Comparison of Nulliparas Undergoing Cesarean Section in First and Second Stages of Labour: A Prospective Study in a Tertiary Teaching Hospital

Objective. We performed a prospective observational audit study to compare neonatal and maternal outcomes of the primary cesarean sections performed in first stage versus second stage of labour. Methods. One thousand three hundred and eighty-nine nullipara women who had undergone cesarean section in a tertiary teaching hospital between February 1, 2009 and January 31, 2010 were included in the study. Primary maternal outcomes of interest were uterine atonia, transfusion requirement, urinary system injury, requirement for hysterectomy, and duration of hospital stay. Results. A total of 1389 women underwent cesarean section at this 12 month time period. Of these 1389 cesarean sections, 1271 were in the first stage of the labour and 171 were in the second stage of the labour. Urinary injuries, transfusion requirement, and uterine atonia hysterectomy were significantly more frequent in women who underwent cesarean section in the second stage of the labour compared to women undergoing cesarean section in the first stage of the labour. Conclusion. Cesarean section in the second stage of the labour is associated with increased maternal and neonatal morbidities. Special attention is required to the patients undergoing cesarean section in the second stage of the labour

A retrospective analysis of amniocenteses performed for advanced maternal age and various other indications in Turkish women

Objective: Prenatal cytogenetic diagnostic methods for the diagnosis of fetal chromosomal anomalies have been used reliably over the last 40 years. Advanced maternal age has become a basic indication for amniocentesis. Methods: We examined the results of the chromosome analyses of 3485 women that had amniocentesis for any reason during their antenatal care in our perinatology clinic in 2007–2009. Amniocentesis was performed for advanced maternal age in 1456 women (41.8%) and for other reasons in the remaining 2029 women (58.2%). Chromosomal anomalies were examined numerically and structurally. Results: When the amniocentesis results of the patients were reviewed as numerically normal or abnormal; 40 (2.7%) of 1456 amniocentesis procedures performed for advanced maternal age, 5 (0.9%) of 531 procedures performed for an increased double-test risk and 14 (1.3%) of 1095 procedures performed for an increased triple test risk were found to have chromosomal aneuploidy. Conclusions: Maternal age is still the most prevalent indication for genetic amniocentesis other than positive prenatal screening tests. Among women with advanced maternal age, prenatal ultrasonography for soft markers of chromosomal aneuploidy accompanied with maternal serum biochemical screening tests should be evaluated during the decision making process of genetic amniocentesis

Asymptomatic Bacteriuria and Antibacterial Susceptibility Patterns in an Obstetric Population

Introduction. Asymptomatic bacteriuria (ASB), occurring in 2–11% of pregnancies, is a major predisposition to the development of pyelonephritis, which is associated with obstetrical complications, such as preterm labor and low birth weight infants. The aim of this study was to determine the prevalence of ASB, the antibacterial susceptibilities of the isolated microorganisms and the associated risk factors in an outpatient clinical setting in Zekai Tahir Burak Women's Health Education and Research Hospital in Ankara, Turkey. Material and Methods. Between December 2009 and May 2010, pregnant women admitted to the antenatal outpatient clinic were included in this study. The results of a complete urine analysis, midstream urine culture and antibacterial susceptibility were evaluated. Results. Of the 2011 pregnant women included, 171 had ASB (8.5%). E. coli was the most frequently isolated microorganism (76.6%), followed by Klebsiella pneumonia (14.6%). Both microorganisms were highly sensitive to fosfomycin, sensivity being 99.2% for E. coli and 88% for Klebsiella pneumonia. Conclusions. In this certain geographical region, we found E. coli as the most common causative agent of ASB in the obstetric population and it is very sensitive to fosfomycin. We recommend fosfomycin for ASB in pregnant women due to its high sensitivity, ease of administration and safety for use in pregnancy

Biochemiczne markery pierwszego trymestru w ciąży bliźniaczej

Objective: Our aim was to investigate the first trimester serum markers and nuchal translucency (NT) measurements in twin pregnancies in our population. Materials and methods: We reviewed the results of all double tests that were performed in our hospital over a three-year period. Out of them, we selected all twins and compared them with a group of three times as many singleton controls. NT measurements and the first trimester serum markers from 49 twin pregnancies were compared to those of 147 pregnant women with normal singleton pregnancy. Results: There were no statistically significant differences in age, gestational age and maternal weight between the two groups (p>0.05). We found similar NT measurements in the two groups. The median MoM of Pregnancy- Associated Plasma Protein A (PAPP-A) and fβ-hCG levels in twins were statistically significantly higher than those in singleton pregnancies. Twelve percent of the twins (12.2 %) were the result of assisted reproduction technologies. IVF versus naturally conceived pregnancies showed similar MoM of PAPP-A (2.2 vs. 1.2, respectively) and fβ-hCG (Mann-Whitney U; p = 0.195 and p = 0.958). Conclusions: Our study revealed that median PAPP-A and fβ-hCG levels for twins were less than twice those of singleton values.Cel pracy: Celem naszego badania było zbadanie surowiczych markerów pierwszego trymestru oraz przezierności karkowej (NT) w ciążach bliźniaczych w naszej populacji. Metoda: Przeanalizowano wyniki wszystkich testów podwójnych wykonanych w naszym szpitalu w ciągu trzech lat. Wyodrębniono grupę ciąż bliźniaczych (n=49) i porównano ją z trzy razy większą grupą kontrolną prawidłowych ciąż pojedynczych (n=147). Wyniki: Nie znaleziono istotnych statystycznie różnic w wieku, wieku ciążowym i masie ciała ciężarnych pomiędzy grupami (p>0,05). Stwierdzono podobne wyniki pomiaru NT w obu badanych grupach. Mediana MoM białka PAPP-A i poziom fβ-hCGw ciążach bliźniaczych był istotnie wyższy niż w ciążach pojedynczych. Dwanaście procent ciąż bliźniaczych było efektem technik wspomaganego rozrodu. Ciąże w wyniku IVF oraz ciąże spontaniczne wykazywały się podobnych wynikiem MoM białka PAPP-A (2,2 vs. 1,2 odpowiednio) i fβ-hCG (Mann-Whitney U; p=0,195 i p=0,958). Wnioski: Średni poziom białka PAPP-A i fβ-hCG dla ciąż bliźniaczych był mniej niż dwa razy większy niż dla pojedynczych ciąż

Did the SARS-CoV-2 effect pregnancy complications?

Objectives: This study aimed to evaluate the effect of SARS-CoV-2 on pregnancy complications, which increased compared to the same period before the pandemic. Material and methods: This prospective study was conducted at Etlik Zübeyde Hanım Women's Health Practices & Research Center between June 2020 and July 2020. The asymptomatic term PROM and miscarriage pregnant women were screened for SARS-CoV-2 (severe acute respiratory syndrome coronavirus-2) positivity by using IgM and IgG antibody tests. All the positive cases were confirmed by real-time reverse transcriptase-polymerase chain reaction (RT-PCR). All the patients answered 12 questions to determine their approach to COVID-19. Result: Four of the 205 (2%) term PROM patients had positive anti-SARS-CoV-2 IgM antibody tests, one of the 205 (0.5%) term PROM patients had a positive anti-SARS-CoV-2 IgG antibody test, and one of the 205 (% 0.5) term PROM patients had positive anti-SARS-CoV-2 IgM and IgG antibody tests. All 230 miscarriage patients had negative IgM/IgG antibody tests. Four of the positive antibody cases had positive RT-PCR tests (2%) and were referred to a pandemic hospital. The patients thought that 93.2% and 95.6% of pregnant women with term PROM and miscarriage, respectively, SARS-CoV-2 would infect themselves, and 89.8% and 92.6%, respectively, would infect their children. The number of patients who would not consider pregnancy if they were not pregnant during this period was significantly higher in the term PROM (48.3%) compared to the miscarriage (27.8%) patients (p < 0.005). Conclusions: No COVID-19 cases were determined in the asymptomatic miscarriage patients. In the asymptomatic term PROM patients, the effects of COVID were not observed

Treatment of Non - Complicated Lower Urinary Tract Infection in Pregnancy: Single Dose Fosfomycin Tromethamine Versus Multiple Dose Nitrofurantoin

OBJECTIVE: To evaluate the efficacy of single-dose fosfomycin tromethamine (FT) treatment in pregnant women with uncomplicated lower urinary tract infection (UTI). STUDY DESIGN: In this study, 421 pregnant women with established, symptomatic, uncomplicated lower UTI were randomly allocated to receive either a single dose of FT (Monurol®, Zambon Group S.p.A, Milan-ITALY) (n=217) or a 7-day course of nitrofurantoin (n=204). The treatment was found to be effective if urine culture was negative 15 days after therapy. RESULTS: Microbiological cure was achieved in 205 (94.5%) patients treated with FT and 164 (80.4%) patients treated with nitrofurantoin (p<0.05). Pathogen microorganisms were predominantly E.coli (199 in FT and 183 in NF group) followed by Klebsiella (18 in FT and 21 in NF group). CONCLUSION: The treatment of acut lower UTI in pregnant women is essential. FT is an effective, safe, single dose treatment choice in the management of uncomplicated lower UTI in pregnant women