Does fear of childbirth in nulliparous women affect fetal outcomes? Omer Demir, Gülsün Ozbay, Mirac Ozalp, Hidayet Sal, Gokce Omeroglu Kayıkcı, Emine Ahu Koç, Turhan Aran, Mehmet Armagan Osmanagaoglu Revista Da Associacao Medica Brasileira, 2025 SUMMARY OBJECTIVE: In this study, an investigation was undertaken to determine whether the well-being of the fetus is affected in pregnant women who have a severe fear of childbirth. METHODS: Participants were nulliparous pregnant women at 37 weeks of gestation. The Wijma Delivery Expectancy Questionnaire-A questionnaire, validated for the Turkish population, was used to assess the degree of fear of childbirth of the study subjects. Cases where labor began spontaneously and resulted in a vaginal delivery were included in the study. A total of 44 patients were investigated during the study period. The cases were divided into two groups according to the Wijma Delivery Expectancy Questionnaire-A scores. RESULTS: There were no statistically significant differences between the groups regarding fetal cord blood gas parameters and Apgar scores at the first and fifth minutes. Fear of childbirth in nulliparous cases did not affect the fetal cord blood gas parameters or Apgar scores. It was observed that the duration of the second stage of labor was statistically significantly longer in women with severe fear of birth (p=0.036). CONCLUSION: As a result, tocophobia can prolong the duration of the second stage of labor, does not affect fetal oxygenation, and does not change fetal cord blood gas parameters and Apgar scores. It is aimed to verify this result with large-scale studies and to encourage prospective studies.
Evaluation of ovarian reserve in unexplained ınfertile cases: a case-controlled study Mustafa Sahin, Suleyman Guven, Hidayet Sal, Emine Seda Guvendag Guven Middle East Fertility Society Journal, 2023 Background The aim of this study was to evaluate the effectiveness of current ovarian reserve tests in unexplained infertile cases. Material and methods This case–control study was conducted on 70 unexplained infertile women who were included in a tertiary university hospital. Both groups of basal FSH, estradiol, antimullerian hormone (AMH), inhibin B, ovarian volume, total antral follicle count (AFC), ovarian volume, and ovarian stromal blood flow (peak systolic velocity (PSV), S/D (systole and diastole ratio), resistance index (RI), and pulsatility index (PI)) values were compared. Results The mean AMH, inhibin B, PSV, and stromal blood flow values of the control group patients were higher than those in the unexplained infertility group. However, the values of the means of RI and PI of the cases in the control group were lower than those in the infertility group. When PI’s value was ≥ 2.00, its sensitivity was 65.7%, and its specificity was 64.3%. In the case of the RI, its value was ≥ 0.745, its sensitivity was 65.7%, and its specificity was 62.9%. In order to show ovarian reserve in unexplained infertile cases, the sensitivity values can be sorted from high to low as follows: PI > RI > estradiol > FSH > ovarian volume > AFC > inhibin B > stromal blood flow > PSV > S/D. Conclusion In the unexplained infertile patient group with normal ovarian reserve test results, basal estradiol, decreased PI, and RI values may be used as good ovarian reserve predictors.
Examination of the change in sexual functions and anxiety as the pregnancy progresses and the effect of nulliparity on this change Omer Demir Northern Clinics of Istanbul, 2023 OBJECTIVE: The objective of the study is to examine the sexual functions and anxiety levels of the same pregnant women during the three periods of pregnancy, and to observe how they change between trimesters and also the effect of nulliparity on these changes. METHODS: This prospective clinical study was conducted between 2019 and 2021 in the University Hospital. Healthy, heterosexual pregnant women were included in this study and were consecutively interviewed regarding their anxiety levels and sexual function in the three trimesters of pregnancy. Participants in the study filled out two questionnaires, the Female Sexual Function Index (FSFI) form and the beck anxiety inventory (BAI). All data were analyzed using SPSS 21 statistical software. RESULTS: There were a total of 35 pregnant women who met the inclusion criteria and completed the questionnaire forms in the three trimesters of pregnancy. Nineteen of the study group were nulliparous (54.3%). FSFI scores were found to be below the cutoff value required to diagnose sexual dysfunction in all three trimesters. The anxiety scores were found to be statistically significantly compatible with mild anxiety in all three periods. In the variance analysis of the survey scores over the three periods, a statistical significance was found for both the FSFI scores and the BAI scores. It was observed that nulliparity had no effect on the change between periods. CONCLUSION: trimester of pregnancy. There was no significant effect of the parity on the significant change in sexual functions and anxiety between trimesters.
Fetal cardiac Doppler changes in gestational diabetic pregnancies and its relationship with perinatal outcomes Miraç Özalp, Omer Demir, Gülseren Dinç, Hidayet Şal, Turhan Aran, Mehmet Armağan Osmanağaoğlu, Embiya Dilber Journal of Obstetrics and Gynaecology Research, 2021 AIM To examine the structural and functional changes of the fetal heart in gestational diabetes mellitus (GDM) and to evaluate the power of fetal cardiac Doppler parameters in predicting adverse perinatal outcomes in this group of pregnancy. METHODS Within the study's scope, 36 cases in the A1 GDM group, 33 cases in the A2 GDM group, and 124 cases in the control group were evaluated. The relationship between structural and functional fetal cardiac parameters and perinatal outcomes was evaluated via fetal echocardiography. RESULTS Fetal left ventricular myocardial performance index (MPI) values were found to be statistically significantly higher when compared between the A1 GDM and A2 GDM groups and the control group (p = 0.000 and p = 0.000, respectively), while the E/A ratio was found to be significantly lower (p = 0.000 and p = 0.000, respectively). It was determined that the maternal blood HbA1c level showed a significant negative correlation with the fetal cardiac E/A ratio and a significant positive correlation with isovolumetric relaxation time and MPI (p = 0.000, p = 0.000, and p = 0.000, respectively). Adverse perinatal outcome rate was higher in the diabetic group (46.4%-22.6%). When the cases with GDM were examined in terms of perinatal outcomes, it was observed that there was a significant difference in HbA1c levels, E/A ratio, and MPI values between the cases in the group with adverse perinatal outcomes and the group with normal results (p = 0.001, p = 0.000, and p = 0.000, respectively). CONCLUSIONS The strong relationship between abnormal cardiac function and adverse perinatal outcomes suggest that cardiac Doppler may be a valuable tool for fetal monitoring and management for the GDM patient group.
The relationship between fetal thymus volume and preterm birth in dichorionic diamniotic pregnancies H. Şal, E. Guven, SuleymanGuven Clinical and Experimental Obstetrics and Gynecology, 2021 Background: The aim of this study was to compare fetal thymus volume in women who delivered at <36 weeks of pregnancy versus those who did not. Methods: A total of 32 dichorionic-diamniotic twin pregnantwomenwere included in the prospective cohort study. The fetal thymus volumesweremeasured in the second trimester for each fetus using the VOCAL ultrasonography program. The data of women who experienced preterm labor (delivered at<36 weeks of pregnancy) and the control group (delivered at≥36 weeks of pregnancy)were compared. Results: Themean thymus volumeof each fetuswas statistically significantly lower in pretermdelivery cases than in the control group. Mean fetal thymus volume could be used as a marker for predicting preterm birth in the study group. The parameter of fetal thymus volume measured in twins at 18–24 weeks can be used as a predictive factor (P < 0.001). When the fetal thymus volume, measured 3-dimensionally by ultrasonography in conjunction with the VOCAL program, was used as amarker for predicting preterm delivery, the cut-o f value was found to be 0.5245 cm, with 83.3% sensitivity and 85.8% specificity (AUC 0.905, P< 0.001, 95% CI, 0.798–0.930). Conclusion: By predicting preterm delivery via measuring the fetal thymus volume in twins, physicians can suggest strategies to prevent preterm delivery at 18–24 weeks of pregnancy. In thisway, fetalmortality/morbidity related topretermdeliverymay be prevented.
Carbon dioxide pneumoperitoneum may alter ovarian apoptosis: An experimental study Suleyman Guven, Hidayet Sal, EmineSeda Guvendag Guven Gynecology and Minimally Invasive Therapy, 2021 Objective: The aim of this study was to evaluate ovarian immunohistochemical CD95 expression in a rabbit carbon dioxide pneumoperitoneum model. Materials and Methods: The study group including seven rabbits was subjected to intra-abdominal pressure (IAP) (12 mmHg); the control group was not subjected to IAP (the sham group, n = 7). At the end of the experiment, ovariectomy was performed. Immunohistochemical stained histologic specimen of the ovary with CD95 was evaluated. Based on the degree of cytoplasmic or membranous staining for CD95 from 0 (none) to 3 (severe), a microscopic apoptosis scoring system was used. Results: Statistically significantly higher apoptosis scores in ovarian surface epithelial cells (2.57 ± 0.53, vs. 1.14 ± 0.38, P = 0.002, Mann–Whitney U-test, respectively), follicular epithelial cells (2.85 ± 0.38, vs. 1.85 ± 0.38, P = 0.002, Mann–Whitney U-test, respectively), and stromal cells (2.71 ± 0.49, vs. 1.29 ± 0.49, P = 0.002, Mann–Whitney U-test, respectively) were observed in pneumoperitoneum group, compared with no-pneumoperitoneum group. Conclusion: Even at safe IAP (12 mmHg) for an acceptable operation time period, there was a significant increase in apoptosis of ovarian cells.
Cord blood gas results of pregnancies complicated by preeclampsia and the relationship of these results with the amount of proteinuria Ömer Demir, Hidayet Sal, Mirac Ozalp, Turhan Aran, Mehmet A. Osmanağaoğlu Journal of Obstetrics and Gynaecology Research, 2021 To evaluate whether there is a statistically significant difference between the cord blood gas parameters of pregnancies complicated with preeclampsia and uncomplicated pregnancies and to show whether the amount of proteinuria affects fetal cord blood gas parameters in pregnancies complicated with preeclampsia.
