The outcomes of triplet pregnancies

Introduction. Extensive use of assisted reproduction has resulted in an increased incidence of triplet pregnancies, which are associated with higher risk of complications in mothers and newborns. Material and Methods. A retrospective study reviewed a total of 85 triplet pregnancies delivered at the Department of Obstetrics and Gynecology, Clinical Center of Vojvodina, Novi Sad, from January 1, 2010 to December 31, 2017. Results. The average maternal age was 32 years and the average body mass index was 30.56 kg/m2. The average gestational age at birth was 32 weeks. One patient (1.18%) had vaginal delivery, while 84 (98.82%) pregnancies were completed by cesarean section. The average blood loss was 1294 ml and there was one postpartum hysterectomy. The most common maternal pregnancy-induced complications were sideropenic anemia (70.58%), hypertensive syndrome (40%) and obstetric cholestasis (35.29%). Preterm premature rupture of membranes was observed in 17 (20%) patients. Prophylactic cerclage was performed in 57 patients (67.05%) and 12 patients (14.11%) received tocolytic therapy. The average birth weight of the first newborn was 1838 g, 1755 g of the second, and 1695 g of the third. Body weight ? 1500 g was observed in 61 newborns (24.01%). The mean Apgar score in the first minute was 7, while in the fifth minute it was 8. Respiratory distress syndrome was found in 64 newborns (25.19%). Conclusion. Monitoring and treatment of triplet pregnancies remains a complex task for obstetricians due to the increased incidence of prematurity and perinatal morbidity.

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Nylon-Darn herniorrhaphy: The method of choice in treatment of primary inguinal hernia

Medicinski pregled ◽

10.2298/mpns0812566i ◽

2008 ◽

Vol 61 (11-12) ◽

pp. 566-570

Author(s):

Dejan Ivanov ◽

Sinisa Babovic ◽

Mirjana Ivanov

Keyword(s):

Inguinal Hernia ◽

Intraoperative Complications ◽

Operative Procedure ◽

Endocrine Surgery ◽

Perioperative Mortality ◽

Advantages And Disadvantages ◽

Primary Inguinal Hernia ◽

Clinical Center ◽

The Mean ◽

Novi Sad

Introduction Nylon-Darn herniorrhaphy is a classic, open technique, simple to perform with a low recurrence rate. It is a 'tension-free' method of herniorrhaphy. The aim of study was to analyze the results of Nylon-Darn herniorrhaphy at our clinic and point out advantages and disadvantages of the technique. Material and Methods This study, dating back to May 1999 and up to May 2005, included 116 patients who underwent Nylon-Darn herniorrhaphy for primary inguinal hernia. Patients were operated at the Clinic for abdominal and endocrine surgery, Institute of surgery, Clinical center Novi Sad and if without complications, left on the first postoperative day. Two patients had cholelithiasis and laparoscopic cholecystectomy was performed simultaneously. Intra- and postoperative complications were analyzed. Results The overall complication rate in our study was 22.4%. There was no perioperative mortality and intraoperative complications. The mean age of 112 males and 4 females was 51 years. An average duration of the operative procedure was 49.2 min, and the patients left hospital after 2.17 days. General endotracheal anestesia was performed in 69 cases and spinal in 47. Conclusion Based on the results of Nylon-Darn herniorrhaphy in our study and on the results in the literature, this technique could be the method of choice for primary inguinal hernia repair. It is suitable for registrars and young surgeons working in clinics not specialized in this pathology.

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Novel Physique Index for the Screening of Skeletal Dysplasia at Birth

Children ◽

10.3390/children8050331 ◽

2021 ◽

Vol 8 (5) ◽

pp. 331

Author(s):

Ryoji Aoki ◽

Nobuhiko Nagano ◽

Aya Okahashi ◽

Shoko Ohashi ◽

Yoshinori Fujinaka ◽

...

Keyword(s):

Birth Weight ◽

Skeletal Dysplasia ◽

Operating Characteristic ◽

Area Under The Curve ◽

Roc Curves ◽

Regression Equations ◽

Fetal Ultrasound ◽

The Mean ◽

Gestational Age At Birth ◽

Age At Birth

This study aimed to devise a novel physique index and investigate its accuracy in identifying newborns with skeletal dysplasia in comparison with head circumference (HC)/height (HT) ratio. The birth weight (W), HT, and HC at birth of 1500 newborns were retrospectively collected. The linear regression equations and coefficients of determination (R2) were determined. The formulated equation was corrected by the mean weight for gestational age at birth (Wcorr) as a novel physique index for screening skeletal dysplasia. The index accuracy was assessed using receiver operating characteristic (ROC) curves in 11 newborns by fetal ultrasound and compared with that of the HC/HT ratio. The R2 values between W and HT, (HT)2, and (HT) 3 were 0.978, 0.990, and 0.993, respectively. Those between W and HC, (HC)2, and (HC)3 were 0.974, 0.984, and 0.988, respectively. W/Wcorr × (HC/HT)3 was used as a novel physique index. Seven newborns had skeletal dysplasia. Our novel physique index had a higher area under the curve (AUC), sensitivity, and specificity than the HC/HT ratio (AUC: 1.00 vs. 0.86, sensitivity: 1.00 vs. 0.86, and specificity: 1.00 vs. 0.75, respectively). Our novel physique index was more accurate than HC/HT ratio and has the potential to accurately identify newborns with skeletal dysplasia.

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Dynamics of Asio otus L., 1758 (Aves: Strigiformes) winter-spring trophic regime in Western Plain (Romania)

Travaux du Muséum National d’Histoire Naturelle “Grigore Antipa” ◽

10.2478/v10191-010-0033-4 ◽

2010 ◽

Vol 53 (1) ◽

pp. 479-487

Author(s):

Ana Benedek ◽

Ioan Sîrbu

Keyword(s):

Seasonal Variation ◽

Body Mass ◽

Significant Variation ◽

Alternative Food ◽

Microtus Arvalis ◽

Main Prey ◽

Group A ◽

Average Body Mass ◽

The Mean ◽

Average Body

Dynamics of Asio otus L., 1758 (Aves: Strigiformes) winter-spring trophic regime in Western Plain (Romania) The trophic regime of Asio otus is dominated by Microtus arvalis. In both areas the proportion of this species in the long-eared owl's food presents an important seasonal variation. In winter it moves usually through tunnels under the snow, thus being less frequently hunted. When the main prey is scarce, alternative food resources are exploited, in these areas mice, which become dominant as a group. A significant variation is recorded also by the mean biomass of preys of Asio otus from Satu Mare. The average body mass increases with one third from January to March, when the efficiency of hunt is maximum.

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Effect of diode laser cyclophotocoagulation in treatment of patients with refractory glaucoma

Vojnosanitetski pregled ◽

10.2298/vsp1501016c ◽

2015 ◽

Vol 72 (1) ◽

pp. 16-20 ◽

Cited By ~ 3

Author(s):

Vladimir Canadanovic ◽

Ljiljana Tusek-Ljesevic ◽

Aleksandar Miljkovic ◽

Sava Barisic ◽

Tatjana Bedov ◽

...

Keyword(s):

Diode Laser ◽

Panretinal Photocoagulation ◽

Safe Procedure ◽

Refractory Glaucoma ◽

Group I ◽

Clinical Center ◽

The Mean ◽

Group Ii ◽

Novi Sad ◽

Diode Laser Cyclophotocoagulation

Background/Aim. Refractory glaucoma is glaucoma resistant to conventional management (maximally tolerated medical therapy, one or more glaucoma surgeries) and glaucoma in cases of neovascularisation after panretinal photocoagulation or cryoablation. The aim of the study was to determine the intraocular pressure (IOP) lowering efficacy of transscleral diode laser cyclophotocoagulation (DCPC) treatment in the management of pain and IOP in patients with refractory glaucoma. Methods. This nonrandomized, retrospective study, included 95 patients (95 eyes) with refractory glaucoma treated at the University Eye Clinic, Clinical Center of Vojvodina, Novi Sad, Serbia, between November 2007 and November 2012 in accordance with the established protocols (16-18 spots, 270?, up to 5J of energy). All the eyes were treated with transscleral DCPC (Iris Medical OcuLight SLx, Iridex Co, Mountain View, USA). Patient's symptoms, bests corrected visual acuity and IOP were recorded 7 days, and 1, 3 and 6 months after the DCPC treatment. Results. Out of 95 patients (95 eyes) enrolled in this study 24 (25.2%) were with primary (the group I), and 71 (74.5%) with secondary (the group II) glaucoma. The mean baseline IOP in these two groups was similar: 36.08 ? 8.39 mmHg for the first group and 37.36 ? 8.19 mmHg in the second group. Measurement of the mean IOP in the group I showed the following results: on the day 7 it was 13.96 ? 8.30 mmHg (62.1% decrease of the baseline value), on the day 30 it was 18.44 ? 8.85 mmHg (48.9% decrease regarding the baseline value), after 3 months it was 22.44 ? 7.36 mmHg (37.8% decrease regarding the baseline value), and after 6 months it was 25.92 ? 7.65 mmHg (28.2% decrease regarding the baseline value). Measurement of IOP in the group II showed the following results: on the day 7 it was 15.77 ? 9.73 mmHg (57.8% decrease of the baseline value), on the day 30 it was 20.14 ? 10.20 mmHg (46.1% decrease regarding the baseline value), after 3 months it was 23.46 ? 9.83 mmHg (37.2% decrease regarding the baseline value) and after 6 months it was 27.23 ? 9.87 mmHg (27.2% decrease regarding the baseline value). Pain was the main symptom in 70 (73.6%) patients before the treatment and it persisted in only 4 (4.2%) of our patients. Other complaints (burning, stinging, foreign body sensation) were experienced by 39 (41%) of the patients, postoperatively. A total of 52 (54.7%) patients had no complaints after the treatment. Conclusion. Our study confirmed that transscleral DCPC is a useful, effective and safe procedure with predictable amount of IOP decrease, which makes it the treatment of choice for refractory glaucoma.

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Perinatal follow up and neonatal outcomes of pregnancies with obstetric cholestasis

Medicinski pregled ◽

10.2298/mpns2102011k ◽

2021 ◽

Vol 74 (1-2) ◽

pp. 11-14

Author(s):

Anita Krsman ◽

Branislava Baturan ◽

Ana Lazarevic ◽

Zorica Grujic ◽

Djordje Petrovic ◽

...

Keyword(s):

Maternal Age ◽

Acid Level ◽

Distress Syndrome ◽

Maternal Deaths ◽

Bile Acid Level ◽

Clinical Center ◽

Fetal Complications ◽

The Mean ◽

Novi Sad

Introduction. Obstetric cholestasis is the most common liver disease during pregnancy, which is predominantly associated with fetal complications. Material and Methods. This retrospective study included a total of 44 pregnant women with obstetric cholestasis who gave birth at the Clinic of Obstetrics and Gynecology, Clinical Center of Vojvodina, Novi Sad, from January 1, 2014 to December 31, 2018. Results. The average maternal age was 34 years. The mean gestational age at diagnosis of obstetric cholestasis was 31 weeks, and at the time of delivery 35 weeks of gestation. Abdominal pruritus was the main symptom of the disease affecting 72.72% of patients. The mean bile acid level in the blood at the time of diagnosis was 25.26 ?mol/L. Twenty nine patients (65.90%) gave birth vaginally, while 15 (34.09%) underwent cesarean section. The main maternal complication was postpartum hemorrhage. The average blood loss was 567 ml. There were no maternal deaths or stillbirths. The average newborn birth weight was 2830 g. Respiratory distress syndrome was diagnosed in 8 newborns (15.09%). The mean Apgar score at 1minute was 7, while at 5 minutes it was 9. Conclusion. Individual approach, continuous clinical and laboratory monitoring with adequate therapeutic treatment are necessary in patients with obstetric cholestasis.

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Suprapubic laparoscopic cholecystectomy: technique and preliminary results

ABCD Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) ◽

10.1590/s0102-67202014000100006 ◽

2014 ◽

Vol 27 (1) ◽

pp. 22-25 ◽

Cited By ~ 1

Author(s):

Leonardo Adolpho S. SALES ◽

João Odilo G. PINTO ◽

Carlos Eduardo F. QUEIROZ ◽

Marcelo CASTRO ◽

Paulo Henrique F. DOURADO ◽

...

Keyword(s):

Body Mass Index ◽

Body Mass ◽

Cystic Duct ◽

Biliary Colic ◽

Average Body Mass Index ◽

Preliminary Results ◽

Average Body Mass ◽

The Mean ◽

The Right ◽

Average Body

Background : The minimally invasive abdominal surgery has evolved to reduce portals, culminating with a single incision and natural orifice operation. However, these methods are still expensive, difficult to implement and with questionable aesthetic results. Aim : To present the standardization and preliminary results of a technique for performing laparoscopic suprapubic access by the principle which was called the Supra Pubic Endoscopic Surgery for cholecystectomy. Method : The average body mass index of patients, the mean operative time, clinical data of the postoperative complications and quality of life were prospectively studied. The operation incisions consisted of: A) umbilical for instrumental dissection and clipping; B) in the right groin for handling and gallbladder gripping; C) suprapubic for the camera. With the patient in reverse Trendelenburg and left lateral decubitus, the operation flew by the camera trocar in C, proceeding with dissection and isolation of the biliary pedicle, identification of cystic duct and artery, with usual instrumentation. Transcystic intraoperative cholangiography was performed in all cases in which there were indications. The procedure was completed with clipping and sectioning of the cystic duct and artery, retrograde resection of the gallbladder and extracting it by the umbilical trocar incision under direct vision. Results : Thirty patients undergone this surgical procedure between March and June 2012 and were evaluated. The mean age was 40.7 years and the indications were typical biliary colic in 18 cases (60 %), cholecystitis in five cases (16.6 %), biliary pancreatitis in one case (3.3%); polyp in three cases (10%) and obstructive jaundice at three cases (10%). The average body mass index was 27.8 (23.1-35.1) and surgical time ranged between 24 and 70 minutes. Conclusion : The technique proved to be feasible and safe , with no significant complications, and satisfactory cosmetic results.

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Refractive Status in Children with Laser-Treated Retinopathy of Prematurity: Our Experience in Bulgaria

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2019.309 ◽

2019 ◽

Vol 7 (8) ◽

pp. 1320-1323

Author(s):

Nevyana Veleva ◽

Violeta Chernodrinska

Keyword(s):

Visual Impairment ◽

Retinopathy Of Prematurity ◽

Refractive Errors ◽

Refractive Status ◽

The Mean ◽

Gestational Age At Birth ◽

Age At Birth ◽

High Hyperopia

BACKGROUND: With the establishment of laser photocoagulation as a standard treatment modality for prethreshold retinopathy of prematurity (ROP), a dramatic reduction of cases with ROP blindness and severe visual impairment have been reported. In the same time, high refractive errors, a common complication in ROP cases and especially in ROP treated infants, have become the main cause of visual and often severe visual impairment. AIM: The purpose of our study was to analyse the long-term refractive status in children at 3.5 years after laser-treatment for type 1 prethreshold ROP. PATIENTS AND METHODS: A retrospective, one centre study of refractive status of 18 children with laser-treated type 1 prethreshold ROP was conducted. The refraction after cycloplegia with 1% cyclopentolate was measured at a mean age of 3.56 years (SD ± 0.34). Hyperopia was subdivided into two groups – low hyperopia (SE < +5.0 D) and high hyperopia (SE ≥ +5.0 D). Myopia was classified as myopia (SE ≥ –0.25D) and high myopia (SE ≥ -5.0 D). Astigmatism was divided into low astigmatism (plus CD ≥ +1.0 D) and high astigmatism (plus CD ≥ +2.0 D). RESULTS: Thirty-three eyes of 18 children were recruited in the study. Three eyes were excluded because of unfavourable anatomical results. The mean gestational age at birth was 27.3 weeks (24-31 weeks, SD ± 1.78), and the mean birth weight – 928.9 g (550-1500 g, SD ± 252.8). The mean spherical equivalent for the whole group was -1.82 D and ranged from -9.00 D to +4.50 D (SD ± 3.48). Hyperopia was observed in 12 (36.4%) eyes. Myopic refraction had 21 (63.6%) eyes. Astigmatism was detected in 18 (54.5%) eyes. Anisometropia had 3 (16.7%) children. Six children (33.4%) had strabismus (4 esotropia; 2 exotropia). CONCLUSION: High per cent of treated infants for vision-threatening ROP have visual significant refractive errors and strabismus that can cause serious visual impairment if not treated properly and on time.

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Putting Knowledge into Practice—The Challenge of Acquiring Healthy Habits during Pregnancy

Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics ◽

10.1055/s-0039-1692633 ◽

2019 ◽

Vol 41 (08) ◽

pp. 469-475

Author(s):

Ana Carolina Godoy-Miranda ◽

Jessica Fernandes Cirelli ◽

Maira Pinho-Pompeu ◽

Daiane Sofia Morais Paulino ◽

Sirlei Siani Morais ◽

...

Keyword(s):

Pregnant Women ◽

Cross Sectional Study ◽

Obstetric Outcomes ◽

Cross Sectional ◽

Gestational Weight ◽

Healthy Habits ◽

Sociodemographic Data ◽

Average Body Mass ◽

The Mean ◽

Average Body

Objective The aim of this study was to investigate the knowledge concerning gestational weight gain (GWG), nutrition, and physical exercise (PE) in pregnant women, and how to put them into practice. Methods A cross-sectional study with 61 pregnant women above 26 weeks of gestation, at the Woman's Hospital, CAISM, University of Campinas. Questionnaires regarding the knowledge of healthy habits (HH) during pregnancy, sociodemographic data, and previous obstetric outcomes were applied. An educational guide with advice on HH during pregnancy and in the postpartum period was offered. Results The average age of women was 28.7 ± 6.23 years, with 85% of them being married; 32% nulliparous; the average body mass index (BMI) before pregnancy was 25.4 ± 9.8 kg/m2, and the mean number of years of schooling was 11.2 ± 3.8. Only 61% of the subjects had received any previous information about GWG during their antenatal care and were aware as to how many pounds they should gain during pregnancy. Among the 61 women, 85% understood that they did not need to “eat for 2” and 99% knew that PE had benefits for their body and was safe for their baby. Half of the women practiced PE prior to pregnancy; however, only 31% continued the practice of PE during the pregnancy. Conclusion Despite understanding the need for HH during pregnancy, women still need encouragement to practice PE during pregnancy, as well as more information about GWG.

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Are The Neutrophil-to-lymphocyte, Platelet-to-lymphocyte And Monocyte-to-lymphocyte Ratios Predictive Factors For The Retinopathy Of Prematurity?

10.21203/rs.2.15902/v1 ◽

2019 ◽

Author(s):

Adem Uğurlu ◽

Erel İçel ◽

Nurdan Gamze Taşlı ◽

Hayati Yılmaz ◽

Turgay Uçak ◽

...

Keyword(s):

Gestational Age ◽

Retinopathy Of Prematurity ◽

Independent Predictor ◽

Inclusion Criteria ◽

Independent Risk Factors ◽

The Mean ◽

Group 2 ◽

Gestational Age At Birth ◽

Age At Birth ◽

Group 1

Abstract Purpose: In this study, we aimed to evaluate the possible relationship between the neutrophil-to-lymphocyte, monocyte-to-lymphocyte and platelet-to-lymphocyte ratio and retinopathy of prematurity (ROP). Method: The data of 348 patients who applied to Erzincan University Ophthalmology Unit for screening the retinopathy of prematurity were analyzed retrospectively. One hundred sixty seven patients who were collected CBC samples within the first 72 hours after delivery and who met the inclusion criteria were included in the study. Infants with a gestational age of ≤35 week were screened for ROP. Pateints were divided into two groups. Group 1 was involved the patients with the diagnosis of ROP and group 2 was involved the normal patients (no ROP). The levels of NLR, PLR and MLR were determined in two groups. Results: Fifty nine patients who were detected ROP are in group 1 and 108 patients who were not seen ROP are in group 2 in the study. The mean gestational age at birth of the patients was 30,4 ± 2,1 [26-34] weeks in group 1 and 33,7 ± 1,7 [27-35] weeks in group 2.( P =0.004) The mean gestational weigth at birth was 1927,2 ± 158,4 [1690-2300] gram in group 1 and 2169,1 ± 283,1 [1750-3100] gram in group 2. ( P <0.001) With the result of logistic regression analysis, gestational age [Odds Ratio(OR): 0.531, 95%CI: 0.388-0.726, P <0.001], NLR [OR:34.849, 95%CI: 2.091-580.779, P :0.013] and PLR [OR: 1.067, 95%CI: 1.034-1.110, P <0.001] were detected the independent risk factors for ROP. Conclusion: Our study revealed that higher NLR and PLR which are evaluated with in first 72h after birth is an independent predictor of ROP.

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Spatially and Temporally Resolved Ambient PM2.5 in Relation to Preterm Birth

Toxics ◽

10.3390/toxics9120352 ◽

2021 ◽

Vol 9 (12) ◽

pp. 352

Author(s):

Whitney Cowell ◽

Elena Colicino ◽

Xueying Zhang ◽

Rachel Ledyard ◽

Heather H. Burris ◽

...

Keyword(s):

Preterm Birth ◽

Fine Particulate Matter ◽

Critical Window ◽

Fine Particulate ◽

Gestational Week ◽

The Mean ◽

Pm2.5 Exposure ◽

Gestational Age At Birth ◽

Weekly Exposure ◽

Age At Birth

Growing evidence suggests that maternal exposure to ambient fine particulate matter (PM2.5) during pregnancy is associated with preterm birth; however, few studies have examined critical windows of exposure, which can help elucidate underlying biologic mechanisms and inform public health messaging for limiting exposure. Participants included 891 mother–newborn pairs enrolled in a U.S.-based pregnancy cohort study. Daily residential PM2.5 concentrations at a 1 × 1 km2 resolution were estimated using a satellite-based hybrid model. Gestational age at birth was abstracted from electronic medical records and preterm birth (PTB) was defined as <37 completed weeks of gestation. We used Critical Window Variable Selection to examine weekly PM2.5 exposure in relation to the odds of PTB and examined sex-specific associations using stratified models. The mean ± standard deviation PM2.5 level averaged across pregnancy was 8.13 ± 1.10 µg/m3. PM2.5 exposure was not associated with an increased odds of PTB during any gestational week. In sex-stratified models, we observed a marginal increase in the odds of PTB with exposure occurring during gestational week 16 among female infants only. This study does not provide strong evidence supporting an association between weekly exposure to PM2.5 and preterm birth.

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