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    Predictors of adverse perinatal outcomes in women at 40 weeks or more of pregnancy
    (Publishing Office of the University of Rzeszow, 2023) Sert, Zekiye Soykan; Evren Dilmaç, Ayşegül; Alkan, Ender; Sert, Ekrem Taha
    Introduction and aim. To evaluate the clinical features of women at ?40 weeks of pregnancy and the utility of obstetric Doppler indices in predicting adverse perinatal outcomes in these pregnancies. Material and methods. This prospective study was conducted at a single academic medical center between 2020 and 2022. Women aged 18 years and older with no risk factors who were at ?40 weeks of pregnancy and delivered their babies in our hospital were included in the study. The fetal biometry, placental maturity grading, and doppler velocytometry indices of the pregnant women were evaluated. The cases were divided into two groups according to the development of adverse perinatal outcomes. The relationship between clinical features and adverse perinatal outcomes was evaluated. Results. Adverse perinatal outcomes developed in 19.6% (42) of the 214 cases. The multiple logistic regression analysis was performed to identify factors affecting perinatal outcomes. Accordingly, a maternal age of ?35 years (odds ratio [OR]: 1.74, 95% confidence interval [CI]: 1.29-3.96, p=0.038), nulliparity (OR: 1.42, 95% CI: 1.13-4.63, p=0.040), and grade 3 placental calcification (OR: 1.98, 95% CI: 1.11-4.53, p=0.029) were independent predictors of adverse perinatal outcomes. Conclusion. Care should be taken in terms of adverse perinatal outcomes in the presence of nulliparity, a maternal age of ?35 years, and grade 3 placental calcification in ?40 week pregnancies.
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    Prevalence of Iron Deficiency and Iron Deficiency Anemia Among Nursing Students Working in the Internal Medicine Clinic
    (Cureus, 2023) Yortanlı, Betül Cigdem; Ecirli, Samil; Sert, Zekiye Soykan
    The objective of this study is to evaluate the frequency of iron deficiency (ID) and iron deficiency anemia (IDA) among nursing students working in the internal medicine clinic of our hospital. Methods The study was designed as a prospective cohort study. The study population comprised nursing students working in the internal medicine clinic of our hospital from January 1, 2016, through June 1, 2016. Data concerning the participants' anamnesis, physical examination findings, and sociodemographic characteristics were recorded. Blood samples were taken. The participants' blood parameters were evaluated for anemia. Results A total of 99 nursing students, 43 (43.4%) male and 56 (56.6%) female, were included in the study. The mean age was 17.4 +/- 0.58 years for the male student group and 17.64 +/- 0.73 years for the female student group. We detected ID in 22.2% of the nursing students, anemia in 8%, and IDA in 4%. ID was present in 22 (39.3%) of the female students. There was a significant difference between the male and female student groups in terms of the prevalence of ID (p < 0.001). The mean hemoglobin levels of the male and female student groups were 15.85 +/- 1.10 g/dL and 12.90 +/- 1.05 g/dL, respectively. Conclusion We determined that the number of students with ID was higher than the number of students with IDA. Once ID is diagnosed, it may be necessary to take precautions and treat it according to the severity of the deficiency. It is extremely important to educate nursing students and raise their awareness about ID and IDA.
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    Prognostic capacity of inferior vena cava diameter for severe postpartum hemorrhage
    (Elsevier, 2021) Sert, Zekiye Soykan
    Purpose: This study sought to evaluate whether or not the sonographic measurement of the inferior vena cava (IVC) diameter predicts severe bleeding in women with postpartum hemorrhage (PPH). It further compared the efficacy of the IVC diameter, shock index, and serum lactate levels in this prediction. Methods: This prospective study included female patients with 500 mL of bleeding after vaginal delivery between September 1, 2019 and May 31, 2021. The IVC diameter during inspiration (IVCmin) and expiration (IVCmax), shock index and serum lactate levels of the patients were measured. The patients were divided into two groups according to the postpartum vaginal blood loss [non-severe PPH and severe PPH (SPPH)]. After multivariate logistic regression analysis revealed the significant parameters, we constructed the receiver operating characteristic (ROC) curves to determine their power in predicting SPPH. Results: Of the 201 patients included in the study, SPPH developed in 21.4% of the population, while nonsevere PPH occurred in 78.6%. The area under the curve (AUC) values of shock index, lactate, IVCmin and IVCmax for SPPH prediction were 0.772, 0.791, 0.851 and 0.874, respectively. According to the ROC analysis, at the cut-off value of 7.3 mm, IVCmax had 90.7% sensitivity and 70.8% specificity in predicting SPPH. IVCmax was independently associated with SPPH (Odds ratio: 0.74, 95% CI: 0.63–0.86). Conclusion: We found that the ultrasonographic measurement of IVC diameter is more valuable than the shock index and lactate parameters in the early detection of SPPH. Therefore, IVC diameter may be a useful prognostic marker for SPPH