Person: ÇETİNKAYA DEMİR, BİLGE
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ÇETİNKAYA DEMİR
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BİLGE
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Publication Pregnancy and kidney transplantation: A single-center experience(Aves, 2022-07-01) Ayar, Yavuz; Sayılar, Emel Işıktaş; Demir, Bilge Cetinkaya; ÇETİNKAYA DEMİR, BİLGE; ERSOY, ALPARSLAN; OCAKOĞLU, GÖKHAN; YILDIZ, ABDULMECİT; ORUÇ, AYŞEGÜL; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nefroloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Jinekoloji ve Doğum Anabilim Dalı.; 0000-0003-4607-9220; 0000-0002-1114-6051; 0000-0002-0342-9692; 0000-0001-6845-9991; AAH-5180-2021; AAH-4002-2021Objective: The possibility of pregnancy increases with kidney transplantation in patients with chronic kidney disease. However, graft dysfunction, risk of fetal growth retardation, and fetal anomaly should be monitored closely. In this study, renal and obstetric outcomes were analyzed in pregnant kidney recipients who were followed in our center.Methods: We analyzed 140 reproductive-aged patients who underwent renal transplantation between January 2009 and May 2015, and clinical and laboratory data were evaluated retrospectively.Results: Twenty-four patients became pregnant (17.1%). In pregnant group, median age was significantly lower than nonpregnant group (P =.014). The median age of pregnant group at the time of transplantation was also significantly lower than non-pregnant patients (P <.001). The rate of pregnant patients was 66.7% in 18-25 year age group (P =.008). The rate of urinary tract infection in non-pregnant group was higher than pregnant group (P =.03). Live birth rates were 83.3% and 45.8% of those whose birth weight was higher than 2500 g. The increased level of daily urinary proteinuria and the time from diagnosis of renal failure to transplantation had significant effect on pregnancy (odds ratio = 13.81;95% CI: 2.06-92.45; P =.007 and odds ratio = 3.25;95% CI: 1.11-9.48; P =.031, respectively). Low serum creatinine level had significant protective effect (odds ratio = 0.001; 95% CI: 0-0.30, P =.018). The patients in 18-25 age group were 48.39 times more eligible for pregnancy compared to those in >35 age group (odds ratio = 48.39; 95% CI: 1.26-1860.72; P =.037). Rejection episodes were observed in 1 of pregnant women and 11 of non-pregnant women (P >.05).Conclusion: Pregnancy is possible in kidney transplant recipients of reproductive age. Calcineurin inhibitors and azathioprine seem to be safe. Maternal age, low-serum creatinine, and urinary proteinuria affect pregnancy. The close monitoring of renal function and fetal parameters is very important.Publication Detecting coagulability status by thromboelastography in women with the history of preeclampsia and inherited thrombophilia(Canada Inc, 2015-01-01) Bülbül, Mehmet; Atalay, Mehmet Aral; Demir, Bilge Çetinkaya; Türker, Gürkan; Esmer, A.; Atalay, Mehmet Aral; ÇETİNKAYA DEMİR, BİLGE; TÜRKER, YUNUS GÜRKAN; Esmer, A.; Uludağ Üniversitesi/Tıp Fakültesi/Jinekoloji Bölümü; Uludağ Üniversitesi/Tıp Fakültesi/Anestezi ve Reanimat Bölümü; 0000-0002-9685-956X; 0000-0001-6845-9991; 0000-0002-3019-581X; AAI-6642-2021; AAH-9834-2021Objective: To assign tendency to thrombosis in patients with preeclampsia and inherited thrombophilia using thromboelastography (TEG), and therefore to evaluate possible relationship between thrombophilia and preeclampsia. Materials and Methods: Kinetics of clot formation was assessed with TEG analyzer in 49 patients with severe preeclampsia, 54 cases with previous diagnosis of inherited thrombophilia, and 31 controls. Results: 'r', 'k', TMA, coagulation index (CI) parameters were found statistically discrete between patients with inherited thrombophilia and controls. The difference between preeclampsia and control groups was not statistically significant. The difference in a angle was statistically significant between thrombophilics and preeclamptics (p = 0.01), and between thrombophilics and controls (p = 0.004). CI was found statistically lower in thrombophilia group than control group (p = 0.006). Particularly, clot lysis time (CLT) was measured to shorten in preeclampsia when compared with controls and patients with thrombophilia (p = 0.032, p = 0.028, respectively). Conclusions: Not only the inherited thrombophilia group but also preeclampsia group demonstrated elongated clot initiation patterns when compared to the controls. Moreover, apart from the patients with inherited thrombophilia, preeclamptics exposed shorter CLT values indicating a possible increment in clot turn over, which eventually results in increased depletion of coagulation substrates, and thus, increased frequencies of oxidative cycle injury.Publication What should we do to optimise outcome in twin pregnancy complicated with placenta percreta? A case report(BMC, 2015-11-05) Atalay, Mehmet Aral; Atalay, Fatma Öz; Demir, Bilge Çetinkaya; Atalay, Mehmet Aral; ÖZ ATALAY, FATMA; ÇETİNKAYA DEMİR, BİLGE; Uludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Cerrahi Patoloji Anabilim Dalı.; 0000-0002-9685-956X; 0000-0001-6845-9991; AAH-9834-2021; A-8779-2013; JHC-4482-2023Background: Patients with morbidly adherent placenta (MAP) are under risk of massive bleeding. It readily necessitates very complicated surgery and massive blood transfusion, and even leads to mortality. Cesarean hysterectomy (CH) is the procedure that is acknowledged worldwide, since it helps to minimize complications.Case presentation: A patient with dichorionic twin pregnancy underwent to cesarean section (CS) due to preliminary diagnosis of placenta percreta at her 35th week of pregnancy. Both of the placentas were left in situ. The patient admitted with signs of infection. Emergency total abdominal hysterectomy was performed 7 weeks after CS. In the course of hysterectomy, 3 units of erythrocyte suspension and 2 units of fresh frozen plasma were transferred, whereas none was required during CS.Conclusion: Abandoning placenta in situ seems to be a logical alternative to the CH in patients with placenta percreta in order to minimize complications related to massive blood transfusion and surgical technique. However, it appears to increase maternal morbidity due to maternal infection in twin pregnancy.Publication Intrahepatic cholestasis of pregnancy: Relationship between bile acid levels and maternal and fetal complications(Galenos Yayıncılık, 2014-09-01) Demir, Bilge Çetinkaya; Güneş, Esra Şahin; Atalay, Mehmet Aral; ÇETİNKAYA DEMİR, BİLGE; Güneş, Esra Şahin; Atalay, Mehmet Aral; Uludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Anabilim Dalı.; 0000-0001-6845-9991; 0000-0002-9685-956X; AAH-9834-2021; IDE-0603-2023; GBG-9889-2022Objective: Intrahepatic cholestasis of pregnancy (ICP) complicates pregnancies which is characterized by elevated serum bile acid levels. ICP increases maternal and fetal morbidities. This study was designed to determine the association of maternal and fetal complications and serum bile acid levels.Material and method: Maternal and fetal characteristics were analyzed from the medical records of 61 patients who gave birth following a pregnancy complicated with ICP between 2009 and 2013.Results: Eighty seven percent of 61 cases were singletons, and 13% of them were twins. Mean SBA level was 36 mu mol/L. Preterm birth rate among singletons and twin pregnancies were 24.5% and 62.5%, respectively. Mean SBA level in preterm birth group was statistically higher with respect to the term birth group (100.8 mu mol/L and 25.61 mu mol/L, respectively; p=0.001). No perinatal mortality associated with ICP was detected in the study group.Conclusion: Pregnant women with the ICP compose high-risk group in regard to fetal and maternal risks. Close follow-up of these patients is required due to increased risks such as preterm delivery, meconium staining and fetal death.Publication Cutaneous fistulization of an ovarian mature cystic teratoma: An unusual occurrence(Karger, 2015-01-01) Atalay, Mehmet Aral; Orhan, Adnan; Atalay, Fatma Öz; Saydam, İlkay; Demir, Bilge Çetinkaya; Atalay, Mehmet Aral; ORHAN, ADNAN; ÖZ ATALAY, FATMA; Saydam, İlkay; ÇETİNKAYA DEMİR, BİLGE; Uludağ Üniversitesi/Tıp Fakültesi/Cerrahi Patoloji Bölümü; Uludağ Üniversitesi/Tıp Fakültesi/Doğum ve Jinekoloji Bölümü; 0000-0002-9685-956X; 0000-0002-7558-8166; 0000-0001-6845-9991; AAH-9834-2021; V-5292-2019; GBG-9889-2022; JHC-4482-2023; DRD-3800-2022A bilobulated mature cystic teratoma (MCT) at the left ovary measuring 6 cm in diameter fistulized to the left lower quadrant of the anterior abdominal wall, contralateral to McBurney's point. This is the first reported case of a MCT fistulized to the skin. Symptoms, if present, usually depend on the size of the teratoma. However, most patients with a MCT are asymptomatic. Complications such as rupture of the cyst capsule are quite rare. Moreover, complication of fistulization is highly infrequent.Publication Prenatal diagnosis of fetal umbilical cord teratoma(Walter De Gruyter Gmbh, 2014-08-01) Demir, Bilge Çetinkaya; Topal, Naile Bolca; Güneş, Esra Şahin; Yazıcı, Zeynep; Yalçınkaya, Ulviye; ÇETİNKAYA DEMİR, BİLGE; BOLCA TOPAL, NAİLE; Güneş, Esra Şahin; YAZICI, ZEYNEP; YALÇINKAYA, ÜLVİYE; Uludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; 0000-0001-6845-9991; AAH-9834-2021; AAH-8924-2021; AAI-2327-2021; AAI-2303-2021; IDE-0603-2023Umbilical cord teratomas are rare tumoral lesions of umbilical cord which have challenging antenatal diagnosis. The cord teratomas contain tissue from all three germ layers and have both cystic and solid components. This ultrasonographic appearance may help the clinician to clarify the correct diagnosis. We report a case of cord teratoma diagnosed prenatally by ultrasonography and magnetic resonance imaging. Since cord teratomas may lead to adverse fetal outcomes, close follow-up of the fetus is recommended.Publication Maternal and fetal outcomes of pregnancies treated for H1N1 virus infection(Galenos Yayıncılık, 2013-12-01) Demir, Bilge Çetinkaya; Akduman, Ayşe Topcu; Okcu, Nefise Tanrıdan; Kimya, Yalçın; ÇETİNKAYA DEMİR, BİLGE; Akduman, Ayşe Topcu; Okcu, Nefise Tanrıdan; Kimya, Yalçın; Uludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Anabilim Dalı.; 0000-0001-6845-9991; AAH-9834-2021; CBC-2905-2022; FNB-4556-2022; FDX-3894-2022Aim: At the time of the outbreak of influenza A H1N1, mostly known as swine flu, first case in Turkey was diagnosed in May 2009. The period from June 2009 to August 2010 was declared to be pandemy H1N1 by World Health Organization (WHO). In this study we aimed to assess the maternal and fetal outcomes of pregnant women with the diagnosis of H1N1viral infection, who were hospitalized during 2009 pandemy.Materials and methods: The clinical data, treatment modalities and maternal and fetal outcomes of 9 pregnant women with H1N1 infection were retrieved from patients file and evaluated retrospectively. Patients were classified as confirmed case if the nasopharyngeal swabs were pozitive with real time PCR (rRT-PCR) and suspected case if rRTPCR was negative.Findings: At admission one patient was in first trimester, 2 were in second trimester and other 6 patients were in third trimester. The presenting symptoms were cough (77%), fever (77%), sore throat (11%), dyspnea/ respiratory distress (44%) and malaise (22%). All of the patients were treated with oseltamivir and with appropriate antibiotics in case of secondary bacterial pneumonia. Median hospitalisation time was 23 days (7- 40). Five patients required mechanical ventilatory support. One of the patients and 2 of the neonates passed away.Conclusion: Although swine flu causes mild to moderate flu like symptoms in most of the population, in pregnant women it may lead to lethal complications. Thus the appropriate antiviral treatment should begin immediately within 48 hours.Publication The efficacy of transcutaneous electrical nerve stimulation therapy in pain control after cesarean section delivery associated with uterine contractions and abdominal incision(Bayçınar Medikal Yayın, 2020-01-01) Kasapoğlu, Işıl; Aksoy, Meliha Kasapoğlu; Demir, Bilge Çetinkaya; Altan, Lale; KASAPOĞLU, IŞIL; ÇETİNKAYA DEMİR, BİLGE; ALTAN İNCEOĞLU, LALE; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Anabilim Dalı; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı; 0000-0002-6453-8382; 0000-0001-6845-9991; 0000-0002-1953-2475; AAH-9834-2021; AAH-1652-2021; CXJ-7203-2022Objectives: This study aims to investigate the effects of transcutaneous electrical nerve stimulation ( TENS) therapy on the intensity of pain associated with uterine contractions and abdominal incision in patients undergoing cesarean section (C-section) delivery.Patients and methods: This single-blind, prospective, randomized-controlled study included a total of 90 female patients (mean age 30.5 years; range, 25 to 36 years) who had a scheduled C- section delivery between November 2017 and April 2018. Forty-five postpartum patients were randomly assigned into the treatment group (Group 1) and TENS electrodes were placed below and above the abdominal incision. The control group (n=45) consisted of 45 patients who had a scheduled C- section (Group 2) (n=45) and received routine follow-up care. The Visual Numeric Scale (VNS) scores were obtained separately for abdominal, low back, and groin pain at baseline (within 1 h after C-section before the TENS replacement), at postpartum 2, 6, 24, and 48 h. In addition to instant scoring, the percentages of change in pain scores from baseline were also calculated for each time points.Results: Data of a total of 87 patients were analyzed. No statistically significant difference was found in the baseline VNS scores measured in any body regions between the groups (p>0.05). However, there was a statistically significant difference in the instant VNS scores for abdominal pain at 2, 6, 24, and 48 h in favor of Group 1 (p<0.05). No significant differences were found in the instant VNS scores for low back and groin pain (p>0.05). The comparison of changes in pain scores from baseline (% change) over time between the groups revealed a statistically significant difference in favor of Group 1 in all VNS scores for abdominal, low back, and groin pain at 2, 6, 24, and 48 h (p<0.05).Conclusion: Our study results suggest that TENS is an effective and safe non-invasive, non-pharmacological treatment modality. It may be preferred as an alternative method in pain control in postpartum women after C-section delivery.Publication An unusual presentation of a submucous leiomyoma accounting to a non-puerperal uterine inversion: A case report(Galenos Yayıncılık, 2013-06-01) Atalay, Mehmet Aral; Demir, Bilge Çetinkaya; Solak, Neşe; Atalay, Fatma Öz; Kuçükkömürcü, Şakir; Atalay, Mehmet Aral; ÇETİNKAYA DEMİR, BİLGE; Solak, Neşe; ÖZ ATALAY, FATMA; Kuçükkömürcü, Şakir; Uludağ Üniversitesi/Tıp Fakültesi/Kadın Hastalıkları ve Doğum Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Cerrahi Patoloji Anabilim Dalı.; 0000-0002-9685-956X; 0000-0001-6845-9991; AAH-9834-2021; GBG-9889-2022; DSL-0496-2022; JHC-4482-2023; JIU-6695-2023Non-puerperal uterine inversion is an extremely rare gynaecological event that is usually associated with uterine tumours such as submucous or cervical leiomyomas. In this report, we describe a case of uterine inversion due to a large submucous leiomyoma in a 42-yearold multiparous and obese Caucasian woman.