IntroductionThe aim of this study is to compare first- and second-trimester Down syndrome biochemical screening markers in intrahepatic cholestasis of pregnancy (ICP) and normal pregnancies.Material and methodsThis observational case-control study was conducted at Health Sciences University Zeynep Kamil Maternity and Children’s Health Training and Research Hospital and the Department of Obstetrics and Gynecology at Erciyes University Medical Faculty during 2016–2017. The study included 165 patients, and consisted of 62 women who had been diagnosed with ICP (the ICP-diagnosed group) and 103 healthy pregnant women (the control group). First-trimester free β-human chorionic gonadotropin (β-hCG), pregnancy-associated plasma protein-A (PAPP-A) and second-trimester total β-hCG, estriol (E3), α-fetoprotein (AFP), and inhibin A levels were compared between the two groups.ResultsThe mean patient age was 28.67 ±5.96 years, with no significant difference between the groups (p > 0.05). Average PAPP-A levels were significantly lower in the ICP-diagnosed group (p < 0.001). When the cut-off value for PAPP-A was taken as ≤ 0.93 multiple of median (MoM), the sensitivity and specificity values for ICP were 73.8% and 56.3%, respectively (95% CI, AUC ± SE: 0.663 ±0.042).ConclusionsThe decrease in PAPP-A MoM value indicates an increase in the risk of developing ICP, while changes in other markers were not sufficient to predict ICP.
<p><strong>Objective:</strong> The aim of this study was to evaluate complete blood count parameters to predict ovarian torsion in cases presented with ovarian mass.</p><p><strong>Study Design:</strong> Pre-operative demographic data and complete blood count parameters of 72 patients, who were operated on preliminary adnexal torsion and diagnosed as adnexal torsion with a benign ovarian cyst (Study group) were retrospectively compared with those of 77 patients who were operated with an indication of persistent benign ovarian cysts without torsion (control group) at Zeynep Kamil Women and Children’s Health Training and Research Hospital and Department of Obstetrics & Gynecology at Erciyes University Medical Faculty between 2011 and 2015. Complete blood count parameters were utilized to predict ovarian torsion cases.</p><p><strong>Result:</strong> Neutrophil (AUC=792, P=<0.001), white blood cell (AUC=787, P=<0.001) counts and neutrophil/lymphocyte ratio (AUC=770, P=<0.001) were significant predictors for adnexal torsion. Optimal cut off value for white blood cell, neutrophil count and neutrophil/lymphocyte ratio were 8.3x103 (72% sensitivity, 73% specificity), 5.5x103 (73% sensitivity, 76% specificity), 2.9 (73% sensitivity, 79% specificity) respectively.</p><p><strong>Conclusion:</strong> Among all the parameters white blood cell count, neutrophil/lymphocyte and neutrophil count were the most powerful predictors for real adnexal torsion cases. Simple blood count parameters detailed evaluation may help clinicians to confirm or rule out adnexal torsion in cases presented with ovarian cyst and adnexal mass.</p>
The incidence of adnexal torsion (AT) is reported 1 in 10000 births. AT is emergency condition in pregnancy, while the risk of late diagnosis is increased, in third trimester. Since it has been described as a severe complication after controlled ovarian hyper-stimulation for in vitro fertilization (IVF), it is more common in IVF pregnancies. This condition mainly occurs in the first trimester; it is rare during the late third trimester. Herein, we report a case of a 26-year-old woman, gravida 1, singleton pregnancy in the 30th week of gestation was presented to emergency department with 24-hour history of a stabbing pain because of AT. Removal of adnexa performed by laparotomy. The patient had labour pain and cervical dilatation at the 36th week of gestation and a healthy girl weighing 2,200 g was born by emergency caesarean section due to breech presentation.
Objective Antenatal steroids are commonly used to stimulate fetal lung maturation, particularly in pregnancies at risk of early preterm labor. This study aimed to compare the effects of administering betamethasone at a 12- versus 24-hour interval on perinatal outcomes. Study Design This retrospective study included 423 early preterm births from 26+0/7 to 33+6/7 weeks of gestation. Patients received betamethasone at either a 12- or 24-hour dosing interval. Results When all patients in each group were evaluated together, there was no statistically significant difference between both groups for complications of prematurity, including respiratory distress syndrome (RDS). When the two groups were divided by gestational age (GA), the 32+0/7 to 33+6/7-week group that received betamethasone at a 24-hour interval had statistically lower 1- and 5-minute APGAR scores (p = 0.06 and p = 0.02, respectively). They also had a greater need for neonatal intensive care unit (NICU), NICU length of stay, RDS, and need for surfactant (p = 0.20, p = 0.09, p = 0.27, and p = 0.23, respectively) than did the infants at 32+0/7 to 33+6/7 weeks, who received betamethasone at a 12-hour interval. In the group with GA between 28+0/7 and 29+6/7 weeks, the 1-minute APGAR score was lower (p = 0.22), and the durations of hospital stay, and mechanical ventilation were longer (p = 0.048, p = 0.21, respectively) in the 24-hour interval group. No statistically significant difference was observed for all parameters in other GA groups. Conclusion A 12-hour dosing interval for betamethasone appears to be more appropriate, as it results in a reduction in some neonatal complications and provides a short dose interval. Key Points
Objective: To evaluate the effects of antenatal steroid administration on neonatal outcomes in late preterm births.Methods: Demographic and neonatal data from women who gave birth between May 2018 and March 2021 at 34 +0 -36 +6 weeks of gestation were screened from the information system of the hospital. The patients were assigned to two groups: those who were and those who were not given steroids. All parameters were compared between the two groups. Results:The 1-minute (9 versus 8) and 5-minute (10 versus 9) Apgar scores, need for a neonatal intensive care unit (NICU) stay (23.7% versus 27.8%), length of stay (Day) in the NICU (1.97 ± 0.24 versus 2.45 ± 0.16), rate of transient tachypnea of the newborn (3.3% versus 7.8%), respiratory distress syndrome (2.5% versus 5.2%), need for mechanical ventilation (1.2% versus 3.8%), and neonatal sepsis (1% versus 2.6%) were lower in the group that received betamethasone compared with the group that did not; the differences between the two groups were statistically significant. Conclusion:Based on the results of the present study, we believe that antenatal steroid administration would be beneficial before late preterm births occurring between 34 +0 and 36 +6 weeks of pregnancy, considering the significant reduction in various respiratory complications, especially in respiratory distress syndrome and the need for an NICU stay. K E Y W O R D S betamethasone, late preterm, respiratory distress syndrome, transient tachypnea of the newborn How to cite this article: Bulut AN, Cundubey CR, Ceyhan V, Aydin E. Comparison of neonatal outcomes with and without the administration of betamethasone in late preterm births. Int
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