Over a 25-year period we examined the anthropological characteristics of mothers and their partners, such as the place of living: urban vs. rural, the degree of education, parity, the time of ...menarche, and the frequency of intentional abortions. We examined 2 414 mothers and their partners in four periods of time extending from 1985 to 2009 in order to establish changes in the said anthropological characteristics over a period of 25 years. The degree of education of mothers and their partners is on the rise. In the period from 1985 to 1994, the percentage of mothers from the country was on the rise. Women with less education have on average more children, and those with better education the least children. Women from rural areas have on average more children than women from urban areas. The time of menarche dropped by 9 months over the period of 25 years. Girls from urban areas have their first menstrual cycle earlier. Women with higher professional qualifications had their first period earlier. The number of intentional abortions over the 25-year period dropped.
Tridesetdvogodišnja trudnica primljena je u bolnicu zbog bolova u abdomenu uz minimalno vaginalno krvarenje. Transvaginalnim ultrazvukom ustanovljena je slobodna tekućina u zdjelici te je učinjena ...laparoskopija kojom je otkrivena višestruka ginekološka patologija. Histopatološki nalaz je uz rupturiranu tubarnu trudnoću ukazao na istodobno postojanje dermoidne, kao i endometriotične ciste te apscesa jajovoda i jajnika. Ovaj prikaz slučaja ukazuje na mogućnost postojanja višestruke patologije na istom organskom sustavu, što bi operater i patolog trebali imati na umu u procjeni opsega operacijskog zahvata.
Endometrioza trbušne stijenke, poznata i kao endometrioza ožiljka, predstavlja relativno rijetku bolest koja u većini slučajeva nastaje nakon carskog reza ili druge ginekološke operacije. Pojavnost ...endometrioze trbušne stijenke procjenjuje se na 0.03%-1.5% žena s prethodnim carskim rezom. Dominantni simptom je ciklička bol. S obzirom na široku diferencijalnu dijagnozu i relativno rijetko pojavljivanje često se kasni u postavljanju točne dijagnoze. U radu se prikazuje slučaj 36-godišnje bolesnice s endometriozom trbušne stijenke nakon 2 prethodna carska reza. Raspravljene su dijagnostičke dileme i terapijske mogućnosti.
Heterotopična trudnoća je rijetka i događa se u manje od 1% trudnoća nakon postupka izvantjelesne oplodnje i prijenosa zametaka, pogotovo kada je komplicirana sindromom hiperstimulacije jajnika. ...Prikazujemo slučaj 31-godišnje žene u 6. tjednu trudnoće postignute nakon izvantjelesne oplodnje, koja se žalila na akutnu bol u donjem desnom abdomenu, napetost, poteškoće s disanjem i vaginalnu sukrvicu. Transvaginalni ultrazvučni pregled i laboratorijski testovi su potvrdili ovarijsku hiperstimulaciju u prisutnosti dvije vijabilne gestacijske vrećice. Pacijentici se zdravstveno stanje pogoršalo pet dana kasnije s iznenadnom pojavom oštre boli, mučnine i povraćanja, zajedno s pogoršanim vrijednostima laboratorijskih testova. Pokušalo se učiniti laparoskopiju, ali su povećani ovariji i priraslice spriječili nastavak operacije te je ista konvertirana u mini-laparotomiju. Operacijsko odstranjenje desne tubarne trudnoće rezultiralo je nekompliciranim tijekom unutarmaternične blizanačke trudnoće i porodom dva zdrava novorođenčeta putem carskog reza u 37. tjednu gestacije. Kliničari moraju biti svjesni moguće rijetke komplikacije u kojoj sindrom hiperstimulacije postoji uz heterotopičnu trudnoću nakon postupka izvantjelesne oplodnje i transfera embrija. Povećani jajnici mogu omesti točnu ultrazvučnu dijagnozu, ali na vrijeme izvedena kirurška intervencija može spriječiti fatalne posljedice i rezultirati normalnim tijekom i ishodom intrauterine trudnoće.
During the eighteen-year period in »Sestre milosrdnice« University Hospital Center, Zagreb, 271 women with ovarian
tumor was studied. 229 women with ovarian cancer and 42 with borderline tumor. The ...pathohistological types of tumors
were different. The age of the patients ranged from 20–83 years. In all patients the value of biochemical marker CA125
was determined. The aim of this study was to determine the usefulness of CA125 measurement in different age groups
and in different patohistologycal forms of tumor. CA125 has proven to be positive in 89.1% of women with ovarian cancer
and in 62% with neoplasm of low malignant potential. The higher values of CA125 were detected in younger women with
lowmalignant tumor potential. Serous and metastatic tumor types were also associated with higher values of CA125.
Pregnant women and premature born children were classified into four groups. In each group there were thirty of
them. The first group included the pregnant women with premature rupture of membranes ...and amniotic fluid effluxed
for 72 hours before the delivery. The second group included the pregnant women with amniotic fluid effluxing less then
72 hours before the delivery. The third group included the pregnant women who were given corticosteroids. The forth
group was a control group formed by those pregnant women (and their premature born children) whose amniotic fluid
did not efflux long and those who weren’t given corticosteroids during pregnancy. In all groups of pregnant women we
observed: median age of pregnant women, the duration of pregnancy and mode of delivery (vaginal or cesarean section).
In groups of premature born children we also observed: newborn birth weight, Apgar score in the first minute after delivery,
Apgar score in the fifth minute after delivery, pH of the blood of umbilical cord, L/S ratio of amniotic fluid (lecithin-
sphingomyelin ratio), RDS (neonatologist valuation in any degree of RDS developed et newborn child). Symptoms
of RDS include tachypnoea, chest wall retraction and cyanosis and a ‘ground glass’ appearance of the chest on X-ray.
Histopatological examinations of placentas compared the frequency of inflammatory or noninflammatory changes, also
in all groups. No significant difference was found among groups of pregnant women for the following factors: the age of
pregnant women, the duration of pregnancy and mode of delivery. No significant difference was found among the groups
of children for the following factors: newborn birth weight, Apgar score in the fifth minute after delivery, blood pH of umbilical
cord, L/S ratio of amniotic fluid. Significant difference was found among groups for the following factors: Apgar
score in the first minute after delivery, the frequency of RDS and hystology of placentas. The prevention of premature delivery
is the most important. All the pregnant women with symptoms of the premature delivery must be transported to the
centers with the well developed unites of intensive neonatal care (»transport in utero«).
The most commonly used staging system for cervical cancer is based on the International Federation of Gynaecology and Obstetrics (FIGO) staging system.Magnetic resonance imaging (MRI) has been ...accepted as the optimal tool for evaluation of the main prognostic factors and selection of therapeutic strategy. The purpose of this study was to compare the preoperative clinical examination FIGO staging findings with MRI and postoperative pathology report in females with primary cancer of the cervix. The study prospectively included 46 females consecutively hospitalized at the Department of Gynaecology and Obstetrics at the »Sestre milosrdnice« University Hospital Center in Zagreb. Interviews, clinical examination, transvaginal ultrasound and MRI were performed in all patients. In selected patients the surgical procedure was done and the correlation of clinical findings according to FIGO classifications, MRI and histopathological findings was
completed. According to FIGO classification, positive clinical findings for stage IIA were found in 26/46 (55.5%) and stage IIB in 20/46 (44.5%) patients. FIGO MR modified classification confirmed stage IIA in 30/46 (66.6%) and stage IIB in 16/46 (33.4%) patients. Surgery (Wertheim radical hysterectomy with bilateral pelvic and selective para-aortic lymphadenectomy) was performed in 33/46 (71%) patients with clinically, MR, cytologically and pathohistologically confirmed findings of cervical cancer: 26 patients with IIA clinically FIGO stage and 7 with IIB stage. MRI examination proved better than clinical examination in staging of cervical carcinoma with 90.9% versus 79.0% accuracy rate. We suggest the
application of the following MR protocol in all clinically staged FIGO IIA and IIB patients: T1W, T2WI and postcontrast dynamic T1WI after 3 and 60 seconds and after 5 minutes, performed on 1.5T MR machine.
We aimed to assess opinion and preferences of Croatian pregnant women regarding the prenatal screening tests for trisomies. The study was conducted in Zagreb, Split, Čakovec, Nova Gradiška, Gospić ...and Zlatar. It was organized in the public primary healthcare centers, among the pregnant volunteers during their first visit to an antenatal clinic (7–12 weeks pregnant). The respondents filled anonymous questionnaire reflecting their knowledge and attitudes to the screening options. In total, 437 completed questionnaires were selected. The average maternal age and the level of education differed significantly between the respondents in the respective cities (P<0.001). Of the respondents with positive attitude towards screening, the majority would prefer the first-trimester combined test (160/219; 73.1%), while 37/219 (16.9%) opted for the second-trimester biochemical screening. The remaining 22/219 (10.0%) would accept only the ultrasound screening. Among the 224 respondents, who would accept the combined first-trimester test, 95 (42.4%) held a college and university degree, whereas among 59 women, who would choose the second-trimester biochemical screening, 14 were highly educated (23.7%). The difference was statistically significant (P=0.016). The univariate regression analysis showed that age, level of education and previous information were significant variables predictive for the choice of the test; the level of education and previous knowledge remained significant in the multivariate model. The survey has revealed some of the points that should be improved in the future concept of screening program in Croatia. Health professionals should persist to mend women’s knowledge about prenatal screening, taking into consideration women’s preferences as well.
Prikazan je broj opstetričkih kreveta za 2003. godinu, u 29 bolničkih i 7 izvanbolničkih rodilišta u Republici Hrvatskoj, broj liječnika specijalista iz ginekologije i porodništva te broj ...kardiotokografskih i ultrazvučnih aparata. Podaci su uspoređeni s brojem žitelja u cjelini i po osam regija u Republici Hrvatskoj. Postoji manjak kreveta za babinjače i trudnice u regiji Zagreba i manjak trudničkih kreveta u regiji Dalmacije. U Hrvatskoj ima 563 aktivnih ginekologa, što je 12,6 na 100000 žitelja: ima 285 bolničkih, 170 ugovornih i 108 ginekologa s privatnom praksom. Zadovoljavajuća je opremljenost rodilišta CTG i UZV aparatima, ali trebalo bi poduzeti mjere u cilju redovitog obnavljanja postojeće opreme.
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