Objective: To determine some associated factors for isthmocele formation 3 months after the treatment of cesarean scar pregnancy (CSP). Materials and Methods: This is a prospective consecutive case series of CSP managed by fertility preservation modalities at a single tertiary care center from May 2016 to March 2019 (n=95). Patients with a diagnosis of CSP were identified and followed prospectively to collect data on the patients’ demographics; detailed medical, surgical, and social history; symptoms; imaging and laboratory parameters at the time of CSP diagnosis and during treatment; treatment modalities, myometrial thickness; and outcomes in terms of isthmocele formation. Results: Mean myometrial thickness overlying scar pregnancy was significantly lower in the group with isthmocele formation, and the mean gestational age of scar pregnancy was also significantly lower in the group with isthmocele formation following treatment of scar pregnancy (p<0.05). Multivariate regression analysis was conducted to determine associations between certain variables and isthmocele development, which revealed that the gestational age of scar pregnancy and myometrial thickness were significantly associated with isthmocele formation. Conclusion: Myometrial thickness and gestational age of scar pregnancy were significantly associated with isthmocele formation 3 months after treatment.
Operative vaginal delivery refers to the application of forceps or a vacuum device to assist the mother in performing a vaginal delivery of a fetus. In the United States, the incidence of operative vaginal birth is estimated to be 5%, although there are large geographical differences in operative vaginal delivery rates throughout the country. [1][2][3][4] In the Northeast, instrumental vaginal delivery rates (5%) and the highest rates (20%-25%) are in the South. 2 Although overall operative vaginal delivery rates have declined, the number of vacuum-assisted deliveries is increasing and is now about 4 times the forceps-assisted vaginal delivery rate. 2 Vacuum systems vary according to the vacuum mechanism (traditional vs. hand type), cup material and hardness (metal, plastic or silicone), cup shape (cork or bell) and whether they are disposable or reusable. These characteristics are thought to have an impact on the profile of efficacy and adverse outcomes as reflected in various studies. [5][6][7][8][9][10][11] There is significant evidence that instrumental deliveries increase perineal pain during labor, early postpartum pain, perineal lacerations, hematomas, blood loss and anemia, urinary retention, and urinary and fecal incontinence and several other maternal morbidities on the other hand vacuum-assisted vaginal deliveries can cause significant fetal morbidity, including scalp lacerations, cephalohematomas, subgaleal hematomas, intracranial hemorrhage, facial
Objectives: The purpose of the study is to explore neural therapy (NT) and the effect of it on pain and the functional status of patients with lateral epicondylitis (LE) and to determine whether clinical changes and demographic characteristics have any correlation. Materials and Methods: Forty-two patients with LE were randomly allocated into two groups; NT & control. The control group was given rest, non-steroidal anti-inflammatory drugs, stretching exercises and a wrist splint. The patients in the NT group received 8 sessions of NT. The visual analog scale (VAS), pain pressure threshold (via algometry) and Duruöz hand index (DHI) scores were noted before and at the end of the treatment in both groups. Results: All parameters improved in both groups. However, improvement of VAS, algometry and DHI scores were more obvious in the NT group. The clinical change and demographic features of the groups showed no correlation. Conclusion: NT is a safe and effective treatment method for treatment of patients with LE. Amaç: Bu çalışmanın amacı lateral epikondilitli (LE) hastalarda nöral terapinin ağrı ve fonksiyonel durum üzerine etkisinin değerlendirilmesidir. Ayrıca, hastaların klinik bulgularında meydana gelen değişiklikler ile demografik özelliklerinin korelasyonunun değerlendirilmesi planlanmıştır. Materyal ve Metot: LE tanısı olan toplam 42 hasta randomize olarak 2 gruba ayrıldı (Nöral terapi & kontrol) Kontrol grubundaki hastalara istirahat, non-steroidal anti-inflamatuar ilaç, germe egzersizleri ve el bileği splinti verildi. Nöral terapi (NT) grubundaki hastalara 8 seans NT uygulaması yapıldı. Her iki grupta, tedavi öncesinde ve tedavi bitiminde hastaların görsel ağrı skalası (GAS), basınç ağrı eşiği (algometre ile) ve Duruöz el indeksi (DEI) skorları kaydedildi. Bulgular: Tüm skorlar her iki grupta düzelme gösterdi. Fakat, GAS, algometre ve DEI skorları NT grubunda daha belirgin olarak düzeldi. Her iki grupta klinik değişiklikler ile demografik özellikler arasında korelasyon saptanmadı. Sonuç: Nöral terapi lateral epikondilitli hastaların tedavisinde etkili ve güvenli bir tedavi yöntemidir.
Giriş: Ofis histeroskopi anormal uterin kanama, infertilite, tekrarlayan gebelik kayıplarınının değer-lendirilmesinde kullanılan önemli bir işlemdir. Klinisyenlerin tecrübesinin artması ve teknolojik gelişme-ler histeroskopi uygulama endikasyonlarını her gün daha da arttırmaktadır. Biz de çalışmamızda tanısal histeroskopi yapılan hastalarda lokal analjezi yön-temlerinin etkinliğini araştırmayı amaçladık. Materyal ve Metod:Çalışmamıza hastanemiz etik kurulundan onay alındıktan sonra 2011 ile 2012 yıl-ları arasında Zeynep Kamil Kadın ve Çocuk Hastalıkları Eğitim ve Araştırma Hastanesi Kadın Doğum Endoskopi Kliniğinde infertilite, habitüel abortus ve anormal uterin kanama nedeniyle tanısal histeroskopi yapılan 100 hasta dahil edildi. Hastalar zarf üsülü ile randomize edilerek, intrauterin lidokain uygulanan, intrauterin lidokain ile beraber servikal sprey uygulanan, servikal sprey uygulanan ve plasebo grubu olarak dört gruba ayrıldı. Verilerin analizinde SPSS 19.0 programı kullanıldı. Bulgular:Bütün hasta gruplarında en fazla ağrının işlem sırasında olduğu ifade edildi. Işlem sırasında (histereskobun kavite içine girişi ve kavite değer-lendirilmesi) kaydedilen VAS puanları intrauterin lidokain kullanılan iki grupta diğer gruplara kıyasla istatistiksel olarak daha düşük saptandı. Tenekulum uygulanması sırasında kaydedilen ağrı puanı servikal sprey kullanılan iki grupta daha düşük saptandı.Sonuç: Servikal sprey uygulanan hastalarda tenekulum takılması sırasında ağrının plaseboya kıyas-la daha az olduğu izlendi. İntrauterin topikal anestezinin ise işlem sırasında ve işlemden sonra ağrıyı azalttığı tespit edildi. Anahtar kelimeler: Ofis Histeroskopi; Lokal anestezi; Ağrı ABSTRACTObjectives: Hysteroscopy is a safe and simple procedure which is performed for evaluation and also for treatment of abnormal uterine bleeding, infertility and recurrent pregnancy loss. In this study we aimed to evaluate the efficacy of the local anesthesia techniques for office hysteroscopy. Material and Methods:This randomised, double-blinded and placebo-controlled trial was performed including the 100 patients who had hysterocopy procedure with the indications of habituel abortus, infertility and anormal uterine bleeding. The study was conducted at Zeynep Kamil Women and Children Diseases Training and Research Hospital, department of endoscopy in Istanbul, between January 2011 and December 2012.Results: VAS score at the insertion of vaginal speculum was significantly lower at the patients who had intrauterine lidocaine administration (p<0.05), there was no statistically significant difference between the other groups (p>0,05). When we compare the VAS scores at the hysteroscope insertion and during the procedure, between the groups, patients who had anesthesia rated lower scores. Also, the patients who had intrauterine lidocaine had lower VAS scores when compared to other groups. Although VAS score at the 30 minutes after the procedure was lower at the groups who had intrauterine lidocaine administration, this difference was not statistically ...
OBJECTIVE: We explored the association between hypertension (>140/90) at the latent phase of labor (resistant hypertension) and the subsequent development of major maternal complications or adverse infant outcomes in women with preeclampsia under medical care. STUDY DESIGN: We drew data from 824 women who were under follow-up at the Department of Perinatology of Health Sciences University Zeynep Kamil Women and Children’s Health Training and Research Hospital with a diagnosis of preeclampsia. Women with and without resistant hypertension were compared in terms of major maternal complications and adverse infant outcomes. RESULTS: Mean age and body mass index were similar between the two groups (p>0.05). The rate of preeclamptic complaints was significantly higher in groups with resistant hypertension (90.1% vs. 67.2%, p<0.05). Proteinuria was more frequent in the resistant hypertension group (78.7% vs. 66.8%, p<0.001). The newborn intensive care unit admission rate was significantly higher in the group with resistant hypertension (65.6% vs. 45.9%, p<0.001). Gestational age at delivery was significantly lower in the group with resistant hypertension compared to the normotensive group (34.6 vs. 32.9 weeks, p<0.001). There was a significant difference between the two groups in terms of the rate of preterm delivery (78.5% vs. 66.7%, p=0.04). CONCLUSION: Resistant hypertension is associated with a higher rate of preeclamptic symptoms during labor and newborn intensive care unit admission.
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