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Öğe The association of triple-marker test results with adverse pregnancy outcomes in low-risk pregnancies with healthy newborns(Springer Heidelberg, 2008) Sayam, N. Cenk; Canda, M. Tunc; Ahmet, Newze; Arda, Sezer; Suet, Necdet; Varol, Fuesun G.Objective This study was designed to investigate the relationship between the second trimester maternal serum markers and adverse pregnancy outcomes in healthy newborns. Materials and methods A total of 749 women who delivered in our institution with complete follow up and second-trimester triple marker test data available were included in the study. Women with multiple pregnancies, chronic diseases, diabetes mellitus, obesity, smokers and infants with chromosomal and congenital abnormalities were excluded. Maternal serum alpha-fetoprotein (AFP), human chorionic gonadotropin (HCG) and unconjugated estriol (uE(3)) values were investigated in our cohort who developed preeclampsia (n = 28), gestational diabetes (GM) (n = 69), preterm labor-birth (n = 100), oligohydramnios n = 37) and macrosomia (n = 59) by using receiver operating characteristic (ROC) curve analysis, with chi-square and Pearson's correlation tests. Results Women with uE(3) <= 1.26 MoM (P = 0.001, AUC = 0.666), HCG > 1.04 MoM (P = 0.032, AUC = 0.599) or AFP <= 0.69 MoM (P = 0.049, AUC = 0.600) values significantly developed oligohydramnios. Also, macrosomic infants were observed in women who had HCG values > 0.86 MoM (P = 0.047, AUC = 0.578). Patients with HCG > 1.04 MoM (P = 0.04, AUC = 0.565) and uE(3) <= 0.88 MoM (P = 0.049, AUC = 0.571) developed GDM. HCG levels, 2.5 or, 3 MoM were significantly associated with the development of oligohydramnios [P = 0.005; OR = 4 (95% CI: 1.7-9.7)], [P = 0.008; OR = 4.9 (95% CI: 1.7-13.7)], respectively. When women with adverse (n = 237) and normal (n = 512) outcomes were compared there were significant differences in maternal serum AFP (1.40 +/- 0.84 vs. 1.23 +/- 0.75 MoM, P = 0.006) and uE(3) values (1.38 +/- 1.42 vs. 1.45 +/- 0.98 MoM, P = 0.001). Conclusions Serum estriol, AFP or HCG values in triple test results may be associated with development of oligohydramnios, gestational diabetes and macrosomia in women with healthy and normal appearing fetuses.Öğe The clinical value of avidity test in the management of serologic rubella infection: a case report(Ekin Tibbi Yayincilik Ltd Sti-Ekin Medical Publ, 2007) Sayin, N. Cenk; Ahmet, Nefise; Varol, Fuesun G.28-year-old pregnant woman presented with positive rubella IgM and IgG antibodies at initial admission and at the 11th, 13th, 30th and 36th weeks of gestation. Rubella avidity test revealed high titers and the patient was followed-up to ensure birth of a healthy infant. Rubella infection may be asymptomatic and re-infection may demonstrate a subclinical course. It is easy to make the diagnosis of rubella by following the antibody titers during pregnancy. The critical point in such patients is to differentiate the condition of disease at admission and decide accordingly. Avidity test may be a useful method for the management of such patients.Öğe Correlation Between Maternal Plasma Thrombomodulin and Infant Birth Weight in Hypertensive Disorders of Pregnancy(Sage Publications Inc, 2009) Varol, Fuesun G.; Ozgen, Levent; Sayin, N. Cenk; Demir, MuzafferObjective: To evaluate the association between maternal plasma thrombomodulin levels and infant birth weights in pregnancy-induced hypertension. Study design: Plasma thrombomodulin levels were measured in 80 pregnat women living in the Trakya region of Turkey. Kruskal-Wallis statistical analysis was performed in comparison of the descriptive and laboratory data (significance at P<.05). Results: The plasma thrombomodulin values in hypertensive disorders in pregnancy were found to be highly correlated with the infant birth weights(P<.001). Conclusion: Elevated plasma thrombomodulin levels in hypertensive disorders of pregnancy were well correlated withh related infant birth weights of these pathhologies. Plasma thrombomodulin levels might point out placental vascular endothelial damage reflecting on infant birth weights.Öğe Do routine preoperative imaging techniques facilitate the operation in endometrial cancer?(Springer Heidelberg, 2009) Sayin, N. Cenk; Varol, Fuesun G.; Yuce, M. Ali; Kaplan, Petek; Ahmet, Nefize; Sut, Necdet; Gucer, FatihTo assess the role of routine intravenous pyelography (IVP), rectoscopy and additional imaging techniques like computed tomography (CT) and abdominal ultrasonography (USG) for the evaluation of patients with endometrial cancer. A total of 97 women with endometrial cancer (82 endometrioid and 15 non-endometrioid type) of all stages (Stage I = 65, II = 14, III = 13, IV = 5) were included in the study. Of these, 50 women were admitted because of postmenopausal bleeding, 24 with irregular vaginal bleeding and 7 with pain and leucorrhea, whereas the others had no complaints. Only one patient had symptoms related to the gastrointestinal system, but none for the urinary system. Preoperative CT (n = 45), IVP (n = 78), rectoscopy (n = 46), and USG or colonoscopy (n = 37) were performed on our patients. All the women had total abdominal hysterectomy and bilateral salpingo-oophorectomy, with/without pelvic (n = 81) and paraaortic (n = 34) lymphonodectomy, and omentectomy (n = 35). In 39 of 45 women who had CT, it had no effect on the operation and did not facilitate the operation. In two women there were pathological findings on CT and some interventions (resection and anastomosis) were performed on the gastrointestinal tract in these patients. However, CT had overcome pathological findings related with the gastrointestinal or urinary systems in four women, who needed interventions to these systems during the operation. CT was not performed on six women who needed interventions to the gastrointestinal system during the operations. Three patients had pathological findings (fissure, external compression) in rectoscopy, but only one patient had ileo-transverstomy, in which rectoscopic finding had not predicted the necessity of that procedure. Out of 78 IVP, the only finding was external compression to the bladder in 38 patients, and this finding had no contribution to the operation. Among women who had USG or colonoscopy (n = 37) performed, five had pathological findings that contributed to the extensiveness or the mode of the operations (liver nodules, polyps in the colon). Routine preoperative computed tomography, intravenous pyelography, rectoscopy or abdominal USG and colonoscopy have little impact on the decision and the prediction of the extensiveness of the operation.Öğe Pregnancies complicated by adnexal masses: a case series(Springer Heidelberg, 2008) Sayin, N. Cenk; Inal, Hasan A.; Varol, Fuesun G.Introduction Adnexal masses >= 5 cm in diameter are rare during pregnancy. Materials and methods We present our experience on six pregnant women with adnexal masses diagnosed and operated during pregnancy and/or at the time of cesarean section. Results Carefully selected cases with a unilateral mass and a solid component with normal tumor marker result can be followed until term and adnexectomy can be performed during cesarean section. On the contrary, gross adnexal masses, even with normal tumor marker levels should be operated when diagnosed, but these women might deliver small for gestational age infants. Conclusion By depending upon restricted criteria according to tumor markers, ultrasound or other radiological imaging techniques, some patients with an adnexal mass carrying an important risk factor for malignancy may be overlooked.
