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Öğe Altered right portal and umbilical vein doppler parameters in fetal macrosomia resulting from pregestational and gestational diabetic mothers: A prospective case-control study(Türkiye Klinikleri Yayınevi, 2023) Sezer, Salim; Oğlak, Süleyman Cemil; Atış Aydın, Alev; Süzen Çaypınar, Sema; Kaya, Başak; Bestel, MelihObjective: To evaluate the blood flow of the umbilical vein and right portal vein in macrosomic fetuses of diabetic mothers and investigate the effect of maternal insulin treatment on these blood flows.Material and Methods: This prospective case-control study was con- ducted between March 2019 and December 2019. Fetuses of the 49 pregestational and gestational diabetic mothers who had an abdominal cir- cumference percentile above 97% were evaluated as macrosomic and formed the study group. The study group was divided into two subgroups: patients treated with insulin and those who did not. In the control group, 48 non-diabetic pregnant women with matched gestatio nal weeks whose fetuses are at the 10-90% percentile were included. Time-averaged maximum blood velocity (TAMXV) values of the right portal vein and the free loop of the umbilical vein were measured.Results: The median right portal vein TAMXV value and umbilical vein TAMXV value were found to be significantly higher in diabetic pregnancies (16.25 cm/s, and 15.28 cm/s, respectively) than in the control group (12.76 cm/s, and 13.38 cm/s, respectively, p<0.001). Umbilical and right portal vein flows were similar in macrosomic fetuses of diabetic mothers who were treated with insulin or those who did not. While umbilical vein flow in macrosomic fetuses increased as the gestational age pro gressed (p=0.028), it was observed steadily in normally growing fetuses. Conclusion: The umbilical and right portal vein flows are higher in macro- somic fetuses of diabetic mothers than in appropriately grown fetuses. Maternal insulin treatment does not affect fetal umbilic al vein and right portal vein blood flow in macrosomic fetuses.Öğe Fetal bronkopulmoner malformasyonlar: Prenatal tanı ve perinatal sonuçlar(Kanuni Sultan Süleyman Eğitim Araştırma Hastanesi, 2020) Kaya, Başak; Kanber Açar, Deniz; Sezer, Salim; Tayyar, Ahmet; Polat, İbrahimAmaç: Bu çalışmada prenatal dönemde konjenital pulmoner hava yolu malformasyonu ve bronkopulmoner sekestrasyon tanısı alan olguların klinik özelliklerinin, prognozu etkileyen faktörlerin ve perinatal sonuçlarının değerlendirilmesi amaçlandı. Yöntem: Ocak 2013-Aralık 2016 tarihleri arasında hastanemiz perinatoloji ünitesinde konjenital pulmoner hava yolu malformasyonu ve bronkopulmoner sekestrasyon tanısı alan 59 olgunun kayıtları incelendi. Torakal kitlenin özellikleri ve doğal seyri ile olguların yönetimleri ve perinatal sonuçları incelendi. Bulgular: Otuz yedi olgu (%71.2) konjenital pulmoner hava yolu malformasyonu ve 15 olgu (%28.8) bronkopulmoner sekestrasyon tanısı aldı. Olguların %17.3’de eşlik eden yapısal anomali saptanırken, eşlik eden yapısal anomalisi olan olguların 4’ünde (%7.7) kromozom anomalisi mevcuttu. Olguların %75’inde canlı doğum gerçekleşti. Yenidoğan döneminde 23 olguda (%59) bronkopulmoner malformasyon varlığı radyolojik olarak gösterildi ve bu olguların 18’i (%78.3) yaşamın ilk bir yılında opere edildi. Sonuç: Eşlik eden anomali ve hidrops yokluğunda fetal bronkopulmoner malformasyon olgularının prenatal dönemde oldukça iyi seyrettiği ve özellikle spontan regresyon izlenen olguların postnatal dönemde operasyon gereksinimi olmadan sorunsuz yaşamlarını sürdürdüklerini saptadık. Fetal bronkopulmoner malformasyonlar ve diğer torakal anomalilerin prenatal tanı sıklığının artırılabilmesi amacıyla temel fetal anatomik tarama sırasında toraks transvers kesitlerden görüntülenmeli ve klinik şüphe varlığında çoklu sonografik planlar kullanılarak ayırıcı tanı yapılmalıdır.Öğe Fetal left ventricular myocardial performance index measured at 11–14 weeks of gestation in fetuses with an increased nuchal translucency(Wiley, 2023) Sezer, Salim; Oğlak, Süleyman Cemil; Kaya, Başak; Behram, Mustafa; Gedik Özköse, Zeynep; Süzen Çaypınar, Sema; Acar, Züat; Gezdirici, Alper; Bornaun, HelenObjective: This study aimed to evaluate the effect of an increase in nuchal translucency (NT) thickness on the myocardial performance index (MPI) in fetuses without cardiac anomaly in the first trimester and to determine whether a difference in MPI between those with and without trisomy 21 in these fetuses could be determined. Methods: The study group consisted of 53 pregnancies complicated with increased NT thickness without any associated structural anomalies. Forty-six gestational age-matched pregnant women whose fetuses had normal NT thickness were enrolled as the control group. Results: In the increased NT thickness group, the mean isovolumetric relaxation time (IRT) value (0.050 ± 0.011 s) was significantly higher and the mean ejection time (ET) value (0.149 ± 0.010 s) was significantly lower than those values in the normal NT thickness group (0.045 ± 0.005 and 0.155 ± 0.009 s, p = 0.023 and p = 0.009, respectively). We found a significantly higher mean left MPI value in the increased NT thickness group (0.574 ± 0.153) versus the normal NT thickness group (0.487 ± 0.107, p < 0.001). Within the increased NT thickness group, the mean left MPI value was similar in the fetuses with normal karyotype and those with trisomy 21 (p = 0.419). Conclusion: We demonstrated a significantly greater mean MPI value in the increased NT thickness group than in the normal NT thickness group. Within the increased NT thickness group, no differences in the left MPI value in the fetuses with normal karyotype and the fetuses with trisomy 21 were found.Öğe Maternal serum galectin-1 and galectin-3 levels in pregnancies complicated with preterm prelabor rupture of membranes(Taylor and Francis Ltd, 2020) Kaya, Başak; Turhan, Uğur; Sezer, Salim; Kaya, Serdar; Dağ, İsmail; Tayyar, AhmetObjective: To investigate maternal serum galectin-1 and galectin-3 levels in pregnancies complicated with preterm prelabor rupture of membranes (PPROM) and to compare with pregnancies delivered at term. Materials and methods: In this cross-sectional study, 40 women with singleton pregnancies complicated with PPROM between 24 and 34 weeks of gestation were compared with gestational age-matched 40 pregnant women with no obstetrics complications, who delivered at term. The maternal serum galectin-1 and galectin-3 levels were measured. Results: Patients complicated with PPROM had significantly higher levels of galectin-1 (p = .001) and galectin-3 (p = .003) than the control group. Maternal serum galectin-3 levels were found significantly negatively correlated with the gestational age at delivery and birth weight. Conclusion: Maternal serum galectin-1 and galectin-3 levels were significantly higher in pregnancies complicated with PPROM. Galectin-1 and galectin-3, with their regulatory effects in key biological processes, may be both an initiating factor in the pathophysiology of PPROM, a marker in the prediction, and a target of preventing strategies of PPROM.Öğe The assessment of cardiac function with tissue Doppler imaging in fetuses with congenital diaphragmatic hernia(Taylor & Francis, 2020) Kaya, Başak; Tayyar, Ahmet; Sezer, Salim; Kaya, SerdarIntroduction: This study aimed to evaluate the cardiac function of fetuses with congenital diaphragmatic hernia by conventional echocardiography and spectral tissue Doppler imaging (s-TDI) and to evaluate the relationship between cardiac function and the severity of pulmonary hypoplasia. We also aimed to investigate the effect of diaphragmatic hernia side on fetal cardiac function. Methods: Fetal cardiac function were evaluated in 28 fetuses (20 with left-sided and 8 with right-sided) complicated with isolated congenital diaphragmatic hernia (CDH) and 56 gestational age matched control in this single center prospective study. s-TDI measurements were obtained at the right atrioventricular valve annulus. The annular peak velocities and their ratios, the time periods of cardiac cycle and myocardial performance index were calculated. Results: In comparison to controls, significantly prolonged isovolumetric contraction time (ICT ') and isovolumetric relaxation time (IRT ') and, significantly shortened ejection time (ET ') were observed in fetuses with CDH by s-TDI. Fetuses with CDH also had higher myocardial performance index (MPI ') z-scores compared to controls. There were no significant differences in terms of s-TDI cardiac function parameters between fetuses with right- and left-sided CDH. In correlation analysis, a significant positive correlation was found between ET ' value and o/e LHR. Conclusion: The signs of both systolic and diastolic altered function were observed in fetuses with CDH with s-TDI independent of the side of the hernia, and a significant positive correlation was observed between fetal cardiac systolic function and the severity of pulmonary hypoplasia.
