Cysts of the fetal abdomen: Antenatal and postnatal comparison.

Background: To evaluate cases diagnosed with fetal abdominal cyst diagnosed in prenatal period. Methods: We retrieved the cases diagnosed with fetal abdominal cyst between the years 2018 and 2020 from hospital's database. The localization, origin, dimensions, properties (simple or complex), and characteristics (solid, cystic, vascularity) were noted both in prenatal and postnatal period. We also tested the diagnostic performance of ultrasonography according to endpoint diagnosis revealed postnatally. Results: During the study period, a total of 29 cases diagnosed as fetal abdominal cyst. Of them, there were 11 (37.9%) gastrointestinal, 9 (31%) ovarian, 6 (20.6%) genitourinary, 3 (10.3%) hepatobiliary system cysts. In our study, we were able to identify 5 (45%) of 11 fetuses with postnatally confirmed gastrointestinal system cysts, 1 (33%) of 3 fetuses with hepatobiliary system cysts, 3 (50%) of 6 fetuses with urinary system cysts and 6 (66%) of 9 fetuses with ovarian cysts. Conclusion: In this study, the most common abdominal cyst was ovarian cysts. The most difficult to diagnose cysts are those that originated from gastrointestinal system and hepatobiliary system.

Can First-trimester AST to Platelet Ratio Index Scores Predict HELLP Syndrome?

OBJECTIVE: To determine whether the ratio of the first-trimester aspartate aminotransferase (AST) to platelet ratio index (APRI) score will be useful as a new determinant of hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome that may develop in the later stages of pregnancy Study Design: Descriptive-analytical study. PLACE AND DURATION OF STUDY: Perinatology Clinic of Etlik Zübeyde Hanim Maternity and Women's Health Teaching and Research Hospital, Ankara, Turkey. The data of patients diagnosed as having HELLP syndrome between 2018 and 2020 were analyzed retrospectively. METHODOLOGY: Forty-two pregnant women with HELLP syndrome as the study group and 74 pregnant women with no morbidities as the control group were included in the study. First-trimester APRI scores were compared for both the groups. A characteristic curve (ROC) analysis of the study was performed to determine the APRI score levels predicting HELLP syndrome. RESULTS: One hundred and sixteen women with HELLP syndrome had significantly lower fibrinogen levels and platelet (PLT) levels than women without HELLP syndrome (p<0.001). Women with HELLP syndrome had significantly higher ALT, AST, creatinine, and INR levels. These differences were significantly different (p<0.001). Women who developed HELLP syndrome in the third trimester of pregnancy had significantly higher first-trimester APRI scores (0.64±0.10) than the control group (0.40±0.12, p<0.001). In the ROC analysis, 0.55 as a cut-off value for first-trimester APRI scores had a sensitivity of 88.1 % and a specificity of 94.6 % for predicting HELLP syndrome developing in the third trimester of pregnancy. CONCLUSION: There was an association of first-trimester APRI scores with the prediction of HELLP syndrome, possibly developing in the later weeks of pregnancy. Predicting HELLP syndrome in the early period can assist in proper management and taking necessary precautions. Key Words: HELLP syndrome prediction, First-trimester APRI, APRI scores in pregnancy, APRI score.

First-trimester aspartate aminotransferase to platelet ratio index in predicting intrahepatic cholestasis in pregnancy and its relationship with bile acids: A pilot study.

OBJECTIVE: To evaluate the predictive value of the first-trimester aspartate aminotransferase (AST)/platelet count ratio [AST to platelet ratio index (APRI) score] for intrahepatic cholestasis in pregnancy (ICP). METHODS: This study consisted of a patient group diagnosed with ICP (n = 37) and a control group (n = 66) who presented to the hospital perinatology clinic between 2018 and 2020. Laboratory tests of both groups were analysed retrospectively. Age, gravida, parity, body mass index, third-trimester laboratory tests and first-trimester APRI scores were compared between the two groups. A receiver operating characteristic (ROC) analysis of the study was performed to determine the cut-off value for APRI score that is predictive of ICP. RESULTS: Patients with ICP had significantly higher first-trimester APRI scores compared with controls (p < 0.001). In the ROC analysis, the cut-off value for APRI score was 0.57, with 86.5 % sensitivity and 77.3 % specificity. Spearman's correlation indicated that there was a significant positive association between first-trimester APRI score and third-trimester fasting bile acid level (r = 0.641, p < 0.001). The demographic characteristics of patients in the third trimester did not differ, except for AST and alanine transferase values. CONCLUSIONS: The APRI score calculated in the first trimester of pregnancy seems to be predictive of the development of ICP in the third trimester.