It is aimed to evaluate the efficacy of using aspartate aminotransferase (AST)/platelet count ratio [AST to platelet ratio index (APRI) score] in ICP patients.This study was carried out including 1...

Introduction: The aim of this study was, first, to investigate the difference in fetal atrioventricular conduction in patients with and without intrahepatic cholestasis of pregnancy (ICP) by measuring the fetal PR interval; second, to evaluate the altering effect of ursodeoxycholic acid (UDCA) treatment on the fetal PR interval in ICP patients. Methods: The study consisted of 42 ICP patients and 48 healthy pregnant women. Fetal echocardiography was performed to measure the mechanical PR interval. The fetal PR interval and the clinical characteristics were compared between the two groups. The effect of UDCA treatment on the fetal PR interval in ICP patients was evaluated. Results: In ICP patients, significantly longer fetal PR intervals were observed than in the control group (123.21 ± 8.54 vs. 115.13 ± 5.95 ms, p < 0.001). In the ICP group, there was a positive correlation between the fetal PR interval and maternal fasting total bile acid (TBA) levels (r = 0.514, p = 0.001). After 1 week of treatment with UDCA in patients with ICP, the PR interval was shorter than before, although the reduction was not statistically significant (120.98 ± 6.70 vs. 123.21 ± 8.54 ms, p = 0.095). In patients with severe ICP (TBA >40 mmol/L, n = 10), a significant reduction in the fetal PR interval was observed after treatment with UDCA (127.5 ms [IQR, 118.0–134.75] before vs. 122 ms [IQR, 109.5–126.5] after, p = 0.037). Conclusion: Fetal PR interval increased in ICP patients in correlation with maternal serum TBA concentration. Treatment with UDCA may have limited positive effects on the fetal AV conduction system. The beneficial effects of UDCA on the fetal PR interval may be more pronounced in patients with higher bile acid levels.

Background: Missed abortion (MA) is a form of spontaneous abortion in which the embryo has died, but the body fails to recognize the pregnancy loss and continues hormone production, accounting for approximately 15% of clinically diagnosed pregnancies. The aim of this study was to compare inflammatory markers measured between 6 and 18 weeks of gestation in the same women during 2 different pregnancies: one that resulted in MA and another that resulted in a healthy birth. Methods: In this retrospective cohort study, medical records from 2016 to 2024 were reviewed. From 350 women with documented MA history, 300 were excluded (280 due to unavailable data from healthy pregnancies, 5 with thyroid disease, 3 with multiple gestations, 5 with coagulation disorders, 5 with chronic conditions, and 2 with fetal chromosomal abnormalities), resulting in 50 eligible participants. The study compared several inflammatory markers (neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, eosinophil-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, and systemic immune-inflammation index) between women with miscarriage and those with healthy pregnancies during the first and early second trimesters (6–18 weeks of gestation). Results: In the 50 women included in the study, hemoglobin levels were significantly higher in healthy pregnancies (12.6 g/dL in healthy pregnancy vs 12.05 g/dL in MA; P = .003). Platelet distribution width was also significantly higher in healthy pregnancy (15.60% vs 12%; P = .001). Similarly, eosinophil percentage was significantly higher in healthy pregnancy compared to MA (1.7% vs 1.15%; P = .047). However, inflammatory indices such as neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, eosinophil-to-lymphocyte ratio, and systemic immune-inflammation index did not show statistically significant differences between both pregnancy states ( P > .05). The ROC curve analysis showed that hemoglobin had the highest diagnostic performance (area under the curve = 0.72) with a sensitivity of 68%, specificity of 62%, positive predictive value of 64%, and negative predictive value of 66% at the optimal cutoff value of 12.3 g/dL. Conclusion: This study reveals that many inflammatory markers do not differ significantly between MA and healthy pregnancy in the same women. These findings suggest that inflammatory markers may be of limited value in predicting MA when individual variability is taken into account.

Objective: The aim of the study was to retrospectively analyze the indications Techniques and complications of pregnancy termination performed in a tertiary center. Materials and Methods: All cases between 10 and 33 weeks of gestation between January 2021 and June 2023 were retrospectively analyzed. The patients were divided into two groups as group 1 with 11+0 to 21+6 gestational weeks and group 2 for those at 22+0 and 33+0 gestational weeks. Results: A total of 568 pregnancy terminations were included in the study. Among all terminations the most common fetal indications were central nervous system anomalies (148 cases, 26%) and trisomy 21 (53 cases, 9%) and the most common maternal/obstetrical Indication was previable premature rupture of the membranes (179 cases, 31.5%). Abnormal genetic results were found in 50 of 173 cases (28.9%) with a termination indication of Structural malformation who accepted invaziv genetic testing. The number of terminations with fetal indications performed after 22 weeks were 148 (41%) and 11 (7.4%) cases of these late terminations of pregnancy were anomalies expected to be diagnosed in the first trimester. Complication rates (12.4%) and abdominal termination rates (3.5%) were significantly higher in group 2 than in group 1 (p<0.05). Conclusion: Improvements in prenatal genetic screening and diagnostic techniques will undoubtedly decrease the gestational ages in terminations of pregnancies. However, there will always be cases that can neither be diagnosed earlier nor can be treated due to the nature of the anomaly. In the management of such cases, terminations will always occupy an important place in prenatal care.