Prevalence of perianal diseases and associated factors in primigravida women: A hospital-based cross-sectional study.

OBJECTIVES: To define the incidence of anorectal diseases in primigravida women as well as in the first month after delivery and the factors affecting the development of anorectal diseases. METHODS: The sample size was determined as 328 primigravida women. Research data were collected from pregnant women who applied to Gynecology and Obstetrics Polyclinic, Kars Harakani State Hospital Gynecology and General Surgery Polyclinic, Kafkas University, Kars, Turkey, between November 2020 and August 2021.The pregnant women were examined and surveyed 4 times; in the second and third trimesters, on the day after delivery, and in the first month after delivery. Chi-square test was used in the analysis of the data determined by counting. Variables which were statistically significant (p<0.05) in the Chi-square test were included in the backward logistic regression analysis. RESULTS: Perianal disease was observed in 103 (38.6%) of the pregnant women. The incidence of perianal disease was found to be 4.917 times (confidence interval [CI]: [2.134-11.327]) higher in those with perianal disease compared with those without, 2.936 times (CI:[1.584-5.439]) higher in those who did not consume fiber-rich foods compared with those who did, 9.512 times (CI: [4.583-19.742]) higher in those with constipation compared with those without, and 23.721 times (CI: [5.363-104.915]) higher in those whose pushing stage duration was above average compared with that in those whose pushing stage duration was below average. CONCLUSION: In primigravida pregnants, the risk of perianal disease increases in those who have perianal disease before pregnancy, those who do not consume fibrous food, those who have constipation, and those who have a long pushing period.

The Comparison of Pelvic Mass Score and Risk of Malignancy Index-3 in Discrimination of Benign and Malignant Adnexal Masses.

OBJECTIVES: Discrimination of benign and malignant adnexal masses is crucial for the follow-up and prognosis of the patient. Since each modality alone does not have enough sensitivity, the combination of all methods called multimodal screening is currently being used. In this study, we aimed to compare pelvic mass score (PMS) and the risk of malignancy index (RMI-3) scoring systems in determining the malignant potential of adnexal masses. METHODS: In this prospective observational study, 40 patients between the age of 15-79 who were diagnosed as an adnexal mass were included between March and October 2016. Patients were classified as benign (n=20) and malignant (n=20). The age, gravida, parity, findings of a pelvic examination, medical and family history, laboratory parameters, sonographic findings, histopathological results, PMS and RMI-3 scores of the patients were recorded. RESULTS: The mean age, CA-125 levels, Sassone scores and ultrasonography scores of patients were higher in malignant cases, whereas the resistance index was lower. Both RMI-3 and PMS scores were higher in the malignant group (1728.14±325.3 vs. 36.27±31.01, p<0.001 and 55.31±40.96 vs. 9.91±5.29, p<0.001, respectively). Receiver operating curve for the predictive value of PMS to diagnose malignancy was performed and a cut-off value of 14 was determined with the area under the curve (AUC) 0.955 (p<0.001). The sensitivity was 95%, specificity was 80%, positive and negative predictive values were 82.6% and 94.1%. Likewise, the discriminative value of RMI-3 to diagnose malignancy was evaluated by the ROC curve. AUC for RMI-3 was 0.930 with a sensitivity of 95%, the specificity of 75%, the positive predictive value of 79.1% and negative predictive value of 93.7% with a cut-off value of >53.2 (p<0.001). CONCLUSION: Age, menopause status, tumor markers and sonographic parameters may be beneficial alone for determining malignancy, whereas the scoring systems integrating all the parameters are more powerful. According to our findings, PMS is more sensitive and more practical than the RMI-3 scoring system.

The effect of first trimester hemoglobin levels on pregnancy outcomes.

OBJECTIVE: The relationship between hemoglobin levels and pregnancy outcomes is still a challenging issue. There is a supported opinion about the increased adverse pregnancy outcomes both with low and high hemoglobin levels. In this study, we aimed to evaluate this association for first trimester hemoglobin levels in a Turkish population. MATERIALS AND METHODS: In this retrospective study, 1306 women who were followed up during their pregnancy and gave birth in our clinic were enrolled. The patients were divided into three groups: hemoglobin <11 g/dL (n=490), 11≤ hemoglobin <13 g/dL (n=673), and hemoglobin ≥13 g/dL (n=143). The hemoglobin <11 g/dL group was classified into two subgroups as hemoglobin ≤9 g/dL (n=64) and hemoglobin >9 g/dL (n=426). Demographic characteristics, first trimester hemoglobin levels, gestational age at delivery and mode, birth weight, Apgar scores, and pregnancy outcomes were recorded and compared between the groups. RESULTS: Pregnancy-induced hypertension, preterm birth, neonatal intensive care unit admission, birth weight, gestational age at delivery, Apgar scores, and postpartum hemorrhage were significantly different between the three groups. In the pairwise comparison, gestational age at delivery, birth weight, and first minute Apgar scores were higher in the 11≤ hemoglobin <13 g/dL group, and pregnancy-induced hypertension was more common in the hemoglobin ≥13 g/dL group as compared with the others. Moreover, the preterm delivery rate was highest in the hemoglobin ≥13 g/dL (26.6%) group and lowest (7.3%) in the 11≤ hemoglobin <13 g/dL group. The neonatal intensive care unit admission rate was higher both the hemoglobin <11 g/dL and hemoglobin ≥13 g/dL groups. Postpartum hemorrhage was more common in the hemoglobin <11 g/dL group as compared with the other groups. Furthermore, pregnancy-induced hypertension was more common in the hemoglobin ≤9 g/dL subgroup (p=0.012). CONCLUSION: In conclusion, both low and high hemoglobin levels are related with adverse pregnancy outcomes. We suggest that hemoglobin levels must be screened during pregnancy to provide maternal and fetal well-being.