Evaluation of the relationship between reduced fetal movement and obstetric-neonatal outcomes and placental pathologies.

BACKGROUND: Fetal movements are one of the simple methods that show the baby's well-being. Conditions associated with decreased fetal movements have not been determined, so it is important to analyze their different aspects. This study aimed to evaluate the relationship between reduced fetal movement and obstetric-neonatal outcomes, and placental pathologies. METHODS: In this prospective controlled study, laboratory results (blood glucose, hemoglobin, thyroid-stimulating hormone [TSH]), a non-stress test (NST), biophysical profile results, obstetric and neonatal outcomes, and placental pathological results of 74 pregnant women at 35 or more gestational weeks (to exclude the effect of prematurity on obstetric and neonatal outcomes) attending the obstetrics clinic between December 26, 2017 and January 30, 2019 with complaints of reduced fetal movement, were compared with 74 healthy pregnant women. Since prematurity and post-maturity may adversely affect obstetric-neonatal and placental pathology results, term pregnancies between 370/7-406/7 weeks were evaluated separately. RESULTS: In the group with reduced fetal movement, the biophysical profile was lower than the controls (P=0.013). Among placental pathologies, chorangiosis and hypercoiled cord were significantly higher in the group with reduced fetal movement than controls (P<0.05). Small for gestational age (SGA) and fetal growth restriction (FGR) in this group had these pathologies. Results of women at 370/7-406/7 weeks were similar except for the additional finding of chorioamnionitis. CONCLUSIONS: Reduced fetal movement may be associated with the low biophysical profile. In cases where fetal movement decreases, placental chorangiosis and hypercoiled cord seem to be associated with fetal growth restriction.

The use of calcium channel blockers as tocolytics may adversely affect pregnancy outcomes: a randomized clinical trial.

OBJECTIVES: To investigate the effect of calcium channel blockers in tocolytic therapy on obstetric outcomes. MATERIAL AND METHODS: For our study, as a retrospective case control study, data were obtained from hospital records. During 2018, there were 65 patients hospitalized with a diagnosis of preterm labor and were treated with calcium channel blockers used as tocolytics (nifedipine, nicardipine) and these patients constituted the study group. Pregnant women with systemic disease were excluded from the total of 1552 patients who were followed and who gave birth in 2018. After exclusion to equalize the samples, we chose 65 healthy pregnant women from the remaining 646 healthy pregnancies using a simple random number table and these patients formed the control group. The obstetric and neonatal results of both groups were compared. RESULTS: There was no difference between the groups in terms of birth week, preterm labor rate, low birth weight, and delivery type. While birth weights were significantly lower, the need for neonatal intensive care and the number of infants weighing 2500-3000 g were higher in the study group (p < 0.05). When the results of pregnancies that gave birth at term weeks and were not administered steroids were compared, the birth weight was lower and the number of infants weighing 2500-3000 g was higher in the study group. CONCLUSION: The use of calcium channel blockers in pregnancy may adversely affect birth weight gain and the need for intensive care.

Relationship of cystatin C, Hs-CRP, neutrophil-lymphocyte ratio and platelet-lymphocyte ratio with isolated oligohydramnios.

OBJECTIVES: We evaluated inflammatory parameters in pregnant women with isolated oligohydramnios. MATERIAL AND METHODS: This prospective cross-sectional study enrolled 54 pregnant with isolated oligohydramnios (IO) and 54 matched by gestational week, healthy pregnant with normal amniotic fluid. Maternal plasma levels of cystatin C, hs-CRP, neutrophil-lymphocyte ratios (NLR), platelet-lymphocyte ratios (PLR), and pregnancy outcomes were compared between two groups. RESULTS: Cystatin C, hs-CRP, and PLR were significantly higher in the IO group than that in the control group (p < 0.05). In the IO group, the rate of primary cesarean section, fetal distress, neonates with meconium-stained, and need for neonatal intensive care unit was higher, and Apgar scores were significantly lower than those in the control group (p < 0.05). There was no significant difference between the groups for meconium-stained neonate rates and the intensive care unit's need in the late-term (410/7-416/7 weeks). Cystatin C, hs-CRP, and PLR were significantly higher in the IO group than the control group (p < 0.05). Cystatin C was positively correlated with the need for neonatal intensive care and negatively correlated with Apgar scores. The PLR was positively correlated with the rate of meconium-stained neonates (p < 0.05). Cystatin C and hs-CRP had significant value in predicting IO (p < 0.05). CONCLUSIONS: Maternal serum levels of Cystatin C and hs-CRP may support the diagnosis and prediction of perinatal outcomes as possible biochemical markers in IO cases. In particular, a high level of cystatin C may indicate the need for neonatal intensive care and low Apgar scores. In addition, late-term IO may show similar results in meconium and neonatal intensive care needs compared to without oligohydramnios.