Objective: In this study, we aimed to evaluate the effects of obstetric emergencies workshops combining theoretical lectures, simulation trainers and fresh cadaver models on daily practices and referrals of obstetrics and gynecology specialists. Materials and Methods: This is a prospective observational study involving obstetrics and gynecology specialists attending the Turkish Society of Obstetrics and Gynecology endorsed obstetrics hemorrhage management courses held in 2018 and 2019. The training course is an annually organized two-day course, one day allotted to theoretical lectures and the other day to practical training on both simulators and fresh cadavers. Trainees participating in the course was surveyed with an anonymous questionnaire on their motivation to attend the course and their juridical history of obstetric patient management. Attendees were asked to disclose whether they had ever independently performed the procedures stated in the questionnaire or not, before commencing the course and 1 year after attending the course. Results: Among the attendees 22% (n=32) had at least one obstetrical malpractice lawsuit and 36.1% (n=52) were accused of Health Care Complaints Comission. The main motivation of the attendees for taking this course was Professional development followed by reducing maternal mortality and morbidity and avoiding malpractice. One year after the course, attendees applying uterine devascularization surgery increased by 36.1% (52/144), uterine compression sutures increased by 52.7% (76/144), and ability to apply uterine balloon tamponade increased by 59.7% (86/144). Besides improvement in other obstetric surgical skills an indirect effect seen that the attandees operated on high-risk cases increased in placenta previa (15.3%), placenta acreata spectrum (30.5%), operative deliveries (27.7%), peripartum hysterectomy (24.9%) and relaparotomy for postpartum hemorrhage (34.7%). Conclusion: Opportunities of attending well organized fresh cadaveric workshops on managing postpartum hemorrhage and other obstetric surgeries, can quickly adapt to daily practice, restore the professional confidence of obstetric and gynecology specialists, and eventually decrease patient referral.

Objective: The aim of this study was to determine the standard mid-trimester cervical lengths of singleton and twin pregnancies. Material and Methods: This study was conducted by retrospective analysis of mid-trimester transvaginal cervical measurements of women with singleton and twin pregnancies that were examined by a single perinatologist in a single center. Results: A total of 4621 consecutive asymptomatic pregnant women admitting for advanced obstetric ultrasound screening were evaluated. Of these 4340 (93.9%) were second trimester singleton pregnancies and 281 (6.1%) were twin pregnancies and were included. Mean cervical length measurements of singleton and twin pregnancies were 38.2±6.5 mm and 37.6±7.2 mm respectively (p=0.17). Overall, the 5 th percentile of cervical length measurement after analysing singleton and twin pregnancies together was 29.4 mm at 16 weeks, 30 mm at 17 weeks, 30 mm at 18 weeks, 30 mm at 19 weeks, 30 mm at 20 weeks, 30 mm at 21 weeks, 30 mm at 22 weeks, 31 mm at 23 weeks, 29 mm at 24 weeks. Conclusion: In our population the 5 th precentile value of cervical length which is 30 mm in singletons and 10 th percentile cervical length which is 31 mm in twins can be used to follow-up and treat pregnant women at risk for preterm delivers.

Objectives: Since recurrent implantation failure (RIF) is a challenging fact, effects of different therapeutic immunomodulatory agents are being investigated to overcome this problem. This study aimed to evaluate the effect of intralipid on pregnancy outcomes of IVF patients with RIF. Methods: 116 of the participants who received only the short antagonist protocol allocated in the control group, whereas 106 patients were in intralipid group by additionally receiving intravenous lipid (SMOFlipid®). Intralipid was given on the day of embryo transfer, on the day of positive pregnancy test and continued weekly until the tenth week of pregnancy. Implantation rate, biochemical pregnancy rate, clinical pregnancy rate and live birth rate were evaluated. Results: The positive pregnancy test, clinical pregnancy rate and live birth rate were statistically significantly higher (p0.05). Conclusions: This study revealed that intralipid therapy has better pregnancy outcomes in patients with RIF compared to patients undergo standard IVF protocol only. Further prospective studies are needed to suggest the routine use of intralipid in patients with RIF.

Endometrial hyperplasia is a disease characterized by an increase in the ratio of endometrial glands to stroma. Excessive proliferation of endometrial glands can cause cytological atypia and progress to endometrial carcinoma if the estrogenic activity is unopposed by progesterone. In addition, endometrial hyperplasia causes abnormal uterine bleeding and reduces the quality of life of patients. Although the main treatment in the presence of atypia is hysterectomy, different types of progestins can be used in different ways for nonatypical endometrial hyperplasia. 1 Progestins act by triggering apoptosis and are used as a nonsurgical alternative to hysterectomy. 2 Although oral progestogens are usually preferred in the treatment of endometrial hyperplasia, local treatment is a good alternative due to the fact that it participates less in the systemic circulation and has a greater local effect