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Objective. To evaluate the characteristics of obstetric malpractice litigations. Study design. This is a retrospective study of 80 expertise reports written for obstetric medico-legal litigations between 2007 and 2017. Results. We showed that obstetric medico-legal litigations have been increasing recently, like in other countries. In most cases, the primary plaintiffs and defendants were the patients and doctors. Most cases (53.7%) were from private hospitals. Intrapartum events and puerperal events were most common claim subjects (77.5%). Among the peripartum claims, shoulder dystocia, fetal asphyxia and caesarean section related complications were the most common claims, with 14 (17.5%), 12 (15%) and 10 (12.5%) cases, respectively. Diagnosis-related claims were subject of 18 (22.5%) cases, 12 of which were related to prenatal diagnosis. The most common issue was found to be fetal morbidities (47.5%). Maternal and fetal mortality occurred in 10 (12.5%) and 22 (27.5%) cases, respectively. The route of delivery was vaginal, through caesarean section, or operative vaginal in 33, 29 and seven cases, respectively. Twenty-six caesarean sections were urgent. Conclusions. Medico-legal claims have been increasing, like in many other countries. Problems involving prenatal screening/diagnosis, intrapartum processes, urgent caesarean sections and operative vaginal deliveries were highly liable situations. Further legal regulations are needed to provide a more comfortable medico-legal climate for physicians. [ABSTRACT FROM AUTHOR]

Background and objective: The effect of SARS-CoV-2 infection on the liver during pregnancy and the impact of SARSCOV- 2-related liver injury during pregnancy on obstetric and neonatal outcomes are not yet clear. The aim of this study was to determine the clinical features of pregnant women at risk of liver injury and to investigate the effect of liver dysfunction on obstetric and perinatal outcomes. Methodology: Pregnant women who were followed up and treated at Selcuk University Medical Faculty Hospital and diagnosed with COVID-19 were determined retrospectively. All pregnant women whose PCR test results were positive between March 1, 2020 and July 31, 2022 were included. A total of 96 PCR positive pregnant women were included in the study. The patients were divided into two groups as those with and without liver damage. Both groups were compared in terms of obstetric and neonatal outcomes. Results: While liver damage findings were observed in 34.4% of the 96 pregnant included in the study; No liver damage was observed in 65.6% of the patients. White blood cell, neutrophil, ferritin, D-dimer, troponin, C-reactive protein, systemic immune-inflammation index, interleukin-6, alanine aminotransferase, aspartate aminotransferase and lactate dehydrogenase levels were higher in patients with liver injury compared to pregnant women without liver injury. Prematurity, premature rupture of membranes, preterm premature rupture of membranes, preeclampsia and fetal death were observed relatively more in the patient group with liver injury, there was no statistical significiant difference between the groups in terms of these complications. Unfortunately, maternal death occurred in four mothers with liver injury and in one patient without liver injury. Birthweight, APGAR scores and obstetric complication rates were similar between two groups. Conclusion: Our study showed that pregnant patients with liver damage had worse inflammatory response than those without liver damage. Women with elevated liver enzymes tend to have severe disease, but obstetric and perinatal outcomes were similar between groups with and without liver damage. [ABSTRACT FROM AUTHOR]

To understand if every other day iron supplementation may be as effective as daily iron intake in anemic pregnant women. This case-control study was conducted at a tertiary hospital in Turkey. The study randomly categorized women into two groups as daily intake (n = 124) vs every other day intake (n = 140) of 100 mg daily oral ferrous fumarate. The numbers of women recruited from the study were 13 and 34 in two groups. Thus, for analysis, there were 111 women in the daily group and 106 women in the other group. The current study obtained hemoglobin (Hb) and ferritin levels two times to evaluate the effects of treatment, noting initial levels before drug administration, and a second blood sample was obtained after two months. Two groups were compared according to the increase in Hb and ferritin levels. The study asked the women whether they experienced gastrointestinal side effects. The ferritin levels increased 4.9 ± 4.2 ng/mL in the daily intake group and 3.9 ± 2.9 ng/mL in every other day group (p =.215). The Hb increased 1.4 ± 0.7 g/dL in the daily intake group and 1.6 ± 0.6 g/dL in the other group (p =.021). Gastrointestinal side effects appeared in 47 (17.8%) out of 264 women. The rate of gastrointestinal side effect was lower in every other day group (41.4% vs 15.1%, p =.0057). Every other day iron supplementation is as effective as daily intake for treating iron deficiency anemia with lesser gastrointestinal side effects during pregnancy. [ABSTRACT FROM AUTHOR]

OBJECTIVES: Fetal megacystis is very rare; however this problem may be associated with other structural or chromosomal abnormalities leading to morbidity and mortality. Due to renal injury and pulmonary hypoplasia, the prognosis is poor especially in fetuses with early-onset oligohydramnios. In this study, we evaluated the management strategies and outcomes of fetal megacystis in our hospital. STUDY DESIGN: The data of cases who were prenatally diagnosed with megacystis between 1 January 2017 and 31 December 2019 were analyzed. Ultrasonography findings and antenatal interventions were withdrawn from the computerized database. Information about postpartum status was also received. The data were analyzed in terms of diagnostic methods, fetal interventions (vesicosynthesis, vesicoamniotic shunt), potential prognostic markers and short/long-term outcomes. RESULTS: A total of 15 megacystis patients were detected. One of the fetuses was female and the remaining cases were male. Six of the patients were isolated. Ten patients underwent invasive procedures for prenatal aneuploidy diagnosis and one of them diagnosed with trisomy 18. Totally, 4 patients underwent vesicosynthesis; however, no vesicoamniotic shunt was recorded. Four fetuses were terminated and intrauterine fetal demise occurred in 2 fetuses. Four patients were lost during follow up. Survival rate was 33.3%. CONCLUSION: Fetal megacystis is an important ultrasonographic finding which may be a component of chromosomal/genetic anomalies. This problem may also be isolated in some cases. Because of the poor outcome, parents should be well informed and all interventions should be offered to families. [ABSTRACT FROM AUTHOR]

BACKGROUND: The objective of this study is to evaluate the obstetric outcomes of pregnancies with congenital diaphragmatic hernia (CDH). METHODS: Fifty one pregnancies prenatally diagnosed with CDH at our institution between January 1, 2002 and August 31, 2018 were retrospectively evaluated. The pregnancies were divided into two groups according to neonatal survival. Demographic features, clinical characteristics and prognostic factors were compared between the neonatal survival (n = 16) and non-survival (n = 28) groups. Cut-off values of fetal lung area to head circumference ratio (LHR), observed/expected LHR (o/e LHR) and observed/expected total fetal lung volume (o/e TFLV) for neonatal survival were calculated. RESULTS: Thirty six (70.6%) and fifteen (29.4%) fetuses had left and right sided CDH respectively. Seven patients chose termination of their pregnancies (13.7%). Statistically significant differences were found between survival and non-survival groups in terms of parity, median gestational week at diagnosis, polyhydroamniosis rate, CDH type, stomach position, liver position, median LHR, o/e LHR, o/e TFLV, median 5th minute Apgar score and neonatal operation rate values (p values were 0.03,<0.001, 0.02, 0.006,<0.001, 0.006,<0.001,<0.001,<0.001, 0.04 and <0.001 respectively). According to ROC curve analysis, 1.05 (82% sensitivity, 74% specificity) for LHR, 22.5 (78.6% sensitivity, 73.9% specifity) for o/e LHR and 23.5 (85.7% sensitivity,74.2% specificity) for o/e TFLV were determined to be cut-offs for neonatal survival, respectively, with highest sensitivity and specificity. CONCLUSION: Earlier gestational week at diagnosis, right sided CDH, presence of liver herniation, supradiaphragmatic stomach position, lower LHR, o/e LHR and o/e TFLV were associated with decreased rates of neonatal survival. [ABSTRACT FROM AUTHOR]