The aim of this study was to examine the utility of the albumin–bilirubin score in cases of intrahepatic cholestasis of pregnancy.

Retrospective analysis of the indications, methods, and complications of pregnancy termination - Turkish Journal of Obstetrics and Gynecology

The objective of this study was to evaluate the descriptive outcomes of 38 prenatally suspected clubfoot cases. This is a retrospective cohort study conducted in Ankara Bilkent City Hospital's perinatology clinic. All consecutive cases with the diagnosis of fetal clubfoot between 2020 and 2023 were included. Multiple pregnancies and skeletal dysplasias were excluded from the study. Demographic features, prenatal ultrasound findings, prenatal screening test results, invasive diagnostic test results, clinical approaches, short-term and long-term postnatal outcomes, and treatment types of clubfoot were reported. There were a total of 38 prenatally diagnosed clubfoot cases noted during the study period. The mean gestational age at diagnosis was 15.3±1.4 weeks. Prenatal ultrasound screening noted bilateral clubfoot in 16 (42.1%) cases and unilateral clubfoot in 22 (57.8%) cases. Clubfoot was isolated in 7 (18.4%) cases, and additional anomalies were present in 31 (81.6%) cases. The gender of the fetuses was 26 (68.4%) males and 12 (31.6%) females. The prenatal noninvasive screening test was high risk in 7 (18.4%) patients and low risk in 16 (42.1%) patients. As a result of amniocentesis performed in 16 (42.1%) patients, abnormal karyotypes were detected in 2 patients (trisomy 18, 22q11.2 del). Six pregnancies were terminated before 24 weeks, and 27 pregnancies resulted in live birth at an average of 37.8±2.5 weeks. The diagnosis was correct in 84.2% of the cases, and 84.6% of the pregnancies resulted in live births. The outcomes of congenital clubfoot are generally favorable, especially in isolated cases.

Objective: The aim of this study was to investigate the association between maternal vitamin D status and fetal cortical maturation using detailed neurosonographic assessment at 28–30 weeks of gestation. Methods: This prospective observational study included 422 singleton pregnancies evaluated between 28 and 30 gestational weeks. Maternal serum 25-hydroxyvitamin D [25(OH)D] was measured by chemiluminescence immunoassay and categorized as deficient (30 ng/mL). Fetal neurosonography was performed with a GE Voluson E8 system to quantify sulcal depths (insula, Sylvian, parieto-occipital, calcarine, and cingulate fissures), corpus callosum thickness, cavum septum pellucidum length, operculization, and cortical maturation grades. Interobserver reliability, correlation, regression, and receiver operating characteristic (ROC) analyses were conducted. Results: Of 422 women, 280 (66.4%) were vitamin D deficient, 110 (26.1%) insufficient, and 32 (7.6%) sufficient. Deficient participants showed significantly lower mean insula, parieto-occipital, and calcarine fissure depths and thinner corpus callosum (p < 0.05). Operculization and cortical maturation grades were also reduced (p = 0.02 and p = 0.01, respectively). Maternal 25(OH)D levels positively correlated with calcarine fissure depth (r = 0.42, p < 0.001) and cortical maturation grade (r = 0.45, p < 0.001). After adjustment for gestational age, vitamin D deficiency independently predicted low cortical maturation (≤ grade 3) (adjusted OR 2.56, 95% CI: 1.34–4.89, p = 0.004). ROC analysis demonstrated good discriminatory ability (AUC = 0.74, p < 0.001), with an optimal vitamin D threshold of ≈ 21 ng/mL yielding 78% sensitivity and 65% specificity. Conclusion: Maternal vitamin D deficiency during the late second to early third trimester is associated with delayed fetal cortical sulcation and reduced operculization grades. Quantitative neurosonography can noninvasively identify early neurodevelopmental vulnerability related to suboptimal maternal vitamin D status, supporting the role of adequate vitamin D as a modifiable determinant of fetal brain development. Given the high prevalence of hypovitaminosis D observed in this cohort, assessment of maternal 25(OH)D levels may be justified in high-risk or high-prevalence populations. Based on commonly applied clinical thresholds, supplementation of approximately 600 IU/day for vitamin D-sufficient women, 1,000 IU/day for those with insufficiency, and 1,500–2,000 IU/day for deficient women may be considered.