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Objectives: To evaluate the perinatal outcomes of antenatally diagnosed omphalocele cases. Material and methods: This was a retrospective study conducted between July 2014 and February 2020 at the prenatal diagnosis center of a university clinic. Gestational week of diagnosis, associated anomalies, karyotype analysis results, complications during pregnancy, termination/delivery characteristics, and postnatal results were evaluated. Results: The analysis was performed on 58 patients. The median diagnosis time was 14.5 weeks of gestation. Thirty-three cases (57%) were defined in the first trimester. 33 (57%) of 58 patients had one or more concomitant anomalies, while 25 patients (43%) had isolated omphalocele. The most common associated anomaly was a cardiac anomaly which was observed in 17 fetuses (30% of all omphalocele cases). Karyotype analysis was performed in forty-five patients (41 in the prenatal period, 4 in the postnatal period). A normal karyotype was detected in 27 cases (60%). Trisomy 18 was the most common chromosomal anomaly (n = 15, 33.3%). Thirty of 58 patients (52%) requested termination of pregnancy (TOP) in the early pregnancy period. Thirteen of the cases died in-utero (22%). Fifteen pregnancies resulted in live births (26%), of those eight were lost in the first year of life (six of them had additional anomalies, while two of them had isolated omphalocele but the omphalocele pouch was containing the liver in those two babies). Conclusions: Most of the cases with an omphalocele can be diagnosed in the first trimester. Cardiac anomalies were the most common associated anomalies, while trisomy 18 is the most common chromosomal anomaly. Thus, earlier and effective counseling can be made about the prognosis of pregnancy.

Objective: Congenital pes equinovarus (PEV) is the most common congenital deformity of the foot, characterized by plantar flexion with a frequency of 0.2-0.3%. It can be diagnosed from the 12th week of pregnancy. Non-isolated cases tend to be syndromic and complex. We aimed to evaluate the results of perinatally diagnosed isolated PEV. Materials and Methods: This was a retrospective cohort study conducted between March 2015-March 2020. Women who presented for fetal anomaly screening or were referred due to any suspected fetal anomaly were subjected to detailed fetal anomaly scans and checked for the presence of PEV. Karyotype analysis was discussed for patients with PEV. Pregnancy termination was recommended for those with chromosomal/life-threatening anomalies. The diagnosis was confirmed by postnatal examination/autopsy. Postnatal diagnosis was accepted as false-positive in those with no PEV. Results: One-hundred thirty-eight patients were found to have PEV, 41 (29.7%) of which were isolated. In the isolated group, the false-positive rate in the first trimester was significantly higher compared with the second trimester, 50%/15.3%, respectively (p

BACKGROUND: Among women who have suffered loss of pregnancy, the level of grief decreases gradually. Age, mental health status and childlessness are the factors known to mostly affect women’s levels of grief. OBJECTIVES: To assess the levels of grief among women who experienced perinatal loss and the changes in their ruminative thought styles over the first year after their loss. DESIGN AND SETTING: One-year follow-up study carried out in a university hospital in Turkey. METHODS: The study population included 70 women who experienced loss of pregnancy in the hospital. The sample size was calculated using G*Power V3.1. Data were collected at 48 hours, at the third month, at the sixth month and at one year after pregnancy loss, between June 2018 and June 2019. A personal information form, the Perinatal Grief Scale and the Ruminative Thought Style Questionnaire were used for data collection. RESULTS: The women’s highest levels of grief and ruminative thought style were in the first 48 hours. Their tendency towards grief and ruminative thought styles decreased over the repeated measurements during the follow-up. Women aged 20-29 years had the highest levels of grief at the third month after perinatal loss. CONCLUSIONS: Nursing assessments regarding grief and ruminative thought style over the first 48 hours after perinatal loss should be integrated into nursing care for these women. Grief follow-up programs for these women can be developed through nursing research.

Objectives Our primary aim was to evaluate the ability of various cerebroplacental ratio (CPR) reference values suggested by the Fetal Medicine Foundation to predict adverse neonatal outcomes in term fetuses exhibiting late-onset fetal growth restriction (LOFGR). Our secondary aim was to evaluate the effectiveness of other obstetric Doppler parameters used to assess fetal well-being in terms of predicting adverse neonatal outcomes. Methods This was a retrospective cohort study of 317 pregnant women diagnosed with LOFGR at 37–40 weeks of gestation between January 1, 2016, and September 1, 2019. Receiver operating characteristic (ROC) curves were drawn to determine the predictive performance of CPR 95th percentile in terms of predicting adverse neonatal outcomes. Results Pregnant women exhibiting LOFGR who gave birth in our clinic during the study period at a mean of 38 gestational weeks (minimum 37+0; maximum 40+6 weeks); the median CPR was 1.51 [interquartile range (IQR) 1.12–1.95] and median birthweight 2,350 g (IQR 2,125–2,575 g). The CPR Conclusions The CPR values below the 5th percentile better predicted adverse neonatal outcomes in pregnancies complicated by LOFGR than the UA PI and CPR

Objectives: We hoped to reveal the frequency of Aberrant Right Subclavian Artery (ARSA) and to find the relationship of isolated/non-isolated ARSA with chromosomal defects and other fetal congenital heart diseases (FCHD) in a heterogeneous population. Material and methods: This was a retrospective cohort study conducted between December 2015 to September 2018. Women admitted for routine ultrasound examination or referred to our hospital for a suspected fetal anomaly were underwent detailed fetal anomaly ultrasonography scan and tested for the presence of ARSA. Results: ARSA was detected in 27 patients and an isolated finding in 13 (48%) cases. Among 13 cases with isolated ARSA, trisomy 21 was diagnosed in 1 case. In the non-isolated group (n: 14, 52%), five cases presented with trisomy 21. There was no significant difference of trisomy 21 frequency between isolated and non-isolated groups (7.6% vs 35.7%, p = 0.08). In 3 patients, FCHD was diagnosed and 2 of them had trisomy 21. Conclusions: Our study shows that ARSA can be the only marker in trisomy 21. The examination of the subclavian artery must be a part of the fetal anomaly ultrasonography. Detecting an ARSA should increase the attentiveness of the sonographer to investigate for the other markers of trisomy 21. In the existence of other findings, invasive diagnostic procedures should be offered to the patients, whereas in cases that arsa is the only finding, other risk factors should be investigated to offer karyotyping or cell-free DNA analysis.

PubMedID: 28647444 Objective The predictive value of spot urine protein-to-creatinine ratio (PCR) for estimating total 24-hour proteinuria in severe preeclampsia is unclear. This study aimed to assess the diagnostic accuracy of spot urine PCR for ascertaining the magnitude of proteinuria in women with preeclampsia of varying severity. Methods A total of 205 patients with prediagnosed preeclampsia were included in this prospective cohort study. Patients were allocated into one of the three groups categorized by severity of disease, as follows: gestational hypertension, group 1 (n = 41); preeclampsia, group 2 (n = 88); and severe preeclampsia, group 3 (n = 76). We assessed the spot urine PCRs to determine significant proteinuria and the magnitude of proteinuria in these groups. Results The spot urine PCR was 0.53, with 81% sensitivity and 93% specificity to detect significant proteinuria. A significant correlation was found between PCR and 24-hour total proteinuria in group 1 (r = 0.473, P = 0.002). There were also significant correlations in group 2 (r = 0.814, P < 0.001) and group 3 (r = 0.912, P < 0.001). The established formula using spot urine PCR to estimate 24-hour total proteinuria in severe preeclampsia was Y = 832.02X + 378.74 mg (r 2 = 0.8304). Conclusion Although 24-hour urine collection remains a merely reliable test to determine the degree of total proteinuria, our findings suggest that it is likely to assess the magnitude of proteinuria by the spot urine PCR, especially in severe preeclampsia. Clinical trial registration www.clinicaltrials.gov NCT01623791 © 2017 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada

Toxoplasmosis is an infectious disease caused by a protozoa named Toxoplasma gondii. It is a very important disease because it is related to fetal anomalies and poor perinatal outcomes like abortus and stillbirth. It spreads via uncooked meat and contaminated food. Timely and appropriate treatment and management of this infection prenatally reduces the risk of serious neurological sequelae. Therefore it is crucial that clinician who takes care of pregnant women know this infection deeply. In this review we aimed to summarize the prenatal diagnosis, complications and treatment of toxoplasma infection. [Archives Medical Review Journal 2016; 25(4.000): 457-466]

Thrombocytopenia, which is encountered in 7-10% of pregnancies is characterized with decreased number of thrombocytes. The most frequent cause of thrombocytopenia during pregnancy is gestational thrombocytopenia. These patients usually do not have symptoms due to mild thrombocytopenia. The diagnosis is usually established by excluding connective tissue disorders, drug effects and obstetric causes. The etiology of thrombocytopenia during early pregnancy is most frequently due to autoimmune causes. Thrombocytopenia secondary to obstetric causes like preeclampsia, HELLP syndrome should always be kept in mind. Under these circumstances the thrombocytopenia will not resolve unless pregnancy is terminated. The clinician should be able to distinguish between thrombocytopenia that does not require treatment and the causes that require emergent and serious medical interventions., Trombositopeni gebeliklerin %7-10’unda saptanan, trombosit sayısının düşüklüğüyle karakterize bir durumdur. Gebelikte görülen trombositopenin en sık sebebi gestasyonel trombositopenidir. Bu hastalarda trombositopeni genelde hafif olduğundan semptom görülmez. Tanı çoğunlukla bağ dokusu hastalıklarının,ilaç etkilerinin, obstetriyle ilişkili sebeplerin dışlanmasıyla konulur. Erken gebelik haftalarında görülen trombositopenin etyolojisinde en fazla otoimmun sebepler rol alır. Preeklampsi,HELLP sendromu gibi obstetriyle ilişkili nedenlere ikincil gelişen trombositopeniler ise her zaman akılda tutulmalıdır. Bu durumların varlığında çoğu zaman doğum gerçekleşmeden trombositopeni düzelmeyecektir. Klinisyen; tedavi gerektirmeyen trombositopenilerle, annenin fetusun hayatını tehdit eden ve bu nedenle acil ve ciddi bakım gerektiren trombositopeni sebepleri arasında ayırımı iyi yapabilmelidir.

Thrombocytopenia, which is encountered in 7-10% of pregnancies is characterized with decreased number of thrombocytes. The most frequent cause of thrombocytopenia during pregnancy is gestational thrombocytopenia. These patients usually do not have symptoms due to mild thrombocytopenia. The diagnosis is usually established by excluding connective tissue disorders, drug effects and obstetric causes. The etiology of thrombocytopenia during early pregnancy is most frequently due to autoimmune causes. Thrombocytopenia secondary to obstetric causes like preeclampsia, HELLP syndrome should always be kept in mind. Under these circumstances the thrombocytopenia will not resolve unless pregnancy is terminated. The clinician should be able to distinguish between thrombocytopenia that does not require treatment and the causes that require emergent and serious medical interventions. [Archives Medical Review Journal 2016; 25(3.000): 420-432]

Aim: The Objective of our study was to evaluate the chromosomal analysis results that were obtained from amniocentesis, cordocentesis and chorionic villus sampling (CVS) inpatients whom had applied to the perinatology unit of Cukurova University Faculty of Medicine gynecology and obstetrics clinic with high risk in terms of chromosome anomaly according to Ultrasonography (USG).Material and Methods: Our study was conducted as a retrospective pattern. CVS, amniocentesis and cordosentesis were performed in 1298 pregnant women whom had applied to the Cukurova University Faculty of Medicine, Gynecology and Obstetrics Clinic, Perinatology Unit in the date interval between 1st December 2014-31st December 2016 with the indication of abnormal maternal serum screening tests, maternal request because of advanced maternal age, history of fetal anomaly with previous pregnancies, history of relatives with Trisomy 21, fetal abnormalities or signs of trisomy which were detected by ultrasonography and only depending on maternal request without any risk factors. Data obtained in the study were assessed using the SPSS (Statistical Package for Social Sciences) 22.0 package program. The relationships between categorical variables were determined by Chi-Square test. Relationship between normal distribution-matched, numerical data were assessed by ANOVA, Independent Sample t-test, and relationship between non-normal distributions of numerical data were assessed using Mann-Whitney U and Wilcoxon Test. Statistical significance level was determined as p 0.05.Results: Fetal anomalies were observed in 28.9% (n: 366) of the patients while 369 (28.4%) of the 1298 patients who had prenatal diagnosis had abnormalities in the maternal screening results. No chromosomal abnormalities were detected in 1120 (86.2%) of the 1298 patients who were taken into the study. 49 patients had Trisomy 21, 27 patients had Trisomy18 and 14 patients had Trisomy13. Turner syndrome was seen in 10 of thepatients. In our study, chromosomal abnormality rate of patients with more than one minor marker was found to be statistically significant (p: 0.01). Chromosomal anomaly was detected in 319 (8.4%) of 349 patients with combined test. Chromosomal anomaly was detected in 70 (19.1%) of the 366 patients who detected fetal anomaly. Chromosomal anomaly was detected in 27 (24.1%) of the 112 increased NT patients.Conclusion: In our study, 1298 invasive procedures are listed as follows; amniocentesis was performed in 841 (64.8%), cordocentesis in 57 patients (4.4%) and CVS in 400 patients (30.8%). As a result of karyotype analysis of the patients, nochromosomal anomaly was detected in 1120 patients (86.28%). In 178 patients, chromosomal anomaly (13.71%) was detected. This study aimed to determine the prevalence of fetal chromosomal anomaly in the Mediterranean region by determining the prevalence of invasive prenatal test indications and evaluating the results of invasive prenatal tests performed in our clinic in the 2-year period.

The management of Human Immunodeficiency Virus (HIV) infection is progressing rapidly. In developed countries, the perinatal transmission rates have decreased from 20-30% to 1-2% with the use of antiretroviral therapy and cesarean section. Interventions for the prevention of prenatal transmission has made the prenatal care of pregnant patients with HIV infection more complex. Rapid development of standard care and continuing increase in the distribution of HIV infection has required clinicians taking care of pregnants to have current information. Therefore, in our review we aimed to summarize the prenatal course, treatment and preventive methods for perinatal transmission of HIV., Human Immunodeficiency Virus (HIV) enfeksiyonunun yönetimi hızlı şekilde değişim göstermeye devam etmektedir. Gelişmiş ülkelerdeki perinatal geçiş oranları, antiretroviral tedavi (ART) ve sezaryen doğumun planlanmasıyla %20-30’lardan, %1-2’lere kadar düşürülmüştür. Perinatal geçişin azaltılması için yapılan girişimler HIV ile enfekte kadınlar için uygulanan prenatal bakımı daha kompleks hale getirmiştir. Standart bakımın çok hızlı değişmesi ve HIV enfeksiyonu yaygınlığının giderek artması nedeniyle gebe takibi yapan klinisyenlerin bu konudaki güncel bilgilere sahip olması önemlidir. Bu nedenle makalemizde, HIV enfeksiyonunun prenatal dönemdeki seyri, tedavisi ve perinatal geçişin önlenmesi için alınacak tedbirleri özetlemeyi amaçladık.

Amaç: Gebeliğin ilk üç ayında hemoglobinopatilerin prenatal tanısı için fetal aortik Doppler incelemesinin değerlendirilmesi amaçlanmıştır.Gereç ve Yöntemler: Ocak 2014 ve Kasım 2014 tarihleri arasında 108 hasta çalışmaya dahil edildi. Çiftler, Çukurova Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum Bölümü Prenatal Tanı Merkezi'ne alfa/beta talasemi, orak hücre anemisi veya bunların kombine taşıyıcısı olup başvuran kişilerden oluşmakta idi. Koryonik villüs örneklemesinden (KVÖ) bir saat önce fetal aortik Doppler incelemesi yapıldı. Pulsatilite indeksi, tepe sistolik hız, kalp hızı not edildi.Bulgular: Farklı KVÖ sonucu grupları sağlıklı kontrollerle karşılaştırıldıklarında Doppler indeksleri açısından istatistiksel olarak anlamlı fark bulunmamıştır.Sonuç: Fetal aortik Doppler incelemesi hemoglobinopatilerin prenatal tanısında etkin bulunmamıştır. Objective: To evaluate fetal aortic Doppler for the prenatal diagnosis of hemoglobinopathies in the first trimester of pregnancy.Materials and Methods: Between January and November 2014, a total of 108 patients were enrolled in the study. The couples were carriers of either alpha/beta thalassemia, sickle cell disease or combined carriers of these and were admitted to Çukurova University Faculty of Medicine, Department of Obstetrics and Gynecology Prenatal Diagnosis Center. One hour before the chorionic villus sampling (CVS), patients were evaluated using fetal aortic Doppler. Pulsatility index, peak systolic velocity, and heart rate were noted.Results: There were no statistically significant differences in Doppler indices between different groups of CVS results when compared with the healthy controls.Conclusion: Fetal aortic Doppler investigation was found to be ineffective for the prenatal diagnosis of hemoglobinopathies.