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Objective: Subclinical hypothyroidism is the most frequent thyroid dysfunction in pregnancy with an incidence of 2-5% which can easily be overlooked due to the absence of clinical symptoms. Studies have shown that thyroid hormones could alter the level of free beta-human chorionic gonadotropin (ß-hCG) and pregnancy-associated plasma protein-A (PAPP-A) released from the placenta during early pregnancy. Since these two serum markers are the two of the parameters used in the first-trimester combined screening, we hypothesized that distorted risk calculation results could be obtained from pregnant women with subclinical hypothyroidism. Methods: We conducted a prospective and cohort study at a tertiary university hospital in northwest Turkey between February 2018 and June 2018, involving 250 pregnant women in their first trimester who were seeking care at the obstetrics outpatient clinic. After evaluation of thyroid functions, first-trimester screening was performed in all 250 singleton pregnancies with fetuses at 11+0 to 13+6 gestational weeks. Thyroid-stimulating hormone (TSH) values above 2,5 mIU/L were considered high. The correlation between the results and parameters of the first-trimester combined screening and thyroid hormone values was examined. Results: Among the participants, after analyzing the fT4 values, all 35 pregnant women with high TSH values were diagnosed with subclinical hypothyroidism. We observed a statistically weak negative correlation between TSH and ß-HCG, which was expected given the similarities in their alpha subunits. There was no statistically significant correlation between TSH and PAPP-A values, combined risk scores, and age risk scores of first-trimester screening. As a matter of course, combined risk scores of first-trimester screening were found to be statistically lower in younger mothers. Conclusion: Pregnant women with normal thyroid functions and subclinical hypothyroidism were investigated for alterations in first-trimester screening parameters and risk scores. As a result, no statistically significant correlation was found between subclinical hypothyroidism and first-trimester screening. [ABSTRACT FROM AUTHOR]

Objective: To assess the indications for termination of pregnancy (TOP) in pregnant patients who were followed up with suspicion of fetal anomaly in a Turkish tertiary referral center. Material and Methods: This retrospective study was carried out in patients who were followed up with suspicion of fetal anomaly between May 2016 and May 2019 at the Perinatology Clinic of Obstetrics and Gynecology Department in Pamukkale University Hospital, which is a tertiary hospital in Denizli province in Turkey. Women were divided into two depending on gestational period: group 1 ≤22 weeks; and group 2 (>23 weeks of gestation). Results: Four hundred and seventeen pregnant women were evaluated and TOP was performed at a mean gestational age of 27.7±6.3 weeks. There were 308 (73.8%) women in group 1 and 109 (26.2%) in group 2. The decision to terminate pregnancy was due to fetal anomaly in 117 (28.1%). The majority of termination pregnancies in group 2 were performed because of multiple malformations and/or central nervous system defects. All chromosomal diseases were detected in group 1. Conclusion: With a good perinatal screening program, fetal anomalies can be diagnosed early. Therefore, early TOP is possible. Thus, pregnancy termination can be made before reaching the life limit. [ABSTRACT FROM AUTHOR]

In this article we describe the implementation and evaluation of a community-based antenatal education programme for first-time expectant mothers carried out in ¸Istanbul, Turkey, as part of the Healthy Beginnings Project. We hypothesized that women participating in an antenatal education programme would be more likely to have a vaginal birth, practice recommended maternal and infant health-related behaviours, and adopt a contraceptive method after the birth than a control group, even after statistically controlling for differences in background characteristics. Methods used to evaluate the antenatal education programme included pre- and post-tests with programme participants and a household survey with participants and a control group. All antenatal education course participants, as well as a control group composed of women giving birth to their first child at the same hospitals, were interviewed in their homes by a trained interviewer 2.5-3 months after the baby's birth, starting in October 1998. Results of statistical analyses indicate that a community-based antenatal education programme, such as the one offered as part of The Healthy Beginnings Project in ¸Istanbul, may increase the chance that women will adopt behaviours beneficial to health in the period following a birth. In particular, behaviours related to infant health (breastfeeding and infant check-up) and contraception appeared to be influenced by participation in the programme. In a developing country such as Turkey, with persistent maternal and child health problems, there is an urgent need to increase both demand for and quality of reproductive health services. Antenatal education is not the only answer, but it can be part of the answer. Reaching couples early in their reproductive lives may encourage them to adopt healthy behaviours and make use of available services during their reproductive years. [ABSTRACT FROM AUTHOR]