OBJECTIVE: To investigate the effect of methods of delivery on pelvic relaxation which is thought to lead to urethral mobility, stress urinary incontinence and development of cystocele.
METHODS: 225 primigravid patients who gave birth in Bakirkoy Gynecology-Obstetrics and Pediatric Research and Training Hospital between June 2011 and September 2011 were involved in the study. Each patient was evaluated during their 35-36 gestation weeks. The patients were re-examined in the 12th postpartum week. The cystocele was assessed. A stress test and Q test (by using a specially designed type of protractor) were performed to those with a history of stress incontinence. Patients with a vaginal delivery (n=155), and with C-section deliveries in the active (n=36) and in the latent phase (n=34) of labor constituted the study groups.
RESULTS: Birth weight was significantly lower in vaginal delivery group. SUI (stress urinary ıncontinence) was present in 19 (12.3 %) patients in the vaginal delivery and in 4 (5.7 %) patients in C-section group. No significant difference was found between the groups. The rates of cystocele was significantly different between the groups. The rate of cystocele was higher in the vaginal delivery group compared to the active phase C-section group. In addition, it was higher in the active phase C-section group than in the latent phase C-section group. In the Q tip test, ≥36 degree descensus was found in 26 (16.8 %) patients in the vaginal delivery and in 4 (5.7 %) patients in C-section groups. The difference was statistically significant. Cases with 2. and 3. degree, and also phase 2 and phase 3 cystoceles were present in vaginal delivery group while only phase 1 cystocele patients were present in latent phase C-section group. A positive correlation was present between the rates of stress incontinence, cystocele, a Q-test positivity, birth weight and duration of 2nd stage of labor.
CONCLUSION: The study results showed that the vaginal delivery is a serious risk factor for pelvic floor relaxation compared to C-section, while C-section performed in the active phase of labor constitutes higher risk than elective C-section and is not completely protective against pelvic relaxation.

OBJECTIVE: The aim of this study is to determine the fetomaternal risks and complications of pregnant population with ß-thalassemia minor and investigation of its the effects on fetal anomaly.
METHODS: Analytical data of 689 pregnant women attended to our hospital were used. Their informed written consents were obtained. Average age of the patients was 27.17±5.41 years. Patients were categorized into one of the three groups according to Hb and HbA2 values: Group-1 37 thalassemic pregnant patients (5.4 %), Group-2 271 pregnant women only with anemia (39.3 %), Group-3 (control group) 381 normal pregnant women (55.35 %). APGAR values of the babies were used as prognastic markers. Statistical tests were applied to data to determine the correlations between parameters and differences between three groups.
RESULTS: Information about the method of delivery, rate of abortus, gestation week at delivery, birth weight, incidence of intrauterine growth retardation and in uteru mort fetus APGAR scores, ceseraen delivery rate, and maternal complications were collected. According to these we could not find any statistically significant difference about delivery method, ratio of abortus, delivery week and development of intrauterine growth retardation among three groups. Any statistically significant diffference was not found as for APGAR score and in uteru mort fetus between thalassemia and anemia groups. But the rates of these complications were lower than the control group.

CONCLUSION: According to our data, patients with ß-thalasemia minor could carry on normal pregnancy period and deliver vaginally. The important part is to diagnose the thalassemia and to treat anemia that can cause serious complications. Because according to our study and other reports from literature; not thalasemia itself cause serious complications, but anemia can lead so many problems.

OBJECTIVE: Our aim is to emphasize the importance of infantile hypertrophic pyloric stenosis (IHPS) under the light of our experiences about its diagnosis and treatment.
METHODS: In this study, a total of 155 patients with IHPS treated by surgery in our clinic between January 1993 and December 2009 were analyzed retrospectively. Age, gender, physical examination, abdominal ultrasound, analysis of blood gases and postoperative complications were evaluated.
RESULTS: Male-female ratio was 3.7: 1 and mean age on admission was 39.7 days (range 15-120 days). An olive-shaped mass was palpated in 76.1 % of the patients. There were signs of dehydration and vomiting in all patients. Also projectile nonbilious vomiting was determined in 131, and significant weight loss was detected in 102 patients. Evisceration was seen in one patient during the postoperative period. There was no mortality.
CONCLUSION: Although diagnosis and treatment of IHPS is very simple, particularly in infants who have nonbilious vomiting and weight loss, it should be accepted as the first disease which has to be eliminated because it may cause severe malnutrition, dehydration and mortality when early diagnosis and appropriate treatment is not achieved.

OBJECTIVE: Spina bifida is a neural tube defect. Spina bifida affects multiorgan systems and causes life-long difficult problems for the baby with congenital spina bifida and their parents. Normally, all the parents expect to have a normal and healthy baby. The birth of a disabled child in the family affects lives, emotions and behaviours of all the family members adversely We intended to search the level of depression and anxiety, and also the ability of to cope with stress of the parents of 30 patients who were operated on because of spina bifida in our neurosurgery department.
METHODS: In this study, we used an Interview Form, Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI) and Scale of Coping With Stress.
RESULTS: We submited in this study, the level of depression and anxiety and the ability to cope with stress of parents of the children who were diagnosed as spina bifida.
CONCLUSION: The parents of the children with spina bifida were included in the psychological rehabilitation program We thought that, parents with a child who requires long-term treatment should participate in a psychological rehabilitation program.

Posterior reversible encephalopathy syndrome is a clinical and radiological entity which is characterised with headache, labile mental state, epilepsy, visual disorders and edema of white matter of the occipitoparietal area. The etiological factors of PRES are hypertensive encephalopathy, preeclampsia, eclampsia, HELLP syndrome, immunosupressive and cytotoxic agents, renal deficiency, collagen vascular diseases, thrombotic thrombocytopenic purpura, administration of high dose steroid hormone, liver insufficiency, massive blood transfusion, HIV infection, acute intermittant porfiria and organ transplantation. Early diagnosis and treatment of PRES is very important. If it is not recognized, neurologic sequels such as established cerebral damage and chronic epilepsy can occur. Aim of this case study is to present characteristics of PRES secondary to preeclampsia in 26 weeks of pregnancy, to discuss differential diagnosis of lesions ordinarily involving occipitoparietal area and to review the literature.

Infants with meningomyelocele consist a large part of neurosurgical spinal emergencies. Additional malformations often seen in infants with meningomyelocele contribute to challenges in applying general anesthesia.

A newborn infant with a open meningomyelocele was referred for emergent surgical closure after the delivery. Since there was a high risk associated with general anesthesia and the spinal anesthesia was unsuitable due to the size and location of the meningomyelocele pouch, the procedure has been performed under sedoanalgesia.

Sedoanalgesia may be regarded as an alternative approach when general and/or spinal anesthesia is difficult to perform. The depth of the sedation and the technique should be tailored for each individual patient.

Hemangiolymphangioma (HL) is a rare vascular malformation. Thirty-two-year-old woman with 38 weeks of pregnancy was referred to our clinic because of the mass of fetal arm. Ultrasonography revealed the large mass which believed to be HL with solid and cystic components in the fetal right upper extremity. In postnatal period, doppler ultrasonography (USG) and Magnetic Resonance Imaging (MRI) tests found the mass to be compatible with HL. Excisional biopsy is not recommended after pediatri, pediatric surgery and orthopedic consultations. In the neonatal period, the propranolol treatment was started because of component of hemangiomas in the mass. The continue treatment with propranolol was decided on the reduction of mass size after the third month.
We aimed to present our experience about prenatal diagnosis, perinatal outcome and the treatment in postnatal period of an extremely rare case of HL.