Purpose: The rates of caesarean section (CS) have been increasing in recent years in Türkiye and throughout the world. A previous CS is known to not be an absolute indication for repeat CS, and vaginal delivery (VD) (trial of labor after caesarean (TOLAC)) can occur after a CS. The aim of this study was to investigate the neonatal outcomes of TOLAC patients in Konya City Hospital. Materials and Methods: A retrospective analysis was made of the records of all the births in Konya City Hospital between 10 August 2020 and 10 June 2022. The study included all patients with full or nearly complete cervical dilation-effacement and who had a previous CS. These patients were compared with patients who had elective CS and VD. A total of 119 patients were included in the study in 3 groups; TOLAC n:32, CS n:42, VD n:45. Results: TOLAC patients gave birth earlier and the infant birth weight (2991.25gr), length (50.66cm) and head circumference (34.09cm) measurements were found to be significantly lower than those of the other groups. The development of any problem (icterus, respiratory distress syndrome (RDS), oxygen requirement, hypoglycemia, hypothermia) was determined at a significantly higher rate in the TOLAC (21.9%). Conclusion: Patients with a history of CS do not have to have a repeat CS. TOLAC can be performed in appropriate cases, but care should be taken against uterine rupture, the need for emergency CS, and adverse neonatal outcomes.

Cesarean scar pregnancy (CSP) is a rare type of ectopic pregnancy where the embryo implants in the scar from a previous cesarean section. CSP is a high-risk condition that can cause serious complications, such as uterine rupture and life-threatening bleeding. This study investigated the accuracy and reliability of elastosonography in diagnosing CSP. A prospective cohort study was conducted at Mardin Training and Research Hospital (Turkey) between October 2023 and January 2024. The study included 61 patients with CSP and a separate control group of 61 patients, all between 6 and 12 weeks of gestation. Both groups were evaluated using elastosonography. Elastosonography parameters, including strain ratio, myometrial shear wave velocity, and scar hardness, were significant in diagnosing CSP. Age, BMI, parity, and number of previous cesarean sections did not significantly correlate with elastosonography findings. Beta-hCG and fetal heart rate were not significant diagnostic factor Elastosonography shows promise as a diagnostic tool for CSP. Further research is needed to confirm its clinical utility.

Aim: In our study, we investigated the relationship between placental thickness and weight, umbilical cord diameter and length, and placental cord insertion site with fetal distress, and its effects on the baby's APGAR score and cord blood gas. Materials and methods: In our study, the data of the patients who gave birth in our hospital, whose gestational patient was between 37+0- 41+6 weeks, and between the ages of 18-45 were recorded prospectively. 385 patients (196 patients fetal distress and 189 patients elective cesarean section) were included in the study. Demographic characteristics, placental thickness and weight, umbilical cord diameter and length, insertion site of the umbilical cord into the placenta, newborn gender, first- and fifth-minute. Apgar score, and umbilical cord blood gas values were recorded. All parameters were compared between both groups. Results: When both groups are compared, Maternal age (29.13 ± 5.20 vs. 25.67 ± 5.27, p<.001) and body mass index (30.10 ± 4.20 vs. 27.15 ± 3.97, p<.001) were found to be statistically lower in Group I than Group II. Placental weight (515 [IQR, 430 – 582.5] vs. 610 [IQR, 520 – 710], p<.001) and thickness (2.42 ± 0.91 vs. 2.72 ± 0.91, p<.001) were found to be statistically lower in Group I than Group II. In Group I patients, umbilical cord length (24.02 ± 10.02 vs. 57.35 ± 13.95, p=.008) was found to be significantly shorter than Group II. Conclusion: Young maternal age, low body mass index, short umbilical cord, low placental weight and thin placenta were found to be positively correlated with fetal distress. More careful follow-up of pregnant women with these features in terms of fetal distress is important for better perinatal and neonatal outcomes.

During pregnancy, there is a physiologic increase in heart rate and blood flow rate along with an increase in plasma volume. Although these changes are physiological, pregnant women with congenital cyanotic heart disease are known to have an increased risk of maternal heart failure, premature birth, intrauterine growth retardation, increased number of cesarean sections, and even maternal death. According to the World Health Organization, cardiovascular diseases (CVD) are the most common cause of indirect maternal deaths. The aim of this study was to assess how well obstetricians and cardiologists manage the care of a pregnant woman with cardiovascular disease. This survey-based study included 45 obstetricians and 30 cardiologists. There is no ready-made scale or survey on the relevant subject. Therefore, the survey questions were created by us as a result of the literature review. In the survey, questions were asked to examine clinical decision-making tendencies and attitudes of obstetrics and cardiology doctors about recommending induced abortion in the first trimester in pregnant women with various heart diseases and about vaginal labor or cesarean section and infective endocarditis prophylaxis in term pregnancy. Survey responses from obstetricians and cardiologists revealed significant differences in management approaches. Regarding first-trimester elective termination, cardiologists overwhelmingly recommended it for most conditions (eg, 100% for pulmonary arterial hypertension, 96.7% for EF < 30%/Class III–IV heart failure), whereas obstetricians showed greater hesitation or preference for cardiology consultation (eg, 48.9% had “no opinion” for Marfan syndrome with aortic dilatation). For mode of delivery at term, cardiologists predominantly recommended cesarean section, often with infective endocarditis prophylaxis, for specific high-risk conditions (eg, 100% for prosthetic valve, 96.7% for severe PAH). In stark contrast, the majority of obstetricians (ranging from 53.3% to 80.0% across various CVDs) opted to defer the decision by seeking a cardiology consultation. Statistical analysis confirmed significant differences (p<0.05) between the two specialist groups in most management decisions. CVDs are the most common cause of non-direct maternal deaths. Patients should be closely monitored during pregnancy, labor and puerperium. Pregnant women with CVD should be evaluated by a multidisciplinary committee of competent physicians.

This prospective randomized controlled study aimed to investigate the effectiveness of tranexamic acid in controlling bleeding due to postpartum vaginal la