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    The effect of physical activity performed in the first trimester on the development of preeclampsia and gestational diabetes
    (2021) Isikalan, Mehmet Murat; Yeniceri, Hacce; Acar, Ali
    Aim: We aimed to investigate the effects of physical activity performed in the first trimester on preeclampsia, gestational diabetes, and other pregnancy outcomes.Materials and Methods: This prospective observational study included 205 healthy pregnant women with 11 to 13 weeks of gestation who applied to our gynecology and obstetrics outpatient clinic between April and July 2019. The demographic information of the patients was recorded and a short form of the International Physical Activity Questionnaire was used to determine physical activity levels. These pregnant women were followed until birth. A confounder control was performed with logistic regression.Results: While 16 (7.8%) of the participants developed preeclampsia, 20 (9.8%) of them developed gestational diabetes. Total physical activity levels were lower in women who developed preeclampsia. In the group that developed gestational diabetes, the number of pregnant women with low physical activity levels and the number of nulliparous pregnant women were found to be significantly higher. There was no effect of daily sitting time on preeclampsia and gestational diabetes development. Second-hour blood glucose levels were found to be higher in the group with low physical activity.Conclusion: Pregnancies complicated by gestational diabetes or preeclampsia are associated with poor pregnancy outcomes and are very important risk factors for postpartum maternal and fatal healt. Inadequate physical activity is a modifiable risk factor for the development of preeclampsia and gestational diabetes. Behavioral changes in women with insufficient physical activity levels in the first trimester may decrease the risk of gestational diabetes and preeclampsia.
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    Maternal outcomes of conservative surgery in women with postpartum hemorrhage caused by abnormally invasive placenta
    (2020) Bulbul, Ramazan; Isikalan, Mehmet Murat; Acar, Ali
    Aim: In this study, we aimed to compare perioperative outcomes of patients who underwent hysterectomy and uterine-sparing surgery in patients operated for the abnormally invasive placenta and to compare the results of cesarean section hysterectomy and uterus-sparing surgery which is the standard surgical approach for abnormally invasive placenta cases.Material and Methods: The record of 45 patients who were treated for abnormally invasive placenta in our clinic between January 2011 and May 2019, were reviewed retrospectively. Fifteen of these patients underwent cesarean hysterectomy, while 30 patients underwent conservative surgery. The decision to perform conservative surgery or hysterectomy was made according to the preferences of the patients. Demographic data, amount of bleeding, gynecological and obstetric histories, laboratory parameters, blood transfusions and duration of hospitalization were recorded. Data were obtained using the hospital electronic archive database.Results: The perioperative results of the conservative surgery group were superior to the hysterectomy group. In the perioperative period, all patients in the hysterectomy group received transfusion therapy, while 54.5% of the conservative surgery group received transfusion therapy (p=0.04). The mean amount of bleeding in the hysterectomy group was 2160(495-5715) mL and 1215(180-3645) mL in the conservative surgery group (p =0.04). When the hospitalization periods of both groups were examined, the mean duration of hospitalization was 6 (3-17) days in the hysterectomy group and 3(1-16) days in the conservative surgery group (p = 0.012). Conclusions: Although the standard treatment for placenta invasion anomalies is cesarean hysterectomy, conservative (uterine sparing) surgery seems to be feasible for patients who desire fertility despite surgical difficulties. Therefore, the surgical treatment of placenta invasion anomalies should be individualized.