Surgical treatment of large smooth muscle tumor of uncertain malignant potential during pregnancy.

This paper presents a case of a 37-year old pregnant woman with a large tumor extending from pelvis to xyphoid, diagnosed at 14 weeks of pregnancy. At 18 weeks myomectomy was performed and the tumor weighing 4250 g was removed. Hystopathological findings showed a uterine smooth muscle tumour of uncertain malignant potential. Due to preeclampsia an urgent caesarean section was performed at 34 weeks of gestational age. A live and healthy female neonate was delivered. According to hystopathological findings and in agreement with the patient hysterectomy without adnexectomy was performed in the same act.

Prevalence and significance of vaginal group B streptococcus colonization in pregnant women from Osijek, Croatia.

The aim of the study was to determine the prevalence of vaginal group B streptococcus (GBS) colonization in pregnant women from Osijek area, the possible effect of GBS colonization on pregnancy outcome and neonatal complications and the role of intrapartum prophylaxis in this context. This retrospective case-control study took place at the Department of Gynecology and Obstetrics, Osijek University Hospital Center from December 2003 to June 2006. A total of 118 pregnant women was enrolled in study and divided into two groups: 59 women in 35th-37th week of gestation, free from risk factors for infection (control group); and 59 women in 25th-41st week of gestation with risk factors for infection. Low vaginal swab for GBS isolation and identification on selective and enriched medium was obtained from each woman. GBS colonization was recorded in 29 (24.6%) women: 12 (20.3%) control and 17 (28.8%) women at risk of infection, yielding a statistically non-significant difference (Chi2 = 1.480489; p < 0.48). Early neonatal infection was observed in six (20.7%) neonates born to 29 mothers with GBS colonization, pointing to a correlation between vaginal GBS colonization and early neonatal infection (r(s) = 0.99). Early perinatal infection was found in 22 (18.6%) neonates, including 17 (28.8%) pregnancies with risk factors, pointing to a significant correlation between vaginal GBS colonization, risk factors and early perinatal infection (Chi2 = 88.68; p < 0.001); however, gestational age and pregnancy outcome were not influenced by GBS colonization. In eight (36.4%) newborns, early neonatal infection developed in spite of intrapartum administration of antibiotics; three of these children were born to GBS positive mothers, and perinatal GBS infection was demonstrated in one (0.84%) child. Study results revealed a relatively high rate of GBS colonization in the population of pregnant women in Croatia, occasionally leading to early neonatal infection. Large studies are needed to develop national strategy for the prevention of GBS infection in Croatia.

Selenium in placenta predicts birth weight in normal but not intrauterine growth restriction pregnancy.

Placental selenium, lead and cadmium concentrations were determined in a group of pregnancies with birth weight appropriate for gestational age and in a group of intrauterine growth restriction cases. Following adjustment for a number of confounding variables, selenium was found to be a significant predictor of newborn weight only in the group of pregnancies with birth weights appropriate for gestational age. Placental lead and cadmium levels were not associated with birth weight in either group.

[Surgical treatment of urinary stress incontinence with the tension-free vaginal tape]. / Lijecenje SSI-ATVT operacijom.

TVT is the modern operative technique for the treatment of female urinary stress incontinence which was invented by Ulmsten and his co-operators. Tension-free vaginal tape implies the implantation of a prolene tape around mid-urethra via a minimal vaginal incision. It is the minimal invasive procedure under local anaesthesia and ambulatory performed. The majority of the women to be discharged from the clinic the same day or the day after the procedure. Results of studies about tension-free vaginal tape operation presents high success rate (90%) without serious complications, specially long term urinary incontinence. There is no signs of rejection the tape.