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    Clinical and hormonal characteristics of women with various phenotypes of polycystic ovary syndrome
    (2020) Düz, Senem Arda; Tuncay, Görkem; Karaer, Abdullah
    Abstract: Aim: The goal of this study is to identify clinical and hormonal characteristics of women with various phenotypes of polycystic ovary syndrome. Material and Methods: One hundred seventy eight cases, between the ages 18-30, diagnosed with PCOS, up to Rotterdam criteria, in our clinic between February 2015 -November 2018 were recruited in this cross sectional study. Results: The number was declined 89 by using National Institutes of Health criteria, 132 up to Androgen Excess and PCOS Society criteria. 34.83% of the patients were phenotype A, 15.16% were phenotype B, 24.15% were phenotype C and 25.84% were phenotype D. When we compared the different phenotypes with each other, body mass index, fasting glucose, postprandial glucose, fasting insulin and homeostatic model assessment for insulin resistance were found to be higher in phenotype A. In addition, luteinizing hormone and luteinizing hormone to follicle stimulating hormone ratio was higher in phenotype D than in B and C. When multivariate analysis was performed, body mass index was found to be as a single statistically significant predictive factor on IR. Conclusion: Body mass index was the most effective factor on insulin resistance and the mean body mass index was significantly higher in phenotype A.
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    Ruptured tubal pregnancy with very low βhCG levels: a case report
    (Turgut Özal Tıp Merkezi Dergisi, 2016) Düz, Senem Arda; Eraslan ,Sevil; Coşkun, Ebru İnci
    Abstract Ectopic pregnancy is a pregnancy that occurs outside the uterine cavity. Although tubal ectopic pregnancy is more common, it can be rarely seen in abdominal cavity, ovarium and cervix. Mortality caused by rupture of the ectopic pregnancy decreased dramatically with the introduction of sonography and measurement of serum β-hCG (beta-human chorionic gonadotropin) levels. However there is no correlation between the clinical findings and β-hCG levels. A 29-year-old nullipar woman with amenorrhea had a β-hCG level of 1051 mUI/mL and ultrasonographic findings were pointing to tubal pregnancy. Because of the patient’s stable clinical condition, it was decided to follow the patient with expectant management. When she was admitted with severe abdominal pain, the β-hCG level was 39,8 mIU/ml and ultrasonography showed a large amount of fluid in the abdominal cavity. The patient underwent laparotomy (right) and salpengectomy. Even though β-hCG levels are low and declining, the possibility of rupture should be kept in mind. Keywords: Ruptured Ectopic Pregnancy; Tubal Pregnancy; Low β-hCG Levels.
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    The effect of different norepinephrine administration methods on hypotension after spinal anesthesia in caesarean sections
    (2024) Gülhas, Nurçın; Ozkan, Ahmet Selim; Düz, Senem Arda; Arslan, Ahmet Kadir; Seyhun, Nurşen
    We aimed to evaluate the effect of different routes of norepinephrine (NE) administration on maternal hypotension in pregnant females undergoing spinal anesthesia for caesarean section. 208 pregnant women were divided randomly into 4 groups (n=52). Bolus 4 μg/ml NE was administered intravenous (iv) immediately after spinal anesthesia in Group PB (Prophylactic Bolus). In Group PI (Prophylactic Infusion), 1 ml of saline solution was applied promptly after spinal anesthesia and then the NE infusion was started at 1 ml/min. In Group TB (Treatment Bolus), 1 ml Physiological Saline (PS) was administered after 1 ml/min infusion of PS immediately after spinal anesthesia and then 1 ml/min NE bolus when blood pressure decreased by 20% after the entry. In Group TBI (Treatment Bolus Infusion), 1 ml PS was administered after 1 ml/min infusion of PS immediately after spinal anesthesia, 1 ml NE and then 1 ml/min NE infusion was initiated when blood pressure decreased by 20% after the entry. At the 4th, 6th, and 8th minutes, the PI Group exhibited higher systolic and mean blood pressures than the other groups (p<.001). Additionally, hypotension was statistically lower in the PI Group than in PB, TB, TBI groups (p<.001), and episodes of hypotension, ephedrine required and extra NE boluses given were statistically lower in the PI Group than in the other groups (p<.001). Umbilical vein (UV) pH values were lower in the TBI Group at compared to the other groups (p<.001). It is suggested that a prophylactic infusion of 4 μg/min of NE in the prevention of hypotension following spinal anesthesia for cesarean section will reduce the possibility of maternal hypotension and better maintain fetal well-being than a prophylactic bolus, a treatment bolus or a posttreatment bolus infusion at the same dose.