A rare case of parasitic myoma mimicking an adnexal mass in a previously hysterectomized, postmenopausal woman is presented. Two years after vaginal hysterectomy (due to myomas), an asymptomatic ...right adnexal tumor was noted during regular annual follow up. Ultrasound
demonstrated a large 4-5 cm solid mass in the right adnexa, while ovarian cancer biomarkers (CA 125 and HE4) were negative. Intraoperatively, another 3 cm large solid tumor located above the vaginal cuff was discovered. Both pelvic tumors were excised by laparoscopic surgery. The masses were confirmed
by histopathology to be leiomyomas.
Background. Since 2005 we have been used new treatment methods for pelvic organs prolapse with polypropylene mesh systems. These methods have been shown as successful, reliable and had minor post ...treatment complications. In the following study we showed the results of operative treatment of pelvic organs prolapse with mesh placement at Department of Gynecology and Obstetrics at Celje General Hospital in 2008. Methods. We analysed a group of 80 female patients who had PERIGEE, APOGEE or PROLIFT mesh placement for pelvic organs prolapsed repair. The complications during the operation, 14 days and 4 weeks after operation, possible reoperations and women satisfaction after procedure were followed. We used data from patient’s medical documentation. Results. 80 women with pelvic organs prolapse were operated at the Department of Gynecology and Obstetrics in 2008 at Celje General Hospital. We placed the PERIGEE system to 40 (50.0 %), APOGEE to 11 (13.7 %), PERIGEE and APOGEE to 23 (28.8 %) and PROLIFT system to 6 (7.5 %) of them. The mesh systems were placed either alone or with another surgical procedure (hysterectomy, cervix removal, tension free vaginal tape – TVT, laparoscopy). 13 (16.2 %) operated women did have complications during or after surgical procedure. 4 weeks after the operation 8 (10.0 %) women complained about symptoms similar to those before the operation. The treatment failure was obvious as well. 2 (2.5 %) women had the same symptoms as before the operation and also voiding problems (urinary incontinence or retention). 11 (13.7 %) women had voiding problems as well. The other complications were: vaginal erosio, unclear abdominal pain and obstipatio. 54 (67.5 %) women were completely satisfied with procedure and had no complications. They were well after check up as well. Conclusions. The patients in this study mostly had complications when we used both – mesh placement and another surgical procedure (hysterectomy, TVT, elongated cervix removal). It is necessary to follow results of the study in the future in order to show success of pelvic organs prolapsed repair with polypropylene mesh.
Background. Postpartum haemorrhage usually occurs due to uterus atonia, adherent placenta, placenta accreta, coagulopathy or uterus rupture. In total placenta previa haemorrhage occurs more often and ...usually is more severe. Case report. We presented the example of severe postpartum haemorrhage with parturient woman after scheduled Caesarean section, due to total placenta previa, which was ended by performing hysterectomy. Conclusions. In postpartum haemorrhage, the treatment is conservative and if there is no improvement timely surgery is required. Abdominal hysterectomy is the final option and in case of severe haemorrhage it proved to be life saving for parturient woman.
The aim of our study was to evaluate HE4 serum concentrations throughout uncomplicated pregnancies in the absence of adnexal masses.
In a retrospectively designed, monocentric study (Department of ...Gynecology and Obstetrics, General Hospital Celje, Celje, Slovenia, EU), 229 women with uncomplicated pregnancies were included. HE4 levels were obtained and analyzed with regard to gestational age of pregnancy.
While having all HE4 levels within reference range, differences in mean concentrations between study groups were found be statistically significant (Group I,
= 22, <20 weeks of pregnancy, mean = 42.2 pmol/L; Group II,
= 40, pregnancies between 20-34 weeks of pregnancy, mean = 43.6 pmol/L; Group III,
= 167, ≥34 weeks of pregnancy, mean = 57.5 pmol/L,
< .001).
Our findings confirmed that HE4 levels in uncomplicated pregnancies are within reference range provided by manufacturer, however its serum concentration rises significantly in third trimester. The HE4 cutoff value (<140 pmol/L) used for nonpregnant women can be helpful in the evaluation of adnexal masses in pregnancy.
Prikazan je rijedak slučaj u kojem parazitski miom oponaša adneksalni tumor u prethodno histerektomizirane, postmenopauzalne
žene. Dvije godine nakon vaginalne histerektomije (zbog rastućeg mioma) ...asimptomatski tumor u predjelu desnih adneksa je uočen tijekom redovitog preventivnog pregleda. Pomoću ultrazvuka prikazan je solidan tumor veličine 4-5 cm u predjelu desnih adneksa, dok su tumorski biljezi kod ovarijskih neoplazmi (CA 125, HE4) bili negativni. Intraoperacijski je otkriven još jedan solidan tumor veličine oko 3 cm smješten iznad svoda rodnice. Oba tumora su odstranjena pomoću laparoskopije, pri čemu je patohistološki nalaz potvrdio da se radi o miomima.
Background: Bilirubin is an antioxidant that protects newborns against free radicals during the first days of their lives, but at high levels is neurotoxic and causes brain damage. In this study we ...aimed to determine whether the measurement of bilirubin level in noninvasively taken cord blood could be a predictor of a pathological jaundice requiring medical treatment. Methods: Cord blood and a control sample taken on the third day of life were taken from 185 healthy full-term newborns of both genders. Bilirubin levels were determined according to the Jandrassik-Grof method. Statistical characteristics were calculated using statistic programs ANOVA and t-test. Results: 117 (63.2 %) of the newborns had physiological jaundice with 28 ± 7.8 μmol/L bilirubin in cord blood, and 68 (36.8 %) had pathological jaundice with 35 ± 7.8 μmol/L bilirubin. 20 (10.8 %) newborns had been treated by phototherapy, and had levels of 40 ± 8.5 μmol/L bilirubin. Differences in cord blood bilirubin levels between groups were statistically significant (p < 0.001). Taking a cut-off value of 28 μmol/L cord blood bilirubin level, pathological jaundice can be predicted by 85.3 % and whether newborns require treatment or not by 100 % clinical sensitivity. Conclusions: The results of our study confirm that measurement of cord blood bilirubin level can be used as a screening test for predicting the development of pathological jaundice that requires medical treatment.
Summary
Objective
The aim of this study was to measure serum concentrations of human epididymis protein 4 (HE4) in premenopausal and postmenopausal women with benign adnexal tumors and compare ...HE4 levels with those of cancer antigen 125 (CA125) measured in the same samples.
Methods
In a retrospectively designed, monocentric study (Department of Gynecology & Obstetrics, General Hospital, Celje, Slovenia, EU), 147 women diagnosed with various benign adnexal tumors were included. Preoperative HE4 and CA125 levels were obtained and analyzed with regard to histopathological classification, menopausal status, and age distribution.
Results
A marked difference was observed in patients with endometriomas in which mean CA125 was elevated above the reference range in the premenopausal (mean 90.1 U/ml) and postmenopausal groups (mean 48.5 U/ml), while HE4 levels were within the reference range, irrespective of age or menopausal status. Inflammatory adnexal tumors were associated with elevated levels of CA125 (mean 142.2 U/ml, premenopausal and mean 62.4 U/ml, postmenopausal patients); HE4 levels were not elevated regardless of age or menopausal status.
Conclusion
HE4 is elevated less frequently than CA125 in benign adnexal tumors, regardless of age or menopausal status.
Abstract
Objective: This study was undertaken to investigate the usefulness of angiogenic markers and standard laboratory parameters measurement after 20th week of pregnancy for the individual ...prediction of preeclampsia (PE).
Methods: A prospective designed study included 34 patients with PE and a control group of 35 uncomplicated pregnancies. Patients were recruited from 20th until 41st week of pregnancy at the Department of Obstetrics and Gynecology, General Hospital Celje, Slovenia. PlGF (placental growth factor), sFlt-1 (soluble fms-like tyrosine kinase 1), erythrocytes, leukocytes, platelets, hemoglobin, hematocrit, lactate dehydrogenase, aspartate aminotransferase, alanine aminotransferase, γ-glutamyl transferase, alkaline phosphatase, total bilirubin, urea, creatinine, urate, body mass index, body surface area, parity, and age were evaluated to predict the occurrence of PE based on multivariate logistic regression model.
Results: When parameters such as PlGF, sFlt-1, and urates were included into logistic regression model, we correctly classified 85% patients. With additional two models which also contained anthropometric parameters, we correctly classified 88% and 91% patients, respectively.
Conclusion: Our results demonstrated that angiogenic markers and urates individually and particularly when used as laboratory test panel have significant prognostic value in the prediction of PE.
Background: Bilirubin is an antioxidant that protects newborns against free radicals during the first days of their lives, but at high levels is neurotoxic and causes brain damage. In this study we ...aimed to determine whether the measurement of bilirubin level in noninvasively taken cord blood could be a predictor of a pathological jaundice requiring medical treatment. Methods: Cord blood and a control sample taken on the third day of life were taken from 185 healthy full-term newborns of both genders. Bilirubin levels were determined according to the Jandrassik-Grof method. Statistical characteristics were calculated using statistic programs ANOVA and t-test. Results: 117 (63.2 %) of the newborns had physiological jaundice with 28 ± 7.8 μmol/L bilirubin in cord blood, and 68 (36.8 %) had pathological jaundice with 35 ± 7.8 μmol/L bilirubin. 20 (10.8 %) newborns had been treated by phototherapy, and had levels of 40 ± 8.5 μmol/L bilirubin. Differences in cord blood bilirubin levels between groups were statistically significant (p < 0.001). Taking a cut-off value of 28 μmol/L cord blood bilirubin level, pathological jaundice can be predicted by 85.3 % and whether newborns require treatment or not by 100 % clinical sensitivity. Conclusions: The results of our study confirm that measurement of cord blood bilirubin level can be used as a screening test for predicting the development of pathological jaundice that requires medical treatment.
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