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GÖKMEN KARASU, AYŞE FİLİZ

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AYŞE FİLİZ
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GÖKMEN KARASU
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Author: TAKMAZ, TAHA × Author: AYDIN, SERDAR ×

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    Administration of rectal cytotec versus rectal buscopan before hysteroscopy
    (2020-06-01T00:00:00Z) GÖKMEN KARASU, AYŞE FİLİZ; AYDIN, SERDAR; ATEŞ, SEDA; TAKMAZ, TAHA; Comba, Cihan; GÖKMEN KARASU, AYŞE FİLİZ; AYDIN, SERDAR; ATEŞ, SEDA; TAKMAZ, TAHA
    Introduction:Our objective was to compare the effect of rectal misoprostol (Cytotec) versus rectal hyoscine-n-butyl bromide (Buscopan) on patients undergoing hysteroscopy. We hypothesised that HBB may have a role in cervical priming. Material and methods:This trial was conducted at Bezmialem Vakif University Hospital. Women of reproductive age between 18-50 years who were scheduled for operative hysteroscopy indicated by type 1 submucous myoma or endometrial polyps were recruited for the study. Ninety patients were divided randomly into three groups. Group 1 received placebo treatment. Group 2 received rectal 200 mcg misoprostol and Group 3 received rectal 20 mg hyoscine-n-butyl bromide two hours before the procedure. Procedures were performed using a bipolar 26 F (9 mm) continuous-flow rigid resectoscope with a 30 degrees lens. The outcome measures included cervical dilation width and time, ease of cervical dilation, procedure time and operative complications. Postoperative self-rated pain was assessed one hour after the procedure. Results:Thirteen patients (43. 3%) in the placebo treatment group, 11 patients (36.7%) in the misoprostol group and four patients (13.3%) in the hyoscine-n-butyl bromide group needed analgesics postoperatively (p = .02). The mean duration of cervical dilation time was longest in Group 1 and shortest in Group 3, however this difference did not reach statistical significance (p=.11). There was no difference with regard to other studied parameters. Summary:HBB reduced the need for pain medication compared to placebo. Larger studies are needed to further investigate the role of HBB in facilitating pre-operative cervical priming.
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    The usual suspect: cross-sectional study of fundal pressure at second stage of delivery and the association with pelvic floor damage
    (2020-09-01T00:00:00Z) TAKMAZ, TAHA; AYDIN, SERDAR; Gorchiyeva, Irana; GÖKMEN KARASU, AYŞE FİLİZ; TAKMAZ, TAHA; AYDIN, SERDAR; GÖKMEN KARASU, AYŞE FİLİZ
    Introduction and hypothesis Uterine fundal pressure is applied to accelerate birth by increasing the expulsive force of the uterus in the second stage of delivery. The aim of the study was to evaluate the effect of using uterine fundal pressure during the second stage of delivery on the rate of pelvic floor damage among primiparous women using three-dimensional transperineal ultrasonography. Methods The women were divided into two groups: the fundal pressure group included women where the fundal pressure maneuver was applied (n = 39); the control group included women who delivered spontaneously without fundal pressure (n = 47). 3D-TPU was performed within 48 h of delivery, and LAM biometry, LAM defect and loss of tenting were determined. Results Anteroposterior hiatal dimensions on resting, maximal Valsalva and maximal PFMC were found to be higher in the fundal pressure group (p < 0.0001,p = 0.008,p = 0.007, respectively). The mean hiatal area at rest was larger in the fundal pressure group than in the control group (p = 0.04). The rate of LAM defect was significantly higher in the fundal pressure group (p = 0.001). The rate of loss of tenting was significantly higher in the fundal pressure group (p < 0.0001). According to multivariate regression models, the fundal pressure was the only independent factor associated with LAM defect (OR = 5.63; 95% CI = 12.01-15.74) and loss of tenting (OR = 8.74; 95% CI = 2.89-26.43). Conclusions Fundal pressure during the second stage of delivery is associated with a higher risk of LAM defect and loss of anterior vaginal wall support.