Objective The study aimed to determine the level of anemia in pregnant women in the first trimester and in the preconception period by conducting nationwide research. Methods The study was designed as retrospective, cross-sectional, and multicenter research. A total of 17 centers from 13 provinces were included in the study. The study was conducted […] Abstract Objective The study aimed to determine the level of anemia in pregnant women in the first trimester and in the preconception period by conducting nationwide research. Methods The study was designed as retrospective, cross-sectional, and multicenter research. A total of 17 centers from 13 provinces were included in the study. The study was conducted […]

Background and Objectives: Predictive performance of the modified myocardial performance index (Mod-MPI) for emergency cesarean delivery secondary to intrapartum fetal compromise (IFC) was examined in late-onset fetal growth restriction (FGR) or small-for-gestational-age (SGA) pregnancies. Materials and Methods: This prospective observational cohort comprised 120 singleton term pregnancies affected by late-onset FGR or SGA, classified in line with the Delphi consensus criteria, for whom a trial of vaginal delivery was planned. The primary endpoint was emergency cesarean delivery indicated by IFC, while the secondary endpoint was the development of composite adverse perinatal outcomes (CAPO). Measurements of Mod-MPI, the umbilical artery, the middle cerebral artery, and the cerebroplacental ratio (CPR) were performed within the final 72 h before delivery and were blinded to the clinicians managing the intrapartum period. Results: IFC constituted 28.3% (n = 34) of the study cohort. The IFC group exhibited significantly higher Mod-MPI values and lower CPR values (p < 0.001). In multivariable analysis, elevated Mod-MPI (≥0.61) and reduced CPR (<5th percentile) were identified as independent predictors of IFC. On receiver operating characteristic analysis, Mod-MPI demonstrated superior discriminative performance compared with CPR for predicting IFC (area under the curve [AUC]: 0.835 vs. 0.759). In contrast, CPR showed the highest diagnostic performance for predicting CAPO (AUC: 0.779). Conclusions: Mod-MPI reflects subclinical cardiac dysfunction in fetuses with late-onset FGR and SGA and represents a valuable parameter for predicting tolerance to acute intrapartum stress. Rather than routine implementation, it appears most appropriate as a complementary tool contributing to intrapartum risk assessment in selected high-risk cases.

Objectives: To assess the correlation and agreement of uterocervical angle (UCA) measurements obtained via transabdominal (TAUS), transperineal (TPUS), and transvaginal ultrasound (TVUS) between 16 and 24 weeks of gestation. Methods: In this prospective cross-sectional study, 136 pregnant women underwent UCA and cervical length (CL) assessments using TVUS, TAUS, and TPUS. All measurements were performed by a single experienced operator with an empty bladder. Correlation was assessed using Pearson analysis, while consistency and agreement were evaluated with intraclass correlation coefficient (ICC) and Bland–Altman plots. Results: Mean UCA values differed significantly between modalities (p < 0.001). Moderate correlation (r = 0.547) and consistency (ICC = 0.545) were found between TAUS and TVUS. The Bland–Altman analysis showed a systematic bias of –8° between TAUS and TVUS, with wide limits of agreement (–64° to +32.6°). TPUS showed a higher correlation with TVUS (r = 0.686), but poor consistency (ICC = 0.052), with broader limits of agreement (–32° to +49.2°). Conclusions: Although both TAUS and TPUS showed significant correlation with TVUS for UCA measurement, only TAUS demonstrated moderate consistency, suggesting that it should be used cautiously in clinical practice. TPUS demonstrated considerable variability in individual assessments and does not seem appropriate as a replacement for TVUS. Further studies are needed to validate these findings and improve measurement reliability.

Background and Objectives: To evaluate the association between the newly defined cerebroplacental–renal ratio (CPRR) and adverse perinatal outcome (APO) in pregnancy-induced hypertension (PIH), and to compare its discriminative performance with the cerebroplacental ratio (CPR) and cerebroplacental–uterine ratio (CPUR). Materials and Methods: This prospective, single-center cohort study included 105 women with PIH (preeclampsia, n = 63; gestational hypertension, n = 42). Doppler assessment was performed at ≥34 + 0 weeks and within 7 days before delivery. CPR was calculated as middle cerebral artery pulsatility index (PI)/umbilical artery PI, CPUR as CPR/mean uterine artery PI, and CPRR as CPR/right renal artery PI. APO was defined by the presence of any of the following: non-reassuring fetal status, a 5 min Apgar score <7, neonatal intensive care unit admission, or neonatal death. Receiver operating characteristic analysis and multivariable logistic regression adjusted for gestational age at ultrasound assessment and diagnosis group were performed. Results: APO occurred in 37 pregnancies (35.2%). CPUR and CPRR were significantly lower in the APO group, whereas CPR did not differ significantly. CPRR showed a higher apparent AUC for APO than CPR and CPUR (AUC 0.786, 95% CI 0.698–0.875), with significantly higher AUCs on pairwise DeLong comparisons. After adjustment, CPRR was the only Doppler index independently associated with APO (adjusted OR 1.423 per 0.1-unit decrease; 95% CI 1.162–1.743; p = 0.001). Conclusions: CPRR was independently associated with APO in PIH and showed higher discriminative performance than CPR and CPUR; however, these findings require validation in independent, multicenter studies before clinical application.