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It has still to be ascertained whether severe acute respiratory syndrome coronavirus 2 infection in pregnancy is associated with worse maternal and fetal outcomes compared to low risk gestations.This study aimed to evaluate maternal and perinatal outcomes in high- and low-risk pregnancies complicated by severe acute respiratory syndrome coronavirus 2 infection.This was a multinational retrospective cohort study involving women with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 infection from 76 centers from 25 countries in Europe, the United States, South America, Asia, and Australia from April 4, 2020, to October 28, 2020. The primary outcome was a composite measure of maternal mortality and morbidity, including admission to the intensive care unit, use of mechanical ventilation, or death. The secondary outcome was a composite measure of adverse perinatal outcome, including miscarriage, fetal loss, neonatal and perinatal death, and admission to the neonatal intensive care unit. All outcomes were assessed in high- and low-risk pregnancies. Pregnancies were considered high risk in case of either preexisting chronic medical conditions in pregnancy or obstetrical disorders occurring in pregnancy. The Fisher exact test and logistic regression analysis were used to analyze the data.A total of 887 singleton pregnancies who tested positive for severe acute respiratory syndrome coronavirus 2 infection using reverse transcription-polymerase chain reaction of nasal and pharyngeal swab specimens were included in the study. The risk of composite adverse maternal outcomes was higher in high-risk pregnancies than in low-risk pregnancies (odds ratio, 1.52; 95% confidence interval, 1.03-2.24; P=.035). In addition, women carrying high-risk pregnancies were at higher risk of hospital admission (odds ratio, 1.48; 95% confidence interval, 1.07-2.04; P=.002), presence of severe respiratory symptoms (odds ratio, 2.13; 95% confidence interval, 0.41-3.21; P=.001), admission to the intensive care unit (odds ratio, 2.63; 95% confidence interval, 1.42-4.88), and invasive mechanical ventilation (odds ratio, 2.65; 95% confidence interval, 1.19-5.94; P=.002). When exploring perinatal outcomes, high-risk pregnancies were at high risk of adverse perinatal outcomes (odds ratio, 1.78; 95% confidence interval, 0.15-2.72; P=.009). However, such association was mainly because of the higher incidence of miscarriage in high-risk pregnancies compared with that in low-risk pregnancies (5.3% vs 1.6%, P=.008); furthermore, there was no difference in other explored outcomes between the 2 study groups. At logistic regression analysis, maternal age (odds ratio, 1.12; 95% confidence interval, 1.02-1.22; P=.023) and high-risk pregnancy (odds ratio, 4.21; 95% confidence interval, 3.90-5.11; P.001) were independently associated with adverse maternal outcomes.High-risk pregnancies complicated by severe acute respiratory syndrome coronavirus 2 infection were at higher risk of adverse maternal outcomes than low-risk pregnancies complicated by severe acute respiratory syndrome coronavirus 2 infection.

BACKGROUND: It has still to be ascertained whether severe acute respiratory syndrome coronavirus 2 infection in pregnancy is associated with worse maternal and fetal outcomes compared to low risk gestations. OBJECTIVE: This study aimed to evaluate maternal and perinatal outcomes in high- and low-risk pregnancies complicated by severe acute respiratory syndrome coronavirus 2 infection. STUDY DESIGN: This was a multinational retrospective cohort study involving women with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 infection from 76 centers from 25 countries in Europe, the United States, South America, Asia, and Australia from April 4, 2020, to October 28, 2020. The primary outcome was a composite measure of maternal mortality and morbidity, including admission to the intensive care unit, use of mechanical ventilation, or death. The secondary outcome was a composite measure of adverse perinatal outcome, including miscarriage, fetal loss, neonatal and perinatal death, and admission to the neonatal intensive care unit. All outcomes were assessed in high- and low-risk pregnancies. Pregnancies were considered high risk in case of either preexisting chronic medical conditions in pregnancy or obstetrical disorders occurring in pregnancy. The Fisher exact test and logistic regression analysis were used to analyze the data. RESULTS: A total of 887 singleton pregnancies who tested positive for severe acute respiratory syndrome coronavirus 2 infection using reverse transcription-polymerase chain reaction of nasal and pharyngeal swab specimens were included in the study. The risk of composite adverse maternal outcomes was higher in high-risk pregnancies than in low-risk pregnancies (odds ratio, 1.52; 95% confidence interval, 1.03-2.24; P=.035). In addition, women carrying high-risk pregnancies were at higher risk of hospital admission (odds ratio, 1.48; 95% confidence interval, 1.07-2.04; P=.002), presence of severe respiratory symptoms (odds ratio, 2.13; 95% confidence interval, 0.41-3.21; P=.001), admission to the intensive care unit (odds ratio, 2.63; 95% confidence interval, 1.42-4.88), and invasive mechanical ventilation (odds ratio, 2.65; 95% confidence interval, 1.19-5.94; P=.002). When exploring perinatal outcomes, high-risk pregnancies were at high risk of adverse perinatal outcomes (odds ratio, 1.78; 95% confidence interval, 0.15-2.72; P=.009). However, such association was mainly because of the higher incidence of miscarriage in high-risk pregnancies compared with that in low-risk pregnancies (5.3% vs 1.6%, P=.008); furthermore, there was no difference in other explored outcomes between the 2 study groups. At logistic regression analysis, maternal age (odds ratio, 1.12; 95% confidence interval, 1.02-1.22; P=.023) and high-risk pregnancy (odds ratio, 4.21; 95% confidence interval, 3.90-5.11; P

Objective: In this study, our aim is to compare discussing maternal and fetal problems non-adolescent pregnancy with maternal and fetal problems in adolescent pregnancy that seen in hospital. Methods: 15-19 years of age (50 patients) and 20-23 years (96 patients) who gave birth at the Gynaecologi­cal and Obstetric Clinic under the Faculty of Medicine of Dicle University between January 2015-October 2015 were retrospectively evaluated. Age at birth, parity, blood pressure, pulse, gestational age, complications at birth, cesarean section indications, maternal biochemical pa­rameters, patients with preeclampsia and preterm birth, maternal and fetal complications were recorded. Results: Total number of births between January 2015- October 2015 were 1715 patients in our clinic. 62 of them (3.6%) were observed in the adolescent group. Maternal blood transfusion needs were found to be significantly higher in the adolescent group (p=0.004). Fetal abnor­malities and fetal intensive care needs were found to be significantly higher in the adolescent group (p=0.014, p=0.018). Conclusion: Adolescent pregnancies were high-risk pregnancies in terms of maternal anemia and blood transfusion requirements and because of adverse perina­tal outcomes. Therefore, to reduce the adolescent preg­nancy and to minimize perinatal complications should be done more extensive studies. Bu çalışmada amacımız hastanede karşılaştığı­mız adölesan gebeliklerdeki maternal ve fetal sorunlar ile adölesan olmayan gebeliklerde görülen maternal ve fetal sorunları karşılaştırılarak tartışmaktır. Yöntemler: Dicle Tıp Fakültesi Kadın Hastalıkları ve Do­ğum kliniğinde Ocak 2015-Ekim 2015 tarihleri arasında doğum yapmış 15-19 yaş (50 hasta) ve 20-23 yaş (96 hasta) gebeler retrospektif olarak değerlendirildi. Yaş, pa­rite, tansiyon, nabız, vücut kitle indeksi, sigara, gebelik haftası, doğum şekli, doğumda gelişen komplikasyonlar, sezaryen endikasyonları, annenin biyokimyasal paramet­releri, preeklampsi ve preterm eylem gelişen hastalar, kan transfüzyonu ve yoğun bakım ihtiyacı, bebeğin 1. ve 5 da­kika APGAR skoru, kilosu, amnion mayisi, fetal anomali varlığı, yoğun bakım ihtiyacı kaydedildi. Bulgular: Ocak 2015- Ekim 2015 tarihleri arasında top­lam doğum sayımız 1715 idi. Bunların 62 (%3,6) ’sinin adölesan yaş grubunda olduğu izlendi. Maternal kan transfüzyonu ihtiyacı adölesan grupta anlamlı olarak yük­sek tespit edildi (p: 0.004). Fetal anomali ve fetal yoğun bakım ihtiyacı adölesan grupta anlamlı olarak yüksek tes­pit edildi (p değerleri sırasıyla p:0.014 p:0.018). Sonuç: Adölesan gebelikler, özellikle maternal anemi ve kan transfüzyonu ihtiyacı açısından artmış risk ve kötü perinatal sonuçlara neden olduğundan yüksek riskli ge­beliklerdir. Bu nedenle bu gebelikleri azaltmak ve peri­natal komplikasyonları en aza indirmek için daha geniş kapsamlı çalışmalar yapılmalıdır.

Objectives: This study aimed to evaluate data on early diagnosis and therapeutic management of rudimentary horn pregnancy (RHP). Material and methods: Patients diagnosed with RHP at a tertiary center between for two periods of 2008–2012 and 2013–2018 were analysed retrospectively. We obtained information of patients from hospital electronic archive registration system. Data on demographic characteristics, clinical presentation, gestational age at presentation, presenting symptoms, diagnostic methods, and therapeutic management were noted and analysed by descriptive statistical method. Demographic datas, the complaint of patient’s admission to hospital, history of cesarean section, preliminary diagnosis and intraoperative diagnosis were compared between periods of 2008–2012 and 2013–2018. Results: A total of 14 RHP patients were included. Eight (57.1%) of these patients were diagnosed between 2008–2012 (Group 1), whereas six patients (42.9%) were diagnosed between 2013–2018 (Group 2). Rudimentary horn was non-communicating in 13 patients (92.8%). Communicated form was observed in 1 patient in group 1. RHP was diagnosed on the left side in nine patients (64.2%). Six of these patients were observed in group 1 and 3 were in group 2. The pre-rupture diagnosis was made in 10 (71.4%) patients. Six (100%) of 10 patients were in group 2. In addition, in group 1, four patients (50%) experienced intraoperative RHP rupture. RHP was diagnosed before rupture in 2 (33.3%) patients in group 2. Conclusions: It is an indication of advanced ultrasonographic technology as well as increased carefulness on the physician side and raised alertness on the patient side that today both RHP and preoperative rupture of RHP are less frequent. Still, further awareness is required among physicians of the necessity of excision of a rudimentary horn that is detected at the time of C-section.

WOS:000599171400013 In February 2020, the World Health Organization identified the coronavirus disease 2019 (COVID-19). The virus that causes COVID-19 is known as severe acute respiratory syndrome coronavirus 2. Nations worldwide have reported high death tolls and are adopting measures, particularly in Turkey wherein efforts are made to ensure that pregnant women are minimally affected by this epidemic that has such terrible effects. To date, a total of 206,844 cases have been confirmed in Turkey in approximately 115 days. However, the exact number of pregnant COVID-19 patients in Turkey or worldwide is not yet known. There are no conclusive data that confirm whether pregnant women are at a higher risk of acquiring this infection compared to the rest of the population. It is also not yet known if or how fetuses will be affected by this infection. However, the body of research evidence concerning COVID-19 is rapidly growing, and multiple organizations are constantly updating and expanding resources for interim guidance. In this review, we aimed to summarize the latest available research on COVID-19 virology and epidemiology as well as the status of pregnant healthcare workers together with the reported data on pregnant women and other recent findings and to discuss COVID-19 during pregnancy based on the available data.

WOS:000610981400003 PMID: 33447992 Objective: To investigate the levels of anti-angiogenic factors, namely sFlt-1 and Netrin-4, in patients with preeclampsia (PE). Material and methods: Cord-blood (UC) sFlt-1 and Netrin-4 concentrations were measured in 30 patients with severe PE, 30 patients with PE and 30 control infants and their mothers (MS). Results: Maternal sFlt-1 levels were significantly higher in the severe PE and PE groups than in the control group. There were no statistical differences among the three groups in maternal and fetal Netrin-4 levels. But Netrin-4 levels were found to be the lowest in the control group and higher in the PE and severe PE groups. The correlation analysis revealed a positive correlation between maternal sFlt-1 levels and maternal Netrin-4 levels (p = 0.012, and r = 0.263), maternal sFlt-1 levels and fetal sFlt-1 levels (p = 0.012, and r = 0.263). Conclusions: There was a positive correlation found between maternal sFlt-1 levels and maternal Netrin-4 levels. We are of the opinion that elevation in levels of Netrin-4 might be secondary to placental hypoxia occurring in PE. The present study led to the consideration of anti-angiogenic biomarkers (sFlt-1 and Netrin-4) on automated platforms for clinical use as an aid in establishing the diagnosis and prognosis of PE.

PMID:31802467 bjectives: To determine the clinical differences and factors affecting early pregnancy outcome in the first and early second trimester subchorionic hematoma cases. Material and methods: This study involved with the retrospective analysis and evaluation of 81 cases diagnosed with subchorionic hematoma. The patients were grouped according to the gestational periods, symptoms at the time of admission, ratio of surrounding hematoma to the gestational sac, and whether there was a pregnancy loss. The groups were compared according to the clinical features and pregnancy outcomes. Results: The ratio of surrounding hematoma to the gestational sac in the group with pregnancy loss was significantly higher (p = 0.002). When the cut-off value was 35.5%, it could determine the possibility of a complication in pregnancy with 70% sensitivity and 75% specificity. Nonspecific pelvic pain were significantly higher in the pregnancy loss group than in the other group. Logistic regression analysis was performed to determine the effect of these two parameters on the pregnancy outcome. Although the presence of non-specific pelvic pain is more in the group with pregnancy loss; there was no effect of on pregnancy outcome (p = 0.141). The risk of pregnancy loss increased 4.5 fold if the ratio of ScH to gestational sac was above 35% (p = 0.027). Conclusions: In the cases of subchorionic hematoma, we concluded that when the ratio of surrounding hematoma to the gestational sac increased and when it was accompanied by nonspecific pelvic pain, the hospitalization period of the patients increased and the ratio of pregnancy loss was higher.

Amaç: Amacımız obstetrik nedenlere bağlı gelişen posterior reversible ensefalopati sendromunun (PRES) görüntüleme yöntemleri kullanılarak kranial değişikliklerin erken saptanması ve yönetimini ele almaktır. Materyal ve Metod: Çalışma kapsamında Dicle Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum Kliniğinde, Ocak 2010-Aralık 2017 tarihleri arasında 48 posterior reversible ensefalopati sendromu tanısı alan ve 37 normal kranial görüntüleme saptanan hastaların bilgileri değerlendirildi. Hastalar Grup-1 (Posterior reversible ensefalopati sendromu), Grup-2 (normal kranial görüntüleme) olarak sınıflandırıldı. Hastalara ait demografik veriler, fizik muayene bulguları, laboratuar parametreleri, hastalara hastanemizde ve/veya öncesinde yapılan cerrahi müdahaleler, hastaneye yatış süresi, hastaların yoğun bakımda kalış süreleri, hastaların başka kliniğe transferi sağlanıp sağlanmadığı gibi bilgiler hastane arşiv dosyalarından ve elektronik arşiv veri tabanından temin edildi. Bulgular: Kliniğimize 7 yıllık dönemde toplamda 274 şiddetli preeklampsi ve eklampsi tanısı alan gebe başvurmuştur. Bu hastalardan nörolojik semptom tarifleyen 94 hastaya ek görüntüleme yöntemleri istenmiştir. İntrakranial kanama+DIC olan 2 hastanın maternal ölümle sonuçlandığı görüldü. Bu çalışmaya ek görüntüleme yöntemlerine başvurulan hastalardan 48 (% 56,47) hasta grup 1 olarak, 37 (%43,53) hasta grup 2 olarak adlandırıldı. Toplamda 85 hasta çalışmaya dahil edildi. Grup 1 hastalarda ALT, PT, INR değerinin Grup 2 hastalara göre anlamlı olarak yüksek bulundu (p

Preterm doğum, gebeliğin yaşayabilirlik sınırından sonra ve 37 hafta veya 259 günden önce doğumun gerçekleşmesidir. Preterm doğumlar perinatal morbidite ve mortalitenin en önemli nedenidir. Çalışmamıza, Dicle Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum Anabilim Dalı kliniğinde Eylül 2010 ile Ağustos 2014 yılları arasında, 24 hafta ile 36 hafta 6 gün arasında doğum yapan 5613 gebeden preterm doğum yapmış 649 hastanın dosyası ve bu gebelikler sonucu doğmuş olan yenidoğanların ilk bir saatlik değerlendirmeleri dahil edildi. Daha önce bir veya daha fazla sezeryan öyküsü olup ek obstetrik bir problemi olmayan hastalar çalışma dışı bırakılmıştır. Veriler hastane elektronik veri tabanından elde edildi. Bu hastalardan, 25'i (%3.85) 18 yaş ve altı, 471'i (%72.57) 19-34 yaş arası, 153'ü (%23.57) 35 yaş ve üzerindeydi. En küçük gebemiz 14 yaşında, en büyük gebemiz 48 yaşındaydı. Daha önce hiç doğum yapmamış 99 gebe (%15.3), bir kez doğum yapmış 95 gebe (%14.6), iki doğum yapmış 89 gebe (%13.7), üç doğum yapmış 44 gebe (%6.8), dört doğum yapmış 45 gebe (% 6.9) beş veya daha fazla doğum yapmış 73 gebe (%11.2) mevcuttu. Çalışmamızda preterm doğum oranı %11.56 olarak bulunmuştur. Preterm doğumların (%25.4) preterm eylem, (%23.7) PPROM (preterm eylem + erken membran rüptürü) nedenli olmuştur. Erken doğumların %50.9'u ise maternal-fetal problemler nedeniyle gerçekleşmiştir. Bu grup içerisinde en fazla hpertansif hastalıklar bulunmaktır (%23.7). Doğum haftası ile yenidoğan ilk bir saati değerlendirildiğinde, doğum haftası azaldıkça yenidoğan yoğun bakıma yatış (p35 years (range, 14-48 years). Numbers of previous births were as follows: none, 99 (15.3%); once, 95 (14.6%); twice, 89 (13.7%); three times, 44 (6.8%), four times, 45 (6.9%) and five times or more, 73 (11.2%). Overall preterm birth rate was 11.56%. Most of the births were resulted from maternal-fetal problems (50.9%), followed by preterm labor (25.4%) and preterm labor + preterm premature rupture of membranes (PPROM) (23.7%). Also, hypertensive disease (23.7%) constituted the majority of the maternal-fetal problems.The analysis on the week of delivery and the first neonatal hours revealed that the decrease in the gestational period was correlated with an increase in the duration of neonatal stay in neonatal intensive care unit (p