Gebelikte Tiroid Hormonlarının Medyan Değerlerin Katları ile Birlikte Trimester Spesifik Referans Aralıkları

Amaç: Popülasyon ve laboratuvara özgü tiroid hormonları için trimester spesifik rasyonel referans aralıkları oluşturmaktır. Gereç ve Yöntem: Çalışma üçüncü basamak bir sağlık kuruluşunda kadın doğum polikliniğinde Nisan 2021-Ağustos 2021 tarihleri arasında gerçekleştirildi. Her üç trimesterde de herhangi bir risk faktörü ve antitiroperoksidaz pozitifliği olmayan sağlıklı gebeler çalışmaya alındı. Serum tiroid stimülan hormon (TSH), serbest tiroksin (FT4) ve serbest triiyodo-tironin (FT3) düzeyleri elektrokemilüminesans tekniği ile ölçüldü. Trimester spesifik referans aralıkları, medyan değerlerin katları (MoM) ile TSH, FT3 ve FT4 değerlerinin 5. ve 95. persentilleri belirlendi. Bulgular: Toplamda, 140’ı birinci trimesterde, 204’ü ikinci trimesterde ve 140’ı üçüncü trimesterde olmak üzere 484 sağlıklı gebe çalışmaya alındı. İlk trimester için kadınların %90’ı (n=126) referans sınırlarındaydı (0,19-3,25 uIU/mL ve 0,19-3,25 MoM) ve %11,1’inin (n=14) TSH seviyeleri 2,5 uIU/L’nin üzerindeydi. İkinci trimester için, %90,2 (n=184) referans sınırlarında (0,65-3,83 uIU/mL ve 0,4-2,36 MoM) TSH seviyelerine sahipti ve %8,15’i (n=15) 3 uIU/L’nin üzerinde TSH seviyelerine sahipti. Üçüncü trimesterde kadınların %90,7’si (n=127) referans sınırlarında (0,62-3,78 uIU/ mL ve 0,39-2,35 MoM) ve %3,15’i (n=4) 3 uIU/L’nin üzerinde TSH değerlerine sahipti. Sonuç: Gebe kadınlarda tiroid hastalığının doğru teşhisi ve yönetimi maternal-fetal sonuçlar için çok önemlidir. Bu çalışmada üç trimester için belirlenen referans aralıklarının tümü, 2011 Amerikan Tiroid Birliği kılavuzunun önerilen sabit aralıklarından daha yüksek bulunmuştur

Responsiveness of urogynecologic quality of life measurements to change after radical gynecologic surgery

In order to assess the responsiveness of short forms of the Incontinence Impact Questionnaire (IIQ-7) and Urogenital Distress Inventory (UDI-6) in a subset of women undergoing radical operations for gynecologic cancer. Women with cervical cancer without any abnormal urodynamic abnormalities who had undergone Class III hysterectomy were included in the study. All women underwent urodynamic investigation and completed the IIQ-7 and UDI-6 questionnaires pre-operatively and post-operatively in the sixth month. Twenty-eight patients were enrolled and general and subscale scores of the questionnaire were calculated in the study between February 2008 and September 2008. Class III hysterectomy was performed in 28 women with stage Ib cervical carcinoma. Scores of IIQ-7 and the irritative and obstructive subscales of UDI-6 in the sixth post-operative month were significantly higher than the pre-operative scores. The Cronbach's alpha was 0.84. Cystometric parameters were in concordance with these changes in the questionnaire scores. The IIQ-7 and UDI-6 questionnaires are sensitive to changes in patients who have undergone radical oncologic operations because their life impact of incontinence may be affected. Validated questionnaires are reasonable measures to detect these changes, which are confirmed by urodynamic findings

The Relationship Between Endometrial Thickness and Histopathological Results in Patients with Postmenopausal Vaginal Bleeding

Amaç: Postmenopozal kanamalı kadınlarda transvajinal ultrasonografi (TVUSG) ile ölçülen endometrial kalınlık değerleri ile endometrial örnekleme sonuçları arasındaki ilişkiyi ve anormal endometrial patolojileri tespitinde transvajinal ultrasonografinin değerini araştırmak. Gereç ve Yöntemler: Postmenopozal kanaması olan 279 hastanın TVUSG ile ölçülen endometrial kalınlıkları ve sonrasında yapılmış olan endometrial örnekleme sonuçları retrospektifolarak incelendi ve karşılaştırıldı. Bulgular: En sık karşılaşılan normal endometrial histopatoloji sonucu endometrial hücre (n=7I), anormal histopatoloji sonucu ise endometrialpolip (n=40) idi. Endometrium kanseri tanısı alan hastaların %73 'ü (n=]9) 60 yaş ve üstündeydi. Endometrial kalınlık değeri mm olan hastaların (n=68) hiçbirinde endometrial hiperplazi veya endometrium kanseri yoktu, olguda endometrial polip saptanırken 5mm endometrial kalınlığa sahip olguların (n=49) hiçbirinde anormal endometrial histopatoloji saptanmadı. mm endometrial kalınlık eşik değerinin sensitivitesi %100, spesifitesi 24. iken mm eşik değerinin sensitivitesi %95.I spesifitesi ise 33.8 olarak hesaplandı. Gereksiz endometrial örnekleme oranı 5mm eşik değeri için 7.8, 6mm eşik değeri için 23 idi. Sonuç: Endometrium kanseri görülme riski yüksek olan postmenopozal kanamalı hastalarda anormal endometrialpatolojiye sahip olguları tespit etmek, morbidite ve mortalite riski olan endometrial örneklemenin gereksiz uygulanmasının önüne geçilebilecek olması nedeniyle endometrial örnekleme kararının verilmesinde VUSG 'nin kolay uygulanabilen, etkili bir klinik araç olduğunu düşünmekteyiz.Objective: investigate the relationship between endometrial thickness detected by transvaginal ultrasonography and the predictive value ofTVUSG in detecting abnormal endometrial pathology in patients with postmenopausal bleeding. Materials and Methods: Endometrial thickness was measured by VUSG and endometrial sampling results of 279 patients with postmenopausal bleeding were assessed and compared retrospectively. Results: The most common encountered normal and abnormal endometrial histopathology results were endometrial cell (n=71) and endometrial polyp (n=40) respectively. 73% (n=19) of the patients with endometrial cancer was above 60 years. There was no endometrial cancer and hyperplasia in the patients with 6mm (n=68) endometrial thickness but endometrial polyps were detected. There was no abnormal endometrial histopathology among the patients with 5mm (n=49) endometrial thickness. cut-of levelfor endometrial thickness of 6mm had sensitivity of 95.1% and specificity of 33.8% while mm cutoflevel had sensitivity of] 00% and specificity of24. 7%. Conclusion: We concluded that VUSG is an effective tool to detect abnormal endometrial pathology andprevent the unnecessary endometrial sampling which has morbidity and mortality risk in the patient with postmenopausal bleeding who has high risk for endometrial cancer

Postpartum sexual function of women and the effects of early pelvic floor muscle exercises

Objective. To evaluate the effects of early pelvic floor muscle training after vaginal delivery on sexual function. Design. Prospective randomized study. Settings. Urogynecology clinic of a tertiary medical center in Istanbul, Turkey. Population. Total of 75 primiparous women. Methods. Pelvic floor-muscle strength was assessed during rest and straining in primiparous women in their 4th postpartum month, after which the women were randomized into training (n = 37) and control (n = 38) groups. Patients were re-evaluated in the 7th postpartum month. Main outcome measures. Female sexual function and pelvic muscle strength scores. Results. Desire, pain and total female sexual index scores were significantly higher in the 7th month compared to 4th month in both groups (p 0.05). All domains except satisfaction were significantly higher in the training group compared with the controls. Pelvic floor-muscle strength was found to be increased in the 7th month in the training group (Wilcoxon rank test, Z = 4.123, p 0.05). Conclusion. Pelvic floor-muscle training improves pelvic floor-muscle function, and starting after the puerperal period, exercise appears to have positive effects on female sexual function

Radical trachelectomy in late pregnancy: is it an option?

[No Abstract Available

Effects of erythropoietin on spontaneous and oxytocin induced myometrial contractions in the nonpregnant rat

WOS: 000417908300002PubMed ID: 29228453OBJECTIVE: Erythropoietin (EPO) is a glycoprotein hormone that regulates erythropoiesis. EPO activity has also been detected in a variety of tissue including the nervous system, and female and male reproductive organs. It has been shown that EPO causes relaxation in vascular smooth muscle. In the present study, we have investigated effects of EPO on spontaneous and oxytocin-induced contractions of non-pregnant rat myometrium. MATERIALS AND METHODS: Myometrial stripes were obtained from adult Wistar rats at the oestrous stage. The samples were placed in an isolated organ chamber under physiological conditions and 1 g passive tension. Epoetin beta (rEPO) was added cumulatively at 0.1, 1 and 10 IU/ml concentrations to the myometrial samples showing regular spontaneous contractions for periods of 30 min. Frequency and amplitude of contractions were electrophysiologically recorded and analyzed by using a BIOPAC data acquisition system. RESULTS: rEPO inhibited both area under curve and frequency of spontaneous contractions (ANOVA, n1, 2 = 9, f1 = 20.938, f2 = 20.492, p1,2 = 0.000). The inhibitory effect was insignificant at 0.1 mIU/ml rEPO level (Tukey HSD, p1 = 0.051, p2 = 0.581). In the oxytocin treated myometrial samples, a single dose of 1 IU/ml rEPO was studied. The area under curve and frequency values of these samples were inhibited by rEPO (Student's t-test, n = 9, t1 = 4.776, p1 = 0.000; t2 = 2.835, p2 = 0.012, respectively). CONCLUSIONS: rEPO inhibited spontaneous and oxytocin-induced rat myometrial contractions at 1 and 10 IU/ml concentrations. It appeared that the effect was dose-dependent.Yeditepe University Research FoundationThis study was supported by Yeditepe University Research Foundation