Objective: To evaluate clinico-pathologic features of 21 cases with Borderline Ovarian Tumor (BOT... more Objective: To evaluate clinico-pathologic features of 21 cases with Borderline Ovarian Tumor (BOT) and to search concurrent primary malignancy or any malignancy developed during their follow-ups. Materials-Methods: Retrospective chart review of 21 patients with BOT treated with fertility sparing surgery or conventional surgery between June 2001 and August 2006. Charts were analyzed for the following: age, clinical behavior, surgical stage, and type of tumor, surgery, adjuvant treatment, survival, pregnancy rates, and recurrences, any other malignancy at the time of diagnosis or during the follow-ups. Results: Mean age was 40.3. Abdominal pain, acute abdomen and a coincidental finding were the presenting symptoms. Serous histology in 11 cases, seromusinous histology in 4 cases and musinous histology in 6 cases were determined. CA 125 values were higher than 16 IU/ml in 11 cases. Eleven patients underwent conventional staging laparotomy, namely total abdominal hysterectomy (TAH) + bilateral salpingooopherectomy (BSO) + omentectomy (O) + pelvic and paraaortic lymphadenectomy (PPL). However, the other ten underwent fertility sparing surgeries. Three of them were laparoscopically operated, namely two unilateral salpingooopherectomies (USO) and cystectomy. Four of them had abdominal USO + O and PPL. Two of them had abdominal USO. One of them had abdominal USO during her pregnancy and restaging laparotomy at 6 weeks after delivery. All of them were staged as la except one patient who staged as 3c and also had micropapillary pattern and adjuvant chemotherapy. Furthermore, all of our patients are alive and we have not seen any recurrence during our follow-ups. We have had three healthy babies including one whose mother diagnosed during her pregnancy period. Two simultaneous neoplasms ( microinvasive cancer of cervix and matur ter atoma of the contralateral ovary ) and one gastrointestinal malignancy (pancreas cancer) in follow-ups were recognized. Conclusion: Spontaneous pregnancy can occur after conservative treatment of BOT. Fertility-sparing surgery for BOT should be considered for women in the reproductive age group who desire preservation of fertility. Further studies are necessary to determine the significance of concurrent or future malignancies in these patients' management and follow-ups.
Yirmiüç yaþýnda, 35 haftalýk gebe, G1P1 bir hastada overin nadir karsinomlarýndan biri olan küçük... more Yirmiüç yaþýnda, 35 haftalýk gebe, G1P1 bir hastada overin nadir karsinomlarýndan biri olan küçük hücreli karsinomunun büyük hücreli varyantý sunulmuþ ve olgunun takip, tedavisi ve prognozu literatür ýþýðý altýnda tartýþýlmýþtýr. Hasta tanýdan sonraki 1 yýl içinde bu hastalýðý nedeni ile kaybedilmiþtir.
Türk jinekoloji ve obstetrik derneği dergisi, Oct 10, 2019
In this study, the current problems and future expectations of obstetrics and gynecology resident... more In this study, the current problems and future expectations of obstetrics and gynecology residents across the nation were evaluated.
Objective: To determine the recurrence and survival rates of uterine sarcomas according to stages... more Objective: To determine the recurrence and survival rates of uterine sarcomas according to stages, treatment methods, histological type. Methods: In this study 29 patients were included who were diagnosed with uterine sarcoma at Zeynep Kamil Women and Children Diseases Hospital between 2001 and 2011. Demographic data of patients, treatment and diagnosis process were investigated retrospectively by accessing the file of patients. Disease progression, survival time, recurrence status was learned by calling. Results were analyzed statistically. Results: Average age of patients were 51, 2 (± 13SD). Most of the patients were in postmenopausal (n=20, 68.9%). The most frequently (72.3%) complain was vaginal bleeding. 51.7% of patients were stage I and 34.4% of patients were stage 3 according to staging FIGO 2009. Twenty-two of the patients were treated with total abdominal hysterectomy (TAH)+ bilateral salpingo-oophorectomy (BSO)+bilateral pelvic and paraaortic lymphadenectomy (BPPLND) and omentectomy. Mean tumor size were 10, 2(±8.5) cm. 34,4% of patients (n = 10) patients had lymph node involvement. Respectively, after the operation, the average life expectancy of 3.2 years. Twelve patients (41.37%) died until data collected up to December 2013. Conclusion: Uterine sarcomas have poor prognosis even at early stages. Each histological type must be evaluated separately. The role of adjuvant therapy is controversial.
Aim: Although most defects can close by primary suturing after radical surgery of gynecological m... more Aim: Although most defects can close by primary suturing after radical surgery of gynecological malignancies, different reconstruction options are available when large defects that require reconstruction occur. In this study, we present the treatment strategy and results for patients who underwent reconstruction after resection for gynecological cancer in the vulva and perineum. Material and Methods: A total of 18 patients who underwent reconstruction between May 2018 and July 2020 were included in this retrospective study. Demographics and clinical data, the resection operation, characteristics of the defect, and the reconstruction methods applied were evaluated. Postoperative treatment strategy and complication rates were evaluated. Results: The mean age was 62.3±13.2 (42-83) years. 88.9% of the patients had additional diseases. Pelvic exentration was performed in 5 (27.8%) patients, anterior resection in 2 (11.1%) patients and vulvectomy in 11 (61.1%) patients. The most common ma...
Objective: The purpose of this study is to evaluate the clinical findings, tumor markers, surgica... more Objective: The purpose of this study is to evaluate the clinical findings, tumor markers, surgical treatment approaches and final pathological results of the dermoid cyst subjects treated at our hospital. Methods: The study was planned retrospectively. 114 subjects with dermoid cyst were included from our hospitals electronic log system. Along with the demographic data's, pre-operative clinical findings, tumor sizes, ultrasonographic characteristics, tumor marker results, surgical treatment method (laparotomy-laparoscopy), administered surgical treatment procedure (cystectomy, oopherectomy, salpingo-oopherectomy, total abdominal hysterectomy-salpingo-oopherectomy) and pathology results were recorded from the patient files. Results: Mean age of the patients was 33.59±12.79 years (11-70). Abdominal pain was observed in 32 patients (%28.07) as the most common complaint during hospital admission. 70 patients (%38.59) were determined incidentally. Average cyst size was 47.70±48...
Amac: Plasenta akreata spektrumu (PAS), ozellikle gelismekte olan ulkelerde fetomaternal morbidit... more Amac: Plasenta akreata spektrumu (PAS), ozellikle gelismekte olan ulkelerde fetomaternal morbidite ve mortalitenin ana sebebi olan obstetrik kanama icin onemli bir risk faktorudur. Bu calismada; PAS olan ve olmayan plasenta previa olgularinin ozellikleri, insidansi, maternal ve fetal sonuclarinin arastirilmasi amaclanmistir. Ek olarak, PAS ile basvuran plasenta previa vakalarinin klinik ozellikleri ve risk faktorlerinin analiz edilmesi amaclanmistir. Gerec ve Yontemler: Plasenta previa ile birlikte PAS olan ve olmayan gebelikleri analiz etmek amaciyla retrospektif kohort bir calisma planlandi. Ocak 2005 ile Aralik 2014 arasinda yazili ve elektronik olarak tibbi kayitlar gozden gecirildi. Plasenta previa tanisi ultrasonografik olarak, PAS ise klinik olarak plasentanin uterustan ayrilma asamasinda zorluk olarak tanimlandi. Bulgular: Ocak 2005 ile Aralik 2014 arasinda toplam 11351 dogumun retrospektif analizi yapildi. 387 plasenta previa tanisi konulmus olgu izlendi. Bu olgularin 11...
ABS TRACT Neurofibromatosis (NF) is an autosomal dominant genetic syndrome which can be seen in 1... more ABS TRACT Neurofibromatosis (NF) is an autosomal dominant genetic syndrome which can be seen in 1: 3000-1:5000 women. Women with NF without infertility problem may have one or more pregnancies during reproductive years. Pregnancies of patients with neurofibromatosis are known to be complicated by intrauterine growth retardation, preterm birth, gestational hypertension and preeclampsia, but history of abruption is very rare in few cases. Physicians should be aware of the complications of this unique pregnancy and manage it multidisciplinary. The purpose of this case report is to share the experience of the pregnancy with neurofibromatosis, having epilepsy and unexplained embolism history, which is complicated with intrauterine growth retardation and placental abruption
Journal of Turkish Society of Obstetric and Gynecology, 2020
Over kanserli hastalarda hayat kalitesini ölçen Avrupa Kanser Araştırma ve Tedavi Örgütü QLQ-OV28... more Over kanserli hastalarda hayat kalitesini ölçen Avrupa Kanser Araştırma ve Tedavi Örgütü QLQ-OV28 sorgu formunun Türk toplumuna uyarlanması ve olguların yaşam kalitesinin belirlenmesi
Journal of Turkish Society of Obstetric and Gynecology, 2018
PRECIS: Karateke packing method can be used as the last life-saving method in patients with postp... more PRECIS: Karateke packing method can be used as the last life-saving method in patients with postpartum hemorrhage. Amaç: Postpartum kanama nedeni ile peripartum histerektomi yapılan ancak kanama kontrolü sağlanamayan hastalarda daha etkili bir abdominal packing yöntemi tariflemek. Gereç ve Yöntemler: İstanbul Zeynep Kamil Kadın ve Çocuk Hastalıkları Eğitim ve Araştırma Hastanesi'nde Ocak 2016-Eylül 2017 tarihleri arasında doğum sonu kanama nedeniyle tekrarlayan cerrahi girişim uygulanan 6 pelvik kanamalı olguyu retrospektif, gözlemsel ve tanımlayıcı olarak inceledik. Bulgular: Postpartum kanama nedeniyle kliniğimize refere edilen ve peripartum histerektomi ve hipogastrik arter ligasyonu yapılan; ancak kanama kontrolü sağlanamayan beş olgu ile plasenta perkreata rüptürü nedeniyle hipovolemik şokta olan ve acil histerektomi ve hipogastrik arter ligasyonu yapılan bir olgunun intraabdominal masif kanamalarını kontrol etmek için Karateke usulü packing yapıldı. Tüm hastalarda kanama kontrolü sağlandı. Yönteme bağlı komplikasyon gelişmedi. Sonuç: Sonuç olarak Postpartum kanama nedeniyle peripartum histerektomi yapılan ve sonrasında hayatı tehdit eden diffüz kanamalarda Karateke packing yöntemi uygulanması oldukça kolay, klasik abdominal packing'ten daha etkili, komplikasyonu az ve herşeyden önemlisi hayat kurtaran bir yöntemdir. Anahtar Kelimeler: Abdominal packing, peripartum histerektomi, near miss Objective: To describe a more effective abdominal packing method in patients with disseminated intravascular coagulation following peripartum hysterectomy due to postpartum hemorrhage (PPH). Materials and Methods: The present retrospective and descriptive study was conducted to document six cases with refractory pelvic bleeding who underwent a second surgery for PPH between January 2016 and December 2017 at İstanbul Zeynep Kamil Woman and Children Diseases Training and Research Hospital. Results: Karateke packing was performed to control intra-abdominal massive hemorrhages of five women who were referred to our clinic due to PPH who had undergone peripartum hysterectomy and hypogastric artery ligation but hemostasis could not be provided. In addition, a case of hypovolemic shock due to placenta percreta rupture in a woman who had also undergone an emergency hysterectomy and hypogastric artery ligation, which had failed. Hemostasis was provided in all patients. No method-related complication developed. Conclusion: Karateke packing is a very easy method to perform, it is more effective than the classic abdominal packing technique, with a low complication rate, and most importantly, life-saving in patients undergoing a peripartum hysterectomy due to PPH and thereafter experiencing diffuse hemorrhage.
OBJECTIVE: Diabetes in pregnancy is associated with several adverse outcomes for both mother and ... more OBJECTIVE: Diabetes in pregnancy is associated with several adverse outcomes for both mother and baby. Awareness is the first step toward identifying pregnant women with diabetes. The purpose of this study was to assess Turkish pregnant women's opinion and practice about 50-g glucose challenge test (GCT) and to assess the reasons why some of them refuse the test. METHODS: This study was conducted on 312 patients at any age and gestational week in Istanbul, Turkey, by a personal interview using self-created questionnaire. Women were asked about their opinion and practice about 50-g GCT. RESULTS: Among women who were ≤28 weeks of gestation, 42.5% (n=82/193) exhibited their desire to have a GCT in their ongoing pregnancy, 40.9% (n=79/193) pointed out their reluctance, and 16.6% (n=32/193) indicated that they had no opinion about the subject. Women who were ≤28 weeks of gestation and did not want to have GCT, were asked to explain the reasons of their reluctance. The most frequently indicated reason was the belief that GCT is harmful for their babies and themselves (n=62/79, 78.5%). Of the women who were >28 weeks of gestation, 37.8% (n=45/119) had GCT in the ongoing pregnancy, while 62.2% (n=74/119) did not have GCT. The most frequently indicated reason why women did not have a GCT was the belief that GCT is harmful for themselves and the baby (n=37/74, 50%). CONCLUSION: This study exposes an important problem-misinformation about 50-g GCT-that carries a dangerous potential for missing the diagnosis of gestational diabetes. Study findings put forth the need for raising awareness among pregnant women and training health-care professionals about the subject.
Overin sklerozan stromal tümörü (SST), over seks kord tümörleri içinde sınıflandırılan ve oldu... more Overin sklerozan stromal tümörü (SST), over seks kord tümörleri içinde sınıflandırılan ve oldukça nadir görülen benign karakterli bir tümördür. Bu tümörler çoğunlukla 20-40 yaş aralığında görülürler, ancak az sayıda olguda postmenopozal dönemde ya da çocukluk döneminde görülebilirler. 13 yaşında anormal uterin kanama ve dismenore yakınması ile başvuran adolesan kızda, alt batın ultrasonografisi (USG) ve pelvik manyetik rezonans görüntülemede (MRG) unilateral heterojen kistik kitle tespit edilmiştir. Bu makalede benign sklerozan stromal tümör olgusunun, görüntüleme, operasyon, histopatolojik özellikleri ve ayırıcı tanısı sunulmuştur.
Journal of Turkish Society of Obstetric and Gynecology, 2017
Zayıf cevaplı hastalarda birbirini takip eden başarılı ve başarısız intrasitoplazmik sperm enjeks... more Zayıf cevaplı hastalarda birbirini takip eden başarılı ve başarısız intrasitoplazmik sperm enjeksiyonu (ICSI) sikluslarında bazı majör özellik farklarının ortaya konmasıdır. Gereç ve Yöntemler: Bologna kriterlerine göre karar verilmiş 60 düşük yanıtlı hasta başarısız bir siklus sonrası ICSI tedavine alındı. Başarılı ve başarısız sikluslarda yaş, vücut kitle indeksi (VKİ), serum folikül stimülan hormon (FSH) ve estradiol düzeyleri, antral folikül sayısı, gonadotropin dozu, stimülasyon, antagonist başlama günü, antagonist uygulama süresi, tetikleme günü endometrial kalınlık, total ve fertilize oosit sayısı, embriyo transfer günü, embriyo hücre sayısı ve fertilizasyon oranlarını içeren değişkenler aynı hasta grubunda klinik gebeliği öngörmek üzere karşılaştırıldı.
Female Pelvic Medicine & Reconstructive Surgery, 2016
Aim The aim of this study was to validate the Turkish-translated version of the Fecal Incontinenc... more Aim The aim of this study was to validate the Turkish-translated version of the Fecal Incontinence Severity Index (FISI) for Turkish-speaking patients. Methods This prospective cohort study included 58 patients: 22 (37.9%) scored 0 (no incontinence), and the remaining 36 (62.1%) scored at least 1 (any level of gas, mucus, liquid, solid incontinence, pad wear, or lifestyle alteration). Test-retest reliability analysis, internal consistency analysis, content-face validity, and criterion validity were used to evaluate the Turkish version of the FISI. Validity of the criteria was assessed through correlation analyses between patient and surgeon scores of FISI and manometric measurement between patients with or without anal incontinence symptoms. Results The 2-week test-retest revealed significant correlation (P < 0.001). The Cronbach α values of the translated version for total scores of the scale were 0.735 and 0.734 for patient-rated scores and surgeon-rated scores, respectively, a...
Objective: To assess some clinical characteristics of patients who were treated for adnexal torsi... more Objective: To assess some clinical characteristics of patients who were treated for adnexal torsion during pregnancy. Methods: Medical records of 14 pregnant women with adnexal torsion who were surgically treated at our hospital between 1 st January 2011 to 30 th October 2015 were screened. In addition to the demographic features obtained from medical records, presenting complaints, physical examination and ultrasonographic findings, type of surgery, histopathologic findings, route of deliveries and complications were all recorded. Results: Mean age of patients included in the study was 27.8 ± 3.9 years, mean gravidity was 2.8 ± 1.8 and mean gestational age was 14.4 weeks. Most commonly seen complaint was pelvic pain followed by emesis and vomiting. All participants underwent abdominal surgery showing an adnexal mass with a mean volume of 48.4 ± 12.1 cm2. Also all participants underwent Doppler ultrasound assessment showing decreased ovarian blood flow. Among 14 patients, 3 of them were managed by laparoscopy while remaining was treated by laparotomy. Detorsion and cystectomy were performed in 10 patients while detorsion was performed in 3 patients, in 1 patient after detorsion no blood flow was observed therefore salpingooophorectomy was performed due to overt necrotic appearance. Most commonly seen histopathologic type was mature cystic teratoma. No operative complication was observed. Conclusion: Adnexal torsion should be kept in mind in pregnant presenting with acute abdominal pain. Early diagnosis and treatment are important for organ preserving surgery.
Objective: To evaluate clinico-pathologic features of 21 cases with Borderline Ovarian Tumor (BOT... more Objective: To evaluate clinico-pathologic features of 21 cases with Borderline Ovarian Tumor (BOT) and to search concurrent primary malignancy or any malignancy developed during their follow-ups. Materials-Methods: Retrospective chart review of 21 patients with BOT treated with fertility sparing surgery or conventional surgery between June 2001 and August 2006. Charts were analyzed for the following: age, clinical behavior, surgical stage, and type of tumor, surgery, adjuvant treatment, survival, pregnancy rates, and recurrences, any other malignancy at the time of diagnosis or during the follow-ups. Results: Mean age was 40.3. Abdominal pain, acute abdomen and a coincidental finding were the presenting symptoms. Serous histology in 11 cases, seromusinous histology in 4 cases and musinous histology in 6 cases were determined. CA 125 values were higher than 16 IU/ml in 11 cases. Eleven patients underwent conventional staging laparotomy, namely total abdominal hysterectomy (TAH) + bilateral salpingooopherectomy (BSO) + omentectomy (O) + pelvic and paraaortic lymphadenectomy (PPL). However, the other ten underwent fertility sparing surgeries. Three of them were laparoscopically operated, namely two unilateral salpingooopherectomies (USO) and cystectomy. Four of them had abdominal USO + O and PPL. Two of them had abdominal USO. One of them had abdominal USO during her pregnancy and restaging laparotomy at 6 weeks after delivery. All of them were staged as la except one patient who staged as 3c and also had micropapillary pattern and adjuvant chemotherapy. Furthermore, all of our patients are alive and we have not seen any recurrence during our follow-ups. We have had three healthy babies including one whose mother diagnosed during her pregnancy period. Two simultaneous neoplasms ( microinvasive cancer of cervix and matur ter atoma of the contralateral ovary ) and one gastrointestinal malignancy (pancreas cancer) in follow-ups were recognized. Conclusion: Spontaneous pregnancy can occur after conservative treatment of BOT. Fertility-sparing surgery for BOT should be considered for women in the reproductive age group who desire preservation of fertility. Further studies are necessary to determine the significance of concurrent or future malignancies in these patients' management and follow-ups.
Yirmiüç yaþýnda, 35 haftalýk gebe, G1P1 bir hastada overin nadir karsinomlarýndan biri olan küçük... more Yirmiüç yaþýnda, 35 haftalýk gebe, G1P1 bir hastada overin nadir karsinomlarýndan biri olan küçük hücreli karsinomunun büyük hücreli varyantý sunulmuþ ve olgunun takip, tedavisi ve prognozu literatür ýþýðý altýnda tartýþýlmýþtýr. Hasta tanýdan sonraki 1 yýl içinde bu hastalýðý nedeni ile kaybedilmiþtir.
Türk jinekoloji ve obstetrik derneği dergisi, Oct 10, 2019
In this study, the current problems and future expectations of obstetrics and gynecology resident... more In this study, the current problems and future expectations of obstetrics and gynecology residents across the nation were evaluated.
Objective: To determine the recurrence and survival rates of uterine sarcomas according to stages... more Objective: To determine the recurrence and survival rates of uterine sarcomas according to stages, treatment methods, histological type. Methods: In this study 29 patients were included who were diagnosed with uterine sarcoma at Zeynep Kamil Women and Children Diseases Hospital between 2001 and 2011. Demographic data of patients, treatment and diagnosis process were investigated retrospectively by accessing the file of patients. Disease progression, survival time, recurrence status was learned by calling. Results were analyzed statistically. Results: Average age of patients were 51, 2 (± 13SD). Most of the patients were in postmenopausal (n=20, 68.9%). The most frequently (72.3%) complain was vaginal bleeding. 51.7% of patients were stage I and 34.4% of patients were stage 3 according to staging FIGO 2009. Twenty-two of the patients were treated with total abdominal hysterectomy (TAH)+ bilateral salpingo-oophorectomy (BSO)+bilateral pelvic and paraaortic lymphadenectomy (BPPLND) and omentectomy. Mean tumor size were 10, 2(±8.5) cm. 34,4% of patients (n = 10) patients had lymph node involvement. Respectively, after the operation, the average life expectancy of 3.2 years. Twelve patients (41.37%) died until data collected up to December 2013. Conclusion: Uterine sarcomas have poor prognosis even at early stages. Each histological type must be evaluated separately. The role of adjuvant therapy is controversial.
Aim: Although most defects can close by primary suturing after radical surgery of gynecological m... more Aim: Although most defects can close by primary suturing after radical surgery of gynecological malignancies, different reconstruction options are available when large defects that require reconstruction occur. In this study, we present the treatment strategy and results for patients who underwent reconstruction after resection for gynecological cancer in the vulva and perineum. Material and Methods: A total of 18 patients who underwent reconstruction between May 2018 and July 2020 were included in this retrospective study. Demographics and clinical data, the resection operation, characteristics of the defect, and the reconstruction methods applied were evaluated. Postoperative treatment strategy and complication rates were evaluated. Results: The mean age was 62.3±13.2 (42-83) years. 88.9% of the patients had additional diseases. Pelvic exentration was performed in 5 (27.8%) patients, anterior resection in 2 (11.1%) patients and vulvectomy in 11 (61.1%) patients. The most common ma...
Objective: The purpose of this study is to evaluate the clinical findings, tumor markers, surgica... more Objective: The purpose of this study is to evaluate the clinical findings, tumor markers, surgical treatment approaches and final pathological results of the dermoid cyst subjects treated at our hospital. Methods: The study was planned retrospectively. 114 subjects with dermoid cyst were included from our hospitals electronic log system. Along with the demographic data's, pre-operative clinical findings, tumor sizes, ultrasonographic characteristics, tumor marker results, surgical treatment method (laparotomy-laparoscopy), administered surgical treatment procedure (cystectomy, oopherectomy, salpingo-oopherectomy, total abdominal hysterectomy-salpingo-oopherectomy) and pathology results were recorded from the patient files. Results: Mean age of the patients was 33.59±12.79 years (11-70). Abdominal pain was observed in 32 patients (%28.07) as the most common complaint during hospital admission. 70 patients (%38.59) were determined incidentally. Average cyst size was 47.70±48...
Amac: Plasenta akreata spektrumu (PAS), ozellikle gelismekte olan ulkelerde fetomaternal morbidit... more Amac: Plasenta akreata spektrumu (PAS), ozellikle gelismekte olan ulkelerde fetomaternal morbidite ve mortalitenin ana sebebi olan obstetrik kanama icin onemli bir risk faktorudur. Bu calismada; PAS olan ve olmayan plasenta previa olgularinin ozellikleri, insidansi, maternal ve fetal sonuclarinin arastirilmasi amaclanmistir. Ek olarak, PAS ile basvuran plasenta previa vakalarinin klinik ozellikleri ve risk faktorlerinin analiz edilmesi amaclanmistir. Gerec ve Yontemler: Plasenta previa ile birlikte PAS olan ve olmayan gebelikleri analiz etmek amaciyla retrospektif kohort bir calisma planlandi. Ocak 2005 ile Aralik 2014 arasinda yazili ve elektronik olarak tibbi kayitlar gozden gecirildi. Plasenta previa tanisi ultrasonografik olarak, PAS ise klinik olarak plasentanin uterustan ayrilma asamasinda zorluk olarak tanimlandi. Bulgular: Ocak 2005 ile Aralik 2014 arasinda toplam 11351 dogumun retrospektif analizi yapildi. 387 plasenta previa tanisi konulmus olgu izlendi. Bu olgularin 11...
ABS TRACT Neurofibromatosis (NF) is an autosomal dominant genetic syndrome which can be seen in 1... more ABS TRACT Neurofibromatosis (NF) is an autosomal dominant genetic syndrome which can be seen in 1: 3000-1:5000 women. Women with NF without infertility problem may have one or more pregnancies during reproductive years. Pregnancies of patients with neurofibromatosis are known to be complicated by intrauterine growth retardation, preterm birth, gestational hypertension and preeclampsia, but history of abruption is very rare in few cases. Physicians should be aware of the complications of this unique pregnancy and manage it multidisciplinary. The purpose of this case report is to share the experience of the pregnancy with neurofibromatosis, having epilepsy and unexplained embolism history, which is complicated with intrauterine growth retardation and placental abruption
Journal of Turkish Society of Obstetric and Gynecology, 2020
Over kanserli hastalarda hayat kalitesini ölçen Avrupa Kanser Araştırma ve Tedavi Örgütü QLQ-OV28... more Over kanserli hastalarda hayat kalitesini ölçen Avrupa Kanser Araştırma ve Tedavi Örgütü QLQ-OV28 sorgu formunun Türk toplumuna uyarlanması ve olguların yaşam kalitesinin belirlenmesi
Journal of Turkish Society of Obstetric and Gynecology, 2018
PRECIS: Karateke packing method can be used as the last life-saving method in patients with postp... more PRECIS: Karateke packing method can be used as the last life-saving method in patients with postpartum hemorrhage. Amaç: Postpartum kanama nedeni ile peripartum histerektomi yapılan ancak kanama kontrolü sağlanamayan hastalarda daha etkili bir abdominal packing yöntemi tariflemek. Gereç ve Yöntemler: İstanbul Zeynep Kamil Kadın ve Çocuk Hastalıkları Eğitim ve Araştırma Hastanesi'nde Ocak 2016-Eylül 2017 tarihleri arasında doğum sonu kanama nedeniyle tekrarlayan cerrahi girişim uygulanan 6 pelvik kanamalı olguyu retrospektif, gözlemsel ve tanımlayıcı olarak inceledik. Bulgular: Postpartum kanama nedeniyle kliniğimize refere edilen ve peripartum histerektomi ve hipogastrik arter ligasyonu yapılan; ancak kanama kontrolü sağlanamayan beş olgu ile plasenta perkreata rüptürü nedeniyle hipovolemik şokta olan ve acil histerektomi ve hipogastrik arter ligasyonu yapılan bir olgunun intraabdominal masif kanamalarını kontrol etmek için Karateke usulü packing yapıldı. Tüm hastalarda kanama kontrolü sağlandı. Yönteme bağlı komplikasyon gelişmedi. Sonuç: Sonuç olarak Postpartum kanama nedeniyle peripartum histerektomi yapılan ve sonrasında hayatı tehdit eden diffüz kanamalarda Karateke packing yöntemi uygulanması oldukça kolay, klasik abdominal packing'ten daha etkili, komplikasyonu az ve herşeyden önemlisi hayat kurtaran bir yöntemdir. Anahtar Kelimeler: Abdominal packing, peripartum histerektomi, near miss Objective: To describe a more effective abdominal packing method in patients with disseminated intravascular coagulation following peripartum hysterectomy due to postpartum hemorrhage (PPH). Materials and Methods: The present retrospective and descriptive study was conducted to document six cases with refractory pelvic bleeding who underwent a second surgery for PPH between January 2016 and December 2017 at İstanbul Zeynep Kamil Woman and Children Diseases Training and Research Hospital. Results: Karateke packing was performed to control intra-abdominal massive hemorrhages of five women who were referred to our clinic due to PPH who had undergone peripartum hysterectomy and hypogastric artery ligation but hemostasis could not be provided. In addition, a case of hypovolemic shock due to placenta percreta rupture in a woman who had also undergone an emergency hysterectomy and hypogastric artery ligation, which had failed. Hemostasis was provided in all patients. No method-related complication developed. Conclusion: Karateke packing is a very easy method to perform, it is more effective than the classic abdominal packing technique, with a low complication rate, and most importantly, life-saving in patients undergoing a peripartum hysterectomy due to PPH and thereafter experiencing diffuse hemorrhage.
OBJECTIVE: Diabetes in pregnancy is associated with several adverse outcomes for both mother and ... more OBJECTIVE: Diabetes in pregnancy is associated with several adverse outcomes for both mother and baby. Awareness is the first step toward identifying pregnant women with diabetes. The purpose of this study was to assess Turkish pregnant women's opinion and practice about 50-g glucose challenge test (GCT) and to assess the reasons why some of them refuse the test. METHODS: This study was conducted on 312 patients at any age and gestational week in Istanbul, Turkey, by a personal interview using self-created questionnaire. Women were asked about their opinion and practice about 50-g GCT. RESULTS: Among women who were ≤28 weeks of gestation, 42.5% (n=82/193) exhibited their desire to have a GCT in their ongoing pregnancy, 40.9% (n=79/193) pointed out their reluctance, and 16.6% (n=32/193) indicated that they had no opinion about the subject. Women who were ≤28 weeks of gestation and did not want to have GCT, were asked to explain the reasons of their reluctance. The most frequently indicated reason was the belief that GCT is harmful for their babies and themselves (n=62/79, 78.5%). Of the women who were >28 weeks of gestation, 37.8% (n=45/119) had GCT in the ongoing pregnancy, while 62.2% (n=74/119) did not have GCT. The most frequently indicated reason why women did not have a GCT was the belief that GCT is harmful for themselves and the baby (n=37/74, 50%). CONCLUSION: This study exposes an important problem-misinformation about 50-g GCT-that carries a dangerous potential for missing the diagnosis of gestational diabetes. Study findings put forth the need for raising awareness among pregnant women and training health-care professionals about the subject.
Overin sklerozan stromal tümörü (SST), over seks kord tümörleri içinde sınıflandırılan ve oldu... more Overin sklerozan stromal tümörü (SST), over seks kord tümörleri içinde sınıflandırılan ve oldukça nadir görülen benign karakterli bir tümördür. Bu tümörler çoğunlukla 20-40 yaş aralığında görülürler, ancak az sayıda olguda postmenopozal dönemde ya da çocukluk döneminde görülebilirler. 13 yaşında anormal uterin kanama ve dismenore yakınması ile başvuran adolesan kızda, alt batın ultrasonografisi (USG) ve pelvik manyetik rezonans görüntülemede (MRG) unilateral heterojen kistik kitle tespit edilmiştir. Bu makalede benign sklerozan stromal tümör olgusunun, görüntüleme, operasyon, histopatolojik özellikleri ve ayırıcı tanısı sunulmuştur.
Journal of Turkish Society of Obstetric and Gynecology, 2017
Zayıf cevaplı hastalarda birbirini takip eden başarılı ve başarısız intrasitoplazmik sperm enjeks... more Zayıf cevaplı hastalarda birbirini takip eden başarılı ve başarısız intrasitoplazmik sperm enjeksiyonu (ICSI) sikluslarında bazı majör özellik farklarının ortaya konmasıdır. Gereç ve Yöntemler: Bologna kriterlerine göre karar verilmiş 60 düşük yanıtlı hasta başarısız bir siklus sonrası ICSI tedavine alındı. Başarılı ve başarısız sikluslarda yaş, vücut kitle indeksi (VKİ), serum folikül stimülan hormon (FSH) ve estradiol düzeyleri, antral folikül sayısı, gonadotropin dozu, stimülasyon, antagonist başlama günü, antagonist uygulama süresi, tetikleme günü endometrial kalınlık, total ve fertilize oosit sayısı, embriyo transfer günü, embriyo hücre sayısı ve fertilizasyon oranlarını içeren değişkenler aynı hasta grubunda klinik gebeliği öngörmek üzere karşılaştırıldı.
Female Pelvic Medicine & Reconstructive Surgery, 2016
Aim The aim of this study was to validate the Turkish-translated version of the Fecal Incontinenc... more Aim The aim of this study was to validate the Turkish-translated version of the Fecal Incontinence Severity Index (FISI) for Turkish-speaking patients. Methods This prospective cohort study included 58 patients: 22 (37.9%) scored 0 (no incontinence), and the remaining 36 (62.1%) scored at least 1 (any level of gas, mucus, liquid, solid incontinence, pad wear, or lifestyle alteration). Test-retest reliability analysis, internal consistency analysis, content-face validity, and criterion validity were used to evaluate the Turkish version of the FISI. Validity of the criteria was assessed through correlation analyses between patient and surgeon scores of FISI and manometric measurement between patients with or without anal incontinence symptoms. Results The 2-week test-retest revealed significant correlation (P < 0.001). The Cronbach α values of the translated version for total scores of the scale were 0.735 and 0.734 for patient-rated scores and surgeon-rated scores, respectively, a...
Objective: To assess some clinical characteristics of patients who were treated for adnexal torsi... more Objective: To assess some clinical characteristics of patients who were treated for adnexal torsion during pregnancy. Methods: Medical records of 14 pregnant women with adnexal torsion who were surgically treated at our hospital between 1 st January 2011 to 30 th October 2015 were screened. In addition to the demographic features obtained from medical records, presenting complaints, physical examination and ultrasonographic findings, type of surgery, histopathologic findings, route of deliveries and complications were all recorded. Results: Mean age of patients included in the study was 27.8 ± 3.9 years, mean gravidity was 2.8 ± 1.8 and mean gestational age was 14.4 weeks. Most commonly seen complaint was pelvic pain followed by emesis and vomiting. All participants underwent abdominal surgery showing an adnexal mass with a mean volume of 48.4 ± 12.1 cm2. Also all participants underwent Doppler ultrasound assessment showing decreased ovarian blood flow. Among 14 patients, 3 of them were managed by laparoscopy while remaining was treated by laparotomy. Detorsion and cystectomy were performed in 10 patients while detorsion was performed in 3 patients, in 1 patient after detorsion no blood flow was observed therefore salpingooophorectomy was performed due to overt necrotic appearance. Most commonly seen histopathologic type was mature cystic teratoma. No operative complication was observed. Conclusion: Adnexal torsion should be kept in mind in pregnant presenting with acute abdominal pain. Early diagnosis and treatment are important for organ preserving surgery.
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