Browsing by Author "Plesinac, S. (55920049900)"

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 relations between abnormal umbilical and cerebral Doppler, cerebral-umbilical (C/U) ratio, and outcomes in pregnancies complicated by gestational hypertension and fetal intrauterine growth retardation were evaluated. Materials and Methods: A retrospective study of 53 monofetal pregnancies in 2010 was conducted at the Institute of Gynecology and Obstetrics, Belgrade. Statistical analysis: chi-square likelihood ratio test, Student's t-test and Spearman's coefficient correlation. Results: There was not a significant correlation between the timing of registration of abnormal umbilical Doppler to delivery and outcomes of high-risk pregnancies. There was a significant correlation between C/U ratio and APGAR-5 (p = 0.003). We found a significant correlation between neonatal birth weight and APGAR-5 (p = 0.000), neonatal asphyxia (p = 0.000), intracranial hemorrhage (p = 0.000) and respiratory distress syndrome (p = 0.000). Conclusion: Umbilical and cerebral artery Doppler is a relatively poor predictor of neonatal outcome. It seems that neonatal birth weight is the best predictor of neonatal outcome in high-risk pregnancies.

Introduction: An aim of the first phase of the present authors' prospective clinical trial was to determine the variation of pulsatile index (PI) in the median cerebral artery (MCA) in low- and in high-risk pregnancies with gestational hypertension, diabetes mellitus, intrauterine growth restriction (IUGR), and congenital thrombophilia, after constant sound stimuli. Materials and Methods: Study was organized as multicentric prospective clinical trial under the supervision of Ministry of Health and Education of Republic of Serbia over four years from 2011-2014. The study included 60 patients in low-risk pregnancies, 31 patients with gestational hypertension, 17 patients with diabetes in pregnancy, four with IUGR, and nine patients with congenital thrombophilia. Ultrasound prenatal auditory screening was performed after the 27th week of gestation, following the protocol established in 1992. Defined sound stimulus was digitally generated sound intensity 90 dB, frequency range 1,500-4,500 Hz, and duration 0.2 seconds. Result: There is significant statistical difference between low-risk pregnancies and pregnancies with gestational hypertension, and insulin dependent diabetes mellitus. Conclusion: A small response interval was detected in pregnancies complicated with diabetes mellitus insulin dependent and gestational hypertension. The authors can conclude that these fetuses are in chronic hypoxia which results in their low reactivity to external stimulation. © 2018 S.O.G. Canada Inc. All rights reserved.

Aim: The relation between biophysical profile (BPP), cerebroplacental (C/P) ratio, and lecithin/sphingomyelin (L/S) ratio as a predictor perinatal outcome in term intrauterine growth restricted (IUGR) neonates was evaluated. Materials and Methods: A retrospective study of the perinatal outcome of 77 term monofetal pregnancies complicated with IUGR fetuses (< 10 percentile) who were terminated by cesarean section in 2010 was performed at the Institute of Gynecology and Obstetrics, Belgrade. Results: The most frequent early neonatal complication was asphyxia. The authors found a strong correlation between the L/S ratio and birth weight (BW) r = 0.609, as well as between BPP and Apgar score 5 r = 0.583. Significant negative correlation was found between asphyxia and BPP r = -0.398, as well as between asphyxia and C/P ratio r = -0.379. Conclusion: In serous IUGR neonates, low values of BPP and L/S ratios predicted asphyxia.

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.