Turkish Journal of Obstetrics and Gynecology最新文献

{"title":"The impact of maternal electrolyte and albumin levels on the efficacy of single-dose methotrexate treatment for ectopic pregnancies.","authors":"Yusuf Başkıran,&nbsp;Kazım Uçkan,&nbsp;Talip Karaçor,&nbsp;İzzet Çeleğen,&nbsp;Züat Acar","doi":"10.4274/tjod.galenos.2023.71509","DOIUrl":"https://doi.org/10.4274/tjod.galenos.2023.71509","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to investigate the impact of maternal albumin and serum electrolyte levels on the efficacy of single-dose methotrexate (SDMtx) therapy for ectopic pregnancies. Building on previous research, recommendations are provided to enhance the success of SD-Mtx therapy in the management of ectopic pregnancy.</p><p><strong>Materials and methods: </strong>Conducted at a tertiary center gynecology clinic, the study included 353 patients diagnosed with ectopic pregnancy and treated with SD-Mtx from 2012 to 2023. Patients who responded positively to SD-Mtx treatment comprised Group 1 (n=313), while those requiring surgical intervention due to failed SD-Mtx therapy constituted Group 2 (n=40). Through the hospital's digital database, patient data including complete blood count, biochemistry, and hormone test results were retrospectively examined.</p><p><strong>Results: </strong>The mean β-hCG value was 1996 IU/mL for Group 1 in contrast to 2058 IU/mL for Group 2. There was no statistically significant difference in β-hCG levels between the two groups. Notably, Group 1 patients exhibited lower serum magnesium levels but higher potassium levels compared to Group 2 patients, with statistically significant differences. Furthermore, Group 1 patients had higher albumin levels than those in Group 2, with a statistically significant difference.</p><p><strong>Conclusion: </strong>Successful SD-Mtx treatment was associated with lower maternal serum magnesium levels and higher potassium and albumin levels. Considering electrolyte levels before administering SD-Mtx and addressing any imbalances could potentially enhance treatment success. Additionally, restoring low albumin levels might improve the efficacy of SD-Mtx treatment for ectopic pregnancies. While this study suggests these trends, further extensive studies with a larger sample size are necessary to establish more definitive evidence.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":"20 3","pages":"214-218"},"PeriodicalIF":1.1,"publicationDate":"2023-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/af/f9/TJOG-20-214.PMC10478729.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10224798","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":"Protective and/or therapeutic effects of berberine in a model of premature ovarian failure induced by cyclophosphamide in rats.","authors":"Orkun İlgen,&nbsp;Filiz Yılmaz,&nbsp;Sefa Kurt","doi":"10.4274/tjod.galenos.2023.70033","DOIUrl":"https://doi.org/10.4274/tjod.galenos.2023.70033","url":null,"abstract":"<p><strong>Objective: </strong>We conducted a biochemical and histological evaluation of whether berberine has a protective and/or therapeutic effect in a cyclophosphamide-induced premature ovarian failure (POF) model.</p><p><strong>Materials and methods: </strong>We divided 28 Wistar albino female rats into 4 groups [control group, POF group, cyclophosphamide (CP)+berberine (Bb) group, and POF+Bb group]. The POF model was established by intraperitoneal administration of 50 mg/kg CP on day 1 followed by 8 mg/kg/day CP dissolved in saline for the following 14 days. The CP+Bb group received Bb concurrently for two weeks with CP. The POF+Bb group received berberine for two weeks following the completion of CP administration. Left ovaries were used for histopathological evaluation and right ovaries were used for biochemical analysis [tumor necrosis factor-alpha (TNF-α), interleukin (IL)-1, IL-6 levels in tissue].</p><p><strong>Results: </strong>Ovarian damage scoring was significantly higher in the POF group than in the other groups (p<0.005). In the POF group, primordial and primary follicle counts were the lowest, while secondary and corpus luteum counts were the highest (p<0.005). There was no significant difference between the other groups. The POF group had significantly elevated levels of TNF-α, IL-1, and IL-6 in the biochemistry results (p<0.005).</p><p><strong>Conclusion: </strong>We demonstrated that berberine could be effective in the protection and treatment of POF by reducing proinflammatory cytokines. We believe that our study can make a considerable contribution to the literature in terms of POF protection and/or treatment.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":"20 3","pages":"227-233"},"PeriodicalIF":1.1,"publicationDate":"2023-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/87/27/TJOG-20-227.PMC10478726.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10159705","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":"When a caesarean section is necessary: Analysis of cesarean sections performed in the Republic of Turkey in 2022 in accordance with the World Health Organization Multi-Country Research Guidelines.","authors":"Şuayıp Birinci,&nbsp;Ümit Murat Parpucu","doi":"10.4274/tjod.galenos.2023.35919","DOIUrl":"https://doi.org/10.4274/tjod.galenos.2023.35919","url":null,"abstract":"<p><strong>Objective: </strong>The aim of our study, in light of the World Health Organization Multi-Country Survey (WHO-MCS) data examining the data of the Ministry of Health for the year 2022, comparing the cesarean sections (C/S) performed in the Republic of Turkey (TR) with the WHO-MCS data, and comparing the number of cesarean sections applied more than the reference values.</p><p><strong>Materials and methods: </strong>According to the database of the Turkish Ministry of Health, in 2022, 1166175 deliveries took place in the Republic of Turkey, and 706370 (60.5%) cesarean section deliveries were recorded as 365764 (51%) primary C/S. Using the Ministry of Health registration system based on the Robson classification.</p><p><strong>Results: </strong>The number and rate of C/S operations performed per birth in 2022 in TR (n=706370; 60.50%) were found to be significantly higher when compared to the number and rate of C/S on a global scale (n=246062; 21.10%), (p<0.001). When cesarean section operations performed in the Ministry of Health hospitals, private institutions, foundation universities, public universities and other public unit hospitals were compared with WHO MCS reference values and C/S ratios, 44.2% versus 24.7% (p=0.05), versus 77.4%, versus 34.2% (p<0.001), 74.3% versus 29.5% (p<0.001), 75% versus 35.8% (p<0.001), 69.3% versus 35.9% (p<0.001).</p><p><strong>Conclusion: </strong>The amount of cesarean sections performed according to the total number of births in the Turkish Republic is relatively high and its cost nearly 1 billion 750 million TL.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":"20 3","pages":"184-190"},"PeriodicalIF":1.1,"publicationDate":"2023-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/04/68/TJOG-20-184.PMC10478727.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10522423","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":"Clinical and genetic aspects of termination of pregnancy; tertiary center experience.","authors":"Ömer Gökhan Eyisoy,&nbsp;Çağdaş Özgökçe,&nbsp;Lütfiye Uygur,&nbsp;Mucize Eriç Özdemir,&nbsp;Ümit Taşdemir,&nbsp;Aydın Öcal,&nbsp;Oya Demirci","doi":"10.4274/tjod.galenos.2023.19677","DOIUrl":"https://doi.org/10.4274/tjod.galenos.2023.19677","url":null,"abstract":"<p><strong>Objective: </strong>The aim of the study was to retrospectively analyze the indications Techniques and complications of pregnancy termination performed in a tertiary center.</p><p><strong>Materials and methods: </strong>All cases between 10 and 33 weeks of gestation between January 2021 and June 2023 were retrospectively analyzed. The patients were divided into two groups as group 1 with 11+0 to 21+6 gestational weeks and group 2 for those at 22+0 and 33+0 gestational weeks.</p><p><strong>Results: </strong>A total of 568 pregnancy terminations were included in the study. Among all terminations the most common fetal indications were central nervous system anomalies (148 cases, 26%) and trisomy 21 (53 cases, 9%) and the most common maternal/obstetrical Indication was previable premature rupture of the membranes (179 cases, 31.5%). Abnormal genetic results were found in 50 of 173 cases (28.9%) with a termination indication of Structural malformation who accepted invaziv genetic testing. The number of terminations with fetal indications performed after 22 weeks were 148 (41%) and 11 (7.4%) cases of these late terminations of pregnancy were anomalies expected to be diagnosed in the first trimester. Complication rates (12.4%) and abdominal termination rates (3.5%) were significantly higher in group 2 than in group 1 (p<0.05).</p><p><strong>Conclusion: </strong>Improvements in prenatal genetic screening and diagnostic techniques will undoubtedly decrease the gestational ages in terminations of pregnancies. However, there will always be cases that can neither be diagnosed earlier nor can be treated due to the nature of the anomaly. In the management of such cases, terminations will always occupy an important place in prenatal care.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":"20 3","pages":"234-241"},"PeriodicalIF":1.1,"publicationDate":"2023-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/00/94/TJOG-20-234.PMC10478725.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10166436","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":"Clear cell carcinoma of the uterine cervix; an unusual HPV-independent tumor: Clinicopathological features, PD-L1 expression, and mismatch repair protein deficiency status of 16 cases.","authors":"Pınar Bulutay,&nbsp;Özgür Can Eren,&nbsp;Özlem Özen,&nbsp;Asuman Nihan Haberal,&nbsp;Nilgün Kapucuoğlu","doi":"10.4274/tjod.galenos.2023.62819","DOIUrl":"https://doi.org/10.4274/tjod.galenos.2023.62819","url":null,"abstract":"<p><strong>Objective: </strong>Endocervical clear cell carcinoma (c-CCC) is a rare and HPV-independent adenocarcinoma type of cervix. Being usually resistant to conventional chemotherapy. Immunotherapy has recently been added as a preferred regimen as a second-line treatment option for programed cell death-ligand 1 (PD-L1)-positive or mismatch repair (MMR) deficient cervical carcinomas. In this study, clinicopathological features, PD-L1 expression, and MMR deficiency status of c-CCCs were investigated.</p><p><strong>Materials and methods: </strong>Sixteen c-CCC diagnosed cases were included in this study. PD-L1 expression was evaluated using two different PD-L1 clones (22C3 and SP263). MMR deficiency status of the cases was evaluated using four MMR proteins (MLH1, PMS2, MSH2, and MSH6).</p><p><strong>Results: </strong>Most of the c-CCC cases were presented as FIGO Stage I (68.75%). PD-L1 expression in either tumoral or tumor-infiltrating immune cells (TILs) was present in 62.5% (10/16) and 69% (11/16) of the 22C3 and SP263 clones, respectively. Most of the cases with high TIL density were also positive for PD-L1. The PD-L1 expression rate was less than 50% in most of the cases and 12.5% of the cases shared extensive PD-L1 staining. Overall, MMR deficiency was observed in 31.25% of the cases. Most of the MMR-deficient cases (80%) were PD-L1 positive.</p><p><strong>Conclusion: </strong>Although our study cohort is limited, we have shown that PD-L1 expression and MMR deficiency can be found in c-CCCs in variable degrees. These findings suggest that accompanying TIL density and MMR deficiency could be used as candidates for predicting PD-L1 positivity for c-CCCs. However, to indicate the clinical importance of these findings, objective treatment outcomes of cases treated with immunotherapy should be seen.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":"20 3","pages":"164-173"},"PeriodicalIF":1.1,"publicationDate":"2023-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/41/53/TJOG-20-164.PMC10478723.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10522420","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":"Cesarean section rates in Turkey 2018-2023: Overview of national data by using Robson ten group classification system.","authors":"Mustafa Mahir Ulgu,&nbsp;Suayip Birinci,&nbsp;Tuğba Altun Ensari,&nbsp;Melih Gaffar Gözükara","doi":"10.4274/tjod.galenos.2023.68235","DOIUrl":"https://doi.org/10.4274/tjod.galenos.2023.68235","url":null,"abstract":"<p><strong>Objective: </strong>Cesarean section (CS) rates continue to rise globally because of various factors. Medically unnecessary cesarean operations have no benefit to the mother or child's health. Since the World Health Organization (WHO) has determined that the acceptable CS rate should not be more than 10-15%, it also stated the use of a classification system to compare different patient groups and facilities. Turkey has the highest CS rates globally and has been rising over the years. This study aims to assess CS rates between 2018 and 2023 using National Health Data and to analyze them according to the Robson classification system and WHO reference values to discuss possible measures against increasing rates.</p><p><strong>Materials and methods: </strong>In this study, we assessed the rates of CSs between 2018 and 2023; the CS rate including all 5-years and analysis of CS rates for each Robson group as advocated by WHO. Also, another assessment was done of the facilities where the CSs were applied (Public, private, or university hospitals).</p><p><strong>Results: </strong>The total number of births recorded between 2018 and2023 was 6.161.976. The overall CS rate was 57.55%. The number of total CS operations was 3.546.049. The primary CS rate was 28.83% (N:1.776.503). Significant differences were observed between the public and private centers for each Robson group.</p><p><strong>Conclusion: </strong>The CS rates of Groups 1-4 are obviously higher than expected. The CSs of these groups cumulatively affect the rates of other groups. Nulliparous women have CSs mostly in private hospitals. There is a need for improvements in the health system in this regard for better maternal and child health.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":"20 3","pages":"191-198"},"PeriodicalIF":1.1,"publicationDate":"2023-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cb/41/TJOG-20-191.PMC10478731.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10540705","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":"Gestational trophoblastic neoplasia of intermediate trophoblasts: Epithelioid trophoblastic tumor and placental site trophoblastic tumor, a study of morphologic, immunohistochemical, and next generation sequencing.","authors":"Fatma Öz Atalay,&nbsp;Fatma Gündoğdu,&nbsp;Gözde Elif Taşar Kapaklı,&nbsp;Ali Can Güneş,&nbsp;Yeşim Gaye Güler,&nbsp;Alp Usubütün","doi":"10.4274/tjod.galenos.2023.73549","DOIUrl":"https://doi.org/10.4274/tjod.galenos.2023.73549","url":null,"abstract":"<p><strong>Objective: </strong>Gestational trophoblastic tumors are very rare neoplasms. We determined the distinctive morphological, immunohistochemical, and clinical features of placental site trophoblastic tumors (PSTT) and epithelioid trophoblastic tumors (ETT) in our cohort.</p><p><strong>Materials and methods: </strong>Nine cases of PSTT and four cases of ETT were retrieved from the archives. Histomorphologic, immunohistochemical, and clinical features were noted. A molecular study was performed on one PSTT and one ETT case using next-generation sequencing.</p><p><strong>Results: </strong>While the nodular pattern, geographic necrosis, and extracellular eosinophilic globules were peculiar to ETTs, vessel wall affinity, marked pleomorphism, intranuclear pseudoinclusion, spindle tumor cell, and vacuolar degeneration were more specific for PSTTs in our series. An immunohistochemical panel of p63, hPL, and CD146 were helpful for the exact typing of the tumor. p63 positivity supports the ETT and diffuse staining of hPL and CD146 supports the PSTT diagnosis. Three of the patients with metastatic disease (lung and brain metastasis) except one have a high mitotic count (12 and 8) and a long interval between (8 and 10 years) antecedent pregnancy and diagnosis. While KIT and TP53 mutations were observed only in PSTT, amino acid changes in KDR, APC, and SMAD4 genes were detected both in the ETT and PSTT cases.</p><p><strong>Conclusion: </strong>In the prediction of metastasis, the long intervals between antecedent pregnancy and diagnosis, deep myometrial invasion, mitotic count, and Ki67 proliferation index were involved rather than other histomorphological parameters, but none of the parameters is an absolute predictor of the metastasis.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":"20 2","pages":"105-112"},"PeriodicalIF":1.1,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d8/57/TJOG-20-105.PMC10236228.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9570825","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":"Barbed versus conventional suture in laparoscopic myomectomy: A randomized controlled study.","authors":"Sezin Ateş Tatar,&nbsp;Burak Karadağ,&nbsp;Ceyda Karadağ,&nbsp;Gökçe Duranoğlu Turgut,&nbsp;Selim Karataş,&nbsp;Barış Mülayim","doi":"10.4274/tjod.galenos.2023.21208","DOIUrl":"https://doi.org/10.4274/tjod.galenos.2023.21208","url":null,"abstract":"<p><strong>Objective: </strong>To compare the surgical and clinical results of traditional absorbable polyglactin 910 and barbed sutures in laparoscopic myomectomy.</p><p><strong>Materials and methods: </strong>This single-center randomized study included 75 women who underwent laparoscopic myomectomy. The uterine wall defects were closed with a continuous conventional absorbable polyglactin 910 suture (Vicryl; Ethicon, Somerville, NJ, USA) in 41 women and with a unidirectional barbed suture (V-Loc 180; Covidien, Mansfield, MA, USA) in 34 women.</p><p><strong>Results: </strong>The time required to suture the uterine wall defect was lower in the V-Loc group than in the Vicryl group (p=0.007). However, no significant difference was observed in the operative time between the two study groups. The intraoperative blood loss and need for postoperative blood transfusion were significantly lower in the barbed group than in the Vicryl group (p=0.018 and p=0.048, respectively).</p><p><strong>Conclusion: </strong>In laparoscopic myomectomy cases, the unidirectional barbed suture is more effective than the conventional absorbable suture. Barbed sutures facilitate the suturing process and reduce the time required to suture the uterine wall defect, blood loss, and the need for postoperative blood transfusion.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":"20 2","pages":"126-130"},"PeriodicalIF":1.1,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/fb/72/TJOG-20-126.PMC10236233.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9570826","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":"The role of different Doppler parameters in predicting adverse neonatal outcomes in fetuses with late-onset fetal growth restriction.","authors":"Cahit Yılmaz,&nbsp;Rauf Melekoğlu,&nbsp;Halis Özdemir,&nbsp;Şeyma Yaşar","doi":"10.4274/tjod.galenos.2023.87143","DOIUrl":"https://doi.org/10.4274/tjod.galenos.2023.87143","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study is to clarify the role of different Doppler parameters such as umbilicocerebral ratio (UCR), cerebroplacentouterine ratio (CPUR), aortic isthmus, renal artery, and umbilical vein flow Doppler in predicting adverse neonatal outcomes in fetuses with late -onset fetal growth restriction.</p><p><strong>Materials and methods: </strong>The study included all patients diagnosed with fetal growth restriction at 32-39 weeks' gestation between 01/02/2020 and 01/02/2022 and treated at the Department of Obstetrics and Gynecology, Inonu University School of Medicine.</p><p><strong>Results: </strong>Patients included in the study had a median gestational week at delivery of 37 (minimum 33+0-maximum 39+0), median CPR of 1.42 (minimum-maximum 0.43-3.57), and median UCR of 0.7 (minimum-maximum 0.28-2.3). Receiver operating characteristic analysis was performed to determine the performance of the measured obstetric Doppler parameters in predicting the development of adverse neonatal outcomes. Umbilical venous blood flow showed the best performance in predicting adverse neonatal outcomes [area under the curve 0.952, 95% confidence interval (CI) 0.902-0.981, p<0.001]. Multivariate logistic regression analysis showed that fetuses with abnormal CPUR had a 4.5-fold (95% CI 0.084-0.583, p=0.02) increased risk of adverse neonatal outcome, whereas fetuses with abnormal umbilical venous flow had a 1.07-fold (95% CI 0.903-0.968, p<0.001) increased risk of adverse neonatal outcome.</p><p><strong>Conclusion: </strong>The results of this study demonstrate that the use of UCR, CPUR, umbilical venous flow, and aortic isthmus PI Doppler parameters along with umbilical artery PI and CPR are effective in predicting adverse neonatal outcomes in fetuses with late -onset fetal growth restriction.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":"20 2","pages":"86-96"},"PeriodicalIF":1.1,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/23/2b/TJOG-20-86.PMC10236225.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9945187","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":"Efficacy and safety of rectal misoprostol versus intravenous oxytocin on reducing blood loss in cesarean section: A PRISMA-compliant systematic review and meta-analysis of randomized clinical trials.","authors":"Ebraheem Albazee,&nbsp;Ahmed Soliman,&nbsp;Khaled Albakri,&nbsp;Mohamed Elbanna,&nbsp;Nada Alaa Moussa,&nbsp;Hazem Metwally Faragalla","doi":"10.4274/tjod.galenos.2023.15098","DOIUrl":"https://doi.org/10.4274/tjod.galenos.2023.15098","url":null,"abstract":"<p><p>Blood loss is an inevitable complication and a major contributor to maternal morbidity and mortality at cesarean deliveries. We detected a potential preference regarding the efficacy and safety of rectal misoprostol over oxytocin as a uterotonic agent. We searched PubMed, Scopus, Web of Science, Cochrane, and other databases for the relevant trials from inception to September 2022. We included randomized clinical trials (RCTs) that compared rectal misoprostol versus intravenous oxytocin to control bleeding in women undergoing cesarean delivery. Our primary outcomes were the intra- and postoperative blood loss, and hemoglobin drop after delivery. Secondary outcomes included the need for blood transfusion, need for additional uterotonics, difference in operative time, as well as safety outcomes such as the incidence of shivering, pyrexia, nausea, and vomiting. Our search strategy revealed 1007 unique records, of them we retrieved full texts of 19 articles to check their adherence to our eligibility criteria. Seven RCTs with 1,090 participants were included. We found a significant reduction in postoperative blood loss [MD: -27.9; 95% confidence interval (CI): (-53.85, -2.10); p=0.03], and Hb drop after delivery [MD: -11; 95% CI: (-0.19, -0.03); p=0.01]. There is no significant difference regarding intraoperative blood loss, operative time, need for blood transfusion, or need for additional uterotonics. We could not find a significant difference between the two groups regarding safety outcomes, except for a higher shivering incidence in the misoprostol group [RR: 0.33; 95% CI; (0.16, 0.70); p=0.004]. We found a significant reduction in postoperative blood loss with a potentially favorable safety profile in women who administrated rectal misoprostol compared with oxytocin administration. Our findings recommend and prefer rectal misoprostol as a cheaper and effective uterotonic agent over oxytocin, which is expensive and requires an adequate cold chain for transportation and storage.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":"20 2","pages":"142-153"},"PeriodicalIF":1.1,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cd/9c/TJOG-20-142.PMC10236227.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9573988","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}