Objective: To evaluate the prevalence and associated risk factors for postpartum depression (PPD) using the Edinburgh Postpartum Depression Scale (EPDS). Study design: The population of this cross-sectional analytic study consisted of 311 women who were admitted to our hospital at 4-6 weeks after birth. The data were collected between April-June 2018 by applying a sociodemographic data form consisting of 44 questions and the EPDS consisting of 10 questions. We used the EPDS in postpartum period to divide parturients into those with (n=47) and without (n=264) PPD using a cut-off score of ³ 13. The primary outcome is the prevalence of PPD, while the secondary outcomes are associated risk factors.Results: The PPD prevalence was 15.1% (n=47). In the PPD group, the difference was highly significant in terms of abortion, antenatal depression, inadequate care for the baby and health problem in the newborn [0.6±0.9 vs. 0.2±0.6, 13 (37.1%) vs. 27 (10.5%), 9 (56.3%) vs. 38 (12.9%), 12 (36.4%) vs. 35 (12.6%), respectively] (p<0.001). The logistic regression analysis revealed that abortion increased PPD by 1.64 fold (1.13-2.37% at 95% CI), antenatal depression by 5.04 fold (2.38-10.68% at 95% CI), inadequate care for the baby by 6.28 fold (1.89-20.86% at 95% CI), and health problem in the newborn increased PPD by 3.59 fold (1.43-8.99% at 95% CI).Conclusion: PPD is a health problem that can affect primarily mother and child. Therefore, it is important to determine highly predictable risk factors using a scale (e.g. EPDS) for early diagnosis and timely treatment of symptoms.
<p><strong>Objective:</strong> Postoperative hematoma following abdominal surgery is relatively rare and mainly depends on the type of surgery. Specific treatment including surgery or interventional radiology is sometimes necessary. The aim of this study is to evaluate the cases of postoperative hematoma after gynecologic and obstetric surgery.</p><p><strong>Study Design:</strong> This is a retrospective cohort study of 30 patients with hematoma developed after gynecologic and obstetric surgery. We included the patients who hospitalized with the diagnosis of a postoperative hematoma between June 2017 and April 2019 at Gazi Yasargil Training and Research Hospital of Health Sciences University. Hematomas occurring after endoscopic surgery and episiotomy were not included. The diagnosed cases were divided into three groups as wound hematoma, rectus sheath hematoma and intra-abdominal hematoma (intraperitoneal and retroperitoneal). All cases were assessed by patient demographics and clinical findings, hematoma of characteristics, treatment methods and results.</p><p><strong>Results:</strong> A total of 30 patients were included in the study with a mean age of 33.0±8.6 years. Incidence of hematoma account for 0.2%. The mean c-reactive protein was 37.9±47.4 mg/dL at admission and 14.6±25.8 mg/dL at discharge, respectively. The decrease was statistically significant (p < 0.001). The mean hemoglobin was 10.6±2.1 g/dL at admission and 10.7±1.5 g/dL at discharge. Fever was detected in 7 (23.3%) patients. Only 12 patients (40%) were followed up by observation and symptom management. In 10 (33.3%) patients, antibiotics were included in the treatment due to infection. In addition, 4 patients (13.3%) had relaparotomy, 5 patients (16.7%) underwent percutaneous radiological drainage and 8 (26.7%) received blood transfusion. The mean time of resorption of the hematoma was 4.6 ± 2.0 days. The evaluation of the hematoma locations revealed that 14 patients (46.7%) had wound hematoma, 7 patients (23.3%) had rectus sheath hematoma (Type I: 2 cases, type II: 3 cases, type III: 2 cases), 8 patients (26.7%) had pelvic hematoma and 2 patients (6.7%) had a retroperitoneal hematoma. The mean hematoma size was 68.1±15.18 mm. </p><p><strong>Conclusions:</strong> In cases of hematoma resistant to antibiotic treatment and non-resorbable hematoma, we can consider percutaneous catheter drainage as an alternative to surgical intervention.</p>
Objective To determine if fetal MR alters the management of pregnancy and family decisions in the isolated corpus callosum agenesis (CCA) cases or not. Methods Fetal MR was carried out in the cases diagnosed with CCA in the Perinatology Unit of our hospital between 2013 and 2019 after they were differentiated as complex and isolated CCA cases. The impact of MR results on the family decisions and their approaches towards termination were assessed. Results A total of 109 out 139 cases were evaluated as isolated CCA. While 93 (85.32%) of them were diagnosed with the complete CCA, 16 (14.68%) cases were diagnosed with the partial CCA. When the period after 2017 during which fetal MR was recommended to all patients was reviewed, it was seen that 7 (23.3%) of 30 cases who underwent fetal MR and 2 (20%) of 10 cases who did not undergo fetal MR terminated their pregnancies. There was no statistical difference between two groups in terms of the decisions of the patients for gestational termination who did and did not undergo fetal MR. Conclusion Fetal MR imaging in the isolated CCA does not change the decisions of the families for the gestational termination. In terms of the termination decision, week of gestation and socio-cultural factors may have more impacts.
<p>Amniotic band sequence (ABS) describes highly variable spectrum of congenital anomalies that occur in association with amniotic bands. İntrauterine synechiae is a condition in which scar tissue develops within the uterine cavity. We aim to present a case of ABS and a case of intrauterine synechiae and compare their ultrasonographic findings. Ultrasonography revealed contraction ring in the right groin area of the first fetus but second fetus was healthy. The diagnosis of ABS is based upon the presence of characteristic structural findings on prenatal ultrasound or postnatal physical examination. The diagnosis of intrauterine adhesions is based upon visualization of intrauterine adhesions either directly by hysteroscopy or indirectly by other imaging studies. The floor of the intrauterine adhesions is widely and lateral of the uterine cavity and occurs from four layers while the amniotic band is a thin layer and forms fluctuations in the amniotic fluid. Amniotic bands may cause variable spectrum of congenital anomalies whereas intrauterine adhesions do not increase the probability of fetal anomaly because it is out of the amniotic cavity.</p>
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