Introduction: Many people grieve in a resilient manner, often having a sense of equilibrium restored within six months. The most devastating type of loss is usually considered to be the death of the child. For such a loss, bereavement may take a period of distressing years with signs and symptoms that are related to grief. There have been different phases identified in the grieving process, and this process encompasses various difficulties with different levels of psychological effects. Women with perinatal losses can suffer long periods of grief. The purpose of this study was to monitor the grief in women who had undergone a termination of pregnancy due to fetal anomaly. Methods: Forty-six women who applied to the Gynaecology Clinic of Istanbul University Cerrahpaşa Faculty of Medicine and who decided to terminate their pregnancy due to fetal anomaly were included in the study. The Perinatal Grief Scale (PGS), the Impact of Event Scale-Revised (IES-R), Beck Anxiety Inventory (BAI), the Edinburgh Postnatal Depression Scale (EPDS), the Multidimensional Relationship Questionnaire (MRQ) and the Adult Attachment Scale (AAS) were administered to the participants six weeks after termination. Participants’ grief signs were re-evaluated with the PGS at the sixth and 12th months. Results: There was no relationship between severity of grief symptoms and socio-demographic and clinical characteristics of the patients. The perinatal grief symptoms can decrease gradually from termination of pregnancy to six months and can persist for a period of six months up to a year. There was positive correlation between the scores of PGS and BAI, IES-R hyper-arousal. The mean score of PGS changed significantly from sixth week to sixth month and from sixth week to 12th months. IES-R hyper-arousal and MRQ relational satisfaction were found to be the predictors for PGS total score at the first year. Conclusion: The diagnosis of fetal anomaly and especially the termination of pregnancy itself may be traumatic and disruptive. In women with perinatal loss, grief may become persistent after the first six months. It would be helpful to examine how the women resolve this experience. Especially the anxiety and the hyper-arousal signs following the termination should not be ignored. Perinatal grief is a unique bereavement experience; specific interventions should be performed for detecting and treating severe perinatal grief.
Background and Aim:The study aimed to investigate the effectiveness of aspartate aminotransferase (AST), alanine aminotransferase (ALT), and platelet values in predicting intrahepatic cholestasis of pregnancy (ICP) in the first trimester, together with the aspartate aminotransferase/platelet ratio index (APRI) score. Materials and Methods:This study consisted of a patient group diagnosed with ICP (n=49) and a control group (n=62). Laboratory tests of both groups were analyzed retrospectively. Results:The first-trimester APRI score and AST and ALT values were found to be statistically significantly higher than those of the control group. The platelet value was found to be statistically significantly lower in the study group, even though it was within the normal reference range. Conclusion:The first-trimester APRI score was found to be effective in predicting ICP. In addition, the first-trimester AST, ALT, and platelet values were found to be effective in predicting ICP diagnosed in the third trimester even though if not as much as the APRI score.
This study aimed to evaluate the effects of propofol and dexmedetomidine over different timescales on the IVF outcomes for transvaginal oocyte retrieval (TVOR). Twenty-four rats included in the study were divided into two main groups and three subgroups were subjected to the ovulation induction process. Group 1 was administered propofol (100 mg/kg i.v.) and group 2 were administered dexmedetomidine (25 µg/kg i.p.) The oviduct collection procedure was completed within 15 min for subgroup Pro15min, Dex15min (n = 4), within 16 to 30 min for subgroup Pro30min, Dex30min (n = 4) and within 31 to 60 min for subgroup Pro60min, Dex60min (n = 4) after euthanasia. The total number of oocytes was counted. After in vitro fertilization, the number and quality of embryos were evaluated. The number of pups born were evaluated after embryo transfer. The embryo number, quality and pup count decreased as the administration time for propofol increased (p < 0.05). No statistically significant difference was found between the dexmedetomidine subgroups for embryo number, quality and pup count(p > 0.05). As the exposure time to propofol increased, the number and quality of embryos obtained, and the pup count, decreased. The use of dexmedetomidine had no negative impacts on the number of embryos, their quality or the number of pups.
DERLEME / Review Öz 2019'un sonunda Çin'in Hubei eyaleti Wuhan şehrinde ortaya çıkan ve yayılan SARS-CoV-2 virüsü sonucu meydana gelen COVID-19 pandemisi halen ciddi bir halk sağlığı problemi olarak etkisini sürdürmektedir. Hızlı yayılması, tedavisinin olmaması ve ölümcül seyretmesi virüsün yarattığı etkiyi önemli kılmaktadır. Pnömoninin maternal morbidite ve mortalitenin önemli bir nedeni olduğu düşünüldüğünde, COVID-19'un ortaya çıkışı ve küresel yayılması, bu salgının gebe kadınlar ve fetüsleri üzerindeki etkileri hakkında endişeleri artırmıştır. Gebelerde enfeksiyon ile ilgili olarak kısıtlı sayıda bilgi mevcuttur ve şimdilik yönetimin gebe olmayanlar gibi yapılması önerilmektedir. Halen geç gebelikte COVID-19 pnömonisi gelişen kadınlarda vertikal geçişin neden olduğu intrauterin enfeksiyona dair kanıt yoktur. Gebelikte COVID-19 'un yönetim prensipleri erken izolasyon, agresif enfeksiyon kontrol prosedürleri, oksijen tedavisi, aşırı sıvı yüklenmesinin önlenmesi, ampirik antibiyotiklerin (sekonder bakteriyel enfeksiyon riski) değerlendirilmesi, virüs ve koenfeksiyon için laboratuvar testi, fetal ve uterin monitorizasyon, ilerleyici solunum yetmezliği için erken mekanik ventilasyon, bireyselleşmiş doğum planlamasını içerir. COVID-19 enfekte gebe hastanın yönetimi multidisipliner bir takım tarafından düzenlenmelidir.
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