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Objective: Isolated tubal torsion in pregnancy is a rare condition we want to present this case. Case(s): In our study, we present a 23-year-old woman primigravida at 37 weeks of gestation with acute right lower abdominal pain. The clinical and Magnetic resonance imaging (MRI) findings led to diagnosis of acute appendicitis. Emergency exploratory laparotomy and cesarean section were performed. A twisted right Fallopian tube and Morgagni’s cyst was noted and right salpingectomy was performed. Conclusion: Although isolated tubal torsion during pregnancy is very rare, it should be included in the differential diagnosis of acute abdomen in pregnancy. Early surgical intervention will decrease obstetric morbidity.

Objective: Preterm premature rupture of membranes (PPROM) complicates 1-5% of pregnancies. Data regarding the outcomes and prognostic factors of pregnancies with pre-viable PPROM (before 24 weeks of gestation) are relatively limited and vary. Therefore, we aimed to evaluate outcomes of PPROM and compare outcomes before and after 24 weeks of pregnancy. Material and Methods: This is a retrospective cohort study that spanned September 1, 2018 to September 30, 2020 at a tertiary hospital. Pregnant women who experienced PPROM between 12 and 33 6/7 weeks were included. Data on maternal obstetric and clinical characteristics, fetal and neonatal characteristics were compared in PPROM occurred before (n=42) and after (n=92) 24 gestational weeks groups. Results: Demographic data were similar for both groups. There were no cases of maternal sepsis and death in either group. Intrauterine death, retention products, necrotizing enterocolitis (NEC), and bronchopulmonary dysplasia (BPD) rates were significantly higher in PPROM occurring before 24 weeks of gestation. A logistic regression analysis showed that significant predictors of survival at discharge were gestational age at diagnosis, corticosteroid prophylaxis for fetal lung maturation, and delivery route. Multivariable regression analysis showed that the only independent predictor for survival rate at discharge was gestational age at diagnosis (odds ratio: 1.34, 95% confidence interval: 1.13, 1.19, p=0.001). Conclusion: Expectant management in pregnancies complicated by PPROM between 12 and 23 6/7 weeks of gestation is associated with an overall neonatal survival rate of 33.3%, high risk of BPD and NEC among survivors, and does not carry severe maternal risks. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to investigate the association between global DNA and PTEN gene methylation changes and the type of delivery. Material and Methods: The study included a total of 129 pregnant women at the >37th week of pregnancy who had a cesarean (CS) (n=62) or vaginal delivery (VD) (n=67) and their infant's cord blood (n=129). The 5-mC DNA ELISA method performed global DNA methylation analyses, while PTEN gene methylation change analyses were conducted using the methylation-specific polymerase chain reaction method. Results: The global DNA methylation changes in the women in the CS (Group 1) and VD (Group 2) groups and their infants were found to be CS 9.15±4.82, VD 10.6±5.09 (p=0.09); CS 11.3±6.78, and VD 11.7±5.69 (p=0.75), respectively. Based on age, when the global DNA methylation changes were examined in the pregnant women under and over 30, and their infants, the differences in both groups were statistically significant (p=0.05, p=0.015). The PTEN gene methylation rates of the pregnant women in Group 1 (22.5%) were higher than in Group 2 (13.4%). The PTEN gene methylation rates of the infants in Group 1 (17.7%) were higher than those in Group 2 (14.9%). Conclusion: In this study, a significant increase was determined in mothers and infants regarding their global DNA methylation based on age. Our study is also the first study showing gene-specific methylation changes in the PTEN gene. Our findings are believed to pioneer new studies and positively contribute to scientific research. [ABSTRACT FROM AUTHOR]

Copyright of Perinatal Journal / Perinatoloji Dergisi is the property of Deomed Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Perinatal Journal / Perinatoloji Dergisi is the property of Deomed Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The aim of the study was to investigate whether serum hypoxia-inducible factor-1alpha (HIF-1α), hepcidin and interleukin-6 (IL-6) concentrations differed between threatened preterm labour (TPL) and uncomplicated pregnancies. This study was conducted on 54 women with TDL pregnancies and 26 healthy pregnant women. The TPL group was further divided into two subgroups according to the gestational age at delivery. Patients who gave birth within 48-72 h after the hospitalisation were referred to as preterm delivery (PD) and who gave birth at ≥37 weeks were referred to as term delivery (TD). Maternal levels of serum HIF-1α, hepcidin and IL-6 were measured with the use of enzyme-linked immunosorbent assay kits. The mean maternal serum HIF-1α, hepcidin and IL-6 levels of PD were significantly higher than TD (p < .001*) and control group (p < .001*). The mean maternal serum HIF-1α and hepcidin levels of TD were no significantly higher than the control group (p=.058, p = .064). The mean maternal serum IL-6 level of TD was significantly higher than the control group (p < .001*). A negative correlation was found between serum concentration of HIF1α, hepcidin, IL-6 with the gestational week of delivery (r = -0.421, p < .01* for HIF-1α; r = -0.578, p < .01* for hepcidin and r = -0.435, p < .01* for IL-6). High levels of HIF-1α, hepcidin and IL-6 may have potential to be used as biomarkers for the differentiation of PD and TD.Impact statementWhat is already knownon this subject? It is known that hypoxia-inducible factor-1alpha (HIF-1α) is a hypoxia marker and hepcidin and interleukin-6 (IL-6) increase in inflammation. Our study is the comparison of maternal serum HIF-1α, hepcidin and IL-6 levels between the TPL group (TD and PD) and healthy control group.Whatthe resultsof this study add? The present study demonstrates that serum HIF-1α, hepcidin and IL-6 levels were significantly higher in TPD group than uncomplicated group. The mean maternal serum HIF-1α and hepcidin levels of TD were no significantly higher than the control group.Whatthe implicationsareof these findings for clinical practice and/or further research? High levels of HIF-1α, hepcidin and IL-6 may be biomarkers in the determination of true preterm labour within the TPL group. [ABSTRACT FROM AUTHOR]

Objective: The present study evaluated the ability of magnetic resonance imaging (MRI) andultrasonography (US) in diagnosing placenta accreta in cases of anteriorly localized placenta previa with a high risk of placental adhesion abnormality. Materia and Methods: A total of 29 patients with anteriorly localized placenta previa and having at least one risk factor for placenta accreta underwent US and MRI. Diagnostic ability of both modalities for the prediction of abnormal placental invasiveness was assessed using various imaging signs described in the existing literature. Results: Of the 29 pregnancies with placenta previa, 13 (44.8%) had placenta accreta that was confirmed at the time of surgery. Cesarean hysterectomy was performed in seven (53.8%) cases. Sensitivity, specificity, and diagnostic accuracy of ultrasound and MRI were calculated to be 84.6%, 81.2%, and 82.7% and 100%, 76.9%, and 86.2%, respectively. In 5 of 29 cases, US and MRI had discordant diagnoses; sonography detected placenta accreta in 2 cases, whereas magnetic resonance imaging predicted it in 3 cases. Conclusion: The diagnostic abilities of ultrasound and MRI for the detection of placenta accreta appear to be comparable. Magnetic resonance imaging may be required to plan the surgical approach and assess the risk of potential surgical morbidity. [ABSTRACT FROM AUTHOR]

Objective: To evaluate maternal and fetal outcomes in pregnant women with systemic lupus erythematosus (SLE). Materials and Methods: This retrospective clinical study included 126 consecutive cases of pregnant women with SLE and was performed in the perinatology clinic of our university hospital. We evaluated lupus pregnancies that were followed and delivered from 2002 to 2016. Results: The mean patient age was 29.1 ± 4.6 years, and the nulliparity rate was 45.2%. Disease flare-up occurred in 11.1% of patients. Lupus anticoagulants and anticardiolipin IgG and IgM antibodies were positive in 23.8%, 18.2%, and 18.2% patients, respectively. The mean gestational age at delivery was 37.2 ± 3.7, and the mean birth weight was 2813 ± 856 g. Fetal growth restriction, preterm delivery, stillbirth, and preeclampsia rates were 16.6%, 10.3%, 10.3%, and 9.5%, respectively. Conclusion: A multidisciplinary approach to the care of pregnant women with SLE is mandatory for good maternal and fetal outcomes. [ABSTRACT FROM AUTHOR]

Objective: To investigate obstetric and perinatal outcomes among pregnant female survivors of adolescent and young adult cancers. Materials and Methods: A retrospective analysis of maternal and perinatal outcomes of 68 pregnant women with a history of cancer who received antenatal care at the Cerrahpasa Medical Faculty Obstetric and Gynecology Department between January 2000 and December 2015 was carried out. Perinatal and maternal outcomes were evaluated according to cancer type, timing of cancer diagnosis, and treatment modality. The distribution of cancer types, the age at which the cancer was diagnosed, the treatment modalities, and the duration of follow-up were analyzed. Maternal and perinatal outcomes were evaluated. Results: The most frequently encountered tumor types in pregnant women with a history of cancer were thyroid cancers (26.5%), hematologic malignancies (22.5%), and genital cancers (18%). The mean maternal age was 31.7±5.5 years, and the frequency of nulliparity was 48.5%. The mean gestational age at delivery was 37.5±2.5 weeks, the mean birth weight was 3020±717 g, and the frequencies of delivery before 37 and 34 weeks were 12.1% and 8.8%, respectively. The incidences of ceaserian section, fetal growth restriction, preeclampsia, and gestational diabetes were 77.2%, 5.8%, 2.9%, and 8.8%, respectively, in women with a history of cancer. There were two miscarriages and three terminations of pregnancy in women who had survived cancer. The lowest mean age at the time of cancer diagnosis was observed for haematological cancers (22.5±6.6). There were no congenital anomalies in our group. Conclusion: Cancer survivors who became pregnant after cancer treatment had good obstetric outcomes. Pregnancy follow- up of these patients should be carried out by a multidisciplinary team at tertiary centers. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to investigate serum Metrnl levels in pregnant women with gestational diabetes mellitus and compare them with pregnant women without gestational diabetes mellitus., Methods: The gestational diabetes mellitus group consisted of 87 pregnant women diagnosed with gestational diabetes mellitus, and the control group consisted of 93 healthy pregnant women without gestational diabetes mellitus. Serum Metrnl levels were determined by the enzyme-linked immunosorbent assay method., Results: The two groups were similar in terms of demographic features. The median serum Metrnl level was found to be 1.16 ng/mL in the gestational diabetes mellitus group, while it was determined as 2.2 ng/mL in the control group (p=0.001). The two groups were divided into two subgroups based on participants' body mass index, normal weight and overweight. The lowest median Metrnl level was detected in the normal weight gestational diabetes mellitus group, followed by the overweight gestational diabetes mellitus group, normal weight control group, and overweight control group (1.1, 1.2, 2, and 2.4 ng/mL, respectively). Receiver operating curve analysis was performed to determine the value of the serum Metrnl level in terms of predicting gestational diabetes mellitus. The area under the curve analysis of serum Metrnl for gestational diabetes mellitus estimation was 0.768 (p=0.000, 95%CI 0.698-0.839). The optimal cutoff value for serum Metrnl level was determined as 1.53 ng/mL with 69% sensitivity and 70% specificity., Conclusion: Serum Metrnl levels in pregnant women with gestational diabetes mellitus were found to be significantly lower than in pregnant women without gestational diabetes mellitus. The mechanisms underlying the decrease in serum Metrnl levels in gestational diabetes mellitus remain unclear for now, and future studies will reveal the role of Metrnl in the pathophysiology of gestational diabetes mellitus.

Objective:  Preeclampsia, whose pathophysiology is still not fully elucidated today, is a pregnancy-specific disease that affects most organ systems in pregnant women, including the central nervous system. In this context, we aimed to investigate the effects of preeclampsia on blood flow in the ophthalmic artery of the eye, which is considered a part of the central nervous system., Materials and Methods:  This prospective, non-interventional cohort study was conducted between February 2022 and June 2022 at Umraniye Training and Research Hospital, Department of Obstetrics and Gynecology, Istanbul, Turkey. Forty-six normotensive healthy pregnant women constituted the control group and 46 preeclamptic pregnant women constituted the preeclampsia group. Prenatal follow-up and delivery of the participants were carried out in our clinic. First, an obstetric ultrasound was performed on all participants with the same ultrasound device and the same clinician. Then, Doppler measurements of the ophthalmic artery of both eyes were made by the same clinician using the linear probe of the same ultrasound. Both groups were compared in terms of the first peak of systolic velocity (PSV), second PSV, pulsatility index (PI), PSV ratio, end-diastolic velocity (EDV), resistance index (RI), and systolic/diastolic ratio (S/D) measurements of the ophthalmic artery. RESULTS : The first PSV, second PSV, PSV ratio, and EDV were significantly higher in the preeclampsia group than in the control group (p=0.001, p<0.001, p=0.019, p<0.001, respectively). According to the receiver operating characteristic analysis, the second PSV with a cut-off value of 43.75 cm/s was the most powerful ophthalmic artery Doppler parameter in detecting preeclampsia with 63% sensitivity and 63% specificity. No significant difference was found between the early and late onset or mild and severe preeclampsia groups in terms of ophthalmic artery Doppler parameters., Conclusion:  Although the number of participants was too small to draw a definitive conclusion, the second PSV seems to be the most powerful parameter for the detection of preeclampsia. Studies with larger series are needed to determine the usability of ophthalmic artery Doppler parameters in the routine clinical diagnosis of preeclampsia and follow-up of the disease., Competing Interests: The authors declare that they have no conflict of interest., (Thieme. All rights reserved.)

Objective: The aim was to evaluate fetal left modified myocardial performance index (Mod-MPI) and renal artery Doppler parameters in fetuses with isolated oligohydramnios and a normal amount of amniotic fluid., Material and Methods: This was a prospective cohort study; 25 pregnancies with isolated oligohydramnios and 25 healthy, gestational age-matched controls, between 24+0 to 36+6 weeks of gestation, were recruited. Primary outcome was to compare left modified MPI and mean fetal renal artery pulsatility index (PI). The secondary outcome was to compare adverse perinatal outcomes between the groups., Results: Mean Mod-MPI was significantly higher (p=0.001) and isovolumetric relaxation time was longer (p=0.009) in the isolated oligohydramnios group. Mean renal artery PI values were not different between the groups. Birthweight (p=0.041) and gestational age at birth (p=0.001) were significantly lower, and incidences of delivery before 37 weeks (p=0.034) and Cesarean section due to non-reassuring fetal heart rate testing (p=0.021) were significantly higher in women with isolated oligohydramnios than the control group. We found no significant relationship between Mod-MPI and adverse perinatal outcomes., Conclusion: Fetuses with isolated oligohydramnios have increased left Mod-MPI, which may be due to mild cardiac diastolic dysfunction. Increased Mod-MPI is not associated with adverse perinatal outcomes and does not seem to help in the management of pregnancies before 37 weeks of gestation with isolated oligohydramnios.

Objective: With the widespread use of ultrasonography for fetal screening, the detection and management of congenital urinary tract abnormalities has become crucial. In this study, we aimed to describe the clinical approaches in patients with prenatally detected urinary tract abnormalities., Material and Methods: This study is a retrospective, single-center study performed at a perinatology unit of a university hospital, between 2010 and 2016. The outcomes of 124 patients who were prenatally diagnosed as having urinary tract abnormalities are reported. Variables included in the analysis were fetal sex, birth week and weight, persistency, and necessity surgery after birth for renal pelvic dilatation. Low-risk renal pelvic dilatation was determined as an anterior-posterior (AP) diameter of 4-7 mm at 16-28 weeks, 7-10 mm after 28 weeks, whereas high-risk dilatation was defined as AP measurements of ≥7 mm at 16-28 weeks, ≥10 mm after 28 weeks, respectively., Results: The majority of patients consisted of male fetuses with bilateral pelviectasis (62.9%, 20.2%, respectively). The mean age was 28.8±6.4 years. The mean gestational age at birth was 34.2±7.8 weeks. The mean birth weight was 2593±1253.3 g. The need for surgery was greater in high-risk patients than in low-risk patients (58.3% vs. 8.7%) (p<0.002)., Conclusion: Patients with high-risk antenatal renal pelvic dilatation require surgical treatment after delivery. Close prenatal and postnatal follow-up is mandatory in specialized centers. Perinatologists, neonatologists, pediatricians and pediatric nephrologists, and radiologists should treat these children with a multidisciplinary approach.

Objective: To determine Turkish women's opinion about vaginal birth., Materials and Methods: This prospective cohort study was conducted in Department of Obstetrics and Gynecology of Süleymaniye Maternity Research and Training Hospital in İstanbul, Turkey, between February 2015 and April 2015. The participants of this study were 100 primiparous pregnant women who had vaginal deliveries. The women were interviewed face-to-face after the birth. Data were collected through a socio-demographic and clinical questionnaire., Results: Ninety percent of the women reported vaginal birth as the ideal mode of delivery route; a minority of the women (10%) had decided on cesarean birth before having a vaginal birth. Anxiety of pain was the major factor that influenced choice of delivery type before giving birth. After vaginal birth, 84% of women were satisfied with vaginal birth and reported that they would prefer vaginal birth for their next pregnancy. However, 16% reported that they would prefer cesarean birth for their next pregnancy due to pain of labor, pain of episiotomy, anxiety, and prolonged duration of labor., Conclusion: The results suggest the majority of women prefer to give birth vaginally and reported vaginal birth as the ideal choice., Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors.