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Öğe Effect of previous cesarean sections on second-trimester uterine artery Doppler(Wiley, 2020) Isikalan, Mehmet M.; Yeniceri, Hacce; Toprak, Erzat; Guleroglu, Filiz Y.; Acar, AliAim In this study, we investigated the effects of previous cesarean sections on uterine artery Doppler indices. Methods This prospective cohort study included 153 healthy pregnant women between 18 and 24 weeks of gestation. Seventy-three pregnant women without previous cesarean sections (control group) and 80 pregnant women with previous cesarean sections (study group) were compared in terms of uterine artery Doppler indices. Results The mean uterine artery pulsatility index (PI) MoM value was 1.18 +/- 0.40 in the study group and 1.07 +/- 0.35 in the control group (P= 0.046). The number of patients with uterine artery PI values above 95 percentile was 18 (22.5%) in the study group and 5(6.8%) in the control group (P= 0.007). The mean gestational age at birth was significantly lower in the study group (38.2 +/- 1.3 vs. 39 +/- 1.0,P < 0.001). There was no significant difference between the mean PI, resistance index (RI) and systolic/diastolic (S/D) ratio values of the uterine artery (P= 0.16, 0.11, 0.08, respectively). When the comparison was made with the number of previous cesarean sections, all three index values of the patients who had had more than two cesarean sections were found to be significantly higher. Conclusion The Doppler flow indices of the uterine artery significantly increased in patients with more than two previous cesarean sections. When evaluating uterine artery Doppler indices in pregnant women with a history of previous cesarean sections, these factors should be considered.Öğe The haemodynamic effects of umbilical cord milking in term infants: a randomised controlled trial(Wolters Kluwer Medknow Publications, 2023) Tekin, Mehmet; Gokdemir, Mahmut; Toprak, Erzat; Silahli, Musa; Energin, Hasan; Gokmen, ZeynelIntroduction: Umbilical cord milking (UCM) is a method that allows for postnatal placental transfusion. The benefits of UCM have been demonstrated in some studies, but knowledge about its haemodynamic effects in term infants is limited. The aim of this study was to evaluate the haemodynamic effects of UCM in term infants. Methods: In this prospective, randomised controlled study, 149 healthy term infants with a birth week of >= 37 weeks were randomly assigned to either the UCM or immediate cord clamping (ICC) group. Blinded echocardiographic evaluations were performed in all the neonates in the first 2-6 h. Results: Superior vena cava (SVC) flow measurements were higher in the UCM group compared to the ICC group (132.47 +/- 37.0 vs. 126.62 +/- 34.3 mL/kg/min), but this difference was not statistically significant. Left atrial diameter (12.23 +/- 1.99 vs. 11.43 +/- 1.78 mm) and left atrium-to-aorta diastolic diameter ratio (1.62 +/- 0.24 vs. 1.51 +/- 0.22) were significantly higher in the UCM group. There were no significant differences in other echocardiographic parameters between the two groups. Conclusion: We found no significant difference in the SVC flow measurements in term infants who underwent UCM versus those who underwent ICC. This lack of significant difference in SVC flow may be explained by the mature cerebral autoregulation mechanism in term neonates.Öğe Prenatal Diagnosis and Intrapartum Management of Congenital Ranula(Georg Thieme Verlag Kg, 2018) Ercan, Fedi; Sarikaya, Muslum; Toprak, Erzat; Findik, Sidika; Arbag, Hamdi; Acar, AliA foetal sublingual cystic lesion was diagnosed by routine prenatal ultrasonography at 27 weeks of gestation. Foetal growth and amniotic fluid volume were normal. An ex utero intrapartum treatment (EXIT) procedure was performed, and the cyst was aspirated to allow breathing during planned Caesarean section. The cyst was totally excised when the newborn was 60 days old, and histopathological examination revealed a mucous cyst of the mouth floor.Öğe Ultrasonographic Imaging of the Fetal Duodenal Tract(Wiley, 2022) Toprak, Erzat; Isikalan, Mehmet MuratObjectives To investigate whether fetal duodenal tract sections can be visualized in the prenatal ultrasonographic examination. Methods This study was designed in cross-section. Healthy singleton pregnant women who applied to the perinatology outpatient clinic for second-level ultrasound scanning between September 2020 and February 2021 were included in the study. Demographic information of the participants was obtained and an ultrasound scan was performed. The fetal duodenal tract was evaluated in three sections, including the pylorus. The fetal duodenal tract was differentiated from adjacent organs by its anatomical location, hyperechoic nature, and presence of fluid in the lumen. Results A total of 278 eligible participants between 18 and 22 weeks of gestation were evaluated. While the fetal pylorus was closed in 76.6% of the participants, it was open in 23.4%. Duodenum pars superior, pars descendens, and pars inferior imaging rates were 99.3%, 98.2%, and 95.7%, respectively. It was possible to distinguish these parts from neighboring organs by 99.6%, 100%, and 100%, respectively. While the first, second, and third parts of the duodenum were observed as solid in 42.0%, 58.2%, and 52.2%, respectively, 57.9%, 41.7%, and 47.7% had fluid in the lumen. Conclusion The fetal duodenal tract can be viewed with prenatal ultrasonography in pregnant women who are not in a dorsoanterior position. This may make an additional contribution to the diagnosis of duodenal obstructions, which is the most common cause of intestinal atresia in prenatal screening.