Objective:To compare pregnant Turkish women and Syrian refugee women in terms of demographic data and obstetric and neonatal outcomes. Methods:In a retrospective study, the records of Turkish women and Syrian refugee women who gave birth at the Health Sciences examined. Maternal characteristics and obstetric and neonatal outcomes were compared between the two groups. Results:The study, which included 7950 Turkish women and 620 Syrian refugee women, found significant differences in maternal age according to nationality. The rate of normal delivery was significantly lower for the Turkish women at 51.6% (P=0.001) compared to 61.3% for the Syrian refugee women. The rate of delivery prior to 37 weeks of gestation was 1.8% for the Turkish women and 3.2% for the Syrian refugee women, indicating earlier delivery for the Syrian refugees than the Turkish women (P=0.017). A significant difference was found between the birth weights of infants born in the two groups (P=0.001).Conclusion: According to the study results, Syrian refugees have a higher rate of adolescent birth and low-birth-weight neonates which could be attributed to poor care and insufficient nutrition during pregnancy while living as a refugee in Turkey. K E Y W O R D S

Summary This study was conducted to find out the group B streptococcus colonisation of pregnant women in Kocaeli, Turkey. A culture plus individualised high‐risk‐based antibiotic prophylaxis was compared with high‐risk‐based approach alone. The screening of women was performed via vaginal and anal cultures for group B streptococcus (GBS). The maternal GBS colonisation rate was found to be 6.5%. All colonised women or preterm labours with unavailable culture results until delivery received prophylactic antibiotics. Neonatal colonisation rate and early‐onset neonatal sepsis due to GBS was 1/200. The unscreened 900 women received prophylactic antibiotics due to a risk factor‐based approach. The neonatal colonisation rate was 17/900 (p = 0.1), and the rate of early‐onset neonatal sepsis was 3/900 (p = 0.6). A culture plus individualised high‐risk‐based antibiotic prophylaxis provided an insignificant change in neonatal colonisation and early‐onset neonatal sepsis with GBS when compared with high‐risk‐based approach alone.

Adolescence is the transition period from childhood to adulthood; the World Health Organization has defined it as the ages between 10 and 19. Approximately 11% of all births in the world are by adolescent mothers. Pregnant adolescent refugees who have been forced to emigrate due to civil wars raging on in their native countries often face difficult social life conditions, have little or no access to hospitals, and experience language barriers and poor nutritional status have been found to experience poor maternal and obstetric outcomes. These include an increase in cesarean births, premature births, intrauterine growth retardation, and low-birth-weight infant rates. The purpose of the article was to share with you the comparative results of the adolescent pregnancies among the immigrants and among the local adolescents who gave birth between January 2016 and July 2017 in Kocaeli Derince Training and Research Hospital Gynecology Clinic in Kocaeli, Turkey. Its materials and method is a comparative study planned retrospectively between 67 adolescent Syrian refugees and 188 adolescent Turkish locals who gave birth between January 2016 and July 2017. The demographic data, obstetric outcomes, hospitalization durations, and neonatal outcomes of the patients were compared between the groups. Results, no statistically significant difference was found between pregnancy numbers, normal birth rates, cesarean sections and interventional birth rates, nullipara-multipara birth rates, or premature birth rates (<37 weeks) of the pregnant Turkish adolescents and pregnant immigrant adolescents (p > .05). The number of days these patients were hospitalized was found to be lower among Syrian immigrants than among the Turkish locals and statistically significant (p = .045 and p < .05, respectively). In addition, an analysis of the birth rates of low-birth-weight infants revealed that said rates were higher among the Syrian refugees than the Turkish local and statistically borderline significant (p = .049, p < .05, respectively). Between January 2016 and July 2017, a total of 8,570 live births were performed in our clinic. In our study of the 255 patients under the age of 19 who gave live births, 188 were Turkish and 67 were Syrian refugees. The average age of Turkish mothers under 19 was found to be 17.30 ± 1.01 years and the average age of immigrant mothers was found to be 17.27 ± 0.82 years. In conclusion, adolescent pregnancies are more common among Syrian refugees. Adolescent pregnancies are at risk for obstetric and neonatal outcomes. Therefore, studies should be done to prevent these pregnancies.

Acute fatty liver of pregnancy (AFLP) is a rare disorder of unknown aetiology that is diagnosed typically in the third trimester or early postpartum period. The incidence is estimated to be 1/6692-1/13,328. The obstetric team must have a high index of suspicion of this pathology, particularly in the presence of clinical and laboratory findings, such as nausea, vomiting, jaundice, increased serum transaminase levels, increased prothrombin time and hypoglycaemia. Early diagnosis followed by prompt delivery and supportive care provides significantly improved mater-nal and perinatal outcome. Delay in diagnosis of this obstetric emergency may lead to rapid progression to hepatic failure, disseminated intravascular coagulation (DIC), haemorrhage, encephalopathy, multiple organ failure and finally death. The case of a 34-year-old woman, gravida 3, para 2, with AFLP complicated with DIC is presented herein with a review of literature and discussion of its origin.

BackgroundAlcohol and substance use is a major health challenge in Turkey, as it is worldwide. Recently, there has been a rapid increase in the number of females using substances and although usage tends to reduce during pregnancy, it is of critical importance to determine its exact level as substance use negatively impacts on the health of both the mother and infant.AimThe aim of the present study was to investigate the frequency of smoking, alcohol, and substance use, and quitting rates during pregnancy.MethodThis study was conducted on pregnant females in Sakarya, Turkey. A total of 1,082 consecutively presenting females who agreed to participate in the study were evaluated. The study team prepared a sociodemographic data form and adapted the “Introduction” section, derived from the Addiction Profile Index, to cover substance use during pregnancy.ResultsThe substances most frequently used by pregnant females in their previous pregnancies and current pregnancies were cigarettes/tobacco products (11% and 11.8%, respectively), alcohol (0.6% and 0.4%, respectively), and rarely, synthetic cannabinoids (0.3% and 0.2%, respectively). Daily tobacco smokers continued to smoke during pregnancy, with a rate of 42.5%. Based on research into predictors of smoking (cigarettes) in pregnancy, a correlation was found between lifetime smoking and smoking during a previous pregnancy. A similar link was found with respect to alcohol.ConclusionCigarettes are the most frequently used substance in pregnancy, and to a lesser extent, alcohol and synthetic cannabinoids, also considered to be risky substances. A high incidence of smoking regularly during pregnancy was found in daily smokers. It is recommended that physicians should sensitively ask pregnant females presenting at clinics about all forms of substance use, including alcohol and synthetic cannabinoids, and to include such questions in their routine enquiries.