[PP-095]
Plasenta İnvazyon Anomalisi Olan Olgularda Konservatif Yönetim
Mehmet Serdar Kutuk, Menşure Tonguç, Mehmet Dolanbay, Semih Uludag, Mahmut Tuncay Özgün, Mustafa Basbuğ
Erciyes Üniversitesi, Tıp Fakültesi, Kadın Hastalıkları ve Doğum AD
Amaç: Bu çalışmanın amacı plasenta akreata ve perkreata gibi plasental invazyon bozukluklarında, plasentanın uterin kavite içerisinde bırakılarak bekleme yönteminin tedavi sonuçlarını incelemektir. Materyal-Metod: Erciyes Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum kliniğinde Ekim 2012 – Şubat 2015 tarihleri arasında konservatif olarak (plasentanın yerinde bırakıldığı) yönetilen yedi plasenta akreata/inkreata olgusunun verileri retrospektif olarak analiz edildi.
Bulgular: Hastaların yaş ortalaması 32.4±4.6 (min-maks: 27- 41) ortanca gravida değeri 3, ortanca parite değeri 2, ortanca sezaryen sayısı 2 (min-maks:1-4) idi Ortalama sezaryen haftası 35±2 hafta ve hastanede yatış süresi 10(min-maks: 4-19) gün idi. Olguların ikisinde bilateral hipogastrik arter ligasyonu işlemi yapıldı, beş olguda pelvik devaskularizasyon prosedürü
uygulanmadı. Ortalama β-hCG negatifleşme süresi 70±15.6 gün (min-maks:48-93), plasentanın atılma süresi ise 143.1±47.7 gün (min-maks:48-180) idi. Altı olguda ek cerrahi müdahele gereksinimi olmaksızın tam iyileşme sağlanırken (6/7, %83.8), bir olguda postoperatif 12. saatte kanama nedeniyle acil histerektomi operasyonu yapıldı (1/, %14.2). İzlem süresince üç hasta toplam dört kez yeniden hospitalize edildi ve en sık hospitalizasyon nedeni vaginal kanama idi (3/4, %75).
Sonuç: Derin plasental invazyon anomalisi olan ve fertiletesini/uterusunu korumak isteyen olgularda, konservatif yönetim sezeryan histerektomiye iyi bir alternatifdir.
[PP-096]
Prediction of Adverse Pregnancy Outcomes with First Trimester Down Syndrome Screening Markers
Aslıhan Yazıcıoğlu1, Mert Turğal2, Özgür Özyüncü3 1Golbası State Hospital, Ankara, Turkey
2Doctor Sami Ulus Training and Research Hospital, Ankara, Turkey
3Hacettepe University Faculty of Medicine, Department of Obstetrics and Gynecology, Ankara, Turkey
Objectives: Down syndrome is the most common form of non-fatal trisomy. Our aim in this study is to investigate the relationship between certain major adverse pregnancy outcomes including pregnancy hypertension, placenta related complications, preterm rupture of membranes, diabetic complications of pregnancy and preterm delivery and first trimester Down syndrome screening markers.
Methods: Patients whose Down syndrome screening tests within the scope of routine pregnancy follow-up and delivery performed at Hacettepe University Faculty of Medicine, Department of Obstetrics and Gynecology Outpatient Clinic, between 1 January 2002 and 31 December 2012 were enrolled. 8394 patients who met the criteria were included.
Findings: Of those 2804 (33.4%) had first trimester Down syndrome screening test. Mean age of these patients was 30.51 ± 4.94, mean number of pregnancies was 2.06 ± 1.31, gestational weeks at an average of 37.81 ± 2.12 weeks and mean birth weight was 3198.61 ± 570, 64 g. Preterm birth was identified as the most common complication (10.3%).
Conclusions: The study concluded that there is a relationship between first trimester Down syndrome screening markers and adverse pregnancy outcomes, however the low levels of
sensitivity and specificity of these markers made us to conclude that routine screening of adverse pregnancy outcomes with serum markers is not advisable.
Keywords: Maternal serum marker, adverse pregnancy outcome, pregnancy, Down syndrome
screening, trisomy 21
[PP-097]
Prediction of Adverse Pregnancy Outcomes with Second Trimester Down Syndrome Screening Markers
Aslıhan Yazıcıoğlu1, Mert Turğal2, Özgür Özyüncü3 1Golbası State Hospital, Ankara, Turkey
2Doctor Sami Ulus Training and Research Hospital, Ankara, Turkey
3Hacettepe University Faculty of Medicine, Department of Obstetrics and Gynecology, Ankara, Turkey
Objectives: Down syndrome is the most common form of non-fatal trisomy. Our aim in this study is to investigate the relationship between certain major adverse pregnancy outcomes including pregnancy hypertension, placenta related complications, preterm rupture of membranes, diabetic complications of pregnancy and preterm delivery and second trimester Down syndrome screening markers. Methods: Patients whose Down syndrome screening tests within the scope of routine pregnancy follow-up and delivery performed at Hacettepe University Faculty of Medicine, Department of Obstetrics and Gynecology Outpatient Clinic, between 1 January 2002 and 31 December 2012 were enrolled. 8394 patients who met the criteria were included.
Findings: Of those 5590 (66.6%) had second trimester Down syndrome screening test. Mean age of these patients was 29.24 ± 5.07, mean number of pregnancies was 2.22 ± 1.28, gestational weeks at an average of 38.04 ± 10.15 weeks and mean birth weight was 3172,40 ± 578.45 g. Preterm birth was identified as the most common complication (12.5%).
Conclusions: The study concluded that there is a relationship between second trimester Down syndrome screening markers and adverse pregnancy outcomes, however the low levels of
sensitivity and specificity of these markers made us to conclude that routine screening of adverse pregnancy outcomes with serum markers is not advisable.
Keywords: Maternal serum marker, adverse pregnancy outcome, pregnancy, Down syndrome
[PP-098]
Analysis of the Association Between Gestational Weight Gain and Substantial Weight Retention 1-year Postpartum
Aslıhan Yazıcıoğlu1, Özge Senem Yücel Çiçek2 1Golbası State Hospital, Ankara, Turkey
2Kecioren Training and Research Hospital, Ankara, Turkey
Objectives: Postpartum weight retention is an important reason of obesity in reproductive age women. This study examined the association between GWG and substantial postpartum weight retention (SPPWR).
Methods: The participants (n = 149) in the study were healthy, mature and fed their infants whose ages were 1, 6 and 12 months, respectively. They self-reported their socio-demographic, clinical prenatal and behaviors via questionnaires. We collected their weight data including pre-pregnancy and prior to delivery, as well as weight at 1, 6 and 12 months postpartum. The major outcomes included weight gain during pregnancy and substantial weight retention 1 year postpartum. Findings: Mean age of the participants was 28.6±8.9. The participants were mostly housewife ( 71.1%), graduated from high school (36.9%). Of the 149 participants, the mean weight retention was 3.23 kg at 12 months postpartum. GWG categories were established as follows: inadequate weight gain (n = 7, 4.7%), adequate weight gain (n = 47, 31.5%), and excessive weight gain (n = 95, 63.8%). 49 of them (32.9%) reported substantial weight retention (>=5 kg). Substantial weight retention was observed as more common in excessive weight gain group.
Conclusions: Excessive GWG would increase the risk of substantial weight retention 1-year
postpartum. The interventions to prevent postpartum obesity should consider the strategies how to attain optimal maternal GWG.
Keywords: Gestational weight gain, postpartum, weight retention, pregnancy
[PP-099]
Knowledge, Attitudes and Practices Towards Family Planning Among Women in a Secondary Referral Center
Aslıhan Yazıcıoğlu1, Özge Senem Yücel Çiçek2 1Golbası State Hospital, Ankara, Turkey
2Kecioren Training and Research Hospital, Ankara, Turkey
Objectives::The choice of available contraceptive methods has increased in recent years; however, recent data on women’s awareness of methods and reasons for their method choice, is limited.The aim of this study was to examine the use and awareness of contraceptive methods in women admitted to secondary referral center.
Methods: Quantitative survey of sexually active ever-married women (n=250).Questions related to demographic properties, knowledge and use of contraceptive methods, reasons for choice and for changing methods, and sources of advice.
Findings: Mean age of the participants was 36.3±10.6.The participants were mostly housewife ( 80.8%), graduated from elementary school (64.8%).There was generally good awareness of most forms of contraception.Awareness was greatest for the intrauterine device (89.6%), and
contraceptive pill (84.4%).The most common contraceptive methods ever used were intrauterine device (48.4%) and oral contraceptive pills (24.0%).Of the women interviewed, 23.6% were currently using intrauterine device.Concerns about side effects (46%) and dislocation of the intrauterine device (11.3%) were the most reported reasons for quitting contraceptives.The most common reported side effect was menstruel irregularities (15.6%).Doctors and other health workers have the greatest influence on women’s choice of contraceptive method (52.4%).About 76% of the women agreed that using family planning had positive advantages for health. Conclusions: The study concluded that sexually active women are aware of a wide variety of contraceptive methods, and knowledge and usage of the contraceptive pill intrauterine device predominates.Changing contraception method is frequent, occurring for a variety of reasons, including dislocation of intrauterine device and for pill users, concerns about side effects.
[PP-100]
Knowledge and Attitudes Towards Cervical Cancer and Associated Risk Factors Among Women in a Secondary Referral Center
Aslıhan Yazıcıoğlu1, Özge Senem Yücel Çiçek2 1Golbası State Hospital, Ankara, Turkey
2Kecioren Training and Research Hospital, Ankara, Turkey
Objectives:: Cervix cancer is worldwide the second most frequent gynecologic cancer and the first most frequent one in developing countries. The present study aims to investigate knowledge, attitude and behavior of women admitted to a secondary referral center towards cervical cancer, associated risk factors, HPV and prevention methods.
Methods: Quantitative survey of sexually active women (n=250). Questions related to demographic properties, knowledge about cervical cancer, associated risk factors, HPV and prevention methods. Findings: Mean age of the participants was 37.0±8.9. The participants were mostly housewife ( 83.6%), graduated from elementary school (64.4%). Of the subjects 78.4% knew the pap-smear test as a screening method and 61.6% underwent such investigation, while only 20.6% knew the appropriate initiation time for this test. Association between cervix cancer and multiple sexual partners, smoking, first sexual intercourse at an early age and HPV are known by 49.6%, 70.4%, 46.8% and 40.0% of the participants, respectively. While 50.0% of the subjects knew that HPV is transmitted with sexual intercourse, only 15.2% knew about the appropriate genital lesion. Although only 33.2% of all the participants knew that there is a vaccine for preventing HPV lesion, 89.6% were ready to use the vaccine.
Conclusions: The study concluded that the knowledge level of women regarding cervical cancer and HPV was remarkably low. There is an urgent need for education.
Keywords: Cervix Cancer, HPV, Prevention, Pap-smear
[PP-101]
Olgu sunumu: Koryoamniyonit sonrası ovaryan ven trombozu
Tugba Sarac Sivrikoz, Emircan Ertürk, İbrahim Halil Kalelioğlu, Aytül Çorbacıoğlu Esmer, Recep Has, Alkan Yıldırım, Hayri Ermiş, Lemi İbrahimoğlu, Atıl Yüksel
İSTANBUL ÜNİVERSİTESİ, İSTANBUL TIP FAKÜLTESİ, KADIN HASTALIKLARI VE DOĞUM ANABİLİM DALI, PERİNATOLOJİ BİLİM DALI
Ovaryan ven trombozu (OVT) gebelik veya erken postpartum dönemde görülebilen nadir ve çok ciddi bir komplikasyondur. Trombofiliye zemin hazırlayan klinik durumların varlığında görülme sıklığı artar. sık görülür. Klinik olarak en sık bulgusu cerrahi akut batını taklit edebilen alt kadran ağrısı olmakla birlikte tanıda klinik şüphe en önemli basamaktır. Fetuste güven vermeyen kalp atım paterni varlığı nedeniyle sezaryen ile doğum yapan primigravid hastanın, postpartum erken
dönemde antibiyotiklere dirençli subfebril ateş nedeniyle kontrastlı bilgisayarlı tomografi ile tetkik edilmesi sonucu septik ovaryen ven trombozu tanısı konuldu. Nonkomplike POVT olgularında günümüzde kabul edilen tedavi modalitesi düşük moleküler ağırlıklı heparin ve geniş spektrumlu antibiyotiklerdir.