Faculty of Medicine
Permanent URI for this communityhttps://repository.ukim.mk/handle/20.500.12188/14
Browse
4 results
Search Results
- Some of the metrics are blocked by yourconsent settings
Item type:Publication, INCIDENTAL STUMP DURING CESAREAN SECTION IN IVFEGG DONATION PREGNANCY: A CASE EMPHASIZING THE IMPERATIVE OF ROUTINE HISTOPATHOLOGICAL EVALUATION OF MYOMAS(Македонско лекарско друштво = Macedonian medical association, 2024-12); ; ; Uterine myomas are commonly benign tumors of the female reproductive system. Although many are diagnosed preoperatively, some are incidentally discovered during obstetric surgery, such as the cesarean section. This case illustrates the necessity of routinely sending any excised uterine myoma for histopathological evaluation to determine its true biological potential and guide further management. We report the case of a 45-year-old primiparous woman (G1P0A1) with a history of in vitro fertilization (IVF) and egg donation, admitted at 37+4 weeks of gestation for elective cesarean section. The procedure was uncomplicated, yet multiple small intramural and subserous myomas were incidentally observed and excised. Histopathological analysis revealed a Smooth Muscle Tumor of Uncertain Malignant Potential (STUMP), characterized by areas of focal necrosis, mild cytologic atypia, and low mitotic activity-features straddling benign leiomyoma and malignant leiomyosarcoma designations. STUMP comprises a rare histologic category representing 0.3-0.9% of presumed fibroids, with unpredictable behavior. Recurrence rates vary from 7% to 36%, with occasional progression to leiomyosarcoma (median time to recurrence ~79 months) [1-5]. Because of this uncertain prognosis, we recommended followup imaging and multidisciplinary consultation. A postoperative MRI followed by hysterectomy revealed additional subserous leiomyomas and chronic granulomatous inflammation. Given the potential risk of progression, the patient underwent definitive hysterectomy with ovarian preservation. This case highlights the crucial role of histopathological evaluation in incidental uterine myomas. Even small lesions may harbor atypical or borderline features warranting close monitoring or definitive treatment. Early detection and accurate classification influence patient prognosis and enable timely surgical and therapeutic interventions. When STUMP is diagnosed, hysterectomy is often recommended as definitive management to reduce recurrence or malignant transformation risk. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Interleukin 6 in pregnancy with gdm(2019-09-14); ; ; ; Abstract Background: Gestational diabetes melitus is a glucose intolerance diagnosed for the first time in pregnancy which may lead to maternal, fetal and neonatal unfavourable outcome. In GDM inflammatory markers like interleukin 6 are elevated and may provide informations on pathophysiology and prediction of perinatal risk. Aim: to evaluate the average concentration of interleukin 6 in GDM and normoglycemic women and the influence of body mass index on concentration of IL-6 in these women. Material and Methods: A case control study was made at the University Clinic for obstetrics and gynecology, Skopje in a period of one year. 100 pregnant women were selected from the pregnant women that performed 75g OGTT in the second trimester for sreening for GDM. Body mass index was calculated according to the terms of Institute of medicine and pregnant women were divided in 4 groups: GDM, BMI>25 (n=25); GDM, BMI<25(n=25); normoglycemic, BMI>25(n=25); normoglycemic BMI<25(n=25). Serum levels of IL-6 were analysed with ELISA method. Results: The medium values of IL-6 were higher in GDM compared to controls (2.77 ± 1.1 pg/ml vs 2.16 ± 0.5 pg/ml, p=0.0016). Pregnant women with GDM and BMI>25 vs GDM and BMI < 25 had statistically different values of IL-6 (2.58 ± 1.1 vs 2.19 ± 0.5 pg/ml, p=0.0019). Overweight women with GDM had significantly higher interleukin 6 than overweight women without GDM (3.06 ± 1.4 pg/ml vs 2.28 ± 0.7 pg/ml, p=0.021). Average value of IL-6 in GDM women with normal weight was 2.48 ± 0.8 pg/ml and significantly higher than normoglycemic women with normal weight, 2.04 ± 0.1 pg/ml, p=0.016. IL- 6 had insignificantly higher values in the overweight women from the control group compared to normal weight women from the control group (2.28 ± 0.7 pg/ml vs 2.04 ± 0.1 pg/ml; p=0.11). Conclusion: IL-6 is significantly higher in GDM compared to normoglycemic women. It can be used in addition with other biomarkers in eventual prediction of this condition. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Prenataly Diagnosed Bilateral Congenital Cystic Adenoid Malformation, Class 2, a Case Report(2022-05); ; Cystic adenomatoid malformations (CCAM) are rare developmental abnormalities of the fetal lung with incidence between 1:11,000 and 1:35,000 live births. They are benign dysplastic lung tumors characterized by overgrowth of terminal bronchioles with a reduction in the number of alveoli. The aim of this paper is to present a case of a prenatal diagnosis of a fetus with congenital cystic adenomatoid lung malformation, discuss the need for pregnancy termination and the prognosis of this condition. We present a case of 30 year old pregnant women (G2, para 1), reffered to University gynecology and obstetrics clinic in 21 gestational week for 2nd trimester anomaly scan. Fetal lung was markedly abnormal with hyperehogenic and cystic lesions mostly in the right lung lobe with displacement of the heart and largest cyst with diameter of 10mm. Amniocentesis was performed: quantitative analysis for trisomy 13,18 and 21was negative for chromosomopathy. MRI was performed and the diagnosis was confirmed. After detaled counceling termination of pregnancy according to the legal procedure was performed. Pathohistological examination of the fetus confirmed the prenatal diagnosis. Conclusion: CCAM is a rare congenital anomaly with reported perinatal mortality as high as 49%. Genetic counseling is necessary and termination of pregnancy is an option in cases of poor prognosis. Postnataly surgical management is the preferred option over conservative management. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Multidisciplinary approach to management of hypofibrinogenemia in pregnancy: a case report(Društvo doktora medicine Republike Srpske, Banja Luka i Univerzitet u Banjoj Luci - Medicinski fakultet, Banja Luka, 2020-06-30); ; Saso StojcevskiInherited fibrinogen disorders introduce risk for recurrent abortions, sub-chorionic haematoma, placental abruption and postpartum haemorrhage. This is a case report of a successful pregnancy outcome in a 37-year old woman with hypofibrinogenaemia. She was referred to a coagulation test in the first trimester because of history of preeclampsia and HELLP syndrome in previous pregnancy. Hypofibrinogenaemia was diagnosed with fibrinogen level of 0.7 g/L. During the pregnancy she was regularly monitored for fibrinogen levels and multiple cryoprecipitate concentrates were given. She delivered at 39th gestation week, with elective caesarean section under general anaesthesia. There was one episode of postpartum haemorrhage treated with 2 units of red blood cells, repeated infusions of cryoprecipitate to obtain the level of fibrinogen of 2 g/L. She was discharged on the 6th postpartum day in a good condition. In these disorders levels of fibrinogen should be higher than 1 g/L during pregnancy or 2 g/L in case of caesarean section for successful prenatal and peripartal management.