Ezgi Turgut

Gazi University

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Evaluation of fetal cardiac output in preterm premature rupture of membranes

Echocardiography (2023)

Merve Öztürk Ağaoğlu Ezgi Turgut Zahid Ağaoğlu Eda Özden Tokalıoğlu Özgür Kara

We aimed to investigate fetal cardiac output (CO) in pregnancies with preterm premature rupture of membranes (PPROM) and its relationship with umbilical cord pH.This was a prospective study in total 90 pregnancies at 24-37 weeks gestation including 42 pregnancies with PPROM and 48 that healthy controls. Fetal cardiac function including combined, left and right CO z-scores were compared. The neonates in the PPROM group were separated with umbilical cord pH above and below 7.25, and cardiac output was compared between groups.In PPROM group, CCO z-score, left cardiac output (LCO) z-score, and right cardiac output (RCO) were significantly lower compared to healthy pregnancies (p = .036, p = .001, p = .032, respectively), while RCO z-score showed no significant differences between the two groups. The aortic annulus and pulmonary artery annulus z-scores were measured smaller in the PPROM group (p = .000 and p = .001, respectively). In PPROM group, the fetal LCO z-score was significantly lower in neonates with an umbilical cord pH of 7.25 or less (p = .048).This study provides evidence that fetal CCO is lower in PPROM compared with healthy pregnancies. Reduced LCO z-scores may be useful for predicting adverse neonatal outcomes in pregnancies with PPROM.

Umbilical artery

10.1111/echo.15689

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Perioperative Management of Bleeding due to Uterine Atony/Rupture in a Parturient after Vaginal Delivery and Intensive Care Unit Follow-up: Pharmacological, surgical and interventional therapies

Türk yoğun bakım derneği dergisi/Türk yoğun bakım dergisi (2019)

Berrin Günaydın Gözde İnan Ezgi Turgut Deniz Karçaaltıncaba Ali Çin

We aimed to present perioperative management of bleeding due to uterine atony and/ or rupture and postoperative intensive care unit (ICU) follow-up of a parturient after spontaneous vaginal delivery.A 36-year-old parturient at 41 weeks of gestation with a history of epilepsy was admitted for induction of labor.During pushing, she had a grand mal seizure treated with diazepam.After delivery of the placenta, emergency hysterectomy under general anesthesia was required to control bleeding despite treatment with uterotonics (carbetocine, methylergonovine, and misoprostol) and tranexamic acid followed by Bakri balloon placement.Crystalloids (2 L), colloids (1.5 L), blood products (3 ES, 4 FFP) and 2 grams (g) of IV fibrinogen concentrate were administered throughout the operation.After extubation, the patient was transferred to ICU and 1 g of IV fibrinogen was administered.During her ICU follow-up, hemoglobin decreased to 7.3 g/dL and a bleeding from uterine artery was diagnosed, and embolization was performed by interventional radiology.Patient was transferred to ward and discharged on the postoperative 7th day.Consequently, perioperative management of PPH with use of fibrinogen along with uterotonics, blood/blood products and fibrinogen demonstrated to be life saving in an epileptic parturient who underwent emergency hysterectomy because of atony and/or rupture after spontaneous vaginal delivery.

Uterine atony

Atony

10.4274/tybd.galenos.2019.82473

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Citations (2)

Evaluation of Midkine levels in pregnant women with preterm premature rupture of membranes: A cohort study from a tertiary hospital

Cytokine (2023)

Bedri Sakcak Atakan Tanaçan Ramazan Denızlı Nihat Farisoğulları Osman Onur Özkavak

Midkine

Demographics

10.1016/j.cyto.2023.156141

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Citations (0)

Determination of the Relationship Between Serum Lactate Level and Antenatal Complications and Early Neonatal Outcomes In Hyperemesis Gravidarum Patients

Eurasian Journal of Medicine and Oncology (2018)

Ezgi Turgut Uğurkan Erkayıran Burak Karadağ Vakkaş Korkmaz

Hyperemesis gravidarum

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Citations (1)

Maternal serum midkine level increases in pregnant women with diabetes mellitus: a case-control study

Gynecological Endocrinology (2022)

Deniz Oluklu Dilek Menekşe Beşer Derya Uyan Hendem Selcan Sınacı Ezgi Turgut

We aimed to compare maternal serum midkine level in pregnant women with different types of diabetes mellitus (DM) and healthy pregnant women. We also assessed maternal serum midkine level performance to predict adverse neonatal outcomes in the DM group.The study included 57 pregnant women diagnosed with gestational diabetes mellitus (GDM) and 41 pregnant women with preexisting DMThe control group consisted of 98 healthy pregnant women.Serum midkine level is higher in the DM group than healthy ones (0.93 ± 0.8 vs. 0.23 ± 0.2, p<.001). When the diabetic groups were compared, the highest serum midkine level was found in GDM, followed by Type 1 DM and Type 2 DM (1.33 ± 0.9 ng/ml, 0.58 ± 0.5 ng/ml vs. 0.30 ± 0.2, respectively). Maternal serum midkine level was higher in the DM group with adverse perinatal outcomes than those without adverse outcomes, but there was no statistical difference (0.97 ± 0.91vs. 0.87 ± 0.73, p=.571).Serum midkine level was significantly higher in pregnant women with GDM, Type 1, and 2 DM than healthy ones. Serum midkine level did not predict adverse neonatal outcomes in the DM group.

Midkine

10.1080/09513590.2022.2045937

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Citations (3)

Umbilical Cord Blood CK-MB, Troponin T, ProBNP, IMA Levels, and Fetal Cardiac Function in Cases of IUGR

Research Square (Research Square) (2022)

Ezgi Turgut Halis Özdemir Belkıs Narlı Canan Uğur Yılmaz Merih Bayram

Abstract Objective: To evaluate umbilical cord blood creatine kinase MB (CK-MB), Troponin T (TnT-hs), pro-brain natriuretic peptide (proBNP), ischemia modified albumin (IMA) levels and fetal cardiac function in intrauterine growth retardation (IUGR). Methods: The study included 39 pregnant women with IUGR and 42 healthy pregnant women in control group. IUGR was diagnosed when estimated fetal weight was <10 percentile. Fetal cardiac function was evaluated by ultrasound in third trimester of pregnancy and compared with control group. Umbilical cord blood biochemical test (CK-MB, TnT-hs, proBNP, IMA) results compared between the groups. Results: In cardiac morphological evaluation, cardiothoracic index was higher and left sphericity index was lower in the IUGR group compared to the control group (p<0,001, p=0,018). Left myocardial performance index (MPI) was higher, tricuspid and mitral annular plane systolic excursion (TAPSE and MAPSE) values were lower in IUGR group than control group (p=0,035, p=0,038 and p=0,011 respectively). In IUGR group only proBNP levels was increased compare to control group in umbilical cord blood biochemical tests (p=0,018). There was negative correalation between umbilical cord blood proBNP levels and MAPSE value (r=-0,332, p=0,002). Conclusions: We observed that IUGR was associated with fetal cardiac morphological changes and systolic dysfunction. Also, in IUGR group cord blood proBNP level was increased and negatively correlated with MAPSE value.

Umbilical artery

Cord blood

Intrauterine growth restriction

Troponin complex

10.21203/rs.3.rs-2048773/v1

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Knowledge, Attitude and Behaviors of Pregnant Women about COVID-19: A Single-Center Cross-Sectional Study

Authorea (Authorea) (2024)

Gökçe Turan Gülnur Kul Ezgi Turgut

Objective: Our aim is to assess the knowledge, attitude, and behaviors of pregnant women about COVID-19. Material and Method: This cross-sectional survey study was performed on pregnant women in their second and third trimester between the November-December 2020. The participants completed a questionnaire consisting of 5 parts. Demographic data of pregnant women, their knowledge, attitude, and risk perceptions toward COVID-19, their practices and worries about COVID-19, and what they knew about pregnancy were assessed. The answers were calculated as a percentile and mean. Results: A total of 1011 participants were included in the statistical analysis. Of the participants, 98.5% knew that COVID-19 was transmitted through close contact. Of the participants, 47.5% extremely trusted healthcare workers in fighting against the COVID-19 pandemic. Affection and respect for healthcare workers during the pandemic increased by 89.1% of the participants. Of the participants, 50.6% were intending to decrease their antenatal visits during the COVID-19 pandemic and 39.4% thought that their baby may be infected after birth. Conclusion: The measures taken can be applied with high awareness of COVID-19. Sufficient training, in that case, can be done through communication routes such as information and public service announcements.

Pandemic

Cross-sectional study

Affection

10.22541/au.170665028.83293144/v1

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Citations (0)

Management of pregnant women with COVID‐19: A tertiary pandemic center experience on 1416 cases

Journal of Medical Virology (2021)

Dilek Şahın Atakan Tanaçan Seyit Ahmet Erol Fatma Didem Yücel Yetişkin Berhan Besimoğlu

The aim of this study is to share the comprehensive experience of a tertiary pandemic center on pregnant women with COVID-19 and to compare clinical outcomes between pregnancy trimesters. The present prospective cohort study consisted of pregnant women with COVID-19 who were followed up at Ankara City Hospital between March 11, 2020 and February 20, 2021. Clinical characteristics and perinatal outcomes were compared between the pregnancy trimesters. A total of 1416 pregnant women (1400 singletons and 16 twins) with COVID-19 were evaluated. Twenty-six (1.8%) patients were admitted to the intensive care unit (ICU) and maternal mortality was observed in six (0.4%) cases. Pregnancy complications were present in 227 (16.1%) cases and preterm labor was the most common one (n = 42, 2.9%). There were 311, 433, and 672 patients in the first, second, and third trimesters of pregnancy, respectively. Rates of mild and severe/critic COVID-19 were highest in the first and second trimesters, respectively. The hospitalization rate was highest in the third trimester. Pregnancy complications, maternal mortality, and NICU admission rates were similar between the groups. The course of the disease and obstetric outcomes may be different among pregnancy trimesters. A worse course of the disease may be observed even in pregnant women without any coexisting health problems.

Pandemic

Tertiary care

10.1002/jmv.27423

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Citations (36)

The assessment of fetal cardiac output in maternal hypothyroidism under levothyroxine treatment

Echocardiography (2022)

Duygu Tuğrul Ersak Deniz Oluklu Derya Uyan Hendem Ezgi Turgut Şule Göncü Ayhan

In this study, we investigated whether maternal hypothyroidism has a role in the cardiac output (CO) of the fetus or not.Pregnant women between 33 and 37 gestational weeks known to have hypothyroidism and using levothyroxine were accepted as the case group. Gestational age-matched healthy euthyroid pregnant women constituted the control group. Fetal echocardiography was performed. Diameters and the velocity waveform of the pulmonary artery (PA) and aortic valves were measured. Velocity time integral (VTI) was also measured from the ventricular outflow tract. CO was calculated using VTI × π (Aortic Valve or Pulmonary Valve diameter/2) 2 × heart rate formula.The aortic and PA annulus were measured larger in the control group. (p = .003, p = .005, respectively). Furthermore, the right and left CO of the case group were lower than the control group. Whereas the mean combined CO (ml/min) of the case group was 674.8 ± 146.2, it was 827.8 ± 167.9 in the control group (p < .001). Additionally, a negative correlation was observed between thyroid-stimulating hormone and aortic VTI (r:-.480; p:.006).The findings of our study suggest that the CO of the fetus may be affected by maternal hypothyroidism.

Levothyroxine

10.1111/echo.15474

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Citations (3)

Evaluation of Fetal Cardiac Functions in Preeclampsia: Does the Severity or Proteinuria Affect Fetal Cardiac Functions?

Journal of Ultrasound in Medicine (2023)

Derya Uyan Hendem Deniz Oluklu Dilek Menekşe Beşer Muradiye Yıldırım Ezgi Turgut

To compare the fetal cardiac functions in preeclampsia and control group, and determine whether the severity or amount of proteinuria affects fetal cardiac functions.This prospective case-control study involves 48 pregnant women with preeclampsia and 48 healthy women. Pulsed wave Doppler, M-mode, and tissue Doppler imaging were used to measure the cardiac function between the 32 and 34 gestational weeks in each group. All Doppler indices and cardiac function parameters were also compared in subgroups with mild and severe preeclampsia and between subgroups with proteinuria >3 g/24 hours and <3 g/24 hours.Decreased diastolic function (decreased E, A, E', and A' values in mitral/tricuspid valves and increased isovolumetric relaxation time) and decreased systolic functions (decreased mitral and tricuspid annular plane systolic excursion and S' value in mitral/tricuspid valves) were detected in the preeclampsia group. Decreased tricuspid E value in severe preeclampsia compared with mild preeclampsia was shown in the present study.Preeclampsia may cause changes in systolic and diastolic functions in the fetal heart. Subclinical functional changes of these fetuses can be detected earlier and more sensitively with the help of tissue Doppler imaging. Biventricular diastolic functional changes are more prominent in preeclamptic cases with proteinuria >3 g/24 hours.

Isovolumetric contraction

Doppler imaging

10.1002/jum.16268

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Citations (5)