Browsing by Author "Kontić-Vučinić, Olivera (16063770000)"

Purpose: Polycystic ovary syndrome (PCOS) is an endocrine, metabolic, and reproductive disorder which, according to the Rotterdam criteria, affects up to 24% of women of childbearing age. Although the prevalence of infertility in this subpopulation of women is high, the optimal treatment has not been fully established yet. Insulin resistance is considered to be an important mechanism involved in the development of PCOS; hence, the aim of this narrative review is to present an overview of the current pharmacological insulin-sensitizing treatment modalities for infertile women with PCOS. Methods: A MEDLINE and PubMed search for the years 1990–2023 was performed using a combination of keywords. Clinical trials with insulin sensitizers used for infertility treatment as well as analyses of systematic reviews and meta-analyses were evaluated. When deemed necessary, additional articles referenced in the retrieved papers were included in this narrative review. Results: Several insulin-sensitizing compounds and various therapeutical protocols are available for infertility treatment of women with PCOS. Metformin is the most common adjuvant medication to induce ovulation in infertile women with PCOS and is more frequently administered in combination with clomiphene citrate than on its own. Recently, inositol and glucagon-like peptide-1 (GLP-1) receptor agonists have emerged as possible options for infertility treatment in PCOS. Conclusion: The future of medical treatment of PCOS women with infertility lies in a personalized pharmacological approach, which involves various compounds with different mechanisms of action that could modify ovarian function and endometrial receptivity, ultimately leading to better overall reproductive outcomes in these women. © The Author(s), under exclusive licence to Hellenic Endocrine Society 2023.

Aim: We aimed to determine maternal hemoglobin A1c (HbA1c) levels and pregestational body mass index (BMI) as the predictors of glycemic control and its importance for fetal echography findings and perinatal outcomes in pregnancies complicated by diabetes mellitus (DM). Methods: Our intention was to evaluate how BMI and HbA1c levels might be used to predict fetal interventricular septum (IVS) thickness, atrioventricular inflow early diastole (E)/ atrial systole (A) velocity ratio, and perinatal outcomes. Patients in the 38th gestational week were divided into three groups according to their insulin therapy: (i) patients with gestational diabetes mellitus (GDM) treated only with dietary changes (GDM group, n = 32); (ii) patients with GDM treated with insulin therapy (DM2 group, n = 27); and (iii) patients with type 1 DM (DM1 group, n = 22). Results: In the DM1 group, we found statistically significant correlations between BMI and IVS thickness (P = 0.036), HbA1c and IVS thickness, as well as the mitral E/A velocity ratio (P = 0.013 vs P = 0.007). In this group, HbA1c showed a statistically significant correlation to neonatal birth weight (P = 0.037) and BMI influenced on appearance respiratory distress syndrome in neonates in DM1 group (P = 0.027). The values of HbA1c predict neonatal respiratory distress syndrome in DM2 and GDM groups (P = 0.036). Conclusion: As good predictors of maternal glycoregulation, BMI and HbA1c levels determine fetal echography findings as well as neonatal outcomes in pregnancies complicated by DM. © 2017 Japan Society of Obstetrics and Gynecology

Backrounds: Fetal arrhythmias represent a significant cause of fetal morbidity and mortality and occur in approximately 1-3% of pregnancies. The unknown fetal arrhythmias are the cause of intrauterine fetal demise in as many as 3-10% of cases, as well as the cause of unexplained fetal hydrops or premature births. Methods: A fetal echocardiography test makes it possible to notice structural heart defects at very early stages of pregnancy. The ultrasound heart rate monitoring also involves the use of specific Doppler methods. Heart rhythm disorders may occur in the form of tachycardia (sinus tachycardia (ST), supraventricular tachycardia (SVT) and atrial flutter (AF)) or in the form of bradycardia (sinus bradycardia (SB), atrial bigeminy (AB) and complete AV block). The most frequently diagnosed fetal heart rhythm disorders are isolated extrasystoles with no clinical significance. Results: In this study, we have examined 7863 fetuses (182 were multiple gestations). Out of the total number of examined patients, 572 fetuses (7.23%) had pathological heart features, while 127 (1.61%) had some form of rhythm disorder. Conclusions: The ability to recognize the heart rhythm disorder and commence the treatment in a timely manner increases the treatment success rate. Copyright: © 2022 The Author(s)