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The aim of this study was to demonstrate the altered metabolic infrastructure of pregnant women with methylenetetrahydrofolate reductase (MTHFR) polymorphisms at first trimester and during delivery. Eight singleton pregnant women with MTHFR polymorphisms were compared with 10 normal pregnant women. Maternal blood samples were obtained twice during their pregnancy period (between the 11th and 14th gestational weeks and during delivery). Metabolomic analysis was performed using GC-MS. The GC-MS based metabolomic profile helped identify 95 metabolites in the plasma samples. In the MTHFR group, the levels of 1-monohexadecanoylglycerol, pyrophosphate, benzoin, and linoleic acid significantly decreased (P ˂ 0.05 for all), whereas the levels of glyceric acid, l-tryptophan, l-alanine, l-proline, norvaline, l-threonine, and myo-inositol significantly increased (P ˂ 0.01 for the first two metabolites, P ˂ 0.05 for the others) at 11-14 gestational weeks. Conversely, the levels of benzoin, 1-monohexadecanoylglycerol, pyruvic acid, l-proline, phosphoric acid, epsilon-caprolactam, and pipecolic acid significantly decreased in the MTHFR group, whereas metabolites such as hexadecanoic acid and 2-hydroxybutyric acid increased significantly in the study group during delivery. An impaired energy metabolism pathway, vitamin B complex disorders, tendency for metabolic acidosis (oxidative stress), and the need for cell/tissue support seem prevalent in pregnancies with MTHFR polymorphisms., (© 2020 John Wiley & Sons, Ltd.)

To examine the fetal thymic-thoracic ratio (TTR) in intrahepatic cholestasis of pregnancy (ICP). This prospective case-control study was conducted in a single tertiary center. The sample consisted of 86 pregnant women at 28–37 weeks of gestation, including 43 women with ICP and 43 healthy controls. TTR was calculated for each patient using the anterior-posterior measurements of the thymus and intrathoracic mediastinal measurements. The median TTR value was found to be smaller in the ICP group compared to the control group (0.32 vs. 0.36, p<0.001). The ICP group had a greater rate of admission to the neonatal intensive care unit (NICU) (p<0.001). Univariate regression analysis revealed that lower TTR values increased the possibility of NICU admission six times (95 % confidence interval: 0.26–0.39, p=0.01). A statistically significant negative correlation was detected between TTR and the NICU requirement (r: −0.435, p=0.004). As a result of the receiver operating characteristic analysis, in predicting NICU admission, the optimal cut-off value of TTR was determined to be 0.31 with 78 % sensitivity and 67 % specificity (area under the curve=0.819; p<0.001). We determined that the fetal TTR may be affected by the inflammatory process caused by the maternal-fetal immune system and increased serum bile acid levels in fetal organs in the presence of ICP. We consider that TTR can be used to predict adverse pregnancy outcomes in patients with ICP. [ABSTRACT FROM AUTHOR]

Introduction: Evaluation of demographic characteristics and postnatal outcomes of fetuses with cavum septum pellucidum et vergae (CSPV) diagnosis followed in a tertiary center. Methods: This retrospective study was conducted in Ankara Bilkent City Hospital perinatology clinic between 2020-2023. Cases with the prenatal diagnosis of CSPV were evaluated. Demographic features, prenatal ultrasound findings, noninvasive screening test results, invasive diagnostic test results, prenatal anomaly screening ultrasound findings, and postnatal outcomes were reported. Results: There was a total of 24 prenatally diagnosed CSPV cases during the study period. The mean gestational week at diagnosis was 25.6 ± 3.2 weeks. Nineteen patients participated in noninvasive screening tests; five patients declined them. Noninvasive screening tests revealed low risk in 17 patients and high risk in 2. Amniocentesis was performed in 5 patients; 3 of them had a normal karyotype, 1 fetus was diagnosed with Smith-Lemli-Opitz syndrome, and 1 fetus had trisomy 21. Six patients with isolated CSPV were accepted and underwent fetal MRI, other eighteen patients refused MRI. MRI corrected the CSPV in all six patients, and they had no additional findings. Five (%21) fetuses were admitted to the intensive care unit because of recurrent absence convulsions (n=1), anal atresia (n=1), cleft lip palate (n=1), respiratory distress (n=1) and hypoplastic left heart syndrome (n=1). Conclusion: CSPV is considered a normal variant of cavum septum pellucidum and can be diagnosed during ultrasound screening for fetal anomalies; in isolated cases perinatal outcomes are favorable. [ABSTRACT FROM AUTHOR]

Objective Methods Results Conclusion Synopsis To determine the value of the Aggregate index of systemic inflammation (AISI) in predicting admission to neonatal intensive care unit (NICU) and chorioamnionitis.The present retrospective cohort study with pregnant women who were diagnosed with preterm premature rupture of membranes (PPROM) in the Department of Perinatology, Ministry of Health Ankara City Hospital between January 1, 2021, and June 1, 2023 (n = 357). The patients were categorized into subgroups: (1) cases with (n = 27) or without (n = 330) chorioamnionitis, (2) admission (n = 182) or no admission (n = 175) to NICU; (3) gestational age at birth <28 weeks or 28 weeks or longer; and (4) gestational age at birth <34 weeks or 34 weeks or longer. AISI values were compared between the subgroups, and cut‐off values for AISI were determined to predict adverse outcomes.AISI values were significantly higher in the admission to NICU group compared with the no admission to NICU group (707.0 vs 551.2) (P < 0.05). AISI values were also significantly higher in the chorioamnionitis group compared with those without chorioamnionitis (850.3 vs 609.4) (P < 0.05). AISI levels were significantly higher in cases delivered before 28 weeks of gestation compared with the cases delivered at 28 weeks of gestation or later (945.6 vs 604.9) (P < 0.05), and were also significantly higher in cases delivered before 34 weeks of gestation compared with the cases delivered at 34 weeks of gestation or later (715.5 vs 550.1) (P < 0.05). Optimal cut‐off values of AISI were found to be 626.19 (74.1% sensitivity, 52.8% specificity), 506.09 (68.9% sensitivity and, 47.7% specificity), and 555.1 (69.8% sensitivity, 48.1% specificity) in predicting NICU admission, chorioamnionitis, and delivery before 28 weeks, respectively.The novel inflammatory marker AISI may be used in the prediction of chorioamnionitis and NICU admission in PPROM cases.Aggregate index of systemic inflammation may be used as a novel marker in predicting high‐risk for chorioamnionitis and neonatal intensive care unit admission in women with preterm premature rupture of membranes. [ABSTRACT FROM AUTHOR]

• Prenatal diagnosis is an important issue in cases like pelvic kidney because early detection can give the opportunity for anatomic and genetic screening for related anomalies. • Pelvic kidneys could be diagnosed in the early prenatal period. • Postnatal follow-up should be performed closely for the assessment of renal functions. Evaluation of demographic characteristics and postnatal outcomes of patients with suspected fetal pelvic kidney diagnosis followed in a tertiary center. This retrospective study was conducted in Ankara Bilkent City Hospital perinatology clinic between 2020–2023. Demographic features, prenatal ultrasound findings, and postnatal outcomes were reported. Pelvic kidney localization was on the left in 11(55 %) patients, on the right in 7(35 %), and bilateral in 2(10 %) patients in prenatal ultrasonography. The gender of the 12(60 %) fetuses were male and 8(40 %) of them were female. The pelvic kidney was an isolated finding in 8(40 %) fetuses, additional findings were present in the remaining 12(60 %) fetuses. Pelvic kidney was confirmed postnatally by ultrasound in all 18 fetuses. However two cases with prenatal ultrasound findings resulted in intrauterine fetal demise and the final diagnosis could not be confirmed as the parents refused autopsia. Cases were divided into 3 groups according to postnatal follow-up duration as 0–12 months (n = 7), 12–24 months (n = 7) and 24–44 months (n = 4). Atrial septal defect was the most common accompanying abnormality in the postnatal period (n = 4). Smaller kidney size (n = 7), vesicoureteral reflux (n = 3), and impaired renal function (n = 3) were the most common postnatal complications. Pelvic kidney can be diagnosed in fetal abnormality screening ultrasound and postnatal follow-up should be performed closely for the assessment of renal functions. [ABSTRACT FROM AUTHOR]

Introductıon: PAPP-A (Pregnancy-associated plasma protein-A) is considered a pro-inflammatory marker and its serum levels are elevated in non-pregnant patients with asthma. In the current research, we aimed to investigate whether maternal serum PAPP-A levels, a biomarker for first-trimester aneuploidy screening, differ in pregnant women with asthma compared to healthy pregnant women. Methods: In the first step, maternal serum PAPP-A MoM values, used as the first-trimester fetal aneuploidy screening marker, were compared between pregnant women with asthma and a healthy pregnant group. In the second step, the groups compared whether PAPP-A and fβ-HCG ( free β human chorionic gonadotropin) levels were below or above the cut-off values for Trisomy 21 and compared them according to maternal age (<35; ≥35). Results: The median PAPP-A level was found to be 2.15 IU/L (0.41-9.91) in the asthma group and 2.54 IU/L (0.56-11.40) in the control group, and there was no difference between the groups (P=0.363). The median PAPP-A MoM value was 0.99 (0.15-3.28) in the asthma group and 1.07 (0.33-3.37) in the control group. This result did not show a statistically significant difference (P = 0.694). No statistically significant difference was shown between the groups below and above 35 age (P=0.456). Conclusion: Maternal serum PAPP-A levels in pregnant women with asthma do not vary compared to the healthy pregnant group without asthma. Based on the results of our study, the first-trimester fetal aneuploidy screening test is a reliable screening method for pregnant women with asthma. [ABSTRACT FROM AUTHOR]

Objectives: To investigate whether fetal cardiac function is affected by underlying heart disease in pregnant women. Methods: A total of 100 pregnant women who were ≥34 gestational weeks were included in the study, 40 in the maternal heart disease (MHD) group diagnosed with heart disease and 60 in the control group. All cardiac diseases in pregnant women were diagnosed preconceptionally and categorized according to the New York Heart Association (NYHA) classification system. Fetal cardiac functions of study groups were evaluated by M‐mode, color tissue Doppler imaging (c‐TDI), and pulsed wave Doppler. Results: Tricuspid annular plane systolic excursion and myocardial performance index (MPI) values were significantly higher and isovolumetric relaxation time was prolonged in the MHD group. The MPI value was found higher in MHD group with NYHA Class II compared to those with NYHA Class I. No significant change in any of the fetal tricuspid annular peak velocity values measured by c‐TDI in the MHD group. There were no differences in fetal cardiac functions and perinatal outcomes between pregnant women with acquired and congenital heart diseases. Patients in NYHA Class II had lower birth weight, 1st and 5th minute APGAR scores, and higher neonatal intensive care unit admission rates. Conclusions: Underlying heart diseases in pregnant women can cause alterations in the systolic and diastolic function of the fetal heart. High fetal MPI values detected in cardiac patients may indicate that cardiac pathologies during pregnancy affect fetal cardiac globular myocardial function. Cardiac pathologies that progress with restricted physical activity may cause changes in fetal cardiac function and may be associated with adverse perinatal outcomes. [ABSTRACT FROM AUTHOR]

OBJECTIVES: This study was conducted to evaluate the impact of listening to fetal heartbeats (FHBs) on the feelings of normal and high-risk pregnancies (HRPs), and to learn the colors and geometrical figures representing their feelings. STUDY DESIGN: This retrospective cohort study consisted of 291 pregnant women who applied for a non-stress test (NST). Participants were divided into two groups; 1: Normal pregnancies (Group1) and 2: HRPs (Group2). Demographic variables, feelings in response to listening to FHBs (negative, neutral, positive), grade mark (0-10) of feelings, color (warm, neutral, cold), and figure (simple, complex) preferences were retrospectively evaluated. RESULTS: Of the 291 women, 172 (59.1%) Group 1 participants were compared to 119 (40.9%) Group 2 participants. Group 1 and Group 2 had similar feelings (p>0.05), however, the rate of negative feelings was higher in Group 2 (11.6% vs. 20.2%). Higher marks were observed in Group 2 with happiness and peace/relaxation after listening to FHBs. Fear was the lowest mark in women with positive/neutral feelings in both groups. Women in Group 1 preferred warm colors regardless of their feelings. Women in Group 2 who have positive feelings chose warm colors, whereas women who felt neutral or negative more commonly chose cold (55.5%) and neutral (41.7%) colors (p=0.017). Independent of feelings, simple figures were predominately preferred (p=0.04). CONCLUSION: NST is more than a perinatal surveillance method and listening to FHBs has a positive impact on the feelings of pregnancies. Warm colors were commonly related to positive feelings. Simple figures were preferred regardless of feelings. [ABSTRACT FROM AUTHOR]

Aim: We aim to compare the maternal serum thiol and ischemia‐modified albumin (IMA) levels between pregnant women with placenta previa and those with uncomplicated pregnancies and to determine whether changes in these levels were useful in predicting cases of abnormally invasive placenta (AIP). Methods: Fifty‐five pregnant women diagnosed with placenta previa according to the diagnostic criteria (case group) were compared to 100 women with uncomplicated pregnancies of similar demographic characteristics (control group). The patients with placenta previa were further divided into two subgroups: AIP (n = 20) and placenta previa without invasion (n = 35). The maternal serum native thiol, total thiol, disulfide, and IMA levels of the groups were evaluated. Results: The native thiol, total thiol, and IMA values were significantly lower in the case group than in the control group (p < 0.001). The disulfide values were similar between the study and control groups (p = 0.488). When the AIP and placenta previa without invasion groups were compared, the levels of native thiol, total thiol, disulfide, and IMA were similar (p > 0.05). Conclusions: Maternal serum thiol and IMA levels were lower in placenta previa cases compared to the control group. However, these parameters were not useful in predicting AIP cases. [ABSTRACT FROM AUTHOR]

Objective. To evaluate the characteristics of obstetric malpractice litigations. Study design. This is a retrospective study of 80 expertise reports written for obstetric medico-legal litigations between 2007 and 2017. Results. We showed that obstetric medico-legal litigations have been increasing recently, like in other countries. In most cases, the primary plaintiffs and defendants were the patients and doctors. Most cases (53.7%) were from private hospitals. Intrapartum events and puerperal events were most common claim subjects (77.5%). Among the peripartum claims, shoulder dystocia, fetal asphyxia and caesarean section related complications were the most common claims, with 14 (17.5%), 12 (15%) and 10 (12.5%) cases, respectively. Diagnosis-related claims were subject of 18 (22.5%) cases, 12 of which were related to prenatal diagnosis. The most common issue was found to be fetal morbidities (47.5%). Maternal and fetal mortality occurred in 10 (12.5%) and 22 (27.5%) cases, respectively. The route of delivery was vaginal, through caesarean section, or operative vaginal in 33, 29 and seven cases, respectively. Twenty-six caesarean sections were urgent. Conclusions. Medico-legal claims have been increasing, like in many other countries. Problems involving prenatal screening/diagnosis, intrapartum processes, urgent caesarean sections and operative vaginal deliveries were highly liable situations. Further legal regulations are needed to provide a more comfortable medico-legal climate for physicians. [ABSTRACT FROM AUTHOR]

Objective Understanding the reflections of prematurity is necessary for the management of neonatal complications. We focused on the impact of prematurity and related "maternal risk factors/obstetric complications" on buccal cells of the neonates via evaluation of the Wnt/β-catenin signaling pathway and apoptosis. Study Design This study consisted of "early preterm neonates (EPN) (≤34th gestational week [gw]) (n = 36)," "late preterm neonates (LPN) (34th– < 37th gw) (n = 46)," and "term neonates (control) (≥37th gw) (n = 56)." Cohort was also subclassified according to the presence of maternal risk factors, obstetric complications, and neonatal complications. Wnt/β-catenin signaling and caspase-3 activation pathways were studied immunocytochemically. Results Wnt/β-catenin signaling positivity was statistically more frequent at buccal smears of the EPN and LPN groups compared with controls (p < 0.001). The cutoff for gestational age at delivery in receiver operating characteristic curve with the best balance of sensitivity (67.4%) and specificity (67.3%) was 35.8th gw for determining the reduction of Wnt/β-catenin signaling positivity (p < 0.001). The study demonstrated that obstetric complications significantly affected the activity of signaling, while maternal risk factors do not have any effect on Wnt/β-catenin signaling pathway (p = 0.003 and p = 0.828, respectively). This study also demonstrated a significant relationship between Wnt/β-catenin signaling pathway and the presence of neonatal complications (p = 0.015). Conclusion Dynamic characteristics of buccal cells are influenced by prematurity and related obstetric and neonatal problems. Buccal smear is a good tool to investigate the impact of prematurity and obstetric problems on perinatal outcome. Key Points Neonatal buccal cells are affected by prematurity and related obstetric/neonatal problems. 35.8th gw is critical for determining the reduction of Wnt/β-catenin signaling positivity. Obstetric and neonatal complications significantly related to Wnt/β-catenin signaling activity. [ABSTRACT FROM AUTHOR]

Purpose: To determine the effects of gestational diabetes mellitus (GDM) on fetal frontal lobe development. Methods: This study was conducted prospectively between May 2023 and August 2023 in Ankara City Hospital perinatology clinic. Maternal age, maternal body mass index (BMI), gestational week (GW), biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), femur length (FL), estimated fetal weight (EFW), frontal antero‐posterior diameter (FAPD), occipito‐frontal diameter (OFD), FAPD/OFD ratio, and FAPD/HC ratio, were compared between GDM (n = 40) and low risk controls (n = 56). Results: The mean maternal age was found higher in the GDM group compared to control group (p = 0.002). Maternal BMI was significantly higher in the GDM group than the control group (p = 0.01). Abdominal circumference (AC) was significantly higher in the GDM group compared to control group (p = 0.04). EFW was significantly higher in the GDM group compared to control group (p = 0.04). FAPD/OFD ratio was found to be higher in the GDM group than in the control group (p = 0.001). Among GDM patients, no statistically significant difference was found in the ultrasound measurements between the groups receiving insulin treatment and those without treatment. According to the correlation analysis results a moderate, positive, and statistically significant correlation was present between FAPD/OFD and GDM. In perinatal outcomes, the rate of neonatal intensive care unit admission was significantly higher in the GDM group. Discussion: Fetal frontal lobe development seems to be affected by GDM. [ABSTRACT FROM AUTHOR]

Copyright of Jinekoloji-Obstetrik & Neonatoloji Tip Dergisi is the property of T.C. Saglik Bakanligi Ankara Sehir Hastanesi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: To investigate the fetal thymic‐thoracic ratio (TT‐ratio) in pregnancies diagnosed with rheumatoid arthritis (RA) and ankylosing spondylitis (AS). Methods: Thirty‐two pregnant women with rheumatic disease and 96 low‐risk pregnant women between 20 and 37 weeks were included in the study. Three control patients were randomly selected for each study patient. TT‐ratio was calculated by measuring the anterior–posterior diameter of the thymus and the intrathoracic mediastinal diameter. Data were compared between the study group, including RA and AS, and the control group. Results: Thirty‐two pregnant women with arthritis, 19 diagnosed with RA and 13 with AS, were evaluated. The mean value of the study group TT‐ratio was 0.33; control group, 0.36; a statistically significant difference was found (p < 0.001). Perinatal outcomes were not different when compared with control patients. There was a negative correlation between disease duration, maternal C‐reactive protein, erythrocyte sedimentation rate, and TT‐ratio. Conclusion: This is the first study to prospectively evaluate the fetal TT‐ratio in patients with RA and AS. Systemic inflammation appears to affect fetal thymus size. Appropriate management of maternal rheumatic diseases is essential for developing the thymus, a vital immune system component. [ABSTRACT FROM AUTHOR]

This study aimed to present perinatal outcomes, clinical challenges, and basic ICU management in pregnant women with severe-critical COVID-19 at our tertiary referral center. In this prospective cohort study, patients were divided into two groups, whether they survived or not. Clinical characteristics, obstetric and neonatal outcomes, initial laboratory test results and radiologic imaging findings, arterial blood gas parameters at ICU admission, and ICU complications and interventions were compared between groups. 157 of the patients survived, and 34 of the patients died. Asthma was the leading health problem among the non-survivors. Fifty-eight patients were intubated, and 24 of them were weaned off and discharged healthfully. Of the 10 patients who underwent ECMO, only 1 survived (p<0.001). Preterm labor was the most common pregnancy complication. Maternal deterioration was the most common indication for a cesarean section. Higher neutrophil-to-lymphocyte-ratio (NLR) values, the need for prone positioning, and the occurrence of an ICU complication were important parameters that influenced maternal mortality (p<0.05). Overweight pregnant women and pregnant women with comorbidities, especially asthma, may have a higher risk of mortality related to COVID-19. A worsening maternal health condition can lead to increased rates of cesarean delivery and iatrogenic prematurity. [ABSTRACT FROM AUTHOR]

Aim: We aimed to investigate the effect of systemic inflammation indices in predicting pregnancy outcomes of inflammatory bowel disease (IBD). Materials and Methods: Pregnant women with Crohn's disease (CD) and Ulcerative colitis (UC) were identified from hospital medical records. Demographic features, disease type, duration and activity, and obstetric outcomes such as gestational age, mode of delivery, birth weight, Apgar scores at the first and fifth minutes after birth, and neonatal intensive care unit admission were assessed. Laboratory tests were conducted in the first trimester, including complete blood count and liver function. Neutrophil/lymphocyte ratio (NLR), derived neutrophil/lymphocyte ratio (dNLR), systemic inflammation index (SII), systemic inflammation response index (SIR-I), and aspartate transaminase/platelet ratio (APRI) were measured. Results: The study involved 48 pregnant women, 26 diagnosed with UC and 22 with CD. At least one attack occurred in 31.3% of all patients during pregnancy. For predicting attacks during pregnancy, the optimal cutoff values of dNLR, NLR, SII, SIR-I, and APRI were 2.12 (86.7% sensitivity, 82.8% specificity), 2.89 (86.7% sensitivity, 81.8% specificity), 850.7 109/L (66.7% sensitivity, 63.6% specificity), 1.06 109/L (66.7% sensitivity, 72.7% specificity), 0.051 (80% sensitivity, 75.8% specificity), respectively. A cut-off value of 0.07 for APRI (71.4% sensitivity and 73.2% specificity) was calculated to predict low birth weight. Conclusion: NLR, dNLR, SII, SIR-I, and APRI might help predict attacks in pregnant women with IBD. In addition, APRI may be utilized to predict low birth weight in pregnant women with IBD. [ABSTRACT FROM AUTHOR]

Introduction: Pregnancy is a physiological process in which the need for iron increases. We aimed to compare the effectiveness and side effects of different oral iron supplements on pregnant women. Methods: 100 pregnant women between the ages of 18-45 who used Fe+2 (ferrous sulfate) valent iron supplementation during their pregnancy were included in the study as group 1. 100 pregnant women in the same age range who used Fe+3 (iron polymaltose complex) valent iron supplementation during their pregnancy were determined as group 2. Response to anemia treatment was evaluated with the results of laboratory parameters (Hgb, Hct). The side effects of the preparations used in oral iron replacement were questioned retrospectively with a questionnaire applied to the patients. Results: 16 of 100 patients (16%) had side effects with oral iron polymaltose complex supplementation. 43 of 100 patients (43%) had side effects with oral ferrous sulfate supplementation. The overall side effect was higher in those taking oral ferrous sulfate supplementation (p<0.001). Hb and Hct values measured at 3-month periods were found to be similar between the groups (p>0.05). The most common side effect was nausea and vomiting with 12%. Conclusion: Both oral ferrous sulfate and iron polymaltose complex supple-mentationhavesimilareffectsonhemoglobinandhematocritlevelsinpregnant women without iron deficiency anemia. However, oral ferrous sulfate supplementation causes more side effects compared to iron polymaltose complex. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to investigate the inflammatory platelet (Plt) indices; Plt/lymphocyte, Plt/monocyte ratio (PMR), and Plt/neutrophil ratio (PNR) in maternal epilepsy patients. Methods: Patients diagnosed with maternal epilepsy in a tertiary center between 2019 and 2022 were included in this retrospective case-control study. Consecutive uncomplicated healthy pregnant women constituted the control group. Complete blood count (CBC) parameter results and Plt indices during the first trimester of pregnancy were recorded. Neonatal outcomes, seizure history of epilepsy patients during pregnancy, and antiepileptic drugs used were also recorded. Results: One hundred thirteen pregnant epilepsy patients were included in this study. As a control group, 339 healthy pregnant women were included. While the Plt was 271x109 /L in the epilepsy group, it was 249x109 /L in the control group (p=0.029). PMR and PNR were significantly higher in the epilepsy group. Fifty of the epilepsy patients had seizures during pregnancy (44.2%). When compared, no significant difference was found between epilepsy patients with a seizure history or not, as to demographic features and CBC parameters during the 1st trimester of pregnancy (all p>0.05). Conclusion: Pregnant women with epilepsy have low-grade inflammation during the first trimester. Inflammatory Plt indices may be used in combination with other parameters for the management of pregnancy. Further studies are required. [ABSTRACT FROM AUTHOR]

Copyright of Medeniyet Medical Journal is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction:We aim to evaluate fetal cardiac function and umbilical cord blood pro-BNP (pro-brain natriuretic peptide) levels in ICP (intrahepatic cholestasis of pregnancy). Methods: The study included 41 ICP cases and 41 controls. All participants were evaluated after 34 weeks of gestation. The pro-BNP levels in umbilical cord blood were assayed, and perinatal outcomes were compared between the groups. Results: In the ICP group SBA (serum bile acid) and pro-BNP levels were higher than the control group (p<0.001 and p=0.001). The left MPI (myocardial performance index) of ICP group was higher among the control group (p=0.043). A positive correlation was evaluated between the pro-BNP levels and MPI values (p<0.001). Conclusion: Both the high MPI values obtained via ultrasonography and the high pro-BNP levels detected in umbilical cord blood may be attributable to the adverse fetal cardiac effects of ICP. [ABSTRACT FROM AUTHOR]

Aim: This study aims to investigate the effects of maternal asthma on fetal cardiac functions. Methods: The study was planned with 30 pregnant women who presented to a tertiary health center and were diagnosed with asthma and 60 healthy controls with similar gestational ages. The fetal echocardiographic assessment was assessed between 33 and 35 weeks of gestation with pulsed‐wave Doppler (PW), M‐mode, and tissue Doppler imaging (TDI). Fetal cardiac functions were compared between maternal asthma and the control group. Cardiac functions were assessed according to the duration of maternal asthma diagnosis, as well. Results: Early diastolic function parameters, tricuspid E wave (p =.001), and tricuspid E/A ratio (p =.005) were significantly lower in the group with maternal asthma. Tricuspid annular plane systolic excursion (TAPSE) and measurements of mitral annular plane systolic excursion (MAPSE) values were statistically lower in the study group than in the control group; p =.010 and p =.012, respectively. Parameters assessed with TDI (E′, A′, S′, E/E′, and MPI′ of tricuspid valves) and global cardiac function parameters assessed with PW like myocardial performance index (MPI) and left cardiac output (LCO) were similar between groups (p >.05). Although, MPI did not change between groups, and the isovolumetric relaxation time (IVRT) value was prolonged in maternal asthma cases (p =.025). Conclusion: We found that maternal asthma disease causes alteration in fetal diastolic and early systolic cardiac functions, but the global fetal cardiac function does not change. Diastolic heart function values also varied with the duration of maternal asthma. Prospective studies are needed to compare fetal cardiac functions with additional patient groups according to disease severity and type of medical treatment. [ABSTRACT FROM AUTHOR]

Aim: To investigate the association of systemic immune‐inflammation index (SII) and systemic immune‐response index (SIRI) with adverse perinatal outcomes in pregnant women with coronavirus disease 2019 (COVID‐19). Methods: The cases were divided into (1) the Mild–moderate COVID‐19 group (n = 2437) and (2) the Severe–critical COVID‐19 group (n = 212). Clinical characteristics, perinatal outcomes, SII (neutrophilXplatelet/lymphocyte), and SIRI (neutrophilXmonocyte/lymphocyte) were compared between the groups. Afterward, SII and SIRI values were compared between subgroups based on pregnancy complications, neonatal intensive care unit (NICU) admission, and maternal mortality. A receiver operator characteristic analysis was performed for the determination of optimal cutoff values for SII and SIRI in the prediction of COVID‐19 severity, pregnancy complications, NICU admission, and maternal mortality. Results: Both SII and SIRI were significantly higher in complicated cases (p < 0.05). Cutoff values in the prediction of severe–critical COVID‐19 were 1309.8 for SII, and 2.3 for SIRI. For pregnancy complications, optimal cutoff values were 973.2 and 1.6. Cutoff values of 1045.4 and 1.8 were calculated for the prediction of NICU admission. Finally, cut‐off values of 1224.2 and 2.4 were found in the prediction of maternal mortality. Conclusion: SII and SIRI might be used in combination with other clinical findings in the prediction of poor perinatal outcomes. [ABSTRACT FROM AUTHOR]

In this study, we aimed to investigate the relationship between unexplained stillbirth (SB) cases and the complete blood parameter indices and we compared them with uncomplicated healthy cases. Patients diagnosed with unexplained SB cases in a tertiary center between 2019-2022 were included in this retrospective case-control study. The gestational age threshold for SBs was accepted as births after the 20th week of pregnancy. Consecutive patients with no adverse obstetric outcomes were accepted as the control group. Patients' complete blood parameter results at the time of the first admission to the hospital until 14 weeks were labeled as "1" and at the time of delivery were labeled as "2" and recorded. As inflammatory parameters, neutrophile-lymphocyte ratio, derivated neutrophile-lymphocyte ratio, platelet-lymphocyte ratio, lymphocyte-monocyte ratio (LMR), and hemoglobin-lymphocyte ratio (HLR) were calculated from complete blood results and recorded. There were statistically significant differences between the groups' LMR1 (p =.040). Additionally, whereas HLR1 of the study group was 0.693 (0.38–2.72), it was 0.645 (0.15–1.82) in the control group (p =.026). However, the HLR2 of the study group was significantly lower than the control group (p =.021). Necessary precautions such as fetal biophysical profile examination can be taken more frequently in the antenatal follow-up in patients considered to be at high risk of SB by using HLR. It is a novel marker that can be easily accessible and calculated from the complete blood parameters. [ABSTRACT FROM AUTHOR]

The article focuses on study conducted to evaluate umbilical cord immune cells in pregnancies with autoimmune disorders (AID) and/or methylenetetrahydrofolate reductase (MTHFR) polymorphisms. Topics discussed include role of homeostasis of the placental maternal-fetal interface (MFI) in pregnancy; methodologies used in study on umbilical cords obtained from women with and without AID; and result showing impact of AID on number, distribution, and morphology of umbilical cord immune cells.

The aim of the present study is to share the experience of a tertiary reference pandemic centre on the labour and delivery of pregnant women with coronavirus disease 2019 (COVID-19). This prospective cohort study was conducted on pregnant women with COVID-19 (n = 337). Patients were divided into two groups based on their severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reaction (PCR) positivity (n = 103 positive and n = 234 negative) during the delivery. Thereafter, clinical characteristics and perinatal outcomes were compared between the groups. Moreover, delivery characteristics and clinical features were compared between primary caesarean section (n = 117) and normal spontaneous vaginal delivery cases (n = 100). Labour induction was performed in 16% of cases with a failure rate of 35%. Caesarean rate was 70% and the most common indication was worsening in maternal condition. Significant, positive and moderate correlations were observed between COVID-19 severity at admission (r = 0.422, p<.001), radiologic findings consistent with COVID-19 (r = 0.400, p<.001), the necessity for oxygen support during the delivery (r = 0.406, p<.001) and postpartum worsening in maternal condition. A significant, positive weak correlation was found between caesarean delivery and postpartum worsening in maternal condition (r = 0.176, p<.001). COVID-19 seems to be associated with increased rates of obstetric complications and caesarean delivery. What is already known on this subject? Increased rates of foetal distress and caesarean section were reported in pregnant women with COVID-19. Appropriate management of labour and delivery in infected pregnant women is crucial to obtain favourable perinatal outcomes. What do the results of this study add? COVID-19 seems to be associated with increased rates of obstetric complications and caesarean delivery. PCR positive group had significantly higher primary and prelabor caesarean delivery rates. Severe/critic COVID-19 infection rate was significantly higher in the primary caesarean group. Significant, positive and moderate correlations were observed between COVID-19 severity at admission, radiologic findings consistent with COVID-19, the necessity for oxygen support during the delivery and postpartum worsening in maternal condition. A significant, positive weak correlation was found between caesarean delivery and postpartum worsening in maternal condition. What are the implications of these findings for clinical practice and/or further research? Management and delivery of pregnant women with COVID-19 should be individualised. The findings of the present study may lead to the establishment of future obstetric protocols in this special population. [ABSTRACT FROM AUTHOR]

Aim: To reveal the preventable complications related to fetal loss more clearly by hypothesizing that the negative effects of the pandemic on antenatal follow-up and daily habits in pregnancies resulting in fetal loss may increase compared to the pre-pandemic period. Materials and Methods: In this question-based study, 80 pregnant women who were diagnosed with fetal death during the pre-pandemic period(September 1, 2019- February 28, 2020) were compared with 80 pregnant women diagnosed with fetal death during the pandemic period (March 1,2020-September 1,2020). Antenatal screening tests, dietary, exercise, smoking, medications, low-income status, fetal anomalies, coexisting medical disorders and, adverse outcomes have been comparatively analyzed between the groups. Results: There was no statistical difference between the periods in terms of the number of antenatal visits (p =0.52). However dietary modification and physical exercise rates were lower during the pandemic (p=0.03, and p<0.01 ), respectively. The use of vitamin D has increased during the pandemic period (p = 0.02). Maternal complication rates in women diagnosed with stillbirth were 20% in the pre-pandemic period and 30% in the pandemic. The stillbirth rates were 1.4%(87/6277) and 1.3%(87/6936), in pre-pandemic and pandemic periods, respectively (p>0.05). Conclusion: In particular, we demonstrated that the pandemic process negatively affected the daily routine such as physical exercise and dietary in women diagnosed with fetal loss. However, we found the stillbirth rates similar between the periods. [ABSTRACT FROM AUTHOR]

To evaluate the association of the Systemic Immune-Inflammation Index (SII), Systemic Immune-Response Index (SIRI), and Neutrophil-to-Lymphocyte Ratio (NLR) with Cesarean Scar Pregnancy (CSP) This prospective case-control study was conducted in Ankara City Hospital perinatology clinic between 2022 and 2023. The diagnosis of CSP was made by transabdominal and transvaginal ultrasound. NLR, SII, and SIRI values were compared between those diagnosed with CSP (n=23) and healthy pregnancies (n=126) at the time of first admission. The study group had significantly higher NLR, SII, and SIRI values compared to the controls. Optimal cut-off values were 3.79 (69 % sensitivity, 78.2 % specificity), 1180.6 (76.7 % sensitivity, 72.7 % specificity), and, 1.9 (83.3 % sensitivity, 72.7 % specificity) for NLR, SII, and SIRI, respectively. When NLR, SII and SIRI values were compared between CSP cases and pregnant women who had previous history of cesarean section but did not have CSP, significantly higher SII values were observed in the CSP group. The optimal cut-off value of SII was found to be 804.4 in predicting CSP among cases with previous history of cesarean delivery (73.9 % sensitivity, 66.2 % specificity). SII, SIRI, and NLR may be useful in predicting cesarean scar pregnancy in pregnant women. • Women with Cesarean scar pregnancy (CSP) had significantly higher systemic immune-inflammation index (SII), Systemic Immune-Response Index (SIRI) and Neutrophil-to-Lymphocyte Ratio (NLR) in the first trimester than low risk group. • Usage of complete blood cell indices in routine clinical practice may be questionable as ultrasonography is still the main diagnostic method in CSP. • Present study has favorable outcomes with early diagnosis and less invasive approaches like balloon tamponade in CSP. [ABSTRACT FROM AUTHOR]

We investigated the importance of prophylactic administration of low-dose low-molecular-weight heparin (LMWH) in women with risk factors associated with placental inflammation. This retrospective cohort study included 300 pregnant women with a singleton pregnancy (30 primigravidas and 270 multigravidas) who received prophylactic low-dose LMWH to prevent placental inflammation. Based on maternal risk factors, patients were categorized into 3 groups as follows: Group 1: Patients with metabolic risk factors for placental inflammation (n = 205), Group 2: Patients with immunological risk factors for placental inflammation (n = 42), Group 3: Patients with metabolic and immunological risk factors for placental inflammation (n = 53). Obstetric histories, demographic features, clinical characteristics, and present pregnancy outcomes were compared between groups. Live birth rates, composite adverse obstetric outcomes, and the Beksac obstetric index were compared between present and previous pregnancies in multigravidas. Pregnancy outcomes were significantly better in the present pregnancy than in previous pregnancies. A significant increase was observed in live birth rates (33.4% vs. 69.9%, 27.5% vs. 60.5%, and 30.1% vs. 69.4% in groups 1, 2, and 3, respectively) and in the Beksac obstetric index (0.32 vs. 0.43, 0.33 vs. 0.47, and 0.38 vs. 0.57 in groups 1, 2, and 3 respectively) (p <.001 for all). A significant decrease in composite adverse pregnancy outcome rates was observed during the present pregnancy (23.5% vs. 100%, 28.9% vs. 100%, and 24.5% vs. 100% in groups 1, 2, and 3, respectively) (p <.001 for all). Live birth and composite adverse obstetric outcome rates were 70% and 33.3%, respectively in primigravidas. Low-dose low-molecular-weight heparin prophylaxis is useful to prevent metabolic and immunological disorders causing placental inflammation, which is the most likely pathophysiological mechanism contributing to various obstetrical complications. [ABSTRACT FROM AUTHOR]

To introduce the effect of a single course of betamethasone for pregnant women at risk of preterm delivery (PTD). In this study, a single course of 12 mg Bethamethasone was administered twice in 24 h (between 24–34 gestational weeks) for antenatal corticosteroid prophylaxis. Four hundred ninety-three neonates fulfilled the inclusion criteria and they were categorized (259 singletons, 192 twins and 42 triplets who met the inclusion criteria) into two groups according to the utilization of antenatal corticosteroid as control (n = 202) and study (n = 291) groups. We used respiratory distress syndrome (RDS), congenital pneumonia, intraventricular hemorrhage (IVH), neonatal sepsis, and bronchopulmonary dysplasia (BPD) as primary outcomes for the evaluation of neonatal morbidity. Study and control groups were similar in terms of clinical characteristics. RDS, congenital pneumonia, neonatal sepsis, and BPD rates were significantly higher in the study group (betamethasone) (p =.05, p =.007, 0.003, and 0.004, respectively) between 24–34 gestational weeks (when the neonates of multiple pregnancies were excluded from the analysis, we have demonstrated that congenital pneumonia (p =.033) and neonatal sepsis (p =.030) were still significantly higher in the betamethasone group). The neonates of 24–28 gestational weeks were compared separately and we demonstrated that RDS (p =.012), congenital pneumonia (p =.022), IVH (p =.044), neonatal sepsis (p =.023), and BPD (0.001) were also more frequent in the study group. When the 28–32 gestational week data were compared, IVH (p =.020) and neonatal sepsis (p =.017) were more frequent in the single course betamethasone users. However, we could not demonstrate a significant difference between the control and study groups between 32–34 gestational weeks in terms of the primary neonatal outcomes used in this study. Single course antenatal betamethasone administration may be ineffective on the respiratory complications of preterm and very preterm infants while it may be unfavorable for extremely preterm infants. Pregnant women at risk for preterm labor must be under intensive antenatal care programs, and if possible, necessary precautions must be undertaken to prevent fetal hypoxia together with etiology specific treatments. This approach might contribute to better perinatal outcomes than just administering antenatal corticosteroid therapy. [ABSTRACT FROM AUTHOR]

To evaluate the effect of cycle threshold (Ct) values on the pregnancy outcomes of women with coronavirus disease 2019 (COVID-19). This prospective cohort study was conducted on pregnant women with COVID-19. A real-time polymerase chain reaction (RT-PCR) assay of a nasopharyngeal and oropharyngeal specimen was used for the diagnosis. Initial Ct values for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RT-PCR tests were recorded. 22.9 was the 50th percentile Ct value of the study population. The study population was divided into two groups based on their Ct values: (1) Cases with Higher Ct values (Ct > 22.9)(n = 50) and (2) Cases with lower Ct values (Ct ≤ 22.9)(n = 55). Demographic features, clinical characteristics, disease progression, laboratory test results and pregnancy outcomes were compared between the groups. A receiver operating characteristic (ROC) curve was used to assess the performance of Ct values in predicting obstetric complications. Obstetric complication rate was significantly higher in cases with lower Ct values (p <.001). A significantly lower lymphocyte count together with higher ESR, procalcitonin and IL-6 values were observed in the cases with lower Ct values (p >.05). Additionally, a significantly higher NICU admission rate and longer hospital stays were present in the cases with lower Ct values (p >.05). The value in ROC curves with the best balance of sensitivity/specificity was 22.5 (85.7% sensitivity, 63.6% specificity). Lower Ct values may be associated with an increased rate of obstetric complications in pregnant women with COVID-19. Physicians should be cautious in the management of cases with Ct levels below 22.5. [ABSTRACT FROM AUTHOR]

Aim. The validation of an artificial intelligent system (AIS) - Ankara System Version 5.0 - for the interpretation of antepartum fetal heart rate (FHR) tracings. Methodology. This study consisted of 3100 assuring FHR tracings obtained from normal pregnancies and 467 non-assuring FHR tracings (13.09% of all cases) obtained from pregnancies with various types of maternal health risk factors and/or obstetric complications. Assuring tracings from complicated pregnancies and non-assuring tracings from normal pregnancies were not included in the study, in order to have a qualified database. All tracings were evaluated twice by a single expert. The first evaluation took place just after data acquisition and the second occurred two weeks later without knowledge of the clinical characteristics of the patient (unmatched tracing evaluations were not included in the database). A total of 3032 of them were used for the training of the algorithms, while 535 of them were used for testing and validation. A Doppler ultrasound fetal heart rate monitor with autocorrelation (Hewlett Packard, 8040A) was connected to a computer system by a special frame grabber. Ten-minute recordings were kept in a special file for pattern recognition and decision making. Wavelet transformation was used for feature extraction as the first step of pattern recognition. Unsupervised and supervised artificial neural networks (vector quantization and backpropagation learning algorithm, respectively), the second step of pattern recognition, were used as the classification steps of the hybrid AIS. Results. The testing group consisted of 480 assuring and 55 non-assuring tracings. The sensitivity and specificity of the Ankara System (Version 5.0) were found to be 61.25% and 98.68%, respectively, while the positive predictive value and negative predictive value were calculated to be 89.1% and 93.5%, respectively. Conclusions. This hybrid AIS (Ankara System Version 5.0) might be an effective alternative decision-making tool in the routine practice for the interpretation of FHR tracings. [ABSTRACT FROM AUTHOR]

Adequate maternal selenium level is essential for immune response and healthy pregnancy. This study aimed to shed light on the selenium status of pregnant women with COVID‐19 and the effects of potential deficiency in serum selenium levels. Totally 141 pregnant women, 71 of them were COVID‐19 patients, in different trimesters were included in the study. Maternal serum selenium levels, demographic and clinical parameters were determined. Serum selenium levels of pregnant women in the second (p:.0003) and third (p:.001) trimesters with COVID‐19 were significantly lower than in the healthy group. Maternal selenium level was found to be negatively correlated with gestational week (p <.0001, r: −.541), D‐dimer (p:.0002, r: −.363) and interleukin‐6 (IL‐6) level (p:.02, r: −.243). In the second trimester, serum selenium level positively correlated with white blood cell (p:.002, r:.424), neutrophil (p:.006, r:.39), lymphocyte (p:.004, r:.410) count and hemoglobin (p:.02, r:.323), hematocrit (p:.008, r:.38) status. In the third trimester, it was found that maternal selenium level positively correlated with monocyte (p:.04, r:.353) and negatively correlated with C‐reactive protein level (p:.03, r: −.384). Serum selenium level was gradually decreased during the pregnancy period, however, this natural decrease was enhanced together with COVID‐19 infection. The reason might be increased selenium needs depended on the immune response against infection. The decrease in maternal selenium level was found to be related to IL‐6 and D‐dimer levels, which indicate selenium's role in disease progression. [ABSTRACT FROM AUTHOR]

It was aimed to evaluate the levels of maternal serum proprotein convertase subtilisin/kexin type 9 (PCSK9) in pregnant women with a fetus diagnosed with open neural tube defects (NTDs). This case‐control study included 38 pregnant women carrying fetuses with open NTDs and 44 age‐matched, pregnant women with no specified risk factors. Comparisons were made of the groups in respect of demographic and clinical data and PCSK9 levels. To examine the performance of PCSK9 levels in the prediction of fetal open NTDs, receiver operating characteristic (ROC) curve analysis was used. In the first and second trimesters, PCSK9 levels were determined to be lower in the NTD group than in the control group (p = 0.010 and p = 0.015, respectively). In the first trimester, the lower PCSK9 levels in the NTD group were not statistically significant (p = 0.575). In the second trimester, the ROC curve value with the best balance of sensitivity/specificity for PCSK9 was 71.9 ng/ml (84.6% sensitivity, 51.7% specificity) and in the first and second trimester combined, 74.4 ng/ml (81.6% sensitivity, 45.5% specificity) (p = 0.015, p = 0.036, respectively). PCSK9 may be involved in the etiopathogenesis of open NTDs at the critical steps of fetal neuronal differentiation. Although it has limitations, PCSK9 may be used as an additional biomarker for the screening of NTDs. [ABSTRACT FROM AUTHOR]

Background: This study aimed to investigate the prognostic value of N-terminal B-type natriuretic peptide (NT-proBNP) in pregnancies with isolated chronic hypertension (HT).Method: 34 pregnant women with chronic HT and 40normotensive controls were enrolled. The association between plasma NT-proBNP levels obtained in the first trimester and perinatal complications were evaluated.Results: NT-proBNP levelsstrongly predicted low birth weight (AUC=0.842, p<0.001). NT-proBNP and birth weight were negatively correlated (r= -0.323, p=0.005). NT-proBNP was found to be an individual determinant of low birth weight in univariate analysis (OR:1.03; 95%CI:1.01-1.04).Conclusion: NT-proBNP levels can be useful to predict low birth weight in pregnancies with chronic HT. [ABSTRACT FROM AUTHOR]

To investigate the effect of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on fetal Doppler parameters. This was a prospective case-control study conducted in Ankara City Hospital with confirmed SARS-CoV-2 infected pregnants between August 1, 2020 and October 1, 2020. There were 54 COVID-19 confirmed pregnant women and 97 age-matched pregnant women as a control group between 28 and 39 weeks. Infection was confirmed based on positive real-time polymerase-chain reaction results. Demographic features, uterine artery (right, left), umblical artery, middle cerebral artery, ductus venosus, cerebro-placental ratio, and cerebral-placental-uterine ratio Doppler parameters were investigated in both groups. Two groups were similar in terms of demographic features and no difference was found for fetal Doppler parameters. COVID-19 seems to have no adverse effect on fetoplacental circulation in mild and moderate patients during the acute phase of the infection. [ABSTRACT FROM AUTHOR]

We evaluated the association of nuchal translucency (NT) values above 99th percentile with perinatal outcomes. Materials and methods: Singleton pregnancies with NT values above 99th percentile were investigated. Pregnancies were divided into 3 groups: group 1, NT = 2.6–<3.5 mm; group 2, NT = 3.5–4.5 mm; and group 3, NT > 4.5 mm. Demographic features, clinical characteristics, structural/chromosomal anomaly rates and perinatal outcomes were compared. Results: Normal ultrasonographic anatomy was found in 47.5%, 7.7%, and 14.3% of groups 1, 2, and 3, respectively (p = 0.006). Group 3 had the lowest normal karyotype rate (44.6%) (p = 0.005). Higher frequencies for both miscarriage and pregnancy termination were observed in group 3 compared to group 1 (8.9% vs. 4.9% and 66.1% vs. 32.7%, respectively) (p = 0.02). The lowest rate of normal postnatal anatomic findings was found in group 3 (10.7%) (p = 0.01). Conclusion: NT values above 99th percentile for gestational age seem to be associated with increased rates of chromosomal/structural abnormalities and adverse perinatal outcomes. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to evaluate the maternal‐fetal Doppler patterns in pregnant women recovered from COVID‐19. Methods: This prospective case–control study was conducted in Ankara City Hospital between July 1, 2020 and August 30, 2020. Thirty pregnant women who were diagnosed with COVID‐19 and completed the quarantine process were compared with 40 healthy pregnant women in terms of the fetal Doppler parameters. All pregnant women diagnosed with severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection were followed up in our clinic and their diagnoses have been confirmed in nasopharyngeal and oropharyngeal samples by quantitative real time reverse transcriptase polymerase chain reaction (RT‐PCR) method. Doppler ultrasonographic assessment of the uterine arteries (UtA) and middle cerebral artery (MCA) were used in addition to umbilical artery (UA) Doppler between 23 and 40 weeks of gestation. Also, cerebroplacental ratio (CPR) was calculated according to gestational age. Results: The pulsatility and resistance indices of umbilical and UtA showed a significant increase in pregnant women in the study group compared to the control group (p < 0.05). Multivariable logistic regression analysis revealed that pulsatility and resistance indices of the mean UtA were independently associated with disease (OR > 1000, 95%CI 9.77 to >1000, p = 0.009; OR 0,000 95%CI 0,000‐0,944, p = 0,049), respectively. Medical treatment was given to 16/30 (53%) of pregnant women diagnosed with COVID‐19. Conclusion: In conclusion, uterine artery Doppler indices in the third trimester may have clinical value in pregnant women recovered from COVID‐19. [ABSTRACT FROM AUTHOR]

To evaluate the maternal serum afamin and vitamin E levels in pregnant women with coronavirus disease 2019 (COVID‐19) and to investigate their association with composite adverse perinatal outcomes. This prospective, case‐control study consisted of 60 pregnant women with COVID‐19 infection and 36 age‐matched pregnant women without any defined risk factors. Demographic features, laboratory test results, afamin and vitamin E levels were compared between the groups. A receiver operating characteristic (ROC) curve was used to assess the relationship of afamin and vitamin E levels in predicting composite adverse perinatal outcomes. A correlation analysis was performed between afamin and C‐reactive protein (CRP) levels in pregnant women with COVID‐19. The obstetric complication rate was higher in the COVID‐19 group (13.3% vs. 2.8%) (p =.01). Afamin levels were higher and vitamin E levels were lower in the COVID‐19 group (p =.02 and p <.001, respectively). Vitamin E levels were lower in the COVID‐19 group for the all trimesters (p <.001, p <.001, and p =.004, respectively). Afamin levels were higher in the COVID‐19 group for the all trimesters without reaching statistical significance (p >.05). The values in the ROC curves with the best balance of sensitivity/specificity for afamin and vitamin E were 0.424 mg/l (70.6% sensitivity, 44.3% specificity) and 3.150 µg/ml (76.5% sensitivity, 58.2% specificity), respectively. A positive moderate statistically significant correlation was found between afamin and CRP levels (r =.264, p =.009). Higher afamin and lower vitamin E levels may support the elevated oxidative stress in the etiopathogenesis of COVID‐19 and the relationship with composite adverse perinatal outcomes. [ABSTRACT FROM AUTHOR]

The aim is to compare VEGF‐A values between pregnant women with coronavirus disease 2019 (COVID‐19) and healthy controls. Furthermore, the association of inflammation parameters, disease severity, and obstetric complications with VEGF‐A was investigated. This prospective case‐control study was conducted on pregnant women who were admitted to Ankara City Hospital between June 14, 2020 and August 28, 2020. Pregnant women with COVID‐19 (n = 95) were compared with a control group of healthy pregnant women (n = 92) with similar clinical and demographic characteristics. Demographic features, clinical characteristics, laboratory test results, VEGF‐A values were compared between the groups. A correlation analysis was performed between VEGF‐A levels, inflammation parameters, and clinical characteristics of the cases for pregnant women with COVID‐19. VEGF‐A levels were also compared between patients with composite adverse outcome and patients without any complication in the COVID‐19 group. The two groups were similar except for obstetric complications (p >.05). The obstetric complication rate was higher in the COVID‐19 group (p =.02). The two groups were comparable in terms of neutrophil to lymphocyte ratio and VEGF‐A values. VEGF‐A values were slightly different between the trimesters. A negative moderate statistically significant correlation was found between the neutrophil and VEGF‐A values (r = −0.231, p =.02). VEGF‐A values were similar between patients with and without composite adverse outcomes (p >.05). VEGF‐A values were similar between pregnant women with COVID‐19 and healthy controls. [ABSTRACT FROM AUTHOR]

Objective: To investigate the clinical course and impact of coronavirus disease 2019 (COVID‐19) infection on pregnant women. Methods: A prospective cohort study was conducted on pregnant women with confirmed COVID‐19 infection. Demographic features, clinical characteristics, and perinatal outcomes were prospectively evaluated. Results: Of the 533 cases, 161 (30.2%) had co‐morbidities and 165 (30.9%) were asymptomatic. Cough (n = 178, 33.4%) and myalgia (n = 168, 31.5%) were the leading symptoms. In total, 261 patients (48.9%) received COVID‐19 therapy, 509 (95.5%) had mild disease, 7 (1.3%) were admitted to the intensive care unit (ICU), and invasive mechanical ventilation was necessary in 2 (0.4%) patients. Maternal mortality was observed in 2 (0.4%) cases. Of the patients, 297 (55.7%) were hospitalized, 39 (7.3%) had suspicious radiologic imaging findings, 66 (12.4) had pregnancy complications (preterm delivery [n =22, 4.1%] and miscarriage [n =12, 2.2%] were the most common pregnancy complications), 131 births occurred, and the cesarean section rate was 66.4%. All neonates were negative for COVID‐19. The rate of admission to the neonatal ICU was 9.9%. One specimen of breast milk was positive for the infection. Conclusion: The course of COVID‐19 was mild in the majority of cases. However, increased rates of pregnancy complications and cesarean delivery were observed. Synopsis: Management of pregnant women with COVID‐19 infection should be conducted by a multidisciplinary team within the framework of an individualized patient approach for favorable outcomes. [ABSTRACT FROM AUTHOR]