Nalan Kuruca

Background/Objectives: Preeclampsia is a leading cause of maternal and perinatal morbidity worldwide, yet its underlying mechanisms remain unclear. Polyunsaturated fatty acids, particularly docosahexaenoic acid (DHA), are essential for placental development and vascular function, but evidence on their role in preeclampsia is inconsistent. This study aimed to compare serum DHA levels between women with preeclampsia and normotensive pregnant women and to examine their association with disease severity and maternal and perinatal outcomes. Methods: A total of 145 pregnant women aged 18–40 years were enrolled, including 47 with newly diagnosed preeclampsia (PE) and 98 normotensive controls. PE was defined according to the ACOG 2019 criteria. Serum DHA levels were measured using ELISA in fasting blood samples collected at the first visit. Results: Maternal serum DHA levels did not differ significantly between preeclampsia and control groups (p = 0.571); they were similar across control, mild PE, and severe PE groups. DHA showed a negative correlation with neutrophil-to-lymphocyte ratio (r = −0.305) and maternal hospitalization duration (r = −0.334). Independent predictors of PE included nulliparity (OR: 4.43), advanced age (OR: 1.14), elevated BMI (OR: 1.29), and low albumin (OR: 0.77). After adjusting for age and BMI, DHA was an independent negative predictor of IUGR (OR: 0.65). Conclusions: DHA levels: Placental and/or fetal DHA metabolism may be impaired in patients with preeclampsia. Although DHA was not associated with the development of PE, it was a negative predictor of IUGR. DHA reduces the length of maternal hospital stay through its anti-inflammatory effect.

Background: Preeclampsia is a major obstetric disorder characterized by platelet activation and dysregulated thrombopoiesis. While conventional platelet indices reflect platelet morphology, the immature platelet fraction (IPF) provides insight into thrombopoietic activity. This study assessed IPF discrimination at presentation and its early post-treatment change in preeclampsia while controlling for potential confounding factors. Methods: In a prospective design, demographic and laboratory parameters—particularly platelet indices—were evaluated in women with preeclampsia and normotensive pregnant controls. Measurements were obtained at diagnosis and repeated 24–48 h after treatment, including initiation of medical treatment or delivery. Logistic regression and ROC analyses were performed, adjusting for age and gestational age. Results: Sixty-four women with preeclampsia and 25 normotensive controls were included; the preeclampsia group was older (31.3 ± 5 vs. 28.4 ± 4 years), and delivery occurred in 73.4%. At diagnosis, IPF, MPV, and PDW were higher, and platelet counts were lower compared with controls. After treatment, IPF decreased markedly (ΔIPF = 3.4; p < 0.001), accompanied by reductions in MPV and PDW, while platelet counts remained unchanged in the preeclampsia group. ΔIPF showed subtype-related differences, being higher in late-onset preeclampsia. Only IPF retained an independent association with preeclampsia (OR = 27.29; p = 0.006), whereas age, platelet count, MPV, PDW, BUN, and CRP were not significant. On ROC analysis, IPF demonstrated strong diagnostic performance (AUC = 0.992; cut-off ≥4%), with 98.4% sensitivity and 100% specificity. Conclusions: Easily measurable as part of a routine complete blood count, IPF may support diagnostic evaluation and clinical monitoring, consistent with its early post-treatment decline and subtype-related patterns.

Objective: Nausea and vomiting of pregnancy (NVP) are frequently encountered in pregnancy and can lead to serious maternal and fetal complications if neglected. This study aims to determine the frequency of NVP and related factors in Rize. Material and Methods: In this prospective study, the severity and frequency of NVP were determined by scoring pregnant women between 5-20 weeks of gestation, using the Pregnancy-Unique Quantification of Emesis and Nausea (PUQE) scoring system. Pregnant women with a PUQUE score below 7 were defined as the mild NVP group, and a score of 7 and above was defined as the moderate and severe NVP group. Demographic data and blood electrolyte levels were compared between the two groups. Results: A total of 221 pregnant women were included. The frequency of moderate-severe NVP was found to be 10% (n = 22). The frequency of hyperemesis gravidarum was 2% (n=4). The average body mass index of pregnant women with moderate-severe NVP symptoms was found to be higher than that of pregnant women with mild symptoms (p<0.001). The average blood sodium and potassium levels of pregnant women with moderate-severe NVP were found to be lower (p=0.003 and <0.001). Conclusion: The frequency of NVP in Rize province is similar to the literature. Increased body mass index may be associated with the frequency of NVP. Electrolyte imbalances may occur in the blood of these pregnant women. For this reason, all pregnant women should be carefully evaluated in terms of NVP, and treatments should be planned to eliminate electrolyte imbalances in patients.

Objective: To determine the prevalence of mood and eating disorders, chronotype, and social jetlag in a cohort of women with polycystic ovarian syndrome (PCOS). Methods: A total of 70 patients, 35 with PCOS and 35 healthy controls, aged between 18 and 40 years, were included in the study. PCOS was diagnosed according to the Rotterdam criteria. Five different questionnaires, namely the “Morningness–Eveningness Questionnaire (MEQ)”, “Social Jetlag Status (SJL)”, “Night Eating Questionnaire (NEQ)”, “Beck Depression Inventory (BDI)”, and “Beck Anxiety Inventory (BAI)”, were administered to patients with and without PCOS, and the “total questionnaire scores” of both groups were compared. Results: In addition to BMI (p = 0.004), serum insulin (p < 0.001), HOMAIR (p < 0.001), total testosterone (p = 0.006), DHEAS (p = 0.004), and LH (p < 0.001) levels were significantly higher in women with PCOS than in the controls. BAI (p = 0.006), BDI (p = 0.007), and NEQ (p = 0.013) scores of participants with PCOS were significantly higher than those in the control group, while MEQ scores were significantly lower than those in the control group (p = 0.005). When categorized according to the total test scores, the number of individuals with moderate and severe anxiety was significantly higher in the PCOS group than in the control group (p = 0.030). Morningness was significantly lower in the PCOS group than in the control group, whereas eveningness was higher than that in the control group (p = 0.013). There was no difference between the PCOS and control groups in terms of the number of individuals with SJL ≥ 2 h and night eating disorders. The NEQ score was positively correlated with BAI, BMI, insulin, and HOMA-IR. Both the BDI and BAI scores were positively correlated with BMI, HOMA-IR, and total testosterone levels. Conclusions: PCOS can lead to mood, appetite, and circadian rhythm issues through variations in chronotype. PCOS-related endocrine, metabolic, and adiposity factors influence mood, eating habits, and chronotype disorders.

Introduction: Cesarean section is an operation that carries a higher risk compared to normal vaginal delivery in terms of bleeding. In this study, we aimed to compare hemoglobin decreases in pregnant women who had normal vaginal delivery and cesarean section. Material and methods: In this study, pregnant women who had normal vaginal delivery and cesarean section between 01.01.2021 and 30.06.2022 in a university hospital were analyzed retrospectively. The pregnant women included in the study were standardized as those between the ages of 18-45, who did not have any systemic disease, and who gave birth to a baby between 2000-4000 gr at 37-41 weeks of gestation. The patients included in the study were divided into two groups as those who had normal vaginal delivery and cesarean section, and those who delivered by cesarean section were divided into two groups as primary cesarean section and previous cesarean section, and the decreases in hemoglobin levels taken before and at the 6th hour after delivery were statistically evaluated. Results: It was determined that 199 of the 473 pregnant women included in the study had normal delivery and 274 had a cesarean section (119 had a previous cesarean section and 155 had a primary cesarean section). Among the pregnant women included in the study, the mean postpartum Hb decrease was 0.73 ± 0.90 g/dl in the pregnant women who had normal delivery, and 1.41 ± 0.93 g/dl in those who delivered by cesarean section, the difference was found to be statistically significant (p=0.000). The mean postpartum Hb decrease in those who underwent cesarean section with a previous cesarean indication was 1.30 ± 0.73 g/dl, and 1.49 ±0.9 g/dl in primary cesarean sections, the difference was statistically significant (p=0.045). Conclusion: With these results determined in accordance with the literature, it would be appropriate to take the necessary precautions by taking these findings into account when making a cesarean section decision.

Aim: Prediction of severity of COVID 19 infection in pregnant population is very important to management. The aim of this study was to investigate the relationship between COVID 19 infection severity and routine hematologic/biochemical laboratory tests. Material and Method: In this retrospective study the hematologic parameters of pregnant women with COVID 19 were investigated. The patients were allocated into 5 subgroups as asymptomatic, mild, moderate, severe and critical. Presenting symptoms were identified. Laboratory test results detected at the first admission were compared between groups. Results: A total of 343 patients were included in the study. The most common symptoms were cough (n=74, %21.6) and fatigue (n=46, %13.4). Statistically significant differences observed at following parameters. The mean Hb level was lower (p=0.001) and WBC, neutrophil, AST, ALT, GGT, LDH, direct bilirubin and total bilirubin levels were higher in critical group (p=, 0.005, 0.001, 0.000, 0.015, 0.000, 0.000, 0.000, 0.007 respectively). The mean lymphocyte and monocytes levels in the severe group were lower (p=0.000, 0.01, respectively). Furthermore, the mean eosinophil levels in the asymptomatic group was higher (p=0.002). Conclusion Low Hb, lymphocyte, monocyte, eosinophil levels and high WBC, neutrophil, ALT, AST, GGT, total bilirubin and LDH levels are associated with more severe disease. Monitoring of these tests may provide guidance for the prediction of the severity of the COVID 19 infection among pregnant women. Key Words: Complete Blood Count, COVID 19, laboratory, pregnancy, symptom, Conclusion Low Hb, lymphocyte, monocyte, eosinophil levels and high WBC, neutrophil, ALT, AST, GGT, total bilirubin and LDH levels are associated with more severe disease. Monitoring of these tests may provide guidance for the prediction of the severity of the COVID 19 infection among pregnant women.