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Introduction. Asymptomatic bacteriuria (ASB), occurring in 2–11% of pregnancies, is a major predisposition to the development of pyelonephritis, which is associated with obstetrical complications, such as preterm labor and low birth weight infants. The aim of this study was to determine the prevalence of ASB, the antibacterial susceptibilities of the isolated microorganisms and the associated risk factors in an outpatient clinical setting in Zekai Tahir Burak Women's Health Education and Research Hospital in Ankara, Turkey. Material and Methods. Between December 2009 and May 2010, pregnant women admitted to the antenatal outpatient clinic were included in this study. The results of a complete urine analysis, midstream urine culture and antibacterial susceptibility were evaluated. Results. Of the 2011 pregnant women included, 171 had ASB (8.5%). E. coli was the most frequently isolated microorganism (76.6%), followed by Klebsiella pneumonia (14.6%). Both microorganisms were highly sensitive to fosfomycin, sensivity being 99.2% for E. coli and 88% for Klebsiella pneumonia. Conclusions. In this certain geographical region, we found E. coli as the most common causative agent of ASB in the obstetric population and it is very sensitive to fosfomycin. We recommend fosfomycin for ASB in pregnant women due to its high sensitivity, ease of administration and safety for use in pregnancy.

BackgroundThe present study aimed to investigate risk factors for expulsion in immediate postplacental IUD insertion. We specifically sought to determine whether cesarean delivery before or during labor have an impact on IUD expulsion.MethodsThe study included 160 pregnant women for immediate IUD insertion following vaginal or cesarean delivery. Three groups of patients were recruited: Patients who underwent pre-planned cesarean delivery (group 1, n: 51), patients who underwent cesarean delivery during active labor (group 2, n: 47), patients who delivered vaginally (group 3, n: 62).ResultsThe cumulative expulsion rates were similar with a frequency of 8.7, 8.9 and 11.3 % respectively in groups 1 to 3 (p > 0.05 in all pairwise comparisons). The rate of patients who had the IUD removed at 12th month was 4,3, 6.7 and 11.3 % for groups 1, 2 and 3 respectively (p > 0.05 in all pairwise comparisons). Multiparity increased the risk of cumulative expulsion within 12 months by 2.1 fold (95 % 1,03–4,37) in the logistic regression model. Previous vaginal deliveries or IUD use did not have an impact on the expulsion of the IUD. The risk of spontaneous expulsion was similar in patients whose IUD was placed after cesarean in the active and latent phase or after spontaneous vaginal delivery.ConclusionsThe rates of IUD expulsion are similar in patients who underwent cesarean section before and during labor and who delivered vaginally. Parity was the only factor independently associated with IUD expulsion.

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Objective. We performed a prospective observational audit study to compare neonatal and maternal outcomes of the primary cesarean sections performed in first stage versus second stage of labour. Methods. One thousand three hundred and eighty-nine nullipara women who had undergone cesarean section in a tertiary teaching hospital between February 1, 2009 and January 31, 2010 were included in the study. Primary maternal outcomes of interest were uterine atonia, transfusion requirement, urinary system injury, requirement for hysterectomy, and duration of hospital stay. Results. A total of 1389 women underwent cesarean section at this 12 month time period. Of these 1389 cesarean sections, 1271 were in the first stage of the labour and 171 were in the second stage of the labour. Urinary injuries, transfusion requirement, and uterine atonia hysterectomy were significantly more frequent in women who underwent cesarean section in the second stage of the labour compared to women undergoing cesarean section in the first stage of the labour. Conclusion. Cesarean section in the second stage of the labour is associated with increased maternal and neonatal morbidities. Special attention is required to the patients undergoing cesarean section in the second stage of the labour.

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.

Improving data surveillance and implementing national guidelines for the prevention and management of major complications of pregnancy, childbirth, and puerperium is necessary to reduce MMR. The healthcare authorities of Turkey should continue to set a sustainable development goal of ≤70 maternal deaths per 100,000 live births by 2030. We believe our results may provide useful information for other developing countries that are aiming to reduce maternal mortality, as well as mobilize global efforts to improve women's health.