Objective: To determine factors affecting obstetric outcomes in pregnancies after conization by loop electrosurgical excision procedure (LEEP) or cold-knife conization (CKC) due to cervical intraepithelial neoplasia. Material and Methods: The maternal and clinical characteristics and obstetric outcomes of CKC, LEEP and control groups were evaluated and compared. Risk factors for adverse pregnancy outcomes were evaluated using multiple logistic regression analyses. Results: The incidence of preterm delivery, preterm premature rupture of membranes (PPROM), low APGAR scores, fetal mortality, and late- period spontaneous abortus was highest in patients who underwent CKC (p<0.05). Cone depth of CKC was greater than LEEP (p=0.025). Cervical length (CL) at pregnancy was CKC < LEEP < controls (p=0.003). Shorter CL at pregnancy and time from conization to pregnancy (tCP) was correlated with a high incidence of preterm delivery and PPROM (p<0.05). To predict preterm delivery, t-CP <14 months had 63.16% sensitivity and 77.42% specificity [area under the curve (AUC): 0.714, 95% confidence interval (CI): (0.603-0.809); p=0.005], and CL at pregnancy <31 mm had 65% sensitivity and 71.78% specificity [AUC: 0.731, 95% CI: (0.675-0.782); p<0.001]. To predict PPROM, t-CP <15 months had 85.71% sensitivity and 65.22% specificity [AUC: 0.730, 95% CI: (0.603-0.809); p=0.024], and CL <32 mm had 72.73% sensitivity and 61.89% spcificity [AUC: 0.685, 95% CI: (0.675-0.782); p=0.007]. Conclusion: Compared with CKC, LEEP has shorter cone depth and fewer adverse pregnancy outcomes. The t-CP <14 months was a risk for preterm delivery and <15 months was a risk for PPROM. CL at pregnancy <31 mm was a risk for preterm delivery and <32 mm was a risk for PPROM. (J Turk Ger Gynecol Assoc. 2024; 25: 238-46)

Objective: This study aimed to investigate the effects of cyst volume and bilaterality on serum Anti-Müllerian Hormone (AMH) and CA-125 levels in patients with benign ovarian cysts. Methods: We retrospectively analyzed 139 patients who underwent cystectomy for benign ovarian cysts. Serum AMH and CA-125 levels were measured preoperatively and at the second post-operative month. Results: The mean preoperative AMH level was 3.96 ± 3.48 ng/mL, which significantly decreased to 3.59 ± 3.92 ng/mL postoperatively (p = 0.026), reflecting an average decline of 9.3%. CA-125 levels significantly decreased from 53.1 ± 157.2 to 21.0 ± 18.4 U/mL (p = 0.002). Patients with bilateral cysts had lower AMH levels at the second month (1.67 ± 0.6 vs. 3.80 ± 4.1 ng/mL; p = 0.003) despite similar baseline values. Conclusion: Bilaterality and cyst volume may negatively affect ovarian reserve postoperatively. The decline in AMH levels, particularly following bilateral ovarian cystectomy, has a significant impact on the ovarian reserve and may have implications for future fertility. Early fertility counselling and ovarian preservation strategies should be considered during surgical planning.

Objective: To predict preeclampsia by the ratio of the HCG MoM value in the first and second trimester screening tests. Material and Methods: The HCG-MoM values of 136 pregnant women with preeclampsia and 222 normatensive pregnant women used for first- and second-trimester screening tests were proportioned , and the difference between the groups was examined. Results: The ratio of the free HCG MoM value in the first trimester to the intact HCG MoM value in the second trimester was significantly higher in the control group (1.06) than in the study group (0.99) (p=0.02). Conclusion: Rating the MoM values of β-HCG, a biochemical marker used in screening tests for chromosomal anomaly, may predict preeclampsia in the later weeks of pregnancy.

Infectious complications at the surgical site complicates 1–4% of cesarean deliveries. Strict aseptic technique, hand hygiene and the use of sterile surgical gloves are essential to reduce the risk of surgical site contamination. Glove perforations are observed in almost 30% of all procedures and represent an underestimated potential risk factor for postoperative infections. The aim of this prospective study was to investigate glove perforation rates in cesarean deliveries and to analyze the impact of unrecognized glove perforations during surgery on surgical site infection rates after cesarean delivery. Surgical gloves from cesarean section were collected prospectively. All gloves were inspected for perforation holes. Cases in which surgical gloves had visible (macro) perforations were excluded from the study. Remaining gloves were examined using a water-fill test. Gloves with a positive water filling test were defined as the study group and negative gloves as the control group. Superficial Surgical Site Infections (SSI) were analyzed for the groups. A total of 1,779 pairs of used surgical gloves were collected and examined for perforations across 593 cesarean operations. Macro perforation were observed in 56 (9.4%) operations. The remaining 1,611 pairs of gloves underwent water-fill testing. Of these, 505 operations had completely intact gloves, while in 32 (5.4%) cases, micro-perforations were identified. SSI occurred in 18 women (3.3%): 7 in the perforation group (21.8%) and 11 in the control group (2.2%) (p < 0.001). In multivariable logistic regression analysis, glove micro-perforation was found to be a significant independent predictor of SSI (adjusted odds ratio: 12.705; 95% CI: 4.244–38.039; p < 0.001), even after adjusting for potential confounders including diabetes, obesity, emergency cesarean, operative duration, and intraoperative blood loss. Our data show that glove perforation is unexpectedly common and underestimated in terms of unfavorable surgical outcomes. The rate of surgical site infections is increasing and we suggest that unrecognized glove perforation must be considered as a risk factor for surgical site infection after cesarean section.