Dilek Erdem

Breast milk (BM) is the only source of iodine and bioactive compounds that influence growth and development in infants. The content of BM may be influenced by maternal body mass index (BMI). The aim of this study was to investigate the effect of maternal weight on BM and cord blood iodine concentrations, growth-related hormones, infant anthropometric measurements. A total of 84 mother-infant pairs participated. Levels of leptin, adiponectin and insulin-like growth factor-I (IGF-I) in postnatal BM and cord blood were analysed by enzyme-linked immunosorbent assay (ELISA), iodine by Sandell-Kolthoff reaction. Dietary iodine intake of women was determined by food frequency questionnaire, and anthropometric measurements of infants at birth and 3 months were evaluated. Dietary iodine intake was found to be similar in normal weight (NW) and overweight/obese (OW/OB) women (p > 0.05). Breast milk iodine concentration (BMIC) was 17.4 μg in NW, 18.2 μg in OB/OW women. Adiponectin in cord blood and IGF-I in BM were higher OB/OW than NW women (p < 0.05). Positive correlations were found between the infant birth weight and adiponectin in BM, between the infant body weight at 3 months and leptin and adiponectin in BM, between the infant birth head circumference and IGF-I in BM (p < 0.05). In multiple linear regression model, leptin and adiponectin in BM had a positive effect on infant body weight (p < 0.05). Maternal BMI may influence infant body weight via leptin and adiponectin in BM and infant head circumference via IGF-I. No relationship was found between maternal BMI and iodine levels and anthropometric measurements of the infant. Longitudinal studies are recommended to understand the effect of BMIC on growth.

Aim: Comparison of the effectiveness and complications of transobturator tape and transvaginal tape methods in the treatment of stress urinary incontinence. Method: Clinical records of 106 patients who underwent surgery in Istanbul Kanuni Sultan Suleyman Training and Research Hospital due to stress urinary incontinence between January 2015 and December 2016 were retrospectively analyzed. The patients were divided into two groups. Trans obturator tape (TOT) was classified as Group 1, and transvaginal tape (TVT) was classified as Group 2. The urogenital distress inventory-6 (UDI-6) and the incontinence impact questionnaire-7 (IIQ-7) were used to determine the severity of preoperative and postoperative incontinence and objectively compare the quality of life in all patients. The ethics committee approval was obtained from the ethics committee of Kanuni Training and Research Hospital. Statistical analysis of data was performed using SPSS version 24 (SPSS Inc, Chicago, Illinois). Results: There was a significant difference between the two groups in terms of mean age, menopausal status, complications, and duration of surgery (p<0.05). In both groups, there was a significant improvement in postoperative UDI-6 and IIQ-7 tests evaluating the negative effects of urinary incontinence on daily life (p=0.01* and p=0.028*, respectively). Conclusion: A significant improvement was observed in UDI-6 and IIQ-7 scores after TOT and TVT operations. There is no significant difference between TOT and TVT methods in terms of efficacy and success in the treatment of stress urinary incontinence.

Objective: This study aimed to identify and highlight the changing trends in cesarean deliveries in a tertiary hospital using the Robson Ten Group Classification Method: A retrospective cohort study included 103745 patients admitted to Istanbul Kanuni Training and Research Hospital's Obstetrics and Gynecology Department between January 1, 2012, and December 31, 2021. Ten groups were established based on five basic obstetric factors: parity, labor initiation, gestational age, number of fetuses, and fetal presentation. All live or dead births over 500 g or 20 gestational weeks were included in the study. Women with missing file information were excluded from the study. Total number of cesarean sections in the group, total number of women in each group, group size (%), group cesarean rate (%), absolute group contribution to general cesarean section rate (%) group contribution relative to general cesarean section rate (%) were calculated. Cesarean section indications were evaluated in 10 categories and their numbers and rates were recorded. Statistical analyzes were performed using SPSS version 24.0 for Windows. Results: Our study’s average CS rate from 2012 to 2021 was 45.77%. The largest contributions to the total cesarean section rate were in group 5 (20.69%), group 3 (5.99%), and group 1 (5.75%). Conclusion: In our study, Robson groups 5, 3, and 1 comprised the majority of contributors to the total cesarean section performed. Any effort to reduce the rate of CS should focus on these subgroups.

Aim: This research aimed to determine the relationship between pregnant women's oral glucose screening test preferences and their health literacy and perinatal anxiety levels. Material and Method: The study is descriptive and cross-sectional. The sample of the study consisted of 120 pregnant women who applied to a university hospital between June and July 2022, were accepted to participate in the study, had no Turkish speaking problems, no pregestational diabetes diagnosis, no vision and hearing problems, no mental health problems, and were literate. The data were collected using face-to-face interviews with pregnant women including a questionnaire asking about the introductory characteristics of pregnant women, Turkish Health Literacy Scale-32 (TSOY-32), and Perinatal Anxiety Screening Scale (PASS). The obtained data were analyzed using one-way analysis of variance, correlation analysis, and chi-square tests. Results: 52.5% of pregnant women believed that they do not need to have an OGT. While the effect of health personnel in this decisions is 66.1%, the effect of the closed environment is 22.9%. A statistically significant negative correlation at p<.05 level was found between the Turkish health literacy scale and the Perinatal anxiety screening scale scores. Participants' believes on the necessity of OGTT test has no effect on their TSOY-32 scores or PASS scores. There is no association between the preference of women and the sub-dimensions of TSOY-32 and the PASS. Conclusion: The health literacy and perinatal anxiety levels of the pregnant women in the sample group did not affect their OGTT preferences. They stated that healthcare professionals were primarily influential in their decisions on OGTT preferences.

Introduction: Biological changes in human metabolism due to daylight and heat are expressed as circadian rhythm, and its classification according to individuals and their genetic differences is called chronotype. In recent years, there has been an increase in studies examining the relationship between circadian rhythm and birth. Purpose: This study’s first aim was to investigate the relationship between the chronotypes of mothers and time of birth, season, meridians in which they were born, and the gender of their babies. Its second aim was to examine the relationship between the birth times and chronotypes of pregnant women and the time of their deliveries. Method: The study was conducted among women presented to Alanya Training and Research Hospital Gynecology and Obstetrics Polyclinic between 01.02.2022 and 31.03.2022. The study included 147 women remembering the date and time of delivery. Participants were selected among the mothers who gave a normal birth, did not have labor induction, whose birth started with spontaneous contractions, and had a healthy pregnancy. A questionnaire form including sociodemographic characteristics, obstetric information, and Horne and Östberg's Morningness- Eveningness scale were applied face to face. One-way ANOVA, Chi-Square, and logistic regression analyses were employed to analyze the data. Results: The chronotypes of the participants revealed that 45 women (30.6%) were morning type, 90 women were intermediate type (61.2%), and 12 women were evening type (8.2%). No difference was found between the chronotype scores of the mothers and the birth hours of their babies (p = .324). There was no difference between mothers' chronotype scores and birth meridians (p = .842). In addition, no significant relationship was found between the mothers' own birth hours and the birth hours of their babies (p= .050). Conclusion: There was no relationship between birth time, season, gender, birth meridian, and chronotype. The limitation of the study may be related to the recall bias, the effect of confounding factors, and the sample size. However, we think it is an interesting field in terms of providing a different perspective on the differences in performance and mood of people with further studies regarding chronotype.

Amaç: Amacımız, benign endikasyonlarda yapılan total laparoskopik histerektomi ve total abdominal histerektomi operasyonlarının sonuçlarını literatür eşliğinde retrospektif olarak karşılaştırmaktır. Gereç ve Yöntem: Antalya Serik Devlet Hastanesi Kadın Hastalıkları ve Doğum Kliniğinde Temmuz 2015 ve Ekim 2020 yılları arasında benign endikasyonlarda total histerektomi uygulanan 240 hastanın kayıtları literatür eşliğinde retrospektif olarak incelendi. Yaş aralığı 40-75 idi. Vakaların 120‘si total laparoskopik histerektomi (TLH Grup1) ve 120‘si total abdominal histerektomi (TAH Grup2) olarak sınıflandırıldı. Malignitesi olanlar, sezaryen sonrası histerektomiler, supraservikal histerektomi, laparoskopik asiste vajinal histerektomi, vajinal histerektomi yapılanlar ve kayıtları eksik olanlar çalışma dışı bırakıldı. Hastalardan operasyon öncesi yazılı onam formu alındı. Hastaların ortalama yaşı, parite, vücut kitle indeksi, çıkarılan ortalama uterus ağırlığı, geçirilmiş batın cerrahisi öyküsü, histerektomi endikasyonları, operasyon süresi, komplikasyon oranları, kan kaybı miktarı, post operatif hastanede yatış süresi iki grup arasında karşılaştırıldı. Bulgular: İki grup arasında demografik özellikler açısından, istatiksel olarak anlamlı fark yoktu. İki grupta da en sık saptanan endikasyonlar, fibromiyom ve tedaviye dirençli anormal uterin kanamaydı. grup 1’de ortalama ameliyat süresi grup 2 ye göre daha uzun olup istatiksel açıdan anlamlı bulundu. grup 1’de ortalama hastanede kalma süresi daha kısa saptandı ve istatiksel açıdan anlamlı bulundu. Operasyonla çıkarılan ortalama uterus ağırlığı grup 2 de daha ağır saptandı. Sonuç: Laparoskopik histerektomi, seçilmiş hastalar için operasyon süresinin daha uzun olması ve tecrübe gerektirmesi ile birlikte güvenli ve uygun bir minimal invaziv cerrahi işlemdir. Daha çabuk iyileşme, daha erken taburcu olma, daha az kan kaybı avantajı vardır.

Background/Aim: The aim of this study is to analyze the rate of cesarean section with Robson 10 Group Classification system in a tertiary center. Methods: This study was conducted with 7437 patients who applied to XXXXXX gynecology and obstetric clinic between 01.01.2020 - 31.12.2020. The mean age, body mass index, and cesarean section indications were evaluated . Robson 10 classification was made . Total number of cesarean sections and total number of women in each group, group size (%), group cesarean section rate (%), absolute group contribution to general cesarean section rate (%),relative group contribution to general cesarean section rate (%) were calculated. Cesarean section indications were evaluated in 16 categories and their numbers and rates were recorded. Results: The study was started with 7443 patients, but 8 patients with missing or incorrect file information were excluded. A total of 7429 patients with a mean age of 28.15±7.9 years and an age range of 15-47 were included in the study. It was determined that 47.8% pregnant women delivered vaginally and 52.2% pregnant women by cesarean section. In terms of the actual contribution of the group to the total cesarean section ratio, the highest rate was found in the fifth group with 22.6%. The highest rate among cesarean indications was found to be previous cesarean section 26.9%. Conclusion: In order to decrease the cesarean section rate, primary cesarean section rates should be decreased. Women should be informed about the advantages of normal delivery and should be encouraged to give birth naturally. Keywords: Robson 10-group classification, pregnancy, cesarean section.

Purpose: The aim of this study is to retrospectively evaluate the results of patients who underwent total laparoscopic hysterectomy with benign indications, in the light of the literature. Material method: The results of 158 Total laparoscopic hysterectomy cases performed with benign indications in Serik State Hospital between July 2015 and October 2020 were evaluated retrospectively.In this study, patients' age, number of births, body mass indexes, hysterectomy indications, intraoperative and postoperative complications, operation times, uterine weight, hospital stay, preoperative and postoperative hematocrit changes were obtained from the records. Mean, standard deviation and ratio values were used in the descriptive statistics of the data. Results: The mean age of the 158 patients included in the study was 48.15 ± 7.96 years. 51 (32.28%) patients with myoma uteri, 40 (25.32%) patients) abnormal uterine bleeding, 18 (11.40%) patients with adenomyosis, 8 (5.06%) patients with descensus uteri, 12 (7.60%) patients with adnexial mass, 8 (5.06%) patients were operated for endometrial hyperplasia, 10 (6.33%) patients for endometrial polyps, 6 (3.79%) patients for cervical intraepithelial neoplasia, and 5 (3.16%) patients for chronic pelvic pain. The mean operation time of the patients was 105±22 minutes. The mean duration of hospitalization was 2.53 ± 1.25, and 3 (1.8%) patients had blood transfusion. The overall complication rate was found to be 8.86%. Conclusion: Similar to the literature, our results have shown that laparoscopic hysterectomy is a safe, feasible minimally invasive surgical procedure with faster recovery, earlier discharge, earlier return to work and social life, better cosmetic results and higher patient satisfaction.

Amaç: Düşükler günümüzde giderek daha önemli bir sorun haline gelmektedir. Üreme çağındaki kadınlarda ilk trimester gebelik kaybının sıklığı artmaktadır. Bu çalışmada, ilk trimester gebelik kayıpları ile PON1 ve ARY düzeyleri arasındaki olası ilişkinin gösterilmesi amaçlanmıştır. Gereçler ve Yöntem: 6-14 gebelik haftasında 25 gebe sağlıklı kadın (Grup 1) ve ilk trimester düşüklü (Grup 2) 25 kadın çalışmaya dahil edildi. Serum örneklerinde paraoksonaz 1 ve arilesteraz aktiviteleri, tam otomatik kolorimetrik yöntemler kullanılarak araştırıldı. Grupları karşılaştırmak için ANOVA testi kullanıldı. Bulgular: PON1 ve ARY aktiviteleri, ilk trimesterde düşük yapan gebelerde Anova testi ile analiz edilen ilk trimesterdeki sağlıklı gebe kadınlara göre istatistiksel olarak anlamlı derecede düşüktür (p

Lenfanjiomalar, cilt ve ciltaltı dokuyu etkileyen lenfatik sistemin nadir görülen hamartomatöz malformasyonlarıdır. En sık görülen tip Lenfanjiyoma sirkumskriptumdur. Vulvar lenfanjiyoma circumscriptum (LC), yaygın görülen semptomları cinsel işlev bozukluğu ve enfeksiyon ile ağrılı, siğil bir lezyon olarak ortaya çıkabilen nadir bir durumdur. Konjenital formu çocuklarda görülürken, edinilmiş formu enfeksiyon, kanser,Crohn hastalığı, geçirilmiş pelvik cerrahiye bağlı olarak erişkinlerde oluşabilir. Bu yazıda, endometrium kanseri nedeniyle cerrahi tedavi sonrası bir yıldır vulvar lezyon ve kaşıntı şikayeti olan 73 yaşında kadın hastada edinilmiş tipte LS olgusunu sunduk. LS’yi genital siğil gibi diğer durumlardan ayırt etmek, hastalığın gidişatını değerlendirmek ve altta yatan hastalığın teşhis ve tedavisini uygulamak açısından önemlidir. Bu nedenle, bu nadir benign durumun klinik görünümünün yanında farklı histolojik görünümünü de tanımak önemlidir.