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Ustunyurt O.B.,Zubeyde Hanim Dogumevi | Ustunyurt E.,Bursa Sevket Yilmaz Research and Education Hospital | Korkmazer E.,Zubeyde Hanim Dogumevi | Bilge U.,Zekai Tahir Burak Womens Health Research and Education Hospital | Danisman N.,Zekai Tahir Burak Womens Health Research and Education Hospital
Journal of Obstetrics and Gynaecology | Year: 2014

To investigate the effects of antenatal betamethasone on fetal pulmonary blood flow velocity waveforms. The study comprised 28 women with singleton pregnancies at high risk for preterm delivery. They were treated with two doses of 12 mg betamethasone intramuscularly 24 h apart to enhance lung maturity. Flow velocity waveforms were recorded with Doppler ultrasound from the middle segment of pulmonary artery (PA). Compared with the pretreatment mean value, a significant decrease in the pulmonary artery pulsatility (PI) and the resistance indexes (RI) was noted at 24 h and 48 h after the administration of first dose of betamethasone (p = 0.022 and p = 0.018 for PI and p = 0.001 and p = 0.004 for RI, respectively). After 7 days, the pulmonary artery velocity waveforms returned to the types of waveform observed before treatment (p = 0.216 for PI and p = 0.249 for RI). Maternal antenatal betamethasone resulted in a significant transient decrease in the pulsatility and the resistance indexes in the pulmonary artery. These findings indicate a direct effect of betamethasone on fetal pulmonary circulation. © 2014 Informa UK, Ltd.


Ustunyurt E.,Bursa Sevket Yilmaz Research and Education Hospital | Cift T.,Bursa Sevket Yilmaz Research and Education Hospital
Oncology Letters | Year: 2014

Situs inversus is a rare congenital anomaly in which the organs are transposed from their normal site to the opposite side of the body. To the best of our knowledge, this is the first study of staging laparotomy performed in a patient with endometrial carcinoma and situs inversus totalis (SIT). This study presents a patient with early endometrial carcinoma with SIT who underwent staging laparotomy. Total abdominal hysterectomy with bilateral salphingoophorectomy, omentectomy and pelvic para-aortic lymph node dissection was successfully performed without additional blood loss and time. The number of retrieved lymph nodes was 47. No abnormal course of blood vessels except for the right/left inversion was found. The postoperative course was favorable and the patient was discharged eight days after surgery.


Yilmaz E.,Uludag University | Ustunyurt E.,Bursa Sevket Yilmaz Research and Education Hospital | Kucukkomurcu S.,Uludag University | Budak F.,Uludag University | Ozkaya G.,Uludag University
Journal of Obstetrics and Gynaecology Research | Year: 2014

Aim The aim of this study is to estimate the effectiveness of cervicovaginal vascular endothelial growth factor (VEGF) in predicting preterm delivery. Methods Cervicovaginal VEGF was measured in 30 women who presented symptoms or signs of threatened preterm labor and the control group of 30 healthy pregnant patients by enzyme-linked immunoassay. Results There was no statistically significant difference in cervicovaginal VEGF values between the threatened preterm labor group and the control group (P > 0.05). Similarly, no statistically significant difference was observed in terms of cervical length and cervicovaginal VEGF values between preterm and term-delivered groups (P > 0.05). Additionally, there was no correlation between cervicovaginal VEGF values and cervical length (P > 0.05) between the threatened preterm labor and the control groups. Conclusion No correlation was found between cervicovaginal VEGF values and the preterm delivery. However, we believe that the role of VEGF in preterm delivery needs to be investigated further in well-designed studies with larger samples. © 2014 Japan Society of Obstetrics and Gynecology.


Ustunyurt E.,Bursa Sevket Yilmaz Research and Education Hospital | Simsek H.,Bursa Sevket Yilmaz Research and Education Hospital | Korkmaz B.,Bursa Sevket Yilmaz Research and Education Hospital | Iskender C.,Dr Zekai Tahir Burak Research and Training Hospital
Journal of Maternal-Fetal and Neonatal Medicine | Year: 2015

Objective: To investigate the relationship between crown-rump length (CRL) and birth weight, length and head circumference of the newborn.Methods: From a database of delivery records of 12 000 pregnancies, we identified 999 women with singleton pregnancies who had no medical problems, a normal menstrual history and a first trimester ultrasound scan in which CRL had been measured. All of the pregnancies resulted in live births without evidence of chromosomal and congenital abnormalities. The population in this study was divided into three groups according to CRL measurement; Group A (smaller-than-expected CRL), Group B (normal CRL) and Group C (larger-than-expected CRL).Results: The incidence of low birth weight infant was higher in Group A than in Group C (p = 0.010). The rate of small for gestational age (SGA) infants was similar between groups. The number of macrosomic or large for gestational age (LGA) infants was higher in Group C than Groups A and B. Both birth head circumference and length of infant were greater in Group C than Groups A and B. No significant difference for ponderal index value was observed between the groups (p = 0.927).Conclusion: The growth pattern in the first trimester affects neonatal birth weight and length symmetrically without changing the ponderal index. © 2014 © 2014 Informa UK Ltd.


Ustunyurt E.,Bursa Sevket Yilmaz Research and Education Hospital | Duran M.,Bursa Sevket Yilmaz Research and Education Hospital | Coskun E.,Bursa Sevket Yilmaz Research and Education Hospital | Ustunyurt O.B.,Bursa Zubeyde HanIm Dogumevi | Simsek H.,Bursa Sevket Yilmaz Research and Education Hospital
Archives of Gynecology and Obstetrics | Year: 2013

Purpose: The purpose of this study was to evaluate the initial and day 4 beta-human chorionic gonadotropin (β-hCG) levels as a predictor of methotrexate (MTX) therapy success for ectopic pregnancy. Methods: Retrospective study of 87 patients with tubal ectopic pregnancy treated with a single dose of 50 mg/m2 MTX at Bursa Şevket YIlmaz Research and Education Hospital between January 2011 and July 2012 was performed. Results: The overall success rate is measured as 72.4 %. The two groups of patients, successfully treated patients (n = 63) and unsuccessfully treated patients (n = 24), were compared. The mean initial β-hCG level was significantly lower in the treatment success group than in the treatment failure group (1,417 mIU/mL versus 5,995 mIU/mL, p < 0.001). The number of cases with decreasing β-hCG level on day 4 was significantly more in the success group compared to the failure group (61.9 and 37.5 %, respectively, p = 0.04). The success rate was 90 % when β-hCG levels were <1,000 mIU/mL, 85.7 % when the levels were between 1,000 and 1,999 mIU/mL, and 76.5 % when the levels were between 2,000 and 2,999 mIU/mL, 54.5 % when the levels were between 3,000 and 3,999 mIU/mL. Conclusion: Single-dose MTX therapy is a safe and effective treatment modality for tubal ectopic pregnancies with the β-hCG serum concentration below 3,000 mIU/mL, and β-hCG level changes between days 0 and 4 after MTX therapy are important in predicting the outcome of treatment. © 2013 Springer-Verlag Berlin Heidelberg.

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