BackgroundPregnancy at advanced maternal age has become more common in both developed and developing countries over the last decades. The association between adverse perinatal outcomes and advanced maternal age has been a matter of controversy in several studies. The objective of this study is to investigate the impact of advanced maternal age on perinatal and neonatal outcomes of nulliparous singleton pregnancies.MethodsRecords of patients admitted to the Department of Obstetrics and Gynecology, University of Cukurova School of Medicine, between January 2011 and July 2015 for routine mid-trimester fetal ultrasonography were retrospectively reviewed. The control (age: 18–34 years), advanced maternal age (35–39 years), and very advanced maternal age (> 40 years) groups included 471, 399, and 87 women, respectively.ResultsGestational diabetes, gestational hypertension, and cesarean delivery rates were more common in the very advanced maternal age group, with compared with the advanced maternal age and the younger age group. There were no significant differences in regarding rates of spontaneous preterm delivery before 34 weeks of gestation, prolonged rupture of membranes, large for gestational age infants, and operative vaginal delivery rates between the groups. Also, there were no significant differences regarding in APGAR scores, the rate of low birth weight infants, and neonatal morbidity rates between the groups. However, admission to the neonatal intensive care unit requirement was more common in the two advanced maternal age groups compared with the control group.ConclusionAdvanced maternal age is a risk factor for gestational diabetes mellitus, gestational hypertension, preeclampsia, small for gestational age infants, spontaneous late preterm delivery, and cesarean section, with significant potential clinical implications.
The results confirmed the opinion that EOP is a distinct and more severe clinical entity than LOP. In particular, higher proteinuria is associated with EOP.
High-resolution melting is a useful method for NIPD of β-thalassemias by detecting paternal mutations in the maternal plasma. Cell-free fetal DNA quantification and MoM values were not informative for HbS or β-thalassemias in early pregnancy.
Problem
The aim of this study was to evaluate serum procalcitonin (PCT), C‐reactive protein (CRP), and plasma D‐Dimer levels in mild and severe pre‐eclampsia.
Method of study
Serum PCT, CRP, and D‐Dimer levels were analyzed in 64 cases with pre‐eclampsia as the study group and 33 healthy pregnant women in the third trimester as the control group. Pre‐eclamptic group consisted of mild (n = 31) and severe pre‐eclamptic subgroup (n = 33). Laboratory results were compared between the groups and diagnostic usefulness of these parameters were evaluated.
Results
PCT, CRP, and D‐Dimer levels were significantly higher in study group than the control group (P = 0.001). PCT, CRP, and D‐Dimer were significantly higher in the patients with severe pre‐eclampsia than mild pre‐eclampsia. There were significant positive correlations between these markers and mean arterial pressure (MAP). Logistic regression analysis using the control and pre‐eclampsia group showed that higher PCT (OR, 15.68; 95%‐CI, 3.15–78.10), CRP (OR, 14.29; 95%‐CI, 3.08–66.34), and D‐Dimer levels (OR, 4.97; 95%‐CI, 1.22–20.29) were found to be risk factors significantly associated with pre‐eclampsia.
Conclusions
This study results confirm that evidence of a possible exaggerated systemic inflammatory response in pre‐eclampsia especially in severe pre‐eclampsia.
Misoprostol inserted vaginally was effective for midtrimester TOP but the safety of using misoprostol in women with 2 or more prior CDs cannot be confirmed from the present study. Misoprostol should be used carefully, particularly in women with 2 or more prior CDs.
Objective:Fetal structural malformations affect approximately 2-3% of all pregnancies. Only focusing on trisomy screening in first trimester and deferring the anatomic screening to second trimester may result with late detection of major anomalies that can be diagnosed earlier with careful examination.Material and Methods:This was a descriptive study of retrospective data that were obtained from all terminated single pregnancies due to ultrasonographic findings of major anomalies from 2011 to 2016 in our department. The study was based on a chart review and only abnormalities that were diagnosed before the 16th week were included.Results:Two hundred forty-four first trimester pregnancy terminations were performed. In total, 273 anomalies were detected in the 244 patients. Cranial NTD comprised 32% of all anomalies (n=89). Fifteen percent of anomalies (n=41) needed detailed anatomic scanning for early diagnosis.Conclusion:In this study, we presented the number and percentage of our early diagnosed anomalies by years, as well showed our diagnostic performance for specific anomalies such as atrioventricular septal defect during a 5-year period. The study provides valuable information for future studies in Turkey and shows the need for an anatomic scan protocol while performing aneuploidy screening during early gestation.
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