Multidisciplinary approach to management of hypofibrinogenaemia in pregnancy: A case report

Inherited fibrinogen disorders introduce risk for recurrent abortions, sub-chorionic haematoma, placental abruption and postpartum haemorrhage. This is a case report of a successful pregnancy outcome in a 37-year old woman with hypofibrinogenaemia. She was referred to a coagulation test in the first trimester because of history of preeclampsia and HELLP syndrome in previous pregnancy. Hypofibrinogenaemia was diagnosed with fibrinogen level of 0.7 g/L. During the pregnancy she was regularly monitored for fibrinogen levels and multiple cryoprecipitate concentrates were given. She delivered at 39th gestation week, with elective caesarean section under general anaesthesia. There was one episode of postpartum haemorrhage treated with 2 units of red blood cells, repeated infusions of cryoprecipitate to obtain the level of fibrinogen of 2 g/L. She was discharged on the 6th postpartum day in a good condition. In these disorders levels of fibrinogen should be higher than 1 g/L during pregnancy or 2 g/L in case of caesarean section for successful prenatal and peripartal management

Maternal and Neonatal Outcomes in Pregnant Women with Gestational Diabetes Mellitus Treated with Diet, Metformin or Insulin

AIM: Aim of the study was to compare outcomes of pregnancy in gestational diabetes mellitus (GDM) treated with metformin, insulin, or diet.MATERIAL AND METHODS: The study included 48 women with GDM treated with metformin, 101 with insulin, and 200 women on a diet from the Outpatient Department of Endocrinology and University Clinic of Obstetrics and Gynecology in Skopje.RESULTS: The groups were comparable in age, smoking cigarettes and positive family history of diabetes. Mean glycosylated haemoglobin (HbA1c) at 37 gestation week, mean fasting, postprandial glycaemia, and gestational age at delivery were lower in diet and metformin than insulin group. No differences in mode of delivery were observed between the metformin and insulin group. Women in metformin group had a significantly lower incidence of LGA newborns than diet and insulin groups. The percent of SGA new-borns was higher in insulin group than diet and metformin groups. The incidence of neonatal hypoglycemia was statistically significantly higher in the insulin group than in the metformin and diet group.CONCLUSION: Metformin in women with GDM can improve maternal and neonatal outcomes compared with those treated with diet or insulin

Icidence of HBsAg and HCV antibodies among workers exposed to HBV and HCV infection in Stip Medical Centre

The results shoving the presence of HIV and HCV infection in the employees of Stip Medical Center laboratories, haemodialysis unit, department of infectious diseases and blood transfusion unit are precented. The employees in the departments with an increased awareness of hepatitis infections show fewer HBV infection markers positive. All employees are exposed at their work place to contact with patients blood samples, but no one is HCV antibodies positive. HBV infection is less present among the employees in the department of infectious diseases: five times less than in the laboratories and eight times than in the haemodialysis unit. The importance of health education for hepatitis prevention is emphasized

HCV infection: presence and nature

The importance and the nature of HCV infection in the word and in our country is considered. The types of NANB hepatitides, HCV infection and hepatitis C, the properties of HCV, clinical manifestations and sequels of HCV infections, test for HCV antibodies determination, types of extrahepatal clinical affections of HCV infection and the inactivation of HCV with thermal and chemical procedures are presented. The data are presented and the epidemiologic in the Republic of Macedonia is emphasized

Occurrence of HCV infection in patients viral hepatitis in the Infectious Diseases Clinic, Stip, 1991-1992

A number of 52 HBsAg negative patients were investigated for the presence of HCV antibodies and only in 3 patients was the test for HCV antibodies positive (5.77% of the patients with hepatitis which is HBsAg negative). The possible explanation for the low per cent of HCV antibodies is considered in the patients with NANB hepatitis

Clinical importance of imunoglobulin classes of HCV antibodies

In the Department of haemostasis and thrombosis of the Institute of Blood Transfusion, Skopje, a method has been developed for the identification of immunoglobulin classes of HCV antibodies, the differentiation of immunoglobulin classes of HCV antibodies gives the possibility of identifying the acute type of HCV infection (only IgM type of HCV antibodies present) and the chronic type of HCV infection (both IgG and IgM type of HCV antibodies present). Both the macro-and micro-ELISA system are employed in the immunoglobulin classes identification of HCV antibodies. The method we used is a double sandwich ELISA technique with the use of monospecific antisera for IgG and IgM

HCV antibodies among blood donors in the Republic of Macedonia

1655 blood donors from our from our country are investigated with the 2nd generation test for HCV antibodies and only 297 blood donors were tested with the 1st generation. With 2nd generation test for HCV antibodies the percentage of HCV antibodies positive blood donors is 1.15% (1992) and with 1st generation HCV antibodies it test is 0.67% (1991) The problems of hepatitis transmitted by blood transfusion are very complex and unresolved in our country. The HCV antibodies test is a new possibility in defining the nature of transfusion mediated hepatitis

HCV-antibodies in orthopaedic patients

The presence of HCV antibodies in patients undergoing minor orthopedic operacions and in patients with inplanted endoprothesis in the postoperative period was determined: in the first group (38 patients) no patients were HCV antibodies positive, in the second group (82) patients) 4 patients were HCV antibodies positive (4,88% in orthopaedic patients and 1.15% in healthy blood donors, a prevalence of HCV antibodies 4,24 higher)

Incidence of HCV antibodies among blood donors in Stip area

A second generation test for HCV antibody detection in sera coming from Stip county is used. The percentage of antibodies positive blood donors in Stip is very similar to to that in the Republic of Macedonia, 1,00% in Stip and 1.15% in Macedonija. Some of the causes related to the possibility that the real percentage of HCV antibodies positive blood donors is higher than that found are presented. The necessity of the introduction of a systemic use of HCV antibodies determination in blood donors is emphasized