25-Hydroxy vitamin D levels in premenopausal Turkish women with uterine leiomyoma

We aimed to evaluate the relationship between serum 25-hydroxy vitamin D levels and the risk of uterine fibroids in premenopausal women in Turkish population in this prospective observational cross-sectional study. Sixty-eight women with at least one uterine leiomyoma >= 10 mm were compared with 56 healthy controls. Serum 25-(OH) vitamin D-3 levels were measured by electrochemiluminescence immunoassay. The groups were similar in terms of age, BMI, gravidity and parity numbers. The mean level of 25-(OH) D3 were 7.28 +/- 4.94 ng/ml and 78% of patients (n=97) had severe vitamin D deficiency (<10 ng/mL). Vitamin D levels were significantly lower in the study group (6.54 +/- 4.66 ng/ml vs. 8.18 +/- 5.16 ng/ml, respectively; p=.009). Vitamin D levels were not correlated with size, volume, localization and number of leiomyomas. Traditional covered clothing style, low education level and being housewife were risk factors for Vitamin D deficiency. This is the first study that investigates the vitamin D levels in women with leiomyomas in Turkish population. Influence of vitamin D on uterine leiomyoma formation to may lead to new preventive strategies in the future

Are the cesarean section skin scar characteristics associated with intraabdominal adhesions located at surgical and non-surgical sites

Objective: To investigate whether skin scar characteristics are associated with the presence and severity of abdominal or pelvic adhesions in women who have undergone previous cesarean section

Risk Factors of Prolonged Hospitalization in Patients with Hyperemesis Gravidarum

Purpose: To evaluate the risk factors of prolonged hospitalization in patients with hyperemesis gravidarum (HEG). Material and Methods: The medical records of 114 patients who were admitted to the Zekai Tahir Burak Womens Health Education and Research Hospital with a diagnosis of HEG in the period January 2013 to June 2014 were analyzed retrospectively. Hospital stay of more than 4 days was considered as prolonged hospitalization. Ninety -three patients with HEG who needed hospitalization less than four days formed the control group and 21 patients with HEG who needed hospitalization equal to or longer than four days formed the study group. The variables regarding age, body mass index, week of pregnancy, number of parity, daily vomiting number, number of days in hospital, need of combined antiemetic use, complete blood count, biochemistry markers, hormone tests, urine analysis were evaluated to assess their relationship with the risk factors for prolonged hospitalization in patients with HEG. Results: Twenty-one of 114 patients diagnosed with HEG had a prolonged hospital stay, with a mean stay of 5.1 days. Age, body mass index, week of pregnancy, need of using combined antiemetics, complete blood count parameters, liver and kidney function tests were not associated with the duration of hospitalization. Daily vomiting, maternal serum TSH levels and blood urea nitrogen levels were 2.4 +/- 1.3 vs 4.2 +/- 1.9; p= 0.01, 1.19 +/- 0.71 vs 0.82 +/- 0.67; p= 0.04, 21.2 +/- 6.4 vs 18.1 +/- 5.3; p= 0.03; respectively, and these differences were found to be statistically significant among groups. The serum maternal TSH < 0.1 and micro;IU/mL and vomiting and #8805; 5 per day were found to be significant indicators for longer hospitalization (OR = 4.05, 95%CI = 1.07-15.3; P <0.05, OR=9.55, 95%CI = 1.81-50.4 P <0.05; respectively). Conclusion: Number of vomiting per day and maternal serum TSH levels could help physicians to estimate the risk of prolonged hospitalization; however further investigations are needed in large population studies. Identifying the high risk patients is important both for prevention of HEG and beginning appropriate antiemetic treatment to avoid complications to reduce the economic costs. [Cukurova Med J 2015; 40(1.000): 113-118

Eyeliner in Bladder: A Case Report

Intravesical foreign objects in bladder are really seen rarely. Most of the time, the reasons of insertions of the foreign body are self-autoerotism to iatrogenic urological procedures, migration from surrounding organs or trauma. It can damage the bladder and may result in several urogenital and bowel complications. Herein, we present a case in a 42-year-old female with an eyeliner pencil self-introduced into the urethra with successfully removal of eyeliner from bladder despite to the anamnesis given involuntarily due to embarrassment, guilt and humiliation. [Cukurova Med J 2015; 40(1.000): 158-161

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

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

Analysis of factors that influence the outcomes of labor induction with intravenous synthetic oxytocin infusion in term pregnancy with favourable bishop score

Purpose: To investigate the factors that influence the success of labor induction with synthetic intravenous oxytocin infusion in term pregnancies with favourable Bishop score. Material and Methods: 150 pregnant women with completed 37 weeks of gestation and Bishop score>6 who had single and cephalic presentation of pregnancy and were decided to underwent labor induction with intravenous oxytocin infusion were included in the study. Labor induction was considered unsuccessful if a vaginal delivery did not occur within 24 hours after the onset of loxytocin infusion or a cesarean section was performed during oxytocin infusion due to foetal distress, cephalopelvic disproportion or failure to progress in labor. Multivariable regression were used to identify odds of induction success. Results: Out of 150 women, induction of labor was unsuccessful in 23 (15.3%). Multivariate analysis demonstrated that nulliparity, shorter gestation period, persistent occiput posterior presentation and greater birth weight were independent risk factors for the induction failure. ROC curve analysis stated that gestation period of 3445-gram-birth weight has a sensitivity of 82.6% and a spesificity of 71.7% for the prediction of failure. Conclusion: Nulliparity, shorter gestation period, persistent occiput posterior presentation and greater birth weight increase the failure risk of labor induction with intravenous synthetic oxytocin infusion. [Cukurova Med J 2015; 40(2.000): 317-325

Analysis of Risk Factors for Post-Hysterectomy Vaginal Vault Prolapse

Purpose: To identify risk factors for vaginal vault prolapse after hysterectomy and also estimate incidence of post-hysterectomy vault prolapse. Material and Methods: This is a retrospective study of women who underwent hysterectomy for benign indications between January 2010 and December 2012. Medical records were reviewed from two groups of women. Case group was women who had undergone surgery for vault prolapse after hysterectomy; control group was women who were not identified with vault prolapse after hysterectomy by the time of the study. Multivariate regression model identified odds of post-hysterectomy vault prolapse. Results: Of 1758 hysterctomies, 56 (3.19%) were cases. Multivariate regression analysis demonstrated that age at hysterectomy and #8805;60 years, presence of asthma, previous pelvic organ prolapse surgery, vaginal route of hysterectomy, genital prolapse as indication of hysterectomy, body mass index and #8805;27 kg/m2 and number of vaginal delivery and #8805;2 are independent risk factors for development of post-hysterectomy vault prolapse. Conclusions: Vault prolapse after hysterectomy is a relatively rare complication. Elderly age, obesity, chronic obstructive lung diseases, prior genital prolapse sugery, vaginal hysterectomy, genital prolapse as indication of hysterectomy and the number of vaginal delivery and #8805;2 increase vault prolapse risk. Identification of these risk factors is important to prevent this complication. [Cukurova Med J 2015; 40(1.000): 63-71