Provision of antenatal care in Europe-A scientific study commissioned by European Board and College of Obstetrics and Gynaecology (EBCOG).

Differences in the way health care delivery across countries may have important impacts on health outcomes and can result in inequalities. A questionnaire survey of members of national societies through EBCOG and EAPM was carried out in 2021. A total of 53 responses were received from 26 countries. Most countries reported that routine antenatal care is primarily delivered by medical staff, involving obstetric specialists or family doctors mostly in government-run facilities. Women from minority groups are able to access antenatal care easily in most countries. Less than 10% of women did not attend antenatal care throughout the pregnancy. Most booking for antenatal care takes place in the first trimester and the number of visits range from 6 to 10 depending on parity. Most countries provide routine ultrasound with 2-3 reported scans performed by specifically trained health care professionals. Facilities for prenatal screening/diagnosis of malformations in both low- and high-risk cases varied across Europe. While antenatal care is relatively standardized throughout Europe, important differences still exist in care delivery and accessibility to care. Antenatal preventive strategies appear to be variably available throughout Europe.

Effects of the COVID-19 pandemic on obstetrics and gynecology residency training in Turkey

Objective: This study aimed to evaluate the effect of the coronavirus disease-19 (COVID-19) pandemic on obstetrics and gynecology residency in Turkey. Materials and Methods: A 40-item questionnaire was prepared by the European Network of Trainees in Obstetrics and Gynecology. The survey included four parts, namely, workload, training aspects, trainees' health and safety, and women's and maternal health, conducted between April 2020 and September 2020. The submission of the questionnaire was voluntary. Results: A total of 103 trainees from 28 cities responded to the survey. The mean duration of training was 2.5 years, and first- to fifth-year residents were included. In this study, 66 trainees (65.3%) were deployed in COVID-19 units, and the number of working hours was 84 hours per week. Moreover, 67% of the trainees reported insufficient outpatient clinic experience to meet education targets. Almost all trainees (101 of 103) trainees reported that the number of surgeries and/or elective surgeries decreased or were canceled. In addition, 63% and 68% of the trainees reported that their surgical skills were hindered by the reduced number of surgeries and dissatisfaction by not achieving a sufficient number of surgeries, respectively. Overall, 71% (n=73) were worried about their training. Only 45 trainees (43.6%) have raised their concerns to their program coordinators. Trainees in Turkey experienced a decrease in the workload during the first COVID-19 wave by 62% (n=64). In average, trainees worked nearly 30 h less than their usual workweek. Only 5% of the trainees (n=5) worked from home. Trainees claimed to have used sufficient personal protective equipment, and 66% (n=68) could keep their social distance in the hospital. The availability of health care was different between departments, and the family planning and reproductive medicine departments were the most affected. Conclusion: The obstetrics and gynecology training in Turkey has significantly been affected by the COVID-19 pandemic.

Increased maternal C1q/TNF-related protein-1 (CTRP-1) serum levels in pregnancies with preeclampsia.

Objective: Metabolic changes and inflammation are involved in the pathogenesis of preeclampsia. Complement C1q tumor necrosis factor-related protein-1 (CTRP-1) is a pleiotropic molecule that possesses insulin-sensitizing effects and is also involved in lipid metabolism and inflammatory responses. The aim of the study was to investigate CTRP-1 levels in pregnancies with preeclampsia.Material and methods: Serum concentrations of CTRP-1 were measured in 29 pregnant women with early-onset preeclampsia (EOPE), 24 pregnant women with late-onset preeclampsia (LOPE), and 26 women with uncomplicated pregnancies using an enzyme-linked immunosorbent assay method.Results: Patients with both EOPE and LOPE had significantly higher serum concentrations of CTRP-1 compared to the healthy controls (p < .001). However, no significant difference was found between the EOPE and LOPE groups regarding CTRP-1 levels (p = 1.000). Correlation analysis showed that CTRP-1 levels were positively correlated with systolic blood pressure (p < .001), diastolic blood pressure (p < .001), and mean UtA PI (p < .001) but negatively correlated with gestational age at delivery (p = .001) and birth weight (p < .001).Conclusions: Serum CTRP-1 levels were significantly higher in patients with both EOPE and LOPE than in healthy pregnant women.

Maternal serum AMP-activated protein kinase levels in mild and severe preeclampsia.

OBJECTIVE: To investigate Phosphorylated adenosine monophosphate activated protein kinase (AMPK) levels in healthy pregnant women and pregnant women with preeclampsia (PE). METHODS: Twenty-eight women with mild-PE, 22 with severe-PE, and 30 normotensive controls were included in this cross-sectional study. The serum AMPK levels of these patients were analyzed. The patients were followed up to delivery. RESULTS: No statistically significant difference was found between the groups for age, gravida, parity, and gestational age at the time the blood samples were obtained (p > .05). No significant difference between the group with mild-PE and the control group was found, while in the severe-PE group, serum AMPK levels were significantly higher relative to both the mild-PE and control groups (p < .001 and p < .001, respectively). No correlation was detected between serum AMPK levels and age, body mass index (BMI), and gestational age at the time the blood samples were collected. A negative correlation was found between AMPK levels and gestational week and birthweight at delivery, while a positive correlation was detected between systolic and diastolic blood pressures and AMPK levels. CONCLUSIONS: Serum AMPK was higher in patients with severe-PE compared with healthy pregnant women and patients with PE without severe features so it might be a new biomarker for the prediction of disease and its severity.