Ectopic pregnancy is a pregnancy complication in which the embryo implants outside the uterine cavity. Although medical treatment is chosen first, sometimes a rupture may occur, and surgical treatment may be required. The parameters to predict rupture have been the subject of many studies. This study aimed to compare the efficacy of different methotrexate protocols in the treatment of ectopic pregnancy and determine the parameters and methotrexate treatment protocols that can predict the risk of rupture. A total of 128 patients diagnosed with ectopic pregnancy were included in this study. Patients were separated into three categories based on their treatment protocols. Regarding the occurrence of rupture, all three groups were compared. The hematological parameters and methotrexate treatment protocols were analyzed and compared between groups. The mean age was 31.9 years. Parity was significantly higher in patients who received multiple doses of methotrexate compared to the other groups. There were significant variations observed among the groups regarding parity, initial β-hCG values, hematocrit (HTC), and mean corpuscular volume (MCV) (p = 0.048, p < 0.001, p = 0.019, and p = 0.047, respectively). According to receiver operating characteristic analysis, neutrophil-to-lymphocyte ratio (NLR) levels were significantly associated with histopathologically confirmed tubal rupture (p < 0.05). NLR levels should be examined in ectopic pregnancy, and the possibility of rupture should be considered in cases with high NLR levels. The potential of NLR to predict ectopic pregnancy rupture should be explored in multicenter prospective studies.

We conducted our study to investigate the relationships between hyperemesis gravidarum (HEG) and inflammatory markers such as the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR). A total of 150 pregnant women diagnosed with HEG and 150 controls were included in our study. The data analysed included demographic variables, complete blood count results, and urinary ketonuria levels. We found that the NLR, PLR and MLR were significantly greater in HEG patients than in controls (p < 0.05), indicating a potential role of systemic inflammation in the pathophysiology of HEG. Receiver operating characteristic (ROC) analysis revealed that these markers had moderate discriminative power, suggesting their utility as adjunctive diagnostic tools in clinical settings. However, no correlation was found between inflammatory markers and the severity of ketonuria. The NLR, PLR and MLR can be used as indicators of HEG as a result of the inflammatory process in pregnant women with HEG.

We aimed to investigate the effect of preoperative intravenous (IV) iron administration on maternal outcomes in patients with placenta acreata spectrum (PAS). The study group comprised 72 patients diagnosed with PAS who underwent surgery and received IV iron preoperatively. The control group consisted of 71 patients who underwent the same diagnosis but did not receive IV iron. We recorded and compared the groups’ demographic and obstetric findings, laboratory results, preoperative and postoperative blood product requirements, operation duration, characteristics, hospital stay, and neonatal outcomes. We compared the IV iron group’s data to that of the control group and found that the study group needed significantly less erythrocyte suspension (ES) transfusions during surgery (32 (44.4%)) and after surgery (56 (77.8%)) than the control group (p < 0.05). Total ES transfusion requirement (1.38 ± 0.896) and total fresh frozen plasma (FFP) transfusion requirement (0.55 ± 0.785) in the study group were significantly less than the control group (p < 0.05). Postoperative hospital stay (hours) was also significantly shorter in the study group (56.34 ± 15.06) than in the control group (83.18 ± 21.64) (p < 0.05). The use of Bakri balloon tamponade was significantly higher in the control group (38 (52.8%)) than in the study group (12 (16.9%)) (p = 0.00), and the number of bilateral hypogastric artery ligations and total abdominal hysterectomy was significantly lower in the study group (13 (18.1)/2.8) than in the control group (53 (74.6)/19 (26.8)) (p < 0.05). There was no statistically significant difference between the groups in terms of the use of compression sutures, lower uterine segment resection, or adjacent organ damage (p > 0.05). Preoperative IV iron administration positively affects intraoperative bleeding, operative time, blood product requirement, peripartum hysterectomy requirement, and hospital stay.

Adenomyosis is increasingly recognized as a significant factor affecting fertility, particularly in the context of assisted reproductive technologies (ART). This study aimed to assess the independent impact of adenomyosis on intrauterine insemination (IUI) success rates in women with unexplained infertility. This retrospective cross-sectional study included 533 IUI cycles in 374 infertile women treated at the University of Health Science, assisted reproductive technologies center, Adana City Hospital. The study identified adenomyosis in 95 patients via 2D transvaginal Doppler ultrasonography and 3D transabdominal ultrasonography, whereas direct and indirect adenomyosis features were not detected in 279 patients. Both groups started ovulation induction on cycle day 2–3 using recombinant follicle stimulating hormone (rFSH) or letrozole combined with rFSH or rFSH combined with recombinant luteinizing hormone (rLH). Clinical and ultrasound findings were recorded systematically. IUI was performed 36 h post-human chorionic ggonadotropin (hCG) administration, with pregnancy defined as a positive β-hCG 12–14 days after IUI. Logistic regression models were used to analyze the independent effects of adenomyosis on clinical pregnancy rates, adjusting for potential confounders. The cumulative pregnancy rate per cycle was significantly lower in women with adenomyosis (12.23%) compared to those without adenomyosis (20.81%). Adenomyosis was identified as a significant negative predictor of IUI success (OR 0.575, 95% CI: 0.335–0.998, p = 0.049). Adenomyosis negatively affects IUI outcomes, suggesting the need for tailored fertility treatment strategies in this population. Routine assessment of adenomyosis should be considered in infertility evaluations to optimize clinical management and treatment success.

Aims: To evaluate the diagnostic performance of the real time shear-wave elastography in patients with endometrial cancer in terms of tumor grade and myometrial invasion depth preoperatively. Methods: In this prospective observational study, forty-eight women who were diagnosed with endometrioid type endometrium cancer in our gynecologic oncology clinic of a tertiary hospital between September 2020-January 2021 in Turkey. All patients underwent an ultrasonographic shear-wave measurements. Mean shear-wave values were measured from the tumor itself. Mean elasticity values were assessed in terms of tumor grade and myometrial invasion depth. Results: The median [%25-%75] shearwave value of the participants was 29.45kPa (5.02-167.21). Shear-wave value for grade 3 endometrial cancer showed a statistically significant difference compared to grade 1 and 2 shear-wave values (p0.05). ROC curve analysis showed significant results to determine the myometrial invasion depth and grade 3 endometrial cancer with the mean shear-wave cut-off values of 28.29 kPa and 57 kPa respectively (p<0.001). Conclusion: Real-time shear-wave elastography is a promising tool to predict the grade 3 tumors and deep myometrial invasion in endometrial cancer patients.

Aims: We aimed to determine the frequency of the PALM group in the FIGO PALM-COEIN system of patients who were operated for AUB, and to evaluate and analyze our data in our clinic. Methods: In a retrospective study, data were obtained for nonpregnant women aged 18–55 years who underwent hysterectomy for AUB at a center in Turkey in 2017-2022. The patients were retrospectively classified according to the PALM-COEIN system. Results: A total of 847 women were included. Leiomyoma was the most common pathology result in only 377 (44.5%) patients. The second most common pathology result was adenomyosis and leiomyoma coexistence in 132 (15.6%) patients. The third most common pathology result was 62 (7.3%) adenomyosis. Conclusion: In addition to the combined use of FİGO AUB system 1 and 2 in AUB, the notation grouping may be useful for clinicians in the management of AUB.