Araştırma Makalesi
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Toxoplasma, Rubella, Cytomegalovirus Screening in Pregnant Women: Should We Do It?

Yıl 2021, Cilt 10, Sayı 4, 861 - 868, 29.12.2021
https://doi.org/10.37989/gumussagbil.801144

Öz

TORCH (Toxoplasma, Rubella, Cytomegalovirus) infections, also called perinatal or congenital infections, can transmit to the fetus and have a teratogenic effect. The aim of the study is to determine the prevalence of TORCH in pregnant women in Trabzon and to investigate the necessity of the test with cost analysis. The study was planned as a retrospective file research. Pregnant women who received outpatient or inpatient treatment at Trabzon Kanuni Training and Research Hospital Gynecology and Obstetrics Clinic between January 2014 and December 2018 were included. Age, gravida, parity, BMI (body mass index), gestational week, number of fetuses, and history were obtained from file scanning. TOX IgG/IgM, RV IgG/IgM, CMV IgG/IgM positivity and avidity data were obtained from laboratory analysis. Chi-square test was applied for significance according to age groups. A total of 15985 tests were performed. The mean age of those with anti TOX IgM positive was 27.31±3.45 years, those with anti rubella IgM positive were 28.23±4.53 years and those with anti CMV IgM positive were 29.01±4.76 years. There was no difference between the groups in the analysis of the data (p>0.05). Anti TOX IgG positivity in all tests 25.9% (n=4142), anti TOX IgM 1.53% (n=145), low avidity in anti TOX IgGM + 13.87% (n=34), anti RV IgG 94.8% (n=15149), anti RV IgM 1% (n=161), low avidity in anti RV IgGM+ 14.2% (n=23), anti CMV IgG 76.1% (n=12163) ), anti CMV IgM 1% (n=165), low avidity 0.1% (n=19) in anti CMV IgGM +s. Total test costs were found to be 554329 Turkish liras. In conclusion, it is recommended to screen for anti rubella IgG in the first trimester of pregnancy. Considering both the cost and the very low confirmatory test positivity in IgGM positives, screening for toxoplasma and CMV is not recommended.

Kaynakça

  • Madrid, L, Varo, R, Sitoe, A. and Bassat, Q. (2016). “Congenital and Perinatally-Acquired Infections in Resource-Constrained Settings”. Expert Rev Anti-Infect Ther, 14(9), 845-861.
  • Stegmann, B.J. and Carey, J.C. (2002). “TORCH Infections. Toxoplasmosis, Other (Syphilis, Varicella-Zoster, Parvovirus B19), Rubella, Cytomegalovirus (CMV), and Herpes Infections. Curr Womens”. Health Rep, 2 (4), 253-258.
  • Neu, N, Duchon, J. and Zachariah, P. (2015). “TORCH Infections”. Clin Perinatol, 42 (1), 77-103.
  • Jong, E.P.D, Vossen, A.C.T.M, Walther, F.J. and Lopriore, E. (2013). “How to Use… Neonatal. TORCH Testing”. Arch Dis Child Educ Pract Edit, 98 (3), 93-98.
  • Pappas, G, Roussos, N. and Falagas, M.E. (2009). “Toxoplasmosis Snapshots: Global Status of Toxoplasma Gondii Seroprevalence and Implications for Pregnancy and Congenital Toxoplasmosis”. Int J Parasitol, 39, 1385-1394.
  • Thie´baut, R, Leproust, S, Cheˆne, G. et al. (2007). “Effectiveness of Prenatal Treatment for Congenital Toxoplasmosis: A Meta-Analysis of Individual Patients’ Data”. Lancet, 369, 115-122.
  • Bahar, İ.H, Karama, M, Kırdar, S, Yılmaz, Ö, Celiloğlu, M. ve Mutlu, D. (2005). “Gebelikte Toxoplasmosis Tanısında Anti-Toxoplasma gondii Ig M, IgG, IgA Antikor ve IgG Avidite Testlerinin Birlikteliği ve Önemi”. Türkiye Parazitoloji Dergisi, 29 (2), 76-79.
  • Devakumar, D, Gibson, C.S, Bamford, A, Ferreira, M.U. et al. (2018). “Infectious Causes of Microcephaly: Epidemiology, Pathogenesis, Diagnosis, and Management”. Lancet Infect Dis, 18, 1-13.
  • Gibson, C.S, MacLennan, A.H, Goldwater, P.N, Haan, E.A, Priest, K and Dekker, G.A. (2006). “South Australian Cerebral Palsy Research Group. Neurotropic Viruses and Cerebral Palsy: Population Based Casecontrol Study”. BMJ, 332, 76-80.
  • Tastad, K.J, Schleiss, M.R, Lammert, S.M. and Basta, N.E. (2019). “Awareness of Congenital Cytomegalovirus and Acceptance of Maternal and Newborn Screening”. PLoS One. 14:e0221725.
  • Ornoy, A. and Diav-Citrin, O. (2006). “Fetal Effects of Primary and Secondary Cytomegalovirus Infection in Pregnancy”. Reprod Toxicoli, 21, 399-409.
  • Yılmazer, M, Altındiş, M, Cevrioğlu, S, Fenkçi, V, Aktepe O. and Sırthan, E. (2004). “Toxoplasma, Cytomegalovirus, Rubella, Hepatitis B and Hepatitis C Seropositivity Rates in Pregnant Women Who Live in Afyon Region”. The Medical Journal of Kocatepe, 5, 49-53.
  • Obut, M, Doğan, Y, Bademkıran, M.H, Akgöl, S, Kahveci, B, Peker, N. et al. (2019). “Toxoplasma, Rubella and Cytomegalovirus Seroprevalence in Pregnant Women in Diyarbakir”. Dicle Med J, 46 (2), 7.
  • Şentürk, Ş, Kağıtcı, M, Balık, G, Şahin, K. and Şahin, F.K. (2016). “Seroprevalence of Rubella Virus among Pregnant Women in Eastern Black Sea Region”. Van Medical Journal, 23 (3), 242-245.
  • Çeltek, N.Y, Tetikçok, R, Günal, Ö, Demirtürk, F, Duygu, F, Barut, H.Ş. et al. (2014). “Seroprevalence for Rubella, CMV and Toxoplasmosis among Pregnant Women in Central Black Sea Region of Turkey”. Gaziosmanpaşa Üniversitesi Tıp Fakültesi Dergisi, 6 (1), 54-62.
  • American College of Obstetricians and Gynecologists. (2015). “Practice bulletin no. 151:Cytomegalovirus, Parvovirus B19, Varicella Zoster, and Toxoplasmosis in Pregnancy”. Obstet Gynecol, 125, 1510-1525.
  • Kale, İ, Bayık, R.N, Uluutku, G.B. and Ergin, B. (2020). “Is routine TORCH Screening Necessary for Pregnancy Follow-Up?”. Turk J Womens Health Neonatol, 2 (4), 115-121
  • Yamamoto, R, Ishii, K, Shimada, M. et al. (2013). “Significance of Maternal Screening For Toxoplasmosis, Rubella, Cytomegalovirus and Herpes Simplex Virus Infection in Cases of Fetal Growth Restriction”. J Obstet Gynaecol Res, 39, 653-657.
  • Chung, M.H, Shin, C.O. and Lee, J. (2018). “TORCH (Toxoplasmosis, Rubella, Cytomegalovirus, and Herpes Simplex Virus) Screening of Small For Gestational Age and Intrauterine Growth Restricted Neonates: Efficacy Study in A Single Institute in Korea”. Korean J Pediatr, 61 (4), 114-120.
  • Çoşkun, B, Gülümser, Ç, Çoşkun, B, Artuk, C. and Karaşahin, K.E. (2020). “Impact of Syrian refugees on Congenital TORCH Infections Screening in Turkey”. J Obstet Gynaecol, Res 46 (7), 1017-1024.
  • Halawa, S, McDermott, L, Donati, M. and Denbow, M. (2014). “TORCH Screening in Pregnancy. Where Are We Now? An Audit of Use in a Tertiary Level Centre”. Journal of Obstetrics and Gynaecology, 34, 309-312.
  • Villard, O, Breit, L, Cimon, B. et al. (2013). “French National Reference Center for Toxoplasmosis Network. Comparison of Four Commercially Available Avidity Tests for Toxoplasma Gondii-Specific IgG Antibodies”. Clin Vaccine Immunol, 20 (2), 197-204.
  • T.C. Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü. (2020) Ankara: 2020 Yılı Fiyat Tarifeleri ve Analiz Bilgileri Rehberi.
  • Nazik, S, Duran İ, Nazik, H. and Duran, Ş. (2017). “Evaluation of Toxoplasma and Rubella Seropositivity in Pregnancy”. Balıkesir Medical Journal ,1(1), 22-25.
  • Bakacak, M, Bostancı, S.M, Köstü, B, Ercan, Ö, Avcı, S.F. and Bakacak Z. (2014). “Seroprevalance of Toxoplasma Gondii, Rubella And Cytomegalovirus among Pregnant Women”. Dicle Medical Journal, 41 (2), 326-331.
  • Craig, P.G, Halvorsen, J, Golemon, T.B. and Anthony, A.D. (2005). “Management of Spontaneous Abortion”. Am Fam Physician, 72(7), 1243-1250.
  • Leeper, C. and Lutzkanin, A. (2018). “Infections During Pregnancy”. Prim Care, 45 (3), 567-586.
  • Staras, S.A.S, Flanders, W.D, Dollard, S.C, et al. (2008). “Cytomegalovirus Seroprevalence and Childhood Sources of Infection: a Population-Based Study among Preadolescents in the United States”. J Clin Virol, 43, 266-271.
  • Silasi, M, Cardenas, I, Racicot, K, Kwon, J, Aldo, P. and Gil, M. (2015). “Viral Infections during Pregnancy”. Am J Reprod Immunol, 73 (3), 199–213.
  • İnci, A, Yener, C. and Güven, D. (2014). “The Investigation of Toxoplasma, Rubella and Cytomegalovirus Seroprevalancies in Pregnant Women in A State Hospital”. Pam Tıp Derg, 7 (2), 143-146.

Gebelerde Toxoplazma, Rubella, Sitomegalovirüs Taraması: Yapalım Mı?

Yıl 2021, Cilt 10, Sayı 4, 861 - 868, 29.12.2021
https://doi.org/10.37989/gumussagbil.801144

Öz

Perinatal veya konjenital enfeksiyonlar olarak da adlandırılan TORCH (Toksoplazma, Rubella, Sitomegalovirüs) enfeksiyonları fetüse bulaşarak teratojen etki gösterebilir. Çalışmadaki amaç, Trabzon ilindeki gebelerde TORCH prevalansını saptamak ve maliyet analizi ile testin gerekliliğini araştırmaktır. Çalışma retrospektif dosya araştırması şeklinde planlanmıştır. Ocak 2014 ve Aralık 2018 yılları arasında Trabzon Kanuni Eğitim ve Araştırma Hastanesi Kadın Hastalıkları ve Doğum Kliniğinde ayaktan ya da yatarak tedavi almış gebe kadınlar dahil edilmiştir. Dosya taramasından yaş, gravida, parite, VKİ (vücut kitle indeksi), gebelik haftası, fetüs sayısı, özgeçmiş elde edilmiştir. Laboratuvar analizinden TOX IgG/IgM, RV IgG/IgM, CMV IgG/IgM pozitifliği ve avidite verileri elde edilmiştir. Yaş gruplarına göre anlamlılık için ki kare test uygulanmıştır. Toplam 15985 test yapılmıştır. Anti TOX IgM pozitif olanların yaş ortalaması 27,31±3,45, anti rubella IgM pozitif olanların 28,23±4,53, anti CMV IgM pozitif olanların ki ise 29,01±4,76 idi. Verilerin analizinde gruplar arasında fark yoktu (p>0,05). Anti TOX IgG pozitifliği tüm testlerde %25,9 (n=4142), anti TOX IgM %1,53 (n=145), anti TOX IgGM +’lerde düşük avidite %13,87 (n=34), anti RV IgG %94,8 (n=15149), anti RV IgM %1 (n=161), anti RV IgGM +’lerde düşük avidite %14,2 (n=23), anti CMV IgG %76,1 (n=12163), anti CMV IgM %1 (n=165), anti CMV IgGM +’lerde düşük avidite %0,1 (n=19) bulunmuştur. Toplam test maliyetleri 554329 Türk lirası bulunmuştur. Sonuç olarak, gebelikte ilk trimesterda anti rubella IgG taranmasını önerilmektedir. Hem maliyet hem de IgGM pozitif çıkanlardaki çok düşük doğrulama testi pozitifliği göz önüne alındığında toxoplazma ve CMV taranmasını önerilmemektedir.

Kaynakça

  • Madrid, L, Varo, R, Sitoe, A. and Bassat, Q. (2016). “Congenital and Perinatally-Acquired Infections in Resource-Constrained Settings”. Expert Rev Anti-Infect Ther, 14(9), 845-861.
  • Stegmann, B.J. and Carey, J.C. (2002). “TORCH Infections. Toxoplasmosis, Other (Syphilis, Varicella-Zoster, Parvovirus B19), Rubella, Cytomegalovirus (CMV), and Herpes Infections. Curr Womens”. Health Rep, 2 (4), 253-258.
  • Neu, N, Duchon, J. and Zachariah, P. (2015). “TORCH Infections”. Clin Perinatol, 42 (1), 77-103.
  • Jong, E.P.D, Vossen, A.C.T.M, Walther, F.J. and Lopriore, E. (2013). “How to Use… Neonatal. TORCH Testing”. Arch Dis Child Educ Pract Edit, 98 (3), 93-98.
  • Pappas, G, Roussos, N. and Falagas, M.E. (2009). “Toxoplasmosis Snapshots: Global Status of Toxoplasma Gondii Seroprevalence and Implications for Pregnancy and Congenital Toxoplasmosis”. Int J Parasitol, 39, 1385-1394.
  • Thie´baut, R, Leproust, S, Cheˆne, G. et al. (2007). “Effectiveness of Prenatal Treatment for Congenital Toxoplasmosis: A Meta-Analysis of Individual Patients’ Data”. Lancet, 369, 115-122.
  • Bahar, İ.H, Karama, M, Kırdar, S, Yılmaz, Ö, Celiloğlu, M. ve Mutlu, D. (2005). “Gebelikte Toxoplasmosis Tanısında Anti-Toxoplasma gondii Ig M, IgG, IgA Antikor ve IgG Avidite Testlerinin Birlikteliği ve Önemi”. Türkiye Parazitoloji Dergisi, 29 (2), 76-79.
  • Devakumar, D, Gibson, C.S, Bamford, A, Ferreira, M.U. et al. (2018). “Infectious Causes of Microcephaly: Epidemiology, Pathogenesis, Diagnosis, and Management”. Lancet Infect Dis, 18, 1-13.
  • Gibson, C.S, MacLennan, A.H, Goldwater, P.N, Haan, E.A, Priest, K and Dekker, G.A. (2006). “South Australian Cerebral Palsy Research Group. Neurotropic Viruses and Cerebral Palsy: Population Based Casecontrol Study”. BMJ, 332, 76-80.
  • Tastad, K.J, Schleiss, M.R, Lammert, S.M. and Basta, N.E. (2019). “Awareness of Congenital Cytomegalovirus and Acceptance of Maternal and Newborn Screening”. PLoS One. 14:e0221725.
  • Ornoy, A. and Diav-Citrin, O. (2006). “Fetal Effects of Primary and Secondary Cytomegalovirus Infection in Pregnancy”. Reprod Toxicoli, 21, 399-409.
  • Yılmazer, M, Altındiş, M, Cevrioğlu, S, Fenkçi, V, Aktepe O. and Sırthan, E. (2004). “Toxoplasma, Cytomegalovirus, Rubella, Hepatitis B and Hepatitis C Seropositivity Rates in Pregnant Women Who Live in Afyon Region”. The Medical Journal of Kocatepe, 5, 49-53.
  • Obut, M, Doğan, Y, Bademkıran, M.H, Akgöl, S, Kahveci, B, Peker, N. et al. (2019). “Toxoplasma, Rubella and Cytomegalovirus Seroprevalence in Pregnant Women in Diyarbakir”. Dicle Med J, 46 (2), 7.
  • Şentürk, Ş, Kağıtcı, M, Balık, G, Şahin, K. and Şahin, F.K. (2016). “Seroprevalence of Rubella Virus among Pregnant Women in Eastern Black Sea Region”. Van Medical Journal, 23 (3), 242-245.
  • Çeltek, N.Y, Tetikçok, R, Günal, Ö, Demirtürk, F, Duygu, F, Barut, H.Ş. et al. (2014). “Seroprevalence for Rubella, CMV and Toxoplasmosis among Pregnant Women in Central Black Sea Region of Turkey”. Gaziosmanpaşa Üniversitesi Tıp Fakültesi Dergisi, 6 (1), 54-62.
  • American College of Obstetricians and Gynecologists. (2015). “Practice bulletin no. 151:Cytomegalovirus, Parvovirus B19, Varicella Zoster, and Toxoplasmosis in Pregnancy”. Obstet Gynecol, 125, 1510-1525.
  • Kale, İ, Bayık, R.N, Uluutku, G.B. and Ergin, B. (2020). “Is routine TORCH Screening Necessary for Pregnancy Follow-Up?”. Turk J Womens Health Neonatol, 2 (4), 115-121
  • Yamamoto, R, Ishii, K, Shimada, M. et al. (2013). “Significance of Maternal Screening For Toxoplasmosis, Rubella, Cytomegalovirus and Herpes Simplex Virus Infection in Cases of Fetal Growth Restriction”. J Obstet Gynaecol Res, 39, 653-657.
  • Chung, M.H, Shin, C.O. and Lee, J. (2018). “TORCH (Toxoplasmosis, Rubella, Cytomegalovirus, and Herpes Simplex Virus) Screening of Small For Gestational Age and Intrauterine Growth Restricted Neonates: Efficacy Study in A Single Institute in Korea”. Korean J Pediatr, 61 (4), 114-120.
  • Çoşkun, B, Gülümser, Ç, Çoşkun, B, Artuk, C. and Karaşahin, K.E. (2020). “Impact of Syrian refugees on Congenital TORCH Infections Screening in Turkey”. J Obstet Gynaecol, Res 46 (7), 1017-1024.
  • Halawa, S, McDermott, L, Donati, M. and Denbow, M. (2014). “TORCH Screening in Pregnancy. Where Are We Now? An Audit of Use in a Tertiary Level Centre”. Journal of Obstetrics and Gynaecology, 34, 309-312.
  • Villard, O, Breit, L, Cimon, B. et al. (2013). “French National Reference Center for Toxoplasmosis Network. Comparison of Four Commercially Available Avidity Tests for Toxoplasma Gondii-Specific IgG Antibodies”. Clin Vaccine Immunol, 20 (2), 197-204.
  • T.C. Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü. (2020) Ankara: 2020 Yılı Fiyat Tarifeleri ve Analiz Bilgileri Rehberi.
  • Nazik, S, Duran İ, Nazik, H. and Duran, Ş. (2017). “Evaluation of Toxoplasma and Rubella Seropositivity in Pregnancy”. Balıkesir Medical Journal ,1(1), 22-25.
  • Bakacak, M, Bostancı, S.M, Köstü, B, Ercan, Ö, Avcı, S.F. and Bakacak Z. (2014). “Seroprevalance of Toxoplasma Gondii, Rubella And Cytomegalovirus among Pregnant Women”. Dicle Medical Journal, 41 (2), 326-331.
  • Craig, P.G, Halvorsen, J, Golemon, T.B. and Anthony, A.D. (2005). “Management of Spontaneous Abortion”. Am Fam Physician, 72(7), 1243-1250.
  • Leeper, C. and Lutzkanin, A. (2018). “Infections During Pregnancy”. Prim Care, 45 (3), 567-586.
  • Staras, S.A.S, Flanders, W.D, Dollard, S.C, et al. (2008). “Cytomegalovirus Seroprevalence and Childhood Sources of Infection: a Population-Based Study among Preadolescents in the United States”. J Clin Virol, 43, 266-271.
  • Silasi, M, Cardenas, I, Racicot, K, Kwon, J, Aldo, P. and Gil, M. (2015). “Viral Infections during Pregnancy”. Am J Reprod Immunol, 73 (3), 199–213.
  • İnci, A, Yener, C. and Güven, D. (2014). “The Investigation of Toxoplasma, Rubella and Cytomegalovirus Seroprevalancies in Pregnant Women in A State Hospital”. Pam Tıp Derg, 7 (2), 143-146.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Bilimleri ve Hizmetleri
Bölüm Makaleler
Yazarlar

Deniz KULAKSIZ
UNIVERSITY OF HEALTH SCIENCES, TRABZON KANUNİ HEALTH RESEARCH CENTER, DEPARTMENT OF SURGICAL MEDICAL SCIENCES, DEPARTMENT OF OBSTETRICS AND GYNAECOLOGY
0000-0003-2351-1367
Türkiye


Recep ERİN (Sorumlu Yazar)
UNIVERSITY OF HEALTH SCIENCES, TRABZON KANUNİ HEALTH RESEARCH CENTER, DEPARTMENT OF SURGICAL MEDICAL SCIENCES, DEPARTMENT OF OBSTETRICS AND GYNAECOLOGY
0000-0002-9488-5414
Türkiye


Kübra BAKİ ERİN
UNIVERSITY OF HEALTH SCIENCES, TRABZON KANUNİ HEALTH RESEARCH CENTER, DEPARTMENT OF SURGICAL MEDICAL SCIENCES, DEPARTMENT OF OBSTETRICS AND GYNAECOLOGY
0000-0002-6626-1735
Türkiye


Yeşim BAYOĞLU TEKİN
UNIVERSITY OF HEALTH SCIENCES, TRABZON KANUNİ HEALTH RESEARCH CENTER, DEPARTMENT OF SURGICAL MEDICAL SCIENCES, DEPARTMENT OF OBSTETRICS AND GYNAECOLOGY
0000-0003-0865-3201
Türkiye

Yayımlanma Tarihi 29 Aralık 2021
Yayınlandığı Sayı Yıl 2021, Cilt 10, Sayı 4

Kaynak Göster

Bibtex @araştırma makalesi { gumussagbil801144, journal = {Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi}, issn = {}, eissn = {2146-9954}, address = {}, publisher = {Gümüşhane Üniversitesi}, year = {2021}, volume = {10}, pages = {861 - 868}, doi = {10.37989/gumussagbil.801144}, title = {Gebelerde Toxoplazma, Rubella, Sitomegalovirüs Taraması: Yapalım Mı?}, key = {cite}, author = {Kulaksız, Deniz and Erin, Recep and Baki Erin, Kübra and Bayoğlu Tekin, Yeşim} }
APA Kulaksız, D. , Erin, R. , Baki Erin, K. & Bayoğlu Tekin, Y. (2021). Gebelerde Toxoplazma, Rubella, Sitomegalovirüs Taraması: Yapalım Mı? . Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi , 10 (4) , 861-868 . DOI: 10.37989/gumussagbil.801144
MLA Kulaksız, D. , Erin, R. , Baki Erin, K. , Bayoğlu Tekin, Y. "Gebelerde Toxoplazma, Rubella, Sitomegalovirüs Taraması: Yapalım Mı?" . Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi 10 (2021 ): 861-868 <https://dergipark.org.tr/tr/pub/gumussagbil/issue/67427/801144>
Chicago Kulaksız, D. , Erin, R. , Baki Erin, K. , Bayoğlu Tekin, Y. "Gebelerde Toxoplazma, Rubella, Sitomegalovirüs Taraması: Yapalım Mı?". Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi 10 (2021 ): 861-868
RIS TY - JOUR T1 - Gebelerde Toxoplazma, Rubella, Sitomegalovirüs Taraması: Yapalım Mı? AU - Deniz Kulaksız , Recep Erin , Kübra Baki Erin , Yeşim Bayoğlu Tekin Y1 - 2021 PY - 2021 N1 - doi: 10.37989/gumussagbil.801144 DO - 10.37989/gumussagbil.801144 T2 - Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi JF - Journal JO - JOR SP - 861 EP - 868 VL - 10 IS - 4 SN - -2146-9954 M3 - doi: 10.37989/gumussagbil.801144 UR - https://doi.org/10.37989/gumussagbil.801144 Y2 - 2021 ER -
EndNote %0 Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi Gebelerde Toxoplazma, Rubella, Sitomegalovirüs Taraması: Yapalım Mı? %A Deniz Kulaksız , Recep Erin , Kübra Baki Erin , Yeşim Bayoğlu Tekin %T Gebelerde Toxoplazma, Rubella, Sitomegalovirüs Taraması: Yapalım Mı? %D 2021 %J Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi %P -2146-9954 %V 10 %N 4 %R doi: 10.37989/gumussagbil.801144 %U 10.37989/gumussagbil.801144
ISNAD Kulaksız, Deniz , Erin, Recep , Baki Erin, Kübra , Bayoğlu Tekin, Yeşim . "Gebelerde Toxoplazma, Rubella, Sitomegalovirüs Taraması: Yapalım Mı?". Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi 10 / 4 (Aralık 2021): 861-868 . https://doi.org/10.37989/gumussagbil.801144
AMA Kulaksız D. , Erin R. , Baki Erin K. , Bayoğlu Tekin Y. Gebelerde Toxoplazma, Rubella, Sitomegalovirüs Taraması: Yapalım Mı?. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi. 2021; 10(4): 861-868.
Vancouver Kulaksız D. , Erin R. , Baki Erin K. , Bayoğlu Tekin Y. Gebelerde Toxoplazma, Rubella, Sitomegalovirüs Taraması: Yapalım Mı?. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi. 2021; 10(4): 861-868.
IEEE D. Kulaksız , R. Erin , K. Baki Erin ve Y. Bayoğlu Tekin , "Gebelerde Toxoplazma, Rubella, Sitomegalovirüs Taraması: Yapalım Mı?", Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi, c. 10, sayı. 4, ss. 861-868, Ara. 2021, doi:10.37989/gumussagbil.801144