Does applied ultrasound prior to laparoscopy predict the existence of intra-abdominal adhesions?

diagnostic tool, in predicting the presence of intraabdominal adhesions, especially near the trocar entry area, to provide safe surgical access to the abdomen. Materials and methods: Fifty-nine women with a previous history of open abdominal surgery (group A) and a group of 91 women with no previous history of surgery (group B) underwent dynamic ultrasound evaluation of the abdominal fields before laparoscopic operations. The anterior abdominal wall was divided into six quadrants: right upper, right lower, left upper, left lower, suprapubic, and umbilical. Adhesions were evaluated by surgeons during the operation and by radiologists using USG prior to the operation. Visceral organ movements greater than 1 cm was defined as normal visceral slide (positive test), with less than 1 cm of movement defined as abnormal visceral slide (negative test). Sliding test measures movements of omental echogenicity or a stable echogenic focus that corresponds to intestine peritoneal echogenicity that underlies abdominal wall during exaggerated inspiration and expiration. Adhesions observed during surgery were evaluated on a four-point scale, with 0 indicating no adhesions present, 1 indicating the presence of a thin, filmy avascular adhesion, 2 indicating the presence of a dense and vascular adhesion, and 3 indicating adhesions that connect surrounding organs with the overlying peritoneal surfaces. The McNemar test was used to compare the results of USG and laparoscopy for each measure. Results: We found that preoperative USG was successful in identifying adhesions [sensitivity, 96.39% (95% CI 89.8–99.2); specificity, 97.43%] Conclusion: Preoperative ultrasound examination of the abdominal wall may enhance the safety of abdominal entry during laparoscopic operations

Evaluation of the Relationship Between the Level of Vitamin D in Maternal Blood and Breast Milk and Postpartum Depression

Objective: This study aimed to evaluate the relationship between postpartum depression (PPD) and vitamin D levels in maternal blood and breast milk. Material and Methods: The study included women who presented to a polyclinic between December 2017 and_x000D_ August 2018, 4-6 weeks after having given live birth, who were aged between 18 and 40 years and married, gave birth after a planned single_x000D_ pregnancy, were feeding their baby with only breast milk and stated that they were taking vitamin D supplementation at the dose recommended by the Ministry of Health. The depression status of the women who agreed to participate in the study by signing the volunteer informed_x000D_ consent form was evaluated using the Edinburgh Postpartum Depression Scale (EPDS). Two groups were formed as Group 1: EPDS score_x000D_ <13 (n=44) (without PPD) and Group 2: EPDS score ≥13 (n=31) (with PPD). The vitamin D levels in breast milk and maternal blood in both_x000D_ groups were compared. Results: 75 female patients included in the study had a mean age of 29.80±4.54 years. The mean vitamin D levels in_x000D_ breast milk and maternal blood were found to be 13.26±5.39 ng/mL and 17.14±6.79 ng/mL, respectively. In terms of depression status, no_x000D_ statistically significant difference was found between the groups regarding the serum vitamin D levels and the mean level of vitamin D in breast_x000D_ milk (p=0.463, p=0.847). Conclusion: No significant correlation was determined between the vitamin D levels in maternal blood and breast_x000D_ milk and PPD, while vitamin D was found to be low both in maternal blood and breast milk

How often do women use non-drug treatment methods for psyschiatric symptoms during pregnancy and postpartum periods?

The aim of this study was to determine the prevalence of complementary and alternative medical applications (CAM) and non-drug treatments of women during their pregnancies, postpartum periods and the changes between these periods. The Screening Form for Non-pharmacologic Methods Used during Pregnancy and Postpartum period was administered to the participants. Passiflora (Incarnata), Hypericum perforatum (St. John’s Wort), omega 3 supplements, bright light treatment, transmagnetic stimulation, S-adenosyl- methionine, herbal teas, biofeedback/neurofeedback, amulets, exercise, acupuncture and psychotherapy were investigated. The ratio of the use of one of the CAM methods for psychiatric complaints during people’s lifetime was found to be 33.3% (n=162). Herbal teas were the main practice used during pregnancy (58.8%) and the postpartum. The use of CAM according to the utilization periods of the participants statistically significantly decreased in those who were currently pregnant (Cochran’s Q=298.007; P<0.05). The use of participants’ non-drug treatments in the periodical follow-up decreased in those who are currently pregnant and increased during the postpartum period

Missing intrauterine devices, laparoscopic and a_x000D_ conventional management: A single–center experience

Introduction: Intrauterine contraception devices (IUCD) are frequently and safely used in pregnancy control. Migration related complications, such as adhesions and perforations, can be encountered as the most important_x000D_ but rare circumstances. In such cases, the laparoscopic approach is beneficial with the least harm principle._x000D_ Materials and Methods: This study included ten patients who were admitted to our hospital between 2015–_x000D_ 2019 with chronic abdominal pain, induced by migrated intrauterine devices. Patients’ complaints, radiological methods used in diagnosis, IUCD insertion timing, migration of IUCD and time interval to diagnosis, intra–abdominal migration points, and types, as well as surgical interventions, were evaluated retrospectively._x000D_ Results: While all patients were diagnosed with abdominal ultrasonography and gynecological examination, some patients underwent computed tomography 60% and plain radiogram 20% as additional imaging._x000D_ While the intra–abdominal migration site of IUCD was ascertained as the most common localization in the_x000D_ lower right quadrant of the omentum (30%), the placement in the umbilical hernia site was the rarest and the_x000D_ only one in the literature. Three different types of IUCD were detected; Copper–T (80%) was the most common, while IUCDs were laparoscopically removed in all patients except for the patient who underwent open_x000D_ surgery due to acute cholecystitis. All patients who had laparoscopic surgery were discharged the next day._x000D_ Conclusion: In conclusion, the IUCD’s frequency of use is increasing as the current method of contraception,_x000D_ dislocation of the device may be encountered if the required conditions are not taken into consideration_x000D_ during the application. In such a situation, laparoscopic removal of a dislocated IUCD is a safe, feasible, and_x000D_ less invasive method

Hematological Parameters to Predict the Severity of Hyperemesis Gravidarum and Ketonuria

Objective Hyperemesis gravidarum (HG) is a pregnancy complication that can progress with persistent nausea and vomiting. The aim of the present study is to evaluate the relationship between hematological parameters and HG

Effects of antepartum education on worries about labor and mode of delivery

Aim This study evaluated the effects of antenatal education, which was provided in a pregnancy education class, on pregnant women’s concerns about labor and the mode of delivery. Materials and Methods Primigravid pregnant women (n = 144) were enrolled into the study between May 2017 and November 2018. Pregnant women received standard education on nutrition during pregnancy, exercise, methods of coping with pain, and breastfeeding. The participants completed the “Introductory Information Form” and “Oxford Worries about Labour Scale” to collect data. Results A statistically significant difference was found between the participants’ pain, distress, uncertainty, and interventions in the pre-education, post-education, and postpartum periods and mean total score on the Oxford scale (p.05). Conclusion Education provided during pregnancy significantly decreased women’s worries about labor, but it did not lead to a significant difference in the modes of delivery

Treatment Results of Patients Followed in Intensive Care Unit in Severe Maternal Morbidity Cases

Objective: The aim of this study was the evaluation of the characteristics and treatment results of women, who were brought to the intensive care unit due to severe obstetric morbidity, together with severe and acute complications in pregnancy. Study Design: Pregnant and puerperal women treated in the intensive care unit of a tertiary care center during two years of time were included in this study, and their files were scanned retrospectively. Patients’ demographic characteristics, length of stay, point of entry, neonatal results, birth statuses and modes of delivery, hemodynamic data, and histories were recorded. The qualitative data were evaluated by the Pearson Chi-squared, Fisher Freeman Halton, and Fisher’s Exact tests. Results: In the two-year period, 16,728 births occurred at our hospital. 68 cases among them were accompanied with severe maternal morbidity, and 2 maternal deaths were observed in our clinic. Of the cases, 58.8% (n=40) had severe hypertensive diseases, whereas 35.3% of the cases (n=24) had obstetric complications that developed due to bleeding. While 40% of the cases (n=16) with hypertension had severe pre-eclampsia, 35% of the cases (n=14) had eclampsia and 25% (n=10) had HELLP. Conclusions: The most important reasons for severe maternal morbidity are the complications related to obstetric bleeding and hypertensive diseases related to pregnancy. Early diagnosis of the obstetric complication risk factors is necessary for preventing maternal morbidity. Antenatal follow-ups and the births of high risk pregnancy patients should be performed in tertiary centers

Evaluation of risk factors for intrauterine device failure

Amaç. Bu çalışmanın amacı RİA kullanımında başarısızlık ile rahim kavite uzunluğu, eğitim seviyesi, RİA ipinin uzunluğu, kullanım süresi, RİA tecrübesi, gravida, parite ve yaş gibi bazı faktörlerin ilişkisinin incelenmesidir. Yöntemler. Kliniğimize rastgele başvuran problemli spirali olan 48 hasta bizim çalışma gurubumuzu oluşturmuştur ve hiçbir yakınması olmayan spiralinin günü geçtiği için yeni spiral isteyen veya bebek yapmayı planlayan 30 hasta kontrol gurubumuzu oluşturmuştur. Her iki gurup demografik özellikler, eğitim seviyesi, düşük öyküsü, adet düzeni, doğum şekli, RİA tecrübesi ve kan sayımı, spiralin kullanım süresi, tipi, kuyruk uzunluğu ve rahim kavitesinin uzunluğu açısından karşılaştırılmıştır. Bulgular. RİA ipinin uzunluğu, kavite uzunluğu, eğitim seviyeleri ve RİA tecrübesi açısından istatistiksel olarak anlamlı sonuçlar saptadık. Sonuç. Biz RİA ipinin uzunluğu, kavite uzunluğu, eğitim seviyeleri ve RİA tecrübesinin spiral kullanımındaki başarısızlıkla ilişkili olduğu düşüncesindeyiz.Aim. The aim of this study was to detect the relationship between IUD failure and some factors such as length of tail, IUD experience, education level, utilization period, gravidy, parity, age and length of uterine cavity. Methods. Our study groups included 48 patients who were randomly admitted to our clinic for problematic IUD and 30 normal patients without any complaints who were admitted to our clinic with out of date IUD who wanted new IUD insertion or desired to become pregnant as control group. Both groups were evaluated for the demographic characteristics such as education level, history of abortion, menstrual regulation, and type of delivery, IUD experience and blood count, duration of IUD use, length of tail, type of IUD, and length of uterine cavity. Results. We detected statistically significant results for length of cavity, length of tail, education level and IUD experience. Conclusion. We are in the opinion that length of uterine cavity, length of IUD tail, educational level and IUD experience are associated with IUD failure