Faculty of Medicine
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Item type:Publication, ROLE OF CYTOKINES AND THEIR PRESENCE IN THE AMNIOTIC LIQUID AS A SIGN OF EARLY DETECTION OF PREMATURE BIRTH IN PREGNANT WOMEN(Македонско лекарско друштво = Macedonian medical association, 2019); ; ; Introduction. Cytokines play a significant role in the pregnancy. They are very powerful and important me-diators of the cell growth as well as regulators of the immune and inflammatory reactions. Several cytokines (IL-1, IL-6, IL-8, TNF- alfa) are of crucial importance during the pregnancy since they are produced by the placentain the amniotic fluid, in case there is intraute-rine inflammation. Inpatients with premature birth, the intrauterine inflammation and infection is often present and leads to inflammatory syndrome of the human fetus. The intrauterine infection of the choriodecidual space and the amniotic fluid are the most common reasons for this obstetric complication, hence the most commonly examined etiologic factor. Aim. The study was conducted in order to prove the ratiobetween the increased level ofIL-6in the amniotic liquid at the beginning of the second trimester (16-22 g.w.) and the premature birth (< 36 g.w.). Methods. This is a case control study that has included 36 patientsso far.The pregnant women wererecruited fromthe Clinic of Gynaecology and Obstetrics. They all gave a signed consent on being informed about the aims of the study, and following the protocol, they were analyzed and examinedi. e. all patients under went ultra-sound examination, vaginal cervicometry; cervical and vaginal swabs were taken and 5 ml. amniotic fluid du-ring the process of amniocentesis. The study was performed at the Clinic ofGynaecology and Obstetrics, the Institute of Microbiology and Para-sitologyas well as the Institute ofImmunology and Hu-man Genetics. Results. The results obtained inthisstudy have confirmed the role of the cytokines i.e. they have shown an in-crease when there is inflammation in the intrauterine cavity which could lead in future to premature birth. There was an association between the risk of premature birth and positive cervical and vaginal swabs, length of cer-vix, and not a single case showed positive amnio-culture. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Increased level of IL-8 in amniotic fluid in early second trimester linked with preterm pregnancies.(ID Design DOOEL Skopje, 2020-01-15); ; ; Cytokines (IL-1, IL-6, IL-8, TNF- alfa) are of crucial importance during pregnancy; they are produced by the placenta in the amniotic fluid and they are elevated in case of intrauterine inflammation. The аim of the study was to prove the ratio between the increased IL-8 in the amniotic fluid in the beginning of the second trimester (16-22 g.w.) and premature birth (< 36.6 g.w.). Material and methods: This was a prospective study that included 150 pregnant patients that had clinical indication for amniocentesis (advanced mother’s age, abnormal test of PRISCA I, suspicious anomalies of the fetus, virus infection or mother’s wish). They all gave a signed consent on being informed about the aims of the study, and following the protocol, they were analyzed and examined i.e. all patients underwent ultrasound examination, vaginal cervicometry. Five ml. of amniotic fluid during the process of amniocentesis was taken for the purpose of the study. All patients were followed until they gave birth, and the exact week of gestation was noted and compered with the IL-8 level. Results: All 150 patients were in the period of 16th-22nd gestational weeks. Twenty of the total of 150 patients had preterm delivery. A total of 139 patients conceived naturally and 9 patients underwent in vitro fertilisation (IVF) and embryo transfer (ET). In those with IVF and ET, 3 had preterm birth. 80% of patients that had preterm birth had increased IL- 8 levels. Median cervical length in those who gave birth at term was 32.1 mm and in those who gave preterm birth was 30.7mm. Conclusion: The study has confirmed the reason for examining cytokines as a method of discovering asymptomatic changes in patients who would give a premature birth. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, THE CORELATION BETWEEN FETO-PLACENTAL UNIT, FETAL BIOMETRY AND AMNIOTIC FLUID IN PREGNANT WOMEN WITH PREECLAMPSIA IN SECOND TRIMESTER(2020); Nevenka VelickovaAbstract: Preeclampsia is a pregnancy complication, characterized by high blood pressure, that exceeds 140/90mmHg, documented in two occasions, at least four hours appart and proteinuria 0.3 g or more proteins in urine for 24 hours. It usually begins after 20 gestational weeks, in normotensive women. The incidence is approximately 3-8% of all pregnant women, worldwide. Etiology of preeclampsia is not known yet, but there are theories that explain it: immunologic, genetic, placental ischemia, etc., and all of them contribute to abnormality of spiral arteries, placental site trophoblastic cell dysfunction, inadequate trophoblastic invasion, that finally results with placental hypoperfusion and ischemia. The study is prospective, proceeding at the Department of Pathologic and High Risk Pregnancy, SHGO "Mother Theresa" in Skopje. The data are estimated from March-December 2019. It was done measurment of doppler values of a. uterine dex. et sin., between 20-24 g.a., fetal biometry measurments and the index of amniotic fluid. From all 150 pregnant women included in the study, in 20 of them was found high doppler values and in four of the same group, presence of notch. In 16 pregnant women with high doppler values, it was found intrauterine growth retardation, while in three of them decreased levels of amniotic fluid. All 20 women were followed up by regulary measuring arterial tension and hospitalisation at the beginning of third trimester for doing analizes of presence of proteins in the urine and given adequate therapy. From 20 pregnant women that had high doppler values, hypertension and other changes in ultrasound parameters, in 11 of them was found preeclampsia. Also, it was found positive correlation between high doppler values of a. uterine and notch in second trimester, and appearance of preeclampsia, later in pregnancy and also a correlation between the values of a. uterine, notch, fetal biometry and index of amniotic fluid.