Pregnancy and delivery outcome in young and older primigravidae

Cilj istraživanja: Utvrditi i usporediti ishod trudnoće i poroda na početku i pri kraju reproduktivne dobi. Materijal i metode: U istraživanje je uključeno 59 prvorotkinja mlađih od 18 godina i 233 prvorotkinje starije od 35 godina, koje su rodile u našoj ustanovi tijekom dvogodišnjeg razdoblja (od 2006. do 2007. god.). Podaci su prikupljeni retrospektivno, pretraživanjem medicinske dokumentacije i rađaoničkog protokola hospitaliziranih rodilja. Rezultati: U starih prvorotkinja značajno je povećan broj medicinskih zahvata u trudnoći kao i učestalost komplikacija u trudnoći (36,48% vs. 16,94%, p<0,05). U starih prvorotkinja značajno je češća i učestalost operativnog dovršenja poroda carskim rezom (23,60% vs. 8,47%, p<0,05) iako nije uočena značajna razlika u nepravilnostima rađanja. Mlade prvorotkinje znatno češće rađaju uz epiduralnu analgeziju (32,20% vs. 25,32%, p<0,01). Ne postoji značajna razlika u trajanju gestacije, u srednjoj vrijednosti rodne mase, niti razlika u Apgar score novorođenčadi. Zaključak: Mlade i stare prvorotkinje su rizične skupine rodilja koje zahtijevaju posebnu opstetričku skrb i planiranje načina rađanja. Negativan učinak životne dobi na ishod trudnoće jače je izražen u starijih prvorotkinjaAim: Tto determine and compare the frequency of the risk of pregnancy and delivery outcome at the beginning and ending of reproductive age. Methods: The study included 59 nulliparous adolescents younger than 18 years and 233 nulliparous women 35 years and older in the period of two years (2006-2007). Birth records and patient files were retrospectively analised and compared. Results: In the primiparae of 35 years or more, medical interventions during pregnancy were higher, and the risk of chronic diseases which complicated their pregnancies increased (36,48% vs. 16,94, p<0,05). The incidence of cesarean section was statistically higher in pregnancies above 35 years (32,20% vs. 25,32 % p<0,01). Birth weight, APGAR scores and, incidence of premature birth, were not significantly different between groups. Conclusion: Both adolescents and women of advanced reproductive age comprise distinct groups of obstetrics patients. Each has special needs and is susceptible to different obstetric risks. Nulliparous women of 35 years and older have higher risk of negative effect of age on their pregnancies

Pregnancy and delivery outcome in young and older primigravidae

Cilj istraživanja: Utvrditi i usporediti ishod trudnoće i poroda na početku i pri kraju reproduktivne dobi. Materijal i metode: U istraživanje je uključeno 59 prvorotkinja mlađih od 18 godina i 233 prvorotkinje starije od 35 godina, koje su rodile u našoj ustanovi tijekom dvogodišnjeg razdoblja (od 2006. do 2007. god.). Podaci su prikupljeni retrospektivno, pretraživanjem medicinske dokumentacije i rađaoničkog protokola hospitaliziranih rodilja. Rezultati: U starih prvorotkinja značajno je povećan broj medicinskih zahvata u trudnoći kao i učestalost komplikacija u trudnoći (36,48% vs. 16,94%, p<0,05). U starih prvorotkinja značajno je češća i učestalost operativnog dovršenja poroda carskim rezom (23,60% vs. 8,47%, p<0,05) iako nije uočena značajna razlika u nepravilnostima rađanja. Mlade prvorotkinje znatno češće rađaju uz epiduralnu analgeziju (32,20% vs. 25,32%, p<0,01). Ne postoji značajna razlika u trajanju gestacije, u srednjoj vrijednosti rodne mase, niti razlika u Apgar score novorođenčadi. Zaključak: Mlade i stare prvorotkinje su rizične skupine rodilja koje zahtijevaju posebnu opstetričku skrb i planiranje načina rađanja. Negativan učinak životne dobi na ishod trudnoće jače je izražen u starijih prvorotkinjaAim: Tto determine and compare the frequency of the risk of pregnancy and delivery outcome at the beginning and ending of reproductive age. Methods: The study included 59 nulliparous adolescents younger than 18 years and 233 nulliparous women 35 years and older in the period of two years (2006-2007). Birth records and patient files were retrospectively analised and compared. Results: In the primiparae of 35 years or more, medical interventions during pregnancy were higher, and the risk of chronic diseases which complicated their pregnancies increased (36,48% vs. 16,94, p<0,05). The incidence of cesarean section was statistically higher in pregnancies above 35 years (32,20% vs. 25,32 % p<0,01). Birth weight, APGAR scores and, incidence of premature birth, were not significantly different between groups. Conclusion: Both adolescents and women of advanced reproductive age comprise distinct groups of obstetrics patients. Each has special needs and is susceptible to different obstetric risks. Nulliparous women of 35 years and older have higher risk of negative effect of age on their pregnancies

CYFRA 21-1 Protein - a Potential Marker of Endometriosis

Endometrioza je kronična upalna bolest karakterizirana pojavom i rastom endometrija izvan maternice. Etiopatogeneza nije razjašnjena, a postoji više teorija nastanka endometrioze. Patološki procesi prisutni u endometriozi jesu adhezija, invazija, proliferacija, angiogeneza i promijenjena imunost. Moguće je da procesi invazije i proliferacije uzrokuju povećanu sintezu određenih proteina koji se zatim izlučuju urinom. Protein citokeratin 19-9 (CYFRA 21-1) pojačano se izlučuje u urinu pacijentica s endometriozom te je potencijalni marker u ranim stadijima ove bolesti kada nije moguće slikovnim metodama postaviti sumnju na bolest ili ciljanu dijagnozu.Endometriosis is a chronic gynaecological inflammatory disease characterized by the appearance and flourishing of endometrium outside the uterine cavity. The etiopathogenesis is not yet clearly understood. The ongoing pathologic processes are invasion, adhesion, proliferation, angiogenesis, and immune dysfunction. There is a possibility of increased production of proteins caused by proliferation and invasion, that are excreted in the urine. The protein CYFRA 21-1 shows increased production in endometriosis and is a potential marker in the early stages of this disease when it is not possible to suspect the disease or diagnose it with imaging techniques

Ishod trudnoća i poroda u mladih i starih prvorotkinja

Aim: To determine and compare the frequency of the risk of pregnancy and delivery outcome at the beginning and ending of reproductive age. Methods: The study included 59 nulliparous adolescents younger than 18 years and 233 nulliparous women 35 years and older in the period of two years (2006-2007). Birth records and patient files were retrospectively analised and compared. Results: In the primiparae of 35 years or more, medical interventions during pregnancy were higher, and the risk of chronic diseases which complicated their pregnancies increased (36,48% vs. 16,94, p<0,05). The incidence of cesarean section was statistically higher in pregnancies above 35 years (32,20% vs. 25,32 % p<0,01). Birth weight, APGAR scores and, incidence of premature birth, were not significantly different between groups. Conclusion: Both adolescents and women of advanced reproductive age comprise distinct groups of obstetrics patients. Each has special needs and is susceptible to different obstetric risks. Nulliparous women of 35 years and older have higher risk of negative effect of age on their pregnancies.Cilj istraživanja: Utvrditi i usporediti ishod trudnoće i poroda na početku i pri kraju reproduktivne dobi. Materijal i metode: U istraživanje je uključeno 59 prvorotkinja mlađih od 18 godina i 233 prvorotkinje starije od 35 godina, koje su rodile u našoj ustanovi tijekom dvogodišnjeg razdoblja (od 2006. do 2007. god.). Podaci su prikupljeni retrospektivno, pretraživanjem medicinske dokumentacije i rađaoničkog protokola hospitaliziranih rodilja. Rezultati: U starih prvorotkinja značajno je povećan broj medicinskih zahvata u trudnoći kao i učestalost komplikacija u trudnoći (36,48% vs. 16,94%, p<0,05). U starih prvorotkinja značajno je češća i učestalost operativnog dovršenja poroda carskim rezom (23,60% vs. 8,47%, p<0,05) iako nije uočena značajna razlika u nepravilnostima rađanja. Mlade prvorotkinje znatno češće rađaju uz epiduralnu analgeziju (32,20% vs. 25,32%, p<0,01). Ne postoji značajna razlika u trajanju gestacije, u srednjoj vrijednosti rodne mase, niti razlika u Apgar score novorođenčadi. Zaključak: Mlade i stare prvorotkinje su rizične skupine rodilja koje zahtijevaju posebnu opstetričku skrb i planiranje načina rađanja. Negativan učinak životne dobi na ishod trudnoće jače je izražen u starijih prvorotkinja

Complete restoration of fertility in a patient treated for androgen-secreting granulosa cell tumor- Case report

Case report: A 35-yr-old patient suffering from secondary amenorrhea for two years before she was diagnosed. Secondary amenorrhea occurred after the first normal vaginal delivery, and it was initially associated with breastfeeding and a formerly diagnosed thyroid disease. Transvaginal ultrasound confirmed a tumorous mass of the right ovary. Blood hormone tests detected high serum inhibin B and Anti-Müllerian hormone levels and high androgen level with no signs of virilization. Surgical treatment was indicated for a definitive diagnosis of suspected sex cord-stromal tumor. Right-sided laparoscopic salpingo-oophorectomy was performed, and the histopathological analysis confirmed the diagnosis of granulosa cell tumor adult type. The oncological team recommended adjuvant chemotherapy after the operation, but the patient did not give an informed consent. One month after surgical treatment, spontaneous menstrual bleeding occurred with normalization of sex hormone levels and the menstrual cycle. Nine months after surgical treatment, the patient was examined again due to secondary amenorrhea. Ultrasound confirmed a vital intrauterine pregnancy. The pregnancy course was normal, and the patient had a full-term spontaneous vaginal delivery of her second child. Conclusion: Restoration of fertility after a temporary loss due to hormone-secreting granulosa cell tumor is possible after sparing surgical treatment. The role of adjuvant chemotherapy is controversial, particularly in patients with stage I-II disease because of the rarity of this tumor and the absence of prospective randomized studies

Proteins in urine – Possible biomarkers of endometriosis

In the pathogenesis of endometriosis, a number of pathological reactions occur. Proteins secreted in the urine are thought to interact with each other and stimulate the pathological processes in endometriosis. Identifying one or more proteins that are specific enough and could serve as biomarkers for endometriosis is both a challenge and a necessity that would facilitate diagnosis. The urine of patients treated in a tertiary university hospital between July 1, 2020 and June 30, 2021 was analyzed. The studied group consists of patients who were treated surgically for endometriosis and in whom the diagnosis was confirmed by pathohistological analysis. The control group consists of patients who were operated for functional ovarian cysts. Urinary proteins were analyzed by chromatography and mass spectrometry (LC-MS/MS). We identified 17 proteins in urine whose concentrations were statistically significantly different in the group with endometriosis (N = 16) compared with the control groups (N = 16). The detected proteins were classified into groups according to their function in invasion, migration and proliferation, proteolysis, immune system, cell adhesion and vascular system. For all mentioned proteins the difference in concentration is statistically significant p < 0.005. Proteins are secreted in the urine of patients with endometriosis that may be involved in the pathogenesis of the disease and are possible biomarkers for endometriosis