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Abstract Objective To evaluate the effectiveness and perinatal outcomes of cerclage procedure according to indication. Methods The pregnancy and neonatal outcomes of the patients who underwent cerclage with the diagnosis of cervical insufficiency between January 2016 and December 2020 were retrospectively analyzed. Patients were categorized into three groups: a history-indicated group, an ultrasound-indicated group and a physical examination-indicated group. Results Seventy-three patients who underwent cerclage were included in the study. Of these, 41 (56.2%) had history-indicated, 17 (23.3%) had ultrasound-indicated and 15 (20.5%) had physical examination-indicated cerclages. Compared to history- and ultrasound-indicated cerclage group, duration from cerclage to delivery (18.6 ± 6.9 weeks vs 17.8±5.9 weeks vs 11 ± 5.3 weeks, p = 0.003) was significantly lower and delivery 0.05). Conclusion Pregnant women who underwent physical examination-indicated cerclage had higher risks for preterm delivery

Aims:Fetal sex plays an important role in pregnancy and its outcomes due to hormonal and chromosomal differences. The current study examines the effect of fetal sex on delivery time, intrauterine death and maternal-neonatal outcomes.Methods:Pregnant women who gave birth in University of Health Sciences Turkey, Tepecik Training and Research Hospital Delivery Unit between 2014 and 2019 were screened retrospectively for the study. Pregnancies of ≥37 weeks (259 days) were included in the study, and pregnancies with ≥42 weeks (294 days) were classified as post-term (prolonged) pregnancy. Intrauterine death and maternal-neonatal outcomes were compared according to fetal gender.Results:The prevalence of post-term pregnancy was 0.76%. A total of 45,147 pregnancies were found, including 22,788 (50.5%) males (M) and 22,359 (49.5%) females (F) who met our criteria for the study. In births between 37-40 0/6 weeks male sexes ratio was higher (M/F sex ratio: 37 0/6 weeks: 1.05; 38 0/6 weeks: 1.01; 39 0/6 weeks: 1.01). The female sex birth rate becames more prominent after the 40th week, 75% of the newborns at the 44th week were observed to be female (M/F sex ratio: 44 0/6 weeks: 0.33). However, although female sex ratio was higher in post-term pregnancies, contrary to the literature, this difference was not significant. Intrauterine fetal death was observed more frequent in post-term pregnancies than term pregnancies (0.93% vs 0.3%, p=0.017). The risk of intrauterine fetal death was approximately three times higher in post-term pregnancies than term pregnancies (Odds ratio: 3.16; 95% confidence interval: 1.16-8.58). In post-term pregnancies, birth weight (3458.7±462.9 g vs. 3338.5±416.5 g), head circumference (35.2±1.1 cm vs. 34.9±1 cm) and body length [50 (44-56) cm vs. 50 (40-55) cm] were higher in male sexes and all these results were statistically significant (p=0.049, p=0.004 and p=0.003, respectively).Conclusions:Contrary to the literature, fetal sex is not a significant risk factor in post-term pregnancy. But intrauterine death increases about 3-fold in post-term fetuses compared to term fetuses.

Objective: To compare the obstetric outcomes of cesarean section in women who had a history of four or more previous cesarean sections with those who had a history of two or three previous cesarean sections., Methods: Total 1318 women who underwent repeat cesarean section between January 2013 and January 2016 were retrospectively reviewed. Of these, 244 (18.5%) had previously had four or more cesarean sections (multiple repeat cesarean section group) and 1074 (81.5%) had previously had two or three cesarean sections (control group). Demographic characteristics and obstetric outcomes were compared using the Independent t and chi-square tests., Results: The adhesion rate (p < 0.001), number of blood transfusion (p = 0.044), operation time (p = 0.012), length of hospital stay (p < 0.001) and tubal ligation surgery (p < 0.001) were significantly higher in multiple repeat cesarean section group compared to control group., Conclusion: Although multiple repeat cesarean section are asscociated with adhesion occurrence, higher number of blood transfusion, increased operation time and length of hospital stay, there is no remarkable difference in serious morbidity associated with multiple repeat cesarean section., Competing Interests: Declaration of interest: The authors declare that there is no conflict of interest.

Objective: To investigate the effect of anemia on perinatal outcomes as preterm delivery (PTD) and low birth weight (LBW) in the different stages of pregnancy., Methods: Medical records of 39,587 Turkish pregnant women who delivered between January 2011 and September 2014 were reviewed. Anemia during pregnancy was defined as hemoglobin (Hb)< 11 g/dl, low birth weight was defined as birth weight <2500 gr and PTD was defined as <37 weeks. The pregnant women were divided into three groups (Hb<10 gr/dl, Hb 10-11 gr/dl, Hb>11 gr/dl). Perinatal outcomes were compared between these anemic and non-anemic groups., Results: The anemia prevalence in our study was 25.1%. In the first and second trimester of Hb<10g/dl group LBW ratio was significantly higher (respectively 13.5%, 9.8%, p=0.03; 22.7%, 14.7%, p=0.01). In the second and third trimesters of Hb<10 g/dl group PTD ratio was significantly higher (respectively 29.1%, 19%, p=0.00; 17.7%, 15.4% p=0.02). In the first trimester Hb<10 g/dl group cesarean section rate was significantly higher (respectively 65.2%, 57.6%, p = 0.01)., Conclusions: LBW infants and preterm birth rate was higher in Hb <10 gr/dl group than non-anemic in the first, second and third trimester. Hb <10 gr/dl group had higher cesarean rate in first trimester. The mean birth weight was significantly lower in anemic pregnant women in the second trimester. Preterm birth and cesarean section rate, in the group of anemic throughout pregnancy was higher than those of non-anemic in the whole pregnancy period., Competing Interests: Declaration of interest: None.