Objective To compare the fetal cardiac morphology and functions of early‐onset fetal growth restriction (EO‐FGR) and late‐onset fetal growth restriction (LO‐FGR) groups with gestational weeks‐matched controls. Methods A total of 164 pregnant women were included, 28 of whom were in the EO‐FGR group, 54 in the LO‐FGR group, and 82 in the control group. Fetal echocardiographic evaluation was performed with two‐dimensional, M‐mode, tissue Doppler imaging (TDI), and pulsed wave Doppler. Results Fetal cardiac morphologic measurements and diastolic and systolic functions changed in EO‐FGR and LO‐FGR fetuses compared with controls. The EO‐ and LO‐FGR fetuses had reduced right and left cardiac output, increased myocardial performance index, and significantly higher mitral and tricuspid E/E' ratios compared with controls. The EO‐FGR fetuses had lower mitral and tricuspid E and E' values. In LO‐FGR fetuses, mitral and tricuspid E' values were lower than in their controls (P = 0.001 and P < 0.001). On the other hand, the mitral and tricuspid E values were not significantly changed (P = 0.107 and P = 0.196). Conclusion We hypothesized that EO‐FGR and LO‐FGR fetuses had insufficient myocardial maturation. Especially in the LO‐FGR fetuses, TDI is the earliest and most sensitive technique to show subtle changes in fetal cardiac functions.

Aim To investigate the association of systemic immune‐inflammation index (SII) and systemic immune‐response index (SIRI) with adverse perinatal outcomes in pregnant women with coronavirus disease 2019 (COVID‐19). Methods The cases were divided into (1) the Mild–moderate COVID‐19 group (n = 2437) and (2) the Severe–critical COVID‐19 group (n = 212). Clinical characteristics, perinatal outcomes, SII (neutrophilXplatelet/lymphocyte), and SIRI (neutrophilXmonocyte/lymphocyte) were compared between the groups. Afterward, SII and SIRI values were compared between subgroups based on pregnancy complications, neonatal intensive care unit (NICU) admission, and maternal mortality. A receiver operator characteristic analysis was performed for the determination of optimal cutoff values for SII and SIRI in the prediction of COVID‐19 severity, pregnancy complications, NICU admission, and maternal mortality. Results Both SII and SIRI were significantly higher in complicated cases (p < 0.05). Cutoff values in the prediction of severe–critical COVID‐19 were 1309.8 for SII, and 2.3 for SIRI. For pregnancy complications, optimal cutoff values were 973.2 and 1.6. Cutoff values of 1045.4 and 1.8 were calculated for the prediction of NICU admission. Finally, cut‐off values of 1224.2 and 2.4 were found in the prediction of maternal mortality. Conclusion SII and SIRI might be used in combination with other clinical findings in the prediction of poor perinatal outcomes.

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Objective: The purpose of the study was to look at the connection between newborn intensive care requirements in low-risk pregnancies and maternal blood pregnancy-associated plasma protein (PAPP-A) and free human chorionic gonadotropin (hCG) levels, which are elements of screening tests within the first trimester. Materials and Methods: In the delivery unit of our hospital, pregnant women between the years of 18 and 35 had singleton pregnancies who delivered between 37 and 41 weeks of pregnancy between July 2021 and January 2022 were split into 2 groups. One hundred eighty two pregnant women with infants who required neonatal intensive care (NICU) were enrolled in the first group, whereas 890 pregnant women with infants who did not require NICU were enrolled in the second. These two groups’ maternal blood PAPP-A and free hCG levels, which are among the first trimester screening procedures, were examined. Additionally, subgroup analysis were performed in terms of cesarean section indications and NICU admission indications. Logistic regression analysis and ROC analysis were performed with related variables for estimating NICU need. Results: The mean serum PAPP-A value was found to be 0.91±0.34 multiples of the median (MoM) in the blood taken from the infant mothers who needed NICU, while the mean serum PAPP-A value in the blood taken from infant mothers who did not need NICU was 1.12±0.59 MoM (p<0.000). The PAPP-A MoM mean of the group with Apgar 5 th minute score ≥8 (1.09±0.57) was higher than the PAPP-A mean (0.84±0.27) of the Apgar 5 th minute score <7 group (p=0.013). According to the results of our study, in groups with a PAPP-A value below 0.95, the possibility of increased NICU need of newborns is higher. Conclusion: The low serum PAPP-A level, which is used as a screening test among pregnant women, demonstrates that it is successful in predicting perinatal outcomes in the low-risk pregnancy group.

Objective The aim of this study is to investigate the relationship between first trimester subchorionic hematomas and pregnancy outcomes in women with singleton pregnancies. Material and methods Between January 2018 and January 2019, patients who had a single pregnancy between the 6th and 14th weeks of their pregnancy and were hospitalized with the diagnosis of abortus imminens in the early pregnancy service were included in the study. According to the ultrasonographic examination, those with subchorionic hematoma and those with no hematoma were compared in terms of demographic data, pregnancy outcomes and pregnancy complications. Results 400 abortus immines cases with subchorionic hematoma and 400 abortus imminens cases without subchorionic hematoma were compared. Preterm delivery percentages were similar in both groups, however abortus percentage was significantly higher in the hematoma group (34.2 vs. 24.7%; p=0.007). In addition, it was revealed that the presence of subchorionic hematoma before the 20th gestational week increased the risk of miscarriage 1.58 times. However, no data could be found in the study that could correlate the size of the hematoma with pregnancy loss. Conclusion The presence of subchorionic hematoma increases abortion rates in abortus imminens cases. And the presence of subchorionic hematoma in cases with ongoing pregnancy does not increase the complications of delivery.

Aim This study aims to investigate the effects of maternal asthma on fetal cardiac functions. Methods The study was planned with 30 pregnant women who presented to a tertiary health center and were diagnosed with asthma and 60 healthy controls with similar gestational ages. The fetal echocardiographic assessment was assessed between 33 and 35 weeks of gestation with pulsed‐wave Doppler (PW), M‐mode, and tissue Doppler imaging (TDI). Fetal cardiac functions were compared between maternal asthma and the control group. Cardiac functions were assessed according to the duration of maternal asthma diagnosis, as well. Results Early diastolic function parameters, tricuspid E wave (p = .001), and tricuspid E/A ratio (p = .005) were significantly lower in the group with maternal asthma. Tricuspid annular plane systolic excursion (TAPSE) and measurements of mitral annular plane systolic excursion (MAPSE) values were statistically lower in the study group than in the control group; p = .010 and p = .012, respectively. Parameters assessed with TDI (E′, A′, S′, E/E′, and MPI′ of tricuspid valves) and global cardiac function parameters assessed with PW like myocardial performance index (MPI) and left cardiac output (LCO) were similar between groups (p > .05). Although, MPI did not change between groups, and the isovolumetric relaxation time (IVRT) value was prolonged in maternal asthma cases (p = .025). Conclusion We found that maternal asthma disease causes alteration in fetal diastolic and early systolic cardiac functions, but the global fetal cardiac function does not change. Diastolic heart function values also varied with the duration of maternal asthma. Prospective studies are needed to compare fetal cardiac functions with additional patient groups according to disease severity and type of medical treatment.

Introduction: Autoinflammation and increase in free oxygen radicals due to maternal familial mediterranean fever (FMF) may affect fetal lung maturation and cause changes in fetal pulmonary artery Doppler parameters. We aimed to investigate the fetal pulmonary artery acceleration time/ejection time (PATET) ratio in the pregnancies complicated with familial mediterranean fever (FMF). Methods: This cross-sectional study included 32 pregnant women with FMF, and 64 gestational ages matched healthy pregnant women, between the 29-30 gestational weeks. Maternal characteristics and fetal ultrasonographic information were recorded. Fetal pulmonary artery acceleration time (AT) and ejection time (ET) were measured manually and PATET ratio were calculated in the study groups. The duration of the disease and the AT and PATET measurements were analyzed with the Pearson correlation test.Results: The study groups were similar in terms of maternal characteristics, gravidity, parity and gestational week at the time of examination. AT and ET values were found to be significantly shorter and PATET (AT/ ET) was found to be significantly lower in pregnant women complicated with FMF. A moderately significant negative correlation was found between the time elapsed since FMF diagnosis and fetal pulmonary artery acceleration time. (r=-.566, p=.001) and PATET (r=-.533, p=.002) Conclusion: This is the first study to investigate the fetal pulmonary artery Doppler indices in the pregnancies with FMF. In the presented study, it was shown that FMF significantly shortened the fetal pulmonary acceleration and ejection time and significantly reduced the PATET ratio. In addition, as the time elapsed from the diagnosis of the disease increased, it was shown that the shortening in AT and the decrease in PATET were higher, with a significant moderate negative correlation between the duration of the disease and these values.

Aim:This study aims to investigate the effects of maternal asthma on fetal cardiac functions. Methods:The study was planned with 30 pregnant women who presented to a tertiary health center and were diagnosed with asthma and 60 healthy controls with similar gestational ages. The fetal echocardiographic assessment was assessed between 33 and 35 weeks of gestation with pulsed-wave Doppler (PW), M-mode, and tissue Doppler imaging (TDI). Fetal cardiac functions were compared between maternal asthma and control group. Cardiac functions were assessed according to the duration of maternal asthma diagnosis, as well. Results:Early diastolic function parameters, tricuspid E wave (p=0.001), and tricuspid E/A ratio (P=0.005) were significantly lower in the group with maternal asthma. TAPSE and MAPSE values were statistically lower in the study group than in the control group; p=0.010 and p=0.012, respectively. Parameters assessed with TDI (E’, A’, S’, E/E’, and MPI’ of tricuspid valves) and global cardiac function parameters assessed with pulsed-wave Doppler like myocardial performance index (MPI) and left cardiac output (LCO) were similar between groups (p> 0.05). Although, MPI did not change between groups, and the isovolumetric relaxation time (IVRT) value was prolonged in maternal asthma cases (p=0.025). Conclusion:We found that maternal asthma disease causes alteration in fetal diastolic and early systolic cardiac functions, but the global fetal cardiac function does not change. Diastolic heart function values also varied with the duration of maternal asthma. Prospective studies are needed to compare fetal cardiac functions with additional patient groups according to disease severity and type of medical treatment.