Browsing by Author "Ülkümen B.A."

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    Familial tetra-amelia syndrome
    (Aras Part Medical International Press, 2014) Eskicioglu F.; Ülkümen B.A.; Pala H.G.; Koyuncu F.M.
    Tetra-amelia is known as an anomaly characterized by the absence of all four limbs. It is a rare congenital anomaly, with an incidence of 1.5-4 per 100,000 births. It occurs as a result of developmental interruption between 24th and 36th days after fertilization. Its etiology is not well known. It may be observed isolated or associated with other anomalies. In this paper, we present an interesting case of an intra-uterine diagnosed tetra-amelia male fetus with the recurrence in the previous two more male fetuses in the same family. Tetra- amelia syndrome observed in all three male fetuses of a couple with blood relationship is presented. The first two male newborn died just after birth due to prematurity in 28th and 32nd weeks. The third male fetus was in 23nd weeks of the intrauterine life. There was no exposure to teratogenic agents in this pregnancy. It detected that the third male baby had subcutaneous edema, intra-abdominal ascites and lateral ventricle enlargement in cranium. Since tetra-amelia due to genetic inheritance based on X chromosome was suspected, the family was offered the options of termination of pregnancy, karyotype analysis and genetic consultation. © 2014 The Author(s).
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    Can maternal urinary and serum carbohydrate antigen 19-9 concentrations be utilized in the diagnosis of fetal hydronephrosis?
    (Galenos Yayincilik, 2020) Akbaş M.; Koyuncu F.M.; Ülkümen B.A.; Taneli F.; Özdemir H.
    Objective: Fetal hydronephrosis (FH) is the most common fetal renal pathology encountered in daily obstetric practice. Urinary and serum carbohydrate antigen 19-9 (CA 19-9) concentrations are elevated in obstructive renal pathologies. Our aim was to assess maternal urinary and serum CA 19-9 concentrations in pregnancies with FH and compare results with controls. Material and Methods: Twenty pregnancies with severe FH, 20 pregnancies with mild-moderate FH, and 20 healthy singleton pregnancies were included in this descriptive, case-control study. The diagnosis and classification of FH was based on the anterioposterior diameter of fetal renal pelvis. Maternal urinary and serum CA 19-9 concentrations were measured and compared between groups. Results: Severe FH cases had significantly higher maternal urinary CA 19-9 concentrations compared to controls (median: 75 vs 24 U/mL; respectively; p=0.014). Concentrations of CA 19-9 did not differ between the mild-moderate FH group and control group. No statistically significant difference was found between the groups with respect to maternal serum CA 19-9 concentrations. Conclusion: Our results show that maternal urinary CA 19-9 concentration is significantly higher in pregnancies with severe FH. However, no difference was detected in serum CA 19-9 concentrations between pregnancies with severe FH, mild-moderate FH and controls. If the mechanisms of transplacental passage and maternal urinary excretion are clarified, maternal urinary CA 19-9 may be a potential marker for indicating fetal kidney damage. © 2020 by the Turkish-German Gynecological Education and Research Foundation.
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    Comparison of Postoperative Analgesic Efficacy of Different Methods after Cesarean-Section; [Sezaryen Sonrası Farklı Yöntemlerin Arasında Postoperatif Analjezik Etkinliğin Karşılaştırılması]
    (Anestezi Dergisi, 2020) Ok G.; Çevikkalp E.; Ülkümen B.A.; Erbüyün K.; Hasdemir P.S.; Özyurt B.C.; Aydın D.
    Objective: In this research study,we compared postoperative analgesic effects of general anesthesia followed with transversus abdominis plane block (TAPB), epidural or spinal anesthesia and we aimed to figure out the efficacy of TAPB for the postoperative pain. Method: After approval of the ethics committee (date: 03.25.2015; decision no: 142) for the study was obtained, the study population scheduled for elective cesarean operations was divided in three subgroups as spinal, epidural and general anesthesia. Group T consisted of 30 cases that underwent general anesthesia and TAP; Group E consisted of 32 cases that underwent epidural anesthesia; and Group S consisted of 30 cases that underwent spinal anesthesia. All cases received 75 mg IM diclophenac sodium after the operation. Data about the postoperative pain (the onset time of the pain, and the severity of the pain evaluated with VAS (Visual Analog Scale) and the need for adjuvant analgesics) were recorded. In addition, heart rate, blood pressure, peripheric oxygen saturation, respiration rates at postoperative 0., 1., 4., 6. and 12. hours and side effects seen were recorded. If the patient needed any additional postoperative analgesics, 50 mg tramadol was injected intravenously. Results: There was no significant difference between the groups regarding postoperative analgesia need (Table II). The need for postoperative tramadol was minimum for patients in Group E and maximum for patients in Group S (p<0.05). VAS scores at postoperative 0., 1. and 6. hours were significantly lower for patients in Group E (p<0,05). Regarding the groups T and S, VAS scores at 6. hours were significantly lower in Group T when compared with Group S (p<0.05). Conclusion: We found that the efficacy of the epidural anesthesia was more prominent and the best method for decreasing postoperative consumption of tramadol. Epidural anesthesia increased the postoperative analgesic efficacy and decreased the tramadol consumption in patients undergoing TAP block. In order to increase the comfort of the mother and newborn, TAPB may be an option for patients who are not candidates for epidural anaesthesia. © Copyright Anesthesiology and Reanimation Specialists’ Society.