Maternal near-miss patients and maternal mortality cases in a Turkish tertiary referral hospital

Oğlak, Süleyman Cemil; Tunç, Şeyhmus; Obut, Mehmet; Şeker, Erdal; Behram, Mustafa; Tahaoğlu, Ali Emre

doi:10.5603/gp.a2020.0187

Cited by 17 publications

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“…There are some limitations to this study. This study has been designed retrospectively and has the potential to contain limitations of such studies [37]. Because of the dependence on information reported in the patient record, we could not identify risk factors for all pregnant patients with COVID-19.…”

Section: Discussionmentioning

confidence: 99%

Abnormal liver function tests in pregnant patients with COVID-19 — a retrospective cohort study in a tertiary center

2022

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Objectives:The current study aimed to describe the incidence of abnormal liver function tests (LFTs) in pregnant COV-ID-19 patients, explore the association between LFTs with current medication, and provide a reference for medical therapy of pregnant patients with COVID-19. Material and methods:This retrospective single tertiary center cohort study included 122 pregnant patients with confirmed COVID-19 admitted and treated from April 1, 2020, to May 31, 2020. We defined abnormal LFTs as the elevation of the following liver enzymes in serum per our hospital's laboratory reference range standards: AST > 35 U/L, ALT > 35 U/L, and TBIL > 1.2 mg/dL. We evaluated patients for demographic and clinical features, laboratory parameters, medications, and hospital length of stay (LOS).Results: Patients in this cohort had clinical presentations of fever (84.4%), dry cough (78.6%), and shortness of breathing (6.5%). In total, 17 (13.9%) patients had abnormal LFTs during hospitalization. Critically ill patients were three-fold higher in the abnormal LFTs group (11.8%) than in the normal LFTs group (3.8%, p = 0.16). The proportion of patients who used hydroxychloroquine and lopinavir/ritonavir were significantly higher in patients with abnormal LFTs (88.2% and 35.3%, respectively) than those with normal LFTs (62.9% and 15.2%, p = 0.04 and p = 0.04, respectively). The hospital length of stay (LOS) was significantly longer in the abnormal LFTs group (8.2 ± 5.8 days) than in the normal LFT group (6.0 ± 2.8 days, p = 0.02).Conclusions: SARS-CoV-2 may induce liver injury and the LFT abnormality was generally mild in pregnant patients with COVID-19. Abnormal LFTs are associated with prolonged hospital LOS. Drug use was the most crucial risk factor for liver injury during hospitalization. The use of lopinavir/ritonavir and hydroxychloroquine were significantly higher, and the course of treatment of these drugs was significantly longer in pregnant women with abnormal LFTs than the patients with normal LFTs. Therefore, pregnant women with COVID-19 who received antiviral treatment should be closely monitored for evaluating LFTs.

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Section: Discussionmentioning

confidence: 99%

Abnormal liver function tests in pregnant patients with COVID-19 — a retrospective cohort study in a tertiary center

2022

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“…Severe antepartum and postpartum hemorrhage in PP is associated with increased risk of maternal morbidity, ICU requirement, blood or blood product transfusion, and the necessity for additional drugs and procedures to staunch bleeding, including uterine compression sutures, balloon tamponade, and hysterectomy [22,[25][26][27][28]. Durukan et al [18], found that the total amount of transfused blood and blood products, intraoperative interventions, and ICU requirement were significantly higher, preoperative and predischarge hemoglobin levels were significantly lower in the ECD group than those of the PCD group.…”

Section: Discusionmentioning

confidence: 99%

The comparison of maternal and neonatal outcomes between planned and emergency cesarean deliveries in placenta previa patients without placenta accreata spectrum

2022

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Objectives: This study aims to investigate whether a significant difference exists in maternal and fetal outcomes between planned cesarean delivery (PCD) compared to emergency cesarean delivery (ECD) in placenta previa (PP) patients without placenta accreata spectrum (PAS) in a tertiary referral hospital. Material and methods:This retrospective cohort study included 237 singleton pregnant women who were diagnosed with PP without PAS at the time of delivery. PP patients who were delivered at the scheduled time were included in the PCD group. Patients with PP delivered in an emergency setting before the scheduled date were assigned to the ECD group. We recorded demographic and clinical characteristics, maternal and neonatal outcomes. Results:Of the 237 patients who met the inclusion criteria, 157 patients (66.8%) underwent PCD, and 80 patients required ECD (33.2%). Patients' hospitalization and pre-discharge hemoglobin levels were significantly lower in the ECD group (11.25 ± 1.97 g/dL and 9.74 ± 2.09 g/dL, respectively) than in the PCD group (10.77 ± 2.67 g/dL and 9.27 ± 2.70, p = 0.002 and p = 0.004, respectively). While six patients (7.5%) were required intensive care unit (ICU) admission in the ECD group, no patient was required to follow up in ICU in the PCD group (p < 0.001). The hospital length of stay (LOS) was tended to be significantly longer in the ECD group (2.8 ± 0.7 days) than in the PCD group (2.4 ± 0.6 days, p < 0.001). Neonatal outcomes of birth weight, Apgar scores, NICU admission, and neonatal death were significantly better in the PCD group than in the ECD group. Conclusions:The PCD group has better maternal outcomes, including preoperative and discharge hemoglobin levels, ICU admission and hospital LOS, and better neonatal outcomes than the ECD group. Clinicians should pay regard to that scheduling the delivery to advanced pregnancy weeks has a failure possibility, and patients could not reach the scheduled day due to the emergency states.

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“…1,2 Preeclampsia is a systemic disorder that may cause multiple maternal organ dysfunctions, including renal, hepatic, pulmonary, neurologic, and hematologic complications. 3,4 Also, preeclampsia may result in fetal complications, including oligohydramnios, growth restriction, preterm birth, placental abruption, and perinatal death. 5,6 Preeclampsia is considered a 2-stage disorder; defective trophoblast invasion and spiral artery remodeling fail-ure are postulated as the primary step responsible for preeclampsia pathogenesis.…”

Section: Introductionmentioning

confidence: 99%

First Trimester Mean Platelet Volume, Neutrophil to Lymphocyte Ratio, and Platelet to Lymphocyte Ratio Values Are Useful Markers for Predicting Preeclampsia

Oğlak

Tunç

Ölmez

2021

TOJ

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Background: Preeclampsia complicates 2% to 8% of all pregnancies. Systemic inflammatory response (SIR) markers are widely used in the diagnosis of many inflammatory diseases and in the prediction of complicated pregnancies. This study examined the diagnostic value of SIR markers during the first trimester of pregnancy to predict preeclampsia development. Methods: This retrospective case-control study was conducted from January 2020 to May 2020. We included 94 patients diagnosed with mild preeclampsia, 107 patients diagnosed with severe preeclampsia, and 100 normotensive pregnant patients as controls. We obtained the first trimester (6 to 14 weeks) complete blood cell counts for all patients. We used a receiver operating characteristic curve to evaluate the cutoff, sensitivity, and specificity values. Results: First trimester mean platelet volume (MPV), neutrophil to lymphocyte ratio (NLR), and platelet to lymphocyte ratio (PLR) values were significantly higher in patients who developed preeclampsia in later pregnancy weeks. The optimal cutoff value for MPV was 10.65 fL, with a sensitivity of 63.7% and a specificity of 65.0%. The best predictor for preeclampsia was NLR at an optimal cutoff value of 4.12, with a sensitivity of 82.1% and specificity of 62.0%. At a cutoff value of 131.8, PLR predicted preeclampsia with a sensitivity rate of 65.0% and a specificity rate of 60.2%. Conclusion:The results of this study suggest that first trimester MPV, NLR, and PLR values are clinically useful markers in the prediction of preeclampsia. The increased first trimester values of MPV, NLR, and PLR also indicate that inflammation may play a crucial role in preeclampsia pathogenesis.

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Maternal near-miss patients and maternal mortality cases in a Turkish tertiary referral hospital

Cited by 17 publications

References 0 publications

Abnormal liver function tests in pregnant patients with COVID-19 — a retrospective cohort study in a tertiary center

Abnormal liver function tests in pregnant patients with COVID-19 — a retrospective cohort study in a tertiary center

The comparison of maternal and neonatal outcomes between planned and emergency cesarean deliveries in placenta previa patients without placenta accreata spectrum

First Trimester Mean Platelet Volume, Neutrophil to Lymphocyte Ratio, and Platelet to Lymphocyte Ratio Values Are Useful Markers for Predicting Preeclampsia

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