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Introduction: HELLP syndrome is a pregnancy complication consisted of hemolysis, elevated liver enzymes and low platelet count, which could be associated with significant maternal and perinatal morbidity and mortality. Objectives: The aim of our study was to determine the incidence of prematurity in pregnancies complicated by HELLP syndrome, as well as to analyze the morbidity and mortality of these newborns. Methods: A retrospective observational study was carried out at Clinic for Gynecology and Obstetrics of the Clinical Center of Serbia in the period from 2007. to 2014. year. We analyzed 39 newborns born from pregnancies complicated with HELLP syndrome and compared them with 28 newborns born from mothers without HELLP syndrome. Gestational age were matched among the groups. The variables were analyzed by chi-square (χ2) test, a Student's t- test , Fisher exact probability test, Mann Whitney U test. Results: From total number of 39 newborns in the HELLP group, 35(89.7%) were born prematurely (from 23 to 36+6/7 GW), with mean gestational age of 33 weeks. Mean birth weight was 1833,85 g, length 42,59 cm, mean head circumference was 31cm and mean Apgar score was 5 in the first minute and 6 in the fifth minute. We did not find differences between the HELLP syndrome group and the control group in the gestational age, Apgar score (5 vs 6 in the first minute p = 0,101; and 6 vs 6 in the fifth minute, p = 0,450), and the incidence of severe RDS (respiratory distress syndrome grade III to V) (33,3% vs 17,6%, p=0,348), IVH (intraventricular hemorrhage) (61,8% vs 52,2%, p=0,472), perinatal asphyxia (15,4% vs 14,3%, p= 0,900), anemia and need for red blood cell transfusion (37,8% vs 28,0%, p=0,422), as well as mean blood glucose values (5,26 mmol / l vs 3,97 mmol / l, p= 0,795). There were significant differences between the HELLP syndrome group and the control group in the incidence of suspected fetal growth restriction (35,9% vs 10,7%, p= 0,0195) and thrombocytopenia in the first day of life (22,9% vs 4,0%,p= 0,044). Neonatal mortality in the whole HELLP group was 7.7% (vs 0,0% in the control group), but was expectedly higher among newborns of gestational age less than 32 weeks (21,4%). Conclusions: This study shows increased risk of thrombocytopenia and intrauterine growth restriction in newborns from pregnancies complicated by HELLP syndrome. Most of the pathological conditions among these newborns are the results of prematurity. [ABSTRACT FROM AUTHOR]

The aim of this study was to analyse the outcome of transported newborns, in correlation to their gestational and postnatal age as well as the length of transportation. This retrospective epidemiological study, includes newborns who were transported from HC Vranje into tertiary care centres during four years period (2009.-2012.). Analysed newborns were divided into three groups: I <32 weeks and BW<1500g; II 32 - 37 weeks and BW from 1500 - 2500 g and III >37 weeks and BM>2500 g. Most common risk factors for morbidity and mortality of transported infants, such as sex, birth weight, gestational age and Apgar score in 5th minute, have been assessed. In regards to the outcome of transport, postnatal age and the duration of transport have been analyzed. The outcome have been defined as favorable (survived) or unfavorable (did not survive). 208 infants have been transported (3%), out of which 72 were preterm infants (35%). Unfavorable outcome had 17 infants (8%). Gestational age had significant influence on the outcome of the transported infants p = 0.000 (24% I, 17% II and 10% III group). Sex of infants have not influenced the outcome of treatments (for preterm infants p = 0.691 and for term infants p = 0.253). Unfavorable outcome was influenced by perinatal asphyxia (low Apgar score in 5th minute 59% p < 0.05). Infants who needed an urgent transport had a large percentage of unfavorable outcome, the mortality was 94% among the infants transported in the first hour of life (p < 0.01). Duration of transport varied from 90 - 210 minutes, and had significant influence on the outcome of the treatment (p = 0.002). Conclusion: the outcome of transported infants was significantly influenced by clinical condition of infants prior to transportation, gestatial and postnatal age, as well as the length of transportation. [ABSTRACT FROM AUTHOR]

Objectives: The objectives of this study were to evaluate risk factors, course and outcomes of sepsis in neonates based on their gestational age. Methods: The study included 115 consecutive neonates who met the following criteria: 1) gestational age between 24. and 39. weeks, 2) blood culture proven sepsis, 3) absence of other significant co-morbidities, and 4) written consent of the parents. The patients were divided in two groups according to the gestational age. Group I included neonates with gestational age between 24. and 32. weeks (74 neonates), and group II included neonates with gestational age between 33. and 39. weeks (41 neonates). Empirical antiobiotic treatment was initially started and adjusted according to the antibiogram results. Results: There were no differences between the groups in terms of maternal risk factors for sepsis. Regarding the neonatal characteristics, group I had lower birth-weight (1286±325 vs 2071±495 grams, p<0.001), and Apgar score after 1 (5.04±2.05 vs 6.77±1.86, p<0.001) and 5 minutes (5.85±1.99 vs 7.32±1.86, p<0.001). There was no difference between the groups with respect to the incidence of early (39/74 (52.7%) vs 18/41 (43.9%), p=0.37) and late sepsis (35/74 (47.3%) vs 23/41(56.1%), p=0.44). The most frequent causative bacteria in both groups was Serratia species (55/74 (74.3%)vs 33/41(80.5%), p=0.77), followed by Acinetobacter in group I, and Klebsiella in group II. Again, antibiotic treatment was similar between the groups, with meropenem being used most frequently (68/74 (91.8%) vs 38/41 (92.7%), p=0.97). Duration of hospitalization was longer in Group I when compared to Group II (83.3±35 vs 42.6±13.4 days, p<0.001). There was a trend towards increase mortality in Group I vs Group II (11/74 (14.9%) vs 2/41 (4.9%), p=0.10). Conclusions: Neonates with lower gestational age tend to have prolonged hospitalization following sepsis. There is a trend toward increased mortality in the same group. Other characteristics are similar between neonates of different gestational age. [ABSTRACT FROM AUTHOR]