BACKGROUND: During pregnancy, the most common indication for non-obstetric surgery in acute abdomen is appendicitis. In pregnancy, appendicitis may be confused with pregnancy-related pathologies and may cause a delay in diagnosis or unnecessary surgery. The present study aims to evaluate the maternal and neonatal outcomes of patients undergoing appendectomy during pregnancy. METHODS: This study was designed retrospectively between 2011-2017. Appendicitis detection rates, admission and laboratory features, operation results and obstetric results were evaluated in pregnant women who underwent surgery for a preliminary diagnosis of acute appendicitis. RESULTS: The findings showed that 2593 patients underwent an appendectomy, 1154 of them were women and 50 of them were pregnant. Negative laparotomy was detected in 12 (16%) patients. Six (12%) of these 50 patients had a laparoscopic appendectomy and 44 (88%) had an appendectomy with laparotomy. The mean time to operation after admission to hospital was 10.5 +/- 11 hours. No maternal mortality was observed. Preterm labor occurred in four (8%) patients. Two patients (4%) were in the second trimester and two patients (4%) were in the third trimester. Two (4%) newborns born in the second trimester died postpartum. One of these newborns had multiple anomalies. Appendectomy was not characterized by an increased risk of perinatal mortality. CONCLUSION: Delay in the diagnosis and surgery of acute appendicitis during pregnancy may increase the risk of perinatal mortality and should not be delayed in diagnosis and surgery in pregnancy.

Objectives: Predicting the success of vaginal delivery is an important issue in preventing adverse maternal and neonatal outcomes. This study sought to examine whether measurement of the angle of progression (AoP) can predict a successful vaginal delivery following induction of labour (IoL) among late term nulliparous women with a low (4>) Bishop score. Methods: This prospective study included consecutive nulliparous pregnant women whose gestational age was 41 weeks and 1–6 days (late-term). The AoP was measured at least three times and their means were calculated. Results: During the study period, data of 150 women were included in the final analysis. Thirty-eight women underwent CS due to failure to progress (n=30) or NRGHR (n=8), while the remaining 112 women underwent NVD, with four women requiring vacuum extraction. The two groups were similar with respect to age, gestational age, BMI, estimated foetal weight, and birth weight. Women undergoing NVD differed significantly from those undergoing CS with respect to a greater ultrasonographic AoP (113.8±11.9° vs. 98.1±10.9°, p=0.0001), a shorter duration of dinoprostone use, shorter time to labour contraction, and a shorter duration of labour. In ROC analysis, the cut-off value for AoP was 100° for the prediction of successful IoL for NVD, with a sensitivity of 96 % and a specificity of 63 %. Conclusions: AoP may be a useful sonographic parameter for predicting successful vaginal delivery among nulliparous women at late term undergoing IoL; an AOP wider than 100° is associated with a high rate of vaginal delivery.

Objective. Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders, affecting up to 10% of reproductive-age women. Anti-Mullerian hormone (AMH) is a member of the transforming growth factor β family and has an inhibitory effect on primordial follicle recruitment in the ovary. The study aimed to investigate the importance of serum AMH levels in the different phenotypes of PCOS and find the optimal cut-off level of AMH in PCOS patients.Methods. This was a prospective clinical trial in which diagnoses of 50 PCOS patients based on Rotterdam revised criteria were compared to 50 normo-ovulatory cases. Additionally, the PCOS group was divided into 2 subgroups based on 2 or 3 Rotterdam criteria and compared to 50 normo-ovulatory cases.Results. When compared with the control group, the AMH levels of the PCOS group were significantly higher than those of the control group (6.81 ± 2.8 ng/ml vs. 3.22 ± 2.2 ng/ml, p < 0.001). In the subgroup analysis, the AMH levels of Group 1 and Group 2 were significantly higher than those of the control group (p < 0.001). The AMH cut-off value of 4.1 ng/ml was found to distinguish healthy women from PCOS patients, with 84% sensitivity and 80% specificity.Conclusions. Subgroup analyses showed higher levels of AMH in the severe PCOS group, but the difference was not statistically significant. More studies are suggested for researching the different PCOS subgroups to detect optimal AMH thresholds.