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Research Interests: Surgery, Public Management, Public Health, Medicine, Public Policy Analysis, and 15 moreGeneral Surgery, Health Systems Strengthening, History of Surgery, Medicine and Surgery, Lancet, Preparedness, Global Surgery, Pandemic, Elective Surgery, Public Policy, The Lancet, Coronavirus COVID-19, CoVid, COVID-19 PANDEMIC, and Medical and Health Sciences
Research Interests: Gynaecology, Personalized Medicine, Medicine, Gynecology and Obstetrics, Obstetrics and Gynaecology, and 13 moreObstetrics and gynecology, Cohort, Ob GYn, Gynecology, Obsterics and Gynecology, Asymptomatic, Obgyn and Gynecology, Coronavirus COVID-19, CoVid, SARS-CoV-2, COVID-19 PANDEMIC, PANDEMIA Covid 19, and leukocytosis
The promptness of providing services to patients directly affects the success of healthcare organizations. In this regard, the implementation of contemporary concepts in healthcare organizations is synonymous with success. Subject of... more
The promptness of providing services to patients directly affects the success of healthcare organizations. In this regard, the implementation of contemporary concepts in healthcare organizations is synonymous with success. Subject of research: The subject being researched in this paper is the possibility of applying the SIPOC method to the clinical process in obstetrics. A more precise application of the abovementioned method would mean a prompter implementation of activities within the clinical process (pregestational counseling, antenatal care of expectant mothers, deliveries, supervision of women during puerperium). Through the activities of the abovementioned clinical process, an effort is made to meet the health needs of expectant and new mothers. The application of the SIPOC method is not sufficiently present in clinical processes, especially the clinical process in obstetrics, and therefore this paper opens a new research area. Aim: The aim of this paper is to indicate the re...
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Background: Vaginal microflora plays an important role in cervical carcinogenesis. An increase in vaginal pH is associated with the severity of squamous intraepithelial lesion (SIL) and a decrease in the number of lactobacilli. Microbial... more
Background: Vaginal microflora plays an important role in cervical carcinogenesis. An increase in vaginal pH is associated with the severity of squamous intraepithelial lesion (SIL) and a decrease in the number of lactobacilli. Microbial dysbiosis contributes to the damage of the epithelial barrier, as well as the reprogramming of immune and metabolic signaling. Dysbiotic bacteria cause damage to the epithelial barrier, immune dysregulation and genotoxicity and create a tumor-permissive microenvironment. Objective: The aim of this study was to determine the presence of risk factors (abnormal colposcopic and microbiological status, elevated pH of the vaginal environment) in regular Pap tests and LSIL. Methods: Retrospective prospective study 2021-2022. 90 women with pap smears were analyzed: 40 with LSIL at the Gynecological Center “Dr. Mahira Jahić” Tuzla and 50 with normal findings at the Tesanj Health Center. General data such as: age of the subjects, reproductive status, contrace...
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Ovarian lymphoma is a rare neoplasm and most commonly represents secondary ovarian involvement in overt systemic disease, usually of the non-Hodgkin’s type. To report a case of acute abdomen caused by torquated large ovarian lymphoma. We... more
Ovarian lymphoma is a rare neoplasm and most commonly represents secondary ovarian involvement in overt systemic disease, usually of the non-Hodgkin’s type. To report a case of acute abdomen caused by torquated large ovarian lymphoma. We report the case of 65-year-old patient admitted to our hospital with signs and symptoms of acute abdomen. Findings were suggestive of left ovary torsion due to the neoplasm. After detorsion, mobilization, and adhesiolysis, a bilateral adnexectomy was performed. Histopathological and immunohistochemical analysis of the left ovarian tumor was performed and diagnosis of diffuse large B‑cell lymphoma (DLBCL) with a GCB (germinal center B‑cell-like) phenotype was made. Additional bone marrow biopsy and imaging techniques excluded other sites of involvement, confirming diagnosis of primary ovarian DLBCL. The prognosis of ovarian lymphomas may be poorer than for other lymphomas because of late diagnosis. The best treatment option appears to be systemic chemotherapy.
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Research Interests: Medicine, Abortion, Pregnancy, Porphyria, Curettage, and 3 moreAbdominal Pain, Vomiting, and Medical Archives
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Background We compared the accuracy of preoperative transvaginal ultrasound (TVUS) versus magnetic resonance imaging (MRI) for the assessment of myometrial invasion (MI) in patients with endometrial cancer (EC), while definitive... more
Background We compared the accuracy of preoperative transvaginal ultrasound (TVUS) versus magnetic resonance imaging (MRI) for the assessment of myometrial invasion (MI) in patients with endometrial cancer (EC), while definitive histopathological diagnosis served as a reference method. Patients and methods Study performed at a single tertiary centre from 2019 to 2021, included women with a histopathological proven EC, hospitalized for scheduled surgery. TVUS and MRI were performed prior to surgical staging for assessment MI, which was estimated using two objective TVUS methods (Gordon’s and Karlsson’s) and MRI. Patients were divided into two groups, after surgery and histopathological assessment of MI: superficial (≤ 50%) and deep (> 50%). Results Sixty patients were eligible for the study. According to the reference method, there were 34 (56.7%) cases in the study with MI < 50%, and 26 (43.3%) with MI > 50%. Both objective TVUS methods and MRI showed no statistical signifi...
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Massive aspiration of gastric contents as a cause of death in pregnancy without anesthesia is possible, but is not documented in the available literature as a separate case report. To describe sudden death of a pregnant woman because of... more
Massive aspiration of gastric contents as a cause of death in pregnancy without anesthesia is possible, but is not documented in the available literature as a separate case report. To describe sudden death of a pregnant woman because of massive aspiration of gastric contents. The presence of a valvular anomaly in a 26-year-old woman had been known since childhood: the prolapse of both mitral cusps. In the 34th week of her second pregnancy, after dinner, she went to take a shower when she collapsed with abundant vomiting of stomach contents. The ambulance came in 20 min and started a resuscitation procedure which was unsuccessful, and the death of the pregnant woman was established in the 34th week of pregnancy. Autopsy revealed massive aspiration of gastric contents into the trachea and bronchi, pulmonary edema, and generalized cyanosis. Left ventricular dilatation was found in the heart, with prolapse of both mitral valve cusps. Sudden deaths in pregnancy are rare and dramatic cond...
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Tvrtko Tupek, Analena Gregori c, Dino Pavokovi c, Anis Cerovac and Dubravko Habek Department of Obstetrics and Gynecology, Clinical Hospital ,,Sveti Duh“, Zagreb, Croatia; School of Medicine, University of Zagreb, Zagreb, Croatia;... more
Tvrtko Tupek, Analena Gregori c, Dino Pavokovi c, Anis Cerovac and Dubravko Habek Department of Obstetrics and Gynecology, Clinical Hospital ,,Sveti Duh“, Zagreb, Croatia; School of Medicine, University of Zagreb, Zagreb, Croatia; Department of Obstetrics and Gynecology, General hospital Virovitica, Virovitica, Croatia; Department of Obstetrics and Gynecology, General hospital Te sanj, Te sanj, Bosnia and Herzegovina; Department for Anatomy, University of Tuzla School of Medicine, Tuzla, Bosnia and Herzegovina; Department of Obstetrics and Gynecology, Croatian Catholic University, University of Zagreb, Zagreb, Croatia
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Background Little is known about pregnancy rates and outcome in women with motoric disabilities like cerebral palsy (CP) and even less in phocomelia. Objective To show complications and psychosocial issues in relation to pregnancy... more
Background Little is known about pregnancy rates and outcome in women with motoric disabilities like cerebral palsy (CP) and even less in phocomelia. Objective To show complications and psychosocial issues in relation to pregnancy burdened by impaired mobility in CP and phocomelia. Case report We present an overview of the pregnancy outcome in two cases of sisters with cerebral palsy and phocomelia. We show complications and psychosocial issues in relation to pregnancy burdened by impaired mobility. Both sisters had a successful pregnancy outcome. Conclusion There is a need to increase awareness, education, support, and advocacy in order to optimize pregnancy course and outcome in women with CP and phocomelia.
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Aim To investigate the prevalence and obstetrical characteristics of low birth weight infants (LBWIs) in ten Cantons of the Federation of Bosnia and Herzegovina (FBiH). Methods The prospective study included newborns of both genders,... more
Aim To investigate the prevalence and obstetrical characteristics of low birth weight infants (LBWIs) in ten Cantons of the Federation of Bosnia and Herzegovina (FBiH). Methods The prospective study included newborns of both genders, gestational age (GA) of 22 to 42 weeks and birth weight(BW) of less than 2,500 grams in the period 1 January 2009 to 31 December 2009. Results In the observed period, 22897 neonates were born, out of whom 669 (2.9%) had a BW less than 2500 grams (average BW was 1295 grams; SD ± 234.2; a coefficient of variation of 0.58). The average GA was 31.4 weeks of gestation. The average lifespan of mothers was 27.7 years (SD ± 1.2). The average Apgar scor (AS) in the first minute was 4.6 (SD ± 2.1) and in the fifth minute it was 6.6 (SD ± 1.9). The LBWIs were most commonly delivered by primiparas, 317 (47.5%). Of the 669 LBWIs, 411 (61.4%) were born per vias naturalis, with cephalic presentation. The highest number of LBWIs was born in Sarajevo Canton, 3.7%, and C...
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Aim To determine stereological structural parameters of the parenchymal part of the placenta, placental weight and volume of adolescent pregnant women and their correlation with newborns' birth weight. Methods This prospective study... more
Aim To determine stereological structural parameters of the parenchymal part of the placenta, placental weight and volume of adolescent pregnant women and their correlation with newborns' birth weight. Methods This prospective study was conducted on a total of 60 human placentas of term pregnancy, divided into two groups according to the age of pregnant women. Experimental group consisted of 30 placentas of pregnant women aged 13-19 years. Control group consisted of 30 placentas of pregnant women aged 20-35 years. Stereological analysis was performed. Results Volumetric density of terminal villi of adolescent placentas was significantly higher than the one of control group (p <0.0001). The volumetric density of fibrinoid of adolescent placentas was significantly lower than of the control group (p <0.0001). Total volume of terminal villi of adolescent placentas was significantly higher than of the control group (p<0.0001). The total volume of fibrinoid of adolescent plac...
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Aim To investigate clinical and obstetrical characteristics, an outcome and a prognosis for pregnant women with diagnosed and treated genital or extragenital cancer and their newborns. Methods This retrospective cohort study included... more
Aim To investigate clinical and obstetrical characteristics, an outcome and a prognosis for pregnant women with diagnosed and treated genital or extragenital cancer and their newborns. Methods This retrospective cohort study included pregnant and childbearing women with a history of cancer diagnosed before pregnancy during the period between 1 January 2014 and 31 December 2018. Data related to the course of pregnancy and childbirth were collected from medical records (mothers' disease history and partogram). The analysis covered clinical and histopathological characteristics of cancers, type of the treatment (surgery, chemotherapy, radiotherapy), demographic data, obstetric characteristics, comorbidities of women, and outcome of the newborns. Results The study recorded 18 414 deliveries, of which 30 (0.16%) were pregnancies in women who had been diagnosed and treated earlier for genital or extragenital cancer. The average age of the women at the time of delivery was 29.43±5.97 y...
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Aim To compare maternal, foetal and neonatal characteristics, and perinatal outcome of preterm and term deliveries in twins pregnancies in order to improve perinatal care in Bosnia and Herzegovina. Methods This retrospective cohort study... more
Aim To compare maternal, foetal and neonatal characteristics, and perinatal outcome of preterm and term deliveries in twins pregnancies in order to improve perinatal care in Bosnia and Herzegovina. Methods This retrospective cohort study included pregnant women with twin pregnancy who delivered during the period between 1 January 2012 and 31 December 2018 at the Clinic for Gynaecology and Obstetrics, University Clinical Centre Tuzla. Results During the seven-year period 26 734 deliveries were recorded, out of which 362 (1.35 %) were twin pregnancies, 226 (62.4%) preterm and 136 (37.5%) term ones. In the preterm group 38 (16.8%) pregnancies were assisted medical reproduction, and 16 (11.7%) of those were in the term group. The average birth weight was significantly higher for the first twin in both groups (p<0.00001). Incipient intrauterine foetal asphyxia was more frequent in the preterm group (p<0.05). The most common indication for Caesarean section was abnormalities of foet...
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We present an overview of the case of a patient with early hysterorrhaphy dehiscence (uteroperitoneal fistula) with endomyometritis and post-cesarean section peritonitis and puerperal acute abdomen in a 35-year-old puerpera. A exploratory... more
We present an overview of the case of a patient with early hysterorrhaphy dehiscence (uteroperitoneal fistula) with endomyometritis and post-cesarean section peritonitis and puerperal acute abdomen in a 35-year-old puerpera. A exploratory relaparotomy, necrectomy, and resuture of the dehiscent part of the hysterotomy were performed with placement of hemostatic sponges on the same portion of the uterus with good recovery.
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Perimortem Caesarean section (PMCS) is a rare surgical procedure that is potentially lifesaving for mother and child. To describes a live fetus 1 h after maternal cardiac arrest and a rare hospital surgical event, PMCS. We report on a... more
Perimortem Caesarean section (PMCS) is a rare surgical procedure that is potentially lifesaving for mother and child. To describes a live fetus 1 h after maternal cardiac arrest and a rare hospital surgical event, PMCS. We report on a 22-year-old gravida 1 para 1 woman who had a convulsive loss of consciousness at 31 weeks’ gestation. A convulsive loss of consciousness was accompanied by profuse vomiting of gastric contents. Cardiopulmonary resuscitation was initiated. Fetal heartbeats were recorded and the patient was referred to the Clinic for Gynecology and Obstetrics. Perimortem Caesarean section was performed. Neonatal cardiopulmonary resuscitation was initiated, but the infant was pronounced dead after 60 min of attempted resuscitation. Maternal cardiopulmonary resuscitation was without success and it was abandoned following discussion with family members. A cooperative team approach is the key factor to producing a good perinatal outcome.
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Balneo-gynaecological treatment methods include external bath hydrotherapy, sedentary baths and topical dressings/cataplasm, and internal (intravaginal or intrarectal use of peloids and mineral water). Hyperosmolar thermal spas have been... more
Balneo-gynaecological treatment methods include external bath hydrotherapy, sedentary baths and topical dressings/cataplasm, and internal (intravaginal or intrarectal use of peloids and mineral water). Hyperosmolar thermal spas have been very popular in the treatment of infertility due to the improvement of symptoms of chronic pelvic pain, endometriosis, chronic vascular and inflammatory pelvic diseases. Acute pelvic inflammatory syndrome is a contraindication for balneo-hydrotherapy while hyperthermal hydrotherapy is contraindicated in endometriosis and neurovegetative dystonia due to the stimulation of hyperemia, which worsens the clinical picture. Balneo-hydrotherapy is not recommended in metrorrhagia and malignancies. Balneogynaecological treatment certainly has its own primary but also complementary role in the treatment of chronic gynaecological diseases and is increasingly recommended today.
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Background: Leiomyomas comprise 0.5%–1% of all benign ovarian tumors and occur between adolescence and postmenopause; ∼ 80% have been reported in premenopausal women. These tumors are very rare, an...
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Dear Editor: Prepartal chronic intrauterine subdural hematomas (SH) and postpartal SH after maternal trauma, instrumentally assisted vaginal delivery, and in fetuses/newborns with hematologiccoagulation disorders and head abnormalities... more
Dear Editor: Prepartal chronic intrauterine subdural hematomas (SH) and postpartal SH after maternal trauma, instrumentally assisted vaginal delivery, and in fetuses/newborns with hematologiccoagulation disorders and head abnormalities are known in the literature [1–3] (Table 1). Spontaneous non iatrogenic bilateral subdural neonatal hematomas (SSH) after spontaneous vaginal delivery are an extremely rare clinical entity with no clear cause, mentioned in only a few case reports, so we present the case of SSH as a contribution to this rarely described, atypical, and unexpected clinical phenomenon. The 28-year-old primiparous woman was admitted to the maternity hospital in spontaneous labor in the 41st week of pregnancy. Personal and family history were neat, negative for hematological and coagulation disorders. The external and internal pelvimetry was neat. The course of the pregnancy was orderly. The fetus was eutrophic in growth and had an orderly biophysical profile, umbilical and cerebral Doppler sonography without ultrasound-detectable intracranial masses. On admission, the obstetric finding were; the cervix was fully effaced and 6 cm dilated. Through membranes the fetal head was felt in the occipital dorsoanterior presentation, spontaneous contractions were present for 3/10 minutes. Cardiotocographic (CTG) record was physiological. An amniotomy was performed. After 3 h of regular labor contractions and an orderly CTG recording with episiotomy followed by spontaneous delivery of a live female newborn, 3830/52 cm, and Apgar score 10/10, without instrumental assistance and fundal pressure. Early neonatological examination was orderly with a minor clinically insignificant caput succedaneum on the occipital portion of the skull. On the first postpartum day, 34 h after delivery, a short-term transient apnea attack with acrocyanosis occurs during breastfeeding. No clinical neurological abnormalities were found, laboratory findings of acid-base status and glycemia were in reference range, and the newborn was observed. Three hours later, there was a repeated episode of apnea and acrocyanosis, which gradually improves. An urgent neurosonographic examination was performed and bilateral frontoparietal subdural hematoma was suspected. Angiographic MRI was indicated to confirm bilateral frontoparietal subdural hematoma of 3 and 4 cm in size without skull fractures, intracerebral hemorrhages, and arteriovenous malformations. Emergency neurosurgery was indicated. Bifrontoparietal craniotomy and hematoma evacuation were performed. The surgery and postoperative course proceeded uncomplicatedly in the NICU. Hematological and coagulation laboratory findings of the newborn were completely orderly. The neuromotor development of the infant was orderly, and later neurological controls were without deviation with orderly psycholinguistic and neuromotor development until the tenth year of life. Neonatal bilateral SH described in the literature can be argued to have arisen as a consequence of traumatic/ iatrogenic or vaginally assisted delivery (Table 1) [1, 4]. In our case, delivery was spontaneous and nontraumatic, without instrumental assistance and fundal pressure. Compression of the soft parts of the delivery canal on the head of the term fetus during natural childbirth is not considered a trauma. Since it is a natural act of birth that has existed since the world existed. Whitby et al. have shown the outcomes and risks of unilateral or bilateral SH compared to obstetric factors [5]. They found a * Anis Cerovac cerovac.anis@gmail.com
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Fetal malpresentations and malpositions are more common in placenta previa and uterine cavity abnormalities. To show successful management of focal increta placentomegaly and uterine preservation in primiparous woman. We describe... more
Fetal malpresentations and malpositions are more common in placenta previa and uterine cavity abnormalities. To show successful management of focal increta placentomegaly and uterine preservation in primiparous woman. We describe posterior low-lying focal increta placentomegaly verified during cesarean section, which is a possible risk factor for persistent posterior asynclitism and consequent mechanical dystocia. In addition to antifibrinolytics and uterotonics, hemostatic compression sutures of the posterior uterine wall were performed with an applied intrauterine balloon, and thus the uterus was preserved in primiparous woman as a definitive therapy. Timely identified malplacentation as well as adequate medical and surgical measures taken by an experienced team of obstetricians and anesthesiologists can contribute to preservation of the uterus and thus the life of mother and neonate.
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Background: In pediatric and adolescent gynecology, ovarian-sparing surgery (OSS) is an approach for preserving the ovaries affected by tumors and torsion during surgical treatment. Materials and Methods: We analyzed participants from a... more
Background: In pediatric and adolescent gynecology, ovarian-sparing surgery (OSS) is an approach for preserving the ovaries affected by tumors and torsion during surgical treatment. Materials and Methods: We analyzed participants from a tertiary Gynecology and Obstetrics University Hospital. Participants were patients <19 years of age with adnexal tumors managed surgically with removal of pathologically confirmed ovarian tissue in the period from 2008 to 2017. Results: The average age of 38 patients who underwent surgery for adnexal tumors and were included in the study was 16.78 ± 2.15 years, from 12 to 19 years, with significantly younger patients in the salpingo-oophorectomy/oophorectomy and laparotomy group (P = .036 and P = .001). The laparoscopic approach was performed in 28 (73.68%) patients and laparotomy in 10 (26.31%) patients (P < .0001). Cystectomy was performed in 29 (76.31%), oophorectomy in 1 (2.63%), and salpingo-oophorectomy in 8 (21.05%) patients. A significantly higher number of patients underwent OSS with laparoscopy in scheduled surgical procedure and emergency surgery groups (P = .021 and P = .028). Benign ovarian tumors were found in 31 (81.57%), borderline in 3 (7.89%), and malignant in 4 (10.52%) patients. Conclusion: Our study has shown a high trend in OSS using the endoscopic approach in management of adnexal tumors despite the fact that the management was done by general gynecologists.
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Fetal shoulder dystocia (FSD) is an unpredictable and critical obstetric intrapartum emergency, where an objective problem is the relationship between the mother's pelvis and the child, i. e., an anthropometric disorder of delivery... more
Fetal shoulder dystocia (FSD) is an unpredictable and critical obstetric intrapartum emergency, where an objective problem is the relationship between the mother's pelvis and the child, i. e., an anthropometric disorder of delivery mechanics and dynamics. It is evident that the need to perform other maneuvers indicates the severity of FSD, which in turn correlates with the consequent iatrogenic injury of the fetus and/or mother. FSD is certainly the most controversial forensic obstetric problem, with the most disputes, compensation for damages due to peripartum injury to the child and/or mother, pain suffered, the need for someone else's care, and permanent disability. Suboptimal procedures and inadequate documentation are factors of forensic risk and subsequent litigations. Prevention of FSD is generally not possible, although good antenatal care can sometimes exclude risky cases of FSD, and some rare, chronic intrauterine disorders can result in orthopedic and neurological...
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Background: The aim of this study is to compare the antenatal care, body weight, and weight gain in pregnancy between the adolescent and adult pregnancies and, thus, examine the impact of adolescence on the studied parameters. Methods:... more
Background: The aim of this study is to compare the antenatal care, body weight, and weight gain in pregnancy between the adolescent and adult pregnancies and, thus, examine the impact of adolescence on the studied parameters. Methods: This prospective study includes 300 pregnant women who were the patients of University Clinical Center Tuzla, Clinic for Gynecology and Obstetrics from January 2011 to December 2014. The women were divided into two groups: an experimental group consisted of 150 adolescent pregnant women aged 13–19 years and a control group consisted of 150 adult pregnant women aged 20–35 years. The following parameters were analyzed: age of pregnant women, number of antenatal controls in pregnancy, prepregnancy body weight, weight gain in pregnancy, parity, and obstetric history data. Results: A significantly higher number of adolescent pregnant women belongs to a subgroup from one to two examinations during pregnancy (P < 0.000013) and to subgroups from three to five examinations (P < 0.000001). A significantly smaller number of adolescent pregnant women performed their first antenatal control in the first 2 lunar months (P < 0.01). A subgroup with optimal body weight (from 51 to 69 kg) are the most prevalent among adolescent pregnant women (P < 0.000001). A significantly larger number of adolescent pregnant women had an optimal weight gain of 7.8 to 12.99 kg (P < 0.001). Conclusions: The adolescent pregnant women have suboptimal antenatal care, which could lead to adverse maternal and birth outcomes, but have optimal body weight and weight gain during pregnancy.
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Background: To investigate the total survival of low birth weight infants (LBWIs) in the Federation of Bosnia and Herzegovina (FB and H) and selected by subgroups of birth weight (BW) and gestational age (GA). Methods: This... more
Background: To investigate the total survival of low birth weight infants (LBWIs) in the Federation of Bosnia and Herzegovina (FB and H) and selected by subgroups of birth weight (BW) and gestational age (GA). Methods: This cross-sectional study included newborns of both genders, GA of 22–42 weeks and BW of less than 2500 g of 10 cantons territory of the FB and H. In the examined period, 22,897 children were born in the FB and H, of which 669 (2.9%) had BW less than 2500 g. Results: Surviving of LBWIs in the FB and H out of the 669 LBWIs in the first level perinatal healthcare institutions (PHI) was 29 (4.3%), the second level was 286 (42.8%), and the third level was 354 (52.9%). The total stillborn rate was 3.9%. The overall perinatal mortality rate for all levels of PHI was 8.6%. The overall rate of early neonatal mortality of LBWIs in all three levels of PHI in the FB and H was 12.7%. By the end of the first month of life (up to 28 days) and to the end of the neonatal period, 385 (57.5%) of LBWIs survived, and 284 (42.4%) died. The LBWIs by subgroups of BW up to 28 days had lower survival rates in second-level PHI than infants of the same BW subgroups (500–999 and 1000–1499) treated in third-level PHI (P = 0.0089 and P = 0.004). Conclusions: Our results show that B and H belongs to developing countries according to perinatal mortality. A unique database system is necessary to follow progress and trends.
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Introduction: Knowledge of the size of surfaces available for transport is important for assessing the amount of nutrients that can be transmitted to the fetus for its normal growth and development. Aim: The aim of our study, was to... more
Introduction: Knowledge of the size of surfaces available for transport is important for assessing the amount of nutrients that can be transmitted to the fetus for its normal growth and development. Aim: The aim of our study, was to determine the stereological structural parameters of the parenchymal part of placenta, ratio of birth weight and placental weight, and to determine their correlation with the body length and head circumference of the newborns of adolescent pregnant women. Methods: The study was conducted on a total of 60 human placentas of term pregnancy, divided into two groups according to the age of pregnant women. The experimental group consisted of 30 placenta of pregnant women aged 13-19. The control group consisted of 30 placenta of pregnant women aged 20-35. Computer assisted morphological analysis of images of histological preparations using stereological methods was performed. Results: Surface density of terminal villi of adolescent placentas is significant higher than the control group (t = 14,179, df = 29, p <0,0001). The T-test (t = -5,868, df = 29, p <0,0001) showed statistically significant difference in the surface density of fibrinoid in two compared groups. T-test (t = 6.438, df = 29, p <0.0001) found that total surface of terminal villi was significantly higher in adolescent placentas. The T-test (t = -6,747, df = 29, p <0,0001) found that total surface of fibrinoid was significantly lower in adolescent group. The T-test (t = 4.203, df = 29, p <0.0001) found that the ratio of birth weight of newborn and adolescent placental weight was significantly higher in relation to the control group. Conclusion: Adolescent placentas was more efficient in increasing the weight of newborns, compared to the control group placentas.
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The aim of the paper is to present the risk of pregnancy for mother and her child in a young patient who had a surgery to repair Tetralogy of Fallot (ToF), who gave a birth to her firstborn by having a cesarean section. 23 years old... more
The aim of the paper is to present the risk of pregnancy for mother and her child in a young patient who had a surgery to repair Tetralogy of Fallot (ToF), who gave a birth to her firstborn by having a cesarean section. 23 years old patient, in 28 weeks of pregnancy was admitted to the clinic due to her medical record. She did not have any subjective complaints. She had two surgeries to repair ToF. After the surgery, she had residual ventricular septal defect (VSD). She had her first surgery 20 years ago (she was 3 years old), and second 7 years ago (she was 16). She had regular check-ups since, and her heart condition was unchanged. Due to her heart surgeries and VSD, a cardiologist indicates that she should deliver by having a c-section when she is 36 weeks pregnant. The patient's heart condition was stabilized and the patient was sent home. She was recommended to have her cardiologist check up on her as she leaves the hospital and to have a gynecological examination in 6 week...
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Aim To compare the prevalence of premature rupture of membranes (PROM) and preterm premature rupture of membranes (PPROM) between adolescent and adult pregnancies, and the influence of gestational age and adolescent pregnancy on the... more
Aim To compare the prevalence of premature rupture of membranes (PROM) and preterm premature rupture of membranes (PPROM) between adolescent and adult pregnancies, and the influence of gestational age and adolescent pregnancy on the frequency of occurrence of PROM and PPROM. Methods This prospective study included 300 pregnant patients, 13 to 35 years of age, divided into two groups. The first group consisted of 150 pregnant women aged 13-19 (experimental group) and the second group consisted of 150 pregnant women aged 20-35 (control group). Results There was a statistically significant higher incidence of both PPROM and PROM in the group of adolescent pregnant women compared to adult pregnant women (p<0.000001). Preterm delivery with PPROM was significantly more common in the group of adolescent pregnant women (p<0.004). Term delivery with PROM was statistically significantly more common in the adolescent pregnancy group than in the adult pregnancy group (p<0.001). Term de...