Anne sütü yenidoğanın gelişimini destekleyecek özelliklere sahip en önemli besindir. Emzirmenin yenidoğanın gelişimi ve anne sağlığı üzerine olumlu etkilerinin yanında, anne-bebek-aile için bir etkileşim aracı olduğu da kabul edilmiştir. Son yıllarda, Dünya Sağlık Örgütü (WHO) ve Birleşmiş Milletler Çocuklara Yardım Fonu (UNICEF) bebeklerin, ilk 6 ay içerisinde sadece anne sütü ile beslenmeleri, tam emzirmenin sağlanması gerektiğini vurgulamıştır. Fakat emzirmenin erken devrede başlatılmasını ve sürdürülmesini engelleyici faktörler bulunmaktadır. Bunlar, emzirmede başarısızlık, doğumun şekli, yenidoğanın durumu, meme başı çatlakları gibi anne ve yenidoğana ait faktörler olabildiği gibi, çalışma hayatı, ten tene temasın sağlanamaması, ilaç kullanımı, alkol ve sigara kullanımı, uyku, babanın rolü, sağlık personelinin ilgisizliği, diyabet, HIV, tüberküloz, meme kanseri gibi hastalıklar da emzirme davranışını olumsuz etkilemektedir. Bu derlemede, başarılı emzirmenin başlatılmasını ve sürdürülmesi etkileyen faktörlere ilişkin çalışmalar incelenecektir. Emzirmenin sürdürülmesinde ve desteklenmesinde hemşirelerin liderlik, bakım verme ve eğitimci rolleri literatür doğrultusunda irdelenecektir.

Breast milk is the most effective nutrient to support newborn’s growing. Besides its positive effects on baby’s development and mother’s health, breastfeeding is also agreed to be a means of communication among mother, baby and family. In recent years, World Health Organization (WHO) and United Nations International Children’s Emergency Fund (UNICEF) suggested that babies shoul feed from breast in the first 6 months and they have emphasized that feeding must be completed fully. However, there are factors which prevent starting breastfeeding in early periods and maintaining it. These factors such as failure to breastfeed, type of delivery, condition of newborn and nipple fissures could originate from the mother or the newborn, or there could be other factors such as working life, failure to provide skin contact, drug use, alcohol and tobacco use, sleep, father’s role, indifference of health personnel, diabetes, tuberculosis, HIV or breast cancer. In this review, studies regarding the factors that affect the start of successful breastfeeding and its maintenance will be analyzed. The leadership, caretaking and educative acts of the nurses in maintenance and support of breastfeeding will be examined in line with the literature.

Postpartum urinary retention (PUR), defined as urinary retention after the delivery, is a common condition that can easily disappear spontaneously. Although this problem could cause stress to the women, PUR has not been clearly described and explored
its causes and symptoms like postpartum urinary incontinence due to the self-limiting condition without treatment. There were not enough reports about this subject in the literature. In this report PUR is reviewed with the literature.

Lipoleiomyomatosis (LPL) is a rare benign tumor composed of fat and smooth muscle. Intravenous LPL is a rare subtype of intravenous leiomyomatosis (IVL). Although LPL is considered to be a benign lesion, IVL recurs in approximately 10% of reported cases, and must be distinguished from low-grade endometrial stromal sarcoma and leiomyosarcoma with vascular invasion. We report a case of intravenous LPL in the light of literature as a diagnostic challenge.

INTRODUCTION: Expression of Luteinizing hormone (LH) receptors has been showed in the tuba uterina; but their role in the Fallopian tube is still unknown. During the normal menstrual cycle, female reproductive system is exposed to fluctuating levels of sex
steroids, including estrogen and progesterone. In this study, we present the cyclical variations of tubal LH, estro-gen receptors (ER), and progesterone receptors (PR).
METHODS: Twenty women operated for benign causes were included in this study. Fallopian tubes from the different stages of menstrual
cycle were collected. Then these tubes sections were examined using immunohistochemistry.
RESULTS: Expression of LH receptor did not change according to phases of menstrual cycle and there is no significant difference between follicular phase and luteal phase groups. Ac-cording to the result of statistically analyzed, there is not a significantly differences between the PR of follicular phase and luteal phase.
DISCUSSION AND CONCLUSION: We report on differences in LHR, SHR expression in the Fallopian tube from cases with follicular phase compared with luteal phase. This information may be important for the understanding of normal tubal function.

INTRODUCTION: The incidence of depression in women increases with pregnancy and delivery. The prevalence of postpartum depression ranges between %12.5-25 and differs among communities. Postpartum depression may affect bonding and the mother’s
learning about baby care and parenting role. The aim of this study is to assess the permanence of breastfeeding at the first two month postpartum period in case given effective breastfeeding education and the impact of postpartum depression on the babies’ weights and heights.
METHODS: High risk patients for postpartum depression were identified in the newly delivered mothers with the Edinburgh Postpartum Depression
Scale; patients also filled a questionnaire form of 43 questions in order to evaluate socio-demographical data. At the time the baby was born, breastfeeding education was given to all of the participants by the doctor and by the nurse. Weight and height of the babies were measured and recorded immediately postpartum, and at the visits of the first and the second month. Collected data were evaluated statistically.
RESULTS: In the present study it was shown that all of the mothers with or without postpartum depression continued breastfeeding at first two months postpartum period. No significant differences in evaluated parameters were found between the two
groups. This situation was considered to be due to several factors such as effective breastfeeding education and economical advantage encourages mothers to feed their babies only with breast milk, social pressure may compel mothers to breastfeed their
babies. It was supposed that mothers’ continuation to breastfeeding in the depressed patients may be because it has a curative effect on postpartum depression.
DISCUSSION AND CONCLUSION:

Recently, number of adolescent and advanced age pregnancies increased and became an important social issue. There are conflicting results
on maternal and perinatal outcomes of those pregnancies. The objective of this study is to compare the short-term outcomes of ≤18 (adolescent) years old and ≥35 years old (advanced age) mothers’ infants with 19-34 years old (control group) mothers’ infants.

INTRODUCTION: Hysteroscopy is a safe and simple procedure which is performed for evaluation and also for treatment of abnormal uterine bleeding, infertility and recurrent pregnancy loss. In this study we aimed to evaluate the efficacy of the local anesthesia techniques for office hysteroscopy.
METHODS: This randomised, double-blinded and placebo-controlled trial was performed including the 100 patients who had hysterocopy
procedure with the indications of habituel abortus, infertility and anormal uterine bleeding. The study was conducted at Zeynep Kamil Women and Children Diseases Training and Research Hospital, department of endoscopy in Istanbul, between January 2011 and December 2012.
RESULTS: VAS score at the insertion of vaginal speculum was significantly lower at the patients who had intrauterine lidocaine administration (p<0.05), there was no statistically significant difference between the other groups (p>0,05). When we compare
the VAS scores at the hysteroscope insertion and during the procedure, between the groups, patients who had anesthesia rated lower scores. Also, the patients who had intrauterine lidocaine had lower VAS scores when compared to other groups. Although VAS score at the 30 minutes after the procedure was lower at the groups who had intrauterine lidocaine administration, this difference was not statistically significant.
DISCUSSION AND CONCLUSION: Intrauterine topical local anesthesia seems to be effective in decreasing the pain in women undergoing hysteroscopy.

INTRODUCTION: The aim of this study is to evaluate the surgical outcomes and complications of transobturator tape (TOT) procedure.
METHODS: In this study, 175 patients who were undergone TOT procedure due to pure stress urinary incontinence (SUI) or mixt urinary incontinence
(MUI) from 2011-2014 and examined at 1st and 3rd postoperative months with physical examination and stress tests were evaluated retrospectively.
RESULTS: All of the patients were multiparous and the median age was 50.0±11.3 years. Sixty-eight (38.8%) of the patients were postmenopausal and sixty-two (35%) of the patients who had TOT operation had extra surgery. One patient is complicated
with bladder perforation. Only one patient had blood transfusion requirement due to TOT operation. Intraoperative bleeding more than 200 ml. is seen in 6 patients. Four patients had vaginal fornix perforation. Three patients had developed perineal pain.
De-novo urge incontinence was seen in 8 patients in the postoperative period and was successfully treated with anticholinergic drugs. Mesh removals and reconstruction of vaginal mucosa were done for 6 patients who had vaginal erosions. The objective and subjective cure rates were found to be 87.4% and 82.8%, respectively.
DISCUSSION AND CONCLUSION: The use of mid-urethral synthetic slingis the first-choice of the surgical treatment of SUI nowadays. The main reasons for this are low complication rates due to surgical technique, the use of good quality materials, short operation time, and short hospital stay.

INTRODUCTION: To evaluate indications and histopathological diagnoses of endometrial samplings in our clinic.
METHODS: Seven hundred and fourty four subjects who required endometrial biopsy to be taken for any indication other than pregnancy between
January 2013 and January 2014 were included in the study. Data collected retrospectively from Dumlupinar University Evliya Celebi Training and Research Hospital obstetrics and gynecology clinic database and pathology clinic. Statistical analysis of data was performed using SPSS for Windows 13 package programme.
RESULTS: Mean age of the subjects was 43.6 ± 8.3. Indications of endometrial sampling were menorrhagia/ menometrorrhagia (87%), myoma uteri (1.6%), postmenopausal bleeding (9.5%), cervical polyp (1.9%). Histopathologic diagnoses were as follows: secretory/proliferative endometrium in 72.8%, atrophic endometrium in 3.5%, simple atypical endometrial hyperplasia in 0.7%, simple typical endometrial hyperplasia in 7.9%, complex atypical endometrial hyperplasia in 0.3%, complex typical endometrial hyperplasia in 0.3%, atrophic endometrium in 3.5%, endometrium cancer in 0.8%, and endometrial polyp in 9.5%. Insufficient sampling material
was reported in 0.9%. Endometrium cancer was detected in 5.6% of postmenopausal group.
DISCUSSION AND CONCLUSION: The most common endometrial sampling indication was menorrhagia/menometrorrhagia, while endometrium cancer was detected most commonly in patients with postmenopausal bleeding. Our results emphasize that endometrial sampling is warranted especially in peri/postmenopausal women with abnormal uterine bleeding. Endometrial evaluation is needed in patients with cervical polyp.

INTRODUCTION: The aim of the present study was to determine the predictive value of dominant follicle count as a marker for pregnancy and multiple pregnancy rate in controlled ovarian hyperstimulation (COH) with intrauterine insemination (IUI) cycles in couples with unexplained subfertility.
METHODS: The study was designed as a prospective non-randomized trial and involving 214 women with unexplained infertility was underwent
COH-IUI at a University of Mersin School of Medicine, Obstetric and Gynecology department between May 2008 and September 2010.
RESULTS: Of 532 COH cycles started, 513 were completed and resulted in 62 clinical pregnancies (12.1% per completed cycle). There were 9 (14.5%) multiple pregnancies and 7 (11.3%) miscarriages. In cycles with a single, two and three dominant follicles (>16 mm) on the day of hCG the clinical pregnancy rate were 8.3%, 14.7% and 27.1% respectively. Three dominant follicles (>16 mm) count
have increased pregnancy rate more than the 1 or 2 (p value 0.001 and 0.044 respectively). In addition cycles with a single, two and three dominant follicles the multiple pregnancy rate were 7.4%, 15.8% and 25% respectively. The multiple pregnancy rate was similar in cycles with 1 and 2 dominant follicles and lower than three (p: 0.004).
DISCUSSION AND CONCLUSION: Three follicular growths are associated with increased pregnancy rates in COH-IUI women with unexplained subfertility. In cycles with one
or two follicles, the multiple pregnancy rates are not significantly different however 3 dominant follicles associated with increased multiple pregnancy rates.