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The aim of the paper is to investigate the impact of drugs utilization during pregnancy in the City of Zagreb. This one-month cross-sectional study was conducted in all four Zagreb maternity hospitals using a questionnaire administered to 893 pregnant women. The women used a mean of 2.6 drugs. The vitamin-mineral complex was the leading medicament used by the women during the study period (62.9%) and during pregnancy period. The leading drugs taken between hospital admission and delivery were metoclopramide (10.1%) and diazepam (6.0%). Utilization of diazepam is high during the entire pregnancy. According to FDA risk classification during pregnancy, most drugs are in B class (88%), and in A class (77%). Percent of FDA C class is 16%. In the FDA classes with fetal risk, D class has 47.5%, and X class, with only one woman using drug from this class has a 0.1% of total utilization. In spite of some limitations of the study, the results pointed to the uneconomical, potentially harmful drug use during pregnancy and puerperium, obviously calling for therapy quality upgrading in this vulnerable period of life.

An abstract of the article "Late CVS: Experience with 5800 cases," by M. Podobnik and colleagues, is presented.

Background: This study comprises data from 3250 women allocated to transcervical CVS (TC-CVS), transabdominal CVS (TA-CVS) and transvaginal CVS (TV-CVS). We have assessed the efficacy of transabdominal CVS compared with transcervical CVS and transvaginal CVS, and examined factors that have been implicated in causing spontaneous abortion. Methods: Over an 11-year period, 3250 women underwent chorionic villus sampling at 9–12 weeks of gestation, by transcervical (500 patients) transabdominal (2650 patients) and transvaginal technique (100 patients). Transvaginal color Doppler was used to investigate the uteroplacental and fetal vessels in 500 pregnancies between 11 and 12 weeks of gestation (400 TA-CVS and 100 TC-CVS) before and after CVS procedures. Results: Five hundred (15.4%) patients underwent TC-CVS and spontaneous abortion after TC-CVS occurred in five cases (1.0%). 2650 (81.5%) patients underwent TA-CVS using a 20 gauge spinal needle and abortion after TA-CVS occurred in 11 cases (0.4%). One hundred (3.1%) patients underwent TV-CVS using a 20-gage needle and abortion after TV-CVS occurred in three cases (3.0%). The spontaneous abortion rate after CVS procedures was 0.7%. Some 121 (4.6%) cases showed chromosomal aberration. The spontaneous abortion rate was lower among cases allocated to TA-CVS after 11 weeks of gestation. There were no significant differences in mean pulsatility indices (PI) between maternal, fetal and intraplacental circulation, before and after CVS procedures. Conclusions: Transabdominal CVS has lower fetal loss rate than transcervical and transvaginal CVS. [ABSTRACT FROM AUTHOR]

Background: The purpose of this article was to evaluate the association between late CVS (placental biopsy) and complications between sampling and delivery. Methods: Late chorionic villus sampling under ultrasound guidance was carried out in 3000 (85.7%) cases in the second trimester and 500 (14.3%) cases in the third trimester of pregnancy. Out of 3500 late CVS, 710 (20.3%) were performed because of suspicious ultrasonographic findings. In the 500 patients between 13 and 16 weeks of gestation color, Doppler was used to investigate the uteroplacental and fetal vessels before and after late chorionic villus sampling. Results: In 30 patients (0.85%), complications between sampling and delivery were found. There were only 11 (0.31%) spontaneous abortions four to six weeks after late chorionic villus sampling. We found 166 (4.74%) chromosomal abnormalities. In the group with suspicious ultrasonic findings (710 cases), we found significant oligohydramnios in 314 (44.2%) and significant polyhydramnios in 155 (21.8%), and 110 (15.5%) had chromosomal abnormalities. Among the 166 patients with chromosomal abnormalities, ultrasonographic findings in 90 (54.2%) were detected after 20th week of pregnancy. There were no significant differences in mean pulsatility indices between uteroplacental and fetal vessels before and after late chorionic villus sampling. Preliminary data for 25 trisomic fetuses indicate an abnormally increased umbilical PI and abnormally decreased middle cerebral artery PI. Conclusions: Late CVS is a safe method of prenatal diagnosis for high-risk couples and does not significantly affect the outcome of pregnancy. [ABSTRACT FROM AUTHOR]