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Aim: To evaluate systemic inflammation in pregnant women diagnosed with placenta previa (PP). First-trimester complete blood count indices of PP patients were assessed. Materials and Method: This cross-sectional study was conducted with 346 singleton pregnant women, including 115 PP cases (study group) and 231 healthy pregnant women (control group) who were operated on in a tertiary center for one year. The study group was then divided into two subgroups. Those who underwent peripartum hysterectomy due to placenta accreta spectrum (PAS) were determined as PAS-positive, and those without invasion were PAS-negative. Demographic and obstetric characteristics laboratory results were recorded retrospectively. Systemic immune-inflammation index (SII) and systemic inflammatory response index (SIRI) values were calculated. Data were compared using the independent sample t-test and presented as mean and standard deviation. Results: The mean value of maternal age, body mass index, and gestational weeks at which hemograms were evaluated were similar between the study and control groups. While white blood cell and neutrophil counts were significantly higher in the PP group, red blood cell and hemoglobin counts were lower (p<0.001). The mean values of SII and SIRI of the PP group were found to be significantly higher than the healthy pregnant women [(1266±846 x10/L and 892±479 x10/L, respectively) and (2±1.2 x10/L and 1.3±0.7 x10/L, respectively) (p<0.001)]. Although SII and SIRI were higher in the PAS-positive group than the PAS-negative group, no statistical difference was found. Conclusion: Evaluation of inflammation is important for PP cases. In addition to other methods, easily accessible laboratory indices can be used to manage high-risk pregnancies. [ABSTRACT FROM AUTHOR]

To demonstrate possible functional changes in the frequently affected fetal interventricular septum (IVS) with spectral tissue Doppler imaging (TDI) and M-mode imaging to compare gestational diabetes mellitus (GDM) and control groups. A total of 63 pregnant women with GDM, 30 on diet (A1 GDM) and 33 on treated with insulin (A2 GDM), and 63 healthy pregnant women randomly selected and matched to the case group in the control group were included. The GDM fetuses had significantly thickened IVS, increased early diastole (E′), atrial contraction (A′), systole (S′), higher myocardial performance index (MPI′), prolonged isovolumetric relaxation time (IVRT′), shortened ejection time (ET′), and decreased septal annular plane systolic excursion (SAPSE) than the controls. The A2 GDM group fetuses had significantly thickened IVS, increased S′ and shortened ET′ than the A1 GDM group. In the GDM group, we found a significantly positive low correlation between glycated hemoglobin levels and maternal serum fasting glucose and one-hour postprandial glucose with fetal IVS thickness. We demonstrated a significantly negative low correlation between maternal serum one-hour postprandial glucose, glycated hemoglobin levels, and gestational weight gain with fetal IVS ET′. Fetal IVS diastolic and systolic functions were altered in the GDM group compared to controls, and systolic functions were altered in A2 GDM compared to A1 GDM. This may alert clinicians to possible cardiovascular diseases in the postnatal life, and early preventive strategies and long-term lifestyle changes may provide protection in fetuses with GDM. [ABSTRACT FROM AUTHOR]

Objective: To compare the cardiac functions of fetuses with preterm premature rupture of membranes (PPROM) between their control groups and investigate its relationship with perinatal outcomes. Methods: This prospective study was conducted with 102 pregnant women. Pregnant women with PPROM were divided into two subgroups Group A, between 26 and 30 weeks, and Group B, between 30 and 34 weeks. A control group was formed by randomly including one healthy pregnant woman for each study patient. Sociodemographic, obstetric data, tissue Doppler imaging, and M‐mode imaging results were compared. The relationship between echocardiographic parameters and perinatal outcomes was also investigated. Results: Tricuspid annular plane systolic excursion (TAPSE), S′, and ET′ of systolic cardiac parameters were shortened in both groups compared with their controls. Diastolic function indicator E′/A′, and global function indicator myocardial performance index' increased in both groups. Isovolumetric contraction time' did not change between groups. A correlation was found between myocardial performance index', and the length of neonatal intensive care unit stay in Group A and TAPSE and duration of respiratory support and length of neonatal intensive care unit stay in Group B. Conclusions: The fetal cardiac function seems to be affected by PPROM, and these changes are associated with neonatal outcomes. Therefore, administering fetal cardiac function evaluation in pregnancies complicated by PPROM may help physicians establish more appropriate clinical management protocols in this special population. [ABSTRACT FROM AUTHOR]

Aim: To investigate fetal adrenal dimensions in pregnant women diagnosed with familial Mediterranean fever (FMF) and healthy pregnant women. Materials and Methods: This study was conducted with 36 women diagnosed with FMF and 72 healthy pregnant women who were followed up and delivered in the perinatology clinic. Fetal adrenal dimensions were evaluated ultrasonographically in axial and coronal sections between the 340/7 and 370/7 weeks of gestation. Height, length, and width were measured in the total adrenal length (TAL), width (TAW), height (TAH), and fetal zone adrenal length (FAL), width (FAW), height (FAH), and the volume (TAV and FAV) were calculated. Participants' birth week, birth weight, and Apgar scores were recorded. The case group was divided into colchicine users and those who did not require colchicine use during pregnancy. Results: The sociodemographic and obstetric characteristics of the participants were similar. TAH, TAV, FAL, and FAV were significantly higher in the FMF group (p<0.001). The mean value of the FAV/TAV was 0.15 cm³ in the FMF group and 0.14 cm³ in the control group. Although the mean value of the volume ratio was increased in the FMF group, there was no statistically significant difference between them (p=0.505). TAH was found to be significantly increased in the group not using colchicine (p=0.014). Conclusion: This is the first study conducted on the fetal adrenal gland in pregnant women diagnosed with FMF. Exposure to intrauterine stress due to chronic inflammation might result in increased fetal adrenal gland sizes. [ABSTRACT FROM AUTHOR]

Objective: To compare the fetal cardiac functions in preeclampsia and control group, and determine whether the severity or amount of proteinuria affects fetal cardiac functions. Methods: This prospective case–control study involves 48 pregnant women with preeclampsia and 48 healthy women. Pulsed wave Doppler, M‐mode, and tissue Doppler imaging were used to measure the cardiac function between the 32 and 34 gestational weeks in each group. All Doppler indices and cardiac function parameters were also compared in subgroups with mild and severe preeclampsia and between subgroups with proteinuria >3 g/24 hours and <3 g/24 hours. Results: Decreased diastolic function (decreased E, A, E′, and A′ values in mitral/tricuspid valves and increased isovolumetric relaxation time) and decreased systolic functions (decreased mitral and tricuspid annular plane systolic excursion and S′ value in mitral/tricuspid valves) were detected in the preeclampsia group. Decreased tricuspid E value in severe preeclampsia compared with mild preeclampsia was shown in the present study. Conclusion: Preeclampsia may cause changes in systolic and diastolic functions in the fetal heart. Subclinical functional changes of these fetuses can be detected earlier and more sensitively with the help of tissue Doppler imaging. Biventricular diastolic functional changes are more prominent in preeclamptic cases with proteinuria >3 g/24 hours. [ABSTRACT FROM AUTHOR]

Aim: Assessment of the fetal adrenal gland (FAG) size and middle adrenal artery (MAA) Doppler parameters in pregnancy recovered from Coronavirus Disease (COVID‐19) and comparison of the values with the healthy control group. Methods: Thirty‐eight pregnant women who had recovered from COVID‐19 infection and 76 healthy control group between 33 and 35 weeks of gestation were involved in this case–control study. Fetuses were examined for fetal biometry, fetal well‐being, adrenal gland dimensions, and Doppler parameters 4–6 weeks after the diagnosis of COVID 19 infection. FAG dimensions were measured in two planes and MAA blood flow velocity was evaluated with pulsed Doppler. Pregnant women with COVID‐19 infection were grouped according to the National Institutes of Health for the severity of the disease, and those with mild and moderate infections were examined in the study. Results: The total adrenal gland (TAG) height, fetal zone (FZ) length and width, and MAA‐Peak Systolic Velocity (MAA‐PSV) were significantly higher, and the MAA‐Pulsatility Index (MAA‐PI) was significantly lower in the COVID‐19 group (p < 0.05). The lower in MAA‐PI and the higher in MAA‐PSV, the width of the FZ, and width of the TAG were found to be significant in the moderate group compared to the mild groups (p < 0.05). Conclusion: COVID‐19 pregnancies might cause early maturation of the FAG and its vasculature depends on the intrauterine stress due to the hyper‐inflammation, so fetuses exposed to maternal COVID‐19 suggested to have an increase in blood flow to the adrenal gland and fetal adrenal size. [ABSTRACT FROM AUTHOR]

Aim: To compare hysterosalpingography (HSG) findings with laparoscopy (LS) and hysteroscopy (HS) findings in infertile patients and evaluate their adequacy in diagnosis Materials and Methods: The presented retrospective study was conducted on 106 patients diagnosed with primary and secondary infertility. LS-HS procedure was applied to the cases who could not get pregnant at the end of six months after HSG. Sociodemographic data and tubal, uterine, endometrial, and pelvic findings were compared. Sensitivity, specificity, and positive and negative predictive values were calculated. Results: Primary infertility was observed at a higher rate. (n=68, 64.2%). Most of the patients were in the 24-29 age group. The maximum duration of infertility has been observed in the range of 1-4 years. Compared with LS in tubal patency, the sensitivity of HSG was 85%, specificity 65%, positive predictivity 88.3%, and negative predictivity 58.6%. Compared with HS in detecting uterine pathologies, the sensitivity of HSG was 94.9%, specificity 53.3%, positive predictivity 72.7%, and negative predictivity 89.7%. Conclusion: In evaluating infertile patients, HSG is reliable in detecting tubal blockage. Due to its low specificity, invasive methods can be applied, especially in unexplained infertility whose pathology is not seen in HSG. These methods are complementary rather than the alternative. [ABSTRACT FROM AUTHOR]

Introduction: Autoinflammation and increase in free oxygen radicals due to maternal familial mediterranean fever (FMF) may affect fetal lung maturation and cause changes in fetal pulmonary artery Doppler parameters. We aimed to investigate the fetal pulmonary artery acceleration time/ejection time (PATET) ratio in the pregnancies complicated with familial mediterranean fever (FMF). Methods: This cross-sectional study included 32 pregnant women with FMF, and 64 gestational ages matched healthy pregnant women, between the 29-30 gestational weeks. Maternal characteristics and fetal ultrasonographic information were recorded. Fetal pulmonary artery acceleration time (AT) and ejection time (ET) were measured manually and PATET ratio were calculated in the study groups. The duration of the disease and the AT and PATET measurements were analyzed with the Pearson correlation test. Results: The study groups were similar in terms of maternal characteristics, gravidity, parity and gestational week at the time of examination. AT and ET values were found to be significantly shorter and PATET (AT/ET) was found to be significantly lower in pregnant women complicated with FMF. A moderately significant negative correlation was found between the time elapsed since FMF diagnosis and fetal pulmonary artery acceleration time. (r=-.566, p=.001) and PATET (r=-.533, p=.002) Conclusion: This is the first study to investigate the fetal pulmonary artery Doppler indices in the pregnancies with FMF. In the presented study, it was shown that FMF significantly shortened the fetal pulmonary acceleration and ejection time and significantly reduced the PATET ratio. In addition, as the time elapsed from the diagnosis of the disease increased, it was shown that the shortening in AT and the decrease in PATET were higher, with a significant moderate negative correlation between the duration of the disease and these values. [ABSTRACT FROM AUTHOR]

Aim: To investigate the association of systemic immune‐inflammation index (SII) and systemic immune‐response index (SIRI) with adverse perinatal outcomes in pregnant women with coronavirus disease 2019 (COVID‐19). Methods: The cases were divided into (1) the Mild–moderate COVID‐19 group (n = 2437) and (2) the Severe–critical COVID‐19 group (n = 212). Clinical characteristics, perinatal outcomes, SII (neutrophilXplatelet/lymphocyte), and SIRI (neutrophilXmonocyte/lymphocyte) were compared between the groups. Afterward, SII and SIRI values were compared between subgroups based on pregnancy complications, neonatal intensive care unit (NICU) admission, and maternal mortality. A receiver operator characteristic analysis was performed for the determination of optimal cutoff values for SII and SIRI in the prediction of COVID‐19 severity, pregnancy complications, NICU admission, and maternal mortality. Results: Both SII and SIRI were significantly higher in complicated cases (p < 0.05). Cutoff values in the prediction of severe–critical COVID‐19 were 1309.8 for SII, and 2.3 for SIRI. For pregnancy complications, optimal cutoff values were 973.2 and 1.6. Cutoff values of 1045.4 and 1.8 were calculated for the prediction of NICU admission. Finally, cut‐off values of 1224.2 and 2.4 were found in the prediction of maternal mortality. Conclusion: SII and SIRI might be used in combination with other clinical findings in the prediction of poor perinatal outcomes. [ABSTRACT FROM AUTHOR]

Aim: We aimed to investigate the placenta accreta index (PAI) score and first-trimester serum markers (pregnancy-associated plasma protein-a: PAPP-A, free beta human chorionic gonadotropin: free 0 HCG) in the prediction of Placenta Accreta Spectrum (PAS) in cases diagnosed with placenta previa (PP). Material and Methods: 30 PAS cases, 30 placenta previa cases without adhesion anomaly, and 60 healthy pregnants were included in our study. The PAI score was determined in the third trimester of the cases included in the study, then first-trimester serum markers and surgical outcomes (cesarean section, hysterectomy) were recorded. Results: In our study, when the cases in the PP and control groups were compared, PAPP-A(mlU/ml), PAPP-A MoM (Multiple of the median), and free 0 HCG MoM values were statistically significantly higher in the PP group (p<0.001). When PP and PAS cases were compared, we found that first-trimester serum markers were statistically significantly higher in the PAS group and the group undergoing peripartum hysterectomy (p<0.001). We found that the strongest parameter was the PAI score in predicting PAS, and first-trimester serum markers are as successful as PAI scoring. Conclusion: Considering that PAI scoring requires a certain experience in sonographic and technical terms and affects patient comfort in the transvaginal application, first-trimester serum markers can also be used because they have a similar value in predicting PAS. Using these data, we think referring patients to tertiary centers and multidisciplinary preoperative preparation that requires an experienced surgical team will help reduce perinatal morbidity and mortality. [ABSTRACT FROM AUTHOR]

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Objectives: To demonstrate possible functional changes in the frequently affected fetal interventricular septum (IVS) with spectral tissue Doppler imaging (TDI) and M-mode imaging to compare gestational diabetes mellitus (GDM) and control groups., Methods: A total of 63 pregnant women with GDM, 30 on diet (A1 GDM) and 33 on treated with insulin (A2 GDM), and 63 healthy pregnant women randomly selected and matched to the case group in the control group were included., Results: The GDM fetuses had significantly thickened IVS, increased early diastole (E'), atrial contraction (A'), systole (S'), higher myocardial performance index (MPI'), prolonged isovolumetric relaxation time (IVRT'), shortened ejection time (ET'), and decreased septal annular plane systolic excursion (SAPSE) than the controls. The A2 GDM group fetuses had significantly thickened IVS, increased S' and shortened ET' than the A1 GDM group. In the GDM group, we found a significantly positive low correlation between glycated hemoglobin levels and maternal serum fasting glucose and one-hour postprandial glucose with fetal IVS thickness. We demonstrated a significantly negative low correlation between maternal serum one-hour postprandial glucose, glycated hemoglobin levels, and gestational weight gain with fetal IVS ET'., Conclusions: Fetal IVS diastolic and systolic functions were altered in the GDM group compared to controls, and systolic functions were altered in A2 GDM compared to A1 GDM. This may alert clinicians to possible cardiovascular diseases in the postnatal life, and early preventive strategies and long-term lifestyle changes may provide protection in fetuses with GDM., (© 2023 Walter de Gruyter GmbH, Berlin/Boston.)