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    Anesthetic management for cesarean birth in pregnancy with the novel coronavirus (COVID-19)
    (Elsevier Science Inc, 2020) Yilmaz, Resul; Kilic, Fatma; Arican, Sule; Hacibeyoglu, Gulcin; Suslu, Halime; Koyuncu, Mustafa; Uzun, Sema Tuncer
    [Abstract Not Availabe]
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    Image-guided drainage management of tubo-ovarian abscess and the role of C-reactive protein measurements in monitoring treatment response: a single-center experience
    (Springer Heidelberg, 2023) Demir, Emine Turen; Energin, Hasan; Kilic, Fatma
    PurposeWe aimed to compare the results of image-guided drainage in addition to antibiotic therapy (antibiotherapy) with antibiotherapy alone in the treatment of tubo-ovarian abscesses (TOAs) and evaluate C-reactive protein (CRP) levels in predicting the success of antibiotherapy.MethodsThis was a retrospective study of 194 patients hospitalized with TOA. Patients were divided into the following two groups: those who underwent image-guided drainage in addition to parenteral antibiotherapy and those who did not undergo image-guided drainage and received antibiotherapy alone. CRP levels on the day of admission (day 0), day 4 of hospitalization (day 4), and day of discharge (last day) were recorded. The percentage of decrease in CRP levels during day 4 and the last day compared with that on day 0 was calculated.ResultsA total of 106 patients (54.6%) underwent image-guided drainage with antibiotherapy, whereas 88 patients (45.4%) did not undergo drainage and received antibiotherapy alone. At admission, the mean CRP level was 203.4 (& PLUSMN; 96.7) mg/L and was similar in both groups. The mean decrease in the CRP level on day 4 compared with that on day 0 was 48.5% and was statistically higher in the group that underwent image-guided drainage. Antibiotherapy failed in 18 patients, and a statistically significant difference was observed between treatment failure and the rate of decrease in the CRP level on day 4 compared with that on day 0. According to the receiver operating characteristic (ROC) analysis, if the CRP level measured on day 4 decreased by < 37.1% compared with that on day 0, the probability of treatment failure would increase (area under the curve = 0.755; 95% confidence interval, 0.668-0.841; sensitivity, 73.6%; specificity, 60%).ConclusionsImage-guided drainage combined with antibiotherapy in the treatment of TOA has high success rates, lower recurrence rates, and lower surgical requirement, and the mean decrease in the CRP level on day 4 can be monitored at treatment follow-up. In patients receiving antibiotherapy alone, if the CRP level on day 4 decreases by < 37.1%, the treatment protocol should be changed.
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    Severe ovarian hyperstimulation syndrome and gonadotropin-releasing hormone agonist trigger in patients with hypogonadotropic hypogonadism: A report of two cases
    (Galenos Yayincilik, 2020) Gurbuz, Ali Sami; Gode, Funda; Kilic, Fatma; Gurbuz, Zeynep Umay; Deveer, Ruya
    Ovarian Hyperstimulation syndrome (OHSS) is a rare condition in patients with hypogonadotropic hypogonadism. Two patients with hypogonadotropic hypogonadism are reported, a rare case of severe OHSS and a case of prevented OHSS via gonadotropin-releasing hormone (GnRH) agonist trigger, respectively. The first case was a 31-year-old patient. in vitro fertilization (IVF) treatment was performed three times but the patient never developed OHSS. The first patient was diagnosed as having severe OHSS on the ninth day after the fresh embryo transfer. She stayed 66 days in hospital and 50.5 litres of fluid were aspirated from her abdomen. The second case was a 26-year-old and primary infertile patient. She had never undergone IVF treatment. The GnRH agonist stimulation test was performed before IVF treatment. After the ovarian stimulation, GnRH agonist trigger was given. Thirty-two oocytes were retrieved from the ovaries and OHSS did not occur. Although severe OHSS is rare, it can develop in patients hypogonadotropic hypogonadism. If a GnRH stimulation test is performed before ovarian stimulation, OHSS can be prevented because the test allows agonist triggering instead of hCG in hypogonadotropic hypogonadism.
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    A Study of the Hepatitis B Frequency and Its Possible Adverse Outcomes on Pregnancy at a University Hospital
    (Galenos Yayincilik, 2022) Gulseren, Yasemin Derya; Kilic, Fatma; Tasbent, Fatma Esenkaya
    Objectives: Hepatitis B virus (HBV) is a major global public health problem. Maternal-fetal transmission of viral hepatitis may contribute to pregnancy-related complications. This study aimed to evaluate the frequency of HBV and its possible adverse pregnancy outcomes. Materials and Methods: The study group consisted of patients followed up in the obstetrics service. Pregnancy-related discharge codes were queried approximately 2017-2019. Hepatitis B surface antigen (HBsAg) levels in serum samples were studied by chemiluminescence enzyme immunoassay method (Architect, Abbott Laboratories, USA). The HBsAg-positive group and HBsAg-negative group data were analyzed using SPSS version 22 (SPSS Inc.; Chicago, IL, USA). Results: HBsAg was positive in 255 (2.1 %) patients. Two groups compared in terms of age and there was no significant difference (p=0.45). Two groups compared in terms of pregnancy outcomes and there was no significant difference (p=0.1). Conclusion: The study group consisted of patients with pregnancy complications and HBsAg positivity was found to be 2.1%. A lower rate was found compared to other regions. Studies to be conducted in different endemic regions of Hepatitis B in our country will illuminate the effect of hepatitis B on pregnancy better.