Objective: This study aimed to evaluate and compare maternal and fetal outcomes between pregnancies in women aged 40 and over and those in women under 40 years of age at a tertiary care hospital. Methods: A retrospective cohort study was conducted at Necmettin Erbakan University Medical Faculty Hospital, analyzing data from 345 women aged 40 and over and 366 women under 40 who delivered between January 2015 and December 2024. Maternal and perinatal outcomes—including mode of delivery, gestational age, birth weight, and complications such as gestational diabetes, preeclampsia, and postpartum hemorrhage—were compared between the two groups. Results: Women aged 40 and over had significantly higher rates of cesarean section (73% vs. 36.1%, p < 0.0001), preterm delivery (27.8% vs. 18%, p = 0.002), and gestational diabetes (14.8% vs. 7.7%, p = 0.002). Additionally, these women had a higher incidence of preeclampsia (13% vs. 5.7%, p = 0.001) and postpartum hemorrhage (18% vs. 10.5%, p = 0.003). Despite these increased risks, the 5 min APGAR score was significantly higher in the ≥40 age group (median 8 vs. 7, p < 0.0001). The incidence of chromosomal abnormalities was significantly higher in patients≥ 40 years, with 5 cases (1.4%) reported, compared to no cases (0%) in the <40 age group (p = 0.025). Conclusions: This study shows that pregnancies in women aged 40 and above carry higher maternal and fetal risks compared to younger women. Complications such as preterm labor, cesarean delivery, gestational diabetes, and preeclampsia occur more frequently in this group. However, with careful prenatal care, positive neonatal outcomes are often achievable, highlighting the need for age-specific management and early risk detection.

The C-reactive protein–albumin–lymphocyte (CALLY) index is a novel immunonutritional marker reflecting systemic inflammation and host immune status. This study aimed to evaluate the diagnostic and prognostic value of the CALLY index and compare its performance with other systemic inflammatory indices in hospitalized patients with pelvic inflammatory disease (PID) and tubo-ovarian abscess (TOA). This retrospective observational study included 124 patients hospitalized with PID and/or TOA between January 2020 and November 2025. Patients were classified into TOA and non-TOA groups based on clinical and radiological findings. Demographic data, laboratory parameters, and length of hospital stay were recorded. Inflammatory and immunonutritional indices, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic inflammatory index (SII), systemic inflammatory response index (SIRI), C-reactive protein-to-albumin ratio (CAR), hemoglobin–albumin–lymphocyte–platelet (HALP) score, neutrophil percentage-to-albumin ratio (NPAR), and CALLY index, were calculated using admission laboratory values. Receiver operating characteristic (ROC) analysis was performed to evaluate diagnostic performance. Patients with TOA had significantly higher C-reactive protein (CRP), procalcitonin, C-reactive protein-to-albumin ratio (CAR), hemoglobin–albumin–lymphocyte–platelet (HALP) score, systemic inflammatory response index (SIRI), and neutrophil percentage, and significantly lower CALLY index compared to non-TOA PID patients (p<0.05). The CALLY index showed a significant negative correlation with length of hospital stay (r = –0.283, p = 0.001), whereas CRP, CAR, HALP, and neutrophil percentage-to-albumin ratio (NPAR) demonstrated positive correlations. ROC analysis revealed moderate diagnostic accuracy of the CALLY index for predicting TOA (AUC = 0.671, p = 0.001). The HALP score demonstrated the highest diagnostic performance among evaluated parameters. The CALLY index is a promising immunonutritional biomarker associated with disease severity and hospitalization burden in patients with TOA. Its integration into routine clinical evaluation may improve early risk stratification and clinical decision-making in PID management.

To compare preterm prelabor rupture of membranes (PPROM) at 34 + 0-36 + 6 weeks with term prelabor rupture of membranes at ≥ 37 weeks in terms of obstetric outcomes, maternal morbidity, and short-term neonatal outcomes. This retrospective cohort study included 646 singleton pregnancies diagnosed with PROM at 34 + 0 weeks or later in a tertiary care center between January 1, 2018 and July 30, 2025. Cases were grouped as PPROM at 34 + 0-36 + 6 weeks (n = 334) and term PROM at ≥ 37 weeks (n = 312). Maternal, obstetric, and neonatal outcomes were compared. Logistic regression was used to identify factors associated with NICU admission and the respiratory neonatal morbidity composite. Compared with term PROM, the 34 + 0-36 + 6 weeks PPROM group had longer antibiotic use, higher rates of tocolysis and antenatal corticosteroid administration and longer latency. Infectious maternal morbidity did not differ significantly between groups. However, PPROM at 34 + 0-36 + 6 weeks was associated with lower birth weight, a higher rate of NICU admission (25.7% vs. 6.7%, p < 0.001), and a higher rate of the respiratory neonatal morbidity composite (14.5% vs. 3.5%, p < 0.001). In multivariable analysis, PPROM at 34 + 0-36 + 6 weeks remained independently associated with NICU admission (aOR 5.05, 95% CI 2.90-8.76) and respiratory neonatal morbidity composite (aOR 5.91, 95% CI 2.82-12.37). PPROM at 34 + 0-36 + 6 weeks appears to be a distinct clinical entity rather than simply an earlier form of term PROM. Despite similar maternal infectious morbidity, its substantially higher neonatal morbidity burden supports individualized management and consideration of expectant management in carefully selected cases.

Aim: To evaluate the reproductive and obstetric outcomes after complete hydatidiform mole (CHM) and partial hydatidiform mole (PHM) in a tertiary referral center. Materials and Methods: This retrospective cohort included 90 women with histologically confirmed molar pregnancy (65 CHM and 25 PHM) who were managed between 2015 and 2024. Cases with ectopic localization, uncertain diagnosis, missing essential data, or insufficient follow-up were excluded. Women with uterine preservation, no permanent contraception, reproductive age, and adequate follow-up were defined as the subgroup with potential for subsequent pregnancy and were included in the reproductive outcome analysis. Postmolar gestational trophoblastic neoplasia (GTN), occurrence of at least one subsequent pregnancy, outcomes of the first postmolar pregnancy, and obstetric outcomes of the first live birth were compared between CHM and PHM. Results: Among women with potential for subsequent pregnancy (43 CHM and 14 PHM), at least one subsequent pregnancy occurred in 22 (51.2%) and 8 (57.1%) women, respectively (p=0.697). When only the first subsequent pregnancy was considered, live birth, miscarriage, and recurrent molar pregnancy rates did not differ significantly between CHM and PHM groups (live birth: 63.6% vs 87.5%, p=0.374; miscarriage: 18.2% vs 12.5%, p=1.000; recurrent mole: 18.2% vs 0%, p=0.550). Obstetric outcomes of the first subsequent live birth were also comparable between groups, including gestational age at delivery (p=0.336), birthweight (p=0.924), Apgar scores (all p>0.05), and mode of delivery (p=1.000); all deliveries occurred at term. Fetal growth restriction, preeclampsia, uterine atony, and oligohydramnios did not differ significantly between groups (all p>0.05). No cases of preterm premature rupture of membranes (PPROM), premature rupture of membranes (PROM), placenta previa, placenta accreta spectrum, or placental abruption were observed. Conclusion: In this single-center cohort, fertility potential and obstetric outcomes appeared generally favorable after both CHM and PHM. However, subgroup comparisons should be interpreted cautiously, as the limited sample size, particularly in the PHM group, may have reduced the statistical power to detect meaningful between-group differences.

This study aims to evaluate the perinatal outcomes of triplet pregnancies reduced from triplets to twins with fetal reduction (FR), followed expectantly without FR, and reduced to triplets from higher-order multiple pregnancies (HOMP) with FR. Multifetal pregnancies followed at the university hospital in the last 8 years were evaluated retrospectively. The study group was composed of three groups. The first group was those who started as trichorionic-triamniotic (TCTA) triplets and were followed by triplets. The second group consisted of HOMPs reduced to TCTA triplets with FR. The third group consisted of pregnant women who started as TCTA triplets and were reduced to dichorionic-diamniotic (DCDA) twins with FR. A total of 69 multifetal pregnancies were included in the study. No statistical difference was observed between miscarriage rates in all groups (p = 0.190). Birth rates below 32 weeks were similar between groups (p = 0.158). The birth rates below 34 weeks were statistically significantly lower in the group in which DCDA was reduced by TCTA compared to the other two groups (p = 0.001). The first and second fetus weights in the group reduced to DCDA twins from TCTA were higher than the group followed expectantly, they were similar to the triplets reduced from HOMP. Stillbirth rates were similar in all groups (p = 0.057). In TCTA pregnancies, when the priority is three live-born babies, expectant management seems to be a reasonable choice, considering the low rate of miscarriage and high rate of survivor neonates in this group.