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    Association between maternal ghrelin levels and hyperemesis gravidarum
    (Tubitak Scientific & Technological Research Council Turkey, 2013) Kaygusuz, Ikbal; Gumus, Ilknur Inegol; Yildirim, Melahat; Erdamar, Husamettin; Uysal, Aysel; Simavli, Serap Aynur; Ayyildiz, Abdullah
    Aim: To investigate serum levels of ghrelin in pregnant women as a potential early marker for hyperemesis gravidarum (HG). Materials and methods: A cross-sectional study was carried out at Fatih University Hospital. Included in the study were 35 women with HG and 31 pregnant women without HG as a control group. The groups were compared in terms of age, gravidity, body mass index (BMI), and fasting serum thyroid-stimulating hormone (TSH) and ghrelin levels. Results: Ghrelin levels of the patients with HG were found to be significantly lower than those in the control group (P = 0.03). No intergroup differences could be found in serum TSH or BMI values. Conclusion: Ghrelin might serve as a reliable marker in the etiopathogenesis of HG.
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    Can either oral glucose challenge test or oral glucose tolerance test parameters predict gestational diabetes mellitus?
    (Springer India, 2017) Yildirim, Melahat; Kosus, Aydin; Kosus, Nermin; Hizli, Deniz; Akcal, Banu; Kosger, Hatice
    This study aims to evaluate the relationship between the glucose challenge test (GCT) levels and any of the oral glucose tolerance test (OGTT) parameters (fasting plasma glucose (FPG), 1-, 2-, or 3-h plasma glucose levels) and their effect on predicting gestational diabetes mellitus (GDM). This analysis was carried out as a retrospective study at Obstetrics and Gynecology Clinic of Turgut A-zal University Hospital. Oral GCT were conducted on patients who are at 24-29 weeks' gestation. The study participants with positive GCT results underwent a 3-h, 100-g OGTT, and the resulting values were evaluated using Carpenter and Coustan diagnostic criteria to determine the gestational glucose tolerance status of patients. The data obtained from both tests (GCT, FPG, 1-, 2-, 3-h OGTT values) were analyzed to observe the effect of each group on predicting GDM. Although all of the GCT and OGTT values were found to be statistically significant (p < 0.001) in determining GDM, the 2-h values of OGTT detected almost all GDM cases with a very high sensitivity level (94.5 %). The 1-h values on the other hand identified 87.6 % of GDM (p < 0.001). The GCT value with the highest sensitivity and specificity for predicting GDM was calculated as 154.50 mg/dl (sensitivity and specificity rates were 79.2 and 72.8 %, respectively). A 2-h OGTT glucose level can detect GDM with 94.5 % sensitivity. This result can guide clinicians to evaluate the patients with GDM.
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    Can hyaluronan binding assay predict the outcome of intrauterine insemination in couples with unexplained or mild male factor infertility?
    (Avicenna Research Institute ajmb@avicenna.ac.ir No.2 and 3, Shabo Alley,Street No.18, Velenjak Avenue,Yemen Street, Shaheed Chamran,Tehran, 19857-43413, 2015) Yildirim, Melahat; Duvan, Zehra Candan İltemir; Pekel, Aslihan; Ayrim, Aylin; Kafali, Hasan
    Background: The purpose of this study was to evaluate the prognostic effect of Hyaluronan Binding Assay (HBA) which has been used as a method of sperm selection for intracytoplasmic sperm injection procedure, on the outcome of intrauterine insemination (IUI) in couples with unexplained or mild male factor infertility. Methods: 77 infertile couples were enrolled in our study. On the day of IUI procedure, HBA test was performed by using fresh semen samples, and the rates of sperm binding to HBA were calculated. HBA values and semen parameters were compared. Fisher exact test was used to evaluate the relationship between HBA ratio and pregnancy status. Mann-Whitney U test was used to compare quantitative variables between pregnant and non-pregnant groups. The p<0.05 was considered statistically significant. Results: In this study, HBA ratio was 69(29.25%) and pregnancy rate was 14.29%. A significant positive correlation between HBA and total motile sperm count, inseminating sperm count, progressive motility, morphology, and sperm concentration (p<0.001, p<0.001, p:0.007, p<0.003, p:0.003 respectively) was observed. Although HBA values in pregnant group were higher than those in non-pregnant group, this result did not reach the statistically significant level (HBA: 67(20%) for nonpregnant group, 80.5(21.3%) for pregnant group). Also, no relationship between HBA values and pregnancy status was found. Moreover, there was no significant correlation between pregnancy status and HBA ratios based on the suggested cut-off value of 60 in literature (p=0.425). Conclusion: HBA does not predict the IUI outcome in couples with unexplained infertility or mild male factor infertility, but it can be used together with semen parameters to verify sperm quality. © 2015 Elsevier B.V., All rights reserved.
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    Effect of Music on Labor Pain Relief, Anxiety Level and Postpartum Analgesic Requirement: A Randomized Controlled Clinical Trial
    (Karger, 2014) Simavli, Serap; Gumus, Ilknur; Kaygusuz, Ikbal; Yildirim, Melahat; Usluogullari, Betul; Kafali, Hasan
    Background/Aims: The control of labor pain and the prevention of suffering are major concerns of clinicians and their patients. The aim of this study was to evaluate the effect of music on labor pain and anxiety, maternal hemodynamics, fetal-neonatal parameters and postpartum analgesic requirement in primiparous women. Methods: Overall, 156 primiparous women who expected vaginal delivery were recruited and randomly assigned to a music group (n = 77) or a control group (n = 79). Women in the music group listened to music during labor. Pain intensity and anxiety level were measured using a visual analogue scale (0-10 cm). The two groups were compared in terms of pain severity, anxiety level, maternal hemodynamics, fetal-neonatal parameters and postpartum analgesic requirement. Results: Mothers in the music therapy group had a lower level of pain and anxiety compared with those in the control group at all stages of labor (p < 0.001). A significant difference was observed between the two groups in terms of maternal hemodynamics and fetal heart rate after intervention (p < 0.01). Postpartum analgesic requirement significantly decreased in the music therapy group (p < 0.01). Conclusion: Listening to music during labor has a positive impact on labor pain and anxiety, maternal-fetal parameters and analgesic requirement. (C) 2014 S. Karger AG, Basel
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    Effect of music therapy during vaginal delivery on postpartum pain relief and mental health
    (Elsevier, 2014) Simavli, Serap; Kaygusuz, Ikbal; Gumus, Ilknur; Usluogullari, Betul; Yildirim, Melahat; Kafali, Hasan
    Background: Childbirth is an important experience in a woman's life, and unfavorable birth experiences have been shown to negatively impact postpartum maternal health. Aim of this study was to evaluate the effects of music therapy on postpartum pain, anxiety level, satisfaction and early pospartum depression rate. Methods: Totally 161 primiparous women were recruited and randomized either music group (n=80) or a control group (n=81). Women in the music group listened to self-selected music during labor. Postpartum pain intensify, anxiety level and satisfaction rate were measured using the visual analog scale (VAS), postpartum depression rate was assessed with Edinburg Postpartum Depression Scale (EPDS) at postpartum day one and day eight. Results: Mothers in the music therapy group had a lower level of postpartum pain and anxiety than the control group and it was statistically significant at all time intervals (1, 4, 8, 16 and 24 h, p < 0.001). A significant difference was observed between the two groups in terms of satisfaction rate (p < 0.001) and postpartum depression rate at postpartum day one and day eight (p <005). Limitations: We only measured the effect of music therapy on early postpartum depression rate. Effect of music on late postpartum depression rate should be investigated in future. Conclusions: Using music therapy during labor decreased postpartum anxiety and pain, increased the satisfaction with childbirth and reduced early postpartum depression rate. Music therapy can be clinically recommended as an alternative, safe, easy and enjoyable nonpharmacological method for postpartum well-being. Published by Elsevier B.V.
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    Is There Any Relationship between Plasma Pentraxin 3 Levels and Gestational Diabetes Mellitus?
    (Karger, 2015) Yildirim, Melahat; Simavli, Serap Aynur; Derbent, Aysel Uysal; Kaygusuz, Ikbal; Uysal, Sema
    Background: Pentraxin 3 (PTX3) is a novel vascular inflammatory marker which increases in vascular events such as diabetes mellitus. The aim of this study was to investigate the relationship between serum PTX3 levels and gestational diabetes mellitus (GDM). Methods: This prospective observational study was comprised of 88 pregnant women with singleton pregnancies. The subjects were classified into 3 groups according to their response to a 50-gram glucose challenge test (GCT) and a 100-gram oral glucose tolerance test: control group (n = 28), impaired glucose tolerance group (n = 30), and GDM group (n = 30). Serum PTX3 levels were measured to examine the relationship between GDM and GCT values. Results: Significant differences in PTX3 levels were observed among the 3 groups in the sample (F = 7.598; p = 0.001). The mean PTX3 value was found to be significantly higher in the GDM group (3.17 +/- 1.16 ng/ml) than in the control group (2.20 +/- 0.83 ng/ml; p = 0.001). A significant positive correlation between PTX3 and GCT values was detected (r = 0.289; p = 0.008). Conclusion: Maternal serum PTX3 levels were found to be significantly related to high blood glucose levels. This may be an indicator of vascular pathology in GDM around the time of an oral glucose tolerance test. (C) 2015 S. Karger AG, Basel
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    Levels of thrombin-activatable fibrinolysis inhibitor and platelet-activating factor in recurrent pregnancy loss patients
    (Elsevier Taiwan, 2016) Eser, Ayla; Gumus, Ilknur Inegol; Erdamar, Husamettin; Kaygusuz, Ikbal; Yildirim, Melahat; Usluogullari, Betul; Erdolu, Muzeyyen Duran
    Objective: The aim of this study was to investigate factors associated with thrombosis that may contribute to recurrent pregnancy loss (habitual abortion), specifically differences in serum levels of platelet-activating factor and thrombin-activatable fibrinolysis inhibitor (carboxypeptidase B2) between women with a history of recurrent miscarriage and those with no recurrent miscarriage history. Materials and methods: A case-controlled, prospective study design was adopted to compare women with a history of two or more first-trimester miscarriages (n = 42) with those with no history of recurrent miscarriage (n = 36). Participants were recruited from the Department of Obstetrics and Gynecology of Turgut Ozal University Hospital. Platelet-activating factor and thrombin-activatable fibrinolysis inhibitor levels in serum samples were measured by an enzyme-linked immunosorbent assay. Results: Platelet-activating factor levels were significantly (p = 0.018) higher in the recurrent miscarriage group. There was no difference in levels of thrombin-activatable fibrinolysis inhibitor expression between the groups. Conclusion: Platelet-activating factor is significantly higher in serum of patients with a history of recurrent miscarriage than in those without such a history, with potential implications for placental function and fetal growth, which could be relevant to miscarriage recurrence. Larger studies are indicated to further examine these findings. Copyright (C) 2016, Taiwan Association of Obstetrics & Gynecology. Published by Elsevier Taiwan LLC.