Iskanje po repozitoriju

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Povzetek: Objectives: Haemolytic disease of the fetus and newborn (HDFN) occurs due to maternal IgG alloantibodies that actively cross the placenta and bind to paternally derived fetal antigens on the erythrocytes. The aims of this study were to describe the Slovenian cohort of patients with severe HDFN, who required fetal treatment, to review the fetal treatment strategies, and to describe pregnancy and neurodevelopmental outcomes. Case series presentation: Data on patients who developed severe HDFN between 2006 and 2021 and were treated at our institution were collected retrospectively. Primary care pediatricians were contacted regarding neurodevelopmental outcomes of surviving infants. There were 19 pregnancies affected with severe HDFN. The most commonly implicated antigen was RhD. Seventeen children were liveborn. Sixteen fetuses were treated with intrauterine transfusion (IUT). Two children had developmental delay at the corrected age of 2 years. Conclusions: In this study, the Slovenian national cohort of severe cases of HDFN is described for the first time. Prevalence of RhD alloimmunization was higher in comparison to the literature. A combined treatment with therapeutic plasmapheresis, immunoglobulins and IUT was successful. Three quarters of newborns were born in the late preterm period. Overall survival rate and long-term neonatal adverse outcomes in our cohort were in line with the literature.
Ključne besede: haemolytic disease of the fetus and the newborn, intrauterine transfusion, neurodevelopmental outcome, severe maternal alloimmunization
Objavljeno v DiRROS: 22.04.2026; Ogledov: 266; Prenosov: 243
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Povzetek: Objectives: Understanding the clinical factors influencing the SARS-CoV-2 antibody response during and after pregnancy is critical for optimizingmaternal care and vaccination strategies. This prospective cohort study aimed to evaluate associations between maternal clinical characteristics and SARS-CoV-2-specific IgG and IgA antibody levels at delivery and 42 days postpartum in unvaccinated pregnant women. Methods: A total of 387 pregnant women with confirmed SARS-CoV-2 infection during pregnancy were included. SARSCoV- 2 infectionwas confirmed using real-time RT-PCR. Clinical data, including age, body mass index (BMI), smoking status, pre-existing morbidities, and obstetric complications, were recorded. SARS-CoV-2-specific IgG and IgA antibodies were quantified using ELISA at delivery and 42 days postpartum. Results: Higher preconception BMI significantly correlated with increased odds of detecting IgG and IgA antibodies at both delivery and postpartum assessments (p<0.05), independently ofmaternal age and chronic diseases.Women without chronic systemic diseases exhibited lower antibody levels at delivery, whereas smokers had significantly lower odds of IgG antibody presence at delivery. Additionally, preexisting cardiovascular diseases were associated with reduced antibody presence at six weeks postpartum. Other clinical parameters did not show significant associations. Conclusions: Preconception BMI and pre-existing systemic diseases may modulate SARS-CoV-2 antibody responses in pregnant women. These clinical factors should inform assessments of maternal and neonatal infection risks and guide vaccination strategies in pregnant populations. Further research is needed to elucidate the mechanisms underlying these associations.
Ključne besede: SARS-CoV-2, IgG antibodies, IgA antibodies, pregnancy, body mass index, comorbidity, postpartum period
Objavljeno v DiRROS: 18.03.2026; Ogledov: 391; Prenosov: 268
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Povzetek: Objectives: First, to report the incidence of non-cephalic presentation at a routine 36-week ultrasound scan, the uptake and success of external cephalic version (ECV) and the incidence of spontaneous rotation from non-cephalic to cephalic presentation. Second, to determine the maternal and pregnancy characteristics that provide a significant contribution to the prediction of non-cephalic presentation at the 36-week scan, successful ECV from non-cephalic to cephalic presentation and spontaneous rotation from non-cephalic to cephalic presentation. Methods: This was a retrospective analysis of prospectively collected data from 107 875 women with a singleton pregnancy who had undergone a routine ultrasound scan at 35 + 0 to 36 + 6 weeks' gestation. Patients with breech or transverse/oblique presentation were divided into two groups: those scheduled for elective Cesarean section for a fetal or maternal indication other than abnormal presentation, and those that would potentially require ECV. The latter group was reassessed after 1-2 weeks and, if the abnormal presentation persisted, the parents were offered ECV or elective Cesarean section at 38-40 weeks' gestation. Multivariable logistic regression analysis was carried out to determine which maternal and pregnancy characteristics provided a significant contribution in the prediction of non-cephalic presentation at the 36-week scan, successful ECV from non-cephalic to cephalic presentation and spontaneous rotation from non-cephalic to cephalic presentation. Results: At the 36-week scan, fetal presentation was cephalic in 101 664 (94.2%) pregnancies and either breech, transverse or oblique in 6211 (5.8%). In 0.3% of cases with cephalic presentation at the 36-week scan, there was subsequent spontaneous rotation to non-cephalic presentation, and in half of these, the diagnosis was made during labor or at birth. ECV was attempted in 1584/6211 (25.5%) pregnancies with non-cephalic presentation at the 36-week scan and was successful in only 44.1% of cases. In the remaining 74.5% of cases, ECV was not attempted because of any of the following reasons: ECV was declined; Cesarean section was planned for a reason other than abnormal presentation; ECV was planned for the subsequent 1-2 weeks but, in the meantime, there was spontaneous rotation to cephalic presentation; or there was spontaneous onset of labor or rupture of membranes before planned ECV. In 5513/6211 (88.8%) pregnancies with non-cephalic presentation at the 36-week scan, ECV was not attempted or was unsuccessful, and in 37.7% of these, there was subsequent spontaneous rotation to cephalic presentation. Among the 6211 pregnancies with non-cephalic presentation at the 36-week scan, the presentation at birth was cephalic in 43.8%; in 74.8%, this was due to spontaneous rotation, and in 25.2%, it was due to successful ECV. Multivariable analysis demonstrated that the likelihood of non-cephalic presentation at the 36-week scan, that of successful ECV and that of spontaneous rotation from non-cephalic to cephalic presentation was affected by several maternal and pregnancy characteristics, but the predictive performance for these events was poor, with the area under the receiver-operating-characteristics curve ranging from 0.608 to 0.717 and the detection rate at a 10% false-positive rate ranging from 19.0% to 33.7%. Conclusions: Routine ultrasound examination at 35 + 0 to 36 + 6 weeks' gestation could improve pregnancy outcome by substantially reducing the risk of unexpected abnormal presentation in labor. However, an additional ultrasound scan for fetal presentation should be considered in all women when they present in labor.
Ključne besede: breech presentation, cephalic presentation, external cephalic version, prenatal diagnosis, pyramid of pregnancy care, third-trimester screening, ultrasound examination
Objavljeno v DiRROS: 07.01.2026; Ogledov: 709; Prenosov: 414
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Ključne besede: ginekološki raki, rak jajčnikov, onkološko zdravljenje
Objavljeno v DiRROS: 30.03.2022; Ogledov: 1727; Prenosov: 951
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