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: This study aimed to evaluate maternal serum afamin levels in women with intrahepatic cholestasis of pregnancy (ICP), examine their relationship with fasting bile acid concentrations, and assess their association with perinatal outcomes. Methods: This prospective case-–control study included 80 singleton pregnancies followed at a tertiary perinatology center between October 2025 and March 2026. Forty women with ICP, defined by pruritus and fasting bile acids > 10 μmol/L, were compared with 40 healthy pregnant controls. Women with ICP were further stratified according to fasting bile acid levels as <40 and ≥40 μmol/L. Maternal serum afamin concentrations were measured using a commercially available enzyme-linked immunosorbent assay (ELISA) kit. Maternal characteristics, liver biochemistry, fetal biometric and Doppler parameters as well as obstetric and neonatal outcomes were compared. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic performance of afamin for ICP, and logistic regression analysis was used to assess its association with ICP. Results: Baseline maternal characteristics were comparable between groups. Maternal serum afamin levels were significantly higher in the ICP group than in controls (6.18 ± 4.24 vs. 3.98 ± 1.95 ng/mL, p = 0.004). Afamin correlated positively with fasting bile acids (r = 0.372, p = 0.018), but not with transaminases, gestational age at delivery, birth weight, or neonatal outcomes. In logistic regression, afamin was independently associated with ICP (adjusted odds ratio [aOR] 1.260; 95% confidence interval [CI] 1.059–1.500; p = 0.009). ROC analysis showed poor discrimination for ICP (area under the curve [AUC] 0.634, 95% CI 0.51–0.76, p = 0.039), whereas afamin did not discriminate between subgroups defined by fasting bile acid levels (<40 vs. ≥40 μmol/L). The optimal cut-off value of 4.93 ng/mL predicted ICP with 55% sensitivity, 67.5% specificity, a positive likelihood ratio of 1.69, and a negative likelihood ratio of 0.67. Conclusions: Maternal serum afamin levels are elevated in ICP and show a modest association with fasting bile acid burden. Its discriminatory performance is limited, and it does not reliably distinguish patients defined by a ≥40 μmol/L threshold. These findings suggest that afamin reflects the maternal response to cholestasis rather than disease severity and may serve as a complementary biomarker.

To assess the structural and hemodynamic characteristics of the foramen ovale (FO) in fetuses with late-onset fetal growth restriction (LO-FGR) using three-dimensional (3D) ultrasonography and Doppler imaging, and to examine their associations with Doppler parameters in FGR and composite adverse perinatal outcomes (CAPO). This case-control study included 40 fetuses with LO-FGR and 40 matched controls exhibiting appropriate-for-gestational-age (AGA) between 34 and 37 weeks. FO area was measured using 3D spatio-temporal image correlation (STIC) imaging, and FO width and pulsatility index (PI) were evaluated using 2D and Doppler ultrasonography. FO parameters were compared between the groups, and partial correlation analyses adjusted for gestational age to assess their associations with FGR and CAPO. Additionally, Receiver Operating Characteristic (ROC) curve analysis was conducted to evaluate the predictive value of FO parameters for CAPO within the FGR group. FO area (p < 0.001), FO width (p < 0.001), left atrial (LA) width (p = 0.029), FO/LA ratio (p < 0.001), and FO/RA ratio (p = 0.024) were significantly reduced in the FGR group compared to the controls. Among FGR fetuses, those who developed CAPO had lower FO area (p = 0.009), FO width (p = 0.001), LA width (p = 0.006), FO/LA ratio (p < 0.001), and FO/RA ratio (p = 0.041). In ROC analysis, the FO/LA ratio exhibited the highest predictive value for predicting CAPO (AUC: 0.851, p < 0.001). Alterations in FO morphology are significantly associated with adverse perinatal outcomes in LO-FGR. The FO/LA ratio may serve as a reliable and noninvasive parameter for risk stratification. Incorporating advanced fetal cardiac morphometry could improve prenatal surveillance in FGR.

Aims: This study aimed to evaluate the prognostic significance of the C-reactive protein-albumin-lymphocyte (CALLY) index in pregnancies complicated by preterm prelabor rupture of membranes (PPROM). Methods: This prospective study included pregnant women diagnosed with PPROM who were followed at the Perinatology Clinic of Ankara Etlik City Hospital between December 1, 2024, and March 1, 2025. The PPROM group consisted of 181 women, while 170 healthy pregnant women, matched for maternal and gestational age, served as controls. Maternal and neonatal outcomes, along with laboratory parameters such as CRP, WBC, and the CALLY index, were evaluated. Results: The PPROM group had significantly lower birth weight (2318.6±493.7 g vs. 3014.0±438.1 g, p

Aims: To investigate the relationship between preoperative and postoperative visceral pain scores and the C-reactive protein albumin–lymphocyte (CALLY) index in patients with endometriosis and to identify predictors of postoperative pain. Methods: This retrospective comparative study included women aged 18–45 years who underwent surgical treatment for stage III–IV endometriosis at Ankara Etlik City Hospital between 2022 and 2024, with postoperative histopathological confirmation of the diagnosis. The control group consisted of healthy women without pelvic pathology who underwent bilateral tubal ligation for sterilization at the same institution during the study period. Preoperative and postoperative (day 7±1) blood samples were analyzed for CRP, albumin, and lymphocytes to calculate the CALLY index. Visceral pain was evaluated using a Visual Analogue Scale (VAS). Univariate and multivariate linear regression analyses were performed to identify predictors of postoperative pain after adjusting for surgical type (laparotomy/laparoscopy). Results: Ninety-four endometriosis patients and 120 controls were analyzed. Preoperative and postoperative VAS scores were significantly higher in the endometriosis group than controls (p