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Purpose: This study aimed to determine fatty acid binding protein‐4 (FABP‐4) concentrations in maternal serum of fetal growth restriction (FGR) pregnancies and controls of normal pregnancies. Furthermore, we hypothesized that the alterations in FABP‐4 levels might correlate with FGR severity. Methods: We performed this prospective case–control study with 83 pregnant women. The study groups included 26 FGR pregnancies without abnormal fetal Doppler flow patterns and 25 pregnancies complicated with FGR accompanied by abnormal fetal Doppler flow patterns. Results: The median serum FABP‐4 concentrations were significantly higher in the FGR cases with abnormal Doppler flow pattern group (2.09 ng/mL) than in the FGR cases without abnormal Doppler flow pattern group (1.62 ng/mL) and the control group (1.20 ng/mL, p < 0.001). A significant negative correlation was observed between maternal serum FABP‐4 levels and time to birth from blood sample collection (r = −0.356 and p = 0.001), gestational week at birth (r = −0.386 and p < 0.001), and birth weight (r = −0.394 and p < 0.001). A 1.35 ng/mL cut‐off value of serum FABP‐4 level could be used to discriminate FGR cases with a 78.4% sensitivity and 60.6% specificity. The optimal cut‐off value of FABP‐4 levels as an indicator for the diagnosis of FGR with abnormal Doppler flow pattern was estimated to be 1.76 ng/mL, which yielded a sensitivity of 84.0% and a specificity of 75.8%. Conclusion: FABP‐4 is a crucial biomarker in the diagnosis and determining the severity of pregnancies with restricted fetal growth. We consider that FABP‐4 is a powerful, reliable, and unique biomarker to diagnose FGR pregnancies. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to examine the effects of infection with the Delta variant of coronavirus disease-2019 (COVID-19) on the clinical course, laboratory parameters, and neonatal outcome in pregnant women. Material and Methods: A total of 96 pregnant women who tested positive for the Delta variant of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) causing COVID-19 were retrospectively examined. The pregnant women were divided into three groups: Asymptomatic; nonsevere; and severe. Age, obstetric history, symptoms and findings, blood tests, medication and vaccination history, clinical course, and perinatal outcome of pregnant women were analyzed. Results: Pregnant women who tested positive for the Delta variant of SARS-CoV-2 had an intensive care unit (ICU) admission rate of 9.4% and a mortality rate of 5.2%. Pregnant women in the severe disease group had significantly higher rates of preterm birth and cesarean section compared with the non-severe and asymptomatic group. Pregnant women in the severe group had high C-reactive protein (CRP) levels at the time of admission. White blood cell count (WBC) and procalcitonin levels were increased in clinical follow-up in women in the severe group. Conclusion: The Delta variant of SARS-CoV-2 was found to increase mortality rates in pregnant women compared to pre-Delta variants of COVID-19. In pregnant women infected with the Delta variant, advanced gestational age at diagnosis, high CRP, WBC, and procalcitonin levels were significantly correlated with poor prognosis. Pregnant women infected with the Delta variant and with severe COVID-19 had an increased risk for preterm delivery and cesarean section. Although newborns of women with severe disease were found to have significantly higher rates of ICU admission, there was no significant difference in neonatal mortality rates. We recommend close monitoring of CRP, WBC, and procalcitonin levels, in addition to symptoms, in pregnant women infected with the Delta variant of SARS-CoV-2 and diagnosed in the third trimester. [ABSTRACT FROM AUTHOR]

We sought to compare maternal and neonatal risk factors in cases with previable premature rupture of membranes (pPPROM, between 14-24 weeks) for optimal counselling. Therefore, 192 pregnancies of 485 cases which met selection criteria and agreed to follow-up were retrospectively analysed. Mean gestational age at pPPROM was 20.45 weeks. Live births occurred in 171 cases, but 67 (39.2%) of them died in the neonatal period (neonatal death group) and 104 cases (60.8%) constituted surviving neonate group. Of the surviving neonates, 37 (33.7%) experienced at least one complication. Most seen maternal complications were chorioamnionitis (24.48%) and placental abruption (8.33%). Although amniotic fluid volume, length of pPPROM period, completing antibiotherapy and CRP values were significant, amniotic fluid volume and length of pPPROM showed also significance for multivariate regression analysis for maternal risk factors. Risk factors for birth were gestational age at pPPROM, gestational age at birth, new-born weight at birth, 1st and 5th minute Apgar scores, umbilical cord pH value and need for neonatal resuscitation. Furthermore, development of respiratory distress syndrome, necrotising enterocolitis, intraventricular haemorrhage and retinopathy of premature were additional risk factors for neonate. Of them, gestational age at birth, new-born weight at birth, respiratory distress syndrome and retinopathy of prematurity were also significant in multivariate regression analysis. What is already known on this subject? Management of previable premature rupture of membranes is controversial and there is no definite consensus on the approach. The factor that best predicts neonatal survival is the gestational age at birth (Deutsch et al. 2010). What do the results of this study add? Appropriate counselling for pPPROM cases is important especially during antenatal period (maternal factors) and postpartum period (neonatal factors). Maternal infection risk is increased with an increased latency period of PPROM. As the gestational age at birth increases, the survival rate increases and neonatal complication rates decrease. Other important determinants of neonatal survival and well-being are the presence of oligo-anhydramnios and latency period of previable PPROM to delivery. What are the implications of these findings for clinical practice and/or further research? Counselling the patient with previable PPROM about pregnancy complications and paediatric outcome is challenging because of the small size, different gestational age ranges, and retrospective nature of the multiple studies on this subject. The most important feature of our study was the relatively high number of patients compared to other series. Thus, we can counsel pregnant women with PPROM prior to 24 weeks of gestation about the maternal antenatal factors and neonatal postnatal factors with related outcomes and help make an informed decision regarding termination or conservative follow-up. Nevertheless, there is a need for larger multicentric prospective studies to validate our data and to establish the prognosis of previable PPROM for both mother and foetus. [ABSTRACT FROM AUTHOR]

Objective:   We aimed to examine both the expression levels of high mobility group box 1 (HMGB1) and vascular cell adhesion molecule-1 (VCAM-1) proteins in the placentas of pregnant women with gestational diabetes mellitus (GDM) and control groups by immunohistochemical (IHC) method., Material and Methods:   An experimental case-control study was conducted, including 40 pregnant women complicated with GDM and 40 healthy pregnant women. Placental tissues obtained following cesarean delivery were subjected to routine tissue monitoring. The placental sections were stained with VCAM-1 and HMGB1 immunostains and subjected to IHC examination under a light microscope. H-score (HS) was used to evaluate the results of IHC staining by semi-quantitative analysis. Pathway analysis in Cytoscape software identified GDM-associated proteins within HMGB1 and VCAM-1 interaction networks, followed by GO analysis to explore associated biological processes., Results:   Placental HGMB1 expression was significantly increased in the GDM group compared to the control group (p<0.001). However, placental VCAM-1 expression was found to be statistically similar in GDM and control groups (p=0.584). The shared 19 proteins were identified between HMGB1 and GDM, and 13 between VCAM-1 and GDM, with notable GO biological process terms such as immune system activation for HMGB1 and interleukin-6 regulation for VCAM-1 associated with GDM., Conclusion:   We consider that GDM-related inflammation and oxidative stress may contribute to tissue damage and inflammation by increasing placental HMGB1 expression. The blockade of HMGB1 and its receptors might represent a promising therapeutic approach to control inflammation in GDM. Understanding the distinct roles of HMGB1 and VCAM-1 may provide valuable insights for the development of targeted therapies aimed at mitigating the inflammatory processes associated with GDM and improving maternal and fetal outcomes., Competing Interests: The authors declare that they have no conflict of interest., (Thieme. All rights reserved.)

Objective: This study aimed to examine the effects of infection with the Delta variant of coronavirus disease-2019 (COVID-19) on the clinical course, laboratory parameters, and neonatal outcome in pregnant women., Material and Methods: A total of 96 pregnant women who tested positive for the Delta variant of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) causing COVID-19 were retrospectively examined. The pregnant women were divided into three groups: Asymptomatic; non-severe; and severe. Age, obstetric history, symptoms and findings, blood tests, medication and vaccination history, clinical course, and perinatal outcome of pregnant women were analyzed., Results: Pregnant women who tested positive for the Delta variant of SARS-CoV-2 had an intensive care unit (ICU) admission rate of 9.4% and a mortality rate of 5.2%. Pregnant women in the severe disease group had significantly higher rates of preterm birth and cesarean section compared with the non-severe and asymptomatic group. Pregnant women in the severe group had high C-reactive protein (CRP) levels at the time of admission. White blood cell count (WBC) and procalcitonin levels were increased in clinical follow-up in women in the severe group., Conclusion: The Delta variant of SARS-CoV-2 was found to increase mortality rates in pregnant women compared to pre-Delta variants of COVID-19. In pregnant women infected with the Delta variant, advanced gestational age at diagnosis, high CRP, WBC, and procalcitonin levels were significantly correlated with poor prognosis. Pregnant women infected with the Delta variant and with severe COVID-19 had an increased risk for preterm delivery and cesarean section. Although newborns of women with severe disease were found to have significantly higher rates of ICU admission, there was no significant difference in neonatal mortality rates. We recommend close monitoring of CRP, WBC, and procalcitonin levels, in addition to symptoms, in pregnant women infected with the Delta variant of SARS-CoV-2 and diagnosed in the third trimester., Competing Interests: Conflict of Interest: No conflict of interest is declared by the authors., (©Copyright 2023 by the Turkish-German Gynecological Education and Research Foundation - Journal of the Turkish-German Gynecological Association published by Galenos Publishing House.)