To evaluate maternal serum Elabela (ELA) levels in pregnancies complicated by placenta accreta spectrum (PAS) and to assess their association with disease

Infectious complications at the surgical site complicates 1–4% of cesarean deliveries. Strict aseptic technique, hand hygiene and the use of sterile surgical gloves are essential to reduce the risk of surgical site contamination. Glove perforations are observed in almost 30% of all procedures and represent an underestimated potential risk factor for postoperative infections. The aim of this prospective study was to investigate glove perforation rates in cesarean deliveries and to analyze the impact of unrecognized glove perforations during surgery on surgical site infection rates after cesarean delivery. Surgical gloves from cesarean section were collected prospectively. All gloves were inspected for perforation holes. Cases in which surgical gloves had visible (macro) perforations were excluded from the study. Remaining gloves were examined using a water-fill test. Gloves with a positive water filling test were defined as the study group and negative gloves as the control group. Superficial Surgical Site Infections (SSI) were analyzed for the groups. A total of 1,779 pairs of used surgical gloves were collected and examined for perforations across 593 cesarean operations. Macro perforation were observed in 56 (9.4%) operations. The remaining 1,611 pairs of gloves underwent water-fill testing. Of these, 505 operations had completely intact gloves, while in 32 (5.4%) cases, micro-perforations were identified. SSI occurred in 18 women (3.3%): 7 in the perforation group (21.8%) and 11 in the control group (2.2%) (p < 0.001). In multivariable logistic regression analysis, glove micro-perforation was found to be a significant independent predictor of SSI (adjusted odds ratio: 12.705; 95% CI: 4.244–38.039; p < 0.001), even after adjusting for potential confounders including diabetes, obesity, emergency cesarean, operative duration, and intraoperative blood loss. Our data show that glove perforation is unexpectedly common and underestimated in terms of unfavorable surgical outcomes. The rate of surgical site infections is increasing and we suggest that unrecognized glove perforation must be considered as a risk factor for surgical site infection after cesarean section.

Objective: To investigate clinical, ultrasonographic, and hematological factors associated with cesarean delivery due to intrapartum fetal compromise in pregnancies complicated by isolated late-onset fetal growth restriction (FGR) undergoing induction of labor at 37 weeks of gestation. Methods: This retrospective cohort study included singleton pregnancies with isolated late-onset FGR undergoing elective induction of labor between 37 + 0 and 37 + 6 weeks of gestation. Patients who underwent cesarean delivery due to intrapartum fetal compromise constituted the study group (n = 44), whereas those who achieved vaginal delivery formed the control group (n = 100). Maternal demographic characteristics, fetal ultrasonographic findings, and systemic inflammatory indices were evaluated. Multivariable logistic regression and receiver operating characteristic (ROC) curve analyses were performed. Results: Gravidity, parity, induction-to-birth interval, cervical dilatation at admission, femur length, and platelet count differed significantly between the groups. In multivariable logistic regression analysis, parity remained the only independent predictor of cesarean delivery due to intrapartum fetal compromise (adjusted OR 0.421, 95% CI 0.191–0.926, p = 0.031). Systemic inflammatory indices and most fetal ultrasonographic parameters did not demonstrate independent predictive value. The combined multivariable model demonstrated acceptable discriminative performance (AUC 0.731, 95% CI 0.636–0.827, p < 0.001). Neonatal outcomes were comparable between the groups. Conclusions: In pregnancies complicated by isolated late-onset FGR undergoing induction of labor at 37 weeks, parity was the only independent predictor of cesarean delivery due to intrapartum fetal compromise. Routine clinical, ultrasonographic, and hematological inflammatory markers demonstrated limited independent predictive value. These findings suggest that intrapartum fetal compromise in FGR pregnancies may primarily reflect reduced fetoplacental reserve rather than isolated antenatal parameters.

Objective: Isolated gestational proteinuria (IGP) has traditionally been considered a benign condition; however, emerging evidence suggests that it may represent an early stage in the spectrum of preeclampsia. This study aimed to evaluate clinical and laboratory predictors of progression from IGP to preeclampsia. Methods: This retrospective cohort study included pregnant women diagnosed with proteinuria ≥ 300 mg/day after 20 weeks of gestation between January 2023 and December 2024. After applying predefined exclusion criteria, 319 women with isolated gestational proteinuria (IGP) were included and stratified according to progression to preeclampsia (n = 42, 17.8%). Baseline clinical and laboratory parameters were compared between groups. Multivariable logistic regression analysis was performed to identify independent predictors of progression, and receiver operating characteristic (ROC) curve analysis was used to evaluate the discriminative performance of significant variables. Results: Preeclampsia developed in 17.8% of women with IGP. In multivariable analysis, higher maternal body mass index (aOR 1.085, p = 0.028) and earlier gestational age at diagnosis (aOR 0.883, p = 0.011) were identified as independent predictors of progression. Although neutrophil count and systemic inflammatory indices were elevated in univariate analyses, they did not retain independent predictive value after adjustment. Conclusions: In pregnancies complicated by isolated gestational proteinuria, clinical parameters appear to be more informative than inflammatory and renal markers for predicting progression to preeclampsia. Laboratory-derived indices offer limited additional value and should be interpreted cautiously in risk assessment.

Aims: This study aims to investigate the relationship between first-trimester eosinophils and eosinophil-based hematological indices and the development of preeclampsia (PE).Methods: In this retrospective study, 105 pregnant women who underwent a complete blood count between the sixth and fourteenth weeks of pregnancy and were subsequently diagnosed with PE who gave birth at our center were compared with 120 healthy pregnant women. Demographic characteristics, hematological values, eosinophil-based indices and perinatal outcomes were compared between groups. Logistic regression analyses were performed to evaluate factors associated with the development of PE. Additionally, receiver operating characteristic (ROC) analysis was performed to assess the predictive performance of these indices for the development of PE. Results: When comparing the PE group with healthy controls, the median eosinophil count (0.08 vs. 0.10, p=0.013), NER (neutrophil-eosinophil ratio) (76.00 vs. 60.50, p=0.016), LER (leukocyte-eosinophil ratio) (105.43 vs. 91.35, p=0.015), ELR (eosinophil-lymphocyte ratio) (0.04 vs. 0.05, p=0.010) and EBR (Eosinophil-to-basophil ratio) (2.25 vs. 3.00, p=0.002) showed significant differences, but there was no difference in EMR (eosinophil-to-monocyte ratio) (p=0.065). In the multivariable analysis, eosinophil count (adjusted odds ratio [aOR]=0.01, p=0.048), EBR (aOR=0.80, p=0.003), EMR (aOR=0.70, p=0.038), NER (aOR=1.00, p=0.020) and LER (aOR=1.00, p=0.017) were associated with the development of PE. ROC analysis revealed that EBR is the most discriminative eosinophil-based marker (area under the curve [AUC]=0.619). There was no significant difference between the groups with severe and non-severe PE in eosinophil count and eosinophil-based hematological indices (p>0.05). Conclusion: Changes in eosinophil count and eosinophil-based hematological ratios during the first trimester reflect immune system abnormalities that occur prior to the clinical onset of PE. In particular, low eosinophil, EMR with EBR parameters and increased NER with LER values can be considered early indicators of PE risk. These parameters alone have limited predictive performance.

Objective: To evaluate the clinical significance of a flat oral glucose tolerance test (OGTT) pattern and its association with obstetric and perinatal outcomes, focusing on fetal growth. Methods: This retrospective cohort study was conducted at a tertiary referral center between January 2023 and November 2025. A total of 1198 women who underwent a two-step OGTT between 24 and 32 weeks of gestation were screened, and 685 eligible participants were included. A flat OGTT pattern was defined as fasting glucose < 95 mg/dL with all postprandial values < 100 mg/dL. The primary outcome was small-for-gestational-age (SGA); secondary outcomes included fetal growth restriction (FGR) and other obstetric outcomes. Logistic regression analyses were performed to assess independent associations. Results: Thirty-nine women (5.7%) exhibited a flat OGTT pattern. These pregnancies were characterized by a markedly attenuated postprandial glycemic response and lower fasting glucose levels. Most maternal and neonatal outcomes were similar between groups. However, SGA was significantly more frequent in the flat OGTT group (20.5% vs. 6.7%, p = 0.001). In multivariable analysis, a flat OGTT pattern remained independently associated with SGA (aOR 4.05, 95% CI 1.70–9.68, p = 0.002). Both SGA and FGR were more frequent among women with a flat OGTT pattern, although the association appeared stronger for SGA. Conclusions: A flat OGTT pattern appears to represent a distinct glycemic response characterized by an attenuated postprandial glucose response and lower fasting glucose levels. Although this pattern was not associated with a generalized increase in adverse obstetric or neonatal outcomes, it was associated with an increased risk of small-for-gestational-age infants.