Browsing by Author "Terzic, Milan M. (55519713300)"

We report a case with bilateral tubal ampullary pregnancy after Clomifen Citrate medication. The first conception in the right tube was after intrauterine insemination or intercourse performed before insemination, while the second one was achieved 10d after insemination, during the intercourse, in the left tube. This life-threatening and routinely unexpected finding must always have in mind all doctors dealing with patients in emergency care, especially those receiving fertility enhancing drugs. According to the literature data available, this is the first and unique such case in the literature. © 2013 Informa UK Ltd.

We report a case with bilateral tubal ampullary pregnancy after Clomifen Citrate medication. The first conception in the right tube was after intrauterine insemination or intercourse performed before insemination, while the second one was achieved 10d after insemination, during the intercourse, in the left tube. This life-threatening and routinely unexpected finding must always have in mind all doctors dealing with patients in emergency care, especially those receiving fertility enhancing drugs. According to the literature data available, this is the first and unique such case in the literature. © 2013 Informa UK Ltd.

An episiotomy is a surgical incision through the perineum made to provide sufficient area for the delivery of the infant. About 10 to 95% of women who deliver will have episiotomy depending on which part of the world they are having delivery. Too early episiotomy causes extensive bleeding and too late episiotomy causes the excessive stretching of a pelvic floor and lacerations could not be prevented. According to widely accepted arguments, there are many benefits of episiotomy for the neonate: prevention of injuries, shoulder dystocia and mental retardation of the infant. Benefits for the mother are: reduction of severe lacerations, prevention of sexual dysfunction, prevention of urinary and fecal incontinence. But those things could also be complications of episiotomy, if it is being used nonrestrictively. Some other complications are also extensive bleeding, hematoma or infection. There are many different opinions in literature about using episiotomy restrictively or routinely, so it is the right doubt arisen: is it inevitable or unnecessary? There is a wide variation in episiotomy practice, and the decision of performing it or not depends of actual clinical situation. There is still a great need for continuous obstetrics education according to the evidence based guidelines for the patient's safety. © 2011 Versita Warsaw and Springer-Verlag Berlin Heidelberg.

Objective: The aim of the study was to investigate which anamnestic, laboratory and ultrasound parameters used in routine practice could predict the nature of adnexal mass, thus enabling referral to relevant specialist. Methods: Study involved the women treated for adnexal tumors throughout a period of 2 years. On admission, detailed anamnestic and laboratory data were obtained, expert ultrasound scan was performed, and power Doppler index (PDI), risk of malignancy index (RMI) and body mass index (BMI) were calculated for all patients. Obtained data were related to histopathological findings, and statistically analyzed. Results: The study included 689 women (112 malignant, 544 benignant, and 33 borderline tumors). Malignant and borderline tumors were more frequent in postmenopausal women (P=0.000). Women who had benignant tumors had the lowest BMI (P=0.000). There were significant (P<0.05) differences among tumor types regarding erythrocyte sedimentation rate, CA125 and carcinoembryonic antigen (CEA) levels. Among ultrasound findings, larger tumor diameter and ascites were more frequent in malignant tumors (P=0.000). Women with malignant tumors had highest values of RMI and PDI (P=0.000). Conclusions: Anamnestic data, ultrasound parameters and laboratory analyses were all found to be good discriminating factors among malignant, benignant and borderline tumors. © Chinese Journal of Cancer Research. All rights reserved.

Objective: The aim of the study was to investigate which anamnestic, laboratory and ultrasound parameters used in routine practice could predict the nature of adnexal mass, thus enabling referral to relevant specialist. Methods: Study involved the women treated for adnexal tumors throughout a period of 2 years. On admission, detailed anamnestic and laboratory data were obtained, expert ultrasound scan was performed, and power Doppler index (PDI), risk of malignancy index (RMI) and body mass index (BMI) were calculated for all patients. Obtained data were related to histopathological findings, and statistically analyzed. Results: The study included 689 women (112 malignant, 544 benignant, and 33 borderline tumors). Malignant and borderline tumors were more frequent in postmenopausal women (P=0.000). Women who had benignant tumors had the lowest BMI (P=0.000). There were significant (P<0.05) differences among tumor types regarding erythrocyte sedimentation rate, CA125 and carcinoembryonic antigen (CEA) levels. Among ultrasound findings, larger tumor diameter and ascites were more frequent in malignant tumors (P=0.000). Women with malignant tumors had highest values of RMI and PDI (P=0.000). Conclusions: Anamnestic data, ultrasound parameters and laboratory analyses were all found to be good discriminating factors among malignant, benignant and borderline tumors. © Chinese Journal of Cancer Research. All rights reserved.

Torsion of the fallopian tube is rare and generally isolated and unilateral. We report a case of acute abdominal pain in an adolescent virgin female caused by a complete torsion that resulted in an infarction of the left fallopian tube. On surgery, extremely large hydatid of Morgagni was found, that caused torsion of the fallopian tube threefold. Case: An 18-year-old virgin presented with severe abdominal pain in the left lower quadrant accompanied by vomiting for three hours. Abdominal examination revealed tenderness and guarding in the left lower abdominal part while on rectal examination there was a palpable mass in the left adnexal region, but no mass or tenderness in the cul-de-sac. Blood (CBC, ESR, CA -125, and serum β-human chorionic gonadotrophin) and urine tests were all within a normal range. Ultrasound scan showed a left adnexal unilocular cyst approximately 10 cm in diameter with no solid areas or ascites. At laparotomy performed due to acute abdomen, the left fallopian tube was twisted threefold, distended and turned into a black colored cyst. The left salpingectomy was performed, electrosurgically, using Ligashure®. Microscopic examination showed a hemorrhagic and necrotic tube and fimbrial cyst lined with flat cuboidal epithelium indicating origin from the hydatid of Morgagni. The postoperative course was uneventful, and she was discharged on the 3rd postoperative day. Conclusion: Large Morgagni hydatid is an extremely rare cause of tubal torsion that is usually detected at surgery. Surgical treatment should not be delayed, although a majority of adolescent females loose function of the twisted oviduct at the time of surgery. © 2011 Versita Warsaw and Springer-Verlag Berlin Heidelberg.

Hydatidiform mole is a pregnancy disorder, of a benign nature. We present a case of molar tissue within a uterine myoma, the first such entity reported in the literature. In May 2006, a thirty-eight year old infertility patient was admitted for myomectomy. She had anamnesis for chronic pelvic inflammatory disease and surgeries performed for tubal pregnancies. After the sixth intracytoplasmal spermatozoa injection procedure performed in January 2006, she conceived, but curettage was performed in March 2006 for a missed abortion. Following the routine preoperative evaluation in May 2006, four months after the last artificial reproductive technology procedure, myomectomy was performed as uneventful operation, but the histological report appeared unusual, showing degenerated chorionic villi within the uterine myoma. Molar tissue within uterine myoma might evolve even after artificial reproductive procedures. Furthermore, this finding might be misinterpreted as a fibromyoma degeneration. This is the first, and a unique case, of molar tissue within uterine myoma reported in the literature. copy; Versita Sp. z o.o.

Aim: Menopause is associated with adverse metabolic changes, especially in plasma lipoprotein and cholesterol levels. Estrogens have beneficial effects on lipid metabolism. Phytoestrogens are plant substances that are structurally and functionally similar to 17β-estradiol and are capable of producing estrogenic effects. The goal of the present study was to estimate the effects of red clover-derived isoflavones on serum lipid levels in postmenopausal women. Methods: The study comprised 40 healthy postmenopausal women with an average age of 56 years. The women were divided into two groups: 22 were allocated to a red clover-derived isoflavone medication group, and 18 were allocated to a non-medication group. Total blood cholesterol, cholesterol fractions and triglycerides in the women of both groups were investigated before treatment and at 4-month intervals over the following 12 months. Results: Both total serum cholesterol and low-density lipoprotein (LDL) cholesterol levels, as well as triglyceride levels, were decreased significantly in the group receiving phytoestrogens. However, high-density lipoprotein (HDL) cholesterol showed a significant increase. Conclusion: Red clover phytoestrogen supplementation in postmenopausal women had favorable metabolic effects on serum lipids. Furthermore, red clover phytoestrogens have no side-effects and can be considered safe. © 2009 Japan Society of Obstetrics and Gynecology.

Objective - Ultrasound examination for each and every pregnancy is being accepted as a standard practice worldwide, and prenatal ultrasound diagnosis of congenital heart disease (CHD) is improving due to both staff education and ultrasound equipment modernization. The objective of this study was to estimate the value and accuracy of fetal echocardiography for diagnosis of fetal CHD in a large tertiary referral center for obstetrics and gynecology. Methods - This study was based on a prospective follow-up of 27,051 consecutive patients at the Institute of Ob/Gyn, Belgrade, during 1999-2003. Out of this population a total of 517 (1.9%) patients were selected for fetal echocardiography. The final diagnosis of congenital heart disease was confirmed or rejected on the basis of autopsy and histopathological findings, for the dead fetuses and newborns, or on the basis of neonatal echocardiography (followed by surgery/invasive diagnostic procedure), for the living neonates. Results - From the total population analyzed, there was 71 gravida (0.26%) with congenital fetal heart disease. In that study group, the most frequent cardiac anomalies were complex congenital heart diseases. Analyzing the outcome, there were 67.6% cases with fetal CHD who delivered live neonates. Out of the 73 fetuses/neonates with CHD, abnormal karyotype was detected in only 9 cases. The parameters of the diagnostic value of fetal echocardiography were as follows: sensitivity 94.4%, specificity 99.8%, positive predictive value 98.5%, negative predictive value 99.1%, and overall diagnostic accuracy 99.0%. Conclusion - Fetal echocardiography has a very high diagnostic accuracy, commending referral of suspected patients to large tertiary referral centers. © 2007 Controversies in Obstetrics and Gynecology, Polish Society of Perinatal Medicine, the International Society of Reproductive Medicine, the World Foundation for Medical Studies in Female Health and the Center for the Study of Cryopreservation of Oocytes and Spermatozoa.