Faculty of Medicine
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Item type:Publication, Diabetes in pregnancy and risk for mother and newborn(2018); ; ; Introduction: DM in pregnancy carries a risk for the course of pregnancy, mother and fetus. It may be progestational (DM1 and DM2) and gestational DM (GDM). Aim: Bad glycemic control before and after conception increases risk for neonatal mortality and congenital malformations. Material and methods: At the clinic for endocrinology for a period of one year were analyzed the risk factors for GDM, glycemic control, maternal and fetal risks in 43 DM pregnant patients. Results: The patients were aged 25-47 years, one of them (2.4%) with DM1, 5 (11.6%) with DM 2 and 37 (86%) with GDM. Of the risk factors for GDM: 31 (72%) had> 30 years, 2 (4.6%) had GDM in the previous pregnancy (PP), 6 (13.9%) had a dead fetus in PP, 26 (60%) have DM in a family. Average HbA1C was 6,4 %, from which 55,6% had HbA1C>6% and 44,4% had HbA1C<6 %. Hypertension had 10 (23.3%) patients, of whom 7 (16.3%) had hypertension in PP and 3 (7%) in this pregnancy. Pregnancy complications: 3(6.9%) had pre-eclampsia, 12 (27.9%) gave birth before 37 weeks of gestation, of which 4 (9.3%) were over 30 years old and 1 (2.3%) became pregnant with invitro fertilization. From obstetric complications: 11 (25.6%) had polyhydramnios, 4(9.3%) macrosomia. The average body weight of a newborn was 3160 grams. A newborn born with a ventricular septal defect and one with a multiorgan disease. Average APGAR score 7/8. Conclusion: Optimal pre-conception glycemic control with HbA1C<6.5% and in pregnancy HbA1C<6% is required to reduce the risk of spontaneous abortions and congenital anomalies. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Evaluation of the osteoporosis risk factors in postmenopausal women on Ibandronic acid treatment(2018); ; ; Introduction: The aim of this study was to evaluate the risk factors for osteoporosis in postmenopausal women with osteoporosis treated with ibandronic acid. Matherials and methods: Examinees were 22 postmenopausal women with Ibandronic acid ampular treatment for osteoporosis. Risk factors for osteoporosis were evaluated as well as ionized Ca (iCa), PTH, vitamin D (D), HBA1C, and spine and hip BMD and BMC (g/cm2). Resuts: All examinees had contraindications for oral bisphosphonate treatment. They had mean BMI values 25.57±4.8kg/m2, no one <19kg/m2. Mean age was 64.89±7.06 yr., all >45 years. Mean menopause on age of 45.13±5.89yr, 53.75% before the age of 45yr. and 21.43% had ovariectomy. Fracture had 31.03% of the examinees with mean age of 67.44±5.2yr. A greater reduction in body height than 3cm had 57.89% of patients, and 14.29% received corticotherapy. No one consumed alcohol, 34.48% smoked moderalety up to 1 box per day. Physical activity for less than 30 minutes was in 39.29% of subjects, 22.22% had sunbathing less than 10 min/day, HTA had 73% and DM type 2 50%, only two were on insulin with good glycoregulation. Average mean HBA1C was 6.33±1.29%. Osteoporosis was generally detected before 7.09±4.33 years. All of them received Sol Vigantol 3 gutts a day and calcium preparation. Mean D levels were 32.85±11.57 ng/ml, mean iCa levels were 1.2±0.29mmol/l, mean PTH levels were 58.64±21.98 pg/ml, L1-L4 was 84.55±7.51%. L1-L4 mean BMC 0.86±0.08 gr/cm2, L1-L4 T score -2.64±0.71 and left hip total -1.72±1.02, and in patients with fracture -2.17±1.07. Right hip total -2.18±0.96 in patients with fracture, mean value for the whole group -1.72 ± 0.93. Conclusion: Postmenopausal women treated with i.v.ibandronate had several risk factor, older age, early menopause, DM type 2, arterial hypertension, fracture, lower height, corticotreatment, reduced physical activity, no sunbathing, lower BMC and BMD. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Subclinical and overt hypothyroidism in pregnancy - adverse neonatal oucomes(2018); ; ; ; Background: Hypothyroidism is associated with an increased risk of adverse maternal and neonatal outcomes, including miscarriage, pre-eclampsia, premature delivery, low birth weight and impaired neuropsychological development of off-spring. Aim: To evaluate the adverse fetal outcomes in women with overt (OH) and subclinical hypothyroidism (SCH) during pregnancy. Material and methods: This retrospective study included 36 women with singleton pregnancies and primary hypothyroidism on levothyroxine replacement, treated at the University Clinic of Endocrinology, diabetes and metabolic disorders. Results: Hypothyroidism was diagnosed prior to the pregnancy in 64% of women, while in 36% hypothyroidism was diagnosed during the pregnancy. SCH was diagnosed in 57%, while 43% had overt hypothyroidism. Optimization of TSH values was observed in the second trimester of pregnancy and mainatined throughout the pregnancy (6.86±1.07 mU/l; 2.49±1.78 mU/l and 1.02±0.53 mU/l, consecutively), with normal fT4 values (11.55±0.63 pmol/l; 13.71±2.75 pmol/l and 13.69±2.87 pmol/l consecutively). Adverse neonatal outcomes in SCH and OH included preterm birth (14%) and low birth weight 14%), with Apgar score of the neonates of 8.83±0.4. Conclusion: The presence of hypothyroidism during pregnancy in our study was associated with adverse neonatal outcomes. Early adequate replacement therapy is especially important in pregnant women presenting with overt hypothyroidism.