Background:The scar tissue formed by episiotomy during vaginal delivery, and the related pain, is very frequent. The change in the normal anatomy can cause cosmetic and physiologic problems. It can affect and cause deterioration in sexual functions. Therefore, making the right diagnosis and applying the right surgical procedures are very important. Aims: Our aim was to examine the effect of the perineoplasty operation on the sexual dysfunctions that present due to vaginal delivery. Study Design: Self-controlled study. Methods: Forty patients, who attended our clinic between April 2012 and May 2013, and who were between the ages of 20 and 50 years, were included in the study. The patients had complaints of scar tissue in the perineum and various sexual dysfunctions after vaginal delivery, and they were suitable for perineoplasty. The Female Sexual Function Index (FSFI) questionnaire was applied to the patients before and 6 months after the operation, and the results were compared. Results: After the perineoplasty operation, there was a statistically significant improvement in the patients in the domains of sexual desire, arousal, lubrication, orgasm, and sexual satisfaction (p<0.005). However, there was no significant improvement in the feeling of pain during sexual intercourse (p=0.184). The mean±SD total FSFI score increased significantly after the operation (p<0.005). Conclusion:The sexual dysfunctions that develop due to perineal damage during vaginal delivery can benefit significantly from the perineoplasty operation if the indications are correct. However, vaginal perineoplasty did not provide an improvement in dyspareunia.
Preeklampsi ve preterm do¤umda nötrofil-lenfosit oran› ve 25 hidroksi D vitamini durumu Amaç: Preeklampsi ve preterm do¤umda düflük 25 hidroksi D vitamini (25-OH D) seviyelerini ve nötrofil-lenfosit oranlar›n› (NLO) incelemektir. Yöntem: ‹stanbul Medipol Üniversitesi Kad›n Hastal›klar› ve Do-¤um Klini¤i'nde 2014-2017 y›llar› aras›nda do¤um yapan toplam 180 gebe çal›flmaya dahil edildi. Çal›flma grubu 61 preeklamptik gebeden (n=61) ve preterm do¤um yapan 74 kad›ndan (n=74), kontrol grubu ise miad›nda do¤um yapan 45 kad›ndan (n=45) olufluyordu. Üç grubun demografik, obstetrik ve laboratuvar sonuçla-r›, 25-OH D seviyeleri ve NLO bak›m›ndan karfl›laflt›r›ld›. Bulgular: VK‹, düflük say›s› ve sosyoekonomik durum yönünden üç grup aras›nda istatistiksel olarak anlaml› farkl›l›k yoktu (p>0.05). Maternal yafl, gravida, parite, gebelik haftas›, do¤um a¤›rl›¤› ve Apgar skorlar›, kontrol grubuna k›yasla preeklamptik ve preterm grupta anlaml› flekilde daha düflüktü (p<0.05). 25-OH D seviyeleri, miad gebeliklere k›yasla preeklamptik ve preterm gebeliklerde anlaml› flekilde daha düflükken (s›ras›yla 18.2±4.3 ng/ml; 19.1±3.7 ng/ml; 34±5.1 ng/ml, p<0.05), NLO ise miad do¤um grubuna k›yasla preeklampsi ve preterm do¤um gruplar›nda an-laml› flekilde daha yüksekti (s›ras›yla 3.96±1.23, 3.98 ±1.34, 3.22± 1.24, p<0.05). Sonuç: Düflük 25-OH D seviyeleri ve artm›fl NLO'nun, spontane preterm do¤um ve preeklampsi etiyolojisinde rol oynamas› muhtemeldir. Maternal D vitamini takviyesinin maternal, fetal ve neonatal sa¤l›¤›n geliflmesi üzerindeki etkisi belirsizdir, ancak potansiyel olumlu etkiler üzerine daha kapsaml› araflt›rma gerekmektedir.
ÖzetAmaç: Bu çalışmada amacımız, 50 g glukoz challenge test (GCT) ile açlık kan glukoz değerlerinin gestasyonel diyabet (GDM) tanısında etkinliğini araştırmak, tarama için bir cut-off değeri belirlemektir. Yöntemler: Dörtyüz kırk dört gebeye 24-28 gestasyonel haftaları arasında 50 gr GCT uygulandı. Gestasyonel diyabet hastalarını atlamamak için eşik değer 130 mg/dl olarak alındı. Plazma glukoz düzeyinin birinci saatte 130 mg/dl ve üzerindeki sonuçlar pozitif olarak kabul edildi ve bu gebelere 100 gr oral glukoz tolerans testi (OGTT) uygulandı. Bulgular: 50 g GCT için cut-off değeri 145 mg/dl olarak bulundu. 145 mg/dl ve üzerindeki değerlerde testin GDM'yi öngörmede duyarlılık %96,30; özgüllük %80,34 olarak belirlendi. Açlık kan glukoz cut-off değeri için belirlenen 88 mg/dl'da duyarlılığın % 48,15 özgüllüğün %70,84 olduğu bulundu. Sonuç: Özellikle 50 g GCT'de birinci saat kan glukoz değeri 145mg/dl ve üzerindeki değerlerde gestasyonel diyabet tanısı koymada etkiniliğin arttığı , açlık kan glukoz düzeyinin GDM için iyi bir tarama testi olamayacağı sonucuna varıldı. Abs tractAim: Our aim in this study was to investigate the efficacy of 50 g glucose challenge test (GCT) in the diagnosis of gestational diabetes mellitus (GDM) and to determine a cut-off value for screening. Methods: 50-g GCT was performed in 444 pregnant women at 24-28 gestational weeks. The threshold was taken as 130 mg/dl in order not to miss GDM cases. A plasma glucose level of ≥130 mg/ dl at the first hour was considered to be a positive result and 100-g oral glucose tolerance test (OGTT) was given to these women. Results: The cut-off value for 50-g GCT was found to be 145 mg/ dl. The sensitivity and specificity of the test for predicting GDM at the levels of ≥145 mg/dl were determined to be 96.30% and 80.34%, respectively. The sensitivity and specificity of the test at the level of 88 mg/dl determined for fasting blood glucose cut-off value were found to be 48.15% and 70.84%, respectively. Conclusion: It was concluded that the efficacy in making diagnosis of GDM was increased at the first hour blood glucose levels of ≥145 mg/dl, especially in 50-g GCT, and fasting blood glucose level could not be a good screening test for GDM. (The Me di cal Bul le tin of Ha se ki 2014; 52: 181-6)
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