Nihat Farisoğulları

Aims: Our aim in this study was to investigate the difference of systemic immune inflammatory index (SII) and systemic inflammatory response index (SIRI) indices between pregnancy-related cerebral venous sinus thrombosis (CVST) patients and healthy pregnant and postpartum women and to evaluate the association between these indices and disease severity and prognosis in the CVST group. Materials and Methods: This retrospective study included 21 patients with CVST and 80 healthy pregnant and postpartum patients as the control group. We looked at whether there was a statistical difference in demographic and clinical characteristics and laboratory results between the groups. Then we compared the SII and SIRI values, whose prognostic value has been studied as new inflammatory indices in many subjects. Results: Neutrophil, monocyte, lymphocyte and platelet counts were similar between the groups. SII and SIRI were significantly higher in the CVST group (p:0.006, p:0.043; respectively). It was found that the SII and SIRI indices were higher in the group with severe disease and the poor prognosis, but the results were not statistically significant. Conclusion: These results showed us that the SII and SIRI indices can be used as a supporting factor for the diagnosis in patients with suspected CVST. Studies with more patients may help to demonstrate the impact of SII and SIRI indices on disease severity and prognosis.

Aim: To predict fetal growth restriction (FGR) and its effect on prognosis according to changes in systemic inflammation indexes, such as the neutrophil-to-lymphocyte ratio (NLR), the systemic immune-inflammation index (SII), and the systemic inflammation response index (SIRI). Materials and Methods: The study group consisted of 200 women with singleton pregnancies diagnosed with FGR, and the control group comprised 280 obstetrically and demographically matched healthy pregnant women. The NLR, SII, and SIRI were compared between the groups according to the first-trimester complete blood count results. Results: When the groups were compared in terms of systemic inflammation indexes, the NLR, SII, and SIRI were found to be statistically lower in the FGR group (p

Objectives: To examine the relationship between the lower uterine segment (LUS) thickness and the onset of labor in dichorionic twin pregnancies experiencing threatened preterm labor. Methods: This prospective cohort study included dichorionic twin pregnancies between 24 and 32 weeks of gestation, presenting with symptoms of preterm labor. The LUS thickness and mid-anterior wall thickness were measured via transabdominal ultrasonography, cervical length, and posterior cervical lip thickness were measured transvaginally. The presence of the cervical sliding sign and funneling findings were recorded. Results: Among the patients with an onset of labor before the 34th week, the mean LUS thickness was 3.8 ± 0.9 mm, compared to 4.6 ± 1.1 mm in those with an onset of labor at or after 34 ^0/7 GW, indicating a statistically significant difference (p=0.012). Similarly, accepting the GW threshold as 35 ^0/7 weeks, a statistically significant difference was found in the mean LUS thickness, which was 4.0 ± 1.0 mm in those with an earlier onset of labor and 4.7 ± 1.0 mm in those with a later onset of labor (p=0.022). While univariate analysis indicated that the LUS thickness was a significant predictor (p=0.017 for <34 GW and p=0.028 for <35 GW), multivariate analysis showed a reduced effect (p=0.04 and p=0.06, respectively). Conclusions: LUS was significantly thinner in pregnancies with an onset of labor before the 34th and 35th GW. The measurement of the LUS thickness can be considered an alternative method for predicting spontaneous preterm birth in dichorionic twin pregnancies.

Aim: To investigate the role of the fetal modified myocardial performance index (Mod-MPI) and fetal cardiac output index measurement in predicting adverse perinatal outcomes among preterm dichorionic twins. Materials and Method: This prospective cohort study was conducted at the X Clinic and included 34 dichorionic twin fetuses born early preterm and 40 dichorionic twin fetuses born late preterm. The early preterm group was divided into two according to whether they were admitted to the neonatal intensive care unit (NICU). The groups' cardiac function and Mod-MPI measurements were compared regarding their predictive ability for adverse perinatal outcomes. Results: The Mod-MPI values were similar between the early and late preterm groups (p=0.144). The left ventricular cardiac output Z-score was lower in the preterm group (p=0.014). The Mod-MPI and left ventricular outflow tract-isovolumetric contraction and isovolumetric relaxation times were significantly higher among the newborns admitted to the NICU in the early preterm group (p=0.002, p=0.003, and p=0.001, respectively). Conclusion: Our study suggests that the Mod-MPI measurement can be used to predict adverse perinatal outcomes in dichorionic twin fetuses born in the early preterm period.

Objective: To compare the levels of oxidative stress markers in the umbilical cord blood between pregnant women diagnosed with iron deficiency anemia (IDA) and low‐risk controls.Methods: The sample consisted of 131 patients, including 55 pregnant women with IDA and 76 controls with similar demographic characteristics. Participants were selected from patients delivered at ≥37 weeks. We compared the two groups in terms of the native thiol, total thiol, disulfide, and ischemia‐modified albumin (IMA) levels measured in pregnant women's umbilical cord venous blood.Results: The native thiol and total thiol values were statistically significantly lower in the anemia group, and the disulfide and IMA values were statistically significantly higher in the IDA group (P < 0.001). Perinatal outcomes were similar between the groups.Conclusion: In the present study, pregnant women with IDA had lower native and total thiol values and higher disulfide and IMA values in umbilical cord blood. Iron deficiency anemia in pregnancy may be a potential cause of increased oxidative stress.

Aim: To investigate midkine levels in women diagnosed with intrahepatic cholestasis of pregnancy (ICP). Materials and Method: This study was conducted with 112 pregnant women, 40 of whom had ICP (study group) and 72 were in the control group. The two groups were compared regarding demographic characteristics, obstetric data, laboratory parameters, and serum midkine levels. In addition, a correlation analysis was undertaken between the midkine level and aspartate aminotransferase (AST), alanine aminotransferase (ALT), and serum bile acid (SBA) values in the study group. Results: The midkine value was determined to be 0.495 ng/ml in the study group and 0.275 ng/ml in the control group. It was statistically significantly higher in the patients with cholestasis (p

Aim: We aim to compare the maternal serum thiol and ischemia-modified albumin (IMA) levels between pregnant women with placenta previa and those with uncomplicated pregnancies and to determine whether changes in these levels were useful in predicting cases of abnormally invasive placenta (AIP). Methods: Fifty-five pregnant women diagnosed with placenta previa according to the diagnostic criteria (case group) were compared to 100 women with uncomplicated pregnancies of similar demographic characteristics (control group). The patients with placenta previa were further divided into two subgroups: AIP (n = 20) and placenta previa without invasion (n = 35). The maternal serum native thiol, total thiol, disulfide, and IMA levels of the groups were evaluated. Results: The native thiol, total thiol, and IMA values were significantly lower in the case group than in the control group (p < 0.001). The disulfide values were similar between the study and control groups (p = 0.488). When the AIP and placenta previa without invasion groups were compared, the levels of native thiol, total thiol, disulfide, and IMA were similar (p > 0.05). Conclusions: Maternal serum thiol and IMA levels were lower in placenta previa cases compared to the control group. However, these parameters were not useful in predicting AIP cases.

Aim: To evaluate the effect of monocyte count and monocyte-based whole blood cell indices in the prediction of intrahepatic cholestasis of pregnancy (ICP) in the first trimester. Materials and Method: The clinical data of patients who presented to the Perinatology Clinic of the Turkish Ministry of Health ----xxxxxxx--- ICP between January 1, 2021, and October 1, 2022, were evaluated retrospectively. Maternal demographic parameters, gestational age at birth, fetal birth weight, first-trimester white blood cell, neutrophil, platelet, monocyte, lymphocyte, and basophil counts, lymphocyte-to-monocyte ratio (LMR), platelet-to-monocyte ratio (PMR), neutrophil-to-monocyte ratio (NMR), and basophil-to-monocyte ratio (BMR) were recorded. These parameters were compared between the ICP and control groups. The relationship between monocyte count, monocyte-based blood cell indices, and fasting bile acid levels was evaluated in the ICP group. The cut-off values of the first-trimester monocyte count and monocyte-based blood cell indices for the prediction of ICP were determined. Results: Gestational week at birth and fetal birth weight were significantly lower, and the neonatal intensive care requirement was significantly higher in the ICP group (p<0.05) compared to the control group. The ICP group had a significantly higher monocyte count (p=0.002), a significantly lower platelet count (p=0.002), and significantly lower values for monocyte-based complete blood cell indices (NMR, LMR, and PMR) compared to the control group (p=0.005, p=0.001, and p<0.001, respectively). Conclusion: A high monocyte count and low monocyte-based inflammatory indices measured in the first trimester of pregnancy seem to be associated with ICP. These novel indices can be used in the prediction of ICP and its adverse perinatal outcomes. Özet Amaç: İlk trimesterde gebeliğin intrahepatik kolestazının (GİK) öngörüsünde monosit sayısı ve monosit bazlı kan hücre indekslerinin etkisini değerlendirmek. Gereçler ve Yöntem: Bu çalışmaya 01/01/2021 ile 01/10/2022 tarihleri arasında Sağlık Bakanlığı –xxxxxxxx- Hastanesi Perinatoloji kliniğinde değerlendirilen GİK tanılı hasta grubu (n=65) ve kontrol grubu (n=107) dahil edildi. Her iki grubun laboratuvar testleri retrospektif olarak incelendi. Grupların maternal demografik özellikleri, ilk trimester monosit sayıları ile lenfosit-monosit oranı (LMO), platelet-monosit oranı (PMO), bazofil-monosit oranı (BMO), nötrofil-monosit oranı (NMO) indeksleri karşılaştırıldı. GİK grubunda monosit sayıları ve monosit bazlı kan hücre indeksleri ile açlık safra asidi düzeyleri arasındaki ilişki değerlendirildi. GİK'i öngörmede ilk trimester monosit sayısı ve monosit bazlı kan hücre indeksleri için eşik değeri belirlendi. Bulgular: GİK grubunda doğum haftası, doğum ağırlığı daha düşük ve yenidoğan yoğun bakım ihtiyacı daha yüksek ve istatistiksel olarak anlamlıydı (p < 0.05). GİK grubunda monosit sayısı daha yüksek (p=0.002), trombosit sayısı daha düşük (p=0.002) ve monosit bazlı tam kan hücre indeksleri sırasıyla NMO, LMO, PMO daha düşük ve istatistiksel olarak anlamlıydı (sırasıyla p=0.005, p=0.001, p<0.001). Sonuç: Sonuç olarak, gebeliğin ilk trimesterinde daha yüksek monosit sayıları ve düşük monosit bazlı tam kan hücre indeks değerleri GİK ile ilişkili görünmektedir. Bu yeni indeksler, GİK'in ve bunun olumsuz perinatal sonuçlarının tahmininde kullanılabilir.