Characteristics of deliveries at a tertiary care hospital in Turkey: results from a retrospective analysis (2012-2016)

Background: Although the choice of a particular method of birth delivery by the pregnant woman is a modern, complex and controversial subject all over the world, the rate of caesarean delivery has risen to nearly 50% in western countries. Apart from medical reasons, several non-medical factors are also involved in this choice, and they comprise the socioeconomic conditions, ethical/legal concerns and psychological and cultural characteristics of the patients and doctors. In this study, we aimed to evaluate the demographic and clinical characteristics of pregnant women who gave birth in a tertiary care hospital between October 2012 and June 2016.Methods: The patients’ charts of pregnant women who presented to the Canakkale Onsekiz Mart University hospital between October 2012 and June 2016 and who gave birth through either vaginal or caesarean delivery were retrospectively analysed. The patients’ age, delivery type, weeks of pregnancy at delivery, number of pregnancies and caesarean indications were recorded.Results: In this study, we retrospectively analysed 2012 pregnant women. The mean age of the pregnant women was 28.9 ±5.4 years. The mean gravida and parity of pregnant women were 1.9±1.0 and 1.5±0.7, respectively. Regardless of the delivery type, the mean pregnancy weeks were found to be 38.6±1.9 weeks. The mean pregnancy weeks of patients undergoing caesarean delivery were 38.4±1.8 weeks. The primary caesarean rates were 52.81%. The most common caesarean delivery indications were foetal distress, cephalopelvic disproportion and presentation anomalies.Conclusions: The steady increase in caesarean delivery rates has become a major cause of concern worldwide. The reasons for this phenomenon are mostly related to advanced age; foetal distress, especially one that is detected in continuous foetal monitoring; intrauterine growth retardation; presentation anomalies and multiple gestation. To avoid unnecessary caesarean births, mothers, especially nulliparous mothers, should be persuaded to undergo vaginal delivery

A STUDY ON THE RELATIONSHIP BETWEEN SELF-PERCEPTION OF PARENTAL ROLE AND MARITAL ATTITUDE

Individuals’ perceptions of parental roles is a significant aspect of their parenting and one's appraisal of parental roles might be related to their global appraisal of marriage. Therefore in this study, it was aimed to examine the relationship between self perception of parental role and marital attitude. The participants of the study are comprised of 220 females and males. In order to gather socio-demographic information, the parents were administered an “Individual Information Form”. In order to assess participants’ self-perception of parental roles Self-Perception of Parental Role Scale, and in order to assess marital attitudes of the participants Marital Attitude Scale (MAS), were administered. As a result, it was found that there are significantly positive correlations (p<0.05) between the scores of the competence and role balance subdimensions of SPPR and the scores of MAS, whereas there are no significant correlations (p>0.05) between the scores of the role satisfaction and investment subdimensions of SPPR and the scores of MAS. The findings are discussed in terms of the relevant literature.  Article visualizations

Alterations in sexual functions during and after pregnancy: Prejudice? Or Real?

Sexual function in women is a complex and dynamic interaction of multiple variables including physical, emotinal, social, and physiological states. Moreover, sexual function is a key part of each human being’s personality and a cornerstone in the overall couple relationship with an obvious affect on health related quality of life. A dysfunction in female sexual cycle can result in lack of desire for sexual contact, arousal and an inability to have an orgasm. Pregnancy is a period with many alterations in human physiology leading to challenges in sexual function. Endocrine, biologic, psychosomatic and social factors as well as anatomical alteations during pregnancy and the different mode of delivery may aggravate female sexual dysfunction. This literature review examines research articles that investigated female sexual function, sexual dysfunction, and sexual functioning in pregnancy in order to obtain how these parameters affect a woman’s sexual related quality of life

The prevelance of human papillomavirus (HPV) genotypes detected by PCR in women with normal and abnormal cervico-vaginal cytology

Objectives: Cervical cancer is the second most common type of cancer for women worldwide with a great proportion proved to be related to human papillomavirus (HPV) infection. As infection with HPV is the strongest risk factor for cervical neoplasia, detection of HPV genotypes in cervical and vaginal specimens of women with normal and abnormal cytology seems to be of paramount importance in cervical cancer screening. The objective of the study is to evaluate the prevalence and HPV genotypes among women with normal or abnormal Pap smear tests. Material and methods: This retrospective study was conducted in a tertiary care university hospital in western Turkey. A total of 201 patients in whom both HPV typing and Pap test was performed between 2012 and 2016 in our obstetrics and gynecology department were enrolled in this study. Clinical and laboratory data were obtained for all participants. Cervical smears of the patients were classified by the Bethesda system and HPV analyses were done using the polymerase chain reaction (PCR) method. Results: This study included 201 women, 72 of whom had normal and 129 of whom had abnormal Pap smear results. HPV DNA was detected in 91 (45.2%) of the 201 investigated women. Out of 72 patients with normal cervico-vaginal cytology, HPV positivity was detected in 35 (49%) patients, whereas 33 (35%) patients out of 94 with ASCUS , 18 (62%) patients out of 29 with LSIL and 5 (83%) patients out of 6 with HSIL had HPV positivity. Out of 35 HPV positive women that had normal pap test results, 25 (75%) were found to have high risk HPV (HR-HPV) genotypes. In women with ASCUS, LSIL and HSIL, HR-HPV genotype rates were found to be 94%, 89% and 100% respectively. The most common identified HPV types were HPV58, HPV16, HPV31, HPV33, HPV11 and HPV35. Conclusions: The frequency of HPV infection was found to be higher in our study compared to previous reports. Moreover, although HR-HPV genotypes were also detected in patients with normal cervical cytology, a majority of patients with HR-HPV genotypes were associated with abnormal cervical smear cytology including high rates of atypical squamous cells of undetermined significance, low-grade squamous intraepithelial lesion, and high-grade squamous intraepithelial lesion

Evaluation of the hematologic system as a marker of subclinical inflammation in hyperemesis gravidarum: a case control study

Objectives: Current evidence suggests that subclinical inflammation plays a significant role in the development of hyperemesis gravidarum (HEG). Simple hematological markers, such as mean platelet volume (MPV), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR), have been shown to reflect inflammatory burden and disease activity in several disorders. This study aimed to determine the diagnostic value of these hematological parameters for HEG. Material and methods: A total of 54 HEG patients and 58 age- and gestational-age-matched control subjects were studied. NLR, MPV, PLR, platelet distribution width (PDW), and red cell distribution width (RDW) values in all patients were calculated and recorded from complete blood cell counts. Results: For HEG patients, the median NLR was 3.2 (1.6–7.1), and the median PLR was 143.7 (78.1–334.6); for control subjects, the values were 2.1 (1.0–4.7) and 93.1 (47.3–194.7), respectively. Although both the NLR and PLR of HEG patients were found to be significantly higher than in the controls, no significant difference was found between the study groups in terms of MPV, RDW, or PDW. Correlation analysis revealed a significant correlation between NLR and CRP (r = 0.872, p < 0.001). Conclusions: Our results show that peripheral blood NLR and PLR values can reflect inflammatory burden in HEG patients and can be used as markers for HEG

The association of oxidative stress with serum irisin and betatrophin in pregnant women with gestational diabetes mellitus

Background. Irisin and betatrophin are polypeptide hormones implicated in glucose metabolism and insulin resistance (IR). Gestational diabetes mellitus (GDM) is accompanied by oxidative stress (OS) and the association between circulating irisin and betatrophin levels and GDM is controversial. The present study aimed to investigate the association of second-trimester irisin, betatrophin concentrations and their correlations between serum OS markers in GDM patients. Methods. The study included 45 GDM patients and 45-age matched pregnant women as controls. Serum fasting glucose, HOMA-IR, ischemia modified albumin (IMA), total oxidative stress (TOS), total antioxidant status (TAS), oxidative stress index (OSI), irisin and betatrophin were measured. Results. Serum irisin levels were decreased and TOS and OSI levels were found to be increased in the patient group. No significant difference was found with respect to serum betatrophin and IMA levels between study groups. A correlation analysis revealed no correlation between serum irisin and other assessed variables. Conclusions. Gestational diabetes mellitus is an OS condition in addition to being a metabolic disease. Although not correlated with OS, irisin but not betatrophin may be a useful biomarker to predict GDM

Serum spexin, adiponectin and leptin levels in polycystic ovarian syndrome in association with FTO gene polymorphism

Objectives: Polycystic ovary syndrome (PCOS) is a complex reproductive endocrinopathy among reproductive-aged women and related with body mass and insulin resistance. Adipocytokines produced by adipose tissue seems to take part in the hormonal and metabolic alterations that arise in PCOS. Fat mass and obesity associated (FTO) gene is linked with body mass index (BMI) and diabetes. Aims — To investigate the association between fat mass related adipocytokines and single nucleotide polymorphisms (SNPs) (rs9939609 T/A) in the FTO gene in women with PCOS.Material and methods: FTO+rs9939609 gene polymorphism and serum spexin, adiponectin and leptin levels were deter-mined in 91 PCOS women and 86 healthy controls. Study participants were subdivided according to BMI and comparisons were made within each group. Results: Serum spexin levels were not differed between study groups. Serum levels of adiponectin were found to be de-creased in PCOS women with BMI lower than 25 kg/m2 (10.1 ± 5.6 vs 14.1 ± 9.1, p = 0.015). Serum leptin levels were elevated in obese PCOS women compared to healthy control group (2197.9 ± 596.3 pg/mL vs 1535.9 ± 812.1 pg/mL, p = 0.001). The prevalence of A risk allele of SNP rs9939609 was more frequent in PCOS patients than in the control group. PCOS risk was found to increase 3 times more in AA genotype when compared with TT genotype (OR = 3.04 95% CI: 1.243–7.309; p = 0.013).Conclusions: Serum adiponectin and leptin levels may serve as independent markers for PCOS diagnosis. Moreover, the FTO+rs9939609 gene polymorphism increase susceptibility to PCOS development independent from serum adipocytokine levels

Characteristics of deliveries at a tertiary care hospital in Turkey: results from a retrospective analysis (2012-2016)

Background: Although the choice of a particular method of birth delivery by the pregnant woman is a modern, complex and controversial subject all over the world, the rate of caesarean delivery has risen to nearly 50% in western countries. Apart from medical reasons, several non-medical factors are also involved in this choice, and they comprise the socioeconomic conditions, ethical/legal concerns and psychological and cultural characteristics of the patients and doctors. In this study, we aimed to evaluate the demographic and clinical characteristics of pregnant women who gave birth in a tertiary care hospital between October 2012 and June 2016.Methods: The patients’ charts of pregnant women who presented to the Canakkale Onsekiz Mart University hospital between October 2012 and June 2016 and who gave birth through either vaginal or caesarean delivery were retrospectively analysed. The patients’ age, delivery type, weeks of pregnancy at delivery, number of pregnancies and caesarean indications were recorded.Results: In this study, we retrospectively analysed 2012 pregnant women. The mean age of the pregnant women was 28.9 ±5.4 years. The mean gravida and parity of pregnant women were 1.9±1.0 and 1.5±0.7, respectively. Regardless of the delivery type, the mean pregnancy weeks were found to be 38.6±1.9 weeks. The mean pregnancy weeks of patients undergoing caesarean delivery were 38.4±1.8 weeks. The primary caesarean rates were 52.81%. The most common caesarean delivery indications were foetal distress, cephalopelvic disproportion and presentation anomalies.Conclusions: The steady increase in caesarean delivery rates has become a major cause of concern worldwide. The reasons for this phenomenon are mostly related to advanced age; foetal distress, especially one that is detected in continuous foetal monitoring; intrauterine growth retardation; presentation anomalies and multiple gestation. To avoid unnecessary caesarean births, mothers, especially nulliparous mothers, should be persuaded to undergo vaginal delivery