OBJECTİVE: In neonatal intensive care, mortality is a source of great pressure and sadness on the family and the doctor. By its nature, intensive care services serve as a support point on the fine line between life and death. Minimizing this mortality is one of our colleagues' primary goals. For this reason, this study, it is aimed to determine the causes that have an effect on mortality and to minimize these causes with subsequent evaluations. MATERİAL AND METHOD: Our study covers the retrospective data of the babies who died in the neonatal unit between 2015 and 2019. In this context, patients who were born at 22 weeks and older and were hospitalized in the neonatal unit or needed resuscitation in the delivery room were included. Our colleagues from three different hospitals participated in this study with the patients they registered. One of these centers is a training and research hospital and the other centers are state hospitals with busy delivery rooms. Babies lost in utero were not included in the study. Maternal and newborn mortality risk factors were recorded in the perinatal period. In addition, family demographic characteristics, causes of death, and mortality rates were recorded. These recorded data were analyzed according to Wiggleswort's mortality classification. Snappe ll scoring was used to evaluate the probability of death. RESULT: Of the 3112 babies admitted to our neonatal units during the aforementioned four years, we lost 79. When we examined the records of the newborns we lost, prematurity stood out as the most common cause of death. The causes we see less frequently, such as fatal congenital anomalies and severe genetic anomalies incompatible with life, drew attention as their incidence decreased. When we focus, we found that the loss rate was higher in the early neonatal period than in other periods. İn further detail, we see that the highest mortality rate occurred on the first day. While losses due to prematurity were more common in the first weeks of gestation, it was observed that the causes of death changed as the weeks of gestation progressed, and the incidence of genetic diseases and congenital anomalies increased. CONCLUSİON: As we know, the causes of neonatal intensive care losses are diverse, although their frequency varies. The most important determinant of this diversity is gestational age. In this retrospective study, we found that causes such as prematurity and congenital anomalies were among the most common causes. Similar to our results, many international publications have shown that these causes have the highest mortality rate. Improving follow-up and care in the perinatal period has an impact on reducing the causes of mortality we listed. Although not all causes can be eliminated, there are ethical debates about abortion for diseases incompatible with life.
Aim: The aim of this study was to investigate the sensitivity of baby birth weight estimation in relation to HbA1c levels of pregnant women diagnosed with pre-gestational diabetes mellitus (PGDM) and gestational diabetes mellitus (GDM). Material and Methods: 105 patients who met the criteria agreed to participate in our study, of whom 7 were type 1 DM and 32 were type 2 DM. The pregnancy history of the patients who agreed to participate was obtained with a lot of demographic information as well as weight gains during pregnancy, HbA1c and fasting blood glucose levels. Results: Fasting glucose values were measured at 28 and 32 weeks of gestation. The blood glucose values that we measured one hour after satiation and HbA1c were higher in the PDGM group than in the GDM group. There was no significant difference between weight gain and BMI values. We used ROC curve analysis to test the predictive power of fasting and postprandial blood glucose levels or weight gain during pregnancy in our patients with GDM for LGA babies(LGA) (AUC: 0.663, %95 CI [0.526, 0.800], AUC: 0.678, %95 CI [0.540, 0.816], AUC: 0.677, %95 CI [0.548, 0.805], respectively).In addition, ROC analysis was used in evaluating fasting blood glucose measurements, 1-hour postprandial blood glucose measurements, and HbA1c levels to predict LGA.(AUC: 0.889, %95 CI [0.782, 0.996], AUC: 0.893, %95 CI [0.737, 1.000], AUC:0.931, %95 CI [0.807, 1.000], respectively). Conclusion: In both healthy people and pregnant women, it is important to keep blood glucose levels within normal limits. In pregnant women diagnosed with PDGM or GDM, this is even more important as the welfare of the baby is considered. LGA deliveries can be avoided in pregnant women with PDGM by close monitoring of postprandial blood glucose and HbA1c levels. Close monitoring of GWG is also beneficial in the follow-up of pregnant women diagnosed with GDM.
Primary dysmenorrhea is uterine cramping that occurs during or before menstruation without pelvic disease and causes suprapubic pain. In researching the causes of dysmenorrhea, several studies have highlighted the role of lacking vitamin D(vit D). Vit D acts by suppressing the synthesis of prostaglandins that cause pain. Our study aims to investigate whether vit D level affects primary dysmenorrhea. For this purpose, vit D 3 level will be studied in patients with primary dysmenorrhea and a control group without dysmenorrhea. Low serum vit D levels and dysmenorrhea are strongly related. İt is obvious that there is a significant relationship between vit D levels, VAS score, and primary dysmenorrhea. More studies at larger scales are needed to underline the efficiency of vit D in primary dysmenorrhea
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