Browsing by Author "Beleslin, Aleksandra (57895738000)"

Introduction There are three groups of disorders during pregnancy: disorders specific for pregnancy that resolve spontaneously or soon after delivery, acute hepatic disorders coinciding with pregnancy, and chronic disorders. Drug-induced liver disease prevails among women and it is estimated to be a leading cause of acute liver injury. Drug-induced hepatitis is rare in pregnancy with only a few cases reported in literature. Alpha-methyldopa is one of the commonly used drugs in pregnancy that could cause hepato-toxicity with different clinical presentations and possible adverse effects on normal course of pregnancy. Case outline We reported a rare case of hepatotoxicity caused by alpha-methyldopa in 26 gestational weeks pregnancy in a 35-year-old patient admitted because of jaundice and elevated liver function tests. She had been using antihypertensive drug, alpha-methyldopa, from 12th gestational week, and no other medication or supplementation was recorded. Ultrasound of the abdomen excluded obstruction or any other abnormalities. Autoimmune panel was done. Biochemical analyses were indicative of toxic acute liver injury caused by alpha-methyldopa according to values of transaminase. After 13 days, patient was discharged recovered from the hospital. Conclusion Diagnosis of alpha-methyldopa hepatotoxicity is challenging since the low incidence, un-predictability, diverse symptomatology and absence of specific biomarkers. That is why timely diagnosis is crucial for the well-being of both future mother and child. © 2024, Serbia Medical Society. All rights reserved.

Introduction: Cancer complicating pregnancy is a rare but potentially life-threatening condition for both the mother and her child. The aim of the present study was to assess the outcomes for mothers and children after pregnancy complicated by malignancy and to investigate which parameters are important for their 1-year survival. Material and methods: The study included 84 pregnant women diagnosed with malignant tumors during pregnancy from 2001 to 2022. The pregnancy course and outcome, as well as parameters that could influence the survival and condition of the mother and child were evaluated. Mothers and children were followed up for 1 year after delivery to assess their condition/complications and overall survival. Results: Most malignancies were gynecological (31%) or hematological (23.8%) and were diagnosed and surgically treated in the second trimester. Most children (69%) showed adequate growth and development throughout pregnancy but were delivered before term (53.6%) to allow mothers to receive therapy. Adjuvant therapy during pregnancy mostly caused a transitory deterioration of the child's condition, while surgery did not significantly impact the pregnancy course. Deliveries, on average, occurred during the 33.01 ± 6.16 gestational week (range: 20–40) and mostly by cesarean section (76.2%). For mothers, the pregnancy survival rate was 95.2% and survival after 1 year was 87.5%. However, 37.5% of women were still ill and required additional therapy 1 year postpartum. The pregnancy survival rate for children was 94%, whereas the 1-year survival rate was 76.2%. Most children had a favorable condition (alive, adequately growing and developing, and without complications) at birth (81%) as well as at the 1-year follow-up (63.7%). Regression analysis identified the following predictors of favorable 1-year maternal condition: applying therapy during pregnancy, no progression of the malignancy during pregnancy, and delivery at a later gestational week. Predictors of favorable 1-year condition of children were lower histopathological grade of malignancy, surgery as therapy for malignancy, obtaining higher birthweight, and delivery by cesarean section. Conclusions: If the malignancy is not progressing, pregnancy should be continued as long as possible for the child to obtain adequate birthweight. Both surgery and chemotherapy were safe therapeutic choices, as most pregnancies continued successfully after therapy. © 2024 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG).

Background: The aim was to determine the effect of regional anesthesia (RA) on postoperative vital functions in contrast to general endotracheal anesthesia (GEA) after the cesarean section. Methods: Prospective cohort study included consecutive term pregnant women delivered by cesarean section (GEA, n = 284; RA, n = 249). Results: Higher levels of blood pressure and heart rate, as well as lower levels of pulse oximetry were found for GEA in contrast to RA (p < 0.001). The application of RA presented less side-effects (p < 0.05). Conclusions: RA for cesarean section should be preferred when balancing the risks and benefits for the mother and fetus. © 2022 Informa UK Limited, trading as Taylor & Francis Group.

Background/Objectives: Due to the rarity and histological heterogeneity of non-epithelial ovarian cancers (NEOCs), monitoring their reproductive and oncological outcomes is challenging. Therefore, this study aimed to investigate the oncological and reproductive outcomes of patients with NEOCs treated with fertility-sparing surgery over the past 10 years at our tertiary referral university clinic. Methods: This retrospective study included all the NEOC patients diagnosed and treated with fertility-sparing surgery from 2010 to 2019. The patient demographic and clinical characteristics; data regarding the treatment andthe clinical, laboratory, and imaging findings during follow-up; and disease recurrences were recorded. In this study, the recurrence-free survival and the overall survival were the oncological outcomes. The reproductive outcomes were assessed as attempting and achieving pregnancy. Results: This study included 39 patients. The most frequent NEOCs were granulosa cell tumors (53.8%). The majority of the tumors were in the IA or IC1 stage. The initial therapy was generally a unilateral salpingo-oophorectomy (30.8%). Adjuvant chemotherapy was received by 48.7% of the patients. An NEOC recurrence was registered in 25.6% of the patients, mostly during the first two postoperative years. The recurrence-free survival was 76.92%. A regression analysis showed that amore advanced stage of NEOC was the most important predictor of disease recurrence. The overall survival rate was 87.2%, with a mean time to an adverse outcome of 23.01 +/−10.68 months. The regression analysis showed that better survival depended mostly on not having disease recurrence. After treatment, ten patients tried to conceive and seven succeeded. All the children were in good condition upon birth. Conclusions: Fertility-sparing treatment for NEOCs was proven as a safe and successful option in terms of both oncological and reproductive outcomes. © 2025 by the authors.

Background/Objectives: Due to the rarity and histological heterogeneity of non-epithelial ovarian cancers (NEOCs), monitoring their reproductive and oncological outcomes is challenging. Therefore, this study aimed to investigate the oncological and reproductive outcomes of patients with NEOCs treated with fertility-sparing surgery over the past 10 years at our tertiary referral university clinic. Methods: This retrospective study included all the NEOC patients diagnosed and treated with fertility-sparing surgery from 2010 to 2019. The patient demographic and clinical characteristics; data regarding the treatment andthe clinical, laboratory, and imaging findings during follow-up; and disease recurrences were recorded. In this study, the recurrence-free survival and the overall survival were the oncological outcomes. The reproductive outcomes were assessed as attempting and achieving pregnancy. Results: This study included 39 patients. The most frequent NEOCs were granulosa cell tumors (53.8%). The majority of the tumors were in the IA or IC1 stage. The initial therapy was generally a unilateral salpingo-oophorectomy (30.8%). Adjuvant chemotherapy was received by 48.7% of the patients. An NEOC recurrence was registered in 25.6% of the patients, mostly during the first two postoperative years. The recurrence-free survival was 76.92%. A regression analysis showed that amore advanced stage of NEOC was the most important predictor of disease recurrence. The overall survival rate was 87.2%, with a mean time to an adverse outcome of 23.01 +/−10.68 months. The regression analysis showed that better survival depended mostly on not having disease recurrence. After treatment, ten patients tried to conceive and seven succeeded. All the children were in good condition upon birth. Conclusions: Fertility-sparing treatment for NEOCs was proven as a safe and successful option in terms of both oncological and reproductive outcomes. © 2025 by the authors.

Introduction/Objective Coronavirus pandemic caused most hospitals in the world to suspend regular activities. The aim of this study was to analyze pandemic influence on patients who underwent hysterectomy with classical (abdominal) and minimally invasive surgery (laparoscopic and vaginal approach) at the Clinic for Gynecology and Obstetrics of the University Medical Centre of Serbia. Methods There were 2446 hysterectomies for five-year period. The study analyzed number and types of hysterectomies before and during COVID-19 pandemic. Results The total number of operated patients was most decreased in the first year of the pandemic. During pandemic, the number of vaginal and laparoscopic hysterectomies did not change, whereas there was an increase in the number of abdominal hysterectomies. Statistical significance (p < 0.01) was found between abdominal and vaginal as well as between abdominal and endoscopic hysterectomies. Conclusion The global pandemic impact on care of symptomatic patients with COVID-19 has led to the redeployment of staff and resources, which has significantly reduced the total number of operations in many hospitals around the world. © 2024, Serbia Medical Society. All rights reserved.

Background and Objectives: Mutations in succinate dehydrogenase (SDH) and fumarate hydratase (FH) give rise to various familial cancer syndromes, with these alterations being characteristic of certain types of histomorphologically specific leiomyomas that hold significant predictive value. Materials and Methods: This study presents two cases of uterine leiomyomas exhibiting rare histomorphological and genetic characteristics, which are crucial for prognosis and further treatment. Results: Distinct histopathological features such as marked nuclear atypia, intracellular eosinophilic globules, and abnormal intratumoral vessels raise suspicion for specific leiomyoma subtypes, which carry predictive significance for additional hereditary cancer syndromes. Immunohistochemical analysis confirmed FH/SDH deficiency in both patients, who underwent careful follow-up. Conclusions: This study describes two cases involving unusual leiomyomas, the histopathological characteristics of which may easily go unrecognized. These features hold predictive significance because their specific mutations point to additional hereditary cancer syndromes, highlighting the need for further examinations. © 2024 by the authors.