Spasova, Rosa
Preferred name
Spasova, Rosa
Official Name
Spasova, Rosa
Translated Name
Спасова Роса
Alternative Name
Spasova Rosa
Rosa Spasova
Spasova, Rosa
Rosa, Spasova
Spasova,Rosa
Rosa,Spasova
Main Affiliation
14 results
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Item type:Publication, Impact of epysiotomy on anal continence in women after vaginal delivery(Macedonian Association of Anatomists and Morphologists, 2019); ; ; - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Influence of obstetrically-associated risk factors in assessing anal incontinence in patients post vaginal delivery(Macedonian Association of Anatomists and Morphologists, 2018); ; ; ; Stojoska Lazarova, AleksandraIntroduction: Anal incontinence (AI) is an inconvenient and limiting medical condition that can cause social and hygienic problems, isolation, low self-esteem and low quality of life. The etiology is multifactorial. Women are eight times more affected than men and the reason is considered to be childbirth. In order to prevent this social, physical and psychological problem, it is necessary to define the risk factors leading to development of such symptoms in female patients after undergoing vaginal delivery. Factors that influence occurrence of anal incontinence in patients after vaginal delivery, have been categorized into obstetric, maternal and fetal factors. Objective: The purpose of this study is to determine the impact of individual obstetric risk factors on occurrences of anal incontinence in patients after vaginal delivery, and express it as anal score value. Materials and methods: We designed the study cross-sectional, and developed the research it at the University Clinic of Obstetrics and Gynecology, "Ss. Cyril and Methodius" University in Skopje, Macedonia, in a 3-month period, from August to November 2017. In this study, we engaged patients in their reproductive age, who had undergone at least one vaginal delivery. The degree of incontinence was determined using St. Mark's Anal Incontinence Score (SMIS). Results: In the examined segments, multi-parity (at least 2 vaginal births) increased by OR = 4.69 (95% CI 2.04-10.82) the patient's risk of having St. Mark’s score of ≥8 and this is statistically significant difference. Induced labor also reduced the likelihood of OR = 0.39 (95% CI 0.15-1.04) for St. Mark’s score of ≥8, but the difference was not a statistically significant one. Use of mediolateral episiotomy had protective significance against the risk of St. Mark score of ≥8. Conclusion: Results of this study show consistency with data published so far on the influence of obstetric risk factors on occurrences of anal incontinence in patients after vaginal delivery. Changes in anal incontinence are expressed in increased St. Mark’s score. Our study showed that the following factors had statistically significant impact on the score value: multi-parity, fetal macrosomia and perineal injury (grades 3 and 4). - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Echocardiographic Heart Changes in Pregnancies Complicated with Gestation Hypertension and Preeclampsia(International Scientific Invention Journals, 2019-02-13); ; ; Introduction: Echocardiography as an imaging method is increasingly being used in obstetrics in the management of hemodynamic changes which occur in normal but also in pregnancies with gestational hypertension/preeclampsia. Aim: The aim of the study is to show that some of the heart changes in pregnancies complicated with gestational hypertension and preeclampsia are abnormal and further follow up of these patients is needed. Methods: A total of 81 patients were enrolled in the study. The patients were further divided in two groups. Pregnant women with gestational hypertension or preeclampsia (51) and a control group of normotensive pregnancies (30). A total of 3 echocardiograph exam were made, the first upon entry in the study (28 -34 g.w), the second 2 weeks after delivery and the last 6 months after delivery. Results and discussion: We found several statistically significant results that involve the IVS, PWLV, LKM, left chamber hypertrophy and diastolic function. Diastolic dysfunction usually shows up before systolic dysfunction in the evolution of ischemic/hypertensive cardiovascular disease and is of prognostic value in predicting long term cardiovascular morbidity. The changes seen 6 months after delivery on our last control mean that those changes are permanent and need further prevention strategies. Conclusion: From the noninvasive methods echocardiography is the most favorable method in identifying structural changes and functional changes in pregnancies with hypertension. Echocardiography allows fast, reproducible information and is both safe for mother and fetus. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Side Effects of Intravenous Patient-Controlled Analgesia with Remifentanil Compared with Intermittent Epidural Bolus for Labour Analgesia - A Randomized Controlled Trial(Walter de Gruyter GmbH, 2019-12-01); ; ; Epidural analgesia is considered a gold standard in obstetric anaesthesia and analgesia. However, in situation when it is contraindicated, unwanted by the patient or simply unavailable, remifentanil can be an excellent alternative. The goal of our study is to analyse the side effects of intravenous patient-controlled analgesia (IV PCA) with remifentanil compared with epidural analgesia during delivery. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Kinetics of Antibody Response to Repeated Vaccination with Sputnik V: A Pilot Study with a Series of Five Cases(2022-08); ; Widespread vaccination is considered as one of the best methods in combating any pandemic including COVID-19. Gam-COVID-Vac also known as Sputnik V, is one of the first vaccines that was registered in 74 countries and received an emergency approval for immunization. Monitoring anti-SARS-CoV-2 antibodies over time is essential for evaluation of post-vaccination humoral immune response.To date, there are only a limited number of clinical studies regarding the analysis of immune response after Sputnik V administration. It is of crucial importance to report independently on safety and efficiency of this vaccine with the aim to speed up the process of its final approval by the WHO. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, ROBSON CLASSIFICATION OF CESAREAN SECTION IN NORTH MACEDONIA - CURRENT TRENDS(Македонско лекарско друштво = Macedonian medical association, 2021); ; ; ; Dalipi, AdelinaAbstract Introduction. Over the last few decades, the global cesarean section rate has significantly increased and reached an unprecedented level. The World Health Organization (WHO) has advised that cesarean section (CS) rates should not rise above 15%. Several classify¬cation systems have been proposed to tackle the increased cesarean section epidemic. Most of the countries have adopted and started using the Robson (10 groups) classification as the best and the one that is the easiest internationally applicable CS classification. Aim. To present the Robson classification as a way to start better classification of cesarean section and hence to reduce the number of unnecessary cesarean section deliveries. Methods: This study was realized at the University Clinic for Gynecology and Obstetrics in Skopje, North Macedonia. It is a retrospective study where two years were compared. Results. The rate of cesarean sections for 2017 was 38.5% and for 2019 42.6%. Categorization of deliveries according to Robson criteria showed a different rate of cesarean section for each subgroup. Discussion. The implementation of the Robson classi-fication in most countries has shown a reduction in the number of cesarean deliveries and thus a reduction in overall maternal and neonatal morbidity and mortality. The analysis has shown that group 5 had the largest number of cesarean section deliveries in both years, 2017 and 2019; these were patients with previous cesarean sections. They were followed by group 1 and 2, or pri¬mi¬para with spontaneous onset and induced delivery. Conclusion. The goal of Robson clasification is to identify the target groups that contribute most in the percentage of cesarean sections and to act on these tar-get groups through appropriate education and training. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, HEART DAMAGE IN PREGNANCIES COMPLICATED WITH PREECLAMPSIA: CASE REPORT(Macedonian Medical Association/ Walter de Gruyter GmbH, 2016); ; ; ; Introduction. Heart function in pregnancy is a subject of many debates and studies. A large number of epidemiologic studies have found association between preeclampsia and cardiovascular morbidity/mortality. About 5-8% of deliveries are complicated with preeclampsia. Until recently, heart damage associated with preeclampsia has not been studied. A number of heart difficulties only appear long after the reproduction period has en-ded. Preeclampsia increases the risk for B stage (asymptomatic) of heart failure. Case report. A 37-year-old pregnant patient, G2P1 27 weeks of gestation, paid her first visit to the Gynecology Outpatient Clinic. She complained on heavy breathing, difficulty with movement and hypertension. She was referred for further evaluation to the Cardiology Outpatient Clinic with a suspicion of gestational hypertension and heart abnormalities. The pregnancy was evaluated several times at the Out-patient Clinics of Gynecology and Cardiology with the diagnosis of gestational hypertension. Echocardiography showed abnormal heart remodeling. In the 36 g.w laboratory findings showed urine dip stick ++,ТА160/110. The diagnosis was changed to preeclampsia. The patient was delivered with a re-caesarean section because of previous S.C and preeclampsia. Postpartum echocardio-graphy confirmed left chamber hypertrophy with per-sistent hypertension. Results. Clinical cardiovascular complications in preec-lampsia continue long after the pregnancy has ended. Studies show that pregnancies with both early and late preeclampsia have an increased risk for asymptomatic left chamber dysfunction/hypertrophy and essential hypertension in the next 2 years after delivery. If the damages are caught early prevention can be started sooner rather than later before patients become symptomatic (C stage of heart failure). - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Usefulness of echocariography in detecting hart abnormalities in pregnancies with Preeclampsia/Gestational Hypertension(Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, 2017); ; ; Introduction. Preeclampsia is a disorder in pregnancy which includes high blood pressure and proteinuria. It is recognized in 5-8% of all pregnancies. In the last several years an association between heart abnormalities and preeclampsia has been observed. Echocardiography as an imaging method is increasingly being used in obstetrics in the management of hemodynamic changes which occur in normal but also in pregnancies with preeclapsia. The aim of the study was to determine the usefulness of echocardiography in the control of pregnancies complicated with preeclampsia/gestational hypertension. Materials and methods. A total number of 38 patients were analyzed in our study. It was realized at the University Clinic for Gynecology and Obstetrics and University Clinic for Cardiology. Pregnant women were recruited from the Outpatient clinic at the University Clinic for Gynecology and Obstetrics. After signing an informed consent for participation in the study pregnant women were divided in two groups ( normotensive and pregnancies with gestational hypertension/preeclampsia). Echocardiographic examination was done at patients entry in the study. Results and discussion. In more than 38% of the cases in the examined group with hypertension an abnormal heart remodeling was seen with asymptomatic left ventricular dysfunction/hypertrophy. In the normotensive control group the heart function was normal in all evaluated cases - Some of the metrics are blocked by yourconsent settings
Item type:Publication, ULTRASONOGRAPHIC ENDOMETRIAL THICKNESS AS A PREDICTOR OF THE RISK OF ENDOMETRIAL CANCER IN PATIENTS WITH POSTMENOPAUSAL BLEEDING(Department of Anesthesia and Reanimation, Faculty of Medicine, "Ss. Cyril and Methodius" University, Skopje, R.N.Macedonia, 2020-06); ; ; ; Objective: to determine the diagnostic performance of endometrial thickness measured by transvaginal sonography in diagnosing endometrial cancer in patients presenting with post-menopausal bleeding. Patients and Methods: The databases of the Department of Gynecological Oncology at the University Clinic of Gynecology and Obstetrics in Skopje, in the period January – December 2015 were searched in order to identify patients that underwent endometrial sampling due to newly-diagnosed postmenopausal bleeding. Results: A total of 158 patient records that met the criteria were identified. The prevalence of endometrial cancer was 15.2%. Endometrial thickness was a statistically significant independent predictor of the presence of endometrial cancer and atypical endometrial hyperplasia (OR 1.19 95% CI 1.09-1.29 for each 1mm increase in thickness, p<0.001). The ROC curve analysis in our study had an AUC of 0.83 (p<0.001) and identified a cut-off level for endometrial thickness of 8mm which was associated to a sensitivity of 88.9%, specificity of 65.6%, PPV of 34.8% and NPV of 96.6% for the detection of endometrial cancer. Using a cut-off for endometrial thickness of ≤3mm achieved 100% sensitivity. Conclusion: None of the analyzed cut-off points for endometrial thickness achieved optimal diagnostic accuracy, as all cut-off values associated to sensitivity rates above 95% had false positive rates of over 60%. Nevertheless, an endometrial thickness cut-off of 3mm, due to the associated high sensitivity, can safely be used to identify women with postmenopausal bleeding who are highly unlikely to harbor endometrial cancer and that can forego initial endometrial sampling. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, NEONATAL SIDE EFFECTS DURING PATIENT CONTROLLED INTRAVENOUS REMIFENTANIL FOR LABOR ANALGESIA(Department of Anaesthesia and Reanimation, Faculty of Medicine “Ss. Cyril and Methodius” University in Skopje, 2020-04); ; ; Introduction: Remifentanil is becoming more and more popular as alternative method for labor analgesia. There are limited studies about the neonatal safety of remifentanil for labor analgesia. Materials and Methods: Our study included 80 pregnant women, at term, receiving intravenous PCA with remifentanil for labor analgesia. Our primary goal was to examine neonatal safety when using remifentanil. During analgesia fetus was monitored through continuous cardiotocography recording. After delivery we recorded neonatal Apgar scores in 1st, 5th and 10th minute, acid-base status, use of naloxone and any neonatal resuscitation. Parturients all the time during labor analgesia have one-to-one care and complete haemodynamic monitoring (SaO2, respiratory rate, non-invasive blood pressure, and heart rate). Results: Fetal heart rate (FHR) abnormalities were recorded in 12 patients, 4 of them had pathological continuous cardiotocograph (CTG) records. The most common Apgar score in the 1st minute was 8, in the 5th it was 9 and in the 10th minute it was 10. Intermediate values of all parameters from the umbilical acid-base status of newborns were within normal limits. Conclusion: Neonatal side effects during patient-controlled intravenous analgesia with remifentanil are minimal. One-to-one care, appropriate continuous monitoring of the parturient and neonate with available resuscitation kit are mandatory