Faculty of Medicine
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Item type:Publication, LOCAL NITRIC OXIDE SYNTHESIS IN THE VAGINA AND ITS IMPLICATION ON PREMATURE DELIVERY(Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, 2023); ; Nitric oxide is a ubiquitous molecule involved in a range of physiologic and pathophysiologic processes, and is often at the centre of the scientific debate with its inherent complexity. Synthesised under the influence of its three isoenzymes, this molecule has been implicated in processes like inflammation, premature birth and carcinogenesis. Via comparative and experimental biochemical analysis of the cervical fluid of a group of patients with premature labour pains, using the indirect method of detection (the Griess spectrophotometric analysis), as well as analysis of the systemic inflammatory response, this study shows the association of nitric oxide with the premature births before the gestational week 34 as an independent marker for development of premature birth. It also showsthe association between the local nitric oxide synthesis in the vagina and the systemic inflammatory response and the significance of this association in the development of premature birth - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Urinary Tract Infections in Pregnant Women in Second Trimester and the Risk of Preterm Birth(BANTAO Association, 2020-06)Introduction. Preterm birth, defined as delivery less than 37 weeks of gestation, is the most common cause of neonatal mortality and morbidity accounting for 11% of pregnancies worldwide. Pregnancy causes nume¬rous changes in the woman’s body that increase the risk of urinary tract infections (UTIs). Hormonal and mechanical changes can promote urinary stasis and ve¬sicoureteral reflux, along with an already short urethra (3-4 cm in females) and difficulty with hygiene due to a distended pregnant belly, help make UTIs the most common bacterial infections during pregnancy predo¬mi¬nantly with Escherichia coli, but also with Staphylococcus saprophyticus, Klebsiella, Enterobacter, Proteus, Entero¬coccus, etc. The aim of the study was to prove the re¬lationship between UTIs in pregnancy and their risk to cause preterm birth (<37 g.w.). Methods. This is a prospective case- control study, conducted at the University Clinic of Gynaecology and Obstetrics, Ss’ Cyril and Methodius University, Medical Faculty, Skopje, Republic of North Macedonia at the Department of High-Risk pregnancy. The study included 103 patients with signs and symptoms of preterm labour. Patients between 28-36 g.w. were followed until the end of the pregnancy. Obstetric ultrasound on Voluson 730 pro machine was performed by two experienced ultrasound observers calculating the fetal weight, esti¬mating the gestational week and measuring the cervi¬cal length so the variations for the measurements have been minimized. Mid-stream urine sample was sent for cytology and culture-sensitivity. Results. All 103 patients in the study had signs and symptoms of preterm labour. Out of the total of 103 patients 65 (63%) had a positive urine sample, and 38 (36.9%) patients had negative urinalysis. The results showed that patients who had signs and symptoms of preterm birth were significantly different in women who had po¬sitive compared to those who had negative urine sample (p=0.0049). Microorganisms cultured in urine were predominantly gram-negative bacilli, although there were also gram-positive bacilli detected. E coli was the commonest microorganism cultured in the urine. Conclusion. Urogenital infections contribute signi¬fy-can¬tly to the preventable causes of preterm labor. The be¬nefit of the study lies in detecting asymptomatic ca-ses, so that this complication can be timely prevented. Making early diagnosis of urogenital infections and treating them adequately with the antimicrobials will help in dec¬reasing the incidence of preterm labor, preterm births, and the associated neonatal and maternal morbidities. - Some of the metrics are blocked by yourconsent settings
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.