Osman Murat Guler

Chronicpelvic pain is a multifactorial condition that significantly impacts women’s quality of life. Pelvic venous disorders (PeVD) are increasingly

Purpose: Surgical-site infections (SSI) remain a major complication of cesarean delivery, increasing maternal morbidity, hospital stay, and healthcare costs. Although several risk factors have been identified, the role of maternal nutritional status—particularly the Prognostic Nutritional Index (PNI)—has not been well established in obstetric surgery. Methods: This retrospective case–control study included 190 women who underwent cesarean delivery at a tertiary referral center between 2020 and 2025. Preoperative PNI was calculated using serum albumin and lymphocyte counts obtained within 24 h before surgery. SSI was defined according to the Centers for Disease Control and Prevention criteria. Demographic, perioperative, and postoperative variables were analyzed to evaluate associations between PNI, SSI status, infection severity, and inflammatory markers. Results: A total of 190 women were analyzed, including 98 cases with surgical-site infection (SSI) and 92 controls without SSI. Although preoperative PNI was not an independent predictor of SSI, lower PNI values were associated with more severe infections requiring broad-spectrum antibiotics, longer hospitalization, and higher postoperative C-reactive protein (CRP) levels. A significant inverse correlation was observed between PNI and CRP among patients with SSI ( r = − 0.338, p = 0.001). Longer operative duration and smoking were also associated with an increased risk of SSI. Conclusion: Although PNI was not an independent predictor of SSI, lower values were strongly associated with infection severity and systemic inflammation. Integrating PNI into preoperative risk assessment—alongside body mass index and operative time—may help identify high-risk women. Larger prospective studies are warranted to confirm these findings and to evaluate the impact of nutritional optimization on postoperative outcomes.

Background: Maternal thyroid hormones are essential for fetal development and the maintenance of pregnancy. While thyroid dysfunction earlier in gestation has been extensively studied, the clinical relevance of thyroid function assessed at labor admission remains unclear. This study investigated the association between maternal thyroid function parameters measured at labor ward admission and obstetric and neonatal outcomes in term pregnancies. Methods: In this retrospective observational study, 664 women with singleton term pregnancies (≥37 weeks) admitted to the labor ward of a tertiary referral center were included. Maternal thyroid-stimulating hormone (TSH), free thyroxine (FT4), and admission complete blood count parameters (hemoglobin, hematocrit, white blood cell count, and platelet count) were recorded. Obstetric and neonatal outcomes were compared across FT4 tertiles using univariable and multivariable regression analyses adjusted for key obstetric confounders. Results: Gestational age at delivery differed significantly across FT4 tertiles, with higher FT4 levels associated with a greater proportion of late-term deliveries. Lower FT4 levels were independently associated with lower neonatal birth weight categories after adjustment for gestational age and parity. Admission complete blood count parameters did not differ significantly across FT4 tertiles or gestational age categories. Maternal TSH levels were not independently associated with obstetric or neonatal outcomes, and no significant associations were observed with Apgar scores or NICU admission. Conclusions: In term pregnancies, maternal FT4 levels measured at labor admission are associated with delivery timing and neonatal birth weight but do not independently predict intrapartum fetal distress or adverse immediate neonatal outcomes.

Objectives: Foetal macrosomia is a significant obstetric problem that can lead to serious maternal/neonatal complications. The aim of this study was to determine which of the 75 g oral glucose tolerance test (OGTT) glucose values – fasting, first-hour, or second-hour – most strongly predicts foetal macrosomia in non-diabetic patients. Methods: This cross-sectional study prospectively screened 1,047 pregnant women who underwent a 75 g OGTT. Women with pregestational or gestational diabetes mellitus (GDM) were excluded from the main analysis. A total of 185 non-diabetic women were included. Among the included patients, those who delivered macrosomic foetuses constituted Group 1 (n=16), while those who delivered normal birth weight infants constituted Group 2 (n=169). Fasting, first-hour, and second-hour glucose values from the 75 g OGTT were compared between the groups. Results: No statistically significant differences were found between the two groups in terms of demographic variables (p>0.05). The mean fasting glucose values in Groups 1 and 2 were 77.75 and 76.11 mg/dL, respectively (p=0.42), the mean first-hour glucose values were 116.25 and 111.51 mg/dL, respectively (p=0.43), and the mean second-hour glucose values were 104.38 and 95.19 mg/dL, respectively (p=0.04). Receiver operating characteristic (ROC) curve analysis was performed for the second-hour glucose concentration, with an AUC of 0.675, and a threshold of 99.5 mg/dL was established. Conclusions: The second-hour glucose value of the 75 g OGTT may be a marker for foetal macrosomia in nondiabetic patients. These findings suggest that when the second-hour glucose value exceeds 99.5 mg/dL, foetal macrosomia may develop.

Background: Maternal thyroid hormones play an essential role in fetal growth and pregnancy maintenance. While thyroid dysfunction earlier in pregnancy has been widely studied, the clinical relevance of thyroid function assessed at the time of labor admission remains unclear. This study aimed to evaluate the association between maternal thyroid function parameters measured at labor ward admission and obstetric and neonatal outcomes in term pregnancies. Methods: This retrospective observational study included 664 women with singleton term pregnancies (≥37 weeks) admitted to the labor ward of a tertiary referral center between May 2020 and May 2025. Maternal thyroid-stimulating hormone (TSH) and free thyroxine (FT4) levels were measured at admission. Obstetric outcomes included gestational age at delivery and mode of delivery, while neonatal outcomes comprised birth weight, Apgar scores, and neonatal intensive care unit (NICU) admission. Univariable analyses and multivariable logistic and ordinal regression models adjusted for key obstetric confounders were performed. Results: Gestational age at delivery differed significantly across FT4 tertiles, with higher FT4 levels associated with a greater proportion of late-term deliveries (p = 0.018). Lower FT4 levels were independently associated with lower neonatal birth weight categories after adjustment for gestational age and parity (adjusted OR per 1 SD decrease: 1.19; 95% CI: 1.02–1.38; p = 0.025). Although an inverse association between FT4 tertiles and cesarean delivery due to fetal distress was observed in unadjusted analyses, this association was not retained after multivariable adjustment. Maternal TSH levels were not independently associated with obstetric or neonatal outcomes. No significant associations were observed with Apgar scores or NICU admission. Conclusions: In term pregnancies, maternal FT4 levels measured at labor admission are associated with delivery timing and neonatal birth weight but do not independently predict cesarean delivery due to fetal distress or adverse immediate neonatal outcomes.

Objectives: To evaluate ultrasonographic measurements of the fetal adrenal gland in pregnancies complicated by preeclampsia (PE), with and without fetal growth restriction (FGR), and to assess the utility of adrenal gland dimensions and ratios as potential diagnostic radiologic markers for PE. Methods: This prospective study included pregnant women between 20 and 41 weeks of gestation followed at the Obstetrics and Gynecology Department of Başakşehir Çam and Sakura City Hospital. Participants were divided into three groups: PE (n=63), PE+FGR (n=63), and healthy controls (n=65). Fetal adrenal gland total width and medulla width were measured via ultrasonography. The cortex width = (total width-medulla width) / 2 and the adrenal gland ratio (cortex width/medulla width) were calculated. Statistical analyses were conducted to evaluate differences between groups and to determine the predictive value of the adrenal gland ratio. Results: Fetal adrenal gland total width (adrenal width), cortex width, and adrenal gland ratio were significantly increased in both the PE and PE+FGR groups compared to healthy controls (p<0.001). An adrenal gland ratio ≥2.8 was significantly associated with PE and PE+FGR (p<0.001), showing high diagnostic accuracy. The adrenal gland ratio was not correlated with gestational age. Conclusions: Fetal adrenal gland enlargement, particularly increased cortex width, is associated with preeclampsia and may serve as a noninvasive ultrasonographic biomarker. An adrenal glandthe ratio≥2.8 demonstrates strong diagnostic potential for identifying PE and PE+FGR, offering a valuable tool for early diagnosis and management.

Introduction: YouTube is an important online source of information and has two billion users globally. Its viewing numbers tend to increase exponentially in extraordinary global situations. Our aim in this study was to review and evaluate the contents of the most frequently viewed YouTube videos during the Coronavirus disease 2019 (COVID-19) pandemic. Methods: In this qualitative study, contents of the most frequently viewed Turkish and English YouTube videos regarding the COVID-19 pandemic were examined and scored with modified DISCERN, medical information and content index (MICI), and video power index (VPI) during April 2020. Results: The mean DISCERN score of Turkish videos was similar to that of English videos (2.55±1.40 and 2.43±1.25, respectively). The total MICI score tended to be higher in Turkish videos. News channels released 86.9% of all 168 videos and 65.2% of all 23 misleading videos. When the descriptive characteristics of videos were compared in terms of their content category, average view counts, view ratios, and VPIs of misleading videos were higher than those of the useful videos. Only, the likes ratio of useful videos was higher than that of the misleading videos. Conclusions: Since there is no peer-review system on YouTube, people can almost release every type of video. It is very important for the content of videos that are released through news channels to be accurate because the important messages can be spread among people in society through them. In our study, especially some Turkish videos included many different rumors and faulty statements. During the extraordinary situations such as the pandemic, the videos of official health authorities and international institutions should be more visible on YouTube.

BACKGROUND YouTube is an important online source of information. And its viewing numbers tend to increase exponentially in extraordinary situations. OBJECTIVE Our aim in this study was to evaluate the contents of the most frequently viewed YouTube videos during the COVID-19 pandemic. METHODS In this study, contents of the most frequently viewed Turkish and English videos regarding COVID-19 pandemics are examined and scored with modified DISCERN, MICI and VPI. RESULTS The mean DISCERN score of Turkish videos is similar to English videos (2.55 and 2.43 respectively). Total MICI score tends to be higher in Turkish videos. 86.9% of all 168 videos and 65.2% of all 23 misleading videos were released by news channels. Average view counts, view ratios, and VPIs of misleading videos are higher than the useful videos. CONCLUSIONS Since there is not a peer-review system on YouTube, it is very important for the content of videos that are released through news channels to be accurate because the important messages can be spread among people in society through them. Especially some Turkish videos included many different rumors and faulty statements. During the extraordinary situations such as the pandemics, the videos of official health authorities and international institutions should be more visible in YouTube. Keywords: SARS-CoV-2, DISCERN, MICI, Video Power Index

Bakcground: YouTube is an important online source of information. And its viewing numbers tend to increase exponentially in extraordinary situations. Our aim in this study was to evaluate the contents of the most frequently viewed YouTube videos during the COVID-19 pandemic. Methods: In this study, contents of the most frequently viewed Turkish and English videos regarding COVID-19 pandemics are examined and scored with modified DISCERN, MICI and VPI. Results: The mean DISCERN score of Turkish videos is similar to English videos (2.55±1.40 and 2.43±1.25 respectively). Total MICI score tends to be higher in Turkish videos. 86.9% of all 168 videos and 65.2% of all 23 misleading videos were released by news channels. Average view counts, view ratios, and VPIs of misleading videos are higher than the useful videos. Discussion: Since there is not a peer-review system on YouTube, it is very important for the content of videos that are released through news channels to be accurate because the important messages can be spread among people in society through them. Especially some Turkish videos included many different rumors and faulty statements. During the extraordinary situations such as the pandemics, the videos of official health authorities and international institutions should be more visible in YouTube.