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To estimate the exact incidence of trocar site hernia (TSH) through sonographic examination and to evaluate the predisposing risk factors of TSH. Three hundred patients who underwent laparoscopic surgery for benign gynecologic indications were included in this study and called back for a follow-up visit. All patients underwent an ultrasound evaluation for the detection of TSH. Risk factors for TSH formation were investigated. Twenty-five (8.3%) TSHs were diagnosed among 300 postoperative laparoscopies. The highest rate of TSH development among the surgeries was found in tubal ligation cases with 19%. Parity ≥3 [odds ratio (OR), 3.13; 95% confidence interval (CI): 1.21-8.09; p=0.018], and not closing fascia (OR: 6.74; 95% CI: 2.72-16.70; p<0.001) were statistically significant risk factors for the development of TSH in multivariate analysis. The prevalence of TSH is higher than previously reported, and ultrasonographic examination is adequate for detecting subclinical types of this complication.

OBJECTIVES: To compare platelet indices in preeclamptic and normotensive pregnants and to investigate the clinical use of these parameters in preeclampsia prediction. MATERIAL AND METHODS: This retrospective case- control study included 257 preeclampsia patients and 264 healthy pregnant women as the control group. The groups were compared in terms of platelet count (PC), mean platelet volume (MPV), platelet distribution range (PDW), plateletcrit (Pct), Pct / MPV ratio and PC / MPV ratio. RESULTS: Between the preeclampsia group and the control group; mean platelet count (227.22 ± 78.58 vs 236.69 ± 64.30), plateletcrit (PCT) (0.21 ± 0.06 vs 0.24 ± 0.27), and platelet distribution width (PDW) (17.11 ± 0.80 vs 17.29 ± 0.82) were not significantly different (p> 0.05). However, MPV values were significantly higher in the preclampsia group compared to the control group (9.66 ± 1.62 and 8.92 ± 1.33, respectively) (p < 0.001). In our study, the optimum cut-off value of MPV was 9.15 with 58.7% sensitivity and 61.7% specificity for the prediction of preeclampsia. Pct/MPV ratio (0.02 ± 0.007 vs 0.027 ± 0.029) ( p = 0.01) and PC/MPV ratio ( 24.63 ± 10.90 vs 27.63 ± 10.24) (p = 0.001) were significantly lower in the preeclampsia group than in the control group. CONSLUSIONS: In preeclampsia, changes in platelet functions, destruction and production lead to changes in platelet indices. Compared with normal healthy pregnant women, preeclamptic pregnant women have higher MPV values. In preeclampsia prediction, MPV and PC/MPV ratio are promising as a diagnostic parameter.

Objectives: To compare maternal and neonatal outcomes concerning emergency or planned cesarean deliveries in pregnancies complicated by placenta previa (PP), and to evaluate factors related to blood transfusion requirement. Methods: Three hundred sixty-three women with PP with (n = 80) and without (n = 283) placenta accreta spectrum (PAS) who delivered between May 2016 and May 2021 were retrospectively reviewed. The patients were allocated to two main groups as PAS and non-PAS and into two subgroups as emergency cesarean delivery (ECD) and planned cesarean delivery (PCD). Results: One hundred twenty-eight deliveries were emergency and 155 were planned in non-PAS group. In PAS group 38 patients were delivered urgently and 42 were delivered as planned. General anesthesia was preferred more frequently in emergency cases. Gestational age, birth weight, and the 1st and 5th minute APGAR scores of the infants were significantly lower and neonatal intensive care unit (ICU) admission was significantly higher in the ECD cases (p < 0.001) in both PAS and non-PAS groups. The total amount of blood and blood product transfused (p = 0.005), length of hospital stay (p = 0.022) were higher in the ECD cases and adult ICU admission was significantly higher in the ECD cases in non-PAS group (p = 0.016). In multilinear regression analysis, the need for blood transfusion was found to increase with the number of previous cesarean sections, ECD, PP with PAS, general anesthesia, and uterine artery ligation. Conclusions: In placenta previa, which is an obstetric condition associated with serious maternal and neonatal morbidity and mortality, adverse maternal and neonatal outcomes increase in cases of emergency cesarean delivery.

Objective: To estimate the exact incidence of trocar site hernia (TSH) through sonographic examination and to evaluate the predisposing risk factors of TSH. Materials and Methods: Three hundred patients who underwent laparoscopic surgery for benign gynecologic indications were included in this study and called back for a follow-up visit. All patients underwent an ultrasound evaluation for the detection of TSH. Risk factors for TSH formation were investigated. Results: Twenty-five (8.3%) TSHs were diagnosed among 300 postoperative laparoscopies. The highest rate of TSH development among the surgeries was found in tubal ligation cases with 19%. Parity =3 [odds ratio (OR), 3.13; 95% confidence interval (CI): 1.21-8.09; p=0.018], and not closing fascia (OR: 6.74; 95% CI: 2.72-16.70; p<0.001) were statistically significant risk factors for the development of TSH in multivariate analysis. Conclusion: The prevalence of TSH is higher than previously reported, and ultrasonographic examination is adequate for detecting subclinical types of this complication. Keywords: Complications, laparoscopy, port site hernia, trocar, trocar site hernia Amac: Bu calismanin temel amaci sonografik inceleme ile trokar bolgesi hernisinin (TSH) kesin insidansini tahmin etmek ve TSH'nin predispozan risk faktorlerini degerlendirmektir. Gerec ve Yontemler: Benign jinekolojik endikasyonlar icin laparoskopik operasyon geciren 300 hasta calismaya dahil edildi ve tekrar takip ziyareti icin cagirildi. Tum hastalara TSH saptanmasi icin ultrason degerlendirmesi yapildi. TSH olusumu icin risk faktorleri arastirildi. Bulgular: Uc yuz laparoskopik ameliyat sonrasinda yirmi bes (%8,3) TSH tanisi kondu. Operasyonlar arasinda en yuksek TSH gelisimi orani %19 ile tubal ligasyon olgularinda bulundu. Cok degiskenli analizde parite =3 [olasilik orani (OR), 3,13; %95 guven araligi (GA), 1,21 ila 8,09; p=0,018] ve kapatilmamis fasya (OR: 6,74; %95 GA: 2,72 ila 16,70; p<0,001) TSH gelisimi icin istatistiksel olarak anlamli risk faktorleri idi. Sonuc: TSH prevalansi daha once bildirilenden daha fazladir ve ultrasonografik inceleme bu komplikasyonun subklinik tiplerini tespit etmek icin yeterlidir. Anahtar Kelimeler: Komplikasyonlar, laparoskopi, port alani hernisi, trokar, trokar alani hernisi

OBJECTIVES: To determine the role of baseline ultrasound findings and the changes between β- human chorionic gonadotropin(hCG) values on day 0 to day 4 in patients receiving single-dose methotrexate (MTX) therapy for tubal ectopic pregnancy. MATERIAL AND METHODS: One hundred fourteen patients who were hospitalized with a diagnosis of ectopic pregnancy andtreated with single-dose methotrexate were included in this retrospective study. The successful treatment group (n = 88)comprised patients in whom serum β-hCG levels were resolved with single-dose methotrexate treatment, and the failedtreatment group (n = 26) included patients who received second dose methotrexate and/or surgery. Ultrasound findings,laboratory findings, and serum β-hCG values at the time of admission and D4 and D7 β-hCG values were compared. RESULTS: The success rate of single-dose methotrexate treatment was 77.2%. In the successful treatment group, the initialβ-hCG values of the patients were lower than the unsuccessful treatment group (1479.14 ± 1253.49, 4442.88 ± 3392.58,respectively) (p = 0.0001). A decrease of more than 35% between D0-D4 increased the probability of successful treatment(p = 0.017). Although ectopic focus size and abdominal free fluid showed no significant difference between the two groups,endometrial stripe thickness was significantly higher in the unsuccessful treatment group (12.61 ± 5.79, 9.28 ± 3.53) (p = 0.002). CONCLUSIONS: In addition to the basal β-hCG value, endometrial stripe thickness of ultrasound findings should also beconsidered in determining patients with a high chance of success in single-dose MTX treatment.β-hCG changes betweenD0-D4 may be advantageous in the clinical management of ectopic pregnancy for earlier evaluation.