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    Examination of pelvic structures of women with polycystic ovary syndrome using magnetic resonance imaging pelvimetry
    (2024) Köle, Emre; Özen, Selda; Deniz, Merve Erol; Kole, Merve Cakir; Deniz, Alparslan; Aksoy, Lale; Aslan, Erdoğan
    Objective: Our study aimed to evaluate patients with Polycystic Ovary Syndrome (PCOS) using Magnetic Resonance (MR) pelvimetry to determine if there is a specific pelvic type associated with hyperandrogenemia. Method: This study retrospectively analyzed data collected from pelvic MR imaging performed on 36 patients diagnosed with PCOS who attended the outpatient clinic of Alanya Education and Research Hospital between 2021 and 2022. All cases were of reproductive age, between 18 and 49 years, and were initially diagnosed with PCOS via ultrasound, had a history of hirsutism or amenorrhea, followed by subsequent MR imaging. A control group of 35 patients, matched for reproductive age without PCOS diagnosis, hirsutism, amenorrhea, or menstrual irregularities, who underwent MR imaging for any other reason were recruited Results: No significant differences were observed between the groups in terms of age, gravidity, parity, abortions, except for weight and Body Mass Index (BMI). Comparison of MR pelvimetry results between the groups, including pelvic inlet transverse diameter (cm), interspinous diameter (cm), midsagittal pelvic inlet anteroposterior diameter (cm), and midsagittal pelvic outlet anteroposterior diameter (cm), revealed no significant differences. Conclusion: Unfortunatelly, the results did not provide convincing evidence to prove our hypothesis. If it were, we believe, it would provide a bridge between the animal expriments and clinical studies regarding the ethiplogy of PCOS.
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    OP-15 Case report pulmoner embolism during pregnancy
    (2023) Güllüoğlu, Ahmet; Köle, Merve Çakır; Deniz, Merve Erol
    Objective Thrombosis is limited to the deep veins of the lower extremities in most cases during pregnancy. In this case, a rare arterial embolism (in the left anterior tibial artery) was observed. A 36-year-old 33-week pregnant woman patient with a history of G3P2 2*CS was admitted into ALKU Hospital due to dyspnea and tachycardia. Pulmonary embolism is a mortal condition seen in 1/7000 pregnancies. There is clinical evidence of DVT in 70% of women who develop pulmonary embolism. Case A 36-year-old 33-week-old pregnant woman applied to the emergency department with complaints of high fever, left flank pain and shortness of breath. Patient’s vitals: TA:135/70 mmHg, Pulse:170/min, Fever:39C, Spo2:91. Laboratory results were: D-dimer: 10520 ng/ml, Procalcitonin: 2.68 ng/dl. Celestone(1x2 amp), Rocephin(1 gr IV), Diltiazem(100cc/hour) were applied to the patient. Oxygen was started at 4lt/min. Sinus tachycardia was seen on ECG and EF was 65% on ECO. No significant dilatation was observed in the right heart structures. Considering the clinical and laboratory evaluation of the patient, it was thought to be compatible with the preliminary diagnosis of pulmonary embolism. The patient was started on Clexane 2x0,6. Due to that the patient’s vital signs were unstable, the partial oxygen pressure was at the intubation limit, and the maternal-fetal tachycardia did not improve, the patient was taken to cesarean section. Postoperative vitals and general condition was good. As a result of thorax CT angiography, there were thickenings in the interstitial septas and frosted glass densities in the bilateral lungs, and the patient was transferred to the chest diseases service with a preliminary diagnosis of alveolar hemorrhage. There was an appearance compatible with thrombosis in the left tibial artery’s branch. On the 14th postoperative day, the patient’s vital signs were stable, the laboratory values were Troponin- negative(less than 0,04 ng/ml), D-dimer (less than 500 ng/ml) Procalcitonin:0.14 ng/dl. One week after discharge, the patient presents to the emergency department again with complaints of fever and flank pain. Sepsis was suspected in the patient who had fever(39C), tachycardia(130/min) and Spo2: 89. After further investigations(CT imaging), the Urinoma secondary to renal pelvis laceration due to nephrolithiasis was considered as the cause of sepsis. Double J stent was inserted to the patient by the urology team under cystoscopy. As soon as the patient’s urinoma and sepsis regressed after antibiotic therapy, the stent was removed on the postoperative 30th day. Discussion Considering similar complaints during pregnancy, sepsis and other pulmonary diseases of pregnancy must be ruled out. Urosepsis is a common cause of septic shock during pregnancy. Genitourinary tract infections can often be asymptomatic. It may be accompanied by nephrolithiasis. Conclusion The risk of thrombosis and pulmonary embolism increases during pregnancy and puerperium. Especially pregnant women with a history of thrombosis should be questioned and anticoagulant treatment should be started.