Down’s syndrome (Mongolism) is an important chromosomal disorder which is encountered one 600-700 chance of conceiving a child in the society and can coexist with mental retardation and various anomalies. Therefore, all expectant mothers should be screened for Down’s syndrome. This screening is performed in two methods:

• Double test and nuchal translucency scan at 11 to 14 weeks of pregnancy
• Triple test at 16 to 18 weeks of pregnancy

Your physician who is in charge of your pregnancy care will inform you on the tests which are suitable for you. In the event that high risk is identified as a result of double test, performing chorionic villus sampling is recommended as an advanced test. As for triple test, amniocentesis is recommended as an advanced test in the event of high risk identification.

Considerations for double test and sonographic nuchal transculancy scan
Blood will be received and nuchal transculancy of the fetus will be measured with ultrasound within the dame day. You do not need to arrive with an empty stomach in order to give blood.

Considerations before triple test
Giving blood is sufficient for triple test. You do not need to come with an empty stomach. You should be sure of the date of your last menstruation, i.e. exact duration of your pregnancy, when you arrive for triple test. As ultrasound scan could be required as an addition if you are unsure, you should definitely inform your physician in such a case.

50-gram oral glucose tolerance test is performed at weeks 24 to 28 of pregnancy for gestational diabetes. Your physician will inform you during your outpatient clinic visit regarding when the test will be performed. 100-gram oral glucose tolerance test is performed on patients with abnormal results in 50-gram oral glucose tolerance test as well as patients who have the risk factors given below. The risk factors for gestational diabetes are:

• Excess weight

• Having a family history of diabetes

• Age greater than 30

• Diabetes in the previous pregnancy

• History of previous childbirth

• Existence of undesirable results of pregnancy

• Multiple pregnancy

In the event of existence of these risk factors, 100-gram oral glucose tolerance test is performed at the initial instant of application without waiting for weeks 24 to 28 of pregnancy. In the event of normal results, these tests are repeated at weeks 24 to 28.

Considerations before oral glucose tolerance test
For oral glucose tolerance test, the patient is requested to drink water which contains high amounts of sugar. Therefore, it is suggested that you bring along a lemon in order to facilitate drinking the water.

50-gram oral glucose tolerance test: The patient does not need to keep an empty stomach. A light breakfast is sufficient. Blood is taken from the patient 1 hour after drinking water with sugar.

100-gram oral glucose tolerance test: The patient needs to arrive with an empty stomach without having anything for breakfast. Fasting/preprandial blood glucose is checked at the outset and, after water with sugar is drunk, blood is taken for 3 more times with intervals of 1 hour.

Amniocentesis is most commonly performed at weeks 16 to 18 of pregnancy for early detection of inherited disorders and early diagnosis of Down’s syndrome in patients who have abnormal screening results. Your physician will inform you at your check-up visit regarding if amniocentesis is required during your pregnancy care. A small amount of liquid is received by introducing a very fine needle into the abdomen with no contact with the baby or placenta and the chromosomes of baby are observed in the liquid.

It is important that you bring along the medical materials which may include a special needle prescribed by your physician who requested the test. You should know your blood type as well as the blood type of your spouse as you will be asked by your physician.

Considerations before amniocentesis
You do not need to come with an empty stomach for amniocentesis, having a light breakfast is sufficient. When you arrive for amniocentesis, you should merely apply to Maternal-Fetal Medicine (next to Maternity Service) Unit located in Ward 81 along with your previous tests and results as well as your test form.

Cordocentesis involves procedures such as sampling blood or delivering blood transfusion through umbilical cord, particularly in high-risk pregnancies. Such a procedure should only be performed in places which have required equipment and host experienced specialists, like our university. Patients with such types of high-risk pregnancies can receive information from Maternal Fetal Medicine Unit via telephone during daytime.

Considerations for cordocentesis
Similar to amniocentesis, knowing the blood types of both parents is important before cordocentesis application. In addition, the patient should bring along previous tests and results. A light breakfast is sufficient, an empty stomach is not required. For cordocentesis, you should merely apply to Maternal-Fetal Medicine Unit (next to Maternity Service) located in Ward 81. You will be informed when your turn comes in the waiting room.

It is performed for diagnosing similar conditions which could be detected with amniocentesis, yet it can prove advantageous as it is performed in the earlier weeks. This test is most commonly performed before week 12 of pregnancy. Similar to the procedure of amniocentesis, a fine needle is introduced to the abdomen of the expectant mother in order to receive sample. Besides, please remember to bring along the special material which was previously prescribed from the physician who requested this test from you. Similar to amniocentesis and cordocentesis, you do not need to keep an empty stomach and a light breakfast is recommended. You should know your blood type as well as the blood type of your spouse.

Pap test involves scraping cervical cells with a special brush and examining these under microscope. This test ensures screening and early diagnosis of cervical cancer, which is the most common type of women’s cancer in our society. Anyone who is over 21 years old should receive a pap test 3 years after becoming sexually active. The test should be repeated periodically. When it is performed effectively, it is highly effective in the prevention of death caused by cervical cancer. You do not need to schedule a specific appointment for this test. This test is performed during outpatient clinic examination. Advanced evaluation is required for those who have abnormal test results.

Considerations before Pap test
As Pap test is performed in vagina, it can be delivered to women who are suitable for this examination. Avoiding engaging in sexual intercourse, using vaginal creams or cleansers 24 to 48 hours before Pap test is important.

Colposcopy is a method which enables observing the details which are not normally visible to eye, by means of magnification with a special microscope. Colposcopy is performed by the physicians in Gynecologic Oncology Unit, particularly for patients who have abnormal Pap test results. In the event of observing suspicious areas during colposcopy, a biopsy (specimen collection) procedure might need to be performed. These biopsies can also lead to treatment of the disease.

Considerations before colposcopic examination
You should bring along the form completed by your physician in charge of your examination in our outpatient clinic as well as your Pap test results. You do not need to come with an empty stomach for colposcopy and biopsy procedures unless otherwise is specifically requested. Similar to Pap test, avoiding engaging in sexual intercourse, using vaginal creams or cleansers 24 to 48 hours before colposcopy is required.

For colposcopy, you should merely wait in the waiting room upon your arrival on the date and time scheduled for your appointment after submitting your documents to the nurse in charge who can be found in Cancer Research Room directly at the entrance of Gynecology and Obstetrics Outpatient Clinic. You will be called by the authorized person when your turn comes.

Endometrial biopsy is the method of sampling which is practiced in order to shed a light on various diseases which could arise on the innermost layer of uterus. It is mainly performed in the event of post-menopausal bleeding or abnormal bleeding before menopause. Endometrial biopsy can be performed with local or general anesthesia upon patient request. This procedure is performed with local anesthesia in Family Planning Unit and Colposcopy Room within our department and it is performed with general anesthesia in the operating rooms unit of Ward 81 or in the operating rooms unit on floor A within Outpatient Surgical Department. Your physician recommending this test will give you detailed information about this procedure and where it will be performed.

Considerations before endometrial biopsy
For endometrial biopsy performed with local anesthesia, you should merely be readily available in the place stated to you on the previously scheduled time of appointment. After having a light breakfast, you should arrive with a person accompanying you, if possible.

For endometrial biopsy to be performed with general anesthesia, you should not eat or drink anything 6 to 8 hours before the procedure.

Laparoscopy is widely used for diagnosis and treatment of several diseases such as endometriosis, ectopic pregnancy, infertility and chronic groin pain. Special camera systems are introduced into the abdomen through incisions of 0.5 cm each in the belly area and the area below the underwear line and the entire surgical procedure is performed with a video system with special equipment. The substantial majority of patients are discharged within the same day, 2 to 3 hours after the procedure and food intake is allowed after 6 to 8 hours on the condition of starting with a fluid diet. In cosmetic terms, laparoscopic procedures also prove superior to open surgical procedures.

In our department, laparoscopy is performed in the operating room unit of Ward 81 or in the operating room unit on floor A within Outpatient Surgical Department. Your physician recommending you the procedure will inform you about its place and time.

Considerations before laparoscopy
You should keep an empty stomach (including not drinking water) as of 24:00 at night before laparoscopy procedure. As long as you arrive in the operating rooms unit stated to you on the given time, you will be given information about your pre-operative preparation after your required forms are completed by the secretary.

Hysteroscopy procedure involves examining cervix, inside of uterus and openings to the fallopian tubes with camera systems similar to, yet finer than those used in laparoscopy. Hysteroscopy procedure can be performed between days 6 to 12, the first day starting with day 1 of your menstruation. Practices such as vaginal cleansing, speculum and teneculum, which would cause discomfort and pain during the operation, are not used before the procedures classified as office hysteroscopy. Approximately 95% of these procedures do not require sedation or general anesthesia. However, you always have the chance for receiving anesthesia in the event that you feel pain during the procedure. Therefore, you are recommended to arrive for the procedure without eating or drinking anything as of 24:00. In scope of office hysteroscopy, diagnoses and treatments of infertility, irregular menstruation, cervical canal and uterine gland diseases can be performed simultaneously.

Considerations before hysteroscopy
As hysteroscopy is generally performed with local anesthesia, an entirely empty stomach is not required. Unless otherwise stated by your physician, you should merely wait in the waiting room after applying to the secretariat of Ward 81 operating rooms unit on the stated time. You should not be menstruating during hysteroscopy. Consult to your physician in the event of an overlap.

HSG test involves examining the interior of uterus and fallopian tubes. On contrary to other tests, this test is performed by an ob/gyn physician accompanied by a radiologist, in the department of radiology. Following an examination given by ob/gyn physician and a special radiopaque material introduced into the uterus, X-ray is taken for a few times. After these X-rays are approved by Radiology Department, reports are received from Radiology Department and brought to ob/gyn physician.

Considerations before HSG
You should apply to the obstetrics outpatient clinic with the special liquid prescribed to you and be available in the HSG room located in Radiology Department by bringing along the medical materials given to you in HSG room as well. You should give the materials to your physician here and wait in the waiting room. When your turn comes, your physician will contact you.

The patient should not be menstruating during HSG. The procedure can be performed between days 6 to 12, the first day starting with day 1 of your menstruation. An empty stomach is not required, having a light breakfast is recommended.

Our family planning services are provided within our outpatient clinic. Patients can receive information on various birth control methods and procedures such as intrauterine device (“spiral”) insertion are performed under outpatient clinic conditions by nurses and staff who have received training.

Please see “Appointments” section for your questions about family planning or receiving an appointment.

Considerations before Intrauterine Device (IUD) Insertion
For Intrauterine Device (IUD) insertion, patients who received an appointment and do not have a disease as far as concerned should apply to the authorized nurse in Family Planning Room located within Gynecology and Obstetrics Outpatient Clinic on the scheduled time of appointment.

Having a light breakfast is sufficient, coming with an empty stomach is not required. Also, if requested, the result of the pregnancy test conducted in blood and arriving for the test during menstruation are required.