Objectives: Current evidence suggests that subclinical inflammation plays a significant role in the development of hyperemesis gravidarum (HEG). Simple hematological markers, such as mean platelet volume (MPV), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR), have been shown to reflect inflammatory burden and disease activity in several disorders. This study aimed to determine the diagnostic value of these hematological parameters for HEG. Material and methods:A total of 54 HEG patients and 58 age-and gestational-age-matched control subjects were studied. NLR, MPV, PLR, platelet distribution width (PDW), and red cell distribution width (RDW) values in all patients were calculated and recorded from complete blood cell counts.Results: For HEG patients, the median NLR was 3.2 (1.6-7.1), and the median PLR was 143.7 (78.1-334.6); for control subjects, the values were 2.1 (1.0-4.7) and 93.1 (47.3-194.7), respectively. Although both the NLR and PLR of HEG patients were found to be significantly higher than in the controls, no significant difference was found between the study groups in terms of MPV, RDW, or PDW. Correlation analysis revealed a significant correlation between NLR and CRP (r = 0.872, p < 0.001). Conclusions:Our results show that peripheral blood NLR and PLR values can reflect inflammatory burden in HEG patients and can be used as markers for HEG.

Objectives The modified myocardial performance index (Mod‐MPI) can be used to assess myocardial function. Fetal growth restriction can affect fetal myocardial function, thereby altering the Mod‐MPI. The results of previous studies on the utility of the Mod‐MPI in growth‐restricted fetuses are conflicting. The aim of this study was to calculate the left modified‐MPI in growth‐restricted fetuses and to compare the results with those of healthy fetuses. Methods This was a prospective cross‐sectional case–control study. In total, 40 women with growth‐restricted fetuses and 40 women with fetuses of normal weight (controls) at 29–39 gestational weeks were enrolled in the study. An experienced obstetrician calculated the Mod‐MPI for each fetus. Women with systemic diseases or fetuses with chromosomal/structural abnormalities were excluded from the study. The results of Mod‐MPI measurements of the two groups were compared. Results The mean single deepest vertical pocket (SDVP) of amniotic fluid, estimated fetal weight (EFW), and isovolumetric relaxation time (IRT) was significantly lower in the fetal growth restriction (FGR) group as compared with these parameters in the control group (P < .05). The uterine artery (UtA) pulsatility index (PI) was significantly higher in the FGR group as compared with that in the control group (P < .05). There were six cases of absent end‐diastolic flow (AED) in the FGR group. There were no statistically significant between‐group differences in the Mod‐MPI, isovolumetric contraction time (ICT), and ejection time (ET) (P > .05). There was also no statistically significant correlation between the Mod‐MPI in the fetuses with AED and the control group for Mod‐MPI (P > .05). Conclusion The utility of the Mod‐MPI in FGR remains unclear. Future studies with larger populations are needed to determine the utility of the Mod‐MPI as a predictor of cardiac compromise in FGR.

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It is not reasonable to discontinue oxytocin infusion at the beginning of active labor. Nevertheless, for an accurate conclusion expanded investigations are needed.

Objectives We aimed to evaluate the cardiotocograph (CTG) traces of 224 women infected with novel coronavirus 2019 (COVID-19) and analyze whether changes in the CTG traces are related to the severity of COVID-19. Methods We designed a prospective cohort study. Two-hundred and twenty-four women who had a single pregnancy of 32 weeks or more, and tested positive for SARS-CoV-2 were included. Clinical diagnosis and classifications were made according to the Chinese management guideline for COVID-19 (version 6.0). Patients were classified into categories as mild, moderate, severe and the CTG traces were observed comparing the hospital admission with the third day of positivity. Results There was no statistically significant relationship between COVID-19 severity and CTG category, variability, tachycardia, bradycardia, acceleration, deceleration, and uterine contractility, Apgar 1st and 5th min. Conclusions Maternal COVID-19 infection can cause changes that can be observed in CTG. Regardless of the severity of the disease, COVID-19 infection is associated with changes in CTG. The increase in the baseline is the most obvious change.

Background. This study aimed to assess fetal cardiac left ventricular function in healthy pregnant women by calculating the modified myocardial performance index (Mod-MPI) and to construct reference ranges for the Turkish population.Methods. One-hundred-two randomly selected healthy singleton pregnant women ranging between 25 and 39 gestational weeks were included in the study. Left fetal Mod-MPI was measured for each pregnant woman. Women with chronic systemic diseases or fetuses with chromosomal or structural abnormalities were excluded from the study. Mitral valve (MV) and aortic valve (AoV) clicks were used as landmarks to define the following time periods that were used to calculate the Mod-MPI: isovolumetric contraction time (ICT), isovolumetric relaxation time (IRT), and ejection time (ET).Results. The mean Mod-MPI was 0.42±0.10. The mean IRT, ICT, and ET were 43.5±10.2, 27.27±8.1, and 170.5±16.9, respectively. A significant correlation was found between Mod-MPI and gestational age, umbilical artery systolic/diastolic (UA S/D) ratio and the middle cerebral artery pulsatility index (MCA PI) values (r=0.199, p=0.047, p=0.001, p=0.001, respectively) Conclusions. The current study's results will be a reference for future studies, especially studies investigating pathological conditions that impact fetal cardiac function.

Since the biochemical and molecular mechanisms responsible for ongoing oxidative stress in hyperemesis gravidarum (HEG) patients have not yet been fully elucidated, the aim of this study was to evaluate the possible role of nitric oxide (NO), malondialdehyde (MDA) and other oxidative stress markers in the disease pathophysiology. Moreover, the relation between oxidative stress markers and Helicobacter pylori (H. pylori) infection was also investigated. Women with pregnancies complicated by HEG (n = 33) were compared with pregnant women without HEG (n = 30) and with healthy non-pregnant women (n = 31). Serum NO, MDA, total oxidant status (TOS), total antioxidant status (TAS), oxidative stress index (OSI) and H. pylori infection status were determined for each subject. Serum NO levels and OSI index were found to be increased (p = .001 and .013, respectively) and TAS levels were decreased (p < .001) in HEG patients compared with both controls regardless of H. pylori infection status. Serum MDA and TOS levels were not different between the study groups. Helicobacter pylori infection rates were similar in each group. The reduced antioxidant activities, as well as the increased OSI and NO levels in HEG patients indicate possible oxidative stress conditions in HEG patients. Moreover, serum NO levels may be used as an adjunctive marker to distinguish HEG patients from other causes of emesis during pregnancy. Impact statement What is already known on this subject? Current evidence suggests that oxidative stress is a significant factor responsible for a number of complications during pregnancy. What do the results of this study add? Hyperemesis gravidarum is an oxidative stress condition, as reflected by increased nitric oxide (NO) and decreased total antioxidant status activity, regardless of H. Pylori infection. What are the implications for clinical practice and/or further research? Full disclosure of the association between circulating NO and hyperemesis gravidarum would shed light on underlying biological mechanisms and could help clinical management of similar pregnancy-associated morbidity states.

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