Survival of periviable infants: 5-year experience at a single center.

Objectives: The primary aim of the present study was to investigate the survival rates of periviable births in a referral Level III NICU center in Turkey; the secondary aim was to determine the perinatal and natal risk factors related to mortality.Methods: This retrospective cross-sectional study was conducted at the Neonatal Intensive Care Unit between 1 January 2011 and 31 December 2015. All live deliveries occurring from 22 0/7 weeks to 25 6/7 week of gestation were included in the study (total n = 165). We documented prenatal, natal, and postnatal clinical processes in each case and assessed morbidity, mortality, and factors related to long-term prognosis.Results: While none of the infants born at 22 weeks of gestation survived until discharge, the survival rates for those admitted to the NICU were 7.5% for infants born at 23 weeks, 29.1% at 24 weeks, and 43.5% at 25 weeks. A total of 46 survived (27.9%), and follow-up data beyond 12 months were available for 22. The prevalence of neurodevelopmental impairment or neurosensory impairment was inversely associated with gestational age.Conclusions: The most important risk factors associated with mortality in periviable infants were SNAPPE score, antenatal corticosteroid use, and gestational age.

Effect of the delivery way and number of parity in the subsequent incidence of placenta previa.

Aim: To appraise the impact of previous birth type and the number of deliveries on placenta previa incidence and the extent of intrapartum massive hemorrhage.Materials: Placenta previa complications among healthy singleton subsequent pregnancies following previous pregnancies without placenta previa history were classified according to their birth types and previous numbers of parity. Subgroups of subsequent pregnancies with massive hemorrhage and placental adhesion anomalies were compared.Result: One, two, three or more previous cesarean births triggered a significant increase in the rate of massive hemorrhage when compared to subgroups of previous vaginal births (31.5% versus 50.9%, p = .02; 32.7% versus 69.0%, p = .001; and 42.9% versus 81.9%, p = .035, respectively). The rate of placental adhesion anomalies in all subgroups of previous cesarean births were statistically higher than subgroups of previous vaginal births (12.4 versus 32.7%, p = .003; 10.2% versus 52.2%, p = .001; and 9.5% versus 63.6%, p = .001, respectively). Urogenital complications in women with one previous cesarean birth were higher than those of the vaginal birth group (9.1 versus 0%, p = .004).Conclusion: Previous cesarean births are more frequently associated with increased massive hemorrhage and placental adhesion anomalies in subsequent pregnancies with placenta previa when compared to previous vaginal births.

The Effect of the Amniotic Fluid Index on the Accuracy of Ultrasonographic-Estimated Fetal Weight.

BACKGROUND: Fetal weight estimation is one of the most important aspects of antenatal care. The effects of amniotic fluid volume on the accuracy of estimated fetal weight (EFW) depend on the amount of fluid, in particular whether it is polyhydramnios or oligohydramnios. Previous studies have reported conflicting results of the effects of amniotic fluid volume on EFW accuracy. AIM: The aim of the study was to evaluate the effects of isolated oligohydramnios cases and polyhydramnios on the accuracy of EFW. MATERIALS AND METHODS: A retrospective study was conducted at a tertiary center. The study groups consisted of 1069 term isolated oligohydramnios cases, 182 term isolated polyhydramnios cases, and 392 term-matched cases with a normal volume of amniotic fluid. Estimated fetal weight error was determined and expressed in terms of systematic error, calculated from mean percentage error and random error. RESULTS: The systematic error did not differ significantly between polyhydramnios and oligohydramnios cases (-3.60 [8.94%] vs -2.73 [9.7%]). The random error was 8.94% in polyhydramnios cases and 9.7% in oligohydramnios cases. The overestimation rate was 63.6% in polyhydramnios cases and 66.3% in oligohydramnios cases. CONCLUSIONS: There were no significant differences in the accuracy of EFW between oligohydramnios and polyhydramnios. However, there was a tendency for overestimation in both types of cases.

Nifedipine increases fetoplacental perfusion.

AIM: Our aim is to evaluate the effect of nifedipine on fetoplacental hemodynamic parameters. METHODS: A retrospective study was conducted at a tertiary center with 30 patients for whom nifedipine treatment was used as a tocolytic therapy for preterm labor. Initiation of this treatment was at 31.6±2.5 weeks of gestation. We combined the pulse Doppler imaging parameters with grayscale imaging via the Bernoulli theorem, which is called the "continuity equation", to get the fetoplacental perfusion (FPP). Evaluated parameters were the resistance index (RI), the pulsatility index (PI), systole/diastole ratios (S/D), the velocity-time integral of the umbilical artery (VTI), the radius of the umbilical artery, the peak systolic velocity and the mean pressure gradient in the umbilical artery. From these parameters, the FPP was acquired. RESULTS: We found that the RI, the PI and the S/D ratio did not change after treatment with nifedipine. The mean pressure gradient, the VTI and the peak systolic velocity increased after treatment with nifedipine. Nifedipine increases FPP from 166±73.81 beat.cm3/min to 220±83.3 beat.cm3/min. DISCUSSION: Although nifedipine had no effect on the PI, the RI or the S/D, it increased the mean pressure gradient, the VTI and FPP.

Use of translabial three-dimensional power Doppler ultrasound for cervical assessment before labor induction.

OBJECTIVE: To compare translabial three-dimensional (3D) power Doppler ultrasound with Bishop score and transvaginal ultrasound measurements for cervical assessment before induction of labor with dinoprostone or cervical ripening balloon. MATERIALS AND METHODS: Translabial cervical volume and length, vascularization indices and transvaginal cervical length were measured. Results were compared among women who had vaginal delivery at 24 h or less and more than 24 h after the insertion of the dinoprostone vaginal insert or cervical ripening balloon and among women who had vaginal delivery and cesarean delivery for failure to go into labor or failure to progress. RESULTS: There was no correlation between the time to delivery after a ripening agent was applied and translabial cervical volume, translabial cervical length, vascularization index (VI), flow index (FI), vascularization flow index (VFI), transvaginal cervical length and Bishop scores. The ultrasonographic measurements were no different among women who had vaginal delivery at 24 h or less and more than 24 h and among women who had vaginal delivery and cesarean delivery for failure to go into labor or failure to progress. CONCLUSION: In this study, we failed to demonstrate the superiority of translabial 3D ultrasonography over Bishop score and transvaginal ultrasonography for predicting the success of induction of labor.

Estimation of fetal weight by ultrasonography after preterm premature rupture of membranes: comparison of different formulas.

OBJECTIVE: To compare different ultrasonographic fetal weight estimation formulas in predicting the fetal birth weight of preterm premature rupture of membrane (PPROM) fetuses. METHODS: Based on the ultrasonographic measurements, the estimated fetal weight (EFW) was calculated according to the published formulas. The comparisons used estimated birth weight (EBW) and observed birth weight (OBW) to calculate the mean absolute percentage error [(EBW-OBW)/OBW×100], mean percentage error [(EBW-OBW)/OBW×100)] and their 95% confidence intervals. RESULTS: There were 234 PPROM patients in the study period. The mean gestational age at which PPROM occured was 31.2±3.7 weeks and the mean gestational age of delivery was 32.4±3.2 weeks. The mean birth weight was 1892±610 g. The median absolute percentage error for 33 formulas was 11.7%. 87.9% and 21.2% of the formulas yielded inaccurate results when the cut-off values for median absolute percentage error were 10% and 15%, respectively. The Vintzileos' formula was the only method which had less than or equal to 10% absolute percentage error in all age and weight groups. CONCLUSIONS: For PPROM patients, most of the formulas designed for sonographic fetal weight estimation had acceptable performance. The Vintzileos' method was the only formula having less than 10% absolute percentage error in all gestational age and weight groups; therefore, it may be the preferred method in this cohort. Amniotic fluid index (AFI) before delivery had no impact on the performance of the formulas in terms of mean percentage errors.

A new mathematical formula to predict the foetal weight in twin pregnancies: A comparison of it with 19 different formulas.

One hundred and seventy-two twin-pregnant patients were enrolled. The estimated foetal weight was calculated using 19 different formulas. Ong's formula (0.954 (95%CI = 0.938/0.966)), which was designed specifically for twins, produced the highest Cronbach's alpha value followed by Hadlock II (0.952 (95%CI = 0.935/0.965)), Hadlock I (0.952 (95%CI = 0.935/0.964)), Hadlock III (0.952 (95%CI = 0.935/0.964)), Hadlock IV (0.952 (95%CI = 0.935/0.964)) and our formula (0.952 (95%CI = 0.935/0.964)), which produced the same Cronbach's alpha values for twin A. For twin B, our formula produced the highest Cronbach's alpha value (0.961 (95%CI = 0.948/0.972) followed by Hadlock II (0.960 (95%CI = 0.946/0.971)), Hadlock I (0.960 (95%CI = 0.946/0.970)), Hadlock III (0.960 (95%CI = 0.946/0.970)) and Hadlock IV (0.960 (95%CI = 0.946/0.970)). In conclusion, our formula (AC, FL) performed well in predicting the foetal weights in twin pregnancies (>24 weeks) in our study. However, it should be tested in other populations. Hadlock II (AC, FL) produced a comparable performance to Hadlock I (BPD, HC, AC, FL), Hadlock III (BPD, AC, FL) and Hadlock IV (HC, AC, FL). Hadlock II may be preferable in twin pregnancies since it is based on AC and FL only.

Predictivity of mean platelet volume in severe preeclamptic women.

INTRODUCTION: To evaluate the predictive and clinical utilization of the mean platelet volume (MPV) in severe preeclamptic women. MPV is known as platelet size and associated with platelet activation or new platelet synthesis. Platelet count is decreased by vascular endothelial damage in cases of severe preeclampsia. It leads to increased turnover of platelets. METHODS: The severe preeclamptic women with and without preeclampsia during pregnancy were divided into subgroups depending on the gestational birth week early, (<34), late (34-37) preterm birth and term (≥37) gestational weeks. Their MPV was measured 24 hours prior to birth and compared with all subgroups according to the gestational week. RESULT: The study subgroups were performed from early (n = 87), late (n = 48) preterm and term (n = 76) birth with severe preeclampsia, whereas early (n = 69), late (n = 63) and term (n = 228) without gestational hypertensive disorders were recruited in the control subgroups. The MPV of the early, late preterm and term preeclamptic subgroups was statistically higher than that of the control subgroups (9.4 ± 1.3fL vs 8.6 ± 1.2 fL, p < 0.001; 9.5 ± 1.0 fL vs 8.5 ± 0.9 fL, p < 0.001 and 10.2 ± 1.1 fL vs 8.9 ± 1.2 fL, p < 0.001), whereas the mean platelet count of all the study subgroups was significantly lower (237.3 ± 81.3 × 109 /L, 270.0 ± 83.9 × 109/L, p = 0.015; 232.3 ± 80.1 × 109/L vs 268.8 ± 92.7 × 109/L, p < 0.001 and 221.8 ± 70.3.9 × 109/L vs 232.9 ± 82.3 × 109/L, p = 0.03). The sensitivity and specificity of the cut-off MPV for all the subgroups were each less than 80%. CONCLUSION: The MPV may be a predictive marker of severe preeclampsia.

The impact of prenatal psychologic and obstetric parameters on postpartum depression in late-term pregnancies: A preliminary study.

OBJECTIVE: To determine the prenatal psychologic (anxiety and depression) and perinatal obstetric (pregnancy and labor complications) predictors of postpartum depression (PPD) in late-term pregnancies. MATERIALS AND METHODS: A total of 149 women with late-term gestation who were hospitalized for antenatal fetal surveillance were included. All participants were asked to complete Hospital Anxiety and Depression Scale immediately after hospitalization and Edinburgh Postnatal Depression Scale in the postpartum period. Demographic, psychologic, and obstetric variables were tested as predictors of PPD by regression analysis. RESULTS: High scores for prenatal anxiety, depression, and PPD were detected in 17.4%, 12.8%, and 23.5% of the participants, respectively. The mode of delivery was not associated with PPD for late-term pregnancies. Women having urgent cesarean, planned cesarean, and vaginal delivery had similar rates of PPD (28.1%, 23.8%, and 21.9%, respectively). In the multivariant analysis, prenatal depression [odds ratio (OR), 9.85; 95% confidence interval (CI), 2.72-35.65], prenatal anxiety (OR, 4.95; 95% CI, 1.59-15.39) and suspicion of fetal distress (OR, 4.44; 95% CI, 1.13-13.64) were found to be independent predictors of PPD. CONCLUSION: For late-term pregnancies, women with prenatal anxiety or depression and had cesarean delivery due to the suspicion of fetal distress were at risk for PPD.

Obstetric outcomes of isolated oligohydramnios during early-term, full-term and late-term periods and determination of optimal timing of delivery.

AIM: Our aim was to evaluate the obstetric outcomes of isolated oligohydramnios during the early-term, full-term, and late-term periods, and to determine the optimal timing of delivery. METHODS: A retrospective study was performed at a tertiary center. Isolated oligohydramnios cases were divided into early-term, full-term, and late-term groups. Evaluated outcomes were fetal birthweight, 5-min Apgar score < 7, meconium-stained amniotic fluid, neonatal intensive care unit admission, transient tachypnea of newborn (TTN), requirement of ventilator, newborn jaundice, mode of delivery, induction of labor, and undiagnosed small-for-gestational-age fetus before delivery. Composite outcome was defined as perinatal outcomes taken together (neonatal intensive care unit admission, TTN, requirement of ventilator, and newborn jaundice). RESULTS: The study period included 1213 cases of term isolated oligohydramnios. Within this cohort there were 347 early-term, 781 full-term and 85 late-term patients. The cesarean rate and the rate of newborn jaundice were higher in early-term cases (37.8% and 3.5%, respectively) than in full-term cases (30.1% and 0.9%, respectively). Meconium-stained amniotic fluid was higher in late-term than full-term cases. Timing of delivery did not affect occurrence of TTN, 5-min Apgar score < 7, ventilator requirement, or composite outcome. In total, 15-17% of isolated oligohydramnios cases involved undetected small-for-gestational-age fetuses. CONCLUSION: As this study was not a randomized controlled trial, a decisive conclusion may not be possible. However, until well-designed controlled studies are conducted, expectant management may be appropriate up to the full-term period and induction of labor may be appropriate management when the full-term period is reached.

Obstetric outcome of second trimester antenatal bleeding.

OBJECTIVE: To evaluate the clinical significance of vaginal bleeding in pregnant women between 14th and 22th gestational weeks. METHODS: This retrospective case-control study was conducted between September 2010 and December 2013. Two-hundred nineteen pregnant women with vaginal bleeding between 14th and 22th gestational weeks were compared with 325 pregnant women without vaginal bleeding for their maternal and early neonatal outcomes. RESULTS: Mean gestational age and birth weight of study group were significantly different from those of the control group respectively (37.9 ± 2.8 versus 38.9 ± 1.4 and 3071 ± 710 versus 3349 ± 446 for groups p < 0.001). Vaginal bleeding between 14th and 22th gestational weeks had increased risk of having preterm birth (PB) and preterm premature rupture of membranes (PPROM) (OR: 10.8, 95% CI: [4.5-26.1]; OR: 12.0, 95% CI: [3.5-40.6], respectively). Gestational diabetes mellitus (GDM) and polyhydramnios ratio in the study group was significantly higher than the control respectively (4.1% versus 1.2%, p = 0.031; 1.9% versus 0%, p = 0.025). CONCLUSION: Pregnant women with vaginal bleeding was a significantly risk factor for PB, PPROM, GDM, and polyhydramnios. Consequently, these pregnancies should be closely followed up for maternal and fetus complications.

Finding the best formula to predict the fetal weight: comparison of 18 formulas.

BACKGROUND: To compare the accuracy of 18 formulas in predicting fetal weight and also to make a comparison of these formulas in low-birth-weight fetuses (<2,500 g) and in fetuses weighing >4,000 g. METHODS: Four-hundred-and-ninety-five pregnant patients were enrolled. The estimated fetal weight was calculated using 18 different formulas. The mean percentage error, the mean absolute percentage error and reliability analysis were used to compare the performance of the formulas. RESULTS: The Cronbach's alpha was the highest in the formulas Hadlock I (0.977 (95% CI = 0.972-0.980)), Hadlock III (0.977 (95% CI = 0.972-0.980)) and Ott (0.975 (95% CI = 0.970-0.979)) in all fetuses. It was the highest in formulas Ott (0.383 (95% CI = 0.091-0.581)), Hadlock IV (0.371 (95% CI = 0.074-0.572)) and Combs (0.369 (95% CI = 0.071-0.571)) in fetuses >4,000 g. It was the highest in formulas Coombs (0.957 (95% CI = 0.940-0.569)), Ott (0.956 (95% CI = 0.939-0.968)) and Hadlock IV (95% CI = 0.956 (0.938-0.968)) in fetuses <2,500 g. CONCLUSION: We noted that formulas Hadlock I, Hadlock III and Ott may be used to predict the estimated fetal weight accurately in all fetuses in our study. Formulas Ott, Hadlock IV and Coombs may be preferred to predict EFW in fetuses <2,500 g and >4,000 g. Better formulas should be developed to predict the fetal weight in fetuses >4,000 g.

Effect of oxytocin discontinuation during the active phase of labor.

OBJECTIVE: To observe the progression of labor when oxytocin use is limited to the onset of the active stage of labor. METHODS: A randomized, prospective controlled study was performed to address the issue of oxytocin infusion after the onset of active labor in 140 patients. In the study group, infusion of oxytocin was discontinued at the onset of the active phase of labor, which was accepted as a cervical dilatation of 5 cm. In the control group, incremental oxytocin infusion was administered until 5 cm cervical dilatation, and then was maintained at the same level until delivery. RESULTS: The primary outcome variable was duration from the beginning of the active phase to delivery. In the study group, the duration of the active phase of labor was about 30 min longer than in the control group and this difference was significant. The secondary outcomes of the study were maternal-fetal complications of oxytocin and in both groups there were no significant differences. CONCLUSION: It is not reasonable to discontinue oxytocin infusion at the beginning of active labor. Nevertheless, for an accurate conclusion expanded investigations are needed.

Effect of body mass index on latency periods after history-indicated cervical cerclage.

BACKGROUND: The impact of maternal body mass index (BMI) on cervical cerclage outcomes is not clear in the literature. AIM: We sought to investigate the impact of BMI on history-indicated cervical cerclage outcomes in our unit. METHODS: We retrospectively reviewed 196 history-indicated cervical cerclage procedures. The results were analysed according to the BMI groups <25, 25-30 and ≥30 kg/m(2) . RESULTS: A total of 122 cases were available for the final analysis. Thirty-two (26.1%) of the women had normal BMI (BMI < 25), 69 (56.5%) were overweight (BMI = 25-30) and 21 (17.4%) were obese (BMI ≥ 30). The mean gestational age of delivery according to BMI groups <25, 25-30 and ≥30 were 37.2 ± 3.1, 36.0 ± 5.3 and 36.0 ± 4.9 weeks (P = 0.591), respectively. The mean latency periods according to BMI groups <25, 25-30 and ≥30 were 24.3 ± 3.2, 21.1 ± 5.1 and 21.4 ± 4.9 weeks (P = 0.171), respectively. We found no correlation between the BMI and latency periods (Spearman's rho = -0.252). The multivariable logistic regression model found no variable to affect preterm birth rates. CONCLUSIONS: The BMI has no impact on history-indicated cervical cerclage procedure outcomes. Normal weight, overweight and obese women had similar latency periods after history-indicated cervical cerclage. This high percentage of preterm birth risk necessitates close surveillance of these women for preterm birth.

The relationship between markedly elevated glucose challenge test results and the rate of gestational diabetes mellitus and gestational impaired glucose tolerance.

BACKGROUND AND OBJECTIVES: Even though the 50 g oral glucose challenge test (GCT) is the most commonly used screening modality for gestational diabetes mellitus (GDM), no consensus for the diagnostic approach is available to patients with a markedly elevated GCT result. We aimed to evaluate the diagnostic utility of markedly elevated GCT results and the impact of age using the oral glucose tolerance test (OGTT) as gold standard. DESIGN AND SETTING: Retrospective study conducted in a women's hospital in Ankara, among patients who underwent GCT from January 2005 to December 2008. PATIENTS AND METHODS: In this retrospective study, we included 626 pregnant women who underwent a 3-hour 100 g OGTT after a GCT result ≥180 mg/dL among 29842 women. We calculated positive predictive values (PPV) of each GCT category to diagnose GDM and both GDM and gestational impaired glucose tolerance (GIGT). RESULTS: A GCT result of ≥240 mg/dL provided 100% PPV for the diagnosis of GDM and a result of ≥230 mg/ dL provided 100% PPV for the diagnosis of GDM + gestational impaired glucose tolerance (GIGT), according to both, National Diabetes Data Group (NDDG) and Carpenter and Coustan (CC) criteria. A result of ≥200 mg/ dL provided 100% PPV for diagnosing GDM+GIGT in patients older than 35 years, according to the CC criteria. CONCLUSIONS: The GCT result of 200 mg/dL is an ideal cutoff value for the diagnosis of GDM + GIGT in patients ≥35 years, and OGTT can be omitted in these patients. In younger patients, the cutoff value should be chosen as 230 mg/dL.

Comparison of low-dose oxytocin and dinoprostone for labor induction in postterm pregnancies: a randomized controlled prospective study.

AIMS: The aim of this study was to compare the efficacy of oxytocin and dinoprostone in achieving successful labor induction and vaginal delivery in postterm women with an unfavorable cervix. METHODS: Postterm women with an uncomplicated pregnancy and a Bishop score of ≤6 were randomized to receive either dinoprostone vaginal pessary (Propess®) or low-dose oxytocin. The primary outcomes were the length of the induction-to-delivery period and the incidence of vaginal delivery. RESULTS: A total of 144 women were available for the analysis. The overall vaginal delivery rates were 75% (54/72) for the dinoprostone group and 80.6% (58/72; p = 0.35) for the oxytocin group; the mean induction-to-vaginal delivery interval was 13.3 and 10.3 h in the dinoprostone and the oxytocin group, respectively (p = 0.003). Uterine hyperstimulation was 7.4% compared with 6.8% (p = 0.8), and abnormal fetal heart rate was 26.4% compared with 18% (p = 0.2), respectively. CONCLUSION: Both oxytocin and dinoprostone seem to have similar obstetric outcomes in postterm pregnancies with an unfavorable cervix, except for a significant superiority of oxytocin for delivery in a shorter period.

Gestational diabetes and gestational impaired glucose tolerance in 1653 teenage pregnancies: prevalence, risk factors and pregnancy outcomes.

STUDY OBJECTIVE: The aim of this study was to determine the prevalence of gestational diabetes mellitus (GDM) and gestational impaired glucose tolerance (GIGT) in adolescent pregnancies, associated risk factors, and pregnancy complications. DESIGN: Retrospective study. SETTINGS: Community-based teaching hospital. PARTICIPANTS: Results of 1653 pregnant women age ≤ 19 years in 2005-2007 were reviewed. INTERVENTION: All pregnant women screened with 50-g glucose challenge test (GCT) and patients with a GCT result ≥ 140 mg/dl underwent a 3-hour 100-g oral glucose tolerance test (OGTT). MAIN OUTCOME MEASURES: GDM was diagnosed with at least two abnormal results and GIGT was diagnosed with one abnormal result. GDM and GIGT cases were evaluated for the presence of any associated risk factors and effects of presence of risk factors on pregnancy outcomes. RESULTS: The prevalence of GDM was 0.85% (95% CI, 0.41-1.29), GIGT was 0.5% (95% CI, 0.15-0.81) and GDM+GIGT was 1.35% (95% CI, 0.78-1.88) by Carpenter and Coustan criteria. 68% of patients had at least one of the risk factors including body mass index ≥ 25, family history of diabetes and polycystic ovary syndrome (PCOS). Only 9.1% (n = 2) of them required insulin for glucose regulation during pregnancy with 9.1% (n = 2) macrosomia rate. All patients were primiparous and cesarean delivery rate was 27.3% (n = 6). We could not find any effect of presence of risk factors on pregnancy outcomes in GDM and GIGT cases. CONCLUSION: We demonstrated that GDM and GIGT are strongly associated with high BMI before pregnancy, PCOS, and family history of diabetes. Since GDM is a state of prediabetes, it is important to diagnose in adolescent pregnancies considering their life expectancy to take preventive measures to avoid diabetes mellitus.

A quantitative evaluation of total antioxidant status and oxidative stress markers in preeclampsia and gestational diabetic patients in 24-36 weeks of gestation.

OBJECTIVE: To assess the plasma and serum maternal total antioxidant status, circulating levels of lipid peroxidation breakdown products (MDA), protein oxidation markers (AOPPs), myeloperoxidase (MPO) and lipid hydroperoxide (LHP) in preeclampsia, gestational diabetes mellitus (GDM) patients and compare them with noncomplicated normal pregnancies between 24 and 36 weeks of gestation. STUDY DESIGN: 27 GDM, 27 preeclampsia and 29 noncomplicated singleton pregnancies were included. The blood samples were taken at the diagnosis of disease. RESULTS: TAS was decreased in GDM and preeclampsia when compared to normal pregnancies. MDA levels were higher only in GDM group than normal pregnancies. AOPP levels were increased but MPO and LHP levels were not changed both in GDM and preeclampsia when compared to normal pregnancies. CONCLUSIONS: We concluded that increased oxidative stress and reduction in antioxidant defense mechanisms may contribute to disease processes both in GDM and preeclampsia.