Browsing by Author "Bila, J. (57208312057)"

Von Willebrand disease (VWD) is the most common inherited bleeding condition that involves extended or excessive bleeding, caused by the deficiency or defect of von Willebrand factor (VWF). Hematoperitoneum as a complication of gynecologic diseases represents acute condition which is usually caused by the hemorrhagic corpus luteum or a rupture of either ectopic pregnancy or a hemorrhagic ovarian cyst. The authors present a unique case of conservatively managed massive hematoperitoneum caused by ovulation in a patient with severe form of von Willebrand disease who had right adnexectomy due to hemorrhagic corpus luteum four months prior. This conservative management by blood product and factor concentrate support could be a method of choice in selected hemodynamically stable patients. Furthermore, recurrent bleeding episodes following ovulation could be prevented by suppression of ovulation using oral contraceptive pills.

Introduction: Good preoperative tumor triage is essential for choosing the appropriate approach. Objective: The study aim was to identify factors from standard preoperatively collected data, which could predict the nature of adnexal masses prior surgery. Material and Methods: The study involved all women treated in the Clinic for Gynecology and Obstetrics Clinical Center of Serbia for adnexal tumors throughout a period of 18 months. On admission, detailed anamnestical and laboratory data were obtained and ultrasound scans were performed. Obtained data were compared with hystopathological findings of tumors. Methods of correlation and logistic regression were applied to create association models. Results: Three new models for predicting tumor nature were achieved from anamnestical data, characteristics of women and tumors, and laboratory analyses. Two statistically significant (p = 0.000) equations were obtained for anamnestical data and characteristics of women and tumors, while three were made for laboratory analyses. Sensitivity of anamnestical malignancy index (AMI) was 73.33%, specificity 72.87%, positive predictive value (PPV) 39.49% and negative predictive value (NPV) 91.88%. Sensitivity of characteristic malignancy index (CMI) was 92.38%, specificity 67.36%, PPV 40.59% and NPV 97.34%. Sensitivity of laboratory malignancy index (LMI) was 56.45%, specificity 90.24%, PPV 68.63%, and NPV 84.57%. Conclusions: The best predictors of malignancy are menopausal status, body mass index (BMI), age, metastases, ascites, tumor marker CEA level, and erythrocyte sedimentation rate (ESR). Along with the risk of malignancy index (RMI), for more reliable triage and preoperative tumor evaluation the authors propose introduction of another three indexes (AMI, CMI, LMI) in clinical practice.

Aim: Determining the prevalence of metabolic syndrome (MS) in the tested sample of pregnant women in the second and third trimesters of pregnancy, as well as the prognostic significance of MS in assessing the course and outcome of pregnancy. Materials and Methods: Prospective cohort study included 135 pregnant women after 24 0/7 weeks of pregnancy, hospitalized in the period from the January 1st, 2014 until September 30th, 2014. Data analysis included descriptive and analytical methods. Results: After assessment of possible confounding effect of age the authors confirmed that women with MS were 1,685-fold more likely give birth by caesarean section (OR = 1.685, p = 0.048), that it was a statistically significant prognostic factor in the earlier weeks of delivery (p = 0.001), and that it was statistically significant prognostic factor of lower Apgar scores in infants (p = 0.003). Conclusion: The early detection of MS during pregnancy reduces perinatal morbidity and is an important factor for the pregnancy outcome. © 2019 S.O.G. CANADA Inc.. All rights reserved.