A 32-year-old multiparous woman at 29 weeks of gestation developed dizziness, fainting, meaningless and difficult speech, stiffness in the extremities, and movement limitation following the non-severe coronavirus disease-2019 (COVID-19) infection. Magnetic resonance imaging of the brain revealed hyperintense lesions in the white matter on T2-weighted and fluid-attenuated inversion recovery (FLAIR) sequences. The COVID-19 nasopharyngeal swab test in our center resulted negative; however, the serum COVID-19 antibody was positive. The cerebrospinal fluid was clear, no pathogen was reproduced in the culture, and the oligoclonal band was negative. Intravenous pulse steroid therapy and six cycles of plasmapheresis were administered. The symptoms improved partially; however, full recovery could not be achieved despite the treatment. This case emphasizes that acute disseminated encephalomyelitis, which can have severe consequences, should be considered in the differential diagnosis of neurological symptoms in pregnant women who are infected with COVID-19.
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Introduction: To examine the indications for termination dueto fetal anomalies performed in our clinic between January2015 and October 2020 and to determine the differencesbetween years.Methods: This study is a retrospective, observational studyinvolving 385 patients who underwent termination beforethe 24th week due to fetal anomalies at Karadeniz TechnicalUniversity, Farabi Hospital, Clinic of Perinatology. Terminationdata were analyzed by dividing the sample into two groups:terminations performed between 11 and 14 weeks (firsttrimester) and those between 15 and 24 weeks (secondtrimester) of gestation.Results: Structural malformations constituted 81.3% oftermination of pregnancy (TOP) cases, chromosomalanomalies 14.5%, and genetic diseases 4.2%. Central nervoussystem (CNS) anomalies, at 43.4%, were the most commoncause of termination. Aneuploidy was present in 56 (34.8%)of 161 cases for which karyotype analysis was available. Thenumber of terminations that took place in both the first andthe second trimesters was the highest in 2019. A continuousincrease was observed in the number of terminations overthe years evaluated. When the systems were evaluatedindividually, it was observed that the number of cases in thesecond trimester with CNS and face and neck anomalies wasstatistically significantly higher than that in the first trimester(p=0.002, p=0.037, respectively). In all, 28.3% of terminationswere performed in the first trimester and 71.7% in the secondtrimester.Conclusion: When the distribution of TOP indications over theyears was examined, it was observed that the number of casesrelated to chromosomal anomalies, cardiovascular systemanomalies, and genetic diseases had increased gradually.
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Pena-Shokeir syndrome (PSS) type 1 is an autosomal recessive disease, characterized by arthrogryposis, facial anomalies, fetal
growth restriction, polyhydramnios and pulmonary hypoplasia. Ultrasound features are varied and may overlap with those of trisomy 18. The
neuromuscular abnormality of the diaphragm and intercostal muscles causes pulmonary hypoplasia, and consequently pulmonary hypoplasia
is the primary cause of early death. PSS is a very rare syndrome and should be considered when indicators of the condition are encountered
in fetal ultrasonic examination. It is important to perform an invasive procedure appropriate for the gestational week for the differential diagnosis
of the condition. Our aim is to share the prenatal and postnatal process of the PSS case we diagnosed at 28 weeks of gestation.
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Objective: To compare the maternal serum catestatin (CST) levels in pregnant women with preeclampsia (PE) and with normal blood pressure and evaluate
the relationship between the maternal serum CST levels and fetal cardiac functions
Materials and Methods: This cross-sectional study was conducted on 27 women with early-onset PE (EOPE), 28 women with late-onset PE (LOPE), and
28 healthy pregnant women. Maternal serum CST levels were measured using the enzyme-linked immunosorbent assay kits. Fetal cardiac functions were
evaluated using the cardiac Doppler.
Results: Maternal serum CST levels were lower in the EOPE group; however, no statistically significant difference was found between the groups. Compared
with the other two groups, a statistically significant difference was found in the fetal E/A ratio and myocardial performance index (MPI) values of the EOPE
group (p=0.013, p=0.002, p=0.005, p<0.001, respectively). The fetal E/A ratio was positively correlated with the maternal serum CST levels in both the PE
and control groups (p<0.001, p<0.001). The fetal isovolumetric relaxation time and MPI values were negatively correlated with maternal serum CST levels
in both the PE and control groups (p<0.001, p=0.001, p<0.001, and p=0.002, respectively).
Conclusion: Lower CST levels are associated with fetal cardiovascular dysfunction, thus CST can be a critical biochemical marker in fetal cardiac function
evaluation.
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Amaç: Fetal üriner sistem anomalilerinin anöploidi ve ek yapısal malformasyonlarla ilişkisini ortaya koymak, prenatal dönemde konan ön tanıları postnatal dönem sonuçları ile karşılaştırmaktır.Yöntemler: 2016-2019 yılları arasında kliniğimizde fetal üriner sistem anomalisi tanısı alan 282 olgu çalışma kapsamında değerlendirildi. Gebeliklere ait yaş, gebelik haftası, gravida, parite, fetal cinsiyet, anomalinin tipi, ek anomali varlığı, prenatal tanı yöntemi, fetal karyotip sonucu, terminasyon durumu ve postnatal sonuçlar kayıt edildi.Bulgular: Fetal üriner sistem anomalileri arasında ilk sırada hidronefroz (HN) yer almaktaydı. Üriner sistem anomalilerine eşlik eden konjenital malformasyonlar incelendiğinde %26,4 ile santral sinir sistemi anomalileri en sık gruptu. Ek anomaliler ile en sık birliktelik gösteren üriner sistem anomalileri; bilateral renal agenezi (%50), bilateral multikistik displastik böbrek (%50) ve ekstrofia vezikaydı (%50). Karyotip sonuçlarına bakıldığında olguların %26’sında trizomi, %4’ünde PKHD1 ve %2’sinde triploidi izlendi. Karyotip sonucuna göre normal karyotipli grup ve trizomili grup karşılaştırıldığında, ek anomalilerin varlığı (p=0,004), bilateral HN (p=0,012) ve terminasyon sonuçları (p=0,002) arasındaki fark istatistiksel olarak anlamlı bulundu. Konsey kararı ile %6,7 olguya terminasyon uygulandı. Postnatal dönemde pediatrik cerrahi kliniğinde/polikliniğinde takip edilebilen olguların oranı %34,6 olup, bu olguların %38,2’sine cerrahi girişim uygulandı.Sonuç: Geniş bir klinik spektruma sahip olan üriner sistem anomalilerinin multidisipliner bir yaklaşım ile gerek prenatal dönemde gerekse postnatal dönemde uygun tanı, takip ve tedavisi büyük önem taşımaktadır.
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Objective: To investigate the relationship between maternal obesity and perinatal and neonatal outcomes in primigravid pregnant women. Methods: A total of 162 primigravid pregnant women were categorized into four groups based on their body mass index (BMI), age, gravida (number of pregnancies), parity (number of births), gestational week, pre-pregnancy body weight, height, prenatal final body weight, delivery patterns and indications, pre-eclampsia, fetuses small for gestational age (SGA), hemoglobin values at the time of hospitalization and after 24 h of delivery, transfusional requirements, birth weight of the babies, neonatal intensive care need, and the babies’ 1st-5th min APGAR scores were compared among the groups. Results: No significant differences were noted among the BMI groups in terms of age, gestational age, delivery type, neonatal intensive care unit needs, and transfusional requirements. The weights of the babies, weight gain during the pregnancy, incidence of pre-eclampsia, incidence of SGA, and APGAR scores were found to be statistically significantly different among the groups. Conclusion: The findings of the present study indicate that maternal obesity is an important factor for increasing risk of pregnancy complications and neonatal morbidity.
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Objective: Oocyte cryopreservation is a subject of great interest today. The aim ofthis study was to measure the knowledge and approach of primary health carepractitioners about oocyte cryopreservation.Methods: This is a cross-sectional study, which is prepared online and has a total of15 questions with 4 subtitles and sent to the physicians who have obtained FamilyMedicine Certificate issued by the Ministry of Health. An online survey was emailedwith one email reminder, to 2,140 family physicians for whom email addresses wereavailable and up to date.Results: 408 completed questionnaires were received giving a 19.1 % response rate.The mean age of the participants was 34.9 ± 6.6. All of the participants (100%) statedthat they had not previously received any training on oocyte cryopreservation. 25% ofthe participants stated that they had patients who had consulted them on this subjectbut that they did not know enough about the subject and referred them to agynecologist. When the meaning of the word cryopreservation was asked of theparticipants, it was seen that 36.8% responded correctly. 69.1% of the familyphysicians who participated in the study responded positively to the question ofwhether they believe that they should be trained in oocyte cryopreservation.Conclusions: Since the concept of fertility preservation is becoming more and moreimportant, family physicians should be aware of this issue. Apparently; their lack ofknowledge about oocyte cryopreservation indicates that they cannot help their clientssufficiently. Therefore, trainings on this subject should be organized and, if necessary,included in the specialist training program.
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