Browsing by Author "Plecas, D. (6603715745)"

Aim: The relation between placental histopathological examination, umbilical cord pathology and abnormal umbilical and cerebral Doppler as a predictor of stillbirth at later gestations was evaluated. Materials and Methods: A retrospective study of 55 monofetal pregnancies complicated with late fetal death from 2005-2008 was conducted at the Institute of Gynecology and Obstetrics, Belgrade. Statistical analysis: chi-square likelihood ratio test and Spearman's coefficient correlation. Results: Intrauterine fetal demise occurred most frequently at term -32.7% of the time. Changes in the umbilical artery resistance index were not significantly different from placental histopathology findings, p = 0.363. There was a significant correlation between neonatal birth weight and weeks of gestation at delivery, r = 0.796; p = 0.001. Conclusion: Umbilical artery Doppler is a relatively poor predictor of stillbirths due to placental dysfunction. It seems that neonatal birth weight is the best predictor of late stillbirth in high-risk pregnancies.

Aim: The analyze the potential influence between obesity in pregnancy and the abdominal delivery-cesarean section and to establish the possibility of its prevention. Materials and Methods: A prospective study examined 200 patients, delivered by cesarean section in a oneyear period. The study included a structured questionnaire; the body weight at the end of pregnancy was measured and it was analyzed against all available medicine documentation. Statistical analysis included: x2 test, Student's t-test, and Fisher's test, as well the Pearson's and Spearman's test of correlation rank. Results: From all 200 (100%) patients delivered by cesarean section, 67 (33.5%) were overweight and obese. Body mass index at the beginning of pregnancy was significantly associated with cesarean section (x2 = 69.141;p < 0.001), along with the appearance of eventual pregnancy complications, and also with the neonatal birth weight (p = 0.224;/p < 0.001). Conclusion: The nutritive status, both at the beginning and at the end of pregnancy is the important factor for the pregnancy outcome.

Velamentous insertion of the cord, or vasa previa, is a malady where fetal vessels tranverse membranes ahead of the fetal part. The incidence of vasa previa is 1: 2000-3000 deliveries. Fetal mortality is over 50-75%. Early diagnosis is needed because these deliveries require emergency cesarean section; it is especially more common with placenta percreta, uterine atony and hemorrhage. Intravascular infusion of red blood cells (RBCs) into the fetus is one of the most successful means of in utero therapy for severe fetal anemia caused by RBC alloimmunization. We performed four fetal intrauterine intravascular transfusions (IVT) as therapy for severe fetal anemia. The patient underwent elective cesarean section. After delivery, profound uterine atony and vaginal hemorrhage were noted and the patient underwent hysterectomy. Pathological examination of the placenta and umbilical cord documented velamentous insertion of the cord. Before intrauterine IVT a detailed US examination is necessary to exclude vasa previa or placenta previa. Uterine atony may be result after a diagnosis of placenta previa or vasa previa. Intrauterine IVT is an irreplaceable diagnostic procedure in the treatment of severe fetal anemia.