Browsing by Author "Jestrovic, Zorica (57210067977)"

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: Pneumothorax implies the presence of air in the pleural space between the visceral and parietal pleura. The aim of this study was to investigate the incidence, clinical characteristics, risk factors, therapy and perinatal outcome in neonates with pneumothorax in a tertiary care center. Materials and Methods: A retrospective study based on a five-year data sample of neonates with pneumothorax was conducted in a Maternity Hospital with a tertiary NICU from 2015 to 2020. We included all neonates with pneumothorax born in our hospital and compared demographic characteristics, perinatal risk factors, anthropometric parameters, comorbidities, clinical course and method of chest drainage between term (≥37 GW) and preterm (<37 GW) neonates. Results: The study included 74 newborns with pneumothorax, of which 67.6% were male and 32.5% were female. The majority of women (59.5%) had no complications during pregnancy. Delivery was mainly performed via CS (68.9%). Delivery occurred on average in 34.62 ± 4.03 GW. Significantly more (p = 0.001) children with pneumothorax were born prematurely (n = 53; 71.6%) than at term (n = 21; 28.4%). Most of the neonates had to be treated with ATD (63.5%) and nCPAP (39.2%), but less often they were treated with surfactant (40.5%) and corticosteroids (35.1%). O2 therapy lasted an average of 8.89 ± 4.57 days. Significantly more (p = 0.001) neonates with pneumothorax had additional complications, pneumonia, sepsis, convulsions and intraventricular hemorrhage (68.9%). However, most children had a good outcome (83.8%) and were discharged from the clinic. Fatal outcomes occurred in six cases, while another six neonates had to be transferred to referral neonatal centers for further treatment and care. Conclusion: Significantly more children with pneumothorax were born prematurely than at term. With adequate therapy, even premature newborns can successfully recover from pneumothorax. © 2022 by the authors.