Objective The objective of this study was to analyze if the addition of simple cardiac scan in cases with increased nuchal translucency (NT) and/or abnormal ductus venosus (DV) blood flow, and/or tricuspid regurgitation (TCR) can improve detection of congenital heart defects (CHD) in chromosomally normal fetuses without non‐cardiac defects at 11‐13 + 6 gestational weeks in a population of singleton pregnancies. Methods During the 10 years period, all singleton pregnancies at 11‐13 + 6 weeks were routinely scanned for NT, DV blood flow and TCR assessment and, if a single of these parameters was abnormal, simple cardiac scan with 2D gray scale and color and/or directional power Doppler in 4‐chamber (4‐CV) and 3 vessel and trachea views (3VTV) was performed. Results The sensitivity and specificity of NT ≥ 95th + DV R/A a‐wave + TCR in detecting CHD were 77% and 97%, respectively, and of simple cardiac scan, 67% and 98%, respectively. Area under the curve of receiver operating characteristic curve of NT ≥ 95th + DV R/A a‐wave + TCR was 0.838, and of NT ≥ 95th + DV R/A a‐wave + TCR + simple cardiac scan was 0.915. Conclusions In chromosomally normal fetuses without non‐cardiac anomalies, addition of simple cardiac scan to the combined first trimester screening parameters improves detection of major CHD during first trimester.

The mental health of healthcare workers, especially the nursing staff in intensive care units, is crucial for the optimal functioning of healthcare systems during medical emergencies. This study implements a cross-sectional design to investigate the associations between nurses’ personal characteristics, workplace challenges, and job satisfaction with the increased perception of tension, stress, and pressure at the workplace (TSPW) before and during the COVID-19 pandemic. In 2021, we surveyed 4210 nurses from 19 intensive healthcare facilities in the capital of Serbia, Belgrade, and, at that time, collected data about their perceived TSPW before and during the COVID-19 pandemic. Our study identified six predictors of the increase in TSPW, as perceived by nurses: their work in COVID-19 infectious zones (OR = 1.446), exhaustion due to work under protective equipment (OR = 1.413), uncertainty and fear of infection (OR = 1.481), a high degree of superiors’ appreciation and respect (OR = 1.147), a high degree of patients’ attitudes (OR = 1.111), and a low degree of work autonomy (OR = 0.889). The study’s findings suggest that a solution to this issue is necessary to ensure that nurses are safe and able to alleviate the physical and mental strain that comes with prolonged use of protective equipment. Nurses on the frontline of the pandemic require better health protection, better conditions, and respect for their role. Strategies to promote mental health would help reduce nurses’ stress and increase job satisfaction.

Background and Objectives: The aim of the present work was to compare the characteristics of delta and omicron variants of COVID-19 infection in pregnant women, the association of infection with comorbidity, clinical manifestation of the disease, type of delivery, and pregnancy outcome. Material and Methods: The study was designed as an observational, retrospective study of a single center. The analysis included the cohort of women who had SARS-CoV-2 infection during pregnancy and/or childbirth in the period from 1 March 2020 to 30 June 2023. Results: Out of a total of 675 pregnant women with SARS-CoV-2 infection, 130 gave birth with the delta and 253 with the omicron variant. In our retrospective analysis, pregnant women with both SARS-CoV-2 variants had a mild clinical history in most cases. In the omicron period, a significantly lower incidence of pregnancy loss (p < 0.01) and premature birth (p = 0.62) admission of mothers and newborns to the intensive care unit (p < 0.05) was recorded. Conclusions: In our retrospective analysis, pregnant women with COVID-19 infection generally exhibited a milder clinical manifestation with both variants (delta and omicron) of the viral infection. During the delta-dominant period, ten percent of affected pregnant women experienced a severe clinical history. However, during the omicron-dominant period infection, a significantly lower incidence of complications, pregnancy loss, preterm delivery, and admission of mothers and neonates to the intensive care unit was recorded. This can be partly explained by the greater presence of pregnant women with natural or induced vaccine immunity.

Background/Aim. Adverse pregnancy outcomes such as preeclampsia (PE), placental abruption (PA), fetal intrauterine growth restriction (IUGR) and stillbirth could be recognized by prenatal screening. The objective of this study was to predict IUGR by using first-trimester extremely low pregnancy-associated plasma protein-A (PAPP-A), extremely low free beta-human chorionic gonadotropin (free ?hCG) levels, and extremely high Pulsatility-index (PI) of uterine arteries, as single and combined predictors for IUGR development. Methods. This was a prospective first-trimester study analyzing singleton pregnancies at 11?13+6 weeks? gestation who underwent routine first-trimester screening at the Department of High Risk Pregnancy of the Clinic for Gynecology and Obstetrics ?Narodni front?, University of Belgrade, Serbia. First-trimester screening for PAPP-A, free ?hCG, and PI was performed in nulliparous, normotensive women with extremely low PAPP-A (PAPP-A ? 0.52 unit multiple of median ? MoM) and/or extremely low free ?hCG (free ?hCG ? 0.56 MoM) and/or extremely high PI (PI ? 2.52). Results. Of 85 pregnant women included in the final analysis, 14 (16.5%) developed IUGR. PAPP-A ? 0.52 MoM and PI ? 2.52, as single categorical variables, found to be with high predictable values for IUGR development (odds ratio ? OR = 3.064, 95% confidence interval ? CI= 0.634-14.810, p = 0.046, and OR = 2.129, 95% CI = 0.449?10.713, p = 0.021, respectively). Furthermore, the receiver operating characteristic (ROC curve identified PAPP-A and PI as continuous variables to be significant predictors of IUGR (area under curve ? AUC = 0.671, 95% CI = 0.521?0.820, p = 0.045, and AUC = 0.744, 95% CI = 0.587?0.902, p = 0.004, respectively). Conclusion. The present study suggests that the first trimester extremely low PAPP-A and increased Doppler-PI levels are single predictors of IUGR. Described model could be used in a routine daily clinical practice in resource limited settings where other parameters are not available for the prediction of IUGR development.

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Introduction/Aim: Increased rates of Cesarean section (CS) and subsequent short-term and long-term maternal complications (MC) and neonatal complications (NC) have been reported. The aim of this study was to compare short-term MC and NC between elective and emergent CS. Material and Methods: Data from medical records of pregnant women who had undergone CS at Gynecology and Obstetrics Clinic "Narodni front" were retrospectively collected. The inclusion criteria were as follows: low-risk, term monofetal pregnancies with obstetrical CS-indications and other non-life-threatening maternal conditions (ophthalmological, orthopedic, psychiatric, lower genital-tract infections). Short-term MC were the following: surgical complications, inflammatory syndrome, the need for blood transfusion, and hospital stay ≥5 days. NC were as follows: respiratory morbidity, asphyxia, sepsis, injuries/lacerations, admission to neonatal intensive-care-unit, hospital stay >4 days. Results: We included 1056 singleton pregnancies. Mean age was 32.63±5.38 years, mainly primipara 566 (53.6%). Of all CS, 774 (73%) were performed emergently. Cephalopelvic disproportion/fetal macrosomia and other CS indications carried a significantly high risk for emergent CS (OR=3.943, 95%CI 2.036-6.591; OR=7.560, 95%CI 3.994-8.327, respectively). Regardless of the urgency of CS there were no significant differences in the frequency of MC. Neonatal sepsis was significantly higher after emergent CS (p=0.027), with a two-times greater risk for its development (OR=2.070, 95% CI 1.072-3.997). There were no fatal maternal/neonatal outcomes and no need for additional care. Conclusion: There were no notable disparities in MC and NC among the individuals who had undergone emergent and elective CS. Neonates born by means of emergent CS had a higher risk of developing neonatal sepsis. Indications for CS had a greater impact on short-term maternal and fetal outcomes than the type of CS.