Faculty of Medicine

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Author: search.filters.author.Arta Islami ZulfiuHas files: Yes

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    ASSOCIATION BETWEEN LOW BIRTH WEIGHT AND MODE OF DELIVERY IN TERM PREGNANCY
    (Association of Albanian Medical Doctors in Macedonia, 2025-10)
    Arta Islami Zulfiu
    ;
    Nurdzan Asani Ajeti
    ;
    Besa Islami Pocesta
    ;
    Introduction: Low birth weight (LBW), defined as a birth weight of less than 2500 grams, regardless of gestational age. Globally, it is estimated that 15-20 % of all births, or 20 million newborns annually, are low birth weight infants. It remains a significant public health concern due to its association with increased neonatal morbidity and mortality. The mode of delivery is frequently influenced by fetal condition, maternal health, and the availability of institutional resources. Understanding the relationship between LBW and delivery method is essential because such cases are common, and decision making must balance clinical urgency with resource availability. 57 XXX Takim profesional mjekësor Aim: The aim of the study was to find out the association between low birth weight and mode of delivery in a term pregnancy. Material and methods: This was a cross-sectional study conducted at the Special Hospital for Obstetrics and Gynaecology “Mother Teresa”, Cair, Skopje, North Macedonia, from January 2024 to September 2024. Data were collected from the hospital register of pregnant women in our population who delivered full-term infants ( 37 0/7 - 41 0/7 weeks of gestation) with a birth weight of less than 2500 grams. The newborns were weighed immediately after birth. Results: During the study period from January 2024 to September 2024 total number of birth was 2677. 102 ( 3.8 %) newborns weighed less than 2500 g. Parity was less than two in 73 %. 50 % were primigravida. In 67% maternal age was from 18 to 24 years old. The majority (87%) of the mothers didn't have any comorbidity, 13% suffered from comorbidity. 61 babies were born by cesarean section (CS), and 41 were delivered by normal vaginal delivery. Of the total number of cesarean sections, 42 were primary cesarian section, 15 were with repeat cesarean section and 4 were with third cesarian section. Conclusion: Caesarean section should not be routinely recommended solely based on low birth weight. Delivery mode decisions must be individualized and guided by obstetric indications such as fetal distress, abnormal presentation, or maternal complications. This approach minimizes unnecessary surgical risks while ensuring optimal maternal and neonatal outcomes. Careful clinical assessment and resource considerations are essential in managing pregnancies complicated by low birth weight unless there are other obstetric indications.
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    PLACENTAL SITE NODULE : A RARE CASE REPORT
    (Македонско лекарско друштво = Macedonian medical association, 2025-09)
    Nurxhan Ajeti
    ;
    Arta Islami Zulfiu
    ;
    ;
    Ilirjan Zulfiu
    Placental site nodule is a rare, benign non neoplastic lesion of intermediate trophoblastic origin which is thought to represent incomplete involution of the placental implantation site. It is often discovered incidentally in women in reproductive period during evaluation for abnormal uterine bleeding. Although typically not harmful, they can sometimes mimic more serious condition, requiring careful diagnosis.It can be associated with recurrent pregnancy loss , infertility, history of prior intrauterine instrumentation and chronic endometritis. We present a case, 30- year old women who developed abnormal uterine bleeding one year after a full term vaginal delivery. From obstetric history,one pregnancy ended with vaginal delivery of the fetus in term without complication.She had no other interventions on the uterus.Transvaginal ultrasound revealed an intrauterine lesion suspected to be an endometrial polyp. A diagnostic endometrial curettage was performed to evaluate for the endometrial pathology. The obtained tisssue was sent for histopathology analysis . According to the described morphology and immunohistochemical analysis during the histopathological examination of the endometrial tissue, finding corresponds to a placental site noule : a small 4 mm nodule composed of intermediate trophoblastic cells of chorionic type embedded in markedly hyalinized stroma. The trophoblastic cells very in size, from relatively small with uniform nuclei to cells with abundant eosinophilic to ampholphilic cytoplasm (PLAP +,BHCG-). At the next check-up immediately after curettage, the endometrium was 10 mm , without pathological lesions intracavitary. Serum B - human chorionic gonadotropin was negative. On follow - up, the patient had regular menstruation and serum B-human chorionic gonadotrpin was negative. Placental site nodule should be considered in the differential diagnosis of intrauterine lesions, especially in women with recent pregnancy history .Timely and accurate diagnosis is essential to distinguish Placental Site nodule from malignant conditions,avoiding unnecessary interventions. Appropriate clinical management ensures optimal outcomes and reduces the risk of complication or misdiagnosis. Early recognition and follow - up are the key to minimizing long term consequences for women's reproductive health.
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    A CASE OF A LYME DISEASE IN THE SECOND TRIMESTER OF PREGNANCY
    (Македонско лекарско друштво = Macedonian medical association, 2025-09)
    ;
    Anamarija Shpishikj Pushevska
    ;
    Pranvera Izairi
    ;
    Arta Islami Zulfiu
    ;
    Bekim Dika
    Introduction: Lyme disease is the most common tick-borne disease in North America and Europe and it is caused by spirochetal bacteria Borelia burgdorferi. Early symptoms of infection include a characteristic rash (erythema migrans), fever, headache and lethargy. If untreated, the disease may affect the heart, nervous system and joints. Regardless of whether maternal exposure to B. burgdorferi occurs before conception or during pregnancy, it does not appear to be associated with fetal death, prematurity or risk of congenital malformations. Even documented infection of the placenta with B. burgdorferi has not been linked to adverse pregnancy outcomes. Also, there have been no reported cases of transmission of B. burgdorferi via breast milk. Antibiotics used during pregnancy are amoxicillin or cephalosporins, 14-21 days. Case report: A 24-year-old primigravida, at 23 weeks of gestation, reported that 3 weeks earlier she had been bitten by a tick that had not been removed by a surgeon. A change appeared as a red ring of about 10 cm in the gluteal region on the right, as well as joint pain, without fever. She was examined by an infectious disease specialist. Serological tests were performed and a high titer of IgG and IgM antibodies for Borelia burgdorferi sensu lato were detected. Antibiotic therapy Amp. Ceftriaxone 2gr/day was administered for 14 days, which prevented further complications in mother or fetus. Conclusion: With this case, we want to point out that Lyme borreliosis is present, that a tick bite is serious and requires an examination by a surgeon and an infectious disease specialist, in order to properly remove the tick and prevent the occurrence of this disease, which is possible even during pregnancy. It is also important to be aware of its symptoms, in order to start antibiotic therapy before more serious complications arise.