Mean Gestational Week Research Articles

The impact of recommending iron supplements to women with depleted iron stores in early pregnancy on use of supplements, and factors associated with changes in iron status from early pregnancy to postpartum in a multi-ethnic population-based cohort

BackgroundWe aimed to evaluate the impact of recommending supplementation to pregnant women with serum ferritin (SF) < 20 µg/L in early pregnancy on use of supplements, and to explore which factors were associated with changes in iron status by different iron indicators to 14 weeks postpartum.MethodsA multi-ethnic population-based cohort study of 573 pregnant women examined at mean gestational week (GW) 15 (enrolment), at mean GW 28 and at the postpartum visit (mean 14 weeks after delivery). Women with SF < 20 µg/L at enrolment were recommended 30-50 mg iron supplementation and supplement use was assessed at all visits. Change of SF, soluble transferrin receptor and total body iron from enrolment to postpartum were calculated by subtracting the concentrations at the postpartum visit from that at enrolment. Linear and logistic regression analyses were performed to assess associations between use of supplements in GW 28 and changes in iron status and postpartum iron deficiency/anaemia. Change of iron status was categorized into ‘steady low’, ‘improvement’, ‘deterioration’, and ‘steady high’ based on SF status at enrolment and postpartum. Multinomial logistic regression analyses were performed to identify factors associated with change of iron status.ResultsAt enrolment, 44% had SF < 20 µg/L. Among these women (78% non-Western European origin), use of supplements increased from 25% (enrolment) to 65% (GW 28). Use of supplements in GW 28 was associated with improved iron levels by all three indicators (p < 0.05) and with haemoglobin concentration (p < 0.001) from enrolment to postpartum, and with lower odds of postpartum iron deficiency by SF and TBI (p < 0.05). Factors positively associated with ‘steady low’ were: use of supplements, postpartum haemorrhage, an unhealthy dietary pattern and South Asian ethnicity (p ≤ 0.01 for all); with ‘deterioration’: postpartum haemorrhage, an unhealthy dietary pattern, primiparity and no use of supplements (p < 0.01 for all), and with ‘improvement’: use of supplements, multiparity and South Asian ethnicity (p < 0.03 for all).ConclusionsBoth supplement use and iron status improved from enrolment to the postpartum visit among women recommended supplementation. Dietary pattern, use of supplements, ethnicity, parity and postpartum haemorrhage were identified as factors associated with change in iron status.

Cardiological Findings of Babies Born to Mothers with Connective Tissue Disease

Objective: Cardiac conduction system is affected and heart blocks can be seen in newborns whose mothers have connective tissue disease, especially with systemic lupus erythematosus (SLE) and Sjögren's syndrome (SS). Anti-SS-A (Ro), anti-SS-B (La) antibodies in the mother's circulation are responsible for this situation. In this study, it was aimed to evaluate the clinical features and long-term follow-up results of babies born to mothers with connective tissue disease in our hospital. Materials and methods: Patients who were hospitalized in the neonatal intensive care unit between January 2001 and January 2016 due to the diagnosis of SLE, SS or connective tissue disease in their mothers were retrospectively screened, and their demographic and clinical characteristics and electrocardiographic findings were recorded. Results: A total of 49 babies from 48 mothers were included in the study. Mean age of mothers at birth was 30.8±5.0 years (28-41), mean gestational week of patients was 35.8±2.5 weeks (28-41), mean birth weight was 2614±680 g (730-3810 g). Ten newborns (20.4%) had 3rd degree atrioventricular (AV) block, and 1 baby had 1st degree AV block. Permanent pacemaker was implanted in five patients in the neonatal period, two of these patients died in the neonatal period. A pacemaker was inserted in a patient who was followed up with AV block in the 6th month. One baby who had no cardiac conduction problem died due to reasons related to prematurity. The mean follow-up period of 46 living babies was 4.6±3.1 (1.2-10.75) years, and the follow-up period of the patients with complete AV block and without a pacemaker was 5.6±2 years. Conclusion: Complete AV block in the neonatal period is a serious cardiac problem that requires rapid intervention. Expectant mothers with known connective tissue disease should be followed in tertiary care centers and the fetus should be followed closely. It is possible for newborns in need to return to their normal lives by inserting pacemakers.

Cysteinyl Leukotriene and Systemic Inflammatory Levels in Preeclampsia.

Background In this study, we aimed to demonstrate the efficacy of cysteinyl leukotriene levels, which play a role in inflammation, in predicting the severity of preeclampsia (PE) and to determine whether this marker can be used as a screening tool. Methods In this cross-sectional analytic study, we classified pregnant women who were normotensive (control) or PE or severe PE (SPE) between March 2019 and July 2019. Singleton pregnant 60 women who met the following criteria for the diagnosis of PE were included in the study group. We identified 30 patients with PE and 30 patients with SPE. Normotensive pregnant women (n=30) who met this criterion were included as a control group by randomly selecting them on odd days of the week. Results All pregnant women who participated in the study had a singleton pregnancy, and maternal age ranged from 18 to 40 years, with a mean age of 28.77±6.37 years. The mean gestational week of the group was 35.54±3.247 weeks. Gestational age was higher in women in the control group (p=0.018), shock index was higher in women in the control group (p < 0.001), and body mass index (BMI) value was lower in this group than in the other groups (p=0.002). The values of mean arterial pressure (MAP) were found to have a strong correlation with shock index value and a weak and negative correlation with gestational week and platelet/lymphocyte ratio (p < 0.05). The mean cysteinyl leukotriene levels of 206.15 pg/mL for the control group, 273.2 pg/mL for PE, and 211.85 pg/mL for SPE were calculated. However, no statistically significant difference was found between the groups (p=0.707). Conclusion We found that cysteinyl leukotrienes were not clinically important in assessing the risk for developing PE and predicting SPE. Alanine aminotransferase, white blood cell, lymphocyte, C-reactive protein, platelet/lymphocyte ratio, and shock index were positively correlated with the value of MAP.

A Cross-Sectional Study on Factors Related to Status of Meconium Stained Liquor Labour Patients Attended at Tertiary Level Hospital in Dhaka, Bangladesh

Background: Meconium-stained liquor during labor is a common almost daily encountered problem. Objective: The purpose of the study was to find out factors related to meconium-stained liquor affecting during labor. Methodology: This is a cross-sectional, hospital-based observational study conducted in the Department of Obs &amp; Gyne, Shaheed Suhrawardy Medical College Hospital, Dhaka. The cases with single, term pregnancy with cephalic presentation presented with meconium-stained liquor was selected. All the cases willingly participated in this study. Data collection and fetal assessment was conducted in the labor room. The meconium-stained liquor was clinically and completely in a structured questionnaire according to the events that happened pre and post-delivery including neonatal outcome data. Data was analyzed by computer using the SPSS program (Statistical Package of Social Sciences), version-22, and p value &lt;0.05 considered as statistically significant. Result: The mean age of the study group was 32.3±6.4 years. The Level of education of the study population, illiterate 12.0%, primary school 21.0%, majority SSC 33.0%, HSC 20.0% and graduation 14.0% and the occupation of the study patients mostly housewife 65.0%, least service.10.0%, business 14.0% and other professions 11.0% and mean gestational week was 40.12±1.43. Conclusion: The meconium-stained liquor labour is a serious condition and related with some factors which can be addressed by these factors and the safety of maternal and fetal outcomes. J Shaheed Suhrawardy Med Coll 2021; 13(2): 109-112

Epidemiological and clinical characteristics, management, and outcomes of antenatal hydronephrosis: A single-centre experience of 229 cases

The advances in utilization of USG in antenatal routine follow-up resulted with increased diagnosis of antenatal hydronephrosis (ANH). This study was conducted to elaborate the epidemiological and clinical characteristics, management, outcomes, and possible risk factors of the ANH. A total of 229 cases diagnosed with ANH during the antenatal follow-up at the Obstetrics and Gynecology Department of OndokuzMayis University between 2004 and 2022 were included. The ANH was defined as an USG finding suggesting a hydronephrosis 7 mm. The epidemiological and clinical characteristics, risk factors, treatment and outcomes in the postnatal period were assessed retrospectively. About 75% of the cases were male, 8% were premature births, and the mean gestational week of diagnosis was 22±3 weeks. About 43.7% of mothers had urinary tract infections, and family history of a kidney disease was present in 24.5% of mothers’ and 20.5% of fathers’ family histories.38.7% of cases undergone surgery. At the end of 6-month follow-up, 37.3% had regressed and 38.7% of them had stable hydronephrosis, and 18.9% of them had normal findings in USG. Male gender, increased gestational urinary tract infections, and family histories of parents for a kidney disease were found as possible risk factors for development of ANH. Close follow-up and timely intervention including surgery provides favorable outcomes in these cases.

Effectiveness of breathing exercise on the duration of labour: A systematic review and meta-analysis.

Prolonged labour intensifies labour pain, and failure to address labour pain may lead to abnormal labour and augments the usage of operative interventions. Prolonged labour is common among women, resulting in maternal morbidity, increased caesarean section (CS) rates, and postpartum complications. It may bring forth negative birth experiences that may increase the preference for CS. There is a dearth of evidence concerning the effectiveness of breathing exercises on the duration of labor. As per our knowledge, this is the first systematic review and meta-analysis on the effect of breathing exercises on the duration of labor. This systematic review and meta-analysis aimed to appraise the evidence concerning the effectiveness of breathing exercises on the duration of labour. Electronic databases MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE, Web of Science, SCOPUS, and ClinicalKey were searched for randomized controlled trials, quasi-experimental studies published in the English language between January 2005 to March 2022 that reported on the effectiveness of breathing exercises on the duration of labour. Duration of labour was the primary analysed outcome. The secondary outcomes assessed were anxiety, duration of pain, APGAR scores, episiotomy, and mode of delivery. Meta-analysis was done using RevMan v5.3. The reviewed trials involved 1418 participants, and the study participants ranged from 70 to 320. The mean gestational weeks of the participants among the reported trials was 38.9 weeks. Breathing exercise shortened the duration of the intervention group's second stage of labour compared with the control group. Breathing exercise is a beneficial preventive intervention in shortening the duration of second stage of labour. The review protocol was registered with PROSPERO (CRD42021247126).

The Effect of Active and Passive Maternal Smoking During Pregnancy on the Uterine Artery Blood Flow and Obstetric Outcomes: A Prospective Study.

Maternal smoking is associated with an increased risk of obstetric and neonatal complications during pregnancy. We aimed to investigate the effects of active and passive smoking on fetal-maternal blood flow and fetal complications in mid-trimester pregnant women. This prospective study was conducted at Zekai Tahir Burak Women's Research and Training Hospital and included women who were 20 to 22 weeks old, with no fetal anomalies, and with a singleton pregnancy. The data used in the analysis were obtained from a total of 168 pregnant women (50 smokers, 50 passive smokers, and 68 non-smokers). Starting from their 20th week of pregnancy, the women were examined at least once in each trimester. Fetal and maternal pregnancy results were evaluated. Fetal biometry, umbilical, and uterine artery Doppler ultrasonography were performed. To evaluate the flow in these veins, the pulsatility index, resistance index, and systole/diastole (S/D) ratio were performed. The mean age of study patients was 25.06 ± 4.36 years and the mean gestational week was 20.03 ± 0.6 weeks. In terms of the umbilical artery pulsatility index (UMBAPI), umbilical artery systolic/diastolic ratio (UMBAS/D),uterine artery resistance index (UARI), uterine artery pulsatility index (UAPI), and uterine artery systolic/diastolic ratio (UAS/D) levels, the mean value of the smoker group was significantly higher compared to the non-smoker group (p<0.001, p=0.043, p=0.021, p=0.020, and p=0.037, respectively). The birth weight of the fetus was significantly lower in the active and passive smoker groups than in the non-smoker group (p=0.009 and p=0.006, respectively). The number of patients diagnosed with intrauterine growth restriction (IUGR) and oligohydramnios were significantly higher in the smoker group than in the passive smoker and non-smoker groups (p=0.003 and p<0.001, respectively). The risk of low birth weight (OR, (95% CI): 3.38 (2.05 - 5.57); p=0.024), oligohydramnios (OR (95% CI): 13.44 (5.22 - 34.57); p=0.001), IUGR (OR (95% CI): 9.33 (4.50 - 19.33); p=0.001), and preterm birth (OR (95% CI): 4.56 (1.25 - 17.32); p=0.001) increased significantly in the active and passive cigarette exposure groups, compared to the non-smokers. During pregnancy, both smoking and passive exposure to cigarette smoke adversely affect the fetus and the newborn. Uterine and umbilical artery Doppler measurements in pregnant women who smoke are significantly higher than the pregnant women who do not smoke.

Trauma in pregnancy: An analysis of the adverse perinatal outcomes and the injury severity score.

Trauma during pregnancy is one of the most important causes of non-obstetric maternal and fetal mortality and morbidity. The aim of our study is to evaluate the adverse perinatal outcomes that may occur according to the type and severity of the trauma. In this retrospective cohort study, pregnant traumatized women aged 18-50 years and referred for consultation to the Prof. Dr. Cemil Tascıoglu City Hospital's emergency services of the departments of gynecology and obstetrics, between January 1, 2017, and December 31, 2022, were evaluated. Demographic characteristics, trauma findings, Injury Severity Scoring (ISS), and obstet-ric outcomes were recorded. A total of 1825 trauma patients, including 900 pregnants were referred to our emergency gynecology clinic for consulta-tion. One hundred and fifty three pregnant patients, whose birth information we reached, were selected as the study group. The mean age of the patients was 25.56±5.99 years and the mean gestational week at the time of trauma was 21.59±9.89 weeks, the patients had fallen (67.97%), had been exposed to violence (30.07%), and had a traffic accient (1.96%). The patient's delivery and hospitalization status on the day of trauma, fracture and ISS ≥9 were statistically significantly at a higher rate in the 3rd trimester. Rates of hospitaliza-tion and 3rd trimester traumas were found to be significantly higher in the ISS ≥9 group. (P=0.0001, P=0.028, respectively). Compared to the general population, the rates of preterm premature rupture of membranes-premature rupture of membranes, fetal death, fetal distress, cesarean delivery, placental abruption, and preterm delivery increased in traumatized pregnant women. Patients with low ISS scores should also be followed closely during pregnancy in terms of perinatal complications, as well as the severe trauma group.

Evaluation of Vesicocentesis Procedure in Patients with Megacystis: A Retrospective Analysis

Objective: To evaluate the patients who underwent vesicocentesis for fetal megacystis. Material and Methods: Patients who underwent vesicocentesis between May 2021 and May 2022 in İzmir Tepecik Training and Research Hospital's Perinatology Department were evaluated retrospectively. Data were collected from the hospital database. Demographic characteristics of patients, indications, laboratory findings, clinical outcomes, and complications of vesicocentesis procedure were evaluated. Results: Vesicocentesis was performed in 25 patients with fetal megacystis. The mean age of the population was 27.6 years (range: 20-36 years) and the mean gestational week at the time of procedure was 18.9 weeks (range: 13-31 weeks). Hydronephrosis was observed in 6 (24%) patients. Multiple organ malformations were observed in 5 (20%) patients. Genetic examination was performed for all fetuses. CHRM3 gene mutation and Prune-belly syndrome were found in 1 (4%) patient. The mean values of the markers examined by vesicocentesis were found as follows: sodium (104.1 mg/dL), chloride (91.5 mg/dL), osmolality (246.5 mOsm/L), calcium (6.4 mg/dL), total protein (35.2 mg/dL), and β2-microglobulin (9.6 mg/L). Vesicoamniotic shunt procedure was performed to 7 (28%) patients. In one (4%) patient, the shunt was reinserted because of the displacement into the intraamniotic cavity. After the vesicocentesis procedure, premature rupture of membranes or intrauterine bleeding did not develop, but one (4%) patient underwent cesarean delivery due to fetal distress. Conclusion: Vesicocentesis could provide information that can be useful when deciding whether a fetus with megacystis could benefit from vesicoamniotic shunting. However, the long-term effects of vesicoamniotic shunting on these fetuses need to be determined to establish the true clinical effectiveness and cost-effectiveness of the intervention.

Comparisons of the diagnostic accuracy of the ultrasonic sign-score method and MRI for PA, PI and PP in high-risk gravid women: a retrospective study.

The diagnosis and management of placenta accrete spectrum (PAS) is a great challenge to obstetricians. Ultrasound (US) and magnetic resonance imaging (MRI) are two main methods to detect PAS. MRI has high resolution, but the examination fee is expensive. US machine and examination fee is cheap, but the resolution is relatively low. Balancing the cost and accuracy for PAS diagnosis is very important. The ultrasonic sign-score method and MRI findings for 49 pregnant women at high risk of placental implantation were retrospectively analyzed. Inclusion criteria: (I) at high risk for PA as described in the Guidelines to Placenta Accreta Spectrum Disorders issued by the American College of Obstetricians and Gynecologists (ACOG) in 2018; (II) complete records of ultrasonic sign-scoring method and MRI data; (III) cesarean section; (IV) definite surgical and/or pathological findings. The results were validated by the gold-standard surgical or postoperative pathological findings, and the efficacy of the 2 imaging approaches in diagnosing placenta PAS was compared. Kappa test was used to analyze the consistency. Receiver operating characteristic (ROC) curves were used to compare the sensitivity and specificity. The mean maternal age was 32.6±4.4 years. The mean gestational week was 35.9±2.0 weeks. The mean gravidity was 3.3±1.1. The surgical or histopathological findings revealed PA in 26, placenta increta (PI) in 19 and placenta percreta (PP) in 4 of the 49 women. The diagnosis accuracy of PA, PI, and PP was higher using the ultrasonic sign-scoring method than MRI (75.51%, 73.47%, and 97.96% vs. 61.22%, 57.14% and 91.84%, respectively). The areas under the ROC curve for the sensitivity and specificity of the ultrasonic sign-scoring method and MRI in the diagnosis of PA, PI, and PP were 0.757 [95% confidence interval (CI): 0.613, 0.868], 0.725 (95% CI: 0.579, 0.843), 0.989 (95% CI: 0.907, 1.000), and 0.607 (95% CI: 0.457, 0.743), 0.544 (95% CI: 0.395, 0.687), 0.614 (95% CI: 0.464, 0.749), respectively. Although the sensitivity and specificity were lower than 0.8, the ultrasonic sign-scoring method was still superior to MRI in the detection of PI and PP. US can be used to help identify high-risk gravid women.

An Implicit Cause of Prolonged Neonatal Jaundice: Vitamin B12 Deficiency

Abstract Objective Prolonged jaundice is defined as a serum bilirubin level of more than 5 mg/dL, which persists at postnatal 14 days in term infants and 21 days following birth in preterm infants. Although the underlying causes cannot be found in the majority of prolonged jaundice cases, this may be the first sign of a serious issue. Therefore, this study aimed to evaluate the association between vitamin B12 deficiency and prolonged jaundice in newborns. Material and Methods This descriptive cross-sectional study was performed in a university hospital between January 1, 2015 and October 1, 2020. All participants consisted of infants who were admitted to the pediatric outpatient clinics. Infants &gt; 35 weeks of gestation and with prolonged jaundice of unknown etiology were included in the study group. The control group consisted of infants &gt; 35 weeks of gestation without prolonged jaundice. Demographic and clinical characteristics and serum vitamin B12 levels were evaluated comparatively. Results A total of 126 infants, 66 of whom had prolonged jaundice, were included. The mean gestational week of the study group was 38.4 ± 1.8, and the control group was 38.6 ± 1.9 weeks. There was no difference between the groups in terms of demographics and laboratory data. The vitamin B12 level of the study group was significantly lower (median = 170 pg/mL) than the control (median = 268 pg/mL). Conclusion Based on the findings of this study, vitamin B12 deficiency was thought to be an important cause of prolonged jaundice, and further studies are needed to explain the role of vitamin B12 deficiency in the etiology of prolonged jaundice.

What is the best treatment for anemia in pregnant women in the third trimester: Ferric carboxymaltose or oral iron therapy?

Objective: Iron deficiency anemia (IDA) is a significant health problem in pregnant women. We aimed to evaluate the effect of gestational IDA and to compare the results of iron therapy in pregnant women. Methods: This retrospective cohort study of pregnant women in the third trimester analyzed the records of 63 women not taking any iron supplements, 70 women receiving intravenous ferric carboxymaltose therapy (FCM), and 73 pregnant women receiving oral iron therapy. It compared maternal and neonatal outcomes of the three groups. Results: The mean age of the 206 pregnant women included in the study was 29.19±4.34 (19-44; min–max). Only 1% of anemic women received a blood transfusion in the postpartum period. There was no difference between the groups' mean age and gestational week. The median values of gravida and parity were the same in all 3 groups (Gravida=2, Parity=1). Maternal hemoglobin (Hb) value of the non-iron group was lower than that of the other groups (p&lt;0.001). Although the mothers' Hb levels at birth were different, the newborns' Hb values were not affected (p=0.547). Neonatal height and weight were lower in the non-iron group than in the FCM and oral iron groups (p=0.048 and p&lt;0.001, respectively). Neonatal head circumference, 1-minute Apgar, and 5-minute Apgar scores were similar in all three groups. Conclusion: FCM is effective in pregnant women with IDA in late pregnancy and women undergoing this treatment deliver healthier newborns.

Obstetrics and perinatal outcomes between elective single versus double blastocyst transfer in women younger than 35 years: A cross-sectional study

IntroductionClinicians have a positive attitude towards multiple embryo transfer in in vitro fertilization (IVF) cycles, considering increased live birth rates compared to single embryo transfer. We aimed to evaluate obstetric and perinatal outcomes among young women who became clinically pregnant after single & double blastocyst transfer. Material-method545 women under 35 years who became clinically pregnant after fresh blastocyst transfer was evaluated retrospectively. The participants were divided11The participants divided into two groups according to.according to the transferred embryo number - the elective single blastocyst transfer group (eSBT) (n=112) and the double blastocyst transfer group (DBT group) (n=433). Obstetric and perinatal outcomes were recorded. ResultsLive birth and abortion rates per pregnancy and per gestational sac, having a fetus with congenital anomaly per pregnancy and per neonate, and gestational complications were comparable between the groups. Multiple pregnancy, Cesarean section, and admission to neonatal intensive care unit (NICU) and hospitalization day in NICU per neonate were higher in the DBT group than in the eSBT group. Mean gestational week, birth weight, birth height decreased with the embryo transfer number. ConclusionDBT transfer appears to be associated with increased multiple pregnancies, Cesarean section, prematurity, decreased fetal anthropometric measurements, and admission to NICU without an increase in live birth and abortion rates. Therefore, it will be easier for clinicians to choose eSBT by providing young couples undergoing IVF treatment with detailed information about multiple pregnancies and prematurity.

Prenatal characteristics and management of pregnants with fetal cerebellar malformation: 4-year single center experience

Introduction: Fetal cerebellar malformations (FCM) are known as very rare central nervous system malformations that occur as hypoplasia or agenesis of the cerebellum or vermis. In this study, the characteristics, diagnostic methods, risk factors and management of pregnant women diagnosed with FCM in the prenatal period were investigated.&#x0D; Material and Method: The patients who diagnosed with prenatal FCM in the perinatology center between March 2017-February 2021 were included, retrospectively. The frequency of fetal magnetic resonance imaging (MRI), amniocentesis and/or karyotype analysis rates, and termination frequency were evaluated. In addition, the factors affecting the amniocentesis and the termination/follow-up decision were investigated. &#x0D; Results: A total of 42 pregnant with FCM were included. The median gestational age was 24.0 years, and the mean gestational week was 25+2 (SD±5+1) weeks. Nearly half (40.5%) of patients were diagnosed before 24 weeks of gestation and 45.2% were primiparous. Cerebellar hypoplasia was observed in 47.6%, while vermis agenesis was observed in almost one third (31.0%); and also 19.0% had multiple FCM. The fetal USG was used in all pregnant women, fetal MRI was performed in only 4.8% for diagnosis of FCM. The rate of amniocentesis and karyotype analysis were 11.9% and 7.1%, retrospectively. No any complications were observed after the amniocentesis. The termination rate was 30.9%. The mean gestational week of those who had live birth was higher than those who were terminated (24+4 vs 20+5) (p=0.019).&#x0D; Conclusion: The frequency of FCM diagnosis has increased with the development of modern medicine and technology. There is no relationship between demographic characteristics of pregnant women and FCM. Socio-economic levels and religious belief differences affect the termination and birth rates.

The effect of COVID-19 disease diagnosed in the first trimester of pregnancy on obstetric outcomes

Aim: The purpose of this article is to analyze the maternal, fetal, and obstetric outcomes of pregnancies diagnosed with coronavirus 2019 disease in the first trimester.&#x0D; Methods: A prospective analysis of patients diagnosed with COVID-19 during the first trimester of pregnancy and hospitalized was performed. Obstetric complications, delivery, and neonatal outcomes were reported in the following weeks of pregnancy.&#x0D; Results: We included seventy-five patients in the study. The mean age of pregnant women, Covid-19 positive, was 28.2 years, and the mean gestational week was 9.9 weeks. The mean delivery week was 31.65±9.47. Twenty-seven of the patients had preterm delivery. There was no neonatal Sars Cov-2 positivity among all the cases in any babies. Fifteen of twenty-nine patients with severe Covid-19 resulted in preterm delivery.&#x0D; Conclusion: Pregnant women with severe Covid-19 in their first trimester are at higher risk of premature birth, intrauterine fetal death, and perinatal complications

Effect of asymptomatic COVID-19 infection on the placenta in the third trimester of pregnancy: A prospective case-control study.

Objective:To clarify the effect of asymptomatic coronaviruse disease-2019 (COVID-19) positivity on the placenta in the third trimester of pregnancy.Materials and Methods:This prospective, case-control study included 30 pregnant women diagnosed with asymptomatic COVID-19 between April 30, 2021 and July 20, 2021 who delivered after the 34th gestational week, and a control group of 30 pregnant women without COVID-19, who delivered between April 2021 and July 2021, matched to the study group regarding age, gestational age and body mass index. Outcomes were compared in terms of demographic characteristics, serum blood outcomes, neonatal results, complications and placental histopathological findings.Results:The mean age of the study population was 28.8 years and the mean gestational week was 38.2 weeks. The C-reactive protein levels (38.2 mg/L vs 5.8 mg/L, p=0.001) and ferritin levels (266.4 μg/L and 40.5 μg/L, p=0.001) were significantly higher in the COVID-19-positive pregnant women. The lymphocyte level was significantly higher in the non-COVID-19 pregnant women (p=0.040). Mural hypertrophy was determined at a significantly higher rate in COVID-positive pregnant women (83.3% vs 30.0%, p=0.001). Multivariate regression analysis showed that only COVID-19 positivity increased the presence of mural hypertrophy in pregnant women with asymptomatic COVID-19 (4.716-fold, 95% confidence interval=1.012-22.251).Conclusion:The results of this study demonstrated that asymptomatic COVID-19 had no significant effect on pregnancy and neonatal complications. However, mural hypertrophy in the placenta was found at a significantly higher rate in pregnant women with asymptomatic COVID-19.

EVALUATION OF BELIEF IN COVID-19 MYTHS AND LEVELS OF COVID-19 ANXIETY AND PERCEPTION OF HEALTH IN PREGNANCY

Objective: The aim of the study was to establish pregnant women's belief in COVID-19 myths, COVID-19 anxiety and perception of health levels during the pandemic.&#x0D; Method: This study was a descriptive study of 473 pregnant women. Introductory Information Form, COVID-19 Anxiety Scale, Health Perception Scale and the form of myths related to COVID-19 Pandemic were used. During data analysis, descriptive statistics, One way anova test, Independent groups t test, Mann Whitney U test, Kruskal Wallis test and Spearman correlation analyses were performed. &#x0D; Results: A correlation was found between the average number of people believing in COVID-19 myths and the mean scores obtained from the COVID-19 anxiety scale (r=0.093, p=0.042) and the perception of health (r=0.115, p=0.012) scale. The difference between mean age and gestational week values and the average number of people believing in COVID-19 myths (p=0.000; p=0.004), the mean scores obtained from COVID-19 anxiety (p=0.000; p=0.006) and perception of Health (p=0.008; p=0.036) scales was significant. The mean number of people believing in myths in unplanned pregnancies (p=0.011) and the mean score from COVID-19 anxiety scale (p=0.004) were higher.&#x0D; Conclusion: The level of belief in COVID-19 myths in pregnant women was found to be associated with anxiety and perception of health. Belief in myths, perception of health and anxiety levels increased with increasing gestational week and increasing gestational age. Belief in myths and anxiety levels were lower in planned pregnancies. While pregnant women's belief in myths increased their anxiety level, it also resulted in an increase in the perception of health.

Components of obstetric violence: A descriptive study on physical abuse, non-consented care and non-confidential care

Objective: This study aimed at assessing the components of obstetric violence of women in receiving care during labor and postnatal period. Material and methods: This research was designed as a web-based descriptive study. The study was conducted with 556 women who had a vaginal delivery were within the first 6 weeks after delivery. The data of the research were collected between November-December 2021. Results: The mean age of women was 27.33±5.75, and the mean gestational week was 38.96±1.42. It was determined that while 95% of the women who underwent the intervention had a vaginal examination for less than 4 hours, 86.9% of them had no freedom of positioning at birth, and information was not provided to 41.2% of them before shaving, 22.2% of them before the amniotomy, 6.3% of them before oxytocin administration, 7.8% of them before episiotomy administration, 23.6% of them before fundal pressure, and 88.9% of them before vacuum support. It was found that 69.8% of the women did not have a companion during the delivery process, 67.1% of them were not involved in the decisions during the delivery process, and 93.9% of them asked for getting permission and providing information in the interventions during the delivery process. Additionally, the difference between the distributions of exposure to obstetric violence according to some sociodemographic and obstetric characteristics of the women was not statistically significant (p<0.05). Conclusion: According to the result of the study, it was determined that women were subjected to some types of obstetric violence during labor and the delivery process.

Analysis of pregnancy outcomes following surgical treatment of cesarean scar pregnancy

PurposeTo investigate the surgical treatment approaches for patients with Cesarean scar pregnancy (CSP) and the effects on subsequent pregnancy.MethodsCSP patients admitted to Shengjing Hospital of China Medical University from January 2013 to December 2018 were retrospectively analyzed to collect their clinical characteristics, and follow-up of postoperative pregnancies.ResultsA total of 1126 CSP patients were enrolled in this study, including 595 (52.84%) CSP type I, 415 (36.86%) CSP type II, and 116 (10.30%) CSP type III cases. There were significant differences between the three types of patients in terms of β-HCG levels, gestational sac diameter, clinical symptoms and presence of fetal heartbeat at diagnosis (P < 0.01). Among these, 89.90% of CSP type I, 88.90% of CSP type II and 50% of CSP type III patients were treated with hysteroscopic lesion excision, 7.9% of CSP type I and 2.2% of CSP type II patients underwent ultrasound-monitored curettage, and the remaining patients underwent lesion excision and and simultaneous repair of excised lesions by different routes (trans-laparoscopic, transabdominal or transvaginal methods). And 5.55% of CSP type I, 22.65% of CSP type II and 43.10% of CSP type III patients were treated with adjunctive uterine artery embolization (UAE). The patients were followed up for more than 2 years after surgery. Among the 166 re-pregnancies, 58 (34.94%) were normal pregnancies, 17 patients reoccurred with CSP, the recurrent rate of CSP was 10.24%. All 58 normal pregnancies were terminated by cesarean section, with a mean gestational week of delivery of (38.36 ± 2.25) weeks, a mean birth weight of (3228.45 ± 301.96)g, and the postnatal Apgar score was (9.86 ± 0.23) points at 1 min and all 5 min were 10 points. Logistic regression analysis suggested that the number of previous cesarean deliveries was a risk factor for recurrent CSP (RCSP) (OR = 10.82, 95% CI: 2.52–46.50, P = 0.001).ConclusionsThe type of CSP is related to β-HCG values, presence of fetal heartbeat, gestational sac diameter and clinical symptoms. Hysteroscopic therapy is a commonly used surgical procedure and UAE is often used as an adjuvant treatment. For subsequent pregnancies, the number of previous cesarean deliveries is a risk factor for recurrent CSP.

The Relationship of Personality Traits on Pregnant Women on Stress and Adaptation to Pregnancy

Aim: This study examined the relationship of personality traits on pregnant women on stress and adaptation to pregnancy. Subject and Method: The study is of descriptive type and the sample of the study consisted of 250 pregnant women who applied to the obstetrics clinic of a state hospital. Data were collected using the Introductory Information Form, Cervantes Personality Scale (CPS), Prenatal Distress Scale (PDS), and Prenatal Self-Evaluation Scale (PSES). The data were evaluated with descriptive statistics, 't-test' and 'pearson correlation analysis' in the SPSS program. Results: It was found that the mean age of the pregnant women was 28.65±5.22 and the mean gestational week was 32.94±5.18, 68.4% of them were at least secondary school graduates and 82.4% of them did not work in any job. It was found that pregnant women were more introverted and emotionally stable, answered questions consistently, had low prenatal distress levels, and showed good pregnancy adjustment. A significant relationship was found between the PDS and PSES (p&amp;lt;0,001). Moreover, a significant relationship was also present between the sub-dimensions of emotional balance/neuroticism and consistency/inconsistency, and PDS and PSES scores (p&amp;lt;0,001). Conclusion: It was observed that as the stress level of pregnant women increased, their adaptation to pregnancy decreased, especially women with neurotic personality traits had higher prenatal distress levels and lower adaptation to pregnancy. It can be suggested that all health professionals serving pregnant women should consider the basic personality traits of women in their attempts to reduce prenatal stress and increase compliance with pregnancy.