Background and Objectives: The purpose of this study is to evaluate the impact of maternal ischemia-modified albumin (IMA) levels on pregnancy-related complications, fetal growth, and development over time. Materials and Methods: The prospective longitudinal and single-center study included 43 pregnant women ages 18 to 43. Routine pregnancy follow-up began at the first antenatal examination for all pregnant women before 14 weeks gestation, with IMA levels measured during the first, second, and third trimesters. The albumin cobalt binding test was used to determine the amount of ischemia-modified albumin (IMA). The patients’ medical, sociodemographic, and nutritional data were analyzed. The primary outcome was to investigate how changes in maternal ischemia affected albumin levels during pregnancy and the relationship between these changes and newborn weight. Results: This study included 43 cases with a mean age of 28.5 ± 5.2 years and a mean gestation period of 39.2 ± 1.3 weeks. The mean IMA levels for cases in the first trimester, second trimester, and third trimester were 0.53 ± 0.06, 0.64 ± 0.11, and 0.64 ± 0.06, respectively. The second and third trimesters showed significantly higher levels of ischemia-modified albumin (IMA) than the first trimester (p < 0.01). There was no statistically significant difference in IMA levels between the second and third trimesters (p = 1.000; p > 0.05). There was no statistically significant correlation between fetal birth and percentage changes in IMA measurements between the first and second trimesters, the first and third trimesters, or the second and third trimesters (p > 0.05). Conclusions: Our study determined that maternal ischemia-modified albumin levels during pregnancy did not correlate with fetal birth weight. Our findings revealed that age, sociodemographic changes, BMI, weight gain, and pregnancy complications had no effect on the change in IMA levels during pregnancy. We believe that this result will serve as a benchmark for future studies on IMA levels during pregnancy.

Background and Objectives: This study aims to compare the neuromuscular structure of the vagina in women with posterior vaginal wall prolapse with the neuromuscular structure of the vagina in women without prolapse, to determine the difference, and to demonstrate the role of neuromuscular structure in the physiopathology of prolapse. Materials and Methods: In this prospective study, women aged between 40 and 75 years who had not undergone any vaginal surgery and had not undergone any abdominal prolapse surgery were included. Thirty-one women diagnosed with rectocele on examination were included in the study group. Thirty-one patients who underwent vaginal intervention and hysterectomy for reasons other than rectocele (colposcopy, conization, etc.) without anterior or posterior wall prolapse were included in the control group. Biopsy material was obtained from the epithelium of the posterior wall of the vagina, including the fascia that fits the Ap point. Immunohistochemical staining with Protein Gene Product 9.5 and smooth muscle α-actin was performed in the pathology laboratory. The epithelial thickness measurement and smooth muscle density parameters obtained with these immunohistochemical stainings were compared between the two groups. The collected data were analyzed using the SPSS 23 package program. p values less than 0.05 were considered statistically significant. Results: In the control group, muscle thickness and the number of nerves per mm² of fascia were statistically significantly higher than in the study group (p < 0.05). Conclusions: We found that smooth muscle tissue and the number of nerves per mm² of fascia were decreased in posterior vaginal wall prolapse compared to the general population. Based on the correlation coefficients, age was the parameter that most affected the degree of prolapse, followed by parity, number of live births, and number of vaginal deliveries.

Aims: Women who have undergone subtotal hysterectomy remain at risk for HPV infection and cervical cancer due to the preservation of cervical structure. This study aimed to assess the efficacy of HPV-based cervical cancer screening following subtotal hysterectomy and the rates of patient compliance. Methods: A group of 284 women who underwent subtotal hysterectomy was evaluated, and data on HPV testing, cytology, and demographics was collected. HPV positivity, genotype distribution, and cytological results were examined. Results: HPV positivity was observed in 14.4% of participants, with genotypes 16 and 18 being the most common types. Cytological abnormalities were identified in 21% of HPV-positive cases. The screening compliance rate was determined at 72.5%. Conclusions: HPV-based screening in women with cervical preservation following subtotal hysterectomy is a crucial and essential approach to mitigate cervical cancer risk. It is recommended to establish particular protocols for this group under national screening programs.

Objective: To compare the demographic characteristics, operative outcomes, laboratory findings, and complications among laparoscopic (n=254), abdominal (n=233), and vaginal (n=334) hysterectomy methods. Methods: A retrospective analysis of 821 patients undergoing hysterectomy was conducted. Groups were compared for age, BMI (body mass index), operative time, intraoperative blood loss, postoperative hemoglobin drop (ΔHb), length of hospital stay, complication rates, wound infections, and presence of malignancy. Statistical significance was assessed with p < 0.05, and post-hoc analyses were adjusted accordingly. Results: Mean age differed significantly among groups (p < 0.001), notably between laparoscopic (48 ± 6 years) and vaginal (50 ± 6 years) groups (adj. p < 0.001); BMI showed no significant difference (p = 0.089). Operative time was longest in the laparoscopic group (95 ± 14 min, p < 0.001, all post-hoc adj. p < 0.001). Blood loss was highest in the abdominal group (253 ± 67 cc) compared to laparoscopic (123 ± 40 cc) and vaginal (135 ± 37 cc) (p < 0.001, adj. p < 0.001). The postoperative hemoglobin decrease was greatest in the abdominal group (–2.73 ± 1.54 g/dL) versus laparoscopic (–1.58 ± 1.11 g/dL) and vaginal (–1.73 ± 0.97 g/dL) (p < 0.001, adj. p < 0.001). Hospital stay was shortest after vaginal hysterectomy (2.0 ± 0.5 days) and longest after abdominal (3.1 ± 0.8 days) (p < 0.001, adj. p < 0.001). Complication rate was highest in the abdominal group (16.3%), including wound infection (10.3%) (p < 0.001). Malignant pathology was more frequent in the abdominal group (9.0%) compared to vaginal (3.3%) (p = 0.013). Conclusion: Abdominal hysterectomy is associated with greater blood loss, larger hemoglobin drop, longer operative time and hospital stay, and higher complication and malignancy detection rates, whereas vaginal hysterectomy offers the shortest hospitalization. These findings underscore the importance of surgical method selection based on perioperative risk profiles.