ObjectivesWith clinical experience from previous coronavirus infections, public health measures and fear of infection may have negative psychological effects on pregnant women. This study aimed to compare the level of anxiety and depression in the same pregnant women before and during the COVID-19 pandemic.MethodsThe pregnant women continuing pregnancy who participated in the first study which was undertaken to clarify the factors associated with mental health of pregnant women before the COVID-19 pandemic, were included for the current study during the outbreak. Anxiety and depression symptoms of the same pregnant women were evaluated by using the Inventory of Depression and Anxiety Symptoms II and Beck Anxiety Inventory twice before and during the pandemic.ResultsA total of 63 pregnant women completed questionnaires. The mean age of the women and the mean gestational age was 30.35±5.27 years and 32.5±7 weeks, respectively. The mean total IDAS II score was found to increase from 184.78±49.67 (min: 109, max: 308) to 202.57±52.90 (min: 104, max: 329) before and during the SARS-CoV-2 pandemic. According to the BAI scores the number of patients without anxiety (from 10 to 6) and with mild anxiety (from 31 to 24) decreased and patients with moderate (from 20 to 25) and severe anxiety (from 2 to 8) increased after SARS-CoV-2 infection. Multivariate linear regression analysis revealed that obesity and relationship with her husband are the best predictors of IDAS II scores.ConclusionsThis study indicated that COVID-19 outbreak affects the mental health of pregnant women negatively which leads to adverse birth outcomes. The level of anxiety and depression symptoms of pregnant women during the COVID-19 infection significantly increased. Healthcare professionals should establish comprehensive treatment plans for pregnant women who are highly vulnerable population to prevent mental trauma during the infectious disease outbreaks.

In this observational study, we investigated the maternal and perinatal complications of caesarean delivery performed in the second stage compared with the first stage of labour at a tertiary hospital in İstanbul. This study was performed from June 2008 to July 2011. Primary maternal outcomes measured included intraoperative surgical complications, surgery duration, need for blood transfusion, endometritis, requirement for hysterectomy, unintended extension and length of hospital stay. Neonatal outcomes included a 5 min Apgar score ≤ 3, admission to a neonatal intensive care unit, fetal injury, septicaemia and neonatal death. In total, 3,817 caesarean deliveries were available for analysis; 3,519 were performed in the first stage, and 298 in the second stage. Caesarean deliveries performed in the second stage were associated with increased intraoperative complications, unintended extensions, need for blood transfusion, higher rates of endometritis and requirement for hysterectomy and were, therefore, associated with longer operation time and hospital stay. Neonatal complications included a significantly low Apgar score at 5 min, increased neonatal death, admission to the neonatal intensive care unit, septicaemia and fetal injury (all p < 0.05). Caesarean deliveries performed in the second stage of labour were associated with higher rates of maternal and neonatal complications, particularly in women who had undergone previous caesarean delivery.

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We found increased rates of obstetric and perinatal complications in subsequent pregnancies in women with histories of stillbirth. Thus, the results of this study suggest that pregnant women with histories of stillbirth should be followed closely, beginning in the early gestational period.

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).

OBJECTIVE: Diabetes in pregnancy is associated with several adverse outcomes for both mother and baby. Awareness is the first step toward identifying pregnant women with diabetes. The purpose of this study was to assess Turkish pregnant women’s opinion and practice about 50-g glucose challenge test (GCT) and to assess the reasons why some of them refuse the test. METHODS: This study was conducted on 312 patients at any age and gestational week in Istanbul, Turkey, by a personal interview using self-created questionnaire. Women were asked about their opinion and practice about 50-g GCT. RESULTS: Among women who were ≤28 weeks of gestation, 42.5% (n=82/193) exhibited their desire to have a GCT in their ongoing pregnancy, 40.9% (n=79/193) pointed out their reluctance, and 16.6% (n=32/193) indicated that they had no opinion about the subject. Women who were ≤28 weeks of gestation and did not want to have GCT, were asked to explain the reasons of their reluctance. The most frequently indicated reason was the belief that GCT is harmful for their babies and themselves (n=62/79, 78.5%). Of the women who were >28 weeks of gestation, 37.8% (n=45/119) had GCT in the ongoing pregnancy, while 62.2% (n=74/119) did not have GCT. The most frequently indicated reason why women did not have a GCT was the belief that GCT is harmful for themselves and the baby (n=37/74, 50%). CONCLUSION: This study exposes an important problem - misinformation about 50-g GCT - that carries a dangerous potential for missing the diagnosis of gestational diabetes. Study findings put forth the need for raising awareness among pregnant women and training health-care professionals about the subject.

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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.