OBJECTIVES: To evaluate clinical features, laboratory test results, maternal and neonatal outcomes of pregnant patients with the Coronavirus disease (COVID-19). BACKGROUND: COVID-19 is a highly contagious disease caused by a severe acute respiratory coronavirus 2 (SARS-CoV-2). Healthy pregnant women are more susceptible to developing COVID-19. METHODS: We reviewed clinical data from pregnant patients with a laboratory-confi rmed SARS-CoV-2, who were admitted to two tertiary care hospitals in Turkey. Demographic, clinical characteristics, laboratory test results, imaging fi ndings, treatment received, maternal and neonatal outcomes were collected. RESULTS: A total of 24 pregnant women were enrolled in this study. The mean maternal and gestational age was 26.9±5.37 years and 24.15 ± 10.61 weeks, respectively. Cough was observed as the most common symptom (n=15; 62.5 %). The lowest lymphocyte percentage was 20.83 ± 13.05 (%). Nine women have delivered by Caesarean section, while one had a vaginal birth. One woman with critical COVID-19 died 2 days later postpartum. The neonate had been transferred to neonatal intensive care unit and died within 24 hours of birth. CONCLUSION: Our fi ndings showed that except for one patient, the clinical course of COVID-19 during pregnancy was mild. Early hospitalization of pregnant women with confi rmed and suspected COVID-19, liberal testing for SARS-CoV-2, active management with a multidisciplinary team seemed to be critical to recovery (Tab. 3, Ref. 31).

Objectives: To investigate association of amniotic fluid index (AFI) with perinatal fetal and maternal outcomes in pregnancies complicated by preterm premature rupture of membranes (PPROM) Material and methods: A total of 70 singleton pregnancies complicated by PPROM at 23-33 weeks' gestation were enrolled in this prospective observational study. Data on maternal clinical and obstetric characteristics [maternal age, gravidity, parity, PPROM time, and AFI (cm), latency period, treatments, type of delivery, length of hospital stay (LOS, day)], fetal characteristics (gestational age at delivery, birth weight (g), gender) and maternal and fetal complications were recorded and compared in AFI < 5 cm (n = 27) and AFI ≥ 5 cm (n = 21) groups. Results: Overall AFI was ≤ 5 cm in 27 (56.3%) patients and > 5 cm in 21 (43.7%) patients. No significant difference was noted in maternal clinical and obstetric characteristics, gestational age at delivery and gender of the newborn as well as in maternal and fetal complications rates with respect to AFI groups. AFI was correlated positively with latency period (r = 0.399, p = 0.018) and negatively with postpartum LOS (r =-0.314, p = 0.030). Conclusions: In conclusion, our findings seems to indicate increased likelihood of shorter latency to delivery and longer postpartum LOS with decrease in AFI after PPROM between 23-33 weeks' gestation, whereas no impact of AFI on mode of delivery and fetal or maternal complications.

Objective: To compare maternal and fetal outcomes of pregnancies complicated and not complicated with hyperemesis gravidarum (HG) necessitating hospitalization. Method: A total of 386 women with singleton deliveries between March 2015 and January 2018 were included in this retrospective single-center study. Of 386 women, 186 women (mean±SD age: 30.7±5.9 years) who were hospitalized with HG within the first 20 weeks of gestation comprised the hyperemetic pregnancy group, while 200 women without HG during pregnancy served as a control group. Results: No significant difference was noted between the HG and control groups in terms of maternal characteristics, gestational age (median 38.6 and 39.0 weeks, respectively), type of delivery (normal spontaneous delivery in 78.0% vs 80.0%), fetal gender (female: 53.2% vs 48.5%), birthweight (median 3250 g vs 3275 g) and 5-min APGAR scores (≥7 in 97.3% vs 97.5%, respectively). Adverse pregnancy outcomes were also similar between groups including preterm birth (8.1% vs 11.0%, respectively), SGA (5.9% vs 9.5%), hypertensive disorder (5.4% vs 7.5%), placental abruption (1.1% vs 0.5%,), stillbirth (0.0% vs 0.5%) and GDM (3.8%vs 2.5%). Weight loss during pregnancy was evident in 91.3% of women in the HG group, while none of women in the control group had weight loss during pregnancy (p<0.001). Conclusions: The findings of this study indicate that HG may not be related with adverse fetal and prenatal outcomes and this conclusion needs to be clarified with large-scale investigations.

Objective To investigate the role of abnormal cerebroplacental ratio (CPR) in predicting adverse fetal outcome in pregnancies with induction of labor. Methods This prospective observational study conducted at Medeniyet University Göztepe Training and Research Hospital between December 1, 2018 and October 31, 2019 enrolled women with scheduled induction of labor at or beyond 37 weeks of pregnancy. Women with singleton non‐anomalous fetuses with cephalic presentation and who had Bishop scores of 5 or less in pelvic examination were included in the study. Exclusion criteria were the presence of uterine scar history, non‐cephalic presentation, multiple pregnancy, vacuum‐ or forceps‐assisted delivery, and shoulder dystocia. Using fetal Doppler ultrasound, CPR was calculated (the ratio of umbilical artery to middle cerebral artery pulsatility index) and categorized into abnormal CPR (<1) and normal CPR (≥1). Data on maternal and delivery characteristics, fetal birth weight, and fetal complications were compared between the groups. Results A total of 145 women were included, 28 in the abnormal CPR group and 117 in the normal CPR group. Multivariate analysis revealed labor induction at a later week of pregnancy (odds ratio [OR] 10.33, P = 0.001), lack of intrauterine growth restriction (IUGR) (OR 13.21, P = 0.001), fetal distress (OR 8.14, P = 0.003) or meconium aspiration (OR 159.91, P = 0.001), and umbilical artery pH values greater than 7.31 (OR 17.51, P = 0.015) to be associated with an increased likelihood of having normal (≥1) CPR values. Receiver operating characteristic analysis revealed association of normal CPR values with later labor induction (cut‐off value of >38.3 weeks, P = 0.001), higher birth weight (cut‐off value of >2460 g, P = 0.022) and higher umbilical artery pH (cut‐off value of >7.31, P = 0.007). Conclusion Our findings revealed the significant role of abnormal CPR in predicting adverse fetal outcome in singleton pregnancies with scheduled induction of labor.

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Objective: The role of amniotic fluid volume, as a potential factor that may affect the estimated fetal weight measurements remains controversial. The objective of our study was to investigate the effect of oligohydramnios on the accuracy of fetal weight estimation in term pregnancies with oligohydramnios. Method: The data of 207 pregnants diagnosed with oligohydramnios and 610 pregnants with a normal amniotic fluid volume in between January 2018 and June 2019 were compared retrospectively.Amniotic fluid volume and estimated fetal weight measurements were performed via ultrasonographic examination in all pregnants up to 48 hours before birth. Hadlock-4 Formula was used as the estimated fetal weight scale. After picking the estimated fetal weights and actual birthweights in two groups, absolute error, absolute error rates, rates of pregnancies with a higher and a lesser fetal weight estimations were compared. Results: The mean estimated fetal weights were 3.110 (550) g in Group 1 (oligohydramnios) and 3420 (665) g in Group 2 (normal amniotic fluid volume). The actual birth weights were 3.130 (620) g and 3.410 (660) g for Group 1 and 2, respectively. Both values in Group 1 were detected as lower significantly, when their estimated and actual fetal birthweights compared with Group 2. The error between estimated fetal weights and actual birthweights was 240 (160) g, error rate was 7.3% (4.5) in Group 1. The error and error rates were 230 (200)g and 6.9% (6.0) in Group 2, respectively. When the error and error rates compared in groups, any significant difference was not detected. Conclusion: There is no any relation between oligohydramnios and estimated fetal birthweight in term pregnancies.There seems a tendency to measure estimated fetal weights higher in oligohydramniotic pregnancies.