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Vol.21 No.4

Date: October-December 2012.

CONTENT:

EMERGENCY CONTRACEPTION UPDATE (Vol.21 No.4, str.133-140)

Authors:

Marina Šprem Goldštajn, Dinka Pavičić Baldani, Velimir Šimunić

Review

Summary:
Despite available contraceptive methods, the unplanned pregnancy rate in Croatia is unacceptable high. Emergency (postcoital) contraception has a great impact on preservation of women’s reproductive health due to significant decrease of pregnancy risk after unprotected intercourse or failure of contraceptive methods. Furthermore, emergency contraception provides additional opportunity for achievement of positive population effect (decrease of unplanned pregnancy and miscarriage rate). Health care providers should be informed about new insights in the field of emergency contraception in order to maximize positive effects on individual and population level. In this article, mechanisms of action, efficacy, safety, tolerability and cost efficacy analysis of emergency contraception are discussed.

Key words:
emergency contraception, postcoital contraception


RISK FACTORS AND DIAGNOSIS FOR PRETERM PREMATURE RUPTURE OF MEMBRANES (Vol.21 No.4, str.141-145)

Authors:

Vito Starčević, Mislav Herman, Marina Horvatiček, Josip Juras, Marina Ivanišević

Review

Summary:
Despite the achievements in perinatology the preterm premature rupture of membranes is still significant and serious obstetrical complication with the adverse fetal and maternal consequences. The rupture of membranes or latin amniorrhexis is usually appears during labour. Preterm rupture of membraines (lat. RVP, ruptura velamentorum praetemporarius) is defined as spontaneous rupture before the onset of labours for what in anglosaxon literature is used term PROM (Premature Rupture of Membranes).4 If it happens before term of delivery term PPROM (Preterm Premature Rupture of Membranes) is used. In this review article the mechanism and causes of membrane rupture and neonatal complications are described.

Key words:
preterm premature rupture of membranes, mechanisms of rupture of membranes, preterm delivery, diagnosis, neonatal complications

 


DIAGNOSIS AND THERAPY OF RH IMMUNISATION (Vol.21 No.4, str.146-153)

Authors:

Berivoj Mišković, Iva Laušin

Review

Summary:
Diagnosis and treatment of Rh isoimmunisation are described in details according to the advancement in the field in the last 10 years. Rh genotype of the ’D’ positive father should be determined with PCR, instead of the traditional serology method. If the father is heterozygous for D antigen, the fetal Rh status should be determined with PCR, either from amniotic fluid cells or directly from the maternal blood. The former method has been used to determine fetal Rh status in Croatia for a few years but the latter method should be introduced into clinical practice soon. By determining fetal Rh status from maternal blood allows us to manage Rh isoimmunisation by noninvasive methods and use targeted prophylaxis. Serial measurement of antibody titer can be useful only in the first episode of isoimmunisation but in all other cases, its significance is doubtful. The measurement of the middle cerebral artery peak systolic velocity with Doppler has become the gold standard in diagnosis of fetal anemia. Amniocentesis and Doppler have similar sensitivity and specificity but the latter is superior as it is non nonvasive and can be easily repeated. However, this technique requires adequate training. IUT is indicated if the middle cerebral artery peak systolic velocity is greater then 1.5 MoM for gestation. The aim of in utero treatment is to prolong pregnancy until 35–37 weeks of gestation with the least number of IUT. Since the Doppler is not useful for the timing of the any subsequent IUT it is done empirically based on prediction of daily fall in fetal hemoglobin and haematocrit level. Results of long-term follow up of children treated with IUT did not show any difference in neurodevelopement compared to children in general population. Children who had fetal hydrops were at the highest risk of neurodevelopment delay.

Key words:
Rh immunisation, diagnosis, RhD genotyping, Doppler, therapy, intrauterine transfusion


DELIVERY AND ANAESTHESIA IN PARTURIENT WITH SEVERE CEREBRAL PALSY (Vol.21 No.4, str.154-156)

Authors:

Damir Žalac,* Marko Kovačević,* Dubravko Habek**

Case report

Summary:
We present a case of 24-year-old cerebral palsy-parturient with praeeclampsia. Caesarean section was performed in 37th pregnancy week and healthy female newborn, 3430/50, was delivered. Maternal recovery from endotraheal anaesthesia after unsuccessful spinal anesthesia was good.

Key words:
cerebral palsy, delivery, caesarean section, anaesthesia


LAPAROSCOPIC TREATMENT OF RECTOVAGINAL SEPTUM ENDOMETRIOSIS– A CASE REPORT (Vol.21 No.4, str.156-160)

Authors:

Mario Ćorić,* Lana Škrgatić,* Marija Gregov,* Mirela Markanović Mišan,** Vesna Sokol,* Gordana Jurić*

Case report

Summary:
The laparoscopic treatment of endometriosis of rectovaginal septum in patient with persistent dysmenorrhea and dyspareunia is described. Laparoscopy is optimal surgical treatment of deep pelvic endometriosis with inclusion of adequate preoperative evaluation as well as experienced surgeon.

Key words:
rectovaginal endometriosis, laparoscopic treatment, pelvic pain


EARLY STAGE OF HODGKIN’S LYMPHOMA IN PREGNANCY (Vol.21 No.4, str.161-161)

Authors:

Mirela Markanović Mišan,* Mislav Herman,** Josip Đelmiš,** Marina Ivanišević**

Case report

Summary:
We present the case of a 30-year old pregnant woman with an early stage (IIa) Hodgkin’s lymphoma, which was initially characterized as a cat scratch disease. Nine months after the first signs of lymphadenopathy, during which the patient became pregnant by means of a fertility procedure, additional cytology punctioning and excisional lymph node biopsy was performed. The final pathohistologic diagnosis was made in the 22nd week of pregnancy, pointing to the Hodgkin’s lymphoma. The advisory council delayed chemotherapy until the termination of pregnancy due to slow disease progression, lack of symptoms, and late gestational age. Corticosteroid therapy was effective in controlling the size of peripheral lymphadenopathy. After a spontaneous rupture of membranes in the 34th week, a cesarean section was performed, resulting in the delivery of a healthy female newborn. Precise staging of the disease was performed after the delivery, at which point the patient was administered a combined ABVD (Doxorubicin, Bleomicyn, Vinblastin, Dakarbamazin) chemotherapy with ongoing corticosteroid therapy. The patient is now receiving an out hospital of chemotherapy which she is managing satisfactorily with a child who is developing appropriately.

Key words:
Hodgkin’s lymphoma, pregnancy, chemotherapy, corticosteroids


Complications of the abdominal drainage in gynecology and obstetrics (Vol.21 No.3, str.165-166)

Authors:

Dubravko Habek, Žarko Rašić,Matija Prka,

Letter to the editor


Prof. dr. sc. ANTE DRAŽANČIĆ (Vol.21 No.4, str.167-168)

Authors:

Slavko Orešković

In memorian


Mjesto održavanja kongresa: Hotel President****, Split, Starčevićeva 1, www.hotelpresident.hr/split
Vrijeme održavanja kongresa: 22.- 24. listopad 2015.