Objective We aimed to investigate the value of maternal serum delta neutrophil index (DNI) levels in predicting placenta accreta spectrum in patients with placenta previa. Methods The patients who were found to have placenta previa totalis were included in our study. Location of placental implantation and depth of myometrial invasion were defined by transabdominal and transvaginal 2D gray scale and Doppler sonography and confirmed during cesarean section and histopathological evaluation. Patients were subjected to complete blood counts, including prenatal hemoglobin level, total white blood cell count, differential leukocyte count, and platelet count. The following formula was used to calculate the DNI level: DNI (%)=(leukocyte subfraction analyzed by cytochemical reaction in the MPO channel) - (leukocyte subfraction analyzed using the nuclear lobularity channel with reflected light beam measurements). Results Placenta previa was detected in 295 patients; 31 of them had PAS. As the control group, 189 patients were evaluated. In the group with PAS, the DNI value was significantly higher (p<0.05) than the other groups. DNI value in the group with previa only was also significantly higher (p<0.05) than the control group. In the univariate model, a significant (p<0.05) effect of DNI value and number of cesarean sections was observed in separating patients with previa only and PAS. In the multivariate model, a significant independent (p>0.05) effect of the DNI value was observed in separating patients with previa only and PAS. Significant efficiency of DNI value [area under the curve 0.899 (0.814–0.984)] was observed in differentiating patients with previa only and PAS. Significant efficacy of DNI 5 cut-off value [area under the curve 0.858 (0.770–0.946)] was observed in distinguishing patients with previa only and PAS (sensitivity 80.0%, positive predictive value 64.9%, specificity 91.6%, negative predictive value 95.9%) Conclusion Maternal DNI values seem to be beneficial with respect to both previa and invasion prediction. Although more comprehensive studies are needed to test this proposition, prediction studies of this practical test should be done in different trimesters and its usability with respect to preventing maternal-fetal morbidity should be investigated.

Objective: This study aims to compare the maternal serum delta neutrophil index (DNI) levels in intrahepatic cholestasis of pregnancy (ICP) and healthy pregnancies. Methods: This study consisted of a group of patients (n = 40) diagnosed with isolated ICP who gave birth in our hospital and a control group (n = 60) between December 1, 2015, and June 30, 2018. The diagnosis of ICP was made based on pruritus and elevated fasting serum bile acids and liver enzymes. Laboratory tests of both groups in the hospitalization process were retrospectively examined. Maternal and neonatal characteristics, pregnancy outcomes, and DNI values of the two groups were compared. Statistical analyses were performed using SPSS version 20. Results: Mean maternal serum DNI levels were significantly higher in women with ICP than in the control group (0.49 AE 4.8 vs -3.99 AE 3.02, p = <0.01). Receiver operating characteristic (ROC) curve analysis was used to define the DNI value where ICP can be best predicted. Conclusion: DNI, a new inflammatory marker, was found to be higher in women with ICP than in normal pregnancies.

With appropriate decision and timely intervention, labor induction decreases the risk of fetal and maternal morbidity and mortality with a minimal increase in risk of cesarean section. 1 Cervical ripening should be present before labor induction, which can generally be divided into two categories: pharmacological and mechanical. 2,3 The single balloon catheter (i.e. Foley catheter [FC]) and Cook cervical ripening balloon have been the most commonly used mechanical methods. 4 The FC applies pressure on the lower uterine segment and cervix in the direction from the uterus to the vagina. 5 The Cook cervical ripening balloon is composed of a cervicovaginal balloon and a uterine balloon. Its mechanism is similar to that of the Foley balloon, but it can apply pressure in two directions simultaneously, on both

Omega-3 supplementation increased implantation markers Laminin and LIF and decreased epithelial height and microvilli thus seems to prepare the endometrium for a favorable environment of implantation.

Proboscis lateralis is a very rare congenital craniofacial malformation characterized by a finger‐like tubular appendage arising usually from the medial canthal region. It is mostly unilateral and associated with other craniofacial malformations. Occasionally, proboscis lateralis is seen with holoprosencephaly. A rare case of bilateral proboscis lateralis which was diagnosed prenatally by ultrasound and magnetic resonance imaging has been presented. In this case of bilateral proboscis lateralis, both lesions arose from a very lateral location and were associated with various central nervous system anomalies other than holoprosencephaly.