Can transvaginal cervical length and cervical strain elastography predict mid-trimester medical induction to abortion intervals?

OBJECTIVE: Mid-trimester pregnancy terminations are becoming an increasingly common practice in obstetrics. Accurate prediction of delay from induction to abortion may help in planning the optimal time for the medical induction process and optimising the use of healthcare services. Therefore, we aimed to assess whether the transvaginal cervical length and cervical elastography can predict the time interval from medical induction to abortion in cases of medically indicated mid-trimester pregnancy termination. MATERIALS AND METHODS: We performed a prospective observational pilot study between January 2022 and October 2022 in patients who have undergone medically indicated mid-trimester pregnancy termination with a non-dilated cervix for foetal morphological, chromosomal abnormalities or preterm premature rupture of membranes. Cervical length (CL) and cervical strain ratio (CSR) were measured by transvaginal sonography. The predictive value of CL and CSR on the induction to abortion interval was calculated after medical induction with misoprostol. RESULTS: Fifty-three eligible pregnant women were evaluated. The mean gestational age at abortion was 17.61 ± 2.81 weeks. The mean time interval from induction to abortion was 31.72 ± 16.57 h. In multivariate linear regression analysis, CL and the history of previous vaginal delivery were the significant independent predictors of the induction to abortion interval (all p < 0.01), with no additional significant contribution from CSR. CONCLUSION: Transvaginal CSR is unlikely to be useful in the prediction of induction to abortion interval in the mid-trimester medically indicated termination of pregnancy.SHORT CONDENSATIONTransvaginal cervical length is the significant independent predictor of the induction to abortion interval in the mid-trimester medically indicated termination of pregnancy with no additional significant contribution from cervical strain ratio.

Evaluation of the selected parameters of the fetal diastolic functions in normally grown or macrosomic fetuses of gestational diabetic mothers with poor glycaemic control.

OBJECTIVE: This study aimed to investigate whether the third trimester fetal cardiac diastolic function measured by selected conventional Doppler indices is affected in appropriate-for-gestational-age or macrosomic fetuses of gestational diabetic mothers with poor glycaemic control. METHODS: This cross-sectional study included 93 pregnant women divided into two groups. Group 1 included 45 appropriate-for-gestational-age or macrosomic fetuses from gestational diabetic mothers with poor glycaemic control (study group). Group 2 included 48 appropriate-for-gestational-age fetuses from gestational age-matched healthy mothers (control group). Functional fetal cardiac parameters and fetoplacental Doppler parameters were measured. Data were compared between the two groups. RESULTS: Maternal characteristics did not differ significantly between the study and the control group. There were no significant differences in the early and late velocity, early/late velocity ratio of both mitral and tricuspid valves, the fetal pulmonary vein pulsatility index, and the ductus venosus pulsatility index between the study and the control group. Moreover, the rate of abnormal Doppler findings in pulmonary vein (pulmonary vein pulsatility index >95th centile), ductus venosus (ductus venosus pulsatility index >95th centile), and peripheral vessels (umbilical artery pulsatility index >95th centile, middle cerebral artery pulsatility index <5th centile, cerebra-placental index >95th centile) were comparable in both groups. CONCLUSIONS: The third trimester fetal diastolic functions measured by selected conventional Doppler techniques do not seem to be altered in appropriate-for-gestational-age or macrosomic fetuses of gestational diabetic mothers who have poor glycaemic control.

Intrahepatic cholestasis of pregnancy may lead to low birth weight.

BACKGROUND/AIM: To evaluate patients hospitalized in our clinic in the last 5 years with the diagnosis of intrahepatic cholestasis of pregnancy (ICP). MATERIALS AND METHODS: One hundred and fifty patients hospitalized with a diagnosis of ICP between January 2008 and May 2013 were evaluated retrospectively and age, week at diagnosis, gestational age at delivery, period between diagnosis and delivery, fetal weight, transaminases, and coagulation parameters were recorded. Patients were divided into groups according to their diagnosis weeks and gravida. Accordingly, patients diagnosed before 32 weeks formed group A (n = 49) and those after 32 weeks formed group B (n = 101). Data were evaluated with SPSS 16.0. RESULTS: There was a significant difference between group A and group B in terms of delivery period and fetal weights (P = 0.001, P 0.035). Accordingly, the period between diagnosis and delivery and fetal weight were found to be longer and lower, respectively, in the early-onset group. In terms of distribution of ICP according to time of diagnosis, patients were diagnosed mostly in the spring season (60 cases, 40%) and in the month of March (27 cases, 18%). CONCLUSION: According to our study, the birth weight of fetuses of patients with ICP diagnosed before 32 weeks are lower, although they have the same gestational age at delivery as the fetuses of the patients with ICP diagnosed after 32 weeks.