Obstetrical complications associated with first-trimester screening markers in twin pregnancies.

AIM: The aim of this retrospective study was to investigate the relation between perinatal complications in twin pregnancies and the combination of first-trimester maternal serum pregnancy-associated plasma protein-A (PAPP-A) and free beta-human chorionic gonadotrophin (ß-hCG) levels. MATERIAL AND METHODS: The study was conducted at the Perinatology Department of Baskent University between January 2005 and December 2011. In total, 104 patients with twin pregnancies were recruited. The association of first-trimester maternal serum-screening markers with perinatal complications was investigated for small-for-gestational-age (SGA) fetuses or intrauterine growth restriction (IUGR), preterm delivery (before 34 weeks of gestation), pregnancy-induced hypertension (PIH), and growth discordance between fetuses. RESULTS: Low serum PAPP-A (below 10th percentile) levels were not correlated with preterm labor, PIH, or IUGR in twin gestations. Elevated free ß-hCG levels (>90th percentile) were linked to increased rates of PIH and small-for-gestational-age fetuses or IUGR. CONCLUSION: Elevated first-trimester free ß-hCG was related to adverse pregnancy outcomes in twin pregnancies, whereas low PAPP-A levels were not linked to adverse pregnancy outcomes.

How safe is pregnancy after liver transplantation? A large case series study at tertiary referral center in Turkey.

Objective: To investigate pregnancy outcomes and to define preventative measures against to risk factors and complications in pregnancy after liver transplantation. Secondary aim is to report postpartum allograft functions in these patients.Method: This is a case series study. All pregnant women with liver transplantations performed in our hospital were enrolled. Patients' hospital medical records, electronic records Neonatal Intensive Care Unit (NICU) records were used to collect data. Obstetric characteristics and antenatal complications, risk factors, pregnancy and neonatal outcomes, all aspects of liver transplant variables and allograft functions after pregnancy were studied.Results: A total of 11 patients were included in the study. All of them were singleton. Mean maternal age was 29.3 ± 3.9 years. And mean gestational week of delivery was 37.2 ± 2.2. 78% of the women were delivered at term (>37 weeks) only two babies were preterm and discharged from NICU without any complications. Birth weight (gr median ± SD) was 2575 ± 345. Five (45%) patients were nulliparous, majority of the cases (8/11, 72%) were conceived of pregnant with natural way. Live birth rate was 81% (9/11). Only one patient for each has suffered from fetal growth restriction, maternal anemia, maternal hyperthyroidism, and ulcerative colitis. Vaginal bleeding was seen in five women during the pregnancy. There was no maternal death, stillbirth or neonatal death. The mode of delivery for all live birth pregnancies was C-section. And none of them was emergency C-section. No complication of allograft function was seen after pregnancy.Conclusion: Pregnancy in women with liver transplantation is not associated with poor pregnancy outcomes and complications for both the mother and the neonates when these patients followed up at tertiary referral center with multidisciplinary approaches.

Increased nuchal translucency and pregnancy outcomes: experience of Baskent University Ankara Hospital.

OBJECTIVE: First trimester nuchal translucency (NT) measurement is considered to be an important tool in antenatal follow-up. This study aimed to evaluate the outcomes of pregnancies with increased NT at Baskent University Ankara Hospital between 2004 and 2016. MATERIALS AND METHODS: Patients with NT measurements ≥1.5 multiples of median (MoM) were divided into two groups; group I included increased NT cases without fetal anomalies (either abnormal fetal karyotype or congenital structural anomalies) or loss (intrauterine fetal death), and group II included increased NT cases with fetal anomalies or loss. The groups were compared with each other with respect to maternal demographic features and NT measurements. RESULTS: Karyotype analyses were normal in 73.1% of cases with increased NT (57/78). Among those, 21.1% (12/57) had structural anomalies, and to specify, 9.6% (5/52 over 18 weeks) had cardiac anomalies. Although maternal demographic features did not differ significantly, NT measurements, both as millimeters and MoM, were significantly higher in group II (p<0.05). According to the receiver operating characteristic (ROC) curves, the optimal cut-off values for NT measurements for predicting fetal anomalies or loss were 3.05 mm and 2.02 MoM. NT measurement >7 millimeters or NT MoM >4.27 resulted in poor fetal outcomes without exception. CONCLUSION: Higher NT measurements indicate poorer pregnancy outcomes. Our study indicates that fetal echocardiography must be considered for all cases with increased NT.