Does Type of Menopause Affect the Sex Lives of Women?

BACKGROUND The aim of this study was to investigate factors affecting the sex lives of middle-aged women, and whether surgical menopause affects sexual function differently from natural menopause, by comparing effects on sexual performance of women with similar demographic features. MATERIAL AND METHODS The study included 151 women with surgical menopause (SM), 357 women with natural menopause (NM), and 186 perimenopausal women (PM). The women were asked to complete a 6-question survey of sexual performance parameters. The relationship between the demographic and clinical features and hormone levels of the groups and sexual function parameters were evaluated. We also compared these parameters between the 3 study groups, and paired comparisons were made between the SM group and the NM group. RESULTS Demographic features, serum DHEA-S, total testosterone, and FSH levels were found to have statistically significant effects on sexual performance of women (p<0.05). The sexual function scores for the frequency of sexual desire, coitus, and orgasm were significantly higher in the PM group, whereas vaginal lubrication scores were lower compared to the NM and SM group (p<0.05). In paired comparison of NM and SM, the scores for the frequency of coitus, orgasm, and vaginal lubrication were significantly higher in the SM group, while sexual desire frequency scores were higher in the NM group (p<0.05). CONCLUSIONS Our study approached to this topic in an extended manner and found significant relationships between several demographic-clinical and hormonal factors. SM was found to not affect female sexual performance, except for sexual desire, more than NM.

Long-Term Outcome of Fetuses with Soft Marker and Without Genetic or Structural Abnormality.

PURPOSE: To determine long-term outcome of infants with isolated or multiple soft markers but no structural or chromosomal abnormalities. METHODS: A retrospective study of 78 pregnant women who were referred for amniocentesis and found to have soft markers including echogenic intracardiac focus/foci (EIF), echogenic bowel (EB), unilateral or bilateral choroid plexus cysts, (UCPCs or BCPCs) mild pyelectasis and single umbilical artery but no structural anomalies and outcomes of the liveborns with a 4- to 9-year follow-up was conducted. RESULTS: Among 28 fetuses with EIF, allergic asthma and epilepsy were diagnosed in two liveborns. We followed up nine pregnancies with EB, epilepsy was present in one case. Allergic asthma was detected in both UCPCs and BCPCs, whereas epilepsy and attention-deficit/hyperactivity disorder (ADHD) were diagnosed in two liveborns with BCPCs. Twelve liveborns with multiple soft markers were evaluated; no pathology was detected in most of them except one case of allergic asthma, one case of hearing impairment and one case of ADHD. CONCLUSIONS: This study shows longer-term favorable outcomes of the liveborns with isolated or multiple soft markers without any aneuploidy and may provide insight into this debated point.

Comparison of perinatal outcome between adolescent and adult pregnancies.

OBJECTIVE: The aim of this study was to compare perinatal outcomes between adolescent and adult pregnancies. MATERIAL AND METHODS: In 527 adolescent and 1334 adult pregnant women who delivered at Ondokuz Mayis University Obstetrics and Gynecology Department between 2006 and 2013, perinatal outcomes were retrospectively compared in terms of including spontaneous abortion, induced abortion rate, dilatation and curettage (D&C), pregnancy-induced hypertension, premature prelabor and prelabor rupture of membranes, polihydramnios, oligohydramnios, maternal anemia, delivery modes and also neonatal outcomes including 5th minute Apgar score and fetal birth weight. RESULTS: The ratio of pregnancy induced hypertension and postpartum hemorrhage was higher in adults, but, anemia was more common in adolescents. There was statistically significant difference in the mode of delivery; the ratio of cesarean section was higher in adults whereas the rate of induced abortions and D&C significantly increased in adolescents. Low birth weight (LBW) and extremely LBW rates were significantly higher in adolescents, however, 5th minute Apgar scores were found to be higher than adult group. CONCLUSION: These results show that the perinatal care is fairly improved in Turkey.

Chromosomal anomalies and additional sonographic findings in fetuses with open neural tube defects.

OBJECTIVE: To evaluate the results and the necessity of chromosome analysis in fetuses prenatally detected with a neural tube defect and to determine the significance of ultrasonographic evaluation for the identification of underlying or accompanying chromosomal anomalies. METHODS: Ninety fetuses that underwent prenatal and/or postnatal chromosome analysis after being diagnosed with open neural tube defects (NTD) between the years 2006 and 2010 in the Department of Obstetrics and Gynecology at Ondokuz Mayis University School of Medicine were included in this study. Detailed fetal ultrasonography was performed in all cases in order to investigate any additional anomalies. Karyotype was determined in the prenatal period by amniocentesis in 72 (80%) of the 90 fetuses, and by cordocentesis in 5 (5.5%). In 13 (13.3%) fetuses, karyotype was determined in the postnatal period by blood sampling. RESULTS: Fourteen (15.5%) of the 90 fetuses were diagnosed with acrania/anencephaly, 14 (15.5%) with encephalocele, 2 (2.2%) with iniencephaly, 60 (66.6%) with open spina bifida. None of the 90 fetuses with open NTD who had undergone chromosome analysis was diagnosed with chromosomal anomalies. None of the 19 (21.1%) fetuses diagnosed with additional ultrasound findings had a chromosomal abnormality, either. Seventy-one (78.9%) fetuses having sonograhically isolated NTD were also isolated in postmortem examination. CONCLUSION: In fetuses with open NTD, we could not find the chromosomal anomaly rate as high as reported in previous literature. The necessity of fetal karyotyping should be questioned especially in isolated cases.

Successful pregnancy and delivery in a patient with bladder exstrophy.

Bladder exstrophy (BE) is a rare congenital anomaly. Owing to the advanced reconstructive surgical techniques and effective antibiotics, the incidence of urinary and systemic complications in patients with BE has decreased and the life expectancy has increased. However, this brings along social, sexual, and psychological problems; particularly, successful pregnancy and delivery is extremely rare in females with BE. We present a pregnancy of an 18-year-old female with BE, who has been followed at our university hospital since birth.

Comparison of single and double courses of antenatal corticosteroid administration on neonatal mortality and morbidity.

OBJECTIVE: We aimed to evaluate the effects of single and double courses of antenatal corticosteroid administration on neonatal mortality and morbidity. MATERIALS AND METHODS: 232 preterm babies delivered between 01. April 2007 and 31. March 2008 with gestational ages of 26-34 weeks were evaluated prospectively. Infants were divided into three groups. The first group did not receive any antenatal betamethasone therapy. The second group received single (two doses of 12 mg betamethasone administered at 24 hour intervals) and the third group received double (repeated course after one week) courses of betamethasone therapy. RESULTS: 156 (67.2%) infants received at least one dose of corticosteroid treatment whereas 76 (37.8%) did not. Of 156 infants who had received antenatal betamethasone, 36 (23.1%) developed respiratory distress syndrome (RDS), while the incidence of RDS was 35.5% in 76 preterms who received no antenatal betamethasone (27/76) (p<0.05). When single and double courses of bethamethasone administration were compared, 20 (24.7%) infants with single course and 16 (21.3%) infants with two course developed RDS (p>0.05). CONCLUSION: When single and two courses of antenatal steroid therapy were compared, there was no statistically significant difference between groups regarding the incidence of RDS and mechanical ventilator treatment.