Search

OBJECTIVE: Pain is an essential element of humane childbirth. Neuraxial analgesia is the most effective method for relieving pain during childbirth. More and more women are using this type of analgesia in childbirth. The aim of the study was to identify ethnic differences in the application of neuraxial analgesia. SUBJECTS AND METHODS: The research was conducted through a face-to-face survey. The respondents are patients after vaginal delivery. The experimental group consists of patients of the ethnic minority, the Romani group (32 women), and the control group consists of patients of the majority, the Serb group (99 women). We investigated the quality and quantity of prenatal care, information about regional anesthesia, and its application in these two groups. RESULTS: There is a significant ethnic disparity between the Serb and Romani ethnic groups. Patients of the Romani ethnic group have qualitatively and quantitatively poorer antenatal care, less information regarding the use of neuraxial analgesia, and use it significantly less often. CONCLUSIONS: Neuraxial analgesia must be available to all patients regardless of ethnicity or social status. [ABSTRACT FROM AUTHOR]

Objectives: To establish whether there is a statistically significant difference in hematological and biochemical parameters between the patients with premalignant changes of the uterine mucosa and those with malignant changes. The aim is to establish whether hematological and biochemical parameters may be useful in predicting the stages of endometrial malignancy and in differentiating premalignant and malignant endometrial changes., Material and Methods: A retrospective study included 100 patients (70 with endometrial carcinoma diagnosis and 30 with atypical hyperplasia). We compared hematological and biochemical parameters in both groups., Results: CRP, granulocytes, platelets, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) are statistically significantly higher in patients with malignant changes. Lymphocyte count is statistically significantly lower in patients with malignant changes. Platelet count is statistically significantly lower in patients with stages I and II in comparison to patients with higher disease stage. NLR and PLR have good discriminatory power for carcinoma presence. Patients with advanced changes have statistically significantly higher CRP values, higher granulocyte and platelet count, as well as higher values of NLR and PLR, and statistically significantly lower values of lymphocytes and MPV in comparison to benign changes., Conclusions: There is a possibility of using hematological and biochemical parameters in the assessment of endometrial changes as well as in the prediction of stages, in confirmed malignant changes of the endometrium.

Introduction: Primary and metastatic malignant melanomas represent a rare diagnosis with a small number of described cases. The aggressive nature of the tumor, non-specific symptoms, difficult diagnosis, and no official protocol about the treatment result in poor disease prognosis., Case Outline: The authors presented a 41-year-old multigravida patient. She had an operation of malignant melanoma in the occipital area of the head. She went to her gynecologist because of increased pale pink vaginal secretion. Gynecological examination didn’t show any significant abnormalities apart from a slightly enlarged uterus. Papanicolaou test and vaginal secretion examination were normal. Colposcopically, a significant dark brown hyperpigmented area around 1 cm in size was observed on the posterior lip of the cervix, near the orifice and cervical canal, suspicious of melanoma, which was proven on targeted biopsy of the hyperpigmented change on the cervix, and by magnetic resonance imaging of the lesser pelvis. Classic hysterectomy with adnexectomy and regional pelvic lymphadenectomy were performed., Conclusion: This case report pointed out the significance of applying colposcopy in diagnosing suspected metastatic melanoma of the uterine cervix, along with other diagnostic methods and anamnestic data.

Objectives: Polycystic ovary syndrome (PCOS) is a common endocrine disorder, primarily affecting women of the reproductive age. The aim of the study was to assess the clinical efficacy and embryo quality in flexible gonadotropin-releasing hormone (GnRH) antagonist protocol in comparison to the long GnRH agonist protocol in PCOS women undergoing in vitro fertilization (IVF)., Material and Methods: This prospective, randomized study was conducted at the Department of Gynecology and Obstetrics, Clinical Center Niš, Serbia, between 2013 and 2014. The treatment included either a flexible GnRH antagonist protocol (n = 45, antagonist group) or a long GnRH agonist protocol (n = 45, agonist group)., Results: The length of the stimulation, total amount of gonadotropins used, as well as the average number of the aspirated and mature oocytes were higher in the agonists group. The endometrial thickness was also greater in the agonists group. A higher number of Class I and Class IV embryos were obtained after the agonist treatment and higher number of Class II and Class III embryos were obtained after the antagonist treatment. Pregnancy, implantation, and miscarriage rates were comparable between the groups., Conclusions: The GnRH antagonist protocol in PCOS patients has a pregnancy rate comparable to that of the GnRH agonist protocol. Since this protocol has a lower rate of complications and is more convenient for patients, we believe that the GnRH antagonist protocol should be used as the first-line treatment for PCOS patients in an IVF program.

Introduction: Epidemiological studies point out that exposure to air pollution during pregnancy is a risk for low birth weight., Objective: The aim of this study was to evaluate the effects of outdoor and indoor air pollution on the occurrence of low birth weight., Methods: The measurement of outdoor air pollutants, sulphur dioxide and black smoke was carried out daily at the Institute for Public Healthcare of Nis at two measuring locations, in Nis and Niska Banja during 2003. Subjects were 367 pregnant women, nonsmokers and who were not profesionally exposed to air pollution. Data on exposure to source of indoor air pollution (passive smoking and mode of heating) was determined on the basis of a questionnaire. Data on the characterisitics of newborns were taken from the register of Obstetrics and Gyanecology Clinic of Nis., Results: We determined that exposure of pregnant women to outdoor air pollution and wood heating systems had influence on the occurence of low birth weight. Exposure to passive smoking had no influence on neonatal low birth weight., Conclusion: Exposure of pregnant women to outdoor and indoor air pollutants can have negative influence on the occurrence of low birth weight.