Faculty of Medicine

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    CASE OF A PATIENT WITH POSTPARTUM ECLAMPSIA
    (Македонско лекарско друштво = Macedonian medical association, 2025)
    Aleksandar Nakov
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    Petko Isjanovski
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    Nurdzan AJeti
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    Shqipe Sarachini - Hajdari
    Gestational hypertension is hypertension without proteinuria or other signs/symptoms of preeclampsia that develops after 20 weeks of gestation in a patient with a previously normal blood pressure. Development of proteinuria upgrades the diagnosis to preeclampsia. Even without proteinuria, patients who develop severe hypertension or other features of severe disease are managed in the same way as those with preeclampsia with severe features.
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    DIASTOLIC DYSFUNCTION IN GESTATIONAL HYPERTENSION/ PREECLAMPSIA
    (DEPARTMENT OF ANAESTHESIA AND REANIMATION, FACULTY OF MEDICINE, “SS. CYRIL AND METHODIUS” UNIVERSITY, SKOPJE, MACEDONIA, 2024-03)
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    Milkovski, Daniel
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    Introduction: Hypertensive disorders in pregnancy including preeclampsia are present in 10% of pregnancies and are one of the biggest reasons for both maternal and fetal morbidity and mortality. Materials and Methods: The study was undertaken at the University Clinic for Gynecology and Obstetrics in Skopje, North Macedonia. After initial assessment, 81 patients were enrolled in the study after signing a written consent. Patients were divided into two groups depending on whether they had hypertension or not. In the hypertensive group 51 patients were enrolled and 30 normotensive pregnancies were used as controls. Results: Based on the values ​​of the parameters of diastolic function obtained with PDA of the transmittance flow and the values ​​of the parameters obtained with TDI of the longitudinal movement of the mitral ring, diastolic dysfunction was found in 17 (33.2%) pregnant women of the studied population, LV function (p <0.001). In the pregnant women from the examined group in whom the presence of LV diastolic dysfunction was identified, the disorders were of mild degree, that is type of delayed relaxation of LV in all 17 pregnant women. Conclusion: Early recognition and management of symptoms are essential. Women who suffer from hypertensive disorders in pregnancy require close monitoring after delivery.
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    The Role of Endothelial Dysfunction in the Pathogenesis of Pregnancy-Related Pathological Conditions: A Review
    (Walter de Gruyter GmbH, 2023-07)
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    Milivojevic, Vladimir
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    Rankovic, Ivan
    In the recent decades, endothelial dysfunction (ED) has been recognized as a significant contributing factor in the pathogenesis of many pathological conditions. In interaction with atherosclerosis, hypercholesterolemia, and hypertension, ED plays a crucial role in the pathogenesis of coronary artery disease, chronic renal disease, and microvascular complications in diabetes mellitus. Although ED plays a significant role in the pathogenesis of several pregnancy-related disorders such as preeclampsia, HELLP syndrome, fetal growth restriction, and gestational diabetes mellitus, the exact pathogenetic mechanisms are still a matter of debate. The increased prevalence of these entities in patients with preexisting vascular diseases highlights the essential pathological role of the preexisting ED in these patients. The abnormal uteroplacental circulation and the release of soluble factors from the ischemic placenta into the maternal bloodstream are the main causes of the maternal ED underlying the characteristic preeclamptic phenotype. Besides the increased risk for maternal and fetal poor outcomes, the preexisting ED also increases the risk of development of future cardiovascular diseases in these patients. This study aimed to look deeper into the role of ED in the pathogenesis of several pregnancy-related hypertensive and liver diseases. Hopefully, it could contribute to improvement of the awareness, knowledge, and management of these conditions and also to the reduction of the adverse outcomes and additional long-term cardiovascular complications.