Ultrasound imaging of the fetal optic nerve from a different plane

Objective In this study, we aimed to visualize the fetal optic nerve and its sheath in a lateral oblique plane by ultrasound. Methods This cross-sectional prospective study was conducted at 20–22 weeks of gestation on healthy pregnant women who applied to our perinatology clinic for anomaly screening. Optic nerve sheath diameter (ONSD) measurements were taken from the lateral orbital and the retroorbital planes twice by the same sonographer. Ultrasound durations were recorded. Intraobserver variability was calculated for both techniques. The Bland-Altman analysis was performed for the lateral orbital technique. Results A total of 45 pregnant women were evaluated in the study. The intraclass correlation coefficient value of the lateral orbital technique was 0.722 (p<0.001), suggesting that the ONSD was measured similarly by the same observer. The ONSD mean measured by the lateral orbital (LO) technique was higher than the ONSD mean measured by the retroorbital (RO) technique (2.10±0.13 vs 1.21±0.13 mm, p<0.001). The ONSD measurement with the LO technique was determined to be more time-effective than the RO technique (129.6±31.3 vs 228.2±32.7 sec, p<0.001). Conclusion It is demonstrated that by using the lateral orbital technique, the optic nerve and its sheath can be visualized separately without the shadowing artifact of the lens. This technique also takes less time than the RO technique. There is a need for more extensive research on this subject with magnetic resonance imaging (MRI) confirmation

The Relationship Between Fetal Prenasal Thickness and Birth Weight

INTRODUCTION: We aimed to investigate the effect of certain maternal and fetal features on fetal prenasal thickness, considering the correlation between prenasal thickness and subsequent birth weight. METHODS: This was a prospective longitudinal study. Uncomplicated pregnancies between 16-23 weeks of gestation seen at a perinatology outpatient clinic for fetal ultrasound examination between September 2019 - January 2020 were included. Demographic data and fetal prenasal thickness measurements were recorded. Pregnant women were followed until delivery. Data were evaluated with Pearson correlation analysis and linear regression. RESULTS: A total of 74 pregnant women were evaluated. The mean maternal age and fetal prenasal thickness was 29.5 +- 5.3 years and 3.2 +- 0.97 mm, respectively. In univariate analysis, maternal body mass index, age, fetal gender and parity were not significantly related with prenasal thickness. Pearson correlation analysis revealed a positive correlation between gestational age and prenasal thickness (r = 0.484, p &lt;0.001). There was no correlation between prenasal thickness and birth weight (r = 0.133, p = 0.258). DISCUSSION AND CONCLUSION: Prenasal thickness on second trimester ultrasound is positively correlated with gestational age, and this effect seems independent of parity, maternal body mass index, age, and fetal gende

The effect of induction duration on postabortal hemorrhage in second-trimester pregnancy termination with misoprostol

Objective: The aim was to investigate how the duration of induction affects postabortion hemorrhage in second-trimester pregnancy terminations using misoprostol. Methods: This single-center retrospective cohort study was conducted between April 2020 and April 2021 at a university hospital. Singleton pregnant women having gestational age of 13–26 weeks and being hospitalized for termination were included in the study. The misoprostol was administered 200 µg every 4 hours intravaginally to patients already diagnosed with miscarriage, and 400 µg every 3 hours to all remaining patients. Estimated blood loss volume (EBLV) was calculated using a formula previously defined by Stafford et al. A total of 117 singleton pregnant women having gestational age of 13–26 weeks and being hospitalized for pregnancy termination were included in the study. Of these, 78 patients aborted within 0–24 hours (Group 2). The remaining 39 patients aborted in more than 24 hours (Group 1). Results: The EBLV was higher in the study group (p=0.003). In addition, the rate of patients with ≥500 cc and ≥1000 cc blood loss was also significantly higher in the study group (p values 0.049 and 0.016, respectively). After adjusting for potential confounder factors, the probability of blood loss of ≥500 cc and ≥1000 cc was found to be higher in the study group (adjusted OR: 2.720, 95% CI: 1.12–6.58 and adjusted OR: 6.987, 95% CI: 1.25–38.98, respectively). Conclusion: Postabortion hemorrhage risk was found to be higher in patients whose induction period lasted longer than 24 hours in second-trimester terminations with misoprostol. However, there was no deterioration in the patient’s clinical status and no increase in transfusion rates. Care should be taken with regard to vaginal bleeding in misoprostol applications lasting longer than 24 hours

Comparison of Pregnancy Rates of Crinone and Intramuscular Progesteron for Luteal Support Following In Vitro Fertilization and Embryo Transfer Cycles.

TEZ9328Tez (Uzmanlık) -- Çukurova Üniversitesi, Adana, 2011.Kaynakça (s. 50-64) var.viii, 65 s. : res. (bzs. rnk.), tablo ; 29 cm.Amaç: Gonadotropin releasing hormon analogları (GnRHa) kullanılarak kontrollü ovaryan hiperstimulasyon yapılan İn Vitro Fertilizasyon - Embriyo Transferi sikluslarında, luteal faz desteği için intramuskuler progesteron ve vajinal progesteron ile elde edilen gebelik oranlarını karşılaştırmaktır. Gereç ve Yöntem: Çalışmaya kontrollü ovaryen hiperstimulasyon ile birlikte İn Vitro Fertilizasyon - İntrasitoplazmik Sperm Enjeksiyonu - Embriyo Transferi yapılan 66 hasta dahil edildi. Oosit toplanma gününden başlayarak 32 hastaya vajinal (günlük 90 mg jel) ve 34 hastaya intramuskuler progesteron (günlük 50 mg) verildi. İki grup arasında ?-hCG pozitifliği(?20 mİU/mL), klinik gebelik, canlı doğum ve implantasyon oranları karşılaştırıldı. Bulgular: İn Vitro Fertilizasyon - İntrasitoplazmik Sperm Enjeksiyonu ve Embriyo Transferi yapılan kadınlarda oosit toplanma günü başlanarak günde bir kez vajinal jel(90 mg) veya intramuskuler progesteron (50 mg) kullanılması ile benzer oranlarda ?-hCG pozitifliği, klinik gebelik, implantasyon oranları ve canlı doğum oranları görülmüştür. Sonuç: Luteal faz desteği olarak kullanılan vajinal progesteron desteği sonuçları ile intramuskuler progesteron desteği ile elde edilen sonuçlar benzer görüldü. Vajinal yolla progesteron desteğinin effektif ve hastalar tarafından daha kolay tolere edilebilen bir metod olması, luteal faz desteğinde vajinal yolun altın standart olmasını sağlamaktadır.Objective: This study aimed to compare pregnancy rates of intramuscular progesterone and vaginal progesterone for luteal phase support in „in vitro fertilization? -intracytoplasmic sperm injection and embryo transfer cycles in which we perform controlled ovarian hyperstimulation with Gonadotropin-releasing hormone analogues. Material and method: Sixty six patients undergoing in vitro fertilization -intracytoplasmic sperm injection and embryo transfer with controlled ovarian hyperstimulation were included. Thirty two patients were supplemented with vaginal gel (90 mg daily) and thirty four patients with intramuscular progesterone 50 mg daily starting at the day of oosit retrieval. Positive ?-hCG(?20 mİU/mL) ,clinical pregnancy, live birth and implantation rates were compared among both these groups. Results: Rates of positive ?-hCG, clinical pregnancy, implantation and live birth are similar for each group. Conclusion: the results of vaginal progesterone administration were similar to the results obtained after intramuscular progesterone. It can be said that luteal phase support though vaginal administration is an effective and tolarable method. Vaginal administration is gold standart for luteal phase support

Does Proteinuria Measured by Dipstick Method Reflect Reality in Patients with Preeclampsia?

Aim: The aim of our study is to compare the proteinuria levels measured by dipstick in complete urine analysis at admission with the proteinuria levels measured in 24-hour collected urine for patients hospitalized with a presumptive diagnosis of preeclampsia. By doing so, we intend to review the reliability of the widely used dipstick proteinuria in patients with preeclampsia.Material ve Metod: Urine specimens were obtained from 70 pregnant women visiting high-risk maternity centers at a third-level healthcare institution. Patients were divided into four groups based on their urine dipstick screening test results: negative, +1, +2, +3, and higher. Proteinuria was considered to be present if the urinary dipstick test showed +1 or higher, while protein levels measured in the 24-hour urine collection were considered to indicate proteinuria if they exceeded 300 mg. The degree of correlation between the urine dipstick test and both 24-hour urine samples and spot urine protein-to-creatinine ratio (Pr/Cr) was compared.Results: The mean age of the 70 preeclampsia patients in the study group was 31.7±6.2, and the mean gestational age was 32.5±4.6. The dipstick test was found to have a sensitivity of 81.4% and a specificity of 85.2%. The dipstick test results were grouped as 0, +1, +2, +3, and higher. Statistically significant differences were detected among the groups in terms of systolic blood pressure, diastolic blood pressure, the amount of protein in the 24-hour urine, and spot urine Pr/Cr (p=0.001, p&lt;0.001, p&lt;0.001, p&lt;0.001, respectively). When examining the correlation between the urine dipstick test and both 24-hour urine samples and spot urine Pr/Cr, a moderate correlation was found (r=0.65, p&lt;0.001, r=0.55, p&lt;0.001, respectively).Conclusion: In hypertensive pregnant individuals, urine dipstick tests demonstrated inadequate performance in ruling out preeclampsia. Consequently, according to our investigation, we posit that the dipstick urine test can be employed as a routine and dependable diagnostic tool for preeclampsia due to its rapid results and cost-effectiveness

The changes in fear of childbirth in pregnancy during and before the COVID-19 pandemic

Abstract We aimed to investigate how factors such as age, education level, planned delivery method and fear of childbirth were affected in pregnant women before and during the pandemic. This cross-sectional study compared a pre-pandemic pregnant group (July 2019 and December 2019) and a pandemic group (November 2020 and May 2021) of patients at Kütahya Health Sciences University Evliya Çelebi Training and Research Hospital. A total of 696 pregnant women in their second trimester were included in the study. All of them were literate and voluntarily agreed to participate in the study. Data were collected with the Wijma delivery expectancy/experience questionnaire (WDEQ-A), and the outpatient doctor asked the questions face-to-face. The mean age of the pregnant women participating in the study was 31.6 ± 6.8 years. While the total Wijma score was 62.1 ± 25.1 in the pre-pandemic group, it was 61.3 ± 26.4 in the pandemic group, and there was no significant difference between the two groups (p = 0.738). Upon analyzing the fear of childbirth among groups based on education level, no statistically significant differences were observed between the pre-pandemic and pandemic periods within any of the groups. While 25.7% (n = 179) of all participants had a normal fear of childbirth, 22% (n = 153) had a mild fear of childbirth, 27% (n = 188) had a moderate fear of childbirth, and 25.3% (n = 176) had a severe fear of childbirth (Wijma score of 85 and above). When the pre-pandemic and the pandemic period were compared, the fear of childbirth was unchanged in pregnant women at all education levels (p = 0.079, p = 0.957, p = 0.626, p = 0.539, p = 0.202). When comparing fear of childbirth before and after the pandemic, it was found that patients with a high school education level have a significantly higher fear of childbirth. To alleviate the fear of childbirth in pregnant women who have completed high school, training or psychosocial support interventions may be prioritized

Role of the systemic immune-inflammation index in threatened abortion patients and predicting of abortion

Purpose: Our study aimed to compare the systemic immune inflammation index (SII), one of the hematological inflammation parameters, between pregnant women diagnosed with threatened abortion (TA) and healthy pregnant women, and to evaluate the prediction of abortion in pregnant women with TA. Methods: This retrospective study compared 150 patients with TA group and 150 age- and gestational week-matched healthy pregnant women (control group). Complete blood count parameters were assessed. SII, white blood cells (WBC), neutrophil to lymphocyte ratio (NLR), red cell distribution width (RDW), plateletcrit (PCT), platelet distribution width and monocyte to lymphocyte ratio (MLR) values were calculated. The SII value was calculated as follows: platelet count × (neutrophil/lymphocyte). Results: SII, NLR, MLR, WBC, RDW, and PCT values were significantly higher in the TA group compared to the control group (923 ± 683 vs. 579 ± 364 [p < 0.001], 3.3 ± 2.0 vs. 2.1 ± 1.1 [p < 0.001], 0.3 ± 0.1 vs. 0.2 ± 0.2 [p < 0.001], 9.84 ± 2.87 vs. 8.6 ± 1.6 [p < 0.001], 13.9 ± 1.9 vs. 14.4 ± 2.3 [p = 0.032] and 0.3 ± 0.1 vs. 0.2 ± 0.0 [p < 0.001], respectively). Using receiver operating characteristics curve analysis to predict abortion in AI patients, the highest area under the curve was found for SII (0.727 for SII and 0.666 for NLR). Conclusion: SII, NLR, MLR, RDW, and platelet to lymphocyte ratio (PLR) levels were significantly increased in patients with TA. This study supports the idea that several inflammatory pathways may play an important role in the pathogenesis of this disorder. SII may be a much better marker than NLR and PLR for predicting the inflammatory status of the disease and abortion in an ongoing pregnancy