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    Diagnostic utility of saline infusion doppler sonohysterography in endometrial mass lesions
    (Professional Medical Publications, 2016) Ogutcuoglu, Bilge; Karadag, Cihan; Inan, Cihan; Dolgun, Zehra Nihal; Yoldemir, Ahmet Tevfik; Aslanova, Lale
    Objective: To evaluate the importance of saline infusion Doppler sonohysterography (SIS-D) in the assessment of transvaginal ultrasound (TVUSG)-suspected intrauterine mass lesions in women complaining about abnormal uterine bleeding with respect to hysteroscopy (H/S) and pathologic diagnosis. Methods: This study was conducted on patients, who visited to our clinic with abnormal uterine bleeding and whose TVUSGs indicated intrauterine masses. The study covered a total of 100 patients. SIS-D and hysteroscopy were performed on those 100 patients. SIS-D results were compared with hysteroscopy results. The relation between SIS-D findings and pathology results were evaluated. Results: For SIS; specificity was 96%, sensitivity was 60%, positive predictive value (PPV) was 87.8%, negative predictive value (NPV) was 83.3%, and the accuracy rate was 87%. For TVUSG; PPV was 75%. According to SIS-D, 92.2% of the lesions that had single-vessel feeding patterns were endometrial polyps, and this was statistically significant (p<0.0001). 57.1% of the lesions that had multiple-vessel feeding patterns were submucous myomas, and this was statistically significant (p<0.0001). Conclusion: SIS should be performed in patients before hysteroscopy because it will protect a considerable number of patients from unnecessary invasive procedures. SIS-D gives an idea on the histopathology of the mass.
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    The Effect of Occupational Groups and Use of Alcohol and Smoking in Thrace on Semen Parameters
    (Trakya Üniversitesi, 2014) Gül, Tuğba; Yılmaz, Gizem; Bayram, Seda; Dolgun, Zehra Nihal; Ege, Sevinç
    Aims: Research of the effect of alcohol and smoking of the male spouses of infertile couples and their occupational groups on sperm quality. Methods: 686 male cases who have applied to Trakya University, Faculty of Medicine, Department of Assisted Reproductive Techniques, Infertility Polyclinic were included in the assessment. As a result of the spermiogram test, every patient’s sperm count, motility and morphology were assessed. Occupational groups, usage of alcohol and smoking were enquired to each case. Mann Whitney U, Willcoxon Test was employed in the statistical analyses and the risk ratios were calculated.Results: Out of the 686 people, 353 were smokers (51.4%) and 333 were non-smokers (48.6%). The number of people who smoked and also consumed alcohol was 59 (8.6%). In terms of occupation, 132 people were unemployed (%19.2), 23 were being exposed to heat (%3.3), 256 had to stand while working (%37.3), 31 were being exposed to radiation and chemicals (%4.5), 199 had to be both stand and sitting while working (%29) and 45 had to sit while working (%6.5). As a result of our study, while no correlation between smoking and the sperm count and morphology could be observed, the sperm motility of the smoking group has been observed to be lower. However, no significant difference in terms of semen analysis could be observed between, just drinkers, both drinker and smokers and non-smokers and drinkers groups. Smokers and those who both smoke and have a job where they have to be sitting have a significantly lower sperm motility. When the sperm quality is observed amongst occupational groups in terms of alcohol, the sperm motility of the people who were only exposed to radiation and chemicals have significantly increased in the alcohol consumers.Conclusion: Semen quality is affected by numerous genetic and environmental factors. Smoking, alcohol consumption and being employed in certain occupational groups are just a few of many risk factors
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    Evaluation of pregnancy rates in infertile women after application of ovulation induction and intrauterine insemination
    (Cukurova Univ, Fac Medicine, 2020) Okten, Sabri Berkem; Dolgun, Zehra Nihal; Ugurel, Vedat; Elter, Koray
    Purpose: The aim of this studywas to investigate the effects of these factors on pregnancy rates in infertile patients following ovulation induction and intrauterine insemination. Materials and Methods: The study was performed retrospectively that investigated examination reports and laboratory results of 201 infertile patients with unexplained infertility, male factor and anovulation. Women were subdivided into two groups according to the ovary-stimulating agent used as gonadotropin or clomiphene citrate. A semen sample was obtained from all men participants. Results: There were 239 cycles of unexplained infertility (77.9%), 39 cycles in ovulatory dysfunction (12.7%) and 29 cycles in male factor (9.4%) groups. The clinical pregnancy rates per cycle according to infertility type were found as 18.4% (n:44) for unexplained infertility, 17.9% (n:7) for ovulatory dysfunction and 13.8% (n:4) for malefactor. In regression analyses, follicle (diameter>10mm) count on the day of hCG administration and inseminated total motile sperm count (ITMSC) were independently affected pregnancy rate. ITMSC area value under the curve (0.63) was significantly different from 0.5. Conclusion: Follicle count on the day of hCG administration and ITMSC independently affect the pregnancy rate. Additionally, the intrauterine insemination method should be attempted in appropriate cases that have an acceptable successful pregnancy rate.
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    İncebarsak Mezosunda RIA: Nadir Bir Olgu
    (2013) Aslanova, Rakhshanda; Sayın, Niyazi Cenk; Turhan, Emrah; Dolgun, Zehra Nihal
    Rahim içi araçların uterusu perfore edip uterus dışına çıkmaları ciddi ancak nadir bir durumdur. Komşu organ laserasyonları görülebilirse de uygulamanın (ve muhtemelen uterin perforasyonun) 5. gününde incebarsak mezosuna dek ilerlemesi bu nadir durumun uç bir örneğidir. Bu bildiride doğum sonrası 30. günde RIA takılmasının 2. gü- nünde karında ağrı şikayeti ile başvuran ve kayıp RIA ileoçekal valvden 150 cm. proksimalde, jejenum mezosu içinde bulunan hasta sunulmuştur.
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    Incidental Intravascular Lipoleiomyomatosis in A Hysterectomy Specimen: How To Manage?
    (Premchand Shantidevi Research Foundation, 2015) Dolgun, Zehra Nihal; Aslanova, Rakhshanda; Can, Nuray; Okten, Sabri Berkem; Aslan, Mehmet Musa
    Leiomyomas are common benign tumors in female gynaecologic surgery. They are originated from smooth muscle cells of the uterus and/ or sometimes of the uterine vessels. Intravascular lipoleiomyomatosis is a very rare form of leiomyomas which grow within veins and can extend up to vena cava inferior and right heart chamber with cardiac symptoms and is diagnosed by cardiovascular surgeons. We report a case of incidental intravascular lipoleiomyomatosis which was confined to the uterus being diagnosed after a total abdominal hysterectomy by pathology and its management strategy.
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    Maternal and fetal outcomes in pregnancies with pulmonary hypertension: Experience of a tertiary center
    (Elsevier Taiwan, 2018) Dolgun, Zehra Nihal; Inan, Cihan; Sayin, N. Cenk
    Objective: Pregnancies complicated with PHT are serious debates for obstetricians due to high maternal and fetal complication potentials. The aim of the study was to present our maternofetal outcomes in pregnant women with pulmonary hypertension. Materials and methods: This study was performed using data extracted from the medical files of 23 pregnancies of 18 patients with PHT who were followed-up in the obstetrics and gynecology department. Results: The average age was 27.09 +/- 6.97 (range: 14-38) years. The most frequent maternal cardiac pathologies were cardiac valvular disease (mitral or aortic insufficiency) (n = 4), atrial septal defect (n = 3), mitral stenosis (n = 3), ventricular septal defect (n = 2) and arrhythmia (n = 2). Caesarean section and normal vaginal delivery were performed in 13 and 7 deliveries, respectively. Therapeutic dilatation and curettage was performed in 3 patients. Preterm delivery occurred in 4 pregnancies and there were 2 intrauterine growth retardations, 1 preeclampsia and 2 maternal pulmonary edemas. One patient underwent re-laparotomy 5 days after delivery due to uterine hematoma. Totally, 20 newborns (14 female, 6 male) were delivered. Most of the complications were seen in advanced PHT classes. Conclusion: The care of the pregnant women with PHT necessitates a well-planned, multidisciplinary approach focusing on close monitoring before, during and after delivery. This approach may contribute to reduction of poor maternal and fetal outcomes. (C) 2018 Taiwan Association of Obstetrics & Gynecology. Publishing services by Elsevier B.V.
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    Myomectomy During Caesarean Section: Seven Years' Experience
    (Premchand Shantidevi Research Foundation, 2017) Dolgun, Zehra Nihal; Okten, Sabri Berkem; Aslanova, Rakhshanda; Ozer, Dilek Pinar; Ordu, Ozge; Sayin, Niyazi Cenk
    Introduction: The incidence of myomas during pregnancy is reported as 1.6-10.7% depending on gestational age. Increased rates of Caesarean Section (CS) together with advanced maternal age bring the decision for caesarean myomectomy (myomectomy during caesarean section) into question. Aim: To compare the obstetric features and clinical outcomes of pregnant women with uterine leiomyoma who had myomectomy together with caesarean section to those who had caesarean section only. Materials and Methods: A retrospective study was performed on a total of 50 pregnant women with myoma that underwent caesarean section in the Obstetrics and Gynaecology Department of Trakya University Medical Faculty between 2007 and 2014. Obstetric history, operative details and type, size and location of leiomyoma were noted and compared. Data were analysed using the IBM Statistical Package for Social Sciences version 17.0 (SPSS Inc., Chicago, IL, USA). Parametric tests were applied to data with normal distribution and non-parametric tests were applied to data without normal distribution. Results: Two groups displayed similar features in terms of age, parity, gestational weeks, type and location of leiomyomas. Notably, average size of leiomyomas was larger (p=0.03) and duration of operation was significantly longer in patients that underwent caesarean myomectomy (72.69 +/- 26.73 minutes vs. 56.25 +/- 6.64 minutes) (p=0.003). Duration of hospitalisation and preoperative/postoperative values for haemoglobin and hematocrit levels did not show any clinically significant difference (p > 0.05). Conclusion: Our results demonstrate that caesarean myomectomy is a safe and effective procedure in especially cases with large uterine leiomyomas.