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Vol.12 No.3

Date: July 2003.

CONTENT:

PRIJEDLOG ORGANIZACIJE PERINATALNE ZAŠTITE U REPUBLICI HRVATSKOJ (Vol.12 No.3, str.87-99)

Authors:

Radna Skupina

Editorial

Summary:
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Key words:
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THE CORRELATION OF UTERINE MUSCLE ELECTROMYOGRAPHIC (EMG) ACTIVITY AND FETOPLACENTAL, FETAL AND UTERINE ARTERIAL BLOOD FLOW (Vol.12 No.3,str.100-101)

Authors:

Snježana Škrablin, Ivan Kuvačić, Vladimir Banović

Original paper

Summary:
Negative factors can influence the development of the placenta during the midterm of the second trimester having negative effects on the fetal growth and development. The aim of this study was to determine possible negative influences of pathologic electromyographic uterine activity (EMG activity) during the second trimester on the process of placental development, the effects of pathologic EMG activity on the fetoplacental, fetal and uterine blood flow, fetal birthweight and the changes depending on the success or failure of ritordine therapy. Methods. 114 pregnant women were divided in four groups (A, B, C, D) according to the electromyographic findings after the 20th week of pregnancy and the ritordine treatment. Group A were pregnancies (N=41) with ellectrically quiet myometrium, group B (N=17) pregnancies with pathologic EMG activity unopposed by the therapy, group C (N=34) were pregnancies with persistent pathologic EMG activity in spite of the therapy, while group D (N=22) were pregnancies with electrically quiet myometrium during the ritodine therapy. Fetal aortal and fetal middle cerebral artery, umbilical and arcuate artery resistance indexes (RI) and blood flow velocities, were measured from the 28th week of pregnancy until the delivery. Results. Pregnant women with pathologic uterine EMG activity before the 24th week who received no treatment (B) had significantly higher values of resistance indexes in the arcuate and umbilical arteries compared to pregnant women without uterine electrical activity (group A), pregnant women who were successfully treated (group D) and those with EMG uterine activity during the ritordine therapy (group C). In total, 70% of children born in group B were growth retarded, compared to 7% in group A and 9% in group D. Resistance indexes in the fetal aorta in group B were significantly higher than in the groups A, C, and D. Group B had a significantly lower systolic, diastolic and middle blood flow velocity in aorta and umbilical artery than in the other groups, with significant velocity increment in the middle cerebral artery, compared to the group A. Conclusion. Pathologic uterine EMG activity predicts placental hemodynamic disorder, which, by causing abnormal placentation, leads to consequential abnormalities in fetal and fetoplacental blood flow and growth retardation. Tocolitic ritordine therapy is just one possibility for stopping pathological EMG uterine activity but still, it is far from perfect. It appears, however, that blood flow divergences during the therapy are not the consequences of the pharmacologic effect of the drug itself, but of the drugs tocolytic success or failure.

Key words:
erelectrical uterine activity, fetal and uterine blood flow, electromyography, preterm labor


NATURAL MICRONIZED PROGESTERONE IN GYNECOLOGY AND HUMAN REPRODUCTION (Vol.12 No.3, str.111-116)

Authors:

Branko Radaković

Preview

Summary:
By comprehending that unopposed estrogens, both of endogenous or exogenous origin, increase the emergence risk of endometrial cancer, the application of progesterone has begun exclusively for the purpose of preserving the health of endometrium. Natural progesterone, because of its quick metabolism in the liver and intestines, low absorption and low bioavailability in the serum, could not be used for that purpose. Therefore, more powerful synthetic progesterones, gestagens, have been synthetized which have a good effect on the endometrium and protect it from unopposed activity of estrogens. But, time has shown that synthetic gestagens can have harmful effect on the metabolism of glucose, lipoproteins in plasma, endothel of blood vessels and the terathogenic effect on the fetus is also possible. By determining the chemical structure and classification of gestagens according to affinity for binding with different receptors the efficiency and possible side- -effects of gestagens could not be foreseen with certainty. By micronizing the progesterone, absorption in the intestines and bioavailability in the serum is increased in both oral and vaginal use. Such progesterone preparation has shown good therapeutical effects in patients with premenstrual syndrome, secondary amenorrhaea, as well as in the treatment of infertility, threatening and repeated spontaneous abortions. Considering that, in the mentioned indications, it appeared to be very efficient, without side-effects, its use is recommended instead of unpredictable and sometimes harmful gestagens.

Key words:
micronized progesterone, premenstrual syndrome, secondary amenorrhea, spontaneous abortion, infertility


VIOLENCE AGAINST PREGNANT WOMEN ( (Vol.12 No.3, str.117-121)

Authors:

Sanja Katalinić, Aleksandra Frković, Renata Dobi-Babić

Review

Summary:
According to Croatian Constitution no one can be subjected to abuse, particularly women, and especially pregnant women. Pregnancy is period of high risk for woman to be subjected to physical, psychological or sexual violence from the part of intimate partner or other family member. The problem of violence against women in family is very complicated and the cause of it needs to be viewed through cultural, economical, judicial and political frames. The most prevalent risk factor for abusing during pregnancy is previous abuse in family and because of that we should recognise it as soon as possible, preferable before pregnancy. In that way we protect woman’s and child’s health, because trauma, stress, alcohol or drug abuse, and non-adequate health care during pregnancy can be the cause of serious negative consequences, even fatal, for woman and child. Discovering, treating and preventing from farther abuse is necessary to adequate resolve abuse against pregnant women. All of this is possible only through co-operation of gynaecologists and the rest of health workers with social services, administration of justice, police, non-government associations and other social structures. In this review article we have used medical literature, but also literature of other professions involved in the system of victim protection (victims of family violence). It is desirable for the physicians and the rest of health workers who treat pregnant women to have some knowledge from those areas, too.

Key words:
family violence, pregnancy, consequences


COMPARISON OF TRANSVAGINAL ULTRASONOGRAPHY AND MINILAPAROSCOPY IN ASSESSMENT OF BENIGN ADNEXAL MASSES (Vol.12 No.3, str.122-122)

Authors:

Božidar Njavro, Damir Hodžić

Professional paper

Summary:
Objective. To evaluate the accuracy of ultrasound examination and of minilaparoscopy in the appraisal of adnexal masses. Methods. During the period from April, 1998 to January, 2000 we treated totally 40 patients with benign adnexal masses by minilaparoscopy with 1.9 mm endo-camera (Wolf GmbH, Germany). All of those patients were preoperatively evaluated by transvaginal ultrasonography with 6.5 MHz probe (Hitachi, Japan). Results. Out of them, there were 5 (12.5%) cases of pelvic inflammatory disease, 8 (20.0%) ectopic pregnancies, 5 (12.5%) endometriosis, 4 (10.0%) dermoid cyst, 3 (7.5%) paraovarial cyst, 4 (10.0%) polycystic ovaries, 8 (20.0%) functional cyst, and 3 (7.5%) other benign adnexal masses. After final diagnostic evaluation by minilaparoscopy, all patients were successfully treated by operative laparoscopy (mostly cyst enucleation, oophorectomy or/and salpingectomy) or laparotomy, in few cases. All patients were dismissed after brief hospitalization and without perioperative complications. Conclusion. Both methods are approximatively of the same accuracy, they are complementary.

Key words:
transvaginal sonography, minilaparoscopy, benign adnexal masses


MUCINOUS CYSTADENOMA OF BODERLINE MALIGNANCY AND BRENNER TUMOR IN THE SAME PATIENT (Vol.12 No.3, str.128-129)

Authors:

Petar Klarić, Lada Bolf Benković, Hrvojka Soljačić Vraneš, Ahmed Pirkić

Professional paper

Summary:
Borderline mucinous tumor of ovary is the tumor of low malignant potencial, associated with a good prognosis. Brenner’s tumor of the ovary is very rare, mostly benign, small and unilateral, usually appears in older women. The case of a 52-year old woman in which we found a mucinous proliferating cystadenoma in the same ovary with the benign Brenner tumor is presented.

Key words:
borderline (»proliferating«) mucinous tumor, tumor Brenner, ovary


APPENDICITIS IN THE EARLY PUERPERIUM: CASE REPORT (Vol.12 No.3, str.130-132)

Authors:

Ivan Kuvačić, Snježana Škrablin, Božidar Župančić, Helena Lovrić

Case report

Summary:
Apendicitis je naju~estalija neobstetri~ka dijagnoza u trudno}i koja zahtijeva kirur{ki zahvat, dok je u ranom postpartalnom periodu iznimno rijetka. Prikazat }emo 27-godi{nju babinja~u s vrlo neobi~nim klini~kim tijekom bolesti. Inicijalni abdominalni simptomi pojavili su se dva dana prije termina poroda, ali su znaci karakteristi~ni za akutni abdomen bili prikriveni samim po~etkom poroda, te uobi~ajenim smetnjama tijekom puerperija. Dan nakon poroda babinja~a se ponovo `alila na mu~ninu i povra}anje. Abdomen je bio osjetljiv, ali bez defansa, laboratorijski parametri u granicama normale, a rendgenski nalaz uredan, pa je primijenjeno konzervativno lije~enje. Tijekom idu}a dva dana pojavio se meteorizam, abdominalna osjetljivost je porasla, a laboratorijski nalazi su se pogor{ali. Prema rendgenogramu indicirana je hitna eksplorativna laparotomija te je pacijentica uspje{no zbrinuta.

Key words:
apendicitis, puerperij


Teks nije dostupan

Konsenzus II. hrvatsko-slovenskog simpozija o menopauzi i andropauzi (Vol.12 No.3, str.133-134)

Authors:

Radna Skupina

Meeting summary

Summary:
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Vrijeme održavanja kongresa: 22.- 24. listopad 2015.