Do triple test results predict risk for neonatal hyperbilirubinemia?

Objective: Neonatal jaundice is the most common condition that requires hospital admission and outpatient follow-up after discharge in neonates

The values of more than 17 mg/dL in term infants are accepted as neonatal significant hyperbilirubinemia. We aimed to define if there is any relationship between second trimester serum markers and neonatal severe hyperbilirubinemia to protect the neonates from its neurological damage

Methods: Total 1372 pregnant women were enrolled who had done triple test between April 2014 and 2015 and then given birth at our hospital. Our primary outcome was neonatal significant hyperbilirubinemia

Results: The mean age of our study population was 27.9+/-5.6. A total of 59 patients had babies with neonatal hyperbilirubinemia after exclusion of Rh incompatibility. We detected that the presence of in vitro pregnancy, maternal health problems or poor obstetric history had no effect on the risk for neonatal hyperbilirubinemia. Neonatal hyperbilirubinemia was related with low E[3] levels. The ratios of AFP/E[3] and hCG/E[3]were the most helpful to predict the neonatal hyperbilirubinemia

Conclusions: According to our results, low E3 levels in the triple test result can be helpful to predict the development of the neonatal hyperbilirubinemia. However, this is a bit expensive and many developing countries may not afford it

Alanine aminotransferase as a predictor of adverse perinatal outcomes in women with intrahepatic cholestasis of pregnancy

Objective: To evaluate the associations between adverse perinatal outcomes and serum transaminase levels at the time of diagnosis in patients with intrahepatic cholestasis of pregnancy

Methods: We performed a retrospective analysis of patients hospitalized for evaluation of intrahepatic cholestasis of pregnancy from January 2013 to June 2014 in a tertiary center. Seventy-one patients were divided into two groups according to the presence [Group I] or absence of adverse perinatal outcomes [Group II]

Results: The mean aminotransferase levels and conjugated bilirubin levels at the time of diagnosis were significantly higher in Group I than in Group II. Receiver operating characteristic curve analysis revealed that the alanine aminotransferase level could predict adverse perinatal outcomes with 76.47% sensitivity and 78.38% specificity, and the cut-off value was 95 IU/L.Among patients with intrahepatic cholestasis of pregnancy, those with adverse perinatal outcomes were significantly older, had an earlier diagnosis, and had higher alanine aminotransferase levels. Using the 95-IU/L cut-off value, patients with intrahepatic cholestasis of pregnancy had a 3.54-fold increased risk for adverse perinatal outcomes

Conclusions: Patients with intrahepatic cholestasis of pregnancy and high alanineaminotransferase levels should be followed up for possible adverse perinatal outcomes

Contraceptive failure with Copper T380A intrauterine device [IUD]: a single tertiary center experience

Objective: The objective of this study was to assess the risk factors of pregnancy with Copper [Cu]T380A IUD and pregnancy outcomes

Methods:A retrospective study evaluating the risk factors and pregnancy outcomes of 81 patients who conceived with CuT380A IUD in situ

Results:Four ectopic pregnancies and 77 intrauterine pregnancies were detected. Twenty-six pregnancies [33.76%, 26/77] were terminated according to maternal desire. Twenty-five patients [32.46%, 25/77] whose IUDs were removed constituted the Removed IUD Group, and the remaining 26 patients constituted IUD Left in situ Group. Term pregnancy rates [76% vs. 20.8%, p=0.002] were significantly higher in the Removed IUD Group compared with the IUD Left in situ Group. Abortion rates [16% vs. 53.84%, p=0.008] were detected significantly higher in the IUD Left in situ Group

Conclusion:The main result of our study was that pregnancy with CuT380A in situ is a significant risk factor for adverse perinatal outcome. Adjusting the scheduled follow-ups for checking the IUD seems to be important in order to prevent accidental pregnancy

Perinatal and neonatal outcomes of growth restricted fetuses with positive end diastolic and absent or reversed umbilical artery doppler waveforms

To evaluate the outcome of intrauterine growth restriction fetuses with absent or reversed end-diastolic flow in the umbilical artery. This was a retrospective study conducted at the Department of Maternal Fetal Medicine of the Bakirkoy Women and Children's Teaching Hospital, Istanbul, Turkey between 2002 and 2006. Three hundred and ten pregnant women with growth-restricted fetuses confirmed by ultrasound were followed up with Doppler studies of the umbilical artery. The population was subdivided into 2 groups. Group 1, intrauterine growth restriction with positive end diastolic flow velocity waveforms, n=137 and group 2, intrauterine growth restriction with absent or reversed end diastolic velocities, n=163. Perinatal and neonatal outcomes of the 2 groups were recorded. Group 1 was associated with a higher perinatal mortality and morbidity rate than group 2 p=0.02, odds ratio [OR]: 1.09, 95% confidence interval [CI] 1-3.5, p=0.03, OR: 2, 95% CI 1.2-3.2. In group 1, significantly more neonates were admitted to the neonatal intensive care unit, but no difference was seen in neonatal intensive care unit stay. The frequency of respiratory distress syndrome, septicemia, and necrotizing enterocolitis increased in group 1. There was no significant difference in need for ventilation of respiratory distress syndrome. Our data suggest that pregnancies with absent or reversed end-diastolic flow in the umbilical arteries have high perinatal mortality and morbidity