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Aim: To investigate imaging findings and postnatal clinical features of fetal intracranial hemorrhage. Materials and Method: Fetal intracranial hemorrhage cases detected in our institution between 2018 and 2020 by ultrasonography and magnetic resonance imaging were included. Maternal characteristics, ultrasonography and magnetic resonance imaging findings, and postnatal outcomes were noted. Results: A total of 10 cases with a gestational age of 21-35 weeks at the time of diagnosis were detected. Eight cases had an intraventricular hemorrhage, one case had a cerebellar hemorrhage, and one case had both intraventricular and subdural hemorrhage. An identifiable risk factor was detected in 60% of the cases. While intracranial hemorrhage was diagnosed by ultrasonography in seven cases, in 3 cases it was detected by magnetic resonance imaging that was performed for indications other than intracranial hemorrhage. In two cases pregnancy was terminated, one intrauterine fetal death occurred and seven cases born alive were followed up for at least six months in the postnatal period. Among these, the neurological disorder was observed in 66.6%. Conclusion: Fetal magnetic resonance imaging plays an important role in the diagnosis and characterization of intracranial hemorrhage and is complementary to ultrasonography. Hence we recommend using ultrasonography and magnetic resonance imaging together in its diagnosis.

Objectives To evaluate the outcomes, and predictive value of uterine artery pulsatility index (UtA-PI) and second-trimester maternal serum alpha-fetoprotein (MSAFP) for adverse obstetric outcomes in cases with morphologically confirmed circumvallate placenta by comparison with normal pregnancies. Study design This prospective study was conducted in a tertiary referral hospital between January 2017 and December 2019. During the study period, 77 patients with a circumvallate placenta and 77 patients without any placental or feto-maternal diseases or abnormalities were evaluated. The final diagnosis was made based on macroscopic examination of the placenta soon after birth. Demographic characteristics, MSAFP, obstetric complications, haemoglobin after delivery, gestational week of birth, fetal sex, 1- and 5-min Apgar scores, postnatal complications and type of delivery were retrieved from hospital records. Bilateral mean transabdominal UtA-PI and MSAFP were evaluated for the prediction of adverse outcomes. SPSS Version 21.0 for Windows was used for statistical analysis, and receiver operating characteristic (ROC) curves were used for the prediction model of adverse outcomes. Results Smoking rate, MSAFP, preterm birth and intrauterine growth restriction (IUGR) were higher in the patients with a circumvallate placenta (p = 0.005, 0.00, 0.025 and 0.027, respectively). The cut-off value of MSAFP was 1.41 (0.60–3.32) and the cut-off value of UtA-PI was 1.2 using the ROC curves, and had sensitivity of 73.7 % and specificity of 71.9 %, and sensitivity of 73.7 % and specificity of 76.3 %, respectively (p Conclusions Circumvallate placenta was associated with a higher rate of IUGR, preterm birth and bleeding at the time of delivery. In patients with a circumvallate placenta, UtA-PI and MSAFP may be valuable as predictors of IUGR.

Aim: To investigate the risk factors and outcomes of emergency intervention in pregnant women with placenta previa (PP). Material and method: This retrospective study was conducted between June 2015 and January 2021. Pregnant women with PP were divided into emergency and planned intervention groups according to surgical planning. The groups were compared in terms of demographic characteristics, presence of antepartum hemorrhage (APH), operation characteristics, and maternal and neonatal outcomes. Results: A total of 434 patients with PP were analyzed. The frequency of PP was 0.52%. The emergency intervention was performed in 168 (38.7%) pregnant women, whereas planned intervention was performed in 266 (61.3%). APH was present in 208 (47.9%) patients; the presence of APH was associated with increased risk of emergency intervention by 3.026 [95% confidence interval (CI), 1.990–4.603; p = 0.000]-fold. The weight gained during pregnancy was associated with reduced risk of emergency intervention by 0.932 (95% CI, 0.887–0.978; p = 0.004)-fold. In the emergency intervention group, more additional surgical procedures and massive transfusion were performed during the operation (p = 0.000 and p = 0.000) Emergency intervention resulted in an increase in adverse maternal and fetal outcomes by 3.064 (95% CI, 1.571–5.975) and 7.5 (95% CI, 4.841–11.620)-fold, respectively. Conclusion: The frequency of an emergency intervention is high in those with PP and is associated with increased adverse maternal and neonatal outcomes.The most effective factor in the prediction of emergency intervention is APH.

Aim The study aimed to determine the frequency of possible missed diagnosis of gestational trophoblastic disease in nonviable pregnancies and to evaluate the importance of histopathological examination. Methods In this retrospective study, the results of the histopathological assessment of patients undergoing uterine surgery with a diagnosis of nonviable pregnancy were analyzed before 14 weeks of gestation. Nonviable pregnancy was defined as anembryonic pregnancy and intrauterine exitus (IU-ex) based on ultrasound findings. The frequency and sonographic characteristics of molar pregnancy in nonviable pregnancy were analyzed. Results Molar pregnancy was detected in 24 (1.62%) of 1481 patients diagnosed with nonviable pregnancy on ultrasound. One thousand one hundred and twenty-one of the cases were IU-ex (75.69%) and the remaining were anembryonic pregnancy (24.31%). The mean crown-rump length of pregnancies in the IU-ex group was 16.7 mm and the mean gestational age was 8 weeks. The average gestational sac diameter was found to be 26 mm in anembryonic pregnancy patients. The hydatidiform mole ratio was significantly higher in anembryonic pregnancy patients (3.06%) than in IU-ex patients (1.16%) (p = 0.013). Conclusions The appearance of early molar pregnancy on ultrasound evaluation may mimic anembryonic pregnancies. Therefore, histopathological examination of anembryonic pregnancies may be useful in early diagnosis and for the treatment of gestational trophoblastic neoplasia.

In this study, we aimed to investigate the role of systemic immune-inflammation index (SII) and other inflammatory parameters in the diagnosis of placenta accreta spectrum (PAS) and its histological subtypes.This retrospective case-control study included patients who underwent surgery for placenta previa (PP). Case group (patients with PAS) included pregnant women diagnosed with histologically confirmed PAS, whereas control group (patients with PP) included pregnant women who underwent cesarean section with a PP diagnosis, required no additional intervention during the operation. Both groups were compared with respect to their demographic data, clinical characteristics, SII, and other laboratory parameters. Cut-off values that can predict PAS were calculated. The PAS group was separated into subgroups based on histology findings, and inflammatory parameters were compared between subgroups.In this study, data of 273 patients were analyzed. Of these, 68 (24.9%) were included in the PAS group and 205 (75.1%) patients were included in the PP group. Significant differences were observed in SII, platelet distribution width, mean platelet volume, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio (p = 0.000, p = 0.006, p = 0.002, p = 0.000, and p = 0.000, respectively). The best SII cut-off value was 985.02109/L (57.4% sensitivity and 72.2% specificity). There was no significant association between the histologic subtypes of PAS and inflammatory parameters.SII can be used to predict PAS in pregnant women with PP. The relationship between the histologic subtypes of PAS and inflammatory parameters should be investigated in more comprehensive studies.

Prenatal diagnosis of persistent right umbilical vein (PRUV) is important due to accompanying malformations. Pregnant women diagnosed with PRUV were analysed retrospectively. Intrahepatic PRUV was seen in 12 of 10.743 foetuses and its incidence was found to be 0.11%. The gestational week at the time of diagnosis was between 20 and 35 weeks. Six of the cases had additional abnormal sonographic findings (50%) and six cases (50%) were isolated. Major congenital malformations were seen in four (33.3%) foetuses, 75% of which were congenital heart disease (CHD). Genitourinary system anomaly accompanied in two cases (16.6%). Invasive diagnostic tests were applied to three pregnant women and the results were reported as normal karyotype. In PRUV cases, a detailed sonographic examination should be performed, especially the cardiovascular system. Although PRUV cases do not appear to be associated with chromosomal abnormalities, invasive diagnostic tests should be recommended in the presence of concomitant anomalies.Impact statementWhat is already known on this subject? The persistent right umbilical vein (PRUV) is a pathological vascular anomaly, in which the left umbilical vein regresses and the right umbilical vein remains open. PRUV can occur in an isolated form that represents its normal variant or be associated with other major or minor anomalies.What do the results of this study add? Additional abnormal sonographic findings were accompanied in 50% of PRUV, major anomaly was detected in 33.3% of them and cardiovascular abnormalities constituted 75% of foetuses with major anomalies.What are the implications of these findings for clinical practice and/or further research? The presence of concomitant anomalies in PRUV cases is not rare and detailed anatomy screening should be done. The most common accompanying abnormality is seen in the cardiovascular system, so foetuses with PRUV should be evaluated by foetal echocardiography.

Objective To investigate fetal anomalies and pregnancy outcomes in pregnancies with persistent left superior vena cava (PLSVC) to provide assistance in prenatal counseling. Methods Cases diagnosed with PLSVC between January 2015 and January 2020 were obtained from the hospital's electronic system and were analyzed retrospectively. Results Twenty-seven cases were analyzed. The prevalence of PLSVC among congenital heart diseases (CHD) was 6.9%. Conotruncal anomalies and renal anomalies were the most common accompanying cardiac and extracardiac anomalies, respectively. Chromosomal abnormality was detected in one fetus.In the postpartum period coarctation of aorta (CoA) was found in one fetus. Conclusions When PLSVC is detected during prenatal ultrasonography, fetal anatomy should be carefully examined because of the anomalies that may accompany it. Prenatal genetic counseling should be given especially to cases with additional anomalies. In isolated cases, cardiac anatomy should be evaluated with repeated echocardiography because of the risk of CoA.

Objective To investigate the association between maternal serum neutrophil-to-lymphocyte ratios (NLRs) and pregnancy outcomes in women with familial mediterranean fever (FMF). Background FMF exists worldwide, it primarily affects Mediterranean countries METHODS: We retrospectively analysed data from 269 pregnant women, who underwent a routine prenatal follow-up and delivery in our hospital from 2016 to 2020. Clinical and demographic data, including age, gravida, parity, abortus, proteinuria in the first trimester, NLR, obstetrical complications, gestational age at delivery, birthweight were retrieved from the patients' medical records. Data from 67 pregnant women with FMF and 202 healthy pregnant women were compared. Results Patients with FMF showed higher rates of preeclampsia and primary caesarean delivery; however, there were no differences between the groups in terms of other obstetric complications or adverse neonatal outcomes. In both the FMF and control groups, NLRs in the third trimester were significantly higher than those in the first trimester. Additionally, patients in the FMF group demonstrated higher NLRs than patients in the control group in the third trimester. Conclusions The NLRs are a haematological parameter that can be used to predict subclinical inflammation and the effects of ongoing subclinical inflammation on the pregnancy outcomes in women with FMF (Tab. 4, Ref. 39).

Background/aim To evaluate the prevalence of tetanus vaccination in pregnant women and determine the factors affecting the vaccination and barriers to vaccination. Materials and methods An observational-descriptive study was conducted on 494 women who gave birth at the Etlik Zubeyde Hanim Women’s Health Training and Research Hospital, Ankara, Turkey. Participants were divided into 2 groups, vaccinated and unvaccinated. Sociodemographic characteristics, obstetric history, and prenatal care status were compared between the 2 groups. Results There were 242 (48.9%) and 252 (51.1%) women in the vaccinated and unvaccinated groups, respectively. The vaccination rate decreased as the number of pregnancies increased (P = 0.009). As the level of income increased, there was a statistically significant increase in the vaccination rate (P = 0.048). The status of education and having an occupation did not affect the vaccination rate (P > 0.05). The vaccination rate was higher in women with regular follow-ups when compared to those who did not get a regular follow-up (76.5% vs. 38.7%) (P = 0.001). The vaccination rate was significantly higher in women who had knowledge about tetanus vaccine during pregnancy (P < 0.005). Conclusions All pregnant women should be encouraged to get regular antenatal care to increase vaccination rates. Health care providers should give all pregnant women detailed information about the safety, effectivity, and benefits of vaccines.

The present study is intended to investigate the causes of stillbirth and its relationship with maternal conditions using the International Classification of Diseases-Perinatal Mortality (ICD-PM) system.All early and late fetal deaths between 2015 and 2020 were analyzed. Time of death, fetal causes, and the maternal conditions involved were identified using the ICD-PM classification system.During the study period, out of 74,102 births a total of 475 stillbirths were recorded (6.4 per 1000 births), of which 83.6% of the cases were antepartum and 11.8% were intrapartum fetal deaths, and the time of death could not be determined in 4.6% of the cases. Fetal developmental disorder was the most common cause of antepartum fetal death (24.2%). Intrapartum deaths were mostly due to extremely low birth weight (44.6%). The most common maternal conditions involved were complications of placenta, cord, and membranes (19.8%).The applicability of the ICD-PM classification system for stillbirths is easy. It was observed that fetal deaths mostly occurred in the antepartum period and the cause of death could not be identified in over half of these antepartum fetal deaths. In over half of the stillbirths, there is at least one maternal condition involved. The most common maternal conditions involved are complications of placenta, cord, and membranes. The most common maternal medical problem is hypertensive diseases of pregnancy.