Knowledge and attitude changes of pregnant women regarding prenatal screening and diagnostic tests after counselling.

OBJECTIVES: This study aimed to reveal the knowledge level of pregnant women about prenatal diagnostic tests, Down syndrome (DS) and amniocentesis, their attitudes toward uptaking these tests, undergoing amniocentesis, and the termination of pregnancy. It also aimed to evaluate the effects of providing information, as well as a written information brochure about all the issues concerning women's knowledge and attitudes. MATERIALS AND METHODS: The gynecologists provided verbal and written information on prenatal screening tests (PSTs) and invasive prenatal diagnostic tests. Data were collected using an anonymous questionnaire, which was designed by the researchers on the basis of the literature. RESULTS: Knowledge of both DS and amniocentesis was found to be significantly higher after the education (p = 0.000 and p = 0.000, respectively). Attitudes toward amniocentesis changed significantly after the education. CONCLUSIONS: This study has shown that women had an inadequate knowledge about PSTs, DS, and amniocentesis. It has also revealed that education provided by gynecologists along with a written brochure of information tended to increase women's knowledge about PSTs.

The effect of diet on pregnancy outcomes among pregnant with abnormal glucose challenge test.

OBJECTIVES: Gestational diabetes mellitus (GDM) is defined as glucose intolerance, first time detected in pregnancy. Diagnostic criteria for GDM have changed over the decades. The aim of the study was to examine the effect of diet on birth weight, number of large for gestational age (LGA) (birth weight > 90th percentile) babies, total maternal weight gain, gestational age and route of delivery among patients with positive 50 g glucose challenge test (GCT) and negative 100 g oral glucose tolerance test (OGTT). PATIENTS AND METHODS: A prospective randomized controlled study was conducted among patients with positive 50 g GCT and negative 100 g OGTT. A plasma glucose value of 140 mg/dL was used as the threshold to define an abnormal GCT result. In group 1 50 patients were given a caloric diet and compared with group 2 with 50 patients without a given diet. Patients were followed up until delivery and evaluated for birth weight, number of LGA babies, total maternal weight gain, gestational age and route of delivery. RESULTS: There were no significant differences between the groups in maternal age, parity, body mass index and gestational age at delivery. There were significant differences in birth weight, number of LGA babies, total maternal weight gain during pregnancy. The mean gestational age at delivery was 38.7±1.2 weeks in group 1 and 38.9±1.1 weeks in group 2 (p = 0.615). The mean birth weight in group 1 was 3328±399 g and 3623±485 g in group 2 (p = 0.007), cesarean rate was 32% in group 1 and 40% in group 2 (p = 0.405). CONCLUSIONS: In the management of patients with positive 50 g GCT and negative 100 g OGTT, patients who were prescribed medical nutrition therapy by a dietitian experienced in GDM management had better perinatal outcomes.

Comparison of pregnancy outcomes in different localizations of uterine fibroids.

OBJECTIVE: The basic aim of this study is to compare the pregnancy outcomes in cases with uterine fibroids located at the anterior and posterior uterine walls. MATERIALS AND METHODS: A total of 84 pregnant women with a diagnosis of uterine myoma larger than 30 millimeter (mm) in diameter were included in the study to determine the obstetric outcomes. In 64 (76.20%) patients, myomas were detected at the anterior uterine wall (group 1), while 20 (23.80%) were detected at the posterior uterine wall (group 2). All patients were followed monthly until the end of pregnancy. Demographic and obstetric characteristics were compared between the two groups. RESULTS: There were no significant differences in age, gravida, parity, and myoma size between the two groups. A significant difference existed between the groups with regard to pelvic pain. Posterior located fibroids were associated with more pelvic pain (p = 0.001). No difference was observed between the two groups with regard to the rates of preterm delivery, bleeding in early pregnancy, infants with small for gestational age, and hospitalization period during pregnancy. Women with posterior located myomas had significantly higher miscarriage rates. CONCLUSION: Our findings suggest that pregnancies with uterine fibroids are at increased risk for complications. Posterior located fibroids larger than 30 mm in diameter are associated with severe pelvic pain compared to anterior located fibroids.

Effectiveness of emergency cervical cerclage in patients with cervical dilation in the second trimester.

OBJECTIVE: Efficacy of emergency cerclage commensed in the second trimester is a controversial issue. In this study, we aimed to assess the success and associated complications of emergency cerclage in patients with cervical dilatation in the second trimester. MATERIAL AND METHODS: In this retrospective study, medical records of 75 pregnant women who had clinically and ultrasonographically confirmed cervical dilatation in the second trimester who had undergone cervical cerclage were analyzed. Pregnancy prolongation was the main outcome measure. RESULTS: Seventy-five women were included to the study. Mean age was 27 and mean gravidity of the patients was three. Mean cervical length was 28.5 mm (12-41 mm). The rate of spontaneous abortion, immature deliveries, prematurity and deliveries after 34 weeks were 2.7% (n = 2), 8% (n = 6), 12 (n = 9) and 77.7 (n = 58), respectively. Fetal survival rate was 89.1% (n = 65). Serious vaginal bleeding from the suture area was noted in two patients (2.6%). No postoperative complications occurred. CONCLUSION: Emergency cerclage is a simple surgical procedure with lower complication rates and can effectively prolong gestation to viability. It can be considered as a useful measure for patients with evidence of cervical changes in the second trimester.

Hydronephrosis of pregnancy associated with torsion of the fallopian tube: a case report.

Isolated tubal torsion accompanying pregnancy is an extremely rare condition. Preoperative diagnosis is generally difficult; most of the cases can be diagnosed intraoperatively. Here, we reported a 36-week pregnant with a complaint of acute pain in right lower quadrant that emanating to right lomber region. Abdominal utrasonography showed grade 3 hydronephrosis in right kidney, other findings were normal. A cesarean section was carried out and a twisted right tube were diagnosed. Right ovary was normal in appearance. The torsioned tube compressed the right ureter and caused ureteral dilatation. Right salpingectomy was performed. Postoperative follow-up of the patient was uneventful.