Comparison of Apgar scores and cord blood gas parameters in fetuses with isolated congenital heart disease and healthy controls.

OBJECTIVE: This retrospective study aimed to investigate how congenital heart disease (CHD) affects early neonatal outcomes by comparing Apgar scores and umbilical cord blood gas parameters between fetuses with structural cardiac anomalies and healthy controls. Additionally, within the CHD group, the study explored the relationship between these parameters and mortality within six months. METHODS: Data from 68 cases of prenatally diagnosed CHD were collected from electronic medical records, excluding cases with missing data or additional comorbidities. Only patients delivered by elective cesarean section, without any attempt at labor, were analyzed to avoid potential confounding factors. A control group of 147 healthy newborns was matched for delivery route, maternal age, and gestational week. Apgar scores at 1, 5, and 10 minutes, as well as umbilical cord blood pH, base deficit, and lactate levels, were recorded. RESULTS: Maternal age, gestational week at delivery, and birth weight were similar between the CHD and control groups. While Apgar score distribution was significantly lower at 1st, 5th, and 10th minutes in the CHD group, umbilical cord blood gas parameters did not show significant differences between groups. Within the CHD group, lower umbilical cord blood pH and larger base deficit were associated with mortality within six months. CONCLUSION: Newborns with CHD exhibit lower Apgar scores compared to healthy controls, suggesting potential early neonatal challenges. Furthermore, umbilical cord blood pH and base deficit may serve as predictors of mortality within six months in CHD cases. Prospective studies are warranted to validate these findings and integrate them into clinical practice, acknowledging the study's retrospective design and limitations.

Can preoperative complete blood count parameters be used in the diagnosis of patients with adnexal torsion: a case-control study.

OBJECTIVE: To determine whether there is a relationship between complete blood count parameters at adnexal torsion and to investigate the clinical utility of these parameters in preoperative diagnosis. METHODS: The retrospective, case-control study was conducted at a tertiary care hospital in Turkey and comprised data of patients who underwent adnexal torsion surgery from 2007 to 2017. Medical records of healthy controls who underwent various gynaecological surgeries during the period were used as the control group. Demographic characteristics and preoperative complete blood count parameters were retrieved from the medical records, and factors influencing adnexal torsion diagnosis were evaluated. Data was analysed using SPSS 21. RESULTS: Of the 296 subjects, 73(24.7%) were adnexal torsion cases and 223(75.3%) were controls. Demographic characteristics did not differ between the groups (p>0.05). Leukocytosis was present in 38(52%) cases. Mean white blood cell, neutrophil, and platelet counts and neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios were significantly higher, and mean platelet volume was significantly lower in the cases compared to controls (p<0.05). Logistic regression analysis identified an independent association between a low mean platelet volume and adnexal torsion (p<0.05). The optimal cutoff value was 10.35fL, with 77.4% sensitivity and 74.2% specificity. CONCLUSIONS: There was found to be a significant relationship between adnexal torsion and certain parameters of the complete blood count. Low mean platelet volume could be considered a useful additional tool for the preoperative diagnosis.

Accuracy of sonographic fetal weight estimation in full-term singleton pregnant women.

OBJECTIVES: To investigate the factors which might influence the sonographic fetal weight estimation (SFWE) accuracy. METHODS: This prospective study was conducted among 949 singleton term pregnant women who delivered at a tertiary center, from January 2017 to December 2017. All participants' maternal (i.e. parity, age, body mass index and gestational weight gain during pregnancy), fetal sonographic (i.e. fetal presentation, amniotic fluid index, localization of placenta and estimated fetal weight) and neonatal (birth weight and gender) characteristics were recorded. A p<0.05 was considered significant. RESULTS: The mean absolute percent error (APE) values of SFWE was 8.2±6.5 percent, and overall failure ratio (APE >10%) was 33%. In failure group, primiparous woman and cephalic presentation fetus were significantly more common compared to accuracy group (55.9% vs.44.8%; p=0.001 and 98% vs. 95.2%; p=0.03, respectively). In contrast, the mean neonatal birth weight (NBW) value was significantly lower in failure group compared to success group (3250±565 gr vs. 3404±410 gr; p=0.001). The correlation between SFWE and NBW was linear, however negative, and significant (p=0.001). Logistic regression analysis revealed that primiparous woman, cephalic presentation fetus and <3300 gr NBW were independent risk factors for the SFWE failure (relative risks were 1.6, 2.8 and 2.4 respectively, p<0.05). CONCLUSION: SFWE has a high correlation with NBW, however it's accuracy is still unsatisfactory, and depend on many unpredictable and inconsistent factors.