Biomedical subjects

F Mikulandra

Publications and source records attributed to F Mikulandra.

At least 19 recordsLinked to original sources

PubMed2002

Perinatal outcome of pregnancies in women aged 40 and over.

Perinatal outcome of pregnancies at forty and over was analyzed starting from the diagnosis of pregnancy to seven days following delivery. Retrospectively, pre-gestational health and reproduction status were dealt with, as well as the course of pregnancy, deliveries, and newborn children (study group). The control group was composed of pregnant women aged 20 to 29, who were identical to study group in terms of parity. Statistical data processing was done by means of chi2-test, and contingency 2 x 2 tables. The difference was significant if p < 0.05. Out of 2,099 diagnosed wanted pregnancies at forty and over, 415 (19.8%) had a miscarriage, in 33 (1.6%) an artificial abortion was performed after determining the fetus karyotype and 1,651 (78.2%) of pregnant women delivered. In 66.2% of pregnancies the fetus karyotype was determined and in 33 (2.5%) fetuses chromosomal abnormalities were found Incidence of deliveries at 40 and over is 1.38%, which is a 35.6-percent increase in the last ten years. Nullipara and pluripara had an increase, and multipara had a decrease. Pre-gestational health and reproduction status in study group is lower than in control group. Complications during pregnancy: threatened abortion, EPH gestosis, placenta praevia, gestational diabetes, late fetal death are more frequent than in control group (p < 0.05). In intrapartal terms, more frequent were induction of delivery, meconium-stained amniotic fluid, fetal distress, operative vaginal deliveries, and Cesarean section (p < 0.05). In neonatal outcome there are more premature infant, there are more VLBW, LBW, SGA, newborn with low Apgar index values, and the total perinatal death is greater than in the control group (p < 0.05). In perinatal terms, (from the diagnosis to the seventh day following delivery) 1,617 children survived (77.0%), meaning that perinatal loss was 482 (23.0%). Authors conclude that pregnancy at 40 and over is a high-risk pregnancy. There is a high risk of pre-gestational and gestational complications, and perinatal loss is high. Therefore, those pregnancies are not desirable from the medical point of view.

Adult↗

PubMed2001

Influence of father's weight and height on weight of male and female newborns.

The study included 1,596 newborns and their parents living in Sibenik County, Croatia. All newborns are born between 37 and 42 weeks of gestation, with no congenital anomalies and from a single pregnancy. Fathers and mothers of male babies are older than those of girl babies (p < 0.01). Mean values for weight, height, BMI in parents and the woman's parity are equal (p = 0.05). Pregnancy with male baby lasts longer and the babies are heavier (p < 0.05). Where the fathers weight between 70 and 79 kg and 80 to 89 kg, and where the fathers are 175 to 179 cm or 180 to 184 cm tall with normal BMI the male babies are heavier than the females at birth (p < 0.05). Increased weight, height and BMI in the father increase the birth weight of both male and female babies (p < 0.00001). The authors concludes that the parents (father and/or mother) of male babies are older than those of girls, that pregnancy for males babies lasts longer and that male babies are born heavier than girls. With increased weight, and height and BMI in the father, the birth weight of both male and female babies increases.

Adult↗

PubMed2001

Effect of insulin and insulin-like growth factor I on fetal macrosomia in healthy women.

The aim of the study was to determine the values of insulin, insulin-like growth factor I (IGF-I) and glucose in the umbilical cord blood of macrosomic (> or = 4000 g) and control (3,000-3,500 g) infants born to healthy mothers, and to assess their possible correlation with the newborns' birth weight and maternal anthropometric parameters. A series of 207 macrosomic term infants, and 200 control term infants, born to healthy mothers with normal oral glucose tolerance test throughout gestation, were studied. The glucose concentration did not differ between the macrosomic and control group while macrosomic infants had significantly higher values of insulin and IGF-I. Female macrosomic infants had significantly higher levels of insulin and IGF-I than male macrosomic infants. The levels of insulin and IGF-I, but not levels of glucose, differed between the macrosomic and control group according to the maternal weight, height, pregestational body mass index, weight gain during gestation, and maternal birth weight. The maternal anthropometric parameters were significantly greater in the macrosomic infants. Accordingly, macrosomia was concluded to be a multifactorial condition.

Adult↗

PubMed2000

The effect of high birth weight (400 g or more) on the weight and height of adult men and women.

Three hundred and twenty eight examined adult men and 346 examined adult women were macrosomic at birth (4000 g or over). The control group consisted of 564 adult men and 749 adult women with birth weights of 2500 to 3999 g. Both male and female macrosomic babies achieve greater weights and heights in adulthood than those in the control group. There are more overweight and obese men in the macrosomic group than in the control group and the same is true of the women (p < 0.001). The mean values of the BMI (body mass index) for the macrosomic adults are greater than those for the control group (p < 0.001). Fetal macrosomia is a good predictor of the weight and height of adult men and women.

Adult↗

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↗

PubMed1989

[Prevention of hemolytic disease in newborn infants using anti-D immunoglobulin G].

The authors have analyzed the prevention of Rh-immunization from 1972 to 1983. Results are presented in two six-year periods, i.e. from 1972 to 1977 and from 1978 to 1983. Prevention was applied to all rh-negative women, who have been delivered from a rh-negative baby in their first childbirth (with negative sensibilization tests). Anti D IgG was also applied to all women after their second, third, fourth or subsequent delivery, if they were willing to have more children. Women with Du variant of the Rh factor and having a Rh-positive child were also protected. Preparations containing 250 to 300 micrograms of IgG anti-D were used. During the first period we found rh-negative mothers in 18.41 per cent, in 63.48 per cent of them the newborn was Rh-positive. During the second period 17.89 per cent of our women were rh-negative with 58.45 per cent Rh-positive babies. During the first period, protection was afforded to 60.26 per cent of the rh-negative women with incompatible babies, and in the second period to 79.11 per cent, respectively (P less than 0.05). During the second period, 99.70 per cent of women were protected after their first delivery (except of one case with immunization already during pregnancy), in contrast to the first period, where this percentage amounted only to 84.66 per cent (P less than 0.05). During both periods, a total of 69.51 per cent of the rh-negative women having Rh-positive babies received anti-D-immunization.(ABSTRACT TRUNCATED AT 250 WORDS)

Antibodies, Anti-Idiotypic↗

PubMed1984