Increased levels of vitamins B1 and B2 may indicate a need for increased energy metabolism at the fetus. So we believe that new studies are required, which will be supported by the placental analyses of the pyruvate and lactate levels in maternal blood at delivery and fetal cord blood in order to develop a better understanding on the fetal effects of energy metabolism.

Aim: The aim of our study was to evaluate the level of knowledge of the adolescent girls who presented to our clinic about human papilloma virus (HPV) infection and HPV vaccine. Material and Methods:Five hundred and one adolescent girls aged between 13 and 18 years who presented to the gynecology outpatient clinic between March 2012 and March 2013 were asked to answer the questions of the questionnaire about HPV and HPV vaccine. The "Participant Information Form" and "HPV Information Assessment Form" were used by examination of the related literature by the investigators. The data obtained were entered into the computer using the SPSS 16.5 program and evaluated. Descriptive statistics were shown with mean, standard deviation, number and percentage values. Results:The mean age of 501 subjects who were included into the study was 15.92 years. 390 subjects (77.8%) who were included in the study had no information about HPV. 111 subjects (22.2%) stated that they heard of HPV before or had information about HPV. The mean age of the subjects who had information about human papilloma virus was found to be 16.52 years. The mean age of 390 subjects (77.8%) who had no information about human papilloma virus was 15.75 years. It was found that only one of the subjects (0.9%) was vaccinated with HPV vaccine. When the subjects who did not wish to be vaccinated were asked for the reason, 40.9% stated that the reason was inadequate information, 26.4% stated that the reason was high cost, 16.4% stated that the reason was the fact that they did not consider themselves at risk and 16.4% stated that the reason was the fact that they were afraid of side effects. Conclusions:In our study, it was found that the adolescent girls who constituted our study group had insufficient information about HPV and HPV vaccine. Verbal, written and visual communication tools and internet should be used intensively and efficiently for the objective of introducing HPV vaccine and teaching the precautions related with prevention of cervix cancer in terms of public health. Primarily pediatrician and gynecologists and family physicians who give service for the adolescence age group should be supported to develop appropriate attitudes and behaviors related with HPV vaccine and infection. (Türk Ped Arş 2014; 49: 142-7)

BackgroundWe aimed to present the relationship between premature progesterone elevation (PPE) and clinical outcomes in high-responder patients who had a coasting period of <4 days in length due to their high risk of developing ovarian hyperstimulation syndrome (OHSS) and who were treated with a long-acting gonadotropin-releasing hormone agonist (GnRH-agonist) protocol in in vitro fertilization-embryo transfer (IVF-ET) cycles.Material/MethodsThis retrospective study was conducted at the University Hospital Assisted Reproductive Technology Center. The outcomes of 101 patients undergoing IVF- intracytoplasmic sperm injection (ICSI) cycles who showed a high response to COH (estradiol >4000 pg/ml and/or >20 follicles each ≥10 mm in diameter and at least 20% ≥15 mm) and who were coasted for <4 days were evaluated. Number of oocytes, 2 pronuclei (PN) embryos, implantation rate, and live birth rate were measured.ResultsThe incidence of PPE was 32.6%. Compared with those without PPE, patients with PPE had a higher number of oocytes retrieved. Total mature and fertilized oocytes and the mean number of embryos transferred were not significantly different between groups. Live birth rates (41.9% vs. 38.7%) and implantation rates (26.5% vs. 23%) were also not significantly divergent in the PPE and non-PPE groups, respectively.ConclusionsP concentrations ≥1.3 ng/ml on the day of human chorionic gonadotropin (hCG) administration, designated in this study as PPE, does not appear to be related to adverse effects in terms of clinical outcomes in high-responder patients undergoing coasting <4 days due to their high risk of developing OHSS treated with a long-acting GnRH-a protocol in IVF-embryo transfer cycles.

Background: Cesarean scar pregnancy is an ectopic pregnancy embedded in the myometrium of a cesarean scar. Several types of conservative treatment have been used to treat cesarean scar pregnancy, but no management protocol has been established for this rare, life-threatening condition. The purpose of this study was to evaluate the feasibility of suction curettage as a first-line treatment in early cesarean scar pregnancy. Methods: During a 4-year period, 19 cases of cesarean scar pregnancy were diagnosed at Süleymaniye Maternity Hospital in Istanbul, Turkey. Suction curettage and Foley balloon tamponade were performed as a first-line treatment in 13 patients. Medical records and treatment results of the patients were evaluated. Results: The mean maternal age was 32.5 years (range, 24-39 years). The mean gestational sac diameter was 13.65 mm (range, 7.6-27 mm), and mean endometrial thickness was 10.7 mm (range, 6.7-14.6 mm). A measurable fetal pole for crown-rump length was available for 6 (46.1%) patients. None of the fetuses had cardiac activity. Suction curettage under ultrasound guidance and Foley balloon tamponade were successful as the primary treatment in 13 of 13 patients. No major complications occurred during or after the procedure. Conclusion: Our data suggest that surgical evacuation under ultrasound guidance with Foley balloon tamponade is a safe and successful treatment modality in carefully selected patients with early cesarean scar pregnancy.

Objective:We aimed to present urinary tract injuries occurring during obstetric and gynecological operations and their clinical consequences. Methods: Twenty-three patients who had urological organ injury during obstetric and gynecological operations that have been conducted in Fatih University School of Medicine Sema Hospital Department of Obstetrics and Gynecology between January 2010 and June 2016 were retrospectively analyzed. Etiology, type of injury, diagnostic process, treatment methods and complications of urologic injuries and success rate have been investigated. Injuries were categorized into two groups as intra-operative early injuries and post-op late injuries. Early injuries were laceration, rupture, ligation and late injuries were hydronephrosis, contrast material leakage or fistula. Results: Eight patients diagnosed in our clinic at intraoperative or post-op early period and 15 patients who were referred to our clinic after having operation in an external clinic were assessed. Thirteen of the injuries were gynecologic and 10 of them were obstetric. Mean age of operated patients was 34.2±9.4 (23-65) years. Ureteral injury and bladder injury was detected respectively in 6 and 2 patients getting early diagnosis. Fistula (5/15), hydronephrosis secondary to urethral stricture (3/15) and vaginal erosion (3/15) were detected as late diagnosed injuries. In a patient whom ureter was ligated non-functioning kidney has developed. Conclusion: To reduce rate of urinary system injuries a sound knowledge of anatomy is required and also correct surgical techniques should be used. Early diagnosis and therapy may prevent complications and loss of organs that may lead to morbidity.