Aim: We aimed to prospectively investigate the effect of first trimester vaginal bleeding on first trimester screening test, uterine artery (UtA) Doppler results and perinatal outcomes. Material and Methods: Fifty cases that presented with vaginal bleeding in the first trimester between 2019 and 2020 constituted the early vaginal bleeding (abortus imminens-threatened abortion) group and fifty cases without a history of vaginal bleeding in pregnancy constituted the control group. Demographic datas were noted at the first visit. Both groups were followed up until birth. First trimester screening test (double screening test) between 11-14 weeks and UtA Doppler examination between 20-24 weeks of gestation was performed. Perinatal outcomes and values of nuchal translucency (NT), free β human chorionic gonadotropin (f β-hCG), pregnancy-associated plasma protein A (PAPP-A), and UtA Doppler were compared between the two groups. Results: There was no statistically significant difference was found between the two groups in terms of NT and PAPP-A among the first trimester screening test results (p=0.741 and p=0.937, respectively). In the group with threatened miscarriage, f β-hCG value was numerically higher, but there was no statistically significant difference (1.24±0.59 vs. 1.1±0.93, p=0.057). In the Doppler examination of the UtA, there was no statistically significant difference between the groups in terms of systolic/diastolic ratio, pulsatility index, resistive index and the presence of a notch (p=0.713, p=0.528, p=424, p=0.538, respectively). Perinatal complication rate was statistically significantly higher in the study group (p=0.013; Odds Ratio:3.2, 95% CI 1.2-8.3). Conclusion: Contrary to some different studies, we believe that first trimester screening test parameters or uterine artery Doppler flow indices do not have a place in predicting perinatal outcomes of pregnant women with a history of vaginal bleeding in the first trimester. In addition, early vaginal bleeding does not significantly affect screening parameters. Perinatal complication rate was found to be statistically significantly higher in the group with a history of threatened miscarriage.

Objectives: To reveal the effect of surgeon's experience on the outcomes of the total laparoscopic hysterectomy (TLH) surgery. Material and methods: Design: Retrospective case series. Setting: A tertiary care university hospital. Patients: 1295 cases with an indication for hysterectomy. Interventions: Total laparoscopic hysterectomy. Results: All cases were grouped according to the surgeon’s experience. For 30 different surgeons, their first 20 operations constituted Group A, 21^st–50^th operations Group B, 51^st–100^th operations Group C, and their operations after the 100^th surgery Group D. Demographic data and post-operative results were compared between the groups. There were no statistical differences in terms of demographic data and major complications. A statistically significant decrease was observed in the post-operative fall in hemoglobin level and the duration of hospitalization in the groups with increased experience (p = 0.021, p < 0.001, respectively). There wasn’t an increase in uterine specimen weight with increased experience (p = 0.267). Conclusions: We obtained that the peak value in the learning curve cannot be evaluated according to the operation time or complication rates. Although the complication rate seems unaffected by surgical experience, concerns about complications may decrease as experience increases. Since the trend of minimally invasive surgery will continue increasingly in the next century because of higher patient comfort, all gynecologists should gain competence in endoscopic surgery. Objectives: To reveal the effect of surgeon's experience on the outcomes of the total laparoscopic hysterectomy (TLH) surgery. Material and methods: Design: Retrospective case series. Setting: A tertiary care university hospital. Patients: 1295 cases with an indication for hysterectomy. Interventions: Total laparoscopic hysterectomy. Results: All cases were grouped according to the surgeon’s experience. For 30 different surgeons, their first 20 operations constituted Group A, 21^st–50^th operations Group B, 51^st–100^th operations Group C, and their operations after the 100^th surgery Group D. Demographic data and post-operative results were compared between the groups. There were no statistical differences in terms of demographic data and major complications. A statistically significant decrease was observed in the post-operative fall in hemoglobin level and the duration of hospitalization in the groups with increased experience (p = 0.021, p < 0.001, respectively). There wasn’t an increase in uterine specimen weight with increased experience (p = 0.267). Conclusions: We obtained that the peak value in the learning curve cannot be evaluated according to the operation time or complication rates. Although the complication rate seems unaffected by surgical experience, concerns about complications may decrease as experience increases. Since the trend of minimally invasive surgery will continue increasingly in the next century because of higher patient comfort, all gynecologists should gain competence in endoscopic surgery.

Objective: The aim of this study is to compare the maternal and perinatal outcomes of twin adolescent pregnancies and twin adult pregnancies. Material and Methods: A study was conducted on twin pregnancies delivered between 2014 and 2019 in tertiary hospital. Twin pregnancies between 10 and 19 years old were classified as the adolescent group (study group) and 20 and 34 years old were classified as the control group. Results: Our study included 54 adolescent twin pregnancies and 818 control group twin pregnancies. The adolescent group delivering approximately 1 week earlier compared with the control group (p=0.023). The adolescent group had approximately 2.3 times higher risk in terms of moderate preterm (28-34 weeks) [OR, 2.34; 95% [CI], 1.34-4.09; p=0.002]. Anemia was significantly higher in adolescents (p=0.039). When 105 live newborns from the adolescent group were compared with 1601 newborns from the control group, the birth weight of the newborns in the adolescent group was 191 g less on average, their height was 1.3 cm shorter on average, and their head circumference was 1 cm smaller on average (p=0.001, p=0.002, and p=0.002, respectively). The adolescent newborns had an approximately 3.1 times increased prevalence of LBW [OR, 3.13; 95% [CI], 1.73-5.65; p<0.001). The fifth-minute APGAR scores were lower in newborns from the adolescent group (p=0.026). Moreover, the need for neonatal intensive care was higher in the adolescent group (p=0.033). Conclusion: Adolescent twin pregnancies should be considered at high risk because of obstetric complications and poor pregnancy outcomes.

Pelvic adhesions are a common consequence of prior abdominal surgery, endometriosis, malignancy, or infection, often leading to infertility, chronic pelvic