Pregnancy outcomes of COVID-19 positive pregnant women at the Cantonal Hospital Zenica, Bosnia and Herzegovina.

Aim To investigate clinical presentation of COVID-19 infection in pregnancy, its course during pregnancy, effects on pregnancy outcomes for both mothers and newborns as well as the potential for vertical transmission. Methods This retrospective observational study included all identifi ed COVID-19-positive pregnant women admitted to the Cantonal Hospital in Zenica at any stage of pregnancy or labour from 30 April 2020 to April 30 2021. Maternity and newborns were followed until discharge from the hospital. Results Twenty-four pregnant women were positive for COVID-19. There were 79.2% asymptomatic cases, 12.5% had mild symptoms, while 8.3% had more severe forms of the disease. The main follow-up morbidities were high BMI 33.3%, anaemia 16.7%, thrombocytopenia 12.5%, hypertensive disorders 4.2% and diabetes 4.2%. The rate of premature births was 33.3%, while 8.3% pregnant women had premature rupture of the amniotic sac. Caesarean section was done for 75% women while 25% delivered vaginally. Previous caesarean section (54.2%) was the most common indication for operative completion of labour. Twentythree (92%) live babies were born, of which 8 (33.3%) were admitted to the neonatal intensive care unit. Two (8%) intrauterine foetal deaths were recorded that occurred before admission to our hospital. Two infants (8.7%) had a positive PCR test for COVID-19. Conclusion COVID-19 viral disease in pregnancy is usually presented as an asymptomatic or mild disease. It is associated with high rates of preterm birth, admission of newborns to the intensive care unit and intrauterine foetal death. Vertical transmission is possible but the newborns were asymptomatic.

Nitric oxide biosynthesis during normal pregnancy and pregnancy complicated by preeclampsia.

Aim To investigate biosynthesis in nitric oxide (NO) during normal pregnancy and in pregnancies complicated by preeclampsia. Methods This prospective cross-sectional study included 80 patients hospitalized at the Department of Women's Health, Neonatology and Perinatology Cantonal Hospital in Zenica. Serum NO concentration in 20 non-pregnant women, 40 healthy pregnant women and 20 pregnant women with preeclampsia aged 17-40 years were measured. The group of healthy pregnant women were divided into 4 subgroups by gestational age. For each woman with preeclampsia, a healthy pregnant control was matched for age, parity and gestational age. Serum NO concentrations were determined after reduction of nitrates to nitrites using the Griess reaction. Results NO concentrations during second trimester of pregnancy (37.2±1.7µM; p<0.05) and third trimester of pregnancy (40.9±2.8µM; p<0.05) were significantly higher in healthy pregnant women than in non-pregnant women (29.3±1.7µM). Serum NO concentrations were lower in preeclamptic women (30.7±1.8µM) compared to matched healthy pregnant women of the third and the late third trimester (35.1±2.2µM), without significant differences. Mean NO concentrations in pre-eclamptic women was positively correlated with systolic blood pressure (r=0.58; p<0.01), diastolic blood pressure (r=0.45; p<0.05), creatinine clearance (r=0.48; p<0.05), uric acid (r=0.49; p<0.05), and negatively correlated with platelet count (r=-0.57; p<0.05). Conclusion NO production was increased with gestational age during normal pregnancy and slightly decreased in preeclampsia suggesting that NO may modulate the cardiovascular changes during normal pregnancy and pregnancy complicated by preeclampsia.

Relation between near work and myopia progression in student population.

AIM: To determine relation between near work and myopia progression in student population. Causes of myopia occurrence are not sufficiently explained. METHODS: This retrospective-prospective, descriptive research included 100 students with verified myopia up to -3 Dsph. Ophthalmological examination and measurement diopter-hours variable (Dh) were done twice, in the period from January 2011 until January 2012. RESULTS: A multivariate regression analysis of impact on the difference of distance visual acuity without correction to the right and left eye and difference of automatic computer refractometry in cycloplegia of both eyes indicates that, diopter-hours variable (Dh) had statistically significant impact on increase of distance visual acuity difference (right eye OR: I measurement-Dh 1.489, II measurement-Dh 1.544, p<0.05; left eye OR: I measurement-Dh 1.602, II measurement-Dh 1.538, p<0.05) and automatic computer refractometry in cycloplegia (right eye OR: I measurement 1.361, II measurement 1.493, p<0.05; left eye OR: I measurement 0.931, II measurement 1.019, p<0.05) during both measurements. CONCLUSION: Near work cause the increase of myopia. This research opened a perspective for other researches on the impact of near work on myopia.

Effect of antihypertensive therapy with alpha-methyldopa on umbilical artery Doppler in pregnancies with hypertensive disorders.

Aim To clarify whether applying alpha-methyldopa treatment influences flow resistance in umbilical cord artery in pregnant women suffering from hypertensive disorder. Methods In this prospective cross-sectional study a follow-up was done for 50 pregnant women with singleton pregnancies between 36 and 40 gestation weeks, who had been hospitalized at the Gynecology and Obstetrics Department of the Cantonal Hospital Zenica, Bosnia and Herzegovina from October 2009 to January 2012. Pregnant women were classified in two groups according to the level of using alpha-methyldopa in the treatment. For all expectant mothers, flow in umbilical cord artery was measured, Resistance Index (RI) was determined and values were compared accordingly. Results There was a statistically significant difference in values of umbilical artery resistance index (UA RI) in terms mother's hypertension (p less than 0.05). Therefore, mothers with chronic hypertension had the highest UA RI (0.885±0.4), as well as mothers with preeclampsia superimposed on chronic hypertension (0.785±0.7), while mothers with gestational hypertension had the lowest UA RI (0.6413±0.13) (p less than 0.05). In mothers using the methyldopa UA RI was lower (0.6875±0.14) in comparison to those who did not use it (0.6686±0.13) but with no statistical significance (p greater than 0.05). Conclusion There was no change in flow resistance in umbilical cord artery in pregnant women suffering from hypertensive disorder. Key words: ultrasonography, umbilical artery, pregnancy-induced hypertension.

Relation between physical activity and myopia progression in student population.

AIM: To determine the relation between physical activity and myopia progression in student population. Causes of myopia occurrence are not sufficiently explained. METHODS: This retrospective-prospective, descriptive research included 100 students with verified myopia up to -3 Dsph. The research was conducted in the Institute for Occupational and Sports Medicine of Zenica-Doboj Canton and at the University of Zenica in the period from January 2011 until January 2012. Ophthalmological examination and Multistage Fitness Test were done twice. RESULTS: A significant correlation was recorded only according to assessment of physical competence during the second measurement with a negative sign, indicating that an increase of physical activity had an impact on the decrease of differences in values of automatic computer refractometry in cycloplegia of measurements (right eye Rho: -0.260, p less than 0.01; left eye Rho: - 0.255, p less than 0.05). Multivariate regression analysis of impact on the difference of distance visual acuity without correction as well as the impact on difference of automatic computer refractometry in cycloplegia indicated that assessment of physical competence during the measurements had statistically significant impact on the decrease of distance visual acuity between measurements (right eye OR: I measurement -0.748, II measurement -0.660, p less than 0.05; left eye OR: I measurement -0.613, II measurement -0.515, p less than 0.05) and on decreased difference of automatic computer refractometry in cycloplegia (right eye OR: I measurement -0.822, II measurement -0.831, p less than 0.05; left eye OR: I measurement -0.641, II measurement -0.706, p less than 0.05). CONCLUSION: Physical activity did not cause the increase of myopia. This research opened a perspective for other researches on the impact of physical activity on myopia.