Browsing by Author "Bratic, Danijela (15069128700)"

Introduction/Objective Congenital heart diseases are the most common congenital anomalies. The objective of the study was to determine reliability, specificity, and sensitivity of fetal echocardiography in detection of congenital heart diseases in a referral center for fetal echocardiography. Methods We analyzed 14,500 fetal echocardiography exams (FEC) between 1991 and 2014, performed in two tertiary centers. Results The average maternal age at the time of diagnosis was 32 years. The mean gestational age at the time of diagnosis was 25.9 weeks. The most common indications for FEC were suspicious abnormal cardiac findings in obstetrical screening sonography (50.6%). Among 9,055 examined fetuses, pathological finding on the fetal heart was found in 638 cases. The most common congenital heart diseases were structural anomalies of the fetal heart in 81%, of which 13.3% were fetuses with hypoplastic left heart syndrome and 11.2% with ventricular septal defect. Of all fetuses with diagnosed congenital heart defect, 46.2% were born alive and had good postnatal prognosis, while 2.7% died in utero, and 10.6% died in the early neonatal period. Pregnancy was terminated in 40.4% of fetuses with severe congenital heart defect. Sensitivity of the diagnostic procedure in our study was 95.9%, and specificity was 99.9%. Conclusion Our study proves that FEC is a reliable, informative diagnostic tool in detecting congenital heart defects with high specificity and sensitivity. With multidisciplinary approach, it provides an optimal time window for improving perinatal outcome. © 2019, Serbia Medical Society. All rights reserved.

Background and Objectives: Forceps delivery is a crucial obstetrical technique that has become increasingly underutilized in favor of cesarean delivery, despite the numerous complications related to cesarean sections. The major concerns with regard to assisted vaginal birth (AVB) are safety and long-term consequences. We aimed to investigate a neurological outcome of neonates and children at the age of 7 who were born via forceps delivery. This would greatly improve informed decision making for both mothers and obstetricians. Materials and Methods: A single-arm cohort study was conducted from January 2012 to December 2016 among 49 women and their children born via forceps delivery at the Clinic for Gynecology and Obstetrics, University Clinical Center of Serbia. The Sarnat and Sarnat classification was used to evaluate the neurological status of neonates, and logistic regression analysis was employed to explore the association with perinatal factors. Long-term neurological outcomes were assessed using the Griffiths Mental Development Scale and a questionnaire for parents based on the Motor and Social Development (MSD) scale, which was derived from the Bayley-III Scale. Results: The main indication for forceps delivery was maternal exhaustion (79.6%), followed by fetal distress (20.4%). A pathological neurological status was observed in 16.3% of newborns, with pathological ultrasound of the CNS in 3%. A statistically significant association was observed with the Apgar score, with an odds ratio of 0.575 (95% CI: 0.407–0.813, p = 0.002) and perinatal asphyxia, with an odds ratio of 9.882 (95% CI: 1.111–87.902, p = 0.04). However, these associations were unlikely to be related to the mode of delivery. Long-term adverse neurological outcomes were seen in three cases, which accounts for 6.4%. These included mild disorders such as delayed milestone, speech delay, and motor clumsiness. Conclusions: The present study highlights the safety of forceps delivery regarding children’s neurological outcomes at 7 years of age. This is an important contribution to the modern management of labor, especially in light of increasing rates of cesarean deliveries worldwide. © 2024 by the authors.