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Aim: The clinical significance of first trimester subchorionic hematoma, which is worrisome to pregnant women in terms of the outcome of the pregnancy, still remains unclear. The objective of this study is to examine the association between subchorionic hematomas in patients with threatened miscarriage and adverse pregnancy outcomes. Materials and Methods: The retrospective cohort study was conducted in a tertiary center from September 2022 to January 2024. 200 patients who were hospitalized with threatened miscarriage during the sixth to fourteenth week of a singleton pregnancy were included. The individuals that satisfy the established criteria for the study were categorized into two groups with threatened miscarriage based on the ultrasound examination: the study group, which included patients with subchorionic hematoma and the control group, which included patients without subchorionic hematoma. Demographic information, maternal and neonatal outcomes were compared for both groups. Results: Maternal age, BMI, parity, gestational age at diagnosis, history of abortus were similar for both groups (p>0.05). Miscarriage rates were higher in the group with SCH than without SCH (28% vs. 25%, p= 0.631), but no statistical significance was observed. The frequencies of intrauterine death, gestational age at delivery, preterm delivery, mode of delivery, hypertensive disorders of pregnancy, placenta previa-placenta accreta spectrum, gestational diabetes mellitus, intrauterine growth restriction were not statistically significant (p>0.05) between groups. The hematoma sizes did not show any statistically significant difference between those whose pregnancies led to miscarriage and those whose pregnancies did not (29.6±14.30 mm vs. 27.1±14.58 mm, respectively; p = 0.367). The subchorionic hematoma diameters did not show any correlation with the gestational age at delivery, birth weight, APGAR scores at 1st and 5th minute. Conclusion: Our study suggests that detection of threatened miscarriage with subchorionic hematoma did not result in an elevation in miscarriage rates, maternal and neonatal complications. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To evaluate maternal Resolvin D1 levels in women with gestational diabetes mellitus (GDM) and investigate the association between perinatal outcomes. STUDY DESIGN: This case-control study included 88 singleton pregnancies, conducted from August 2023 to January 2024, at a tertiary care center. Participants were divided into two groups: 44 pregnant women diagnosed with GDM comprised the study group, and 44 healthy pregnant women served as the control group. Additionally, the GDM group was categorized based on management approach into 21 women managed with diet alone and 23 women requiring insulin therapy. Maternal plasma Resolvin D1 levels and maternal-neonatal outcomes were then compared between groups. The analysis involved determining the optimal Resolvin D1 cut-off levels for predicting composite adverse neonatal outcomes in GDM using receiver operating characteristic curve (ROC) analysis. RESULTS: The plasma Resolvin D1 level in pregnant women with GDM was significantly higher compared to the control group (337±74.1 vs. 297±56.7, p<0.001). Furthermore, maternal plasma Resolvin D1 levels were associated with composite adverse neonatal outcomes [presence of at least one of the following conditions: preterm birth (<37 weeks), low birth weight (LBW) (<2500 grams), neonatal hypoglycemia, hyperbilirubinemia, APGAR score at 5th minute <7, respiratory distress syndrome (RDS), and admission to the neonatal intensive care unit (NICU)], with a cut-off of >338.75, showing a sensitivity of 56.3%, a specificity of 79.2%, and an AUC of 0.675 (95% CI: 0.567-0.771, p=0.024). CONCLUSIONS: This study demonstrated that pregnancies affected by GDM exhibit elevated levels of Resolvin D1, which is associated with a higher incidence of composite adverse neonatal outcomes. [ABSTRACT FROM AUTHOR]

OBJECTIVE: We aimed to determine the effect of uterine leiomyoma characteristics and cesarean myomectomy on maternal and perinatal outcomes. STUDY DESIGN: The study included patients with singleton pregnancies and uterine leiomyomas who had delivered at or beyond 24 weeks' gestation; without comorbidities, uterine anomalies, or fetal malformations. Data from 240 patients were studied between 2012 and 2022 in the perinatology clinic of a tertiary care center. Maternal and perinatal outcomes were obtained from medical records. RESULTS: Among the women with uterine leiomyomas, 21.7% were delivered vaginally and 78.3% via cesarean section. Myomectomy was performed in 150 out of 188 (79.8%) patients undergoing cesarean section. It was found that cases with leiomyomas =7 cm, compared to those with <4cm, had deliveries at earlier gestational weeks (36w6/7±2d vs. 37w+6/7±2d, p=0.018) and had lower newborn birthweight (2849.44±516.74 g vs. 3237.5±350.6 g, p<0.001), longer operation time (105.92±34.78 min vs. 68.21± 22.31 min, p<0.001) and a higher rate of neonatal intensive care unit requirement (48.1% vs. 13.7%, p<0.001). In cases with =2 leiomyomas compared to those with single leiomyomas, gestational age at birth was smaller and birthweight was lower (p<0.05). The amount of blood loss (969.66±427.21 mL vs. 738.15±337.2 mL and 553.84±366.46 mL), duration of surgery (83.23±29.56 min vs. 64.47±17.96 min) and transfusion requirements (36% vs. 5.3% and 28.8%) were higher in women who underwent myomectomy during cesarean section than in the other women undergoing only cesarean section or delivering vaginally (p<0.05). CONCLUSION: It was found that a leiomyoma size of =7 cm and number of =2 were both associated with earlier gestational age at birth and lower birth weight. Myomectomy performed during cesarean section increased the blood loss, duration of surgery, and the need for transfusion. [ABSTRACT FROM AUTHOR]

Purpose: Thyroid hormones and antibodies are known to participate in angiogenesis and invasion and also thyroid hormone receptors are expressed in the placenta. We aimed to evaluate the relationship of serum levels of thyroid-stimulating hormone (TSH), thyroid hormones (TH), and anti-thyroid antibodies with abnormally invasive placenta (AIP). We also aimed to investigate whether they are related with cesarean hysterectomy and massive blood transfusion need in AIP cases. Methods: A total of 88 pregnant patients were enrolled in this prospective case-control study (30 with AIP, 28 with non-adherent placenta previa totalis (PPT) and 30 controls). Serum TSH, thyroid hormone [T3 (triiodothyronine) and T4 (thyroxine)] and thyroid antibodies against thyroglobulin (TgAb) and thyroid peroxidase (TPOAb) levels were studied in maternal serum at initial admission to our Perinatology Unit (at early third trimester). The factors associated with increased risk of AIP, cesarean hysterectomy, massive blood transfusion, and adverse perinatal outcomes were evaluated with multiple logistic regression analysis. Adjusted odds ratios and 95% confidence intervals were also calculated. Results: Serum TSH and TgAb levels were significantly lower in the AIP group than both PPT and control groups (p = .01, p < .001 and p < .001, p < .001 respectively). Decreased serum levels of TSH (<2.16 mIU/L) and TgAb (<2.70 mIU/L) levels and high previous cesarean section rates were found to be independently associated with AIP in pregnant women with PPT (OR: 0.4, 95% CI: 0.1–0.9; p = .04, OR: 0.7, 95%CI: 0.4–1.3, p = .02 and OR: 0.1, 95% CI: 0.1–0.5, p = .01). Decreased serum TSH and TgAb levels were found to be independently associated with an increased rate of cesarean hysterectomy and massive blood transfusion in AIP cases (OR: 3.7, 95% CI: 1.4–9.8; p = .01, OR: 1.8, 95% CI: 1.1–3.1; p = .03 and OR: 2.6, 95% CI: 1.0–6.5; p = .05, OR: 2.2, 95% CI: 1.1–4.1 p = .02). Decreased TSH and TgAb serum levels were also found to be independently associated with adverse perinatal outcomes in AIP cases (OR: 3.4, 95% CI: 1.3–11.0; p = .01 and OR: 1.978, 95% CI: 2–3.6; p = .03). Conclusion: Decreased serum TSH and TgAb levels, and previous history of cesarean section were all found to be significantly associated with AIP in cases with PPT. We suggest that maternal serum TSH and TgAb levels can provide additional contribution to obstetric Doppler ultrasound in the diagnosis of AIP and thus can reduce the risks of unplanned cesarean hysterectomy in cases with PPT. [ABSTRACT FROM AUTHOR]

Objective The purpose of this study is to evaluate antioxidant balance in pregnant women with meconium-stained amniotic fluid. Methods Forty pregnant women with meconium-stained amniotic fluid and 40 pregnant women with non-meconium-stained amniotic fluid were included in the study. By checking the ischemia modified albumin (IMA) level and thiol/disulfide homeostasis in the maternal blood during labor and in newborn umbilical cord blood at the first minute after birth, antioxidant/oxidant balance was evaluated. Results No statistically significant difference was found between the maternal albumin levels. Maternal IMA level was statistically significantly higher in the meconium group than in the control group (p = .045). Maternal native thiol (SH) and maternal total thiol levels were statistically significantly higher in the control group than in the meconium group (p = .042 and p = .009, respectively). No statistically significant difference was found between maternal disulfide/native thiol (p = .262), maternal disulfide/total thiol (p = .152), maternal native thiol/total thiol (p = .153) rates in both groups. No statistically significant difference was determined between the patients with meconium and the control group in terms of cord blood IMA (p = .474), Albumin levels (p = .664), cord blood Native thiol (p = .944), cord blood total thiol (p = .612) levels and cord blood disulfide/native thiol (p = .240), cord blood disulfide/total thiol (p = .276), cord blood native thiol/total thiol (p = .277) rates. Conclusion Determination of a decrease in SH and Total Thiol levels in maternal serum and an increase in the meconium group’s IMA level was interpreted as a shift of antioxidant balance toward oxidant in this group. [ABSTRACT FROM AUTHOR]

Objective: First trimester thyroid-stimulating hormone (TSH) level is an important determiner of neonatal outcome. In this study we investigated the relationship between first-trimester TSH level and fetal birthweight. Materials-Methods: First-trimester serum TSH, age, gravidity, parity, body mass index (BMI), gestational age, and birth weight were analyzed. Patients were divided two ways. The first division- group 1 with TSH < 2.5 mU/l, group 2 with TSH > 2.5 mU/l). The second division- group 3 with TSH < 4 mU/l and group 4 with TSH > 4 mU/l). Results: The study included 302 patients. High TSH levels are associated with an increased risk of macrosomic and post-term babies. A significant association was found for both thresholds of 2.5 and 4.0 mU/l. However, this relation was not significant after binary logistic regression. Conclusion: High maternal first trimester TSH levels are not associated with birth weight after separating out macrosomia-related factors. [ABSTRACT FROM AUTHOR]

Objective(s): To compare the presence and severity of striae gravidarum in pregnant women with and without stress urinary incontinence and to evaluate whether there is a relationship between the severity of striae gravidarum and the severity of incontinence in pregnant women with stress urinary incontinence., Study Design: Healthy primigravid pregnant women with an uneventful singleton pregnancy at 36-37 weeks of gestation were included. All women were asked two questions to assess the presence of urinary incontinence. Women who answered 'yes' to the question 'Do you have any involuntary urinary leakage during coughing/laughing/sneezing/running/jumping?' and 'no' to the question 'Do you have any involuntary urinary leakage accompanied by a strong urge to void?' were classified as women with stress urinary incontinence, and women who answered 'no' to both questions were classified as women without stress urinary incontinence. The presence and severity of striae gravidarum of these two groups were evaluated with the Davey score, and the severity of incontinence of women with stress urinary incontinence was evaluated with the Incontinence severity index questionnaire., Results: The Davey score of pregnant women with stress urinary incontinence was significantly higher than the score of women without stress urinary incontinence and the presence of severe striae gravidarum was more common in women with stress urinary incontinence. There was a positive, significant correlation between Incontinence severity index and Davey scores in women with stress urinary incontinence, and this was the only independent correlation that was significant in linear regression analysis., Conclusion(s): Presence and severity of striae gravidarum is correlated with the presence and severity of stress urinary incontinence in primigravid pregnant women. Evaluation of striae gravidarum may be useful in predicting the development of stress urinary incontinence and taking necessary precautions against it. This issue should be evaluated with good quality studies., (Copyright © 2022 Elsevier B.V. All rights reserved.)