Introduction Uterine incarceration is the entrapment of the uterus between the subpromontory sacr... more Introduction Uterine incarceration is the entrapment of the uterus between the subpromontory sacrum and the pubis, during the growth of the gravid uterus (Jacobsson and Wide-Swensson 1999). It is relatively more common during the first trimester of gestation (10–15%) which, as the gestation progresses into the second trimester resolves spontaneously as the gravid uterus grows out of the true pelvis. Uterine incarceration at term pregnancies are observed at a rate of about 1:3000 (Diericks et al. 2014). The association of anomalous placental insertions (in our case, a placenta percreta) with uterine incarceration has been referred to in only a few publications, previously (Sutter et al. 2006; De Friend et al. 2000; Pongthai and Sumawong 1978).
Turkiye Klinikleri Journal of Gynecology and Obstetrics, 2015
isterna magna is located in the posterior fossa of the brain dorsal to the cerebellum and it cont... more isterna magna is located in the posterior fossa of the brain dorsal to the cerebellum and it contains cerebrospinal fluid. It links to the fourth ventricle by foramen Magendie and foramen Luschka. Cisterna magna could be accepted as enlarged if the anteroposterior diameter between dorsal aspect of the cerebellar vermis and inner edge of the occipital bone was measured larger than 10 mm. 1 There is limited data in literature about outcomes of isolated cisterna magna enlargement. These limited amount of data indicates normal neonatal and developmental outcomes however shortness of the available evidences about the outcomes of iso
Journal of Turkish Society of Obstetric and Gynecology
Akar et al. Obstetric hemorrhage training workshops Obstetric hemorrhage and surgical emergencies... more Akar et al. Obstetric hemorrhage training workshops Obstetric hemorrhage and surgical emergencies training workshops on fresh cadavers and simulators result in high application in daily practices and decreased patient referral Taze kadavralar ve simülatörler üzerinde obstetrik kanama ve cerrahi acil durumlar eğitim atölyeleri, günlük pratikte yüksek uygulama ile sonuçlanır ve hasta sevkini azaltır
Endometriosis is the growth of endometrial cells outside the uterine cavity. Most common localiza... more Endometriosis is the growth of endometrial cells outside the uterine cavity. Most common localizations are pelvic organs and peritoneum. Endometriosis mostly affects women in their reproductive years. After surgery it can be seen on the abdominal wall. This article includes two patients, one has abdominal wall endometriosis and the other has inguinal endometriosis. Both of them had surgical excision without recieving any medical treatment.
Journal of Obstetrics and Gynaecology Research, 2022
OBJECTIVE Reliable aneuploidy risk estimation in first trimester is prominently interconnected wi... more OBJECTIVE Reliable aneuploidy risk estimation in first trimester is prominently interconnected with accurate assessment of maternal serum biomarkers. Some maternal factors like insulin-dependent diabetes, weight, and rhesus status are known to alter levels of these biomarkers. Adjustment of biomarker values for specific factor is crucial to avoid excessive invasive procedures or missed diagnoses. We aimed to investigate the effects of noncavity distorting intramural uterine fibroids on first trimester aneuploidy screening test maternal serum biomarkers. METHODS Pregnant women who underwent first trimester aneuploidy screening test in a single tertiary center between 2011 and 2020 were retrospectively assessed. One hundred ninety-eight women were found to have at least one noncavity distorting intramural uterine leiomyoma (Figo type 3-6) of at least 2 cm diameter and remaining women were assigned as controls. First trimester aneuploidy screening test parameters were compared. RESULTS Pregnancy associated plasma protein-A (PAPP-A) MoMs were found significantly lower in leiomyoma group in comparison to control group (1.19 ± 0.60 MoM vs. 1.40 ± 0.73 MoM, p = 0.002). PAPP-A MoMs in women with leiomyomas larger than 5.5 cm were significantly lower in comparison to both control group and women with ≤5.5 cm leiomyomas (0.82 ± 0.376 vs. 1.40 ± 0.73, p < 0.001; 0.82 ± 0.376 vs. 1.33 ± 0.61 p < 0.001, respectively). PAPP-A MoM and size of leiomyoma were found inversely correlated when fibroid size exceeds 5.5 cm (r = -0.467, p < 0.001). CONCLUSION Noncavity distorting intramural uterine leiomyomas >5.5 cm are associated with low first trimester PAPP-A MoMs (<0.5). PAPP-A concentrations are inversely correlated with fibroid size in women with >5.5 cm intramural uterine leiomyomas. Fibroids ≤5.5 cm are not associated with alterations in first trimester aneuploidy screening test parameters.
Vulvar neoplasias are rarely encountered lesions at female genital tract, regardless if they are ... more Vulvar neoplasias are rarely encountered lesions at female genital tract, regardless if they are primary or metastatic. Presence of signet ring cells in a tumour at female genito-urinary tract is highly suggestive of a metastatic lesion particularly from a gastrointestinal tumour. Here the authors present a case of vulvar carcinoma with signet ring cells with an undetermined primary site possibly originating from embryonic cloaca.
Purpose: To evaluate the effects of adjuvant letrozole administration on outcomes of gonadotropin... more Purpose: To evaluate the effects of adjuvant letrozole administration on outcomes of gonadotropin releasing hormone (GnRH) antagonist cycles with intracytoplasmic sperm injection in POSEIDON group 3 and 4 expected poor responder women. Methods: This study was conducted by retrospective analysis of patients with expected poor ovarian response (POSEIDON group 3 and 4) that underwent GnRH antagonist cycles with intra-cytoplasmic sperm injection between 2010 and 2020. A total of 488 patients with letrozole co-administration and 2564 patients without any adjuvant treatment that underwent GnRH antagonist cycles within the selected period of time were included in the study. Results: Implantation rates, clinical pregnancy rates and live birth delivery rates were significantly higher in letrozole administered patients in comparison to controls among POSEIDON group 3 women (0.39±0.46 vs 0.27±0.40, p=0.01; 46.1% vs 33%, p=0.014; 42.7% vs 31.5%, p=0.034, respectively). Mean total doses of gonad...
Gynecology Obstetrics and Reproductive Medicine, 2016
Aim of the paper is to investigate the suspicious role of HPV in synchronous endometrial and cerv... more Aim of the paper is to investigate the suspicious role of HPV in synchronous endometrial and cervical carcinomas and to discuss the relation between HPV and endometrium epithelium. The first case is 68- year-old and the second case is 56 year-old postmenopausal woman who were diagnosed with invasive cervical carcinoma synchronously with endometrial carcinoma. Following surgical procedures, high risk HPV DNA analysis using PCR were undertaken in both cases to investigate the possible role of HPV in synchronous malignancies. All endometrial samples were considered as negative for high risk HPV types however all cervical samples were considered as positive. Unlike cervical pathologies, HPV does not seem to play active role as etiologic agent in endometrial neoplasms, even detected synchronously with invasive cervical cancers.
Turkiye Klinikleri Journal of Gynecology and Obstetrics, 2014
Caffey disease or cortical hyperostosis is characterized by massive subperiostal new bone formati... more Caffey disease or cortical hyperostosis is characterized by massive subperiostal new bone formation at diaphyses of long bones mandible and clavicle as a result of a multifocal inflammatory skeletal process and classified into two forms regarding the onset of the disease: infantile form and prenatal form. Prenatal form with earlier onset tends to be more severe and a less frequently encountered diagnosis while late onset infantile form is usually presents with a self limiting disease. Polyhydramnios, irregularly shaped bones and hepatomegaly should raise suspicion about this rare disease when detected on ultrasonographic examinations. Here we present a case of severe prenatal cortical hyperostosis diagnosed by ultrasonographic examinations performed at 31 weeks of gestation that was revealed to have polyhydramniosis, hepatomegaly, pulmonary hypoplasia and irregularly shaped long bones.
Ovarian torsion in pregnancy is a rare event occurring approximately 1 in every 5000 live births ... more Ovarian torsion in pregnancy is a rare event occurring approximately 1 in every 5000 live births and it is a surgical emergency that usually managed by salpingoophorectomy or detorsion. Early recognition and intervention could be valuable to preserve ovarian reserve and to prevent the development of further complications. This condition usually occurs at first or second trimester in pregnancy and it is a difficult diagnosis to establish or even to be suspicious about. However ovarian torsion in late pregnancy especially in the course of labor is more infrequent and diagnosis is even thornier. Uneasy nature of labor could lead physicians to miss the diagnosis. Thereby abdominal pain in the course of labor that anywise diverges from the pain caused by normal labor processes requires high level of suspicion also in regard of a newly developed ovarian torsion amongst several other possible causes of acute abdomen. Here we present a case of ovarian torsion developed in the course of labo...
Introduction Uterine incarceration is the entrapment of the uterus between the subpromontory sacr... more Introduction Uterine incarceration is the entrapment of the uterus between the subpromontory sacrum and the pubis, during the growth of the gravid uterus (Jacobsson and Wide-Swensson 1999). It is relatively more common during the first trimester of gestation (10–15%) which, as the gestation progresses into the second trimester resolves spontaneously as the gravid uterus grows out of the true pelvis. Uterine incarceration at term pregnancies are observed at a rate of about 1:3000 (Diericks et al. 2014). The association of anomalous placental insertions (in our case, a placenta percreta) with uterine incarceration has been referred to in only a few publications, previously (Sutter et al. 2006; De Friend et al. 2000; Pongthai and Sumawong 1978).
Turkiye Klinikleri Journal of Gynecology and Obstetrics, 2015
isterna magna is located in the posterior fossa of the brain dorsal to the cerebellum and it cont... more isterna magna is located in the posterior fossa of the brain dorsal to the cerebellum and it contains cerebrospinal fluid. It links to the fourth ventricle by foramen Magendie and foramen Luschka. Cisterna magna could be accepted as enlarged if the anteroposterior diameter between dorsal aspect of the cerebellar vermis and inner edge of the occipital bone was measured larger than 10 mm. 1 There is limited data in literature about outcomes of isolated cisterna magna enlargement. These limited amount of data indicates normal neonatal and developmental outcomes however shortness of the available evidences about the outcomes of iso
Journal of Turkish Society of Obstetric and Gynecology
Akar et al. Obstetric hemorrhage training workshops Obstetric hemorrhage and surgical emergencies... more Akar et al. Obstetric hemorrhage training workshops Obstetric hemorrhage and surgical emergencies training workshops on fresh cadavers and simulators result in high application in daily practices and decreased patient referral Taze kadavralar ve simülatörler üzerinde obstetrik kanama ve cerrahi acil durumlar eğitim atölyeleri, günlük pratikte yüksek uygulama ile sonuçlanır ve hasta sevkini azaltır
Endometriosis is the growth of endometrial cells outside the uterine cavity. Most common localiza... more Endometriosis is the growth of endometrial cells outside the uterine cavity. Most common localizations are pelvic organs and peritoneum. Endometriosis mostly affects women in their reproductive years. After surgery it can be seen on the abdominal wall. This article includes two patients, one has abdominal wall endometriosis and the other has inguinal endometriosis. Both of them had surgical excision without recieving any medical treatment.
Journal of Obstetrics and Gynaecology Research, 2022
OBJECTIVE Reliable aneuploidy risk estimation in first trimester is prominently interconnected wi... more OBJECTIVE Reliable aneuploidy risk estimation in first trimester is prominently interconnected with accurate assessment of maternal serum biomarkers. Some maternal factors like insulin-dependent diabetes, weight, and rhesus status are known to alter levels of these biomarkers. Adjustment of biomarker values for specific factor is crucial to avoid excessive invasive procedures or missed diagnoses. We aimed to investigate the effects of noncavity distorting intramural uterine fibroids on first trimester aneuploidy screening test maternal serum biomarkers. METHODS Pregnant women who underwent first trimester aneuploidy screening test in a single tertiary center between 2011 and 2020 were retrospectively assessed. One hundred ninety-eight women were found to have at least one noncavity distorting intramural uterine leiomyoma (Figo type 3-6) of at least 2 cm diameter and remaining women were assigned as controls. First trimester aneuploidy screening test parameters were compared. RESULTS Pregnancy associated plasma protein-A (PAPP-A) MoMs were found significantly lower in leiomyoma group in comparison to control group (1.19 ± 0.60 MoM vs. 1.40 ± 0.73 MoM, p = 0.002). PAPP-A MoMs in women with leiomyomas larger than 5.5 cm were significantly lower in comparison to both control group and women with ≤5.5 cm leiomyomas (0.82 ± 0.376 vs. 1.40 ± 0.73, p < 0.001; 0.82 ± 0.376 vs. 1.33 ± 0.61 p < 0.001, respectively). PAPP-A MoM and size of leiomyoma were found inversely correlated when fibroid size exceeds 5.5 cm (r = -0.467, p < 0.001). CONCLUSION Noncavity distorting intramural uterine leiomyomas >5.5 cm are associated with low first trimester PAPP-A MoMs (<0.5). PAPP-A concentrations are inversely correlated with fibroid size in women with >5.5 cm intramural uterine leiomyomas. Fibroids ≤5.5 cm are not associated with alterations in first trimester aneuploidy screening test parameters.
Vulvar neoplasias are rarely encountered lesions at female genital tract, regardless if they are ... more Vulvar neoplasias are rarely encountered lesions at female genital tract, regardless if they are primary or metastatic. Presence of signet ring cells in a tumour at female genito-urinary tract is highly suggestive of a metastatic lesion particularly from a gastrointestinal tumour. Here the authors present a case of vulvar carcinoma with signet ring cells with an undetermined primary site possibly originating from embryonic cloaca.
Purpose: To evaluate the effects of adjuvant letrozole administration on outcomes of gonadotropin... more Purpose: To evaluate the effects of adjuvant letrozole administration on outcomes of gonadotropin releasing hormone (GnRH) antagonist cycles with intracytoplasmic sperm injection in POSEIDON group 3 and 4 expected poor responder women. Methods: This study was conducted by retrospective analysis of patients with expected poor ovarian response (POSEIDON group 3 and 4) that underwent GnRH antagonist cycles with intra-cytoplasmic sperm injection between 2010 and 2020. A total of 488 patients with letrozole co-administration and 2564 patients without any adjuvant treatment that underwent GnRH antagonist cycles within the selected period of time were included in the study. Results: Implantation rates, clinical pregnancy rates and live birth delivery rates were significantly higher in letrozole administered patients in comparison to controls among POSEIDON group 3 women (0.39±0.46 vs 0.27±0.40, p=0.01; 46.1% vs 33%, p=0.014; 42.7% vs 31.5%, p=0.034, respectively). Mean total doses of gonad...
Gynecology Obstetrics and Reproductive Medicine, 2016
Aim of the paper is to investigate the suspicious role of HPV in synchronous endometrial and cerv... more Aim of the paper is to investigate the suspicious role of HPV in synchronous endometrial and cervical carcinomas and to discuss the relation between HPV and endometrium epithelium. The first case is 68- year-old and the second case is 56 year-old postmenopausal woman who were diagnosed with invasive cervical carcinoma synchronously with endometrial carcinoma. Following surgical procedures, high risk HPV DNA analysis using PCR were undertaken in both cases to investigate the possible role of HPV in synchronous malignancies. All endometrial samples were considered as negative for high risk HPV types however all cervical samples were considered as positive. Unlike cervical pathologies, HPV does not seem to play active role as etiologic agent in endometrial neoplasms, even detected synchronously with invasive cervical cancers.
Turkiye Klinikleri Journal of Gynecology and Obstetrics, 2014
Caffey disease or cortical hyperostosis is characterized by massive subperiostal new bone formati... more Caffey disease or cortical hyperostosis is characterized by massive subperiostal new bone formation at diaphyses of long bones mandible and clavicle as a result of a multifocal inflammatory skeletal process and classified into two forms regarding the onset of the disease: infantile form and prenatal form. Prenatal form with earlier onset tends to be more severe and a less frequently encountered diagnosis while late onset infantile form is usually presents with a self limiting disease. Polyhydramnios, irregularly shaped bones and hepatomegaly should raise suspicion about this rare disease when detected on ultrasonographic examinations. Here we present a case of severe prenatal cortical hyperostosis diagnosed by ultrasonographic examinations performed at 31 weeks of gestation that was revealed to have polyhydramniosis, hepatomegaly, pulmonary hypoplasia and irregularly shaped long bones.
Ovarian torsion in pregnancy is a rare event occurring approximately 1 in every 5000 live births ... more Ovarian torsion in pregnancy is a rare event occurring approximately 1 in every 5000 live births and it is a surgical emergency that usually managed by salpingoophorectomy or detorsion. Early recognition and intervention could be valuable to preserve ovarian reserve and to prevent the development of further complications. This condition usually occurs at first or second trimester in pregnancy and it is a difficult diagnosis to establish or even to be suspicious about. However ovarian torsion in late pregnancy especially in the course of labor is more infrequent and diagnosis is even thornier. Uneasy nature of labor could lead physicians to miss the diagnosis. Thereby abdominal pain in the course of labor that anywise diverges from the pain caused by normal labor processes requires high level of suspicion also in regard of a newly developed ovarian torsion amongst several other possible causes of acute abdomen. Here we present a case of ovarian torsion developed in the course of labo...
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