There are numerous debates in the management of Gastroschisis (GS). The current study aimed to evaluate perinatal outcomes, surgical and clinical characteristics among Gastroschisis (GS) patients based on their type of GS, abdominal wall closure method, and delivery timing. This study was a retrospective analysis of prospectively collected data of 29 fetuses with GS that were prenatally diagnosed, delivered, and managed between June 2015 and December 2019 at the Obstetrics and Pediatric Surgery Clinics of Kanuni Sultan Süleyman Training and Research Hospital. Twenty-three of the patients were simple GS, and six of them were complex GS. The reoperation requirement, number of operations, duration of mechanical ventilation, time to initiate feeding, time to full enteral feeding, total parenteral nutrition (TPN) duration, TPN-associated cholestasis, wound infection, sepsis, and necrotizing enterocolitis were significantly lower in the simple GS group than the complex GS group. The mean hospital length of stay was 3.5 times longer in the complex GS group (121.50±24.42 days) than that of the simple GS group (33.91±4.13 days, p=0.009). There were no cases of death in the simple GS group. However, two deaths occurred in the complex GS group. This study indicated that simple GS, compared with complex GS, was associated with improved neonatal outcomes. We suggest that the main factor affecting the patients? outcomes is whether the patient is a simple or complex GS rather than the abdominal wall closure method.

Amaç: Bu çalışmada üçüncü basamak pandemi hastanesinin kadın hastalıkları ve doğum ünitesinde görevli doktor, hemşire, ebe ve anestezi teknisyenlerinde tükenmişlik sendromu ile ilişkili risk faktörlerinin belirlen-mesi amaçlanmıştır.Materyal ve metod: Sosyo-demografik bilgileri ve iş yeri ile ilgili özellikleri içeren anket formu ile Maslach Tükenmişlik Ölçeğini 1-15 Eylül 2021 tarihleri arasında dolduran 316 katılımcı çalışmaya dahil edilmiştir.Bulgular: Genç çalışanlarda duyarsızlaşma skoru (p=0,001), kadınlarda duygusal tükenmişlik ve kişisel başarı skorları anlamlı olarak yüksek saptandı (p=0,043 ve p=0,003). Kadın hastalıkları ve doğum uzmanlarında diğer branşlara göre anlamlı olarak daha yüksek duygusal tükenmişlik ve duyarsızlaşma skorları bulunmuştur (p=0,021 ve p=0,038). Çalışılan birimler incelendiğinde, yoğun bakımda çalışanlarda en yüksek, poliklinikte çalışanlarda en düşük duyarsızlaşma tespit edilmiştir (p=0,039). Toplam hizmet süresindeki artış ile duyarsızlık skorundaki azalış ve kişisel başarı skorundaki yükseliş korele bulunmuştur (p=0,003 ve p=0,004). Meslekten beklentilerinin karşılanmadığını ya da kısmen karşılandığını belirtenlerde duygusal tükenmişlik skoru anlamlı yüksek saptanmıştır (p=0,032). Ekstra saat çalışanlarda duygusal tükenmişlik ve duyarsızlaşma skorları anlamlı yüksek bulunmuştur (p=0,004 ve p=0,012). Fiziki koşulların yetersiz olduğunu bildiren çalışanlarda duygusal tükenmişlik skorunda anlamlı yükseklik saptanmıştır (p<0,001). COVID-19’lu hastalara doğrudan hizmet sunan grupta duygusal tükenmişlik ve duyarsızlaşma skorunda anlamlı yükseklik, kişisel başarı skorunda anlamlı düşük-lük saptanmıştır(p=0,014, p=0,003 ve p=0,014).Sonuç: COVID-19 pandemisi çalışanlarda tükenmişlik sendromu riskinde artışa neden olmaktadır. Ağır çalışma koşulları ve çalışma ortamındaki fiziki yetersizlikler tükenmişlik sendromu riskini artıran diğer nedenlerdendir.Anahtar Kelimeler: COVID-19 Pandemisi, Tükenmişlik Sendromu, Kadın hastalıkları ve Doğum

Objective: This study aimed to examine the effects of infection with the Delta variant of coronavirus disease-2019 (COVID-19) on the clinical course, laboratory parameters, and neonatal outcome in pregnant women.Material and Methods: A total of 96 pregnant women who tested positive for the Delta variant of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) causing COVID-19 were retrospectively examined. The pregnant women were divided into three groups: Asymptomatic; non -severe; and severe. Age, obstetric history, symptoms and findings, blood tests, medication and vaccination history, clinical course, and perinatal outcome of pregnant women were analyzed.Results: Pregnant women who tested positive for the Delta variant of SARS-CoV-2 had an intensive care unit (ICU) admission rate of 9.4% and a mortality rate of 5.2%. Pregnant women in the severe disease group had significantly higher rates of preterm birth and cesarean section compared with the non-severe and asymptomatic group. Pregnant women in the severe group had high C-reactive protein (CRP) levels at the time of admission. White blood cell count (WBC) and procalcitonin levels were increased in clinical follow-up in women in the severe group.Conclusion: The Delta variant of SARS-CoV-2 was found to increase mortality rates in pregnant women compared to pre-Delta variants of COVID-19. In pregnant women infected with the Delta variant, advanced gestational age at diagnosis, high CRP, WBC, and procalcitonin levels were significantly correlated with poor prognosis. Pregnant women infected with the Delta variant and with severe COVID-19 had an increased risk for preterm delivery and cesarean section. Although newborns of women with severe disease were found to have significantly higher rates of ICU admission, there was no significant difference in neonatal mortality rates. We recommend close monitoring of CRP, WBC, and procalcitonin levels, in addition to symptoms, in pregnant women infected with the Delta variant of SARS-CoV-2 and diagnosed in the third trimester.

Objective: This study aimed to report the clinical prognoses, laboratory findings, treatment procedures, and neonatal outcomes, from hospitalization to death, of Coronavirus Disease 2019 (COVID-19)-related cases of maternal mortality at our clinic. Methods: Fifteen cases of COVID-19-related maternal mortality, between April 2020 and October 2021, in the Department of Obstetrics & Gynecology of a Training and Research Hospital were retrospectively analyzed for the purpose of the study. Results: During the study period, a total of 501 symptomatic pregnant women received inpatient treatment for COVID-19. In our case group, 93.3% of maternal deaths due to COVID-19 occurred as a result of the worsening of the clinical condition of third-trimester pregnant women. In these patients whose clinical condition deteriorated, delivery was performed after the decision to give birth, and 86.6% of mortalities occurred in the postpartum period and 13.4% before delivery. There was at least one risk factor in 60% of the cases, with obesity being the most prevalent. In all mortality cases, there were pulmonary complaints (shortness of breath and cough) at admission, and bilateral lung involvement was observed during lung imaging; furthermore, there was a corresponding increase in the mean leukocytosis, AST, ALT, LDH, D-dimer, ferritin, procalcitonin, IL-6, and pro-BNP levels with the worsening of the clinical prognosis. The duration of hospitalization and intensive care unit stays were 6.87±3.18 and 5.33±3.27 days, respectively. The mean period of the delivery-to-mortality for mothers was 5.92±3.48 days and the mean period of the intubation-to-mortality for mothers was 3.33±3.15 days. Conclusion: The risks of severe illness and death associated with COVID-19 increased in the third trimester compared to the first and second trimesters. All mortality cases involved unvaccinated pregnant women, of which most had at least one risk factor, obesity being the most prevalent. There was no COVID-19-related mortality in the newborns, and it was found that prematurity rates increased due to maternal disease.