Aim: It is thought that asymmetric dimethyl arginine(ADMA) level is significantly higher in pregnant women with preeclampsia compared to healthy pregnant women, ADMA elevation develops before the clinical signs of preeclampsia, and ADMA plays a role in the pathogenesis of preeclampsia. In this study, it was aimed to investigate whether serum ADMA, total nitrite and nitrate (NOx), arginine and total antioxidant capacity (TAC) and levels in placenta samples taken from healthy and preeclamptic pregnant women and their babies are associated with preeclampsia, whether preeclampsia can be detected beforehand with these markers, and whether possible problems that may develop in the mother and baby can be prevented as a result. Material and Methods: 62 pregnant women and their babies who were followed up in Zonguldak Bülent Ecevit University obstetrics service are divided two groups; 31 preeclamptic pregnant and babies (Group I), formed Patient group; 31 pregnant and babies without preeclampsia (Group II), formed Control Group. Blood samples were obtained from mothers before birth, from the cord during birth, from babies in first 24 hours after birth and placenta samples were obtained from each pregnant to evaluate in the study. Age, weight, initial pregnancy state, pregnancy period, systolic and diastolic blood pressure levels of mothers with and without pre-eclampsia diagnosis, while birth weights, genders, problems and complications during treatment process, clinic and laboratory properties, prognosis, ADMA, arginine, NOx and TAC levels of babies were examined in this study. Results: There was no significant difference between two groups about antenatal factors that effect on prognosis. In the comparison of blood values, ADMA level of preeclamptic group was significantly higher (p

BACKGROUND:Postpartum hemorrhage (PPH) is one of the emergency situations of obstetrics practice that constitutes of 1 to 5% of vaginal and cesarean deliveries. Uterine atony is the number one cause of PPH and is responsible for at least 75% of PPH cases. Uterine compression sutures have been regarded as an effective method in PPH cases, as well as preserving fertility by preserving the uterus.AIMS:The main purpose of this study was to report on our results with a new uterine compression suture technique that was developed by us.SUBJECTS AND METHODS:In this study we included all women who needed uterine compression sutures because of uterine atony while cesarean section from January 2014 to December 2018. Fifteen cases with PPH with uterine atony were reported, who were treated with our uterine compression suture technique after conservative medical and uterine massage treatment failure.RESULTS:All of the cases in this study were managed successfully namely none of the patients needed a hysterectomy or reoperation because of bleeding again. One week, one month, three months later all patients were followed up. Six months later 11 patients were examined, four patients lost to follow-up, but they were reached by phone since they were outside of the city, they reported no complaints. Ultrasound examination was performed to follow up patients. Short-term follow-up revealed no complications such as pyometra, endometritis, reoperation, amenorrhea, or uterine necrosis.CONCLUSIONS:We described our practice with our uterine compression suture that is easy to learn and apply. All of the cases that participated in our study showed improvement to the compression sutures, so no other surgical interventions were applied. The same suture technique was applied by only one physician. This is a feasible and easy way to stop bleeding in uterine atony and in uterine preservation, especially in rural areas when help may not be available in case of complications.

Proteinuria is a component of preeclampsia, and the presence of proteinuria without an increase in blood pressure can precede preeclampsia. This study aims to investigate the perinatal effects of isolated proteinuria detected in a 24-h urine sample after the 20th week of pregnancy. This is a prospective study of the perinatal outcomes of 60 pregnancies without proteinuria and matched 58 pregnancies with isolated proteinuria in patients consecutively admitted to the department of obstetrics at a university hospital in Turkey. The pregnant patients with proteinuria and without proteinuria were statistically similar with respect to age, gravidity, parity and the number of living children on enrolment. There were no significant differences in terms of gestational age at enrolment, gestational age at delivery, or intrauterine growth restriction (IUGR) between patients with isolated proteinuria and patients without proteinuria. However, preeclampsia developed significantly more frequently in patients with isolated proteinuria (20.6% vs 6.6%, p = 0.048). There were no significant differences in terms of newborn weight, Apgar scores, need for the neonatal intensive care unit (NICU), or umbilical artery blood pH in patients with proteinuria and without proteinuria. Isolated proteinuria after 20 weeks of pregnancy does not appear to impair maternal or foetal outcomes. Identifying pregnant women with risk factors for preeclampsia, ensuring they attend meticulous follow-up schedules and performing their delivery at tertiary health care centres would help to improve maternal and foetal morbidity and prevent perinatal mortality.

The fibrin sealant emanates from the unique complex structure of the native soluble plasma protein fibrinogen comprising an intricate arrangement of three pairs of polypeptide chains with two connecting three regions of more compact, complicated trinodular configurations. The autologous native cryoprecipitated fibrinogen concentrates, produced under blood-bank standards, have yet to be assessed for effectiveness during in vivo tissue healing in terms of tissue strength and elasticity in order to complete restoration of biomechanical integrity. It is to this restoration of tissue healing, using cryoprecipitated native fibrinogen, that this presentation is directed. It illustrates a fibrin sealant reference standard compared to routine suture closure in an in vivo animal model. The fibrin-sealant reference standard of this restricted presentation with specified test dimensions is intended to serve as a basis for the numerous other chemically variant precipitated fibrinogens, with further considerations of variables of adjustments in pH, ion concentrations, and imposed means of viral inactivation.

Amaç: Preterm doğumu önlemek amacıyla servikal yetmezlik saptanıp proflaktik serklaj ve acil serklaj operasyonu yapılmış olan olguların perinatal sonuçlarını karşılaştırmak Gereç ve Yöntem: Ocak 2009 - Ocak 2019 arasında Zonguldak Bülent Ecevit Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum Kliniği’nde serklaj yapılmış olan hastaların medikal bilgileri retrospektif olarak incelendi. Servikal yetmezlik ile ilişkili bir veya daha fazla ikinci trimester gebelik kaybı hikayesi bulunan ya da servikal yetmezlik nedeniyle daha önce serklaj yapılmış olan hastalar proflaktik serklaj grubu olarak, ikinci trimesterde ağrısız servikal dilatasyon ve/veya membranların vajene prolabe olduğu saptanarak serklaj yapılan olgular ise acil serklaj grubu olarak ayrıldı. Gruplar arasında gebelik süresince gelişen komplikasyonlar, perinatal sonuçlar ve inflamatuar belirteçlerden lökosit (WBC), periferik kan nötrofil-lenfosit oranı (NLR) ve trombosit-lenfosit oranı (PLR) karşılaştırıldı. Bulgular: Yirmi yedi olgudan oluşan proflaktik serklaj grubunda canlı doğum oranı %96,6 iken, 16 olgudan oluşan acil serklaj grubunda canlı doğum oranı yine oldukça yüksek bir oran olan %81,3 olarak saptandı. Proflaktik serklaj ve acil serklaj yapılan hastaların canlı doğum oranı, doğum haftası, preterm doğum oranı ve doğum kilosu her iki grupta da benzerdi (p=0,137; p=0,179; p= 0,085; p=0,602). Acil serklaj yapılan olguların servikal dilatasyonları 1-4 cm arasında değişmekteydi. Beş olguda servikal dilatasyon ≥3 cm ve membranlar prolabe idi, bu olguların sadece biri (%20) canlı term doğumla sonuçlandı. Acil serklaj grubunda lökosit (WBC) sayısı proflaktik serklaj grubundan daha yüksek bulundu (p=0,037). Buna karşılık NLR, PLR, nötrofil, lenfosit ve trombosit sayıları ise her iki grupta farksız saptandı. Tüm olgular içinde preterm doğumlar ile term doğumlar arasında yapılan karşılaştırmada ise WBC, NLR ve PLR değerleri açısından fark saptanmadı. Sonuç: Acil serklaj operasyonunun perinatal sonuçları proflaktik serklaj operasyonu ile benzer ve her iki grupta da canlı doğum ve term doğum oranları yüksek saptanmıştır. Bununla beraber acil serklaj yapılan grupta servikal dilatasyonun ≥3 cm olduğu olgularda ise neonatal mortalite, abortus ve preterm prematür membrane rüptürü oranı yüksektir. Bu bulgular özellikle acil serklaj yapılacak hastaların seçiminde dikkatli olmak gerektiğini göstermektedir. Objective: To compare perinatal outcomes of prophylactic cerclage and emergency cerclage operations in patients with cervical insufficiency to prevent preterm birth. Material and Method: A retrospective study was conducted between June 2009 and June 2019 in University of xxxxxxxxxx Obstetrics and Gynecology Department. All medical records were evaluated. Patients with history of one or more second-trimester pregnancy losses related to painless cervical dilation and in the absence of labor or abruptio placentae or history of prior cerclage due to painless cervical dilation in the second trimester were included to prophylactic cerclage group and patients with painless cervical dilation and/or prolabed membranes at physical examination in the second trimester were included to emergency cerclage group. Pregnancy complications, perinatal outcomes and inflammatory markers such as WBC count, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) were assessed. Results: Live birth rate were 96,6% in prophylactic cerclage group which was consisted of 27 patients and 81,3% in emergency cerclage group which was consisted of 16 patients. Similarity were observed in comparison of live birth rate, gestational age at birth, preterm birth rates and birthweight between both groups (p=0,137; p=0,179; p= 0,085; p=0,602). Cervical dilatation was between 1 and 4 cm in emergency cerclage group. Cervical dilatation were ≥3 cm and membranes were prolabed in 5 patients. Only one of five patient’s pregnancy was resulted with term birth. WBC count were higher in emergency cerclage group than prophylactic cerclage group (p=0,037). On the contrary, no difference was seen in comparison of NLR, PLR, neutrophil, lymphocyte, and platelet count between groups. Likewise, WBC, NLR and PLR were not different between the patients who were delivered preterm and term in all groups. Conclusion: Our study suggests that, both prophylactic cerclage and emergency cerclage increases the live birth and term birth rates. However increased neonatal mortality, abortus and preterm premature membrane rupture rates were observed in patients with cervical dilatation ≥3 cm. Patients must be evaluated carefully before emergency cerclage operation.

Abstract The aim of this study was to determine the accuracy of the 24-h urine collection in preeclamptic pregnant women. This study included 65 singletons with preeclampsia and 53 singleton patients in a control-matched group. The ratio of inaccurate 24-h urine collection was measured by calculating expected urine creatinine excretion according to the proportion of pre-pregnancy weight and the lean body mass (LBM) of the patients. Comparisons were made between the accurately-collected 24-h urine protein excretion rates and the instant and 24-h urine protein/creatinine (P/Cr) and albumin/creatinine (A/Cr) ratios. Twenty-four-hour urine collection used to diagnose patients with preeclampsia was incorrectly collected 15–73.5% of the time among the patients and the control group. Instant and 24-h urine P/Cr and A/Cr ratios were correlated with total 24-h proteinuria among the patients in whom urine was collected correctly. Considering the 24-h urine P/Cr ratio, rather than the 24-h urine protein excretion value, is a better way to diagnose preeclampsia. IMPACT STATEMENT What is already known on this subject? Twenty-four-hour urine collection is considered as the gold standard of diagnosing proteinuria in preeclampsia, in case of the correctly collected. What do the results of this study add? Generally, in the literature the correctness of 24-h proteinuria is not questioned. However, it is actually quite important in daily practice to make the correct diagnosis of the proteinuria not to misdiagnose preeclampsia. What are the implications of these findings for clinical practice and/or further research? In this article, we aimed to show the importance of accurately collected 24-h urine in preeclampsia. We consider and advise to change the gold standard of this technique to 24-h protein/creatinine (P/Cr) ratio, in order to make correct diagnosis of the preeclampsia.

Aim: The aim of this study was to determine midkine (MK) expression in women with preeclampsia (PE) compared with those in a normal pregnancy. Materials and Methods: This study included 45 patients with PE and 35 patients in a control group. Women with PE who had a diagnosis of preeclampsia before gestational week 34 were included in the early PE group (n = 20). Women diagnosed with PE after gestational week 34 were in the late PE group (n = 45). Serum MK levels were compared between the groups. Results: MK level was neither different between normotensive women and those with early PE nor was it different between the early and late PE groups. MK levels were significantly different between the normal pregnancy and late PE groups. The MK level decreased in the late PE group compared with that in the normal pregnancy group. Conclusion: Serum MK levels significantly decrease in late PE women compared with normally pregnant women.

ÖzetEktopik gebelik ilk trimesterde morbidite ve mortalitenin en sık nedenidir.İnterstisyal gebelik ektopik gebeliğin en nadir formlarından olup tüm ektopik gebeliklerin %2-4'ünü oluşturmaktadır.Bu yazımızda girişime gerek kalmadan sistemik Metotreksat ile başarılı şekilde tedavi edilmiş interstisyal gebelik olgusunu tartıştık.Seri β-hCG ölçümlerinde yeterli regresyon izlendi ve operasyona ihtiyaç kalmadı

Objectives: This study was conducted to determine the frequency, predisposing factors and impact of urinary incontinence (UI)during pregnancyon quality of life (QOL). Materials and Method: A preliminary cross-sectional survey was carried out among pregnant women from January to June of 2014. A total of 132 pregnant women were enrolled. We used a questionnaire form for sociodemographic features, ICIQ-SF-Turkish version to determine the occurrence and characteristics of UI and Wagner’s Quality of Life scale to assess impact on QOL. Results: Urinary incontinence was present in 56 out of 132 pregnant women (42.4%); these women were referred to as the UI-present group. The remaining 76 women comprised the UI-absent group. The overall mean age was 27.5 ± 5.1 y (p=0.780), median height in UI-present group was 160 cm (min-max: 153-176, p=0.037 <0.05) and median BMI was 28.7 kg/m2(min-max: 22.4-50.0, p=0.881).For women in the UI-present group, urine leakage occurred once a week (n=18, 32.1%) to twice or thrice a week (n=8, 14.3%), few times a day (n=14, 25%), once a day (n=5, 8.9%) and always (n=8, 14.3%). The pregnant women in the UI-present group mainly reported a small amount of urine leakage (n=33, 58.9%) or a moderate amount of leakage (n=4, 7.1%). There were statistically significant relationships between QOL scores and frequency of UI (p=0.002 <0.05) as well as the amount of leakage (p=0.002 <0.05). Impact on QOL scores ranged from mild (n=33, 58.9%) or moderate (n=4, 7.1%) to severe (n=4, 7.1%) levels. QOL has ‘mildly deteriorated’. The following features were found to favour the onset of UI: age of pregnant woman (OR= 0.845, 95% CI 0.268-2.669), occupational status (OR=1.800, 95% CI 0.850-3.810), anaemia (OR=0.939, 95% CI 0.464-1.901), parity (OR=0.519, 95% CI 0.325-0.829), miscarriage in previous pregnancies (OR=1.219, 95% CI 0.588-2.825) and living in rural vs urban settlement (OR=1.800, 95% CI 0.887-3.653).Heigt (p= 0,037<0.05), educational status (p=0.016 <0.05), miscarriage, parity and place of living (p=0.002, p=0.006, p=0.020 <0.05 respectively)were significant in favour of UI-present. Conclusions: Urinary incontinence was frequently encountered among pregnant women (42.1%). Urinary incontinence distorted the QOL in pregnant women at a mild level and caused life style changes. Frequency and amount of UI were the significant factors in deterioration. Age, parity, miscarriage, being housewife, place of living (rural) and anaemia were the factors in favour of onset of UI during pregnancy. Among them, height, educational status (primary-intermediate school graduate), place of living (rural), miscarriage and parity were statistically significant predictors. It is necessary to pay attention to UI and its impact on women’s health during pregnancy.

Objectives. The frequency, predisposing factors and impact of urinary incontinence (UI) on quality of life (QoL) during pregnancy were investigated. Materials and Method. A preliminary cross-sectional survey was studied among pregnant women between January and July of 2014. A total of 132 pregnant women were recruited using a questionnaire form for sociodemographic features, the Turkish version of the International Consultation on Incontinence-Short Form (ICIQ-SF), for the characteristics of UI and Wagner's Quality of Life scale to assess impact on QoL. p < 0.05 was set significant. Results.Urinary incontinence was present in 56 out of 132 pregnant women (42.4%, UI-present group): mean age, 26.7 ± 5.4y(p = 0.780); median height, 160 cm (min-max: 153-176, p = 0.037); median BMI, 28.7 kg/m(2)(min-max: 22.4-50.0, p = 0.881); urine leakage occurred per week once (n = 18, 32.1%), twice or thrice (n = 8, 14.3%); per day few times (n = 14, 25%), once (n = 5, 8.9%) and always (n = 8, 14.3%) with mainly a small amount of urine leakage (n = 33, 58.9%) or a moderate (n = 4, 7.1%). There were statistically significant relationships between QoL scores and frequency of UI (p = 0.002) or amount of leakage (p = 0.002). Impact on QoL scores ranged from mild (n = 33, 58.9%), moderate (n = 4, 7.1%) to severe (n = 4, 7.1%) levels in daily life. UI impacted the daily life activities of women by making them less likely to undertake activities outside their homes (23.2%), by affecting their working performance and friendships (8.9%), their daily home activities (7.1%), their general health status (12.5%), their sexual relations (12.5%), by making them more nervous or anxious (10.7%) and by the need to wear pads or protectors (25%). ANOVA, Tukey, and Tamhane tests as the minimal important difference model yielded significant relevance between statistical analyses and clinical outcomes by using standard deviations (p = 0.001, 0.001 and 0.005 respectively). The following features favored the occurence of UI: Age (OR = 0.845, 95% CI [0.268-2.669]), being a housewife (OR = 1.800, 95% CI [0.850-3.810]), anemia (OR = 0.939, 95% CI [0.464-1.901]), parity (OR = 0.519, 95% CI [0.325-0.829]), miscarriage (OR = 1.219, 95% CI [0.588-2.825]) and living in rural areas (OR = 1.800, 95% CI [0.887-3.653]). Height (p = 0, 037), educational status (0.016), miscarriage (0.002), parity (0.006) and place of living (0.020) were significant factors. Conclusions.Many pregnant women are suffering from UI, which warrants a significant public health consideration in the region. Age, height, being a housewife or graduation level higher than primary school, living in rural, parity, miscarriage, and anemia were the factors in favor of the onset of UI. The authors plan a health promotion program in the region according to the results in order to provide information to health caregivers, especially family physicians, and to educate women about the predictors of UI and pelvic floor exercises for primary prevention and secondary relief of UI during and after pregnancy and provide some hygienic supplies to the poor in this aspect.

OBJECTIVE: The aim of this study was to determine the risk factors, that may cause preterm labor among the pregnant women. STUDY DESIGN: Our study was performed between the dates 1st September 2008 - 1st May 2009, among pregnant women, who are hospitalized in Obstetrics and Gynecology Department of Bulent Ecevit University Faculty of Medicine. A survey sheet was constituted to determine possible risk factors of preterm labor. RESULTS: Variables, which were evaluated as significant according to Logistic Regression Analysis, were found as age, systolic blood pressure, multiple pregnancies, presence of chronic disease, anemia, intercourse, experiencing a bitter event within the last month, trauma, low income and leukocytosis. CONCLUSIONS: Conditions related to low socio-cultural level, high blood pressure, stress, multiple pregnancies, therapeutic pregnancies, vaginal infections, presence of a chronic disease, or severe anemia led us to suspect about preterm labor; risk factors should be eliminated by intensive monitoring of these pregnant women.

Objective: Smoking in pregnancy and postpartum period causes serious healthy risks for fetuses, newborns, and children. The purpose of this study was to determine the prevalence of smoking and associated socio-demographic factors and knowledge, attitude levels, and behaviors of pregnant smokers.Methods: A descriptive study was performed on 335 pregnant women who were admitted to our clinic between March 1 and April 30, 2014. A questionnaire prepared by researchers comprising 24 questions was applied to eligible women. Statistical analysis was performed using SPSS 19 software program. Descriptive statistical data are presented as frequencies, and measurements are presented as mean +/- standard deviation. Chi-square test was used for comparison between categorical variables. Mann-Whitney U test and Kruskal-Wallis analysis of variance were used for comparisons between paired groups.Results: A total of 20.5% of pregnant women smoked throughout pregnancy. Education and income status of pregnant women did not have a significant association with smoking during pregnancy (p=0.172 and p=0.203, respectively). Smoking status was compared with pregnancy, breastfeeding, and total knowledge scores. While a significant difference did not exist between pregnancy and total knowledge scores (p=0.126, p=0.051), knowledge scores of breastfeeding was significantly lower in smoking women (p=0.031). Education status and knowledge scores were compared. Each of the three knowledge scores was higher in women with higher education levels (p=0.003, p=0.000, and p=0.001).Conclusion: Smoking during pregnancy is a major health problem. Control frequency should be increased for pregnant smokers and for their babies as well as to aid in the early diagnosis of potential problems. Doctors, nurses, and midwives should remind patients who quit smoking during pregnancy that they should take professional help to not start smoking again in the postpartum period.

OBJECTIVE:Noninvasive and simple markers are needed for the prediction of preterm delivery in women at risk for preterm labour. The aim of this study was to determine the value of platelet indices in the prediction of preterm delivery.DESIGN:A retrospective study.SETTING:Routine antenatal care in Zonguldak Bülent Ecevit University between 2008 and 2011.SAMPLE:Ninety patients who delivered between 28 and 37 weeks of gestational age and 128 patients who delivered at term.METHODS:Plateletcrit and other haematological markers, cervical dilatation and effacement, and the neutrophil-to-lymphocyte ratio as an inflammation marker.MAIN OUTCOME MEASURE:The role of platelet indices in predicting the preterm delivery.RESULTS:The platelet count, plateletcrit, white blood cell count, red cell distribution width, and neutrophil count were significantly higher in the preterm delivery group. Receiver operating characteristic curve analysis showed that the plateletcrit cut-off value for predicting spontaneous preterm labour was 0.201%, with a sensitivity of 95.6% and specificity of 87.5%; the cut-off value for the platelet count was 234 ? 103/mm3 with a sensitivity of 81.0% and specificity of 71.0%.CONCLUSION:Plateletcrit is a low-cost, widely available, and noninvasive marker that might be used for the prediction of preterm delivery in patients with a history of preterm labour.

A case of unilateral absent ovary together with clear cell type epithelioid leiomyoma of uterus mimicking ovarian malignancy discovered during laparotomy is presented. Unilateral absence of an ovary is an extremely rare finding. Although the exact pathophysiological mechanism is not known, it could result from a defect in embryological development or asymptomatic torsion of ovary. Clear cell type epithelioid leiomyoma of uterus is also a rare variant, composed of round or polygonal 'clear' cells rather than typical spindle-shaped cells and ultra structurally differs from non-uterine counterparts.

We aimed to determine the oxidative stress and antioxidant status in preeclamptic placenta. Also, we investigated the apoptotic index of villous trophoblast and proliferation index of cytotrophoblasts. The study included 32 pregnant with preeclampsia and 31 normotensive healthy pregnant women. Malondialdehyde (MDA) and total antioxidant status (TAS) levels were measured in the placenta. For detection of apoptosis and proliferation in trophoblast, apoptosis protease activating factor 1 (APAF-1) and Ki-67 were used. Placental MDA levels in preeclamptic women were significantly higher than normal pregnancies (p=0.002). There was no significant difference between the groups in the TAS levels of placenta (p=0.773). Also, the apoptotic index in villous trophoblasts increased (p<0.001), but proliferation index did not change in preeclampsia (p=0.850). Increased oxidative stress and apoptosis in pathological placenta are not balanced by antioxidant systems and proliferation mechanisms.

OBJECTIVE:To evaluate the diagnostic and the predictive value of Arizona Sexual Experience Scale among primary infertile couples regarding sexual dysfunction. METHODS:The cross-sectional and prospective pre, post study comprising primary infertile patients was carried out at Bulent Ecevit University Hospital, Zonguldak, Turkey. Fifty consecutive primary infertile couples not treated previously were investigated between 2003 and 2007 for the presence of sexual dysfunction by a psychiatrist. Arizona Sexual Experience Scale scoring was self-administered to determine sexual dysfunction among couples before treatment and also 3 months after the initiation of the treatment. RESULTS:Pretreatment mean values of the index parametres in both women and men were significantly increased after treatment. Statistically significant positive correlation was observed between pre- and post-treatment total scores in both women (r = 0.83; p < .001) and men (r = 0.92; p < .001). Receiver operating characteristic curve analyses revealed optimum cut-offs of pre- and post-treatment scores in women were were > 14 (Sensitivity: 57%; Specificity: 90%) and > 13 (Sensitivity: 83%; Specificity: 93%), respectively. Pre- and post-treatment scores in men were > 10 (Sensitivity: 65%; Specificity: 61%), > 11 (Sensitivity: 83%; Specificity: 62%), respectively. Binary logistic regression analyses revealed women's pre-treatment and post-treatment scores as a significant factor for prediction of sexual dysfunction independent of sociodemographic factors (p = 0.001 and p = 0.001, respectively). CONCLUSION:Evaluation and treatment of infertility is an important risk factor for sexual dyfunction. Pre- and posttreatment Arizona Sexual Experience Scale score could be used as a screening test for sexual dysfunction and might be used to decide pre/post-treatment consultation of couples with a specialist.

Objective: To compare the results of intracytoplasmic sperm injection (ICSI) and embryo transfer (ET) cycles in men with severe oligoospermia and non-obstructive azoospermia. Materials and Methods: This study included 91 ICSI cycles performed due to male factor infertility. Patients are divided into two groups according to source of spermatozoa. Group 1 consisted of 38 cycles in which sperm was obtained from testicles (cases with non-obstructive azoospermia). In Group 2, 53 consecutive cycles were included in which ejaculated sperm was available for ICSI in spite of severe oligospermia (< 100,000/ml). Fertilization, embryo quality and clinical pregnancy rates were compared between the groups. Results': Although, the female age and mean number of oocytes retrieved were similar among the two groups, fertilization rate was significantly lower in the non-obstructive azoospermia (34.6%) group compared to group in which patients underwent ICSI with ejaculate spermatozoa (55.3%) (p < 0.05). However, there were no differences regarding mean number of available grade 1 embryos on day 3 and pregnancy rate between the two groups. Conclusion: Testicular sperm from non-obstructive azoospermia patients had significantly lower fertilization rates than the ejaculated spermatozoa from severe oligospermia patients in ICSI cycles. However, it did not bring about improved pregnancy rate.

AIM:The aim of the study was to compare maternal and perinatal mortality and short-term outcomes of maternal and perinatal health between a cesarean group with relative indications and a vaginal delivery group.METHODS:A total of 1,119 patients were included; 582 were delivered by spontaneous vaginal birth and 537 delivered by cesarean section without labor. The indication for cesarean section was tocophobia and fear of childbirth for all patients. Maternal and perinatal morbidity and mortality were compared between the groups.RESULTS:No maternal mortality was recorded. Maternal morbidity was significantly lower in the vaginal birth group than the cesarean group (7 vs 30, p<0.05). Perinatal mortality (2 vs 0) and perinatal morbidity were not significantly different between the two groups (33 vs 17). The vaginallly delivered group had significantly higher newborn hospitalization rates than the cesarean group (p<0.05), but hospitalization time did not differ. Newborns with the first minute Apgar score below 7 were higher in the cesarean group (p<0.05). Fifth minute Apgar scores and umblical cord pH values were similiar. Cesarean neonates weighed more than vaginally delivered ones (p<0.05).CONCLUSION:Short-term maternal complications were more frequently seen in cesarean deliveries with relative indications than spontanous vaginal deliveries but no difference was found in perinatal mortality and morbidity. There is a clear need for research on health outcomes for mothers and infants associated with cesarean delivery without any medical indication.