Zeitschrift fur Geburtshilfe und Neonatologie最新文献

Background and purpose: Mandala is recognized as an art therapy that provides psychological support and healing. This study aimed to determine the effects of mandala art therapy on blood glucose levels, mood, and anxiety in pregnant women with abnormal oral glucose tolerance test (OGTT) values.

Materials and methods: This experimental study, designed as a pre-test post-test control group trial, was conducted in a public hospital in eastern Türkiye. The study involved 68 pregnant women (intervention group=34, control group=34). In the intervention group, the pregnant women received mandala art therapy twice: once at 0 hour after fasting plasma glucose (FPG) and once at 1 hour after plasma glucose (PG). Data collection tools included a Personal Information Form, the State-Trait Anxiety Inventory (STAI), and the Brief Mood Introspection Scale (BMIS), while glucose levels were obtained from patient records. Statistical analysis included frequency, percentage, mean, standard deviation,chi-square test, independent samples t-test, paired t-test, and ANCOVA.

Results: Following the intervention, pregnant women in the intervention group had significantly lower post-test STAI total and BMIS-negative mood subscale mean scores compared to those in the control group (p<0.05). Additionally, those in the intervention group scored higher on the positive mood and overall mood subscales of BMIS compared to those in the control group (p<0.05). There was no statistically significant difference between the groups' FPG(0-hour), PG(1-hour), and PG(2-hour) measurements (p>0.05).

Conclusion: Mandala art therapy was found to reduce anxiety and negative mood while positively affecting positive mood and overall emotional well-being in pregnant women with abnormal OGTT values.

In recent years, the role of healthy dietary patterns-particularly the Mediterranean diet-has been increasingly investigated in the prevention and management of gestational diabetes mellitus (GDM) and its associated complications.To evaluate the effects of adherence to the Mediterranean dietary pattern (MedDiet) adopted prior to conception or early in gestation on GDM and its association with maternal and fetal outcomes.A systematic literature search was conducted, including randomized and non-randomized clinical trials. Data were collected from Biblioteca Virtual em Saúde (BVS), PubMed, Embase, and Google Scholar databases for articles published between 2015 and 2025. The review protocol was registered in PROSPERO under the registration number CRD420251008611. The average incidence of GDM was lower in the MedDiet group (15.2%) compared to the control group (18.5%), suggesting a beneficial effect of the intervention. There was also a reduction in urinary tract infection rates (6.8% vs. 14.9%) and in the incidence of hypertension/preeclampsia (6.9% vs. 9.5%) in the intervention group. Cesarean section rates were similar between groups, with minor variations. Regarding neonatal outcomes, birthweight was slightly higher in the MedDiet group, and the incidence of small-for-gestational-age newborns was lower, reflecting an overall favorable effect on neonatal growth patterns. The rate of preterm birth was also lower in the intervention group, as was perinatal mortality in some studies. The need for neonatal intensive care unit admission varied across studies, with a trend toward reduction in the MedDiet group.The Mediterranean diet appears to be effective in reducing the incidence of GDM and improving maternal and fetal outcomes.

Anti-Müllerian hormone (AMH) is commonly used in artificial reproductive treatments. Unfortunately, there is only limited data about AMH in adverse pregnancy outcomes. Here, we searched the role of first-trimester AMH to predict adverse pregnancy outcomes in women without polycystic ovary syndrome (PCOS).A total of 240 pregnant women were enrolled in this prospective study. The inclusion criteria were being in the first trimester of pregnancy, having AMH levels measured, not having PCOS, and having had regular antenatal visits. Adverse outcomes were preeclampsia, gestational hypertension, gestational diabetes, preterm birth, pregnancy loss, and stillbirth. Demographic features, obstetric outcomes, and AMH levels were recorded and compared for each adverse outcome. AMH levels were lower in preeclampsia, gestational hypertension, gestational diabetes, and pregnancy loss compared to the control group. In ROC analysis, a cut-off value of 2.14 ng/mL for predicting preeclampsia yielded a sensitivity of 84.2% and specificity of 55.5% (p=0.027, AUC=0.658). For gestational hypertension, a threshold of 2.65 ng/mL resulted in a sensitivity of 94.4% and specificity of 41.2% (p=0.004, AUC=0.662). In predicting gestational diabetes, a cut-off of 1.98 ng/mL achieved a sensitivity of 83.3% and specificity of 59.7% (p<0.001, AUC=0.723). For pregnancy loss, a cut-off value of 2.94 ng/mL showed a sensitivity of 93.8% and specificity of 33.6% (p=0.001, AUC=0.660). The study provides initial indications about the role of AMH in predicting adverse pregnancy outcomes in pregnant women without PCOS. We believe that our study, when supported by randomized controlled studies with a large population, could confirm first-trimester AMH as a biomarker that can be used to predict adverse pregnancy outcomes. By using this marker, patients can be informed about the complications that will develop in the later period of pregnancy and can be referred to appropriate centers.

There are limited number of randomized controlled studies on the effectiveness of perineal massage and warm compresses in reducing perineal trauma.To evaluate the effectiveness of massage and warm compresses implemented by nurses and midwives on perineal trauma, volume of hemorrhage, length of episiotomy, and pain.The single-center, single-blind randomized controlled trial (RCT) included 120 pregnant women in labor. Women were randomly divided into four groups: receiving massage only, warm compress only, both massage and warm compress, and the control group.The application of warm compresses and massage was effective for reducing perineal trauma (p<0.001). Warm compress application was found to be effective to decrease first-degree trauma (p<0.001). The hemorrhage volume and length of episiotomy for the intervention groups were lower than in the control group (p<.001). Massage and warm compress interventions were effective for reducing pain (p<0.05).Massage and warm compress methods are effective in reducing trauma, pain, hemorrhage, and episiotomy length. Furthermore, the use of the two methods together does not provide an advantage.

Brucellosis is one of the most common zoonotic diseases in the world, causing high morbidity in animals and humans. The aim of this study was to investigate the effects of Brucella infection during pregnancy on the fetus and neonate.In our study, fetal and neonatal characteristics of women with positive Brucella agglutination tests during pregnancy between January 2017 and January 2023 were evaluated retrospectively. Included were all pregnant women with a tube agglutination test>1:160 for Brucella melitensis during pregnancy. Maternal characteristics, intrauterine abortion, intrauterine growth retardation, and neonatal findings were recorded.A total of 23 patients were included in the study. The most common complaints of pregnant women were fever (69.6%), malaise (78.3%), and myalgia (47.8%). A total of 21.7% of the pregnancies ended in abortion. Ten (55.6%) babies had low birth weight. Two babies had congenital brucellosis, and one baby had brucella infection due to transmission through breast milk.Brucella infections in pregnancy cause adverse effects in pregnant women, the fetus and newborn. Especially in endemic areas, it should be considered in the differential diagnosis.

This study aims to investigate the relationship between posttraumatic stress disorder (PTSD) and sleep quality among pregnant earthquake survivors. A cross-sectional study was designed. The sample consisted of 272 pregnant earthquake survivors who were admitted to a hospital in southern Türkiye. Data were collected using "The Personal Information Disclosure Form," "The Impact of Event Scale (IES)," and the "Pittsburgh Sleep Quality Index (PSQI)". Statistical analyses included descriptive statistics, independent samples t-test, one-way ANOVA, Pearson correlation, and multiple linear regression.The mean IES total score was 41.37±19.73. The mean scores for the IES subscales were: Intrusion 15.17±8.19, Avoidance 15.25±6.74, and Hyperarousal 10.95±6.40. Considering the diagnostic cut-off value of 33 for PTSD on the IES, the mean IES score among the pregnant women in this study (41.37±19.73) indicates that their PTSD levels were above average and they were found to be at risk for PTSD. In general, positive, significant, but weak correlations were observed between the scale scores. A non-significant, positive, and very weak correlation was found between the IES and PSQI total scores (p>0.05).Pregnant earthquake survivors exhibited elevated PTSD levels and poor sleep quality. Although the association between PTSD and sleep quality was weak, the findings highlight the need for psychological screening and supportive interventions in antenatal care following disasters.

The aim of this study was to assess the relationship between maternal anti-thyroid peroxidase (anti-TPO)-negative subclinical hypothyroidism (SCH) in the first trimester with complications of pregnancy and neonatal outcomes.The study was done at a maternity and children's research training hospital. First-trimester thyroid function tests (TFTs) (free thyroxine (FT4), thyroid stimulating hormone (TSH), anti-TPO) were checked for mothers who gave birth at the center, and their newborns were accepted for the study. Based on the results of the TFTs, two groups were formed, the normal thyroid function (euthyroid) and SCH groups. The neonatal and maternal outcomes were noted. This study included 150 mothers, of whom 110 (73.3%) had normal thyroid function and 40 (26.7%) had anti-TPO-negative subclinical hypothyroidism (SCH). Based on thyroid function tests (TSH: 0.1-4.0 mIU/L, FT4: 0.7-1.8 ng/dL), significant differences in pregnancy complications wereobserved, with higher rates of placental abruption, preeclampsia, and postpartum hemorrhage in the SCH group (p<0.001). Neonatal outcomes in the SCH group showed significantly higher rates of small for gestational age (SGA) (52.5%), NICU admission (77.5%), low Apgar score (52.5%), and transient tachypnea of the newborn (TTN) (67.5%) (all p<0.001). Logistic regression analysis identified SCH as a significant risk factor for TTN (OR=7.24; 95% CI: 3-17; p<0.001), while no significant associations were found with gestational age (p=0.194) or maternal age (p=0.600). Anti-TPO-negative SCH in pregnancy has undesirable effects, not only during pregnancy but also in siblings, and surprisingly, it may be a risk factor for TTN.

Duplications of the gastrointestinal tract exist in various forms and present differently depending on their location. They are extremely rare congenital malformations, and especially duplication cysts of the pyloric channel are among the rarest. They appear with a variety of symptoms, above all with severe vomiting. To date a surgical resection seems to be the only effective treatment. In order to share our experience with a congenital gastric duplication cyst, we present the case of a 36-day-old girl.