REVIEW | |
1. | Pelvic Organ Prolapse; Anatomic Fundamentals and Surgical Management Emel Canaz, Hasan Cemal Ark, İsmet Alkış, Ağahan Han, Hatice Ölmez doi: 10.5222/JOPP.2013.047 Pages 47 - 61 As the population lives longer, pelvic floor disorders become more evident and increasing health and social issue. More than %10 of women needs surgery for prolapse or stres incontinence in a life time, with %30 of those patiens requiring repeated surgical repair for failure. This chapter will review pelvic organ prolapse in aspects of anatomic fundamentals and pathophysiologic mechanisms; classify prolapse as anterior, posterior and apical prolapse as anatomic compartments, and describe surgical methods with cure and complication rates. |
RESEARCH ARTICLE | |
2. | The Effects of Ovulation Induction with Recombinant FSH and Urinary FSH to the Pregnancy Outcomes in Intrauterine Insemination Cycles Ali Ekiz, İbrahim Polat, Gonca Yıldırım, Naile Gökçe Akagündüz, İsmet Alkış, Volkan Ülker, Ali İsmet Tekirdağ doi: 10.5222/JOPP.2013.062 Pages 62 - 69 OBJECTIVE: The purpose of this study is to evaluate outcomes of pregnancy after ovulation induction with recombinant Follicle Stimulating Hormone and urinary Follicle Stimulating Hormone and to determine whether there is a statistically significant difference. METHODS: A randomized controlled prospective clinical study. Ethic committee approved our application with 303 numbered decision at 15th February 2010. 105 infertile women who failed to conceive on treatment with clomiphene citrate was included in the study. A total of 90 cycles of ovulation induction with rFSH and IUI were performed to 55 patients of rFSH group. A total of 90 cycles of ovulation induction with uFSH and IUI were performed to 50 patients of uFSH group. Days of stimulation, dose of gonadotrophin, dominant follicle number, endometrial thickness on HCG day, cycle cancellation rate, OHSS incidence, total motile sperm account (TMSS) on IUI day, first trimester abortion ratio and pregnancy ratios per cycles, multiple pregnancy rates were evaluated. RESULTS: Pregnancy ratios per cycles were 16,7 % in Gonal F group and 14,4 % in Fostimon group. There is no significant difference between pregnancy rates. There is also no significant difference between days of stimulation, dominant follicle number, endometrial thickness on HCG day, cycle cancellation rate, OHSS incidence and first trimester abortion ratio. CONCLUSION: According to the results of our study, pregnancy rates were achieved similar with rFSH or uFSH usage for ovulation induction in IUI cycles. Additionally, there is no significant difference in other parameters |
3. | Second Trimester Placental Location: Effects of Pregnancy Outcomes Nadiye Köroğlu, Sinem Sudolmuş, Hatice Ölmez, Aysun Fendal Tunca, Ahmet Gülkılık, Gonca Yetkin Yıldırım doi: 10.5222/JOPP.2013.070 Pages 70 - 75 OBJECTIVE: The purpose of this study was to determine whether an association exists between second- trimester placental location and maternal - neonatal outcomes METHODS: A prospective, observational study was performed in singleton pregnancies between February 2009 and January 2010 in Istanbul Bakirkoy Women and Children Hospital at Department of Obstetrics to investigate the association between placental location and subsequent risk of an adverse pregnancy outcome. Placental location was determined by sonography at 16 to 22 weeks’ gestation. All ultrasounds were performed by the same operator. Placental location was divided into five categories, anterior, posterior, fundal, lateral ( left or right lateral) and low- lying. Statistical analyses were conducted using MedCalc Statistical Software v11.3. RESULTS: There were 807 pregnancies analyzed in this study [ anterior location: 328 (%40.6), posterior location: 290 (%35.9), fundal location: 46 (%5.7), left or right locations 117 (%14.5), and lower uterine segment location: 26 (%3.2) ]. The risk of developing preeclampsia, preterm delivery (P = 0.085) and the risk of having a fetus with IUGR (P = 0.658), gestational hypertension (P=0.278), and abruptio placentae (P= 0.877) were not increased in this study by the site of placentae. CONCLUSION: There was no association between second- trimester placental location and adverse pregnancy outcome. |
4. | Evaluation of the Effects of Levonorgestrel-Releasing System on Anemia and Changes of Menstrual Pattern at the First Year of Treatment of Menorrhagia Cihangir Uzunçakmak, Ebru Akbay, Murat Ekin, Zeynep Akçığ doi: 10.5222/JOPP.2013.076 Pages 76 - 80 OBJECTIVE: : The aim of this study is to evaluate the effect of the levonorgestrel intrauterine system (LNG-IUS) on menorrhagia and determine the amount of menstrual bleeding, bleeding pattern and serum ferritin levels difference in a 1 year follow up period. METHODS: Menstrual bleeding scores are evaluated by using pictorial blood assessment chart. Menstrual bleeding scores, bleeding patterns, serum ferritin and hemoglobin levels were compared with preinsertion and on-treatment group. RESULTS: Fourty-three (68.75%) women were eligible for control in the on-treatment group. Mean age of the patients was 40,46±5,79 years. There occurred a statistically significant increase in the hemoglobin levels (pre-treatment 11,14 gr/dl, on-treatment 12,08g/dl; p=0,006) and ferritin levels (pre-treatment 9.84±1.88 μg/L, on-treatment 46.24±2.92 μg/L; p=0,001). When the pre-insertion and on-treatment group were compared the pictorial scores were statistically significantly decreased (pictorial score 191±9,62 vs 36±6,97; p< 0.001, respectively). CONCLUSION: The amount of blood loss decline in LNG-IUS users is remarkable. LNG-IUS may be the first choice in the treatment of menorrhagia especially in reproductive age because of its reversibility and efficiency. |
5. | Does Vaginal Preparation with Povidone-Iodine Prior to Cesarean Delivery Reduce the Risk of Endometritis? Hatice Ölmez, Nadiye Duğan, Sinem Sudolmuş, Aysun Fendal Tunca, Gonca Yetkin Yıldırım, Ahmet Gülkılık doi: 10.5222/JOPP.2013.081 Pages 81 - 88 OBJECTIVE: The purpose of the present study was to determine whether the vaginal preparation with povidone–iodine prior to caesarean delivery decreased the incidence of postpartum wound infection and endometritis. METHODS: The present study was a prospective randomized controlled trial in which subjects received a vaginal preparation with povidone–iodine solution immediately prior to caesarean delivery or received no vaginal preparation. The primary outcome measure were the rate of postpartum wound enfection and endometritis. RESULTS: A significant decrease in post-caesarean wound was noted in the group that received the povidone–iodine vaginal preparation (n = 332) compared with the control group (n = 335) (p=0,015). No statistically significant differences in the incidence of endometritis were noted between the experimental and control groups among women who were not in labor at the time of the caesarean delivery (p=0,841). CONCLUSION: Vaginal preparation with povidone–iodine solution immediately prior to a caesarean delivery reduces the risk of post-operative wound infection. |
6. | A Comparison of Pelvipedal Casting and Titanium Elastic Nailing After Traction in the Treatment of Pediatric Femur Diaphysis Fractures Gökhan Polat, Hasan Hüseyin Ceylan, Mehmet Erdil, Kerem Bilsel, Necdet Demir, Nejat Tunçer, Gökçer Uzer doi: 10.5222/JOPP.2013.089 Pages 89 - 93 OBJECTIVE: Pediatric femur diaphysis fractures are common children injuries. In our study we aimed to compare the results of the pelvipedal casting after traction and titanium elastic nailing treatment in these patients. METHODS: We retrospectively evaluated 39 patients (mean follow-up of 5 (3-10) months) who had admitted to our clinic because of femur diaphysis fracture between September 2011 and July 2012. 26 patients were enrolled as Group 1. These patients were hospitalized for application of traction. After soft callus formation pelvipedal casting were applied and the patients were discharged from hospital. Other 13 patients who had operated with titanium elastic nailing, were enrolled as Group 2. In Group 1 the mean age were 3.9 (1-9) years. In Group 2 the mean age were 8.7 (4-15) years. RESULTS: There were no statistical differences according to the follow-up. All fracture were united at the end of follow-up. In Group 1 (10.1 days) the hospitalization time was statistically longer than Group 2 (2.2 days) (p< 0.05). There were 2 complications that need revision operation in Group 1 and 1 complication in Group 2. There were no statistical differences between two groups regarding complications and posttraumatic deformity. CONCLUSION: Relative longer hospitalization time, longer recovery time and patient care problems for parents are main disadvantages of pelvipedal casting. In our study we did not find any differences regarding treatment success between two groups. But we think that titanium elastic nailing treatment may be chosen more due to shorter hospitalization time, comfortable and faster recovery time. |
CASE REPORT | |
7. | Cesarean Scar Pregnancy: Two Case Reports Ahmet Şahbaz, İbrahim Polat, İsmet Alkış, Ali İsmet Tekirdağ doi: 10.5222/JOPP.2013.094 Pages 94 - 96 Although cesarean scar pregnancy is one of the rarest form of ectopic pregnancy, it's incidence is rising along with highly increacing cesarean section delivery ratios. Cesarean Scar Pregnancy is also one of the most life threatening emergency of the obstetrical clinic. We hereby report two cases of cesarean scar pregnacy diagnosed and threated in our hospital in order to bring attention to this highly devastating obstetric emergency. |