Secular Changes in Growth and Obesity in Perinatal Population

The survey was conducted during the last 25 years and included 2414 healthy women who delivered in »Sestre milosrdnice« University Hospital Center in Zagreb, Croatia and their newborns. The aim was to establish the secular trend of some anthropological factors through two generations. Anthropological features such as pre-pregnancy weight, body mass index before pregnancy, height, age, place of residence, educational level, parity and the newborn weight were registered. The study was randomized. The mothers from the city of Zagreb and the surrounding villages, rural areas are examined. The women age was different and also different levels of education and socioeconomic status. The study included women who had not given birth yet, who had delivered once, twice, and three or more times. Maternal height in 25 years increased by 3.1cm. and increases with education. The pre-pregnancy weight increased 2.8 kg and increases with age, parity and rural life. The body mass index (BMI) which the women had before pregnancy was calculated, and according to its value the participants were divided in three groups: with normal weight, overweight and fat. Among the studied periods BMI does not differ significantly, but does differ significantly with respect to the ordinal number of births, parity, age and living environment. Higher BMI was associated with deliveries to heavier children

CHANGES IN SEX LIFE AFTER CHILDBIRTH

Background: Childbirth is major event in the life of closer and extended family. The aim of this study is to explore sex desire after childbirth and challenges for usual rhythm of intercourse. Subjects and methods: We studied 113 women who filled up questionnaire at the follow up examination. Inclusion criteria were: all women were secundigravidae and time between pregnancies was more than a year. Women anonymously filled out a survey with question on the time before first intercourse after delivery, frequency of sexual intercourse after delivery, sexual desire after delivery, sexual desire of partner after delivery, reasons for postponing sexual intercourse after delivery and frequency of intercourse in the first year after delivery. Results: Most women had same number of intercourse after delivery like before pregnancy (Hi-square test: Ȥ2(2)=22.04, p<0.0001). Significant proportion of women find their partners sexual desire to be the same like in the pre-pregnancy period (H i- square test: Ȥ2(2)=64.64, p<0.0001). Most women had intercourse once a week (several times a month) during first year after delivery (Hi-square test: Ȥ2(3)=91.93, p<0.001). Fatigue, sleep deprivation, bad mood and lack of time are the most common reasons for intercourse postponement. Most women find life conditions to be very good. They do not find that they neglect their children and partners find them attractive. Conclusion: Sex life after delivery is still taboo in most countries. Women should have the information that sex life after delivery will turn to normal after a certain time

Antropologic Factors in Prediction of Ovary Cancer

The aim of the study was to determine a combination of anthropometric variables that would enable better differentiation between benign and malignant ovarian masses. Prospective study has been performed in a two year period in which 208 women with ovarian lesions were analyzed and correlated with histopathologic surgical findings. We examined the relation between self-reported anthropometric and other variables (height, weight, body mass index – BMI, parity, marital status, education, age, rural versus urban residence, menopausal status) and incidence of ovarian cancer. Age, parity, marital status and menopausal status individually showed statistical significance

Brennerov tumor jajnika

Brenner tumor of the ovary is very rare, mostly benign, small, and unilateral. It mostly occurs in elderly women and produces no symptoms. In the last ten years (1994-2004), seven women were operatively treated at Sestre milosrdnice University Hospital in Zagreb for Brenner tumor. Six patients were treated for this type of tumor, whereas in one patient Brenner tumor was an accidental finding. The former six patients underwent preoperative ultrasonography and Ca 125 determination. The patient age ranged from 41 to 72 years. In six cases, the tumor was unilateral. One patient had a mucionus proliferating cystadenoma in the same ovary affected with benign Brenner tumor. The size of tumors varied from 0.5 to 20 cm in diameter.Brennerov tumor jajnika je vrlo rijedak, uglavnom benigan, većinom malen, najčešće jednostran. Obično se javlja u starijih osoba i ne izaziva nikakve smetnje. U posljednjih 10 godina (1994.-2004.) u Kliničkoj bolnici "Sestre milosrdnice" operirano je sedam bolesnica s Brennerovim tumorom. Šest ih je operirano zbog tumora jajnika, dok je kod jedne bolesnice Brennerov tumor otkriven kao slučajan histopatološki nalaz. Kod šest bolesnica koje su operirane zbog tumora jajnika prijeoperacijski je učinjena ultrasonografija i pretraga na biljeg Ca 125. žene su bile u dobi od 41 do 72 godine. U šest bolesnica je tumor bio jednostran. Kod jedne žene nađen je mucinozni proliferirajući cistadenom u istom ovariju s benignim Brennerovim tumorom. Tumori su bili promjera od 0,5 do 20 cm

Endometrioza trbušne stijenke jedanaest godina nakon carskog reza: prikaz slučaja

Endometriosis is a common chronic disease characterized by growth of the endometrial gland and stroma outside the uterus. Symptoms affect physical, mental and social well-being. Extrapelvic location of endometriosis is very rare. Abdominal wall endometriosis occurs in 0.03%-2% of women with a previous cesarean section or other abdominopelvic operation. Th e leading symptoms are abdominal nodular mass, pain and cyclic symptomatology. Th e number of cesarean sections is increasing and so is the incidence of abdominal wall endometriosis as a potential complication of the procedure. There are cases of malignant transformation of abdominal wall endometriosis. Therefore, it is important to recognize this condition and treat it surgically. We report a case of a 37-year-old woman with abdominal wall endometriosis 11 years after cesarean section. She had low abdominal pain related to menstrual cycle, which intensified at the end of menstrual bleeding. A nodule painful to palpation was found in the medial part of previous Pfannenstiel incision. Ultrasound guided biopsy was performed and the diagnosis of endometriosis confirmed. Surgery is the treatment of choice for abdominal wall endometriosis. Excision with histologically proven free surgical margins of 1 cm is mandatory to prevent recurrence. A wide spectrum of mimicking conditions is the main reason for late diagnosis and treatment of abdominal wall endometriosis. In our case, the symptoms lasted for eight years and had intensified in the last six months prior to surgery.Endometrioza je česta kronična bolest obilježena rastom endometrijskih žlijezda i storme izvan maternice. Simptomi utječu na pad fizičkog, mentalnog i socijalnog blagostanja. Ekstrapelvična lokacija endometrioze je rijetka. Pojavnost endometrioze trbušne stijenke je 0,03%-2% žena s prethodnim carskim rezom ili nekom drugom abdominopelvičkom operacijom. Vodeći simptomi su abdominalna nodularna masa, bol i ciklička simptomatologija. Broj carskih rezova je u porastu pa tako raste i pojavnost endometrioze trbušne stijenke kao potencijalne komplikacije ovoga zahvata. Opisani su slučajevi maligne transformacije endometrioze trbušne stijenke. Zato je potrebno pravodobno prepoznati ovo stanje i liječiti ga kirurški. Prikazan je slučaj 37-godišnje bolesnice s endometriozom trbušne stijenke 11 godina nakon carskog reza. Imala je bolove u donjem dijelu trbuha koji su bili povezani s menstruacijskim ciklusom i pojačavali su se prema kraju menstrualnog krvarenja. Bolni čvorić se pipao u srednjem dijelu ožiljka od carskog reza. Ultrazvučno navođena biopsija je potvrdila dijagnozu endometrioze. Metoda izbora u liječenju endometrioze trbušne stijenke je kirurški zahvat. Široka ekscizija s patohistološki dokazanim slobodnim rubom od 1 cm je obvezna kako bi se spriječio recidiv endometrioze. Široka diferencijalna dijagnoza je razlog kasne dijagnoze i liječenja endometrioze trbušne stijenke. Simptomi su trajali osam godina, a pojačali su se šest mjeseci prije operacije

SECULAR CHANGES IN EDUCATION, URBAN-RURAL LIVING, MENARCHE AND ABORTION RATES IN PERINATAL POPULATION

Over a 25-year period we examined the anthropological characteristics of mothers and their partners, such as the place of living: urban vs. rural, the degree of education, parity, the time of menarche, and the frequency of intentional abortions. We examined 2 414 mothers and their partners in four periods of time extending from 1985 to 2009 in order to establish changes in the said anthropological characteristics over a period of 25 years. The degree of education of mothers and their partners is on the rise. In the period from 1985 to 1994, the percentage of mothers from the country was on the rise. Women with less education have on average more children, and those with better education the least children. Women from rural areas have on average more children than women from urban areas. The time of menarche dropped by 9 months over the period of 25 years. Girls from urban areas have their first menstrual cycle earlier. Women with higher professional qualifications had their first period earlier. The number of intentional abortions over the 25-year period dropped

Male to female birth ratios over a 35-year period

Aim Along with changes to the human physique recorded over the past decades in certain countries, there are also changes concerning the male-female birth ratio. The aim of this study was to establish the movement of male-female birth ratios and factors affecting the ratio. Methods This retrospective study was conducted in Zagreb, Croatia, in the period from 1985 to 2019 on a sample of 3804 newborns. Results In the 35-year period the ratio of boys and girls at birth did not change significantly. Girls had lower birth weight, and boys had higher birth length. In the war period (1992-1994), a mild increase in the ratio of boys was noted, but not statistically significant. Father’s age in the last period examined (2007-2009) showed to be a statistically significant predictor of the child’s gender. Namely, the descendants of younger fathers were statistically significantly more frequently girls, while the descendants of older fathers were more frequently boys. Married mothers had higher percentage of male births (51.5%), and a lower percentage (47.1%) by unmarried mothers. Conclusion The changes in birth ratios are particularly pronounced in different age and socioeconomic groups of parents nowadays when the growth of living standards is accompanied by significant changes of the human physique

Diagnostic Approach for Precancerous and Early Invasive Cancerous Lesions of the Uterine Cervix

Invasive cervical cancer is second most common female cancer worldwide with about 493 000 new cases per year. About 273 000 women die from cervical cancer each year, 85% of which take place in developing countries. Cervical cancer has a slow progress, from pre-invasive cervical intraepithelial neoplasia (CIN) to invasive phases, meaning that the disease can be diagnosed while in the phase of pre-invasive lesion, and treated successfully thanks to the regular screening of asymptomatic women (the Pap smear). The authors review new possibilities of early detection of cervical cancer with emphasis on colposcopy. The role of colposcopy is discussed among possibilities of early diagnosis. The authors discuss additional diagnostic procedures for preinvasive lesions of the uterine cervix like DNA cytometry, (flow cytometry). This method can point to dysplasia which can progress to severe stages, such as HSIL (High grade Squamous Intraepithelial Lesion). If the level of chromosomal disturbance is higher (aneuploidy), it is more probable that HSIL will develop. Laser screening of cells extracted with modern cytologic screening LBC (Liquid Base Cytology) enables us to automatically measure ploidy (chromosome regularity, or irregularity) and PCR provides analysis of HPV types. These methods are recommended for a routine check-up of borderline cervical lesions in order to anticipate ones likely to regress or progress