Serife Suna Oguz

Dr. Zekai Tahir Burak Women's Health Research and Education Hospital, Engüri, Ankara, Turkey

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Publications (143)181.43 Total impact

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    ABSTRACT: We report an infant who developed encephalopathy within the first 3 days of life. He had persistent hiccups that progressed to deep coma 72 hours after admission. The sepsis parameters and cerebrospinal fluid examination (CSF) were normal. The metabolic evaluation confirmed hyperammonemia, and hypercitrullinemia. The ratio of CSF/plasma glycine concentration was normal. This did not agree with our initial diagnosis of nonketotic hyperglycinemia where hiccups is present more often. Neonatal onset of argininosuccinic acid synthetase deficiency (ASD; citrullinemia) should be brought in mind in the differential diagnosis of encephalopathy in association with hiccups in the neonatal period suggesting inborn errors of metabolism.
    Archivos argentinos de pediatria. 10/2014; 112(5):e206-e208.
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    ABSTRACT: Twin anemia/polycythemia sequence (TAPS) is characterized by large intertwin hemoglobin (Hb) differences without signs of twin oligopolyhydramnios. The spontaneous form complicates approximately 3-5% of monochorionic twin pregnancies. TAPS placentas are characterized by the presence of only very few and small unidirectional arteriovenous anastomoses, which allow a slow transfusion of blood from the donor to the recipient, gradually leading to highly discordant Hb levels. Neonatal morbidity in TAPS appears to be mainly limited to hematological problems at birth. Donor twins may be severely anemic and require blood transfusions, whereas recipient twins may be severely polycythemic and require partial exchange transfusion (PET). We herein report monochorionic twins with TAPS: the anemic twin was transfused with the blood concomitantly obtained from the polycythemic co-twin during PET. To our knowledge this is the first therapeutic approach using a recipient twin's whole blood as a donor source instead of a foreign blood donor. In this case, we have approached this recently (un)known form of chronic fetofetal transfusion from a different aspect. In our opinion, this will lead to new postnatal therapeutic approaches for optimal TAPS management. © 2014 S. Karger AG, Basel.
    Fetal Diagnosis and Therapy 07/2014; · 1.90 Impact Factor
  • Genetic counseling (Geneva, Switzerland) 01/2014; 25(1):75-6. · 0.32 Impact Factor
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    ABSTRACT: To compare the efficacy and safety of oral paracetamol and oral ibuprofen for the pharmacological closure of patent ductus arteriosus (PDA) in preterm infants. This prospective, randomized, controlled study enrolled 90 preterm infants with gestational age ≤30 weeks, birthweight ≤1250 g, and postnatal age 48 to 96 hours who had echocardiographically confirmed significant PDA. Each enrolled patient received either oral paracetamol (15 mg/kg every 6 hours for 3 days) or oral ibuprofen (initial dose of 10 mg/kg, followed by 5 mg/kg at 24 and 48 hours). Spontaneous closure rate for the entire study group was 54%. After the first course of treatment, the PDA closed in 31 (77.5%) of the patients assigned to the oral ibuprofen group vs 29 (72.5%) of those enrolled in the oral paracetamol group (P = .6). The reopening rate was higher in the paracetamol group than in the ibuprofen group, but the reopening rates were not statistically different (24.1% [7 of 29] vs 16.1% [5 of 31]; P = .43). The cumulative closure rates after the second course of drugs were high in both groups. Only 2 patient (2.5%) in the paracetamol group and 3 patients (5%) in the ibuprofen group required surgical ligation. This randomized, controlled clinical study compared oral paracetamol with ibuprofen in preterm infants and demonstrated that paracetamol may be a medical alternative in the management of PDA.
    The Journal of pediatrics 12/2013; · 4.02 Impact Factor
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    ABSTRACT: To evaluate the effect of oral Lactobacillus reuteri (L reuteri) first on the incidence and severity of Necrotising enterocolitis (NEC) and second on sepsis. Prospective randomised controlled study. Tertiary neonatal intensive care unit. Preterm infants with a gestational age of ≤32 weeks and a birth weight of ≤1500 g were included (n=400). Infants in the first group were given 100 million CFU/day (5 drops) of lyophilised L reuteri (DSM 17938) mixed in breast milk or formula, starting from first feeding until discharge. Participants in the control group were given a placebo. To determine and compare the frequency of NEC and/or death after 7 days, frequency of proven sepsis, rates of feeding intolerance and duration of hospital stay. There was no statistically significant difference between groups in terms of frequency of NEC stage ≥2 (4% vs 5%; p=0.63) or overall NEC or mortality rates (10% vs 13.5%; p=0.27). Frequency of proven sepsis was significantly lower in the probiotic group compared to the control group (6.5% vs 12.5%; p=0.041). A significant difference was also observed with regard to rates of feeding intolerance (28% vs 39.5%; p=0.015) and duration of hospital stay (38 (10-131) vs 46 (10-180) days; p=0.022). Our results show that oral L reuteri does not seem to affect the overall rates of NEC and/or death in preterm infants followed up in the neonatal intensive care unit, and significant reductions were observed in the frequency of proven sepsis, rates of feeding intolerance and duration of hospital stay. NCT01531179.
    Archives of Disease in Childhood - Fetal and Neonatal Edition 12/2013; · 3.45 Impact Factor
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    ABSTRACT: To determine the risk factors associated with lower respiratory tract infections (LRTI) related hospitalizations in preterm infants receiving palivizumab throughout the high season for respiratory syncytial virus (RSV) infection.
    Iranian Journal of Pediatrics 12/2013; 23(6):693-700. · 0.26 Impact Factor
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  • Neonatology 11/2013; 105(1):25. · 2.57 Impact Factor
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    ABSTRACT: Abstract Objective To determine the effect of delivery type on macronutrient content of colostral milk. Material and Methods The study was conducted at Zekai Tahir Burak Maternity Teaching Hospital. Colostral milk samples from term lactating mothers who gave birth by vaginal or cesarean delivery (CD) were obtained on the 2nd postpartum day. Milk protein, fat, carbohydrate (CHO) and energy levels were measured by using a mid-infrared human milk analyzer. Results A total of 204 term lactating mothers were recruited to the study; 111 mothers gave birth by vaginal route and 93 mothers by CD. Protein levels were statistically lower in colostral milk of mothers after CD compared to mothers who delivered vaginally (median 2.4 (range 0.3-6.4) gr/dl vs 3 (0.5-6.3) gr/dl, respectively; p=0.036). Colostral fat, CHO and energy levels were similar between groups. In linear regression analysis, CD and maternal age were independently associated with lower protein content in colostrum. Conclusion Vaginal delivery is associated with higher colostrum protein content. Hormonal activity induced by labor pain and uterine contractions might account for the alterations in the protein composition of human milk to facilitate optimal development of important physiologic functions in newborns.
    The journal of maternal-fetal & neonatal medicine: the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians 10/2013; · 1.36 Impact Factor
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    ABSTRACT: Abstract Background and objectives: Chorioamnionitis is an acute inflammation of the membranes and chorion of the placenta. The aim of this study was to determine the effect of histological chorioamnionitis on the short-term outcome of preterm infants. Subjects and methods: The clinical characteristics and outcomes of the preterm infant including respiratory distress syndrome, duration of mechanical ventilation, patent ductus arteriosus requiring medical treatment or ligation, necrotizing enterocolitis, bronchopulmonary dysplasia, death and intraventricular hemorrhage (grade III-IV) were analyzed. Results: Two hundred and eighty-one infants born at ≤32 weeks gestational ages were included. Infants were divided into two groups: one with histological chorioamnionitis (n=145) and without histological chorioamnionitis (n=136). Mean gestational age was 28.8±2.6 weeks and 29.1±2.5 weeks, and mean birth weight was 1138±350 g and 1210±299 g, respectively. There were no differences in gestational age and birth weight among the groups. Compared with the group, histological chorioamnionitis was associated with early onset sepsis (p=0.007), patent ductus arteriosus (p=0.003), intraventricular hemorrhage (p=0.03), and death (p=0.04). Conclusion: Maternal histological chorioamnionitis is an important risk factor for preterm deliveries and associated with serious morbidities such as early onset sepsis, intraventricular hemorrhage, patent ductus arteriosus and increased mortality.
    The journal of maternal-fetal & neonatal medicine: the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians 10/2013; · 1.36 Impact Factor
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    ABSTRACT: Objectives and aim: Very low birth weight infants require 3 - 4 g/kg/day protein intake to provide satisfactory postnata growth rates and neurodevelopmental outcomes. However, they have fewer functional nephrons, thereby increasing vulnerability for impaired renal functions. The aim of this study was to investigate the effect of different amounts of enteral protein intake during the fortification of human milk on renal glomerular and tubular functions. Material and methods: Preterm infants were randomized into three groups in terms of their daily protein intake: standard fortification (3 g/kg/d), moderate fortification (3.3 g/kg/d), and aggressive fortification (3.6 g/kg/d). Serum urea, creatinine (Cr), Cystatin C (Cys-C) and urinary β2 microglobulin (β2M) levels were assessed and compared between groups. Results: Serum urea, Cr, Cys-C and urinary β2M levels were similar in all three groups, both on discharge and postnatal Day 14 (p > 0.05). Mean Cr and β2M levels were significantly lower on discharge (p < 0.05), while Cys-C levels did not differ in time (p > 0.05). Conclusion: Enteral protein intake up to 3.6 g/kg/d did not alter the tubular and glomerular functions in very preterm infants. However, the long-term renal effects in these infants maintained on a high protein intake remain unknown and should be addressed in future studies.
    Clinical nephrology 10/2013; · 1.29 Impact Factor
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    ABSTRACT: Evidence that oxidative stress plays a role in the development of bronchopulmonary dysplasia (BPD). There is a close relationship between oxidative stress and inflammation. In this study, it is aimed to investigate influences of hydrocortisone used in the treatment of BPD on anti-oxidant system in preterm infants with BPD. The study enrolled 33 infants with severe BPD who were undergone inpatient treatment in neonatal intensive care unit (NICU) of our Hospital and received therapy with hydrocortisone. Total oxidant status (TOS) and total anti-oxidant capacity (TAC) levels of infants enrolled to the study before and one week after the hydrocortisone therapy were studies and oxidative stress index levels were calculated. Pre- and post-treatment TOS, TAC and OSI index levels were statistically compared. In preterm infants with BPD, who were enrolled into the study, TOS and OSI index were found high, whereas TAC values were low. Following the treatment with hydrocortisone, statistically significant decrease in TOS and OSI index and statistically significant elevation in TAC levels were found in comparison with pre-treatment levels. The treatment with hydrocortisone, which is used for BPD, improves anti-oxidant system and reduces oxidative stress in infants with BPD. There is need for further studies in order to clarify the physio-pathogenesis.
    European review for medical and pharmacological sciences 10/2013; 17(19):2594-7. · 1.09 Impact Factor
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    ABSTRACT: Introduction: The aim of our study was to determine whether hydrocortisone even at low dose could be an effective and safe alternative treatment for bronchopulmonary dysplasia. Materials and Methods: This prospective pilot study was conducted in a tertiary referral neonatal intensive care unit placed in Ankara Zekai Tahir Burak Maternity Teaching Hospital. Preterm babies (> 32 week gestational age or > 1500 g birth weight) who were ventilator dependent approximately at or beyond three weeks of age (defined as rescue treatment) or were oxygen dependent on postmenstrual 36th week without evidence of any infection (defined as bronchopulmonary dysplasia treatment) were enrolled in the study. Hydrocortisone was used orally in an initial dose of 1 mg/kg twice a daily for a week and then the dose was tapered by 10-20% every other day regarding to clinical response. Results: A total of 90 infants were enrolled in this study. After hydrocortisone treatment only 3 (3.4%) patients were still on respiratory support. When safety of the drug was evaluated 8 (8.8%) infants had early complications of hydrocortisone treatment. Conclusion: To the best of our knowledge this study is the first trial in the literature along with the hydrocortisone dose and the initiation time in treatment of bronchopulmonary displasia.
    Tuberkuloz ve toraks 09/2013; 61(3):ilksayfa-sonsayfa.
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    ABSTRACT: The aim of red blood cell (RBC) transfusion is to improve tissue oxygenation and relieve anemia-related symptoms in preterm infants. We sought to assess regional cerebral (rSO2 C) and mesenteric (rSO2 M) tissue oxygenation using a near-infrared spectroscopy (NIRS) method and vital signs (heart rate, arterial oxygen saturation, mean arterial blood pressure) in symptomatic preterm infants with anemia who received RBC transfusions. Twenty-three symptomatic patients with anemia who were at least 1 month old, whose gestational age was less than 30 weeks, and whose hematocrit level was not more than 27% were involved in the transfusion group. The control group consisted of preterm infants (Hct ≥ 32) matched for gestational age and postnatal days. The transfusion group was divided into two subgroups based on transfusion duration (2 or 4 hr). Both study groups were monitored for vital signs and rSO2 C, rSO2 M, and mesenteric-cerebral oxygenation ratio (MCOR) via NIRS for 24 hours simultaneously and compared with the control group. NIRS variables and vital signs obtained before, during, and after transfusion were compared both within and between 2- and 4-hour groups. rSO2 C, rSO2 S, and MCOR increased during and after transfusions, while cerebral fractional oxygen extraction (FOEC) and mesenteric fractional oxygen extraction (FOEM) decreased. No significant difference was found between subgroups for NIRS measurements and vital signs. A weak correlation between hemoglobin concentration and FOEC and FOEM was found. RBC transfusion improved cerebral-mesenteric oxygenation and MCOR in symptomatic infants with anemia, independent of the transfusion duration.
    Transfusion 07/2013; · 3.53 Impact Factor
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    ABSTRACT: Abstract Objective: Surfactant treatment in the early hours of life significantly decreases the rates of death and air leak, and increases survival without bronchopulmonary dysplasia (BPD) in preterm infants. We aimed to compare the impact of early surfactant (ES) administration to late selective (LS) treatment on neonatal outcomes in preterm infants. Methods: All preterm infants between 25 and 30 wks gestational age and who were not entubated in the delivery room and did not have any major congenital malformation or perinatal asphyxia were randomized to ES treatment (200 mg/kg Curosurf® administration in 1 hour after birth) or LS treatment (200 mg/kg Curosurf® administration in the first 6 hours of life). The patients were treated by nasal continuous positive airway pressure (nCPAP) treatment regardless of the surfactant requirement. Outcomes were the necessity of mechanical ventilation, nCPAP duration, the oxygen requirement duration, the rates of BPD, retinopathy of prematurity (ROP) and mortality, and the assesment of the following situations; (pneumothorax, patent ductus arteriosus (PDA), necrotizing enterocolitis (NEC), and intraventricular hemorrhage (IVH) ≥ grade III). Results: Among 159 infants enrolled in the study, 79 were randomized to ES and 80 to LS treatment groups. Thirty-five patients (44%) in the LS treatment group needed surfactant administration. Necessity of second dose surfactant administration was 8.9% in the ES treatment group. Although necessity of mechanical ventilation, nCPAP duration, oxygen need duration, rates of PDA, NEC, BPD, ROP stage >3 and mortality did not show a significant difference between groups, the ES treatment group had lower rates of pneumothorax and IVH≥ grade III when compared to the LS treatment group. Conclusions: ES treatment decreases IVH (≥ grade III) and pneumothorax rates but does not have any effect on BPD when compared to LS.
    The journal of maternal-fetal & neonatal medicine: the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians 06/2013; · 1.36 Impact Factor
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    ABSTRACT: Abstract Background: Hemodynamically significant patent ductus arteriosus (PDA) is a common problem in preterm infants which often causes significant morbidities. Although PDA induces alterations in various tissue perfusion, there is scarce information about the effect of oral ibuprofen on hemodynamics of regional tissues. Objective: To investigate, using near-infrared spectroscopy, the effect of oral ibuprofen on renal and mesenteric tissue oxygenation and oxygen extraction in preterm infants with a diagnosis of hemodynamically significant PDA. Patients and Methods: Fifteen infants (gestational age < 32 weeks) with the diagnosis of hemodynamically significant PDA treated with oral ibuprofen were monitored for near-infrared spectroscopy - determined renal and mesenteric oxygenation. The infants with PDA were matched for gestational age, postnatal age with infants without PDA, who served as control subjects. Results: In infants with PDA, mean arterial blood pressure was significantly lower compared with the control infants [39.3 (range:36-54) vs 51 (range:43-66) mmHg, respectively; p<0.001)]. There were no significant differences in regional oxygen saturation and fractional oxygen extraction of renal and mesenteric tissues in PDA and control infants (p>0.05). And ibuprofen treatment did not negatively influence renal and mesenteric oxygenation and extraction in infants with PDA (p>0.05). Conclusion: Renal and mesenteric tissue oxygenation and oxygen extraction were preserved in preterm infants with a diagnosis of hemodynamically significant PDA treated with oral ibuprofen.
    The journal of maternal-fetal & neonatal medicine: the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians 06/2013; · 1.36 Impact Factor
  • Z Eras, S S Oguz, U Dilmen
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    ABSTRACT: Gastroesophageal reflux disease (GERD) may occur with poor weight gain, esophagitis, hematemesis and respiratory problems in an infant. Common treatment strategies include positioning, feeding thickeness, histamine2 receptor antagonists, antiacids, and prokinetics. Metoclopramide is a prokinetic drug used to treat GERD and it has been reported to be a most commonly prescribed medication in neonatal intensive care unit (NICU). This research involves a patient that was born at 30 weeks' gestation age and on the twentieth day of his admission, vomiting and gastric residuals were observed. All diseases which are related these symptoms were excluded. With no improvement observed following non-pharmacological interventions and metoclopramide was started with a dosage of 0.1 mg/kg, per dose 12 hours. After the second dose of metoclopramide, dystonic reactions occured. The premature infant was evaluated for differential diagnosis of the abnormal movements. No abnormal findings were reported. The dystonic reactions didn't recur after metoclopramide was stopped. The observed adverse effects of metoclopramide in the preterm infant might be due to an excessive serum concentration of the drug as a result of its prolonged plasma clearance in this age group. Attention is drawn to the serious adverse effects of metoclopramide in the neonate, particularly premature infant.
    European review for medical and pharmacological sciences 06/2013; 17(12):1655-7. · 1.09 Impact Factor
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    ABSTRACT: OBJECTIVE/AIM: The present investigation was designed to study the effect of blood transfusion on cardiac output and perfusion index. The aim was to demonstrate a relationship between hematocrit, lactate, cardiac output and perfusion index in anemic preterm infants and to investigate significant changes in these parameters induced by RBC transfusion. METHODS: Anemic infants who were under 35weeks of gestational age (GA) and were in a stable clinical condition without respiratory or cardiac problems, signs of sepsis, or renal disease at the time of investigation were enrolled in the study. Enrolled infants received 15ml/kg pure red blood cells over 4h. Hematocrit and lactate levels were studied before and after transfusion. Cardiac output was measured by an ultrasound device (USCOM 1A) and perfusion index was monitored by pulse oximeter (MasimoRad7). RESULTS: Cardiac output decreased by 9% (p<0.05), due to decrease in heart rate by 10% (p<0.05) and stroke volume significantly by 5% (p<0.05) both in left and right sided cardiac measurements. Perfusion index significantly increased and lactate levels significantly decreased after transfusion (p<0.05). Htc was inversely correlated with lactate levels, HR, CI and CO (r=-0.33, p=0.01; r=-0.53, p=0; r=-0.37, p=0.004, r=-0.28, p=0.03). PI was not significantly correlated with Htc levels before and after transfusion (r=0.07, p=0.7 and r=0.007, p=0.97). CONCLUSION: Our data support that heart rate, CO and CI and lactate levels increased as a response to anemia in preterm infants and RBC transfusion improved perfusion index suggesting better tissue oxygenation.
    Early human development 05/2013; · 2.12 Impact Factor
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    ABSTRACT: BACKGROUND AND OBJECTIVES: Our aim was to evaluate fetal and maternal predisposing factors associated with clavicular fracture. PATIENTS AND METHODS: In this study we reviewed all term uncomplicated deliveries in our Hospital between January 2009 and April 2010. The diagnosis of clavicular fracture was established by physical examination and in clinically diagnosed patients confirmed by radiology. We compared deliveries with clavicular fracture (study group) with a sample of 150 patients (control group) matched for time at active phase of labor from all vaginal deliveries. The data included maternal age, gestational age, fetal weight, and infant sex, presence of gestational diabetes, labor duration and induction and shoulder dystocia. RESULTS: In the Unit 16819 deliveries occurred during the period. The study included 9700 uncomplicated pregnancies at > or = 37 weeks of gestation delivered vaginally. We identified 73 cases of clavicular fracture with an prevalence of (73/9700) 0.75%. The study group had a significantly higher prevalence of shoulder dystocia (6.8% vs. 0.6%). Logistic regression analysis revealed maternal age and fetal weight as significant risk factors influencing clavicular fractures. CONCLUSIONS: Main risk factors for clavicular fracture identified from our study seem as maternal age and birth weight.
    European review for medical and pharmacological sciences 05/2013; 17(9):1269-1272. · 1.09 Impact Factor
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    ABSTRACT: As scant information is present about the effect of water birth on newborns, we aimed to detect the fetal outcomes of water birth. A hundred and ninety one among totally 220 newborns who were born by water birth were enrolled. The demographic and clinical features of the patients, birth complications, infection rates and rates of neonatal intensive care unit attendance were evaluated. The mean gestational week and birth weight were 39.2±1.3 weeks and 3326±409 g. 26% of the mothers was primiparous. Birth trauma was observed in three patients (1.6%) as one brachial nerve paralysis, one cord rupture and one cephal hematoma. Six of the patients (3.1%) were admitted to neonatal intensive care unit (NICU); four of whom had respiratory tract problems. Water birth is a safe method of delivery for the neonates when certain criteria are met.
    European review for medical and pharmacological sciences 05/2013; 17(10):1395-8. · 1.09 Impact Factor

Publication Stats

242 Citations
181.43 Total Impact Points

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Institutions

  • 2008–2013
    • Dr. Zekai Tahir Burak Women's Health Research and Education Hospital
      Engüri, Ankara, Turkey
  • 2012
    • Turgut Özal University
      Malatia, Malatya, Turkey
  • 2011
    • Gazi University
      • Department of Pediatrics
      Ankara, Ankara, Turkey