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Vol.22 No.1

Date: January–March 2013.

CONTENT:

EARLY MARKERS FOR PREECLAMPSIA DETECTION (Vol.22 No.1, str.1-1)

Authors:

Mirna Vuković Bobič, Dubravko Habek

Review

Summary:
Preeclampsia is a complicated disturbance of pregnancy with possible high-risk complications. It is still not detectable by routine early diagnostics and impossible to prevent complications. Research of the last decade is directed to different biochemical and biophysical aspects aimed to early prediction of possible development of preeclampsia. This work presents the role of angogenic, imunologic factors, influence of endothelial dysfunction, markers of systemic inflammation, regulators of growing factors included in angiogenesis, as well as the role of changed uterine arteries circulation with respect to preclampsia.

Key words:
preeclampsia, ultrasounds marker’s, biochemical’s markers


PREVENTIVE EFFECTS OF EXERCISE ON THE OCCURRENCE OF GESTATIONAL DIABETES MELLITUS (Vol.22 No.1, str.9-15)

Authors:

Iva Šklempe Kokić, Marina Ivanišević

Review

Summary:
Key words: pregnancy, gestational diabetes mellitus, exercise, physical activity Gestational diabetes mellitus (GDM) refers to impaired glucose tolerance of various degrees first manifested during pregnancy, is related to an increased risk of complications during pregnancy, during and after birth, and has longterm health consequences for mother and child. The principal goals of treatment are to optimize glycaemic control and improve pregnancy outcomes. The article provides an overview of findings on the preventive effects of exercise before and after pregnancy on the occurrence of GDM. In May 2012 Pubmed, OvidSP and ClinicalTrials.gov databases were searched for trials on the protective effects of exercise and physical activity on the occurrence of GDM. The effects of exercise before and during pregnancy on the prevention of GDM, and the parameters of glycaemic control, are described mainly in cohort studies and a small number of randomized controlled trials, with discrepant and contradictory results. Cohort studies relate higher levels of physical activity before and during early pregnancy to lower risk of developing GDM. Published randomized controlled trials have not succeeded in confirming the preventive effects of structured exercise programmes on the occurrence of GDM and insulin resistance decrease, partly due to small samples and methodological issues. Regular exercise before and during early pregnancy may have a more important role in the prevention of GDM than exercise during the second half of pregnancy, but producing more specific results calls for additional randomized controlled trials, especially for the high-risk population, as well as defining the optimal exercise intensity, type, duration and frequency.

Key words
pregnancy, gestational diabetes mellitus, exercise, physical activity

 


ON DEVELOPMENT OF COLPOSCOPY IN CROATIA On 15th anniversary of the First Croatian colposcopic course (June 20. 1998.–June 20. 2013.) (Vol.22 No.1, str.16-16)

Authors:

Goran Grubišić

Review

Summary:
During the First Croatian colposcopic course (20. June 1998.) I analyzed how to report the development of colposcopy in Croatia. The course was organized due to everyday insight in growing number of patients with abnormal cytological findings of the uterine cervix and lower genital tract as well as with growing interest for colposcopy in practice. Additional incentive was important anniversaries of these years (125th anniversary of the Croatian Medical Association 1874.–1999., and 75th anniversary of colposcopy 1925.–2000.). Some additional bibliographic research on colposcopy revealed a great number of interesting data, which we want to convey to all our colleagues interested in colposcopy.

Key words:
the beginning of colposcopy in Croatia, the role of continuous medical education

 


ANAESTHESIA IN PATIENT WITH THE MELAS SYNDROME FOR CESAREAN SECTION (Vol.22 No.1, str.22-22)

Authors:

Vlatka Marijić, Marija Matas, Renata Marohnić, Slobodan Mihaljević, Ljiljana Mihaljević

Case report

Summary:
We present a case of a parturient in 34th week of gestational age with the MELAS syndrome whose pregnancy ended with cesarean section because of threatening fetal asphyxiation. The MELAS syndrome is a rare mitochondropathy with multigrain presentation and diverse clinical picture, which is most often characterized with myopathy, encelophathy, lactic acidosis, convulsions and stroke like episodes. Our patient was preoperatively hemodinamically stabile, and despite using sevoflurane and succinilcholine there were no signs of malignant hyperthermia as no other complications otherwise possible during general anesthesia.

Key words:
MELAS syndrome, anesthesia


ARTERIAL THROMBOSIS OF THE LOWER EXTREMITY LIMB OF THE NEWBORN – UNUSUAL BIRTH COMPLICATION (Vol.22 No.1, str.25-25)

Authors:

Ivica Sjekavica, Danilo Gardijan, Vlatko Duspara, Marija Jelušić Dražić,*Hrvoje Kniewald,* Andrea Dasović Buljević,* Ernest Bilić*

Case report

Summary:
Thromboembolic events in children are most common within first year of life and the main risk factor is catheterization of large vessels. Spontaneous thrombosis is rare. Most affected vessels are large veins. Drug of choice is heparin with individually decided dose and length of using. Doppler ultrasound is preferable diagnostic method of imaging with plenty of advantages.

Key words:
arterial thrombosis of lower extremity limb, newborn, Doppler ultrasound


PERSISTING PORTAL VEIN VALVE AS A CAUSE OF PORTAL VENOUS SYSTEM DILATATION IN PATIENT WITH OVERACTIVE BLADDER SYNDROME (Vol.22 No.1, str.28-28)

Authors:

Ivica Sjekavica, Luka Novosel, Slavko Orešković,* Irena Hrstić,** Melita Rupčić

Case report

Summary:
We present a case of a female patient with an initially diagnosed overactive bladder syndrome, who was discovered to have dilatation of the intrahepatic segment of the portal venous system on additional Doppler ultrasound examination. A portal venous system dilatation may be congenital or acquired. Persisting portal veinvalve is a known, but extremely rare cause of dilatation. It is a form of congenital anomaly usually accidentally discovered during an ultrasound or other radiological examination and normally requires no treatment.

Key words:
portal vein valve, portal venous system dilatation, Doppler ultrasound of the portal venous system, overactive bladder syndrome


TOWARD THE NINETIETH ANNIVERSARY OF COLPOSCOPY (1924.–2014.) (Vol.22 No.1, str.31-31)

Authors:

Goran Grubišić

Review

Summary:
The ninetieth anniversary of colposcopy (1924. – 2014.) is approaching and stimulates us to point out basic data, which can enable to readers very thorough insight in this as simple as responsible method of screening and secondary prevention of neoplastic changes of the uterine cervix and lower genital tract. Thanks to colposcopy, it is possible to choose the most acceptable way of therapy. Furthermore, it is necessary to point out new circles that emerge fromcolposcopy as there are molecular-biological investi gations related to HPV genome and anti HPV vaccines. From theother side there are lot problems related to psychosocial aspects in women who undergo to colposcopy, their fears andnecessity to explain complex problems. Nowadays, we witness sexual assaults, so that the role of colposcopy in victims of sexual abuse became inevitable and helpful tool from the medico legal point of the view. Summarizing all above mentioned we would point let colposcopy be the helper, not the servant of gynecology, or in Latin speech: »Non ancilla, sed adiutrix gynaecologiae colposcopia!«

Key words:
colposcopy, important anniversary, generations of creators


PERINATAL MORTALITY IN REPUBLIC OF CROATIA IN THE YEAR 2012 (Vol.22 Suppl 1, str.S47-S47)

Authors:

Josip Đelmiš,* Josip Juras,* Urelija Rodin**

Original paper

Summary:
In the Republic of Croatia in the year 2012. 42062 infants with birthweight ≥500 grams (516 more than in previous 2011) and 41911 infants with birthweight ≥1000 grams have been born. In the year 2012 the incidence of preterm infants was 6.4% and of those LBW 5.1%. Perinatal mortality for infants ≥1000 grams was 3.6‰ and for those ≥500 g 5.4‰. Fetal mortality for infants ≥1000 g was 2.7‰ and for those ≥500 g 3.6‰. The corresponding early neonatal mortality was 0.9‰ and 1.7‰. Eigth fetuses died intra partum i.e. 0.17‰. The early neonatal mortality decreases with increase of body weight: for infants 500–999 grams was 312.5‰, for those 1000–1499 g 53.4‰, for 1500–1999 g 7.5‰, for 2000–2499 g 2.3‰, and for infants ≥2500 grams 0.5‰. During pregnancy, labor or puerperium died three women, maternal mortality was 7.15/100.000. 12 ecclampsias were registered i.e. 0.29‰. By cesarean section were accomplished 8171 births i.e. 19.7%, there is increase (1.0%) in relation to the previous year 2011. The repeated CSs ormed 32.01% of all sections. Out of 3276 gravidas with previous CS in 68.6% the pregnancy was again accomplished by repeated CS. Out of 1415 breech presentations the 1110 (78.4%) of them were accomplished by CS. The antenatal care showed mild decrease in relation to previous year: the mean number of antenatal visits per pregnant patient was 8.5, the 77.7% of pregnant patients had ≥9 visits, the 25.6% of them ≥10 visits; however 3% of pregnant women had no visit or 1–2 visits, 9.5% 3–5 visits. The mean value of ultrasound examination was 4.6, the 77.8% of patients had ≥4 US examinatios, the 48.5% of them ≥5 examinations. In the 3-rd level hospitals, in those with NICU, the fetal, early neonatal and perinatal mortality were lower for infants 500–1499 grams. The primary task of the perinatal care in Croatia would be the institutional organization of the hospitals on the 3-rd and 2-nd level, with NICU units, along with additional supply of technology and human resources.

Key words:
perinatal mortality, maternal mortality, preterm delivery, ecclampsia, cesarean section, antenatal care


PERINATAL DEATH’S CAUSES IN CROATIA IN THE YEAR 2012 (Vol.22 Suppl 1, str.S63-S63)

Authors:

Urelija Rodin,* Boris Filipović-Grčić,** Marina Kos***

Original paper

Summary:
In the year 2012, the decreasing trend of perinatal mortality rate in the Republic of Croatia continued, accompanied by decreasing early neonatal mortality. Fetal mortality was on the same level. For the 2007–11 period, there were lower perinatal and fetal mortality rates but higher early neonatal mortality rates in Croatia than the average of Member States and WHO Eur-A countries. The lower early neonatal mortality was connected with significant survival from preterm births, mortality rate was 22.9/1.000 livebirths ‹37 gestational age in the year 2012 and 37.1/1.000 livebirths ‹37 gestational age in the year 2011. Preterm early neonatal deaths were 76% and stillbirths 73%. The leading causes of early neonatal deaths were congenital malformations in 32.1% cases, following by pregnancy-related complications in 29.5% perinatal infections in 19.2%, mother’s diseases/disorders (8.9%), immaturity without other diagnosis (6.4%), birth asphyxia (2.6%) and birth injury (1.3%). The leading causes of stillbirths were pregnancy-related complications in 38.9%, in the most cases connected with placenta and cord disorders (24.1% of all fetal deaths), mother’s diseases/disorders (16.7%), undetermined or unknown causes (14.8%), perinatal infection (12.3%), congenital malformations (10.5%) and birth asphyxia (1.9%).

Key words:
perinatal mortality, causes of perinatal deaths


PATTERNS OF NEWBORNS’ DEATHS TO DISCHARGE FROM HOSPITAL IN CROATIA IN THE YEAR 2012 (Vol.22 Suppl 1, str.S69-S76)

Authors:

Boris Filipović-Grčić, Željka Mustapić, Hrvoje Kniewald, Urelija Rodin, Ruža Grizelj, Jasminka Stipanović-Kastelić, Dorotea Ninković, Snježana Gverić-Ahmetašević, Milan Stanojević, Ivanka Antončić Furlan5, Branimir Peter, Vesna Milas, Jesenka Borošak, Ana Čolić, Linda Pavić, Karmen Magaš, Ivan Krajinović, Mirna Milevoj-Ražem, Svjetlana Razum

Original papers

Summary:
Early neonatal mortality (ENM) was in 2012 in Croatia for newborns of all birth-weights (BW), including those of BW <500 g 1.7 ‰, lower than the previous year. Neonatal mortality (NM) was also lower than 2011. (2.2‰ vs. 3.2‰), and almost half of the NM in the year 2009 (4.0‰). Mortality to discharge from hospital (MDH) was also reduced in comparison to the previous year (2,4‰ vs. 3.4‰), and considerably smaller than in 2009 (4.2‰). As much as 88.5% of infant deaths are caused by perinatal conditions, congenital anomalies and chromosomal abnormalities. ENM for all infants did 70.5% of MDH, and other 29.5% infants died after the first week of life. This shows decreasing ENM in 2012, and with regard to decreased MDH, it will be necessary to identify new factors that have influenced these results, especially in the early care within the first 7 days of life. In the year 2011 three fourths of newborns of BW <1500 g were born in maternities of 3rd level. Through the years the proportion of these infants born in maternities of 3rd level is increasing, but that proportion is decreasing in last two years. Comparisons of ENM and NM with some European countries show the possibility of further improvement in perinatal indicators.

Key words:
newborn, ELBW, VLBW, infant, mortality till discharge from hospital


Mjesto održavanja kongresa: Hotel President****, Split, Starčevićeva 1, www.hotelpresident.hr/split
Vrijeme održavanja kongresa: 22.- 24. listopad 2015.