Correction: Avsar Aydin, E. 3D-Printed Graphene-Based Bow-Tie Microstrip Antenna Design and Analysis for Ultra-Wideband Applications. Polymers 2021, 13, 3724.

In the original publication [...].

Trauma in pregnancy: An analysis of the adverse perinatal outcomes and the injury severity score.

BACKGROUND: Trauma during pregnancy is one of the most important causes of non-obstetric maternal and fetal mortality and morbidity. The aim of our study is to evaluate the adverse perinatal outcomes that may occur according to the type and severity of the trauma. METHODS: In this retrospective cohort study, pregnant traumatized women aged 18-50 years and referred for consultation to the Prof. Dr. Cemil Tascioglu City Hospital's emergency services of the departments of gynecology and obstetrics, between January 1, 2017, and December 31, 2022, were evaluated. Demographic characteristics, trauma findings, Injury Severity Scoring (ISS), and obstet-ric outcomes were recorded. RESULTS: A total of 1825 trauma patients, including 900 pregnants were referred to our emergency gynecology clinic for consulta-tion. One hundred and fifty three pregnant patients, whose birth information we reached, were selected as the study group. The mean age of the patients was 25.56±5.99 years and the mean gestational week at the time of trauma was 21.59±9.89 weeks, the patients had fallen (67.97%), had been exposed to violence (30.07%), and had a traffic accient (1.96%). The patient's delivery and hospitalization status on the day of trauma, fracture and ISS ≥9 were statistically significantly at a higher rate in the 3rd trimester. Rates of hospitaliza-tion and 3rd trimester traumas were found to be significantly higher in the ISS ≥9 group. (P=0.0001, P=0.028, respectively). CONCLUSION: Compared to the general population, the rates of preterm premature rupture of membranes-premature rupture of membranes, fetal death, fetal distress, cesarean delivery, placental abruption, and preterm delivery increased in traumatized pregnant women. Patients with low ISS scores should also be followed closely during pregnancy in terms of perinatal complications, as well as the severe trauma group.

Evaluation of balance and executive function relationships in older individuals.

BACKGROUND: Executive function is an important cognitive factor in gait and balance control. Weakening of balance system components and executive functions due to aging may affect walking and balance and increase the risk of falling. AIMS: The present study aimed to investigate the relationship between balance and executive function in older individuals and the contributions of physical activity and depression to this relationship. METHODS: A total of 84 healthy individuals aged 60 and over were included in the study. In the study, the Timed Up and Go Test (TUG), Mini Balance Evaluation Systems Test (Mini-BESTest), Digit Symbol Substitution Test (DSST), Trail Making Test A and B (TMT A and TMT B), Physical Activity Scale for the Elderly (PASE), and Geriatric Depression Scale (GDS) were applied. RESULTS: The Mini-BESTest and TUG correlated with DSST, TMT A, and TMT B. GDS was correlated with TUG. PASE was correlated with Mini-BESTest and TUG. Executive functions differed according to education level; DSST, TMT B, and GDS were effective in fall history. DISCUSSION: There was a significant relationship between balance and executive function. It was found that balance and walking speed increased as executive function skills increased. Depression and physical activity are associated with balance and gait speed. CONCLUSIONS: Balance and executive functions are related to each other, and physical activity and depression contribute to this relationship. In order to protect against the negative effects of aging, cognitive and physical training can be performed to prevent balance and executive function declines.

The Effect of Betamethasone Dosing Interval on Perinatal Outcomes: 12 Hours or 24 Hours Apart.

OBJECTIVE: Antenatal steroids are commonly used to stimulate fetal lung maturation, particularly in pregnancies at risk of early preterm labor. This study aimed to compare the effects of administering betamethasone at a 12- versus 24-hour interval on perinatal outcomes. STUDY DESIGN: This retrospective study included 423 early preterm births from 26+0/7 to 33+6/7 weeks of gestation. Patients received betamethasone at either a 12- or 24-hour dosing interval. RESULTS: When all patients in each group were evaluated together, there was no statistically significant difference between both groups for complications of prematurity, including respiratory distress syndrome (RDS). When the two groups were divided by gestational age (GA), the 32+0/7 to 33+6/7-week group that received betamethasone at a 24-hour interval had statistically lower 1- and 5-minute APGAR scores (p = 0.06 and p = 0.02, respectively). They also had a greater need for neonatal intensive care unit (NICU), NICU length of stay, RDS, and need for surfactant (p = 0.20, p = 0.09, p = 0.27, and p = 0.23, respectively) than did the infants at 32+0/7 to 33+6/7 weeks, who received betamethasone at a 12-hour interval. In the group with GA between 28+0/7 and 29+6/7 weeks, the 1-minute APGAR score was lower (p = 0.22), and the durations of hospital stay, and mechanical ventilation were longer (p = 0.048, p = 0.21, respectively) in the 24-hour interval group. No statistically significant difference was observed for all parameters in other GA groups. CONCLUSION: A 12-hour dosing interval for betamethasone appears to be more appropriate, as it results in a reduction in some neonatal complications and provides a short dose interval. KEY POINTS: · RDS is reduced when betamethasone is used 12 hours apart.. · When betamethasone is used 12 hours apart, the need for surfactant is reduced.. · The use of betamethasone 12 hours apart is advantageous with its short dose interval..

Investigation of some bioactive compounds, in vitro bioaccessibility, and sensory acceptability of couscous produced by pre-gelatinized rice flour.

BACKGROUND: The purpose of this study was to investigate the sensory properties, antioxidant capacities, total phenolic content, and their bioaccessibility in gluten-free rice couscous that is produced without additives. Since rice does not contain gluten, pre-gelatinized rice flour (GRF) was added instead of gum and enzymes in order to provide the desired structure in the couscous samples. RESULTS: According to the results, the total phenolic content of couscous samples was increased with GRF addition. The highest extractable and hydrolyzable antioxidant capacity values were observed in the couscous samples supplemented with 30% GRF using the 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) radical cation, cupric-reducing antioxidant capacity, and ferric reducing antioxidant capacity methods. The bioaccessibility of antioxidant capacity was found to be significantly higher (P < 0.05) than the control sample in all methods except the 1,1-diphenyl-2-picrylhydrazyl free radical method in the couscous samples. CONCLUSION: According to the data obtained, it has been determined that couscous, which has a very small round shape, can be produced with GRF without additives. In this context, gluten-free rice couscous could be used as an alternative valuable food in terms of nutrition and can be an alternative traditional food for celiac diseases as well as for individuals preferring the consumption of gluten-free products. © 2022 Society of Chemical Industry.

Effect of asymptomatic COVID-19 infection on the placenta in the third trimester of pregnancy: A prospective case-control study.

To clarify the effect of asymptomatic coronaviruse disease-2019 (COVID-19) positivity on the placenta in the third trimester of pregnancy. Materials and Methods: This prospective, case-control study included 30 pregnant women diagnosed with asymptomatic COVID-19 between April 30, 2021 and July 20, 2021 who delivered after the 34th gestational week, and a control group of 30 pregnant women without COVID-19, who delivered between April 2021 and July 2021, matched to the study group regarding age, gestational age and body mass index. Outcomes were compared in terms of demographic characteristics, serum blood outcomes, neonatal results, complications and placental histopathological findings. Results: The mean age of the study population was 28.8 years and the mean gestational week was 38.2 weeks. The C-reactive protein levels (38.2 mg/L vs 5.8 mg/L, p=0.001) and ferritin levels (266.4 µg/L and 40.5 µg/L, p=0.001) were significantly higher in the COVID-19-positive pregnant women. The lymphocyte level was significantly higher in the non-COVID-19 pregnant women (p=0.040). Mural hypertrophy was determined at a significantly higher rate in COVID-positive pregnant women (83.3% vs 30.0%, p=0.001). Multivariate regression analysis showed that only COVID-19 positivity increased the presence of mural hypertrophy in pregnant women with asymptomatic COVID-19 (4.716-fold, 95% confidence interval=1.012-22.251). Conclusion: The results of this study demonstrated that asymptomatic COVID-19 had no significant effect on pregnancy and neonatal complications. However, mural hypertrophy in the placenta was found at a significantly higher rate in pregnant women with asymptomatic COVID-19.

Musculoskeletal and anthropometric factors associated with urinary incontinence in pregnancy.

INTRODUCTION: Urinary incontinence (UI) is a common pelvic floor dysfunction in pregnancy. The relationship between biomechanical changes and pregnancy-related UI has not been fully elucidated. OBJECTIVE: To investigate the association of various musculoskeletal and anthropometric changes in pregnancy that affect gestational UI. METHODS: The study was conducted with 275 pregnant women. Ninety-three, 110 and 72 women were in first, second and third trimesters, respectively. Incontinence Impact Questionnaire for UI, Urogenital Distress Inventory-Short Form and Incontinence Severity Index were applied. Lumbar lordosis measurement was performed by Baseline Bubble Inclinometer while diastasis recti abdominis (DRA) measurement was carried out by finger-width method. Manual muscle test for rectus abdominis and right and left external oblique abdominal muscles, and Benign joint hypermobility test with Beighton scoring method were also applied as musculoskeletal measurements. Tape measurement at the waist, umbilical and hip levels, caliper with bi-iliac and bi-trochanteric diameters were also recorded as anthropometric measurements. RESULTS: Significant associated factors for UI were: umbilical DRA (OR = 1.57; p = .012); rectus abdominis muscle strength (values of 3 and below, OR = 1.2; p = .014); umbilical environment (OR = 1.1; p = .029); bi-iliac diameter (OR = 1.1; p = .05;) and bi-trochanteric diameter (OR = 1.3; p = .05), respectively. CONCLUSION: Changing musculoskeletal and anthropometric characteristics of pregnant women should be taken into consideration in UI follow-up during pregnancy.

Radioanatomic study of maxillary sinus palatal process pneumatization.

OBJECTIVES: To perform a detailed analysis of palatal process pneumatization (PPP) on cone beam computed tomography (CBCT) images. METHODS: This study consisted of 376 maxillary sinuses of 188 patients aged 22-88 years who had maxillary CBCT scans. The radioanatomy of the PPP was evaluated at distances 4, 8, 16, and 24 mm posterior to incisive foramen. The types of PPP were classified as follows: type I: maxillary sinus palatal process non-gasified; type II: palatal process gasification into the nasal floor, but not more than half of the width of the nasal floor; and type III: palatal process gasification into the nasal floor more than half of the width of nasal floor. Sinus opening angle (SOA), palatonasal recess angle (PNRA), palatal junction angle (PJA), and palatal depth measurement (PDM) were the evaluated parameters. RESULTS: Among the identified 1315 PPPs, type I PPP (880, 66.92%) was the most frequently observed, followed by type II (426, 32.4%), and the least observed was type III PPP (9, 0.68%). There was no significant difference between SOA and PJA according to the types of PPP (p > 0.05). The difference between PNRA and PDM of type I and type II PPP showed a statistically significant difference (p < 0.05). Type I PPP was the most encountered with the highest PDM, and PNRA was narrower in type III than in type II PPP. CONCLUSION: Physicians must be aware of these variations to prevent possible complications during surgery because 33.08% of the maxillary sinuses showed extensive pneumatization through the palatal process.

Comparison of neonatal outcomes with and without the administration of betamethasone in late preterm births.

OBJECTIVE: To evaluate the effects of antenatal steroid administration on neonatal outcomes in late preterm births. METHODS: Demographic and neonatal data from women who gave birth between May 2018 and March 2021 at 34+0 -36+6  weeks of gestation were screened from the information system of the hospital. The patients were assigned to two groups: those who were and those who were not given steroids. All parameters were compared between the two groups. RESULTS: The 1-minute (9 versus 8) and 5-minute (10 versus 9) Apgar scores, need for a neonatal intensive care unit (NICU) stay (23.7% versus 27.8%), length of stay (Day) in the NICU (1.97 ± 0.24 versus 2.45 ± 0.16), rate of transient tachypnea of the newborn (3.3% versus 7.8%), respiratory distress syndrome (2.5% versus 5.2%), need for mechanical ventilation (1.2% versus 3.8%), and neonatal sepsis (1% versus 2.6%) were lower in the group that received betamethasone compared with the group that did not; the differences between the two groups were statistically significant. CONCLUSION: Based on the results of the present study, we believe that antenatal steroid administration would be beneficial before late preterm births occurring between 34+0 and 36+6  weeks of pregnancy, considering the significant reduction in various respiratory complications, especially in respiratory distress syndrome and the need for an NICU stay.

3D-Printed Graphene-Based Bow-Tie Microstrip Antenna Design and Analysis for Ultra-Wideband Applications.

In this study, the effects of graphene and design differences on bow-tie microstrip antenna performance and bandwidth improvement were investigated both with simulation and experiments. In addition, the conductivity of graphene can be dynamically tuned by changing its chemical potential. The numerical calculations of the proposed antennas at 2-10 GHz were carried out using the finite integration technique in the CST Microwave Studio program. Thus, three bow-tie microstrip antennas with different antenna parameters were designed. Unlike traditional production techniques, due to its cost-effectiveness and easy production, antennas were produced using 3D printing, and then measurements were conducted. A very good match was observed between the simulation and the measurement results. The performance of each antenna was analyzed, and then, the effects of antenna sizes and different chemical potentials on antenna performance were investigated and discussed. The results show that the bow-tie antenna with a slot, which is one of the new advantages of this study, provides a good match and that it has an ultra-bandwidth of 18 GHz in the frequency range of 2 to 20 GHz for ultra-wideband applications. The obtained return loss of -10 dB throughout the applied frequency shows that the designed antennas are useful. In addition, the proposed antennas have an average gain of 9 dBi. This study will be a guide for microstrip antennas based on the desired applications by changing the size of the slots and chemical potential in the conductive parts in the design.

A novel 3D printed curved monopole microstrip antenna design for biomedical applications.

This paper proposes a novel and compact monopole microstrip antenna design with a three-dimensional (3D) printed curved substrate for biomedical applications. A curved substrate was formed by inserting a semi-cylinder structure in the middle of the planar substrate consisting of polylactic acid. The antenna was fed with a microstrip line, and a partial ground plane was formed at the bottom side of the substrate. The copper plane with two triangular slots is arranged on the curved semi-cylinder structure of the substrate. The physical dimensions of the radiating plane and ground plane were optimally determined with the use of the sparrow search algorithm to provide a wide-10 dB bandwidth between 3 and 12 GHz. A total of six microstrip antennas having different parameters related to physical dimensions were designed and simulated to compare the performance of the proposed antenna with the help of full-wave electromagnetic simulation software called CST Microwave Studio. The proposed curved antenna was fabricated, and a PNA network analyzer was used to measure the S11 of the proposed antenna. It was demonstrated that the measured S11 covers the desired frequency range.

Short-term outcomes of pregnant women with convalescent COVID-19 and factors associated with false-negative polymerase chain reaction test: A prospective cohort study.

AIM: To evaluate the clinical factors associated with false-negative RT-PCR results and to report the outcome of a cohort of pregnant women with COVID-19. METHODS: This cohort study was conducted in a tertiary referral pandemic hospital and included 56 pregnant women. A study including pregnant women with either a laboratory or clinical diagnosis for COVID-19 were included in the study. The primary outcome was clinical factors associated with false-negative RT-PCR results defined as a positive immunoglobulin M assessed by rapid testing in clinically diagnosed patients. Clinical outcomes of laboratory diagnosed patients were also reported. RESULTS: In total, 56 women with either RT-PCR or clinical COVID-19 diagnosis were included in the study. Forty-three women either had RT-PCR positivity or IgM positivity. The clinical outcome of these pregnancies was as follows: mean maternal age 27.7, immunoglobulin M positive patients 76.7%, RT-PCR positive patients 55.8%, maternal comorbidities 11.5%, complications in patients below 20 weeks 34.8%, complications in patients above 20 weeks 65.1%, elevated CRP 83.7%, lymphopenia 30.2%, time from hospital admission to final follow-up days 37 and stillbirth 8.3%. The proportion of women who tested positive for SARS-CoV-2 immunoglobulin M was 100% in the RT-PCR positive group and 56.5% in the clinical diagnosis group (P = .002). The symptom onset to RT-PCR testing interval longer than a week (risk ratio: 2.72, 95% CI: 1.14-5.40, P = .003) and presence of dyspnoea (risk ratio: 0.38, 95% CI: 0.14-0.89, P = .035) were associated with false-negative RT-PCR tests. The area under the curve of these parameters predicting false-negative RT-PCR was 0.73 (95% CI: 0.57-0.89). CONCLUSIONS: Symptomatic women with a negative RT-PCR should not be dismissed as potential COVID-19 patients, especially in the presence of prolonged symptom onset-test interval and in women without dyspnoea.

A cut-off value of epicardial fat thickness for the prediction of large for gestational age foetuses.

Estimation of foetal weight in the prenatal period is important in many respects. For this purpose, during different periods of pregnancy; mostly in the last trimester; many methods or formulas have been described, almost of them using ultrasound. Foetal epicardial adipose tissue has previously been described as a metabolic organ in studies. Foetal epicardial fat tissue thickness (EFT) measurement has been previously described in the literature and has been associated with metabolic conditions such as preeclampsia or gestational diabetes. The purpose of this study was to determine the strength and cut-off value of EFT measured by ultrasound in the second trimester in the prediction of large for gestational age (LGA) foetuses. Epicardial fat tissue thicknesses which were recorded during second trimester anomaly screening were evaluated retrospectively. Birth weights of the same cases were also obtained from the database and analysed with IBM SPSS Statistics for Windows Version 22.0 (IBM Corp., Armonk, NY, USA). LGA babies had thicker EFT measurements and we established a cut-off EFT value of 1.38 mm. Our results suggest that EFT thickness measured by ultrasound in the second trimester may be useful in predicting LGA foetuses.Impact statementWhat is already known on this subject? It is known that foetal epicardial fat tissue is an adipose tissue with metabolic functions. Previously the relationship between this tissue and prenatal complications; such as, preeclampsia, gestational diabetes and infant growth and development were investigated. We planned this study considering that a tissue with metabolic functions affecting foetal growth may also affect birth weight.What do the results of this study add? Foetal epicardial fat thickness measurement only once in the second trimester may predict the 90th percentile limit at birth which is considered as the LGA limit.What are the implications of these findings for clinical practice and/or further research? In our study, we determined that the thickness of epicardial fat tissue measured in the second tirmester could predict the 90 th percentile limit at birth and that the cut-off value for this group was 1.38 mm. We believe that this measurement may help to determine LGA babies at birth as early as the second trimester. In future studies, the 97 percentile limit can be determined from the early weeks with reaching larger groups. Thus, babies who are likely to experience birth trauma in clinical practice can be reached from early weeks.

Mini-laparoscopic adrenalectomy with transgastric specimen extraction.

We aimed to describe the initial experience of mini-laparoscopic adrenalectomy combined with transgastric specimen extraction and to assess its safety and feasibility. We used only 5-mm trocars, three ports for left adrenalectomy and four for right. Intraoperative gastroscopy was performed for specimen extraction through the mouth via an endoscopic snare. The gastrotomy was closed intracorporeally. Demographic, perioperative and pathological data were analyzed. There were 16 patients (12 females) with the mean age of 46.5 ± 11.3 years and half of them had previous abdominal surgeries. The median operative time was 150 (45-432) min with a median blood loss of 88 (0-350) ml. The median oral intake time was 2 (1-4) days and the median length of hospital stay was 2 (2-5) days. There was no mortality and extraction-related complication. Histopathological median tumor length, width and depth were 3 cm, 2.15 cm, and 1.9 cm, respectively. The median specimen length, width and depth were 6.25 cm, 4 cm, and 2.2 cm, respectively. Mini-laparoscopic adrenalectomy combined with transgastric specimen extraction is a safe and feasible surgical technique. It provides a less invasive surgery and may also have some benefits on wound-related complications and cosmesis.

3D printed PLA/copper bowtie antenna for biomedical imaging applications.

This study aims to increase the performance of the microwave antenna by using 3D printed conductive substrates, which is mainly used in biomedical imaging applications. Conventional antennas such as Horn and Vivaldi have coarse dimensions to integrate into the microwave imaging systems. Therefore, 3D printed Bowtie antenna structures were developed, which yield low cost and smaller sizes. PLA, PLA/copper, and PLA/carbon substrates were produced with a 3D printer. These materials were tested in terms of their dielectric constants between 1 and 10 GHz. The conductive part of the antenna was copper, with a thickness of 0.8 mm, which was embedded in the substrate parts. The reflection coefficients of the antennas were tested within 0-3 GHz frequency range via miniVNA network analyzer. The results show that the 3D printed PLA/copper and PLA/carbon antenna are highly suitable for the usage in biomedical imaging systems.

Effect of coffee consumption on fetal renal artery blood flow and amniotic fluid volume in third trimester of pregnancy.

OBJECTIVE: Coffee is frequently (one or two cups/day) consumed throughout pregnancy. Although there are a few studies evaluating caffeine effects on pregnancy; however, a diuretic effect of caffeine on fetal kidneys has not been reported. Therefore, after drinking coffee whether changing of amniotic fluid index (AFI) and fetal renal artery blood flow (FRABF, RI, Resistive index; PI, Pulsatility index) were evaluated in this study. METHODS: This clinical study was performed with two groups. For the study group, 63 participants with isolated borderline oligohydramnios who agreed to drink one cup of instant coffee were included in this study while 63 participants with isolated borderline oligohydramnios who did not drink one cup of instant coffee formed the control group. AFI, RI and PI were evaluated both before and after coffee intake. RESULTS: Maternal characteristics of all study population were homogenous. FRABF indices were similar in both before and after coffee consumption. AFI was increased significantly six hours after drinking coffee (p<0.001). CONCLUSIONS: The coffee consumption increased the amniotic fluid volume. However it does not seem to affect on FRABF. According to our study findings, coffee consumption may offer a new opportunity to improve amniotic fluid volume for pregnant women with oligohydramnios.

Metabolic infrastructure of pregnant women with methylenetetrahydrofolate reductase polymorphisms: A metabolomic analysis.

The aim of this study was to demonstrate the altered metabolic infrastructure of pregnant women with methylenetetrahydrofolate reductase (MTHFR) polymorphisms at first trimester and during delivery. Eight singleton pregnant women with MTHFR polymorphisms were compared with 10 normal pregnant women. Maternal blood samples were obtained twice during their pregnancy period (between the 11th and 14th gestational weeks and during delivery). Metabolomic analysis was performed using GC-MS. The GC-MS based metabolomic profile helped identify 95 metabolites in the plasma samples. In the MTHFR group, the levels of 1-monohexadecanoylglycerol, pyrophosphate, benzoin, and linoleic acid significantly decreased (P ˂ 0.05 for all), whereas the levels of glyceric acid, l-tryptophan, l-alanine, l-proline, norvaline, l-threonine, and myo-inositol significantly increased (P ˂ 0.01 for the first two metabolites, P ˂ 0.05 for the others) at 11-14 gestational weeks. Conversely, the levels of benzoin, 1-monohexadecanoylglycerol, pyruvic acid, l-proline, phosphoric acid, epsilon-caprolactam, and pipecolic acid significantly decreased in the MTHFR group, whereas metabolites such as hexadecanoic acid and 2-hydroxybutyric acid increased significantly in the study group during delivery. An impaired energy metabolism pathway, vitamin B complex disorders, tendency for metabolic acidosis (oxidative stress), and the need for cell/tissue support seem prevalent in pregnancies with MTHFR polymorphisms.

Association Between Nasal Obstruction Symptoms and Anxiety.

AIM: The aim of this study was to determine the correlation between nasal function assessment and anxiety scales. METHODS: A total of 120 patients with the complaint of nasal obstruction were classified as nasal septum deviation group (DNS) and no nasal pathology group (NON). A control group was formed of 57 healthy participants. Nasal obstruction severity was assessed using the Nasal Obstruction Symptom Evaluation (NOSE) scale, nasal resistance level with rhinomanometry and anxiety levels with the Agoraphobic Cognitions Questionnaire (ACQ), and the Body Sensations Questionnaire (BSQ). RESULTS: There was a statistically significant difference between both the DNS and the NON groups and control group in terms of NOSE scale, ACQ, and BSQ (P < .001). The total nasal resistance values were higher in the DNS group compared to both the NON and control groups (P < .001), although the difference between the NON group and control group was not statistically significant. CONCLUSION: The results of this study showed that patients with nasal breathing complaints, but no organic pathology, had the same level of nasal obstruction symptoms as patients with nasal septal deviations. Anxiety levels are elevated in patients with symptoms of nasal obstruction, even when there is lack of organic nasal pathology.

Congenital heart defects: the 10-year experience at a single center.

Objective: We aimed to evaluate congenital heart disease (CHD) cases according to EUROCAT subgroup classification that were diagnosed during the prenatal period in our center.Methods: CHDs that were prenatally diagnosed using ultrasonography and confirmed by fetal echocardiography were reviewed over a 10-year period. Subgroup classification was finalized at the post-partum period in terms of the EUROCAT guide 1.3. Congenital heart defect subtypes and obstetric outcomes (gestational week at delivery, birth weight, gender, extracardiac structural abnormalities, karyotype results if performed) were analyzed.Results: The data of 180 cases with CHD were examined. Left ventricular outflow tract obstruction (LVOT) was the most common CHD subtype (57/180; 31.6%), which included 48, five, and four cases of hypoplastic left heart syndrome (HLHS), coarctation of the aorta, and aortic valve atresia/stenosis, respectively. Eighteen pregnancies were terminated; the most common CHD subtype among patients of terminated pregnancies was hypoplastic left heart syndrome (HLHS) (n = 7, 38.8%). The most common extracardiac malformations were a single umbilical artery, esophageal atresia, and situs inversus in our study group. Eighteen of the 96 (18.75%) neonates with CHD died during the neonatal period. The most common CHD subtype was HLHS (7/18; 38%) among the newborns who died after birth.Conclusion: Prenatal diagnosis of a CHD and subgroup classification is very important for clinical decision making, including prenatal management, recommendations for termination of the pregnancy, postnatal management of the patient, and for early referral to pediatric cardiology and cardiovascular surgery centers.

Antenatal management and outcomes of pregnancies with congenital diaphragmatic hernia.

BACKGROUND: The objective of this study is to evaluate the obstetric outcomes of pregnancies with congenital diaphragmatic hernia (CDH). METHODS: Fifty one pregnancies prenatally diagnosed with CDH at our institution between January 1, 2002 and August 31, 2018 were retrospectively evaluated. The pregnancies were divided into two groups according to neonatal survival. Demographic features, clinical characteristics and prognostic factors were compared between the neonatal survival (n = 16) and non-survival (n = 28) groups. Cut-off values of fetal lung area to head circumference ratio (LHR), observed/expected LHR (o/e LHR) and observed/expected total fetal lung volume (o/e TFLV) for neonatal survival were calculated. RESULTS: Thirty six (70.6%) and fifteen (29.4%) fetuses had left and right sided CDH respectively. Seven patients chose termination of their pregnancies (13.7%). Statistically significant differences were found between survival and non-survival groups in terms of parity, median gestational week at diagnosis, polyhydroamniosis rate, CDH type, stomach position, liver position, median LHR, o/e LHR, o/e TFLV, median 5th minute Apgar score and neonatal operation rate values (p values were 0.03,<0.001, 0.02, 0.006,<0.001, 0.006,<0.001,<0.001,<0.001, 0.04 and <0.001 respectively). According to ROC curve analysis, 1.05 (82% sensitivity, 74% specificity) for LHR, 22.5 (78.6% sensitivity, 73.9% specifity) for o/e LHR and 23.5 (85.7% sensitivity,74.2% specificity) for o/e TFLV were determined to be cut-offs for neonatal survival, respectively, with highest sensitivity and specificity. CONCLUSION: Earlier gestational week at diagnosis, right sided CDH, presence of liver herniation, supradiaphragmatic stomach position, lower LHR, o/e LHR and o/e TFLV were associated with decreased rates of neonatal survival.