Preterm premature rupture of membranes (PPROM) is a serious obstetric condition associated with increased maternal, fetal, and neonatal morbidity and mortality. It accounts for approximately one-third of all spontaneous preterm births and is associated with complications such as respiratory distress syndrome (RDS), sepsis, pulmonary hypoplasia, and neonatal mortality. Despite significant advances in prenatal care, proper management, particularly in early gestational age, remains unclear. Identifying factors associated with neonatal mortality in PPROM is important to develop therapeutic interventions and improve perinatal outcomes. This retrospective study examined clinical data and neonatal outcomes in 183 pregnant women with PPROM between the gestational ages of 23 and 36 + 6 weeks who were admitted to a tertiary referral hospital. The study population was categorized into four gestational age cohorts: Group I (23–27 + 6 weeks), Group II (28–31 + 6 weeks), Group III (32–33 + 6 weeks), and Group IV (34–36 + 6 weeks). Neonatal outcomes, including admission to the neonatal intensive care unit (NICU), the incidence of respiratory distress syndrome, the requirement for oxygen and mechanical ventilation, the necessity for surfactant and inotropic support, sepsis, suspected pulmonary hypoplasia, and early and late neonatal mortality were compared between the groups. Group I had the highest CRP values (18.68 ± 21.34), while Group III had the lowest (6.81 ± 5.16). Significant differences were found between the groups in terms of death at discharge, gestational age at delivery, birth weight, and presence of oligohydramnios. The intubated group had higher CRP levels and lower gestational age and birth weight. Of the 14 neonatal deaths, eight occurred in the early neonatal period, corresponding to a mortality rate of 7.6%. The neonatal mortality rate was 63.2% in Group I. No deaths were recorded in Groups II and III. In Group IV, the mortality rate was 2.2%. Neonatal mortality was associated with low gestational age, low birth weight, and oligohydramnios. The predominant cause of early infant deaths was RDS, whereas late neonatal mortality was primarily attributed to sepsis. Specifically, active management options after 34 weeks of gestational age have demonstrated enhancements in neonatal outcomes, underscoring the significance of tailored clinical approaches in cases of PPROM.

The aim of this study was to evaluate the potential of immunonutritional markers, specifically the hemoglobin, albumin, lymphocyte, and platelet (HALP) score and the prognostic nutritional index (PNI), in predicting late-onset fetal growth restriction (LO-FGR) during the first trimester. This retrospective study was conducted at a tertiary care center between October 2022 and August 2023. The study included a total of 213 singleton pregnancies, with 99 women in the LO-FGR group and 114 in the healthy control group, matched by maternal age and gestational age at delivery. All blood samples were collected between 11 and 14 weeks of gestation (during the first-trimester screening test). We analyzed first-trimester laboratory parameters, specifically focusing on hemoglobin levels, white blood cells (WBCs), lymphocytes, platelets, and albumin levels. Afterwards, we calculated the HALP score and PNI, and then compared the values of both groups. Both HALP score (3.58 ± 1.31 vs. 4.19 ± 1.8, p = 0.012) and PNI (36.75 ± 2.9 vs. 39.37 ± 3.96, p < 0.001) were significantly lower in the FGR group than in the control group. The HALP score cut-off value of < 3.43 in predicting FGR had a sensitivity of 62.3% and specificity of 54.5% (AUC = 0.600, 95% CI: 0.528–0.672, p = 0.012). The PNI cut-off value of < 37.9 in predicting FGR had a sensitivity of 65.8% and specificity of 62.9% (AUC = 0.707, 95% CI: 0.632–0.778, p < 0.001). While the HALP score was not a significant predictor of composite adverse neonatal outcomes in the FGR group, PNI showed a cut-off value of < 37.7 with a sensitivity of 60.9% and specificity of 59.7% (AUC = 0.657, 95% CI: 0.581–0.733, p < 0.001). The HALP score and PNI are valuable prognostic tools for predicting the risk of FGR in the first trimester. Low PNI values are also associated with composite adverse neonatal outcomes in pregnancies complicated by FGR.

Background: The aim of this study was to examine the relationship between conventional and novel Doppler parameters, including cerebroplacental ratio (CPR), cerebral–placental–uterine ratio (CPUR), umbilical-to-cerebral ratio (UCR), and amniotic-to-umbilical-cerebral ratio (AUCR), with the diagnosis of preeclampsia (PE) and adverse neonatal outcomes in PE cases. Methods: This prospective case-control study was conducted at the Ankara Etlik City Hospital Perinatology Clinic between November 2023 and May 2024. The study population was divided into two groups: Group 1, consisting of 74 patients diagnosed with preeclampsia, and Group 2, consisting of 80 healthy control patients. Composite adverse perinatal outcomes (CANOs) include presence of at least one adverse outcome: 5th-minute APGAR score < 7, transient tachypnea of the newborn (TTN), respiratory distress syndrome (RDS), need for continuous positive airway pressure (CPAP), need for mechanical ventilation, neonatal intensive care unit (NICU) admission, neonatal hypoglycemia, need for phototherapy, intraventricular hemorrhage (IVH), and neonatal sepsis. Results: The CPR, CPUR, and AUCR were significantly lower in the PE group compared to the control group, while the UCR was notably higher in the PE group. Among the combined ratios, the CPUR exhibited the highest diagnostic performance for both PE diagnosis and the prediction of CANOs. Additionally, while the UCR, CPR, and AUCR were significant for PE diagnosis, only AUCR demonstrated a significant association with the prediction of CANOs. Conclusions: Combined Doppler parameters, especially CPUR and AUCR, offer valuable insights into diagnosing PE and predicting CANOs. CPUR demonstrated the highest diagnostic accuracy, underscoring its potential utility in clinical settings.