The aim of our study was to investigate the relationship between extreme values of first trimester screening markers and adverse obstetric outcomes. Our study was conducted by examining the prenatal and postnatal perinatal records of 786 singleton gestations between the ages of 18-40, who applied to Prof. Dr. Cemil Taşçıoğlu City Hospital outpatient clinics for first-trimester screening for aneuploidy, between January 1, 2017 and December 31, 2019. The presence of small for gestational age (SGA) was found to be statistically significant for the <5 percentile (<0.37) pregnancy-associated plasma protein A (PAPP-A) group (p = 0.016). For <5 percentile β-hCG group, the presence of gestational diabetes mellitus (GDM), premature rupture of membrane (PROM) and preterm premature rupture of membrane (PPROM) was determined as a statistically significant risk (p = 0.015, p = 0.005, p = 0.02 respectively) In the univariate test, fetal death rate was found to be high for ≥90 percentile at nuchal translucency (NT), but the presence of fetal death was found to be statistically insignificant in logistic regression analysis. (p: 0.057). First trimester screening test can be used in predicting pregnancy complications. In this study we found that serum levels of PAPP-A are associated with developing SGA, while GDM, PROM and PPROM are more common in low serum free β-hCG.

Background: Gastrointestinal system (GIS) malignancy with pregnancy is a very rare condition and is not common outside Japan. The incidence is between 0.025–0.1% for each pregnancy. GIS malignancies are diagnosed late in pregnancy and detected at an advanced stage. The most common cause of this condition is that the symptoms such as vomiting, nausea, loss of appetite and abdominal growth are mistaken with pregnancy and malignancy is overlooked. Especially in the second trimester, symptoms such as nausea and vomiting, weight loss, melena, hematemesis and deep anemia should suggest malignancy. Upper GIS endoscopy and colonoscopy are the recommended screening methods in these patients, especially in the third trimester. Case presentation: We present a rare case presenting to our emergency room with the complaint of bloody vomiting, at the 36th week of gestation with a live singleton pregnancy, and receiving the diagnosis of undifferentiated gastric carcinoma from the biopsy taken from the ulcerated lesion on the stomach cardia, with upper GIS endoscopy performed due to deep anemia, who underwent simultaneous cesarean section and subtotal gastrectomy. Conclusion: Gastrointestinal system (GIS) malignancy with pregnancy is a very rare condition, but it should be considered when symptoms such as nausea and vomiting, weight loss, melena, hematemesis and deep anemia occur, especially in the second trimester, and endoscopic screening should be recommended. Because of the delay in diagnosis of malignancy and the detection in advanced stages, patients should be referred for treatment without delay.

This study aimed to investigate the prenatal features, genetic findings, and perinatal outcomes of fetuses with congenital anomalies of the kidney and urinary tract (CAKUT), with a particular focus on associations with additional structural or chromosomal abnormalities. A retrospective cohort analysis was conducted on 277 fetuses diagnosed with CAKUT between December 2020 and December 2024 at a tertiary center. Data on anomaly subtypes, associated findings, genetic testing, pregnancy outcomes, and postnatal follow-up were evaluated. Logistic regression was used to identify predictors of termination. Urinary tract dilatation was the most frequent anomaly (28.2%), followed by multicystic dysplastic kidney (11.6%) and bilateral renal agenesis (11.2%). Extrarenal anomalies were present in 33.9% of fetuses, primarily involving the CNS. Genetic testing was performed in 48.4%; chromosomal abnormalities were found in 17.3%, most commonly trisomy 21 (5.8%). Termination was significantly associated with early diagnosis (adjusted OR = 0.82; p < 0.001), oligohydramnios (OR = 4.94; p < 0.001), CNS (OR = 3.74; p = 0.001), and cardiac anomalies (OR = 4.21; p = 0.002). Neonatal death occurred in 29.2% of cases, and mortality was higher in non-isolated anomalies (60% vs. 32.9%, p < 0.001). Fetuses with CAKUT, particularly those with early diagnosis or coexisting anomalies, carry a higher risk of adverse outcomes. Prenatal detection, coupled with comprehensive genetic and structural evaluation, is essential for informed counseling and postnatal planning.

Background: Severe maternal complications requiring intensive care unit (ICU) admission remain important indicators of maternal health, particularly in middle-income settings. This study aimed to evaluate the indications for intensive care unit (ICU) admission, maternal and neonatal outcomes, and near-miss events among obstetric patients in a tertiary referral center in Turkey. Methods: This retrospective cohort study included all obstetric patients admitted to the ICU of the University of Health Sciences, Başakşehir Çam and Sakura City Hospital between January 2021 and December 2024. Demographic, clinical, and laboratory data, together with maternal and neonatal outcomes, were analyzed using descriptive statistics and appropriate group comparisons ( IBM SPSS Statistics version 25.0, Armonk, NY, USA ). Results: A total of 176 women were included. The mean maternal age was 30.5 ± 6.8 years, and the mean gestational age at ICU admission was 34.4 ± 4.3 weeks. Most admissions occurred in the postpartum period (93.2%). Obstetric hemorrhage (37.5%) and hypertensive disorders (24.4%) were the leading indications of ICU admission. Overall maternal mortality was 5.1%. WHO organ dysfunction (life-threatening condition) criteria were present in 77/176 (43.8%); among survivors ( n = 167), 68 (40.7%) met the maternal near-miss definition. Mortality was significantly associated with delivery status (vaginal/cesarean/ongoing pregnancy; p = 0.022), ICU admission during pregnancy ( p = 0.001), prolonged ICU stay ( p < 0.001), and sepsis ( p < 0.001). Non-survivors more frequently required mechanical ventilation, vasoactive drugs, dialysis, blood transfusion, and cardiopulmonary resuscitation. Neonatal outcomes included 91.5% live births and 8.5% stillbirths. Conclusion: Obstetric hemorrhage and hypertensive disorders remain the primary indications for ICU admission, with postpartum women being the most vulnerable group. Incorporating near-miss evaluation offers a more comprehensive assessment of maternal health and provides national data from Turkey, situating outcomes between those reported in high- and low-resource settings. Strengthening postpartum surveillance, ensuring timely recognition of sepsis and hemorrhage, and optimizing critical care interventions are essential strategies to reduce maternal morbidity and mortality.

Purpose: Complete blood count-derived inflammatory indices are widely studied in pregnancy, with inconsistent findings; if they capture a persistent maternal characteristic, a woman’s value at one timepoint should locate her value at another. We examined within-woman tracking of six indices, and their relation to fetal overgrowth, in insulin-treated gestational diabetes (GDM). Patients and Methods: Retrospective cohort of 358 women with insulin-treated GDM at a tertiary centre. Six indices (NLR, PLR, MLR, SII, SIRI, PIV) were calculated at the oral glucose tolerance test (OGTT, 24– 28 weeks) and at delivery admission, two physiologically distinct occasions. The primary outcome was large-for-gestational-age (LGA) birth (INTERGROWTH-21st); macrosomia was secondary. Tracking was quantified by Spearman correlation and the between-woman variance share from a mixed model. Analytic samples were 358 (group comparisons, discrimination), 353 (paired) and 284 (adjusted models), one lower in each for MLR, SIRI and PIV. Results: LGA occurred in 139 infants (38.8%). No index discriminated LGA to a clinically useful degree (AUC 0.51– 0.57). Adjusted for body-mass index (BMI) and HbA1c, SIRI was associated with LGA (OR 1.64 per standard deviation, 95% CI 1.18– 2.39; n = 283) and survived Bonferroni correction (corrected P = 0.040), though not consistently across samples; we regard this nominal finding as exploratory. BMI and HbA1c, per standard deviation, had odds ratios of 1.42 and 1.48 and numerically higher AUCs (0.63 each). All six indices changed between the two occasions (all P< 0.001); within-woman rank correlation was weak to moderate (ρ 0.27– 0.54) and the between-woman variance share 0.25– 0.56. Conclusion: CBC-derived indices tracked poorly within women between the two occasions, and none discriminated LGA to a clinically useful degree. Whether this reflects instability of the underlying inflammatory state or the differing clinical circumstances of the two samples cannot be determined from this design.