Gestational diabetes mellitus and maternal overweight and obesity are associated with increased risk for adverse maternal and perinatal outcomes, such as fetal overgrowth. Although most studies addressing the effects of maternal BMI on adverse outcomes include women with GDM, a little is known about associations between maternal BMI and fetal metabolic status evaluated by ultrasonography means. One of the ultrasound parameter of glycemic controlis the measurement of fetal liver length. Prospective study of 385 women with monofetal pregnancies and established risk for GDM underwent mid-trimester ultrasound exam, during which fetal liver length were measured. After exam, body mass index (BMI) was determined for each patient. Each participant underwent 100 g fasting oral glucose challenge test (oGTT) in order to confirm or to exclude diagnosis of GDM. There was a statistically highly significant positive correlation between the BMI and fetal liver length for the entire sample (N=385; p<0.001; R=+0.55) as well in the sample of GDM patients (N=96; p<0.001; R=+0.58) and controls (N=289; p<0.001; R=+0.33). Maternal BMI has impact on fetal liver length assessed by ultrasound exam. This influence is even higher in GDM.

The role of elevated C-Reactive Protein (CRP) serum levels has been questioned in gestational diabetes mellitus (GDM) because of the evidences that metabolic syndrome and GDM are related to increased serum levels of inflammation markers (such as CRP). The aim of the study was to evaluate the sensitivity of elevated CRP levels for diagnosis of chorioamnionitis and to compare it with sensitivity of other standard laboratory or clinical signs used in the establishing of diagnosis of chorioamnionitis. Elevated CRP level was present in 93,33% cases. Fetal tachycardia was present in 91,67% cases. Increased white blood cell count was present in 63,33%. A statistically significant difference was found in the level of sensitivity of CRP and of the increased white blood cell count (P<0.01). Elevated C-reactive protein levels were more sensitive than other standard laboratory or clinical signs in predicting chorioamnionitis in women with GDM.

The psychological impact of developing gestational diabetes mellitus (GDM) has been investigated widely in both children and adults. Although these studies suggest that person who develop GDM is at risk for emotional/ psychological distress, this finding is not universal. The aim of our study was to look at the state of anxiety in the group of pregnant women with well controlled GDM class A1 patients at 36 weeks of gestation and to compare it with the healthy controls at the same gestational age in population of pregnant women in Belgrade, Serbia. The study was carried on in 48 pregnant women with GDM and 80 healthy controls. The anxiety state of the two groups was evaluated with Hamilton Anxiety Scale (HAMA). The incidence rate of anxiety in the pregnant women with GDM were 27.03% (13/48), and in the healthy pregnant women 13.75% (11/80). The incidence rate of anxiety in pregnant women with GDM was higher significantly than control group, and there were significant difference in total score and its factorial score of HAMA in the two groups. The incidence rate of anxiety in the pregnant women with GDM is higher, and anxiety is the dangerous factor of GDM. Psychological state in pregnant woman, especially in pregnant women with GDM must be noticed, and psychological counseling and psychological therapy may be carried on as early as possible.

Preeclampsia complicates about 5% of all pregnancies worldwide. It is a major cause of maternal, fetal and neonatal morbidity and mortality. The aim of this systematic review was to study the literature on the predictive potential of screening for preeclampsia based on serum markers and uterine artery Doppler velocity waveform assessment. First-trimester uterine artery Doppler can identify over half of women who will develop preeclampsia. Detection rates may be increased by a combination with maternal serum markers. In screening for early preeclampsia, the detection rate for a 10% falsepositive rate was 96.3% for a combination of maternal factors, soluble endoglin, placental growth factor and uterine artery lowest Pulsatility Index. First trimester placental protein 13 predicts preeclampsia in women at increased a priori risk and predicts early-onset better than late-onset disease. The Fetal Medicine Foundation has released in 2009 the new software to allow calculation of risks for preeclampsia and gestational hypertension. Uterine artery Doppler velocimetry in combination with some biochemical markers seems to be an effective first-trimester screening tool for preeclampsia and in particular early-onset preeclampsia.

The 50-gram non-fasting one hour Glucose Challenge Test (GCT) is today the one most widely implemented as a screening test for Gestational Diabetes Mellitus (GDM). Positive result of GCT creates a preliminary GDM diagnosis. Diagnosis of GDM labels a pregnancy high risk. Any highrisk pregnancy can cause maternal anxiety. The aim of the study was to investigate pretest and posttest anxiety levels in pregnant women undergoing GCT. Anxiety levels were evaluated by Hamilton Rating Scale for Anxiety (HAMA score). Pretest HAMA score was 7.1±3.34 in the women with preliminary GDM diagnosis, and 6.69±5.51 in the women with negative GCT results. After delivering GCT results, HAMA score was 8.64 ± 8.10 in the women with preliminary GDM diagnosis and 4.29±2.29 in the women without preliminary GDM diagnosis. Pretest levels of anxiety among all pregnant women undergoing GCT were increased. However, this was temporary in women with negative GCT, whose anxiety levels decreased after delivering GCT results. Among women preliminary diagnosed with GDM, posttest HAMA evaluation revealed sustained increased levels of anxiety. Concerns regarding the anxiety caused by screening for GDM were confirmed by the results of our study

Diabetes mellitus (DM) and maternal obesity are in parallel related with adverse maternal and neonatal outcomes. Examination of the combined association of these common metabolic problems with pregnancy outcomes is an important question. Objective of our study was to determine associations of diabetes mellitus and obesity with adverse delivery outcomes. The primary outcome measures were duration of labor, mode of delivery, Apgar scores in 1st and 5th minute, obstetric interventions and maternal injuries at births. Women with DM were more likely to have Cesarean Section (p < 0.01) and less likely to have had an episiotomy and perineal repair than women without DM (all p < 0.05). Connections between DM and obesity with other adverse outcomes of labor have not been found.

Dobrovoljno davalaštvo (DDK) je jedini način za obezbeđivanje kontinuirane zalihe ovog jedinstvenog leka. Stoga je neophodno motivisati i informisati stanovištvo o pozitivnim efektima donatorstva krvi, a u cilju da se regrutuju novi i zadržavanja postojećih DDK. Cilj ovog rada bio je ispitivanje načina informisanosti, motiva i prepreka za dobrovoljno davanje krvi, kao i razloga za ponovno davalaštvo. Ispitivanje je obuhvatilo 65 DDK koji su popunjavali upitnik u Službi za transfuziju krvi KBC Zemun- Beograd. Pitanja su se odnosila na strukturne podatke (pol, starosna dob, obrazovanje), znanje i informisanost o davalaštvu, kao i na motaviciju i prepreke u vezi budućeg dobrovoljnog davanja krvi. Statistička obrada je obuhvatila standardne metode deskriptivne statistike kao i grafičke prikaze. Dobijeni rezultati su pokazali da je većina ispitanika za dobrovoljno davanje krvi saznalo od porodice i prijatelja (40.6%). Namensko davanje krvi je u većini slučajeva (33.8%) bio prvi kontakt sa davalaštvom. Čak 66.5% DDK se tokom procedure davanja krvi oseća odlično, međutim 7.7% kao prepreku u davanju krvi bira ubod igle. Njih 73.9% se odlučilo da će nastaviti redovno da daruje krv, a kao glavni razlog su uglavnom navodili altruizam (33.8%). Među onima koji bi krv darovali možda povremeno (26.1%), glavni motiv je bio slučaj da krv zatreba nekome iz bliskog okruženja (12.3%). Na osnovnu ispitivanja, može se reći da je u našoj lokalnoj zajednici dobrovoljno davalaštvo krvi zasnovano na altruizmu. Ipak, u cilju okupljanja većeg broja potencijalnih DDK i zarad zadržavanja postojećih, neophodna je stalna motivacija i promocija davalaštva kao jedinstvne karike zdravstvenog sistema u koje je uključeno celokupno stanovništvo.

Study objective was to test the relationship between maternal body mass index (BMI) and fetal abdominal subcutaneous fat tissue (ASCT) measured by ultrasound. The total number of pregnant women enrolled in the prospective study was 280. For all participants BMI was determined. Study participants underwent ultrasound exam at 32nd week of gestation and ASCT was measured. Positive correlation has been found between ASCT and maternal BMI (p<0.01, r=0.1612). The study showed that intrauterine growth and development is partially regulated by the maternal BMI.

Cilj rada: utvrđivanje učestalosti uzročnika nekomplikovanih i komplikovanih infekcija urinarnog trakta novorođenčadi rođene u terminu kao i utvrđivanje eventualnih prediktornih faktora povezanih sa prisustvom najčešćih uzročnika u uzorcima urina. Metod: Retrospektivna studija obuhvatila je terminsku novorođenčad hospitalizovanu na Univerzitetskoj dečijoj klinici zbog urinarnih infekcija u periodu od deset godina. Podaci su prikupljeni iz raspoložive medicinske dokumentacije. Rezultati: Od 4261 hospitalizovanih novorođenčadi u periodu od deset godina, 286 (6.7%) primljeno je na odeljenje zbog infekcije urinarnog trakta. Komplikovane urinarne infekcije dijagnostikovane su kod 61 (21.3%) ispitanika a nekomplikovane kod 225 (78.7%). Kao vodeći uzročnici nekomplikovanih infekcija urinarnog trakta među neonatusima izdvojili su se coli (60.8%), Klebsiella (13.3%) i Enterococcus (4.9%). Pomenuta tri uzročnika najčešće su izolovani i u uzorcima urina kod komplikovanih infekcija (Escherishia coli 52.5%, Klebsiella 23.0% i Enterococcus 11.5%). Rezultati su ukazali da je veća starost neonatusa na prijemu povezana sa većom šansom da je uzročnik Escherichia coli (OR=1.06, 95% IP:1.02-1.11), dok su ženski pol i znaci komplikovane urinarne infekcije protektivni faktori (OR=0.27, 95% IP:0.14-0.49, odnosno OR=0.38, 95% IP:0.19 – 0.74). Sa druge strane ženski pol je faktor rizika za razvoj urinarne infekcije izazvane bakterijama Klebsiella (OR=2.75, 95% IP:1.44- 5.26) i Enterococcus (OR=3.05, 955 IP:1.33 – 6.97). Dodatni faktor rizika za infekciju urinarnih puteva novorođenčadi izazvanu Enterococcus je i komplikovanost infekcije (OR=2.61, 95% IP:1.10 – 6.20). Zaključak: Podaci dobijeni u istraživanju mogu biti od koristi pri odluci o izboru antibiotika u ranoj fazi lečenja urinarnih infekcija terminske novorođenčadi. Poželjna su dalja istraživanja o profilu rezistencije vodećih uzročnika urinarnih infekcija novorođenčadi na antibiotike.