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Öğe Abscess in adenomyosis mimicking a malignancy in a 54-year-old woman(2003) Erguvan R.; Meydanli M.M.; Alkan A.; Edali M.N.; Gokce H.; Kafkasli A.Background: Although there are a few reports describing abscess formation in endometriotic foci no report of abscess formation arising de novo within adenomyosis appears in the literature. Preoperative diagnosis of adenomyosis is frequently difficult because of non-specific signs and symptoms. Synchronous pelvic pathologies such as leiomyoma, endometrial polyp, endometrial hyperplasia, as well as endometrial cancer may cause differential diagnostic problems. Case: A 54-year-old postmenopausal woman complaining of inguinal pain, nightsweats and hot flashes is presented. Radiologic examinations of the pelvis revealed a 95 x 85 mm leiomyoma-like lesion including a 53 x 43 mm cystic space and 9 x 6 mm papillary formation within the uterus raising clinical suspicion of malignancy. A total abdominal hysterectomy and bilateral salpingo-oophorectomy were performed accompanied by a frozen section diagnosis. The frozen section revealed an abscess formation arising in a focus of adenomyosis. The postoperative period of the patient was uneventful. Conclusion: The present case, to our knowledge, is the first report representing abscess formation in adenomyosis. Abscess arising within adenomyosis can strongly raise the suspicion of endometrial cancer, particularly if the patient is postmenopausal. If endometrial cancer cannot be ruled out with definitive histopathological diagnosis in the preoperative period, a frozen section becomes mandatory during surgical intervention.Öğe Effect of postpartum counseling on postpartum contraceptive use(2007) Engin-Üstün Y.; Üstün Y.; Çetin F.; Meydanli M.M.; Kafkasli A.; Sezgin B.Objective: The aim of this study was to evaluate the effect of postpartum counseling on postpartum contraceptive use. Methods: One hundred and forty-three women who delivered between 1 January 2004 and 31 September 2004 and counseled about postpartum contraception were included in the study. The participants were interviewed by telephone. Age, gravidity, parity, and mode of delivery of the participants were recorded. Their method of contraception before pregnancy, their decision on the contraceptive method after counseling and the method actually used were asked. Results: Just after postpartum counseling, 47 women (32.9%) decided to use the intrauterine device (IUD), 23 (16.1%) condoms, 16 (11.2%) progestin injections, 7 (4.9%) oral contraceptives, and 7 (4.9%) coitus interruptus for contraception. Thirty-six women (25.2%) did not decide on any method of use. At the time of the telephone interview the actual method used was learned. Fifty-one women (35.7%) were using coitus interruptus, 45 women (31.5%) condoms, and 14 (9.8%) the IUD. Sixteen women (11.2%) were reported as not using any methods. Conclusion: In spite of postpartum counseling, a high majority of the women appeared to use traditional and less effective contraceptive methods. © 2006 Springer-Verlag.Öğe Elevated nucleated red blood cell count: A population-based study(2006) Üstün Y.; Engin-Üstün Y.; Kaya E.; Meydanli M.M.; Kulak N.OBJECTIVE: To assess the prevalence and causes of elevated nucleated red blood cell (NRBC) count. STUDY DESIGN: We conducted a 1-year, population-based surveillance study that included pregnant women and their infants from our medical center, which serves as a tertiary referral hospital. Outcome measures included NRBC count, gestational age, mode of delivery, birth weight, Apgar scores, cord blood gasses, rate of neonatal intensive care unit admission. Statistical analyses were performed with Mann-Whitney U-test, independent samples t test, ? 2 test, Fisher's exact test and Spearman's correlation test, as appropriate. RESULTS: NRBC count obtained from 423 women had a median of 4 (0-163). A cutoff point of 13.5 for predicting fetal acidosis had the highest combined sensitivity (77.8%) and specificity (84%). Three hundred forty-nine neonates had a NRBC count ?13.5, whereas 73 had >13.5. Logistic regression analysis revealed that preeclampsia (OR = 5.9, 95% CI = 2.8-12.3) remained the most prominent risk factor for elevated NRBC count. CONCLUSION: Elevated NRBC appears to be associated with preeclampsia. © Journal of Reproductive Medicine®, Inc.Öğe Evaluation of cases with neural tube defects in an University Hospital in Eastern Anatolia(2007) Engin-Üstün Y.; Üstün Y.; Türkçüo?lu I.; Sezgin B.; Meydanli M.M.; Kafkasli A.AIM: To evaluate cases of neural tube defects detected at or referred to Inonu University Faculty of Medicine Gynecology and Obstetrics Department between 2004 and 2006. DESING STUDY: In this study, cases of neural tube defects detected at or referred to Inonu University Faculty of Medicine Gynecology and Obstetrics Department between 2004 and 2006 were evaluated. Cases were identified by a definitive prenatal radiology report. FINDINGS: There were 14 cases with spina bifida, 13 with anencepaly, 8 with spina bifida and hydrocephaly, 9 with spina bifida and acrani. Nine cases were primarily diagnosed and treated in our hospital whereas 35 were referred from other hospitals. During the study period, 3877 deliveries were performed in our clinic. When referrals from other hospitals were excluded, the incidence of neural tube defect was calculated as 2.3 per 1000 deliveries. Mean maternal age was 27.5±5.1 years and body mass index was 25.9±3.6 kg /m 2. Median gestational age at the time of diagnosis was 23 (13-41) weeks, gravida was 2 (1-9) and parity was 1 (0-6). Thirty four percent of cases were diagnosed in the third trimester and 63.6 % of cases were not under routine control. None of the patients used folic acid before of during the pregnancy. CONCLUSION: Folic acid supplementation and antenatal screening is mandatory for all pregnancies.
