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Aim: To demonstrate the effect of the Syrian refugee population on the prevalence of congenital TORCH (Toxoplasmosis, Other [syphilis, varicella‐zoster, parvovirus B19], Rubella, Cytomegalovirus [CMV] and Herpes) infections and to evaluate the cost‐effectiveness of population‐based TORCH screening during pregnancy in Turkey. Methods: Pregnant women (n = 9754) were enrolled. Ultrasonographic findings, immunoglobulin (Ig)M and IgG seropositivity, avidity, amniocentesis and DNA‐polymerase chain reaction (PCR) results were compared. Costs were calculated based on invoice amounts from the Health Applications Communique pricing system. Results: The prevalence of TORCH seropositivity in Turkey was not significantly different between all regions (P > 0.05). Overall, 1333 (13.67%) pregnant Syrian refugees were included in the study. Acute CMV, rubella and Toxoplasma gondii infections (according to low IgG avidity in IgM positive patients) were detected in 17.82%, 21.53% and 14.07% of women, respectively. Twenty‐four women underwent an amniocentesis procedure and nine of them had positive DNA‐PCR and reverse transcription‐PCR results. All women with positive results opted to terminate the pregnancy. There was no statistical difference among groups according to the rate of low IgG avidity in IgM‐positive patients and termination rates for T. gondii, rubella and CMV (P > 0.05). Total cost for screening the entire study population was presented in US dollars (USD). A total of 71 529 and prenatal diagnosis with positive invasive test results were obtained in nine women: toxoplasmosis in four, CMV in three and rubella in two women. Conclusion: Population‐based screening for prenatal TORCH infections is not cost‐effective in Turkey. Syrian refugees have a limited effect on the increasing prevalence of congenital TORCH infections. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effects of maternal body mass index (BMI) and total weight gain during the pregnancy (WGDP) on all stages of labor. Material and Methods: This is a prospective case-control study carried out at a tertiary referral hospital during 1-year period of time. We divided study population into 4 groups according to BMI and classified women according to WGDP; inadequate, optimum, excessive. Then we assessed the maternal characteristics, cesarean rate, all variables of labor stages, delivery complications, operative delivery rates, and interventions such as; induction rate and episiotomy. Results: A total of 523 women were included in the study [n=55 (10.5%) cesarean section and n=468 (89.5%) vaginal delivery]. There were 435 pregnant Turkish women and 88 Syrian Refugees in the study population. Younger maternal age and need for episiotomy was more common in low-weight group than others. All stages of labor except transition stages (duration between 7 and 10 cm of cervical dilatation) was longer in obese group (222.9±35.6 min, 195.8±29.6 min, 200.6±30.4 min, 255.8±38.2 min in group 1,2,3 and 4, respectively) (p<0.05). We found no statistically significant effect of weight gain on the duration of labor. Conclusion: Either low and high pre-gestational BMI are found to lead to increased risk of adverse labor results in compatible with literature. Therefore, professionals should support weight loss or gain to achieve optimal BMI in women planning pregnancy. [ABSTRACT FROM AUTHOR]

We aimed to investigate whether first and second-trimester prenatal screening test parameters may be useful in predicting HELLP Syndrome. HELLP syndrome was defined according to Sibai criteria. The collected data were as follows; age, gravida, parity, body mass index, gestational week at labor, route of delivery, birth weight, aspartate aminotransferase (AST), Lactate dehydrogenase (LDH), bilirubin, first trimester multiple of medians (MOM) of pregnancy-associated plasma protein-A (PAPP-A) and Beta human chorionic gonadotropin (B hCG), second trimester B hCG, unconjugated estriol (uE3) and AFP levels were measured. A total of 80 patients in the study group and 135 patients in control groups were included in the study. All the markers of HELLP syndrome were significantly higher in the study group due to the markers was the criteria for HELLP syndrome. While first-trimester PAPP-A was significantly lower in the study group, B hCG levels were similar between groups. The second trimester B hCG level was significantly higher in the study group. AFP level and uE3 level were not different in the control and study groups. Low PAPP-A levels and high second trimester B hCG levels may be associated with HELLP syndrome in subsequent gestational weeks. [ABSTRACT FROM AUTHOR]

Objective: We aimed to determine if any of the second trimester serum marker levels had a significant association with birth weight in uncomplicated pregnancies. Material and Method: Five hundred and forty pregnant women whose second trimester (16-18 weeks) aneuploidy screening and delivery was performed at SBU Zekai Tahir Burak Health Application and Research Center Obstetrics and Gynecology Clinic, are included in this retrospective study. All women had their last menstrual period confirmed by their first trimester ultrasound. Levels of maternal serum alpha-fetoprotein (AFP), β-human chorionic gonadotropin (hCG), and unconjugated estriol (uE3) were calculated as coefficients of the median (MoM). Associations between the second trimester markers levels and infant birth weights were assessed using correlation analysis. The effects of various contributing factors on birth weight were investigated with linear regression analysis. Results: There were significant negative correlations between maternal age at screening (r =-0.48; p =0.03), maternal serum AFP level (r =-0.45; p =0.03) and birth weight of the newborn. Besides, there were positive correlations between amount of weight gain during pregnancy (r =0.44; p =0.04), maternal serum uE3 level (r =0.47; p =0.03) and birth weight of newborn. However, maternal weight and BMI at screening and maternal serum β hCG level did not have a significant correlation with birth weight of newborn. However, maternal serum uE3 level was the only factor that affected the birth weight on linear regression model. Conclusion: Second trimester maternal serum uE3 level might be useful in predicting birth weight among uncomplicated pregnant women. [ABSTRACT FROM AUTHOR]

Aim The aim of this study was to evaluate the predictive value of symptomatic evaluation with transvaginal ultrasonographic findings for diagnosis of retained products of conception (RPOC) after voluntary pregnancy termination via manual vacuum aspiration (MVA). Methods A total of 466 patients with a gestational age < 10 weeks were followed up at the 7th day after MVA of unwanted pregnancies. The patients who had intense or moderate bleeding and other symptoms related to RPOC had a re-evacuation and all the patients were followed up until the next menstruation. Ultrasonographic evaluation was repeated weekly in asymptomatic patients with abnormal ultrasonographic findings (increased endometrial thickness, presence of hyperechogenic, mixed and hypoechogenic material) until a normal endometrial cavity was visualized. Results Out of the 466 patients, 15 (3.2%) had symptoms of RPOC at day 7 while the remaining 451 (96.8%) were asymptomatic and 20 (57.9%) had normal ultrasonographic findings. The 15 symptomatic patients (3.2%) had a repeated MVA. Nine of these 15 patients (60%) had endometrial echogenicity with mixed patterns, two (13.3%) had endometrial echogenicity with hyperechoic patterns, and the remaining four (26.7%) had normal endometrial echogenicity at day 7. Histopathologic examination of 12 of these 15 patients (80%) showed chorionic villi while no gestational tissue was noted in the remaining three of these patients. Endometrial thickness ≥ 10 mm on day 7 had 75% sensitivity and 100% specificity for diagnosis of RPOC in symptomatic women. None of the 451 asymptomatic patients developed any symptoms or needed any further intervention. Conclusion As abnormal ultrasonographic findings return to normal over time in asymptomatic patients, the diagnosis of RPOC should not be based on ultrasonographic findings. [ABSTRACT FROM AUTHOR]