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  • PublicationMetadata only
    Effect of maternal smoking during pregnancy on fetal circulation and growth
    (2023-06-25) Kütük M. S.; Bakar R. Z.; Toluk Ö.; Çetin Ç.; Yozgat C. Y.; Doygun Ö.; KÜTÜK, MEHMET SERDAR; BAKAR, RABIA ZEHRA; TOLUK, ÖZLEM; ÇETİN, ÇAĞLAR
    Objective To understand the pathogenic mechanism of smoking on abnormal fetal growth by assessing the umbilical, and middle cerebral pulsatility index (MCA- PI, and UmA-PI, respectively) cerebroplacental ratio (CPR) and middle MCA peak systolic velocity (MCA-Vmax). Methods A hundred and eighty-one pregnant women were included in the study, 118 of whom were ever smoker and 62 were smoker. Smoking status of the cases were based on the participants statements and confirmed with breath CO test. Patients were undergo Doppler examination according to thecurrent guidelines at 24, 28, 32 and 36 weeks and the results were expressed as z- scores. UmA- PI, MCA-PI, CPR (MCI-PI/UmA-PI), MCA- Vmax were compared between control and smoking groups. As a subgroup analysis, effect of heavy smoking (>10/day) on fetal growth and Doppler indexes were also compared. Results Body mass index (BMI), gravida, rate of gestational hypertension and neonatal intensive care admission is significantly higher in smoking group. Birthweight and gestational age at birth was significantly higher in control group [3355 (1960.0-4660.0) vs 3162.5(550.0-4190.0), p=0.003, and274.0(250.0-294.0) vs. 271(175.0-288.0), p=0.015, respectively]. When controlled for confounding factors, no significant difference was detectedbetween smokers and control groups with regard to UmA-PI, MCA-PI, MCA- V Max and CPR, at 24 , 28 , 32 , 36 weeks. EFW at all gestational ages were significantly lower in smoker group (p=0.033). At subgroup analysis, no significant difference was detected between control and heavy smokers in terms of EFW and all Doppler parameters. Conclusion Smoking during pregnancy is associated decreased fetal growth and increased abnormal neonatal outcome. However, it has no demonstrable effect on any of the Doppler indexes and velocities at any given gestational ages. Abnormal effect of smoking on fetal growth seems not to operate throughimpaired uteroplacental circulation
  • PublicationMetadata only
    The Effects of Maternal Smoking on Thyroid Function: Findings from Routine First-Trimester Sonographic Anomaly Screening
    Aim This study aimed to assess the effect of tobacco exposure on maternal thyroid function and investigate its relationship to subclinical hypothyroidism in pregnant women during the first trimester. Subjects and Method A comparison of maternal thyroid function was made on 45 smokers, who composed the study group, and 72 non-smokers, pregnant women, who constituted the control group. After determining smokers by questionnaire, carbon monoxide (CO) levels in the expiratory air of the participants in both groups were measured and recorded, and the smokers\" exposure was objectively confirmed. Results Smoking and non-smoking pregnant women were similar regarding body mass index (BMI). While the TSH and fT4 levels were respectively 1.48 mlU/L and 11.43 pmol/L in pregnant women who smoked, that ratio changed to 1.72 mlU/L and 11.17 pmol/L in the non-smokers\" group. But the differences between the groups were not statistically significant (p=0.239, p=0.179). Even though the rate of subclinical hypothyroidism was 8.9% in the smoking group, it was approximately 19.4% in the non-smoker group; the difference was not statistically significant (p=0.187). Conclusion This study proved that there is no statistically significant difference between maternal serum TSH and fT4 levels and the rate of subclinical hypothyroidism in smokers during pregnancy in the first trimester.
  • PublicationMetadata only
    Prenatal Detection and Postnatal Outcome of Persistent Left Superior Vena Cava and Agenesis of Ductus Venosus Associated with Postnatal Bovine Aortic Arch
    (2023-12-20) Elbistanli C.; YOZGAT Y.; Dogan M. S.; Yozgat C. Y.; KÜTÜK M. S.; KÜTÜK, MEHMET SERDAR
    Background Isolated agenesis of ductus venosus (ADV) is usually a benign condition, but it may be associated with cardiovascular defects, hydrops, growth restriction, and chromosomal abnormalities. Additionally, persistent left superior vena cava (PLSVC) and bovine aortic arch are relatively common fetal anomalies. To the author\"s knowledge, this is the first report of prenatal detection of DV agenesis and PLSVC associated with the postnatal bovine aortic arch with a hypoplastic transverse aortic arch.Case A 25-year-old, G2P1 woman was referred to our department at 31 weeks due to fetal growth restriction and short femur. On fetal echocardiography, DV could not be viewed via two-dimensional (2D) and Doppler ultrasound (US) imaging; there was also evidence of the co-occurrence of PLSVC and an aortic arch anomaly. We revealed the intrahepatic continuation of the umbilical vein. A weekly follow-up program was scheduled for the patient and the rest of the pregnancy was uneventful. Postnatal, thorax computer tomography and transthoracic echocardiography (TTE) demonstrated PLSVC and bovine aortic arch associated with hypoplastic transverse aortic arch. Routine echocardiographic examinations revealed that the blood flow of the aortic arch had increased gradually, and the male infant\"s aortic arch had significantly widened and reached the normal range until the baby was discharged from the hospital.Conclusion DV agenesis and PLSVC are usually benign conditions but underlying serious heart diseases may accompany them. Therefore, in situations like ours, a prenatal aortic arch evaluation is of capital importance. Postnatal hemodynamic changes should be taken into consideration in the management of these cases. This is the first example in the literature that these abnormalities co-existed in one case.