20 research outputs found
THERAPEUTIC OPTIONS IN PREVENTING UTEROPLACENTAL UNIT HYPOXEMIA
Get PDFA miscarriage is primarily defined as an unintentional loss of pregnancy before the 20th week of gestation. Both the practice and theory show that pregnancy losses up to the 10th week of gestation may, besides many other gynecological and microbiological causes, also be brought down to the existence of some of the acquired thrombophilia such as antiphospholipid syndrome. Numerous studies have been conducted to examine the efficiency of therapy administration to prevent adverse outcomes of pregnancy. Hereditary thrombophilia are more connected with adverce pregnancy outcomes
ISO Standards Framework To Guide Organizations In Improving Performance
No full textIn an economic environment characterized in recent years by globalization and the integration of economic processes, standardization in management systems has had a high growth. In this context, there has been a remarkable increase in certain standards, or norms, issued by international organizations. Among these standards, two main groups stand out, both issued by the International Organization for Standardization (ISO): one for quality management systems – the family of ISO 9000 standards – and the other for environmental management systems – the ISO 14000 standards. This paper aims to analyze the world wide diffusion process of these two standards, using data provided by the ISO itself
Depressive Symptoms during Pregnancy and the Postpartum Period: A Tertiary Hospital Experience
No full textBackground and Objectives: The prevalence of depressive symptoms during pregnancy is about 20%, and 10–15% in the postpartum period. Suicide is a worrying cause of death among women in these periods. Although ICD-10 lacks specific definitions for perinatal depression (it is planned in ICD-11), the DSM-5 defines it. Various etiological factors and treatment options are being investigated. This study aimed to examine potential etiological factors in order to contribute to potential preventive and therapeutic approaches. Material and Methods: A prospective study at the Clinic for Gynecology and Obstetrics, University Clinical Center of Serbia, from October 2023 to January 2024 was conducted. Two hundred and five healthy women were surveyed before giving birth (37+ gestational weeks) and 2 weeks and 2 months after childbirth. The following factors were examined: sociodemographic, psychological, and obstetric (using a specially designed questionnaire); relationship quality (DAS-32); and depression, anxiety, and stress symptoms (EPDS; DASS-21). Results: Depression frequency was 26.3% before childbirth, 20% in the second week, and 21.9% in the second month after delivery. DASS-21 test results showed a statistically significant correlation before delivery and two weeks postpartum (p = 0.02). Factors that are significantly associated with the presence of depressive symptoms include the following: before childbirth—miscarriages (p < 0.01); in the second week after childbirth—personal experiences of a difficult birth (p < 0.01), cesarean delivery instead of planned vaginal delivery (p = 0.03), and application of epidural anesthesia (p = 0.04); and in the second month after childbirth—satisfaction with financial status (p = 0.035). Relationship quality is significantly correlated with DASS-21 test results before childbirth, in the second week, and in the second month after childbirth (p < 0.01), and it is significantly different in women with and without depressive symptoms (before childbirth, in the second week, and in the second month after childbirth, p < 0.01). Conclusions: There are risk factors that can be addressed preventively and therapeutically during pregnancy and in labor. This could be achieved through psychotherapy, partner support, and appropriate management of labor
Application of transvaginal sacrospinous colpopexy in the treatment of pelvic organs prolapse
No full textIntroduction. The incidence of uterovaginal and vaginal vault prolapse appears to be higher due to the increased longevity of women. Sacrospinous ligament colpopexy is a surgery procedure which suspends the vagina up to the sacrospinous ligament and brings upper vagina over the levator plate. This technique is very useful for the primary treatment of uterovaginal prolapse in young women who want to preserve their fertility. The main aim of our study was to present the effectiveness of the us of this technique at our clinic, to investigate the possible intraoperative and postoperative complications of this technique, and to find out its effectiveness in the prevention of repeated vaginal vault prolapse. Methods. Patients were treated with sacrospinous colpopexy with uterine conservation, vaginal hysterectomy with simultaneous sacrospinous colpopexy or obliteration of the enterocele sac, and sacrospinous colpopexy. Follow-up examinations of the patients we performed at 4 weeks, 6 months and 12 months after the surgery and yearly thereafter. Results. Thirtyseven women were treated with sacrospinous ligament suspension of vaginal vault. The 5 women had vault prolapse following the hysterectomy (the 3 of then had abdominal, and the 2 vaginal hysterectomy), and another 32 women had the various degrees of uterovaginal prolapse. We obtained satisfactory results in 33 patients, in the 3 we noticed asymptomatic cystocele, and the 1 (2,7%) had partial vaginal vault prolapse six months after the surgery. With regard to postoperative complications, 3 patients had urination disturbance, 3 patients had urinary tract infection, 2 patients had febrile temperature, and the 2 patients had low back pain. Discussion. We performed sacrospinous fixation on the right side, and the postoperative results demonstrated no disturbance in vaginal axis and vault prolapse except in 1 patient. We had no intraoperative complications noted related to sacrospinous ligament colpopexy, such as the damage to the pudendal vessels and nerve, the sciatic nerve and rectum. The possibility of injury to the vessels and nearby nerves was preventid with the careful placement of suture through the sacrospinous ligament in the two fingerbreadths medial to its insertion in the ischial spine. In our series, we had 3 patients with conservation of the uterus. The 3 asymptomatic cystocele in our series were diagnosed 6 months after the operation. Our results were satisfactory, since we hade only one postoperative vault prolapse (2,7%). Conclusion. The results of numerous studies, as well as the results of our study, showed that transvaginal sacrospinous colpopexy could be performed along with vaginal hysterectomy and the anterior and posterior vaginal wall repair in the patients with uterovaginal prolapse because of its high success in the prevention of postoperative vaginal vault prolapse and the low intra- and postoperative complication rates. This operative technique is successful in prevention of repeated vaginal vault prolapse.</jats:p
Trends in forceps deliveries in a tertiary health care facility in Serbia
No full textIntroduction/Objective. Increased incidence of cesarean sections leads to the reduction of incidence of instrumental vaginal deliveries. The aim of this study was to analyze the trends of forceps deliveries at the tertiary healthcare facility. Methods. The study was performed at the Clinic of Gynecology and Obstetrics, covering a 30-year period, from 1987 to 2016 with a total of 198,882 births. Results. Forceps delivery rate was significantly lowering during time, while the cesarean section rates were rising. Conclusion. Using linear, cubic and quadratic prediction models, we can estimate that in the year 2020 there will be no more forceps deliveries. However, minding the confidence interval of 95% some forceps deliveries might still be carried out. Since it has been shown that the forceps is a very useful obstetric tool, this very important skill might soon be neglected due to the lack of training.</jats:p
Fetal echocardiography - 25-year experience in Serbia
No full textIntroduction/Objective. Congenital heart diseases are the most common congenital anomalies. The objective of the study was to determine reliability, specificity, and sensitivity of fetal echocardiography in detection of congenital heart diseases in a referral center for fetal echocardiography. Methods. We analyzed 14,500 fetal echocardiography exams (FEC) between 1991 and 2014, performed in two tertiary centers. Results. The average maternal age at the time of diagnosis was 32 years. The mean gestational age at the time of diagnosis was 25.9 weeks. The most common indications for FEC were suspicious abnormal cardiac findings in obstetrical screening sonography (50.6%). Among 9,055 examined fetuses, pathological finding on the fetal heart was found in 638 cases. The most common congenital heart diseases were structural anomalies of the fetal heart in 81%, of which 13.3% were fetuses with hypoplastic left heart syndrome and 11.2% with ventricular septal defect. Of all fetuses with diagnosed congenital heart defect, 46.2% were born alive and had good postnatal prognosis, while 2.7% died in utero, and 10.6% died in the early neonatal period. Pregnancy was terminated in 40.4% of fetuses with severe congenital heart defect. Sensitivity of the diagnostic procedure in our study was 95.9%, and specificity was 99.9%. Conclusion. Our study proves that FEC is a reliable, informative diagnostic tool in detecting congenital heart defects with high specificity and sensitivity. With multidisciplinary approach, it provides an optimal time window for improving perinatal outcome.</jats:p
Macrophage migration inhibitory factor is involved in endovascular trophoblast cell function in vitro
Get PDFMacrophage migration inhibitory factor (MIF) is a multifunctional cytokine abundantly present at the feto-maternal interface proposed to play a role in establishment of pregnancy. We have previously shown that pharmacological inhibition of enzymatic activity of MIF decreases extravillous trophoblast invasion and migration in vitro. This study aimed to further elucidate potential role of endogenous trophoblast MIF, and to assess its importance for endovascular trophoblast cell function in particular. Attenuation of MIF by siRNA reduced HTR-8/SVneo cell invasion through Matrigel (59 % of control), expression of integrin α1 (86 % of control) and levels of MMP2 and MMP9 (87 % and 57 % of control, respectively). MIF specific siRNA reduced the ability of HTR-8/SVneo to differentiate in to endothelial-like phenotype, as determined by Matrigel tube formation assay. The total tube length was decreased to 68.6 %, while the number of branching points was reduced to 57.8 % of control. HTR-8/SVneo cell capacity to integrate into HUVEC monolayers was reduced by knock-down of MIF. This could be partly caused by reduced N-cadherin expression to 63 % of control, which decreased with knock-down of MIF, as the expression of this protein was recently shown essential for trophoblast-endothelial interaction. These novel findings indicate a novel role for trophoblast MIF in spiral artery remodeling process
Splenectomy during cesarean section in a patient with severe idiopathic thrombocytopenic purpura (ITP) refractory to the medical treatment
No full textPROTECTION AT WORK AS APPROXIMATE PROCESS MANAGEMENT
No full textThe basics of the management in the area of occupational safety consists of planning, organization,
leadership and controlling all key activities, the engineers of occupational safety should act as a link or coordinators of these interdependent relations. In our example, occupational safety management should be elaborated as systematic and inseparable activity, which helps the employers and their associates in their successful economic and social business. We will present the analysis of current research in the field of
planning, leadership and controlling of occupational safety and modern education needs in this field.Publishe
