Maternal-fetal outcome associated with adolescent pregnancy in a tertiary referral center: a cross-sectional study

Objectives: This study was conducted to compare pregnancy outcomes of early-middle adolescent, late adolescent and adult women. Material and methods: The study focused on early-middle adolescent (n = 145), late adolescent (n = 1655) and adult (n = 1585) women who gave birth during 2014 through 2017, utilizing data obtained from the Zeynep Kamil Women and Children’s Health Training and Research Hospital. Pregnancy outcomes were determined according to the rates of preg¬nancy complications, including method of delivery, birth weight, as well as the rate of newborn intensive care admissions. Results: Comparisons between the studied groups for various pregnancy complications showed highest rates of pre¬term deliveries (PD), preterm premature rupture of membranes (PPROM) and neonatal intensive care unit admission in early-middle adolescent group, whereas the highest cesarean section rates were observed in the adult group (p < 0.001). Conclusions: Analysis of the data revealed that adolescent pregnancy, especially the early-middle adolescent pregnancies, is associated with increased risks of adverse pregnancy outcomes

Effectiveness of tranexamic acid on bleeding in conization

Objective: Bleeding is the most common complication of conization of cervix. Hemostatic sutures, intraoperative ferric subsulfate, or vasopressin can be used when intraoperative bleeding occurred, whereas oral tranexamic acid (TA) may be used for post-operative bleeding. In this study, we aimed to find out whether intraoperative cervical TA administration in patients undergoing conization caused changes in the amount of intraoperative bleeding and post-operative hemogram. Material and Methods: Patients who have undergone cervical conization between January 2019 and July 2019 in Zeynep Kamil Health Application and Research Center Gynecological Diseases and Birth Clinic were evaluated. One hundred and five patients were included to our study. One ampoule of 10% TA was applied cervically to 47 of these patients. Both groups were evaluated in terms of measuring the intraoperative amount of blood in the aspirator, changes in post-operative hb/htc/plt values compared to the pre-operative values, and the rate of post-operative bleeding. Results: In our study, the amount of intraoperative hemorrhage and pre-operative hemoglobin, hematocrit, and platelet values compared to the post-operative values were found to be similar in both groups. Conclusion: Although TA has been shown to be effective on hemorrhage in benign gynecologic operations, menorrhagia, and postpartum hemorrhages, no significant effect on hemorrhage in conization with cervical TA administration has been demonstrated

Confounders for Neonatal Intensive Care Unit Admission ın Neonates of Mothers with Preeclampsia

Objective: The aim of this study was to investigate the effect of some maternal and neonatal clinical parameters on the neonatal intensive care unit admission rates of neonates born to mothers who had preeclampsia. Study Design: Study included 402 singleton pregnant women with preeclampsia who admitted to Maternal-Fetal Medicine Unit of Zeynep Kamil Children and Women’s Health Training and Research Hospital. Pregnancies with uterine rupture, chorioamnionitis and congenital malformations were excluded. Some maternal and neonatal clinical characteristics were assessed to predict neonatal intensive care unit admission. Results: Among 402 neonates, 140 (35%) of them had an indication for neonatal intensive care unit admission, among 140 neonates, 136 (97%) of them were preterm neonates. Comparison of groups with and without neonatal intensive care unit admission indicated significant differences between groups in terms of gestational age, Apgar scores at 1st and 5th minutes, birth weight, some maternal laboratory parameters (Hemoglobin, hematocrit, alanine aminotransferase, aspartate aminotransferase, albumin). In multivariate analysis, among all study population, gestational age at delivery, birth weight and Apgar scores were found to be significantly associated with neonatal intensive care unit admission. On the other hand, in subgroup of term neonates, none of the variables was shown to be associated with neonatal intensive care unit admission. Conclusion: Gestational age at delivery and the birth weight are the main risk factors for neonatal intensive care unit admission of neonates born to mothers who had preeclampsia