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8 Medicinski Glasnik, Volumen 8, Number 1, February 2011 28. Huggon IC. Practical guide to fetal echocardiography. Prenat Neonat Med 2001; 6:38-53. 29. Yagel S, Cohen SM, Achiron R. Examination of fetal heart by five short-axis view: a proposed screening method for comprehensive cardiac evaluation. Ultrasound Obstet Gynaecol 2001; 17:367-9. 30. Ibrahimović J, Begić H. Ventrikularni septalni defekt –rezultati desetogodišnjeg praćenja. Pedijatrija danas 2007; 3:194-200. 31. Jouannic JM, Gavard L, Fermont L, Le Bidois J, Parat S, Vouhé PR, Dumez Y, Sidi D, Bonnet D. Sensitivity and specificity of prenatal features of physiological shunts to predict neonatal clinical status in transposition of the great arteries. Circulation 2004; 110:1743-6. 32. Yagel S, Arbel R, Anteby EY, Raveh D, Achiron R. The three vessels and trachea view (3VT) in fetal cardiac scanning. Ultrasound Obstet Gynecol 2002; 20:340-5. 33. DeVore GR, Polanco B, Sklansky MS, Platt LD. The ‘stic’ technique: a new method for examination of the fetal outflow tracts using three-dimensional ultrasound. Ultrasound Obstet Gynecol 2004; 24:72- 82. 34. Turan S, Turan OM, Maisel P, Gaskin P, Harman CR, Baschat AA. Three-dimensional sonography in the prenatal diagnosis of aortic arch abnormalities. J Clin Ultrasound 2009; 37:253-7. 35. Hartung J, Kalache KD, Chaoui R. Three-dimensional power Doppler ultrasonography (3D-PDU) in fetal diagnosis. Ultraschall Med 2004; 25:200-5. Fetal echocardiography in the 15 th week of gestation 36. DeVore GR, Falkensammer P, Sklansky MS, Platt LD. Spatiotemporal image correlation (STIC): new technology for evaluation of the fetal heart. Ultrasound Obstet Gynecol 2003; 22:380-7. 37. Viñals F, Poblete P, Giuliano A. Spatio-temporal image correlation (STIC): a new tool for the prenatal screening of congenital heart defects. Ultrasound Obstet Gynecol 2003; 22:388-94. 38. Volpe P, Campobasso G, Stanziano A, De Robertis V, Di Paolo S, Caruso G, Volpe N, Gentile M. Novel application of 4D sonography with B-flow imaging and spatio-temporal image correlation (STIC) in the assessment of the anatomy of pulmonary arteries in fetuses with pulmonary atresia and ventricular septal defect. Ultrasound Obstet Gynecol 2006; 28:40-6. 39. Turan S, Turan A, Baschat A. Three- and four-dimensional fetal echocardiography. Fetal Diagn Ther 2009; 25:361–72. 40. Stoeckl C. An automated approach to visualize standard views of the fetal heart. New findings, new visualization planes. GE Healthcare Zipf, Austria [Online] (2009). http://www.volusonclub.net/ whitepapers&id=345 (3. februar 2010.) 41. Falkensammer P. Spatio-temporal Image correlation for volume ultrasound studies of the fetal heart. GE Healthcare, Zipf, Austria [Online] 2010. http:// www.volusonclub.net/whitepapers&id=181 (3. februar 2010). Adem Balić 1 , Devleta Balić 2 Department of Obstetric and Gynaecology, Health Centre Tuzla, Human reproduction centre “Dr Balić” Tuzla ABSTRACT A fast development of the ultrasound technology has enabled a very high resolution of images thus opening a possibility for better quality of images of all fetal structures including fetal heart. Transabdominal ultrasound examination of heart is commonly conducted after the 10th week when it is possible to get a quality image of all relevant heart structures using 3-5MHz probes. Having in mind that fetal heart is mostly formed by the end of the 14th week, an idea of a vaginal ultrasound examination in the 15th week using 5-9MHz probes has been a logical one. In that period the length of the fetus ranges from 9 to 10 centimeters, which is a basis for an assumption that a quality examination of the fatal heart may be conducted using the vaginal probe. This paper is showing all standard cross-sections of fetal heart (4 chambers, outflow tracts, cross-section of three great vessels and longitudinal view of aortic and ductal arches) obtained by vaginal examination in the 15th week and abdominal examination in the 20th and 22nd week. The transvaginal examination of fetal heart is possible in the 15th week and it is recommended to be done in all pregnant women with problematic personal and reproductive anamnesis and those with positive ultrasonographic markers for chromosomal defects. Key words: echocardiography, fetus, 15 weeks Originalna prijava: 18. februar 2010.; Korigirana verzija: 04. mart 2010.; Prihvaćeno: 13. april 2010.
ORIGINAL ARTICLE Better stability of acenocoumarol compared to warfarin treatment in one-year observational, clinical study in patients with nonvalvular atrial fibrillation Aida Kulo 1 , Jasna Kusturica 1 , Elvedina Kapić 1 , Fahir Bečić 1 , Maida Rakanović-Todić 1 , Lejla Burnazović- Ristić 1 , Amila Mehmedović 2 , Orhan Lepara 3 , Nedžad Mulabegović 1 1 Institute of Pharmacology, Clinical Pharmacology and Toxicology, School of Medicine, University of Sarajevo, 2 Clinic for Gastroenterohepathology, Clinical Centre of the University of Sarajevo, 3 Institute of Physiology and Biochemistry, School of Medicine, University of Sarajevo; Sarajevo, Bosnia & Herzegovina Corresponding author: Aida Kulo Institute of Pharmacology, Clinical Pharmacology and Toxicology, Faculty of Medicine, University of Sarajevo, Čekaluša 90, 71000 Sarajevo, Bosnia and Herzegovina Phone: +387 61 56 61 69; fax: +387 33 441 813; E-mail: aidakulo@yahoo.com Original submission: 11 January 2010; Revised submission: 14 March 2010; Accepted: 13 April 2010. ABSTRACT Med Glas Ljek komore Zenicko-doboj <strong>kantona</strong> 2011; 8(1):9-14 Aim To evaluate differences in the treatment quality between often used oral anticoagulants, warfarin and acenocoumarol in patients with nonvalvular atrial fibrillation (NVAF). Methods This was an observational, comparative, one-year clinical study, conducted in the Blood Transfusion Institute of Sarajevo, Bosnia & Herzegovina. All patients who were using warfarin/ acenocoumarol and monitored were eligible. Patients who met inclusion criteria (the age of 40-80, diagnosed NVAF, CHADS 2 index score ≥2, the planned long-term treatment) were included in two parallel groups of 60 patients, composed according to the warfarin/acenocoumarol treatment as well as the gender and age. Routinely measured International normalised ratio (INR) values were the basic parameter for individual quality and stability assessment. Results All average, monthly INR values were in therapeutic range (2.0-3.0) in both therapeutic groups. There were no significant differences either in the number of therapeutic INR values per patient (50.53±23.72% vs. 51.74±26.68%, P = 0.795) or in individual quality of treatment: >50% therapeutic INR values (60.0% vs. 64.9%, P = 0.721) and >75% therapeutic INR values (18.3% vs. 22.8%, P = 0.714) in the warfarin and acenocoumarol group, respectively. Significantly better stability was determined for acenocoumarol as compared with warfarin treatment in terms of a longer period of the total observed time during which therapeutic INR values were stable (37.6% vs. 35.7%, P = 0.0002). Conclusion Both drugs have shown similar quality of individual anticoagulation control, but acenocoumarol have shown significantly better anticoagulation stability with therapeutic INR values covering significantly longer time of treatment. Key words: nonvalvular atrial fibrillation, warfarin, acenocoumarol, INR, stability 9
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