Zeliha Çiğdem Demirel Güler

Günümüzde, estetik ve fonksiyonel kaygılarla birçok medikal alandaki prosedürlere olan ilgi artış göstermiştir. Medya etkisi, yaşlanma ve doğum gibi faktörler, kadınlarda genital bölge estetiği konusunda özelikle cinsel aktivite sırasında yaşanan rahatsızlıklardan dolayı kadınları cerrahiye yöneltmektedir. Kadın genital estetik cerrahisi, kadınların bu operasyonlara olan ilgisinin artmasıyla birlikte jinekolojinin bir alt dalı haline gelmektedir. Bu bölümde, en yaygın cerrahi prosedürler olarak labioplasti (iç dudak estetiği), klitoral başlık redüksiyonu, labia majora'yı dolgunlaştırmaya yönelik yağ enjeksiyonu ve dolgu uygulamaları, ayrıca doğum sonrası değişiklikleri hedefleyen vajinoplasti ve perineoplasti gibi konular detaylı olarak ele alınmaktadır. Bu prosedürlerin her birinin kendine özgü yararları ve riskleri vardır. Ameliyat kararı verirken, hastanın motivasyonlarını ve beklentilerini doğru bir şekilde anlamak, psikolojik değerlendirme yapmak ve bilgilendirilmiş onam almak çok önemlidir. Bu bölüm, bu alandaki güncel yaklaşımları vurgulamakta ve cerrahların hastaları için en güvenli ve en uygun tedavi yöntemini belirlemesinin önem taşıdığını vurgulamaktadır.

Objective The aim of this study was to investigate the anxiety levels of pregnant women with gestational diabetes mellitus (GDM) followed by different treatment methods. Methods Our study was carried out with 141 cases whose pregnancy follow ups were made in Gynecology and Obstetrics Clinic. Cases which had GDM screening with 75-g oral glucose tolerance test (OGTT) were divided into 3 groups. Group 1 (control group) consisted of 50 cases with 75-g OGTT results in normal range, Group 2 consisted of 50 cases which had significant 75-g OGTT results and followed up by diet (A1), and Group 3 consisted of 41 cases which were diagnosed with GDM as a result of 75-g OGTT and received diet as well as medical therapy (A2). Beck anxiety inventory (BAI) was administered to the patients in Group 1 in 24th week, and to patients in Groups 2 and 3 in the 24th and 32nd weeks. Results In the first evaluation of the patients, BAI scores of the control group were statistically found to be significantly lower than the patients with GDM (p=0.001). There was no significant difference in BAI scores among patients diagnosed with GDM, and high anxiety scores were found in both groups. There was a significant decrease in anxiety levels in the Groups 2 and 3 after the treatment (p<0.01). In the Group 2, the BAI scores were observed to decrease from 51.76±4.47 to 45.62±3.65, and from 51.73±5.27 to 41.48±3.29 in the Group 3 (p<0.001). Conclusion In addition to the metabolic disorders brought by the disease itself, GDM can cause various problems by increasing the levels of anxiety in patients. With an effective treatment for glycemic control, anxiety levels of patients can be reduced.

Objectives To assess the intra- and postoperative results of cesarean myomectomy. Methods A retrospective study was conducted to collect the results of cesarean myomectomy procedures performed in our tertiary center between June 2013 and December 2018. The subjects were 2219 pregnant women undergoing cesarean section at these units. Results A total of 2219 scheduled patients undergoing CS were included in the present study. Sixty-five patients have undergone intramural myomectomy during CS; 82 patients have had subserosal myomectomy during CS. No statistically significant differences were found between the three groups in changes of preoperative Hb, postoperative Hb, mean Hb and length of hospital stay. Operation times were significantly longer in both intramural and subserosal myomectomy groups (45.23 ± 8.498 vs. 39.02 ± 6.824 vs. 32.14 ± 5.423 min, p 0.01). Only in the intramural myomectomy group, two patients were subjected to blood transfusion (3%). Assessment of intramural myomectomy patients was carried out by taking 5 cm as the cutoff value. No statistical differences were found between the two groups in terms of mean Hb change, operation time, length of hospital stay. In the group with intramural myomectomy larger than 5 cm, two (15.38%) patients needed a blood transfusion. Conclusions Cesarean myomectomy operation performed by experienced surgeons has no adverse effects other than lengthening the duration of operation and can be safely implemented.

Objective: This study aims to detect the role of thyroid hormones in the etiology of hyperemesis gravidarum (HG), which has apparent adverse effects on fetal and maternal outcomes. Methods: In this study, we retrospectively evaluated 1634 term primiparous cases of single-birth deliveries (37–42 weeks of gestation) at the Koru Hospital Ankara between November 2012 and September 2014. Maternal age, existence of any treatment during pregnancy, the history of alcohol consumption before pregnancy, smoking habits, and newborn’s gender were detected. The first-trimester HG cases and thyroid-stimulating hormone (TSH) and free tyroxine (fT4) levels were recorded. Results: Compared with other two groups, the TSH level was lower in the HG group, while the fT4 level was higher. Despite this fact, no statistical significance was detected (p=0.06). Compared with other groups, maternal age was significantly lower in the group with HG and was thus statistically significant (p=0.01). Conclusion: In HG pregnancies, the thyroid-metabolism-related disorders and maternal age should be kept in mind, and laboratory-clinical analyses and early diagnosing and treatment should be considered. Cite this article as: Güler AE, Yıldız B, Çakmak B, Demirel Güler ZÇ, Kıncı MF. Are Thyroid Functions Effective in Pregnant Women with Hyperemesis Gravidarum?. Cerrahpasa Med J 2019; 43(3): 80-84.