Emergency peripartum hysterectomy is significantly related to CS in index or previous pregnancy. Placenta accreta is the most common indication to perform peripartum hysterectomy. EPH is associated with a high incidence of maternal morbidity and mortality.

Background: Young maternal age is variously defined in studies of its effect on obstetrics and perinatal outcomes. Also, pregnancy has been reported as the leading cause of death in adolescent girls in low-and middle-income countries. Aims: The aim of the study was to evaluate whether young maternal age was associated with an increased risk of obstetrics and perinatal adverse outcomes. Study Design: Case-control study. Methods: This case-control study was derived from a database of the medical records between January 2008 and December 2012. In the present study, 1374 teenage pregnancy and 1294 adult pregnancy cases were included. After restriction of analyses to singleton primiparous women, 1282 teenage pregnancy and 735 adult pregnancy cases were analyzed. Maternal age was separated into three groups: 15 and less, 16-19, and 20-34 years. Adjusted odds ratios (ORs) were derived through logistic regression models for the potential confounding factors. Results: Adolescents aged 15 years and younger had higher risks of preterm delivery, early preterm delivery, intrauterine fetal death and neonatal death compared with women aged 20 to 34 years after adjustment for confounding factors. In addition, both groups of adolescents had higher risks for anemia and episiotomy and lower risk of cesarean delivery. The rates of preeclampsia, gestational diabetes, chronic diseases, intrauterine growth restriction (IUGR) were higher in the adult group. Adolescent pregnancy is defined as pregnancy in girls aged less than 20 years. It is estimated that 16 million 15-19 yearold women give birth every year, accounting for approximately 11% of all births worldwide (1). In low-and middle-income countries, pregnancy has been reported as the main factor of death in adolescent girls (1). Young maternal age has usually been considered a high risk in relation to adverse pregnancy outcomes (1-16). Possible explanations for adverse pregnancy outcomes have been thought to be their biological immaturity or poor social, economic and behavioral factors such as smoking, alcohol/substance abuse, malnutrition and inadequate prenatal care (17-22). However, the previous studies had conflicting findings regarding whether the effect of young maternal age on adverse pregnancy outcomes were caused by their biological immaturity or poor social, economic and behavioral factors (17)(18)(19)(20)(21)(22). ConclusionThe aim of the present study was to investigate whether there is an association between young maternal age and poor maternal and perinatal outcomes independent of possible confounding factors.

Objective: The aim of this study is to evaluate the impact of advanced maternal age on pregnancy outcomesMethods: A retrospective analysis of 951 birth registry records of Zeynep Kamil Hospital, were analyzed between January 2003 and December 2007. Study group was made up of women ≥40 years old and control group was made up of women younger than 40 years.Results: Mean maternal age was 41.48 years in the study group and 26.41 years in the control group. Mean gestational age at the time of delivery is 37.73 weeks in study group and 38.10 weeks in the control group. There was no statistical difference in terms of preterm delivery, multiple pregnancy, fetal anomaly, IUGR, superimpose preeclampsia oligohidramnios, presentation anomaly and placenta previa rates between the study and control groups. Incidence of preeclampsia (p=0.041), Chronic hypertension (p=0.001), GDM (p= 0.003),is found to be higher in study group. Cesarean birth rate is higher (p<0.05) and hospitalization time is longer in study group (p=0.001). 1 st minute and 5 th minute APGAR scores of the study group (6.99±2, 8.27±2) was lower than the 1 st minute and 5 th Minutes APGAR scores of the control group (7.38±1.6, 8.58±1.7). Neonatal intensive care unit administration rate is seen also higher in study group (p<0.01). Conclusion:Advanced maternal age was related to increased pregnancy complications and poor perinatal outcome. Preeclampsia, GDM, chronic hypertension is seen more common in advanced age pregnancies. Neonatal intensive care administration is higher and APGAR scores are lower; cesarean delivery was performed more common, and hospitalization time was longer in advanced age pregnancies. Bulgular: Ortalama anne yaşı Çalışma grubunda 41,48 kontrol gurubunda 26,41'dir. Doğumda ortalama gebelik haftası çalışma gurubunda 37,73 kontrol grubunda 28,10'dur Çalışma ve kontrol grupları arasında Preterm doğum, çoğul gebelik, fetal anomali, intrauterin gelişme geriliği, süperimpoze preeklampsi, oligohidramniyos, prezentasyon anomalisi ve plasenta previa oranları arasında istatistiksel anlamlı fark saptanmadı. Çalışma grubunda preeklampsi, kronik hipertansiyon, gestasyonel diyabet, insidansı kontrol grubundan istatistiksel olarak anlamlı olarak yüksek saptandı (p=0,041, p=0,001, p=0,003). Sezaryen doğum oranı, hastanede kalış süresi çalışma grubunda anlamlı olarak yüksek bulundu (p<0,05, p=0,001).Çalışma grubunda yenidoğan 1. ve 5. Dakika APGAR skorları kontrol grubundan düşük saptandı (p<0,01). Çalışma grubunda yenidoğan yoğun bakım ünitesine yatış oranı istatistiksel olarak anlamlı derece yüksek saptandı (p<0,01). Sonuç:İleri anne yaşı yüksek gebelik komplikasyonları ve kötü perinatal sonuçlarla ilişkilidir. Preeklampsi, Gestasyonel Diyabet, kronik hipertansiyon ileri anne yaşı gebeliklerinde daha sık görülmektedir. İleri anne yası gebeliklerinde Yenidoğan yoğun bakım yatış oranı daha yüksek, APGAR skorları daha düşük, sezaryen doğum oranı daha yüksek hastanede kalış daha uzundur.Anahtar kelimeler: Perinatal sonuçlar, ileri anne yaş gebelikle...

Introduction:The co-existence of pregnancy and liver disease is considered to be a rare and complex clinical situation. Besides pregnancy has specific complications even in a healthy liver, the previous liver damage associated to portal hypertension develops additional risks as a result of marked hemodynamic disturbances. Case:We report the management of a pregnancy of a 22-year-old patient without additional complications beside NCPH and a history of prophylactic endoscopic ligation of esophageal varices. The pregnancy continued until term and cesarean section was performed successfully. Conclusion:In non-cirrhotic portal hypertension (NCPH) the liver function is usually preserved, and the increased risk of bleeding from esophageal varices in pregnancy is open to debate.