PROSPECTIVE FATHERS: PSYCHOSOCIAL ADAPTATION AND INVOLVEMENT IN THE LAST TRIMESTER OF PREGNANCY

Background: Paternal involvement in pregnancy has been recognized to have an impact on new-born’s outcomes and only recently got under the spot light of mental health perspective. The aim of this study was to test differences in paternal involvement in pregnancy, perceived stress and relationship quality regarding complications in pregnancy and pregnancy duration (gestational weeks) in the last trimester of pregnancy. The role of personality traits (neuroticism and extroversion), relationship quality satisfaction and perceived stress in prospective father’s perception of pregnancy involvement were examined. Subjects and method: One-hundred forty-three primiparus couples in the last trimester of their pregnancy participated in the study. Prospective fathers completed a booklet with questionnaires including The Quality of Marriage Index, The Perceived Stress Scale, Eysenck Personality Questionnaire and Partner’s Involvement in Pregnancy Scale. Prospective mothers completed only Eysenck Personality Questionnaire and questions on pregnancy complications and demographics. Results: The prospective fathers showed high involvement in their partner’s pregnancies, elevated levels of perceived stress and high relationship quality. There were found no differences in the above named variables regarding complications in pregnancy and pregnancy duration. Higher involvement of prospective fathers was related with older age, lower male neuroticism and higher female extroversion, better relationship quality and lower perceived stress. Conclusion: The findings demonstrate that prospective father’s involvement in pregnancy is supported with psychological factors, namely personality traits, quality of relationship and perceived stress. These results should lead to target interventions that can modify and improve fathers’ involvement perspective and promoting a couples mental health during pregnancy: thus clinically important for promotion of healthy prenatal behaviour and decrease in mothers’ emotional distress

Relapsed ovarian high-grade serous carcinoma with long-term survival associated with synchronous primary squamous cell carcinoma of the colon

High-grade serous ovarian cancer (HGSOC) is the most common and also the most aggressive subtype of ovarian cancer while squamous cell carcinoma (SCC) of the colon is an extremely rare histologic subtype of all colonic malignancies with poor prognosis. Here we report a unique case of synchronous primary SCC of the colon and second recurrence of HGSOC in a patient with 15-years survival. Our patient developed two recurrent HGSOCs with disease-free survival time of five and nine years, respectively. The second recurrence of HGSOC was associated with the synchronous primary SCC of the ascending colon and was further complicated with the patient′s development of platinum resistance. Awareness of this unusual occurrence should emphasize the need for adequate sampling of tumor tissue in patients with relapsing ovarian cancer. Reports of more cases of SCC of the colon would possibly help to establish appropriate management modality and strategies for treatment

Papillary Thyroid Carcinoma Arising within a Mature Cystic Teratoma of the Ovary: A Report of Two Cases with Long-Term Follow Up

Objectives: To report two patients with papillary thyroid carcinoma arising within mature cystic teratoma with long term follow-up. Methods: The cases are compared with previous reports of similar entities, with special reference to the treatment modalities and management options in follow-up of these patients. Results: Final diagnosis of both tumors was established after the initial surgery. Both tumors were histologically classified as the malignant transformation of the thyroid tissue within the mature cystic teratoma, both were papillary type and confined to one ovary. We presented two similar cases, but our therapeutic approach was surgically different. Both patients were treated with surgery alone and are alive with no evidence of the disease after 10 and 5 years, respectively. Conclusion: Preoperative and intraoperative frozen section diagnosis of malignant transformation within teratoma is very difficult, so optimal management of the patients has not yet been established. Treatment of this tumor should be individualized, but a contour of treatment modalities and management options are visible and our cases may contribute in this achievement

Cervical Cancer Screening Programme in Primorsko-Goranska County, Croatia – The Results of the Pilot Study

The opportunistic cervical cancer screening has been conducted in Croatia since its introduction in the 1960s, in the context of a high quality gynaecological cytology with a long tradition and a wide network of primary care gynaecologists. In 2006, a pilot screening programme under the title »Early detection of cervical cancer was conducted in Primorsko-Goranska County (PGC)«, as the first organised cervical cancer screening ever conducted in the Republic of Croatia. The pilot screening programme targeted women aged 20–64 years. The pilot group consisted of 6,000 randomly sampled primary care patients of six gynaecologists. The women were invited via a personal letter and were given a questionnaire. The results of the first and the second year of screening, as well as of both years together were analysed. The response rate to the anamnestic questionnaire was 49.1%. The participation rates to the screening were 35.2% in 2007, and 46.5% in 2008, total of 42.7%. The increase in participation between years 2007 and 2008 was statistically significant (p=0.01). According to the age, the lowest participation rate of 33.3% was observed in the youngest group of women (20–29) and the highest of 60.7% in the oldest group (60–64). The detection rate of cytological abnormalities was 4.6% with 2.6% of borderline (ASCUS) cytology and referral rate of 1.2%. The highest abnormal Pap test frequencies of 6.8% and 7.1% were observed in the youngest age groups (20–29 and 30–39), and the lowest (2%) in the age group of 60–64. Specimen adequacy was generally of high quality with unsatisfactory rate of 0.8%, with statistically significant improvement in 2008, compared to the previous year (p=0.001). Although to a limited extension, during two-year pilot cervical cancer screening programme in PGC the participation rates and Pap smear adequacy have improved. We expect that the continuation of the programme will result in further increase of participation and higher overall quality of the programme

Liver Disease During Pregnancy: A Challenging Clinical Issue

One of the least studied topics in the field of obstetrics is liver disease during pregnancy, which creates a challenge for both gynecologists and hepatologists. Approximately 3% of pregnant women are affected by some form of liver disease during pregnancy. Some of these conditions can be fatal for both the mother and child. In addition, 3 types of liver disease need to be differentiated during pregnancy. One type is liver disease directly related to pregnancy, which can occur at a specific time during pregnancy. Another type is liver disease not related to pregnancy, which can occur at any time, such as viral- or drug-induced hepatitis. Furthermore, pregnancy can occur in women with pre-existing liver disease. It is essential that the clinicians are familiar with this disorder so they can respond promptly and appropriately in all of these situations, especially when emergency delivery is needed and must not be postponed