This study aimed to investigate the effectiveness of intraabdominal irrigation with saline on postoperative gastrointestinal functions and short-term complications in patients who underwent cesarean section under general anesthesia. This prospective randomized controlled clinical trial was conducted between March 2022 and May 2022 and included 60 patients who underwent elective cesarean. The participants were randomized into two groups: abdominal irrigation (n=30) and control group (n=30). Participants undergo a standard cesarean procedure, and general anesthesia was preferred. The patients were questioned regarding nausea, vomiting, highest pain scores, time of flatus, and stool passage during the postoperative period. Although no significant differences were found between the two groups (p>0.05), the return of bowel functions, i.e., passage of flatus and stool, occurred in a shorter period in the irrigation group (19.53 and 34.63 versus 16.73 and 33.7). The postoperative visual analog scale (VAS) scores of the two groups were comparable; VAS score of 4-6 was the sole difference when comparing both groups. Although postoperative vomiting was more common in the control group, no significant difference in postoperative vomiting, postoperative nausea, and postoperative antiemetic need was found between the two groups (p>0.05). The results revealed that intraoperative abdominal irrigation did not affect gastrointestinal functions and short-term maternal morbidity and did not provide additional benefits.

Background: Fumarate hydratase (FH)-deficient uterine leiomyomas are rare tumors that may be associated with germline FH variants and FH tumor predisposition syndrome. This study aimed to evaluate the clinical characteristics, germline genetic findings, and follow-up outcomes of patients with FH-deficient uterine leiomyomas, and to determine the frequency of germline pathogenic/likely pathogenic (P/LP) FH variants. Methods: This ambispective single-center cohort study included 19 patients diagnosed with FH-deficient uterine leiomyomas at a center between February 2021 and February 2026. Clinical characteristics, surgical data, FH and S-(2-succino) cysteine (2SC) immunohistochemical findings, germline FH analyses, renal imaging, dermatologic evaluation, and follow-up outcomes were reviewed. Results: Mean age was 44.9 ± 7.2 years, and the median largest leiomyoma diameter was 6.5 cm. Loss of FH expression was observed in 17/19 cases, while diffuse 2SC positivity was present in all cases. Among 17 patients who underwent germline testing, two (11.8%) harbored P/LP FH variants, [c.434C>G, p.(Ser145Ter) and c.1256C>G, p.(Ser419Ter)], and one (5.9%) had a variant of uncertain significance (VUS) [c.1090G>A, p.(Gly364Arg)]. Dermatologic evaluation was completed, with no cutaneous leiomyomas identified; no renal malignancy was detected on imaging in the two P/LP variant carriers. Among nine patients who underwent myomectomy, three developed recurrence; the patient carrying the likely pathogenic variant conceived after myomectomy. Conclusions: Identification of an FH-deficient uterine leiomyoma on pathologic examination is an important finding that should prompt evaluation for germline FH variants. These patients require integrated genetic, renal, dermatologic, and gynecologic follow-up. Obstetricians and gynecologists have an important role in initiating genetic evaluation and long-term surveillance after surgery.

ObjectiveMaternal micronutrient status in early pregnancy may influence fetal growth and neurodevelopment. Vitamin D, vitamin B12, and iron deficiencies are common, but their associations with perinatal outcomes and later childhood development remain unclear. This study evaluated first-trimester maternal vitamin D, vitamin B12, and ferritin levels in relation to maternal, fetal, neonatal, and early neurodevelopmental outcomes at age ≥4 years.Study DesignThis ambispective cohort included 726 singleton pregnancies with at least one first-trimester serum 25-hydroxyvitamin D, vitamin B12, or ferritin measurement. Maternal, fetal, and neonatal outcomes were retrieved from electronic records, and 217 offspring underwent Denver II assessment at age ≥4 years. Micronutrient levels were classified using predefined thresholds, and multivariable regression assessed independent associations after adjustment for potential confounders.ResultsMaternal micronutrient status was not significantly associated with maternal complications. Vitamin D and vitamin B12 sufficiency were associated with higher birth weight (3331.2 ± 483.7 vs. 3194.5 ± 521.9 g, p = 0.034; and 3265.2 ± 557.2 vs. 3141.8 ± 551.3 g, p = 0.015, respectively), whereas vitamin D deficiency was associated with a higher small-for-gestational-age rate (10.3% vs. 2.5%, p = 0.027). These associations remained significant after multivariable adjustment. Low maternal vitamin B12 was independently associated with modest delays in head control and independent sitting, although milestone ages remained within normal ranges.ConclusionsFirst-trimester maternal micronutrient status may influence fetal growth and selected early motor milestones; however, developmental differences were modest and not reflected in neurodevelopmental screening. Larger prospective studies are needed to clarify long-term clinical significance.

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