Hypertensive disorders of in-vitro fertilization pregnancies: A study from Kosovo.

BACKGROUND: Relationships between in-vitro fertilization (IVF), gestational hypertension, and pregnancy outcomes are demonstrated in a number of studies. However, it is still debated if IVF treatment or specific characteristics of infertile patients are responsible for worse obstetrical and neonatal outcomes. OBJECTIVE: The aim of this study was to investigate maternal characteristics associated with hypertensive disorders (HD) in IVF conceived pregnancies and to assess the obstetrical and neonatal outcomes. MATERIALS AND METHODS: In this observational, cross-sectional study, 207 pregnant women who underwent IVF treatment were consecutively divided into two groups: a group that had no HD during pregnancy (IVF group) and a group that had HD during pregnancy (IVF+HD group). Maternal, obstetrical and neonatal data of the two groups were compared. RESULTS: Some maternal characteristics were significantly higher in IVF+HD compared to IVF group such as: older age (p=0.0001), primiparity (p=0.038), obesity (p=0.0001), and cigarette smoking (p=0.0001). There were no significant differences between the groups in regard to obstetrical outcomes besides premature rupture of membranes time that was significantly higher in IVF+HD group compared to IVF group (p=0.036). In regard to neonatal outcomes, the only statistically significant difference was in the 5th min Apgar score, which was higher in IVF+HD group compared to IVF group without HD (p=0.002). CONCLUSION: With regard to significantly higher differences in maternal characteristics of IVF conceived pregnancies complicated with HD, compared to uncomplicated ones, development of a specific national prevention measure for HD of IVF conceived pregnancies in Kosovo is strongly suggested. In addition, setting up of a national registry is recommended in order to evaluate the outcomes of IVF treatments properly.

Recurrent abortions and down syndrome resulting from Robertsonian translocation 21q; 21q.

AIM: The purpose of the present research was a presentation of case report of Robertsonian translocation composed of homologous chromosomes 21q;21q and reproductive risk found in the family affected by this type oftranslocation. METHODS: Cytogenetic diagnosis has been done on chromosome preparations of lymphocytes cultured from peripheral blood by Moorhead method. RESULTS: Analyses of cytogenetic diagnosis was performed on the couple who has been through 10 spontaneous miscarriages and two additional births with Down syndrome. The woman had Robertsonian translocation between homologous chromosomes 21: 45XX,der(21;21)(q10;q10), and there was no change in her phenotype, whereas her husband had a normal phenotype and karyotype: 46, XY. Their first child with Down syndrome symptoms did not undergo the cytogenetic analysis. By cytogenetic analysis it was discovered that their second child has Trisomy 21 with Robertsonian translocations between homologous chromosomes 21: 46,XY,+21,der(21;21) (q10;q10)mat, and that he inherited it from his mother. CONCLUSION: Chromosomal aberration that our patient suffered from and that is presented in this paper has caused spontaneous miscarriages and birth of children with Down syndrome. Based on cytogenetic analysis in prenatal diagnosis and genetic consultation of affected family with Robertsonian translocation 21q;21q, it is unlikely to select healthy offspring by a parent with that aberration.

Impact of parity and intrauterine fetal condition during vacuum extraction.

PURPOSE: The main goal of this study was to investigate the impact of parity and intrauterine fetal condition on vacuum extraction. MATERIAL AND METHODS: This study included 10742 newborns who were delivered during 2008 in obstetrics/gynecology clinics in Kosovo, Yugoslavia. One hundred fifty-eight of these were vacuum deliveries. Data were collected for indicators such as parity, maternal age, gestation duration, newborn vitality, and birth weight. RESULTS: Vacuum extraction was used in 158 cases (1.47 %), of whom 116 (73%) were nulliparous and 42 (27%) were multiparous. In 121 cases (76.5%), vacuum extraction was performed in women with no history of abortion, and 101 (64%) of the women were aged 21-30 years. The main reason for vacuum extraction in 115 women (72%) was arrest (stasis) in the second stage of labor. Vacuum extraction was carried out at a gestational age of 34-40 weeks in 94 cases (59.5%). Amniotic fluid was clear in 125 cases (80%), and meconial amniotic fluid was seen in three cases (1.8%). Birth weight was > 3.5 kg in 77 infants (48.5%) and < 2.5 kg in seven (4.5%). Apgar score (AS) was 0-3 in 19 (12%), 4-7 in 129 (81.6%), and 8-10 in eight (6.4%) infants. In 91 cases (57.6%), newborn resuscitation was necessary and neonatal complications occurred in 11 cases (6.96%). CONCLUSIONS: We conclude that vacuum extraction was performed mostly in nulliparous women aged 21-30 years. Most newborn infants had a birth weight of > 3.5 kg, the most frequent AS was 4-7, and newborn resuscitation was needed in most cases.