Objective: Numerous articles have been written on macrosomic fetuses, including the American College of Obstetricians and Gynecologists practice bulletin. However, there is no clear consensus about the time of birth. The aim of this study was to compare the maternal and fetal outcomes of women giving birth at 38+0-38+6 weeks and those with deliveries at ≥39 weeks in pregnancies complicated by fetal macrosomia, and to determine the effect on morbidity and mortality of delivery in the 38th gestational week.Material and Methods: Data of women and their infants born in Kayseri Training and Research Hospital between 01 May 2018 and 31 March 2020 were analyzed retrospectively. The patients included were those with a singleton pregnancy delivered at ≥38 weeks with a birthweight of ≥4000 gr. Demographic data and medical history and birth outcomes of the patients were recorded from the hospital data system. Multiple pregnancies, those with fetal anomalies and births <38 weeks were excluded from the study. The patients were separated into two groups as those who gave birth at 38+0-38+6 gestational weeks (Group 1) and those who gave birth at ≥39 weeks (Group 2).Results: Maternal and/or fetal trauma was found to be statistically significantly higher in nulliparous women with vaginal delivery ≥39 weeks compared to those with vaginal delivery at 38+0-38+6 weeks (p=0.017). No significant difference was observed between the groups in respect of fetal morbidity and mortality.Conclusion: When fetal macrosomia is determined antenatally, rates of fetal and/or maternal trauma can be reduced with delivery planned for the 38th week without increasing fetal morbidity and mortality.
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The aim of this study was to assess the correlation between uterine artery Doppler parameters examined from 20-24 weeks of pregnancy with glycoledin level in maternal blood. The study included 80 patients attending our clinic from September 2019 to June 2020. Participants were divided into two groups according to uterine artery findings. Group 1 included pregnant patients who had abnormal uterine artery Doppler USG at 22–24 weeks of pregnancy, and Group 2 consisted of healthy pregnant patients with uterine artery Doppler USG performed during the same period of pregnancy. Serum glycodelin levels were analyzed at 24 weeks of gestation of two goups and their perinatal outcomes were compared. No significant difference were seen between the groups regarding age, body mass index, blood pressure, gestational age, and blood test sampling time for serum glycodelin analysis. The mean pulsatility index values detected with Doppler ultrasonography were 1.92±0.41 and 0.82±0.25 for Groups 1 and 2, respectively. Comparative analysis revealed that the mean glycodelin level was significantly higher in Group 1 than Group 2 (521.75±21.68 -475.67±41.09; p< 0.001). Glycoledin may assist in predicting negative perinatal outcomes especially preeclampsia. However, many more comperative studies with larger series from multicenter are need to support this conclusion.
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OBJECTIVE: To determine whether there is a relationship between placental thickness and the umbilicalartery and uterine artery Doppler evaluation in the second trimester.STUDY DESIGN: The placental thickness and the umbilical artery and uterine artery Doppler evaluationswere recorded by a single operator for patients who were admitted for an obstetric follow-up or fetalanatomy screening at 18-28 gestational weeks. The relation between these variables was investigatedby evaluating the patients only once.RESULTS: In our study, the mean placental thickness was 31.7 (SD±8.01) mm. The umbilical arteryDoppler parameters did not correlate with the placental thickness. The uterine artery Doppler systolic/diastolic velocity, Pulsatility index and Resistance index values positively correlated with the placentalthickness. However, these correlations were not statistically significant.CONCLUSIONS: Although there was no relationship between the placental thickness and obstetricDoppler parameters in this study, we suggest that they are likely important factors and their significanceshould be evaluated in future studies.
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ABS TRACT Objective: To evaluate the clinical characteristics and obstetric outcomes of pregnant women with epilepsy at a tertiary center. Material and Methods: A total of 81 pregnant women with epilepsy were included in this retrospective cohort study. Clinical characteristics and obstetric outcomes were evaluated. Results: The mean maternal age of our cohort was 28.81±5.2 years, mean gravida was1.78±1.17, mean gestational week at delivery was 37.8±2.07 , and mean birth weight was 2973±688.8 g with 4 (4.9%) preterm deliveries. Gestational diabetes mellitus was observed in 2 cases. Fetal growth restriction was detected in 3 (3.7%) cases. Ten neonates (12.3%) were admittedto the neonatal intensive care unit and no congenital chromosomal/structural anomalies were detected in any of the cases. Intrauterine fetaldemise was observed in 1 (1.2%) case. The mean duration of epilepsy was 8.14 ± 5.8 years. Antiepileptic drugs were continued in 59 (72.8%)cases (11 polytherapy and 48 monotherapy). Six cases (7.4%) had seizures during pregnancy, and all 6 cases included patients who used medications during pregnancy. Conclusion: Favorable outcomes can be achieved in pregnant women with appropriately managed epilepsy.
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Objective: Our goal was to highlight the prenatal diagnosis and management of central nervous system (CNS) anomalies through sharing ourclinic’s experience.Material and Methods: We evaluated prenatal findings and postnatal outcomes of neonates who had a CNS anomaly diagnosis in our clinicover a ten-year period. A total of 183 cases with various CNS anomalies were included in the study. Birth or termination preferences of motherswere recorded in all cases, and postnatal diagnosis concordance and prognosis after surgical procedures were evaluated in mothers who choseto continue the pregnancy.Results: The mean maternal age was 28.2±5.5 years, mean gravida was 2.2±1.3, and the mean gestational age at diagnosis was 30.5±5.5 weeks.Seventy-five out of 183 (41%) patients chose to terminate their pregnancy. Twenty babies (26.6%) in the termination of pregnancy group hadadditional anomalies. One hundred eight patients gave birth at our institution. The mean birth weight was 3060±647.5 g, the mean gestationalweek at delivery was 37.9±1.7 weeks, and mean APGAR score (5th minute) was 8.8±2.3. Four neonates died on the postpartum first day. Thepostnatal diagnosis of 60 of the 108 (55.5%) patients who gave birth was concordant with the prenatal diagnosis, and 32 of the 108 (29.6%) babiesunderwent surgical interventions.Conclusion: CNS anomalies have a broad spectrum and variable prognoses. This study highlights the limitations of prenatal diagnoses, andthe need for parents to have this information in order to determine the course of their pregnancy and prepare themselves for the postnatalchallenging treatment/rehabilitation process. (J Turk Ger Gynecol Assoc 2019; 20: 170-7)
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