Browsing by Author "Lukic, R. (6603430390)"

This is a case report of consequences that malignant gestational trophoblastic disease (GTD) can cause on reproductive health protruding into uterine wall and damaging uterine tissue. Transvaginal Doppler ultrasound examination can be of great value in detecting molar tissue, protrusion of malignant trophoblast in uterine wall, and neovasularization in malignant tissue. It is expected to measure a low resistance index in a field of neovascularization, because neovascularization in malignancy is not rare and those vessels do not have muscular stratum. This case is an example of possible irreversible serious and large damages that can be seen after successful treatment of GTD. They are warning on possible high degree of malignancy in GTD as well as on possible serious impact on reproductive health.

Purpose of investigation: The objective of this study was to predict preeclampsia using extreme-low first-trimester pregnancy-associated- plasma-protein-A-(PAPP-A), extreme-low free-beta-human-chorionic-gonadotropin-(free-βhCG)-levels, and extreme-high pulsatility- index (PI) of uterine arteries, as single and combined predictors for preeclampsia development in resource-limited-settings. Materials and Methods: First-trimester screening for PAPP A, free-βhCG, and PI was performed between 11-13 +6 gestation-weeks in nulliparous, normotensive women with singleton pregnancy with extremely-low PAPP-A (PAPP-A ≤ 0.52 MoM), extremely-low free- βhCG (free-βhCG ≤ 0.56 MoM) and extremely-high PI (≥ 2.52). Results: Of 85 pregnant women, 14 (16.5%) developed preeclampsia. PAPP-A ≤ 0.52 MoM and PI ≥ 2.52, as a single categorical variables, found to be with high OR for preeclampsia-development (OR = 7.07, 95% CI = 0.873-57.204, p = 0.067; OR = 5.098, 95% CI = 0.625-41.575, p = 0.128, respectively). The ROC-curve identified PAPP-A and PI as continuous variables to be significant predictors of preeclampsia (AUC = 0.864, 95% CI = 0.750-0.978, p = 0.000; AUC = 0.762, 95% CI = 0.598-0.925, p = 0.002, respectively). A prediction model for preeclampsia including PAPP-A ≤ 0.52 MoM + PI ≥ 2.52 was found to be significantly associated with preeclampsia (p = 0.027). Conclusion: The present study suggests that the firsttrimester extreme low-PAPP-A and increased Doppler-PI levels have significant predictive capability for preeclampsia.