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    Predictive value of umbilical artery Doppler for adverse perinatal outcome in patients with HELLP syndrome
    (Verduci Publisher, 2013) Simsek, Y.; Celen, S.; Simsek, A.; Danisman, N.; Mollamahmutoglu, L.
    OBJECTIVE: In this study, we aimed to evaluate in a prospective design the importance of pathologic umbilical artery (UA) Doppler findings as a predictive marker for neonatal outcome in patients with HELLP syndrome. PATIENTS AND METHODS: A total of 45 pregnant women at 24-42 weeks of gestation with a diagnosis of HELLP syndrome were included. The study group consisted of 20 patients with abnormal UA Doppler results, and the remaining 25 HELLP syndrome patients with normal UA Doppler results were assigned to the control group. All patients were followed up until delivery, and the neonatal characteristics were compared. RESULTS: Baseline characteristics of the groups were similar. In the study group, gestational week at delivery and infant birth weight were significantly lower (p < 0.05). The rates of significant neonatal morbidity, neonatal mortality, and neonatal intensive care unit (NICU) admission were significantly higher in study group patients (p < 0.05). CONCLUSIONS: UA Doppler abnormalities can be considered predictive of poor neonatal prognosis in patients with HELLP syndrome, as they were significantly related with higher rates of neonatal mortality and significant morbidity.
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    Removal of uterine fibroids during cesarean section: a difficult therapeutic decision
    (I R O G Canada, Inc, 2012) Simsek, Y.; Celen, S.; Danisman, N.; Mollamahmutoglu, L.
    Purpose of investigation: Myoma excision during cesarean delivery has traditionally been discouraged, however controversy persists among studies of myomectomy being performed during cesarean section. In this study, medical records of patients who underwent cesarean section our institution were evaluated retrospectively. Methods: A total of 70 cases of cesarean myomectomy done during this period were included (group 1) and compared with the patients who underwent cesarean section alone (group 2). Results: Mean surgical time of the myomectomy group was 58.1 +/- 23 minutes which was significantly increased (p < 0.01). Mean postoperative hemoglobin value was 9.6 +/- 1.5 in the myomectomy group and 10.8 +/- 1.01 in controls (p = 0.01). Length of hospital stay was significantly longer in the myomectomy group (p < 0.05). Conclusion: This study shows that myomectomy during cesarean section is a feasible procedure without any serious complications. The procedure is related with increased blood loss that does not require blood transfusion.
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    Severe preeclampsia and fetal virilization in a spontaneous singleton pregnancy complicated by hyperreactio luteinalis
    (Verduci Publisher, 2012) Simsek, Y.; Celen, S.; Ustun, Y.; Danisman, N.; Bayramoglu, H.
    Background: Hyperreactio luteinalis is a rare condition that stems from theca cell hyperplasia in the ovaries due to a high level of human chorionic gonadotropin during gestation. It occurs commonly in pregnant patients with trophoblastic disease, occasionally in multiple pregnancies, and rarely in normal singleton pregnancy. Case Report: A 24-year-old pregnant woman, G3 P0, who was admitted to the Perinatology Clinic with increasing findings of virilization during pregnancy was presented. The patient had bilaterally enlarged multicystic ovaries on sonographic examination and elevated serum androgen levels She was managed conservatively until 38th week of gestation as a presumptive diagnosis of hyperreactio luteinalis. Elevated blood pressure and prominent proteinuria were detected during the follow-up of the patient and labor was induced. She underwent an emergency caesarean delivery because of fetal distress. During caesarean section, ovarian biopsies were taken and a histopathological diagnosis of hyperreactio luteinalis was determined. The female fetus also presented virilization. Conclusion: Although infrequent, hyperreactio luteinalis with both maternal and fetal virilization can occur in women with spontaneous singleton pregnancies. The clinical manifestations in such women may be complicated by severe preeclampsia.