The assessment of twin pregnancies delivered in our clinic: three-year experience

Objective: Twin pregnancies constitute 1–2% of all pregnancies. With the recent developments in assisted reproductive technologies, the incidence of multiple pregnancy has increased. Preterm labor is held responsible for the poor neonatal outcomes primarily. In our study, we aimed to assess fetal-maternal outcomes of twin pregnancies seen in our clinic. Methods: One hundred and thirty twin pregnancy cases out of 4241 pregnant women who delivered in our clinic between 01.01.2017 and 01.01.2020 were included in the study. The labor records of the patients were reviewed retrospectively and their data for age, week of gestation, delivery type, birth weight, fetal sex, chorionicity characteristics and laboratory parameters were recorded. Definitive statistics and SPSS 21.0 for statistical analyses were used to evaluate the data obtained from the study. The data were presented as mean ± SD (standard deviation). Results: The incidence of twin pregnancy was found 3%. In the ultrasonographic imaging evaluated during diagnosis, 27.7% of the cases were monochorionic and 72% of them were dichorionic. Of the pregnant women, 12.3% were at term and 87.7% were at preterm period. When the preterm fetuses were evaluated, 37.7% of 114 preterm fetuses were delivered at late preterm period, 29.2% of them at mid-preterm period and 20.8% at premature preterm period. The rates of treatment pregnancy (pregnancy provided by ovulation induction and assisted reproductive technologies) and spontaneous twin pregnancy were 20% and 80%, respectively. Mean maternal age was found 31.3. When evaluated in terms of maternal morbidity, preterm labor and premature rupture of membrane were the most common problems. Mean newborn weight was 1832g and 59.3% of the newborns had low birth weight and 21.8% of them had very low birth weight. While one fetus had transverse presentation in 12.5% of the patients, at least one fetus had breech presentation in 53.1% of the cases and 34.4% of the cases had head-head presentation. Conclusion: Twin pregnancies are characterized by the increased feto-maternal risks. Therefore, both antenatal and intrapartum management should be maintained diligently

The assessment of maternal deaths between 2015 and 2020 in Elazığ, Turkey

Objective: To determine the maternal deaths and the factors affecting them in our city. Methods: The maternal deaths occurred in our city between January 2015 and June 2020 were reviewed retrospectively. The review was conducted by checking “Maternal Death Registry Forms” of the Provincial Directorate of Health. In cases where additional data related with the cause of death were required, the relatives of the cases, associated family practitioner, The Council of Forensic Medicine or local authorities were contacted. The data of the cases including age, gravida, parity, abortion, delivery type, week of gestation during delivery, period of death and maternal deaths due to direct, indirect and incidental causes were recorded. Based on total live births and maternal deaths within 6.5 years, maternal mortality rate was found as the maternal death number per 100,000 live births. Descriptive statistics were used for the statistical analysis of the data. Results: A total of 46.618 live births occurred between 2015 and 2020 in Elazığ. The number of maternal deaths due to direct and indirect causes is 7, and maternal mortality rate was found 15.01/100,000. Hypertensive diseases during pregnancy (n=3, 42.8%), pulmonary embolism (n=1, 14.3%) and cerebral thrombosis (n=1, 14.3%) were among the natural causes of maternal deaths. Indirect cause for maternal death was cardiac diseases (n=2, 28.6%). When they were categorized according to the Three Delays Model, there were 3 death cases in the first delay model and 2 death cases in the third delay model, but there was no maternal death in the second delay model. Conclusion: Maternal death is an significant public health issue which develops due to the generally preventable causes and maintains its importance. The factors contributing to death should be paid attention in order to decrease maternal death rates

Elabela levels in pregnancies with intrauterine growth retardation

Objectives: The aim of our study is to examine maternal serum Elabela levels in pregnancy with intrauterine growth retardation (IUGR). IUGR is one of the most important causes of perinatal mortality and morbidity. IUGR is also related future comorobidities such as diabetes mellitus, hyperlipidemia, hypertension and coronary artery disease. Material and methods: Fifty pregnancies diagnosed as IUGR (Group 1) and fifty healthy pregnancies (Group 2) enrolled into the study. Obstetric and demographic characteristics of the patients, serum elabela levels, ultrasound parameters, cord pH value and APGAR scores of the newborns were recorded. In the study, which was planned as a prospective case-control study, an independent t test was used for the evaluation of continuous data and the Mann Whitney U test was used for the statistical evaluation of ordinal data. p < 0.05 was considered significant. Results: The mean gestational age of the cases at delivery was 36.35 ± 1.29 in Group 1 and 38.16 ± 0.94 weeks in Group 2 (p < 0.05). Mean serum Elabela levels were 15.05 ± 9.03 in Group 1 and 8.96 ± 4.33 ng/mL in Group 2 (p < 0.0001). Mean newborn weights were 2498.20 ± 465.92 in Group 1 and 3179.44 ± 387.99 gr. in Group 2 (p < 0.0001). Systolic and diastolic blood pressure measurements taken on the day of delivery were higher in Group 1, and diastolic blood pressure was 77.0 ± 9.53 in Group 1 and 72.60 ± 13.37 mmHg in Group 2 (p < 0.05). Bilateral uterine artery Pulsatile Index (PI) and umbilical artery PI value were significantly higher in Group 1 (p < 0.05), and middle cerebral artery PI and cerebroplacental ratio were significantly lower in Group 1 compared to Group 2 (p < 0.05). Although the cord pH value, 1st and 5th minute APGAR scores were lower in Group 1 compared to Group 2, no statistically significant difference was found (p > 0.05). Conlusions: In our study, it was found that serum Elabela levels increased significantly in pregnancies complicated by IUGR compared to the control group

Ghrelins, obestatin, nesfatin-1 and leptin levels in pregnant women with and without hyperemesis gravidarum

Catak, Zekiye/0000-0003-1973-3645; KUMRU, Selahattin/0000-0001-6615-7666; CITIL, Cihan/0000-0002-3006-4035WOS: 000319549100025PubMed: 23380589Objectives: The goal of this study was to compare levels of acyl and des-acyl ghrelin, obestatin, nesfatin-1 and leptin in healthy gravidas to hyperemesis gravidarum (HG) patients. Design and methods: Twenty pregnant women with HG and twenty healthy pregnant women all of similar ages, BMI and all at similar pregnancy development comprised the study cohort. Fasting serum samples were obtained and measured for acyl and des-acyl ghrelin, leptin, obestatin and nesfatin-1. Results: Nesfatin-1 concentrations in the HG group were higher compared to the control group whereas; leptin concentrations during pregnancy were lower in the HG group as compared to the control group. The two groups did not differ with regard to acyl and des-acyl ghrelin and obestatin. Conclusion: This pilot study suggests a possible role of leptin and nesfatin-1, which might be involved in the pathology of the disease. (C) 2013 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.Firat UniversityFirat University [1929]The authors would like to extend their thanks to Firat University for their financial support (project no: 1929)