Screening for chromosomal anomalies: first or second trimester, biochemical or ultrasound?

Prenatal diagnosis pf chromosomal abnormalities can be accurately made by cytogenetic studies of samples obtained from invasive procedures, such as amniocentesis or chorionic villus sampling. Because these procedures are associated with a risk of miscarriage, the common approach is to perform non-invasive test to define an individual woman's risk of having a chromosomal abnormal pregnancy. Screening for chromosomal abnormalities has developed over the last decade. Prenatal screening can be performed in the late first trimester, the early second trimester or in both. Screening test can be carried out biochemically, ultrasonographically or by both modalities. A major goal of screening test is to achieve maximum accuracy and minimum harm at low cost. The integrated test currently meets best those criteria.

[Ectopic pregnancy in women who use intrauterine contraceptive devices]. / Ektopicne trudnoce kod korisnica intrauterinih kontraceptivnih ulozaka.

This study analyzes occurrence of ectopic pregnancies in women using intrauterine contraceptive devices. During a 5-year period, 1990-1994, 524 women with ectopic pregnancies underwent surgery at our Clinic, while 22 (4.2%) had intrauterine devices. At admission most patients had signs of heavy intraabdominal bleeding, so in 77.27% cases the diagnosis was made by punction of the Douglas area, and only in 9.09% by laparoscopy, that is other methods for early detection of diseases. Rupture of the fallopian tube occurred in 50% of patients, tubal abortions in 36.36% and ovarian pregnancies in 13.64%, whereas 18 salpingectomies and 4 adnexectomies were performed. Late diagnosis and impossibility of performing conservative operations on fallopian tubes are the consequence of disregarding the possibility of getting pregnant by the users of intrauterine devices themselves, as well as by physicians whose help is asked for after symptoms appear.

[Nutritional status in women and estrogen production in surgical menopause]. / Uhranjenost zena i produkcija estrogena u hirurskoj postmenopauzi.

The objective of this study was to examine how nutritional status, in women with bilateral ovariectomy and after preservation of ovaries, influences estrogen production. After bilateral ovariectomy statistically significant low values of urinary estrogens were recorded (21.76 nmol) in regard to ovarian preservation (87.80 nmol). Urinary estrogen values correlated with obesity in women with bilateral ovariectomy: in undernourished they were 10.50 nmol, in normally nourished 21.05 nmol, and in obese women 25.05 nmol. These differences are statistically significant. This can be explained by a higher conversion of androstendione to estrone, in the massive tissue, which is the main source of estrogen in postmenopause. This correlation does not exist in women with preserved ovaries, because in that case they are the basic source of estrogen.