Current Issue - new design

 
 

Recommendation

Bolesti štitnjače u trudnoći

 

Read more...

Lijekovi u trudnoći i laktaciji

Read more...

 

 

Vol.20 No.2

Date: April 2011.

CONTENT:

INTRACYTOPLASMATIC SPERM INJECTION (ICSI) IN INFERTILITY TREATMENT. ANALYSIS OF 3.339 CONSECUTIVE CYCLES (Vol.20 No.2, str.65-71)

Authors:

Jure Knez, Veljko Vlaisavljevič, Borut Kovačić

Original paper

Summary:
Objective. Introduction of intracytoplasmic sperm injection (ICSI) represented an important step in male infertility treatment. Today it is used in more than half of assisted reproductive procedures. Our aim was to investigate the paternal influence on ICSI procedure outcome. Methods. A total of 3.339 ICSI cycles were included in the retrospective analysis. After exclusion of female factor infertility related cycles, 919 cases remained for detailed analysis. Patients were classified according to sperm analysis and ICSI outcome was evaluated. Results. In 3.339 cycles, oocyte fertilization rate was 74%. There were 1.134 clinical pregnancies (34% per cycle) and 942 deliveries (28% per cycle). Comparing ICSI with testicular spermatozoa to ICSI with ejaculated spermatozoa, lower fertilization rate (64% vs. 73%, p<0.05), blastulation rate (40% vs. 53%, p<0.05) and day 5 blastocyst transfer rate (65% vs. 78%, p<0.05) can be observed. Among the cycles using ejaculated spermatozoa, cryptozoospermia shows a negative effect on fertilization rate (50%, p<0.05) and blastocyst development (43%, p<0.05), but does not influence clinical pregnancy (44%, p>0.05) and delivery rates (41%, p>0.05). Conclusion. Very low sperm concentration and motility can predict low fertilization rate and slow embryo development after ICSI. The possibility of high quality embryo selection for transfer on day 5 allows high delivery rates in different groups of patients treated with ICSI using ejaculated or testicular spermatozoa.

Key words:
intracytoplasmic sperm injection, ICSI, sperm concentration, sperm motility, paternal effect, ICSI results


DELIVERIES IN SMALL MATERNITIES IN CROATIA (Vol.20 No.2, str.72-79)

Authors:

Ante Dražančić,* Urelija Rodin***

Original paper

Summary:
Objective. To analyze in 10-years period the deliveries and newborns in small Croatian maternities, i.e. in those with less than 500 deliveries per year and compare them to out-hospital maternities where the cesareans were not feasible. Material and methods. In Croatian small maternity hospitals (Vukovar, Na{ice, Nova Gradi{ka, Ogulin, Gospi} and Knin) at the period 2000–2009 were delivered 20.968 newborns with birth-weight ³500 grams. Investigated were the fetal, early neonatal and perinatal mortality, the rate of preterm deliveries, of cesarean section and vacuum extractions were investigated and correlated to out-hospital deliveries. Results. Through 10 years the fetal mortality was 4,2‰, early neonatal 1,50‰ and the perinatal 5,7‰. The perinatal mortality was significantly lower than the Croatian average for all maternities, but significantly higher than for out-hospital maternities. Among single maternity wards exist significant differences in perinatal mortality. The rate of preterm deliveries was 2,62%, significantly less than is Croatian average (5,0%), but significantly over the average in out-hospital maternities (0,94%). By CS were born 15,14% of newborns, significantly less than Croatian average. The Cesarean Section deliveries were different in single maternities, from 8,0% to 20,4%; the average was 15,14%. By vacuum extraction every year less and less births were accomplished, the rates were decreased for all maternities (1,70%®0,98%), for small hospitals (0,79%®0,59%) and for out-hospital maternities (3,67%®0,48%). Maternal mortality for all Croatia was 9,75/100,000, at small hospitals 4,76/100,000 and in out-hospital maternities 7,77/100.000, the difference between them is not significant. Conclusion. The primary task of small hospital maternities, like of those out-hospitals, is a well antenatal screening and the birth by vaginal route or by CS of newborns in whom the complications are not expected; the pregnant women in whom the complications are expected should be transfered to the higher degree maternity hospital.

Key words:
small maternity hospitals, out-hospital maternities, perinatal mortality, preterm deliveries, cesarean section, vacuum extraction, maternal mortality

 


FETAL ANOMALIES AS THE INDICATION FOR TERMINATION OF PREGNANCY IN A TERTIARY FETAL ANOMALY SCREENING CENTER (Vol.20 No.2, str.80-84)

Authors:

Khalid Abed Sumayah, Aleah A. K. A. Montathar, Ahmed Badreldeen

Original paper

Summary:
Objectives. To assess the incidence of fetal anomalies by ultrasound as the indication for termination of pregnancy (TOP) in the tertiary fetal anomaly screening center. Methods. A routine 18–20 weeks anomaly scan was offered to all pregnant women. Prenatal invasive procedures including chorionic villous sampling, amniocentesis, and cordocentesis were performed when indicated. After diagnosis of fetal anomaly, the couple was counseled by multidisciplinary medical team concerning the management options, place and method of TOP. Results. A retrospective study was conducted between 2003 and 2009 at Feto Maternal Unit of the Women’s Hospital, Hamad Medical Corporation in Qatar. Elective TOP for fetal anomaly was offered and accepted by 117 women (114 singleton and 3 twin pregnancies) at gestational age ranging between 6 and 29 weeks. There were 96026 registered births during the study period. The rate of termination of pregnancy was 11.1 per 10,000 registered births. The mean gestational age at diagnosis was 15.7±4.6 gestational weeks (GW) and at TOP it was 17.3±4.8 GW. The majority of TOP were performed because of central nervous system (CNS) defects (29.1%), multiple malformations (20.5%), and chromosomal abnormalities (18.8%). Trisomies 21 and 18 were the leading indications among chromosomal anomalies. Chorionic villous sampling was done in 55.6%, and amniocentesis in 44.4% of patients. TOP methods were as follows: vaginal misoprostol in 59.8%, misoprostol and curettage in 36.8%, and only curettage in 3,4%. Post evacuation morbidity was not diferent. Conclusion. Improvements in diagnostic ultrasound with prenatal diagnostic procedures have resulted in early diagnosis and clear indications for TOP in our patients. False positive indications for TOP were not noted in the population during investigated period.

Key words:
fetal anomalies, ultrasound screening, chorionic villous sampling, amniocentesis, cordocentesis, termination of pregnancy.


ADIPOKINES AND PREGNANCY (Vol.20 No.2, str.85-90)

Authors:

Danko Bljajić, Marina Ivanišević, Josip Juras, Josip Đelmiš

Review

Summary:
Adipocytes secrete numerous compounds having endocrinic, paracrinic and autocrinic effects: leptin, adiponectin, resistin, visfatin, angiotensinogen, PAI-1, TNF-a, interleukin-6, ASP (an acylation stimulating protein). Adipokines play an important role in the intake and consumption of energy, the activity of insulin, metabolism of fats and carbohydrates and in angiogenesis, regulation of blood pressure and coagulation. The data from literature and authors results from following adipokines: leptin, adiponectin, TNF-a, and resistin are presented. Obesity leads to increased secretion of all the adipokines with the exception of adiponectin, as its secretion is reduced in obesity. Increased concentrations of leptin, TNF-a, and resistin, and reduced secretion of adiponectin lead to the development of insulin resistance.

Key words:
adipokines, pregnancy, adiponectin, resistine, leptin, TNF-a


NEONATAL RISKS OF LATE PRETERM INFANTS (Vol.20 No.2, str.91-94)

Authors:

Mirta Starčević, Jasna Tumbri*

Professional paper

Summary:
Objective. »Late preterm infants«, defined by birth at 340/7 through 366/7 weeks’ gestation are often the size and weight of some term infants, but immaturity predisposes them for a variety of medical complications. Methods. Retrospectively the association between weight for the gestational age cathegory and late preterm morbidity of 82 »late preterm« infants: 30 small for gestational age (SGA) and 52 appropriate for gestational age (AGA)were analyzed. Results. Feeding difficulties, temperature instability and apnea rates did not differ between the SGA and AGA groups. The frequency of hyperbilirubinaemia and transient tachypnea was similar in both groups. SGA infants were found to be at a higher risk of hypoglycemia and sepsis, as well as ultrasound brain lesions (particularly periventricular leucomalacia). Time of hospitalization was longer in this group, too. Pregnancy complications were common in both groups. Hypertension, delivery induction and cesarean section rates were higher in the SGA group. Conclusion. Late preterm births are associated with pregnancy complications as well as neonatal morbidity with the need for intensive care. Weight for gestational age affects the morbidity of late preterm infants. Being SGA increases the risk of early complications. Clinicians caring for late preterm newborns should be aware of these risk factors.

Key words:
late preterms, morbidity, weight for gestational age


ULTRASOUND DIAGNOSIS OF AN ATRIOVENTRICULAR SEPTAL DEFECT IN THE 12+0 WEEKS OF PREGNANCY (Vol.20 No.2, str.91-94)

Authors:

Vesna Harni*, Samo Vesel**, Željko Duić***

Case report

Summary:
------

Key words:
------


THE LETTER OF JOANNIS BAPTISTE LALANGUE TO THE VARA@DIN DISTRICT – THE CONTRIBUTION TO ORIGINS OF MIDWIFERY IN CROATIA (Vol.20 No.2, str.100-106)

Authors:

Rajko Fureš,* Alojz Jembrih**

Review

Summary:
John the Baptist Lalangue was the author of the first Croatian textbook of midwifery »Brevis institutio de re obstetritia« or »Short learning of the navel mastership for the use of the men and poor rustic people of Croatian kingdom and close to them countryside«, Zagreb 1977. Based on new researches, up to now unpublished and unsystemized documents, Lalangue was the founder of the first Croatian midwifery school at Vara`din. Lalangue created the school soon after his arrival to Croatia i.e. in at that time capital – Vara`din. The Vara`din’s midwife school dates from the year 1776, perhaps and earlier. In the paper the Lalangue’s letter to the Vara`din district dated December, 10-th 1785 is analyzed. The letter is a scientific proof that Lalangue, by help of a midwife Elizabeth Gärtin, has surely started the midwife learning school. Besides his first midwifery textbook the Lalangue insures to schoolgirls the necessary tools for practical teaching. The mentioned Lalangue’s letter has to be an encouragement to research the history of Croatian midwifery.

Key words:
Lalangue John Baptist, midwifery, obstetrics, history of medicine


Simpozij o najsuvremenijim metodama u liječenju stresne urinarne inkontinencije u žena. (Vol.20 No.2, str.107-107)

Authors:

Rajko Fureš

Meeting report

Summary
*

Key words:
*


Marina Kos i Tanja Leniček:OSNOVE PATOLOGIJE POSTELJICE (Vol.20 No.2, str.107-107)

Authors:

Ante Dražančić*

Book review

Summary
*

Key words:
*

 


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