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General obstetrics

General obstetrics
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  General Obstetrics - Oral Presentations OraI-Obstet-001 A safe and effective method of pre mduction cervical dilation by a double balloon device in patients undergoing labor induction with unfavorable cervical conditions: Presentation of studies and last decade experience Atad j1, Auslender R 2 Bardicef M 2 Calderon 13 Hallak M 4, Abramovici H 5 1Atad Development Medical Services, Haifa, Israel 2 Department of OB G YN, Carmel Medical Center, Haifa, Israel 3 Department of OB GYN, Bnei-Zion Medical Center, Haifa, Israel 4 Department of OB GYN, Soroka Medical Center, Beer Sheva, Israel 5 The Bruce Rappaport Faculty of Medicine, Haifa, Israel OBJECTIVES: Induction of labor (IOL)in women with unfa- vorable cervical conditions. METHODS: Pre-induction cervical dilators (PICD) are dou- ble balloon catheters that function as mechanical de- vices.Women undergoing IOL had the pre-induction cervical dilators inserted. Insertion of the PICD was performed through the cervical canal, both balloons inflated first the uterine balloon inflated at the level of internal cervical os, the vaginal balloon adjacent to the external os. The double balloon devices were kept in place for 12hours then re- moved, ARM performed and management of labor carried out.There are 3types of(PICDs),each of which is based on the double balloon catheter construction:Typel-provides no optional use of intra-cervical PG Type2-provides a concomi- tant treatment option with its intra-cervical application of PG gel preparations through an opening located between the two balloons (uterine and vaginal)Type3-has a concomitant extra-amniotic instillation option. RESULTS: A Study of 250 women successfully induced with unfavorable cervical conditions, a study of 34 women with previous Caesarean section induced with 78 success of VBACS and a randomized study using low doses of PG will be presented. CONCLUSIONS: 1.PICD induced significant ripening and dilatation of the unfavorable cervix2.1OL was successfully achieved following removal of the PICD3.The Caesarean section rate was low (16 ) compared to other methods of ICE KEY WORDS: labor induction, cervical dilatation, double balon device OraI-Obstet-002 The effects of maternal anxiety prior to amniocentesis on uterine and fetal umbilical blood flow Caliskan E 1, Ozkan S 1, Yalcinkaya 0 2 Turkoz El, Polat A 3 Corakci A 1 i Department of Obstetrics and Gynecology, University of Kocaeli, Kocaeli, Turkey 2 Department of Psychology, Middle East Technical University, Ankara, Turkey 3 Department of Psychiatry, Kocaefi University, Kocaeli, Turkey OBJECTIVES: To investigate the effect of couples' anxiety levels on fetomaternal circulation. S 8 METHODS: A prospective survey was conducted regarding the assessment of couples' anxiety levels by means of Spielberger State-Trait Anxiety Inventory in 60 pregnant women having genetic amniocentesis and 60 control before and soon after the procedure or ultrasonography. Additional- ly Doppler ultrasonographic measurements of fetoplacental circulation were recorded in both groups. A regression mod- el was built to determine the possible predictors of fetal Doppler measurements. RESULTS: Both patients' and husbands' state anxiety scores were found to be significantly higher in the amnio- centesis group (p<0.001, p=0.008 respectively). Maternal heart rate was significantly higher in the amniocentesis group (p<0.05), while the fetal heart rate was significantly lower (p<0.05) compared to the control group. Uterine artery Doppler measurements were comparable in the two groups but umbilical artery resistance index (p<0.05) and S/D ratio (p<0.05) was significantly higher in the amniocentesis group. Regression analysis revealed that the time elapsed from offering amniocentesis until performed (B=0.58, p<0.001) and maternal state anxiety scores (B=0.34, p=0.001) are the main predictors of fetal umblical artery S/D ratio. CONCLUSIONS: Our study provides the evidence that ma- ternal anxiety and its duration lead to adverse effects on the fetal blood flow. KEY WORDS: Maternal anxiety, genetic amniocentesis, Doppler ultrasonography OraI-Obstet-003 Transvaginal Ultrasonography For Cervical Assesment Before Induction Of Labor Numanoglu N Seyhan A Usta T Sidal B Deparment of Obstetrics and Gynecology, Vakif Gureba Research and Training Hospital, ISTANBUL, TURKEY OBJECTIVES: Labor induction has been shown to reduce perinatal morbidity when compared to expectant manage- ment in prolonged pregnancies. Methods for predicting the chance of successful vaginal delivery consist of digital ex- amination and transvaginal cervical length measurement. Our purpose was to evaluate the effect of parity, Bishop score and cervical length in predicting successful induction. METHODS: The study enrolled 80 women undergoing labor induction at 41 or more weeks' gestation. TVUS measure- ment of cervical length, bishop scoring were performed. RESULTS: 80prolonged pregnancies were included.Vaginal delivery occurred in 82 of the patients.Nulliparous women had Mean Bishop score of 3,8+ 2,4 and cervical length 3,74_+0,9 cm whereas multiparous women had mean Bishop score of 3,4_+ 2,2 and cervical length 4,1• The mean in- duction to vaginal delivery interval was 10,4_+6,8h in nulli- parae and 6,2_+4,1 in multiparae. (p<0.05) The percentage of nulliparous women delivering within 24h was 83 for those with cervix <20mm whereas it was 12 for those with a cervix >30 mm. 60 of women with a Bishop score <4 de- livered vaginally. CONCLUSIONS: Both cervical length and Bishop predict duration of labor. But in the group of women where the cer- vix is closed clinically, ultrasonographic cervical assessment is better predictor for the risk of Cesarean section. KEY WORDS: induction of labor, transvaginal ultrasonogra- phy, cervical lenght  S General Obstetrics - Poster Presentations Poster-Obstet-001 Does myomectomy during cesarean section cause infertility postoperatively? Ertas E, Kalyoncu S, Kahyaoglu S, Yilmaz B, Ozel M, Mollamahmutoglu L, Oral H Zekai Tahir Burak Women s Health Education and Research Hospital, Ankara, Turkey OBJECTIVES: Our goal was to analyze the reproductive outcome of patients who underwent myomectomy for intra- mural (interstitial) and/or subserosal fibroids during cesare- an delivery. METHODS: We retrospectively evaluated 51 women who underwent myomectomy at time of cesarean delivery from January 1998 to January 2003. All patients were telephoned and questioned about fertility and pregnancy outcome. P<0.05 was considered as statistically significant. RESULTS: Five patients were lost to follow-up. The mean number of myomas removed was 2.09 and the mean size of the myomas was 3.59 cm. In follow up two patients had spon- taneous abortions 4.3 , 21 delivered viable term neonates by cesarean section 45.6 , 17 patients are still using a family planing method 36.9 and in 6 patients infertility problem had occured 13 .Multiple regression analysis showed that the only significant and independent predictor of reproductive out- come was the localization of the myoma; infertility problem was significantly more after removal of a posterior myoma 40 (4/10; OR:7.2, 95 C1:1,5-33.7; p=0.01). CONCLUSIONS: Before performing myomectomy during cesarean section especially the myomas of posterior uterine wall, we must keep in mind that post myomectomy pelvic adnexial adhesions may develop, damage tube-ovary rela- tionship as well and may cause infertility. KEY WORDS: Cesarean section, myomectomy, posterior myomas,intramural,subserosal fibroids Poster-Obstet-002 Survey of exercise effect on mild postpartum de- pression in women in Ardebil Health Centers 2002 Mardi A 1, Dr. Molavi p1, Tazakori Z 2 Mashoufi M 1 i Medical Faculty-Ardebil University of Medical Sciences-lran 2 Nursin Faculty-Ardebil University of Medical Sciences-lran BACKGROUND OBJECTIVES: Postpartum depression is a problematic and destructive disease and if don't be rec- ognize and treatment, it will be aggravate or longing. Exer- cise is the one of the efforts to advise to prevent of any dis- orders in companionship and securing of mother, child and family health. Aim of this study was appointment of exercise effect on postpartum mild depression in women in Ardabil Health centers. METHODS: This study was a double blind clinical trial. About 50 subject with natural delivery at second week of postpartum that had mild depression with Beck scale, se- lected randomly in two groups (exercise and non-exercise). Then Beck test was done 6 weeks after delivery again. And results were compared in two groups. RESULTS: The findings indicated that between mild de- pressed women, 36 had 26-30 years old, 82 were house- keeper, 44 had under diploma education, 60 had two pre- vious of delivery and 32 of non-exercise group had well-be- ing, and 8 Versus 18 needed to psychologist counseling at 6 weeks after delivery. Qui-square test showed significant differences between two groups (p<0.05). CONCLUSIONS: Results showed that exercise had a posi- tive effect on the well-being of postpartum mild depression. KEY WORDS: Exercise, Mild depression, Postpartum. Poster-Obstet-003 Acidosis at birth. May fetal oxygen saturation values help ? Arikan G, Giuliani A the Department of Obstetrics and Gynecology, University of Graz, Graz, Austria. OBJECTIVES: To measure umbilical blood oxygen satura- tion(SO2), to assess the predictive value of SO2 for acido- sis. METHODS: Umbilical cord blood samples of 1537 singleton neonates were analyzed. SO2, pH and base excess were measured. Preductal SO2 was calculated with an empirical equation. The predictive value for acidosis (7.09 and -10.50 mmol/L, respectively) of UA and umbilical vein (UV) SO2 and calculated preductal SO2 was determined with receiver operating characteristic curves. RESULTS: The mean values (+_SD) of UV, UA, and calculat- ed preductal SO2 were 52_18 , 26_17 , and 31_+16 , re- spectively. Forty-seven neonates had UA pH less than 7.09 and 60 had UA base excess less than-10.50 mmol/L. Re- ceiver operating characteristic areas under the curve were higher when predicting low pH compared with low base ex- cess (for UV, UA, and calculated preductal SO2:0.716 ver- sus 0.699,0.747 versus 0.586,and 0.765 versus 0.628, re- spectively). The difference was significant for UA SO2 (P<0.05). Tests showed high sensitivity and negative predic- tive values, but low specificity and positive predictive values. CONCLUSIONS: Low fetal SO2 at birth seemed to be asso- ciated with low fetal pH and base excess values, but its pre- dictive value for acidosis in an unselected population was limited, particularly if acidosis was metabolic. KEY WORDS: acidosis, birth, neonates, oxygen saturation Poster-Obstet-004 Postpartum idiopathic transient ascitis; is it a clinical variety of ovarian hyperstimulation syndrome? Kocak [, Yusuf Akcan Y, OstOn C, Tasdemir S Department of Internal medicine, OMU, Medical School, section of Gynecology and obstetrics, Turkey OBJECTIVES: To discuss whether the pathogenetic mecha- nisms in the development of ovarian hyperstimulation syn- drome are valid to cause a similar postpartum syndrome in patients sensitized early in induction period. CASE: A 32 year-old woman who had become pregnant af- ter a controlled ovarian induction developed postpartum as- cites. Three days following hCG injection she developed lower abdominal pain, followed by distention. Intervention (s):making necessary lab evaluations, observational follow- up, a total of 4000 cc paracentesis in two sessions.Main out- come measure (s):lmprovement of ascites self limitedly con-  General Obstetrics - Poster Presentations S 9 sistent with the natural history of OHSS patients. The etiopathogenesis of postpartum ascites were evaluated. No apparent cause was detected. The Patient was followed conservatively, and a total of 4000 cc paracentesis was per- formed in two sessions just to relieve the abdominal tension. The patient showed a spontaneous improvement after an observational and supportive hospitalization period and was discharged at 15 th day post operatively. CONCLUSIONS: It must be a focus of research to evaluate the hormonal changes after parturition in woman who has undergone ovarian induction. KEY WORDS: Postpartum period, ascites, ovarian hyper- stimulation Poster-Obstet-005 Prophylactic antibiotics in cesarean section Torgac M GQrkan N Kocak I, 0st0n C Department of Obstetrics and Gynecology, medical school, University of Ondokuz Mayis, Samsun/Turkey OBJECTIVES: This study was to determine which antibiotic regimen is most effective in reducing the indidence of infec- tious morbidity in women undergoing cesarean sections De- sign. Randomized, nonblinded comparative study of a single preoperative dose of first generation cephalosporins vs. a post cesarean scheme (first generation cephalosporins 7 days) for infection prevention. Methods. Pregnant women (n=320) with indication for elective or emergency cesarean section were randomly allotted to two groups. Group 1 (n=155) received the single dose of first generation cephalosporins and group 2 (n=165) received, over 7 days, the postoperative standard scheme (first generation cephalosporins) of antibiotics followed in the department. Both groups were followed up during 10 days for detection of signs of wound infection, idiopatic fewerr, endometritis, peritonitis and urinary tract infection. Prevalence of postop- erative infection, mean hospital stay Results. Women com- pleting the study (n=320) were distributed into group 1 (n=155) and group 2 (n=165). No significant difference was found neither in the prevalence of postoperative infection nor in the mean hospital stay. No death occurred. The cost of the single dose of prophylactic antibiotics was less than one-tenth of the cost of the standard postoperative scheme.Conclusion. In our setting, the administration of a single dose of 2 mg of first generation cephalosporins be- fore cesarean section for prevention of infection is clinically equivalent to existing conventional week-long postoperative therapy. Multiple dose regimen prophylaxis appears to offer no added benefit over a single dose regimen. KEY WORDS: antibiotic prophylaxy, cesarian section, mor- bidity Poster-Obstet-006 Pregnancy rates and oss before and after abdominal myomectomy a retrospective analysis Verit F 1, Artuc H 2 Department of Obstetrics and Gynecology, Harran Universitesi Tip Fakultesi, Sanliurfa, Turkey 2 Department of Obstetrics and Gynecology, Harran Universitesi Tip Fakultesi, Sanfiurfa, Turkey OBJECTIVES: The aim of the study was to establish the im- pact of abdominal myomectomy on pregnancy rates and pregnancy loss. METHODS: Data of 25 infertile patients who underwent ab- dominal myomectomy and wished to conceive after surgery were evaluated retrospectively. The characteristics of the patients, myomata and associated infertility factors such as tubal, ovulatory and male factor were collected in a system- atic way. RESULTS: Conception rates and pregnancy loss were 14 , 51 and 32 , 0 before and after abdominal myomectomy respectively (p>0.05 and p<0.05). CONCLUSIONS: In our study, we found that abdominal myomectomy cause significant effect on reducing pregnancy loss, but no effect on conception rates. However, expectant management may be needed before proving the effective- ness of this conservative surgical procedure with larger se- ries with randomized controlled trials. KEY WORDS: myomectomy, pregnancy rate, pregnancy loss Poster-Obstet-007 Ovarian Mucinous Cystadenomas Complicating Pregnancy Sen S, G0ng6r E.S, Mollamahmutoglu L, Danisman N Dr. Zekai Tahir Burak Women s Health Education and Research Hospital Ankara, Turkey OBJECTIVES: To report two pregnancies complicated by gi- ant ovarian mucinous cystadenoma. CASE: The first case at 33rd week of gestation was referred to our perinatology clinic with the diagnosis of adnexal mass in maternal abdomen.Ultrasonographic examination re- vealed a cystic mass occupying the whole abdomen. Lapa- rotomy was performed due to increasing abdominal pain which revealed a cyst measuring about 25x22 cm srcinat- ing from rigth ovary. Right salpingo-ooferectomy was per- formed. The mass was mucinous cystadenoma histopatho- logically. Second patient presented with preterm labor 3 weeks after surgery. The second case admitted to our peri- natology clinic at 14th week of gestation, ultrasound scan showed a large multilocular cyst. Laparotomy was per- formed due to severe abdominal pain which revealed an ad- nexal mass about 20x 15cm srcinating from right ovary which was proven to be a mucinous cystadenoma after sal- pingo-oopherectomy. Spontaneous labor began at 40th week of gestation. CONCLUSIONS: Adnexal masses in pregnancy may be dif- ficult to diagnose and manage.The management depends on gestational age,sonographic appearance and size of the mass.Accurate timing and correct intervention in selected cases is important in management. KEY WORDS: Ovary, mucinous cystadenoma, pregnancy  s 9 General Obstetrics oster resentations Poster-Obstet-008 Incidence and Distribution of Congenital Malformations in a University Hospital Biri A, Onan MA, Korucuoglu U, Taner MZ, Tiras MB, Himmetoglu O Department of Obstetrics and Gynecology Gazi University Faculty of Medicine Ankara Turkey OBJECTIVES: It is aimed to determine the incidence and types of congenital anomalies among all neonates in the Department of Obstetrics and Gynecology, Gazi University Faculty of Medicine, between 1988-2005. METHODS: Registries of 17.259 neonates were studied ret- rospectively.Total malformation incidence,types of these malformations,percentages of isolated and multiple anoma- lies and their distribution according to gender and maternal age were determined. RESULTS: 205 anomalies and a 1.18 incidence of con- genital malformation was detected.Risk of any anomaly among male fetuses was 1.21 and it was 1.15 among females;and no difference was detected (p>0.05).Most com- mon anomaly was was followed by other central nervous system anomalies such as anencephaly and hydrocephaly.70 of anomalies were isolated and rest were multiple.Risk of having a fetus with congenital malformation varies with age and is most common under 20 and over 40. CONCLUSIONS: Overall congenital anomaly incidence in newborns of our population is 1.18 . Most common anoma- ly is meningocele, followed by other central nervous system anomalies such as anencephaly and hydrocephaly. KEY WORDS: congenital malformation, anomaly Poster-Obstet-009 Successful Treatment of Brucellosis in a Twin Pregnancy Case Report s K~, Inanmis RA 2 Department of Obstetrics and Gynecology Government Hospital of Ahlat Bitlis Turkey 2 Department of Family Practice Government Hospital of Ahlat Bitlis Turkey OBJECTIVES: To present a case of prenatally diagnosed brucellosis in a twin pregnancy treated with rifampicin and successful delivery of healthy twins. CASE: A 30-year-old woman with a 10 weeks' of twin preg- nancy was admitted to our department due to back pain, fa- tigue and slight arthralgia. There was no finding on physical examination. Brucella standard tube agglutination (STA) and Rose-Bengal tests (RB) were performed. RB test was posi- tive and STA test was also positive with a titer >1/200. The patient's blood culture yielded brucella abortus. Antimicrobial therapy with rifampicin was started immediately with 900 mg/day and continued for 6 weeks. Since the babies were in breech presentation, the patient was delivered with cesarean section at the 38th weeks of gestation. The fetuses were brought to life as healthy twins. Cord blood RB and STA IgG and IgM tests, and also blood culture tests were all negative. CONCLUSIONS: The incidence of spontaneous abortion and intrauterine death among women with active brucellosis is higher compared to healthy pregnant women. In our case, early and adequate treatment might have prevented the ear- ly detrimental consequences of infection. Rifampicin 900 mg/day for 6 weeks can be considered the drug of choice for treating prenatally diagnosed brucellosis. KEY WORDS: twin pregnancy, brucellosis, treatment Poster-Obstet-010 Congenital Cervical Teratoma A Case Report Duvan CI~ Atabey S 1 Bolkan F ~ Turhan N ~ Dilmen G 2 1 Department of Obstetrics and Gynecology Fatih University Faculty of Medicine Ankara Turkey 2 Department of Radiology Fatih University Faculty of Medicine Ankara Turkey BACKGROUND: Congenital cervical teratoma is an ex- tremely rare abnormality. Neonatal teratomas occur in about 1:20 000-40 000 live births and only 5 are in the region of the neck. They can be detected sonographically. CASE: In this case report, we presented a 24 year old, gravida 2, para 1, 16 week pregnant woman with a prenatal diagnosis of cervical teratoma. The prenatal diagnosis of this case showed a rapid and early growth of the tumour, which indicated the agressive nature of it and assisted the parents' decision to terminate the pregnancy. CONCLUSIONS: We present our case with a review of the literature, and the optimal treatment and management of congenital cervical teratoma is discussed. KEY WORDS: Fetal Teratoma, pregnancy, outcome Poster-Obstet-011 Persistent Gestational Trophoblastic Disease after Partial Hydatidiform Mole in a twin pregnancy Ingec M 1, Borekci B 1, Altas S 2 Kadanali S 1 1 Department of Obstetrics and Gynecology University of Ataturk Erzurum Turkey 2 Department of Pathology University of Ataturk Erzurum Turkey BACKGROUND: Hydatidiform mole with coexistent fetus is a rare condition. CASE: We report a case of partial hydatidiform mole and co- existent fetus that developed persistent gestational tropho- blastic disease (pGTD). Transvaginal ultrasonography re- vealed two gestational sacs, and dichorionic-diamniotic twin pregnancy was identified as lambda sign was observed. A normal appearing live fetus at 11 weeks' of gestation and a normal placenta in one of the sacs was demonstrated. A large placenta having multiple-echogenic areas suggesting molar degeneration was observed in the other sac; the fetus was absent. Serum 6-hCG level was 276,079 mU/ml. It decreased to 5457 mU/ml two weeks after the suction curettage. The di- agnosis of partial hydatidiform mole was confirmed with histo- pathologic examination. After pregnancy termination she was lost to follow-up. Two months later, she presented with vagi- nal spotting, and an increase in the I~-hCG level (6690 mU/ml). With the diagnosis of pGTD, she was treated with two courses of methotrexate and folinic acid. At 9-months of follow-up no evidence of recurrence developed. CONCLUSIONS: Although, the risk of pGTD following par- tial hydatidiform mole is very low, it is necessary to follow up the patients for persistent gestational trophoblastic disease after termination, even if suction curettage has been per- formed.  General Obstetrics Poster Presentations S I KEY WORDS: Gestational trophoblastic neoplasia, multiple pregnancy, outcome Poster-Obstet-012 The Prevalence of Urinary System Infection In Our Adolescent Aged 20 To 34 And Over 35 Years Old Pregnants Yucer G, Sagsoz N, Yucel A, Noyan V Department of obstetrics and gynecology kirikkale university medical faculty kMkkale Turkey OBJECTIVES: To evaluate the UTI (urinary tract infection) prevalence in pregnant adolescents, women aged 20-34 and over-35 years old. METHODS: 1900 pregnants who applied to our clinic were enrolled to our study. These pregnants were classified as adolescent, aged 20-34 and over-35. Urine analysis was performed to each pregnants and necessary treatment was given. After treatments, the urine analysis was repeated and results were evaluated. RESULTS: In our research 1612 (84.8 ) pregnants were aged 20-34, 128 (6.8 ) were over-35 and 160 (8.4 ) were under 19 years old. UTI was observed in 152 (8.0 ) preg- nants; 23.7 (38) of the adolescents, 5.7 (92) of women aged 20-34 and 17.1 (22) of women over-35 years old. 17 of 152 retreated pregnants was reinfected. The urine analy- sis of 9 of the 17 treated pregnants revealed recurrent infec- tion. 7 of them were adolescents. After third treatment, no infection was observed. In all groups, frequently Staphylo- coccus was determined. CONCLUSIONS: The prevalence and recurrence of UTI in adolescent pregnants were higher compared to other age groups. KEY WORDS: Urinary tract infection, adolescents, pregnancy Poster-Obstet-013 Ovarian Torsion in the Late Second Trimester of a Twin Pregnancy in a Polycystic Patient: Detorsion via Paramedian Incision Kurdoglu Z, Kurdoglu M, Onan MA, Bozkurt N, Gunaydin G, Taner Z, Himmetoglu O Department of Obstetrics and Gynecology Gazi University School of Medicine Ankara Turkey OBJECTIVES: With the increasing use of ovarian stimula- tion protocols, ovarian enlargement and subsequent risk of adnexal torsion during pregnancy became more apparent. We present a rare case of ovarian torsion at the end of the second trimester of pregnancy in a polycystic patient treated with clomiphene citrate. CASE: A 29-year-old pregnant women in the 24th week of twin gestation was admitted to our clinic with acute onset of lower colicy abdominal pain, nausea and vomiting. She had conceived following an ovulation induction with clomiphen citrate for polycystic ovarian syndrome. With a presumptive diagnosis of left adnexal torsion, surgery was performed via a left paramedian incision. On surgical exploration the left ovary was ischemic and edematous and its pedicle was ob- served to be twisted around itself three times. Although as being very congested, it rapidly reperfused following un- twisting and was conserved. The contralateral ovary was normal. CONCLUSIONS: Beside the mostly accused gonadotropins, the usage of clomiphen citrate in a polycystic ovarian patient can lead to ovarian torsion in her pregnancy even in the late second trimester.The management of these cases should be as conservative as possible and paramedian incision may be a prompt choice in unilateral cases. KEY WORDS: ovulation induction, pregnancy, ovarian tor- sion Poster-Obstet-014 Maternal Mortafity at the G6ztepe Educational and Research Hospital: Analysis of cases between 1997 and 2004 Tuncay YA, Bilgic E, Kirecci A, Sezginsoy S YL~cel N Deparment of Obstetrics and Gynecology GOztepe Research and Training Hospital Istanbul Turkey OBJECTIVES: To determine the incidence and causes of maternal mortality over a eight-year period in our hospital. MATERIAL-METHODS: Data were collected retrospectively from our hospital's intensive care unit and delivery room records between 1997 and 2004 for women who died from pregnancy-related causes while pregnant or within 42 days of a pregnancy being delivered or terminated. We calculated maternal mortality ratio (MMR), its distribution by each year, and evaluated the leading causes of death. RESULTS: During study period, a total of 25 maternal deaths occurred among 97.112 deliveries, yielding the MMR of 25.74 deaths per 100 000. MMR levels demonstrated yearly fluctuations that reached the lowest levels in 1998 and the highest level in 2002 as 7.00 and 38.11 per 100.000 deliveries, respectively. Hypertensive disorders (60 ), haemorrhage (12 ) and cerebrovascular disease (12 ) were the leading causes of maternal death. Most of the deaths were in young women (26-30 years) and multigravi- dae who had received inadequate antenatal care. CONCLUSIONS: Most of the deaths evaluated were pre- ventable. These results appears that maternal mortality can be reduced by improving quality of peripheral antenatal care units. KEY WORDS: maternal mortality rate, retrospective study Poste r-Obstet-015 Emergency peripartum hysterectomy and associated factors GOzin K, Kayabasoglu F, Kirecci A, Tuncay Y, Kanadikirik F Department of Obstetrics and Gynecology Gdztepe Research and Training Hospital Istanbul Turkey OBJECTIVES: To evaluate the incidence,risk factors, indi- cations, outcomes and complications of emergency hyster- ectomy performed after caesarean deliveries (caesarean hysterectomy) and vaginal deliveries (postpartum hysterec- tomy). METHODS: We analyzed retrospectively 23 cases of emer- gency peripartum hysterectomy operations performed be- tween January 2001 and 15 january 2004 at Health Minis- tery GSztepe Research and Education Hospital. The indica-
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