Turkish Journal of Obstetrics and Gynecology最新文献

{"title":"Prenatal diagnosis of severe glutaric acidemia type II due to a novel homozygous ETFDH frameshift variant: Case report and literature review.","authors":"Seda Kaplan, Büşra Berfin Polat, Rauf Melekoğlu","doi":"10.4274/tjod.galenos.2026.09552","DOIUrl":"https://doi.org/10.4274/tjod.galenos.2026.09552","url":null,"abstract":"<p><p>Glutaric acidemia type II (GA2) is a rare autosomal recessive fatty acid oxidation disorder that can present prenatally with bilateral hyperechoic cystic kidneys. We report a 23-year-old gravida 2 woman who was referred at 18+2 weeks for suspected fetal renal anomalies, with a history of consanguinity and a prior unexplained neonatal death. Quantitative fluorescent polymerase chain reaction and microarray were normal; whole-exome sequencing identified a novel homozygous <i>ETFDH</i> frameshift variant (c.1200_1203del; <i>p.His401GlnfsTer3</i>). The parents were heterozygous, and the variant was classified as likely pathogenic. The family terminated the pregnancy after counseling. This case highlights both GA2 in the differential diagnosis of fetal renal anomalies and the value of prenatal exome sequencing for diagnosis and counseling.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149231288","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":"Sexual function and surgical outcomes after vaginal natural orifice transluminal endoscopic surgery versus total laparoscopic hysterectomy.","authors":"Hanne Bulat Çim, Melis Altuğ İnan, Şeyma Taştekin, Neslişah Ar, Bilge Kapudere, Meryem Hocaoğlu, Abdulkadir Turgut","doi":"10.4274/tjod.galenos.2026.57431","DOIUrl":"https://doi.org/10.4274/tjod.galenos.2026.57431","url":null,"abstract":"<p><strong>Objective: </strong>To examine whether vaginal natural orifice transluminal endoscopic surgery (vNOTES) and total laparoscopic hysterectomy (TLH) differ in postoperative sexual health, patient-reported recovery measures, and perioperative outcomes.</p><p><strong>Materials and methods: </strong>Sexually active women treated with vNOTES or TLH for benign gynaecological indications between January 2023 and January 2026 were included in this ambispective cohort. Clinical and operative information was retrieved retrospectively, while patient-reported postoperative data were obtained prospectively a minimum of six months after surgery. Sexual function was measured with the Female Sexual Function Index (FSFI). Additional outcomes included dyspareunia, time to resumption of sexual intercourse, return to work, postoperative satisfaction, and willingness to undergo the same procedure again. Selected outcomes were further examined using multivariable regression models incorporating clinically relevant confounding variables.</p><p><strong>Results: </strong>The analysis comprised 159 women, of whom 105 underwent TLH and 54 underwent vNOTES. Compared with TLH, vNOTES was associated with a shorter operative duration [160 (60) vs. 198 (90) minutes, p<0.01], earlier return to sexual intercourse [8 (3) vs. 9 (4) weeks, p<0.01], and higher postoperative satisfaction [10 (9-10) vs. 9 (8-10), p<0.01]. In adjusted analyses, the associations with shorter operative time [β=-27.24, 95% confidence interval (CI): -50.62 to -3.86; p=0.02] and earlier resumption of intercourse (β=-1.60 weeks, 95% CI: -2.93 to -0.27; p=0.01) persisted. No significant differences were identified in FSFI-based sexual function, dyspareunia, time to return to work, or composite adverse events.</p><p><strong>Conclusion: </strong>vNOTES and TLH showed comparable postoperative sexual function and dyspareunia outcomes. vNOTES was associated with an earlier return to sexual intercourse, greater postoperative satisfaction, and shorter operative duration. Further prospective multicentre research is required to clarify longer-term sexual outcomes after these procedures.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149231313","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":"Chromosomal abnormalities in isolated persistent left superior vena cava: A systematic review and meta-analysis","authors":"Süreyya Sarıdaş Demir, Bülent Demir","doi":"10.4274/tjod.galenos.2026.01678","DOIUrl":"10.4274/tjod.galenos.2026.01678","url":null,"abstract":"<p><p>Persistent left superior vena cava (PLSVC) is the most common systemic venous anomaly detected prenatally, yet the risk of chromosomal abnormalities in truly isolated cases remains uncertain. This systematic review and meta-analysis aimed to determine the rate of chromosomal anomalies in fetuses with isolated PLSVC by including only fetuses who underwent chromosomal analysis. A systematic search of PubMed/MEDLINE, EMBASE, and the Cochrane Library was performed from January 2000 through March 2026. Studies reporting chromosomal data for fetuses with sonographically confirmed isolated PLSVC were eligible. Isolated PLSVC was defined as PLSVC in the absence of intracardiac or extracardiac structural anomalies, irrespective of the presence of the right superior vena cava. Only isolated fetuses with prenatal or postnatal chromosomal analysis were included; untested fetuses were not assumed to be chromosomally normal. The pooled proportion was calculated as the total number of events divided by the total number of genetically assessed isolated fetuses, with 95% confidence intervals (CIs) calculated using the Wilson score method. Twelve studies were included, comprising 892 isolated PLSVC fetuses, of whom 302 underwent genetic testing. Eight chromosomal anomalies were identified, yielding a pooled chromosomal anomaly rate of 2.6% (95% CI: 1.3-5.1%). In the leave-one-out sensitivity analysis, the pooled rate ranged from 1.3% to 4.8%. The risk of chromosomal abnormalities in isolated PLSVC is low but not negligible. Because genetic testing was performed more often in higher-risk pregnancies, this estimate probably overestimates the background risk. The available evidence does not support a universal recommendation for invasive prenatal diagnosis based solely on an isolated PLSVC; decision-making should be individualized based on maternal age, serum screening or cell-free DNA results, nuchal translucency, detailed fetal anatomical assessment, and patient preference.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018168","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":"Giant clitoral inclusion cyst without prior genital mutilation: A case report.","authors":"Burak Tatar, Gülbin Yıldıran","doi":"10.4274/tjod.galenos.2026.58458","DOIUrl":"https://doi.org/10.4274/tjod.galenos.2026.58458","url":null,"abstract":"<p><p>Clitoral epidermoid inclusion cysts are rare benign lesions that may cause physical discomfort, genital disfigurement, and psychosocial distress when they become large. A 47-year-old woman presented with a rapidly enlarging clitoral mass measuring approximately 11 cm. She had no history of female genital mutilation, vulvar trauma, or vulvar surgery. Clinical, hormonal, and imaging findings did not suggest hyperandrogenism, virilization, or malignancy. Complete cyst excision, accompanied by clitoral hood plasty and labioplasty, was performed with careful preservation of the dorsal clitoral neurovascular structures. Histopathology confirmed an epidermoid inclusion cyst. The postoperative course was uneventful.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149196929","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":"Comparison of maternal serum calcidiol and microRNA-1323 expression in term and early preterm births.","authors":"Danil Armand, Yusrawati Yusrawati, Jamsari Jamsari, Masrul Masrul","doi":"10.4274/tjod.galenos.2026.79054","DOIUrl":"https://doi.org/10.4274/tjod.galenos.2026.79054","url":null,"abstract":"<p><strong>Objective: </strong>Preterm birth remains a leading cause of neonatal morbidity and mortality. Maternal vitamin D status and epigenetic regulation may contribute to its pathogenesis. This study aimed to analyze differences in subject characteristics, calcidiol [25(OH)D] levels, and maternal blood microRNA-1323 (miRNA-1323) expression between term and early preterm (28-34 weeks) deliveries.</p><p><strong>Materials and methods: </strong>An analytical observational study with a comparative cross-sectional design was conducted among 80 parturient women, including 40 term (37-42 weeks) and 40 early preterm deliveries. Calcidiol levels were measured using enzyme-linked immunosorbent assay, and miRNA-1323 expression was analyzed by quantitative reverse transcription polymerase chain reaction with the ΔCq method. Statistical analyses included normality, non-parametric, and correlation tests (p<0.05).</p><p><strong>Results: </strong>Mean maternal calcidiol levels were significantly higher in the early preterm group than in the term group (27.49±9.18 vs. 23.34±9.64 ng/mL; p=0.022), although both remained below the normal range. Median miRNA-1323 expression was also higher in the early preterm group, but not statistically significant (p=0.709). No significant correlation was observed between maternal calcidiol levels and miRNA-1323 expression in either group, indicating that these biomarkers were not directly associated in the present study and supporting further investigation into their individual contributions to early preterm birth.</p><p><strong>Conclusion: </strong>Maternal calcidiol levels differed significantly between term and early preterm deliveries, whereas miRNA-1323 showed a non-significant increasing trend. Both biomarkers may reflect biological changes associated with preterm birth.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082323","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":"Comparison of high uterosacral ligament suspension and sacrospinous ligament fixation for apical prolapse: Two-year outcomes.","authors":"Ömür Keskin, Süleyman Serkan Karaşin, Seyhan Sönmez, Senem Aslan","doi":"10.4274/tjod.galenos.2026.21784","DOIUrl":"https://doi.org/10.4274/tjod.galenos.2026.21784","url":null,"abstract":"<p><strong>Objective: </strong>Pelvic organ prolapse is a prevalent condition that significantly impacts women's quality of life. This study aimed to compare anatomical and patient-reported outcomes after high uterosacral ligament suspension (HUS) and sacrospinous ligament fixation (SSLF) performed during vaginal hysterectomy for apical pelvic organ prolapse.</p><p><strong>Materials and methods: </strong>This retrospective study included 46 women who underwent total vaginal hysterectomy with either HUS (n=20) or SSLF (n=26) between 2022 and 2023. Patient characteristics, surgical outcomes, and quality-of-life data were evaluated. Validated patient-reported outcome measures were used: Pelvic Pain Impact Questionnaire (PPIQ) and Pelvic Floor Disability Index (PFDI-20). Follow-up was conducted at 1, 6, 12, and 24 months postoperatively.</p><p><strong>Results: </strong>Both HUS and SSLF improved prolapse stage, Pelvic Organ Prolapse Quantification System C point, and pelvic floor symptoms after 24 months (p<0.01). Both HUS and SSLF improved anatomical and quality-of-life outcomes. In adjusted analyses, HUS was associated with lower PFDI-20 scores (β: -4.37, p=0.015) and showed a similar trend for PPIQ scores (β: -1.33, p=0.059). No major intraoperative complications were observed, and recurrence rates were low and similar between groups.</p><p><strong>Conclusion: </strong>Both procedures provided satisfactory anatomical correction and quality-of-life improvement at two years. HUS was associated with lower PFDI-20 scores after adjustment, whereas the difference in PPIQ scores did not reach statistical significance.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149076059","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":"Predictive value of fasting bile acids and liver enzymes for perinatal outcomes in intrahepatic cholestasis of pregnancy.","authors":"Ali Çıtırke, Zahid Ağaoğlu, Dilek Şahin","doi":"10.4274/tjod.galenos.2026.26797","DOIUrl":"10.4274/tjod.galenos.2026.26797","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the value of fasting bile acid (FBA) levels and liver enzymes [aspartate aminotransferase (AST) and alanine aminotransferase (ALT)] in predicting adverse perinatal outcomes in intrahepatic cholestasis of pregnancy (ICP).</p><p><strong>Materials and methods: </strong>This retrospective study included 296 pregnant women diagnosed with ICP between 2020 and 2025. Patients were classified as having mild (FBA 10-40 μmol/L, n=223) or severe ICP (FBA >40 μmol/L, n=73). Clinical, laboratory, and neonatal outcomes were compared; receiver operating characteristic (ROC) analysis was performed to evaluate the predictive value of FBA for meconium passage; and patients who received ursodeoxycholic acid (UDCA) therapy were compared with those who did not.</p><p><strong>Results: </strong>Compared with the mild ICP group, patients with severe ICP had earlier gestational ages at diagnosis and at delivery, and lower birth weight and neonatal pH (all p<0.05). FBA levels were significantly associated with fetal growth restriction (p=0.042), preterm birth (p=0.003), neonatal intensive care unit (NICU) admission (p<0.001), and meconium passage (p<0.001). AST was associated only with NICU admission and meconium passage, whereas ALT showed no significant association with perinatal complications. The median FBA level was significantly higher in patients with meconium passage (105 vs. 20 μmol/L; p<0.001). ROC analysis identified an FBA cut-off of 88.45 μmol/L (area under the curve=0.694), with 57.1% sensitivity and 81.3% specificity.</p><p><strong>Conclusion: </strong>FBA is the strongest predictor of adverse perinatal outcomes in ICP. AST provides complementary prognostic information, whereas ALT has limited predictive value. Clinical management should be guided by FBA-based risk stratification and individualized timing of delivery.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":" ","pages":"210-217"},"PeriodicalIF":1.5,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13544013/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148473337","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":"Vaginal microbiome metabolite shifts as early predictors of premature ovarian insufficiency in adolescents with novel gene variants.","authors":"Ramal Sufiyan, Minhal Nadeem, Syeda Momina Shah Bokhari, Bibi Samia Khan, Mahnoor Fatima","doi":"10.4274/tjod.galenos.2026.72418","DOIUrl":"10.4274/tjod.galenos.2026.72418","url":null,"abstract":"","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":" ","pages":"291-292"},"PeriodicalIF":1.5,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13544017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148875883","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":"Vulvar re-antisepsis and urinary tract infection after CO₂ cystoscopy in laparoscopic hysterectomy.","authors":"Alaattin Karabulut, Sevim Selen Karabulut, Sercan Kantarcı, Uğurcan Dağlı, Nilsu Özaslan Kutucu, Ahmet Güdüklü, Volkan Karataşlı, Adnan Budak, Abdurrahman Hamdi İnan","doi":"10.4274/tjod.galenos.2026.12428","DOIUrl":"10.4274/tjod.galenos.2026.12428","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate whether vulvar re-antisepsis before carbon dioxide (CO₂) cystoscopy after laparoscopic hysterectomy is associated with a lower incidence of postoperative urinary tract infection (UTI).</p><p><strong>Materials and methods: </strong>This prospective observational study included 98 women who underwent laparoscopic hysterectomy between November 25, 2025, and March 1, 2026. All patients received routine preoperative abdominal and vulvovaginal preparation with 10% povidone-iodine. According to routine intraoperative practice and surgeon preference, 53 patients underwent standard antisepsis alone, and 45 received additional vulvar and periurethral re-antisepsis immediately before CO₂ cystoscopy. The primary outcome was a postoperative UTI, defined according to Centers for Disease Control and Prevention/National Healthcare Safety Network criteria. Logistic regression was used to explore factors associated with postoperative UTI. The study was registered at clinicaltrials.gov (NCT07232446).</p><p><strong>Results: </strong>Postoperative UTI occurred in 8 patients (15.1%) in the standard antisepsis group and in 4 patients (8.9%) in the re-antisepsis group (p=0.538). Vulvar re-antisepsis was not associated with postoperative UTI in the exploratory multivariable model [adjusted odds ratio (OR)=0.89, 95% confidence interval (CI): 0.19-4.23; p=0.881]. Delayed catheter removal (>6 hours) was associated with postoperative UTI (adjusted OR=12.87, 95% CI: 2.13-77.62; p=0.005).</p><p><strong>Conclusion: </strong>Vulvar re-antisepsis before CO₂ cystoscopy did not result in a statistically significant reduction in postoperative UTIs. Given the limited number of events and the non-randomized design, these findings should be interpreted as exploratory.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":" ","pages":"242-249"},"PeriodicalIF":1.5,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13544006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148875920","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":"Microplastics in the umbilical vein of fetal growth restricted and healthy fetuses: A preliminary Turkish selected case series.","authors":"İsmail Bıyık, Harun Şener, Andrea Tinelli","doi":"10.4274/tjod.galenos.2026.67523","DOIUrl":"10.4274/tjod.galenos.2026.67523","url":null,"abstract":"<p><strong>Objective: </strong>Microplastics are ubiquitous environmental pollutants, yet their potential association with fetal growth restriction (FGR) remains unclear. This observational, analytical case-control study aimed to evaluate the presence and size characteristics of microplastics in umbilical venous blood samples from fetuses with FGR, compared with healthy controls.</p><p><strong>Materials and methods: </strong>Fourteen pregnant women with singleton pregnancies, aged 20-36 years, who delivered between 36+0 and 39+6 weeks' gestation were included. Pregnancies were classified as FGR (n=8) or healthy controls (n=6). Maternal and neonatal characteristics, including birth weight, Apgar scores, delivery mode, ultrasound and Doppler findings, and neonatal intensive care unit admission, were recorded. Umbilical vein blood samples collected at delivery were analyzed for the presence and particle size of microplastics using micro-Raman spectroscopy.</p><p><strong>Results: </strong>Microplastics were detected in 83.3% of control cases and 50% of FGR cases, with no statistically significant difference between groups (p=0.198). Mean microplastic particle size was larger in the FGR group than in controls (54.41±20.15 μm vs. 36.28±16.33 μm), although the difference was not statistically significant (p=0.133). Birth weight was significantly lower in the FGR group (p=0.003).</p><p><strong>Conclusion: </strong>Microplastics were detected in umbilical vein blood samples of both FGR and healthy fetuses. No significant association between the presence of microplastics and FGR was observed; however, further studies with larger sample sizes are required.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":" ","pages":"226-233"},"PeriodicalIF":1.5,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13544020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844273","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}