INTRODUCTION: Preterm labor is a major obstetric challenge that contributes significantly to neonatal morbidity and mortality. This pilot study investigated the feasibility of machine learning techniques for predicting the risk of threatened preterm labor, rather than confirmed preterm birth, among first-time mothers using readily available sociodemographic and obstetric variables.
METHODS: This retrospective, single-center study included 102 nulliparous women with singleton pregnancies. Five machine learning models were developed using basic clinical parameters. Model performance was evaluated using an 80/20 training–test split and assessed based on accuracy, ROC-AUC, sensitivity, and specificity.
RESULTS: The XGBoost classifier demonstrated the best performance, with an accuracy of 70% and a ROC-AUC of 0.64. Body mass index and a history of abortus imminens were the most influential predictors.
DISCUSSION AND CONCLUSION: Machine learning models based on simple clinical data can modestly predict threatened preterm labor. Although these models are not intended for immediate clinical application, the findings demonstrate feasibility and support further large-scale, externally validated studies incorporating maternal and neonatal outcomes.

INTRODUCTION: This study aimed to examine temporal trends in vaginal and cesarean deliveries in public hospitals in Istanbul between 2020 and 2024, with a focus on primary and primiparous cesarean sections across maternal age groups.
METHODS: This retrospective, descriptive, multicenter study included delivery records from six public maternity hospitals affiliated with the Ministry of Health in Istanbul, Türkiye. All live births at ≥24 weeks of gestation with complete demographic and delivery data were analyzed. Primary cesarean was defined as the first cesarean delivery in a woman, and primiparous cesarean was defined as a cesarean delivery in a woman giving birth for the first time. Maternal age was categorized into four groups: 15–18, 19–35, 36–39, and ≥40 years. Data were extracted from electronic medical records, cross-verified against official statistics, and analyzed using descriptive statistics, chi-square tests, and the Cochran–Armitage trend test.
RESULTS: A total of 78,998 deliveries were recorded, of which 40,427 (51.1%) were vaginal deliveries and 38,571 (48.9%) were cesarean sections. The annual cesarean rate increased from 45.8% in 2020 to 51.2% in 2023 before slightly declining to 50.9% in 2024 (p<0.0001). Primiparous cesareans accounted for 11.8% of births and showed a significant upward trend (p<0.001), while primary cesarean rates remained stable (13.1%, p=0.412). Most primary and primiparous cesareans occurred among women aged 19–35 years, with notable increases among adolescents.
DISCUSSION AND CONCLUSION: Cesarean rates in Istanbul’s public hospitals remain far above the thresholds recommended by the World Health Organization, with high proportions of primary and primiparous procedures. Targeted strategies addressing high-risk subgroups, standardization of classification systems, and strengthening care through greater involvement of midwives are urgently needed to reduce unnecessary cesarean deliveries.

INTRODUCTION: Due to the increased frequency of multiple pregnancies associated with the growing use of assisted reproductive technologies (ART), babies born from multiple pregnancies continue to attract global attention. Whether conceived through ART or spontaneously, newborns from multiple pregnancies require neonatal intensive care services much more frequently than singletons and have increased morbidity and mortality rates. Furthermore, some researchers argue that ART alone, regardless of the number of fetuses, may contribute to increased morbidity and mortality. In this study, we aimed to determine the morbidity and mortality rates in multiple pregnancies and identify the factors influencing these outcomes.
METHODS: Data on babies born or miscarried from multiple pregnancies between January 2008 and June 2013 at a single university hospital were investigated. Data on the patients and their mothers were collected retrospectively. Data on gestational age, birth weight, ART use, plurality, and sex were evaluated in relation to morbidity and mortality.
RESULTS: A total of 488 babies were born from multiple pregnancies during the study period, and 49.6% of them were conceived through ART. The number of ART-related multiple pregnancies decreased over the years. Of the babies, 60.9% were born between 32 and 37 weeks of gestation, and 53.9% had birth weights between 1500 and 2500 g. Prematurity and its severity were found to be higher in infants born from ART-related multiple pregnancies (p=0.00). Newborns conceived via ART had a significantly lower gestational age at birth (32.59±3.57 vs. 34.17±3.36 weeks) and significantly lower birth weights (1953±672 vs. 2088±621 g).
DISCUSSION AND CONCLUSION: In conclusion, we observed an increased frequency and severity of prematurity among newborns from ART-related multiple pregnancies. Mortality rates demonstrated a declining trend over time, in parallel with the reduced use of ART. These findings, highlighting prematurity as a major risk factor in multiple births, emphasize the critical importance of implementing strategies aimed at preventing multiple pregnancies in ART practices.

INTRODUCTION: This prospective observational study aimed to evaluate the prevalence of allergic diseases in children with nutritional anemia caused by iron, vitamin B12, or folate deficiencies using clinical assessment tools, including the ISAAC questionnaires, skin prick testing, and laboratory markers.
METHODS: Between July 2013 and February 2014, a total of 123 children aged 3–18 years, including 77 children with anemia and 46 controls, were prospectively evaluated at Zeynep Kamil Women and Children’s Health Training and Research Hospital. The ISAAC questionnaires were administered to determine the frequency of asthma, allergic rhinitis, and atopic dermatitis. Complete blood count, ferritin, serum iron, folic acid, vitamin B12, total IgE, and eosinophil levels were analyzed, and skin prick testing was performed.
RESULTS: Allergic disease was detected in 24.7% of the patient group and 30.4% of the control group. No significant differences were found between the groups in the rates of physician-diagnosed asthma (1.3% vs. 4.3%), allergic rhinitis (22.1% vs. 26.1%), or atopic dermatitis (1.3% vs. 0%) (p>0.05). The frequency of atopy was 15.8% in the patient group and 14.2% in the control group. No differences were found in total IgE or eosinophil levels.
DISCUSSION AND CONCLUSION: Nutritional anemias, including iron deficiency anemia and vitamin B12 and folate deficiencies, were not found to increase the frequency of allergic diseases in children. In line with the current literature, it was concluded that this relationship may be bidirectional (allergic disease → anemia or anemia → atopic severity) and that larger prospective studies are needed.

INTRODUCTION: The aim of this study was to establish the reliability of evoked compound action potential (ECAP) thresholds obtained using the conventional AutoNRT programming system and the CR220 Intraoperative Remote Assistant. Another objective was to compare intraoperative NRT thresholds with postoperative thresholds.
METHODS: Nineteen patients who received a Nucleus CI24RE or CI422 cochlear implant for severe-to-profound hearing loss were included in the study. The patients’ ages ranged from 13 months to 15 years, with a mean age of 4 years. Intraoperative NRT thresholds were measured on all functioning electrodes using both the conventional AutoNRT programming system and the CR220 Intraoperative Remote Assistant. Postoperative ECAP thresholds were obtained 4–6 weeks after surgery using the conventional AutoNRT system and were compared with the intraoperative measurements.
RESULTS: NRT thresholds showed no statistically significant differences between the conventional and remote conditions for any electrode, except E20 (p=0.027). Intraoperative NRT thresholds were also compared with postoperative AutoNRT thresholds for five representative electrodes (E1, E6, E11, E16, and E22); a statistically significant difference was observed only for E22 (p=0.015), while no significant differences were found for the remaining electrodes.
DISCUSSION AND CONCLUSION: The CR220 Intraoperative Remote Assistant provides reliable NRT thresholds. There were no statistically significant differences between the NRT thresholds obtained using the CR220 and those obtained using the conventional AutoNRT method. Although newer intraoperative platforms, such as SmartNav, have recently emerged, the CR220 Remote Assistant is still used in many centers worldwide and remains an essential tool in clinical settings where newer systems are not yet accessible. Therefore, establishing its reliability relative to AutoNRT continues to have clinical value, particularly for pediatric cochlear implant candidates and institutions interpreting large volumes of historical intraoperative NRT data.

INTRODUCTION: Artificial intelligence (AI) significantly impacts medical education by enhancing learning methods and educational materials. Advanced AI platforms, such as ChatGPT and InVideo AI, offer promising tools for creating interactive and detailed content for medical training. This study evaluates their feasibility and limitations in generating pediatric surgery–focused videos, specifically content on newborn physical examinations, within an innovative methodological framework rather than an original research design.
METHODS: Scripts were initially created using ChatGPT and subsequently converted into educational videos using the InVideo AI platform (https: //ai.invideo. io/). We produced four distinct videos: two based on brief scripts (12 words) and two based on detailed scripts (405 words), formatted for YouTube and YouTube Shorts. Video creation times, file sizes, content accuracy, formats, and durations were analyzed to assess effectiveness.
RESULTS: Videos generated from detailed ChatGPT scripts required longer creation times (~10 minutes) and had larger file sizes (~700 MB) than those generated from brief scripts (~3 minutes and ~180 MB). Although video generation was efficient, notable limitations emerged regarding the accuracy and availability of specialized pediatric surgical content, primarily due to the limited medical databases available to AI-driven platforms.
DISCUSSION AND CONCLUSION: The integration of ChatGPT and InVideo AI demonstrated significant potential for enhancing pediatric surgery education by streamlining educational video production. However, substantial challenges regarding content accuracy and the comprehensiveness of medical data remain. Addressing these issues through continued technological advancements will be crucial for fully leveraging the educational potential of AI. Future improvements in AI databases and algorithms may profoundly enhance medical training, benefiting both educational outcomes and patient care in pediatric surgery.

INTRODUCTION: Imperforate hymen is the most prevalent congenital obstructive abnormality of the female genital tract. This study was conducted to determine which department children who underwent surgery for imperforate hymen first presented to or were referred to at a maternity and children’s hospital. The primary aim was to emphasize the importance of a comprehensive physical examination in reducing the age at diagnosis because of the serious complications associated with delayed diagnosis.
METHODS: The medical records of children who underwent surgery for imperforate hymen between January 2014 and 2024 were retrospectively reviewed.
RESULTS: Of the 32 patients who underwent surgery for imperforate hymen at our hospital over a 10-year period, the mean age at surgery was 116±69 months (minimum: 1 month, maximum: 192 months). Thirteen of the 32 patients (40.6%) underwent surgery in the Department of Pediatric Surgery; six of these 13 patients (46%) were neonates. Among the patients presenting to pediatric surgery, four had prenatally diagnosed hydrocolpos, and five were diagnosed during the first postnatal physical examination. Four adolescents presented directly to pediatric surgery with primary amenorrhea, abdominal pain, and an abdominal cystic mass. Nineteen of the 32 patients (59.4%) underwent surgery in the Department of Gynecology and Obstetrics. The primary reason for referral to the Department of Gynecology and Obstetrics was primary amenorrhea, followed by pelvic pain.
DISCUSSION AND CONCLUSION: A comprehensive physical examination can facilitate the diagnosis of imperforate hymen at an earlier age, particularly when a cystic structure suggestive of hydrometrocolpos is detected on prenatal or postnatal ultrasonography.

INTRODUCTION: This study examined maternal mortality rates and causes in three state hospitals—Hadejia General Hospital (HGH), Kafin Hausa General Hospital (KGH), and Birniwa General Hospital (BGH)—in the North-East Senatorial District of Jigawa State, Nigeria, between 2018 and 2022.
METHODS: This descriptive study retrospectively reviewed the hospital records of all maternal deaths, as defined by the World Health Organization International Classification of Diseases–Maternal Mortality (WHO ICD-MM). Maternal mortality ratios (MMRs) were calculated per 100,000 live births, and the causes were classified as direct or indirect. Trends over time and differences among the hospitals were analysed. Data are presented as numbers, percentages, and rates per 100,000 live births. SPSS version 22 was used for the analysis.
RESULTS: A sharp increase was observed in 2020, coinciding with the COVID-19 pandemic. The MMR increased from 1,454 to 5,045 in BGH, from 3,578 to 9,627 in HGH, and from 0 to 1,709 in KGH. Rates declined slightly in 2021–2022 but remained far above national and global targets. In BGH, anaemia was the leading cause of maternal mortality (45.35%), followed by eclampsia (27.91%) and postpartum haemorrhage (8%). In HGH, eclampsia was the leading cause (27.89%), followed by placental abruption, pulmonary embolism, hypovolaemic shock, and transfusion reactions, which collectively accounted for 24% of deaths. In KGH, postpartum haemorrhage was the most common cause (36.59%), followed by eclampsia (17.07%), difficult delivery (14.63%), and anaemia (9.76%).
DISCUSSION AND CONCLUSION: Maternal mortality in Jigawa State remains unacceptably high and is largely attributable to preventable direct obstetric causes and indirect factors. Reducing maternal mortality requires urgent improvements in obstetric care, stronger referral systems, greater consideration of indirect causes, continuity of services during crises, and sustained health education.

Timely diagnosis of uterine inversion is critical for favorable maternal outcomes. This article presents the case of a 26-year-old postpartum woman with a history of epilepsy who was diagnosed with uterine inversion during a seizure. A 26-year-old woman, gravida 3, with a history of two previous vaginal deliveries, presented at 38 weeks of gestation with contractions. She delivered a viable male infant vaginally but experienced postpartum complications, including an epileptic seizure, uterine atony, and uterine inversion. Postpartum hemorrhage occurred, requiring blood transfusion, surgical intervention, and subsequent admission to the intensive care unit. Hemostasis was successfully achieved through ligation of the ascending branches of both uterine arteries and insertion of a Bakri balloon. Uterine inversion is a life-threatening obstetric emergency that, if not promptly recognized and managed, can result in severe hemorrhage, shock, and maternal mortality. This case demonstrates the simultaneous occurrence of an epilepsy-related seizure and uterine inversion, highlighting the importance of close monitoring and timely, coordinated management of postpartum complications in women with epilepsy.

Osteogenesis imperfecta (OI) type VIII is a rare genetic disorder characterized by brittle bones that are susceptible to fractures. This condition is associated with mutations in the LEPRE1 gene, which plays a key role in collagen synthesis and is critical for bone strength. The patient presented with a novel homozygous c.446TG mutation in the P3H1 gene that has not previously been reported in the literature. Individuals with OI type VIII commonly exhibit frequent fractures, skeletal deformities, short stature, blue sclerae, hearing loss, and dental abnormalities. Management focuses on symptom relief and fracture prevention through physical therapy, bracing, and surgical interventions. This report highlights the treatment of a patient with OI type VIII who sustained two femoral shaft fractures. The fractures were successfully managed with telescopic nailing, emphasizing the importance of tailored surgical approaches in the management of this rare condition. Given its rarity, further research is needed to deepen our understanding of OI type VIII and improve therapeutic options.