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  • PublicationMetadata only
    Prenatal 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, TAHA
    Background: 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 only
    The 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 SERDAR
    Introduction: 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
  • PublicationMetadata only
    Characterization 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 SERDAR
    Problem 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.