INTRODUCTION: Stillbirth is one of the most adverse outcomes for both families and obstetricians. In this study, we aimed to evaluate the incidence, causes, risk factors, delivery methods, and placental pathologies associated with stillbirth at our obstetric center.
METHODS: This retrospective descriptive study was conducted in the obstetrics clinic of a tertiary hospital. Stillbirths occurring between February 2018 and October 2023 were included in the study. A total of 109 stillbirths among 27,034 live births were included. The obstetric, perinatal, and neonatal outcomes of the women included in the study were examined.
RESULTS: The stillbirth rate at our hospital was 4.03 per 1000 births. In this study, 49 (45%) women were admitted to the hospital with reduced fetal movement. Fetal growth restriction, observed in 21 (19.3%) cases, was determined to be the leading cause of stillbirth. The rate of unexplained/unclassifiable stillbirth was 18 (16.5%). Among the placentas of stillborn fetuses examined, the most frequently detected histopathological findings were perivillous/intervillous fibrin accumulation in 52 (74.3%) cases, calcification in 33 (47.1%), intraparenchymal hemorrhage/hematoma in 31 (44.3%), decidual inflammation in 31 (44.3%), increased syncytial knots in 26 (37.1%), and necrotic decidua in 23 (32.9%).
DISCUSSION AND CONCLUSION: Stillbirth rates are among the main indicators of the quality of obstetric care. Stillbirth causes emotional devastation and grief among parents. To reduce stillbirth rates, specific risk factors in women should be identified, and strategies to prevent pregnancy complications should be established during antenatal visits. Pathological examination of the placenta should be performed as part of the evaluation of stillbirths.

INTRODUCTION: This study aimed to compare maternal serum Sestrin2 levels between women diagnosed with missed abortion and those with healthy pregnancies at 7–13 weeks of gestation and to investigate the possible association between Sestrin2 levels and missed abortion.
METHODS: This prospective study included 45 pregnant women diagnosed with missed abortion and 45 healthy pregnant women who presented to the obstetrics and gynecology outpatient clinic or emergency department of our hospital between January and June 2023. Maternal blood samples were collected to measure serum Sestrin2 levels. Demographic and clinical data, including age, body mass index (BMI), gravidity, parity, history of abortion, gestational age, chorionic localization, last menstrual period (LMP), uterine artery pulsatility index (PI), and crown–rump length (CRL), were recorded. The groups were compared in terms of these parameters.
RESULTS: The mean age and BMI of the participants were 30.52 years and 24.15 kg/m², respectively. The mean maternal serum Sestrin2 level was 787.4±504.6 ng/mL in the missed abortion group and 609.6±449.1 ng/mL in the healthy pregnancy group. The right and left uterine artery PI values were significantly higher in the missed abortion group, indicating increased vascular resistance compared with the healthy pregnancy group. No statistically significant differences were observed between the groups in terms of age, gravidity, parity, history of abortion, chorionic localization, or LMP. Additionally, no significant difference was found in maternal serum Sestrin2 levels between the missed abortion and healthy control groups.
DISCUSSION AND CONCLUSION: This study found no significant difference in maternal serum Sestrin2 levels between women with missed abortion and those with healthy pregnancies. These findings suggest that maternal serum Sestrin2 may not play a significant role in the pathophysiology of missed abortion. Further large-scale, multidisciplinary, prospective studies are needed to confirm these results and provide more comprehensive insights into the role of Sestrin2 in early pregnancy outcomes.

INTRODUCTION: Monochorionic twin pregnancies carry high perinatal risks due to shared placental circulation, predisposing them to complications such as twin-to-twin transfusion syndrome (TTTS), twin anemia-polycythemia sequence (TAPS), and selective fetal growth restriction (sFGR). Early recognition and timely intervention are essential to improve neonatal survival. This study evaluates the perinatal outcomes of monochorionic twin pregnancies managed at a single perinatology center.
METHODS: A retrospective cross-sectional study was conducted using medical records from January 2020 to December 2023. Forty-six monochorionic twin pregnancies were analyzed for maternal factors, obstetric complications, and neonatal outcomes. Statistical analyses included Pearson correlation, t-tests, and chi-square tests.
RESULTS: The mean gestational age at delivery was 32.46±4.48 weeks. The average birth weight of the first twin was 1809.76±797.37 g and that of the second twin was 1683.13±887.06 g. Mean APGAR scores were 7.15±2.74 and 8.41±2.69 for the first twin, and 6.80±3.12 and 8.11±3.14 for the second twin, at one and five minutes, respectively. TTTS occurred in 8.7% and sFGR in 50% of pregnancies. Higher birth weights were significantly correlated with better APGAR scores (p<0.01), whereas advanced TTTS and sFGR were associated with lower birth weights and adverse neonatal outcomes.
DISCUSSION AND CONCLUSION: Monochorionic twin pregnancies are associated with increased risks of prematurity, low birth weight, and neonatal distress, particularly in the presence of TTTS and sFGR. Reporting outcomes with measures of variability highlights the substantial heterogeneity in neonatal status. Routine surveillance and timely interventions remain essential to improving perinatal survival.

INTRODUCTION: The aim of this study was to investigate the pregnancy course, outcomes, and the progression, persistence, or regression status of postpartum cervical intraepithelial lesions (SIL) and high-risk Human Papillomavirus (HR-HPV) positivity in pregnant women who were diagnosed with cervical intraepithelial lesions and/or HR-HPV positivity detected through cervical Pap smear testing shortly before or at the onset of pregnancy.
METHODS: The study was conducted between 2018 and 2021 at Zeynep Kamil Women’s and Children’s Diseases Training and Research Hospital, including seventy pregnant women who were identified either with preinvasive cervical lesions in cervical cytology tests or with high-risk Human Papillomavirus (HR-HPV) positivity through Real-Time PCR testing. Pregnancy outcomes were evaluated. A control group of 146 non-pregnant patients comparable in terms of age, parity, cytology, and HPV typing results was selected. The natural evolution of cervical intraepithelial lesions and HR-HPV infection in both groups was compared using samples obtained 12–18 months after the first evaluation.
RESULTS: In the pregnant group, the regression rate of squamous intraepithelial lesions was 87.1%, whereas the rate of HPV infection regression was 68.8%. Comparatively, these rates in the control group were 64.6% and 43.0%, respectively. The regression rate of abnormal cervical cytology was significantly higher in the pregnant group (3.2%) than in the control group (23.8%), with a minimal progression rate (p=0.001). The regression rate of HR-HPV infection was significantly higher in the pregnant group than in the control group (p=0.009). When both groups were analyzed, the regression rate of squamous intraepithelial lesions in the presence of other HR-HPV types (72.6% (n=61)) was significantly higher than that in HPV 16–18-positive cases (54.1% (n=33)) (p=0.021). Of the total pregnancies, 14.7% resulted in abortion, 11.4% resulted in preterm birth, 8.7% resulted in post-term birth, and 65.2% resulted in term birth. Regarding the increase in the rate of preterm birth, there was no significant difference in preterm birth rates among HR-HPV types. There was no significant difference in the frequency of pregnancy-related complications based on HR-HPV types and the regression status of HR-HPV infection.
DISCUSSION AND CONCLUSION: Preinvasive lesions of the cervix and HR-HPV infection exhibit a high rate of spontaneous regression after pregnancy. In cases of low-grade lesions and situations without suspicion of invasive cancer, histopathological examination and definitive treatment may be considered for postponement until after pregnancy. This observed regression appears to be associated with progesterone dominance during pregnancy. Further advanced molecular and histopathological studies are required to elucidate the impact of progesterone on squamous intraepithelial lesions and cervical HR-HPV infection.

INTRODUCTION: Fever is one of the most common symptoms in childhood and a major reason for pediatric emergency department visits. Despite being a natural defense mechanism, misconceptions and heightened anxiety among parents may lead to unnecessary healthcare utilization and inappropriate interventions. This study aimed to determine the knowledge and attitudes of parents of children aged 6 months to 6 years regarding fever management and the use of antipyretic medications.
METHODS: This descriptive study was conducted with 322 parents who presented to the pediatric emergency department of a university hospital with their children because of fever complaints. Data were collected through face-to-face interviews using a questionnaire developed by the researcher. Analyses were performed using SPSS version 21.0, with descriptive statistics and chi-square tests, and the significance level was set at p<0.05.
RESULTS: The mean age of the children was 2.7±1.49 years, and 57.6% were girls. Nearly all parents (97.2%) measured their child’s body temperature when fever was suspected, with 73.6% preferring a digital axillary thermometer. Although 93.5% of parents reported knowing the normal temperature range, 24.2% identified values below 37°C as fever. In cases of high fever, 75.8% of parents removed the child’s clothing, 58.7% gave the child a lukewarm bath, and 58.7% administered an antipyretic. Paracetamol was the most commonly used antipyretic (57.5%), but only 47.8% of parents reported being aware of medication side effects. A significant association was found between a child’s history of febrile illness and the parents’ practice of recording temperature measurements (p<0.05).
DISCUSSION AND CONCLUSION: Although parents’ practices regarding temperature measurement and antipyretic use were generally appropriate, misconceptions about fever thresholds and nonevidence-based practices, such as wiping the child with vinegar, persist. The high level of anxiety related to fever complications indicates the persistence of “fever phobia.” These findings highlight the need for structured, guideline-based education programs for parents, which may reduce inappropriate practices and unnecessary healthcare visits.

INTRODUCTION: The World Health Organization (WHO) recommends continued breastfeeding up to two years of age and beyond. However, breastfeeding beyond infancy remains uncommon and is often hindered by cultural barriers and misconceptions. Physicians play a crucial role in guiding families on infant feeding practices; yet, limited evidence exists regarding their knowledge and attitudes toward breastfeeding beyond two years. This study aimed to evaluate the knowledge and attitudes of physicians from different specialties toward breastfeeding beyond two years and to identify factors influencing their awareness and counseling practices.
METHODS: This multicenter, descriptive, cross-sectional study was conducted in four hospitals among physicians working in pediatrics, family medicine, obstetrics and gynecology, and other clinical specialties. Data were collected using a face-to-face structured questionnaire assessing demographic characteristics, personal breastfeeding experience, knowledge of WHO recommendations, perceived benefits and challenges of extended breastfeeding, and counseling behaviors. Data were analyzed using descriptive statistics and chi-square tests.
RESULTS: Although 95.9% of participants correctly identified the WHO recommendation for exclusive breastfeeding, only 17.9% accurately recognized the total recommended duration of breastfeeding. Knowledge levels were significantly higher among pediatricians and family physicians and among those who frequently provided breastfeeding counseling. While 90% of pedodontists believed that extended breastfeeding could contribute to dental caries, most physicians remained uncertain about its protective effects on maternal health. Only 19.9% reported recommending breastfeeding beyond two years. Both knowledge and attitudes varied significantly across medical specialties.
DISCUSSION AND CONCLUSION: Physicians’ knowledge and attitudes toward breastfeeding beyond two years were limited. Integrating evidence-based breastfeeding education into medical curricula, residency programs, and continuing professional training may strengthen physicians’ ability to support mothers who breastfeed beyond infancy.

INTRODUCTION: This study aimed to assess parental knowledge, attitudes, and practices regarding rational antibiotic use in children under six years of age with upper respiratory tract infections and to examine their associations with sociodemographic factors.
METHODS: A cross-sectional survey was conducted among 399 parents who presented to the Pediatric Emergency Department of Göztepe Training and Research Hospital between February and March 2019. The questionnaire comprised 12 knowledge, 5 attitude, and 3 practice items, and responses were evaluated in relation to sociodemographic characteristics and parents’ awareness of media campaigns on rational antibiotic use.
RESULTS: Parents demonstrated an overall correct response rate of 78%, with accuracy being highest for practice items (89.2%), followed by attitude (84.2%) and knowledge (72.7%) items. Higher educational attainment and household income were significantly associated with better scores, whereas parental age, number of children, and relationship to the patient were not. Although most parents recognized that isolated symptoms such as sore throat, ear pain, or fever do not require antibiotics, nearly half incorrectly believed that antibiotics are indicated for the common cold or purulent nasal discharge. Notably, substantial knowledge gaps persisted even among university-educated parents regarding the appropriate use of antibiotics in streptococcal pharyngitis. Awareness of media campaigns was associated with a modest improvement, equivalent to one additional correct response.
DISCUSSION AND CONCLUSION: Parental knowledge gaps regarding antibiotic use in children remain substantial. Education and income were the strongest predictors of accurate knowledge and attitudes. Strengthening accessible, targeted public education initiatives, particularly for socioeconomically disadvantaged families, is essential to promote rational antibiotic use.

INTRODUCTION: Idiopathic epiretinal membrane (ERM) is a fibroglial proliferation on the retinal surface that distorts the macular contour and impairs visual acuity. Restoration of the foveal pit following pars plana vitrectomy (PPV) is considered a key determinant of postoperative outcomes. This study aimed to evaluate the relationship between macular contour recovery and functional improvement after ERM surgery.
METHODS: This retrospective study included 168 eyes of 155 patients who underwent PPV for idiopathic ERM between January 2009 and January 2011. Patients were grouped according to pre- and postoperative macular contour (MC) as regular or irregular. Best-corrected visual acuity (BCVA) and central macular thickness (CMT) were measured using the Snellen chart and spectral-domain optical coherence tomography (SD-OCT) before and 6 months after surgery. Statistical analyses were performed using paired t-tests, ANOVA, and Tukey’s post hoc tests (p<0.05).
RESULTS: The mean age differed significantly among groups (p=0.03). Preoperative BCVA was higher in patients with regular MC (0.37±0.23) than in those with irregular MC (0.16±0.11; p=0.02). Postoperative BCVA improved significantly in all groups (p=0.01). The greatest CMT reduction occurred in patients whose MC normalized postoperatively (CMT=-338.9±159.2 µm; p=0.01), indicating concordant structural and visual recovery.
DISCUSSION AND CONCLUSION: PPV for idiopathic ERM provides significant visual and anatomical improvement. Postoperative restoration of the foveal pit is strongly associated with superior BCVA gain and CMT reduction, highlighting foveal morphology as a key prognostic marker for surgical success.

Familial Mediterranean fever (FMF) is the prototype of monogenic autoinflammatory diseases. The disease is characterized by recurrent attacks of fever, abdominal pain, and chest pain. Menstruation can be a triggering factor for these attacks. We report two cases of FMF in which abdominal pain attacks occurred exclusively during menstrual periods. A 14-year-old female patient was diagnosed with FMF at the age of 10 after experiencing recurrent episodes of fever and abdominal pain lasting 1–3 days and recurring every 1–2 months since the age of 3. After colchicine treatment, her fever and abdominal pain attacks resolved; however, she reported severe abdominal pain lasting for 3 days during every menstrual period over the past year. The patient was considered to have FMF characterized by isolated menstrual attacks. The family acknowledged that the patient was not taking colchicine regularly. With regular colchicine therapy, a significant reduction in isolated menstrual attacks was observed. A 15-year-old female patient was referred because of recurrent abdominal pain over the past 3 years. Upon further questioning, she reported no associated fever or chest pain. It was noted that the abdominal pain occurred specifically during menstrual periods and lasted for 2–4 days. Significant elevations in C-reactive protein levels were detected during episodes of abdominal pain and menstruation. Given her typical history of isolated menstrual attacks, she has remained attack-free for 2 years while receiving colchicine therapy. Although the exact mechanism underlying the relationship between menstruation and FMF attacks remains unclear, FMF attacks typically begin immediately before the onset of menstruation. In some cases, however, the attacks begin just after menstruation starts. These patients appear to have a higher rate of dysmenorrhea and an increased frequency of attacks before and after menarche compared with patients with typical clinical presentations of FMF. Fever may not always be present during attacks; therefore, elevated acute-phase reactant levels may be useful in distinguishing menstrual FMF attacks from dysmenorrhea.

Rectal atresia is an extremely rare condition among anorectal anomalies. Rectal atresia and associated congenital anomalies have been reported previously; however, rectal atresia with left renal agenesis and hypospadias has not been previously reported in the English literature. We report the successful treatment of rectal atresia in a neonate with left renal agenesis and hypospadias using a single-stage endoanal approach without stoma. A one-day-old male neonate was transferred to our department because a firm tube could not be passed into the rectum. On inspection of the perineum, the anal opening was normal, and the external genitalia showed hypospadias with hooded prepuce. During the operation, a cross-shaped incision was made in the most proximal mucosa of the anal canal, which ended blindly above the dentate line, and the rectal canal was reached by dissection. The proximal rectal mucosa and distal dentate line mucosa were anastomosed. Thus, type II rectal atresia was repaired primarily and successfully without stoma using a single-stage transanal approach. Follow-up was uneventful for four years. Transanal anorectal anastomosis without stoma offers a safe, effective, and comfortable technique for the treatment of rectal atresia and decreases the risk of injury.