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    Down's Syndrome Screening Markers and HLA-G to Determine High-risk Pregnancies
    (Duzce Univ, 2013) Biyik, Ismail; Karatas, Ahmet; Kose, Seyit Ali
    High risk pregnancy defines pregnancies that affects mother or fetus, and experience one or more health problems. Pre-eclampsia, intrauterine growth retardation, preterm labor, preterm premature rupture of membranes is the leading cause of fetal morbidity and mortality. Preeclampsia is still continuing actuality as the most common risk increasing factor on maternal and fetal morbidity and mortality in high-risk pregnancies. Especially, in recent years, steps have been taken to identify high-risk pregnancies during the first trimester. Among the molecules studied in soluble HLA-G associated with defect in placental trophoblast invasion, pregnancy-associated plasma protein A, free beta human chorionic gonadotrophin, alpha feto-protein, inhibin, estriol are included. In the case of detection of high risk pregnancies in the first trimester, closer monitoring will be provided and strategies for preventing pregnancy complications will be improved.
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    EARLY NEONATAL OUTCOMES IN PATIENTS WITH LATE PRETERM BIRTH
    (Galenos Publ House, 2013) Karatas, Ahmet; Albayrak, Mustafa; Keskin, Fatih; Biyik, Ismail; Okur, Mesut; Gunes, Cemalettin; Kose, Seyit Ali
    Objective: Preterm deliveries increased in many countries in recent years. However, despite fetal lung maturity, substantial neonatal morbidity may occur even after 34 weeks of gestation. The aim of this study was to evaluate neonatal morbidity and mortality in women with late preterm births. Design: Retrospective. Setting: Duzce University School of Medicine, Departments of Obstetrics and Gynecology and Pediatri Clinics. Patients: Medical records of 291 pregnant women and newborns born between the 340/7-366/7 weeks of gestation were reviewed. Interventions: The whole population is first divided into two groups as depending on the presence of PPROM or not; and then also divided into-three groups based on the gestational age at delivery as 34(0/7)-34(6/7) week (Group 1), 35(0/7)-35(6/7) week (Group 2), and 36(0/7)-36(6/7) week (Group 3). Main outcome measures: Groups were compared with respect to neonatal complications related to prematurity, and early membrane rupture. Results: Of the 291 neonates included in the study, 85 were delivered preterm due to PPROM, 206 were non-PPROM group, and 76 were in Group 1, 108 were in Group 2, and 107 were in Group 3. Sepsis rate was higher in Group 1 and 2 compared to Group 3 (p=0.016, p=0.029). NICU stay period was longer in Group 1 and Group 2 than group 3 (p=0.028, p=0.015 respectively). Newborns in Group 1 had significantly longer hospital stay than Group 3 (p=0.010), and total hospital stay period were significantly higher in newborns with sepsis. Conclusions: The late-preterm infants especially in earlier weeks represent a significantly higher risk category for neonatal complications, and they have a significantly longer NICU and hospital stay period.
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    EVALUATION OF TREATMENT SUCCESS IN PATIENTS WHO UNDERWENT TRANSOBTURATOR TAPE SURGERY
    (Galenos Yayincilik, 2014) Karatas, Ahmet; Duran, Bulent; Ozlu, Tulay; Koc, Onder; Donmez, Melahat Emine; Guler, Arzu
    Aim: Transobturator tape (TOT), a minimal invasive surgery for patients with urinary incontinence, is also frequently applied in addition to other gynecologic surgeries. Previous studies report a cure rate of 80-92% with TOT. In this study, we aimed to evaluate treatment success in patients to whom TOT was applied in our clinics. Materials and methods: Patients to whom TOT was applied in our clinics between January 2009 and April 2013 were retrospectively evaluated. Follow up records were investigated to find out our TOT success rate and other urogynecologic problems that developed during follow up. Presence of ongoing urinary incontinence was accepted as TOT failure. Results: 107 cases to whom TOT was applied and with accessible data were included. Median age of the cases was 59 (26-84). 72% (n= 77) of these were in menopause, 91.6% (n= 98) were multiparous and 59.8% (n= 64) had simultaneous gynecologic surgeries. Most frequent additional operation was vaginal hysterectomy (n= 42, 39.3%). Median postoperative follow up duration was 2.4 years (0.5-4years). 13.1% (n= 14) of the cases had ongoing urinary incontinence during follow up. Our TOT success rate was 87.9%. This rate was 87.5% in cases with and 88.4% in cases without a simultaneous surgery (p>0.05); 85.7% in postmenopausal and 93.3% in premenopausal cases (p>0.05). During follow up, cystocele developed in 8.4% and cuff prolapsus developed in 11.2% of the cases. Conclusions: Cure rate of TOT cases in our clinics is in accordance with the numbers in the literature. TOT success rate is not affected from the menopausal status or the application of any other simultaneous gynecologic surgery.