Faculty of Medicine

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PREVALENCE OF ANEMIA IN PATIENTS WITH MISSED ABORTION
(Македонско лекарско друштво = Macedonian medical association, 2025-09)
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Jasmina Chelebieva
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Bekim Dika
Introduction: Miscarriage (abortion), 85% of which may happen during the first trimester, is one of the most common adverse pregnancy outcomes. Almost half of miscarriages are a consequence of chromosomal abnormalities. The risk factors include advanced maternal age, comorbidities (obesity, diabetes, hypertension), previous miscarriages, smoking and inappropriate nutritional status. Anaemia is the most prominent haematological abnormality during gestation and it is a global health problem affecting nearly half of all pregnant women. Anaemia has been linked to a higher risk of adverse outcomes, including maternal mortality, stillbirth, preterm births, small-for-gestational-age (SGA). World Health Organization has defined anaemia in pregnancy as the haemoglobin (Hgb) concentration of less than 110g/L. The primary cause of anemia during pregnancy is iron deficiency secondary to chronic inadequate dietary intake and menstruation, heightened by the physiologic demands of the fetus and maternal blood volume expansion during pregnancy. The aim of our study was to determine the prevalence of anemia in women with missed abortion in the first trimester of pregnancy, who are not bleeding. Material and methods: In 80 patients with missed abortion in the first trimester of pregnancy, we determined the level of Hgb in capillary blood. Results: In 31 women (38,8%), we detected anemia (the level of Hgb below 110g/L), and 7 of them (8,8% of the total number of women) had a severe anemia with Hgb levels below 90 g/L. As pregnancy progresses, we expect this prevalence to increase. Conclusion: We want to emphasize that a large percentage of women are anemic even preconceptually and early in pregnancy, so if it is not detected and treated, the severity of anemia worsens as the pregnancy progresses.
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ANEMIA IN PREGNANCY AND RISK FACTORS
(Македонско лекарско друштво = Macedonian medical association, 2025-09)
Aleksandar Nakov
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Bekim Dika
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Introduction: During pregnancy, there is a “dilution” of hemoglobin concentration due to the increase in plasma volume. Iron and folic acid are necessary for the development of the fetus and are transported to it, so the mother can develop anemia due to their deficiency. Anemia affects 36% of pregnant women worldwide. Of those affected, about 40% are due to iron deficiency. Iron is an essential micronutrient involved in vital processes such as erythropoiesis, immune responses, and during pregnancy in the development of the placenta and fetus. The aim of our research was to determine the prevalence of anemia in pregnancy as well as the influence of certain risk factors: age, body mass index - BMI, parity and history of taking iron supplements. Material and methods: A blood count was performed in 100 patients in the third trimester of pregnancy in order to determine the hemoglobin concentration. The patients' body weight and height (to determine BMI) were measured and data were collected about age, number of previous births, and whether they were taking iron supplements. Results: Anemia (hemoglobin level below 110g/L) was present in 42.1% of pregnant women. Anemia was significantly common in women with ≥3 births and in those not taking iron supplements. Statistically insignificant anemia was more common in women under 25 years of age and in those with a BMI below 20. Conclusion: The results of the study showed the importance of regular controls of hemoglobin levels as well as the significance of iron supplementation during pregnancy, when the needs for this element are significantly higher.
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PERINATAL AND EARLY NEONATAL MORTALITY IN A FIVE-YEAR PERIOD IN SBGA – CHAIR
(Македонско лекарско друштво = Macedonian medical association, 2025-09)
Iskra Martinovska
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Besa Islami Pocesta
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Luljeta Beqiri
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Dobrila Kapushevska
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Shpresa Useini Muaremoska
Perinatal mortality (PM) is a rate that combines fetal and early neonatal mortality (ENM), and is an indicator of the socio-economic development of a particular country, indicating the efficiency of antenatal, perinatal and neonatal health care. THE AIM of the paper is to analyze the rates of PM and ENM in SBGA-CHAIR in the five-year period from 2020 to 2024. MATERIAL AND METHODS - A retrospective analysis of medical documentation was performed using the histories of the studied group as well as the database of the neonatal department. Stillbirth, early neonatal mortality, and perinatal mortality were calculated according to standardized formulas for each year separately. RESULTS - During the five-year period, a total of 19,289 deliveries were realized in SBGA-Cair, resulting in 19,225 live births and 63 stillbirths. In the early neonatal period 8 newborns died, and including those transferred to a tertiary institution, the total number of deaths was 14. The paper tabulates the rates of stillbirth, early neonatal and perinatal mortality by year, with these indicators showing a decreasing trend. Analyzing the structure of PM, fetal mortality is maintained at the same level, unlike ENM, which shows a decreasing trend. Early neonatal mortality is most often due to extreme prematurity and congenital malformations. CONCLUSION - In order to further reduce the rate of PM, it is crucial to reduce fetal mortality with improved antenatal care, take measures to reduce premature birth, timely detection of life-threatening congenital anomalies with the aim of planned delivery in a tertiary center. Overall engagement of the wider community and a longterm strategy is necessary to achieve a rate similar to more developed countries.
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A CASE OF A LYME DISEASE IN THE SECOND TRIMESTER OF PREGNANCY
(Македонско лекарско друштво = Macedonian medical association, 2025-09)
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Anamarija Shpishikj Pushevska
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Pranvera Izairi
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Arta Islami Zulfiu
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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.
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THE IMPACT OF SUBCLINICAL HYPOTHYROIDISM ON THE LIPID PROFILE IN PERIMENOPAUSAL AND POSTMENOPAUSAL WOMEN
(Македонска асоцијација на гинеколози и опстетричари = MACEDONIAN ASSSOCIATION OF GYNECOLOGISTS AND OBSTETRICIANS, 2025)
Aleksandar Nakov
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Aleksandra Eftimova - Kitanova
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Marijana Filipovska - Rafajlovska
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Iskra Martinovska
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RISK FACTORS AND MATERNAL AND NEONATAL COMPLICATIONS ASSOCIATED WITH VACUUM EXTRACTION DELIVERY
(SHMSHM - AAMD, 2025)
Ilir Shurlani
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Anita Morarcalieva Chochkova
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Iskra Martinovska
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Sashko Olumcev

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