Perinatal mortality of preterm twins

Ispitana je perinatalna smrtnost prijevremeno rođenih blizanaca (do 37. tjedna) u Šibeniku, Zadru i Splitu u razdoblju od 1. siječnja 1988. do 31. prosinca 1990. godine (Period A) i od 1. siječnja 1991. do 30. rujna 1993. godine (Period B). Period A je vrijeme društveno političkih previranja u bivšoj Jugoslaviji, a Period B je vrijeme izravne vojne agresije. U Periodu A je bilo 23826 porođaja, od kojih je 234(0,98%) blizanačkih, a u Periodu B na 22292 porođaja 260(1,17%) su porođaji blizanaca. U periodu A nalazimo 140(29,9%), a u Periodu B 198(38,1%) prijevremeno rođenog blizanca (X 2 = 7,28; P0.05). Da je perinatalna smrtnost blizanaca u Periodu B bila kao u Periodu A, tada bi 14 blizanaca prijevremeno rođenih ostalo u životu. Autori zaključuju da je izravna vojna agresija na područje Šibenika, Zadra i Splita u trudnica sa blizancima prouzročila s jedne strane slabu neonatalnu zaštitu, ili je potpuno onemogućila, a s druge strane prouzročila je fizičke i psihičke traume, što je udruženo dovelo do povećanog prijevremenog rađanja blizanaca, posebice blizanaca do 31. tjedna trudnoće, povećanog rađanja blizanaca porođajne težine do 1499 g, s posljedičnim visokim perinatalnim mortalitetom. Izravna vojna agresija je neizravno prouzročila smrt 14 blizanaca, koji su prijevremeno rođeni.Perinatal mortality of preterm twins (up to 37 weeks of gestation) is analyzed, born in Šibenik, Zadar and Split in the two examined periods of time. Period A (1st January 1988 - 31st December 1990) is the time of socio-political turmoil in ex-Yugoslavia, whereas Period B (1st January 1991 - 30th September 1993) is the time of the direct military aggression on the area in question. In the Period A there were 23826 births, 234 (0.98%) of which were twins. Out of 22292 births in the Period B, 260 twins (1.17%) were born. In the Period A 140 twins (29-9%) were born prematurely, compared to 198 (38.1%) in the Period B (X2 = 7.28; pcO.Ol). Twin births before 31 weeks of pregnancy occurred less frequently in the Period A than in the Period B (4.3% :10.1%). Similarly, in the Period A there were less twins of the birthhweight under 1500 g (4.3% -14.7%) (p0.05). Had the perinatal mortality in the Period B been the same as in the Period A (and one should have expected even lower mortality rates), 14 premature twins would have lived. The authors draw a conclusion that the direct military aggression on the regions of Šibenik, Zadar and Split caused on the one hand poor or no antenatal care and on the other hand physical and psychological traumas to pregnant women. This led to an increased number of premature twin births, especially before 31st week of gestation, higher number of twins of birth weight under 1500 g and consequently to a high perinatal mortality. Direct military aggression indirectly caused the death of 14 premature twins

Effect of Parental Anthropometric Parameters on Neonatal Birth Weight and Birth Length

Data on 550 healthy pregnant women, 550 healthy fathers and their healthy term neonates born from singleton pregnancies (37+0 through 41+6 week) during a one-year period were reviewed. Maternal mean age was 27.79.37 years, mean pregestational weight 64.09.50 kg, mean gestational weight gain 15.44.33 kg, mean height 169.75.81 cm, and mean gestational age 40.10.95 weeks. Paternal mean age was 31.46.22 years, mean weight 84.610.35 kg, and mean height 182.86.84 cm. Mean birth weight was 3,709.8500.48 g and 3,562.5443.02 g, and mean birth length 51.51.91 cm and 50.71.62 cm in male and female newborns, respectively, yielding a birth weight greater by 147.3 g and birth length by 0.8 cm in the former. Study variables showed statistically significant correlations: maternal age contributed to the significant correlation between maternal weight and parity, maternal pregestational weight, weight at delivery, gestational weight gain and body height correlated significantly with neonatal birth weight and birth length, gestational age correlated significantly with neonatal weight and length (p=0.01 all), parity had no major impact (p>0.05). Paternal height and weight correlated significantly with neonatal birth weight and birth length (p=0.01). Study results pointed to a significant correlation of maternal pregestational weight, gestational weight gain and body height, and of paternal weight and height with the neonate birth weight and birth length

Psoas abscess as the first manifestation of Crohn’s disease – case report

A case of 16-year-old female with secondary psoas abscess as the complication of the Crohn’s disease was analysed. Her pre-hospital, long lasting, non-specific symptoms led to ultrasound (US) and radiologic imaging confirming the diagnosis. The antibiotic treatment was insufficient and worsening of the patient’s condition required surgical treatment including descendent colectomy, abscess drainage and negative pressure wound therapy (NPWT). In spite of numerous complications the condition of the child gradually improved and she was discharged from the hospital on the 71st postoperative day. Two years after the colectomy, the occlusion of her colostomy was performed

RETROPERITONEAL ABSCESS IN PREGNANCY

Retroperitonealni apsces je stanje koje se rijetko susreće u trudnoći. Češće se viđa nakon poroda, pobačaja ili carskog reza. Etiološki može biti primarni, nastao hematogenim putem, ili sekundarni, razvijajući se iz intraperitonealnih struktura, poglavito dijelova probavnog trakta koji naliježu na m. psoas. Prikazan je slučaj 27-godišnje drugorotkinje s verificiranim retroperitonealnim apscesom, liječene kirurškom incizijom i drenažom apscesa koja je uz antibiotsku terapiju i pojačanu njegu uredno iznijela trudnoću i rodila zdravo, donošeno dijete. Primarna bolest je kirurški zbrinuta u puerperiju.Retroperitoneal abscess in pregnancy is rarely encountered condition. It is more frequently reported to occur subsequent to deliveries, abortions or caesarean sections. Primary abscesses of this localization develop via hematogenous route. Alternatively, secondary abscesses result from a direct extension of an infectious process into retroperitoneum, expecially from infected parts of digestive tract adjacent to psoas muscle. We reeport on 27-year secundigravida with verified retroperitoneal abscess, treated with surgical incision and drainage of the abscess. Supported by causal antibiotic therapy and intensive care measures the patient completed the course of pregnancy and vaginally gave birth to healthy, term, newborn. Primary disease was solved by surgery following delivery