Turkish Journal of Obstetrics and Gynecology最新文献

{"title":"A preliminary investigation of gene expression and levels of FSH, IL-10, and TNF-α and histological staining in natural aging mice.","authors":"Yulice Soraya Nur Intan, Soetrisno Soetrisno, Abdurahman Laqif, Dono Indarto","doi":"10.4274/tjod.galenos.2026.94515","DOIUrl":"10.4274/tjod.galenos.2026.94515","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to compare estrous cycle patterns, serum hormone and cytokine levels, gene expression, and ovarian morphology between healthy and aging mice, to evaluate their potential as models of reproductive aging.</p><p><strong>Materials and methods: </strong>Female BALB/c mice older than 9 months were used as the aged group and were compared with healthy controls (6-8 weeks old). Estrous phases were monitored for six days using vaginal cytology. Ovarian morphology was analyzed using hematoxylin and eosin staining and immunohistochemistry. Serum levels of follicle-stimulating hormone (FSH), interleukin (IL)-10, and tumor necrosis factor-alpha (TNF-α) were measured by enzyme-linked immunosorbent assay. Gene expression of IL-10 and TNF-α was assessed by reverse transcription polymerase chain reaction.</p><p><strong>Results: </strong>Healthy mice cycled through all estrous phases, whereas aging mice were predominantly arrested in diestrus and exhibited increased immune-cell infiltration and inflammatory changes. Ovarian histology showed enlargement, fibrosis, and the presence of non-functional structures. Follicle counts were reduced in aging mice, though the reduction was not statistically significant. Serum FSH (1.37±0.20 vs. 1.10±0.03 pg/mL) and TNF-α (37.05±17.31 vs. 21.57±4.62 pg/mL) were significantly elevated, whereas IL-10 was significantly decreased (4.53±0.32 vs. 6.23±0.99 pg/mL) (p<0.05). TNF-α mRNA levels increased and IL-10 mRNA levels decreased; however, these changes were not statistically significant.</p><p><strong>Conclusion: </strong>Aging BALB/c mice exhibit disrupted estrous cycles, ovarian fibrosis, increased FSH and TNF-α, and reduced IL-10, changes that resemble those associated with menopause. These findings support the use of aging BALB/c mice as a model for reproductive aging and therapeutic studies.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":" ","pages":"71-80"},"PeriodicalIF":1.5,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12963788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146207947","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 relationship between oocyte maturation and follicle size: A comparative analysis of 2D and 3D ultrasound.","authors":"Özge Karaosmanoğlu, Ayşen Yücetürk, Nuri Peker, Ömür Albayrak, Burak Elmas, İlke Özer Aslan, Bülent Tıraş","doi":"10.4274/tjod.galenos.2026.05763","DOIUrl":"10.4274/tjod.galenos.2026.05763","url":null,"abstract":"<p><strong>Objective: </strong>To compare the ability of three-dimensional (3D) and conventional two-dimensional (2D) ultrasound to predict oocyte maturity during in vitro fertilization cycles, and to evaluate their contribution to trigger timing and to the determination of optimal cut-off values for maximizing metaphase II (MII) oocyte yield using automated volume-calculation software.</p><p><strong>Materials and methods: </strong>Forty-three infertile women who had ≤5 follicles, were younger than 40 years, had a body mass index <30, and had no previous oocyte maturation problems were included in this retrospective study. Follicle diameter was measured using 2D ultrasound, while follicle volume was measured using 3D ultrasound with SonoAVC software. The obtained values were compared with those from MII oocytes, and receiver operating characteristic (ROC) analysis and logistic regression were performed.</p><p><strong>Results: </strong>A total of 203 oocytes were analyzed; 70% of them were in the MII stage. In the ROC analysis, the optimal cut-off for 2D measurement was determined to be 17.05 mm [area under curve (AUC)=0.737], and for 3D measurement, it was 1.83 cm³ (AUC=0.709). 2D measurements showed specificity, while 3D measurements showed sensitivity. In logistic regression analysis, both 2D diameter and 3D volume were found to be independent predictors of MII oocyte development.</p><p><strong>Conclusion: </strong>Our findings suggest that 3D ultrasound measurements may provide greater sensitivity for predicting oocyte maturity. However, falsepositive results may occur in the presence of multiple or nested follicles, and observer dependence cannot be completely eliminated. Therefore, optimization and large-scale validation studies are needed to improve the accuracy of the method.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":"23 1","pages":"64-70"},"PeriodicalIF":1.5,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12963798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147356930","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":"Inverted microscopy as a high performance tool for pre denudation evaluation of oocyte nuclear maturity.","authors":"Nuri Peker, Ayşen Yücetürk, Özge Karaosmanoğlu, Esra Tığlı, Burak Elmas, İlke Özer Aslan, Sadık Doğan, Bülent Tıraş","doi":"10.4274/tjod.galenos.2026.98440","DOIUrl":"10.4274/tjod.galenos.2026.98440","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to show that inverted microscope is a reliable and highly accurate method for evaluating oocyte nuclear maturation before cumulus-oocyte complex (COC) denudation.</p><p><strong>Materials and methods: </strong>This single-center prospective observational study was conducted between 15 October and 15 November 2025. Non-dominant follicles with a diameter <10 mm were retrieved and evaluated under an inverted microscope to predict oocyte nuclear maturation prior to COC denudation. A total of 974 oocytes were retrieved from 59 patients; 250 COCs obtained from follicles <10 mm were analyzed. COCs were divided into three groups: (i) COCs with germinal vesicle (GV) oocytes, (ii) COCs with non-GV oocytes, and (iii) unclassified COCs. Two hours later, COCs were denuded, and the diagnostic accuracy of the inverted microscope was assessed.</p><p><strong>Results: </strong>Ninety-seven COCs were classified as GV, 127 as non-GV, and 26 as unidentified. After denudation, 94 of 97 COCs were confirmed as GV oocytes, and 124 of 127 COCs were confirmed as non-GV oocytes. The accuracy of the inverted microscope in identifying nuclear maturation for GV and non-GV oocytes was 96.91% and 97.64%, respectively. No statistically significant difference in diagnostic accuracy was observed between embryologists.</p><p><strong>Conclusion: </strong>Currently, no method can definitively determine oocyte nuclear maturation before COC denudation. This method allows the prediction of oocyte nuclear maturation before denudation with high accuracy, potentially improving in vitro maturation outcomes by preserving cumulus-oocyte communication.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":"23 1","pages":"81-87"},"PeriodicalIF":1.5,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12963785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147356975","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":"Inflammatory indices, machine learning and artificial intelligence in tubal ectopic pregnancy management.","authors":"Uğurcan Zorlu, Senem Arda Düz, Gül Kurtaran, Mohammad İbrahim Halilzade, Burak Elmas","doi":"10.4274/tjod.galenos.2026.37165","DOIUrl":"10.4274/tjod.galenos.2026.37165","url":null,"abstract":"<p><strong>Objective: </strong>To assess the predictive value of hematologic and biochemical inflammatory indices for methotrexate (MTX) treatment outcomes in tubal ectopic pregnancy (TEP) and to develop machine learning (ML) models for individualized risk stratification.</p><p><strong>Materials and methods: </strong>This retrospective cohort included 293 hemodynamically stable TEP patients who were treated with a single dose of MTX between January 2019 and December 2023. Demographic, clinical, ultrasonographic, and laboratory data were analyzed. Inflammatory indices-including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio, systemic immune-inflammation index, systemic inflammation response index (SIRI), aggregate index of systemic inflammation (AISI), and fibrinogen-to-albumin ratio (FAR)-were calculated. Outcomes were categorized as single-dose MTX success, requirement for additional MTX, or surgery. Predictive accuracy of five supervised ML algorithms was evaluated using receiver operating characteristic analysis.</p><p><strong>Results: </strong>Single-dose MTX was successful in 65.5% of patients; 18.4% required an additional dose, and 16.0% underwent surgery. AISI had the highest predictive accuracy for surgery [area under the curve (AUC)=0.929], followed by SIRI (AUC=0.899) and FAR (AUC=0.847). NLR best predicted the need for additional MTX (AUC=0.675). Naïve Bayes achieved the highest performance for surgical prediction (accuracy=98.3%, AUC=0.998), while random forest and gradient boosting were most effective in predicting the need for additional MTX (accuracy=83.1%, AUC=0.884-0.896). Feature importance analyses consistently ranked AISI, SIRI, and FAR as top predictors.</p><p><strong>Conclusion: </strong>AISI, SIRI, and FAR are strong predictors of MTX failure and surgical intervention in TEP. Combining these biomarkers with ML models markedly improves predictive performance and supports a personalized approach to TEP management. Multicenter prospective validation is needed before clinical application.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":" ","pages":"47-55"},"PeriodicalIF":1.5,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12963803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146259282","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":"Evaluating midpregnancy Gas6 levels as predictive value for gestational diabetes and birth outcomes.","authors":"Yeşim Cıvıl Ürkmez, Neşet Gümüşburun, Sebati Sinan Ürkmez, Samettin Çelik, Kübra Şahin","doi":"10.4274/tjod.galenos.2025.95515","DOIUrl":"10.4274/tjod.galenos.2025.95515","url":null,"abstract":"<p><strong>Objective: </strong>This study investigated the relationship between maternal serum growth arrest-specific 6 (Gas6) levels measured in the second trimester of pregnancy and the development of gestational diabetes mellitus (GDM); it also evaluated the possible links between this biomarker and maternal and neonatal outcomes.</p><p><strong>Materials and methods: </strong>A total of 173 pregnant women were included in this prospective study (89 diagnosed with GDM, 84 healthy controls). Gas6 levels were measured using the ELISA method from blood samples taken during routine screening in the second trimester. The relationships between Gas6 levels and body mass index (BMI), oral glucose tolerance test results, and neonatal data were statistically analysed.</p><p><strong>Results: </strong>Gas6 levels were significantly higher in the GDM group (p<0.001). A strong positive correlation was found between Gas6 and maternal BMI (r=0.774), and a moderate positive correlation between Gas6 and oral glucose tolerance test 1-hour glucose level (r=0.577). Additionally, high Gas6 levels were found to be statistically significant in association with increased birth weight and intensive care requirements.</p><p><strong>Conclusion: </strong>Increased Gas6 levels in the second trimester may be a potential biomarker for early prediction of GDM risk and perinatal complications.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":" ","pages":"1-7"},"PeriodicalIF":1.5,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12963787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145373026","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":"Preinvasive lesion creation prevalence of other HPV types other than HPV type 16-18.","authors":"Tuğçe Baykara, İbrahim Serdar Serin, Mehmet Dolanbay, Bülent Özçelik, Enes Karaman","doi":"10.4274/tjod.galenos.2025.93384","DOIUrl":"10.4274/tjod.galenos.2025.93384","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to investigate the prevalence of preinvasive lesions in cytology cases of high-risk human papillomavirus (HR-HPV) types other than types 16-18.</p><p><strong>Materials and methods: </strong>A retrospective file scan of 342 patients with normal cytology was performed between January 2016 and April 2019 in our hospital's obstetrics and gynecology outpatient clinic. In the first group, with the exception of HR-HPV type positivity, normal cytology and preinvasive lesions were present as a result of biopsy. In the second group, women were HPV type 16-18 positive, had normal cervical cytology, and were found to have preinvasive lesions as a result of biopsy. At the end of the study, we calculated the percentages of HPV types seen in preinvasive lesions.</p><p><strong>Results: </strong>Three hundred and forty-two patients with normal cytology were included in our study. The average age of women was 41.09±10.61. In 58 (16.9%) patients with 342 HR-HPV type positivity, preinvasive lesions were detected as a result of biopsy. High-grade squamous intraepithelial lesion-low-grade squamous intraepithelial lesion was reported in 54 (15.7%) cases, squamous cell carcinoma in 3 (0.92%) cases, and mixed surface epithelial carcinoma (endometrioid adenocarcinoma 95%, clear cell carcinoma 5%) in 1 (0.3%) case. The age variable was not significant in biopsy subgroups (p>0.05).</p><p><strong>Conclusion: </strong>Among the biopsy results with preinvasive lesions, approximately half were positive for HPV type 16 or 18, and these cases were identified accordingly. Colposcopy and biopsy should be recommended in suspicious lesions, even if cytology is normal, since other HR-HPV types may also have certain rates of preinvasive and invasive lesions.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":" ","pages":"34-39"},"PeriodicalIF":1.5,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12963799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146019978","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 letrozole use in reproductive medicine: Beyond aromatase inhibition - a comprehensive review.","authors":"Gerçek Aydın, Şafak Hatırnaz, Ebru Saynur Hatırnaz, Mehmet Bilge Çetinkaya, Muhterem Akdeniz, Nur Dokuzeylül Güngör, Oğuz Güler, Merdan Ali Merdanoğlu, Asiye Uzun, Semra Eroğlu, Önder Tosun, Ali Bahadırlı, Engin Yurtçu, Betül Keyif, Huri Güvey, Naziye Gürkan, Pervin Karlı, Zehra Yılmaz, Giorgio Maria Baldini, Aziz İhsan Tavuz, Radmila Sparic, Nikoleta Tabakova, Andrea Tinelli, Mingju Cao, Seang Lin Ta, Oğuz Hatırnaz, Michael Dahan","doi":"10.4274/tjod.galenos.2026.02391","DOIUrl":"10.4274/tjod.galenos.2026.02391","url":null,"abstract":"<p><p>Letrozole and other aromatase inhibitors are increasingly recognized as first-line ovulation induction (OI) medications, offering an efficient and physiologic approach to ovarian stimulation that enhances outcomes in reproductive medicine. By selectively inhibiting aromatase and maintaining lower peripheral estrogen levels, letrozole supports mono- or bi-follicular development while reducing the risk of supraphysiologic estradiol exposure seen with traditional gonadotropin regimens. These pharmacological characteristics have contributed to its expanding use not only in OI but also in various assisted reproductive technologies. To evaluate the clinical benefits, effectiveness, and safety of using letrozole in in vitro fertilization (IVF), in vitro maturation (IVM), and OI, with particular attention to reproductive outcomes, ovarian response, endometrial effects, cycle characteristics, and treatment-related adverse events. A comprehensive systematic search covering the period from December 2000 to November 2025 was conducted across major electronic databases including PubMed, Embase, the Cochrane Library, and Google Scholar. The search strategy incorporated predefined keywords related to letrozole, aromatase inhibition, OI, IVF, and IVM. Studies involving randomized controlled trials, observational cohorts, and meta-analyses were included, while non-clinical and non-reproductive data were excluded. Relevant outcomes were extracted and synthesized qualitatively. Letrozole demonstrates broad clinical utility in reproductive medicine, spanning assisted reproductive techniques, ovarian stimulation strategies, and the management of ovarian hyperstimulation syndrome risk, ectopic pregnancy, and endometriosis-related infertility. Its targeted estrogen suppression, cost-effectiveness, and favorable safety profile make it a valuable component of individualized treatment protocols. Nonetheless, further high-quality research is required to refine optimal dosing strategies, identify ideal patient populations, and clarify long-term reproductive and obstetric safety.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":" ","pages":"101-114"},"PeriodicalIF":1.5,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12963804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146208008","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":"Differential expression of c-kit, E-cadherin, and beta-catenin in endometriosis and normal endometrial tissue.","authors":"Esra Ayhan Atasayar, Fatih Şendağ, Gürdeniz Serin, Ali Akdemir","doi":"10.4274/tjod.galenos.2026.53358","DOIUrl":"10.4274/tjod.galenos.2026.53358","url":null,"abstract":"<p><strong>Objective: </strong>C-kit, E-cadherin and beta-catenin adhesion molecules and proto-oncogenes are thought to be associated with molecular mechanisms related to the invasion, implantation and persistence of ectopic endometrial cells. Comparing the expression levels of these molecules in endometriomas, other types of endometriosis, and normal endometrial tissue may provide further insight into the mechanisms driving endometriosis development. The present study sought to examine the molecular pathophysiological roles of these molecules by determining their expression profiles in different types of endometriosis and in the healthy endometrium.</p><p><strong>Materials and methods: </strong>Retrospective data from 180 cases were analyzed, comprising 60 endometriomas, 60 cases of other types of endometriosis (superficial and deep), and 60 normal proliferative endometrial tissue samples. Immunohistochemical staining for c-kit, E-cadherin, and beta-catenin was performed. The expression levels of E-cadherin and beta-catenin were quantified using the H-score method.</p><p><strong>Results: </strong>C-kit positivity was found in 9% of endometriomas and 10% of other endometriosis tissues, but was absent in normal endometrium. Beta-catenin H-scores were significantly lower in endometriosis tissues compared with normal endometrial tissues (p<0.001). E-cadherin levels showed no significant difference between the groups. A post-hoc power analysis confirmed that the study was adequately powered to detect group differences in E-cadherin, indicating that the non-significant finding likely reflects a true absence of a difference.</p><p><strong>Conclusion: </strong>Increased c-kit expression, along with reduced beta-catenin expression in endometriosis samples, suggests that these molecules contribute to endometriosis pathogenesis. However, because no significant difference was found in E-cadherin expression, a definitive conclusion cannot be made regarding the involvement of E-cadherin in endometriosis development.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":" ","pages":"88-94"},"PeriodicalIF":1.5,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12963786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147327703","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 neonatal outcomes in placenta accreta spectrum: Influence of antenatal diagnosis and surgical strategy.","authors":"Lumayat Orujova, Rauf Melekoğlu, Ercan Yılmaz, Halis Özdemir, Şeyma Yaşar","doi":"10.4274/tjod.galenos.2025.28235","DOIUrl":"10.4274/tjod.galenos.2025.28235","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the influence of antenatal diagnosis and surgical management strategies on maternal and neonatal outcomes in placenta accreta spectrum (PAS) disorders, emphasizing risk factors, timing of delivery, and operative approaches.</p><p><strong>Materials and methods: </strong>A retrospective cohort analysis was conducted on 210 women with histopathologically confirmed PAS managed at İnönü University Faculty of Medicine between January 2014 and March 2024. Demographic data, antenatal findings, delivery type, and surgical details were compared between elective and emergency procedures, as well as between uterus-preserving surgery and peripartum hysterectomy. Uterus-preserving surgery refers to conservative techniques that aim to avoid peripartum hysterectomy while controlling hemorrhage.</p><p><strong>Results: </strong>Of the total cohort, 66.7% underwent elective surgery, whereas 33.3% required emergency intervention. Emergency deliveries occurred earlier (mean 32.1 vs. 36.0 weeks, p<0.001) and were associated with higher blood loss (799 vs. 511 mL, p<0.001), increased perinatal mortality (20% vs. 1.4%, p<0.001), and greater neonatal morbidity, mainly respiratory distress syndrome (47% vs. 14%, p<0.001). Hysterectomy was required in 45.2% of patients, primarily with placenta percreta (60% vs. 23.5%, p<0.001). Anterior placental location (89.5%) strongly correlated with complete invasion (77.7%) and bladder involvement (27.7%, p=0.038). Bladder injuries were more common in elective cases, while ureteral injuries occurred more often in emergencies (p=0.024). Preoperative hematocrit independently predicted hysterectomy risk (odds ratio: 1.092, p=0.034).</p><p><strong>Conclusion: </strong>Antenatal diagnosis and well-planned elective management significantly improve maternal and neonatal outcomes in PAS. Individualized surgical planning based on invasion depth and maternal condition remains essential to reduce morbidity and mortality.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":" ","pages":"8-33"},"PeriodicalIF":1.5,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12963797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146019953","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":"Inverted microscopy-based assessment reveals major maturation gap between denuded and non-denuded GV oocytes: A novel r-IVM approach.","authors":"Nuri Peker, Ayşen Yücetürk, Özge Karaosmanoğlu, Esra Tığlı, Burak Elmas, İlke Özer Aslan, Burcu Aksu Türan, Bülent Tıraş","doi":"10.4274/tjod.galenos.2026.26098","DOIUrl":"10.4274/tjod.galenos.2026.26098","url":null,"abstract":"<p><strong>Objective: </strong>To compare the maturation rate and developmental potential of immature oocytes subjected to and spared from cumulus-oocyte complex (COC) denudation.</p><p><strong>Materials and methods: </strong>This single-center prospective observational study was conducted between 15 November-15-December 2025. Germinal vesicle (GV) oocytes were allocated to two groups: Group 1 included oocytesobtained from follicles >10 mm and identified as GV following denudation, whereas group 2 included immature oocytes retrieved from non-dominant follicles with diameter <10 mm, and assessed under an inverted microscope immediately after oocyte retrieval and placed into culture medium without being denuded. All immature oocytes were cultured separately in Continuous Single Culture-NX Complete medium, supplemented with gentamicin and human serum albumin, for 24 hours. COCs in group 2 were subsequently denuded and evaluated for nuclear maturation. Oocytes reaching metaphase II (MII) underwent intracytoplasmic sperm injection. The primary outcome was the MII maturation rate; secondary outcomes included 2PN formation rate and cleavage-stage embryo rate.</p><p><strong>Results: </strong>A total of 885 oocytes were retrieved from 52 patients. Group 1 included 84 denuded GV oocytes, and group 2 comprised 141 non-denuded COCs. After 24 hours of culture, maturation rates in groups 1 and 2 were 3/84 (2.37%) and 52/141 (36.9%), respectively. In group 1, only one oocyte was fertilized, and the resulting embryo arrested on day 3. In group 2, the fertilization and day-3 embryo rates were 23/48 (47.9%) and 14/23 (73.4%), respectively.</p><p><strong>Conclusion: </strong>Non-denuded immature oocytes demonstrated significantly higher maturation, fertilization, and embryo development rates compared with denuded oocytes.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":"23 1","pages":"95-100"},"PeriodicalIF":1.5,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12963801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147356995","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}