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Öğe Acute Promyelocytic Leukemia Diagnosed at the End of First Trimester with a Successful Outcome(Kare Publ, 2018) Baysal, Mehmet; Umit, Elif G.; Ozdover, Ali Caner; Sutcu, Havva; Cilingir, Isil Uzun; Kirkizlar, Onur; Sayin, CenkThe treatment and management of patients with acute promyelocytic leukemia (APL) diagnosed in pregnancy can involve a wide range of difficulties and limitations. Thus, these cases are each unique and present challenges to physicians. The aim of this study was to present the case of a 24-year-old patient who was diagnosed with APL in the 14th week of pregnancy who was treated successfully with all-trans retinoic acid and chemotherapy.Öğe 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 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 Comparison of postpartum sonographic findings after uneventful vaginal and cesarean section deliveries(Medical Communications, 2018) Cilingir, Isil Uzun; Sayin, Cenk; Sutcu, Havva; Alici, Ebru; Inan, Cihan; Erzincan, Selen; Yener, CemObjective: To prospectively determine the sonographic findings of the postpartum uterus 24 hours after vaginal delivery and cesarean section. Methods: Women who had uneventful vaginal delivery or cesarean section from July 2015 to May 2018 in a tertiary care hospital were prospectively included. Uterine lengths, endometrium, amout of free fluid, the distance between the uterine fundus-promontorium and uterine fundus-L5 were evaluated 24 hours after delivery. Results: The mean (min-max) endometrial thickness in the vaginal delivery and cesarean section groups were 13.3 (4-25) and 12.4 (4-29) mm, respectively. Fundus-cervix length was significantly higher in the vaginal delivery group compared to the cesarean section group (184.05 +/- 16.8 vs 163.6 +/- 6.7 mm, p < 0.001). The measurements of anterior and anterior-posterior walls of the uterus, anteroposterior uterine length and uterine width were similar in both groups. Promontorium-fundus length was significantly higher in patients who delivered vaginally than those by cesarean section (123.3 +/- 13.6 vs 108.7 +/- 23.3 mm, p = 0.005). Conclusion: The measurement of L5-fundus distance is a simple and effective technique to evaluate the size of the uterus. Homogenous endometrium up to 30 mm in asymptomatic patients may be a normal finding 24 hours after delivery. The results of this study may be helpful in the decision-making process in cases of early postpartum hemorrhage or hemodynamic instability.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 The effect of the systematic birth preparation program on fear of vaginal delivery and quality of life(Springer Heidelberg, 2018) Ozdemir, Mucize Eric; Cilingir, Isil Uzun; Ilhan, Gulsah; Yildiz, Elif; Ohanoglu, KarolinThe aim of this study was to assess the impact of systematic birth preparation program on fear of vaginal delivery and quality of life (QoL) in pregnant women who request elective cesarean delivery without any obstetric indication. This study was conducted prospectively. A total of 100 women who requested elective cesarean delivery due to psychosocial reasons were included into the study. Women were divided into two groups according to their desire to participate in the systematic birth preparation program. Group A: case group (n = 50) consisted of women who participated in the systematic birth preparation program. Group B: control group (n = 50) received usual antenatal care. All patients were interviewed with questionnaires including the World Health Organization Quality of Life Assessment-BREF (WHOQOL-BREF) and Edinburgh Postnatal Depression Scale (EPDS) at postpartum 6th week. Type of delivery, maternal request for cesarean section, scores for QoL, and postpartum depression were compared between the two groups. Vaginal delivery rate was significantly higher in among the patients who received the systematic birth preparation program (group A: 78%, group B: 56%). Maternal request for elective cesarean section significantly decreased after the systematic birth preparation program (group A: 8%, group B: 28%). In group A, the WHOQOL-BREF-TR mean scores (SD) for physical domain, psychological domain, and environmental domain were significantly higher than the values exhibited in group B. In scores of the postpartum depression scale, there were no significant differences between the two groups (p = 0.075). The current study indicates that systematic birth preparation program may decrease the rate of elective cesarean delivery by reducing fear of vaginal delivery and improve the quality of life at postpartum period.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 Evaluation of Detailed Fetal Renal Sonographic Findings and the Early Neonatal Outcomes of the Patients with Fetal Pelviectasis Whom Referred After 24th Weeks of Pregnancy(Galenos Publ House, 2022) Cilingir, Isil Uzun; Sayin, Cenk; Suetcue, Havva; Inan, Cihan; Erzincan, Selen Guersoy; Varol, FuesunObjective: Analysis of detailed renal sonographic findings in the patients whom referred to our tertiary center with the diagnosis of renal pelvic dilatation (RPD) after 24 weeks of gestation.Method: The study group consisted of the patients who have referred by their doctors to our perinatology center with a diagnosis of pelviectasy. Maternal age, gestational week, right and left renal pelvis diameter, bladder diameter, amniotic fluid index, other sonographic findings and antenatal diagnosis were analysed.Results: Bilateral hydronephrosis were detected in 19 (44.1 8%) patients. Unilateral left hydronephrosis were found in 10 (23.2 5%) patients while right hydronephrosis were found in 6 (13.9 5%) patients. Mearn left renal pelvis diameter was 11.20 (4-32) mm and mean right renal pelvis diameter was 7.89 (4-18) mm. Antenatal diagnosis was vesicoureteral reflux in 16 (37.2 0%) patients, ureteropelvic junction obstruction in 9 (20.9 3%) patients, posterior urethral valves in 5 (11.6 2%) patients. The antetanal diagnosis was renal agenesia in one patient, renal cortikal cyst in one patient, policyctic renal disease in one patients and multiple dysplastic renal disease in 3 patients.Conclusion: When RPD is detected in the fetal ultrasound of during pregnancy, directing the patients to the perinatal centers for advanced evaluation is important, since it can prevent the progressive renal damage that may develop in the later years of life.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 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.
