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Objectives Methods Results Conclusion To investigate the fetal heart using pulsed wave Doppler, M‐mode, and tissue Doppler imaging (TDI) in cases of intrahepatic cholestasis of pregnancy (ICP).This prospective study was conducted at a single tertiary center and included 35 patients with ICP and 70 healthy pregnant women at 28–36 weeks of pregnancy. Among the patients with ICP, 26 had serum bile acid (SBA) levels less than 40 μmol/L and nine had SBA levels of 40 μmol/L or greater. Pulsed wave Doppler, M‐mode, and TDI evaluations were performed on the patients to assess fetal cardiac function.The ICP group exhibited significantly higher myocardial performance index (MPI) and isovolumetric relaxation time (IRT), but similar isovolumetric contraction time (ICT). The tricuspid and mitral valve E, A, and E/A ratios were significantly reduced in the ICP group. The TDI parameters showed significantly reduced tricuspid and mitral valve E′/A′ ratios in the ICP group compared with the control group (P < 0.001). The E/E′ ratio was significantly increased in the ICP group (P < 0.001). According to the M‐mode Doppler findings, tricuspid and mitral annular plane systolic excursion values were significantly decreased in the ICP group (P = 0.005 and P = 0.001, respectively). In the subgroup analysis, MPI and IRT were significantly higher in the severe ICP group.ICP might induce changes in the fetal heart during the early systolic and diastolic phases. The detection of these early changes using M‐mode and TDI during the antenatal period can provide valuable insights into the condition of the fetus. [ABSTRACT FROM AUTHOR]

Aim: To evaluate theperinatal outcomes of 14 HIV (humanimmunodeficiency virus) positive pregnant women followed up in a tertiary center. Materials and Methods: This is a retrospective cohort study conducted in Ankara Bilkent City Hospital perinatology clinic. All pregnant women who were followed up with a diagnosis of HIV positive between 2020 and 2023 were included in the study. Demographic characteristics of pregnant women, time of diagnosis, antiretroviral treatment received in the prenatal and intrapartum period, antiretroviral treatment received by infants and duration, and vertical transmission rate were evaluated. Results: A total of 14 HIV-positive pregnant women were included in the study. Two cases (14.28%) were in the first trimester, one case (7.14%) was in the second trimester, 10 cases (71.42%) were in the third trimester, and one case (7.14%) was in the 10th postpartum day at first admission to hospital. Nine (64.3%) of the patients had regular hospital follow-ups with regular tests and treatment. While 5 (35.7%) did not attend regular follow-ups and did not receive regular treatment. The mean CD4+ count was 611±243 cell/mm3 and the CD8+ count was 852±366 cell/mm3. The mean CD4/CD8 ratio was 0.94±0.74. The maternal HIV plasma RNA copy numberwas not checked in one patient, the result was negative in 5 patients and was positive in the remaining 8 patients. The median HIV RNA was 471 (range 0-106559) copy/mL. Since the infants were born at different times, they were divided into 2 groups: 0-18 months and 18-40 months. All babies were regularly followed up by a pediatrician and an infectious disease specialist. All infants were given standard treatment with lamivudine/zidovudine and raltegravir. IV positivity was not detected in any of the babies in the controls performed after 18 months. Conclusion:In conclusion, maternal HIV infection is associated with favorable outcomes if managed appropriately by a multidisciplinary team. [ABSTRACT FROM AUTHOR]

Aim: To compare composite adverse perinatal outcomes (CAPO) in women with early- and late-onset intrahepatic cholestasis of pregnancy (ICP). Materials and Methods: This study was designed as a single-center, retrospective study in a tertiary hospital and included a total of 198 patients with ICP, including 36 patients with early-onset ICP (EO-ICP) and 162 patients with late-onset ICP (LO-ICP). ICP that developed before the 28thweek of gestation was defined as EO-ICP, and ICP that occurred after the 28thweek of gestationwas defined as LO-ICP. The existence of at least one of the following criteria was defined as CAPO: umbilical cord arterial pH < 7.20, fifth-minute Apgar score < 5, andneonatal intensivecarestay of>24 hours. Results:The rates of spontaneous preterm birth and neonatal intensive care admission were statistically significantly higher in the EO-ICP group (p<0.001). In the same group, a significantly higher number of neonates were born with meconium (p=0.040). The use of ursodeoxycholic acid was significantly greater in the EO-ICP group (p=0.007). The two groups did not show any significant differences in terms of neonatal umbilical cord arterial pH or base excess (p>0.05), however, the CAPO rate was significantly higher in the EOICP group(p=0.028). Receiver operator characteristic analysis revealed an optimal cut-off value of 33.5 μmol/L for the serum bile acid level, at which this parameter had 74% sensitivity and 68% specificity (area under the curve=0.759; p<0.001) in the prediction of CAPO. Conclusion: We consider that the high CAPO rates in the fetuses of patients with EO-ICP are due to the effect of high serum bile acid levels on the fetus for a longer time than in the LO-ICP group. The differentiation of cases of EO-ICP and LO-ICP will serve as a guide for clinicians in predicting possible complications. [ABSTRACT FROM AUTHOR]

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]

Introductıon: The objective of this study was to present the results of fetuses followed up for choroid plexus cysts(CPC) in our clinic and to provide an additional benefit to the existing literature. Methods: This is a retrospective cohort study conducted in Ankara Bilkent City Hospital perinatology clinic. All pregnant women who were followed up with a antenatally diagnosed choroid plexus cyst between 2021 and 2023 were included in the study. Demographic characteristics, prenatal ultrasound findings, non-invasive screening test results, invasive diagnostic test results, clinical management and postnatal outcomes were evaluated and compared between unilateral CPC group and bilateral CPC group. Results: A comparison between unilateral and bilateral groups revealed no significant differences in maternal age, gravidity, parity, or number of abortions. However, the week of diagnosis was found to be smaller in the group with bilateral choroid plexus cysts (p=0.004). Patients undergoing invasive testing were higher in the bilateral CPC group, although these differences were not statistically significant. There was no statistically significant difference between the groups in terms of pregnancy termination rate, gestational week at delivery, neonatal weight, NICU admission, and APGAR scores. The group with additional anomalies exhibited a higher rate of high-risk screening tests, a higher rate of anomaly detection in invasive tests, and a higher rate of pregnancy termination. Nevertheless, these differences were not statistically significant. Conclusion: In conclusion, fetal choroid plexus cysts represent a risk factor for aneuploidy when associated anomalies are present. [ABSTRACT FROM AUTHOR]

Introductıon: This retrospective study evaluated women in whom transvaginal cervical cerclage (TCC) was performed in a previous pregnancy but delivered without cervical intervention in the most recent pregnancy. The primary aim was to underline the importance of etiology based management protocols on favorable pregnancy outcomes in patients with a history of TCC. Methods: We retrospectively evaluated 34 patients with at least one failed TCC for the treatment of cervical insufficiency (CI) but who gave birth without TCC in their most recent pregnancies. Results: All patients were evaluated preconceptionally and examined for maternal risk factors. At least one risk factor was present in all cases. The autoimmune antibody positivity rate was 41.2%. Twelve patients had Hashimoto thyroiditis, two had systemic lupus erythematosus, two had pernicious anemia, and two had anti-phospholipid antibody syndrome. 32 had homozygous or heterozygous methylenetetrahydrofolate reductase (MTHFR) gene polymorphisms, while 11 were homozygous or heterozygous for factor 5 Leiden or prothrombin-20210A gene mutations. Conclusion: The elimination and management of risk factors for cervical ripening and dilatation are important for preventing unnecessary cervical interventions. [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]