The efficacy of onion extract in the management of subsequent abdominal hypertrophic scar formation.

OBJECTIVE: Development of postoperative scars is often a problem. This study aimed to evaluate the efficacy of gel containing Allium cepa extract, allantoin and heparin (Contractubex, Merz Pharmaceuticals GmbH, Frankfurt, Germany) in reducing scarring after a caesarean section by comparing it with a control group, and also intra-individually, using the Vancouver Scar Scale (VSS). METHOD: A total of 120 patients who underwent a second elective caesarean delivery and who presented with hypertrophic scar development after their first caesarean section were included in the study. A scar revision was performed for all patients during the second caesarean operation. Patients in the study group (n=60) were advised to apply the topical scar gel postoperatively for a period of 6 months. The control group (n=60) received no treatment. RESULTS: Significant reductions were observed in the vascularity, pigmentation and height subgroups of the VSS for those in the group who continued the treatment to 24 weeks. An intra-individual analysis showed that the gel effectively reduced scarring after the second caesarean section. CONCLUSION: The prophylactic use of the gel to reduce scar development offers better results for vascularity, pigmentation and height subscales of the VSS after surgical removal of the primary caesarean scar during the second caesarean section. The results were better both intra-individually, and also in comparison with the control group and support the use of a gel containing Allium cepa extract, allantoin and heparin to reduce scarring after a caesarean section.

Effect of intrauterine insemination treatment on sexual function and quality of life for infertile women.

OBJECTIVES: To evaluate the effect of intrauterine insemination (IUI) on sexual functioning, quality of life and psychological well-being. METHODS: One hundred and thirty four infertile women going to IUI treatment as study group and 134 women who do not report any infertility complaint attending to gynecology clinic for routine control as control group were enrolled. Demographic data of the patients were collected. Patients were asked to complete Female Sexual Functioning Index (FSFI), Beck Depression Inventory (BDI) and SF 36 form. RESULTS: Total FSFI score (mean±SD) for study group was 23.4±4.1 and 24.8±3.4 for control group (p<0.05). This means a lower sexual function for patients going to IUI. There were also statistically significant differences according to subscales of FSFI scores for sexual desire, arousal and satisfaction. Mean±SD scores for Beck Depression Inventory analysis was 18.6±9.8 for study group and 18.5±7.1 for control group. According to SF-36 scores, there were statistically significant differences between the groups for four subscales: Role physical,bodily pain,general health and vitality. CONCLUSIONS: Going to an IUI treatment has negative effects on FSFI scores and some of SF 36 scores but we did not find a significant negative effect on BDI scores.

Do Syrian refugees have increased risk for worser pregnancy outcomes? Results of a tertiary center in Istanbul.

OBJECTIVE: To compare obstetric and perinatal outcomes of Syrian refugee pregnants and Turkish counterparts who gave birth at a tertiary center in Istanbul. MATERIALS AND METHODS: A retrospective study including the birth records of 704 Syrian refugees and 744 Turkish pregnant women between January 2016 and May 2017 were analyzed. Demographic data, obstetric and neonatal outcomes were compared. The primary aims of this study were to evaluate the pregnancy outcomes and cesarean rates between the groups. The secondary outcomes were the use of antenatal vitamin supplementation, hemoglobin-hematocrit values, and maternal complications. RESULTS: Our results showed that the use of folic acid and iron supplementation rates during pregnancy were similar between the groups (folic acid supplementation 8.1% vs 6.5%, p=0.264; iron supplementation 20.7% vs 19.6%, p=0.125; respectively for Turkish women and Syrian refugees). Cesarean rates were significantly higher for Turkish patients than in Syrian refugees (42.7% vs 32.7%; p<0.05). Gestational age at delivery was significantly higher among Turkish women when compared with Syrian refugees (37.7±2.3 vs 36.4±2.3 weeks, p<0.05), but there was no significant difference regarding the birtweights' of the newborns (3134 g vs 3066 g for Turkish women and Syrian refugees, respectively, p=0.105). Although obstetric complications were seen more often in Syrian refugees, it did not reach statistical difference (9.7% vs 8.1%, respectively, p=0.285). CONCLUSION: Syrian refugees use antenatal vitamin supplementations at similar rates to Turkish citizens and obstetric and perinatal outcomes are similar between the groups.

Preliminary evaluation of foetal liver volume by three-dimensional ultrasound in women with gestational diabetes mellitus.

The aim of the study was to assess the standard foetal biometric measurements and foetal liver volume (FLV) in pregnancies complicated by gestational diabetes mellitus (GDM) at the time of GDM screening and to compare the results with foetuses in normal pregnancies. Ninety-seven pregnant women with normal singleton uncomplicated pregnancies between 24 and 28 weeks of gestation were allocated into GDM (+) (n: 33) and GDM (-) (n: 64) groups based on their 75 g oral glucose tolerance test results. Foetal biometric measurements and FLV measurements of the groups were compared. Although there were no significant differences in the standard biometric measurements between the two groups, FLV was significantly higher in the women with GDM (p < .01). The ROC analysis implied that with a cut-off value of FLV of 32.72 cm3 for GDM prediction, the sensitivity was 78.8% and specificity was 56.3%. We suggest that FLV measurements during the second-trimester ultrasound scanning may be a tool for the prediction of GDM in the obstetric population. Impact statement What is already known on this subject? GDM is an important pregnancy disease, because of its possible foetal and maternal complications. Besides the standard biometric measurements, some other foetal body dimensions such as the anterior abdominal wall thickness, skinfold thickness, adipose tissue thickness, Wharton's jelly thickness, foetal liver length and foetal liver volume (FLV) have been evaluated as ultrasound parameters of glycaemic control. While the evaluation of foetal liver dimensions has a role in identifying foetal growth acceleration, previous studies addressed patients with insulin-dependent diabetes mellitus rather than gestational diabetes mellitus, utilised two-dimensional ultrasound and did not argue the diagnostic value of these findings. What do the results of this study add? In our study, besides the standard biometric measurements, the FLV measurements were evaluated by a three-dimensional ultrasound. Although there were no significant differences in the standard biometric measurements between the GDM (+) and GDM (-) groups, the FLV was significantly higher in women with GDM. The FLV was found to be a potential predictive factor for GDM. The ROC analysis implied that as a cut-off value of FLV of 32.72 cm3 for GDM prediction, the sensitivity was 78.8% and the specificity was 56.3%. What are the implications of these findings for clinical practise and/or further research? Screening for GDM with oral glucose tolerance test within the limited weeks of gestation may not always be feasible. On the other hand, the mid-trimester ultrasound scanning is done almost in all pregnancies. Accordingly, FLV measurement might be an alternative method for the GDM diagnosis.

Effect of Betamethasone on Fetal Pulmonary and Umbilical Artery Doppler Velocimetry and Relationship With Respiratory Distress Syndrome Development.

OBJECTIVES: Respiratory distress syndrome (RDS) is a major cause of neonatal morbidity and mortality. It is primarily a disease of premature neonates. The aim of this study was to evaluate the impact of maternal betamethasone administration on the fetal pulmonary arteries (PAs) and umbilical arteries (UAs) and the correlation between RDS development and PA Doppler results. METHODS: Forty singleton pregnancies between 24 and 34 gestational weeks with a diagnosis of preterm birth were included prospectively. They received corticosteroids to enhance fetal lung maturity. Fetal PA and UA Doppler parameters were evaluated before and 48 to 72 hours after steroid administration. Maternal records were matched to neonatal charts, and demographic and outcome data were abstracted. RESULTS: There were no differences between groups for maternal age, body mass index, mode of delivery, and mean GA at steroid administration. Apgar scores at 1 and 5 minutes were significantly lower for neonates who developed RDS (P < .05). There were no statistically significant differences in PA Doppler results between fetuses who developed RDS and those who did not, and there were no significant differences in PA Doppler results before and after steroid administration for both groups. The UA pulsatility and resistive indices were significantly lower after steroid administration for the neonates who developed RDS (P < .05). CONCLUSIONS: There were no significant differences in PA Doppler indices for fetuses with or without RDS after steroid administration.

Cervical Conization and the Risk of Preterm Birth: A Population-Based Multicentric Trial of Turkish Cohort.

INTRODUCTION: Cold Knife Conization (CKC) is one of the most effective methods for the treatment of Cervical Intraepithelial Neoplasia (CIN). Some studies showed a relation between preterm birth and the treatment of CIN; on the other hand, other studies do not show such a relationship. AIM: The present study was conducted with the aim to investigate the pregnancy outcomes of Turkish women regarding demographic characteristics, obstetric history, removed tissue, and residual cervical length after CKC and to determine the effect of removed cervical tissue volume and height on preterm birth. MATERIALS AND METHODS: This study was a population-based, multicenter trial that was conducted on singleton pregnancies between January 2007 and December 2013. The control group comprised of 38,892 patients who gave birth during this period. On the other hand, patients who conceived after CKC during this period were invited to the hospital and included in the case group (n=20). The course of pregnancy following CKC was studied. Preterm birth rates, risk factors for preterm birth, conisation age, cervical smear and colposcopic biopsy results and the volume and height of the removed cervical tissue of those patients were evaluated. RESULTS: There was no statistically significant difference in preterm birth rates between the case and the control groups. None of our cases had any identified preterm birth risk factor except for one case. The average height of removed cervical tissue was 12.6±5.4 mm and the average length of the residual cervix after birth was 28.7±4.3 mm. CONCLUSION: Removal of cervical tissue of 12.6±5.4 mm in height and 2.35±2.27 cm3 in volume will not increase the risk of preterm birth of women who do not have any other preterm birth risk factors. If there is no other preterm birth risk factors, term birth is most probably possible after conisation.

What is Turkish women's opinion about vaginal delivery?

OBJECTIVE: To determine Turkish women's opinion about vaginal birth. MATERIALS AND METHODS: This prospective cohort study was conducted in Department of Obstetrics and Gynecology of Süleymaniye Maternity Research and Training Hospital in Istanbul, Turkey, between February 2015 and April 2015. The participants of this study were 100 primiparous pregnant women who had vaginal deliveries. The women were interviewed face-to-face after the birth. Data were collected through a socio-demographic and clinical questionnaire. RESULTS: Ninety percent of the women reported vaginal birth as the ideal mode of delivery route; a minority of the women (10%) had decided on cesarean birth before having a vaginal birth. Anxiety of pain was the major factor that influenced choice of delivery type before giving birth. After vaginal birth, 84% of women were satisfied with vaginal birth and reported that they would prefer vaginal birth for their next pregnancy. However, 16% reported that they would prefer cesarean birth for their next pregnancy due to pain of labor, pain of episiotomy, anxiety, and prolonged duration of labor. CONCLUSION: The results suggest the majority of women prefer to give birth vaginally and reported vaginal birth as the ideal choice.

Relationship between serum uric acid, creatinine, albumin and gestational diabetes mellitus.

BACKGROUND: During normal pregnancy, plasma concentrations of creatinine and uric acid normally decrease as a consequence of their increased glomerular filtration. Hyperuricemia in pregnant women has been associated with several pregnancy complications. We researched the relationship between serum uric acid, creatinine and albumin levels in pregnant women with normal glucose tolerance and gestational diabetes mellitus. METHODS: A total of 112 patients were evaluated, 56 of whom had gestational diabetes. All of the patients had single estimations of serum uric acid, creatinine, albumin and liver enzymes carried out on booking between the 24th and 28th gestational weeks. The women were followed up throughout pregnancy. RESULTS: Significant differences were found between the two groups for maternal age, gravida, parity and maternal weight gain during pregnancy, but not for body mass index or blood pressure. Creatinine levels were significantly higher in the diabetic group than in the control group [0.6+/-0.15 vs. 0.43+/-0.1 mg/dL (53.04+/-13.26 micromol/L vs. 38.01+/-8.84 micromol/L), p<0.001]. Uric acid levels were also higher in the diabetic patients, but this elevation was not statistically significant [4.42+/-1.09 vs. 4.1+/-0.84 mg/dL (260.78+/-64.31 micromol/L vs. 241.49+/-49.56 micromol/L), p>0.05]. There were no differences in mean albumin concentrations or liver function tests. CONCLUSIONS: In this prospective study of Turkish women, we found that patients with gestational diabetes had significantly higher levels of creatinine than normal pregnant women.