Evaluation of controlling nutritional status (CONUT) score in the prognosis of hyperemesis gravidarum.

OBJECTIVE: To investigate the predictive value of the Controlling Nutritional Status (CONUT) score on hyperemesis gravidarum (HG) severity, hospitalization, and length of stay. MATERIALS AND METHODS: This retrospective cross-sectional study, conducted between December 2022 and June 2023, involved two groups. Group 1 comprised 52 pregnant women diagnosed with HG in the first trimester, receiving hospitalization and treatment. Group 2 included 105 pregnant women diagnosed with HG in the first trimester, managed and treated as outpatients. The CONUT score was calculated with the formula: Serum albumin score + total lymphocyte score + total cholesterol score. This score is calculated with a number of points between 0 and 12. The interpretation of the score involves four categories: normal (0-1), light (2-4), moderate (5-8), and severe (9-12). RESULTS: The CONUT score differed significantly between the hospitalized (4, IQR: 2.25-5) and outpatient groups (2, IQR: 2-3) (p < 0.001). A CONUT score >3 was associated with the need for hospitalization, demonstrating a sensitivity of 60%, a specificity of 84% (p < 0.001). The CONUT score was the parameter with the highest odds ratio (OR) value among the parameters related to the need for hospitalization, and each unit increase in the CONUT score increased the need for hospitalization by 1.683 times [OR = 1.683 (95% CI: 1.042-2.718), p = 0.033]. A positive correlation was found between the CONUT score and the duration of hospital stay (r = 0.316, p = 0.023). CONCLUSIONS: This study suggests CONUT score as a valuable tool for predicting HG severity, hospitalization need, and duration of hospital stay.

The significance of Syndecan 1, a new marker for endothelial dysfunction, in cases of fetal growth retardation.

PROBLEM: In the current study we aimed to investigate Syndecan 1 (SDC1) levels in pregnant women diagnosed with fetal growth restriction (FGR) and the relationship between SDC1 levels and clinical and doppler parameters in FGR cases associated with endothelial dysfunction, angiogenesis and uteroplacental insufficiency METHOD OF STUDY: A total of 90 pregnant women included in the study, (45 with FGR, 45 healthy control) matched by week of gestation and maternal age. Venous blood samples were collected and plasma concentrations of SDC1 were determined by a specific immunoassay. Doppler examination was performed to evaluate the relationship between the SDC1 levels and placental blood supply. RESULTS: Doppler parameters; mean UtA-PI (p < .001), CPR (p = .002) and CPUR (p < .001) were different between the groups, however MCA PI, umbilical artery PI and umbilical artery S/D were not (p > .05). While gestational age at delivery, birth weight, APGAR score at 1 and 5 min were significantly lower (all, p < .001) in the study group, non-reassure fetal heart rate tracing (p = .09) and NICU admission (p = .02) were significantly higher. SDC 1 level was 2,00 ± 1,47 ng/mL and 2,34 ± 1,12 ng/mL in the FGR and control groups, respectively (p = .008). In the study group SDC 1 level was 1,69 ± 2,00 in those with gestational age below 32 weeks and 2,13 ± 1,18 in those with gestational age above 32 weeks and there was a statistically significant difference between the groups (p = .015). Plasma SDC 1 concentration of 2,1850 ng/mL or less had a sensitivity of 70%, a specificity of 72%, area under the ROC curve .65 (p < .005). CONCLUSIONS: Low maternal plasma SDC1 level may be associated with placental insufficiency and FGR. Low levels of SDC1 may be helpful as a predictor for the development of FGR during gestation.

A new Doppler index, cerebro-placental-uterine ratio, and fetal cardiac parameters in early onset preeclampsia.

OBJECTIVE: Our aim was to investigate the significance of cerebro-placento-uterine ratio CPUR, a new Doppler index, and fetal cardiac parameters (Mod MPI, EFT) in early-onset preeclampsia (EOPE) and to examine whether these parameters are related to perinatal outcome. STUDY DESIGN: Forty participants diagnosed with EOPE (preeclampsia cases diagnosed before 34 weeks of gestation) and 40 healthy pregnant women were included in this study. Demographic data were recorded. Doppler parameters such as middle cerebral artery (MCA), umbilical artery (UA), and uterine artery (Ut-A), and left modified myocardial performance index (Mod-MPI) and epicardial fat thickness (EFT) were measured. Cerebroplacental ratio (CPR) was determined by dividing MCA pulsatility index (PI) by UA PI. CPUR was calculated as the ratio of CPR to mean UtA-PI (CPUR = CPR/UtA-PI). All parameters were compared between the EOPE and control groups. Correlation tests were used to examine the relationship between Doppler parameters and perinatal outcome. p values less than 0.05 were considered statistically significant. RESULTS: The pulsatility index of the middle cerebellar artery, CPUR and CPR values were statistically lower in the EOPE group than in the control group (p = 0.002; p = <0.001; p = <0.001; respectively). No statistical differences were found between groups for isovolumetric contraction time (ICT), isovolumetric relaxation time (IRT), ejection time (ET), left mod-MPI, EFT (p = 0.117; p = 0.093; p = 0.398; p = 0.882; p = 0.202, respectively). Umbilical artery Doppler pulsatility index (PI), mean uterine artery Doppler pulsatility index (PI), were higher in the EOPE group than in the control group (p = 0.006; and p = <0.001, respectively). The CPUR value for predicting EOPE was ≤1.3652 with 74. 4% sensitivity and 94.9% specificity. Positive correlations were found between CPUR, CPR, and some neonatal parameters. CONCLUSION: CPUR, a new index combining fetal and uterine Doppler indices, may add contribution to predict adverse perinatal outcome and EOPE.

Results of Routine Antenatal Screening for Cytomegalovirus at a Tertiary Center.

Objective: Cytomegalovirus (CMV) is the most common viral infection. In this study, we discussed the results of pregnant women who underwent antenatal CMV screening in a tertiary center and the value of CMV antenatal screening. Methods: For this retrospective study, the data of pregnant patients with antenatal CMV screening test results between 2019 and 2022 were obtained from hospital records. CMV immunoglobulin M (IgM), CMV IgG, anti-IgG avidity test results, amniocentesis, CMV polymerase chain reaction (PCR), and the outcome of the babies were recorded. Results: A total of 31,912 CMV IgM and 26,969 CMV IgG tests were performed. CMV IgG seropositivity was observed in 78.99% of pregnant women, and 0.09% of the pregnant women were confirmed to have a positive CMV IgM test result. Pregnant women with positive IgM accompanying low avidity were referred to perinatology clinics for detailed ultrasonography and amniocentesis. Only 3 of the 44 pregnant women who underwent amniocentesis were confirmed to have positive CMV PCR testing. Conclusions: CMV screening should be preserved for pregnant women with ultrasonographic findings at high risk of congenital CMV infection.

Assessment of the COVID-19 Pandemic's Impact on Physical Intimate Partner Violence Against Pregnant Women in Ankara (Turkey): A Hospital-Based Study.

Purpose: A significant increase in physical intimate partner violence (IPV) cases has been reported from many countries during the COVID-19 pandemic, and particularly during lockdown periods. The current study's objectives are to define the COVID-19 pandemic's impact on physical IPV against pregnant women in Ankara. Patients and Methods: During the one-year pre-pandemic and two-year pandemic, records of patients who sent by the judicial authorities to the Obstetrics and Gynecology Emergency Room (ER) at Ankara City Hospital were reviewed, and pregnant women who had been subjected to IPV were identified. Results: Of pregnant women 19.1% in the pre-pandemic period, 29.4% in the first year and 51.5% in the second year of the pandemic period exposed to IPV. The mean age of IPV victims was 28.8 ± 6.5 years. Most ER applications were in the evening hours (48.5%), and majority of assailants were the victim's husband (77.9%). Vast majority of victims were multigravida women (89.7), and most of the traumas were localized in abdomen and genitalia (50%). Three of the women (4.4%) had miscarriage. Conclusion: The increase in cases of IVP against pregnant women during the pandemic was striking, according to the current study. We think that this first study from Turkey on the IPV that pregnant women are exposed to during the pandemic can lead to extensive research focused on measures against IPV during pandemics, such as dissemination of telephone applications for IPV victims, increasing home visits by marriage therapists, and intensifying of education campaigns against violence.

The effect of mother-infant skin-to-skin contact on the involution process and maternal postpartum fatigue during the early postpartum period.

Evidence has been limited on the effect of mother-infant skin-to-skin contact on the involution process and maternal postpartum fatigue. This study aimed to determine such effects in a randomized controlled trial conducted in a hospital in Sivas, Turkey. Seventy-five women were randomized into one of two groups. The Mother-Infant Information Form, Involution Process Evaluation Form and Visual Analogue Scale for Fatigue were used to collect data between October 1, 2015 and May 1, 2016. Repeated Measures ANOVAs were used for data analyzes. In the intervention group, routine care and mother-to-infant skin-to-skin contact were provided for 30 minutes in first postnatal hour. In the control group, routine care was provided. At the postnatal second, fourth and 24th hours, fundus heights were 13.4 ± 0.3, 12.9 ± 0.3 and 11.8 ± 0.3 cm, respectively, in the intervention group, and 14.4 ± 0.4, 13.8 ± 0.3 and 12.9 ± 0.3 cm in the control group (p < .05). At the 24th hour, women in the intervention group had higher mean energy levels (29.8 ± 10.1) than the control group (25.1 ± 10.0) (p < .05), and fatigue score, amount of lochia and number of pads were statistically similar between the groups (p > .05). Mothers expressed satisfaction with skin-to-skin practice. Thus, mother-to-infant skin-to-skin contact can be used as a care practice in the postpartum period.