Objective: Cystic hygromas of nuchal origin are reported to be associated with fetal aneuploidy and structural anomalies in 50-80% of the cases. We aimed to report our experience on cystic hygromas via 18 cases. Study Design: We conducted a retrospective study based on a review of medical records of patients who had fetal septated cystic hygroma, diagnosed by ultrasonography, in the Ankara University School of Medicine, Department of Obstetrics and Gynecology, between 2012 and 2016. All patients were provided with genetic counselling and prenatal invasive diagnostic procedures were applied to obtain fetal karyotype. Results: We observed 18 cases of fetal cystic hygroma among these patients (0.39%). The abnormal karyotypes were: Turner syndrome (45X0) in 3 (16.7%), trisomy 21 in 2 (11.1%), trisomy 18 in 1 (5.6%) and mosaic Turner syndrome in 1 (5.6%) patient. Conclusion: The presence of cystic hygroma carries a high risk for aneuploidy and major structural malformations. Invasive prenatal diagnostic procedures for fetal karyotype analyses and parental counselling about poor perinatal prognosis is mandatory.

Objective: The aim of this study was to evaluate the risk factors and outcomes of umbilical cord prolapse Study Design: In this descriptive retrospective study, 94 cases of umbilical cord prolapse between January 2013 and December 2014 in our department were analyzed. Results: 45.166 births occurred in our hospital during the study period, and the prevalence of umbilical cord prolapse was 2.08 (n=94) per 1000 live births, and the perinatal mortality rate was 1.1%. In all pregnant women, the delivery had been performed by emergent caesarean section. The average age, gravida, parity and gestational week of pregnant women were 29.11±6.17, 3.69±2.48, 2.69±2.48 and 37.61±3.17, respectively. Singleton pregnancies were 95.7% (n=90) of all pregnancies and twin pregnancies were 4.3% (n=4). Presentation of the cases were vertex, breech or transverse at 75.5% (n=71), 16% (n=15) and 8.5% (n=8) of all cases respectively. Polyhydramnios complicated 13.8% (n=13) of all cases and average birth weight was 3138.62±759.89 grams. 16% (n=15) of the cases had a birthweight lesser than 2500 gr. 1st and 5th minute APGAR scores were 6.89±2.05 and 8.69±1.39, respectively. The time period between the diagnosis and delivery was demonstrated as 8.24±1.22 minutes. Conclusion: Breech presentation, polyhydramnios, multiple pregnancies and low birth weight are risk factors for umbilical cord prolapse. Shortening the time interval between diagnosis and delivery significantly reduces perinatal mortality. It can be provided at clinics that presenting the appropriate infrastructures for rapid intervention.

Objective: Gestational diabetes mellitus is a common disorder of carbohydrate metabolism, with onset or first recognition during pregnancy, resulting in hyperglycemia of variable severity. Insulin resistance and chronic subclinical inflammation are the underlying mechanisms of the disease. Soluble interleukin-2 receptor, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio are the markers of inflammatory disease processes such as type 1 and 2 diabetes mellitus, hepatitis, and neoplasms. Study Design: In our study, we measured complete blood count, serum soluble interleukin-2 receptor, serum glucose in blood samples from 52 women with gestational diabetes mellitus and 50 pregnant women with normal glucose tolerance. Pregnant women which were tested for oral glucose tolerance test (75 gr load) between 24 and 28 weeks of pregnancy were selected for the study. Gestational diabetes mellitus was defined according to the criteria provided by the National Institute for Health and Care Excellence. Results: In terms of age, gestational diabetes mellitus patients (mean±SD; 31±6 years) were older than controls (mean±SD; 25±5.3 years). Mean platelet volume values were lower in gestational diabetes mellitus patients (mean±SD; 10.3±1.4 fL) as compared to normal glucose tolerance group (mean±SD; 10.8±1fL). No statistically significant differences in serum glucose concentration, white blood cell count, neutrophil count, lymphocyte count, hemoglobin concentration, platelet count, neutrophil-to-lymphocyte ratio value, platelet-to-lymphocyte ratio value, and serum soluble interleukin-2 receptor concentration were found. Conclusion: This study did not reveal an increase in the inflammatory markers, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and serum soluble interleukin-2 receptor, in gestational diabetes mellitus. The mean platelet volume values were observed to be lower in gestational diabetes mellitus patients.

Objectives: There is not yet a consensus on the optimal surgical technique for cesarean section. This is the first study comparing two different (Cesarean Section) with respect to the following inflammatory reaction in means of changes in inflammatory marker levels. To evaluate the differences in inflammatory reactions following two different (Cesarean Section) techniques, the modified Misgav-Ladach versus the Pfannenstiel-Kerr technique. Study Design: The study population included 88 pregnant women who met the inclusion criteria. These women were randomized into two groups according to Consolidated Standards of Reporting Trials guidelines: Group 1 (Misgav-Ladach group) and Group 2 (Pfannenstiel Kerr group). To compare the inflammatory reactions following surgery, Interleukin-6 (IL-6) and Tumor Necrosis Factor-a (TNF-a) levels were measured in venous blood samples drawn from the patients just before (0 hour) and 24 hours (24th hour) after the surgery. In 5 women from Group 1 and 2 women from Group 2, the 24th hour blood samples could not be obtained or were lost. Thus, a total of 81 women, 39 women from Group 1 and 42 women from Group 2, comprised the population of study. The differences in inflammatory reactions between the 0 and 24th hours were analyzed by calculating the percent change in IL-6 and TNF-a levels, and these percentages were then compared between the groups. Results: There was a statistically significant difference between Group 1 and Group 2 regarding the serum IL-6 level change between 0 and 24th hour (530±653% and 196±168%, respectively, p=0.022. The difference in TNF-a was also higher in Group 2, but the difference was not statistically significant (229±306% vs. 571±824%, p=0.12). The mean operation time was significantly shorter in Group 1 (9.44 min. vs. 16.86 min, p=0.0001). Conclusions: The results of this study indicate that the modified Misgav-Ladach technique has a weaker inflammatory reaction, which indicates fewer short- and long-term surgical complications.

OBJECTIVE: The objective of the study was to investigate the effect of immersion in water strategy during labor on postpartum bleeding by calculating the postpartum reduction rates of the hematocrit values of the patients. STUDY DESIGN: The study groups consisted of 84 women undergoing vaginal delivery with immersion in water during labor (group 1) and the control group (group 2) of 84 women undergoing normal vaginal delivery. Patients who have received additional medical and surgical interventions for alleviation of postpartum hemorrhage, patients who have undergone an episiotomy and/or perineal trauma were not included in the study. All data were taken from patients who have delivered with spontaneous vaginal delivery. Postpartum hematocrit fall rates of the groups have been compared and the effect of immersion in water on postpartum hemorrhage has been evaluated. RESULTS: The study groups consisted of 84 women undergoing vaginal delivery with immersion in water during labor (Group 1) and the control group (Group 2) of 84 women undergoing vaginal delivery at the hospital. The women in the two groups were matched with respect to age, parity, birth weight and gestational age. The mean age of the women was 29.8±4.8 and 30.5±4.9 respectively. The mean hematocrit difference in the first group was 2.08 ± 1.88 and in the second group was 3.81 ± 1.55. The mean percentage of hematocrit reduction in the first group was 5.71% and in the second group 10.23%. CONCLUSION: Our data showed that mean hematocrit level decreases among women following vaginal delivery more than women who give birth vaginally within immersion in water during labor. The percentage of hematocrit reduction in the water birth group was lower than in the control group. Water birth seems to facilitate uterine contractions more efficiently following vaginal delivery.