Objective: Cesarean delivery rates are increasing worldwide, while operative vaginal delivery rates continue to decline. It was evaluated that the use of operative vaginal delivery may help to perform vaginal delivery safely and prevent cesarean section in stage II of labor performed for various maternal or fetal indications, reducing cesarean section rates. Design: A retrospective study. Setting: Department of Obstetrics and Gynecology, Turkish Ministry of Health Elazığ Fethi Sekin City Hospital Population: Patients who had operative delivery and 121 patients who had spontaneus vaginal delivery between 2019-2023. Methods: 75 patients who had operative delivery at Elazığ Fethi Sekin City Hospital between 2019 and 2023 were compared with 121 pregnant women who had spontaneous vaginal delivery as a control group. Singleton deliveries after 37 weeks of gestation and patients with no history of maternal complications were included in the study. Multiple pregnancies or cases with a history of maternal complications were excluded. Main Outcome Measures : Demographic data (age, gravida, parity), maternal characteristics (BMI, gestational week), fetal and neonatal parameters (fetal birth weight, Apgar scores, fetal pH) and postnatal outcomes (NICU requirement, presence of complications) were obtained retrospectively and compared. Result: Gravida and parity values were found to be significantly lower in the study group. There was no significant difference between the groups in terms of gestational week. The first minute Apgar scores of the infants in the study group were significantly lower than those in the control group. The mean fetal pH was significantly lower in the study group and the NICU requirement was higher in this group. Conclusion: The high rate of operative delivery in the first pregnancy may indicate that maternal-fetal adaptation complicates the delivery process.

Objective: To evaluate both short and mid-term effects of maternal COVID-19 on cardiac functions of fetuses and children. Methods: The present case-control study was conducted on 36 pregnant women who had COVID-19 infection in the second trimester of pregnancy and 30 pregnant women as healthy controls. Fetal, neonatal and infant cardiac functions were compared between the groups. Assessment of fetal cardiac functions were performed in the last trimester of the pregnancy at least 6 weeks after the recovery of infection. The first postnatal echo was performed within the first two weeks and the follow-up (second) echo was performed in the 6-8 weeks of life. Results: The demografic data were similar between groups. Interventricular septum and left ventricular posterior wall end-diastolic dimensions were significantly higher in the study group in both fetal, neonatal and infant periods. Impaired diastolic functions of right and left ventricles were detected and myocardial performance indexes with tissue doppler imaging of both lateral walls and septum were significantly higher than controls at all periods. Conclusion: Maternal COVID-19 seems to have a global impact on cardiac functions of babies in the short and mid-term periods after maternal recovery.

Aim: We aimed to examine fetal cardiac output (CO) in patients who recovered from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Materials: This prospective study included 48 pregnant women recovered from SARS-CoV-2 infection and 50 control cases. SARS-CoV-2 infection was diagnosed by polymerase chain reaction (PCR) test in patients. Fetal echocardiographic evaluations were performed at 24-37 weeks of gestation in pregnant women who recovered from the infection and control group. Results: The median value of ultrasound evaluation was 34 (2.6) weeks of gestation in the recovery from the SARS-CoV-2 infection (RSI) group, and 32 (7.6) weeks in the control group (p=0.565). Left cardiac output (LCO) z score was significantly lower in the RSI group than the control group (p=0,041). LCO and combine cardiac output (CCO) z score were significantly lower in the severe disease group than mild, moderate disease groups, and controls (p=0,019 and p=0,013). CCO (mL/min/kg) was decreased in the severe disease group when compared with control and mild disease groups (p=0,044). Fetal distress, preterm delivery rate, and neonatal intensive care unit (NICU) admission were found to be higher in the severe disease group compared to the control group (p=0,010, p=0,009, and p<0,001 respectively). Conclusion: In the present study, fetal cardiac output in pregnant women with recovery from SARS-CoV-2 infection was found significantly decreased, especially in whom had severe diseases. Placental dysfunction and inflammatory cytokines might cause fetal cardiac changes. Further studies could be clarified on the impact of SARS-CoV-2 infection on fetal cardiac function.