To investigate maternal adverse effects and perinatal and neonatal outcomes of women receiving coronavirus disease-2019 (COVID-19) vaccination during pregnancy. Seven hundred and sixty pregnant women who were followed up in obstetrics outpatients were included in this prospective cohort study. COVID-19 vaccination and infection histories of the patients were recorded. Demographic data, including age, parity, and presence of systemic disease and adverse events following COVID-19 vaccination were recorded. Vaccinated pregnant women were compared with unvaccinated women in terms of adverse perinatal and neonatal outcomes. Among the 760 pregnant women who met study criteria, the data of 425 pregnant women were analyzed. Among these, 55 (13%) were unvaccinated, 134 (31%) were vaccinated before pregnancy, and 236 (56%) pregnant women were vaccinated during pregnancy. Of those who were vaccinated, 307 patients (83%) received BioNTech, 52 patients (14%) received CoronaVac, and 11 patients (3%) received both CoronaVac and BioNTech. The local and systemic adverse effect profiles of patients who received COVID-19 vaccination either before or during pregnancy were similar (p=0.159), and the most common adverse effect was injection site pain. COVID-19 vaccination during pregnancy did not increase the ratio of abortion (24 wk), preeclampsia, gestational diabetes mellitus, fetal growth restriction, second-trimester soft marker incidence, time of delivery, birth weight, preterm birth (<37 wk) or admission to the neonatal intensive care unit compared to the women who were not vaccinated during pregnacy. COVID-19 vaccination during pregnancy did not increase maternal local and systemic adverse effects or poor perinatal and neonatal outcomes. Therefore, regarding the increased risk of morbidity and mortality related to COVID-19 in pregnant women, the authors propose that COVID-19 vaccination should be offered to all pregnant women.

OBJECTIVE: Aberrant right subclavian artery, which is detected in 1-1.5% of the population, is considered an anatomical variant. Aberrant right subclavian artery is usually not symptomatic, but can sometimes lead to dysphagia due to esophageal compression. On the other hand, it has been found that it has accompanied some fetal anomalies in the last two decades. Although aberrant right subclavian artery is seen at a rate of 1-1.5% in normal chromosomal fetuses, it is seen at a rate of 19-36%, especially in fetuses with Down syndrome. STUDY DESIGN: Our study was carried out in the Department of Obstetrics and Gynaecology at Ankara University Faculty of Medicine between the dates of January 2017-January 2020. Pregnant women have had their detailed ultrasonography at our clinic and who were between 18th-24th gestational weeks were included. Amniocentesis was performed on the patients who have accepted, and genetic results were followed up. The patients who did not accept were followed up until after birth, and genetic testing was requested for babies suggestive of anomaly. RESULTS: Our study included 6205 patients who underwent detailed ultrasonography in our clinic between January 2017 and June 2020. Our detailed ultrasonography application week was between 16-24 weeks. During this period, aberrant right subclavian artery was detected in 47 of our patients. The detection rate of ARSA in the normal population in our study was 0.7% (46/6205). While aberrant right subclavian artery was the only ultrasonographic finding in 28 patients, extra anomalies were observed in 18 patients. Down syndrome was detected in four fetuses, CONCLUSION: We did not find any chromosomal anomalies in any of the patients with isolated aberrant right subclavian artery. Therefore, we do not recommend invasive intervention in patients with isolated aberrant right subclavian artery. On the other hand, our study confirmed that aberrant right subclavian artery screening should be a part of a detailed fetal ultrasonographic examination. Further studies with larger patient groups are needed.

This study aimed to evaluate the perinatal outcomes of isolated single umbilical artery (iSUA) and incidence of fetuses diagnosed with Single Umbilical Artery (SUA) in the second trimester. We retrospectively analyzed the data of 40,800 pregnant women who had undergone detailed ultrasonography between September 2011 and September 2021 in the perinatology clinic of tertiary university hospital. Those diagnosed with SUA accompanied by structural and genetic anomalies and maternal diseases among the 402 cases and multiple pregnancies were excluded from the study. The remaining 307 iSUA cases were compared with 650 randomly selected cases Double Umbilical Artery (DUA) by need for cesarean section due to fetal distress or suspicious Non-Stress Test (NST), delivery frequency before 37 and 34 weeks, birth weight, fetal gender, oligohydramnios, small for gestational age (SGA; <10% percentile birth weight)), intrauterine fetal death (IUFD), Apgar scores, and admission to a neonatal intensive care unit (NICU) for antenatal and perinatal outcomes. A total of 402 (0.9%) cases were diagnosed with SUA. Thirty-nine (9.7%) cases had structural anomalies, and 13 (3.2%) had genetic anomalies. While the most frequently detected chromosomal disorder was trisomy 18, central nervous system (CNS) and cardiovascular system (CVS) anomalies were the most prevalent accompanying structural anomalies. Comparing 307 cases with iSUA with 650 cases with DUA, we detected that the group with iSUA yielded significantly lower Apgar scores at 1 st and 5th minutes, lower birth weight, SGA prevalence, higher cesarean section need due to fetal distress and unreliable non-stress test, higher IUFD, and higher preterm birth. Overall, we believe that the patients need to be recruited for a detailed ultrasonographic examination, as well as CNS and CVS examinations, following the diagnosis of SUA and that interventional diagnostic tests need to be applied to those with structural anomalies. Although genetic diagnostic tests are not required among iSUA cases, we found that cases with iSUA had higher IUFD in the second trimester, premature birth, low birth weight, and need for cesarean section.

Background: Early-onset preeclampsia (EO-PE) remains a major cause of maternal and perinatal morbidity and mortality, and early risk stratification is still limited by the lack of simple and widely accessible biomarkers. The neutrophil percentage-to-albumin ratio (NPAR) has emerged as a composite marker reflecting systemic inflammation and endothelial dysfunction. Methods: In this retrospective, nested case–control study (n = 1176), we evaluated the predictive performance of first-trimester NPAR for EO-PE (n = 168) versus frequency-matched normotensive controls (n = 840) and its incremental value beyond established clinical and hemodynamic parameters. Multivariable models were adjusted for gestational age at sampling, and internal validation was performed via bootstrapping. Results: NPAR demonstrated superior discrimination (AUC = 0.848) compared with NLR (AUC = 0.629) and MAP (AUC = 0.614) (p < 0.001 for both). At the optimal cutoff of 16.52, NPAR showed a sensitivity of 81.5% (95% CI: 74.8–87.1%) and a specificity of 76.0% (95% CI: 72.9–78.9%), yielding a prevalence-adjusted positive predictive value (PPV) of 6.5% and a negative predictive value (NPV) of 99.5% based on Bayes’ Theorem. In multivariable analysis, NPAR remained independently associated with EO-PE (aOR 2.25, 95% CI 1.81–2.80; p < 0.001, per 1 SD increase). The addition of NPAR significantly improved model performance, increasing the AUC from 0.612 to 0.830 (DeLong p < 0.001), with robust bootstrap stability. Conclusions: First-trimester NPAR stands out as a potential independent clinical risk vector for early-onset preeclampsia and may offer meaningful additive prognostic utility beyond conventional clinical parameters. Given its low cost and routine availability, it may represent an accessible framework for initial frontline triage in early pregnancy risk stratification, particularly in resource-limited clinical settings where advanced multi-marker screening algorithms are unavailable. Rigorous external validation in prospective, multicenter longitudinal cohorts remains an absolute prerequisite before routine implementation in clinical management pathways.

Amaç: İkinci trimesterde nukal fold (NF) kalınlık artışı saptanan fetüslerin antenatal ve doğum sonrası sonuçlarını ortaya çıkartmak. Gereç ve Yöntem: Ocak 2014- Ocak 2021 yılları arasında ayrıntılı ultrasonografi için başvuran gebelerden NF kalınlığı saptanan 45 gebe çalışmaya alındı. NF kalınlık artışı saptanan tüm gebelere amniyosentez (A/S) önerildi. A/S’yi kabul etmeyen gebelerin bebeklerinde doğum sonrası anormal bulgu saptanması durumunda genetik test istendi. Ayrıca NF kalınlık artışı saptanan gebelere fetal ekokardiyografi dahil olmak üzere ayrıntılı ultrasonografi yapıldı. Antenatal ve doğum sonrası eşlik eden yüz anomalileri, kardiyovasküler, kraniyal, gastrointestinal, genitoüriner ve iskelet sistemi patolojiler kaydedildi. Bulgular: NF kalınlık artışı saptanan 45 hastadan 13’ üne antenatal genetik test (9 A/S, 4 koriyon villus örneklenmesi (CVS)) yapıldı. Üç hastada antenatal, üç hastada postnatal olmak üzere 6 (%13,3) hastada genetik anormallik saptandı. Bu fetüslerden %6,6’sında Trizomi 21 (n:3, biri mozaizm), %2,2’sinde (n:1) ring 18 kromozom saptandı. Ayrıca bir Noonan Sendromu ve bir Genito-pateller Sendromlu hastaya postnatal tanı konuldu. Fetüslerden %28’ sinde izole NF kalınlığı saptandı. Bu fetüslerde kromozomal ve yapısal anomali saptanmadı. Gebelerin %30’unda (14/45) kardiyovasküler sistem anomalisi, %20’ sinde (9/45) yüz anomalisi, %18’inde (8/45) genitoüriner sistem, %13’inde (6/45) kraniyal, %11’inde (5/45) ekstremite anomalisi saptandı. Sonuç: Nukal fold kalınlık artışı saptanan gebelere ayrıntılı ultrasonografı yapılmalı ve genetik inceleme önerilmelidir. Eşlik eden ultrasonografik bulgu saptanması durumunda kromozomal anomali ihtimali artmaktadır. Ancak izole NF kalınlık artışı saptanması durumunda kromozomal anomali riski düşüktür. Ayrıca genetik inceleme sonucu kromozomal anomali saptanmasa bile, hastalar postnatal dönemde olası kardiyak, kraniyal, genitoüriner ve iskelet sistemi patolojileri açısından bilgilendirilmelidir.

Background:Gestational glycemia represents a continuous metabolic spectrum rather than a binary condition. Although the oral glucose tolerance test (OGTT) is routinely used to diagnose gestational diabetes mellitus (GDM), accumulating evidence suggests that distinct OGTT-derived glycemic patterns may confer distinct perinatal risks beyond the dichotomous GDM classification.Methods:This retrospective, dual-center cohort study included 1457 singleton pregnancies undergoing a 75-g OGTT between 24 and 28 weeks of gestation. Women were categorized into OGTT-derived glycemic groups based on fasting, 1-h, and 2-h plasma glucose values. The primary outcome was large-for-gestational-age (LGA) birth. Secondary outcomes included neonatal intensive care unit (NICU) admission and insulin therapy requirement. Multivariable logistic regression was used to assess the associations with LGA after adjustment for maternal age, pre-pregnancy body mass index (BMI), gestational weight gain (GWG), parity, smoking history, and study center. The predictive performance of fasting glucose and the combined multivariate model for LGA was evaluated using receiver operating characteristic (ROC) analyses.Results:Perinatal outcomes differed significantly across glycemic categories. The prevalence of LGA increased progressively from 6.3% among normoglycemic women to 26.6% in those with ≥2 abnormal OGTT values. In multivariable-adjusted analyses, LGA risk increased in a stepwise manner across glycemic categories, with the highest risk observed in women with fasting-dominant glycemic abnormalities. Fasting-driven glycemic categories were further associated with higher rates of NICU admission and insulin therapy requirement. Among individual OGTT time points, fasting glucose demonstrated the greatest discriminative ability for LGA prediction (area under the curve [AUC] = 0.64), while combined multivariate models yielded only modest incremental improvement (AUC = 0.67).Conclusions:Perinatal outcomes varied systematically across OGTT-derived glycemic categories. Fasting-dominant hyperglycemia and multiple abnormal OGTT values constituted the highest-risk metabolic phenotypes, whereas isolated post-load abnormalities were associated with comparatively milder perinatal consequences. Collectively, these findings suggest that risk stratification based on the temporal pattern of OGTT abnormalities may facilitate identification of clinically meaningful risk gradients, and prospective evaluation of this approach.