Comparison of four different treatment regimes in hirsutism related to polycystic ovary syndrome.

Polycystic ovary syndrome is the most common endocrinological problem associated with hirsutism. The objective of this study was to compare four different treatment modalities for hirsutism related to this syndrome. Pelvic ultrasonography was performed on all patients who were referred to our Reproductive Endocrinology Outpatient Clinic because of complaints of hirsutism.

Transvaginal sonographic findings of chronic ectopic pregnancy.

Chronic ectopic pregnancy is not precisely defined in gynecologic and sonographic texts. The diagnosis of this enigmatic clinical condition is frequently not made until laparotomy. In the present retrospective study, we evaluated the transvaginal sonographic findings of cases who were diagnosed as chronic ectopic pregnancy intraoperatively and/or postoperatively.

Threshold value of glucose screening tests in pregnancy: could it be standardized for every population?

We aimed to determine a threshold value that perfectly demarcates women at high risk for gestational diabetes mellitus (GDM) in the Turkish population. One thousand gravid women of 24 to 32 weeks of gestation were given 50 g, 1-hour glucose screening tests. A 100 g, 3-hour glucose tolerance test (GTT) was performed on all patients whose screening test plasma glucose value was 130 mg/dL or greater.

The prognostic value of serum estradiol, progesterone, testosterone and free testosterone levels in detecting early abortions.

Objective: Hormonal levels in early pregnancy may have predictive value in regard to outcome of pregnancy. In this study, the levels of estradiol (E2), progesterone (P), total testosterone (tT) and free testosterone (fT) were investigated in this respect.

Materials And Method: Seventy women with early pregnancies of 6-12 weeks who applied to the hospital for a pregnancy test were included into this study and were divided into three groups according to their final diagnosis.

Malignant degeneration of mature cystic teratomas.

Malignant transformation of benign cystic teratoma is rare and the most common malignancy is squamous cell carcinoma. The diagnosis is rarely made preoperatively and the prognosis is usually poor. We report 4 cases with dermoid cysts showing malignant transformation, 3 with squamous carcinoma and 1 with adenocarcinoma.

Chronic ectopic pregnancy: a clinical analysis of 62 cases.

Chronic ectopic pregnancy is a form of tubal pregnancy in which salient minor ruptures or abortions of an ectopic pregnancy instead of a single episode of bleeding, incites an inflammatory response often leading to the formation of a pelvic mass. Its clinical features are often confusing, and laboratory evaluations are often misleading. Surgery for chronic ectopic pregnancy is frequently difficult since chronic inflammatory changes and adhesions distort the normal anatomy.

Reverse end-diastolic uterine artery velocity in a pregnant woman complicated by mild preeclampsia and severe growth retardation.

In a pregnant woman with mild preeclampsia and severe intrauterine growth retardation, a reverse end-diastolic flow velocity was detected in both uterine arteries by colour Doppler ultrasound at 30 weeks 4 days of pregnancy. During follow up, both umbilical and internal iliac arteries also showed reverse end-diastolic velocity waveforms and the fetus died in utero at 33 weeks gestation.

Laparoscopy for adhesion prevention following myomectomy.

Objective: To evaluate adhesion formation after classic abdominal myomectomy and the role of early, second-look laparoscopic adhesiolysis in the management of post-myomectomic pelvic adhesions in a prospective study.

Method: Forty-eight patients with infertility, recurrent abortion or symptomatic myoma underwent second-look laparoscopy (SLL) 8 days after abdominal myomectomy. The degree of adnexal adhesions were scored according to the American Fertility Society Classification and were lyzed laparoscopically.

Hydatidiform mole: clinical analysis of 310 patients.

Objectives: The aim of the study was to analyze the clinical characteristics, treatment and outcome of 310 patients with hydatidiform mole.

Methods: Three hundred ten patients with hydatidiform mole admitted to Dr Zekai Tahir Burak Women's Hospital between 1989 and 1994, were evaluated retrospectively according to their clinical characteristics, treatment modalities and follow-up.

Results: The incidence of molar pregnancy was 2.

Causative factors in first trimester abortion failure.

Objective: To evaluate the main contributors to failed first trimester abortions.

Patients And Design: Forty-two cases of unintentional continued pregnancy were detected among 23,000 termination procedures performed between 1989 and 1995. The patients were diagnosed either at follow-up visits or at the time of operation due to abnormal pelvic findings or discrepancy between the expected and obtained tissue.

Plasma human chorionic gonadotropin levels after induced abortion.

In the present study, we evaluated the elimination time and the disappearance curve of maternal plasma hCG after induced abortion in 44 patients. The patients were divided into two groups: patients in group 1 had gestations at or at less than 8 weeks and group 2 consisted of patients with gestations at more than 8 weeks in whom sharp curettage was utilized. The entire group had a mean of 48,342 mIU/ml baseline level of maternal plasma hCG.

Transvaginal sonographic diagnosis of ovarian endometrioma.

Objective: To assess the efficacy of transvaginal sonography (TVS) in differentiating endometriomas from other adnexal masses.

Methods: One thousand thirty-five adnexal masses undergoing laparoscopy or laparotomy were evaluated prospectively using TVS. Masses diagnosed as endometrioma according to their sonographic appearance were divided into two groups: those with a round shape, regular margins, thick walls and homogeneous, low-level echoes (group A); or those with irregular margins, internal septations and an anechoic appearance (group B).

The effect of intraumbilical oxytocin on the third stage of labour.

The umbilical vein administration of oxytocin in saline was compared with umbilical vein saline alone and the traditional management of the third stage of labour. Seventy-two women were randomized to 3 groups. Group 1 received intraumbilical 20 IU of oxytocin diluted to 40 mL with saline.

The use of GnRH agonists in the treatment of endometriomas with or without drainage.

To assess the efficacy of GnRH-agonist therapy in the treatment of endometriomas with or without surgical intervention, 26 women with laparoscopically proven endometriomas larger than 3 cm were recruited to the study. Fourteen women with 19 endometriomas (5 bilateral), had drainage of endometrioma at initial laparoscopy. After the procedure, ovarian suppression was done with GnRH-a therapy for 6 months.

The effects of hormone replacement therapy on uterine fibroids in postmenopausal women.

Objective: To evaluate and compare the effects of two different modalities of hormone replacement therapy (HRT) on the size of uterine fibroids.

Design: Randomized clinical study.

Setting: The Menopause Center of a public hospital.

Vaginal birth following unmonitored labor in patients with prior cesarean section.

Following a previous cesarean section, trial labour followed by spontaneous birth is currently popular but is still debatable. In an effort to assess the risks of unmonitored labor, the outcomes of 165 patients with previous cesarean section who delayed coming to hospital were reviewed. Seventy-one patients were allowed to continue labor and 62 achieved successful vaginal delivery, a success rate of 87.

The efficiency of ultrasonography in the diagnosis of dermoid cysts.

The aim of the study was to assess the efficiency of sonography in differentiating dermoid cysts of the ovary (mature cystic teratoma) from other adnexal masses. It was carried out prospectively at Dr. Zekai Tahir Burak Women's Hospital of Ankara, Turkey.

Urinary incontinence in women of reproductive age.

We investigated the prevalence and the consequence of urinary incontinence in the Turkish population, representing a composition of European and Asian populations. During a 12-month period, the standard urinary incontinence questionnaire was answered by 1,250 women of reproductive age who were admitted to the outpatient clinic with various gynecologic complaints, except for women whose main complaints were urinary incontinence. These patients were randomly selected by stratification according to the following five age-groups: 18-24, 25-29, 30-34, 35-39, and 40-44.

Anatomic distortion of clinically normal appearing fallopian tube: to what extent does it contribute to infertility?

We analyzed whether patent but anatomically deranged tubes were more commonly encountered in infertile women than in fertile women. The fertile group consisted of 100 women who were apparently normal with respect to fertility and the infertile group consisted of 100 infertile women with no certain etiology identified. The individual tubal structure was recorded at laparoscopy and the results of the two groups were then compared.

Ultrasonographic appearance of non-Hodgkin's lymphoma in a pregnant woman.

Non-Hodgkin's lymphoma during pregnancy is rare. We report a case of non-Hodgkin's lymphoma detected in a pregnant women. She was initially diagnosed as having an ovarian tumor by ultrasonography, but definitive diagnosis was made at the time of cesarean section.

The importance of endometrial fluid collection in postmenopause.

Objective: We sought to determine the importance of postmenopausal endometrial fluid collection, which has almost invariably been accepted as a finding of a malignant process.

Methods: Out of 1,500 postmenopausal patients admitted to our center mainly for their postmenopausal symptoms, endometrial fluid collection was detected in 15 cases during transvaginal pelvic ultrasonographic evaluations. These patients were evaluated with cervical smears as well as endocervical and endometrial curretages.

Demographic and epidemiologic features of female adolescents in Turkey.

Objectives: To determine the average menarcheal age and menstrual cycle pattern, prevalence of dysmenorrhea, frequency of smoking, alcohol and drug use, sexual education level, and the gynecologic problems in female adolescents in Turkey.

Methods: A questionnaire consisting of 43 questions were given to 13,665 high school girls between the ages 13-18 years.

Results: The results showed that average menarcheal age was 13.

Treatment of vaginitis.

Objective: The purpose of this study was to evaluate the efficacy of metronidazole 500 mg and miconazole nitrate 100 mg (Neo-Penotran, Embil Pharmacy Company, Istanbul, Turkey) in the treatment of vaginitis.

Method: One hundred patients (mean age 26.5 years, range 18-50) with a clinical diagnosis of vaginitis entered this open, noncomparative study.

Twin sisters with impetigo herpetiformis.

Impetigo herpetiformis is a rare and serious pustular eruption resembling pustular psoriasis that mostly occurs in pregnant women. The etiology of the disease is unclear and it is not known if genetic factors play a role. We present two sisters (twins) with impetigo herpetiformis supporting an inheritance pattern.