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Gynecology & Obstetrics

In our Obstetrics and Gynecology Department, many families are enabled to have a healthy child and help is served all subjects concerning women health. While planning these services, in order to prevent the disease before they emerge, the important practical information for health of women and families are shared.

Some Situations in Pregnancy Leading to Decision of Caesarean Section

Those who gave a birth previously in caesarean section method
In cases where baby has a posture disorder or is too large In ladies whose hip nature does not allow a birth
In diseases preventing the mother candidate from pushing (such as various eye disorders, high blood pressure, herniated disk, orthopedic problems]
In incidents of babies with growth retardation
Those who had an operation of vagina contraction
In violent high levels of blood pressure developed during pregnancy
In incidents where the mother candidate cannot tolerate normal birth mentally or psychologically
In many of the twin, triplet births
In cases where placenta (that of the child] close the cervical area and thus birth way
In some cases that there is a known germ or disease in vagina (such as herpes or tumor)
In pregnancies in advanced years and as a result of severe endeavor such as tube baby

Infertility

It can appear as Lack of any pregnancy before or lack of repetition of pregnancy despite a previous pregnancy. In couples younger than 25 years, 2 years can be awaited in order to initiate the infertility examinations. On the other hand in infertility treatment it is necessary to continue the treatment protocol at least for 6 months.
Reasons for infertility: The reasons concerning men are 25-4-0%, concerning women 4-0-55%, concerning both sexes 10-15% and the unexplainable reasons are at a level of 10-15%. In other words, almost both parties of the couple are equally responsible for infertility.

Approach Towards a Couple Without Children

It is possible initially to reveal some reasons by holding a detailed meeting with the couple and carrying out a detailed examination. After this meeting, the basic examinations are initiated:
Firstly, an easy examination, that is spermogram, a sperm analysis, is carried out to asses the male.
In the next phase, it is investigated whether the female ovulates normally or not. Even though many methods are used today, it is investigated most widely today by means of blood analysis (third day of the period Later on the uterus of the female and its channels are assessed by means of a medicine x-ray (HSG -Hysterosalpingography). The bleeding due to changes in physiological conditions are called irregular bleeding. When using the term menstrual irregularity firstly regular menstrual bleeding and the underlying conditions for that should be defined.

Physiological Conditions for Regular Menstrual Bleeding

The stimulus coming from the brain to the ovary, the impact of this stimulus on ovary which in turn leads to release of estrogen and to ovulate, then the release of secondly important progesterone, having a normal uterus and genital system and psychological health of the female which in the end leads to periods lasting 3-7 days usually in every 21-35 days are acceptable in terms of normal levels.

Irregularities in the Period of Fertility

After a certain period during adolescence, the ovulation becomes regular and so do the periods. This is the period when the female might get pregnant and this period lasts until menopause. Indeed the regularities which necessitate treatment and lead women to see a gynecologic doctor are observed in this period.
The menstrual irregularities can occur by delays, interim bleedings, over-menstruation and its long or short period. The most encountered problem which appears as the very infrequent menstruation is the problem that we call Polycystic Over. In this disorder, due to a slowing down or halt in the growth of ovum, there appears a cyst and the ovum remains without cracking instead of growing and then cracking. This case repeats every month and the number of cysts in ovary thus increases. They can be accompanied by pubescence, acnes on face and overweight due to increase in testosterone. In an examination of ultrasonography, the typical ovary image is observed. Of course pregnancies of these kind of women have difficulties and frequently they need treatment.

Menstrual Delays

For every woman who has an active sexual life, when encountered with menstrual delays the primary issue to be considered is whether there is pregnancy. Second probable reason isthe failure of ovulation due to certain reason, and thus delays in menstrual bleeding.

Over-Menstrual Bleeding and Extended Periods

The increase in menstrual bleeding is indicative of a case necessitating a treatment. This increase will cause the female to be anemic as well as a deterioration of her general health. In such cases an examination by a gynecologist is required to state the underlying reasons.
The underlying reasons might be in relation with the genial tumors that we call myoma, hyperplasia, endometritis or polyp. All of them require the treatment of a physician. Especially in bleedings aftermath of an intercourse the problems in the uterus mouth and scars are frequently observed.
The most important approach here is to determination of the scar in terms of its relation with any cancer or pre¬cancer images. And this is possible by means of a scanning method called smear.

Bleeding after Menopause

In this period none of bleedings are normal and even though these bleedings can be a result of usually cell weakness it should not be forgotten that 10-15% of them are related to cancer; and thus they must be thoroughly examined. Samples from the inner uterus should be taken, outer uterus should be assessed well and medications should be investigated.

Myoma

Whenever you call tumor in uterus, they are primarily myoma. Myomas are genial tumor bodies which can be seen in uterus mouth, can grow in rectus tissues. They are mostly seen in woman at the age group between 35 and 45.
What are the complaints that myoma causes?
Myomas usually do not reveal symptoms
Over menstrual bleeding and extended periods
Interim bleedings between menstrual periods
Anemia due to loss of over bleeding
Over urine due to pressure upon the urinary
Panicula in stomach and cyst that can be sensed by hand
In menstrual periods or in the course of a sexual intercourse a pain towards the coccyx.
• General gynecological diseases
• Pregnancy and high risk pregnancy monitoring
• Routinedouble and quadruple screening tests in pregnancy
• Amniocentesis
• Four-dimensional Ultrasonography
• Monitoring menopause and osteoporosis
• Gynecologic oncology monitoring
• Laparoscopic operations for removal of uterine and ovary
• Laparoscopic surgeries for women’s cancers
• Laparoscopic treatment of uterine fibroid and ovarian cysts
• Chorionic villus sampling
• Urogynecological surgery (urinary incontinence)
• Single incision laparoscopic surgery (SILS) for treatment of uterine and ovarian disease
• Delivery

Gülin Okay

Gynecology & Obstetrics

Education Celal Bayar University Faculty of Medicineİzmir Tepecik Education and Research Hospital  &...

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İlkay N. Topaloğlu

Gynecology & Obstetrics

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L. Buket Saçkıran

Gynecology & Obstetrics

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Mehmet Bal

Gynecology & Obstetrics

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Volkan Emirdar

Gynecology & Obstetrics

Education Dokuz Eylül University Faculty Of MedicineIzmir Tepecik Education and Research Hospital Re...

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Zekeriya Güner

Gynecology & Obstetrics

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