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    Amnioinfusion vs. standard management for the second trimester PPROM: a systematic review and meta-analysis of observational studies and RCTs
    (Taylor & Francis Ltd, 2023) Celik, Ebru; Yildiz, Abdullah Burak; Cekic, Sebile Guler; Unal, Ceren; Ayhan, Isil; Melekoglu, Rauf; Gursoy, Tugba
    Objective This meta-analysis aims to review the effect of serial transabdominal amnioinfusion (TAI) on short-term and long-term perinatal outcomes in mid-trimester preterm premature rupture of membranes (PPROM). Methods Literature searches of PubMed, Web of Sciences, Scopus, and Cochrane Library were performed from their inception to April 2022. Studies comparing conventional treatment with serial TAI in women with proven PPROM at less than 26 + 0 weeks of gestation with oligohydramnios were included. Studies that included oligohydramnios due to other reasons such as fetal growth retardation or renal anomalies were excluded. Risk of bias in observational studies was assessed using the tool of the Cochrane Review group identified as risk of bias in non-randomized studies - of interventions. The risk of bias assessments for RCTs were performed according to the Cochrane risk-of-bias tool for randomized trials. An I (2) score was used to assess the heterogeneity of included studies. The analyses were performed by using random-effect model, and the results were expressed as relative risk (RR) or mean difference with 95% confidence intervals (CIs). Results Overall, eight relevant studies including five observational studies (n = 252; 130 women allocated to the intervention) and three RCTs (n = 183; 93 women allocated to the intervention) were eligible. The pooled latency period was 21.9 days (95% CI, 13.1-30.8) and 5.8 days (95% CI, -11.6-23.2) longer in the TAI group in the observational studies and RCTs, respectively. The perinatal mortality rate reduced in the intervention group when tested in observational studies (RR 0.68; 95% CI, 0.51-0.92), but not in RCTs (RR 0.79; 95% CI, 0.56-1.13). The rate of long-term healthy survival was higher in the children whose mothers were treated with the TAI (35.7%) than those were treated with the standard management (28.6%) (RR 1.30, 95% CI 0.47-3.60, best case scenario). Conclusions The efficacy of serial TA on early PPROM associated morbidity and mortality is not attested. Additional randomized control trials with adequate power are needed.
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    Perinatal outcomes of adolescent pregnancy: A single-center experience
    (2019) Yenigul, Nefise Nazli; Asicioglu, Osman; Ayhan, Isil
    Aim: To compare the delivery methods and maternal and fetal outcomes of adolescent and adult pregnancies. Material and Methods: This study enrolled 420 pregnant adolescents aged between 14 and 19 years and 940 pregnant women aged between 20 and 40 years who gave birth in our maternity clinic between January 2010 and December 2014. Their demographic and clinical data were reviewed. Results: There were no significant differences between the two groups in terms of their birth patterns. The risks for preeclampsia, intrauterine growth retardation (IUGR), and placental abruption increased with decreasing maternal age. The adjusted analyses suggested that adolescent pregnant women were at a significantly increased risk for very preterm birth (adjusted OR = 4.40, [95% CI: 1.90-10.30]) but not late preterm birth (adjusted OR = 0.90, [95% CI: 0.50-1.40]) Conclusions: Adolescent pregnancy is a risk factor for early preterm birth, placental abruption, IUGR, and preeclampsia, with significant potential clinical implications.