Aim: To investigate markers of sepsis/inflammation in twin neonates according to placental, demographic, neonatal, and twin-related complications. Materials and Methods: In this retrospective study, we compared these parameters in twins with suspected sepsis for whom laboratory data on infection markers were available on the first postnatal day. Sepsis was later ruled out in all the neonates. After obtaining institutional ethics committee approval, twin pairs who were admitted to the neonatal intensive care unit of Hacettepe University IhsanDogramacı Children's Hospital between 2005 and 2017 were screened for inclusion. Data on the twins’ sepsis markers, complete blood counts, immature to total neutrophil (I/T) ratios, procalcitonin and CRP levels, and blood culture results in the first 24 h of life were recorded.Results: In total, 194 twin pairs (388 neonates) were included in the study. Of the 194 twin pairs, 50 were monochorionic twins (25.8 %), and the remaining 144 (74.2 %) were dichorionic twins. Monochorionic and dichorionic twins, twin-to-twin transfusion syndrome with twins and discordant twins showed no significant differences in I/T ratio, procalcitonin, or CRP values in the first 24 h (p>0.05).Conclusion: Based on our findings, chorionicity (monochorionic/dichorionic placenta), twin-to-twin transfusion syndrome, and size discordance were not related to any significant differences in the CRP level, procalcitonin level, or I/T ratio.
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Objective: To evaluate perinatal outcomes in human immunodeficiency virus (HIV) infected pregnant women in Turkey.Material and Methods: Maternal characteristics, pregnancy complications, laboratory findings including HIV load, CD4 cell count, CD4/CD8ratio, neonatal features and final HIV status of the baby were retrospectively analyzed.Results: The sample included 26 singleton pregnancies, from 25 HIV-infected women. The ethnicities were Turkish (n=18), East European(n=4), Asian (n=2) and African (n=2). The majority (76.9%) was aware of their HIV status before becoming pregnant. Four cases (15.3%) werediagnosed during pregnancy and two (7.8%) at the onset of labor. The results for median HIV viral load, CD4 count, and CD4/CD8 ratio at birthwere 20 copies/mL (0-34 587), 577/mm3 (115-977), and 0.7 (0.1-1.9), respectively. The HIV viral load rate was 5.5% in eighteen women takinganti-retroviral treatment. The rates of gestational diabetes mellitus, gestational hypertension, intrauterine growth restriction, and preterm deliverywere 3.8%, 3.8%, 7.6%, and 8% (numbers are 1;1;2;2), respectively. The mean gestational week at birth was 38 weeks and mean birthweight is2972±329 g. Two babies were congenitally infected with HIV (infection rate of 8.3%). There was one needle-related accident during surgery.Conclusion: Timely diagnosis of HIV infection during pregnancy is important for preventing mother to child transmission. HIV infected womenmay give birth to HIV negative babies with the help of a multidisciplinary team, composed of perinatology, infectious diseases, and pediatricsspecialists. (J Turk Ger Gynecol Assoc 2020; 21: 180-6)
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Background. The aim of the current study was to demonstrate the neonatal outcomes of infants born to mothers with early-onset preeclampsia (EP) and late-onset preeclampsia (LP), and compare the neonatal outcomes before and after 34 weeks of gestation in EP group. Methods. In this retrospective study, we evaluated preeclamptic mother and child pairs who were followed-up at Hacettepe University Hospital between the years 2010 and 2017. The pregnant women were classified as having EP if diagnosed before 34 weeks of gestation (n=91) and LP if diagnosed after 34 weeks of gestation (n=34). The women in the EP group were further divided into subgroups according to the gestational week at birth, including those who gave birth before 34 weeks of gestation (early birth; n=57) and after 34 weeks of gestation (late birth; n=34). Necessary clinical and demographic data were withdrawn from the electronic registry and patient files. Results. Neonates in the EP/late birth subgroup had significantly lower gestational age and birthweight. Small for gestational age (SGA) frequency was higher in the early-onset subgroup born after 34 weeks’ gestation compared to the late-onset preeclampsia group (p= 0,016). The incidence of neutropenia was significantly higher in the EP/late birth subgroup than in the LP group (p= 0.002). After correcting for gestational week and birth weight, neutrophil count was still significantly lower in the EP/late birth subgroup (p= 0.002). EP/late birth subgroup and LP group had comparable outcomes regardless of neutrophil count and SGA rate. Conclusions. Close follow up and postponing delivery in stable and appropriate pregnant women with preeclampsia would be beneficial for neonates.
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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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