A retrospective investigation of preterm birt h in breech presentation during the period of 26 years

Breech presentation is childbirth, during which may be expected higher perinatal mortality and morbidity when compared to cephalic presentation. The breech presentation complicates 20–35 % of preterm delivery. This group of neonates is exposed to hypoxic damages, as well as birth injuries with consequent intracranial hemorrhages. The mortality rate of preterm infants is much higher than the mortality of full-term infants. A higher risk of perinatal asphyxia and birth trauma makes obstetricians decide for operative completion by Cesarean section. Research methods. We conducted a retrospective study and analyzed and compared perinatal categories: perinatal mortality and morbidity, the mode of pregnancy completion, and the incidence of Cesarean section and vaginal delivery in six periods. Patients and research methods. The studied material was collected for the period of the past 26 years from the archives in the Department of Obstetrics and Gynecology. All singleton pregnancies with the breech presentation were analyzed, delivered either vaginally or by Cesarean section. Results. The incidence of Cesarean sections in preterm births with breech presentation gradually grows through the studied period. Obstetricians were increasingly opting for a Cesarean section in the situation of preterm birth and breech presentation, to eliminate traumatic and hypoxic damage, and thus tried to reduce perinatal mortality. The perinatal mortality rate of premature fetuses in a breech presentation who were delivered vaginally, according to numerous authors was statistically significantly higher compared to the perinatal mortality of premature neonates who were delivered by Cesarean section. Conclusion. The research emphasizes the importance of the completion of the premature birth of a child in the breech presentation by Cesarean section if the child is alive and there are no identifiable development defects

Ultrasound assessment of fetal weight in pregnancies burdened by diabetes

Gestacijski dijabetes melitus je opisan kao prolazni oblik dijabetesa izazvan inzulinskom rezistencijom i disfunkcijom β-stanica gušterače tijekom trudnoće, koji se prvi put javlja ili prvi put dijagnosticira u trudnoći. Dijabetes u trudnoći značajno ugrožava zdravlje majke povećanjem rizika razvoja preeklampsije, zatim oštećenjem endotelnih stanica predisponira majku na razvoj kardiovaskularnih bolesti i povećava rizik od nastanka dijabetesa melitusa tipa 2 kasnije u životu. Kod fetusa dolazi do mogućnosti razvoja makrosomije tijekom trudnoće, zatim respiratornog distres sindroma i hipoglikemije nakon porođaja. Makrosomija je definirana kao fetalna masa veća od 4 000 g ili 4 500 g, bez obzira na gestacijsku dob. Potrebno je na vrijeme prepoznati rizične čimbenike razvoja makrosomije, kako bi se na njih moglo utjecati. Trenutno se fetalna masa procjenjuje formulama koje koriste biometrijske parametre (biparijetalni promjer, opseg abdomena, opseg glave, duljina bedrene kosti) izmjerene ultrazvukom, no preciznost procjene pada sa porastom fetalne mase veće od 4 000g. Najčešće korištene formule za procjenu fetalne mase su Hadlock i Shepard, uz koje postoje još oko 30 drugih formula. Međutim, ni jedna nije dovoljno precizna u slučaju razvoja makrosomije. Točna dijagnoza makrosomije se može postaviti tek mjerenjem mase nakon porođaja. Sprječavanje komplikacija makrosomije se provodi dijagnosticiranjem i liječenjem gestacijskog dijabetesa melitusa.Gestational diabetes mellitus has been described as a transient form of diabetes caused by insulin resistance and pancreatic β-cell dysfunction during pregnancy, which first occurs or is first diagnosed in pregnancy. Diabetes in pregnancy significantly endangers the mother's health by increasing the risk of developing preeclampsia, then by damaging endothelial cells predisposes the mother to the development of cardiovascular diseases and increases the risk of developing type 2 diabetes later in life. The fetus may develop macrosomia during pregnancy, followed by respiratory distress syndrome and postpartum hypoglycemia. Macrosomia is defined as a fetal weight greater than 4000 g or 4500 g, regardless of gestational age. Risk factors for macrosomia need to be identified on time so that they can be influenced. Currently, fetal weight is estimated using biometric parameters (biparietal diameter, abdominal circumference, head circumference, femur length) measured by ultrasound, but the accuracy of the estimate decreases with an increase in fetal weight greater than 4000 g. The most commonly used formulas for fetal weight assessment are Hadlock and Shepard, together with about 30 other formulas. However, none is precise enough in the case of the development of macrosomia. An accurate diagnosis of macrosomia can only be made by measuring weight after birth. Prevention of complications of macrosomia is carried out by diagnosis and treatment of gestational diabetes mellitus

Ultrasound assessment of fetal weight in pregnancies burdened by diabetes

Gestacijski dijabetes melitus je opisan kao prolazni oblik dijabetesa izazvan inzulinskom rezistencijom i disfunkcijom β-stanica gušterače tijekom trudnoće, koji se prvi put javlja ili prvi put dijagnosticira u trudnoći. Dijabetes u trudnoći značajno ugrožava zdravlje majke povećanjem rizika razvoja preeklampsije, zatim oštećenjem endotelnih stanica predisponira majku na razvoj kardiovaskularnih bolesti i povećava rizik od nastanka dijabetesa melitusa tipa 2 kasnije u životu. Kod fetusa dolazi do mogućnosti razvoja makrosomije tijekom trudnoće, zatim respiratornog distres sindroma i hipoglikemije nakon porođaja. Makrosomija je definirana kao fetalna masa veća od 4 000 g ili 4 500 g, bez obzira na gestacijsku dob. Potrebno je na vrijeme prepoznati rizične čimbenike razvoja makrosomije, kako bi se na njih moglo utjecati. Trenutno se fetalna masa procjenjuje formulama koje koriste biometrijske parametre (biparijetalni promjer, opseg abdomena, opseg glave, duljina bedrene kosti) izmjerene ultrazvukom, no preciznost procjene pada sa porastom fetalne mase veće od 4 000g. Najčešće korištene formule za procjenu fetalne mase su Hadlock i Shepard, uz koje postoje još oko 30 drugih formula. Međutim, ni jedna nije dovoljno precizna u slučaju razvoja makrosomije. Točna dijagnoza makrosomije se može postaviti tek mjerenjem mase nakon porođaja. Sprječavanje komplikacija makrosomije se provodi dijagnosticiranjem i liječenjem gestacijskog dijabetesa melitusa.Gestational diabetes mellitus has been described as a transient form of diabetes caused by insulin resistance and pancreatic β-cell dysfunction during pregnancy, which first occurs or is first diagnosed in pregnancy. Diabetes in pregnancy significantly endangers the mother's health by increasing the risk of developing preeclampsia, then by damaging endothelial cells predisposes the mother to the development of cardiovascular diseases and increases the risk of developing type 2 diabetes later in life. The fetus may develop macrosomia during pregnancy, followed by respiratory distress syndrome and postpartum hypoglycemia. Macrosomia is defined as a fetal weight greater than 4000 g or 4500 g, regardless of gestational age. Risk factors for macrosomia need to be identified on time so that they can be influenced. Currently, fetal weight is estimated using biometric parameters (biparietal diameter, abdominal circumference, head circumference, femur length) measured by ultrasound, but the accuracy of the estimate decreases with an increase in fetal weight greater than 4000 g. The most commonly used formulas for fetal weight assessment are Hadlock and Shepard, together with about 30 other formulas. However, none is precise enough in the case of the development of macrosomia. An accurate diagnosis of macrosomia can only be made by measuring weight after birth. Prevention of complications of macrosomia is carried out by diagnosis and treatment of gestational diabetes mellitus

Ultrasound assessment of fetal weight in pregnancies burdened by diabetes

Gestacijski dijabetes melitus je opisan kao prolazni oblik dijabetesa izazvan inzulinskom rezistencijom i disfunkcijom β-stanica gušterače tijekom trudnoće, koji se prvi put javlja ili prvi put dijagnosticira u trudnoći. Dijabetes u trudnoći značajno ugrožava zdravlje majke povećanjem rizika razvoja preeklampsije, zatim oštećenjem endotelnih stanica predisponira majku na razvoj kardiovaskularnih bolesti i povećava rizik od nastanka dijabetesa melitusa tipa 2 kasnije u životu. Kod fetusa dolazi do mogućnosti razvoja makrosomije tijekom trudnoće, zatim respiratornog distres sindroma i hipoglikemije nakon porođaja. Makrosomija je definirana kao fetalna masa veća od 4 000 g ili 4 500 g, bez obzira na gestacijsku dob. Potrebno je na vrijeme prepoznati rizične čimbenike razvoja makrosomije, kako bi se na njih moglo utjecati. Trenutno se fetalna masa procjenjuje formulama koje koriste biometrijske parametre (biparijetalni promjer, opseg abdomena, opseg glave, duljina bedrene kosti) izmjerene ultrazvukom, no preciznost procjene pada sa porastom fetalne mase veće od 4 000g. Najčešće korištene formule za procjenu fetalne mase su Hadlock i Shepard, uz koje postoje još oko 30 drugih formula. Međutim, ni jedna nije dovoljno precizna u slučaju razvoja makrosomije. Točna dijagnoza makrosomije se može postaviti tek mjerenjem mase nakon porođaja. Sprječavanje komplikacija makrosomije se provodi dijagnosticiranjem i liječenjem gestacijskog dijabetesa melitusa.Gestational diabetes mellitus has been described as a transient form of diabetes caused by insulin resistance and pancreatic β-cell dysfunction during pregnancy, which first occurs or is first diagnosed in pregnancy. Diabetes in pregnancy significantly endangers the mother's health by increasing the risk of developing preeclampsia, then by damaging endothelial cells predisposes the mother to the development of cardiovascular diseases and increases the risk of developing type 2 diabetes later in life. The fetus may develop macrosomia during pregnancy, followed by respiratory distress syndrome and postpartum hypoglycemia. Macrosomia is defined as a fetal weight greater than 4000 g or 4500 g, regardless of gestational age. Risk factors for macrosomia need to be identified on time so that they can be influenced. Currently, fetal weight is estimated using biometric parameters (biparietal diameter, abdominal circumference, head circumference, femur length) measured by ultrasound, but the accuracy of the estimate decreases with an increase in fetal weight greater than 4000 g. The most commonly used formulas for fetal weight assessment are Hadlock and Shepard, together with about 30 other formulas. However, none is precise enough in the case of the development of macrosomia. An accurate diagnosis of macrosomia can only be made by measuring weight after birth. Prevention of complications of macrosomia is carried out by diagnosis and treatment of gestational diabetes mellitus