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Vol.23 No.1

Date: January 2014.

CONTENT:

ENDOTHELIN IN HUMAN PLACENTA (Vol.23 No.1, p.1-5)

Authors:

Mila Červar-Živković 

Review

Summary:

Endothelin-1 (ET-1) is a member of endothelin family consisted of three peptides, ET-1, ET-2 and ET-3 which are encoded by a distinct gene on different chromosomes. Endothelins play the central role in the vasomotor control of blood vessels. The best-known functions additional to vasomotor effects are the regulation of cell processes as invasion, proliferation, migration and apoptosis. Compared to the non-pregnant state, normal pregnancy is associated with about 60% lower plasma concentrations of ET-1 as the result of down-regulation of ECE. In pregnancies complicated by pre-eclampsia, the increased levels of ET-1 in maternal blood correspond to non-pregnant values. The expression of ETRs in all compartments of human placenta, strongly suggests the various functions of ET-1. The presence of both endothelin receptors in extravillous and villous cytotrophoblast suggests the possible growth factor role of ET-1 in the early placenta. The crucial tasks of the cytotrophoblast in the first trimester of pregnancy are proliferation and invasion. This includes the replacement of endothelium and destruction of elastic and muscular media. ET-1 stimulates the proliferation and invasion of the first trimester trophoblasts in vitro in a receptor-specific manner. The relative decrease of ETR expression in cytotrophoblasts during pregnancy and lack of ET-1/ETRs in syncytiotrophoblasts suggest the effect of ET-1 predominately on the proliferation and invasion in the first trimester of pregnancy. The expression of ET-1 and both ETRs in placenta was shown to be changed in the opposite manner in mild and severe early onset pre-eclampsia. However, a decreased secretion of ET-1 from pre-eclamptic trophoblasts in vitro does not depend on the severity of disease or gestational age. Furthermore, it could not be affected by common drugs used in the prevention or therapy of pre-eclampsia.

Key words:

placenta, endothelin, pre-eclampsia, trophoblast

 


CONVENTIONAL RADIOLOGICAL DIAGNOSTICS OF THE MOST COMMON PATOLOGICAL CONDITIONS OF THE GASTROINTESTINAL TRACT IN NEWBORNS (Vol.23 No.1, str.6-13)

Authors:

Vinka Barbarić Babić, Ivica Sjekavica, Ivana Jurca, Ana Čolić

Review

Summary:

The gastrointestinal tract in neonates has its own anatomical and functional characteristics that are different from those in older children and adults. The most common patological disorders that present in newborn period include developmental anomalies, conditions resulting from the immaturity and genetic diseases. For the purpose of more accurate and well-timed diagnosis of these disorders, close co-operation between clinician and radiologist is needed. In this article we present an overview of the most common pathological conditions and available conventional radiological methods.

Key words:

newborn, patological disorders of gastrointestinal tract, radiological methods

 


CEPHALOHAEMATOMA – POSSIBLE PERINATAL NEURORISK FACTOR (Vol.23 No.1, p.14-18)

Authors:

Zora Zakanj

Original paper

Summary:

Cephalohaematoma is a collection of blood, between the skull bone and periosteum, which according to clinical presentation, could be admitted to perinatal risk factors. The aim of this paper is to present the most common brain ultrasound (US) change in infants with cephalohaematoma, and assess eventual neurorisk in examined population. Methods. We retrospectively analyzed the US brain changes in healthy term infants with cephalohaematoma, additionally to anamnesis and other clinical risk factors. We analyzed 2970 participants during one calendar year in the maternity ward of our institution. Results. The frequency of cephalohaematoma is 1.55%. The average birth weight was 3443.26±412.41 g, length 49.69±1.57 cm and head circumference 35.22±0.62 cm. We did not observe any other birth trauma, congenital anomalies, coagulation disorders, or neurological deviations. Normal brain US observed in 67.39% of the respondents. Abnormal US findings had 32.61% of the respondents, of which a significant change in US had three children (6.53%). Cephalohaematoma was the only risk factor in 17 children (36.96%). Low neurorisk factors had five patients (10.87%), and in 24 infants with cephalohaematoma we found factors of high neurorisk (52.17%). The most common additional risk factors are gestational diabetes (19.57%), infections during pregnancy (17.39%) and head circumference above the 95th percentile (17.39%). Conclusion. US of the brain is useful, simple and objective method that is already in the maternity ward may be supplemented by anamnesis and clinical data in order to assess the possible factors of neurorisk in newborns with cephalohaematoma.

Key words:

cephalohaematoma, newborn, birth injuries, perinatal brain damage, neonatal brain ultrasound

 


COMPARISON OF THE INFLUENCE OF DIFFERENT OVULATION INDUCTION PROTOCOLS ON CUMULATIVE PREGNANCY RATES IN AN IVF/ET PROGRAM (Vol.23 No.1, p.19-24)

Authors:

Jelena Jovica, Sanja Zovkić, Romana Dmitrović

Original paper

Summary:

Objective:The aim of this study was to compare the cumulative pregnancy rate of in vitro fertilization (IVF) per cycle in patients in whom the ovulation induction was conducted in a modified natural cycle and in cycles with mild and standard ovarian stimulation. Methods: Retrospective analysis was carried out on 126 consecutive IVF cycles in patients who matched the inclusion criteria, performed at our institution from January 2012 to July 2013. Results: In a modified natural cycle after 12th week of pregnancy, three pregnancies in five cycles were achieved (60.0%), in mild stimulation 16 pregnancies in 40 cycles (40.0%), and in standard stimulation 24 pregnancies in 81 cycles (29.6%). These were followed by eight cryoembryotransfers after mild stimulation, resulting in three clinical pregnancies (37.5%) and 29 cryoembryotransfers after standard stimulation, resulting in 15 clinical pregnancies (51.7%). The cumulative clinical pregnancy rate in mild stimulation cycles was 47.5%, and in standard stimulation cycles 48.1%, which was not statistically significant (p=0.95). Conclusion: In this study, mild ovarian stimulation proved to be equally successful in achieving clinical pregnancy as the standard ovarian stimulation.

Key words:

ovulation induction, IVF/ET, cumulative pregnancy rate

 


THE IMPACTS OF GESTATIONAL DIABETES AND OBESITY OF MOTHERS ON INSULIN RESISTANCE AND ADIPOKINES LEVELS IN THE UMBILICAL BLOOD (Vol.23 No.1, p.25-29)

Authors:

Danko Bljajić, Jozo Blajić, Marina Ivanišević, Edina Berberović, Josip Đelmiš, Davor Mayer, Ksenija Tuškan

Original paper

Summary:

Due to the stressful and sedentary lifestyle with the plenty of calorie-rich food obesity reaches pandemic proportions.It is increased interest of scientist to discovery previously unknown metabolic-endocrine effects on obesity. Aims. The aim of this study was to determine the influence of obesity of the mother and GDM as individual and combined factors on the levels of glucose, C-peptide, adiponectin and leptin in umbilical serum, and on insulin resistance in the child. Methods. This case control study included 160 pregnant women divided into four groups according to BMI and GDM. The concentration of C-peptide, adiponectin and leptin were determined using the ELISA method. Results. Obese women in both diabetic and healthy groups had higher concentrations of C-peptide. The concentration of adiponectin was positively correlated to newborn’s weight among women with normal BMI values in both diabetic and healthy groups and leptin concentrations and newborn’s weight only among obese diabetic women. Conclusion. This study has shown that the activities of increasingly common pathogenic factors in the mother – weight and increased insulin resistance – either independent or combined, alter the in utero metabolism of the child.

Key words:

obesity, insulin resistance, adipokines, gestational diabetes, pregnancy

 


LAPAROSCOPIC CORNUAL RESECTIAL IN MANAGEMENT OF INTERSTITIAL PREGNANCY: A CASE REPORT (Vol.23 No.1, p.30-34)

Authors:

Magdalena Karadža, Franjo Grgić, Dubravko Barišić

Case report

Summary:

The incidence of interstitial pregnancy is rising due to increased frequency of assisted reproductive procedures. Availability of high-resolution ultrasonography has enabled the early diagnosis of interstitial pregnancies before rupture. Medical treatment is appropriate for patients who desire future fertility. Surgical treatment is necessary when treating women with more advanced interstitial pregnancies, when medical treatment has failed, uterine rupture is suspected or recurrent ipsilateral interstitial pregnancy is found. Minimally invasive surgery has improved the treatment options. There is abundant literature that supports the safety and efficacy of laparoscopic treatment that appears the most suited surgical treatment. The greatest risk to patients after treatment of interstitial pregnancy is uterine rupture during subsequent pregnancy. Careful antenatal surveillance with a planned cesarean delivery at term seems to be the safest method of delivery.

Key words:

Interstitial pregnancy, laparoscopy, cornual resection

 


UTERINE PERFORATION WITH LEVONORGESTREL-RELEASING INTRAUTERINE SYSTEM: CASE REPORT (Vol.23 No.1, p.35-37)

Authors:

Lana Škrgatić, Dinka Pavičić Baldani, Dubravko Barišić, Ante Ćorušić, Mario Ćorić, Vesna Elveđi Gašparović

Case report

Summary:

Uterine perforation related to the insertion of levonorgestrel-releasing intrauterine system (LNG – IUS) is a rare but potentially serious complication. There are no specific diagnostic guidelines for diagnosis and management of uterine perforation with LNG-IUS. We present a case of 38-year-old patient admitted to the Clinic for Women’s Diseases complaining of lower abdominal pain eight days following the insertion of LNG-IUS that reported to be painless and uneventful. The pelvic examination performed on arrival confirmed non-visualization of the LNG-IUS strings. Transvaginal ultrasound that was performed failed to identify the LNG- IUS deviceinside the uterine cavity,whereas transabdominal ultrasound (TAUS) was suggestive of LNG-IUS located inside the abdominal cavity. Laboratory findings were unremarkable. Abdominal X-ray study was obtained, and it confirmed the diagnosis of intra-abdominal location of LNG-IUS. Laparoscopy was performed; the LNG-IUS was found and easily removed from the right part of the posterior cul-de-sac.

Key words:

levonorgestrel-releasing intrauterine system, uterine perforation

 


 

 

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