Person: KÜTÜK, MEHMET SERDAR
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- PublicationMetadata onlyThe Role of the Urine Dipstick Test in the Detection of Abnormal Proteinuria Using Different Cut-off Levels in Hypertensive Pregnancies Hipertansif Gebeliklerde Farklı Kesim Değerleri Kullanılarak Anormal Proteinüri Saptanmasında Spot İdrar Protein Ölçümünün Rolü(2022-01-01) Takmaz T.; Gorchiyeva I.; Arici Halici B. N.; TOPRAK A.; ÇETİN Ç.; KÜTÜK M. S.; TAKMAZ, TAHA; ARICI HALICI, BELFİN NUR; TOPRAK, ALİ; ÇETİN, ÇAĞLAR; KÜTÜK, MEHMET SERDAR© 2022, Duzce University Medical School. All rights reserved.Aim: The aim of this study was to determine the diagnostic accuracy of different urine dipstick protein threshold levels in predicting the presence of abnormal proteinuria in pregnant women with hypertension. Material and Methods: A total of 326 singleton pregnant women who underwent 501 urine protein tests and who had suspected preeclampsia were included in this retrospective study. Patient data was taken including medical and obstetric history. The results of dipstick urinalysis and concurrent 24-hour urine protein excretion measurements were compared to determine the accuracy of urinalysis. Results: A dipstick result of 1+ was found to be the best cut-off to predict 500 mg of protein excretion per day, with sensitivity and specificity of 62.09% and 88.97%, respectively. A 2+ proteinuria dipstick cut-off had high specificity and positive predictive value (PPV) (99.05% and 98.84%, respectively) for the prediction of 300 mg of protein excretion per day; this cut-off had low sensitivity (21.46%). A cut-off of 1+ also provided satisfactory specificity and PPV (91.43% and 94.48%, respectively) for the detection of 300 mg of protein excretion per day, but sensitivity was compromised (38.89%). Among 301 patients with negative dipstick results, 212 had a 24-hour urine protein extraction greater than 300 mg, with a false negative rate of 70.43%. Conclusion: The results suggest that the urine protein dipstick measurement has limited quantitative ability for the prediction of abnormal proteinuria. Additionally, the use of 500 mg 24-hours protein excretion as a cut-off value for abnormal proteinuria may provide useful data.
- PublicationMetadata onlyPrenatal Sonographic Detection of Monochorionic Twins with Bipartite Placenta(2020-02-10T04:00:00Z) KÜTÜK, MEHMET SERDAR; TAKMAZ, TAHA; Bayram, Arslan; Ozturk, Sule; KÜTÜK, MEHMET SERDAR; TAKMAZ, TAHABackground: Determination of placentation and amnionicity is important for antenatal and intrapartum management in twin gestations. We present an typical monozygotic twin placenta and underscore the sonographic features and diagnostic pitfalls that may interfere with antenatal diagnosis. Case report: A 35-year-old G4P2 with a spontaneous pregnancy applied for routine second trimester anomaly screening. Upon prenatal ultrasonography at 20 weeks, an anatomically normal, same sex twin pregnancy was detected. A thin dividing membrane and a T-sign suggestive of a monochorionic diamniotic pregnancy were visualized. Antenatal follow-up was uneventful. Cesarean delivery was performed at 37 week. Postpartum examination revealed two distinct placental discs connected with each other through membranes. Microscopic examination of the membranes supported monochorionicity. Short Tandem Repeat Profile Analysis revealed identical pattern and confirmed monozygosity. Conclusion: Two separate placentas with a T-sign in same-sex twins should raise the suspicion of monozygosity, and should be followed accordingly.
- PublicationMetadata onlyExcision of subcutaneous endometriosis lesions in obese patients by marking them with methylene blue with ultrasound guidance: a novel technique(2023-01-01) ÇETİN Ç.; KÜTÜK M. S.; Tanoğlu F. B.; ATEŞ S.; ÖZCAN P.; BAKAR R. Z.; ÇETİN, ÇAĞLAR; KÜTÜK, MEHMET SERDAR; TANOĞLU, FATMA BAŞAK; ATEŞ, SEDA; ÖZCAN, PINAR; BAKAR, RABIA ZEHRA
- PublicationMetadata onlyEvaluation of Anxiety in Turkish Parents of Newborns with Cleft Palate with or Without Cleft Lip(2023-01-01) SUNAL AKTÜRK E.; ŞEKER E. D.; ÇAPKIN D.; KÜTÜK M. S.; SUNAL AKTÜRK, EZGİ; ŞEKER, ELIF DILARA; ÇAPKIN, DUYGU; KÜTÜK, MEHMET SERDAR© 2023, American Cleft Palate Craniofacial Association.Objective: (1) To compare anxiety between parents of newborns with cleft lip and palate (CLP), isolated cleft palate (CP), and healthy newborns and (2) to evaluate anxiety between parental dyads within these groups. Design: A cross-sectional study. Setting: University Hospital. Participants: Surveys were completed by 20 mothers and 20 fathers of newborns with CLP, 21 mothers and 21 fathers of newborns with CP, and 23 mothers and 23 fathers of healthy newborns (controls). Main Outcome Measure: The State-Trait Anxiety Inventory (STAI) assessed parental anxiety. Mothers of newborns with a cleft reported on concerns regarding cleft-related issues and facial appearance. Results: State and trait anxiety were generally in the moderate range for parents of newborns with a cleft, while control parents had low state anxiety and moderate trait anxiety. Mothers of newborns with CP and CLP had significantly higher state and trait anxiety levels than control mothers (p <.05). Fathers of newborns with CLP had a higher state anxiety level than control fathers. When maternal and paternal anxiety was compared within the groups, only trait anxiety scores were significantly higher in mothers of newborns with CLP than that of fathers (p <.05). More than half of mothers of newborns with a cleft were concerned about their newborn\"s feeding, speech, and palate. Conclusions: Parents of children with a cleft may need psychological support in the early postnatal period. It is important for neonatal cleft team providers to help reduce parental anxiety and educate families about cleft care, with a focus on feeding.
- PublicationMetadata onlyThe effects of maternal smoking on fetal cranial development. Findings from routine midtrimester sonographic anomaly screening(2023-12-01) ÇETİN Ç.; BAKAR R. Z.; Takmaz T.; PASİN Ö.; KÜTÜK M. S.; ÇETİN, ÇAĞLAR; BAKAR, RABIA ZEHRA; PASİN, ÖZGE; KÜTÜK, MEHMET SERDARThe aim of this study was to assess the effect of continued smoking before and during pregnancy on mid-trimester fetal head development. A total of 250 pregnant women enrolled in the study. All participants were confirmed to be smokers or non-smokers by verifying breath carbon monoxide readings. Biparietal diameter (BPD), head circumference (HC), lateral ventricle (LV), and cisterna magna (CM) were evaluated by ultrasound between 20-22 weeks of pregnancy. Gender and gestational age-adjusted BPD z- scores were not statistically different between smokers and non-smokers (-0.75 ± 1.6 vs -0.51 ± 1, p = .3). HC measurements and z- scores were significantly lower in the smoking group than in the non-smoking groups (183.38 ± 14.56 vs. 189.28 ± 12.53, p = .003, 0.18 ± 1.39 multiple of median (MoM) vs. 0.56 ± 0.92, respectively, p = .023). At linear regression analysis, maternal smoking was the only independent factor associated with fetal HC z score (p = .041). In conclusion, continued smoking during pregnancy reduces fetal HC and has no effect on BPD, LV, or CM measurements at mid-gestation.IMPACT STATEMENTWhat is already known on this subject? Smoking during pregnancy is one of the most common environmental factors affecting fetal and neonatal growth and well-being. Despite the well-known effects of smoking on somatic growth, current studies have shown that it selectively affects some parts of the fetal brain, even in appropriately growing fetuses.What do the results of this study add? Continued smoking during pregnancy reduces fetal HC and has no effect on BPD, LV or CM measurements at mid-gestation. Since smoking is well known for its early and late childhood behavioral and neurological consequences, smaller mid-trimester fetal HC measurements should bring maternal smoking to mind as one of the potentially reversible causes.What are the implications of these findings for clinical practice and/or further research? The harmful effects of smoking start before the third trimester and antenatal counseling should be started early in the gestation. Every effort should be made to quit smoking before or early in pregnancy.
- PublicationMetadata onlyCharacterization of cord blood CD3(+)TCRV alpha 7.2(+)CD161(high) T and innate lymphoid cells in the pregnancies with gestational diabetes, morbidly adherent placenta, and pregnancy hypertension diseases(2022-05-01T00:00:00Z) Haliloglu, Yesim; ÖZCAN, ALPER; Erdem, Serife; Azizoglu, Zehra Busra; Bicer, Ayten; Ozarslan, Ozcan Yeniay; Kilic, Omer; Okus, Fatma Zehra; Demir, Fatma; CANATAN, HALİT; KARAKÜKCÜ, MUSA; ULUDAĞ, Semih Zeki; KÜTÜK, MEHMET SERDAR; Unal, Ekrem; EKEN, AHMET; KÜTÜK, MEHMET SERDARProblem Although pregnant women with gestational diabetes (GD), morbidly adherent placenta (MAP), and pregnancy hypertension (pHT) diseases lead to intrauterine growth restriction (IUGR), little is known about their effect on mucosal-associated invariant T (MAIT) and innate lymphoid cells (ILC) in the umbilical cord. This study aimed to quantify and characterize MAIT cells and ILCs in the cord blood of pregnant women with GD, MAP, and pHT diseases. Method of study Cord blood mononuclear cells (CBMCs) were isolated by Ficoll-Paque gradient. CD3(+)TCRV alpha 7.2(+)CD161(high) cells and ILC subsets were quantified by flow cytometry. CBMCs were stimulated with PMA/Ionomycin and Golgi Plug for 4 h and stained for IFN-gamma, TNF-alpha, and granzyme B. The stained cells were analyzed on FACS ARIA III. Results Compared with healthy pregnancies, in the cord blood of the pHT group, elevated number of lymphocytes was observed. Moreover, the absolute number of IFN-gamma producing CD4(+) or CD4(-) subsets of CD3(+)TCRV alpha 7.2(+)CD161(high) cells as well as those producing granzyme B were significantly elevated in the pHT group compared to healthy controls suggesting increased MAIT cell activity in the pHT cord blood. Similarly, in the MAP group, the absolute number of total CD3(+)TCRV alpha 7.2(+)CD161(high) cells, but not individual CD4(+) or negative subsets, were significantly increased compared with healthy controls- cord blood. Absolute numbers of total CD3(+)TCRV alpha 7.2(+)CD161(high) cells and their subsets were comparable in the cord blood of the GD group compared with healthy controls. Finally, the absolute number of total ILCs and ILC3 subset were significantly elevated in only pHT cord blood compared with healthy controls. Our data also reveal that IFN-gamma(+) or granzyme B+ cell numbers negatively correlated with fetal birth weight. Conclusions CD3(+)TCRV alpha 7.2(+)CD161(high) cells and ILCs show unique expansion and activity in the cord blood of pregnant women with distinct diseases causing IUGR and may play roles in fetal growth restriction.
- PublicationMetadata onlyThe Importance of Postpartum Kleihauer-Betke Test in Low Risk Rh-Incompatible Pregnant Population(2021-04-01T00:00:00Z) Bilgili, Ümmühan Zeynep; Gül, Ayşe Zehra; Kütük, Mehmet Serdar; GÜL, AYŞE ZEHRA; KÜTÜK, MEHMET SERDARIntroduction: Prevalence of Rh disease is estimated to be 276 per 100,000 live births, which is significant considering its relationship with conditions like fetal anemia, hydrops fetalis, fetal death and recurrent fetal demises in future pregnancies. In order to prevent these, anti-D immunoglobulin should be given after inciting events, in a dose sufficient. In Turkey and some other countries, anti-D dose is given on -one shot fits for all- principle. Here, we challenge the conventional wisdom and evaluate the amount of fetomaternal hemorrhage (FMH) and adjusted the dose of anti-D accordingly. Method: In our study, Rh incompatible women who gave birth between October 2020 and March 2021 were included. FMH was determined by the Kleihauer-Betke test in the blood sample taken from the mothers after delivery. Blood smears were fixed with ethyl alcohol and incubated in citric acid buffer solution. In acid medium, HbF becomes resistant to elution, while other types are removed from erythrocytes. The smears are then taken under a microscope to examine the percentage of cells containing fetal hemoglobin. We used Oski-Naiman method to count fetal cells present, then estimated FMH using Mollison-s formula. Clinical data were available at hospital-s digital system. Results: Seventy patients got tested during study period. Twenty-five (39.6%) of cases had more than 4 mL of FMH. Among them, one (1.6%) case was found to have more than 30 mL of FMH, and was given an additional dose. This case had no obstetrical risk factor such as antepartum bleeding, preeclampsia, or manual removal of placenta. The rate of smoking was significantly higher in cases with more than 4 mL of FMH (p=0.001). There were no other variables differed significantly in women having more than 4 mL of FMH. Conclusion: FMH requiring more than 300 mcg of anti-D is significantly high in low-risk pregnant women in Turkey. Implementation of quantitative FMH testing with Kleihauer-Betke or flow cytometry test is necessary. Key words: Fetomaternal hemorrhage, Rh incompatibility