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    Bernard-Soulier Syndrome from the Perspective of the Obstetrician: A Case Report with a Review of the Literature
    (Georg Thieme Verlag Kg, 2023) Saridogan, Erdinc; Onat, Taylan; Duz, Senem Arda; Tuncay, Gorkem; Abdurahmanova, Nuray; Orujova, Lumayat; Karaer, Abdullah
    Objective Bernard-Soulier syndrome (BSS) is one of the rare inherited platelet disorders that is characterized by macrothrombocytopenia and adhesion abnormality due to the absence or malfunctioning of the membrane GPIb-IX-V complex. There is no high-quality evidence on obstetric management of BSS owing to its rarity. Here we report an uncomplicated delivery of an adolescent with BSS and review the literature on the topic of BSS and pregnancy.Methods PUBMED, EMBASE, COCHRANE, and Google Scholar databases were searched up to April 2022 without language and year restriction using the terms Bernard Soulier and Pregnancy . The primary objectives were to evaluate maternal and fetal outcomes. The secondary objectives were to analyze pregnancy complications, gestational age at delivery, mode of delivery, administered prophylaxis, treatment approaches, duration of postpartum hospitalization, and the postpartum requirement of blood and blood product.Results The patient was a 19-year-old and 39-week pregnant woman who was diagnosed with BSS at the age of 10 by flow cytometry and genetic analysis. Single donor platelet transfusions and oral tranexamic acid were administered as prophylaxis at the peripartum period. She was delivered by cesarean section due to failure of labor. The postpartum period was uneventful for both mother and neonate. In the literature review, postpartum hemorrhage (PPH) was found in 52.9% (27/51) of deliveries. Late PPH occurred more frequently than early PPH (35.3 and 31.4%, respectively). 49% (25/51) of pregnancies had severe thrombocytopenia, and antepartum hemorrhage was observed in 11.8% (6/51) of those. The platelet count was in close relation to antenatal complications. 64.7% (33/51) of the patients were delivered via cesarean section. PPH and late PPH were found to be more common in those who delivered vaginally compared to those who delivered by caesarean section. It was observed that PPH was less common in women who were given prophylaxis in the peripartum period.Conclusion BSS is an inherited macro-thrombocytopathy that may cause adverse maternal and neonatal outcomes. The optimal mode and timing of delivery remain unclear. A multidisciplinary approach with prophylaxis at the peripartum period should be applied.
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    Endometriyum kanserinde inflamasyon indekslerinin önemi ve prognozla ilişkisi
    (İnönü Üniversitesi, 2025) Abdurahmanova, Nuray; Coşkun, Ebru İnci
    Amaç: Trombosit, nötrofil ve lenfosit sayıları kullanılarak hesaplanan inflamasyon indekslerinin son zamanlarda yapılan çalışmalarda kanserli hastalarda prognostik bir gösterge olarak dikkat çekmektedir. Bu çalışmanın amacı, endometriyum kanserinde sistemik inflamasyon indekslerinin prognostik önemini ortaya koymaktır. Materyal ve Metod: Çalışma, İnönü Üniversitesi Turgut Özal Tıp Merkezi Kadın Hastalıkları ve Doğum Anabilim Dalı, Jinekolojik Onkoloji Kliniği'nde, Ocak 2014 ile Aralık 2023 tarihleri arasında 35-75 yaş aralığında endometriyum kanseri tanısı ile ameliyat olan 166 hastayı kapsamaktadır. Hastaların genel bilgileri, dosyaları ve preoperatif olarak istenen periferik kan değerleri incelenmiş ve SII ve PIV değerleri hesaplanmıştır. İstatistiksel analizlerde p<0.05 değeri anlamlı kabul edilmiştir. Analizler IBM SPSS 25.0 yazılımı kullanılarak gerçekleştirilmiştir. Bulgular: Preoperatif alınan, periferik kan örneklerinden hesaplanan SII ve PIV değerlerinin nüks, lenf nodu metastazı, evre, progresyonsuz sağkalım ve 5 yıllık sağkalım süreci üzerinde etkisine bakılmış olup istatiksel olarak anlamlı ilişkili bulunmamıştır. Sadece Grade II için bakılan SII (p=0.024) ve PIV (p=0.045) üzerinde anlamlı değişiklik bulunmuştur. Sonuç: Çalışmamızda incelenen inflamasyon indekslerinden yalnızca Grade II için, SII ve PIV değerlerinde anlamlı değişiklikler bulunmuştur. Çalışmaya dâhil olan hastaların %73.5'ini Evre 1 (122 hasta) hastalar oluşturduğundan, ileri evre hasta grubuna yönelik daha detaylı çalışmaların yapılması ve incelenmesi gerektiği düşünülmektedir. Anahtar kelimeler: Endometriyum kanseri, prognoz, inflamasyon, sağkalım
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    Inflammation-driven pathogenesis of hyperemesis gravidarum: assessing the role of pan-immune-inflammation value and hematologic parameters
    (Springer Heidelberg, 2025) Cicek, Sevil; Coskun, Ebru Inci; Abdurahmanova, Nuray; Yilmaz, Ercan
    Objective Hyperemesis gravidarum (HG) is a severe form of nausea and vomiting during pregnancy that frequently leads to hospitalization and significant maternal morbidity. Despite its clinical significance, the pathogenesis of HG remains poorly understood, with systemic inflammation emerging as a possible contributing factor. The aim of this study was to investigate the role of novel inflammatory markers, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), and pan-immune-inflammation value (PIV), in the pathophysiology of HG and their association with disease severity. Materials and methods This retrospective case-control study included 259 pregnant women (159 with HG and 100 healthy controls) enrolled in Inonu University School of Medicine between January 2020 and August 2023. Hematologic parameters, including leukocyte, neutrophil, lymphocyte, and platelet counts and ketonuria levels, were collected from electronic medical records. Inflammatory indices (NLR, PLR, SII, and PIV) were calculated and their diagnostic performance was evaluated using receiver-operating characteristic (ROC) curve analysis. Logistic regression was used to assess the risk factors for HG. Statistical analyses were performed using SPSS version 22, with p < 0.05 considered significant. Results The HG group had significantly higher NLR (p = 0.004), PLR (p = 0.003), SII (p < 0.001), and PIV (p < 0.001) compared to controls. ROC analysis revealed that NLR [cut-off: 5.67, area under the curve (AUC) 0.608, 95% confidence interval (CI) 0.545-0.668, p = 0.002], PLR (cut-off: 154.5, AUC 0.610, 95% CI 0.547-0.669, p = 0.002), SII (cut-off: 948.4, AUC: 0.636, 95% CI 0.575-0.695, p < 0.001), and PIV (cut-off: 866.51, AUC 0.637, 95% CI 0.575-0.696, p < 0.001) showed moderate diagnostic performance with high specificity (70-94%) but variable sensitivity (25.8-55.3%). Logistic regression identified low gestational age and increased platelet distribution width (PDW) as significant risk factors for HG (p < 0.05), while PIV and other inflammatory markers did not emerge as independent predictors. Conclusion This study emphasizes the role of systemic inflammation in HG as evidenced by increased inflammatory indices in HG patients. NLR, PLR, SII, and PIV prove to be promising diagnostic markers for HG and offer high specificity and sensitivity. However, their lack of correlation with ketonuria suggests that inflammation alone cannot fully explain the severity of the disease. These findings highlight the need for further research to validate these markers and explore their potential for the development of personalized treatment strategies for HG.