Evaluation of the SII and HALP scores in predicting perinatal outcomes in pregnancies with preterm premature rupture of membranes Cagdas Nurettin Emeklioglu, Mirac Ozalp, Elif Akkoc Demirel, Simten Genc, Veli Mihmanli BMC Pregnancy and Childbirth, 2026 Preterm premature rupture of membranes (PPROM) is a leading cause of preterm birth and neonatal morbidity, with inflammation playing a key role in its pathogenesis. This study aimed to evaluate the predictive value of the Systemic Immune-Inflammation Index (SII) and the Hemoglobin-Albumin-Lymphocyte-Platelet (HALP) score for perinatal outcomes and delivery timing in pregnancies complicated by PPROM. This retrospective cross-sectional study included 317 pregnant women who were diagnosed with PPROM between 24 and 36 + 6 weeks gestation, from January 2018 to January 2024. SII and HALP scores were calculated from blood parameters at admission using the following formulas: SII = [platelets(/L) × neutrophils(/L)] / lymphocytes(/L) and HALP = [hemoglobin(g/L) × albumin(g/L) × lymphocytes(/L)] / platelets(/L). Neonatal outcomes (birth weight, APGAR scores, NICU admission) and delivery timing were analyzed. ROC curves and logistic regression models were used to assess predictive performance. Higher SII values were significantly associated with lower birth weights, lower 1- and 5-minute APGAR scores, and increased NICU admission. The SII showed modest predictive power for NICU admission (AUC: 0.653, cut-off = 1145.75) and strong discriminative ability for predicting delivery within 7 days (AUC: 0.860, cut-off: 1421, sensitivity and specificity: 78%). In contrast, the HALP showed limited and inconsistent discriminative performance and was not significantly associated with adverse outcomes. Multivariate logistic regression confirmed that the SII was as an independent predictor of NICU admission (p = 0.012). The SII is a promising biomarker for predicting adverse neonatal outcomes and the timing of delivery in PPROM patients. A SII value > 1421 may indicate delivery within 7 days, aiding in clinical management. Each 100-unit increase in SII was associated with an increased risk of NICU admission. The HALP score was not a reliable predictor.
Evaluation of Doppler parameters and obstetric outcomes in intrahepatic cholestasis of pregnancy Mümine Eda Şık, Miraç Özalp, Murat İbrahim Toplu, Veli Mihmanlı Journal of Perinatal Medicine, 2026 Objectives To investigate the association between Doppler ultrasonographic parameters and maternal serum bile acid levels in pregnancies complicated by intrahepatic cholestasis of pregnancy (ICP) and to evaluate their potential role in fetal monitoring. Methods In this prospective observational study, 59 pregnant women diagnosed with ICP and 59 healthy controls were included. The diagnosis of ICP was based on pruritus and serum bile acid levels >10 μmol/L. Doppler assessments – performed by a blinded perinatologist – included the uterine artery pulsatility index (PI), middle cerebral artery (MCA) PI, umbilical artery (UA) PI, and cerebroplacental ratio (CPR). Participants were further stratified by bile acid levels (<10, 10–40, >40 μmol/L), and intergroup comparisons and correlation analyses were performed. Results The ICP cases had significantly higher uterine artery PI and lower MCA PI and CPR values compared to controls (p<0.05). Bile acid levels were positively correlated with uterine artery PI and inversely correlated with MCA PI and CPR. ICP pregnancies also demonstrated increased rates of preterm delivery, low birth weight, and neonatal intensive care unit (NICU) admissions. Conclusions Alterations in uterine and fetal Doppler indices in ICP pregnancies suggest underlying placental dysfunction. These findings support the clinical utility of Doppler ultrasound in the risk stratification and perinatal surveillance of patients with ICP.
Procalcitonin and inflammatory biomarkers in tuboovarian abscess: Predicting surgical intervention Simten Genç Ulusal Travma Ve Acil Cerrahi Dergisi, 2025 BACKGROUND Pelvic inflammatory disease (PID) and tubo-ovarian abscess (TOA) are significant gynecological infections that can lead to serious complications such as infertility and chronic pelvic pain. This study aimed to evaluate the diagnostic and prognostic value of procalcitonin (PCT) and other inflammatory biomarkers (C-reactive protein [CRP], white blood cell count [WBC], and neutrophil-to-lymphocyte ratio [NLR]) in patients with PID and TOA, and to identify predictors of treatment failure. METHODS A retrospective cohort study was conducted on 136 patients diagnosed with PID or TOA at Prof. Dr. Cemil Taşçıoğlu City Hospital between January 2021 and December 2023. Demographic data, clinical findings, and laboratory results (PCT, CRP, WBC, NLR) were collected. Statistical analyses were performed using the Number Cruncher Statistical System (NCSS) 2007 software. RESULTS Of the 136 patients, 103 (75.73%) were diagnosed with TOA and 33 (24.26%) with PID without TOA. The TOA group had significantly longer hospital stays and higher levels of PCT, CRP, WBC, and NLR compared to the PID group (p<0.05). Multivariate analysis identified CRP as the most significant predictor of TOA (p=0.03). Among TOA patients, 53.3% required surgical intervention. Patients who underwent surgery had significantly higher PCT and NLR levels (p<0.05). Receiver operating characteristic (ROC) analysis showed that a PCT cut-off value of 0.21 ng/mL predicted the need for surgical treatment with a sensitivity of 69.09% and specificity of 64.58%. CONCLUSION Procalcitonin and neutrophil-to-lymphocyte ratio are valuable biomarkers in the diagnosis and management of TOA. Elevated PCT and NLR levels are associated with an increased likelihood of surgical intervention. Together with abscess size, these biomarkers can help predict treatment failure and support clinical decision-making. However, further prospective multicenter studies are necessary to validate these findings.
Prenatal diagnosis and management of desbuquois dysplasia type 1 due to CANT1 mutation: A case report Miraç Özalp, Murat İbrahim Toplu, Biray Ertürk, Aybekcan Batman, Veli Mihmanlı Taiwanese Journal of Obstetrics and Gynecology, 2025 OBJECTIVE: To report a rare case of Desbuquois dysplasia Type 1 (DBQD1) diagnosed prenatally, caused by mutations in the CANT1 gene. CASE REPORT: DBQD1 is an autosomal recessive skeletal dysplasia with severe disproportionate dwarfism, joint laxity, and multiple skeletal anomalies. A 26-year-old woman, gravida 3, para 1, abortus 1, was referred due to short femur (FL) and humerus (HL) lengths on ultrasound. The patient and her husband are consanguineous. Ultrasound at our clinic revealed a hypoplastic thorax, severe limb anomalies, brachydactyly, overlapping fingers, clubfoot, and rocker-bottom feet, along with ventricular septal defects (VSDs). Genetic testing identified a homozygous pathogenic variant in the CANT1 gene (c.902_906dup, p.Ser303AlafsTer21). Both parents were heterozygous carriers. Following genetic counseling, the family opted for pregnancy termination. CONCLUSION: This case highlights the importance of comprehensive genetic testing and early, precise diagnosis for informed decision-making in managing rare skeletal dysplasias.
Does fear of childbirth in nulliparous women affect fetal outcomes? Omer Demir, Gülsün Ozbay, Mirac Ozalp, Hidayet Sal, Gokce Omeroglu Kayıkcı, Emine Ahu Koç, Turhan Aran, Mehmet Armagan Osmanagaoglu Revista Da Associacao Medica Brasileira, 2025 SUMMARY OBJECTIVE: In this study, an investigation was undertaken to determine whether the well-being of the fetus is affected in pregnant women who have a severe fear of childbirth. METHODS: Participants were nulliparous pregnant women at 37 weeks of gestation. The Wijma Delivery Expectancy Questionnaire-A questionnaire, validated for the Turkish population, was used to assess the degree of fear of childbirth of the study subjects. Cases where labor began spontaneously and resulted in a vaginal delivery were included in the study. A total of 44 patients were investigated during the study period. The cases were divided into two groups according to the Wijma Delivery Expectancy Questionnaire-A scores. RESULTS: There were no statistically significant differences between the groups regarding fetal cord blood gas parameters and Apgar scores at the first and fifth minutes. Fear of childbirth in nulliparous cases did not affect the fetal cord blood gas parameters or Apgar scores. It was observed that the duration of the second stage of labor was statistically significantly longer in women with severe fear of birth (p=0.036). CONCLUSION: As a result, tocophobia can prolong the duration of the second stage of labor, does not affect fetal oxygenation, and does not change fetal cord blood gas parameters and Apgar scores. It is aimed to verify this result with large-scale studies and to encourage prospective studies.
