Journal of the Turkish German Gynecological Association最新文献

{"title":"Serum osteopontin as a diagnostic marker for missed abortion: evidence from a prospective study.","authors":"Denizhan Bayramoğlu, Erhan Okuyan, Yusuf Başkıran, Emre Günakan, Zeynep Bayramoğlu, Celal Akdemir","doi":"10.4274/jtgga.galenos.2026.2025-10-13","DOIUrl":"https://doi.org/10.4274/jtgga.galenos.2026.2025-10-13","url":null,"abstract":"<p><strong>Objective: </strong>Osteopontin (OPN) is a multifunctional molecule involved in embryo implantation and blastocyst adhesion. Given its role at the maternal-fetal interface, OPN has been proposed as a potential biomarker for early pregnancy outcomes. The aim of this study was to evaluate the association between serum OPN levels and missed abortion in women presenting with early pregnancy bleeding.</p><p><strong>Material and methods: </strong>In this prospective study, primigravid women between 6 and 11 weeks of gestation with confirmed fetal cardiac activity were enrolled. Participants were classified into three groups according to clinical presentation: normal pregnancy, threatened abortion, and missed abortion. Blood samples were obtained at admission, and serum OPN levels were measured using an enzyme-linked immunosorbent assay. Inflammatory markers including white blood cell count, neutrophil-to-lymphocyte ratio, C-reactive protein levels, and body mass index were also recorded.</p><p><strong>Results: </strong>The study cohort numbered 198 women, aged 18-42 years, with 38, 80 and 80 women in the normal pregnancy, threatened and missed abortion groups, respectively. OPN levels showed a significant and progressive increase with the lowest levels observed in normal pregnancies, higher levels in threatened abortion, and the highest levels in missed abortion (p<0.001). Receiver operating characteristic curve analysis demonstrated strong discriminative capacity of OPN for pregnancy loss (area under the curve =0.846, p<0.001). A cut-off value of 1.15 ng/mL was associated with 100% sensitivity, whereas a cut-off value of 2.15 ng/mL was associated with 100% specificity.</p><p><strong>Conclusion: </strong>Elevated serum OPN levels are associated with early pregnancy loss and may serve as a potential biomarker in missed abortion. However, these findings should be interpreted with caution given the exploratory nature of the analysis.</p>","PeriodicalId":17440,"journal":{"name":"Journal of the Turkish German Gynecological Association","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147480927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic management of a ruptured rudimentary horn pregnancy","authors":"Anupama Bahadur, Udit Chauhan, Ayush Heda","doi":"10.4274/jtgga.galenos.2025.2025-3-1","DOIUrl":"10.4274/jtgga.galenos.2025.2025-3-1","url":null,"abstract":"<p><p>Unicornuate uterus results from incomplete Müllerian duct development and often includes a rudimentary horn. Pregnancy in such a rudimentary horn is rare. The video presents the robotic management of a 21-week, ruptured rudimentary horn pregnancy, emphasizing preoperative planning and surgical excision using a robotic platform, highlighting a novel minimally invasive technique for this rare obstetric emergency. A primigravida with a unicornuate uterus presented with a ruptured rudimentary horn pregnancy at 21 weeks and 4 days of gestation. Imaging confirmed fetal expulsion into the peritoneal cavity with moderate hemoperitoneum. The patient underwent right internal iliac artery embolization to minimize blood loss, followed by robotic excision of the ruptured horn, fetus, and placenta through posterior colpotomy. The procedure was completed using a multiport robotic setup with minimal intraoperative blood loss. The surgery was completed in 45 minutes with minimal complications. The patient had an uneventful postoperative recovery. Robotic-assisted surgery provides a safe, minimally invasive alternative to laparotomy for ruptured rudimentary horn pregnancies in well-selected patients. Meticulous planning, patient selection, and a multidisciplinary approach are key to success.</p>","PeriodicalId":17440,"journal":{"name":"Journal of the Turkish German Gynecological Association","volume":" ","pages":"68-70"},"PeriodicalIF":1.4,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12954634/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145377800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conventional in vitro fertilization at the age of fourties","authors":"Mete Işıkoğlu, Ayşenur Avcı, Ayşe Kendirci Çeviren, Batu Aydınuraz","doi":"10.4274/jtgga.galenos.2025.2025-5-12","DOIUrl":"10.4274/jtgga.galenos.2025.2025-5-12","url":null,"abstract":"<p><strong>Objective: </strong>Contrary to international guidelines, intracytoplasmic injection (ICSI) has increasingly been applied to a widening range of indications. The aim of this study is to present our experience with conventional in vitro fertilization (C-IVF) in women in their forties and to contribute to the ongoing debate on whether advanced maternal age should be considered an indication for preferring ICSI.</p><p><strong>Material and methods: </strong>We analyzed cases of non-male factor infertility in women aged ≥40 years. The primary outcome measures were fertilization rate, implantation rate, live birth rate, and miscarriage rate.</p><p><strong>Results: </strong>The cohort included 204 patients with a mean age of 42.30±1.97 years, a mean antral follicle count of 4.65±2.60, body mass index of 25.80±4.54 kg/m² and a mean duration of infertility of 4.12±4.03 years. The mean duration of stimulation was 8.73±2.22 days, with a mean gonadotropin dose of 261.82±65.25 IU. The fertilisation rate was 74.69%. A mean of 1.77±0.60 embryos were transferred resulting in an implantation rate, clinical pregnancy rate and live birth rate of 10.44%, 18.62%, 12.25% respectively.</p><p><strong>Conclusion: </strong>Fertilisation, implantation, live birth and miscarriage rates after C-IVF are satisfactory for women ≥40 years of age. Given its lower cost, ease of application and comparable clinical outcomes, C-IVF should be considered the preferred method of fertilisation in advanced-age patients.</p>","PeriodicalId":17440,"journal":{"name":"Journal of the Turkish German Gynecological Association","volume":" ","pages":"36-42"},"PeriodicalIF":1.4,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12954629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145952486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum.","authors":"","doi":"10.4274/jtgga.galenos.2026.e001","DOIUrl":"10.4274/jtgga.galenos.2026.e001","url":null,"abstract":"","PeriodicalId":17440,"journal":{"name":"Journal of the Turkish German Gynecological Association","volume":"27 1","pages":"71"},"PeriodicalIF":1.4,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12954632/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147344539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic and prognostic role of maternal serum prokineticin-1 in preeclampsia and adverse pregnancy outcomes.","authors":"Merve Ayas Özkan, Aziz Kından, İslam Aslanlı, Kadriye Yakut Yücel","doi":"10.4274/jtgga.galenos.2026.2025-10-12","DOIUrl":"10.4274/jtgga.galenos.2026.2025-10-12","url":null,"abstract":"<p><strong>Objective: </strong>Prokineticin-1 (PROK-1), known as endocrine gland-derived vascular endothelial growth factor, is an angiogenic peptide mostly produced in endocrine and placental organs. It is important for placental vascular remodeling and trophoblast control. This study sought to investigate the potential of maternal serum PROK-1 levels as a diagnostic or prognostic marker in preeclampsia (PE).</p><p><strong>Material and methods: </strong>This prospective case-control study included women diagnosed with PE and normotensive pregnant controls. Serum samples were collected at hospital admission, and PROK-1 concentrations were quantified using a commercial ELISA kit. Clinical characteristics and perinatal outcomes were compared between groups. Receiver operating characteristic analyses were used to assess the diagnostic and prognostic performance of PROK-1 for PE, disease severity, and composite adverse perinatal outcomes (CAPO).</p><p><strong>Results: </strong>There were 45 women in the PE group and an equal number of controls. PROK-1 levels were significantly higher in PE than in controls [8.37 (10.51) vs. 4.89 (3.26) ng/mL, p<0.001). PROK-1 predicted PE with an area under the curve (AUC) of 0.721 (cut-off >5.40 ng/mL; sensitivity 75.6%, specificity 60.0%; positive predictive value 65.5%, negative predictive value 71.4%). Furthermore, severe PE cases had significantly higher PROK-1 levels than mild PE cases. PROK-1 predicted severe PE with an AUC of 0.716 (cut-off >9.80 ng/mL) and CAPO with an AUC of 0.673 (cut-off >6.53 ng/mL).</p><p><strong>Conclusion: </strong>Maternal serum PROK-1 was elevated in PE and correlated with disease severity and adverse perinatal outcomes. Although inadequate as a stand-alone marker, PROK-1 may complement existing angiogenic biomarkers in multimarker prediction models.</p>","PeriodicalId":17440,"journal":{"name":"Journal of the Turkish German Gynecological Association","volume":"27 1","pages":"43-50"},"PeriodicalIF":1.4,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12954624/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147344475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe thrombocytopenia and neurological symptoms in pregnancy: a diagnostic challenge between hemolysis, elevated liver enzymes, and low platelet syndrome and thrombotic thrombocytopenic purpura-what is your diagnosis?","authors":"Halenur Öner Soy, Hasan Süt, Özhan Özdemir","doi":"10.4274/jtgga.galenos.2025.2025-6-3","DOIUrl":"10.4274/jtgga.galenos.2025.2025-6-3","url":null,"abstract":"","PeriodicalId":17440,"journal":{"name":"Journal of the Turkish German Gynecological Association","volume":" ","pages":"61-64"},"PeriodicalIF":1.4,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12954633/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145564491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is first trimester screening an opportunity for early diagnosis of structural anomalies?: A retrospective cohort study.","authors":"Talat Umut Kutlu Dilek, Eren Kaya, Elif Aygün, Özlem Pata","doi":"10.4274/jtgga.galenos.2025.2024-9-6","DOIUrl":"10.4274/jtgga.galenos.2025.2024-9-6","url":null,"abstract":"<p><strong>Objective: </strong>To share our experience of ultrasonographic evaluation of fetal anatomy in the first trimester and pregnancy follow-up in a tertiary center.</p><p><strong>Material and methods: </strong>This retrospective study was conducted in the Acıbadem University Atakent Hospital and Acıbadem University Bakırköy Hospital Prenatal Diagnosis Units between April 2015 and December 2019. The study group included pregnant women referred for first-trimester aneuploidy screening and anomaly survey.</p><p><strong>Results: </strong>The mean maternal age was 31.28±4.43 years and ranged from 20-49 years. The median gestational week at which first-trimester evaluation was made was 12.4 weeks. Of 3254 cases, 55 (1.69%) had pathologic ultrasound findings in the first-trimester anomaly scan, including increased nuchal translucency (NT) value over 95^th percentile in 34 fetuses (52.3%) with structural anomaly. Median (range) crown-rump length was 58.69 (45-83) mm, and the median NT value was 3,5 (1.5-12) mm for fetuses with abnormal sonographic findings. The total detection rate for sonographic anomalies in the first-trimester scan was 60.43%. Of note, 27.3% of fetuses with detected anomalies had multiple congenital anomalies. Twenty-four new cases were diagnosed in the second trimester, and 11 new cases were detected in the last trimester from the same cohort.</p><p><strong>Conclusion: </strong>Screening between 11-14 weeks of pregnancy may be an opportunity to evaluate maternal health and detect severe fetal anomalies. The family should be counseled about structural anomalies that may be detected later, especially in the second and third trimesters, the limitations of the technique, and the ongoing progress of fetal development.</p>","PeriodicalId":17440,"journal":{"name":"Journal of the Turkish German Gynecological Association","volume":" ","pages":"8-18"},"PeriodicalIF":1.4,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12954639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145850379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meta-analysis of changes in epithelial ovarian cancer incidence rates associated with salpingectomy: A comparison of 2022-2023 and earlier periods.","authors":"Greg Marchand, Daniela Gonzalez Herrera, Brooke Hamilton, McKenna Robinson, Emily Kline, Sarah Mera, Michelle Koshaba, Greenley Jephson, Nidhi Pulicherla, Ali Azadi","doi":"10.4274/jtgga.galenos.2025.2025-5-7","DOIUrl":"10.4274/jtgga.galenos.2025.2025-5-7","url":null,"abstract":"<p><p>This systematic review and meta-analysis evaluated epithelial ovarian cancer (EOC) incidence rates associated with salpingectomy, with an exploratory assessment of temporal trends following guideline-driven increases in opportunistic salpingectomy. A literature search was conducted across PubMed, Web of Science, Cochrane, and Scopus, targeting cohort studies published between January 2015 and September 2023. Eligible studies were cohort studies reporting EOC incidence in women undergoing salpingectomy (opportunistic or risk-reducing) compared to controls without salpingectomy, with sufficient sample sizes (>100 salpingectomy cases) and homogeneous populations. The Newcastle-Ottawa Scale (NOS) was used to assess methodological quality. A meta-analysis calculated the risk ratio (RR) of EOC incidence, with subgroup analysis exploring temporal trends, using a random-effects model. Five cohort studies, involving 5,819,102 women with 31,586 EOC cases, were included, all with low risk-of-bias (NOS scores ≥6). Salpingectomy was associated with a 77.7% reduction in EOC incidence compared to control patients [RR =0.223, 95% confidence interval: (0.182, 0.274), p<0.001; I²=0]%. The 2022-2023 period should be interpreted as a recent evidence window rather than a formally powered comparative period owing to the small number of studies available. These findings confirm that salpingectomy, particularly opportunistic procedures, substantially reduces EOC incidence. Clinicians should consider offering salpingectomy to average-risk women during gynecologic surgeries, with informed consent. Further research with longer follow-up of contemporary cohorts is needed.</p>","PeriodicalId":17440,"journal":{"name":"Journal of the Turkish German Gynecological Association","volume":" ","pages":"51-60"},"PeriodicalIF":1.4,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12954638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146119170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal and fetal neudesin levels in pregnancy: associations with gestational diabetes mellitus and pregnancy outcomes.","authors":"Aya I Moussa, Ahmed W Morad, Nahla A Nosair, Mostafa F Ellakany, Ahmed Soliman, Ahmed Fath","doi":"10.4274/jtgga.galenos.2026.2025-1-7","DOIUrl":"10.4274/jtgga.galenos.2026.2025-1-7","url":null,"abstract":"<p><strong>Objective: </strong>Gestational diabetes mellitus (GDM) is significantly associated with short- and long-term adverse maternal and perinatal outcomes. Despite the important role of neudesin in modulating glucose metabolism and insulin sensitivity, extant literature is scarce on the link between neudesin and GDM. This study investigated neudesin in GDM and its potential as a diagnostic marker and future therapeutic target.</p><p><strong>Material and methods: </strong>We conducted a case control study at our department. Forty-five Pregnant women with GDM were included in the study group, while an equal number of healthy pregnancies constituted the controls. The enzyme-linked immunosorbent assay technique was employed to quantify the concentration of neudesin in both maternal and cord samples.</p><p><strong>Results: </strong>Women with GDM (n=45) exhibited significantly higher maternal and umbilical cord serum neudesin levels compared to controls (median maternal neudesin: 4.9 ng/mL vs. 1.9 ng/mL; median umbilical cord neudesin: 2.6 ng/mL vs. 1.2 ng/mL). Maternal neudesin levels correlated positively with body mass index, fasting insulin, measures of insulin resistance, and neonatal birth weight and inversely with APGAR scores. A maternal neudesin cut-off of 5.25 ng/mL demonstrated high diagnostic accuracy for GDM (area under the curve =0.967, 91.1% sensitivity, 93.3% specificity, 92.2% accuracy).</p><p><strong>Conclusion: </strong>Neudesin may serve as a potential diagnostic tool for GDM. Future investigations into neudesin as a novel GDM biomarker and potential therapeutic target are urgently warranted.</p>","PeriodicalId":17440,"journal":{"name":"Journal of the Turkish German Gynecological Association","volume":"27 1","pages":"1-7"},"PeriodicalIF":1.4,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12954636/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147344531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complex braided true umbilical cord knots (TUCK) and cord entanglement with fetal demise in monochorionic monoamniotic twin pregnancy: a catastrophic sequela-what is your diagnosis?","authors":"Anusha Devalla, Akhila Pagolu, Geetha Sulochana Gopidas, Srujana Veldi, Bhargavi Palati","doi":"10.4274/jtgga.galenos.2026.2025-10-8","DOIUrl":"https://doi.org/10.4274/jtgga.galenos.2026.2025-10-8","url":null,"abstract":"","PeriodicalId":17440,"journal":{"name":"Journal of the Turkish German Gynecological Association","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147344441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}