Background/Objectives: The objective of this study was to assess the diagnostic accuracy of the Triglyceride-Glucose (TyG) index for screening gestational diabetes mellitus (GDM) at 24–28 weeks of gestation, to determine its optimal diagnostic threshold, and to compare its predictive performance with conventional lipid ratios (LDL/HDL, TG/HDL, and TC/HDL). Materials and Methods: We retrospectively analyzed 440 pregnant women with singleton pregnancies who underwent a 75 g oral glucose tolerance test (OGTT) between January and July 2025. The TyG index and lipid ratios were calculated, and their associations with GDM were evaluated. Subgroup analyses were conducted to assess the efficacy of the TyG index in predicting GDM, using logistic regression to estimate odds ratios (ORs) with 95% confidence intervals (CIs), and receiver operating characteristic (ROC) curve analysis along with restricted cubic spline modeling to evaluate diagnostic performance and determine the optimal cutoff value. Results: The overall prevalence of GDM, as defined by the IADPSG (International Association of the Diabetes and Pregnancy Study Groups) criteria, was 22.7%. The median TyG index was significantly higher in the GDM group compared with the non-GDM group (9.1 vs. 8.9, p = 0.001). The TyG index was a significant predictor of GDM (p < 0.05), with each one-unit increase associated with significantly higher odds of GDM (OR = 12.29), after adjusting for covariates. ROC analysis demonstrated an AUC of 0.716 (95% CI: 0.627–0.793, p < 0.001) for the TyG index, and the optimal cut-off value was identified as 9.35, yielding a sensitivity of 38.5% and a specificity of 96.5% and a negative predictive value of 83.7%. Subgroup analyses indicated that the TyG index had limited discriminative ability for predicting GDM in both the post-load and insulin-requiring groups. Among conventional lipid ratios, TG/HDL demonstrated the highest predictive performance (AUC = 0.587), while LDL/HDL (AUC = 0.483) and TC/HDL (AUC = 0.509) demonstrated low predictive accuracy. Compared with conventional lipid ratios, the TyG index demonstrated superior predictive performance. Conclusions: A higher TyG index was positively associated with the development of GDM and showed better predictive ability than conventional lipid ratios. However, its low sensitivity limits its use as a standalone diagnostic tool, suggesting it may be most useful when combined with other clinical parameters.

Aim: This study aimed to evaluate the pregnancy outcomes of patients who applied to our clinic between the 11th and 14th weeks of pregnancy and whose nuchal translucency (NT) measurement was ≥1.5 multiples of the median (MoM). Material and Methods: The study included 85 patients whose NT measurement was determined ≥1.5 MoM and pregnancy results were available. Demographic characteristics of the patients, prenatal invasive diagnostic test results, fetal anomaly screening, fetal echocardiography (ECHO) results, and neonatal and obstetric results were evaluated. Results: Abnormal karyotype was detected in 10.6% (n=9) of the patients. Trisomy 21 was the most common chromosomal anomaly. Fetal structural anomaly was detected in 29.4% (n=25) of the patients. A structural fetal anomaly was detected in 21% (n=13) of fetuses with normal karyotypes and 66.7% (n=6) of fetuses with abnormal karyotypes. Cardiac anomalies were found to be the most common anomalies with 9.7% (n=6) in patients with normal karyotype. NT and NT MoM values in patients with fetal structural (both p=0.001) or chromosomal anomalies (p=0.011, and p=0.019, respectively) were found significantly higher than those without. NT and NT MoM values in patients whose pregnancies resulted in fetal loss were found significantly higher than in patients who had a live birth (both p=0.001). Conclusion: Increasing NT or NT MoM values indicate an increase in the risk of chromosomal anomalies, structural anomalies, and poor pregnancy outcomes in the fetus. Fetal anomaly screening and fetal ECHO should be recommended in patients with increased NT, even if a normal karyotype is detected.

Objective: This study aimed to compare fetal adrenal gland volume (AGV), fetal zone (FZ) depth, and middle adrenal artery pulsatility index (MAA-PI) between pregnancies presenting with preterm labor and gestational age-matched asymptomatic controls, and to evaluate size-adjusted adrenal metrics (corrected AGV [cAGV] and fetal zone–total gland depth ratio) in relation to gestational age at delivery and neonatal outcomes. Methods: This prospective analytical cross-sectional (case–control) study included 60 singleton pregnancies (30 with preterm labor and 30 asymptomatic controls) evaluated at a tertiary perinatology unit between 24 + 0 and 36 + 6 weeks’ gestation. Transvaginal cervical length and transabdominal fetal adrenal measurements (AGV, FZ depth, and MAA-PI) were obtained at enrollment. Estimated fetal weight (EFW) at the index scan was retrieved, and corrected AGV (cAGV = AGV/EFW) and fetal zone–total gland depth ratio were calculated. Outcomes were gestational age at delivery, birthweight, Apgar scores, and neonatal intensive care unit (NICU) admission. Nonparametric group comparisons and Spearman correlations were used. Results: Gestational age at ultrasound was identical between groups (median 31 + 6 weeks). Compared with controls, the preterm labor group had shorter cervical length (12.5 vs. 33.5 mm, p < 0.001), higher AGV (1.53 vs. 1.08 cm³, p < 0.001) and FZ depth (7.45 vs. 5.30 mm, p < 0.001), and lower MAA-PI (1.11 vs. 1.46, p < 0.001). EFW at the index scan did not differ between groups (p = 0.900). Corrected AGV (cAGV) was higher in the preterm labor group (0.87 (0.76–1.06) vs. 0.59 (0.51–0.70), p < 0.001), and the fetal zone–total gland depth ratio was higher (0.328 (0.312–0.346) vs. 0.263 (0.241–0.278), p < 0.001). The preterm labor group delivered earlier (33 + 0 vs. 36 + 2 weeks, p < 0.001), had lower birthweight (1875 vs. 3188 g, p < 0.001), and more frequent NICU admission (50.0% vs. 6.7%; odds ratio 14.0, 95% CI 2.82–69.56; p < 0.001). Within the preterm labor group, gestational age at delivery correlated positively with cervical length (ρ = 0.900) and MAA-PI (ρ = 0.770) and negatively with AGV (ρ = −0.770) and FZ depth (ρ = −0.733), all p < 0.001; correlations were stronger for cAGV (ρ = −0.953, p < 0.001). Conclusions: Enlarged fetal adrenal gland volume and fetal zone depth together with reduced middle adrenal artery pulsatility index are associated with preterm labor and earlier delivery. Size-adjusted adrenal metrics (cAGV and fetal zone–total gland depth ratio) remained significantly different between groups, supporting these measures as potential adjuncts for risk stratification at presentation.

Background: Gestational hypertension (GHT) is associated with adverse maternal and perinatal outcomes, and reliable biomarkers for risk stratification remain limited. Thrombospondin-4 (TSP-4), a matricellular glycoprotein implicated in vascular remodeling, may play a role in hypertensive disorders of pregnancy. This study aimed to investigate maternal serum TSP-4 levels in GHT and their associations with obstetric and neonatal outcomes. Methods: This prospective cohort study included 44 women with GHT and 44 normotensive controls. Maternal serum TSP-4 levels were measured between 20–30 weeks’ gestation, and demographic, obstetric, and neonatal data were recorded. The development of preeclampsia (PE) and composite adverse perinatal outcomes (CAPO) was subsequently compared between the groups. Results: TSP-4 levels were significantly higher in the GHT group compared with controls (9.50 vs. 7.92 ng/mL, p < 0.001). Women with GHT had lower gestational age at delivery and birth weight, with higher rates of preterm delivery, fetal distress, NICU admission, and composite adverse perinatal outcomes (all p < 0.01). Within the GHT group, patients who developed PE had notably higher TSP-4 levels (13.45 vs. 9.33 ng/mL, p < 0.001). Conclusions: Elevated maternal serum TSP-4 is independently associated with GHT and progression to PE. TSP-4 may serve as a novel biomarker for risk assessment in hypertensive disorders of pregnancy.

Objective: To evaluate whether fetal intrahepatic umbilical–portal anastomosis type is associated with late-onset fetal growth restriction (FGR) and adverse neonatal outcomes. Methods: This prospective, single-center case–control study included 160 singleton pregnancies in the third trimester: 80 with late-onset FGR defined according to Delphi consensus criteria and 80 appropriate-for-gestational-age (AGA) controls. Umbilical–portal anastomosis was assessed by ultrasound and classified as T-shaped, X-shaped, or H-shaped. Maternal, sonographic, obstetric, and neonatal data were recorded. Multivariable logistic regression evaluated associations with FGR, and Firth’s penalized regression assessed composite adverse perinatal outcome (CAPO) within the FGR group. Results: X-shaped anastomosis predominated in FGR (55.0%; T-shaped, 26.3%; H-shaped, 18.8%), whereas T-shaped was most common in controls (61.3%; X-shaped, 23.8%; H-shaped, 15.0%). FGR cases showed higher umbilical artery pulsatility index, lower middle cerebral artery pulsatility index and cerebroplacental ratio, earlier delivery, lower birth weight, and higher rates of NICU (neonatal intensive care unit) admission, transient tachypnea of the newborn, and CAPO (35% vs. 15%). Both X-shaped and H-shaped types were independently associated with FGR, with a stronger effect for X-shaped (adjusted odds ratio [aOR], 5.27 vs. 2.85). Predicted probabilities increased stepwise from T-shaped to H-shaped to X-shaped (30.3%, 55.3%, and 69.6%). Within the FGR group, only X-shaped anastomosis was independently associated with CAPO, whereas Doppler indices were not discriminatory. Conclusions: X-shaped fetal intrahepatic umbilical–portal anastomosis was independently associated with both late-onset FGR and adverse neonatal outcome. Intrahepatic vascular configuration may provide additional value beyond conventional fetal biometry and arterial Doppler in risk stratification.