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Öğe Can myometrial thickness/cervical length ratio predict preterm delivery in singleton pregnancies with threatened preterm labor? A prospective study(Springer Heidelberg, 2019) Erzincan, Selen Gursoy; Sayin, N. Cenk; Korkmaz, Selcuk; Sutcu, Havva; Inan, Cihan; Cilingir, Isil Uzun; Varol, Fusun G.ObjectiveTo investigate whether myometrial thickness (MT) to cervical length (CL) ratio could be used in the prediction of preterm birth (PTB) in singleton pregnancies presented with threatened preterm labor (TPL).MethodsAfter 48h of successful tocolysis, MT was measured transabdominally from the fundal, mid-anterior walls and the lower uterine segment (LUS) in 46 pregnancies presented with TPL. MT measurements were divided into CL, individually. The main outcome was PTB before 37weeks of gestation.ResultsThe patients were divided into two groups as women delivered37weeks (38.681.01weeks) (n=25) and those delivered<37weeks (34.28 +/- 2.53weeks) (n=21). The mean +/- SD CL in the preterm delivery group was significantly shorter than the term delivery group (23.77 +/- 9.23 vs 29.91 +/- 7.03mm, p<0.05). Fundal, mid-anterior or LUS MT values were similar in both groups. However, in those who delivered preterm, the ratios of fundal MT-to-CL (p=0.026) and mid-anterior MT-to-CL (p=0.0085) were significantly different compared to those delivered at term. The optimal cutoff values for CL, fundal MT-to-CL and mid-anterior MT-to-CL ratios in predicting PTB were calculated as 31.1mm, 0.19 and 0.20, respectively. Fundal MT-to-CL ratio predicted preterm delivery with 71% sensitivity, 72% specificity, 68% positive and 75% negative predictive values. For mid-anterior MT-to-CL ratio, respective values were 76, 76, 73 and 79%.Conclusion p id=Par4 Measurement of MT along with CL may offer a promising method in the management of women presented with TPL.Öğe Fetal cloacal dysgenesis sequence presented with first trimester megacystis and associated umbilical cord abnormalities(Wiley, 2020) Erzincan, Selen Gursoy; Sayin, N. Cenk; Inan, Cihan; Uzun, Isil; Ugurlar, Ozge Yapici; Varol, Fusun G.Cloacal dysgenesis sequence occurs as a result of complete developmental failure of the urorectal septum. Typically, the sequence is featured by a smooth perineum, without any urethral, genital or anal openings. Its clinical manifestation differs throughout gestation. We report an interesting case of first trimester megacystis with associated umbilical cord abnormalities in a female fetus having cloacal dysgenesis sequence. This rare association reflecting high urinary pressure should first suggest urethral atresia. Our case highlights the importance of routine inspection of umbilical cord in the workup of early megacystis in terms of both etiology and fetal diagnosis.Öğe Guideline on Pregnancy and Diabetes by the Society of Specialists in Perinatology (PUDER), Turkey(Turkiye Klinikleri, 2020) Bayram, Merih; Biri, Aydan Asyali; Buyukbayrak, Esra Esim; Daglar, Halil Korkut; Ercan, Fedi; Erzincan, Selen Gursoy; Esmer, Aytul CorbaciogluDiabetes mellitus (DM) is the most common endocrinologic problem in pregnancy. In Turkey, the reported prevalance is between 1.9-27.9%, with an average of 7.7%. While some of these cases are pregestational diabetes (PGDM), about 90% are detected during the pregnancy for the first time and diagnosed as gestational diabetes (GDM). Diabetes in pregnancy confers serious risks regarding the fetus, newborn and the mother. Therefore, we offer GDM screening for all pregnant women preferantially between 24-28 weeks of gestation. Either one-step 75-g oral glucose tolerance test (OGTT) or two-step 50-g glucose challenge test and 100-g OGTT may be used for the screening and diagnosis. In pregnancies with high-risk for DM, screening should be performed earlier, if possible, in the first antenatal visit. When GDM is diagnosed, maternal glycemic control is tried to be achieved by diet and exercise program, and if necessary, by using insulin. The use of metformin or glyburide in pregnancy is also possible. In women with the diagnosis of DM before pregnancy, preconceptional control of plasma glucose levels is of utmost importance in order to prevent adverse pregnancy outcomes. In pregnancies with GDM regulated by diet and exercise, pregnancy follow-up may be performed as in the low risk group without any pregnancy complications. If maternal or fetal distress is not observed, delivery is planned between 39+0 -40+6 weeks. Although caesarean section is recommended when estimated fetal weight is 4500 g or more, the mode of delivery may be decided more appropriately on a case-by-case basis.Öğe A large posterior encephalocele associated with severe ventriculomegaly, cerebellar atrophy and transposition of the great arteries(Wiley, 2018) Inan, Cihan; Sayin, Niyazi Cenk; Gurkan, Hakan; Erzincan, Selen Gursoy; Uzun, Isil; Sutcu, Havva; Atli, Emine Ikbal; Varol, FusunPosterior encephalocele is a neural tube defect, which is a sac-like protrusion of the neural tissue and cerebrospinal fluid through a defect in the occipital bone. This embryonic anomaly may coexist with cortical dysplasia, agenesis of the corpus callosum, hydrocephalus, microcephaly, craniofacial abnormalities, ventricular and atrial septal defect. We report a case of a large posterior encephalocele in a fetus accompanied by unexpected major abnormalities including transposition of the great arteries, severe ventriculomegaly and cerebellar atrophy. Postnatal surgical corrections of the posterior encephalocele and then of the transposition of the great arteries were performed but the neonate died 2 months after delivery.Öğe Placental chorioangioma complicated with preterm delivery: A case report(Modestum Ltd, 2017) Inan, Cihan; Sayin, N. Cenk; Tastekin, Ebru; Erzincan, Selen Gursoy; Uzun, Isil; Sarikas, Nurtac; Varol, Fusun G.Chorioangioma is the most common tumor of the placenta. Since these tumors generally have small sizes, they cannot be detected during the routine ultrasonography (USG) examination and might not present any symptom. When they become larger in size, they can cause various maternal and fetal complications. We presented a patient whose obstetric USG examination revealed a placental mass compatible with chorioangioma and who had preterm delivery at the 34th gestational week. The size of the mass increased rapidly in last four weeks. The pathological examination indicated that the placental mass was 9x8 cm in size and compatible with angiomatous type chorioangioma.Öğe Prenatal diagnosis of chromosomal polymorphisms: most commonly observed polymorphism on Chromosome 9 have associations with low PAPP-A values*(Taylor & Francis Ltd, 2019) Inan, Cihan; Sayin, N. Cenk; Dolgun, Z. Nihal; Gurkan, Hakan; Erzincan, Selen Gursoy; Uzun, Isil; Sutcu, HavvaIntroduction: To identify the prevalence and types of fetal chromosomal polymorphisms in pregnant women and to examine possible associations with screening test parameters. Materials and methods: Fetal chromosomal polymorphism rate was investigated in pregnant women who had been implemented for invasive prenatal test in a tertiary reference center in Thrace Region of Turkey. Fetal chromosomal polymorphisms were determined and their effects on screening tests' parameters were investigated. Possible differences in the first and second-trimester screening test parameters between women; with fetal chromosomal polymorphism who had screening test results (Group 1) and those with a normal karyotype (Group 2) were evaluated. Results: Fetal chromosomal polymorphism prevalence was 5.3% (n = 101). The most common polymorphisms were identified on chromosome 9, 1, and 16 [54.5% (n = 55); 8.9% (n = 9), and 6.9% (n = 7), respectively]. The most common polymorphic variant was 9qh+ (n = 23; 22.8%). Among the screening test parameters, significantly lower pregnancy-associated plasma protein-A (PAPP-A) (p = .028) and higher unconjugated estriol (uE3) (p = .019) values were found in Group 1. In patients having fetuses with polymorphic variants on chromosome 9, a significantly lower PAPP-A values were observed compared to women with other fetal polymorphic variants (p = .048) or women having fetuses with normal karyotype (p = .007). Conclusions: Lower PAPP-A and higher uE3 levels were observed in women having fetuses with chromosomal polymorphisms, which might affect screening test results. Lower PAPP-A levels were apparent in women having fetuses with polymorphism on chromosome 9.Öğe Rapidly growing cervical teratoma - fetal death during delivery(Hygeia Press Corridori Marinella, 2017) Cilingir, Isil Uzun; Sayin, N. Cenk; Erzincan, Selen Gursoy; Inan, Cihan; Sutcu, Havva; Dogan, Sumeyra; Can, NurayHere we present a rapidly growing fetal cervical teratoma associated with agenesis of the corpus callosum that caused an early delivery resulting in rupture of the mass and neonatal death during Cesarean section. Large cervical lesions may threaten the life of the fetus during delivery of the head.Öğe The relation of fetal colon and rectum diameters with labor in healthy late-third trimester pregnancies(Elsevier Science Bv, 2018) Inan, Cihan; Sayin, N. Cenk; Dolgun, Z. Nihal; Erzincan, Selen Gursoy; Uzun, Isil; Sutcu, Havva; Varol, FusunObjective: To investigate the associations of fetal colon-rectum diameters with labor and fetal distress or meconium passage in healthy pregnancies in the late 3rd trimester. Study design: A total of 162 healthy, singleton pregnant women at >= 36(0/7) weeks who were in the latent phase of labor (n = 69) or those not in labor (n = 93, controls) at the time of ultrasound examination were enrolled. Fetal colon (ascending, transverse, descending, sigmoid) and rectum diameters, Doppler indices of materno-fetal vessels were measured. Data were analyzed according to the mode of delivery. Results: Fetal colon-rectum diameters were smaller in women in labor compared to controls (p = 0.001). Positive correlations were observed between fetal colon-rectum diameters and interval between ultrasound and labor onset in the control group except for those who had scheduled cesarean sections (C/S) (p = 0.001). Similar colon-rectum measurements were obtained in fetuses delivered via cesarean section due to fetal distress or to other indications (p>0.05). In women who had uterine contractions during ultrasound examination; later delivered by vaginal route, no association was observed between Apgar scores and colon-rectum diameters during latent-phase (p > 0.05), and also there were significant positive correlations between different segments of colon-rectum diameters and duration of neonatal meconium passage (p < 0.05). Conclusion: Fetal colon and rectum diameters are smaller during labor and the measurements tend to diminish as the labor approaches, but do not indicate fetal distress. (C) 2018 Elsevier By. All rights reserved.Öğe Schizencephaly accompanied by occipital encephalocele and deletion of chromosome 22q13.32: a case report(Taylor & Francis Inc, 2019) Inan, Cihan; Sayin, N. Cenk; Gurkan, Hakan; Atli, Engin; Erzincan, Selen Gursoy; Uzun, Isil; Sutcu, HavvaBackground: Schizencephaly is a neuronal migration anomaly characterized by presence of a cleft between ependymal layer of the ventricle and pia mater of the cerebral cortex. It may be associated with additional cerebral abnormalities, including polymicrogyria, pachygyria, gray matter heterotopy, ventriculomegaly and corpus callosum agenesis. Case Report: We present a female fetus with schizencephaly accompanied by occipital encephalocele, polymicrogyria, agenesis of the corpus callosum, dysmorphic facies and cardiac muscular ventricular septal defect. Array comparative genomic hybridization (array-cGH) analysis revealed a deletion of chromosome 22q13.32 including FAM19A5 gene that is a member of TAFA family. Conclusions: Schizencephaly may be accompanied by unexpected structural and genetic anomalies as in our case with occipital encephalocele, dysmorphic facies, cardiac ventricular septal defect and chromosome 22q13.32 deletion.Öğe Use of prokineticin-1 (PROK1), pregnancy-associated plasma protein A (PAPP-A) and PROK1/PAPP-A ratio to predict adverse pregnancy outcomes in the first trimester: a prospective study(Taylor & Francis Ltd, 2018) Inan, Cihan; Varol, Fusun Gulizar; Erzincan, Selen Gursoy; Uzun, Isil; Sutcu, Havva; Sayin, N. CenkIntroduction: To compare the predictive effectiveness levels of prokineticin-1 (PROK1), pregnancy-associated plasma protein A (PAPP-A) and the PROK1/PAPP-A ratio in the first trimester for preeclampsia (PE), foetal growth restriction (FGR), gestational diabetes mellitus (GDM) and spontaneous preterm birth (SPB).Materials and methods: A total of randomly selected 162 pregnant women were included. Peripheral blood samples were obtained between 11(0/7) and 13(6/7) gestational weeks (GWs). All women were followed throughout the pregnancy and classified into five groups as having PE, FGR, GDM, SPB and uncomplicated pregnancies. The cut-off levels of the markers were identified to predict adverse outcomes.Results: PROK1 predicted PE with 83.3% sensitivity, 85.7% specificity at a value of >293.4pg/mL; at a value of >260.2pg/mL, PROK1 predicted FGR with 85.7% sensitivity, 72.5% specificity in the first trimester. The area under receiver operating characteristic (ROC) curve of PAPP-A was lower than that of PROK1 and PROK1/PAPP-A in differentiating PE and FGR from the uncomplicated group (p<.001). PROK1 levels and the PROK1/PAPP-A ratios in the SPB and GDM groups were lower than in the uncomplicated group (p<.01).Conclusions: Elevated PROK1 in the first trimester is a more effective marker than PAPP-A in the prediction of PE and FGR. Lower PROK1 levels are associated with the development of SPB and GDM.
