Altered fetal cardiac function in smoking during pregnancy

Maternal smoking during pregnancy remains a major public health issue and is associated with adverse perinatal outcomes. This study aimed to evaluate fetal cardiac functions in chronic maternal smoking during pregnancy and to compare them with non-smoker pregnant women. Forty-two smoker pregnant women between 24 and 34 weeks of gestation and gestational age-matched 44 non-smoker pregnant women were enrolled in this cross-sectional study. Fetal cardiac functions were measured using conventional Doppler echocardiography. The peak velocities of the mitral valve during early diastole (E) and atrial contraction (A) were measured, and the E/A ratio was calculated. The following time periods were also calculated; isovolumetric contraction time (ICT), isovolumetric relaxation time (IRT), and ejection time (ET). Then, the fetal left ventricle modified myocardial performance index (Mod-MPI) was calculated. No significant differences were noted between the groups in terms of E, A, and E/A ratio z-scores (p > 0.05). The ICT and IRT z-scores were found to be significantly higher in the study group compared with those in the control group (p = 0.001 and p = 0.034). Mod-MPI z-score was also found significantly higher in the study group than in the control group (p = 0.034). There was no significant difference between the groups in terms of ET (p > 0.05). The signs of systolic, diastolic, and global cardiac dysfunction were demonstrated in fetuses of pregnant women with chronic smoking. It, therefore, merits consideration that the fetal heart is also exposed to the detrimental effects of smoking

Placental Chorioangioma Diagnosis and Management

Placental chorioangioma constitutes major importance in perinatology practice, as being the most common type of placental tumors, and having the potential of devastating perinatal outcomes. In this review, we report the symptoms, diagnostic findings and recent temporary and definitive treatment choices in patients with chorioangioma

Vakum ekstraksiyonuyla vajınal doğum

Operative vaginal delivery is simply defined as the use of either vacuum or forceps device to asist mother in effecting vaginal delivery of a fetus. Medicolegal problems, patients desire and the obstetricians position after a possible complication of the vaginal delivery has increased the rate of ceserean section. With the recent enforcements among obstetricians to reduce this rate, operative vaginal delivery will come forward in delivery and labor practice. In this review, we discussed the indications, contrindications, patient selection, maternal - neonatal risks and the technique of vacuum extraction for a safe expedient vaginal delivery.Operatif vajinal doğum basit tanımıyla vakum ya da forseps kullanılarak yaptırılan vaginal yolla doğumdur. Özellikle son yıllarda artışgösteren medikolegal problemler, hasta isteği ve doğumda gerçekleşen komplikasyonlar sonrası hekimin düşürüldüğü durum sezeryan oranının artışıyla sonuçlanmışgibi görünmektedir. Ancak son dönemlerde sezeryan oranını düşürmeye yönelik uygulamalar operatif doğumları yeniden öne çıkaracaktır. Bu derlemede, vakum ekstraksiyonuyla yaptırılacak sağlıklı bir vajinal doğum için gerekli endikasyon, kontrendikasyon, hasta seçimi, maternal ve neonatal riskleri ve uygun tekniği tartıştı

Meconium Peritonitis and Periorchitis: Report of a Prenatal Case

Meconium peritonitis refers to rupture of the bowel prior to birth, resulting in fetal meconium escaping into peritoneum leading to inflammation (peritonitis). Meconium periorchitis is an extension of meconium peritonitis into the scrotum via a patent processus vaginalis. The most common causes of meconium peritonitis are ischemic lesions of the small bowel associated with mechanical obstruction (atresia, volvulus, intussusception, congenital bands, Meckel diverticulum and internal hernia). These likely account for 50% of the cases of meconium peritonitis. Meconium peritonitis may also be caused by viral infections (cytomegalovirus or parvovirus B19) and cystic fibrosis. Here, we report of a patient with fetal meconium peritonitis - periorchitis and perinatal management

Seasonal Impact in the Frequency of Intrahepatic Cholestasis of Pregnancy

Objective: To evaluate the presence of any seasonal variation in the frequency of intrahepatic cholestasis of pregnancy (ICP). Study Design: A total of 126 cases with ICP were compared with a cohort of 37614 pregnant women who delivered. The diagnosis ICP was performed on the basis of severe itching and the absence of dermal rash and any other hepatic disease, with the co-existence of elevated serum aminotransferase levels and/or serum bile acid concentration. For each month and season, observed and expected ICP rates were analysed and compared by using chi-square statistics. Multivariate logistic regression was performed to investigate certain parameters on cumulative risk. Results: A significantly lower frequency of ICP in winter (6/126 (4.8%), p=0.001) and a significantly higher frequency in spring (44/126 (34.9%), p=0.034) were detected. A 2.1 and 3.8-fold higher risk were found for the nulliparity and the twin pregnancy, respectively. Logistic regression analysis confirmed the significant (10-fold) decrease in the frequency of ICP in winter. The significance of spring did not persist after the adjustment. Conclusion: Main outcome of the study points at seasonality in ICP frequency. Future studies in different populations may reveal data about factors that interact with seasonality and playing roles in ICP