Perinatal trends and birth outcomes of Syrian refugee and turkish women

Aim: The impact of migration on health is far-reaching, making migrant populations particularly vulnerable, fueling health inequalities and resulting in serious implications for global health. The aim of our study to assess antenatal care, pregnancy and neonatal outcomes of Syrian refugee women in Turkiye. Material and Methods: Syrian and Turkish pregnants who delivered between 2013-2019 were recruited and categorized into groups according to maternal age at delivery. First trimester combined test, second trimester triple test, preterm delivery, maternal anemia; neonatal stillbirth, APGAR scores, birth weight and breastfeeding status were assessed. Results: 4992 Syrian and 6846 Turkish pregnants were included. Maternal anemia was higher in Turkish patients in 20-34 and ?35 groups. First trimester combined test, APGAR scores and birth weights were lower in Syrian women. Preterm rates higher in Turkish patients in only 20-34 age group. Second-trimester triplet tests were only higher in Turkish women in ?35 age group. Low birth weight was higher in younger Syrian patients. Satisfying breastfeeding results were found in Syrian women. Conclusion: Our study stated that Syrian women are at risk of low birth weight in adolescent and 20-34 age groups and low rates in first trimester combined test in all age groups. However decreased risk of pregnancy complications such as maternal anemia, preterm delivery, cesarean delivery and satisfying breastfeeding results were found in Syrian patients

Obstetric Perineal Tears in Pregnant Adolescents and the Influencing Factors

Study Objective: The incidence and risk factors of obstetric perineal tear occurrence in vaginal delivery of adolescent pregnant patients are not well established. We aimed to describe the incidence of obstetric perineal tears in adolescents and the maternal obstetric risk factors associated with this situation. Design: Retrospective cohort study Setting: Department of Obstetrics and Gynecology, Tepecik Education and Research Hospital, Izmir, Turkey Participants: Adolescent pregnant patients (=19 years) who delivered vaginally in our institution between January 2014 and January 2021 Interventions and Main Outcome Measures: The main outcome measures were the incidence of perineal tears, the degree of perineal tears, and the risk factors associated with severe perineal tears in adolescents. Severe perineal tears include third- and fourth-degree lacerations. A third-degree tear is defined as partial or complete disruption of the anal sphincter muscles, and a fourth-degree tear is defined as lacerations involving the rectal mucosa. Results: A total of 3441 adolescents who had a vaginal delivery were included in the study. The rate of severe perineal tear was 5.8% (200/3441). Risk factors associated with obstetric laceration in adolescents in multivariate analysis were nulliparity (OR = 1.72; 95% CI, 1.14-2.41; P = 0.007), high birth weight (OR = 4.1; 95% CI, 2.71-6.21; P < 0.001), and labor induction (OR = 1.36; 95% CI, 1.01-1.85; P = 0.02). Spontaneous onset of labor and previous delivery reduced the risk of severe perineal tear in adolescent pregnant patients (respectively, OR = 0.68; 95% CI, 0.51-0.94; P = 0.02 and OR = 0.51; 95% CI, 0.33-0.79; P = 0.007). Conclusions: In adolescents, the risk of severe perineal tear was associated with nulliparity, birth weight, and labor induction. The only possible modifiable risk factor was labor induction

Effect of Levothyroxine Sodium Intake on the Fetal Fraction in Non-Invasive Prenatal Testing: A Cross-Sectional Study

Objective: Non-invasive prenatal testing (NIPT) and fetal fraction (FF) are shown to be affected by various factors like maternal characteristics or medications. Recently medications are now undergoing evaluation as influencing factors. Still no data are presented on the relation between levothyroxine, NIPT and FF results. The study's aim is to assess the effect of levothyroxine sodium on the FF. Material and Methods: This retrospective case control study was conducted with medical records of pregnant women who underwent NIPT between 2016-2020 at our institution. Women with multiple gestation, body-mass index >= 25, abnormal fetal karyotype, pregnancy with assisted reproductive techniques, those without FF report and non-euthyroid patients were excluded. The pregnant euthyroid women included in the study were divided into two groups: using and not using levothyroxine. Maternal characteristics, FF of the NIPT, TSH, FT4 values and levothyroxine dosing were noted and compared between the two groups. Results: Data were collected from 51 pregnant women using levothyroxine and 102 pregnant women who did not. There was no difference in demographic characteristics, also no significant difference was shown in TSH and FT4 between the groups (p=0.180, p=0.920). The mean FF level in pregnant women using levothyroxine is lower, but the situation did not reach statistical significance (p=0.070). Conclusion: The knowledge of relation between FF and medications is largely based on very limited data. This is the first report of assessing levothyroxine effect on FF percentage in NIPT. Levothyroxine sodium was not confirmed to be associated with any significant change in the FF

Diagnostic accuracy of pre-induction cervical elastography, volume, length, and uterocervical angle for the prediction of successful induction of labor with dinoprostone

Purpose: The study’s aim is to define among a group of ultrasonographic cervical measurements a candidate parameter predictive of successful of induction of labor in term pregnancies with unfavorable cervix. Methods: This prospective observational study included 141 pregnant women at term with an unfavorable cervix (Bishop score ≤ 6). All patients underwent clinical and ultrasonographic cervical evaluation before dinoprostone induction. Pre-induction cervical assessments included the Bishop score, cervical length, cervical volume, uterocervical angle, and cervical elastographic parameters. Vaginal delivery (VD) was accepted as successful dinoprostone induction. Multivariate logistic regression was conducted to identify the potential risk factors significantly associated with CS while controlling for possible confounding variables. Results: The vaginal delivery rate was 74% (n = 93) and the cesarean section (CS) rate was 26% (n = 32). Sixteen patients who had a cesarean section due to fetal distress before the active phase of labor were excluded from the study. The mean induction-to-delivery interval was 1176.1 ± 352 (540–2150) for VD and 1359.4 ± 318.4 (780–2020) for CS (p = 0.01). Bishop score was lower in women with cesarean section (p = 0.002). When both groups were compared in terms of delivery type, no difference was found between cervical elastography values, cervical volume, cervical length, and uterocervical angle measurements. Multivariable logistic regression model failed to show significant differences between cervical elastography values, cervical volume, cervical length, and uterocervical angle measurements. Conclusion: Cervical length, cervical elastography, cervical volume, and uterocervical angle measurements did not provide a clinically useful prediction of outcomes following labor induction in our study group with unfavorable cervix. Cervical length measurements significantly predicted the time interval from induction to delivery