Browsing by Author "Mihajlovic, S. (57191859364)"

[No abstract available]

Objective: The objective of the present study was to evaluate the accuracy of the sentinel lymph node (SLN) detection procedure in Serbian sample of women with early-stage endometrial cancer (EC). Materials and Methods: In the period from March, 2015 to May 2016, all consecutive patients with histologically confirmed EC, were considered for enrolment in the study. Exclusion criteria included preoperative FIGO Stages II-IV, previous surgery that could influence the uterine lymphatic drainage, history of congenital uterus anomalies, duplex malignancies or deep vein thrombosis on lower extremities, and allergies to the contrast agent. Finally, 27 patients underwent SLN detection, followed by systematic pelvic lymphadenectomy. Demographic, surgical, and pathologic data on all patients were evaluated. Results: The SLNs were identified in 25 patients, with overall detection rate of 92.6%. Twenty-two (81.5%) patients had bilateral, while 11.15% had unilateral intraoperative visualization of SLNs. Of the seven females with positive SLNs, at definitive histology evaluation, pelvic non-SLNs were metastatic in four (57.1%) cases and negative in three (42.9%) cases. The false-negative rate of sentinel procedure was 0%. The evaluation of prognostic values of SLN status, for prediction of presence of metastases in non-SLNs showed the negative predicive value of 100%, and the positive predictive value of 57.1%. Additionally, the sensitivity of SLN method in sample of women with early-stage EC was 100%, while the specificity was 86.9%. Conclusions: SLN procedure has good diagnostic performance and is reliable in prediction of the metastatic status of the regional pelvic lymph nodes in women with early-stage EC.

Background: Pregnancy poses a risk factor for respiratory infections due to hormonal changes, reduced tolerance to hy-poxia, immunodeficiency, and increased susceptibility towards viral infections. Pregnant women might develop a broad spectrum of clinical conditions associated with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in-fection, from asymptomatic to potentially life-threatening complications. Critical respiratory failure associated with the progression of viral pneumonia is the most severe complication of the coronavirus disease (COVID-19). In some cases, it may require intubation and invasive mechanical ventilation. Case series: In this case series, we evaluated the outcomes and clinical features of eight critically ill pregnant patients requiring invasive mechanical ventilation during treatment. The most commonly observed symptoms were fever at admission to the hospital, cough, difficulty breathing, and fatigue. Less frequently observed were sore throat and loss of smell and taste. All patients had anemia, and hypertension was the second most common comorbidity in pregnancy. Pregnant patients with lethal outcomes were older than those who recovered. They had higher body mass index values, more symptoms at admission, and higher C-reactive protein values and ferritin levels. Acute Respiratory Distress Syndrome (ARDS) was diagnosed in five cases, and none of these patients survived. Conclusion: Obesity, maternal age, and diagnosis of ARDS were most commonly observed in our group of patients with lethal outcomes. Preventive measurements, counseling, and enlightenment of potential risk factors, such as obesity, advanced maternal age, and pregnancy-related comorbidities, should be the cornerstones in crises such as COVID-19 when medical care and resources are limited or restricted. © 2022, Lithografia Antoniadis I - Psarras Th G.P.. All rights reserved.

Purpose: The aim of this study was to assess the accuracy of transvaginal ultrasound in detecting endometrial malignancy in perimenopausal women. Material and Methods: The cross-sectional study included 100 perimenopausal women who had changes on the endometrium discovered through a regular ultrasound check-up and were referred to Clinic of Gynecology and Obstetrics "Narodni Front" in Belgrade during the period from September 1, 2012 to September 1, 2013. Transvaginal ultrasound was performed on each participant in the study. Parameters of the ultrasound examination composed a score system. Result: The results of regression analysis showed that this transvaginal ultrasound score have independent prognostic value for detection of endometrial malignancy. Score system showed that the value 8 had the best validity for the detection of endometrial malignity, with the sensitivity of 0.857 and specificity of 0.785. Conclusion: The collected transvaginal ultrasound sample had high predictive value for the discovery of malign changes on endometrium.

The authors present the case of a 28-year-old nulliparous woman, who successfully carried a term pregnancy in a unicornuate uterus with a solid non-communicating rudimentary horn, and a history of myomectomy, without cerclage placement or tocolytic therapy. The patient was admitted to the present clinic for uterine fibroids and menorrhagia. The patient underwent laparotomy, during which a myomectomy was performed. Twelve months after the surgery, the patient conceived spontaneously. Routine obstetric ultrasounds revealed normal intrauterine fetal development. Cerclage and tocolytic therapy were not indicated at any stage of the pregnancy. A live female neonate was delivered via cesarean section at 39 weeks’ gestation. © 2019 S.O.G. CANADA Inc. All rights reserved.

Purpose of investigation: To assess fertility and pregnancy outcomes in infertile patients after hysteroscopic myomectomy according characteristics of submucous fibroids. Materials and Methods: The authors included 56 infertile women, who were diagnosed with a submucous uterine fibroid, and assessed their fertility and pregnancy outcomes after hysteroscopic myomectomy, which was the exposure of interest. The control group consisted of 63 women who underwent a hysteroscopic polypectomy. The submucous fibroid and endometrial polyp were diagnosed preoperatively using 2D ultrasound, and the diagnosis was confirmed during hysteroscopy. All my-omectomies and polypectomies were performed using a resectoscope with a bipolar loop electrode. In the first postoperative year, the authors analyzed the rates of pregnancy, spontaneous abortion, preterm and term deliveries, as well as mode of delivery according to type, size, location, and number of submucous fibroids or polyps in each group. Results: In the first postoperative year, pregnancy occurred in 30.4% of patients. The greatest proportion of pregnancies occurred after removal of type 1 submucous fibroids, fibroids < 3 cm, and those localized on the posterior wall of the uterine corpus. Spontaneous abortion occurred in 7.1% of pregnancies, while delivery occurred in 19.6%. Term delivery occurred in 16.1%, while preterm delivery occurred in 3.6%. Vaginal delivery occurred in 14.3% of women, while caesarean section was performed in 5.4% of women. There were not significant differences in rates of pregnancy and delivery according to type, size, and localization of the fibroid or endometrial polyp. Conclusion: For infertile patients, in whom infertility is caused by a submucous fibroid, hysteroscopic myomectomy increases the pregnancy rate, and leads to good reproductive outcomes. © 2019 S.O.G. CANADA Inc. All rights reserved.