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Objective: To assess the neonatal outcome of macrosomic neonates in uncomplicated, singleton, term deliveries., Study Design: A retrospective analysis was performed on 5738 live-born term neonates born in the period 2008-2009. The neonatal outcomes were compared between two birth weight (BW) groups: the macrosomic neonates born with BW≥4000g and a control group: 2500-3999g. There were 410 (7.1%) neonates in the macrosomic group, 4757 (82.9%) in the control group, while 571 (10.0%) were less than 2500g at birth. A correlation analysis of two subgroups of the macrosomic neonates (4000-4499g vs. ≥4500g) was also carried out., Results: The rate of caesarean section (CS) was significantly higher in the macrosomic group as compared with the control group (49.3% vs. 39.9%), as were the prevalences of hypoglycaemia (6.1% vs. 2.9%), adrenal haemorrhage (0.98% vs. 0.15%) and the male to female ratio (2.15 vs. 0.95). The rate of icterus was significantly higher in the control group (30.4% vs. 18.5%). The macrosomic subgroups were similar in many aspects, but we found significantly more neonates in the higher weight subgroup as regards a low Apgar score, clavicle fracture and the need for intensive care., Conclusions: The macrosomic infants were born in good general condition, although those with BW ≥4500g more frequently had an adverse outcome. The macrosomic and control groups' data revealed significant differences in the rate of CS, the male to female ratio, hypoglycaemia and adrenal haemorrhage., (Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.)

Objective: To determine the utility of the first-trimester fetal nuchal translucency (NT) thickness in the prediction of fetal cardiac malformations., Design: Retrospective study., Setting: Department of Obstetrics and Gynecology and Medical Genetics, University of Szeged., Methods: The pre- and postnatal course and outcome, and the relationship between the first-trimester fetal NT thickness and fetal congenital heart defects (CHDs) in 4309 pregnancies ended up with birth or therapeutic abortion between January 1998 and June 2000 were registered. Prenatal care included first- and second-trimester fetal sonography at weeks 10-13 and 18-20, respectively., Results: 4251 births and 58 first- and second-trimester therapeutic abortions due to lethal congenital malformations or chromosomal abnormalities were recorded. Altogether 209 (4.9%) congenital malformations were detected, 39 (18.7%) of which were heart defects with normal karyotype. At birth, 151 congenital malformations were diagnosed, 34 of them were known prenatally. The prevalence of CHDs was 9 per 1000 pregnancies. The measurement of fetal NT thickness was available in 35 of the 39 fetuses with heart defects: it was > or = 3 mm in 18 (51.4%) and <3 mm in 17 (48.6%). A sensitivity of 51.4% was found at a cutoff of 3mm., Conclusions: An increased NT thickness in chromosomally normal fetuses was found to be highly associated with CHDs and identified in more than half of the affected cases. Furthermore, an increased NT of > or = 3 mm can be regarded a selection criterion for early second-trimester targeted fetal echocardiography and for increased fetal and neonatal surveillance.

Objective: The aim of this study was to examine the social conditions of women who never attended prenatal care and to evaluate the perinatal outcome of their newborns., Study Design: A retrospective analysis of uncared pregnancies of women who delivered at the Department of Obstetrics and Gynaecology, University of Szeged, Hungary between 1 January 1996 and 31 December 1998. There were 5262 deliveries during this period, of which 54 (1%) had no prenatal care. Matched controls (108 cases) were selected on the basis of maternal age, educational level, the number of gravidity and parity, and marital status., Results: The mean age of women with out-of-care pregnancies was 27 years+/-3.9; 5 women were under 18, 23 (43%) were unmarried, 5 (9.3%) did not finish elementary school and 35 (65%) had only elementary school education. Compared to the controls there were more in preterm labors (33 versus 14% (OR 3.1, 95% CI 1.4-6.8)), lower birth weight (P<0.001) and more given up for adoption (17 versus 0.9% (OR 21.4, 95% CI 2.63-173.9))., Conclusion: These data underline the importance of regular prenatal care in the prevention of preterm delivery.