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Öğe Analysis of Antenatal Sonographic Features of the Fetuses with Trisomy 21(Kowsar Publ, 2018) Uzun, Isil; Sayin, Cenk; Erzincan, Selen; Ivan, Cihan; Sutcu, Havva; Varol, FusunObjectives: To evaluate the second trimester ultrasound findings of the fetuses with Down syndrome. Patients and Methods: We conducted a retrospective analysis of 781 patients who underwent prenatal invasive test between November 2011 and July 2015. Based on the patients' medical records, the demographic data and second trimester ultrasound findings of the fetuses with Down syndrome were retrospectively analyzed. Results: Trisomy 21 was detected in 26 (3.3%) patients. The median (min-max) maternal age of trisomy 21 cases was 31.9 (17 - 41) years. The karyotype indications were high risk in the combined test, triple test, quadruple test and pathologic findings on the ultrasound examination. One case in the ultrasound group had both of combined test and triple test in the low risk area. In this patient, ultrasound examination revealed talipes equinovarus and delayed chorioamniotic fusion at 27 weeks of gestation. Trisomy 21 was detected in four patients by chorion villus biopsy at the first trimester. Second trimester ultrasound was performed in 22 out of these 26 women. However, there were sonographic findings in only 16 (72.7%) patients. Six (27.2%) fetuses had no minor or major anomaly at the detailed ultrasound examination. The frequency of major cardiac anomaly was 22.7%. Choroid plexus cyst and aberrant right subclavian artery were the single findings in two fetuses at the second trimester ultrasound exam. Conclusion: Although the sensitivity of second trimester genetic ultrasound for detection of fetal Down syndrome at our perinatology unit was rather high, nearly one of three patients with Down syndrome had no detectable sonographic finding. Second trimester ultrasound alone is not strong enough to exclude the diagnosis of Down's syndromeÖğe Analysis of Ear y and Late Cases of Idiopathic Abruptio Placenta in Preterm Patients(Galenos Yayincilik, 2019) Cilingir, Isil Uzun; Varol, Fusun; Sutcu, Havva; Inan, Cihan; Yener, Cem; Sayin, CenkObjective: To evaluate the cases of idiopathic abruptio placenta in early and late preterm period. Methods: Normotansive singleton pregnancies with the diagnosis of abruptio placenta between 23 and 37 weeks of pregnancy were included in the study. The patients with a risk factor for abruptio plaicenta (preeclampsia, travma, heavy smoking, polyhydoamnios etc) were excluded from the study. The patients were divided into two groups according to the gestational weeks at delivery. Group I was consisted of the pregnant patiens between 23 and 32 weeks of gestation and group II was consisted of pregnant patients between 32 and 37 weeks of gestation. Results: Mean maternal age of the pregnant patients was 28.3 years.The demographic characteristics were smilar in the groups. The most common complaint at the admission was bleeding in group I (13/17, 76.4%), whereas pain (5/11, 45.4%) in group II. There were statistically significant difference in breech and transvers position of the fetuses between the early cases and late cases of abruptio placenta (p<0.05). Conclusion: Abruptio placenta may occur even in the patients without any risk factors. It should be borne in mind that abruptio placenta may have may different clinical presentations. It has different clinical symptoms and prognosis in early and late preterm period.Öğe Assessment of CA-125 area under the curve as a prognostic factor in patients with ovarian cancer(Humana Press Inc, 2013) Uzunoglu, Sernaz; Aybatli, Aysun; Kaplan, Petek Balkanli; Cicin, Irfan; Sut, Necdet; Sayin, Cenk; Varol, FusunThe goal of this study was to evaluate the efficacy of CA-125 area under the curve (CA-125 AUC) as a prognostic factor following surgical treatment for ovarian cancer patients. A retrospective analysis was conducted on ninety-five patients with ovarian cancer who had primary treatment in a tertiary center between 2000 and 2010. After either optimal or cytoreductive surgery, all patients underwent adjuvant chemotherapy. CA-125 AUC was calculated for each patient that had a minimum of three CA-125 serum measurements during the treatment period. The mean age at diagnosis and mean survival were 53.9 years (range, 16-75 years) and 35.6 +/- 22.9 months (range, 3.1-95.4 months), respectively. The mean (and median) CA-125 AUC of patients of FIGO stages I, II, III, and IV was 53.0 (42.5), 58.06 (58.06), 97.8 (54.6), and 405.2 (149.3) IU/ml day, respectively (p = 0.004). The mean CA-125 AUC was 57.7, 410.1, and 636.3 IU/ml day for patients with a complete response, partial response, and no response/progressive disease to first-line chemotherapy, respectively (p < 0.001). The CA-125 AUC cut-off level for an overall survival of >= 5 years was 99.75 IU/ml day with a sensitivity of 90.9 % (95 % CI, 70.8-98.6) with 1.27 as positive likelihood ratio. Patients who suffer from ovarian cancer, with a lower CA125 AUC, have a better overall survival than those with a higher CA125 AUC. CA-125 AUC could be used as an independent factor for evaluating the treatment efficacy and chemotherapy response.Öğe A Case of Maternal Spina Bifida Associated with Tethered Spinal Cord and Mode of Delivery(Gazi Univ, Fac Med, 2012) Ugurel, Vedat; Tuncel, Sedat; Varol, FusunTethered spinal cord syndrome (TCS) or occult spinal dysraphism sequence refers to a group of neurological disorders related to malformations of the spinal cord. Spinal lipomas and cutaneous stigmata are the most common manifestations of the occult spinal dysraphic lesions. The spinal cord normally hangs loose in the spinal canal, free to move up and down with growth, bending and stretching, while a tethered cord is held taut at the end. A 41 year-old 35 weeks and 4 days pregnant woman with a lumbosacral giant lipoma associated with spina bifida and tethered cord syndrome was admitted to our clinic, an uneventful vaginal birth was achieved, and this rare case is hereby presented with MRI findings.Öğe Clinical Significance of Abnormal Results of Second Trimester Hormones in the Absence of Aneuploidy(Kowsar Publ, 2018) Uzun, Isil; Sayin, N. Cenk; Inan, Cihan; Erzincan, Selen; Sutcu, Havva; Varol, FusunBackground: Abnormal levels of hormones during the second trimester of pregnancy may predict genetic disorders and complications of pregnancy. Objectives: This study was performed to evaluate the clinical significance of abnormal results in second-trimester markers in the absence of aneuploidy. Methods: This case-control study was conducted between May 2014 and December 2015 in the maternal-fetal unit, Trakya University Faculty of Medicine in Turkey. Overall, 108 Turkish pregnant females were included in this study. This research recruited patients (n = 46) with normal karyotype, who underwent invasive prenatal tests because of abnormal levels of second-trimester hormones, along with a cohort of controls (n = 31) with hormonal results within normal ranges. For each patient, the researchers recorded the mode of delivery, gestational age at delivery, birth weight, complications, and adverse outcome of the pregnancy. Data were analyzed using Fisher's exact tests and Yates continuity correction tests for qualitative variables, and t- test and Mann-Whitney U test for quantitative variables. Results: Maternal age (mean +/- SD) of the entire group was 31.77 +/- 5.68 years (study group: 31.23 +/- 4.39; controls: 32.13 +/- 6.43, P > 0.05). Preterm delivery and preeclampsia were significantly higher in the study group (P = 0.02). In the study group, Alpha Fetoprotein (AFP) levels were significantly higher in patients with preeclampsia yet not in the controls. The AFP values under 0.77 multiple of the median in patients with elevated test results in the absence of aneuploidy appeared to be associated with the development of preeclampsia later in pregnancy. Conclusions: Although the significance of higher AFP values have been discussed in the literature in terms of the development of adverse outcomes, the present study suggests that lower values must also be taken into account during patient follow-up.Öğe Comparison of the efficacy of the immediate-release and osmotic push-pull system formulations of nifedipine for tocolysis(Wiley, 2019) Iran, Cihan; Sayin, Cenk; Dolgun, Nihal; Uzun, Isil; Erzincan, Selen G.; Sutcu, Havva; Varol, FusunAim To compare the immediate-release (IR) and osmotic push-pull system formulations of nifedipine used for tocolysis in prolonging pregnancy, neonatal outcomes and maternal-fetal adverse effects. Methods We evaluated 140 pregnant women who received the IR (n = 72) and osmotic push-pull system (n = 68) formulations of nifedipine for tocolysis due to threatened preterm labor between 24(0/7) and 33(6/7) weeks of gestation. Groups were compared in terms of efficacy of tocolysis in prolonging pregnancy for more than 48 h, 7 days and up to 37 weeks of gestation, total number of days gained for prolonging pregnancy, delivery weeks, maternal-fetal adverse effects and neonatal outcomes including ventilation support, need for intubation or surfactant, intraventricular hemorrhage, respiratory distress syndrome, necrotizing enterocolitis, admission to neonatal intensive care unit, neonatal death, Apgar scores at the 1st and 5th minutes. Results There was no significant difference between the two groups in prolonging pregnancy for more than 48 h or 7 days, total number of days gained after tocolysis initiation, delivery weeks, the number of births at 34(0/7)-36(6/7) weeks or after 37 weeks of gestation (P > 0.05). Maternal-fetal adverse effects and neonatal outcomes were similar in both groups (P > 0.05). Conclusion The efficacy of IR and osmotic push-pull system formulations of nifedipine have similar effects in terms of tocolysis and neonatal outcomes, adverse effects. Osmotic push-pull system formulation of nifedipine may be an alternative medication in tocolytic therapy due to its ease of use and the absence of loading dose necessity.Öğe Computer aided detection of spina bifida using nearest neighbor classification with curvature scale space features of fetal skulls extracted from ultrasound images(Elsevier, 2015) Konur, Umut; Gurgen, Fikret S.; Varol, Fusun; Akarun, LaleThis paper addresses the problem of detecting the common neural tube defect of spina bifida by a computer aided detection (CAD) system. We propose a Method which extracts the curvature scale space (CSS) features of fetal skull contours viewed in the ultrasound (US) modality and performs nearest neighbor (kNN) classification on those features having the desired properties of invariance with respect to translation, orientation and scale changes, thus improving robustness. The distance between two sets of CSS features, each set corresponding to the description of the contour of a particular skull, is measured as the cost of matching the two sets of CSS features. Such a CAD system may act as a second observer and help experts in prenatal diagnosis. Our data possess absolute and relative rarity. The experiments are performed with two different rare class handling methods and over a range of operating conditions. All experiments are based on a group of settings; associated with using either balanced or unbalanced datasets, employing different types of CSS features and how CSS matching costs are computed. Comparatively evaluating the classification performance of the settings is carried with the aid of the whole-curve metric of area under the receiver operating characteristics (ROC) curve (AUC). Optimal operating conditions for any setting can be identified and some settings reveal advantages over others. The observations indicate that using balanced datasets offers better performance and our proposed version of estimating CSS matching costs is generally superior to the classical method. Furthermore, using enhanced sets of CSS features improves classification accuracy. When classification is performed on balanced data using enhanced CSS features and the matching cost is computed with our proposed technique; one can observe an F-measure of 0.76 along with 70% TP rate (recall), 17% FP rate (false alarms) and 82% precision. (C) 2015 Elsevier B.V. All rights reserved.Öğe Conjoined Twins: Unicephalus Non-Janiceps Tetrapus Tetrabrachius(Springer India, 2022) Yener, Cem; Sayin, N. Cenk; Altan, Esra; Varol, FusunConjoined twins are an uncommon type of monoamniotic twins with an incidence of about 1.5 per 100,000 births worldwide. Non-janiceps is the extremely rare sub-type of cephalopagus which is reported as 1 in 58 of all conjoined twins or 1 in 3 million births. We present a G6, P5 31-year-old pregnant who was diagnosed with a unicephalus non-janiceps conjoined twins. Due to its incompatibility with life, the pregnancy was electively terminated. The prognosis of conjoined twins depends on the location and extent of the conjoined area and the accompanying congenital anomalies of the fetuses. Early diagnosis is vital because it can help in assessing the type of conjoined twins and subsequently pre-postnatal decision making. Elective termination of non-janiceps type of conjoined twins which is incompatible with life is a justifiable possibility.Öğe Deletion of macro domain containing 2(MACRO D2) associated with transient hydrops fetalis(Elsevier Taiwan, 2018) Cilingir, I. Uzun; Sayin, Niyazi Cenk; Gurkan, H.; Ciftdemir, N. A.; Atli, E.; Inan, C.; Erzincan, S.; Sutcu, H.; Vatansever, U.; Varol, FusunMacro Domain Containing 2 (MACRO D2) gene is a gene from macro family which is highly expressed in the ventriculer zone of the brain during embryonic development. Association between Autism spectrum disorders and MACRO D2 gene polymorphisms has been reported before [1] . Deletion in MACRO D2 gene has also been associated with Kabuki Syndrome which is a well described congential anomaly syndrome [2] .Öğe Does emergency cerclage really works in patients with advanced cervical dilatation?(Elsevier Masson, Corp Off, 2019) Cilingir, Isil Uzun; Sayin, Cenk; Sutcu, Havva; Inan, Cihan; Erzincan, Selen; Yener, Cem; Varol, FusunObjective: To asses the efectivity of emergency cerclage in the patients with advance cervical dilatation and prolapsed membranes. Material methods: The patients who have >= 4 cm cervical dilatation with protruding membranes were included in the study. The patients were divided into two groups. Group I was consisted of the patients who had emergency cerclage procedure and group II was consisted of the patients who denied the operation and expectantly managed. The physical examination, pregnancy outcomes and the complications were compared between the groups. The results of the patients with emergency cerclage were analysed. Results: 21 patients were referred with a >= 4 cm cervical dilatation with protruding membranes 33.3% of women with emergency cerclage were delivered within one week from the admission. One patient, who was a grand multiparous (G6P4A1), was delivered a healthy infant at 40 weeks of gestation. The remaining five patients were delivered between 21 and 24 weeks, but all the infants were died due to extreme prematurity. Two patients (22.2%) developed chorioamnionitis that necessitated long hospitalization (14-21 days). In group II (expectant management) 83,3% of the patients were delivered within the 48 h from the admission. There were no case of chorioamnionitis in group II. Conclusion: Emergency cervical cerclage is not a rationale option for the patients with an advanced cervical dilation (>4 cm) together with protruding membranes in early second trimester because of the short prolongation time and high complication rate. (C) 2019 Elsevier Masson SAS. All rights reserved.Öğe Emergency cerclage in twins during mid gestation may have favorable outcomes: Results of a retrospective cohort(Elsevier Masson, 2018) Cilingir, Isil Uzun; Sayin, Cenk; Sutcu, Havva; Inan, Cihan; Erzincan, Selen; Yener, Cem; Varol, FusunPurpose. - Cervical cerclage treatment for cervical changes at mid trimester is a very controversial topic in twins. The aim of the study was to present our maternal and fetal outcomes of mid-trimester cervical cerclage in twin pregnancies. Basic procedures. - This study was performed using data extracted from the medical files of the twin pregnancies whom performed emergency cervical cerclage between January 2012 and March 2018 at Trakya University, Facuty of Medicine, Department of Perinatology. Main findings. - Mean (min.-max.) gestational age at delivery was [27.3 (21-34) weeks]. The median time between cervical cerclage and delivery was 6.4 weeks, while the maximum prolongation of the pregnancy was 11 weeks. The median prolongation period of pregnancy was 4.1 weeks in patients with bulging membranes, but 10 weeks in patients with cervical effacement and cervical shortening. Eight infants died at the neonatal period. Two patients (20%) developed late abortions at 21 and 22 weeks of gestation, and 2 women (20%) delivered extremely premature neonates at the 24th weeks. Overall neonatal mortality rate was 40% (8/20 neonates). Twelve out of twenty were born alive (60%). Principal conclusions. - Despite the lack of randomized controlled trials, it seems reasonable to offer emergency cervical cerclage to twin pregnancies with cervical shortening (<15 mm). For the twin pregnancies with advanced cervical dilatation and protruding membranes, emergency cervical cerclage should be an option only for carefully selected patients after informing about the complications and low success rate. (C) 2018 Elsevier Masson SAS. All rights reserved.Öğe Hemorrhagic cyst of the canal of Nuck after vaginal delivery presenting as a painful inguinal mass in the early postpartum period(Elsevier Science Bv, 2017) Uzun, Isil; Inan, Cihan; Varol, Fusun; Erzincan, Selen; Sutcu, Havva; Sayin, Cenk[Abstract Not Available]Öğe Inevitable Myomectomy of a Huge Submucous Myoma During Cesarean Section A Case Report(Sci Printers & Publ Inc, 2018) Uzun, Isil; Sayin, Cenk; Inan, Cihan; Erzincan, Selen; Varol, FusunBACKGROUND: Submucous myoma during pregnancy is a very rare clinical entity. CASE: A 39-year-old woman was able to carry her pregnancy to term despite a huge submucous myoma and inevitable myomectomy during cesarean section. CONCLUSION: Cesarean section is indicated in patients with myomas obstructing the birth canal, and myomectomy during cesarean section is not only a reasonable option, but sometimes inevitable.Öğe Intrauterine growth restriction (IUGR) risk decision based on support vector machines(Pergamon-Elsevier Science Ltd, 2012) Gurgen, Fikret; Zengin, Zeynep; Varol, FusunThis paper studies the risk of intrauterine compromise in the fetuses with intrauterine growth restriction (IUGR) using support vector machines (SVM). A structured and globally optimized SVM system may be preferable procedure in the identification of IUGR fetus at risk. The IUGR risk is estimated in two stages: In the first stage, noninvasive Doppler pulsatility index (PI) and resistance index (RI) of umbilical artery (UA), middle cerebral artery (MCA) and ductus venosus (DV), and amniotic fluid index (AFI) are retrospectively analyzed and the Doppler indices are applied to the SVM system to make a diagnosis decision on the fetal well being as reactive or nonreactive and/or fetal distress (FD) on the nonstress test (NST) (training data). In the second stage (testing data), the decision is validated by the NST (target value). Experiments are performed in retrospective clinical situation. Forty-four preterm with IUGR and without IUGR pregnancies before 34 weeks gestation are considered. Also, the nonparametric Bayes-risk decision rule, k-nearest neighbor (k-NN), is used for comparison. It is observed that the SVM system is proven to be useful in predicting the expected risk in IUGR cases in the small population study. Also, the PI and RI values of UA, MCA and DV are effective in distinguishing IUGR cases at risk. (C) 2011 Elsevier Ltd. All rights reserved.Öğe The investigation of tumoral angiogenesis with HIF-1 alpha and microvessel density in women with endometrium cancer(Galenos Yayincilik, 2012) Aybatli, Aysun; Sayin, Cenk; Kaplan, Petek Balkanli; Varol, Fusun; Altaner, Semsi; Sut, NecdetObjective: Hypoxia inducible factor 1 alpha (HIF-1 alpha) is a nuclear protein upregulated in response to reduced cellular oxygen concentration which therefore acts as a marker for hypoxia. The aim of this study was to determine tumoral angiogenesis with immunohistochemical markers in endometrium cancer and its relation with stage, grade, survival rates and other prognostic factors. Material and Methods: Using the database in our Gynecologic Oncology clinic, we selected 94 patients who were diagnosed with endometrial cancer and underwent primary surgery at our institution between 2001 and 2010. Tissue microarrays believed to demonstrate the optimum part of the tumor were reprepared from the paraffin blocks. Angiogenesis and microvessel density (MVD) were investigated with the aid of HIF-1 alpha and CD34 antibodies. Results: High expression of HIF-1 alpha was significantly more frequent in advanced grade endometrial cancers (p=0.044). HIF-1 alpha expression was highly correlated with CD34 expression in the tumor cells (p<0.001). However lack of relation among stage, overall survival rates and histological types were analyzed with HIF-1 alpha. When we compared HIF-1 alpha positive and negative cases with cervical, adnexial, lymphovascular and myometrial invasion, there was no difference between these groups. MVD was evaluated with CD34 and it was remarkable and significantly different on advanced grade tumors (r=0.268; p=0.009). A similar significant difference was observed between the high expression of CD34 and type II endometrial cancer histology (p<0.001). However, there was no relationship between the MVD and stage or survival rates. Conclusion: High expression of HIF-1 alpha is associated with tumoral angiogenesis in endometrial adenocarcinomas. Further studies targeting HIF-1 alpha for disrupting mechanisms essential for tumor growth in endometrium cancer will be significant investigations in the future.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 Letter to the editor related to the article Surgical outcomes of cesarean scar pregnancy: an 8-year experience at a single institution published by Xu et al.(Springer Heidelberg, 2022) Yener, Cem; Sayin, Cenk; Inan, Cihan; Altan, Esra; Ates, Sinan; Varol, Fusun[Abstract Not Available]Öğe Molecular nanoarchitectonics of proton triggered tetraphenylethylene-based detector: colorimetric, reversible, and intracellular pH(Wiley, 2023) Cilingir, Isil Uzun; Sayin, Cenk; Sutcu, Havva; Inan, Cihan; Erzincan, Selen; Varol, FusunObjectiveTo evaluate the changes in the diameters of superior vena cava (SVC) and inferior vena cava (IVC) and to measure the ratio between SVC and IVC in growth-restricted fetuses and compare these results with normally grown fetuses.MethodsTwenty-three consecutive patients with fetal growth restriction (FGR) (Group I) and 23 pregnant gestational age-matched controls (Group II) between 24 and 37 weeks of gestation were enrolled in the study between January 2018 and October 2018. The diameter of the SVC and IVC from inner wall to inner wall was measured in all patients by sonographic examination. The ratio between the diameter of the SVC and IVC was also measured in each patient to eliminate the gestational age factor. We have named this ratio the vena cava ratio (VCR). All parameters were compared between the two groups.ResultsThe diameter of the SVC was significantly greater in the fetuses with FGR (2.6-7.7 [5.4]) than in controls (3.2-5.6 [4.1]; P = .002; P < .01). The diameter of the IVC was significantly less in the fetuses with FGR (1.6-4.5 [3.2]) than in controls (2.7-5 [3.7]; P = .035; P < .05). The VCR was between 1.1 and 2.3 and the median value was 1.8 in Group I. The VCR was between 0.8 and 1.7 and the median value was 1.2. VCR was significantly higher in fetuses with FGR (P = .001 P < .01).ConclusionThis study shows that VCR is higher in fetuses with growth restriction. Further studies are needed to clarify the association between VCR and antenatal prognosis and postnatal results.Öğe Placental and serum levels of human Klotho in severe preeclampsia: A potential sensitive biomarker(W B Saunders Co Ltd, 2019) Cilingir, Isil Uzun; Varol, Fusun; Gurkan, Hakan; Sutcu, Havva; Atli, Engin; Eker, Damla; Inan, CihanIntroduction: The Klotho (KL) gene, initially defined as an anti-aging gene in mice, shares 86% of the amino acid sequence withthe human KL protein. The KL gene plays roles in endothelial nitric oxide production, angiogenesis, antioxidant enzyme production and protecting against endothelial dysfunction, all of which may be associated with preeclampsia (PE). Human KL is the precursor of the gene products: alpha-KL and beta-KL. In this study, we evaluated the gene expression, serum and placental levels of human KL in women with severe PE, pregnant women with chronic hypertension and healthy pregnant controls. Also, the gene expression, serum and placental levels of human decorin (DCN) were evaluated. Methods: A total of 36 patients with severe PE, 10 with chronic hypertension, and 28 with healthy controls were enrolled. Placental and serum levels together with of KL and DCN were measured by ELISA and alsogene expression of these were evaluated. Results: Placental and serum KL levels were significantly higher in the PE than in the controls and in women with chronic hypertension. Serum DCN levels were significantly higher in the PE women compared to controls and pregnant women with chronic hypertension. Placental DCN was similar in PE and healthy controls. There was no significant difference in the gene expression of KL and DCN in the groups. The best cut-off level for human KL to identify the presence of PE was calculated as 12.48 pg/ml with a sensitivity of 100% and and specificity of 96%, whereas for DCN 62.33 ng/ml to assess the presence of PE with a sensitivity of 86.1% and a specificity of 88%. Conclusion: Human KL may be a valuable marker for PE, with high sensitivity and specificity. It also appears to be more sensitive and specific than human DCN.Öğe Quadruplet Pregnancy with Complete Mole and Three Viable Fetuses(Taylor & Francis Inc, 2022) Yener, Cem; Sayin, N. Cenk; Keskin, Fatma Elif Usturali; Altan, Esra; Ates, Sinan; Varol, FusunBackground: The coexistence of a hydatidiform mole and a fetus can occur in a multiple pregnancy, being less frequent in triplets and quadruplets because of their infrequency. With assisted reproduction, multiple pregnancies are becoming more frequent, and we can expect more frequent coexistence with a molar pregnancy. Case report: This G3, P1 30-year-old mother, after assisted conception, was diagnosed with a quadruplet pregnancy, one of which was a molar conceptus. Due to the potential for malignancy, the pregnancy was electively terminated. Conclusion: Despite the difficulty in conceiving, elective termination of a multiple pregnancy associated with a molar pregnancy may be the most judicious course of action to protect the mother's life.
