Ultrasound guided vacuum aspiration treatment of caesarean scar ectopic pregnancy

OBJECTIVE: To describe the case of ectopic pregnancy in the scar after caesarean section and its successful treatment using the technique of sonographically controlled vacuum aspiration. CASE REPORT: The case of a 35-year-old patient with a history of two caesarean sections referred by a district gynecologist in the 6th week of pregnancy with suspected pathological localization of pregnancy in a scar after a previous caesarean section. The procedure for the diagnosis and treatment of ectopic pregnancy in the scar after previous caesarean sections has been successfully resolved using sonographically controlled vaginal vacuum aspiration. CONCLUSION: Caesarean scar pregnancy occurs as a complication of previous caesarean section or other uterine instrumental performances. The use of the sonographically controlled vacuum aspiration technique appears to be a successful method of treating pregnancy in a scar after a caesarean section.

Fetal lower urinary tract obstruction: a current overview of intrauterine diagnosis and treatment.

OBJECTIVE: The aim of this review article is to provide a practical and concise overview of diagnosis and management of pregnancy with fetal lower urinary tract obstruction. METHODS: Review of literature and current studies. CONCLUSION: Proper diagnosis and management of isolated fetal lower urinary tract obstruction with oligohydramnios allows appropriate implementation of intrauterine treatment in indicated cases. The treatment is a prevention of pulmonary hypoplasia and also improves renal function; this  finally contributes to the improvement of overall perinatal morbidity and mortality.

Problems with the bedbug (Cimex lectularius) in Slovakia.

INTRODUCTION: In the 1970s and 1980s, the occurrence of bedbugs (Cimex lectularius Linnaeus, 1758) was noticed only sporadically in accommodation facilities in Slovakia. Under regular monitoring, it was possible to even eradicate its occurrence in the 1980s. Today, the problem is once again a major global health issue. OBJECTIVE: The aim of the study was to point out the occurrence of cimicosis in the case of atypical urticaria in patients referred to parasitological examination by inpatient and outpatient physicians. MATERIAL AND METHODS: During the period 2006-2015, 102 patients with suspected ectoparasitosis were examined in the Diagnostic Laboratory of Human Parasitology at the Faculty of Medicine of Comenius University in Bratislava. Specialists and general practitioners referred the patients with itching red efflorescences. Parasitological examination and entomologic analysis of insects confirmed in many of them the presence of skin ectoparasitosis caused by Cimex lectularius, and in one case Oeciacus hirundinis. RESULTS: A total number of 102 parasitologically patients were examined - 62 adults and 40 children. Among the 62 adults, there were 57 patients positive for cimicosis. In 5 patients cimicosis was not confirmed, in one of them (Sarcoptes scabiei Linnaeus, 1758) was detected. Among the 40 children, there were 34 positive for cimicosis. One female child was diagnosed with lesions caused by Sarcoptes scabiei.. CONCLUSIONS: The bed bug should again be subjected to the reporting service to public health authorities, and thus recording the monitoring of its incidence and spread in the population.

Maternal Body Mass Index and Gestational Weight Gain and Their Association with Pregnancy Complications and Perinatal Conditions.

This study aimed to evaluate the impact of selected pregnancy pathologies statistically depending on overweight/obesity and excessive maternal weight gain during pregnancy on women who gave birth in the years 2013-2015 at the Second Department of Gynecology and Obstetrics at the University Hospital in Bratislava, Slovakia. In a retrospective study, we analyzed data gathered from the sample, which consisted of 7122 women. Our results suggest a statistically significant, higher risk for the groups of women with overweight and obesity and gestational hypertension (adjusted odds ratio (AOR) = 15.3; 95% CI 9.0-25.8 for obesity), preeclampsia (AOR = 3.4; 95% CI 1.9-6.0 for overweight and AOR = 13.2; 95% CI 7.7-22.5 for obesity), and gestational diabetes mellitus (AOR = 1.9; 95% CI 1.2-2.9 for overweight and AOR = 2.4; 95% CI 1.4-4.0 for obesity). A higher incidence of pregnancies terminated by cesarean section was observed in the group of obese women. Gestational weight gain above IOM (Institute of Medicine) recommendations was associated with a higher risk of pregnancy terminated by C-section (AOR = 1.2; 95% CI 1.0-1.3), gestational hypertension (AOR = 1.7; 95% CI 1.0-2.7), and infant macrosomia (AOR = 1.7; 95% CI 1.3-2.1). Overweight and obesity during pregnancy significantly contribute to the development of pregnancy pathologies and increased incidence of cesarean section. Systematic efforts to reduce weight before pregnancy through prepregnancy dietary counseling, regular physical activity, and healthy lifestyle should be the primary goal.

Determinants of ETS exposure in a sample of Slovak pregnant women.

Environmental tobacco smoke (ETS) is one of the greatest and the most frequent environmental toxic exposures presenting a high risk to children and to their mothers as well. The aim of the study was to find determinants of the household ETS in the sample of pregnant women living in the household with smokers and to assess their physical and mental health. The survey was distributed to women being seen for follow-up at the obstetric/gynecology departments in hospitals and at gynecological out-patient departments in Bratislava, Slovakia. The medical outcomes short form-12 (SF-12) was included to quantify the mental and physical health of mothers. From the total sample of 617 women, 35.5% (219) were pregnant, 88.6% of them (194) non-smokers, 27.8% (54) lived with a smoking partner, the average mental component summary (MCS) score was 50.8±9.1 and physical component summary (PCS) score was 41.6±10.3. The average age was 31.3±5.1 years. In the sample of 309 non-pregnant non-smoking mothers 23% (71) lived with a smoking partner; the average age was 31.7±4.8 years. The average PCS score was 47.8±8.7 and MCS score 49.1±9. Non-smoking, pregnant women living with a smoker have fewer years of education (p=0.0003) and lower MCS scores (48.50±9.8) (p=0.03). Non-smoking, non-pregnant women living with a smoker are older (p=0.0042), with lower income (p=0.0145), have fewer years of education (p=0.002) and lower PCS score (45±9.1) (p=0.0056). Multivariate analyses revealed the decrease of MCS score in pregnant women and the decrease of PCS score in non-pregnant women living with a smoker. Our results show that living with a smoker is independently associated with worse physical and mental health in a selected sample of Slovak women, which represents an important argument for intervention in families.