OBJECTIVE: The aim of this study is to evaluate perinatal outcome of fetal echogenic bowel.
STUDY DESIGN: In this retrospective cohort study, fetuses with echogenic bowel diagnosed and followed in our center between 2013-2017 were included. Fetuses and infants were evaluated in terms of
antenatal comorbidities and postnatal persistent diseases. Infants were followed-up to June 2018 from
time of diagnosis. Demographic questionnaire and face to face interview were used to obtain data including immune system diseases and respiratory system pathologies in infants.
RESULTS: A total of 100 fetuses with echogenic bowel were included in the study. Fetal aneuploidy was
detected in 7 (7%) cases. Trisomy 21 was the most common aneuploidy and identified in 4 (4%) cases.
Other chromosomal disorders were tetrasomy 12p (1%), 69XXX (1%) and 46 XX, t (2,22) (9q9) (1%). A
fetal echogenic bowel was associated with major congenital malformations in 25 (%25) cases. Cardiac
abnormality was the most prevalent (%7). First and second trimester vaginal bleeding history was found
in 5 pregnant women. In 3 case with isolated echogenic bowel (no congenital malformation and aneuploidy), lactose intolerance, celiac disease, and non-obstructive hydrocephalus were diagnosed in early
childhood.
CONCLUSION: Isolated fetal echogenic bowel which can be considered as a soft marker for aneuploidy
may be associated with lactose intolerance and celiac disease. Further clinical studies are warranted to
evaluate this relationship.
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OBJECTIVE: To analyze whether the time the patients entering into prenatal care affects the route of
delivery, maternal, and fetal outcomes.
STUDY DESIGN: The electronic medical files of 17,035 women who delivered at the same hospital between January 2008 and December 2014, were retrospectively reviewed. Pregnant women were distributed into one of 5 groups (No-prenatal-visit group, Only-pregestational-visit group, First-visit-prior-to24-weeks-follow-up group, Early-third-trimester-follow-up group, Late-third-trimester-follow-up group)
according to the time of their first pregnancy follow-up visit. The route of delivery, maternal anemia, and
fetal outcomes were compared among the groups.
RESULTS: Pregnant women in the no-prenatal-visit group were younger and showed higher rates of
vaginal delivery (56%), term deliveries (90.7%), and postpartum anemia. Those in the first-visit-prior-to24-weeks group were older and showed higher rates of both primary and secondary cesarean (58%),
and higher rates of term deliveries (93.6%) and lower postpartum anemia. Both the primary and secondary cesarean rates were higher in groups with frequent and early follow-up visits than in a no-prenatal-visit group and late-third-trimester-follow-up group (p<0.001).
CONCLUSION: The rates of cesarean deliveries were found to be increased prominently in pregnant
women who began antenatal care early in pregnancy with frequent follow-ups.
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OBJECTIVE: In this study, we aimed to determine the frequency of etiologic factors that causes postmenopausal bleeding.
STUDY DESIGN: For the purpose, a total number of 200 women with postmenopausal bleeding were
included in the study. Medical records regarding history, physical examination, and endometrium biopsy
of these cases were retrospectively analyzed. The frequency of etiologic factors and relevancy of pathological results with demographic factors were determined.
RESULTS: Most frequent histopathologic diagnosis of the women with postmenopausal bleeding were
established as endometrial atrophy, endometrial polyp, inadequate material, cancer, proliferative endometrium, endometrial hyperplasia, and other disorders respectively. Contrarily the previous studies,
our study showed that estrogen replacement therapy was not a reason for postmenopausal bleeding.
CONCLUSION: Although endometrial atrophy is the most frequent cause, postmenopausal bleeding
should promptly be evaluated since endometrial hyperplasia and cancer are frequently the underlying
cause. We found that premalignant and malignant lesions were related to the patients’ BMI (body mass
index), duration of postmenopause, the presence of diabetes, determination of thick endometrium by ultrasonography.
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OBJECTIVES: Suppressed immune system and physiological changes in pregnancy put pregnant
women vulnerable to various viral diseases. Various studies have reported adverse pregnancy outcomes in SARS-CoV-2 infection. This study aimed to evaluate the maternal and fetal outcomes in
SARS-CoV-2 affected pregnancies at our set up.
STUDY DESIGN: It was a prospective cohort study conducted at a tertiary care Army Hospital, India.
The first 50 cases of SARS CoV-2 positive pregnant women and 144 suspected cases that were found
SARS-CoV-2 negative, received and managed at separate set up, during a period extending from 01
April 2020 to 15 Sep 2020 were included in our study. Their obstetric and neonatal outcomes along with
the demographic and other clinical data were compared.
RESULTS: Total RT-PCR positivity rate of SARS-CoV-2 infection in pregnant women was 2.7%. 96%
of our patients were asymptomatic for SARS-CoV-2 infection. Premature rupture of membrane, preterm
delivery, and Neonatal intensive care unit admission was similar in both groups. There were increased
incidences (70%) of cesarean section in SARS-CoV-2 positive pregnant women.
CONCLUSION: The study reported comparable maternal and fetal outcomes in SARS-CoV 2 positive
pregnant women when compared with SARS-CoV-2 negative pregnant women
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OBJECTIVE: To determine the factors indicating the accuracy of fetal weight estimation in the last prenatal ultrasonography before delivery in preterm newborns with normal amniotic fluid volume.
STUDY DESIGN: Three hundred and seventy-one singleton pregnancies with normal amniotic fluid volume and delivered at between 24+0 and 37+0 gestational weeks were evaluated in a retrospective
study. Any possible associations between the absolute percentage error of fetal weight estimations and
the maternal and fetal data were examined.
RESULTS: In 135 of the 371 women (36%), the absolute percentage error was greater than 10%. The
mean absolute percentage error was 8.7±7.5%. The mean absolute percentage errors were 4.1±2.7%
and 16.8±6.4% in the accurate and inaccurate estimation groups, respectively.
The rate of women examined during labor was significantly higher in the inaccurate estimation group
compared to the accurate estimation group. There were no significant differences in age, body-massindex, gestational age at delivery, estimated-fetal-weight, actual birth weight, days from the last ultrasound examination to delivery, small for gestational age rate, placenta localization or fetal presentation
between the two groups.
Examination during labor (β=0.224) was the most important factor for the prediction of the absolute percentage error, followed by gestational age at delivery (β=–0.198), presence of (β=–0.158), and bodymass-index (β=0.142).
CONCLUSION: In 36% of our study population, the absolute percentage error was >10%. Examination
during labor was the most important factor for the prediction of the absolute percentage error, followed
by gestational age at delivery, presence of small for gestational age, and body-mass-index.
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OBJECTIVE: To determine the indications for termination of pregnancy, and their consistency with autopsy data to offer an insight into termination of pregnancy having regard to conditions in Turkey.
STUDY DESIGN: Three hundred and ninety-one pregnancies terminated before the 24th gestational
week were enrolled in this study. Maternal age, gravidity, parity, abortion, the status of folic acid usage,
consanguineous marital status, gestational week, anomalies that led to termination and pathological diagnoses were recorded. Anomalies that led to termination were grouped as central nervous system ,
cardiovascular system, gastrointestinal system, genitourinary system, pulmonary, musculoskeletal,
head-neck, chromosomal, genetic, multiple anomalies and others. Four groups were formed based on
the consistency of prenatal ultrasound diagnosis with pathological diagnosis.
RESULTS: Mean age, gravidity, parity, abortion, and gestational week were 28 years, 3, 1, 1, and 15.7
weeks, respectively. One hundred and thirty-eight (35.2%) patients had consanguineous marriage.
Three major causes of termination were central nervous system (45.78%), head-neck (17.4%) and multiple anomalies (14%). One hundred and twenty-eight (71.5%) patients with central nervous system
anomalies were not using folic acid. Comparison of prenatal ultrasound findings with pathology results,
275 (70.3%) patients had full consistency, 46 (11.8%) had other findings at autopsy besides the confirmed sonographic findings, 34 (8.7%) had some sonographic findings not confirmed at autopsy, and 4
(1%) had no consistency between the findings.
CONCLUSION: Central nervous system anomalies constitute the most common indication for termination of pregnancy in this retrospective study. Low rate of periconceptional folic acid among those cases
is remarkable. First-trimester screening for earlier detection of fetal anomalies may be important in highrisk groups such as those with consanguineous marriages.
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OBJECTIVE: Iodine deficiency is a commonly seen problem and associated with pregnancy complications. In this study, we aimed to evaluate urinary iodine status in pregnant women with hyperemesis
gravidarum
STUDY DESIGN: A total of 121 women experiencing singleton pregnancies between 6 and 18 weeks
of gestation were included in the study. The participants were divided into two groups; group 1 comprised 81 healthy pregnant women, and group 2 comprised 40 pregnant women with Hyperemesis
Gravidarum.
RESULTS: Urinary iodine levels were found to be significantly higher in healthy pregnant women than
women with Hyperemesis Gravidarum (p=0.008). Urinary iodine was significantly correlated with the urinary ketone (r= -0.252, p=0.005) and FT3 (r= -0.190, p=0.037).
CONCLUSION: In pregnant women with hyperemesis gravidarum, oxidative stress was increased, urinary iodine levels were significantly low and negatively correlated with disease severity. Thus, ıodine replacement might be essential to prevent pregnancy complications.
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OBJECTIVE: Placenta previa may cause massive hemorrhage at antenatal, intrapartum or postpartum
periods and is one of the leading causes of maternal morbidity and mortality. Anterior or posterior location of placenta previa can change cesarean technique and management of the operation. Aim of this
study is to assess factors increasing intraoperative complications in patients with placenta previa and investigate the significance of anterior placenta location apart from other factors.
STUDY DESIGN: This is a retrospective cohort study which was conducted in one center including 83
patients followed with placenta previa in three years’ duration. Placental location, presence, and depth
of myometrial invasion, previous uterine surgery and the type of uterine incision were evaluated.
Intraoperative hemorrhage, need for blood transfusion and hysterectomy, complete blood count parameters of mother and newborn were compared between the anterior and posterior placenta previa.
RESULTS: Previous uterine surgery, abnormally invasive placenta and need for blood transfusion were
significantly higher in patients with anterior placenta previa. The increasing number of previous cesarean
operations enhanced placental invasion to cesarean scar area in anterior placentation, leading to higher
rates of blood transfusion, classical incision, and hysterectomy. Also, when the patients with previous
cesarean or classical incision were excluded, anterior placentation differed significantly when compared
with posterior placentation with respect to hemoglobin differences between preoperative and postoperative values.
CONCLUSION: Anterior location of placenta previa increases hemorrhagic complications. Placental location, presence, and depth of invasion should be assessed and timing of delivery should be planned
with appropriate preparation of blood products before delivery.
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OBJECTIVE: To evaluate the subsequent pregnancy outcomes of women who have experienced unexplained stillbirth in their previous gestations.
STUDY DESIGN: This retrospective cohort consisted of 14 pregnancies who had stillbirth (without
known risk factors) in their previous pregnancies. These patients had been included in a special preconceptional care program to be evaluated in terms of etiological risk factors for stillbirth. At least one
of the risk factors, such as methylenetetrahydrofolate reductase polymorphisms, hereditary thrombophilias and autoimmune problems, were defined in this study population. After detection of pregnancy,
the patients were administered low-dose low-molecular-weight heparin (enoxaparin, 1×2000 Anti-XA
IU/0.2 mL/day), low-dose salicylic acid (100 mg/day) and low-dose corticosteroid (methylprednisolone,
1×4 mg/day orally) in necessary cases.
RESULTS: Out of 14 pregnancies, 4 (28.5%) ended up with miscarriages at 9, 11, 11 and 15 gestational
weeks, respectively. The remaining 10 pregnancies ended up with alive deliveries. The mean gestational week at birth was 36.4±0.51, while the mean birthweight was 2882±381.01 g. Out of 10 pregnancies, only one was diagnosed as IUGR. Only two newborn necessitated hospitalization in the neonatal intensive care unit due to respiratory problems. Both newborns were discharged from the neonatal
intensive care unit without any further complication at the post-partum 5th day.
CONCLUSION: Patients with a prior stillbirth should be screened for methylenetetrahydrofolate reductase polymorphisms, autoimmune problems and hereditary thrombophilias, especially in case of absence of any etiological factor. Management of these patients with low-dose aspirin, low-dose low
molecular weight heparin and corticosteroids seemed to be beneficial for increasing live birth rates and
avoiding obstetric complications.
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OBJECTIVE: In recent years, the number of infertile couples who desire pregnancy with assisted reproduction techniques is increasing. Smoking and alcohol consumption are important factors affecting
the treatment of fertility and assisted reproductive techniques. To evaluate the effect of smoking and alcohol consumption on spermiogram results
STUDY DESIGN: This prospective case-control study was conducted at current urology and infertility
department in a tertiary research hospital and a total of 6171 cases included in the study. Data collected
and evaluated were age and sperm parameters (liquefaction, semen volume, sperm concentration, total
number, total motility, progressive motility, slow motility, non-progressive motility, morphology).
RESULTS: Of 6171 patients; a total of 3247 men was smoker (n:3247, %52.6) and 3511 was alcohol
users (n:3511, %56.9). Mean age of the patients in the study group was 32.8±6.5 years. There was a statistically significant difference between the smoker and nonsmoker in terms of sperm concentration and
slow motility (p <0.05). There was a statistically significant difference between alcohol consumption and
no alcohol consumption in terms of; semen volume, sperm concentration, normal morphology (p <0.05).
CONCLUSION: According to this study, smoking has a negative effect on sperm concentration and slow
motility. Alcohol consumption has a negative impact on semen volume, sperm concentration, normal
morphology. Smoking and alcohol consumption separately and combined were found to have a deleterious effect on sperm parameters. It is suggested that both habits may contribute to infertility problems.
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