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Öğe Alteration of nerve growth factor mRNA in the rat uterus during pregnancy(1998) Varol, Füsun; Hadjıconstantınou-Neff, Maria; Duchemın, Anne-MarieOBJECTIVE: To evaluate the existence and alteration of Nerve Growth Factor (NGF) mRNA and receptor proteins in virgin and pregnant rats. STUDY DESIGN: Nerve growth factor (NGF) mRNAs were assayed in virgin (NP) and pregnant uteri (u) by northern blot hybridization. NGF receptor proteins were measured by ELISA method. RESULTS: NGF mRNA was detected in virgin (NP) and pregnant uteri (u). Both corpus and cervix uteri contained different amounts of NGF mRNA in virgin rats. NGF mRNA in cervix uteri (ex) was found in all stages of pregnancy. However, early pregnant corpus (Day 3) (Eu) contained the highest NGF mRNA levels, whereas undetectable levels were found in late pregnant corpus uteri (Day 21). Mid pregnant corpus uteri (Day 14) demonstrated lower levels than early pregnant uteri. NGF receptor proteins were also correlated with NGF mRNA in virgin and pregnant uteri. CONCLUSION: There is gestational decrease of NGF mRNA and receptor content in corpus uteri that may help uterine quiescence.Öğe Early Serum Heme Oxygenase-1, Soluble Vascular Endothelial Growth Factor Receptor-1, and B-Cell Lymphoma/Leukemia-2 Levels and Unfavorable Obstetric Outcomes(2022) Sütçü, Havva; Varol, Füsun; İnan, Cihan; Uzun, Işıl; Sayın, CenkOBJECTIVE: To examine early pregnancy levels of serum heme oxygenase-1, soluble vascular endothelial growth factor receptor-1, B-cell lymphoma/leukemia-2 in relation to unfavorable pregnancy outcomes, including preeclampsia, fetal growth restriction, spontaneous preterm birth, gestational diabetes mellitus and fetal macrosomia. STUDY DESIGN: A total of randomly selected 140 pregnancies were included in this prospective study. Peripheral blood samples were obtained between 110/7 and 136/7 gestational weeks. All pregnancies were followed up until the outcomes were obtained and classified as preeclampsia, fetal growth restriction, spontaneous preterm birth, gestational diabetes mellitus, fetal macrosomia, and uncomplicated ones. RESULTS: Significantly high levels of early serum heme oxygenase-1 were found in the cases who subsequently developed preeclampsia, spontaneous preterm birth, and fetal macrosomia (p<0.05), in concordance with high soluble vascular endothelial growth factor receptor-1 levels of the preeclampsia group, however, B-cell lymphoma/leukemia-2 s were similar in all groups. As soluble vascular endothelial growth factor receptor-1 predicted preeclampsia at a value of 11.905 ng/mL, the cutoff values for the heme oxygenase-1 to predict preeclampsia, spontaneous preterm birth, and fetal macrosomia were 0.372 ng/mL, 0.354 ng/mL and 0.494 ng/ml, respectively. CONCLUSION: Elevated first trimester heme oxygenase-1 levels are remarkable in the pregnancies associated with preeclampsia, spontaneous preterm birth, and fetal macrosomia in comparison with uncomplicated ones.Öğe Intrahepatic Cholestasis and Adverse Perinatal Outcomes in the Third Trimester: A 10-year Case-control Study(2022) Yener, Cem; Sayın, Cenk; Erbilen, Esra Altan; Ateş, Sinan; Varol, FüsunBackground: To evaluate the perinatal outcomes in women whom developed intrahepatic cholestasis of pregnancy (ICP). Materials and Methods: Medical records of 76 patients who were followed up in a tertiary center due to ICP between January 2010 and December 2019 were evaluated retrospectively. Women with ICP (n=76) and age matched controls (n=228) were included to our study. Bile acid (BA) values could be reached in 42 of 76 patients. Results: There was no significant difference in terms of family history, fetal gender, or the presence of meconium in the amniotic fluid between the groups (p>0.05) except cesarean rates were significantly higher in ICP group (p<0.001). The median gestational weeks at delivery, fetal weight and Apgar scores at the 1st- and at the 5th-minutes in the ICP group were significantly lower than those in the controls (p<0.05). Gestational weeks at delivery was similar in women with BA values above or under 40 ?mol/L (p>0.05). Conclusion: ICP has important fetal implications. There is an increased risk for poor fetal outcomes, including preterm delivery and fetal demise. Therefore, close follow-up and meticulous observation is indispensable. Keywords: Intrahepatic cholestasis, neonatal outcome, pregnancy, ursodesoxycholic acidÖğe İntravajinal Mizoprostolün Gebelik Sonlandırılmasında Etkinliğinin Değerlendirilmesi(2020) Yener, Cem; Ateş, Sinan; Sayın, Cenk; Görmez, Süheyla; Varol, FüsunAmaç: Çalışmamızın amacı Trakya Üniversitesi Tıp Fakültesi Doğum Kliniğinde Mayıs 2016 –Aralık 2018 tarihleri arasındaki 2,5 yıllık zaman aralığında terminasyon yapılan gebeliklerin endikasyonlarının dağılımını değerlendirmek ve 10 (on) hafta üzeri gebelik sonlandırmasında dört saatte bir intravajinal ve yirmi dört saatte bir vajinal yolla uygulanan sırasıyla 400 ?g ve 600 ?g mizoprostolün etkinliğini karşılaştırmak. Gereç ve Yöntem:Retrospektif dosya incelemesi şeklinde planlanan çalışmamızda kliniğimizde terminasyon kararı verilen 10 (on) hafta üzeri gebeliklerin sonlandırılma endikasyonları ve uygulanmakta olan mizoprostol tedavi protokollerinin etkinliği incelendi. 18-45 yaş arası, 10 (on) hafta ve üzeri olan gebeliklerin sonlandırılmasının planlandığı toplam 128 kadının dosyası değerlendirildi. 63 hastaya (Grup 1) 4 saat ara ile tekrarlanan 400 ?g vajinal yolla mizoprostol uygulandı. 65 hastaya (Grup 2) 24 saat ara ile tekrarlanan 600 ?g vajinal yolla mizoprostol uygulandı. Her iki grupta yeterli uterin kontraksiyon elde edilene kadar doz tekrarlanıp 48 saat sonrasında abortus/doğum gerçekleşmemesi halinde yöntem başarısız olarak kabul edildi. Bulgular: Çalışmamızda termine edilen 128 hastanın terminasyon endikasyonları belirlendi. Gebelik terminasyon endikasyonları: Missed Abort ve IUGR (in utero mort fetus) 32(%25), santral sinir sistemi anomalileri 30(%23,4), anhidramniyoz 28(%21,8), kromozal anomaliler 11(%8,5), kardiyak anomaliler 7(%5,4), çoklu sistem anomalileri 6(%4,6), kas iskelet anomalileri 5 (%3,9), gastrointestinal ve genitoüriner sistem anomalileri 5(%3,9), teratojen ilaç kullanımı ve radyasyona maruz kalma 4(%3,1) bulundu. Grup 1 olgularda 48 saatte abortus oranı (%90.4) idi. Grup 2 olgularda 48 saatte başarı oranı ise (%92,3) bulundu.Sonuç: İlk trimester ve ikinci trimesterde yapılan obstetrik ultrasonografi fetal yapısal anomalilerin tanısında tek yöntemdir. Santral sinir sistemi anomalileri fetal anomaliler içerisinde en büyük grubu oluşturmaktadır. Hastanemizde 10 (on) hafta ve üzeri gebelik sonlandırılmasında kullanılan mizoprostolün etkili ve güvenilir olduğu düşünülmektedir.Öğe A Local Study on Antenatal Features of Preterm Births at 26-32 Versus 33-36 Weeks of Pregnancy(2018) Varol, Füsun; Er, Nuray; Süt, Necdet Hilmi; Sayın, N. CenkOBJECTIVE: The antenatal features of pregnancies affect the incidence of preterm births. This retrospectivestudy from Trakya University of Northwestern Turkey, describes antenatal factors involved inpreterm births at 26-32 weeks of pregnancy and compares with those involved in preterm births at 33-36 weeks.STUDY DESIGN: The records of preterm births at 26-32 weeks (earlier preterm births, n=419) and at33-36 weeks (later preterm births, n=158) during the years 2002-2010 were reviewed and the demographic,obstetric and medical features were evaluated retrospectively. The data was expressed as numbersand percentages and analyzed by SPSS 20.0.RESULTS: Iron supplementation [OR 0.27 (0.16-0.45), p=<0.001], short cervix [OR 9.12 (2.09-39.73)p=0.003] and infection [OR 2.6 (1.2-5.6) p=0.014] were important factors in the emergence of earlierpreterm births which occurred at the rate of 1.4%.CONCLUSIONS: Earlier preterm births at 26-32 weeks of pregnancy, which compose an obstetric issue,are associated with several antenatal risk factors such as nutrition, cervical problems and infections inNorthwestern Turkey.Öğe MEASUREMENT OF FETAL NASAL BONE LENGTH, PRENASAL THICKNESS AND CORPUS CALLOSUM LENGTH OF FETUSES IN THRACE REGION OF TURKEY(2020) Varol, Füsun; Yener, Cem; Sütçü, Havva; Altan, Esra; Ateş, Sinan; Sayın, CenkAim: The nasal bone can be imaged with ultrasonography from the 10th week of pregnancy. In situations where the nasal bone isaplastic or hypoplastic, the risk of chromosomal anomalies increases. Thickening of the prenasal soft tissue is also apparent in the vastmajority of second-trimester fetuses with Down syndrome. In addition to these, corpus callosum is an another fetal structure that can bevisualized from 18th weeks of the gestation by ultrasound. Agenesis or dysgenesis of it is related with neuro-disabilities. In this study ourobjective was to provide reference charts for fetal nasal bone length, prenasal thickness and corpus callosum length obtained byprenatal sonography between 19th and 23rd weeks of pregnancy.Materials and Methods: The medical records of pregnant women who were followed-up in Trakya University School of Medicine,Department of Obstetrics & Gynecology, Division of Perinatology during the time period of 1st of January 2018 to 31st of December2019 were reviewed retrospectively. We studied 167 patients in between 19th and 23rd weeks of pregnancy.Results: Nasal bone length, prenasal thickness and corpus callosum length increased as the gestation proceeded. Mean±SD for nasalbone length, prenasal thickness and corpus callosum length (mm) between 19th and 23rd weeks were 6.65±0.7, 4±0.5, 20.1±1.4respectively.Conclusion: Ultrasound measurements of nasal bone length, prenasal thickness and corpus callosum can be performed within thesecond-trimester anomaly scan, and these measurements appear to be highly necessary because these measurement sensitive forprenatal diagnosis of chromosomal abnormalities and genetic syndromes.Öğe Measurement of Fetal Penile Length in Thrace Region of Turkey(2021) Yener, Cem; Varol, Füsun; Erbilen, Esra Altan; Ateş, Sinan; Sayın, CenkAim: To provide a reference range for fetal penile length obtained by prenatal sonography between 19th and 23rd weeks of pregnancy. Material and Method: The medical records of pregnant women who were followed-up in our department of Perinatology during the time period of 1st of January 2019 to 31st of December 2019 were reviewed retrospectively. Total 103 patients between 19th and 23rd weeks of gestation were included in the study. Results: Fetal penile length increased as the gestation proceeded. Mean ± SD penile length (cm) between 19th and 23rd weeks of gestation was found to be 0.81±0.23. Conclusion: Ultrasound measurements of fetal penile length can be performed within the second-trimester anomaly scan, and these measurements appear to be necessary because identification of true penile maldevelopment obligates further diagnostic workup.Öğe Neonatal outcome of premature infants of preeclamptic mothers(2002) Soyuçen, Erdoğan; Karasalihoğlu, Serap; Vatansever, Ülfet; Varol, Füsun; Acunaş, BetülPreeklamptik anne 45 prematüre yenidoğan, preeklamptik olmayan annelere ait, gebelik yaşı, cinsiyet açısından eşleştirilmiş 45 prematüre yenidoğan ile neonatal komplikasyonlar açısından karşılaştırıldı. Preeklamptik anne infantları respiratuar distres sendromunu, polisitemiyi, trombositopeniyi, nekrozitan enterokolitisi biraz daha sık, intraventriküler hemorajiyi daha az geliştirmekle birlikte, istatistik açıdan farklılık görülmedi. Her iki grupta hastanede kalış süresi, mortalite hemen hemen aynı idi. Bununla birlikte preeklamptik annede daha sıklıkla gelişme geriliği ve sezaryenle doğum görülmektedir.Öğe Normal gebeliklerde ikinci trimester maternal plasma dimerik inhibin-A(2000) Varol, Füsun; Aral, Sema; Arslan, Gülten; Ergür, SadıkAMAÇ: Anöploidi açısından normal gebeliklerde 14-20 haftalar arasında anne plasma inhibin-A seviyelerini değerlendirmek GEREÇ VE YÖNTEM: Anöploidi açısından normal gebelikle sonuçlanmış 67 gebede 14 ile 20 inci hafta arasında maternal plasma inhibin-A değerleri çalışmaya alınmış ve median değerler gebelik yaşına göre olarak değerlendirilmiştir. BULGULAR: Anöploidi açısından normal sonuçlanmış gebelerde, II. Trimester plasma inhibin-A değerleri 14. hafta:80.57±29.99, 15. hafta:97.63±17.25, 16. hafta +93.14+12.52 , 17.hafta 80.1+42 , 18.hafta 76.62+48, 19.hafta 91.12±28, 20.hafta 121.25±1 pg/ml olarak bulunmuştur. SONUÇ: Maternal plasma dimerik inhibin-A konsantrasyonları H.trimester anöploidi taraması açısından faydalı bir belirteç olabilir.Ancak, plasma inhibin-A metodunda assay performansını ve maliyetini azaltma yönünde çalışmalar yapılmalıdır.Öğe Prenatal Sitogenetik Anormallikler ve Ultrasonografik olarak Saptanan Fetal Anomalilerin Korelasyonu(2022) Atlı, Emine İkbal; Atlı, Engin; Yalçıntepe, Sinem; Akurut, Cisem; Demir, Selma; Gürkan, Hakan; Varol, FüsunBu çalışmada, Trakya Üniversitesi Tıp Fakültesi Hastanesi'nde 8 yıllık süreçte anormal ultrasonografi bulguları ile gelen 141 adet amniyosentez, 9 koryon villus ve 5 fetal kan örneği sitogenetik olarak analiz edilmiştir. Amacımız ultrasonografi taramasında anomali riski öngörülen gebeliklerdeki karyotipik anormalliklerin korelasyonunu belirlemekti. Amniyosentez, koryon villus ve kordosentez örnekleri ile yapılan hücre kültürlerinden elde edilen karyotipler değerlendirilmiştir. Ayrıca hızlı tanı için interfaz nukleuslarında X,Y,13, 18,21 kromozomları için floresan insitu hibridizasyon yöntemi ile anöploidi taraması yapılmıştır. Anormal ultrasonagrafi bulgusu ile refere edilen 155 hastadan 23 tanesinde (%14.83) kromozom anomalisi saptanmıştır. NT artışı en sık tespit edilen ultasonografi bulgusuydu. Kromozom anomalilerinden 2 tanesi yapısal kromozom anomalisi olarak değerlendirildi. Geriye kalan 21 hastada saptanan anomaliler sayısal kromozom anomalisiydi. Bu 21 sayısal anomaliden 5 tanesi trizomi 13, 3 tanesi trizomi 18, 13 tanesi trizomi 21’dir. Trizomi 21 vakalarından 1 tanesi kordosentez materyalinden, 1 tanesi ise CVS materyalinden elde edilmiştir. Sonuçlarımız, yüksek riskli bir populasyonda kromozom anomalileriyle, ultrasonografik bulgular arasındaki ilişkinin anlamlı olduğunu ortaya çıkarırken, seçilen ultrasonografik belirteçlerin fetüsteki anöploidiyi saptamadaki geçerliliğini doğrulamaktadır.Öğe The Screening of Antiphospholipid Antibodies in Obstetric Antiphospholipid Syndrome-Like Events: A Regional Perspective(2020) Önen, Önder; Varol, FüsunOBJECTIVE: Obstetric antiphospholipid antibody syndrome is clinically recognized by adverse obstetric outcomes. To determine which antibody level best corresponds to the risk of these clinical outcomes is difficult. Obstetric antiphospholipid antibody syndrome-like adverse obstetric outcomes with single(n=108) and repeat (n=79) documented antiphospholipid antibody titers were evaluated.STUDY DESIGN: Serum samples of 108 Obstetric antiphospholipid antibody syndrome cases and 50 healthy gestational matched controls with no history of thrombosis and congenital anomalies were subjected to testing for antiphospholipid antibodies with ELISA after the events. Of this obstetric antiphospholipid antibody syndrome group, only 79 cases underwent repeat testing within 12 weeks. Quantitative data were described by values and percentages at the levels of (>10) and (>40 U).RESULTS: By one documented antiphospholipid test, the mean values of anticardiolipin, and anti-?2 glycoprotein1 (a?2GP1) of obstetric antiphospholipid antibody syndrome versus controls were significantly different (p<0.001). Of 79 women who came for repeat sampling, a total number of women withpersistent antiphospholipid antibody positivity was only 43 (54.43%). The number of obstetric antiphospholipid antibody syndrome cases with >40 U of antiphospholipid antibody was only 8 (18.60%).CONCLUSION: Not all obstetric antiphospholipid antibody syndrome associated pregnancy morbidities may own high (>40U) antiphospholipid antibody titers, but low antiphospholipid antibodies (>10U) also accompany to this clinical picture. Obstetric antiphospholipid antibody syndrome should always be taken into account clinically prior to laboratory findings. Besides, long persistence of antiphospholipid-M positivity in these placenta-mediated disorders may make sense in terms of trophoblastic damageÖğe Seroprevalence of Toxoplasma Gondii Antibodies in Pregnant Women in Thrace Region of Turkey - A Tertiary Center Experience(2021) Yener, Cem; Varol, Füsun; Uzun, Işıl; Sütcü, Havva; Yeşildağ, Burcu; Başar, Birsen; Ateş, SinanIntroduction: The objective of the study is to investigate Toxoplasma gondii antibody seroprevalence in pregnancies who applied for prenatal care to the tertiary center in Trakya (Thrace) Region of Turkey between January 01, 2014, and December 31, 2018, retrospectively. Methods: This study retrospectively analyzes seroprevalence of T. gondii IgM and IgG antibodies of 2.317 pregnant patients in their first trimester attended to the Obstetrics and Gynecology Antenatal Care Unit in Trakya University, Faculty of Medicine between January 01, 2014, and December 31, 2018. For this purpose, IgM, IgG and if necessary, IgG avidity results were evaluated. Results: In our study period 2.317 pregnant women were analyzed. 1.630 pregnant women (70.3%) were IgG and IgM seronegative, 607 (26.1%) were IgG seropositive, 61 (2.6%) were both IgG and IgM seropositive and 19 (0.9%) were only IgM positive. 30 of 61 patients with both IgG and IgM seropositivity showed low avidity. After 2 weeks for seroconversion control, in 16 of the patients with just IgM positivity, only 3 18.7%) showed seroconversion. We excluded patients who did not participate our routine follow-ups. Discussion and Conclusion: Even toxoplasma exposure rate in the pregnant women from the Trakya Region of Turkey is high (26.1%) before pregnancy, about 70% of first-trimester pregnant patients were found seronegative. Screening during the first trimester would be appropriate and prenatal education should be given to the patients.
