BACKGROUND: Coronavirus disease 2019 (COVID-19) may be asymptomatic or symptomatic in pregnant women. Compared to non-pregnant reproductive-aged women, symptomatic individuals appear to have a higher risk of acquiring severe illness sequelae. OBJECTIVES: We assessed the clinical and laboratory characteristics and outcomes of pregnant COVID-19 patients unvaccinated for severe acute respiratory syndrome coronavirus 2 according to the trimester of pregnancy. DESIGN AND SETTING: This was a retrospective observational study conducted in a tertiary-level hospital in Turkey. METHODS: This retrospective study reviewed the clinical and laboratory characteristics and outcomes of 445 pregnant COVID-19 patients hospitalized during the first, second, and third trimesters of pregnancy and 149 other pregnant women as controls in a tertiary center from April 2020 to December 2021. All participants were unvaccinated. RESULTS: Overall, the study groups were comparable in terms of baseline clinical pregnancy characteristics. There was no clear difference among the study participants with COVID-19 in the first, second, and third trimesters of pregnancy. However, a considerably high number of clinical and laboratory findings revealed differences that were consistent with the inflammatory nature of the disease. CONCLUSIONS:The study results reveal the importance of careful follow-up of hospitalized cases as a necessary step by means of regular clinical and laboratory examinations in pregnant COVID-19 patients. With further studies, after implementing vaccination programs for COVID-19 in pregnant women, these data may help determine the impact of vaccination on the outcomes of pregnant COVID-19 patients.

Aims We evaluated the clinical value of selected serum biomarkers BMP-4, BMP-2, GDF-15, MMP-9, and GP39 in pregnant women with obesity and the comorbidities diabetes mellitus (DM) and gestational hypertension (GHT). Methods This observational study had groups of controls, including healthy pregnant women; women with only obesity, including pregnant women with BMI≥30 kg/m2; women with gestational DM (GDM) with obesity, including pregnant women with GDM and obesity; women with pregestational DM (PGDM) with obesity, including pregnant women with PGDM and obesity; and women with GHT with obesity, including pregnant women with GHT and obesity. We measured serum levels of selected biomarkers by ELISA. ResultsObesity increased serum levels of all the biomarkers; GDM developed in obese women caused a more pronounced increase in the serum levels of BMP-4 and BMP-2, and GHT developed in obese women caused a more pronounced increase in the serum levels of GDF-15. In the women with GDM-, PGDM-, and GHT-complicated obesity, serum levels of MMP-9 and GP39 did not change meaningfully. Conclusions Obesity and its comorbidities DM and GHT lead to meaningful changes in the studied serum biomarkers. Since obesity has a causal effect on developing numerous conditions, reliable clinical biomarkers are needed to improve the early prediction and diagnosis of high-risk conditions during pregnancy.

Objective: To evaluate the effect of the timing of episiotomy repair on the incidence of postpartum hemorrhage. Methods: This randomized controlled trial included 307 pregnant women who delivered vaginally and underwent mediolateral episiotomy in a tertiary-care hospital. In Group I, the repair of the episiotomy was started while the placenta was still inside. In Group II, spontaneous delivery of the placenta was waited, and then the repair was initiated. The primary outcome was the incidence of postpartum hemorrhage. Secondary outcomes were the mean blood loss, postpartum 24 th hour hemoglobin (Hb) and hematocrit (Hct) levels, mean Hb and Hct change, and the need for transfusion. Results: The rate of postpartum hemorrhage (>500 mL) did not differ significantly between the two groups (5.2% in Group I vs. 6.5% in Group II, p=0.62). The mean blood loss did not differ significantly between the two groups (206±120 mL in Group I vs. 210±134 mL in Group II, p=0.76). There was no statistical difference between the two groups regarding postpartum Hb and Hct levels, mean Hb and Hct change, and the need for transfusion. Discussion: Timing of episiotomy repair has no effect on the incidence of postpartum hemorrhage in a tertiary hospital.