Scar endometriosis is an infrequent type of extrapelvic endometriosis that is rather close together with obstetrical and gynecological surgeries. It is mostly confused with other dermatological or surgical conditions and delays the diagnosis. We report a case of a 50-year-old woman presenting with scar endometriosis 23 years after her last lower segment caesarean section. The epidemiology, diagnosis, pathogenesis, and treatment of the situation are discussed.

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BackgroundTo investigate the cesarean Section (C/S) rates and maternal mortality (MM) causes and its relation between 2002 and 2013.MethodsData were gathered from Turkish Ministry of Health and Istanbul Health Administration. The Annual Clinical Reports for 2002–2013 were reviewed and analyzed: C/Ss and maternal deaths in women who gave birth ≥20 weeks between January 1, 2002, and December 31, 2013, in any hospital in Turkey and Istanbul.ResultsThe major causes of MM were hemorrhage (20%), hypertensive disorders (18.2%), embolism (10.3%), cardiovascular conditions (9%), infection (8.5%), and other causes (10.4%). Overall, the average annual CS delivery rate was 46.4% in Istanbul and 36.6% in Turkey. There was a significant increase in the CS rates in Istanbul and Turkey from 2008 to 2013 relative to those from 2002 to 2007 (p = 0.004). There was a statistically significant and inverse relationship (97.2%) between the MMR and CS rate from 2002 to 2013 in Turkey (p = 0.001). However, no significant relationship was detected between the MMR and CS rate from 2002 to 2013 in Istanbul (p > 0.05). There was a significant inverse correlation (66.3%) between the CS rate and peripartumhemorrhage in Turkey (p = 0.019) and there was a significant inverse correlation (66.5%) between the CS rate and peripartumhemorrhage(p = 0.018) in Istanbul between 2007 to 2013. There were no significant differences in ante-intrapartum haemorrhage bleeding (p > 0.05) or postpartum hemorrhage (p > 0.05) from 2007 to 2013.ConclusionsThis study demonstrates that there was a inverse correlation between increased CS and maternal mortality rates during the previous decade in Turkey. Although cesarean rates increase excessively, it appears that improved health care facilities have a positive effect on MMRs in Turkey.

Amaç: Çalışmamızda 2005-2012 yılları arasındaki sezaryenlerin yıllara göre dağılımını, sezaryen endikasyonlarını ve epidemiyolojik değişimleri karşı-laştırarak, geleceğe yönelik yapılması gerekenleri tartışmak amaçlanmıştır.Yöntemler: İstanbul Eğitim Araştırma Hastanesi Kadın Hastalıkları ve Doğum Kliniği'nde 2005-2012 yılları arasındaki 10499 doğum içinden sezaryen uygulanan 4137 hastanın dosyaları retrospektif olarak incelendi. Yılla-ra göre sezaryenle doğum yapmış hastalar sezaryen endikasyonlarına, yaş gruplarına, gebelik haftalarına, doğum ağırlıklarına, bebek cinsiyetlerine, sezaryende tercih edilen anestezi türüne ve sezaryenin normal doğuma oranlarına göre yıllık bazda değerlendirildi ve karşılaştırıldı. Results: Cesarean section was performed for 32.5% and 40.1% patients in 2005 and 2012, respectively. The main indications were previous uterine surgery (44.5%), fetal distress (18.3%) and cephalopelvic disproportion (33.7%). There was no statistical difference in terms of gravida, parity, anesthesia, and birth weight in either year. However, cesarean rates were significantly increased in the last four years of the study period in comparison with the first four years. Conclusion:Rates of caesarean section are increasing. To counteract this trend, patients should be informed about the benefits of vaginal delivery and be encouraged to attempt vaginal delivery after cesarean section now that the skills of staff in delivery clinics are improving. Clinicians and patients must be aware of side effects of elective cesarean sections. Pain management during delivery may be considered as a means of reversing the increasing cesarean rates.

Puerperal hematoma is one of the life threatening obstetrical emergencies. Surgical ligation of bleeding vessel may not always be possible for the patients who were hemodynamically unstable, hence pelvic arterial angiography may be preferred as the first line treatment modality for these cases. Pelvic arterial angiography and embolization is a safe, tolerable, and minimally invasive treatment modality in the diagnosis and treatment of pelvic hemorrhage. We present a case of puerperal hematoma after a normal spontaneous delivery treated with bilateral iliac arterial embolization.

Objective: In this study, we investigate the effects of maternal body mass index (BMI), weight gain during pregnancy, delivery stage, amount of amniotic fluid, and amniotic membrane status on the calculation of estimated fetal weight. pregnant women who gave birth in our hospital were reviewed. From records, demographic data of patients, maternal BMI (kg/m 2 ), weight gain during pregnancy, delivery stage, amniotic fluid volume and amniotic membrane status, mode of delivery, ultrasound-estimated fetal weight, and the actual birth weight of the newborn have been reviewed.Results: Birth weight of fetuses estimated by sonography was in the range of 2680-4345 g with an average of 3467.33±417.30 g. The actual birth weight of the newborns was 3468±383.99 g with an average of 2600-4550 g. With ultrasound-estimated fetal weight and the actual birth weight with error range of ±10%, 76% correct prediction rate (n=76) found. When considering maternal parity, stage of labor (latent phase-active phase), sex of the fetus, preconceptional BMI, and maternal weight gain during pregnancy, there is no statistically significant effect (p<0.05) of these factors on the accuracy of the estimated fetal weight. Decreased amniotic fluid and/or rupture of amniotic membranes in pregnant women ultrasound-estimated fetal weight was closer correlation to the actual birth. Conclusion:The correct prediction of fetal weight is of great importance because of the potential risk estimation for the mother and newborn and in deciding the mode of delivery. Therefore, variables that affect the probability of errors in ultrasonographic measurements should be considered in advance, and if necessary, measures should be planned again MethodsThe files of pregnant women applying to our clinic and giving birth between January 2012 and January 2013 were screened. One hundred pregnant women for whom estimated fetal weight measurement was performed using obstetric ultrasonography (USG) and who were 37-42 weeks according to the last menstrual period, singular, alive, and at head presentation were included in the study. Cases with fetal anomalies, multiple pregnancies, dead fetuses, and cases in which detailed fetal biometric measurements cannot be performed because of obstetric emergencies

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Introduction: The objective of this study was to review the patients' characteristics and surgical findings of surgically excised abdominal wall endometriosis (AWE) cases. Methods: We retrospectively analyzed the medical records of patients diagnosed with AWE between 2005 and 2015. Descriptive data were collected and analyzed. Results: Sixty-six patients with histopathological diagnosis of AWE were included in our study. The mean age was 32±6.8 years and all cases were multiparous. All patients had a history of previous abdominal surgery and 63 patients had a history of cesarean delivery. The primary symptom was a painful palpable mass. The excised mass was generally on the previous surgical scar. The excised mass location was observed as subcutaneous tissue, fat layer, fascia and muscle tissue. There was no statistical correlation depth of invasion and mass size with the number of previous surgeries. Conclusion: Caesarean incision was considered as the most important predisposing factor for AWE. As caesarean rates are increasing, we believe that the incidence of AWE will increase in the future. For this reason, more prospective studies are needed for prognosis and prophylaxis of the disease.