Stališče ZPMS o preventivnem zdravljenju nosečnic s povečanim tveganjem za preeklampsijo z nizkoodmernim aspirinom

Preeklampsija je pomemben vzrok maternalne in neonatalne umrljivosti in obolevnosti po vsem svetu. Opredeljena je kot pojav povečanega arterijskega tlaka po 20. tednu nosečnosti s pridruženo proteinurijo in/ali disfunkcijo materinih organov ali zastojem plodove rasti. Medtem ko je smrt mater zaradi preeklampsije v razvitih državah manj pogosta, pa je obolevnost velika in pomembno prispeva k pogostosti sprejemov na oddelke za intenzivno nego in terapijo. Preeklampsija je vzrok za približno 15–20 % vseh prezgodnjih porodov, kar povečuje neonatalno umrljivost in dolgoročno obolevnost novorojenčkov. Aspirin v majhnem odmerku ima preventivni učinek na pojav preeklampsije le v primeru, če se začne jemati pred 16. tednom nosečnosti. Da bi odkrili, pri katerih nosečnicah je tveganje za preeklampsijo povečano, potrebujemo učinkovito presejanje, ki bo organizacijsko, cenovno in po učinkovitosti najprimernejše za izvajanje na primarni ravni

Principles of threedimensional ultrasound in gynecology and obstetrics

V zadnjih desetih letih je razvoj ultrazvočne diagnostike hiter, posebej na področju tri- in štiridimenzionalnega ultrazvoka. Namen članka je približati bralcu fizikalne osnove in možnosti uporabe teh tehnologij v ginekologiji in porodništvu. Opisani so načini prikaza informacij (prostornin), ki jih pridobimo s pomočjo tridimenzionalnega ultrazvočnega tipala. Predstavljeni so računalniški programi, ki se nahajajo v tridimenzionalnih ultrazvočnih aparatih in omogočajo merjenje in analizo prostornin. Podani so rezultati kliničnih študij, ki so analizirale različne možnosti uporabe tridimenzionalnega ultrazvoka pri reševanju problemov, s katerimi se srečujemo v ginekologiji in porodništvu.In the past ten years, development of ultrasound diagnostic technology has been very fast, especially in the field of three- and four-dimensional ultrasound. The purpose of this article is to familiarise the reader with the physical background and possible applications of these technologies in gynecology and obstetrics. Different display modes of information (volumes) acquired using a three-dimensional ultrasound probe are described. Software integrated in three-dimensional ultrasound machines, which offer the possibility of measurement and analysis of acquired volumes are presented. The results of clinical studies which evaluated the usefulness of three-dimensional ultrasound at solving different problems in gynecology and obstetrics are also reported

The Association of Vitamin D Levels with Common Pregnancy Complications

The association between vitamin D deficiency and various adverse pregnancy outcomes has been extensively investigated in recent years. The pregnant woman is the only source of vitamin D for the foetus. The main sources of vitamin D for pregnant women are sunlight, fortified dairy products, oily fish and dietary supplements. Vitamin D deficiency during pregnancy has been associated with some adverse neonatal outcomes as well as an increased risk of late pregnancy complications. The outcomes of the published studies investigating preeclampsia and gestational diabetes mellitus vary with some large trials suggesting a potential positive effect of vitamin D supplementation during pregnancy on the decreased risk of these complications. Research also suggests a possible connection between lower vitamin D concentrations and increased risk of preterm labour. In our manuscript, we aim to review the existing literature regarding the prevalence of vitamin D deficiency during pregnancy, the factors associated with vitamin D deficiency, and possible pregnancy complications arising from it

A Randomised Controlled Trial Comparing Induction of Labour with the Propess Vaginal System to the Prostin Vaginal Tablet in Premature Rupture of Membranes at Term

Aim: To compare the perinatal outcome and delivery intervals after the induction of labour with the Prostin vaginal tablet versus the Propess vaginal system in pregnant women with term-PROM. Design: One centre paralleled randomised controlled trial with a computer-generated table to allocate treatments. Setting: University Medical Centre in Slovenia. Participants: A total of 205 singleton healthy pregnant women with term-PROM. Intervention: Induction of labour with the Propess vaginal system (intervention group) versus Prostin tablets (control group). Main outcomes: The rate of failed inductions, complications in labour, time intervals between the PROM, induction, the beginning of the active phase, and delivery. Results: A total of 104 patients received Prostin, and 101 patients received Propess. Induction failure rates in the Prostin and the Propess groups were 8/104 (7.7%) and 5/101 (5.0%), respectively (p = 0.80). Delivery abnormalities were uncommon and comparable across the groups. The rates of caesarean sections in the Prostin and Propess groups were 4/96 (4.2%) and 6/96 (6.3%), respectively. The delivery intervals were comparable across the groups. Conclusions: In term-PROM pregnancies, the Propess vaginal system is a safe and effective option for inducing labour