[Prenatal diagnosis of coiling of the umbilical cord around the neck and its effect on early neonatal prognosis]. / Antenatalna dijagnoza omotane pupkovine oko vrata i utjecaj na ranu neonatalnu prognozu.

"Real time" ultrasonic equipment enables antenatal diagnosis of nuchal encirclement by the umbilical cord. One hundred cases of normal term pregnancies were sonographically examined immediately before programmed delivery induction with a purpose of finding the cord around fetal neck. During the delivery all the patients were CTG monitored, after delivery the blood was taken from the umbilical artery for the acid-base balance analysis and also the Apgar score was determined. One of a hundred examined cases falsely negative and one falsely positive result were found which indicates that the method is highly sensitive and specific (sensitivity 94.1%, specificity 98.8%). There was a statistically significant difference (P less than 0.005) between acid-base balance, CTG and Apgar score in a group of the newborns with nuchal cord. The active antenatal ultrasonic search for umbilical cord around the fetal neck can significantly reduce the frequency of intrapartal hypoxia as well as the perinatal mortality and morbidity.

[The breech partogram]. / Partogram zatka.

A partogram was made after analysis 383 spontaneous breech deliveries of primiparas and 343 of multiparas. The height of parturients was 160 cm or more, gestational age between 37 and 42 weeks and the newborn birthweight between 2500 and 3900 g. The newborns did not show any signs of fetal damage from the period of pregnancy or delivery. The duration of delivery was counted from the time of the cervical dilatation of 2 cm or more. A partogram was made after the statistical analysis of particular cervical dilatation phases; the duration of delivery in primiparas was up to 13 hours and 15 minutes and in multiparas up to 10 hours and 40 minutes. The second stage of delivery in primiparas was 1 hour and 20 minutes and in multiparas 40 minutes. The distribution of data concerning the duration of delivery demonstrated by the mean value and SD was symmetrical; the mean value of the duration of delivery with 99% of reliability was from 9 hours up to 10 hours and 54 minutes for primiparas and from 8 hours and 19 minutes up to 9 hours, and 18 minutes for multiparas. Breech delivery was accelerated in the earlier dilatation phase if compared to the later phase which was significantly slowed down.