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Volume : 42 Issue : 4 Year : 2022

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ZEYNEP KAMIL MEDICAL JOURNAL - Zeynep Kamil Med J: 42 (4)
Volume: 42  Issue: 4 - 2011
ORIGINAL RESEARCH
1.Elektif Sezaryen Olgularında Kordon Dolanması
Serkan Ertuğrul, Nuri Kaya, Ismet Gün
Pages 147 - 150
INTRODUCTION: The aim of this study was to investigate the incidence of nuchal cord entanglement and neonatal outcomes after elective cesarean delivery.
METHODS: In the study, 1784 viable singleton pregnancies who were delivered by elective caesarean at term from January 2005
to April 2011 were included. Maternal and fetal complications were excluded from the study. The incidence of nuchal cord entanglement was found in the study group. Characteristics of the groups with and without cord entanglement and perinatal outcomes were compared. Chi-square test was used for the statistical analysis. Statistical significance was defined as p < 0.05.
RESULTS: The incidence of nuchal cord entanglement was 10.3%. There were no statistically significant differences in either NICU admission, maternal age,1-minute Apgar score, neonatal gender and birth weight between the two groups. The incidence of nuchal cord increases as gestational age at delivery increased (p <0.001). Newborns with nuchal cord demonstrated an increased rate for meconium-stained amniotic fluid (p<0.001).
DISCUSSION AND CONCLUSION: There were no statistically significant association between adverse neonatal outcomes and nuchal cord. When evaluating the last
trimester and post term pregnancies, we should investigate nuchal cord for preventing the meconium-stained amniotic fluid and complications of meconium.

2.Overlerde Neoplastik ve Non-neoplastik Kistik Lezyonlarının Değerlendirilmesi
Dilek Benk Silfeler, Arif Güngören, Serdar Kenan Dolapçıoğlu, Ebru Turhan, Sibel Hakverdi, Duygu Erdem, Ali Ulvi Hakverdi, Ali Baloğlu
Pages 151 - 156
INTRODUCTION: Determination of the rates of neoplastic and non-neoplastic lesions in ovary cyst cases having been operated.
METHODS: Files of 126 patients being operated with pre-diagnosis of cystic mass in ovary in obstetrics and gynecology service of our hospital between 2005 and 2010 were inspected retrospectively.
RESULTS: TNon-neoplastic cysts in 41 patients (32,5%) and neoplastic tumors in 85 patients (67,4%) were observed out of ovarian masses. 74
benign (58,7%), 3 borderline(2,4%) and 8 malign tumors (6,3%) were observed in neoplastic tumors. All malign ovary tumors cases were operated in elective conditions using laparoscopy. While the average age of patients having these problems was 46±13, average cyst diameter was measured as 18±7.9 cm. 75% of malignancy was resulted from right ovary. The average Ca-125 value was 1420 ± 2079.
DISCUSSION AND CONCLUSION: 91 % of cystic masses resulting from ovary were detected as benign in histopathological inspection. Each case has to be evaluated considering ultrasonography, age, tumor determinant and operated in elective conditions if possible. Laparoscopy has to be preferred first of all for the patients that were supposed to suffer from benign and protection of ovary tissue has to be taken care of with minimal invasive approach.

CASE REPORT
3.Şok Tablosuna İlerlemiş Postpartum Primer Peritonit
Zeynep Özkan, Ayşe Nur Gönen, Bekir Sarıcık, Seyfi Emir, Fatih M. Yazar, Cengizhan Özdemir, Metin Kement
Pages 157 - 160
Peritonitis may occur due to various inflammatory causes. Primary, secondary and tertiary forms can be seen. Clinical findings vary depending on localized inflammatory pain, as long as the findings of sepsis and shock. Postpartum peritonitis is infrequent but can cause serious clinical conditions. The treatment is surgical drainage and antibiotic therapy. In this article, a case of peritonitis in an 38 year- old- women with a gestation that resulted with a premature birth in the 22 week 3 days, was discussed. As postpartum peritonitis can be avoided by simple measures we wanted to remind this clinical situation to reduce perinatal maternal mortality and morbidity.

4.A Giant Dermoid Cyst of the Ovary
Hüseyin Levent Keskin, Tuba Semerci, Elçin Işlek Seçen, A. Filiz Avşar
Pages 161 - 163
Teratomas are the most common ovarian neoplasms that occur especially during the reproductive age. We report a benign cystic teratoma
with an unusual size. In a 17 years old patient, ultrasound examination revealed a mass of 37x37x37 cm. The mass had originated from the
right ovary, filled the full abdomen and pushed the diaphragm to the superior. The patient underwent right salpingo-oopherectomy. The weight of the mass was 11.5 kg, which accounted for approximately 16% of the preoperative total body weight. Pathologic examination revealed benign cystic teratoma.

5.Akciğere Metastaz Yapan Koryokarsinom ve Yoğun Bakım
Elif Bombacı, Serhan Çolakoğlu, Ersan Şensoy, Gözde Ateş, Serkan Tulgar, Mustafa Tekin
Pages 165 - 169
Bu çalışmada 39 yaşında, akciğerde çoklu metastazlarla ortaya çıkan bir koryokarsinom olgusu kadın hastayı sunmaktayız. Hastanın endometriyal kürtajdan sonra vajinal kanama devam ediyordu. Serum Human Chorionic Gonodotrpin (HCG) seviyesi 57463 mIU/mL idi. Yoğun bakım ünitesine kabulünde hasta taşipneik, hipoksemikti ve akciğer grafisinde çok sayıda bilateral metastatik lezyonlar mevcuttu. Akut respiratuvar distres sendromu nedeniyle entübe edilerek mekanik ventilasyon uygulandı. Hastaya akciğere metastaz yapan koryokarsinom tanısı kondu. Hasta reanime edilirken eş zamanlı kemoterapi kürleri başlatıldı. Yoğun bakım ünitesine girişinden 21 gün sonra hasta klinik olarak düzelme gösterdi. Medikal onkoloji kliniğine devredildi. Medikal onkoloji kliniğine devredildikten yirmi dört gün
sonra hasta solunum yetmezliği ve febril nötropeni nedeniyle kaybedildi. Yüksek riskli koryokarsinom olgularında çoklu ilaç kemoterapisinin onkolojik yoğun bakım ünitelerinde yapılması gerektiği kanaatine vardık.

6.Boyutları Artmış Fetal Safra Kesesi
Zülfü Birkan, Işıl Başara
Pages 171 - 174
Boyutları artmış safra kesesi sık görülen bir bulgudur. Gebelik yaşı ilerledikçe öngörülebilir oranda boyut artışı gösterir. Boyutları artmış
safra kesesi trizomi 13’ün iyi bilinen post-natal karakteridir. Kese boyutlarının artışı kromozomal aneploidi riskinin göstergesi de olabilir. Gestasyon süresince safra kesesinin gelişimi ve normal boyutlarının değerlendirimi için literatürde birkaç çalışma bildirilmiştir. Bazı araştırmacılar, fetal safra kesesinin, 2. trimesterin erken dönemlerinde değerlendirilmesi gerektiğini belirtmişlerdir. Bu dönemde safra kesesinin görüntülenememesi, kistik fibrozis, safra kesesi atrezisi ve bilier atrezi gibi patolojilerin göstergesi olabilir. Bu nedenle
özellikle 2. trimesterde, fetal abdominal ve safra kesesi değerlendirimi oldukça önemlidir ve dikkatle yapılması gerekmektedir. Biz bu olgu
sunumunda ultrasonografi (US) ünitemize kadın doğum polikliniğinden rutin takip ve ayrıntılı US inceleme amacıyla gönderilen, 21 hafta 3 günlük gebeliği olan, G0P0 olguyu sunduk. Fetal US taraması tamamen normal olan fetusta safra kesesi boyutu artmış olarak değerlendirildi. Fetal safra kesesi boyut artışını ayırıcı tanılarla birlikte literatür eşliğinde değerlendirmeyi amaçladık

ORIGINAL RESEARCH
7.Çocuklarda Hepatit A Seropozitivitesi ve Sosyoekonomik Faktörlerle İlişkisi
Abdulkadir Bozaykut, Vildan Akcan, Rabia Gönül Sezer, Cem Paketci, Lale Pulat Seren, Ahu Paketçi
Pages 175 - 179
INTRODUCTION: The purpose of this study was to determine the seropositivity of Hepatitis A virus (HAV) in children between the ages of 2-18 and to establish the relationship of socioeconomic factors.
METHODS: A total of 400 children, from the pediatric clinics of Zeynep Kamil Maternity and Children’s Diseases Training and Research
State Hospital, between the ages of 2-18 who were not vaccinated with Hepatitis A vaccine were included in the study. A survey about the
sociodemographic characteristics of families was performed. Anti-HAV Ig G level was determined with the method of ELISA.
RESULTS: The anti-HAV seropositivity was 12.5 % in children between the ages of 2-18. There was a statistically significant relationship between HAV seropositivity and socioeconomic level, history of jaundice, having preschool education under the age of 6 (p<0,05).
DISCUSSION AND CONCLUSION: We have found a lower seropositivity rate compared to other national studies. This situation in our country made us think that the age
of first contact with HAV is increasing. Therefore, there is a high risk for symptomatic HAV infection in adolescents and young adults, also because our country is in middle endemisity area, the starting of the routine hepatitis A vaccination programme by Ministry of Health will decrease the risk of future epidemics.

CASE REPORT
8.İnvajinasyon Sonucu Gelişen Kazanılmış Bir İleojejunal Atrezi Olgusu
Gökmen Kurt, Ayşenur Cerrah Celayir, Şefik Çaman
Pages 181 - 185
35 day female patient evaluated for abdominal distention, intermittent feeding intolerance and bilious vomiting. Patient with intestinal
obstruction was operated. Intraoperative findings were compatible with type II ileal atresia secondary to intussusception. Meckel’s diverticulum
was found in the histopathological evaluation of intussuscepted segment.

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