No abstract

Intrauterine growth restriction (IUGR) can be described as condition in which fetus fails to reach his potential growth. It is common diagnosis in obstetrics, and carries an increased risk of perinatal mortality and morbidity. Moreover, IUGR has lifelong implications on health, especially on neurological outcome. There is a need for additional neurological assessment during monitoring of fetal well-being, in order to better predict antenatally which fetuses are at risk for adverse neurological outcome. Studies have revealed that the behavior of the fetus reflects the maturational processes of the central nervous system (CNS). Hence, ultrasound investigation of the fetal behavior can give us insight into the integrity and functioning of the fetal CNS. Furthermore, investigations carried out using modern method, four-dimensional (4D) sonography, have produced invaluable details of fetal behavior and its development, opening the door to a better understanding of the prenatal functional development of the CNS. Based on previous observations and several years of investigation, our reaserch group has proposed a new scoring system for the assessment of fetal neurological status by 4D sonography named Kurjak antenatal neurodevelopmental test (KANET). The value of KANET in distinguishing fetal brain and neurodevelopmental alterations due to the early brain impairment in utero is yet to be assessed in large population studies. However, preliminary results are very encouraging.

Normal fetal biometry charts for population of pregnant women in the northern coastal region of Croatia were constructed. Due to existence of statistically significant differences in ultrasound fetal biometry values among various populations under comparison, construction of own charts and their implementation in routine obstetrical work are justified.

A great number of lifelong disabilities are due to congenital malformations. Evolution of prenatal ultrasound diagnosis and improvement of surgical technique have enabled us to detect most of these malformations in utero early and accurately with a possibility of early surgical management in selected cases even in utero. Advances in pre-/perinatal management have enabled us to interfere and change the origin of the disease in order to optimize the best postsurgical outcome. Only a multidisciplinary team of specialists could provide such appropriate treatment.

In all neonates, regardless of hearing impairment, genetic testing for the 35delG/GJB2 mutation is desirable in southern Croatia. The incidence of affected homozygous and healthy heterozygous transmitters of the 35delG/GJB2 mutation was in concordance with findings in southern European countries.