Purpose To compare the clinical features and perinatal outcomes of pregnant women with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the pre-variant and post-variant periods. Methods This prospective cohort study includes pregnant women with SARS-CoV-2 who were followed-up at Ankara City Hospital between 11, March 2020 and 15, September 2021. Demographic features, clinical characteristics and pregnancy outcomes were compared between the pre-variant ( n = 1416) and post-variant ( n = 519) groups. Results The rates of severe and critical cases significantly increased in the post-variant group (9.7% vs 2%, p < 0.001). The rates of respiratory support (26.8% vs 7.3%, p < 0.001), ICU admission (12.9% vs 1.8%, p < 0.001) and maternal mortality (2.9% vs 0.4%, p < 0.001) were significantly higher in the post-variant group. A significant increase was observed for pregnancy complications in the post-variant group (45.6% vs 18.8%, p = 0.007). The rates of preterm delivery (26.4% vs 4.4%, p < 0.001) and NICU admission (34% vs 18.8%, p < 0.001) were significantly higher in the post-variant group. Positive, weak, statistically significant correlations were observed between the post-variant period, disease severity and maternal mortality ( r = 0.19, r = 0.12 and p < 0.001). Conclusion Post-variant COVID-19 period was associated with a severe course of the disease and increased rates of adverse obstetric outcomes in pregnant patients.

Objective To compare the fetal cardiac morphology and functions of early‐onset fetal growth restriction (EO‐FGR) and late‐onset fetal growth restriction (LO‐FGR) groups with gestational weeks‐matched controls. Methods A total of 164 pregnant women were included, 28 of whom were in the EO‐FGR group, 54 in the LO‐FGR group, and 82 in the control group. Fetal echocardiographic evaluation was performed with two‐dimensional, M‐mode, tissue Doppler imaging (TDI), and pulsed wave Doppler. Results Fetal cardiac morphologic measurements and diastolic and systolic functions changed in EO‐FGR and LO‐FGR fetuses compared with controls. The EO‐ and LO‐FGR fetuses had reduced right and left cardiac output, increased myocardial performance index, and significantly higher mitral and tricuspid E/E' ratios compared with controls. The EO‐FGR fetuses had lower mitral and tricuspid E and E' values. In LO‐FGR fetuses, mitral and tricuspid E' values were lower than in their controls (P = 0.001 and P < 0.001). On the other hand, the mitral and tricuspid E values were not significantly changed (P = 0.107 and P = 0.196). Conclusion We hypothesized that EO‐FGR and LO‐FGR fetuses had insufficient myocardial maturation. Especially in the LO‐FGR fetuses, TDI is the earliest and most sensitive technique to show subtle changes in fetal cardiac functions.

Aim: To evaluate the clinical significance of the systemic immune-inflammation index (SII) for patients who had miscarriages. Materials: The retrospective study included 709 pregnant women who had a miscarriage (nonviable intrauterine pregnancy up to 20 weeks of gestation) and 676 women who carried a viable intrauterine pregnancy up to 20 weeks of gestation-serving as the control group. The study and the control group were compared in terms of demographic characteristics, laboratory test results, and SII values. Furthermore, laboratory test results and SII values were compared between patients in the study group and the control group with a history of genital bleeding (threatened abortion). Results: The mean gestational week of pregnancy was 9.5 AE 3 for the control group and 8.3 AE 2.5 for the study group (p = 0.150). The SII values were higher in the study group than in the control group (p = 0.030). In all participants with a clinical history of genital bleeding, the leukocyte count, neutrophil count, neutrophil-to-lymphocyte ratio (NLR), and SII values were higher in the miscarriage group than the group with viable fetus (p = 0.031, p = 0.003, p = 0.002, p < 0.001). Based on a receiver operating characteristic (ROC) curve analysis, the SII cutoff value for miscarriage was 883.95 (10 9 /L) (62.6% sensitivity, 62% specificity) in patients with a clinical history of threatened abortion. Conclusion: High SII values in early pregnancy may be used as an additional marker for the prediction of miscarriage, in pregnant women with threatened abortion. Further prediction models including maternal risk factors and multiple markers may be more valuable for clinical practice.

Objective We aimed to evaluate and compare fetal cardiac morphology and functions of pregnant women with familial Mediterranean fever (FMF) and healthy pregnant women. Methods The study included 34 pregnant women with FMF and 68 healthy pregnant women matched with maternal age, gravidity, parity, gestational age, and pre‐pregnancy body mass index (BMI) in 34th–37th gestational weeks. Fetal echocardiographic evaluation was performed with two‐dimensional (2D) imaging, M‐mode imaging, pulsed wave (PW) Doppler, and tissue Doppler imaging (TDI). Results Fetal cardiac morphological measures, including cardiothoracic ratio, cardiac axis angle, right and left ventricular area, sphericity index, and ventricular septal thickness was similar in both groups. Compared with the control group, myocardial performance index (MPI), which indicates global myocardial performance, was significantly higher, and ejection time (ET) was significantly shortened in the FMF group. In addition, which shows the diastolic functional parameters such as, tricuspid E wave, E/A, E/E' ratio, and mitral E wave, E/A, E/E' ratio, were significantly higher; tricuspid A and mitral A waves were significantly lower. We found that mitral and tricuspid annular plane systolic excursion (MAPSE and TAPSE) were significantly lower in those with FMF duration over eight years than those with FMF duration less than 8 years. Conclusion There is no fetal cardiac morphological change in pregnant women with FMF. However, there may be changes in diastolic function. As the maternal FMF duration increases, systolic functions may also change.

OBJECTIVE: To determine the effect of SARS-CoV-2 infection on fetal thymus size by ultrasound. STUDY DESIGN: In this prospective study sonographic fetal thymus size was measured in pregnant women attending our hospital with confirmed SARS-CoV-2 infection by RT-PCR test and age-matched control group. The anteroposterior thymic and the intrathoracic mediastinal diameter was determined in the three-vessel view and their quotient, the thymic-thoracic ratio, was calculated. Results were compared between these two groups. RESULTS: Thirty-six SARS-CoV-2-infected and 47 control group pregnant women were included in this study. Two groups were similar in terms of demographic features and no difference was found for fetal thymus size. CONCLUSION: COVID-19 seems to have no adverse effect on fetal thymus size in mild and moderate patients during the acute phase of the infection.