. This studyemphasizes the therapeutic potential of antioxidant supplementation, which is becoming an increasingly used approachin treating the symptoms of women with ketone positive

A comparison between a combination of letrozole and clomiphene citrate versus gonadotropins for ovulation induction in infertile patients with clomiphene citrateresistant polycystic ovary syndrome — a retrospective study

Objectives: The aim of this study was to compare a combination treatment with CC plus letrozole versus gonadotropinsin CC-resistant polycystic ovary syndrome (PCOS) patients with regard to ovulation and clinical pregnancy rate.Material and methods: One hundred sixteen CC-resistant infertile PCOS patients were evaluated retrospectively. The patientswere divided into two groups. Group 1 (n = 73) received CC plus letrozole, and Group 2 (n = 43) received gonadotropins.Results: The ovulation rate in Group 1 was 65/73 (89%), the pregnancy rate was 13/73 (18%), the twin foetuses rate was1/73 (1.3%) and the miscarriage rate was 2/73 (2.7%). In Group 2, the ovulation rate was 41/43 (95%), and the pregnancyrate was 8/43 (19%) the rate of the twin foetuses was 1/43 (2.3%) and the miscarriage rate was 1/43 (2.3%). There was nostatistically significant difference in the ovulation (p = 0.25), pregnancy (p = 0.91), twin foetuses (p = 0.89) and miscarriagep = 0.89) rates between two groups.Conclusions: This new drug combination suggests that it may be a lower cost, lower risk alternative treatment that increasesthe rate of ovulation. Larger randomized clinical trials are needed to provide information on live birth rates of thiscombination

Ghrelin does not change in hyperemesis gravidarum

Objectives: Ghrelin levels can play an important role in maintaining the energy balance of pregnant women. Therefore,we investigated the relationship between HG and Ghrelin.Material and methods: 50 female patients admitted to the VAN Yüzüncü Yıl University, Gynecology and Obstetrics Departmentwere evaluated. The patients were divided into two groups: Group 1 included 25 pregnant women with HG, Group 2included 25 healthy pregnant women.Results: The two groups showed similarities in terms of age, gravidity, B-HCG and gestational age. There was no statisticallysignificant difference between the two groups in terms of the Ghrelin levels (p = 0.867).Conclusions: This study shows that there is no difference between Ghrelin levels and HG during pregnancy. IncreasedGhrelin in previous studies was attributed to low oral intake. Another study reported lower Ghrelin levels are not the resultof, but are rather the cause of, reduced oral intake during. The balancing of these two conditions does not lead to a changein the level of Ghrelin

Evaluation of catalase, myeloperoxidase and ferroxidase values in pregnant women with hyperemesis gravidarum

Objectives: To investigate maternal serum catalase, myeloperoxidase and ferroxidase levels in pregnant women with Hyperemesis Gravidarum and to compare the results with healthy pregnancies.  Material and methods: In this study, 60 female patients admitted to the Health Sciences University, Gazi Yaşargil Training and Research Hospital, Gynecology and Obstetrics Department were evaluated. The patients were divided into two groups: Group 1 included 30 pregnant women with hyperemesis gravidarum; Group 2 included 30 healthy pregnant women. Pregnancies over 14 weeks were excluded from the study.  Results: The laboratory and laboratory characteristics of both groups are shown in Table 1. No significant differences were found between the groups in terms of the maternal age, gestational age, gravidity, parity, fasting glucose level, and BMI. The maternal blood CAT levels were significantly higher in the HG group (219.6 ± 111.3 kU/L) when compared to the control group (71.5 ± 52.5 kU/L) (p < 0.001). The maternal blood MPO levels were lower in the control group (121.5 ± 36.3 U/L) than in the study group (90.9 ± 56.4 U/L) (p = 0.016). However, the ferroxidase levels were similar between the two groups. The independent variables BMI, age, parity, gravidity and gestational week effects were adjusted according to the logistic regression method with groups. Significant differences were observed between the two groups in the levels of CAT (0.001), MPO (0.005) values.  Conclusions: This study suggests that antioxidants in response to oxidative stress gave different reactions with different mechanisms; Also, we believe that insufficient food intake suppresses the immune system and this has an important role on antioxidants

Unscarred uterine rupture and subsequent pregnancy outcome — a tertiary centre experience

Objectives: The aim of this study was to investigate the incidence, etiology and obstetric outcomes of rupture in unscarreduterine rupture and in those with a history of uterine ruptureMaterial and methods: The hospital records of women who had delivered between May 2005 and May 2017 at a tertiarycenter were examined retrospectively. Data on patients with unscarred uterine rupture in pregnancy who had undergonefertility-preserving surgery were evaluated.Results: During the study period, 185,609 deliveries occurred. Of those, unscarred uterine rupture has occurred in67 women. There were no ruptures reported in nulliparous women. The rupture was observed in the isthmic region in60 (89.6%) patients and in the fundus in 7 (10.4%) patients. Thirty-eight (56.7%) patients had undergone a total or subtotalhysterectomy, and 29 (43.3%) patients had received primary repair. Ten patients had reconceived after the repair. Of these,eight patients who had a history of isthmic rupture, successfully delivered by elective C-section at 36–37 wk. of gestation,and two experienced recurrent rupture at 33 and 34 wk. of gestation, respectively. Both patients had a history of fundalrupture, and their inter-pregnancy interval was 9 and 11 mo., respectively.Conclusions: The incidence of rupture in unscarred pregnant uteri was found to be one per 2,770 deliveries. Owing to thehigh morbidity, regarding more than half of the cases with rupture eventuated in hysterectomy, clinicians should be prudentin induction of labour for multiparous women since it was the main cause of rupture in this series. Short inter-pregnancyintervals and history of fundal rupture may confer a risk for rupture recurrence. Those risk factors for recurrence should bevalidated in another studies