Makrozomik fetuslar 38. gebelik haftasında doğurtulabilir mi?

Objective: Numerous articles have been written on macrosomic fetuses, including the American College of Obstetricians and Gynecologists practice bulletin. However, there is no clear consensus about the time of birth. The aim of this study was to compare the maternal and fetal outcomes of women giving birth at 38+0-38+6 weeks and those with deliveries at ≥39 weeks in pregnancies complicated by fetal macrosomia, and to determine the effect on morbidity and mortality of delivery in the 38th gestational week.Material and Methods: Data of women and their infants born in Kayseri Training and Research Hospital between 01 May 2018 and 31 March 2020 were analyzed retrospectively. The patients included were those with a singleton pregnancy delivered at ≥38 weeks with a birthweight of ≥4000 gr. Demographic data and medical history and birth outcomes of the patients were recorded from the hospital data system. Multiple pregnancies, those with fetal anomalies and births <38 weeks were excluded from the study. The patients were separated into two groups as those who gave birth at 38+0-38+6 gestational weeks (Group 1) and those who gave birth at ≥39 weeks (Group 2).Results: Maternal and/or fetal trauma was found to be statistically significantly higher in nulliparous women with vaginal delivery ≥39 weeks compared to those with vaginal delivery at 38+0-38+6 weeks (p=0.017). No significant difference was observed between the groups in respect of fetal morbidity and mortality.Conclusion: When fetal macrosomia is determined antenatally, rates of fetal and/or maternal trauma can be reduced with delivery planned for the 38th week without increasing fetal morbidity and mortality.Amaç: Makrozomik fetüsler hakkında, Amerikan Obstetrik ve Jinekoloji Derneğinin bültenleri de dahil olmak üzere çok sayıda makale yazılmıştır. Ancak doğum zamanı konusunda net bir fikir birliği yoktur. Bu çalışmanın amacı fetal makrozomi ile komplike gebeliklerde 38+0-38+6 hafta arasında doğum yapan kadınlar ile ≥39 hafta sonrasında doğum yapan kadınların maternal ve fetal sonuçlarını karşılaştırmak ve doğum haftasının 38. haftaya çekilmesinin yenidoğanın morbidite ve mortalitesini etkileme düzeyini belirlemektir.Gereç ve Yöntemler: Bu retrospektif çalışmada, 01 Mayıs 2018-31 Mart 2020 tarihleri arasında Kayseri Eğitim ve Araştırma Hastanesinde doğum yapan kadınların ve bebeklerinin verileri geriye dönük olarak tarandı. Doğum ağırlığı ≥4000 gram, tekil, ≥38 hafta üzerinde doğum yapan hastalar çalışmaya dâhil edildi. Hastaların demografik ve medikal öyküleri ve doğum sonuçları hastane veri sisteminden kayıt edildi. Çoğul gebelikler, fetal anomaliler ve <38 gebelik haftasındaki doğumlar çalışma haricinde tutuldu. Hastalar 38+0- 38+6 hafta arasında doğum yapanlar (Grup 1) ve ≥39 haftada doğum yapanlar (Grup 2) olarak iki gruba ayrıldı.Bulgular: ≥39 haftadan sonra vajinal doğum yapan (grup 2) nullipar kadınlarda maternal veya fetal travma 38+0 - 38+6 (grup 1) hafta arasında vajinal doğum yapan nullipar kadınlara oranla istatistiksel anlamlı olarak yüksek bulundu (p=0.017). İki grup arasında fetal morbidite ve mortalite incelendiğinde gruplar arasında anlamlı farklılık izlenmedi.Sonuç: Doğum öncesi değerlendirmede fetal makrozomi saptanan gebelerde fetal ve/veya maternal travma oranları, fetal morbidite ve mortalite arttırılmadan 38. haftada planlanacak bir doğum ile azaltılabilir

Evaluation of the IVF success in frozen-thaw in vitro fertilization cycles in terms of endometrial thickness

The aim of this research was to analyze the link between endometrial thickness (EMT), as measured during progesterone administration, and the results observed in individuals who underwent frozenthawed embryo transfer. A retrospective analysis was performed on 233 hormone replacement therapy (HRT) methods of endometrial preparation in frozen-thawed embryo transfer (FET) cycles (HRT-FET). HRT-FET cycles that were conducted between January 2021 and December 2022 at the In vitro fertilization (IVF) Clinic of 19 May University Medical Faculty Training and Research Hospital. The patients&apos; age, infertility duration, basal follicle-stimulating hormone (FSH) level, body mass index (BMI), number and day of embryos transferred, and pregnancy rates were evaluated. Endometrial thickness was measured using transvaginal ultrasound (TV USG) on the day of progesterone administration. The endometrial thickness of patients who achieved clinical pregnancy and those who did not were analyzed. No significant differences in demographic factors were found between the groups in terms of age, infertility duration, basal FSH level, and BMI (p=0.209, p=0.959, p=0.866 and p=0.685, respectively) . The success rates of clinical pregnancy did not strongly correlate with endometrial thickness. The study found that EMT is not a valid indicator for clinical pregnancy in frozen-thawed embryo transfer cycles. [Med-Science 2023; 12(4.000): 1306-9

Exercise and outcomes in macrosomic pregnancies

Objectiv

Impact of insufficient weight gain after GDM diagnosis on small for gestational age and adverse perinatal outcomes

Aim: In the current study, we purposed to examine the role of insufficient weight gain after GDM diagnosis in small for gestational age (SGA) and other adverse perinatal outcomes. Materials and Methods: This retrospective cohort study conducted in a referral center over a 5-year period from 2017 through 2022 and 260 pregnant women who met the inclusion criteria were classified as insufficient weight gain (n:68) or appropriate weight gain as a control group (n:192) based on the United States Institute of Medicine (IOM) recommendations for body mass index as calculated by gestational weight gain per week after a diagnosis of GDM. Results: Maternal demographic characteristics and delivery outcomes were similar be- tween groups. BMI at the first visit, BMI at GDM screening, and BMI at delivery were significantly higher in the appropriate gain group compared to the insufficient gain group. After adjusting for the variables, we observed that insufficient weight gain after a GDM diagnosis was not associated with SGA (adjusted odds ratio [aOR], 1.964; 95% confidence interval [CI], 0.306–12.590).In addition, we found that other variables such as the prema- turity (aOR, 1.205; 95% CI, 0.335–4.320) and NICU admission rates (aOR, 2.361; 95% CI, 0.456–12.231) were not associated with insufficient weight gain after a GDM diagnosis. Conclusion: Our results indicate that insufficient weight gain after a GDM diagnosis is not a risk factor for SGA, prematurity, and NICU admission rates

The Effect of Iron Deficiency Anemia Early in the Third Trimester on Small for Gestational Age and Birth Weight: A Retrospective Cohort Study on Iron Deficiency Anemia and Fetal Weight

Aim. The aim of the present study was to evaluate the relationship between iron deficiency anemia and small for gestational age (SGA) in early third trimester pregnancies. Methods. A total of 4800 pregnant women who met the inclusion criteria were analyzed retrospectively. We included pregnant women who had iron deficiency anemia between 26(+0) and 30(+0) weeks of gestation and delivered singletons between 37(+0) and 41(+6) weeks of gestation. Patients were divided into four groups according to anemia level: (1) hemoglobin (Hb) 11 mg/dl (n = 3100, control group). The primary outcome of this study was the presence of SGA. Results. The demographic and obstetric characteristics were similar among all the groups. Maternal age, BMI <30 kg/m(2), nulliparity rates, and previous cesarean delivery rates were similar among groups. Ethnicity was significantly different in the severe and moderate anemia groups (<0.001). Mean fetal weight was 2900 +/- 80 g in the severe anemia group, 3050 +/- 100 g in the moderate anemia group, 3350 +/- 310 g in the mild anemia group, and 3400 +/- 310 g in the control group. Fetal weight was significantly lower in the severe and moderate anemia groups compared to the mild anemia and control groups (<0.001). The SGA rate was 18.7% in the severe anemia group, 12.1% in the moderate anemia group, 5.3% in the mild anemia group, and 4.9% in the control group. SGA was significantly higher in the severe and moderate anemia groups compared to the mild anemia and control groups (<0.001). Conclusion. The results of this study indicated that early third trimester severe and moderate iron deficiency anemia was associated with SGA. Iron deficiency anemia in pregnant women may lead to low birth weight