Background: To review the obstetric outcomes of pregnancies with anencephalic fetuses when these pregnancies are not terminated and ongoing. Methods: A retrospective chart review is made of the cases with a prenatal diagnosis of anencephaly and who were opted to continue the pregnancy in 1-year period. The evaluated data included gestational age at diagnosis, gestational age at birth, labor induction rates, cesarean delivery rates, stillbirth, shoulder dystocia rate, antepartum and postpartum hemorrhage. Results: A total of 28 cases that were selected from 87 cases with the diagnosis of anencephaly are included in the study. The average gestational age at diagnosis was 18 weeks. The average gestational age at birth was 31 weeks (range 23 - 37 weeks). Stillbirths were reported in 32% (9/28). Polyhydramnios developed at six patients and two of them required amniodrainage due to severe polyhydramnios. Vaginal birth was achieved in 67% (19/28) of the patients. Labor induction was applied at total 17 patients and one of them had gone to cesarean section due to failed induction. There were two cases of shoulder dystocia. Nine patients had gone to cesarean delivery. Any other complication was not encountered. Conclusions: Parents should be counseled in detail about continuation of an anencephalic pregnancy before making their decision. The information about “what an anencephalic pregnancy can lead”' should be given. The redundant cesarean deliveries, polyhydramnios and associated complications, obstetrical hemorrhage risk should be discussed with patients. It should also be emphasized that these maternal risks are for the sake of a non-life expectant baby. J Clin Med Res. 2019;11(5):332-336 doi: https://doi.org/10.14740/jocmr3777

Mini-laparoscopy can be safely and effectively used to perform benign adnexal mass surgery.

Background: The management of women with chronic benign vulvar dermatoses has been one of the most difficult and challenging aspects of women's healthcare for a long time. Aim: Our aim was to compare the ability to approach the specific diagnosis of nonneoplastic and noninfectious vulva diseases, between the new classification system and the old classification system. Methods: One hundred women with chronic vulvar pruritus were included in the study. After detailed examination of the vulva, all visible lesions were biopsied, with normal skin included. All specimens was sent for dermatopathology and examined simultaneously under a binocular microscope by two pathologists. Specific diagnosis if possible and histopathological findings were classified according to both the 1987 and 2006 International Society for the Study of Vulvar Diseases (ISSVD) classifications. The ratios that were able to be approached on the specific diagnosis, with the aid the two classification systems, were compared. Results: Specific clinical diagnosis by both pathological and after using clinicopathological correlation was possible in 69 out of 91 patients (75.8%) according to the 1987 ISSVD classification, and in 81 out of 91 patients (89.0%) according to the ISSVD 2006 classification system. The difference in the clinical diagnosis ratios between the two classification systems was statistically significant ( P < 0.05). In a subgroup of women without specific diagnosis at the time of pathological examination, clinical diagnosis was made in 28 out of 50 women (56%) after using the clinicopathological correlation according to the ISSVD 1987 classification, whereas, specific diagnosis was made in 39 out of 49 (79.6%) women after using the clinicopathological correlation according to the ISSVD 2006 classification. The difference was statistically significant in terms of the ratio of the ability to achieve a specific diagnosis ( P < 0.01). Conclusion: ISSVD 2006 classification of nonneoplastic and noninfectious vulvar disease is more useful than the former classification, in terms of approaching the specific diagnosis of vulvar dermatoses.

Background. In gynecological surgery, one particular area of concern after hysterectomy is the risk of developing an enterocele or vaginal apical prolapse. The aims of this study were to evaluate the safety and efficacy of prophylactic McCall culdoplasty (MC) performed during mini-total laparoscopic hysterectomy (mini-TLH), as well as to compare the differences in apical support, total vaginal length (TVL), and sexual function at one and two years postoperatively. Methods. Data were retrospectively reviewed for all women who underwent mini-TLH and mini-TLH + MC at a tertiary care center between August 2012 and January 2016 were from the hospital database. There were 18 women who underwent mini-TLH + MC and were considered as the study group, while 20 women who were treated with mini-TLH were considered as the control group. The primary outcome measures were the differences in apical support and TVL and impact on sexual function. Results. After mini-TLH + MC, the apical vaginal support difference was improved by 2.2 cm. The mean difference in C point was 1.03 cm in the mini-TLH group, which was not significant at two years after the operation. The vaginal vault descent at two years after operation was more prominent in the mini-TLH group than the mini-TLH + MC groups. Apical support changes at two years after the operation were more prominent in the mini-TLH group (0.5 ± 0.6 cm) than the mini-TLH + MC group (1.9 ± 1.2 cm). Conclusion. Prophylactic MC by a vaginal approach during mini-TLH is safe, satisfactory, and efficient for apical support without severe morbidity.

Central nervous system (CNS) abnormalities are often isolated but can accompany various genetic syndromes. In this study, we evaluated conventional karyotype results and associated findings of fetuses that were diagnosed with CNS abnormalities. Cases included in the study were diagnosed with fetal CNS anomalies and underwent conventional karyotyping. Conventional karyotype results of subjects were compared with karyotype results of fetal karyotyped patients as a result of maternal anxiety in a two-year period. In this period, 69 patients were diagnosed with fetal CNS anomalies and 64 of them underwent invasive fetal karyotyping. Of these, 32 patients had isolated CNS anomalies, while 32 were associated with other anomalies. There was no significant difference between karyotype results when compared with the control group (p = 0.76). Apart from some specific anomalies, the aneuploidy rate does not significantly differ between fetuses with CNS anomalies and the control group. Advanced genetic evaluation may provide additional diagnostic benefits, especially for this group.

This study evaluates the statistical analysis of cervicovaginal smear results at postmenopausal period accompanied by literature. Cervicovaginal smear results of 894 postmenopausal women were evaluated retrospectively according to the 2001 Bethesda system (BS) in Adana Numune Training and Research Hospital of Obstetrics and Gynecology Clinic from 2007–2010. The study found, normal results on 287 patients (32.1%), benign findings on 556 patients (62.2%), abnormal epithelial cell changes on 48 patients (5.36%) and malignant changes on 3 patients (0.33%). The abnormal epithelial changes were observed to be atypical cells of undetermined significance (ASC-US) for 22 patients (2.46%), low-grade squamous intraepithelial lesion (LSIL) for 11 patients (1.23%), high-grade squamous intraepithelial lesion (HSIL) for 7 patients (0.78%), findings that cannot exclude a high-grade squamous intraepithelial lesion (ASC-H) for 6 patients (0.55%) and atypical glandular cells-not otherwise specified (AGC-NOS) for 2 patients (0.22%). Malignant results were 2 squamous cell carcinomas (SCC) (0.22%) and 1 adenocarcinoma (ACC) (0.11%). Cervical cancer screening programs should be expanded and Pap smear screening should be applied to all postmenopausal women. The longer time span involved from premalignant lesions to cancer improves our chance for the diagnosis and treatment. As the incidence of invasive cancer increases in menopausal period, gynecological smear examination and regular check-up are crucial. A high rate of abnormalities of epithelial cells was detected in this study.