Berna Seyhan

Background: Differentiating late-onset fetal growth restriction from constitutional smallness can be challenging in routine practice. The Society for Maternal-Fetal Medicine (SMFM) primarily defines FGR using fetal biometric cutoffs, whereas the Delphi/International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) approach also takes growth trajectory and Doppler findings into account.Objective: We aimed to compare the level of agreement between the SMFM and Delphi/ISUOG definitions and to assess how each performed in relation to perinatal outcomes within the same late-gestation cohort.Methods: We reviewed 280 singleton pregnancies managed at a single center between January 2023 and May 2026. All pregnancies were evaluated at 32 weeks of gestation or later. Each case was classified according to both the SMFM and Delphi/ISUOG criteria. The primary endpoint was a composite adverse perinatal outcome.Secondary outcomes were birth weight below the 10th and 3rd percentiles. We calculated diagnostic performance with 95% confidence intervals, Cohen kappa agreement, and exact McNemar tests.Results: The SMFM definition classified 36 pregnancies (12.9%) as fetal growth restriction, compared with 15 (5.4%) by Delphi/ISUOG. Twelve pregnancies met both definitions, 24 met only SMFM, and 3 met only Delphi/ISUOG. Agreement was moderate (kappa 0.43; 95% confidence interval 0.24-0.59). The composite outcome occurred in 37 cases (13.2%). SMFM sensitivity and specificity for this outcome were 16.2% and 87.7%; corresponding Delphi/ISUOG values were 10.8% and 95.5%. Delphi/ISUOG was more specific (p

Objective: This study aimed to evaluate the association between attendance at an institutional antenatal education program and early postpartum depressive symptom burden assessed using the Edinburgh Postnatal Depression Scale (EPDS).Methods: This retrospective study included women who completed antenatal follow-up and delivery. Women who attended at least one theoretical antenatal education session were included in the antenatal education group. EPDS was recorded within the first 24 hours postpartum as part of routine assessment. High EPDS risk was defined as EPDS ≥13. Results: The cohort included 170 women, with 85 women in each group. Median EPDS score was lower in the antenatal education group than in the control group (7 vs 14 , p

Objective: To investigate whether polycystic ovary syndrome (PCOS) is associated with increased maternal and perinatal complications in in vitro fertilization (IVF) pregnancies, and to evaluate the relationship between anti-Müllerian Hormone (AMH) levels and adverse maternal and perinatal outcomes within the PCOS group. Methods: This retrospective cohort included 424 women with singleton IVF pregnancies delivered at Ankara Etlik City Hospital between September 2022 and June 2025. Participants were classified as PCOS (n = 106; AMH ≥ 4.5 ng/mL) or non-PCOS (n = 318; AMH 1.0–4.5 ng/mL). Maternal outcomes were gestational diabetes mellitus (GDM) and preeclampsia, while perinatal outcomes included preterm birth, small-for-gestational-age (SGA), large-for-gestational-age (LGA), 5-min Apgar ≤ 7, and neonatal intensive care unit (NICU) admission. Composite adverse maternal outcomes (CAMO) and composite adverse perinatal outcomes (CAPO) were defined as the occurrence of at least one respective complication. Outcomes were compared between groups, and multivariable logistic regression identified predictors of CAMO and CAPO in the PCOS cohort. Results: Women with PCOS had significantly higher incidences of GDM and preeclampsia compared to controls (p < 0.05 for all). CAMO was more common in the PCOS group (34.0% vs. 11.9%, p < 0.001). Median gestational age at delivery was lower among women with PCOS (p = 0.026). Rates of LGA neonates, low 5-min Apgar scores, and NICU admissions were significantly higher in the PCOS group (p < 0.001 for each). CAPO rates were comparable between groups (p = 0.132). In multivariable models, AMH level remained an independent predictor of both CAMO and CAPO (p = 0.002 and p = 0.014, respectively). Conclusions: Women with PCOS and elevated preconception AMH levels are at increased risk for both maternal metabolic complications and adverse neonatal outcomes following IVF conception. These findings suggest that preconception AMH levels, when interpreted alongside a PCOS diagnosis, may help identify women at higher obstetric and perinatal risk.

Aims: This study aimed to evaluate perinatal outcomes in pregnancies with isolated non-visualization of the fetal gallbladder (NVFGB) identified during second-trimester anatomical screening. Methods: This retrospective cohort study included 22 pregnancies diagnosed with isolated NVFGB between November 2022 and January 2025 at a tertiary maternal–fetal medicine unit. Cases with additional structural anomalies, multiple gestations, or elective terminations were excluded. Maternal demographics, antenatal ultrasound findings, and neonatal outcomes were reviewed. Postnatal imaging and clinical follow-up were evaluated for gallbladder visualization and underlying pathology. Results: In half of the included cases (11/22), the gallbladder was visualized either on follow-up scans or after birth. Among the remaining 11 cases, two had midline-located gallbladders on postnatal imaging, one of which required surgical correction for intestinal malrotation. Two fetuses were prenatally diagnosed with cystic fibrosis, including one complicated by meconium peritonitis requiring surgery. Two additional cases were diagnosed postnatally with biliary atresia and underwent hepatoportoenterostomy. Chromosomal microarray analysis (CMA) was performed in ten cases; no anomalies were identified aside from cystic fibrosis. Overall, five cases (23%) were associated with significant postnatal diagnoses requiring medical or surgical intervention. Conclusion: Although isolated NVFGB is often a benign and transient finding, it may occasionally indicate serious underlying conditions such as biliary atresia or cystic fibrosis. Detailed follow-up, repeat imaging in late gestation, and thorough postnatal evaluation are essential for appropriate diagnosis and management.

Objective: We aimed to evaluate the diagnostic utility of albumin-related inflammatory indices in predicting placental abruption (PA) and to explore their potential advantages over conventional clinical and laboratory parameters. For this purpose, we assessed the neutrophil-to-albumin ratio (NAR), neutrophil percentage-to-albumin ratio (NPAR), blood urea nitrogen-to-albumin ratio (BAR), and serum albumin-to-creatinine ratio (sACR), and examined their associations with neonatal outcomes. Study Design: This retrospective cohort study included 179 singleton pregnancies, comprising 64 patients diagnosed with PA and 115 healthy controls. Maternal demographic and clinical characteristics were recorded, including age, gravidity, parity, pre-pregnancy body mass index (BMI, kg/m²), history of preterm birth, previous cesarean delivery, use of low-molecular-weight heparin (LMWH), need for blood transfusion, and length of hospital stay. Neonatal outcomes included gestational age at birth, birth weight, 1- and 5-minute Apgar scores below 7, and neonatal intensive care unit (NICU) admission. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic performance of the indices, while multivariate logistic regression and analysis of covariance (ANCOVA) were performed to adjust for gestational age. Results: NPAR and BAR levels were significantly higher in the PA group compared to controls. These indices demonstrated moderate discriminatory ability and remained statistically significant after adjustment for gestational age. Although NAR and sACR were also associated with PA, their diagnostic utility appeared more limited. Conclusion: Among the albumin-associated inflammatory indices evaluated, NPAR and BAR demonstrated the strongest associations with placental abruption and may serve as useful adjunctive markers in clinical evaluation. Although NAR and sACR also showed statistically significant associations, their limited diagnostic performance suggests the need for further investigation before clinical implementation.