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  • Küçük Resim
    Öğe
    Centile charts of cervical length in singleton and twin pregnancies between 16 and 24 weeks of gestation
    (2023) Akar, Bertan; Ceylan, Yasin; Kahraman, Alper; Çalışkan, Eray
    Objective: The aim of this study was to determine the standard mid-trimester cervical lengths of singleton and twin pregnancies. Material and Methods: This study was conducted by retrospective analysis of mid-trimester transvaginal cervical measurements of women with singleton and twin pregnancies that were examined by a single perinatologist in a single center. Results: A total of 4621 consecutive asymptomatic pregnant women admitting for advanced obstetric ultrasound screening were evaluated. Of these 4340 (93.9%) were second trimester singleton pregnancies and 281 (6.1%) were twin pregnancies and were included. Mean cervical length measurements of singleton and twin pregnancies were 6.5±38.2 mm and 7.2±37.6 mm respectively (p=0.17). Overall, the 5th percentile of cervical length measurement after analysing singleton and twin pregnancies together was 29.4 mm at 16 weeks, 30 mm at 17 weeks, 30 mm at 18 weeks, 30 mm at 19 weeks, 30 mm at 20 weeks, 30 mm at 21 weeks, 30 mm at 22 weeks, 31 mm at 23 weeks, 29 mm at 24 weeks. Conclusion: In our population the 5th precentile value of cervical length which is 30 mm in singletons and 10th percentile cervical length which is 31 mm in twins can be used to follow-up and treat pregnant women at risk for preterm delivers. © 2023 by the Turkish-German Gynecological Education and Research Foundation. Journal of the Turkish-German Gynecological Association is published by Galenos Publishing House.
  • [ X ]
    Öğe
    Cerrahi Alan Enfeksiyonlarında Dönemsel Faktörlerin Etkisi: Pandemi Öncesi ve Dönemi Karşılaştırması
    (Alanya Alaaddin Keykubat Üniversitesi, 2025) Aybek, Özlem Yüksel; Ceylan, Yasin; Kovalak, Evrim Ebru; Karacan, Tolga; Güraslan, Hakan
    Amaç: Bu çalışma, COVID-19 pandemisinin cerrahi alan enfeksiyonlarının (CAE) insidansı üzerindeki etkisini araştırmayı, ilişkili risk faktörlerini belirlemeyi ve morbidite, mortalite ile sağlık hizmeti maliyetlerini azaltmaya yönelik kanıta dayalı stratejiler önermeyi amaçlamaktadır. Yöntem: Bu çalışma, 1 Mart 2018 ile 1 Mart 2022 tarihleri arasında Sağlık Bilimleri Üniversitesi Bağcılar Eğitim ve Araştırma Hastanesi’nde ameliyat edilen 5.064 hastayı kapsamaktadır. Ameliyat sonrası 30 gün içinde cerrahi alan enfeksiyonu (CAE) gelişen hastalar değerlendirilmiştir. Pandemi öncesi dönemde 62, pandemi döneminde ise 39 olgu tespit edilmiştir. Bulgular: COVID-19 pandemisi öncesinde 2.864, pandemi döneminde ise 2.200 hasta cerrahi operasyon geçirmiştir. Bu hastalar arasında sırasıyla 287 (%10) ve 274 (%12,5) olgu jinekolojik ameliyatlardan oluşmaktaydı. Cerrahi alan enfeksiyonu (CAE), pandemi öncesi dönemde 62 hastada (%2,2), pandemi döneminde ise 39 hastada (%1,8) tespit edilmiştir. Hastaların ortalama yaşı 33 ± 10 yıl, ortalama beden kitle indeksi (BKİ) ise 33 ± 7 idi. Uygulanan işlemlerin çoğunluğunu sezaryenler oluşturmakta olup, insizyonların %96’sı Pfannenstiel tekniği ile yapılmıştır. Hastaların %21’i sigara kullanıcısıydı, %42’sinde daha önce geçirilmiş cerrahi öyküsü mevcuttu ve %19’unda en az bir komorbid hastalık bulunmaktaydı. Sonuç: COVID-19 pandemisi döneminde, pandemi öncesi döneme kıyasla cerrahi alan enfeksiyonu (CAE) oranlarında bir azalma gözlemlenmiş olsa da, bu fark istatistiksel olarak anlamlı bulunmamıştır. Bulgularımız, enfeksiyon önleme önlemlerinin hem pandemi öncesinde hem de pandemi sırasında etkin bir şekilde uygulandığını ve pandemiye yönelik ek önlemlerin CAE insidansını azaltma üzerinde anlamlı bir etkisinin olmadığını göstermektedir.
  • Küçük Resim
    Öğe
    Obstetric hemorrhage and surgical emergencies training workshops on fresh cadavers and simulators result in high application in daily practices and decreased patient referral
    (2022) Akar, Bertan; Ceylan, Yasin; Kahraman, Alper; Köle, Emre; Çalışkan, Eray
    Objective: In this study, we aimed to evaluate the effects of obstetric emergencies workshops combining theoretical lectures, simulation trainers and fresh cadaver models on daily practices and referrals of obstetrics and gynecology specialists. Materials and Methods: This is a prospective observational study involving obstetrics and gynecology specialists attending the Turkish Society of Obstetrics and Gynecology endorsed obstetrics hemorrhage management courses held in 2018 and 2019. The training course is an annually organized two-day course, one day allotted to theoretical lectures and the other day to practical training on both simulators and fresh cadavers. Trainees participating in the course was surveyed with an anonymous questionnaire on their motivation to attend the course and their juridical history of obstetric patient management. Attendees were asked to disclose whether they had ever independently performed the procedures stated in the questionnaire or not, before commencing the course and 1 year after attending the course. Results: Among the attendees 22% (n=32) had at least one obstetrical malpractice lawsuit and 36.1% (n=52) were accused of Health Care Complaints Comission. The main motivation of the attendees for taking this course was Professional development followed by reducing maternal mortality and morbidity and avoiding malpractice. One year after the course, attendees applying uterine devascularization surgery increased by 36.1% (52/144), uterine compression sutures increased by 52.7% (76/144), and ability to apply uterine balloon tamponade increased by 59.7% (86/144). Besides improvement in other obstetric surgical skills an indirect effect seen that the attandees operated on high-risk cases increased in placenta previa (15.3%), placenta acreata spectrum (30.5%), operative deliveries (27.7%), peripartum hysterectomy (24.9%) and relaparotomy for postpartum hemorrhage (34.7%). Conclusion: Opportunities of attending well organized fresh cadaveric workshops on managing postpartum hemorrhage and other obstetric surgeries, can quickly adapt to daily practice, restore the professional confidence of obstetric and gynecology specialists, and eventually decrease patient referral.