Fetal Diaphragmatic Excursion Is Decreased in Hospitalized Pregnant Women Infected with COVID-19 during the Second and Third Trimesters.

OBJECTIVE: In the present study, we aimed to evaluate coronavirus disease 2019 (COVID-19) infection effects on fetal diaphragm thickness and diaphragmatic excursion, which together show the quality of diaphragmatic contractions. STUDY DESIGN: One hundred and ninety-two pregnant women were included in this prospective case-control study. Patients were divided into four groups according to their COVID-19 infection history in their second or third trimester: hospitalized COVID-19-infected pregnant women group (n = 48), outpatient COVID-19-infected pregnant women group (n = 48), common cold (COVID-19 polymerase chain reaction negative) pregnant women group (n = 48), and noninfected healthy controls (n = 48). The number of patients was determined by power analysis following the pilot study. All participants underwent an ultrasound examination to determine fetal diaphragm parameters at 32 to 37 weeks of gestation. RESULTS: Demographic characteristics were similar among the four groups. The gestational age at ultrasound examination and gestational age at delivery were similar among the groups. Neonatal intensive care unit (NICU) admission rate was significantly higher in the hospitalized COVID-19-infected pregnant women group than the other groups. The fetal diaphragm thickness during inspiration and expiration, and fetal costophrenic angles at inspiration and expiration were similar among the groups. Fetal diaphragmatic excursion was significantly decreased in the hospitalized COVID-19-infected pregnant women group compared with the other groups. CONCLUSION: Our results indicated that moderate maternal COVID-19 infection decreased fetal diaphragmatic excursion, and ultrasonographic evaluation of fetal diaphragmatic excursion before delivery can provide critical information to predict whether infants will require NICU admission. KEY POINTS: · Diaphragm ultrasound as a new technique for characterizing the diaphragm's structure and function.. · Fetal diaphragmatic excursion is decreased in the presence of moderate COVID-19 infection.. · Ultrasonographic evaluation of fetal diaphragmatic excursion provides critical information to predict NICU admission..

Maternal serum telomerase levels increase in pregnancies with mild and severe preeclampsia.

INTRODUCTION: Considering that preeclampsia is characterized by oxidative stress, inflammation, and endothelial dysfunction, we hypothesized that preeclampsia and preeclampsia severity may affect the telomerase levels of the mother. METHODS: This cross-sectional case control study comprised 86 participants who were separated into three groups as severe preeclampsia, non-severe preeclampsia, and healthy control group. Venous blood samples were obtained from pregnant women with severe preeclampsia just before delivery for biochemical analysis and to evaluate maternal serum telomerase levels. Since gestational age, maternal age and BMI would have an effect on maternal serum telomerase levels, serum samples were taken in the control group and non-severe preeclampsia group at similar gestational age during clinical visits in order to homogenize these parameters, and these patients were followed up. Telomerase levels in maternal serum were evaluated using the enzyme-linked immune-sorbent assay. RESULTS: Maternal age, nulliparity, body mass index (kg/m2) at blood sampling day, ethnicity, smoking and history of caesarian section were statistically similar among the groups. The mean birth weight percentiles were the lowest in the severe preeclampsia group. Fetal growth restriction rates were significantly higher in the severe preeclampsia group than in the non-severe preeclampsia group. Gestational age at blood drawn was similar among groups. Neutrophil lymphocyte ratio, platelet lymphocyte ratio, mean platelet volume, red cell distribution width and white blood cell were statistically different among groups. The serum telomerase level was 1.137 ± 0.390 ng/mL in the severe preeclampsia group, 0.763 ± 0.390 ng/mL in the non-severe preeclampsia group, and 0.425 ± 0.160 ng/mL in the control group (p < .001). DISCUSSION: This study indicated that maternal serum telomerase levels were significantly increased in both preeclampsia groups.

Effect of preeclampsia and its severity on maternal serum NGAL and KIM-1 levels during pregnancy and the post-pregnancy period.

OBJECTIVE: The purpose of this trial was to appraise the effects of preeclampsia and its intensity on maternal serum neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule-1 (KIM-1) levels during pregnancy and the post-pregnancy period. STUDY DESIGN: Firstly pregnant participants (n = 156) were separated into three groups, as control, mild, and severe preeclampsia. Secondly women in post-pregnancy period (n = 368) were separated into three groups according to history of pregnancy, as healthy control, mild, and severe preeclampsia. These women were identified through the hospital data system and contacted by telephone to participate in the study. RESULTS: Our study comprised 147 patients, 77 of whom were pregnant and 70 of whom were in their post-pregnancy period after the exclusion criteria had been applied. In terms of maternal serum NGAL levels, there is a significant increase in the severe preeclampsia group compared with that in the mild preeclampsia and normal pregnancy groups (p < 0.001). During the post-pregnancy period, the maternal serum NGAL levels were found significantly higher in the severe preeclampsia group than in the mild preeclampsia group and non-hypertension control group (p < 0.001). Maternal serum KIM-1 levels were found as significantly higher in the severe and mild preeclampsia groups than in the non-hypertension pregnancy group (p = 0.004). During the post-pregnancy period, maternal serum KIM-1 levels were found as similar among all post pregnant groups (p = 0.792). CONCLUSIONS: Our results indicated that as the severity of preeclampsia increases, kidney damage as assessed using NGAL levels continues for a long period of time, even during the post-pregnancy period.

Adverse fetal outcomes in patients with IUGR are related with fetal diaphragm evaluation parameters.

INTRODUCTION: The aim of the present study was to evaluate the relationship between diaphragmatic thickness, during both inspiratory (DTI) and expiratory (DTE) stages; diaphragmatic excursion (DE); diaphragm thickening fraction (DTF); and adverse fetal outcomes in pregnant women with intrauterine growth restriction (IUGR). MATERIALS AND METHODS: A total of 77 participants were included in this case-control study. The case group was diagnosed as having both symmetric and asymmetric IUGR (n = 39). The control group included gestational age (GA)-matched healthy pregnant women (n = 38). DTI, DTE, DE (reflecting the capability of diaphragmatic movement during the respiratory cycle), and DTF were analyzed. RESULTS: Maternal demographic characteristics were similar between groups. DTI and DTE were significantly lower in the IUGR group compared to the control group (p < 0.001 and p < 0.001). DE was similar between the groups (p = 0.07). Additionally, in the IUGR group, DTI, DTE, and DE were significantly altered in newborns that required treatment in the neonatal intensive care unit (NICU). ROC curve analysis determined that the DTI cut-off was 1.36 for NICU admission with 78% sensitivity and 100% specificity. DTE cut-off was 1.195 for NICU admission with 78% sensitivity and 96% specificity. DE cut-off was 4.25 for NICU admission with 71% sensitivity and 80% specificity. CONCLUSION: Measurement of DTI, DTE and DE may help clinicians to predict whether newborns with IUGR would require NICU hospitalization.

Genome-wide expression analysis of endometrium before and after endometrioma surgery.

OBJECTIVE: This study was planned to investigate possible alteration in the number of differentially expressed genes (DEGs) in eutopic endometrium before and after laparoscopic removal of the ovarian endometrioma. STUDY DESIGN: Six infertile women with ovarian endometrioma who underwent laparoscopic endometrioma cystectomy and six fertile control subjects who underwent tubal sterilization were included the study. Endometrial samples were collected before and 3 months after surgery throughout the mid-luteal phase. Genome-wide expression profiling was performed with Illumina Human HT-12V4 microchip, a high density silica bead-based microarray which utilizing more than 47.000 probs. Illumina microsequence system was used to assess detection of p value for each probe in every sample. Probes revealing significant assessment (p < .05) were selected for comparative analysis. RESULTS: We have detected 1478 DEGs in the comparison between endometrium of women with endometrioma and fertile controls. 118 out of 1478 genes (7.9 %) were significantly increased or decreased more than 1.5-fold in their expression. When the preoperative values of the control and patient groups are compared the number of DEGs was 243 (7.5 %). In 9 out of 243 genes, the fold change was found to be 1.5 and more (3.7 %). Comparison of the number of DEGs after endometrioma surgery and tubal ligation revealed that expression patterns of 1036 genes (33.7 %) were changed in endometrioma group. In 105 out of 1036 genes, the fold change was found to be 1.5 and above (10 %). A comparison using 2706 probes revealed changes in the expression patterns of 106 different genes (3.9 %) after endometrioma resection. In 4 out of 106 genes, the fold change was found to be 1.5 and above (3.7 %). The comparison using 6035 probes revealed changes in the expression patterns of 93 genes (1.5 %) after tubal ligation. None of the 93 genes had a fold change of 1.5 or higher. The number of DEGs in endometrioma groups after surgery was approximately 3-fold higher than control group. CONCLUSIONS: Endometrium of women with endometrioma displayed abnormal expression of genes associated with implantation, immunological, endocrine and neuracrine functions. Positive alteration of the expression pattern of DEGs and signal transduction pathways following endometrioma surgery can improve the receptive capacity and implantation rates of eutopic endometrium.

Effect of preeclampsia and preeclampsia severity on insulin, HOMA-IR, and betatrophin levels in non-diabetic pregnant women.

BACKGROUND: The aim of the study was to evaluate the effect of preeclampsia and its severity on insulin, the homeostatic model assessment of insulin resistance (HOMA-IR), and betatrophin levels in non-diabetic pregnant women. METHODS: Our study comprised 102 pregnant women who were divided into the following three groups: (1) control, (2) severe preeclampsia, and (3) mild preeclampsia. The women were screened with the single-stage 75-g oral glucose tolerance test (OGTT), and the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria were used for diagnosis. Those women with type 2 diabetes (T2D) mellitus or gestational diabetes mellitus (GDM) were excluded from the study. RESULTS: Maternal demographic characteristics were similar among the groups. Fasting plasma glucose and postprandial 2-h plasma glucose levels were significantly increased in the severe-preeclampsia group compared to that in the other groups. Fasting insulin levels were 14.3 ± 8.7uU/mL in the severe-preeclampsia group, 19.1 ± 6.0uU/mL in the mild-preeclampsia group, and 20.5 ± 12.5uU/mL in the control group and significantly lower in the severe-preeclampsia group than in the mild-preeclampsia and control groups. The serum betatrophin level was 7.8 ± 2.6 ng/mL in the severe-preeclampsia group, 6.1 ± 1.8 ng/mL in the mild-preeclampsia group, and 5.8 ± 1.3 ng/mL in the control group and significantly increased in the severe-preeclampsia group compared to other groups. HOMA-IR was similar among the groups. Maternal serum insulin levels were negatively (r = -0,255; P = 0.010) and serum betatrophin levels were positively (r = 0.368; P ≤ 0.001) correlated with preeclampsia severity. CONCLUSION: Our results indicated that severe preeclampsia effect maternal serum glucose, insulin and betatrophin levels. Histhopatholical and immunohistochemical demostrations on pancreatic cells in new preeclampsia rat models will expand the information on the current situation.

The role of serum progesterone induced blocking factor on unexplained infertility.

OBJECTIVE: The aim of this study was to determine whether the progesterone-induced blocking factor (PIBF) level in women with unexplained infertility differed from that in fertile women. STUDY DESIGN: Volunteers between 18 and 35 years old were included in this cross-sectional study and were divided into two groups-the unexplained-infertility group and the control group. Demographic data on all the women were collected using a detailed questionnaire. The infertile participants and their male partners received complete infertility examinations according to the protocol. Blood samples were taken from all participants after the examinations during regular clinic visits. Serum PIBF levels were measured using an enzyme-linked immunosorbent assay. RESULTS: Of the 46 healthy participants in the study, 22 had unexplained infertility. Age, body mass index, ethnicity, education level, age at first menarche, and length of menstrual cycles, serum follicle stimulating hormone, luteinizing hormone, estradiol, prolactin, thyroid stimulating hormone, and progesterone were similar between two groups. The mean right antral follicle count (AFC) was 6.6 ± 1.8 in the unexplained-infertility group and 6.5 ± 2.0 in the control group. The mean left AFC was 6.6 ± 2.0 in the unexplained-infertility group and 6.9 ± 1.5 in control group. The mean serum PIBF level was 6.92 ± 3.41 ng/mL in the unexplained-infertility group and 12.10 ± 10.47 ng/mL in the control group, which was a significant difference (p = 0.02). CONCLUSION: The present study showed that serum PIBF levels were significantly lower in unexplained-infertility group than in the fertile control group.

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.

Evaluation of the levels of secretory leukocyte protease inhibitor in the cervical mucus of women with unexplained infertility.

AIM: Secretory leukocyte protease inhibitor (SLPI) has specific effects on the immune system. SLPI is overexpressed in inflammation triggered by immune responses, which could have significant effects on the local immune responses in cervical mucosa. This over expression may be greater in women with unexplained infertility, which would increase the immune reaction in the cervical region against sperm. The aim of our study was to assess the levels of SLPI in cervical mucus in women with unexplained infertility. METHODS: This prospective cross-sectional study was conducted using 50 Caucasian volunteers between 20 and 40 years old. The 50 participants were divided into two groups as unexplained infertility (n = 20) and control (n = 30). The control group comprised healthy fertile women with demographic characteristics similar to those of the infertility group. The enzyme-linked immunosorbent assay method was used to assess SLPI levels in the cervical mucus of all participants. RESULTS: The median SLPI level in cervical mucus was 3767 (3541-4594, 95% CI) pg/mL (25th percentile; 3139 pg/mL, 75th percentile; 5047 pg/mL) in the unexplained-infertility group and 3204 (2602-3539, 95% CI) pg/mL (the 25th percentile = 2615 pg/mL; 75th percentile = 3990 pg/mL) in the control group, which was a significant difference (P = 0.013). CONCLUSION: Our results indicated that SLPI levels in cervical mucus were remarkably higher in patients with unexplained infertility than in the control group.

The effects of antenatal corticosteroid exposure on the rate of hyperbilirubinemia in term newborns.

OBJECTIVE: Neonatal hyperbilirubinemia is a short-lasting benign condition that affects approximately 60% of infants born at term infants. This study aimed to evaluate the effects of antenatal corticosteroid (ACS) exposure on the rate of hyperbilirubinemia in term newborns. METHODS: This retrospective study was conducted at the Health Sciences University Kayseri Education and Research Hospital, Turkey from June 2017 to June 2018. A total of 6254 pregnant participants aged between 18 and 35 years with a singleton pregnancy were included in the study. The study group included 354 women with low-risk pregnancies (no perinatal risk except threatened preterm labor) who received ACS treatment and were hospitalized because of the threat of preterm labor before the 34th gestational week but delivered after 37 weeks of gestation. The control group was composed of 5900 women with low-risk pregnancies who did not receive ACS treatment throughout their pregnancy and delivered after 37 weeks of gestation. RESULTS: Maternal age, mean body mass index, gestational week at delivery, nulliparity, previous cesarean history, sex of the baby, fetal weight, labor induction, vaginal delivery, and five minutes. Apgar score were similar in both groups. The neonatal hyperbilirubinemia rate was 20/354 (5.6%) in the ACS treatment group and 564/5900 (9.6%) in the control group. CONCLUSIONS: The neonatal hyperbilirubinemia was significantly decreased in term-born babies exposed to ACS before 34 weeks.

How Well Do the Popular Ultrasonic Techniques Estimate Amniotic Fluid Volume and Diagnose Oligohydramnios, in Fact?

The aims of the study were to compare the different estimation methods for the diagnosis of oligohydramnios and to determine concordance between estimated amniotic fluid volume (AFV) measured by ultrasonography and actual AFV measured directly. Another purpose was to investigate the effect of oligohydramnios on neonatal outcome. This study was done at a tertiary care center. The participants were scheduled between 37 and 40 weeks for cesarean delivery. Estimated AFV was ultrasonographically assessed, and then actual AFV was directly measured during the cesarean delivery to compare the subjective method (SM), amniotic fluid index (AFI), single deepest pocket (SDP), and 2-diameter pocket. Totally, 138 patients were included in the present study. Of 35 (34%), 24 (21%), 12 (9.5%), and 10 (7.8%) were defined as oligohydramnios by the SM, AFI, SDP, and 2-diameter pocket, respectively. The number of patients with actual oligohydramnios was 35 (34%). Most authors suggest as a method use of the SDP more than the AFI, because of overmanagement through the AFI. However, this study, which was conducted using both nonprejudiced and criterion-standard methods, showed that the SM and AFI technique were more successful to estimate oligohydramnios than other methods. Also, adverse pregnancy outcome was not closely associated with isolated oligohydramnios.

Effect of vitamin D deficiency on the 75 g oral glucose tolerance test screening and insulin resistance.

Gestational diabetes mellitus (GDM), is the most common medical complications of pregnancy. This study aimed to clarify the effect of second-trimester vitamin D deficiency on the 75 g oral glucose tolerance test (OGTT) screening and insulin resistance. A total of 120 pregnant women with a singleton pregnancy at a gestational age of 26-28 weeks were analyzed. Participants were divided into two groups according to 25-hydroxyvitamin D levels; vitamin D deficiency, and control groups. For GDM scan, 75 g OGTT was preferred. GDM prevalence was 17.5% in vitamin D deficiency group and 13.75% in control group, there is no significant difference in GDM prevalence (p = 0.149). Fasting plasma glucose and 1-h plasma glucose levels were significantly higher in the vitamin D deficiency group than in the control group (p < .001 and p < .001, respectively). No significant differences were observed between 2-hour plasma glucose levels (p = .266). The HOMA-IR level was significantly higher in the vitamin D deficiency group than in the control group (p < .001). The findings of the present study suggested that vitamin D deficiency in the second trimester was inversely correlated with fasting and 1-h plasma glucose after 75 g glucose challenge test; also, low 25 OHD3 levels were associated with insulin resistance.

The Effect of Anterior Uterocervical Angle on Primary Dysmenorrhea and Disease Severity.

Background: Primary dysmenorrhea, defined as painful menstrual cramps originating in the uterus without underlying pathology, is a gynecological disease that affects quality of life and school success. Our goal was to determine the effect of anterior uterocervical angle on primary dysmenorrhea and disease severity. Methods: A total of 200 virgin adolescents, 16 to 20 years of age, were included in the study. The Andersch and Milsom scale was used to determine dysmenorrhea severity. Those with pathologies causing secondary dysmenorrhea were excluded from the study. Study subjects were grouped based on severity of pain. Demographic characteristics and uterocervical ultrasonographic measurements were compared among groups. Results: Of the 200 participants enrolled in the study, 50 were healthy controls and 150 had primary dysmenorrhea. Those with primary dysmenorrhea had a significant family history of primary dysmenorrhea compared with controls (P < 0.001). Age (P=0.668), body mass index (P=0.898), menarche age (P=0.915), and length of menstrual cycles (P=0.740) were similar in all groups. The uterine corpus longitudinal axis, uterine corpus transverse axis, and uterine cervix longitudinal axis were also similar (P=0.359, P=0.279, and P=0.369, resp.). The mean uterocervical angle was 146.8 ± 6.0 in controls and 143.3 ± 7.3 in those with mild pain with no significant difference between the groups. In those with moderate pain, the mean uterocervical angle was 121.2 ± 7.3 compared with 101 ± 9.2 in those with severe pain, which was a significant difference. Additionally, there was also a significant difference in the uterocervical angle among those with mild, moderate, and severe pain (P < 0.001). Conclusion: Our results indicate that a narrower anterior uterocervical angle is associated with primary dysmenorrhea and disease severity.

Cervical Local Immune Response for High-Risk Human Papillomavirus Infection: Involvement With Cervical Mucus SLPI Proteins.

PURPOSE: To evaluate cervical mucus secretory leukocyte protease inhibitor (SLPI) concentrations in patients with high-risk human papillomavirus (hrHPV) 16 or 18 positive and low-grade squamous intraepithelial lesions (LGSIL) or high-grade squamous intraepithelial lesions (HGSIL). METHOD: Patients with HPV 16 or 18 positive from 30 to 45 years of age whose cervical cancer screening results reported cytologically LGSIL or HGSIL were included in the study. In the control group, we included participants in the same age with cytology negative and HPV-negative healthy women. All cytological LGSIL or HGSIL results were histopathologically confirmed with colposcopic biopsy specimens. Finally, the study consisted of a total of 3 groups each containing 25 participants as follows: (1) Pap smear and HPV-negative control group, (2) HPV 16 or HPV 18 and LGSIL-positive participants, and (3) HPV 16 or 18 and HGSIL-positive participants. Cervical mucus SLPI levels were analyzed using the enzyme-linked immunosorbent assay method. RESULTS: The mean cervical mucus SLPI levels were 32.94 ng/mL (range: 23-41.29 ng/mL) in the hrHPV + LGSIL group, 29.40 ng/mL (range: 21.03-38.95 ng/mL) in the hrHPV + HGSIL, and 18.75 ng/mL (range: 13.58-29.24 ng/mL) in the healthy control group. Cervical mucus SLPI levels were found to be significantly higher in the hrHPV + LGSIL and hrHPV + HGSIL groups compared to the control group ( P < .001). CONCLUSIONS: The data from the present study indicate that SLPI seems to be one of the important immunomodulatory proteins that provide local immune response in cervical mucosa.

High Immune Expression of Progesterone-Induced Blocking Factor in Epithelial Ovarian Cancer.

BACKGROUND: Progesterone-induced blocking factor, which is released from maternal lymphocytes during pregnancy mediates the immune effect of progesterone. According to new reports, it is suggested that proliferating cells, such as human trophoblasts, mesenchymal stem cells, and malignant tumors, can excrete progesterone-induced blocking factor at high ratio to escape from maternal immunity. It is shown in recent studies that progesterone-induced blocking factor is overexpressed in many malignant tumors such as breast, cervical, lymphoma, and leukemia. There are no data about progesterone-induced blocking factor expression in ovarian cancer cells. Hence, it is aimed to determine the progesterone-induced blocking factor expression levels in epithelial ovarian cancer. METHODS: The study which was a retrospective cross-sectional study was conducted in a University Hospital. Twenty tissue specimens of patients with epithelial ovarian cancer and 20 tissue specimens of patients with healthy ovary were included in the study. Primary rabbit polyclonal anti- progesterone-induced blocking factor antibody was used to incubate the sections at a ratio of 1:300. RESULTS: When the tissue sections were compared based on immunostaining with progesterone-induced blocking factor, we detected high stromal progesterone-induced blocking factor expression in the epithelial ovarian cancer group as check against to the normal ovarian group ( P = .007). Similarly, we found high glandular progesterone-induced blocking factor expression in the epithelial ovarian cancer group as check against to the normal ovarian group ( P < .001). CONCLUSION: Proving the existence of progesterone-induced blocking factor expression in epithelial ovarian cancer cells may lead new visions or new studies for epithelial ovarian cancer immunotherapy. As a result, epithelial ovarian cancer cells have greater levels of expression of progesterone-induced blocking factor protein than normal ovarian tissue according to immunohistochemistry. Further research is needed to understand the clinical importance of this finding, to learn outcomes of high levels of progesterone-induced blocking factor, and to investigate its underlying mechanisms.

Perinatal outcomes in uncomplicated late preterm pregnancies with borderline oligohydramnios.

PURPOSE: The purpose of this study is to determine the adverse perinatal outcomes in uncomplicated late preterm pregnancies with borderline oligohydramnios. METHODS: A total of 430 pregnant women with an uncomplicated singleton pregnancy at a gestational age of 34 + 0-36 + 6 weeks were included. Borderline oligohydramnios was defined as an amniotic fluid index (AFI) of 5.1-8 cm, which was measured using the four-quadrant technique. Adverse perinatal outcomes were compared between the borderline and normal AFI groups. RESULTS: Approximately 107 of the 430 pregnant women were borderline AFI, and 323 were normal AFI. The demographic and obstetric characteristics were similar in both groups. Delivery <37 weeks, cesarean delivery for non-reassuring fetal heart-rate testing, meconium-stained amniotic fluid, Apgar 5 min <7, transient tachypnea of the newborn, respiratory distress syndrome, neonatal intensive care unit, and hyperbilirubinemia were not statistically different between the groups (p = .054, p = .134, p = .749, p = 0.858, p = .703, p = .320, p = .185, and p = .996, respectively). Although gestational age was full-term, induction of labor rates were significantly higher in the borderline AFI group (p = .040). In addition, fetal renal artery pulsatility index pulsatility index (PI) was significantly lower in the borderline AFI group than in the normal AFI group (p = .014). CONCLUSION: Our results indicated that borderline AFI was not a risk for adverse perinatal outcomes in uncomplicated, late preterm pregnancies.