Term babies with delayed cord clamping: an approach in preventing anemia (.).

OBJECTIVE: We investigated the effects of delayed and early clamping of the cord on the hematologic status of the baby at birth and at the end of second month. METHODS: Umbilical cord of 74 babies were clamped in the first 30 s (Group 1) and 76 were clamped at 90-120 s (Group 2). Levels of hemoglobin, hematocrit, iron and ferritin were analyzed from the umbilical cord blood at birth and from the venous samples at the end of second month. RESULTS: Hemoglobin, hematocrit, iron and ferritin levels of cord blood were similar in both groups. However, their levels other than ferritin were higher in Group 2 at the end of second month. Two babies had respiratory distress and twelve neonates received phototherapy in Group 2 whereas only five neonates received phototherapy in Group 1. CONCLUSION: Term babies to whom delayed cord clamping was performed had improved hematological parameters at the end of second month. Therefore, delaying cord clamping in these babies may be a favorible approach in preventing anemia.

Effect of thyroid dysfunction and autoimmunity on pregnancy outcomes in low risk population.

PURPOSE: The objective of this study was to assess the effect of thyroid dysfunction and autoimmunity in early pregnancy on adverse pregnancy and neonatal outcome. METHODS: 497 pregnant women between 10 and 12 gestational age were invited who were attending for their first antenatal visit and asked to perform blood tests for thyroid function and antithyroid peroxidase antibodies. A total of 395 women were recruited in the present study. Cases were classified into four groups according to thyroid function and anti-TPO results. The pregnancy outcomes included gestational diabetes mellitus, preeclampsia, preterm delivery, cesarean rate, small for gestational age, low birth weight. RESULTS: 2.5-(OR 2.5, 95% CI 1.06-5.89) and 4.8-(OR 4.85, 95% CI 1.89-12.42) fold increase in preterm delivery was detected in groups with isolated anti-TPO positivity and subclinic hypothyroidism with anti-TPO positivity compared to reference group, respectively. No association was found between thyroid dysfunction and anti-TPO positivity with gestational diabetes, preeclampsia, cesarean rates, low birth weight and small for gestational age neonates. CONCLUSION: Pregnant women with anti-TPO antibody positivity alone or with subclinic hypothyroidism were more likely to experience a spontaneous preterm delivery.

Does aggressive and expectant management of severe preeclampsia affect the neurologic development of the infant?

OBJECTIVE: To compare and evaluate the influences of expectant and aggressive management of severe preeclampsia on the first year neurologic development of the infants in pregnancies between 27 and 34 weeks of pregnancy. METHODS: Seventy women with severe preeclampsia between 27 and 34 weeks of gestation were included in the study. 37 patients were managed aggressively (Group 1) and 33 patients were managed expectantly (Group 2). Glucocorticoids, magnesium sulfate infusion and antihypertensive drugs were administered to each group. After glucocorticoid administration was completed Group 1 was delivered either by cesarean section or vaginal delivery. In Group 2 magnesium sulfate infusion was stopped after glucocorticoid administration was completed. Antihypertensive drugs were given, bed rest and intensive fetal monitorization were continued in this group. RESULTS: The average weeks of gestation, one minute and five minute apgar scores and hospitalization time in intensive care unit were similar in both groups (P > 0.05). Three neonatal complications in Group 2 and five in Group 1 were detected according to the Denver Developmental Screening Test-II and one pathologic case was detected in both groups following neurologic examination. Neonatal mortality was seen in seven patients in Group 1 and one in Group 2. There were no significant differences between groups in terms of neonatal mortality and morbidity and maternal morbidity (P > 0.05). The average latency period was 3.45 ± 5.48 days in Group 2 and none in Group 1. CONCLUSION: There was no significant difference in the first year neurological development of infants whose mothers underwent either expectant and aggressive management for severe preeclampsia.

The Bakri balloon for the management of postpartum hemorrhage in cases with placenta previa.

OBJECTIVE: To evaluate the success rate of the Bakri balloon in the event of uncontrollable hemorrhage due to placenta previa. STUDY DESIGN: We evaluated 25 patients who were treated with the Bakri balloon who had severe postpartum hemorrhage with placenta previa and failed medical treatment with uterotonic agents. RESULTS: The Bakri balloon was inserted abdominally during cesarean section in 24 of 25 cases. In only one case was it inserted vaginally. The Bakri tamponade was effective in 22 cases (88%). There were three cases with failure: two patients needed an additional procedure (hypogastric artery ligation and B-Lynch suture) and one patient needed hysterectomy. CONCLUSIONS: The Bakri balloon is the least invasive, rapid method in the management of bleeding due to placenta previa with minimal complications.

Prenatal diagnosis of a huge facial tumor: report of a rare case and literature review.

Neonatal tumors are reported to occur in approximately 17-121 per million live births worldwide. They are often diagnosed by ultrasonography after mid-pregnancy. Teratomas are the most frequent solid neoplasms, accounting for between one-quarter and one-third of cases. Here, we describe the prenatal diagnosis of a fetal face teratoma located on the right temporal side at 26 weeks of gestation. Besides 2D and 4D ultrasound imaging, fetal magnetic resonance imaging provides substantial support in perinatal management and promotes the perception of fetal malformations by the family. Extreme intrauterine growth of the tumor with remarkable pressure to the surrounding facial structures and good perinatal prognosis following complete tumoral resection are reviewed.