Browsing by Author "Pilić, I. (13612571200)"

Purpose: To determine the role of fetal multiples of the median of middle cerebral artery peak systolic velocity (MoM MCA-PSV), in predicting the degree of fetal anemia for determination of the best timing for the second intrauterine intravascular transfusion (IUIVT) in hydropic fetuses with Rh alloimmunization. Materials and Methods: Prospective study of 30 monofetal pregnancies with maternal Rh D alloimmunization and hydrops fetalis, from 2005 to 2012 that underwent first and second IUIVT were assessed. Results: Thirty IUIVT were performed at 26.9 weeks (standard deviation, SD 4.3). Mean interval to the second procedure was 11.23 (SD 6.21) days and average hematocrit decline rate was 1.45%/day. The study did not demonstrated statistical significance between MCA-MoM-3 before the second IUIVT, and the mean decline rate in fetal hematocrit levels (expressed in percentage/day) r = 0.220; p = 0.242, and between MCA-MoM-3 and the time interval between both procedures (T) r = -0.157; p = 0.408. Conclusion: The measurements fetal MoMMCA before every IUIVT cannot be useful as predictor for the best timing for the next IUIVT, but it can be useful in predicting severity of fetal anemia.

Purpose: Advances in cardiac surgery significantly improve life expectancy and quality of life of patients with congenital or acquired heart disease. Materials and Methods: The present study included 146 pregnant women who had antenatal care and gave birth at the Institute of Gynecology and Obstetrics in an interval of ten years from 1994-2004. Patients were divided in four groups according to the type of heart surgery. Group I included four patients with surgically corrected coarctation of the aorta. Group II included 27 patients with correction of the ostial stenosis. Group III had 68 patients with correction of congenital heart diseases, and group IV had 47 patients with artificial heart valves. Results: There was 4% of heart failure after delivery. The incidence of hemorrhagic complications during pregnancy was 2.7% and 4.1% after delivery. The incidence of thromboembolic complications after delivery was 6%. Four newborns died, one of hydrocephalus and three of hypoxic ischemic encephalopathy. Two patients died. Conclusion: Patients with artificial heart valves need an enhanced level of medical care during pregnancy and labor.

Granulosa cell tumors are sex-cord stromal tumors, and since their incidence is very low, it is difficult to design treatment and evaluate its efficacy. In these cases it is very difficult and challenging to give any advice regarding future pregnancies. In the present case, since treatment of granulosa cell tumor was affected by decision to have another pregnancy, one is inevitably concerned whether the pregnancy and hormonal status regarding pregnancy could change prognostic factors regarding the tumor itself. After the pregnancy the patient declined hysterectomy and her reasons were mainly that she felt safe because the second look during cesarean section showed no evidence of the disease. There are no sufficient data in the literature regarding planned pregnancies during the course of follow up for granulosa cell tumors.