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    Placenta Previa and Adverse Neonatal Outcomes in A Tertiary Center
    (2024) Bestel, Melih; Alpay, Verda; Ekiz, Ali; Bestel, Aysegul; Karaaslan, Onur; Yildirim, Dogukan; Polat, İbrahim
    Objective: Abnormal localization of the placenta with complete or partial closure of the cervix is called placenta previa. Placenta previa occurs in approximately 0.3-0.5% of pregnancies. In this study, we aimed to determine the risk factors and adverse fetal outcomes by comparing the neonatal outcomes of patients who underwent cesarean section for placenta previa with those of patients who underwent cesarean section for other indications. Method: Patients with singleton pregnancies diagnosed with placenta previa were retrospectively analyzed. Placenta previa, risk factors, and adverse neonatal outcomes were estimated using multivariate logistic regression models. Results: A total of 61,110 deliveries were analyzed, and 632 deliveries (288 patients, 344 controls) were included in the study. The prevalence of placenta previa was 0.47%. Advanced maternal age [odds ratio (OR)=3.03], multigravida (?5) (OR=2.31), previous abortion (OR=1.58) and curettage (OR=2.32) were significant risk factors for placenta previa. However, these patients had an increased risk of 1st minute Apgar score <7 (OR=1.59) and neonatal intensive care unit (NICU) admission (OR=2.15). At the same time, the risk of Apgar score <7 at 1 min (OR=5.59) and 5 min (OR=3.94) and NICU admission (OR=28.47) increased in infants of patients with placenta previa <34 weeks. Newborns in the >37 weeks gestational age group with placenta previa were more likely to have a lower birth weight (OR=4.21) and an Apgar score <7 at 5 min (OR=1.89). Conclusion: Pregnancies with a diagnosis of placenta previa were associated with an increased risk of serious fetal outcomes compared with cesarean deliveries for all other indications, regardless of delivery timing.
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    The Impact of Different Management Options of Ectopic Pregnancy on Future Fertility
    (2023) Bestel, Aysegul; Gunkaya, Osman Samet; Bestel, Melih; Aldikactioglu Talmac, Merve; Yazkan Erdoğan, Kübra; Göksever Çelik, Hale
    In this study, our aim was to evaluate the subsequent fertility status of women treated with different methods for ectopic pregnancy. Patients diagnosed with ectopic pregnancy between January 2012 and July 2020 were included in the study. Fertility outcomes of the patients treated with medical or surgical options were questioned. In the study, 659 patients who met the eligibility criteria were included . A single dose of MTX was administered in 37 patients (32.2%) and two doses of MTX were applied in 14 patients (12.2%) and surgery was preferred in 64 patients (55.7%) in the infertile group. In 213 patients (39.2%) in the fertile group, MTX was administered as a single dose while two doses of MTX and surgery was preferred in 49 patients (9.0%) and 282 patients (51.8%), respectively. No statistically significant difference was detected between the groups according to treatment approaches. There was no significant difference regarding fertility outcomes following different typ es of treatments for ectopic pregnancy. For this reason, the methods to be chosen for the treatment of ectopic pregnancy should be evaluated according to the individual factors of the patient.