Istanbul Bakirkoy Maternity and Children Diseases Hospital

İstanbul, Turkey

Istanbul Bakirkoy Maternity and Children Diseases Hospital

İstanbul, Turkey
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Gedikbasi A.,Istanbul Bakirkoy Maternity and Children Diseases Hospital | Oztarhan K.,Istanbul Bakirkoy Maternity and Children Diseases Hospital | Yildirim G.,Istanbul Bakirkoy Maternity and Children Diseases Hospital | Gul A.,Istanbul Bakirkoy Maternity and Children Diseases Hospital | Ceylan Y.,Istanbul Bakirkoy Maternity and Children Diseases Hospital
Anadolu Kardiyoloji Dergisi | Year: 2011

Objective: To determine the clinical outcomes and decisions of families of fetuses with prenatally-diagnosed cardiac abnormalities. Methods: Prenatally diagnosed cases (n=155) with congenital heart disease were retrospectively categorized according to the Allan-Huggon grading system: Group A (cardiac disease associated with severe / lethal extracardiac disease); Group B1 (low risk with a postnatal prognosis); Group B2 (moderate risk, amenable to surgical repair with a low mortality); and Group B3 (high risk, associated with high mortality after surgery). Neonatal outcomes, including termination of pregnancy, were recorded for 18 months of follow-up after counseling the parents. Student's t-test, Mann-Whitney U, Pearson's Chi-square test and Fischer's exact Chi-square test were used for statistical analyses. Results: One hundred forty-five cases completed follow up. Thirty-nine cases (Group A) were associated with extracardiac lethal defects and the pregnancies were terminated; these cases were excluded from statistical evaluation. Twenty parents in Group B3 opted also for termination. The survival rates of ongoing pregnancies after 18 months of follow-up between the three cardiac abnormality Groups (Group B1, n=37; Group B2, n=12; and Group B3, n=37) were 89.2%, 66.7%, and 13.5%, respectively. Significance was present between the survival rates of the three Groups [Group B3 vs. Group B1: p=0.0001; OR: 52.8 (12.9-214.5); Group B3 vs. Group B2: p=0.0009; OR: 12.8 (2.8-58.9); Group B2 vs. Group B1: p=0.087; OR: 4.12 (0.84-20.2)]. Conclusion: Our practice and the findings reported herein support the efficacy of this staging system and counseling parents of fetuses for congenital heart diseases. © 2011 by AVES Yayi{dotless}nci{dotless}li{dotless}k Ltd.


Gedikbasi A.,Istanbul Bakirkoy Maternity and Children Diseases Hospital | Oztarhan K.,Istanbul Bakirkoy Maternity and Children Diseases Hospital | Gunenc Z.,Maltepe University | Yildirim G.,Istanbul Bakirkoy Maternity and Children Diseases Hospital | And 3 more authors.
Hypertension in Pregnancy | Year: 2011

Objective. Mirror syndrome (Ballantyne's syndrome) refers to the association of fetal hydrops and maternal preeclampsia. The aim of this study was to determine the relation and incidence between fetal hydrops and preeclampsia in our clinic. Methods. A retrospective review of patients associated with fetal hydrops and findings with preeclampsia was used. Seventy-five cases with single pregnancy and diagnoses with nonimmune hydrops fetalis were found. According to the data 4 cases were found related with preeclampsia. Results. Mirror syndrome is rarely encountered and underdiagnosed. We found a frequency of 5.3% (4 cases in 75 affected pregnancies) for single non-immune hydrops cases in which maternal hypertension occurred. Fetal outcome is depending on etiology and prognosis is mainly very low. Maternal symptoms and laboratory findings are resolving after intrauterine fetal death or delivery. Conclusion. Hydrops fetalis must be considered as a potential risk factor for preeclampsia. It is important that this clinical condition has a potential of about 5% for proceeding preeclampsia. © 2011 Informa Healthcare USA, Inc.


Bingol B.,Istanbul Science University | Gunenc Z.,Maltepe University | Gedikbasi A.,Istanbul Bakirkoy Maternity and Children Diseases Hospital | Guner H.,Gazi University | And 2 more authors.
Journal of Obstetrics and Gynaecology | Year: 2011

We aimed to compare the accuracy of transvaginal sonography (TVS), saline infusion sonohysterography (SIS) and hysteroscopy (HS) for uterine pathologies among infertile women. A total of 346 patients were selected for operative hysteroscopy, following SIS after TVS. SIS was performed with a Cook Soft 500 IVF catheter. Sensitivity, specificity, positive and negative predictive values (PPV, NPV) were calculated to compare the accuracy of TVS, SIS and hysteroscopy for uterine abnormalities. SIS showed a sensitivity of 87%, specificity of 100% and PPV of 100% for endometrial hyperplasia, and a sensitivity and NPV of 100% for polypoid lesions. For submucosal myoma SIS showed a sensitivity of 99% with PPV of 96%. Hysteroscopy had a sensitivity, specificity, PPV and NPV of 98%, 83%, 96% and 91%, respectively for overall uterine pathologies. Finally, SIS seems to be superior to TVS, for uterine pathologies, with respect to hysteroscopy as the gold standard. © 2011 Informa UK, Ltd.


Bingol B.,Istanbul Science University | Abike F.,Medicana International Ankara Hospital | Gedikbasi A.,Istanbul Bakirkoy Maternity and Children Diseases Hospital | Tapisiz O.L.,Etlik Zubeyde Hanim Womens Health Education and Research Hospital | Gunenc Z.,Istanbul Alman Hospital
Journal of Assisted Reproduction and Genetics | Year: 2012

Objective: To compare cytogenetic data of first-trimester missed abortions in intracytoplasmic sperm injection (ICSI) for non-male factor-mediated and spontaneous pregnancies. Methods: Using karyotype analysis, we conducted a retrospective cohort trial of missed abortions following ICSI for non-male factor and spontaneous pregnancies. Patients experienced missed abortions during the first 12 weeks of pregnancy. Dilation and curettage procedure was performed followed by cytogenetic evaluations. Two patient groups were created: ICSI (n = 71) and spontaneous pregnancies (n = 81). At least 20 GTG-banded metaphases were analyzed in each case for cytogenetic analyses. Statistical analyses were performed using NCSS 2007 Statistical Program software. The significance level and confidence interval for all analyses were set to p < 0.05 and a 95% confidence interval, respectively. Results: A total of 49.3% (75/152) of the miscarriages were cytogenetically abnormal among the patients. We detected cytogenetically abnormalities in 47.9% (34/71) of the ICSI group and 50.6% (41/81) of the control group, which were not statistically significant differences (p=NS). The sex chromosome abnormalities were similar between the ICSI and control groups (p=NS). The most prevalent abnormalities that were observed in the ICSI and control groups with first-trimester pregnancy loss were trisomy (n = 42; 27.6%), Turner syndrome (45, X0, n = 13; 8.6%), triploidy (n = 13; 8.6%), 48 chromosomes (n = 5; 3.3%), and mixed chromosomal abnormalities (n = 3; 1.2%). In addition, the karyotypes were similar between the ICSI and control groups (p=NS). We observed increases in fetal aneuploidy rates with increased maternal age (<30 years = 23.9% vs. 31-34 years = 37.0% vs. 35-39 years = 82.9% vs. >39 years = 90.9%). However, the observed increases in fetal aneuploidy rates were not statistically significant (p=NS). Conclusion: The aneuploidy rates and sex chromosome anomalies following ICSI for non-male factor were similar to those following natural conception. © 2011 LSpringer Science+Business Media, LLC.


Akbayir O.,Istanbul Bakirkoy Maternity and Children Diseases Hospital | Gedikbasi A.,Istanbul Bakirkoy Maternity and Children Diseases Hospital | Akyol A.,Istanbul Bakirkoy Maternity and Children Diseases Hospital | Ucar A.,Istanbul University | And 2 more authors.
Journal of Clinical Ultrasound | Year: 2011

A 38-year-old gravida 4, para 2 woman with a history of two Cesarean sections and one curettage was referred to our hospital, because of painless vaginal bleeding and 6 weeks + 2 days of amenorrhea. The first diagnosis was Cesarean scar pregnancy, managed with methotrexate. Subsequently, an arteriovenous malformation developed, which was diagnosed with color Doppler imaging. The diagnosis was confirmed with angiography. Successful bilateral uterine artery embolization was performed with ethylene vinyl alcohol copolymer (Onyx), n-butyl-2-cyanoacrylate (Histoacryl), and gelfoam. © 2011 Wiley Periodicals, Inc.


Gedikbasi A.,Istanbul Bakirkoy Maternity and Children Diseases Hospital | Akyol A.,Istanbul Bakirkoy Maternity and Children Diseases Hospital | Bingol B.,Nightingale | Cakmak D.,Istanbul Bakirkoy Maternity and Children Diseases Hospital | And 3 more authors.
Taiwanese Journal of Obstetrics and Gynecology | Year: 2010

Objective: To evaluate the maternal and neonatal risk related with multiple repeated cesarean sections. Materials and Methods: A case control study was conducted in a single tertiary maternity and children's center. The outcome of a study group including 122 pregnant women undergoing cesarean section for the fourth or fifth time was compared with a control group comprising 146 women sectioned for the second and third time. All multiple repeated cesarean sections were divided into urgent and elective groups to compare the outcome measures of demographic, neonatal, intra- and post-operative data. Results: Compared with the control group, the study group had significantly lower birth weights (p=0.026), lower Apgar scores at 1 minute (p=0.0001) and 5 minutes (p=0.042), higher numbers of fetal death (p=0.03), higher rate of omentum adhesions (p =0.0001) and peritoneal adhesions (p=0.008), increased risk of cesarean hysterectomy (p = 0.014), increased need for transfusion (p = 0.018), and an increase in hospitalization days (p=0.005). Compared with the elective group, preterm birth incidence was higher (p = 0.01) and birth weight was lower (p=0.004) in the urgent group. The risk for myometrium herniation (p=0.018), need for drainage during operation (p=0.018), and post-operative fever (p =0.001) was also more common in the urgent group. Conclusion: Multiple repeated cesarean sections increase the risks for operative complications and poor perinatal outcomes. Patients must be informed about the related risks of multiple repeated cesarean sections and tubal ligation needs to be encouraged. © 2010 Taiwan Association of Obstetric & Gynecology.


Bingol B.,Istanbul Science University | Gunenc M.Z.,Maltepe University | Gedikbasi A.,Istanbul Bakirkoy Maternity and Children Diseases Hospital | Guner H.,Gazi University | And 2 more authors.
Archives of Gynecology and Obstetrics | Year: 2011

Objective: To compare the diagnostic accuracy of transvaginal sonography (TVS), saline infusion sonohysterography (SIS) and hysteroscopy (HS) with respect to pathological diagnosis in the detection of uterine cavity abnormalities associated with abnormal uterine bleeding among postmenopausal women. Methods: Being a prospective, investigator-blind trial, the present study was conducted on 137 postmenopausal women, with abnormal uterine bleeding, admitted to the Department of Obstetrics and Gynecology of Istanbul Bilim University, Florence Nightingale Hospital and Fertigyn Woman Health and IVF Center. After TVS, all patients underwent SIS using Cook Soft 500 IVF transfer catheter and HS, consecutively. Sensitivity, specificity, and positive and negative predictive values (PPV and NPV) were calculated to compare the diagnostic accuracy of TVS, SIS and HS. Results: Most commonly encountered endometrial lesions were polypoid lesion (38.0%) and hyperplasia (28.4%) among our study population consisting of 137 women (mean age 61.6 ± 9.6 years) in their postmenopausal stage. Overall sensitivity rates were 70.0% for TVS, 89.6% for SIS and 92.3% for HS, while the overall specificity rates were 50.0, 77.3 and 80.7%, respectively. HS had PPV of 96.2% and NPV of 65.3%, whereas PPV was determined to be 80.9 versus 95.3% and NPV was 35.4 versus 58.3% for TVS and SIS, respectively. Conclusions: As an easy to perform, safe and well-tolerated procedure yielding high diagnostic accuracy, saline infusion SIS via this catheter seems to be superior to TVS and very close to HS. It may be used as the primary method for the detection of uterine abnormalities among postmenopausal women with abnormal uterine bleeding. © 2010 Springer-Verlag.


Gedikbasi A.,Istanbul Bakirkoy Maternity and Children Diseases Hospital | Akyol A.,Istanbul Bakirkoy Maternity and Children Diseases Hospital | Ulker V.,Istanbul Bakirkoy Maternity and Children Diseases Hospital | Yildirim D.,Istanbul Bakirkoy Maternity and Children Diseases Hospital | And 3 more authors.
Archives of Gynecology and Obstetrics | Year: 2011

Aim: To compare the effectiveness of the Pfannenstiel - Kerr method (PKM) or modified Misgav-Ladach method (MMLM) in previous cesarean sections (C/Ss). Methods: Hundred and fifteen gravidas were included with previous one C/S, using either a PKM or MMLM. Demographic characteristics, operative outcomes, surgical complications, and neonatal outcomes were compared in two groups. Results: The mean operative time (18.0 ± 3.5 vs. 23.5 ± 5.7 min; p < 0.0001) and mean extraction time (90.1 ± 41.2 vs. 208.1 ± 79.1 s; p < 0.0001) were significantly shorter in the MMLM group than the PKM group. Postoperative recovery (mobilization, normalization of bowel function, need for analgesics, time to oral feeding, and intra-operative blood loss) was similar between the MMLM and PKM groups. Conclusion: The MMLM appears to be a faster alternative to PKM for previous C/Ss, with similar results as in previous studies with primary CSs. © Springer-Verlag 2010.


Akbayir O.,Oncology Unit | Gedikbasi A.,Atakoy | Akyol A.,Oncology Unit | Numanoglu C.,Oncology Unit | And 2 more authors.
Journal of Obstetrics and Gynaecology Research | Year: 2011

Benign cystic mesothelioma (BCM) is a rare tumor of unknown origin, most frequently encountered in women of reproductive age and with unknown etiology. Most patients have a history of previous pelvic operation, endometriosis, or pelvic inflammatory disease. Preoperative diagnosis is difficult. We report the cases of three patients, with one case complicated by pregnancy, and discuss the diagnostic evaluation and treatment of this rare disease. Complete surgical resection is recommended if feasible. However, recurrent disease is not uncommon. Clinical positive effects of different adjuvant medical treatments are also discussed. © 2011 The Authors.


Gedikbasi A.,Istanbul Bakirkoy Maternity and Children Diseases Hospital | Oztarhan K.,Istanbul Bakirkoy Maternity and Children Diseases Hospital | Ulker V.,Istanbul Bakirkoy Maternity and Children Diseases Hospital | Aslan G.,Istanbul Bakirkoy Maternity and Children Diseases Hospital | And 3 more authors.
Journal of Clinical Ultrasound | Year: 2011

We report the case of a male fetus with tuberous sclerosis complex (TSC), in whom multiple cardiac rhabdomyomas and renal angiomyolipomas were detected at 33 weeks by ultrasound with additional brain lesions detected on MRI, all confirmed after birth. DNA analysis of the TSC2 gene detected a de novo mutation in the TSC2 gene. Postnatal follow-up and neurological examination were normal, as were the results of Holter monitoring. © 2011 Wiley Periodicals, Inc.

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