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E Stojnić

Publications and source records attributed to E Stojnić.

10 recordsLinked to original sources
PubMed1996

When is fetal macrosomia (> or = 4500 g) an indication for caesarean section?

Caesarean and vaginal deliveries of macrosomic infants weighing > or = 4500 g were studied, and pregnant women analysed by indication for caesarean section, presentation, parity and age. Both maternal and neonatal injuries occurred. Puerperal morbidity was noted in women delivered either by caesarean section or vaginally. The control group consisted of 321 parity- and age-matched pregnant women and their newborn infants weighing 3000-3499 g. The two groups were studied according to the same criteria. In the maternity unit of the General Hospital in Sibenik, Croatia, 10852 newborn infants were delivered (only singleton pregnancies included) between 1 January 1984 and 31 December 1993, of whom 321 (2.96%) weighed > or = 4500 g (290 weighing 4500-4999 g, and 31 weighing > or = 5000 g). Caesarean section was performed in 36 (11.2%) and 14 (4.4%) in the macrosomic and control groups, respectively (X2 = 10.50; P < 0.01). Of the 321 women with a macrosomic infant, 10 (3.1%) had a caesarean section for cephalopelvic disproportion and 7 (2.2%) for breech presentation. Caesarean section for vertex presentation was used more frequently in the macrosomic than in the control group (9.0% vs. 3.3%) (P < 0.01), as well as it was used for breech presentation (77.8% vs. 16.7%) (P < 0.01). As regards transverse and oblique lies, no difference was observed. The rates of macrosomic infants delivered from primiparous and grand multiparous women by caesarean section (i.e., 23.1% vs. 5.9% vs. 18.2%) were highly significant (X2 = 19.07; P < 0.001), as were the rates in adolescent pregnant women, in those of optimal childbearing age and in old pregnant women (60.0% vs. 9.0% vs. 26.9%) (X2 = 18.67; P < 0.001). Injuries were sustained by 28 (9.8%) women with a macrosomic infant delivered vaginally and by 12 (3.9%) controls (X2 = 6.25; P < 0.05). No maternal injuries were reported with caesarean delivery in either group. There was no birth trauma in the macrosomic and control infants delivered by caesarean section. With vaginal delivery birth trauma involved clavicular fracture (5.6%), brachial plexus palsy (2.8%) and central nervous system syndrome (2.1%). A total of 30 (10.5%) macrosomic infants and 4 (1.3%) controls, were identified as having birth trauma (X2 = 20.99; P < 0.001). No difference in puerperal morbidity rates were observed between the two groups with regard to caesarean and vaginal delivery (P > 0.05), showing significantly lower rates for vaginally delivered macrosomic infants (12.3% vs. 30.6%) (X2 = 8.51; P < 0.01). There was no perinatal death among those delivered by caesarean section in either group; however, when delivered vaginally, the rates were 0.70% (2 of 285) and 0.65% (2 of 307) for the macrosomic and control infants, respectively (P > 0.05). No women in either the macrosomic or control group died. In conclusion, decision making on management options when delivering a macrosomic infant depends on fetal presentation and maternal age and parity. Vertex presenting macrosomic infants weighing > or = 4500 g should be delivered vaginally, but liberal judgement is suggested in resorting to caesarean section delivery. Abnormal presentation, as well as malpresentations in primiparous women, are an absolute indication for caesarean section, whereas malpresentations in multiparous women are a relative (underlying) indication for caesarean section.

Adolescent↗
PubMed1993

Fetal macrosomia--pregnancy and delivery.

The authors have studied pregnancy, delivery and early neonatal status of macrosomic infants (> or = 4000 g) delivered between January 1, 1984, and December 31, 1992. The control group comprised age--and parity--matched pregnant women and their newborns weighing 3000 to 3999 g. From 9980 singleton pregnancies, 2021 (20.3%) macrosomics were delivered. The incidence of macrosomia was 16.7% in the primiparous group, 23.1% in the parity 2-4 group, and 28.2% in the multiparous group (parity > or = 5) (P < 0.001). The rates of macrosomic infants for pregnant adolescents (aged < or = 19 years), pregnant women aged 20-34 years and old pregnant women (> or = 35 years) were 12.0%, 20.6% and 21.5%, respectively (P < 0.001). Macrosomia was not influenced by occupation and antenatal visits (P > 0.05). The rates of > or = 16 kg weight gain in the macrosomic and control groups were 36.2% (mean 14.30 +/- 4.66 kg) and 16.7% (mean 12.18 +/- 4.82 kg), respectively (t = 12.05; P < 0.001). Of 546 pregnant women with fetal macrosomia subjected to oral GT testing, glucose intolerance was found in 20.0% and gestational diabetes in 4.8%. The rates of glucose intolerance and gestational diabetes in 259 control subjects were 13.9% and 2.3%, respectively (P < 0.05). Light (index 1-4) and moderate (index 5-7) forms of EPH gestosis were more common in the macrosomic group, whereas no difference was observed for severe forms (index > or = 8) between the groups (P > 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1993

Pregnancy and delivery in women aged 35 years and over.

At the Medical Centre Department of Gynaecology and Obstetrics in Sibenik there were 26 116 deliveries over the 1970-1991 period, of which 1502 (5.75%) occurred in women aged 35 years and older. Among them 254 (0.97%) were primiparas, 1074 (4.11%) multiparas (two to four deliveries) and 174 (0.6%) grand multiparas (five deliveries and more). The control group consisted of 7920 primiparas, 7920 multiparas (two to four deliveries) and 80 grand multiparas (five deliveries and more) aged 20 to 34 years. There was no difference for occupation between the two groups (P > 0.05), whereas rural women (59.5%), unmarried women (4.2%), women with spontaneous (21.0%) or induced abortions (23.3%) were more common in the study group (P < 0.001). No antenatal visit received 5.9% and 1.8% (P < 0.001) in the study and control groups, respectively; the mean number of antenatal visits was 6.05 +/- 3.20 and 6.26 +/- 3.12, respectively (t = 2.41, P < 0.05). Threatened abortion (16.8%), EPH gestosis (9.5%), cervical cerclage (5.8%), weight gain above 14 kg (9.8%), preterm labour (8.4%), delivery at > or = 42 weeks (3.1%), premature rupture of the membranes (16.4%), meconium-stained amniotic fluid (14.4%), and up to 6-hour duration of labour (73.2%, elective caesarean section (6.8%), emergency caesarean section (5.7%), vacuum extraction (3.8%) and placental lysis or uterine exploration (3.8%) were more common in women > or = 35 years of age (P < 0.05). Higher rates for 7-to-12-hour duration of labour (33.6%) and episiotomy (64.2%) were found in the control group (P < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Croatia↗
PubMed1992

The grand multipara--an obstetric problem?

At the Medical Central Department of Obstetrics and Gynecology in Sibenik over 1970-1991 period there were 26,116 deliveries (multiple births excluded), of which 254 (0.97%) occurred in grand multiparas (five and more deliveries). The authors have found that the number of grand multiparas decreased by 38.3% (P < 0.001) over the past eleven years. Control subjects were 7920 multiparas (two to four deliveries, 20-34 years of age, from the same period). In 84.3% of the cases grand multiparas were delivered of their fifth or sixth infant, and 68.5% were > or = 35 years of age. Spontaneous abortion occurred in 16.9%, and 14.2% had no antenatal visit. EPH gestosis (8.3%), glucose intolerance (9.9%), preterm delivery (8.3%) and meconium-stained amniotic fluid (15.0%) were more common in the grand multiparas, whereas cervical cerclage (5.4%) and 7-to-12-hour duration of labour (12.8%) were more common in the control group. No significant differences were found in weight gain, prolonged pregnancy, caesarean delivery, assisted breech and vacuum extraction between two groups. There was also no difference in the incidence of neonatal morbidity and congenital abnormalities between the grand multiparas and controls. Late fetal and early neonatal deaths in the grand multiparous and control group occurred in 1.18% and 1.57, respectively, resulting in a 2.75% overall perinatal death rate for both groups (P > 0.05). No case of maternal death or uterine rupture occurred in either group. The authors conclude that pregnancy and delivery in grand multiparas are at higher risk due to poorer antenatal care and advancing maternal age.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

[Perinatal outcome in older primiparas].

Pregnancy, delivery and the newborn infant of 212 old primiparas (aged greater than or equal to 35 years) and of 1968 age-matched old multiparas as controls were studied for the 1970-1989 period. The frequency of old primiparas and old multiparas was 0.9% and 4.1%, respectively, with no change for the 1970-1979 (1.0%) and 1980-1989 (0.8%) periods. The mean age in the old primiparous and old multiparous groups was 38.08 + 4.2 and 38.2 + 4.8 years, respectively (P greater than 0.05). The old primiparas had an average of 7.37 +/- 2.8 antenatal visits, whereas the old multiparas had 6.08 +/- 3.3 visits (P less than 0.05). The old primiparous group included more employees and fewer unskilled workers and housewives (P less than 0.05), more urban and unmarried pregnant women (P less than 0.001), whereas the old multiparas had more spontaneous and induced abortions (P less than 0.05). Threatened abortion (23.7%), EPH gestosis (20.3%), meconium-stained amniotic fluid (21.7%), caesarean section (35.8%), placental lysis or uterine exploration (6.6%) and episiotomy (100.0%) are more frequent in old primiparas than in old multiparas (P less than 0.05). The duration of labour in old primiparas tends to be longer: there was a significantly smaller number of pregnant women with an up 6-hour duration of labour (42.5%; P less than 0.05). The average duration of labour in the old primiparous and old multiparous groups was 8.18 +/- 5.40 and 5.89 +/- 3.80 hours, respectively (P less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗
PubMedDate not supplied

[The course and outcome of pregnancy in adolescence in relation to chronologic and gynecologic age].

A total of 509 single pregnancies in teenagers up to 18 years old were examined. Younger teenagers proved to have low (1-2) gynecological years in 10.7% and older teenagers in 3.9%. There is no difference in the frequency of threatened abortions, EPH gestosis, placenta removal, and uterine exploration between the groups of younger and older, teenagers, but in teenagers with low gynecological years these complications observed significantly more frequently than in those with more gynecological years (p less than 0.001). No significant difference was recorded in the frequency of pre-term deliveries between younger and older teenagers (chronological age), whereas in teenagers with a low gynecological age there were significantly more pre-term deliveries than in those with more gynecological years (p less than 0.05). Vacuum extractor was applied significantly more frequently in teenagers 15-16 years old than in those 17-18 years (p less than 0.01). There is an even more pronounced significance in the frequency of delivery termination by vacuum extractor in teenagers with a low than in those with a higher gynecological age (p less than 0.001). Chronological and gynecological age have an significant effect on low birth mass children, the frequency of early neonatal complications, or perinatal mortality which in the teenagers examined was 15.7.

Adolescent↗
PubMedDate not supplied

[Proportion of psoriasis in cases treated at the dermatology service at the Sibenik Medical Center over a 5-year period].

The paper reviews medical record data on psoriasis at the Sibenik Medical Center, Department of Skin Diseases, over a five-year period (1986-1990). Separate analysis was performed for hospital and outpatient departments. Various parameters were analysed, the most important being sex, age, type of disease and occupation. The outpatient department recorded 539 psoriasis patients, 302 (56.0%) males and 237 (44.0%) females. Psoriasis vulgaris was found in 478 (88.7%), arthropathic in 39 (7.2%), pustular in 9 (1.7%) and erythrodermic in 13 (2.4%) patients. Out of a total of 54,129 visits to the outpatient department, 2281 (4.2%) were due to psoriasis. A total of 1598 patients were hospitalized over the same study period, of whom 131 (8.2%) due to psoriasis, i.e. 81 (61.8%) males and 50 (38.2%) females. Psoriasis vulgaris was reported in 92 (70.2%), arthropathic psoriasis in 19 (14.5%), pustular in 9 (6.9%) and erythrodermic in 11 (8.4%) patients. A total of 46,368 hospital days were realized, with an average of 18 inpatient days. Out of those, 4710 (10.2%) were due to psoriasis, the average treatment lasting 16.7 days. In relation to the incidence and nature of this disease, as well as to health care costs, it can be concluded that psoriasis represents not only a serious medicosocial but also an economic and public problem.

Adult↗