Biomedical subjects

Aleksandra Novakov-Mikić

Publications and source records attributed to Aleksandra Novakov-Mikić.

6 recordsLinked to original sources

PubMedDate not supplied

[The Bishop score and induction of labor].

INTRODUCTION: Induction of labor represents initiation of uterine contractions before their spontaneous onset. The aim of the study was to establish the role of Bishop score in prediction of labor induction in routine clinical work. MATERIAL AND METHODS: The study was a prospective, blind, observational one. All patients had a vaginal examination prior to induction, during which Bishop score was evaluated. The mode of induction was either intravenous infusion of oxytocin or endovaginal prostaglandins. The induction was considered successful if vaginal delivery took place within 24 hours from the onset of induction. RESULTS: There were 100 patients, and induction was successful in 74% and unsuccessful in 26%. Mean Bishop score in group A was 5.65 (SD 1.40, 95% CI 5.27-6.03), and in group B 4.15 (SD 1.04, 95% CI 3.66-4.63) (p < 0.01). Statistical analysis of the area under the ROC curve showed that Bishop score is a good and reliable predictor of the outcome of labor induction (0.816, 95% CI od 0.710-0.896), with the best statistical performances at the cut-off value of 5 (sensitivity 65.5%, specificity 95%, PPV 97.3%, NPV 50%). CONCLUSION: In our study Bishop score proved to be a reliable and good method for prediction of the outcome of pregnancy if a single, experienced operator evaluates it, with best statistical performances at the cut-off value more than 5 (sensitivity 65.5%, specificity 95%, PPV 97.3%, NPV 50%). The next step would be introduction of more operators, of different skills and experience and subsequent further testing of the method in different conditions.

Cervix Uteri↗

PubMedDate not supplied

[Amnionic infusion therapy in conditions with low amnionic fluid levels].

INTRODUCTION: Amniotic fluid volume reduction can have serious consequences: prior to 24 gestational weeks hypoplasia of fetal lungs and later in pregnancy cord compression and fetal hypoxia as well as contractions of extremities. Diagnosis of oligohydramnios is made either after a subjective estimation of amniotic fluid reduction or if the biggest amniotic fluid pocket is less than 1 cm. Amnioinfusion is a procedure during which a crystalloid solution, most often saline, is instilled into the amniotic cavity substituting amniotic fluid. To estimate the efficacy and safety of amnioinsfusion using our results and literature review. MATERIAL AND METHODS: Up to 800 ml of sterile saline solution was instilled intraamniotically (10-15 ml/min) in cases where the amniotic fluid index was less than 10 and intraamniotic infection was excluded. After that, 1 g of Longaceph was given intraamniotically. Infusion was stopped immediately when 800 ml was instilled, if a subjective estimation showed that there was enough fluid or if contractions occurred. RESULTS: During a six-month period there were five amnioinfusions--four therapeutical and one diagnostic; in four cases the procedure was successful and in one preterm rupture of membranes occurred 20 hours after the procedure. The procedure was most often done in the first half of the third trimester and continuation of pregnancy in successful cases was between 4 and 5 weeks, with average fetal weight gain of about 1200 gr. No complications occurred in cases where pregnancy continued. CONCLUSION: In our preliminary study amnioinfusion led to prolongation of pregnancy in majority of cases providing better maturation of fetal lungs and higher birth weight, without any complications. Further studies are necessary to reach definite conclusions about the efficacy and safety of amnioinfusion.

Crystalloid Solutions↗

PubMedDate not supplied

A longitudinal follow-up of cervical length during pregnancy.

A prospective longitudinal study of cervical length during pregnancy included 60 women. Three groups of patients were analyzed: group I--cervical length was measured in all three trimesters, group II--cervical length was measured in the first and second trimesters, and group III--length was measured in the second and third trimesters. Cervical length was measured in each group individually, with the aim of establishing the trend of change. In the group in which the cervical length was measured in all three timesters, there was either a mild progressive cervical shortening or cervix remained of the same length. The number of examined women is very small, though, so more valid is the information that the trend of mild shortening occurs in the second and third trimesters. None of the trends is particulary explicit and shows that there is a period in an uncomplicated singleton pregnancy of low risk for preterm delivery, during which there is a significant shortening before delivery takes place. During pregnancy there are different, individual modes of cervical changes, which leads to individualization when estimating the risk for preterm delivery. Reference values should be established for cervical length in order to assess risk for preterm delivery, rather than use the "cut-off" value after which the risk is considered higher.

Cervix Uteri↗

PubMedDate not supplied

[Amnioreduction in treatment of increased amniotic fluid volume].

INTRODUCTION: Increased amniotic fluid volume may significantly increase the risk for preterm delivery. Amniodrainage is a symptomatic treatment by which excess amniotic fluid is reduced to provide fetal lung maturation. The aim of this stuldy is to estimate the efficacy and safety of this procedure, our results and give a literature review. MATERIAL AND METHODS: Sonografic criteria were used (AFI >400 ml, or the biggest amniotic fluid pocket >150 mm) to choose patients in whom 18G needle was used to allow leaking of excessive amniotic fluid. RESULTS: 10 patients underwent 26 procedures. The procedures were performed at 28.6 th week gestation, on average and 6.25 weeks average gain or 1000 g. We had two sets of monochorionic twins with twin-to-twin transfusion syndronme (TTTS), where one child survived. One procedure was followed by premature placental abruption, and premature delivery in 28th week. The rest of procedures were uneventful. CONCLUSION: In our series of 10 women, 26 procedures were performed to prolong pregnancies, enable fetal maturation and weight gain. In majority of cases amnioreduction was done without complications, so we could repeat the intervention and prolong the pregnancy. Survival of one child in two TTTS pregnancies should not be regarded unsulccessful in our conditions.

Amniotic Fluid↗

PubMedDate not supplied

Systemic lupus erythematosus in pregnancy--case report.

Systemic lupus erythematosus (SLE) is a chronic inflammatory connective tissue disease commonly diagnosed after the age of 20, mostly around the age of 30 years. It is more common in women than in men, especially during the fertile period. Women with SLE are at higher risk for spontaneous abortions, intrauterine fetal death, preeclampsia and eclampsia, preterm delivery and intrauterine growth retardation. This paper is a case report of a pregnant woman with SLE complicated with preeclampsia, but it also discusses follow-up of such pregnancies.

Adult↗

PubMedDate not supplied

[Previous obstetric history and cervical length in pregnancy].

INTRODUCTION: The cervical length is a predictor of premature delivery or abortion. In order to detect the risks of such complications, it is necessary to establish the factors affecting the length of the cervix. MATERIAL AND METHODS: A transversal prospective study was carried out in a sample of 579 pregnant women with low risk, singleton pregnancies of various gestational ages. Cervical length was measured by transvaginal ultrasound as part of routine pregnancy monitoring. At the same time, data on previous first-trimester or mid-trimester abortions, as well as on premature deliveries and term deliveries, were collected and taken into consideration. RESULTS: The cervical length in primiparous women was not statistically significantly longer than in women with a previous pregnancy, except during the second trimester, (primiparous women: 33.8 mm, women with a previous pregnancy: 35.8 mm). Bearing in mind the empirical facts that the cervix in primiparous women, since intact, is significantly longer, the above mentioned findings cannot be easily explained. The cervix in women with a previous vaginal delivery was statistically significantly longer (35.6 mm) than in women with no vaginal delivery (34.09) (p = 0.011). In women with previous abortions of any kind, the cervical length was 34.2 mm. The cervical length in women without previous abortions was 34.7 mm, and there were no significant differences. Moreover, no statistically significant differences were established in women with or without previous abortions, regardless of the type. CONCLUSION: Taking into consideration the data from previous obstetric histories, the results of our study indicate that cervices of women.

Abortion, Spontaneous↗