Effect of maternal asthma on fetal pulmonary artery Doppler parameters: a case-control study.

OBJECTIVES: To compare fetal pulmonary artery Doppler parameters between pregnant women with asthma and healthy pregnant women. METHODS: This prospective, cross-sectional study was conducted on 50 pregnant women diagnosed with asthma and 61 healthy pregnant women. Fetal pulmonary artery Doppler parameters and the fetal main pulmonary artery acceleration time/ejection time (PATET) ratio were compared between the study and control groups. Thereafter, the study group was divided into two subgroups as non-severe and severe asthma. PATET ratio was compared between the subgroups. RESULTS: The fetal main pulmonary artery acceleration time was 25 ms in pregnant women with asthma and 33 ms in the healthy group, indicating a statistically significant difference (p=0.001). The acceleration time/ejection time ratio was statistically lower in the asthma group (0.185 vs. 0.240, p<0.001). The acceleration time/ejection time ratio was 0.172 in patients with severe asthma and 0.195 ms in the non-severe study group (p=0.156). In the maternal asthma group, the PATET ratio of those who went to the NICU due to respiratory distress was also 0.188, and the PATET ratio of those who went to the NICU for other reasons was 0.269 (p=0.053). CONCLUSIONS: Fetal pulmonary artery acceleration time and PATET decreased statistically in pregnant women with severe or non-severe asthma. Maternal asthma is associated with changes in pulmonary Doppler parameters in the fetus.

Fetal cortical development and neurosonographic findings in obese pregnant women: a case control study from a tertiary hospital.

PURPOSE: To investigate the effect of obesity on fetal cortical development. METHODS: This prospective cross-sectional study was conducted with 91 pregnant women. Fetal neurosonography scans were performed in the third trimester, and according to body mass index (BMI) values, the patients were evaluated in two groups: obese (BMI ≥ 30 kg/m2) and normal weight (BMI < 30 kg/m2). During neurosonography, fetal insular depth and Sylvian fissures, parieo-occipital and cingulate fissure depth, frontal lobe length, and the sizes of the corpus callosum and cavum septum pellucidum were measured using a transvaginal approach. Fetal cortical development and Sylvian fissure operculization were graded. RESULTS: The number of patients with grade 2 fetal cortical development was significantly higher among the pregnant women in the obese group compared to the normal weight group (n = 17, 41.5% and n = 8, 16.0%, respectively; p = 0.007). In the obese group, the number of pregnant women with grade 4 or below fetal Sylvian fissure operculization was significantly higher (n = 13, 31.7%), and the number of those with grade 9 or above operculization was significantly lower (n = 1, 2.5%) (p = 0.003). The fetal insular depth, frontal lobe anterior-posterior diameter, cingulate fissure depth, and corpus callosum thickness were lower in the obese group, albeit with no significant difference. Parieto-occipital depth significantly decreased in the obese group [6.8 (6) mm)] compared to the control group [10.5 (7.2) mm)] (p = 0.008). The fetal Sylvian fissure ratio and the cavum septum pellucidum ratio were found to be similar between the groups. CONCLUSION: The data obtained from this study showed that obesity caused fetal cortical changes in pregnant women.

Effects of SARS-COV-2 infection on fetal pulmonary artery Doppler parameters.

PURPOSE: To determine the effect of SARS-CoV-2 infection on the fetal pulmonary system using the acceleration time (AT), ejection time (ET), and acceleration/ejection time ratio (PATET) of the fetal main pulmonary artery Doppler waveform. METHODS: We prospectively studied pregnant women attending our hospital with confirmed SARS-CoV-2 infection by RT-PCR test and an age-matched control group who admitted for routine prenatal care. An ultrasound examination that included measurements of the AT, ET, and AT/ET ratio (PATET) were performed and the results were compared. RESULTS: Fifty-five SARS-CoV-2-infected and 93 control group pregnant women were included in this study. AT found higher in the COVID-19 positive group when compared with controls. When the ET and PATET parameters were compared, no differences were detected between the groups. Eleven neonates had Neonatal Intensive Care Unit (NICU) requirement in the COVID-19 positive group while there were none in the control group. All fetal pulmonary artery Doppler values were decreased in NICU admitted fetuses. The mean gestational week of this group was lower than non-NICU COVID-19 positive group and the control group. CONCLUSION: COVID-19 infection increases fetal pulmonary blood flow, which appears high AT values on Doppler parameters. NICU admission only occurred in the COVID-19 group and their Doppler values were found significantly lower than non-NICU COVID-19 group. The clinical significance of this result must be evaluated with further studies.

Comparison of the effect of single-dose and multiple-dose methotrexate therapy on tubal patency.

OBJECTIVE: To compare tubal patency by using hysterosalpingography (HSG) in women with unruptured ectopic tubal pregnancy who were treated with either single-dose or multiple-dose methotrexate (MTX) regimen. DESIGN: A case series with a retrospective statistical analysis. SETTING: Maternity and teaching hospital in Turkey. PATIENT(S): Sixty-one patients treated with MTX therapy for unruptured tubal ectopic pregnancy. INTERVENTION(S): Thirty-one patients received single-dose and 30 multiple-dose MTX treatment. The HSG was performed 4 to 6 months after treatment to assess tubal patency. MAIN OUTCOME MEASURE(S): Ipsilateral and contralateral tubal obstruction rates. RESULT(S): Free passage through the ipsilateral tube was observed in 17 of 30 cases (56.7%) after multiple-dose, and 26 of 31 cases (83.9%) after single-dose MTX therapy. Patency of the contralateral tube was higher after single-dose than multiple-dose MTX treatment, although the value was not statistically significant. Binary logistic regression analysis was used to evaluate the parameters of age, gravida, parity, initial titers of beta human chorionic gonadotropin, size of the adnexal mass, and MTX regimen and their correlation with the HSG results after the clinical treatment for unruptured ectopic pregnancy. Only the type of MTX regimen was found to be used as a predictor of ipsilateral tubal obstruction. CONCLUSION(S): In terms of ipsilateral tubal obstruction, multiple-dose MTX therapy appears to have a greater negative effect on tubal patency than single-dose therapy.