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Öğe Deep vein thrombosis in pregnant women with heterozygous factor-V Leiden mutation: a case report(Ekin Tibbi Yayincilik Ltd Sti-Ekin Medical Publ, 2009) Fansa, Iyad; Gungoren, Arif; Hakverdi, Ali Ulvi; Zeteroglu, Sahin; Yetim, CagcilDeep vein thrombosis during pregnancy is an important risk factor increasing maternal morbidity and mortality. Factor V Leiden mutation is the most frequent one among many hereditary and acquired thrombophilic risk factors during pregnancy. In a 23-year-old woman who had been pregnant for 11 weeks and applied to hospital with sudden onset pain, swelling, and erythema in her left lower extremity, a thrombus from left main iliac to superficial femoral veins was detected via Doppler ultrasonography. She was hospitalized and low molecular-weight heparin (enoxaprine sodium) was initiated with a dosage of 12000 IU/day. She showed a rapid healing clinically and was followed up with enoxaprine and varsity sock until delivery. After labor, the dosage of enoxaprine was halved and withdrawn after six weeks, and oral warfarin sodium was started. The patient is still continued to be followed up without any problems.Öğe Induction of labor with misoprostol in pregnancies with advanced maternal age(Elsevier Science Bv, 2006) Zeteroglu, Sahin; Sahin, Guler H.; Sahin, Huseyin A.Objective: The objective was to compare the efficacy and complications of intravaginal misoprostol application with oxytocin infusion for induction of labor in advanced aged pregnancies with a Bishop score of <6. Study design: A hundred advanced aged (>= 35 years) pregnant patients with a Bishop score of <6 were randomized into two groups. The first group (50 patients) received 50 mu g intravaginal misoprostol four times with 4 h intervals and the second group received oxytocin infusion for induction of labor starting from 2 mIU/min and was increased every 30 min with 2 mIU/min increments up to a maximum of 40 mIU/min. The time from induction to delivery, the route of delivery, fetal outcome, and maternal complications were recorded. Statistical analyses were performed using the Mann-Whitney U, Chi-squared and t tests to determine differences between the two groups. A p value <= 0.05 was considered significant. Results: Misoprostol was superior for induction of labor in advanced aged pregnancies with Bishop score of <6, as the mean time from induction to delivery was 9.61 +/- 4.12 h and 11.46 +/- 4.86 h in the misoprostol and oxytocin groups respectively, with a significant difference between the groups (p = 0.04). The rate of vaginal delivery was higher in the misoprostol group (84.0%) than in the oxytocin group (80.0%), but the difference did not reach significance (p = 0.60). The rates of placental abruption and postpartum hemorrhage were similar in both groups and no cases of uterine rupture occurred. The 1- and 5-min mean Apgar scores were 6.98 +/- 1.17 to 9.08 +/- 0.99 and 6.88 +/- 1.81 to 9.00 +/- 1.35 in the misoprostol and oxytocin groups respectively, with no significant differences between the groups (p = 0.74, p = 0.83). No cases of asphyxia were present. The rate of admission to the neonatal intensive care unit was similar in both groups. Conclusion: Intravaginal misoprostol seems to be an alternative method to oxytocin in the induction of labor in advanced aged pregnant women with low Bishop scores, as it is efficacious, cheap, and easy to use. But large studies are necessary to clarify safety with regard to the rare complications such as uterine rupture. (C) 2005 Elsevier Ireland Ltd. All rights reserved.Öğe Intravenous leiomyomatosis of uterus: A case report(De Gruyter Open Ltd, 2006) Atik, Esin; Altintas, Suleyman; Akansu, Bulent; Zeteroglu, Sahin; Gungoren, ArifIntravenous leiomyomatosis is an uncommon variant of uterine leiomyomas. These tumors originate from smooth muscle cells of veins or lymphatics. Generally, they can't be diagnosed before surgery. Both gross and histopathological findings are important for diagnosis. Growing into the right ventricle through inferior vena cava may be seen in some of the cases. Benign cystic lung metastases have been also reported. In this article, a 42 year-old woman who had 3 children applied to our outpatient clinic of gynecology with pelvic pain and abnormal menstrual bleeding which had started 7 years ago, is presented. In physical examination uterus was palpated as hard, painful, and abnormally large. Total abdominal hysterectomy and unilateral salphingo-oophorectomy was performed with myomatosis uteri prediagnosis. During operation, frozen section specimen was diagnosed as intravenous leiomyomatosis. By presenting this case, we aim both to emphasize the importance of post-diagnosis follow-up of patients, and also evaluate intravenous leiomyomatosis in the light of literature.Öğe Re: Comment to Peripartum hysterectomy in a teaching hospital in the eastern region of Turkey(Elsevier Ireland Ltd, 2006) Zeteroglu, Sahin; Sahin, Guler; Kamaci, Mansur[Abstract Not Available]Öğe Seroprevalence of Toxoplasma gondii, rubella and cytomegalovirus among pregnant women in southern Turkey(Informa Healthcare, 2007) Ocak, Sabahattin; Zeteroglu, Sahin; Ozer, Cahit; Dolapcioglu, Kenan; Gungoren, ArifPrimary infections caused by Toxoplasma gondii, rubella and cytomegalovirus (CMV) can lead to serious complications in pregnant women. The aim of this study was to determine the seroprevalence of Toxoplasma, rubella and CMV infections through antenatal screening. In this study, the consecutive records of 1652 pregnant women examined between the period March 2004 to January 2006 were included. The results of the antenatal screening for Toxoplasma, rubella and CMV during the first trimester of pregnancy were evaluated. Anti-Toxoplasma, anti-rubella and anti-CMV IgG and IgM antibodies were assayed using an enzyme linked immunosorbent assay method. Of the 1652 pregnant women tested, anti-Toxoplasma IgG antibody was found in 860 (52.1%) of the cases, while 9 (0.54%) of the subjects tested positive for anti-Toxoplasma IgM. Anti-rubella IgG and IgM antibodies were reactive in 1570 (95.0%), and in 9 ( 0.54%) of the tested women, respectively. Moreover, 1568 (94.9%) of them were found to be positive for anti-CMV IgG, while 7 (0.4%) tested positive for anti-CMV IgM. Consequently, because of the high seropositivity of T. gondii, rubella and CMV in the pregnant women, the country's health authorities should be alerted, and preventive measures should be taken.Öğe Uterine Artery Catheterisation and Selective Leiomyoma Embolization: Patient Acceptance and Clinical Outcome(Galenos Yayincilik, 2007) Zeteroglu, Sahin; Caliskan, Eray; Harman, Mustafa; Sengul, Muzaffer; Coskun, Ebru; Tiras, Bulent; Kamaci, MansurObjective: To evaluate the patient acceptance and clinical outcome after selective uterine leiomyoma embolization. Materials and Methods: Twenty-four women with symptomatic uterine fibroid were recruited for this study. Selective uterine leiomyoma embolization proceeded until complete vascular occlusion was achieved. The main outcome measure was the decrease in the leiomyoma volume and factors that predict it. Pearson correlation analysis and linear regression analysis were performed to identify possible correlates and predictors of decrease in leiomyoma volume. Patient satisfaction was assessed by asking the subjects to indicate their degree of satisfaction on a five-point scale. Results: The mean age of the patients was 41.5 +/- 4.9 (Range: 28-52). The mean leiomyoma volume before the procedure was 157 +/- 214 cm(3) which was calculated to be 44 +/- 66 cm3 with a 76 +/- 17% (Range: 30-99%) decrease in the mean leiomyoma volume at the end of one year. Correlation analysis revealed that only preoperative estradiol level was positively correlated with the extent of decrease in the leiomyoma volume (r=0.54, p=0.005). This was also proved in the regression analysis (beta=0.25, p=0.01). During the follow-up 17 (70.8%) patients had complete remission of the symptoms, 5 (20.8%) had partial remission and 2 (8.3%) had no clinically significant change. Twenty patients (83.3%) were completely satisfied, 2 were satisfied and 2 were dissatisfied with the leiomyoma embolization procedure. Discussion: There is a positive correlation between the preoperative estradiol level and the extent of the decrease in the leiomyoma volume after the embolization procedure. As leiomyoma is a hormone dependent tumor, the shrinkage of the leiomyoma seems also dependent on the estradiol levels before the precedure besides the incurred ischemic necrosis secondary to arterial embolization.
