ObjectiveTo examine the inferior vena cava (IVC) diameter, aortic diameter, and caval aortic index in fetuses with growth restriction and to compare the findings with fetuses from uncomplicated pregnancies at similar gestational weeks.MethodsThis prospective study was conducted with a total of 176 pregnant women. According to the diagnostic criteria, 84 pregnancies diagnosed with fetal growth restriction (FGR) were compared with a control group of 92 uncomplicated pregnancies at similar gestational weeks.ResultsThe aortic and IVC diameter values were significantly lower in the FGR group (P < 0.001), whereas the caval aortic index was similar between the two groups. The examination of the ultrasound parameters of the cases with FGR according to the neonatal intensive care requirement revealed similar aortic diameter and caval aortic index values but a significantly smaller IVC diameter in the cases requiring neonatal intensive care (P = 0.022).ConclusionWe determined that the aortic and IVC diameter values were smaller in the fetuses with growth restriction, but the caval aortic index was similar in the two groups. The measurement of the IVC diameter in FGR may be useful in predicting the neonatal intensive care requirements of these fetuses.
ObjectiveTo compare H‐Hayman, a modified uterine compression suturing technique (UCS) that we describe for the first time in the literature, with conventional vertical UCS techniques.MethodsThe H‐Hayman technique was used in 14 women and the conventional UCS technique in 21 women. In order to provide standardization in the study, only patients who had developed upper‐segment atony during cesarean section were recruited for the study.ResultsBleeding control was achieved in 85.7% (12/14) of the cases using the H‐Hayman technique. In the remaining two patients with persistent hemorrhage in this group, bleeding control was provided with bilateral uterine artery ligation, and a hysterectomy was avoided in all cases. With the conventional technique, bleeding control was achieved in 76.1% (16/21) of the patients, and the overall success rate was 95.2% after bilateral uterine artery ligation in those with persistent hemorrhage. In addition, the estimated blood loss and the need for erythrocyte suspension transfusion were significantly lower in the H‐Hayman group (P = 0.01 and P = 0.04, respectively).ConclusionWe found the H‐Hayman technique to be at least as successful as conventional UCS. In addition, patients who underwent suturing with the H‐Hayman technique had less blood loss and a lower requirement for erythrocyte suspension transfusion.
This study aims to investigate the perinatal outcomes in COVID-19 pregnant women with intrahepatic cholestasis of pregnancy (ICP) and elevated liver enzymes. Present study was carried out on pregnant women with COVID-19 between March 11, 2020, and August 11, 2021. Patients with liver enzyme levels higher than twice the upper limit of the reference range for aspartate aminotransferase(AST) and/or alanine aminotransferase (ALT) were included. Patients with unexplained pruritus and elevated fasting biliary acid (FBA) levels were considered ICP. The remaining cases were used as the control group. There were a total of 1751 patients in the study period. Among them, 126 had elevated liver enzymes. Nineteen of these cases had also ICP. AST and ALT values were statistically higher in the ICP group. Demographic features, clinical characteristics, and perinatal outcomes were similar between the groups. The rate of ICP in pregnant women with COVID-19 was similar to the literature in this study. Although the preterm delivery rates for both groups were higher than in the current literature, the preterm delivery rates in the study and control groups were similar. Elevated liver enzymes can be observed in pregnant women with COVID-19 with higher rates of preterm delivery compared to the previous literature. However, the diagnosis of ICP in addition to elevated liver enzymes seems to have no significant impact on the perinatal outcomes. Future studies conducted on larger populations are necessary to confirm these results.
Purpose This study aimed to investigate fetal cardiac output and
myocardial performance index in pregnant women with idiopathic polyhydramnios
and compare them to healthy pregnant women.
Methods Thirty patients admitted to Ankara City Hospital at 24–39
weeks of gestation with idiopathic polyhydramnios were included as the study
group. Clinical characteristics, fetal cardiac output, and fetal modified
myocardial performance index (Mod-MPI) were compared between the groups.
Results The combined cardiac output (CCO), left cardiac output (LCO),
right cardiac output (RCO), pulmonary artery velocity time integral (PA-VTI),
and aortic VTI were statistically significantly higher in the study group
(p=0.003, p=0.028, p=0.002, p=0.000, and
p=0.017, respectively).The idiopathic polyhydramnios group had a
significantly higher Mod-MPI and isovolumetric contraction time (ICT) and a
significantly lower ejection time (ET) compared to the controls (p=000,
p=0.003, and p=0.023, respectively). In the idiopathic
polyhydramnios group, the aortic max (p=0.009) and aortic VTI
(p=0.047) values were significantly lower and the left ventricular
outflow tract isovolumetric relaxation time (LVOT-IRT) (p=0.021) was
significantly higher in cases where the NICU was required. According to the ROC
analysis performed in the idiopathic polyhydramnios group, the optimal cut-off
values of aortic max, aortic VTI, and LVOT-IRT in the prediction of the NICU
requirement were (57.5, 0.089 and 41.5, respective cut-off value)
(p=0.010, p=0.048, p=0.021, respectively).
Conclusions Both fetal cardiac output and Mod-MPI values were altered in
fetuses with idiopathic polyhydramnios.
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