ObjectivesWe aimed to investigate the efficacy of maternal ophthalmic artery (OA) and cervical internal carotid artery (CICA) in predicting adverse maternal outcomes and gestational age at birth in preeclampsia (PE).MethodsThe study was performed at the Zeynep Kamil Women and Children's Diseases Training and Research Hospital. Measurements were made in 2 groups consisting of 50 pregnant women with PE and 50 healthy pregnant women. The peak systolic velocity (PSV), end‐diastolic velocity, PI, RI, first diastolic peak velocity, systolic/diastolic (S/D) ratio, and peak ratio of the maternal OA were measured by a transorbital Doppler ultrasound (US) scan. The PSV, end‐diastolic velocity, PI, RI, and S/D ratio of the CICA were measured. The differences of Doppler indices between groups with P < .05 were considered statistically significant. Cutoff values were calculated, which could be used to predict adverse maternal outcomes and gestational age at birth.ResultsThe RI and PI values of the OA were lower, and the first diastolic peak velocity, PSV, and peak ratio values were higher among the PE group. The RI and S/D values of the CICA were significantly lower in the PE group compared to the healthy group. The OA RI was determined to be the strongest US variable in predicting adverse maternal outcomes and gestational age at birth, with a cutoff value of 0.72, 76% sensitivity, and 76% specificity.ConclusionsMaternal OA Doppler indices can be used as US markers to predict adverse maternal outcomes.
Aim: The aim of this study was evaluating the effectiveness of vitamin D in the treatment of primary dysmenorrhea. Material and Methods: A total of 142 patients between 16 and 35 years of age who were admitted to a university hospital and diagnosed with primary dysmenorrhea were included in the study in a randomized controlled manner. Cases were randomized into three groups of 667 IU vitamin D once a day, 200 IU vitamin E once a day and 400 mg ibuprofen twice a day. The treatment was given two days before the expected date of menstruation and the first three days of menstruation. Treatment was continued in two consecutive cycles. Severity of menstrual pain was measured with Visual Analogue Scale (VAS), as the primary outcome. Need for using nonsteroidal anti-inflammatory drugs (NSAIDs) during two-month study period was evaluated as the secondary outcome. Results: There were no significant difference in age, body mass index and baseline VAS scores between groups. Pain severity of vitamin D group after treatment was found as low as in the ibuprofen group. Median VAS scores of vitamin D, vitamin E and ibuprofen groups were 5 (1-10), 7 (1-10) and 7 (2-10), respectively after treatment (p<0.001). Requirement of NSAIDs was significantly less in vitamin D group than the vitamin E group (27.3% vs 65.9%, p<0.001). There were no side effects in groups. Conclusion: Both vitamin D and E are effective in alleviation the pain of primary dysmenorrhea, however the effect of vitamin D is clearer.
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.
Background: Cesarean scar pregnancy is an ectopic pregnancy embedded in the myometrium of a cesarean scar. Several types of conservative treatment have been used to treat cesarean scar pregnancy, but no management protocol has been established for this rare, life-threatening condition. The purpose of this study was to evaluate the feasibility of suction curettage as a first-line treatment in early cesarean scar pregnancy. Methods: During a 4-year period, 19 cases of cesarean scar pregnancy were diagnosed at Süleymaniye Maternity Hospital in Istanbul, Turkey. Suction curettage and Foley balloon tamponade were performed as a first-line treatment in 13 patients. Medical records and treatment results of the patients were evaluated. Results: The mean maternal age was 32.5 years (range, 24-39 years). The mean gestational sac diameter was 13.65 mm (range, 7.6-27 mm), and mean endometrial thickness was 10.7 mm (range, 6.7-14.6 mm). A measurable fetal pole for crown-rump length was available for 6 (46.1%) patients. None of the fetuses had cardiac activity. Suction curettage under ultrasound guidance and Foley balloon tamponade were successful as the primary treatment in 13 of 13 patients. No major complications occurred during or after the procedure. Conclusion: Our data suggest that surgical evacuation under ultrasound guidance with Foley balloon tamponade is a safe and successful treatment modality in carefully selected patients with early cesarean scar pregnancy.
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