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Öğe Association between postpartum depression and synthetic oxytocin use for postpartum hemorrhage prevention and treatment(2019) Karakus, Resul; Pulatoğlu, ÇiğdemÖz:Objective: The aim of this study was to examine the relationship between postpartum synthetic oxytocin administration and the deve lopment of depressive and anxiety disorders after delivery. Material and Methods: We hypothesized that women exposed to postpartum exogenous oxytocin would have a reduced risk of postpartum depressive and anxiety disorders compared with those without exposure. The cases were examined under two groups as "Oxytocin users" (n = 100) and "Control" (n = 100) groups . Oxy - tocin group was given introvenous oxytocin just after the delivery for postpartum hemorrhage prevention and treatment. Questionna ires of depression and maternal anxiety were performed at the sixth week after the delivery. Results: The incidence of depression (4%) in the oxytocin group was significantly lower than the control group (14%) (p: 0.026, p <0.05). Patients who do not use oxytocin have a 3.9-fold greater risk of developing depression. We identified a relationship between using oxytocin for postpartum hemorragie and decreased postpartum depressive symptoms. Conclusion: Our findings suggest using exogenous oxytocin may contribute to postpartum symptoms of depression and anxiety among women. Future research should watch the longitudinal role of exogenous oxytocin in maternal mood and anxiety, the safety of high-dose long-term use of oxytocin.Öğe Koronavirüs (COVID-19) pandemisi ve seksüalite(TR- Dizin, 2020) Pulatoğlu, ÇiğdemKoronavirüs hastalığının (COVID-19) Dünya Sağlık Örgütü (DSÖ) tarafından pandemi olarak ilan edilmesiyle beraber sosyal mesafenin korunması, zorunlu haller dışında evden çıkılmaması ve el hijyenine dikkat edilmesi önerilmiştir. Bu durumda çiftlerin sağlıklı bir cinsel hayatı nasıl olmalı ve ne gibi önlemler alınmalıdır? Cinsel ilişki güvenli midir? Koronavirüs vajinal sekresyonlarda ve spermde saptanmamıştır. Bu da cinsel yolla bulaşan bir hastalıktan ziyade damlacık yolu ile bulaşan bir enfeksiyon olduğunu göstermektedir. DSÖ tarafından belirlenen 1 metre güvenli mesafesinin cinsel ilişki sırasında korunamayacak olması ve yakın temas,enfeksiyonun bulaşma riskini artıran temel etkendir. Semptomatik hastalar gibi minimal semptomatik veya asemptomatik hastaların da taşıyıcı olabileceği bilindiğinden cinsel ilişki sırasında yakın temasa bağlı olarak bulaşa sebep olabilirler. Salgın dönemlerinde cinsel ilişkiden sakınılması önerilmektedir. Ancak cinsel ilişki isteği mevcut ise en güvenli cinsel partner kişinin kendisidir ve en güvenli cinsel tatmin şekli mastürbasyondur. Bir sonraki en güvenli partner ise kişinin ortak alanını paylaştığı birlikte yaşadığı kişidir. Seks dahil olmak üzere sadece küçük bir çevre ile yakın temasta bulunmak COVID-19'un yayılmasını önlemeye yardımcı olurÖğe Maternal and neonatal outcomes related to iron deficiency anemia and serum ferritin status: a multicenter prospective study from Eastern Marmara, Turkey(2019) Pulatoğlu, Çiğdem; Başbuğ, Derya; Akar, Bertan; Şimşek, Hayal; Çakır, Pınar; Başbuğ, Alper; Çalışkan, ErayThe aim was to evaluate the incidence of iron deficiency anemia in pregnancy in the East Marmara region of Turkey in order to determine its prevalence along with the effects and associations of iron supplementation on maternal and neonatal outcomes. Materials and Methods: This study was conducted in six centers and included a total of 1102 pregnant women. Blood samples were collected for hematological status and serum ferritin levels during pregnancy, and the adverse maternal and perinatal outcomes were determined. Iron deficiency anemia was diagnosed according to the World Health Organization criteria as hemoglobin level of < 11 g/dl and ferritin level of <15 ?g/dL. Results: The rate of anemia was 19.8%, with 44% of them receiving iron supplementation. The maternal age was lower in the anemic group (26.5 vs. 27.7, p = 0.01). Selective iron use was more frequent in the anemic group, while routine iron use was more frequent in the non-anemic group (47.1% vs. 29.3%; p = 0.01). Conclusion: Iron deficiency anemia is a frequent problem in pregnancy. However, many anemic pregnant women do not receive iron therapy. Iron supplementation may have positive effects on maternal and perinatal outcomes. In order to combat iron deficiency anemia in pregnancy, wide spread use of iron supplements should be established.Öğe Mikro besin takviyesinin maternal–fetal sonuçlara etkisi: d vitamini, kalsiyum ve magnezyum(2018) Doğan, Ozan; Ellibeş Kaya, Aşkı; Pulatoğlu, Çiğdem; Akar, Bertan; Başbuğ, Alper; Çalışkan, ErayAmaç: Fetal ve maternal sağlığa olumlu etkileri olması nedeniyle gebelik döneminde artan ihtiyaçla orantılı olarak vitamin ve mineral desteğine ihtiyaç vardır. Bu çalışmada mikro besin takviyesi olarak D vitamini, Kalsiyum (Ca) ve Magnezyum (Mg) desteği alan gebelerin postnatal sonuçlarını ve gebelik komplikasyonlarını araştırmak amaçlandı. Gereçler ve Yöntem: Yapılan bu prospektif, longitudinal ve kalitatif çalışmaya Ocak 2016 ve Ocak 2018 tarihleri arasında 18-40 yaş arası toplam 2114 hasta dahil edilmiştir. Bulgular: Maternal yaş aralığı tüm hasta grupları için 28.11 ± 6.12‘ dir. Multivitamin kullanan grubun yaş ortalaması D vitamini grubuna göre daha düşük saptandı(p= 0.001). Yalnızca Mg ve D vitamini kullanan grupta yüksek lisans seviyesinde eğitim görenler daha fazlaydı(p=0.001). Mg, Ca, D vitamini ve multivitamin kullananımı ile gebelik komplikasyonları arasında anlamlı ilişki bulunamadı. Multivitamin kullanan gebelerde LGA daha fazla görüldü(p=0.038). İlk gebelik yaşı Ca ve mulivitamin kullanan grupta Mg ve D vitamini kullanan gruba göre daha düşük bulunmuştur(p=0.001). Sonuç: Annenin sağlıklı bir gebelik geçirmesi, maternal komplikasyonlardan korunması, fetusun büyüme ve gelişmesi için annenin düzenli beslenmesinin yanı sıra vitamin ve mineral takviyesi önemlidir. Bu takviyelerin literatürde gösterilmiş olan yararlarını desteklemek ve rutin kullanımda yer vermek için daha çok prospektif çalışmaya ihtiyaç vardır.Öğe Patients' perceptions toward and the driving factors of decision-making for opportunistic bilateral salpingectomy at the time of cesarean section(Galenos Yayincilik, 2020) Yassa, Murat; Pulatoğlu, ÇiğdemObjective: Enough data can be found in the literature regarding the protective effect of tubal ligation on gynecological cancers. In addition, a large body of evidence revealed that prophylactic bilateral salpingectomy had no significant negative effect on the ovarian function, quality of life, sexuality, surgery duration, and cost-effectivity. This study was aimed at exploring the underlying factors that motivate women for either opportunistic bilateral salpingectomy (OBS) or tubal ligation, particularly focusing on their preferences, knowledge, and beliefs toward female sterilization, satisfaction from counseling, and body image following the salpingectomy. Materials and Methods: A total of 54 patients who had undergone surgical sterilization with either OBS or tubal ligation were included in this prospective cohort study. The acceptance rate of the OBS at the time of cesarean section among pregnant women seeking surgical sterilization was calculated. The underlying reasons for women's acceptance or refusal for salpingectomy were assessed by a non-validated data collection tool that had 14 open-ended questions focusing on the women's preferences, knowledge, beliefs toward female sterilization, satisfaction from counseling, and body image following the salpingectomy. Results: The acceptance rate of OBS at the time of cesarean section among pregnant women and electively among non-pregnant women were 93.5% (n=43/46) and 75% (6/8), respectively. The main driving factors influencing the decision of preferring OBS over tuba! ligation were the risk-reducing effect for ovarian cancer and superior pregnancy prevention. Conclusion: The acceptance rate of OBS at the time of cesarean section was found to be very high, and it should therefore be offered at the time of cesarean section to women who desire permanent contraception.Öğe Relationship of orgasm with measurable dimensions of clitoris and visibility of clitoral glans(DergiPark, 2020) Pulatoğlu, Çiğdem; Ellibay Kaya, AskiAim: The clitoris is the dominant sexual organ in the female, varies in size and plays an active role in genital sensation and orgasm. Since the importance of clitoral glans visibility is known, surgeries of clitoris are increasing day by day. However, there is insufficient literature on the subject. The aim of this study is to determine the effect of measurable dimensions of clitoris and the clitoral glans visibility on female sexual function. Methods: Seventy-seven patients included in this cross-sectional study were examined in the lithotomy position and the measurable dimensions of the clitoris, the visibility of the clitoral glans and the length of the prepuce were noted. The Female Sexual Function Index (FSFI) was applied to all participants, which were divided into two groups, as those with normal orgasmic function and orgasmic dysfunction. One researcher made all measurements. Results: There were no statistically significant differences in clitoral glans width, length, or prepuce length (P=0.11, P=0.63, P=0.35, respectively). Clitoral glans was visible in 41 of 51 patients in the normal orgasmic function group, which was significantly higher than the group with orgasmic dysfunction (P<0.001). Conclusion: Since there is a significant relationship between clitoral glans visibility and orgasm, genital surgeries performed to increase clitoral glans visibility can facilitate sexual satisfaction and/or increase orgasm intensity. The fact that the relationship between measurable dimensions of clitoris, length of prepuce and orgasm cannot be shown suggests that clitoral glans visibility is more important than clitoral size for sexual stimulation.Öğe Surgical anatomy of the pectineal ligament during pectopexy surgery: The relevance to the major vascular structures(Galenos Yayincilik, 2020) Pulatoğlu, Çiğdem; Dogan, Ozan; Medisoglu, Mahmut Sabri; Yassa, Murat; Kaya, Aski Ellibes; Selcuk, Ilker; Bayik, Rahime NidaObjective: During pectopexy surgery, the prolapsed uterus or the vaginal apex is fixed to the pectineal ligament. The anatomic structures found in the lateral part of the prevesical and paravaginal space above the obturator fossa, raise the importance of the surgical steps required to prevent complications. This study was conducted to evaluate the proximity of vascular structures to the pectineal ligament. Materials and Methods: The distances between the surgical suturing area during pectopexy surgery and the external iliac vein, pubic anastomotic vessel (corona mortis) and obturator canal were measured bilaterally in seven fresh female cadavers. Results: The total length of the pectineal ligament was 5.9 +/- 0.76 cm on the left and 6.5 +/- 1.14 cm on the right side; the midpoint of the pectineal ligament was 2.8 +/- 0.52 cm on the left and 3.6 +/- 0.47 cm on the right side. From the midpoint of the left pectineal ligament, the mean distance to the left external iliac vein was 1.04 +/- 0.23 cm, to the left corona mortis it was 2.15 +/- 0.48 cm, and to the left obturator canal it was 3.12 +/- 0.95 cm. From the midpoint of the right pectineal ligament, the mean distance to the right external iliac vein was 1.25 +/- 0.43 cm, to the right corona mortis it was 2.37 +/- 0.63 cm, and to the right obturator canal it was 3.57 +/- 0.93 cm. Conclusion: The anatomic findings of the study confirmed that the pectineal ligament was in close association with main vessels. The external iliac vein was measured as the closest anatomic structure to the pectineal ligament. Surgeons must be careful to minimize life-threatening complications because of the proximity of the pectineal ligament to main vessels.Öğe Vaginal axis on MRI after laparoscopic lateral mesh suspension surgery: a controlled study(Springer Science and Business Media Deutschland GmbH, 2021) Pulatoğlu, Çiğdem; Yassa, Murat; Turan, G.; Turkyilmaz, Deniz; Dogan, OzanIntroduction and hypothesis: Laparoscopic lateral mesh suspension (LLMS) has emerged as a practical, safe, and feasible alternative to sacrocolpopexy (SCP) for treating female genital apical prolapse. Although several prior studies have reported changes in the vaginal axis in women who have undergone SCP or sacrospinous ligament fixation (SSLF) surgery for prolapse, there is a lack of data on changes in the vaginal axis after LLMS. This study was aimed at investigating the level of anatomical correction following LLMS and comparing the vaginal axis on magnetic resonance imaging (MRI) in patients with apical genital prolapse. Methods: Patients who underwent LLMS and a nulliparous control group were included in this observational prospective case–control study. MRI was performed on the control group and the study group pre- and postoperatively. The angle between the pubococcygeal line and the lower vaginal segment, the angle between the levator plate and the pubococcygeal line, and the angle between the lower and upper vaginal segments were measured and compared. Results: The angles measured between the pubococcygeal line and the lower vaginal segment and between the levator plate and the pubococcygeal line were significantly lower in the preoperative than in the postoperative measurements (p < 0.001). All angles were found to be similar in the nulliparous women and in the patients following LLMS surgery. The Pelvic Organ Prolapse Symptom Score (POP-SS) score decreased significantly after the operation (p < 0.001). Conclusion: The vaginal axis was found to be near-normal in patients who underwent LLMS.Öğe Women's knowledge and beliefs towards vaccination for influenza during pregnancy in Turkey and underlying factors of misinformation: a single-centre cross-sectional study(NLM (Medline), 2020) Pulatoğlu, Çiğdem; Turan G.OBJECTIVE: The aim of the study was to evaluate the knowledge and perceptions of the pregnant women presenting to our hospital for seasonal vaccination for influenza and to determine the factors associated with it. METHOD: In this cross-sectional study pregnant woman presenting to our hospital between October 2018 and March 2019 were evaluated. A non-validated, well-detailed questionnaire addressing the vaccination rates, participants' perceptions about the facts behind the vaccination for influenza and the factors associated with refusal of vaccination was performed. Women's knowledge level provided by their healthcare providers was also questioned. RESULTS: A total of 250 participants were included in the study. The average age of the patients was 28.85 ± 5.42 years (range 18-43); and the average pregnancy week was 19 ± 9.75. It was determined that 98% (n = 245) of the participants did not have any vaccinations before, and 98.8% (n = 247) did not have any vaccination during their current pregnancy. 65.2% (n = 163) of the participants did not know that the vaccination for influenza was safe in pregnancy; and 64% (n = 160) did not know that the vaccination for influenza was recommended in pregnancy. The most frequent responses given by the participants to justify their refusal for the vaccination was "my doctor was against" and "it can be harmful to my baby" (25.6% and 24%, respectively). It was determined that 98.4% (n = 246) of the participants were not recommended about the vaccination for influenza by any healthcare centres; and 92.8% (n = 232) did not receive any information on vaccination for influenza. CONCLUSION: The knowledge of the participants on vaccination for influenza was inadequate and had misconceptions. The inadequacy of healthcare employees, government institutions and the media may have played roles in this outcome. The reasons underlying the inadequacy of the healthcare providers on vaccination for influenza may be questioned.
