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Sinreih M, Štupar S, Čemažar L, Verdenik I, Frković Grazio S, Smrkolj Š, Lanišnik Rižner T. Data on expression of genes involved in estrogen and progesterone action, inflammation and differentiation according to demographic, histopathological and clinical characteristics of endometrial cancer patients. Data Brief 2017; 12:632-643. [PMID: 28540356 PMCID: PMC5430149 DOI: 10.1016/j.dib.2017.04.050] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 03/16/2017] [Accepted: 04/27/2017] [Indexed: 12/03/2022] Open
Abstract
Endometrial cancer is the sixth most common cancer in women worldwide. It is associated with aberrant actions of steroid hormones, estrogens and progesterone, but also with enhanced inflammation and reduced cellular differentiation. Here, we show data on demographic and histopathological characteristics of 51 patients with endometrial cancer, together with data on correlations between the expression of 38 genes involved in estrogen and progesterone actions, inflammation and differentiation, and demographic characteristics. We also show data on changes in gene expression of these 38 genes according to histopathological and clinical characteristics of these patients. This article includes data referenced in the manuscript entitled »STAR and AKR1B10 are down-regulated in high-grade endometrial cancer by Sinreih et al. (in press) [1].
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Affiliation(s)
- Maša Sinreih
- Institute of Biochemistry, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Saša Štupar
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Luka Čemažar
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Ivan Verdenik
- Division of Gynaecology and Obstetrics, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Snježana Frković Grazio
- Department of Pathology, Division of Gynaecology and Obstetrics, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Špela Smrkolj
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.,Division of Gynaecology and Obstetrics, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Tea Lanišnik Rižner
- Institute of Biochemistry, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
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Janša V, Blickstein I, Lučovnik M, Fabjan-Vodušek V, Verdenik I, Tul N. The impact of inter-pregnancy interval on subsequent risk of preterm birth. J Matern Fetal Neonatal Med 2017; 31:621-624. [PMID: 28395550 DOI: 10.1080/14767058.2017.1293027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The aim of the study was to assess optimal time to conceive after previous delivery associated with smallest risk of preterm birth. METHODS We selected all women (n = 2723) with their first and second singleton delivery between the years 2004 and 2012. Inter-pregnancy interval was defined as that between live birth and subsequent conception. We performed logistic regression analyses to assess the risk of preterm birth adjusted for maternal age and body mass index. RESULTS Association between inter-pregnancy interval and the natural logarithm of the adjusted relative risk of preterm birth had a J-shaped curve with lowest risk at 15 months after last birth. CONCLUSION The optimal time to conceive after a previous delivery is 15 months, as longer or shorter interval are associated with increased risk of preterm birth. Women with short or long inter-pregnancy intervals were 1.6 times more likely to experience preterm birth.
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Affiliation(s)
- Vid Janša
- a Division of Obstetrics and Gynecology, Department of Perinatology , University Medical Centre Ljubljana , Slovenia
| | - Isaac Blickstein
- b Department of Obstetrics and Gynecology , Kaplan Medical Center, Rehovot, Affiliated with the Hadassah-Hebrew University School of Medicine , Jerusalem , Israel
| | - Miha Lučovnik
- a Division of Obstetrics and Gynecology, Department of Perinatology , University Medical Centre Ljubljana , Slovenia
| | - Vesna Fabjan-Vodušek
- a Division of Obstetrics and Gynecology, Department of Perinatology , University Medical Centre Ljubljana , Slovenia
| | - Ivan Verdenik
- a Division of Obstetrics and Gynecology, Department of Perinatology , University Medical Centre Ljubljana , Slovenia
| | - Nataša Tul
- a Division of Obstetrics and Gynecology, Department of Perinatology , University Medical Centre Ljubljana , Slovenia
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Blickstein I, Doyev R, Trojner Bregar A, Bržan Šimenc G, Verdenik I, Tul N. The effect of gestational diabetes, pre-gravid maternal obesity, and their combination ('diabesity') on outcomes of singleton gestations. J Matern Fetal Neonatal Med 2017; 31:640-643. [PMID: 28282765 DOI: 10.1080/14767058.2017.1293030] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To assess the effect of the combination of gestational diabetes mellitus (GDM) and pre-gravid obesity ('diabesity') in singleton gestations. METHODS We compared perinatal outcomes of singleton gestations in mothers with GDM and pre-gravid obesity, with GDM but with normal pre-gravid BMI, and obese mothers without GDM. RESULTS We compared diabesity mothers (n = 1525, 24.4% of mothers with GDM, 9.9% of all obese women) to mothers with GDM but with normal BMI (n = 4704, 75.6% of mothers with GDM) and to obese mothers without GDM (n = 13,937, 90.1% of all obese mothers). Obesity, with and without GDM, increased the odds of having chronic hypertension whereas preeclampsia appears to be influenced by obesity only, as were the risk of births at <33 weeks' gestation, of birth weight >4000 g, low 5-min Apgar scores and NICU admissions. CONCLUSION Obesity (without diabetes) is more frequently associated with adverse perinatal outcomes than diabesity or GDM in non-obese mothers. A campaign to decrease pre-gravid obesity should have at least the same priority as any campaign to control GDM.
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Affiliation(s)
- Isaac Blickstein
- a Department of Obstetrics and Gynecology , Kaplan Medical Center , Rehovot , Israel.,b Hadassah-Hebrew University School of Medicine , Jerusalem , Israel
| | - Reut Doyev
- b Hadassah-Hebrew University School of Medicine , Jerusalem , Israel
| | - Andreja Trojner Bregar
- c Division of Obstetrics and Gynecology, Department of Perinatology , University Medical Centre Ljubljana , Slovenia
| | - Gabrijela Bržan Šimenc
- c Division of Obstetrics and Gynecology, Department of Perinatology , University Medical Centre Ljubljana , Slovenia
| | - Ivan Verdenik
- c Division of Obstetrics and Gynecology, Department of Perinatology , University Medical Centre Ljubljana , Slovenia
| | - Natasa Tul
- c Division of Obstetrics and Gynecology, Department of Perinatology , University Medical Centre Ljubljana , Slovenia
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Fabjan AF, Verdenik I, Kavšek G. Single cephalic, term, nulliparous, healthy (low-risk) women in Slovenia from 2003 to 2012: trends in caesarean section rate. Eur J Obstet Gynecol Reprod Biol 2016. [DOI: 10.1016/j.ejogrb.2016.07.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Lučovnik M, Sršen TP, Leskošek V, Krajnc M, Pavše L, Verdenik I, Velikonja VG. Sociodemographic characteristics of pregnant women as indicators of domestic violence victims. Eur J Obstet Gynecol Reprod Biol 2016. [DOI: 10.1016/j.ejogrb.2016.07.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Gersak K, Gersak ZM, Vodusek VF, Verdenik I. Inflammatory bowel disease and pregnancy. Eur J Obstet Gynecol Reprod Biol 2016. [DOI: 10.1016/j.ejogrb.2016.07.386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Lukanovič A, Kunič T, Lugovski S, Verdenik I, Lukanovič D. Extracorporeal magnetic stimulation for the treatment of pelvic floor dysfunction. Is it effective? Eur J Obstet Gynecol Reprod Biol 2016. [DOI: 10.1016/j.ejogrb.2016.07.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Druskovic M, Kavsek G, Verdenik I, Premru-Srsen T. Trends in caesarean section rates in Slovenia from 2003 to 2012: flaws and benefits of increasing caesarean delivery rate in term breech delivery. Eur J Obstet Gynecol Reprod Biol 2016. [DOI: 10.1016/j.ejogrb.2016.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Bricelj K, Tul N, Lasic M, Bregar AT, Verdenik I, Lucovnik M, Blickstein I. Respiratory morbidity in twins by birth order, gestational age and mode of delivery. J Perinat Med 2016; 44:899-902. [PMID: 27089397 DOI: 10.1515/jpm-2015-0404] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Accepted: 03/07/2016] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To evaluate the relationship between respiratory morbidity in twins by gestational age, birth order and mode of delivery. METHODS All twin deliveries at <37 weeks, registered in a national database, in the period 2003-2012 were classified into four gestational age groups: 33-36, 30-32, 28-29, and <28 weeks. Outcome variables included transient tachypnea of the newborn (TTN), respiratory distress syndrome (RDS) and need for assisted ventilation. RESULTS A total of 1836 twins were born vaginally, and 2142 twins were born by cesarean delivery, for a grand total of 3978 twins. TTN did not appear to be related to birth order and to the mode of delivery. In contrast, RDS was more frequent among the second born twins in the vaginal birth groups born at 30-36 weeks [odds ratio (OR) 2.5, 95% confidence interval (CI) 1.2-5.1 and OR 2.0, 95% CI 1.2-3.5 for 33-36 weeks and 30-32 weeks, respectively], whereas this trend was seen in the cesarean birth groups born earlier (OR 3.8, 95% CI 1.1-13.0 for 28-29 weeks). Cesarean delivery significantly increased the frequency of RDS in twin A as well as in twin B compared with vaginal birth, but only at gestational ages <30 weeks. CONCLUSION Mode of delivery and birth order have a gestational age dependent effect on the incidence of RDS.
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Tul N, Lasic M, Bricelj K, Bregar AT, Verdenik I, Lucovnik M, Blickstein I. Outcome of small for gestational age preterm singletons: a population-based cohort study. J Perinat Med 2016; 44:941-944. [PMID: 27176738 DOI: 10.1515/jpm-2015-0321] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Accepted: 04/18/2016] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To examine the outcomes of births among small and appropriate for gestational age (SGA and AGA) infants by gestational age and maternal characteristics. MATERIALS AND METHODS We used a national perinatal registry to compare the selected maternal and neonatal outcomes between AGA and SGA neonates born at gestational age groups 33-36, 30-32, 28-29, and <28 weeks. We evaluated maternal body mass index (BMI), pre-gestational/gestational diabetes, hypertensive disorders, and cesarean births as well as frequencies of 5-min Apgar score <7, intraventricular hemorrhage (IVH), respiratory distress syndrome (RDS), the need for assisted ventilation, and early neonatal deaths. RESULTS We evaluated 159,774 AGA (8871 preterm) and 13,735 SGA (1147 preterm) infants and found a gradual decrease in the incidence of SGA infants with increasing gestational age. Diabetes was unrelated to having an SGA or AGA infant among preterm births, but the odds ratio (OR) for preeclampsia among preterm-SGA pregnancies was up to 6.9 (95% CI 3.8, 12.5) at <28 weeks. SGA infants fare worse compared to AGA neonates in every parameter tested but only in preterm births >30 weeks. CONCLUSIONS Being SGA further complicates preterm births after 30 weeks of gestation but not earlier. This might suggest that an extended period in the hostile intrauterine environment, or that being born at <30 weeks, is bad enough and is not further aggravated by being SGA.
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Trojner Bregar A, Blickstein I, Verdenik I, Lucovnik M, Tul N. Outcome of monochorionic-biamniotic twins conceived by assisted reproduction: a population-based study. J Perinat Med 2016; 44:881-885. [PMID: 27219096 DOI: 10.1515/jpm-2015-0406] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Accepted: 04/11/2016] [Indexed: 11/15/2022]
Abstract
UNLABELLED Objecive: To evaluate the perinatal outcome of monochorionic-diamniotic twins conceived by assisted reproduction technology (ART). METHODS We compared data from a national population-based perinatal registry on perinatal outcomes of monochorionic-diamniotic twins conceived by ART with their dichorionic counterparts and with spontaneous monochorionic-diamniotic twins. We compared maternal characteristics, pregnancy complications and perinatal outcomes. RESULTS Monochorionic-diamniotic twin pregnancies (n=45) comprised 5.5% of all ART twins, and 9.3% of all monochorionic twins in this dataset. ART does not appear to increase the already high risk of monochorionicity compared to spontaneous conception, with the latter having an increased incidence for birth weight <1500 g [odds ratio (OD) 2.6, 95% confidence interval (CI) 1.2-5.4]. CONCLUSION Our results disagree with hospital-based data and suggest that monochorionic-diamniotic twins following ART are not at increased risk of adverse perinatal outcomes compared to spontaneous monochorionic-diamniotic twins as well as to dichorionc twins conceived by ART.
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Ferrero DM, Larson J, Jacobsson B, Di Renzo GC, Norman JE, Martin JN, D’Alton M, Castelazo E, Howson CP, Sengpiel V, Bottai M, Mayo JA, Shaw GM, Verdenik I, Tul N, Velebil P, Cairns-Smith S, Rushwan H, Arulkumaran S, Howse JL, Simpson JL. Cross-Country Individual Participant Analysis of 4.1 Million Singleton Births in 5 Countries with Very High Human Development Index Confirms Known Associations but Provides No Biologic Explanation for 2/3 of All Preterm Births. PLoS One 2016; 11:e0162506. [PMID: 27622562 PMCID: PMC5021369 DOI: 10.1371/journal.pone.0162506] [Citation(s) in RCA: 109] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 08/01/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Preterm birth is the most common single cause of perinatal and infant mortality, affecting 15 million infants worldwide each year with global rates increasing. Understanding of risk factors remains poor, and preventive interventions have only limited benefit. Large differences exist in preterm birth rates across high income countries. We hypothesized that understanding the basis for these wide variations could lead to interventions that reduce preterm birth incidence in countries with high rates. We thus sought to assess the contributions of known risk factors for both spontaneous and provider-initiated preterm birth in selected high income countries, estimating also the potential impact of successful interventions due to advances in research, policy and public health, or clinical practice. METHODS We analyzed individual patient-level data on 4.1 million singleton pregnancies from four countries with very high human development index (Czech Republic, New Zealand, Slovenia, Sweden) and one comparator U.S. state (California) to determine the specific contribution (adjusting for confounding effects) of 21 factors. Both individual and population-attributable preterm birth risks were determined, as were contributors to cross-country differences. We also assessed the ability to predict preterm birth given various sets of known risk factors. FINDINGS Previous preterm birth and preeclampsia were the strongest individual risk factors of preterm birth in all datasets, with odds ratios of 4.6-6.0 and 2.8-5.7, respectively, for individual women having those characteristics. In contrast, on a population basis, nulliparity and male sex were the two risk factors with the highest impact on preterm birth rates, accounting for 25-50% and 11-16% of excess population attributable risk, respectively (p<0.001). The importance of nulliparity and male sex on population attributable risk was driven by high prevalence despite low odds ratios for individual women. More than 65% of the total aggregated risk of preterm birth within each country lacks a plausible biologic explanation, and 63% of difference between countries cannot be explained with known factors; thus, research is necessary to elucidate the underlying mechanisms of preterm birth and, hence, therapeutic intervention. Surprisingly, variation in prevalence of known risk factors accounted for less than 35% of the difference in preterm birth rates between countries. Known risk factors had an area under the curve of less than 0.7 in ROC analysis of preterm birth prediction within countries. These data suggest that other influences, as yet unidentified, are involved in preterm birth. Further research into biological mechanisms is warranted. CONCLUSIONS We have quantified the causes of variation in preterm birth rates among countries with very high human development index. The paucity of explicit and currently identified factors amenable to intervention illustrates the limited impact of changes possible through current clinical practice and policy interventions. Our research highlights the urgent need for research into underlying biological causes of preterm birth, which alone are likely to lead to innovative and efficacious interventions.
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Affiliation(s)
| | - Jim Larson
- Boston Consulting Group, Boston, MA, United States of America
| | - Bo Jacobsson
- Department of Obstetrics and Gynecology, Institute for the Health of Women and Children, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Genes and Environment, Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway
| | - Gian Carlo Di Renzo
- International Federation of Gynecology and Obstetrics, London, United Kingdom
- Department of Obstetrics and Gynecology, University of Perugia, Perugia, Italy
| | - Jane E. Norman
- Tommy’s Centre for Fetal and Maternal Health, Medical Research Council Centre for Reproductive Health, Queen’s Medical Research Institute, The University of Edinburgh, Edinburgh, United Kingdom
| | - James N. Martin
- Division of Maternal-Fetal Medicine, University of Mississippi, Medical Center, Jackson, MS, United States of America
| | - Mary D’Alton
- Department of Obstetrics and Gynecology, Columbia University / College of Physicians and Surgeons, New York, NY, United States of America
| | - Ernesto Castelazo
- International Federation of Gynecology and Obstetrics, London, United Kingdom
| | - Chris P. Howson
- March of Dimes Foundation, White Plains, NY, United States of America
| | - Verena Sengpiel
- Department of Obstetrics and Gynecology, Institute for the Health of Women and Children, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Matteo Bottai
- Unit of Biostatistics, IMM, Karolinska Institutet, Stockholm, Sweden
| | - Jonathan A. Mayo
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, United States of America
| | - Gary M. Shaw
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, United States of America
| | - Ivan Verdenik
- Department of Perinatology, Division of Obstetrics and Gynecology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Nataša Tul
- Department of Perinatology, Division of Obstetrics and Gynecology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Petr Velebil
- Institute for the Care of Mother and Child, Perinatal Centre, Prague, Czech Republic
| | | | - Hamid Rushwan
- International Federation of Gynecology and Obstetrics, London, United Kingdom
| | | | - Jennifer L. Howse
- March of Dimes Foundation, White Plains, NY, United States of America
| | - Joe Leigh Simpson
- March of Dimes Foundation, White Plains, NY, United States of America
- * E-mail:
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Abstract
Since the introduction of in vitro fertilization (IVF) in clinical practice of infertility treatment, the indicators for high quality embryos were investigated. Cumulus cells (CC) have a specific gene expression profile according to the developmental potential of the oocyte they are surrounding, and therefore, specific gene expression could be used as a biomarker. The aim of our study was to combine more than one biomarker to observe improvement in prediction value of embryo development. In this study, 58 CC samples from 17 IVF patients were analyzed. This study was approved by the Republic of Slovenia National Medical Ethics Committee. Gene expression analysis [quantitative real time polymerase chain reaction (qPCR)] for five genes, analyzed according to embryo quality level, was performed. Two prediction models were tested for embryo quality prediction: a binary logistic and a decision tree model. As the main outcome, gene expression levels for five genes were taken and the area under the curve (AUC) for two prediction models were calculated. Among tested genes, AMHR2 and LIF showed significant expression difference between high quality and low quality embryos. These two genes were used for the construction of two prediction models: the binary logistic model yielded an AUC of 0.72 ± 0.08 and the decision tree model yielded an AUC of 0.73 ± 0.03. Two different prediction models yielded similar predictive power to differentiate high and low quality embryos. In terms of eventual clinical decision making, the decision tree model resulted in easy-to-interpret rules that are highly applicable in clinical practice.
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Affiliation(s)
- R Devjak
- Division of Medical Oncology, Institute of Oncology, Ljubljana, Slovenia
| | - T Burnik Papler
- Reproductive Unit, Department of Obstetrics and Gynaecology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - I Verdenik
- Reproductive Unit, Department of Obstetrics and Gynaecology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - K Fon Tacer
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - E Vrtačnik Bokal
- Reproductive Unit, Department of Obstetrics and Gynaecology, University Medical Centre Ljubljana, Ljubljana, Slovenia
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Lučovnik M, Blickstein I, Lasič M, Fabjan-Vodušek V, Bržan-Simenc G, Verdenik I, Tul N. Hypertensive disorders during monozygotic and dizygotic twin gestations: A population-based study. Hypertens Pregnancy 2016; 35:542-547. [PMID: 27420020 DOI: 10.1080/10641955.2016.1197936] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To determine whether the incidence of hypertensive disorders is different in monozygotic compared to dizygotic twin pregnancies. METHODS A registry-based survey of twin pregnancies delivered during 2003 to 2012. We used the best clinical estimate of zygosity based on the concept that all monochorionic twins are monozygotic and all unlike-sex pairs are dizygotic, thus excluding same-sex dichorionic twin gestations for which zygosity cannot be ascertained on clinical grounds. Study cohorts were twin pregnancies with or without preeclampsia and gestational hypertension. RESULTS A total of 3419 twin gestations met the inclusion criteria, of which 442 (12.9%) were monochorionic and 1255 (36.7%) were unlike-sex twins, excluding 1722 same-sex dichorionic twin gestations (50.4%). There was no significant difference in the incidence of preeclampsia (OR: 0.9; 95% CI: 0.4-2.0 for monozygotic males and OR: 0.6; 95% CI: 0.3-1.4 for monozygotic females) and gestational hypertension (OR: 0.7; 95% CI: 0.2-2.5 for monozygotic males, and OR: 0.7; 95% CI: 0.2-2.3 for monozygotic females) between monochorionic and unlike-sex pairs. Maternal prepregnancy obesity and nulliparity were the only significant associated factors of preeclampsia (OR: 3.8; 95% CI: 2.0-7.0, and OR: 2.5; 95% CI: 1.4-4.4, respectively). Maternal prepregnancy obesity (OR: 5.5; 95% CI: 2.5-12.2), maternal age ≥36 years (OR: 2.5; 95% CI: 1.1-6.1), and family history of hypertension (OR: 2.6; 95% CI: 1.3-5.1) were significantly associated with gestational hypertension. CONCLUSION Based on a large population-based dataset and on the best clinical estimate of twin zygosity, it appears that zygosity is not associated with hypertensive disorders in twin gestations.
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Affiliation(s)
- Miha Lučovnik
- a Department of Perinatology, Division of Obstetrics and Gynecology , University Medical Center Ljubljana , Ljubljana , Slovenia
| | - Isaac Blickstein
- b Department of Obstetrics and Gynecology, Kaplan Medical Center , Rehevot and the Hadassah-Hebrew University School of Medicine , Jerusalem , Israel
| | - Mateja Lasič
- a Department of Perinatology, Division of Obstetrics and Gynecology , University Medical Center Ljubljana , Ljubljana , Slovenia
| | - Vesna Fabjan-Vodušek
- a Department of Perinatology, Division of Obstetrics and Gynecology , University Medical Center Ljubljana , Ljubljana , Slovenia
| | - Gabrijela Bržan-Simenc
- a Department of Perinatology, Division of Obstetrics and Gynecology , University Medical Center Ljubljana , Ljubljana , Slovenia
| | - Ivan Verdenik
- a Department of Perinatology, Division of Obstetrics and Gynecology , University Medical Center Ljubljana , Ljubljana , Slovenia
| | - Nataša Tul
- a Department of Perinatology, Division of Obstetrics and Gynecology , University Medical Center Ljubljana , Ljubljana , Slovenia
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Trojner Bregar A, Blickstein I, Bržan Šimenc G, Janša V, Verdenik I, Lučovnik M, Tul N. Perinatal Advantages and Disadvantages of Being Underweight before Pregnancy: A Population-Based Study. Gynecol Obstet Invest 2016; 82:303-306. [DOI: 10.1159/000447557] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 06/13/2016] [Indexed: 11/19/2022]
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Lucovnik M, Bregar AT, Steblovnik L, Verdenik I, Gersak K, Blickstein I, Tul N. Changes in incidence of iatrogenic and spontaneous preterm births over time: a population-based study. J Perinat Med 2016; 44:505-9. [PMID: 26646020 DOI: 10.1515/jpm-2015-0271] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2015] [Accepted: 11/02/2015] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To examine the proportion of iatrogenic births among all preterm births over a 26-year period. PATIENTS AND METHODS A registry-based survey of preterm deliveries between 1987 and 2012 analyzed by the onset of labor: spontaneous with intact membranes, preterm premature rupture of membranes (PPROM) or iatrogenic. Stratification into categories by gestation (22 weeks to 27 weeks and 6 days, 28 weeks to 31 weeks and 6 days, 32 weeks to 33 weeks and 6 days, 34 weeks to 36 weeks and 6 days) was performed. Preterm birth rates were analyzed using the Mantel-Haenszel linear-by-linear association χ2-test (P<0.05 significant). Logistic regression was used to account for potential confounders. RESULTS Overall preterm birth rate was 5.9% (31328 deliveries) including 2358 (0.4%) before 28 completed weeks, 3388 (0.6%) between 28 weeks and 31 weeks 6 days, 3970 (0.8%) between 32 weeks and 33 weeks and 6 days, and 21611 (4.1%) between 34 weeks and 36 weeks and 6 days There was an increase in overall preterm birth rate (P<0.001). The rate of iatrogenic preterm births and PPROM increased over time (P<0.001 and P<0.014, respectively). Rates of spontaneous preterm birth decreased (P<0.001). After accounting for potential confounders, year of birth remained an independent risk factor for iatrogenic preterm delivery in all four gestational age categories (P<0.001). CONCLUSION The incidence of iatrogenic preterm birth is increasing with a concomitant decrease in the incidence of spontaneous preterm birth. Attempts to analyze, interpret and decrease preterm birth rates should consider spontaneous and iatrogenic preterm births separately.
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Bricelj K, Blickstein I, Bržan-Šimenc G, Janša V, Lučovnik M, Verdenik I, Trojner-Bregar A, Tul N. Growth curves for twins in Slovenia. J Matern Fetal Neonatal Med 2016; 30:479-481. [PMID: 27053137 DOI: 10.1080/14767058.2016.1175425] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Abnormalities of fetal growth are more common in twins. We introduce the growth curves for monitoring fetal growth in twin pregnancies in Slovenia. Slovenian National Perinatal Information System for the period between 2002 and 2010 was used to calculate birth weight percentiles for all live born twins for each week from 22nd to 40th week. The calculated percentiles of birth weight for all live-born twins in Slovenia served as the basis for drawing 'growth' curves. The calculated growth curves for twins will help accurately diagnose small or large twin fetuses for their gestational age in the native central European population.
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Affiliation(s)
- Katja Bricelj
- a Perinatology Unit, Department of Obstetrics and Gynecology , University Medical Center Ljubljana , Ljubljana , Slovenia , and
| | - Isaac Blickstein
- b Department of Obstetrics and Gynecology, Kaplan Medical Center, Rehovot , Affiliated with the Hadassah-Hebrew University School of Medicine , Jerusalem , Israel
| | - Gabrijela Bržan-Šimenc
- a Perinatology Unit, Department of Obstetrics and Gynecology , University Medical Center Ljubljana , Ljubljana , Slovenia , and
| | - Vid Janša
- a Perinatology Unit, Department of Obstetrics and Gynecology , University Medical Center Ljubljana , Ljubljana , Slovenia , and
| | - Miha Lučovnik
- a Perinatology Unit, Department of Obstetrics and Gynecology , University Medical Center Ljubljana , Ljubljana , Slovenia , and
| | - Ivan Verdenik
- a Perinatology Unit, Department of Obstetrics and Gynecology , University Medical Center Ljubljana , Ljubljana , Slovenia , and
| | - Andreja Trojner-Bregar
- a Perinatology Unit, Department of Obstetrics and Gynecology , University Medical Center Ljubljana , Ljubljana , Slovenia , and
| | - Nataša Tul
- a Perinatology Unit, Department of Obstetrics and Gynecology , University Medical Center Ljubljana , Ljubljana , Slovenia , and
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Tul N, Bregar AT, Steblovnik L, Verdenik I, Lucovnik M, Blickstein I. A population-based comparison between actual maternal weight gain and the Institute of Medicine weight gain recommendations in singleton pregnancies. J Perinat Med 2016; 44:389-92. [PMID: 25879309 DOI: 10.1515/jpm-2014-0386] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2014] [Accepted: 02/16/2015] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To compare the actual maternal weight gain to that recommended by the Institute of Medicine (IOM) in term singleton gestations. METHODS We used data from the Slovenian National Perinatal Information System to select singleton pregnancies born at ≥38 weeks during the period from 2003 to 2012. We calculated the frequencies of mothers who gained less than, more than, and as recommended by the IOM according to their pregravid body mass index (BMI). We also compared the fetal size parameters in under- and over-gainer to those who gained weight as recommended by the IOM. RESULTS We selected 173,715 patients who delivered at ≥38 weeks. Of these patients, the recommended weight gain was achieved by 56,868 (32.7%, 95% CI 32.5, 32.9) only, 82,617 (47.6%, 95% CI 47.3, 47.8) were over-gainers, and 34,230 (19.7%, 95% CI 19.5, 19.8) gained less than recommended. Neither undergaining nor overgaining were always synonymous with adverse fetal outcomes. CONCLUSIONS Roughly two-thirds of singleton mothers did not gain weight during pregnancy according to the IOM recommendations. Inappropriate maternal weight gain, however, was not always associated with adverse fetal outcomes and this implies that a tailored approach rather than strict adherence to the IOM recommendations may be more practical.
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Trojner-Bregar A, Blickstein I, Lucovnik M, Steblovnik L, Verdenik I, Tul N. The relationship between cesarean section rate in term singleton pregnancies, maternal weight, and weight gain during pregnancy. J Perinat Med 2016; 44:393-6. [PMID: 26352070 DOI: 10.1515/jpm-2015-0117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2015] [Accepted: 07/15/2015] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Pregravid maternal weight and appropriate weight gain during pregnancy might be associated with increased cesarean section rate. STUDY DESIGN We used data from the Slovenian National Perinatal Information System to select singleton pregnancies born at ≥38 weeks, during the period between 2003 and 2012. We calculated the frequencies of urgent and elective cesarean sections (UCS and ECS, respectively) in mothers who gained less than, more than, and as recommended by the Institute of Medicine (IOM) according to their pregravid body mass index (BMI). RESULTS The analysis included 170,121 women who delivered singletons ≥38 weeks. A total of 24,327 (14.3%) women underwent cesarean section: 14,692 (8.6%) UCS and 9635 (5.7%) ECS. The frequency of cesareans, both UCS and ECS, increases as BMI increases irrespective of weight gain pattern. The frequency of urgent cesareans in all women increases and that of elective cesareans among obese women decreases as the level of weight gain increases from undergainers to overgainers. CONCLUSION The combination of pregravid BMI and weight gain pattern is an important determinant of cesarean section rates at term.
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Bricelj K, Tul N, Lucovnik M, Kronhauser-Cerar L, Steblovnik L, Verdenik I, Blickstein I. Neonatal respiratory morbidity in late-preterm births in pregnancies with and without gestational diabetes mellitus. J Matern Fetal Neonatal Med 2016; 30:377-379. [PMID: 27052752 DOI: 10.3109/14767058.2016.1174208] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To evaluate neonatal respiratory morbidity in infants born late-preterm to mothers with or without gestational diabetes mellitus (GDM). METHODS Analysis of a population-based cohort of all live-born singletons, born at 34 0/7 to 36 6/7 weeks to mothers with and without GDM, focusing on transient tachypnea of the newborn (TTN) and respiratory distress syndrome (RDS). RESULTS The study group comprised 363 (4.7%) singletons born to mothers with GDM and the controls were 7400 born to mothers without GDM. Mothers with GDM were older (31.4 ± 5.1 versus 29.5 ± 5.1 years, p < 0.001) and were more likely to be hypertensive (OR 1.5, 95% CI 1.1-2.1). Neonates of GDM mothers were heavier at birth (2769 ± 539 versus 2636 ± 473 g, p < 0.001). We found a similar incidence of RDS and TTN in both groups. The multiple regression analysis showed cesarean delivery and lower gestational age were independently associated with RDS and TTN. CONCLUSION GDM, per se, is not a major contributor to RDS in late pre-term infants. Rather, the combination of prematurity and cesarean birth act independently to increase the risk of respiratory morbidity.
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Affiliation(s)
- Katja Bricelj
- a Department of Perinatology , Division of Obstetrics and Gynecology, University Medical Centre Ljubljana , Ljubljana , Slovenia , and
| | - Natasa Tul
- a Department of Perinatology , Division of Obstetrics and Gynecology, University Medical Centre Ljubljana , Ljubljana , Slovenia , and
| | - Miha Lucovnik
- a Department of Perinatology , Division of Obstetrics and Gynecology, University Medical Centre Ljubljana , Ljubljana , Slovenia , and
| | - Lilijana Kronhauser-Cerar
- a Department of Perinatology , Division of Obstetrics and Gynecology, University Medical Centre Ljubljana , Ljubljana , Slovenia , and
| | - Lili Steblovnik
- a Department of Perinatology , Division of Obstetrics and Gynecology, University Medical Centre Ljubljana , Ljubljana , Slovenia , and
| | - Ivan Verdenik
- a Department of Perinatology , Division of Obstetrics and Gynecology, University Medical Centre Ljubljana , Ljubljana , Slovenia , and
| | - Isaac Blickstein
- b Department of Obstetrics and Gynecology , Kaplan Medical Center , Rehovot , Israel
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Heino A, Gissler M, Hindori-Mohangoo AD, Blondel B, Klungsøyr K, Verdenik I, Mierzejewska E, Velebil P, Sól Ólafsdóttir H, Macfarlane A, Zeitlin J. Variations in Multiple Birth Rates and Impact on Perinatal Outcomes in Europe. PLoS One 2016; 11:e0149252. [PMID: 26930069 PMCID: PMC4773186 DOI: 10.1371/journal.pone.0149252] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Accepted: 01/11/2016] [Indexed: 01/31/2023] Open
Abstract
OBJECTIVE Infants from multiple pregnancies have higher rates of preterm birth, stillbirth and neonatal death and differences in multiple birth rates (MBR) exist between countries. We aimed to describe differences in MBR in Europe and to investigate the impact of these differences on adverse perinatal outcomes at a population level. METHODS We used national aggregate birth data on multiple pregnancies, maternal age, gestational age (GA), stillbirth and neonatal death collected in the Euro-Peristat project (29 countries in 2010, N = 5 074 643 births). We also used European Society of Human Reproduction and Embryology (ESHRE) data on assisted conception and single embryo transfer (SET). The impact of MBR on outcomes was studied using meta-analysis techniques with random-effects models to derive pooled risk ratios (pRR) overall and for four groups of country defined by their MBR. We computed population attributable risks (PAR) for these groups. RESULTS In 2010, the average MBR was 16.8 per 1000 women giving birth, ranging from 9.1 (Romania) to 26.5 (Cyprus). Compared to singletons, multiples had a nine-fold increased risk (pRR 9.4, 95% Cl 9.1-9.8) of preterm birth (<37 weeks GA), an almost 12-fold increased risk (pRR 11.7, 95% CI 11.0-12.4) of very preterm birth (<32 weeks GA). Pooled RR were 2.4 (95% Cl 1.5-3.6) for fetal mortality at or after 28 weeks GA and 7.0 (95% Cl 6.1-8.0) for neonatal mortality. PAR of neonatal death and very preterm birth were higher in countries with high MBR compared to low MBR (17.1% (95% CI 13.8-20.2) versus 9.8% (95% Cl 9.6-11.0) for neonatal death and 29.6% (96% CI 28.5-30.6) versus 17.5% (95% CI 15.7-18.3) for very preterm births, respectively). CONCLUSIONS Wide variations in MBR and their impact on population outcomes imply that efforts by countries to reduce MBR could improve perinatal outcomes, enabling better long-term child health.
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Affiliation(s)
- Anna Heino
- THL National Institute for Health and Welfare, Helsinki, Finland
| | - Mika Gissler
- THL National Institute for Health and Welfare, Helsinki, Finland
| | - Ashna D. Hindori-Mohangoo
- TNO, Netherlands Organisation for Applied Scientific Research, Department Child Health, Leiden, The Netherlands
- Anton de Kom University of Suriname, Faculty of Medical Sciences, Department Public Health, Paramaribo, Suriname
| | - Béatrice Blondel
- INSERM, Obstetrical, Perinatal and Paediatric Epidemiology Research Team, Centre for Epidemiology and Biostatistics (U1153), Paris-Descartes University, Paris, France
| | - Kari Klungsøyr
- Department of Global Public Health and Primary Care, University of Bergen and Medical Birth Registry of Norway, Norwegian Institute of Public Health, 5018, Bergen, Norway
| | - Ivan Verdenik
- Ljubljana University Medical Center, Ljubljana, Slovenia
| | - Ewa Mierzejewska
- Department of Epidemiology, National Research Institute of Mother and Child, Warsaw, Poland
| | - Petr Velebil
- Institute for the Care of Mother and Child, Prague, Czech Republic
| | - Helga Sól Ólafsdóttir
- Department of Obstetrics and Gynaecology, Landspitali University Hospital, Reykjavik, Iceland
| | - Alison Macfarlane
- Centre for Maternal and Child Health Research, School of Health Sciences, City University London, London, Great Britain
| | - Jennifer Zeitlin
- INSERM, Obstetrical, Perinatal and Paediatric Epidemiology Research Team, Centre for Epidemiology and Biostatistics (U1153), Paris-Descartes University, Paris, France
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Globevnik Velikonja V, Lozej T, Leban G, Verdenik I, Vrtačnik Bokal E. The Quality of Life in Pregnant Women Conceiving Through in Vitro Fertilization. Zdr Varst 2015; 55:1-10. [PMID: 27647083 PMCID: PMC4820176 DOI: 10.1515/sjph-2016-0001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Accepted: 06/22/2015] [Indexed: 11/15/2022] Open
Abstract
Objective The aim was to determine whether pregnant women conceiving through in vitro fertilization (IVF) differ from those conceiving spontaneously in terms of psychological well-being and the quality of life. Methods In a prospective study we included 75 women conceived after IVF and 78 who conceived spontaneously in the same time period (control group). All the women were sent a self-report questionnaire about demographic and reproductive history, health, pregnancy concerns, containing Subjective Quality of Life Scale (QLS), Positive and Negative Affect Schedule (PANAS), the Psychological Well-Being Scale (PWB), Beck Depression Inventory (BDI), and Zung Self-Assessment Anxiety Scale (SAS); obstetric and newborn’s data were obtained from medical records. Response rate was 66.6% in the IVF and 83.3% in control group. Results The mean women’s age was 33.8 years in the IVF, and 32.5 years in the control group (NS). There were no significant differences between groups on the most of the outcome measures assessing psychological status. IVF mothers were just less satisfied in “friend/acquaintances” (P=0.03), a higher percentage had sexual problems prior to conception (P=0.03); the length of hospitalization during pregnancy was longer (P=0.02), and the preterm delivery rate was higher (P=0.01). Withingroup changes over gestation time indicated that IVF women, not controls, showed an increase in positive affect (P=0.04) and purpose in life (P=0.05). Conclusions IVF women are inclined to social isolation. Despite more medical problems during pregnancy, they reported improved positive emotions and purpose in life as the pregnancy progressed.
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Affiliation(s)
- Vislava Globevnik Velikonja
- University Medical Center Ljubljana, Division of Obstetrics and Gynaecology, Šlajmerjeva 3, 1000 Ljubljana, Slovenia
| | - Tina Lozej
- Dr. Franc Derganc General Hospital, Ulica padlih borcev 13 a, 5290 Šempeter pri Novi Gorici, Slovenia
| | - Gaja Leban
- Community Health Centre Ljubljana, Unit Šiška, Derčeva 5, 1000 Ljubljana, Slovenia
| | - Ivan Verdenik
- University Medical Center Ljubljana, Division of Obstetrics and Gynaecology, Šlajmerjeva 3, 1000 Ljubljana, Slovenia
| | - Eda Vrtačnik Bokal
- University Medical Center Ljubljana, Division of Obstetrics and Gynaecology, Šlajmerjeva 3, 1000 Ljubljana, Slovenia
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Trojner Bregar A, Lucovnik M, Verdenik I, Jager F, Gersak K, Garfield RE. Uterine electromyography during active phase compared with latent phase of labor at term. Acta Obstet Gynecol Scand 2015; 95:197-202. [DOI: 10.1111/aogs.12818] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Accepted: 10/09/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Andreja Trojner Bregar
- Department of Perinatology; Division of Obstetrics and Gynecology; University Medical Center Ljubljana; Ljubljana Slovenia
| | - Miha Lucovnik
- Department of Perinatology; Division of Obstetrics and Gynecology; University Medical Center Ljubljana; Ljubljana Slovenia
| | - Ivan Verdenik
- Department of Perinatology; Division of Obstetrics and Gynecology; University Medical Center Ljubljana; Ljubljana Slovenia
| | - Franc Jager
- Faculty of Computer and Information Science; University of Ljubljana; Ljubljana Slovenia
| | - Ksenija Gersak
- Department of Perinatology; Division of Obstetrics and Gynecology; University Medical Center Ljubljana; Ljubljana Slovenia
| | - Robert E. Garfield
- Department of Obstetrics and Gynecology; St Joseph's Hospital and Medical Center; Phoenix Arizona USA
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Vidic Z, Blickstein I, Štucin Gantar I, Verdenik I, Tul N. Timing of elective cesarean section and neonatal morbidity: a population-based study. J Matern Fetal Neonatal Med 2015; 29:2461-3. [PMID: 26444222 DOI: 10.3109/14767058.2015.1087500] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To assess the incidence of neonatal complications related to gestational age at elective cesarean section near term. METHODS We used a population-based dataset to compare neonatal outcomes by gestational age in uncomplicated singleton pregnancies delivered by elective cesarean section ≥37 weeks. RESULTS A total of 7364 mothers had an elective cesarean during 2002-2012; 343 (4.7%) at 37, 21 753 (3.8%) at 38, 3140 (2.6%) at 39, 1718 (23.3%) at 40 and 410 (5.6%) at ≥41 weeks. Infants born at a lower gestational age had a higher rate of Apgar scores <7 (2%, 0.4%, 0.6%, 0,3%, 0.2% at 37, 38, 39, 40 and ≥41 week, p = 0.013), hypoglycemia (1.5%, 1.0%, 0.8%, 0.4%, 0.5% at 37, 38, 39, 40 and ≥ 41 week, p = 0.012), hyperbilirubinemia (12.2%, 9.5%, 6.4%, 4.8%, 4.1% at 37, 38, 39, 40 and ≥ 41 week, p < 0.001), respiratory distress syndrome (5.5%, 2.2%, 1.6%, 0.5%, 0.7% at 37, 38, 39, 40 and ≥ 41 week, p < 0.001), and neonatal intensive care admissions (8.7%, 2.3%, 1.9%, 1.0%, 1.7% at 37, 38, 39, 40 and ≥ 41 week, p < 0.001). CONCLUSIONS Elective cesarean section at ≥ 39 weeks gestation would significantly reduce neonatal complications.
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Affiliation(s)
- Zala Vidic
- a Department of Perinatology , Division of Obstetrics and Gynecology, University Medical Centre Ljubljana , Slovenia and.,b Department of Obstetrics and Gynecology , Kaplan Medical Center , Rehovot , Israel (Affiliated with the Hadassah-Hebrew University School of Medicine, Jerusalem)
| | - Isaac Blickstein
- a Department of Perinatology , Division of Obstetrics and Gynecology, University Medical Centre Ljubljana , Slovenia and.,b Department of Obstetrics and Gynecology , Kaplan Medical Center , Rehovot , Israel (Affiliated with the Hadassah-Hebrew University School of Medicine, Jerusalem)
| | - Irena Štucin Gantar
- a Department of Perinatology , Division of Obstetrics and Gynecology, University Medical Centre Ljubljana , Slovenia and.,b Department of Obstetrics and Gynecology , Kaplan Medical Center , Rehovot , Israel (Affiliated with the Hadassah-Hebrew University School of Medicine, Jerusalem)
| | - Ivan Verdenik
- a Department of Perinatology , Division of Obstetrics and Gynecology, University Medical Centre Ljubljana , Slovenia and.,b Department of Obstetrics and Gynecology , Kaplan Medical Center , Rehovot , Israel (Affiliated with the Hadassah-Hebrew University School of Medicine, Jerusalem)
| | - Nataša Tul
- a Department of Perinatology , Division of Obstetrics and Gynecology, University Medical Centre Ljubljana , Slovenia and.,b Department of Obstetrics and Gynecology , Kaplan Medical Center , Rehovot , Israel (Affiliated with the Hadassah-Hebrew University School of Medicine, Jerusalem)
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Trojner Bregar A, Blickstein I, Steblovnik L, Verdenik I, Lucovnik M, Tul N. Do tall women beget larger babies? J Matern Fetal Neonatal Med 2015; 29:1311-3. [DOI: 10.3109/14767058.2015.1046830] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Ribnikar N, Šćepanović D, Verdenik I, Žgur L. Effect of pelvic belt and physiotherapy advice on pain in pregnant women with pelvic girdle pain. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.1226] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Herzog M, Cerar LK, Sršen TP, Verdenik I, Lučovnik M. Impact of risk factors other than prematurity on periventricular leukomalacia. A population-based matched case control study. Eur J Obstet Gynecol Reprod Biol 2015; 187:57-9. [PMID: 25748489 DOI: 10.1016/j.ejogrb.2015.02.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Revised: 01/22/2015] [Accepted: 02/06/2015] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Periventricular leukomalacia (PVL) is a neonatal brain white matter injury associated with development of cerebral palsy, intellectual impairment, and visual disturbances. PVL is more common in premature neonates. Our objective was to examine the impact of several potential risk factors other than prematurity on the incidence of PVL. STUDY DESIGN A case-control study based on the Slovenian National Perinatal Information System data for the period 2002-2011. All singleton and twin pregnancies delivered at ≥22 weeks' in Slovenia during the study period were included. Cases were pregnancies with PVL in at least one neonate. For each pregnancy in the case cohort, three pregnancies matched by gestational age and plurality were selected. Chi-square test was used to examine the associations between PVL and several potential risk factors: maternal age, pre-pregnancy body-mass-index, preexisting diabetes, gestational diabetes, pregnancy after in-vitro-fertilization, severe preeclampsia, vaginal delivery, no steroid therapy prior to delivery, small for gestational age, and fetal-inflammatory-response-syndrome. P<0.05 was considered statistically significant. RESULTS One lakh ninety one thousand and eighty three singleton and 3377 twin pregnancies delivered at ≥22 weeks' in Slovenia during the study period. PVL was diagnosed in 86 singletons (0.045%) and 25 twins (0.74%). In all twin pregnancy cases only one twin was diagnosed with PVL. 258 singleton and 75 twin controls were matched to the 86 singleton and 25 twin cases. Of all risk factors studied, only maternal obesity and chorioamnionitis were significantly associated with PVL. CONCLUSION Maternal obesity and chorioamnionitis increase the risk of PVL beyond that expected solely from prematurity.
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Affiliation(s)
- Maruša Herzog
- Department of Perinatology, Division of Obstetrics and Gynecology, University Medical Centre Ljubljana, Slajmerjeva 4, 1000 Ljubljana, Slovenia
| | - Lilijana Kornhauser Cerar
- Department of Perinatology, Division of Obstetrics and Gynecology, University Medical Centre Ljubljana, Slajmerjeva 4, 1000 Ljubljana, Slovenia
| | - Tanja Premru Sršen
- Department of Perinatology, Division of Obstetrics and Gynecology, University Medical Centre Ljubljana, Slajmerjeva 4, 1000 Ljubljana, Slovenia
| | - Ivan Verdenik
- Department of Perinatology, Division of Obstetrics and Gynecology, University Medical Centre Ljubljana, Slajmerjeva 4, 1000 Ljubljana, Slovenia
| | - Miha Lučovnik
- Department of Perinatology, Division of Obstetrics and Gynecology, University Medical Centre Ljubljana, Slajmerjeva 4, 1000 Ljubljana, Slovenia.
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Premru-Srsen T, Verdenik I, Steblovnik L, Ban-Frangez H. Early prediction of spontaneous twin very preterm birth: a population based study 2002-2012. J Matern Fetal Neonatal Med 2014; 28:1784-9. [PMID: 25245228 DOI: 10.3109/14767058.2014.968774] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The aim of this study was to establish early pregnancy risk indicators for spontaneous twin very preterm birth. METHODS We conducted a retrospective observational population-based study. Twenty-one potential early pregnancy risk factors were analyzed using multivariable logistic regression to determine which of them was independently associated with spontaneous twin very preterm birth. RESULTS Of 1815 spontaneous twin births 15.3% (277) occurred before 32 weeks. Previous preterm delivery (aOR 3.73; 95% CI, 2.52-5.52), nulliparity (aOR 2.94; 95% CI, 2.09-4.14), body mass index <18.5 (aOR 1.86; 95% CI, 1.12-3.10), body mass index ≥30 (aOR 1.87; 95% CI, 1.21-2.89), hysteroscopic metroplasty (aOR 1.63; 1.07-2.49), conization (aOR 2.05; 95% CI, 1.07-3.94) and monochorionicity (aOR 1.83; 95% CI, 1.28-2.63) were significantly associated with twin very preterm birth. CONCLUSIONS Pending verification in other populations, twin pregnancies at significant risk for spontaneous very preterm birth can be identified in early pregnancy using several risk indicators.
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Oblak C, Verdenik I, Swain MV, Kosmac T. Survival-rate analysis of surface treated dental zirconia (Y-TZP) ceramics. J Mater Sci Mater Med 2014; 25:2255-2264. [PMID: 24781534 DOI: 10.1007/s10856-014-5217-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2013] [Accepted: 04/11/2014] [Indexed: 06/03/2023]
Abstract
The role of surface preparation, hydrothermal ageing exposure and subsequent cyclic fatigue testing on the biaxial strength of a dental Y-TZP material are investigated. The initial strength and survival rate of a dental Y-TZP ceramic material to fatigue testing was found to be highly dependent upon surface preparation more so than exposure to various hydrothermal exposure conditions. The results suggest that the monoclinic phase generated by either surface damage (especially sandblasting) and to a lesser extent hydrothermal exposure does appear to mitigate strength and fatigue degradation. The results are discussed in terms of the size of defects generated following various surface treatments and the role of cyclic fatigue induced crack growth. A critical ratio is established between the monotonic strength and fatigue stress survival. From the specimens that failed and exhibited reduced strength after cycling a plot of averaged crack growth rate versus max cyclic stress intensity factor was established which closely matched existing results for Y-TZP ceramics.
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Affiliation(s)
- Cedomir Oblak
- Department of Prosthodontics, Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
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80
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Jerman KG, Kobal B, Jakimovska M, Verdenik I, Cerne K. Control values of ovarian cancer tumor markers and standardisation of a protocol for sampling peritoneal fluid and performing washing during laparoscopy. World J Surg Oncol 2014; 12:278. [PMID: 25185697 PMCID: PMC4167500 DOI: 10.1186/1477-7819-12-278] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Accepted: 08/16/2014] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Determination of the tumor marker concentration in peritoneal fluid (PF) may help to assess its potential to detect small concentration changes between benign ovarian pathology and early stage ovarian cancer. Peritoneal washing, which can also be obtained when PF is absent, is already included in the International Federation of Gynecology and Obstetrics (FIGO) staging classification for ovarian cancer but sampling has not yet been standardized. Since our aim was to evaluate the relationship between marker concentration in PF and washing, standardization of the sampling protocol was a prerequisite to ensure reliable results. METHODS Thirty-three women with non-malignant pathology of the reproductive organs were included in the study. We used three promising tumor markers for evaluation of the marker concentration in local fluid: osteopontin (sOPN), splice variant 6 of sCD44 (sCD44-v6) and vascular cell adhesion molecule-1 (sVCAM-1). After aspiration of PF, washing of the uterus, ovaries and pelvic peritoneum was performed with saline solution. Patients were divided into two groups based on the solution volume: A-20 ml and B-50 ml. To determine the efficiency of washing in relation to solution volume, washing was repeated three times. Concentrations of markers in samples were determined using flow cytometry. RESULTS Mean concentrations of markers were significantly higher (P <0.001) in PF than in the first washing. We demonstrated a significant positive correlation between marker concentrations in PF and first washing (sOPN: r = 0.447, P = 0.048; sCD44-v6: r = 0.660, P = 0.002; sVCAM-1: r = 0.526, P = 0.017). When using a smaller solution volume for washing, significantly higher (sVCAM-1: 2.5-fold, P = 0.021; sOPN: 3-fold, P = 0.024) or equal (sCD44-v6) mean concentrations of tumor markers were obtained. CONCLUSIONS Our work demonstrates for the first time that concentrations of sOPN, sCD44-v6 and sVCAM-1 in PF correlate with peritoneal washing in women with non-malignant pathology of the reproductive organs. This indicates that, for selected tumor markers, washing can replace PF when PF is absent. A standardized protocol for sampling PF and performing washing during laparoscopy was established.
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Affiliation(s)
- Katarina Galic Jerman
- />Department of Gynecology, Division of Gynecology and Obstetrics, University Medical Centre Ljubljana, Zaloška 2, 1000 Ljubljana, Slovenia
- />Department of Gynecology and Obstetrics, Faculty of Medicine, University Ljubljana, Slajmarjeva 3, 1000 Ljubljana, Slovenia
| | - Borut Kobal
- />Department of Gynecology, Division of Gynecology and Obstetrics, University Medical Centre Ljubljana, Zaloška 2, 1000 Ljubljana, Slovenia
- />Department of Gynecology and Obstetrics, Faculty of Medicine, University Ljubljana, Slajmarjeva 3, 1000 Ljubljana, Slovenia
| | - Marina Jakimovska
- />Department of Gynecology, Division of Gynecology and Obstetrics, University Medical Centre Ljubljana, Zaloška 2, 1000 Ljubljana, Slovenia
- />Department of Gynecology and Obstetrics, Faculty of Medicine, University Ljubljana, Slajmarjeva 3, 1000 Ljubljana, Slovenia
| | - Ivan Verdenik
- />Department of Gynecology, Division of Gynecology and Obstetrics, University Medical Centre Ljubljana, Zaloška 2, 1000 Ljubljana, Slovenia
- />Department of Gynecology and Obstetrics, Faculty of Medicine, University Ljubljana, Slajmarjeva 3, 1000 Ljubljana, Slovenia
| | - Katarina Cerne
- />Institute of Pharmacology and Experimental Toxicology, Faculty of Medicine, University Ljubljana, Korytkova 2, 1000 Ljubljana, Slovenia
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81
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Lucovnik M, Blickstein I, Verdenik I, Trojner-Bregar A, Tul N. Maternal obesity in singleton versus twin gestations: a population-based matched case–control study. J Matern Fetal Neonatal Med 2014; 28:623-5. [DOI: 10.3109/14767058.2014.928854] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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82
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Prelec A, Verdenik I, Poat A. A comparison of frequency of medical interventions and birth outcomes between the midwife led unit and the obstetric unit in low-risk primiparous women. Obzor Zdrav Neg 2014. [DOI: 10.14528/snr.2014.48.3.16] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introduction: The purpose of this national research was to compare birth, maternal and newborn outcomes in the midwife led unit and the obstetric unit to ascertain whether a midwife led unit reduced medicalisation of childbirth. Methods: A prospective observational case-control study was carried out in Ljubljana Maternity Hospital in the period May - August 2013. The sample comprised 497 labouring women; 154 who attended the midwife led and 343 who attended in the obstetric unit, both matching the same inclusion criteria: low risk primiparous; singleton term pregnancies, normal foetal heart beat, cephalic presentation; spontaneous onset of labour. The primary outcome was the caesarean section rate. Chi-square test was used to compare medical interventions and birth outcomes. Results: Women in the midwife led unit had statistically significant higher spontaneous vaginal births (p < 0.001), less augmentation with oxytocin (p < 0.001), less use of analgesia (p < 0.001), less operative vaginal deliveries (p < 0.001) and less caesarean sections (p < 0.001), lower rates of episiotomy (p < 0.001) and more exclusively breastfed (p = 0.002). Discussion and conclusion: These significant findings showed that in the midwife led unit fewer medical interventions were used. For generalisation of the findings more similar studies in Slovenia are needed.
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Ban Frangez H, Korosec S, Verdenik I, Kotar V, Kladnik U, Vrtacnik Bokal E. Preterm delivery risk factors in singletons born after in vitro fertilization procedures. Eur J Obstet Gynecol Reprod Biol 2014; 176:183-6. [DOI: 10.1016/j.ejogrb.2014.03.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2013] [Revised: 01/19/2014] [Accepted: 03/01/2014] [Indexed: 10/25/2022]
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Lucovnik M, Blickstein I, Verdenik I, Steblovnik L, Trojner Bregar A, Tul N. Impact of pre-gravid body mass index and body mass index change on preeclampsia and gestational diabetes in singleton and twin pregnancies. J Matern Fetal Neonatal Med 2014; 27:1901-4. [PMID: 24506066 DOI: 10.3109/14767058.2014.892069] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To examine pre-gravid body mass index (BMI) and gestational BMI change impact on preeclampsia and gestational diabetes mellitus (GDM). METHODS Retrospective population-based cohort study. Data from Slovenian National Perinatal Information System were analyzed for the period 2002-2011. Three singleton controls were matched by parity and maternal age to each twin pregnancy delivered at >36 weeks. Student's t test was used to compare pre-gravid BMI and gestational BMI change in different groups (p < 0.05 significant). RESULTS 2046 twin and 6138 singleton pregnancies were included. Twin and singleton patients with preeclampsia or GDM had higher pre-gravid BMI (p < 0.001). Gestational BMI change was smaller in twins with GDM (p < 0.001), and not associated with preeclampsia (p = 0.07). Smaller gestational BMI change in singleton pregnancies was associated with GDM (p < 0.001), and greater BMI change with preeclampsia (p = 0.004). CONCLUSIONS Pre-gravid BMI is more strongly associated with preeclampsia and GDM in twin and singleton pregnancies than gestational BMI change. Smaller gestational BMI change in GDM pregnancies reflect the importance of dietary counseling.
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Affiliation(s)
- Miha Lucovnik
- Department of Perinatology, Division of Obstetrics and Gynecology, University Medical Centre Ljubljana , Slovenia
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85
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Tul N, Lucovnik M, Verdenik I, Druskovic M, Novak Z, Blickstein I. The contribution of twins conceived by assisted reproduction technology to the very preterm birth rate: a population-based study. Eur J Obstet Gynecol Reprod Biol 2013; 171:311-3. [DOI: 10.1016/j.ejogrb.2013.09.040] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2013] [Revised: 09/28/2013] [Accepted: 09/30/2013] [Indexed: 11/25/2022]
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Slabe N, Meden-Vrtovec H, Verdenik I, Kosir-Pogacnik R, Ihan A. Cytotoxic T-Cells in Peripheral Blood in Women with Endometriosis. Geburtshilfe Frauenheilkd 2013; 73:1042-1048. [PMID: 24771894 DOI: 10.1055/s-0033-1350702] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2013] [Revised: 06/03/2013] [Accepted: 06/17/2013] [Indexed: 01/29/2023] Open
Abstract
Aim: The etiology of endometriosis remains unknown, but increasing evidence suggests that immune regulation may be important. Our study aimed to evaluate peripheral blood lymphocyte subpopulations during the menstrual cycle in women with peritoneal and ovarian endometriosis relative to healthy women. Methods: In this study, 65 women with endometriosis (37 in the follicular phase and 28 in the luteal phase of the menstrual cycle) and 61 healthy women (33 in the follicular phase and 28 in the luteal phase) were enrolled. Flow cytometric analysis measured peripheral blood lymphocyte subpopulations. The serum levels of cortisol were also determined. Results: In healthy controls, we detected an increased concentration of cytotoxic (CD8+) T cells and activated (HLA-DR) T cells in the luteal phase compared with the follicular phase of the menstrual cycle (p = 0.020 and p = 0.045), whereas no such fluctuation was detected in endometriosis. However, a marked increase in regulatory T-cell concentration in the luteal phase was detected only in endometriosis patients (p = 0.005). Women with endometriosis had higher levels of serum cortisol (p = 0.022), which correlated with the concentration of regulatory T cells (p = 0.048). Conclusions: Women with endometriosis do not exhibit fluctuations in the concentrations of cytotoxic and activated peripheral blood lymphocytes during the menstrual cycle. The marked fluctuation of regulatory T cells detected in endometriosis could be attributed to altered immune response.
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Affiliation(s)
- N Slabe
- Obstetrics and Gynecology, University Clinical Centre Ljubljana, Ljubljana, Slovenia
| | - H Meden-Vrtovec
- Obstetrics and Gynecology, University Clinical Centre Ljubljana, Ljubljana, Slovenia
| | - I Verdenik
- Obstetrics and Gynecology, University Clinical Centre Ljubljana, Ljubljana, Slovenia
| | - R Kosir-Pogacnik
- Obstetrics and Gynecology, University Clinical Centre Ljubljana, Ljubljana, Slovenia
| | - A Ihan
- Institute of Microbiology and Immunology, Faculty of Medicine, Ljubljana, Slovenia
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Gandhi G, Allahbadia G, Kagalwala S, Allahbadia A, Ramesh S, Patel K, Hinduja R, Chipkar V, Madne M, Ramani R, Joo JK, Jeung JE, Go KR, Lee KS, Goto H, Hashimoto S, Amo A, Yamochi T, Iwata H, Morimoto Y, Koifman M, Lahav-Baratz S, Blais E, Megnazi-Wiener Z, Ishai D, Auslender R, Dirnfeld M, Zaletova V, Zakharova E, Krivokharchenko I, Zaletov S, Zhu L, Li Y, Zhang H, Ai J, Jin L, Zhang X, Rajan N, Kovacs A, Foley C, Flanagan J, O'Callaghan J, Waterstone J, Dineen T, Dahdouh EM, St-Michel P, Granger L, Carranza-Mamane B, Faruqi F, Kattygnarath TV, Gomes FLAF, Christoforidis N, Ioakimidou C, Papas C, Moisidou M, Chatziparasidou A, Klaver M, Tilleman K, De Sutter P, Lammers J, Freour T, Splingart C, Barriere P, Ikeno T, Nakajyo Y, Sato Y, Hirata K, Kyoya T, Kyono K, Campos FB, Meseguer M, Nogales M, Martinez E, Ariza M, Agudo D, Rodrigo L, Garcia-Velasco JA, Lopes AS, Frederickx V, Vankerkhoven G, Serneels A, Roziers P, Puttermans P, Campo R, Gordts S, Fragouli E, Alfarawati S, Spath K, Wells D, Liss J, Lukaszuk K, Glowacka J, Bruszczynska A, Gallego SC, Lopez LO, Vila EO, Garcia MG, Canas CL, Segovia AG, Ponce AG, Calonge RN, Peregrin PC, Hashimoto S, Amo A, Ito K, Nakaoka Y, Morimoto Y, Alcoba DD, Valerio EG, Conzatti M, Tornquist J, Kussler AP, Pimentel AM, Corleta HE, Brum IS, Boyer P, Montjean D, Tourame P, Gervoise-Boyer M, Cohen J, Lefevre B, Radio CI, Wolf JP, Ziyyat A, De Croo I, Tolpe A, Degheselle S, Van de Velde A, Tilleman K, De Sutter P, Van den Abbeel E, Kagalwala S, Gandhi G, Allahbadia G, Kuwayama M, Allahbadia A, Chipkar V, Khatoon A, Ramani R, Madne M, Alsule S, Inaba M, Ohgaki A, Ohtani A, Matsumoto H, Mizuno S, Mori R, Fukuda A, Morimoto Y, Umekawa Y, Yoshida A, Tanigiwa S, Seida K, Suzuki H, Tanaka M, Vahabi Z, Yazdi PE, Dalman A, Ebrahimi B, Mostafaei F, Niknam MR, Watanabe S, Kamihata M, Tanaka T, Matsunaga R, Yamanaka N, Kani C, Ishikawa T, Wada T, Morita H, Miyamura H, Nishio E, Ito M, Kuwahata A, Ochi M, Horiuchi T, Dal Canto M, Guglielmo MC, Fadini R, Renzini MM, Albertini DF, Novara P, Lain M, Brambillasca F, Turchi D, Sottocornola M, Coticchio G, Kato M, Fukunaga N, Nagai R, Kitasaka H, Yoshimura T, Tamura F, Hasegawa N, Nakayama K, Takeuchi M, Ohno H, Aoyagi N, Kojima E, Itoi F, Hashiba Y, Asada Y, Kikuchi H, Iwasa Y, Kamono T, Suzuki A, Yamada K, Kanno H, Sasaki K, Murakawa H, Matsubara M, Yoshida H, Valdespin C, Elhelaly M, Chen P, Pangestu M, Catt S, Hojnik N, Kovacic B, Roglic P, Taborin M, Zafosnik M, Knez J, Vlaisavljevic V, Mori C, Yabuuchi A, Ezoe K, Takayama Y, Aono F, Kato K, Radwan P, Krasinski R, Chorobik K, Radwan M, Stoppa M, Maggiulli R, Capalbo A, Ievoli E, Dovere L, Scarica C, Albricci L, Romano S, Sanges F, Barnocchi N, Papini L, Vivarelli A, Ubaldi FM, Rienzi L, Rienzi L, Bono S, Capalbo A, Spizzichino L, Rubio C, Ubaldi FM, Fiorentino F, Ferris J, Favetta LA, MacLusky N, King WA, Madani T, Jahangiri N, Aflatoonian R, Cater E, Hulme D, Berrisford K, Jenner L, Campbell A, Fishel S, Zhang XY, Yilmaz A, Hananel H, Ao A, Vutyavanich T, Piromlertamorn W, Saenganan U, Samchimchom S, Wirleitner B, Lejeune B, Zech NH, Vanderzwalmen P, Albani E, Parini V, Smeraldi A, Menduni F, Antonacci R, Marras A, Levi S, Morreale G, Pisano B, Di Biase A, Di Rosa A, Setti PEL, Puard V, Cadoret V, Tranchant T, Gauthier C, Reiter E, Guerif F, Royere D, Yoon SY, Eum JH, Park EA, Kim TY, Yoon TK, Lee DR, Lee WS, Cabal AC, Vallejo B, Campos P, Sanchez E, Serrano J, Remohi J, Nagornyy V, Mazur P, Mykytenko D, Semeniuk L, Zukin V, Guilherme P, Madaschi C, Bonetti TCS, Fassolas G, Izzo CR, Santos MJDL, Beltran D, Garcia-Laez V, Escriba MJ, Grau N, Escrich L, Albert C, Zuzuarregui JL, Pellicer A, LU Y, Nikiforaki D, Meerschaut FV, Neupane J, De Vos WH, Lierman S, Deroo T, Heindryckx B, De Sutter P, Li J, Chen XY, Lin G, Huang GN, Sun ZY, Zhong Y, Zhang B, Li T, Zhang SP, Ye H, Han SB, Liu SY, Zhou J, Lu GX, Zhuang GL, Muela L, Roldan M, Gadea B, Martinez M, Perez I, Meseguer M, Munoz M, Castello C, Asensio M, Fernandez P, Farreras A, Rovira S, Capdevila JM, Velilla E, Lopez-Teijon M, Kovacs P, Matyas SZ, Forgacs V, Reichart A, Rarosi F, Bernard A, Torok A, Kaali SG, Sajgo A, Pribenszky CS, Sozen B, Ozturk S, Yaba-Ucar A, Demir N, Gelo N, Stanic P, Hlavati V, ogoric S, Pavicic-Baldani D, prem-Goldtajn M, Radakovic B, Kasum M, Strelec M, Canic T, imunic V, Vrcic H, Ajina M, Negra D, Ben-Ali H, Jallad S, Zidi I, Meddeb S, Bibi M, Khairi H, Saad A, Escrich L, Grau N, Meseguer M, Gamiz P, Viloria T, Escriba MJ, Lima ET, Fernandez MP, Prieto JAA, Varela MO, Kassa D, Munoz EM, Morita H, Watanabe S, Kamihata M, Matsunaga R, Wada T, Kani K, Ishikawa T, Miyamura H, Ito M, Kuwahata A, Ochi M, Horiuchi T, Nor-Ashikin MNK, Norhazlin JMY, Norita S, Wan-Hafizah WJ, Mohd-Fazirul M, Razif D, Hoh BP, Dale S, Cater E, Woodhead G, Jenner L, Fishel S, Andronikou S, Francis G, Tailor S, Vourliotis M, Almeida PA, Krivega M, Van de Velde H, Lee RK, Hwu YM, Lu CH, Li SH, Vaiarelli A, Antonacci R, Smeraldi A, Desgro M, Albani E, Baggiani A, Zannoni E, Setti PEL, Kermavner LB, Klun IV, Pinter B, Vrtacnik-Bokal E, De Paepe C, Cauffman G, Verheyen G, Stoop D, Liebaers I, Van de Velde H, Stecher A, Wirleitner B, Vanderzwalmen P, Zintz M, Neyer A, Bach M, Baramsai B, Schwerda D, Zech NH, Wiener-Megnazi Z, Fridman M, Koifman M, Lahav-Baratz S, Blais I, Auslender R, Dirnfeld M, Akerud H, Lindgren K, Karehed K, Wanggren K, Hreinsson J, Rovira S, Capdevila JM, Freijomil B, Castello C, Farreras A, Fernandez P, Asensio M, Lopez-Teijon M, Velilla E, Weiss A, Neril R, Geslevich J, Beck-Fruchter R, Lavee M, Golan J, Ermoshkin A, Shalev E, Shi W, Zhang S, Zhao W, Xue XIA, Wang MIN, Bai H, Shi J, Smith HL, Shaw L, Kimber S, Brison D, Boumela I, Assou S, Haouzi D, Ahmed OA, Dechaud H, Hamamah S, Dasiman R, Nor-Shahida AR, Wan-Hafizah WJ, Norhazlin JMY, Mohd-Fazirul M, Salina O, Gabriele RAF, Nor-Ashikin MNK, Ben-Yosef D, Shwartz T, Cohen T, Carmon A, Raz NM, Malcov M, Frumkin T, Almog B, Vagman I, Kapustiansky R, Reches A, Azem F, Amit A, Cetinkaya M, Pirkevi C, Yelke H, Kumtepe Y, Atayurt Z, Kahraman S, Risco R, Hebles M, Saa AM, Vilches-Ferron MA, Sanchez-Martin P, Lucena E, Lucena M, Heras MDL, Agirregoikoa JA, Martinez E, Barrenetxea G, De Pablo JL, Lehner A, Pribenszky C, Murber A, Rigo J, Urbancsek J, Fancsovits P, Bano DG, Sanchez-Leon A, Marcos J, Molla M, Amorocho B, Nicolas M, Fernandez L, Landeras J, Adeniyi OA, Ehbish SM, Brison DR, Egashira A, Murakami M, Nagafuchi E, Tanaka K, Tomohara A, Mine C, Otsubo H, Nakashima A, Otsuka M, Yoshioka N, Kuramoto T, Choi D, Yang H, Park JH, Jung JH, Hwang HG, Lee JH, Lee JE, Kang AS, Yoo JH, Kwon HC, Lee SJ, Bang S, Shin H, Lim HJ, Min SH, Yeon JY, Koo DB, Kuwayama M, Higo S, Ruvalcaba L, Kobayashi M, Takeuchi T, Yoshida A, Miwa A, Nagai Y, Momma Y, Takahashi K, Chuko M, Nagai A, Otsuki J, Kim SG, Lee JH, Kim YY, Kim HJ, Park IH, Sun HG, Lee KH, Song HJ, Costa-Borges N, Belles M, Herreros J, Teruel J, Ballesteros A, Pellicer A, Calderon G, Nikiforaki D, Vossaert L, Meerschaut FV, Qian C, Lu Y, Parys JB, De Vos WH, Deforce D, Deroo T, Van den Abbeel E, Leybaert L, Heindryckx B, De Sutter P, Surlan L, Otasevic V, Velickovic K, Golic I, Vucetic M, Stankovic V, Stojnic J, Radunovic N, Tulic I, Korac B, Korac A, Fancsovits P, Pribenszky C, Lehner A, Murber A, Rigo J, Urbancsek J, Elias R, Neri QV, Fields T, Schlegel PN, Rosenwaks Z, Palermo GD, Gilson A, Piront N, Heens B, Vastersaegher C, Vansteenbrugge A, Pauwels PCP, Abdel-Raheem MF, Abdel-Rahman MY, Abdel-Gaffar HM, Sabry M, Kasem H, Rasheed SM, Amin M, Abdelmonem A, Ait-Allah AS, VerMilyea M, Anthony J, Bucci J, Croly S, Coutifaris C, Maggiulli R, Rienzi L, Cimadomo D, Capalbo A, Dusi L, Colamaria S, Baroni E, Giuliani M, Vaiarelli A, Sapienza F, Buffo L, Ubaldi FM, Zivi E, Aizenman E, Barash D, Gibson D, Shufaro Y, Perez M, Aguilar J, Taboas E, Ojeda M, Suarez L, Munoz E, Casciani V, Minasi MG, Scarselli F, Terribile M, Zavaglia D, Colasante A, Franco G, Greco E, Hickman C, Cook C, Gwinnett D, Trew G, Carby A, Lavery S, Asgari L, Paouneskou D, Jayaprakasan K, Maalouf W, Campbell BK, Aguilar J, Taboas E, Perez M, Munoz E, Ojeda M, Remohi J, Rega E, Alteri A, Cotarelo RP, Rubino P, Colicchia A, Giannini P, Devjak R, Papler TB, Tacer KF, Verdenik I, Scarica C, Ubaldi FM, Stoppa M, Maggiulli R, Capalbo A, Ievoli E, Dovere L, Albricci L, Romano S, Sanges F, Vaiarelli A, Iussig B, Gala A, Ferrieres A, Assou S, Vincens C, Bringer-Deutsch S, Brunet C, Hamamah S, Conaghan J, Tan L, Gvakharia M, Ivani K, Chen A, Pera RR, Bowman N, Montgomery S, Best L, Campbell A, Duffy S, Fishel S, Hirata R, Aoi Y, Habara T, Hayashi N, Dinopoulou V, Partsinevelos GA, Bletsa R, Mavrogianni D, Anagnostou E, Stefanidis K, Drakakis P, Loutradis D, Hernandez J, Leon CL, Puopolo M, Palumbo A, Atig F, Kerkeni A, Saad A, Ajina M, D'Ommar G, Herrera AK, Lozano L, Majerfeld M, Ye Z, Zaninovic N, Clarke R, Bodine R, Rosenwaks Z, Mazur P, Nagorny V, Mykytenko D, Semeniuk L, Zukin V, Zabala A, Pessino T, Outeda S, Blanco L, Leocata F, Asch R, Wan-Hafizah WJ, Rajikin MH, Nuraliza AS, Mohd-Fazirul M, Norhazlin JMY, Razif D, Nor-Ashikin MNK, Machac S, Hubinka V, Larman M, Koudelka M, Budak TP, Membrado OO, Martinez ES, Wilson P, McClure A, Nargund G, Raso D, Insua MF, Lotti B, Giordana S, Baldi C, Barattini J, Cogorno M, Peri NF, Neuspiller F, Resta S, Filannino A, Maggi E, Cafueri G, Ferraretti AP, Magli MC, Gianaroli L, Sioga A, Oikonomou Z, Chatzimeletiou K, Oikonomou L, Kolibianakis E, Tarlatzis BC, Sarkar MR, Ray D, Bhattacharya J, Alises JM, Gumbao D, Sanchez-Leon A, Amorocho B, Molla M, Nicolas M, Fernandez L, Landeras J, Duffy S, Campbell A, Montgomery S, Hickman CFL, Fishel S, Fiorentino I, Gualtieri R, Barbato V, Braun S, Mollo V, Netti P, Talevi R, Bayram A, Findikli N, Serdarogullari M, Sahin O, Ulug U, Tosun SB, Bahceci M, Leon AS, Gumbao D, Marcos J, Molla M, Amorocho B, Nicolas M, Fernandez L, Landeras J, Cardoso MCA, Aguiar APS, Sartorio C, Evangelista A, Gallo-Sa P, Erthal-Martins MC, Mantikou E, Jonker MJ, de Jong M, Wong KM, van Montfoort APA, Breit TM, Repping S, Mastenbroek S, Power E, Montgomery S, Duffy S, Jordan K, Campbell A, Fishel S, Findikli N, Aksoy T, Gultomruk M, Aktan A, Goktas C, Ulug U, Bahceci M, Petracco R, Okada L, Azambuja R, Badalotti F, Michelon J, Reig V, Kvitko D, Tagliani-Ribeiro A, Badalotti M, Petracco A, Pirkevi C, Cetinkaya M, Yelke H, Kumtepe Y, Atayurt Z, Kahraman S, Aydin B, Cepni I, Serdarogullari M, Findikli N, Bayram A, Goktas C, Sahin O, Ulug U, Bahceci M, Rodriguez-Arnedo D, Ten J, Guerrero J, Ochando I, Perez M, Bernabeu R, Okada L, Petracco R, Azambuja R, Badalotti F, Michelon J, Reig V, Tagliani-Ribeiro A, Kvitko D, Badalotti M, Petracco A, Reig V, Kvitko D, Tagliani-Ribeiro A, Okada L, Azambuja R, Petracco R, Michelon J, Badalotti F, Petracco A, Badalotti M. Embryology. Hum Reprod 2013. [DOI: 10.1093/humrep/det210] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Lucovnik M, Tul N, Verdenik I, Antolic ZN, Blickstein I. 139: Perinatal outcomes in singleton and twin pregnancies following first-trimester bleeding. Am J Obstet Gynecol 2013. [DOI: 10.1016/j.ajog.2012.10.304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
OBJECTIVE To examine the population-based trend for cesarean births in twin pregnancies for the last 13 years in Slovenia, and to find correlates for this trend. METHODS We evaluated data from the Slovenian national perinatal information system (NPIS) of all twin pairs born at ≥24 weeks during the period 1997-2009 (n=3916 pairs). RESULTS We noted a significant and steady increase of about 1.1% cesarean births/year, concomitant with significant increased birth rates at 34-36 weeks, but with a significant decrease over time in neonatal mortality. These trends were neither associated with any particular maternal characteristic nor with increased neonatal morbidity. CONCLUSIONS An association exists between an increased cesarean birth rate, increased preterm births at 33-36 weeks and concomitant significantly reduced neonatal mortality in twins.
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Affiliation(s)
- Nataša Tul
- Department of Perinatology, Division of Obstetrics and Gynecology, University Medical Centre Ljubljana, Slovenia
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Meden-Vrtovec H, Slabe N, Pogacnik RK, Verdenik I. 136 NEUROVEGETATIVE AND SEXUAL SYMPTOMS IN PERIMENOPAUSAL WOMEN IN SLOVENIA. Maturitas 2012. [DOI: 10.1016/s0378-5122(12)70247-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Lučovnik M, Tul N, Verdenik I, Novak Z, Blickstein I. Risk factors for preeclampsia in twin pregnancies: a population-based matched case-control study. J Perinat Med 2012; 40:379-82. [PMID: 22752768 DOI: 10.1515/jpm-2011-0252] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2011] [Accepted: 01/25/2012] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To evaluate associated factors for preeclampsia in twin gestations and to compare incidences of pregnancy complications among twin pregnancies with vs. without preeclampsia. PATIENTS AND METHODS We performed a case-control study using a population dataset of twin pregnancies delivered after 24 weeks of gestation, in Slovenia, between 1997 and 2009. Cases were twin gestations complicated by preeclampsia and controls were cases matched by gestational age, parity, and chorionicity. RESULTS We identified 181 cases (4.7%) of preeclampsia among 3885 twins and 542 matched controls. High pre-pregnancy body mass index (BMI) and gestational diabetes were significantly associated with preeclampsia [odds ratio (OR) 1.8, 95% CI 1.26, 2.77 for overweight (BMI 25.0-29.9); OR 4.72, 95% CI 2.83, 7.89 for obese (BMI≥30), and OR 2.19, 95% CI 1.03, 4.68 for gestational diabetes]. The association was not significant for preexisting hypertension, maternal age, smoking, and pregnancy following assisted reproduction. Placental complications (previa, abruption, or adherent placenta) were more common, and low birth weight less common in the preeclampsia group (P=0.03 and P=0.01, respectively). CONCLUSIONS High pre-pregnancy BMI carries an especially high risk for the development of preeclampsia and its complications in twin gestation.
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Affiliation(s)
- Miha Lučovnik
- Division of Obstetrics and Gynecology, Department of Perinatology, University Medical Centre Ljubljana, Slovenia
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Gergolet M, Campo R, Verdenik I, Kenda Suster N, Gordts S, Gianaroli L. No clinical relevance of the height of fundal indentation in subseptate or arcuate uterus: a prospective study. Reprod Biomed Online 2012; 24:576-82. [PMID: 22417666 DOI: 10.1016/j.rbmo.2012.01.025] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2011] [Revised: 01/23/2012] [Accepted: 01/24/2012] [Indexed: 01/12/2023]
Abstract
The American Fertility Society has classified the arcuate uterus as a minor malformation with a benign clinical behaviour. The aim of this prospective study was to verify whether there is any scientific basis for this differentiation. Patients with at least one early miscarriage and a subseptate or arcuate uterus were admitted for hysteroscopic metroplasty. Patients were allocated to a subseptate uterus group, with an indentation of 1.5 cm or more, or an arcuate uterus group, with a smaller indentation. The miscarriage rates after metroplasty were similar between the two groups (14.0% in the subseptate uterus group versus 11.1% in the arcuate uterus group). Before metroplasty, the miscarriage rates were significantly higher in subseptate uterus group, as well as in the arcuate uterus group (both P<0.001). According to these results, there is no evidence to support that the arcuate uterus has a different effect on the reproductive outcome in comparison to the subseptate uterus, neither before nor after surgical correction of the anomaly. Since there is no scientific basis for a separate classification of the arcuate uterus, a review of the classifications of uterine congenital anomalies should be considered as necessary. Congenital uterine malformations have been classified by the American Fertility Society (AFS) since 1988. Although the AFS classification received wide acceptance and is still the most broadly used system, it is associated with various limitations in effective categorization of the anomalies. It is interesting that, until now, none of the other available options have been able to effectively replace the AFS system. Numerous papers indicate septate or subseptate (partial septate) uterus (AFS class V) is a possible cause of an unfavourable pregnancy outcome. Arcuate uterus (AFS class VI), a slight malformation similar to septate uterus, should differ from septate or subseptate uterus, because this 'minor' malformation should behave benignly with respect to the septate uterus. The aim of this study was to scientifically validate the difference between the arcuate and subseptate uterus in their effect on reproductive outcome through the results of a metroplasty in both groups of patients. A group of 96 patients, who underwent metroplasty after at least one early miscarriage, was divided into two groups according to the severity of the congenital uterine malformation. Our results indicate that there are no differences in pregnancy outcome after metroplasty either in patients with septate or arcuate utera. The poor pregnancy outcome in women with septate uterus seems not to be correlated to the dimension of the septum itself. There are no scientific bases for a separate classification of the arcuate uterus and it is proposed that a review of the classification of uterine congenital anomalies is necessary.
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Affiliation(s)
- Marco Gergolet
- S.I.F.E.S. d.o.o., Reproductive Surgery, Sedejeva 6, 5000 Nova Gorica, Slovenia.
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Tul N, Lučovnik M, Novak Ž, Verdenik I, Blickstein I. No "masculinization" effect of a male on birth weight of its female co-twin. J Perinat Med 2012; 40:255-7. [PMID: 22505503 DOI: 10.1515/jpm-2011-0233] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2011] [Accepted: 12/14/2011] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To test the hypothesis that the presence of a male affects birth weight of its female co-twin. PATIENTS AND METHODS We evaluated a large population dataset of bichorionic twins after exclusion of potential confounders and after controlling for parity and gestational age. We tested the hypotheses that males (M) are heavier than females (F) irrespective of gender mix, parity and gestational age, and the hypothesis that birth weight of twins might be influenced by the gender of the co-twin. RESULTS There were 819 MM pairs, 777 FF pairs and 1097 MF sets, for a total of 2735 males and 2651 female twins. Male twins were heavier than female twins, irrespective of parity or gestational age; twins born to multiparas were heavier than twins born to nulliparas, except for very preterm births (≤32 weeks); males from MF pairs were heavier than males from MM pairs, but the mean birth weight of females from MF was not different from that of females from FF sets suggesting no "masculinization" effect of the male on birth weight of its female co-twin, irrespective of parity and gestational age. CONCLUSIONS After exclusion of potential confounders and controlling for chorionicity, parity, and gestational age, our data do not support the presence of a "masculinization" effect on birth weight.
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Affiliation(s)
- Nataša Tul
- Division of Obstetrics and Gynecology, Department of Perinatology, University Medical Centre Ljubljana, Ljubljana, Slovenia
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Abstract
OBJECTIVE To calculate a population-based prospective risk of fetal death in monochorionic-diamniotic twins. STUDY DESIGN We evaluated 387 monochorionic-diamniotic twin pregnancies that were followed and delivered after 24 weeks in Slovenia during the period 1997-2007. Surveillance was not standardized. The prospective risk of fetal death was calculated as the total number of deaths after the beginning of the gestational period divided by the number of continuing pregnancies at or beyond that period. RESULTS Fetal death rate was 32 of 774 fetuses (4.1%; 95% confidence interval (CI), 3.0%-5.9%); the prospective risk of stillbirth per pregnancy after 33 weeks of gestation was 6.2% (95% CI, 4.2%-9.1%). CONCLUSION The Slovenian population-based prospective risk of fetal death in monochorionic-diamniotic pregnancies that remained undelivered after 33 weeks' gestation is higher than previously reported from hospital-based studies.
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Affiliation(s)
- Nataša Tul
- Division of Obstetrics and Gynecology, Department of Perinatology, University Medical Centre Ljubljana, Slovenia
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Gergolet M, Gianaroli L, Šuster NK, Verdenik I, Magli MC, Gordts S. Possible role of endometriosis in the aetiology of spontaneous miscarriage in patients with septate uterus. Reprod Biomed Online 2010; 21:581-5. [DOI: 10.1016/j.rbmo.2010.05.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2009] [Revised: 05/26/2010] [Accepted: 05/28/2010] [Indexed: 10/19/2022]
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Franić D, Verdenik I, Meden-Vrtovec H. Effect of counseling on adherence to perimenopausal hormone therapy in Slovenia. Int J Gynaecol Obstet 2010; 111:260-3. [PMID: 20870230 DOI: 10.1016/j.ijgo.2010.07.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2010] [Revised: 07/13/2010] [Accepted: 08/17/2010] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To evaluate the effect of counseling on women's adherence to hormone therapy (HT) in Slovenia following the publication of the results of the Women's Health Initiative prospective study. METHOD In this 24-month prospective, randomized, controlled study with 125 women in early menopause, those in the study group (n=64) attended oral presentations on menopause and HT whereas those in the control group (n=63) did not. Data were collected from 2 questionnaires, one completed before starting HT and the other during follow-up visits after 3, 6, 12, and 24 months. The results were analyzed according to the intention-to-treat principle. RESULTS In the second year, an improved quality of life and friends critical of HT negatively affected adherence to HT. After 24 months, 47% of the participants in the study group and 32% in the control group were still using HT. The difference between the 2 groups in the rates of participants who discontinued HT was the same in the first than and in the last 12 months of the study (49 [76.6%] vs 15 [23.4%]). CONCLUSION Since there were no changes in discontinuation rates between the groups from one study period to the other, and a total of 15 women in each group stopped using HT in the second year of the study, the effect of the educational presentations on HT adherence was long-term rather than temporary.
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Affiliation(s)
- Damir Franić
- Outpatient Clinic of Obstetrics and Gynecology, Celjska 10, 3250 Rogaska Slatina, Slovenia.
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Jiang Y, Zhao J, Hua M, Zhen X, Yan G, Hu Y, Sun H, Selvaggi L, Zannoni GF, Tagliaferri V, De Cicco S, Vellone VG, Romualdi D, Lanzone A, Guido M, Fassbender A, Vodolazkaia AV, Bossuyt XB, Kyama MK, Meuleman CM, Peeraer KP, Tomassetti CT, D'Hooghe TM, Lumini A, Nanni L, Manna C, Pappalardo S, Melin A, Lundholm C, Malki N, Swahn ML, Sparen P, Bergqvist A, Manna C, Crescenzi F, Farrag A, Sallam HN, Zou L, Ding G, Zhang R, Sheng J, Huang H, von Kleinsorgen C, Wilson T, Thiel-Moder U, Ebert AD, Reinfandt M, Papadopolous T, Melo AS, Rodrigues JK, Dib LA, Andrade AZ, Donabela FC, Ferriani RA, Navarro PA, Tocci A, Royo P, Lucchini C, Ramos P, Alcazar JL, Habara T, Terada S, Yoshioka N, Hayashi N, Haouzi D, Assou S, Monzo C, Anahory T, Dechaud H, De Vos J, Hamamah S, Gonzalez-Ramos R, Rojas C, Rocco J, Poch A, Sovino H, Kohen P, Munoz A, Devoto L, Aygen MA, Atakul T, Oner G, Ozgun MT, Sahin Y, Ozturk F, Li R, Qiao J, Zhylkova I, Feskov A, Feskova I, Somova O, Chumakova N, Bontekoe S, Blake D, Heineman MJ, Williams EC, Johnson NP, Motta A, Colaci D, Horton M, Faut M, Bisioli C, Kopcow L, de Zuniga I, Wiener-Megnazi Z, Khaytov M, Lahav - Baratz S, Shiloh H, Koifman M, Oslander R, Dirnfeld M, Sundqvist J, Andersson KL, Scarselli G, Gemzell-Danielsson K, Lalitkumar PGL, Tokushige N, Markham R, Crossett B, Ahn S, Nelaturi V, Khan A, Fraser IS, Van Vaerenbergh I, Fatemi HM, Blockeel C, Van Lommel L, In't Veld P, Schuit F, Kolibianakis EM, Devroey P, Bourgain C, Sugino N, Tamura I, Lee R, Maekawa R, Gelbaya T, Gordts S, D'Hooghe TN, Gergolet M, Nardo LG, Yu H, Wang H, Huang H, Lee C, Soong Y, Kremenska Y, Masliy Y, Goncharova Y, Kremenskoy M, Veselovskyy V, Zukin V, Sudoma I, Delgado-Rosas F, Gomez R, Tamarit S, Abad A, Simon C, Pellicer A, Racicot M, Dean NL, Antaki R, Menard S, Kadoch IJ, Garcia-Guzman R, Cabrera Romero L, Hernandez J, Palumbo A, Marshall E, Lowry J, Maybin JA, Collins F, Critchley HOD, Saunders PTK, Chaudhury K, Jana SK, Banerjee P, Mukherjee S, Chakravarty BN, Allegra A, Marino A, Lama A, Santoro A, Agueli C, Mazzola S, Volpes A, Delvoux B, de Graaff AA, D'Hooghe TM, Kyama CM, Dunselman GAJ, Romano A, Caccavo D, Pellegrino NM, Totaro I, Panzarino M, Nardelli C, Depalo R, Flores R, Montanana V, Monzo A, Polo P, Garcia-Gimeno T, Cabo A, Rubio JM, Pellicer A, de Graaff AA, Dunselman GAJ, Beets GL, van Lankveld JJ, Kim HY, Lee BS, Cho SH, Choi YS, Seo SK, Lee KE, Yang HI, Abubakirov A, Vacheyshvili T, Krechetova L, Ziganshina M, Demura T, Nazarenko T, Fulop I, Rucz A, Herczegh SZ, Ujvari A, Takacs SZ, Szakonyi T, Lopez - Muniz A, Zamora L, Serra O, Guix C, Lopez-Teijon M, Benadiva C, Alvarez JG, Goudakou M, Karkanaki A, Kalogeraki A, Mataliotakis I, Kalogiannidis I, Prapas I, Hosie M, Thomson KJ, Penny CB, Thomson KJ, Penny C, Hosie MJ, McKinnon B, Klaeser B, Bersinger N, Mueller MD, Horcajadas JA, Martinez-Conejero JA, Montesinos M, Morgan M, Fortuno S, Simon C, Pellicer A, Yi KW, Shin JH, Park HT, Kim T, Kim SH, Hur JY, Chan RWS, Chan YY, Ng EHY, Yeung WSB, Santulli P, Borghese B, Chopin N, Marcellin L, de Ziegler D, Chapron C, Elnashar A, Badawy A, Mosbah A, Tzioras S, Polyzos NP, Messini CI, Papanikolaou EG, Valachis A, Patavoukas E, Mauri D, Badawy A, Messinis IE, Acar N, Hirota Y, Tranguch S, Daikoku T, Burnum KE, Xie H, Kodama A, Osuga Y, Ustunel I, Friedman DB, Caprioli RM, Dey SK, Mitra A, Sahu R, Pal M, Bhattachrayya AK, Bhattachrya J, Ferrero S, Remorgida V, Rollandi GA, Biscaldi E, Cho S, Choi YS, Kim HY, Seo SK, Yang HI, Lee KE, Shin JH, Lee BS, Arena E, Morando A, Remorgida V, Ferrero S, Tomazevic T, Ban-Frangez H, Virant-Klun I, Verdenik I, Pozlep B, Vrtacnik-Bokal E, Valenzano Menada M, Biscaldi E, Remorgida V, Morotti M, Venturini PL, Rollandi GA, Ferrero S, Dimitriadis E, Salamonsen LA, Hannan N, O'Connor O, Rombauts L, Stoikos C, Mahmoudi M, Shaikh A, Mousavifar N, Rastin M, Baharara J, Tabasi N, Takemura Y, Fujimoto A, Osuga Y, Tsutsumi R, Ooi N, Yano T, Taketani Y, Karkanaki A, Goudakou M, Kalogiannidis I, Panagiotidis I, Prapas Y, Zhang D, Lv PP, Ding GL, Zhang RJ, Zou LB, Xu GF, Gao HJ, Zhu YM, Sheng JZ, Huang HF, Martinez-Conejero JA, Labarta E, Alama P, Pellicer A, Horcajadas JA, Bosch E. Posters * Endometriosis, Endometrium and Implantation. Hum Reprod 2010. [DOI: 10.1093/humrep/de.25.s1.242] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Ban-Frangež H, Tomaževič T, Virant-Klun I, Verdenik I, Ribič-Pucelj M, -Bokal EV. The outcome of singleton pregnancies after IVF/ICSI in women before and after hysteroscopic resection of a uterine septum compared to normal controls. Eur J Obstet Gynecol Reprod Biol 2009; 146:184-7. [DOI: 10.1016/j.ejogrb.2008.04.010] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2007] [Revised: 02/02/2008] [Accepted: 04/21/2008] [Indexed: 10/22/2022]
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Meglic L, Smrkolj S, Mozina A, Rakar S, Verdenik I. P1065 Cytology quality in year 2007 in Slovenian national cervical screening program. Int J Gynaecol Obstet 2009. [DOI: 10.1016/s0020-7292(09)62550-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Antolic B, Gersak K, Verdenik I, Novak-Antolic Z. Adverse effects of thyroid dysfunction on pregnancy and pregnancy outcome: Epidemiologic study in Slovenia. J Matern Fetal Neonatal Med 2009; 19:651-4. [PMID: 17118740 DOI: 10.1080/14767050600850332] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To evaluate the consequences of maternal thyroid dysfunction for pregnancy outcome. METHODS A retrospective analysis involving all pregnant women who delivered in Slovenia in the 1997-1999 triennium; those having a medical history of thyroid dysfunction and/or taking thyroid medications were allotted to the study group (n = 748) and the remaining ones to the control group (n = 52 253). RESULTS Significantly higher incidences of infertility (5.5% vs. 3.7%, p < 0.05), menstrual cycle irregularities (3.2% vs. 1.9%, p < 0.05), hypertensive disorders (7.0% vs. 4.2%, p < 0.05), threatened preterm delivery (9.1% vs. 5.6%, p < 0.001), and delivery before 32 weeks (2.7% vs. 1.5%, p < 0.05) were found in the study than in the control group. There were no significant differences in the incidences of miscarriage, non-gestational diabetes mellitus, proteinuria, hyperemesis, intrahepatic cholestasis of pregnancy, intrauterine growth restriction, placental abruption, preterm delivery, small for gestational age newborns (SGA), and stillbirths. CONCLUSIONS This is the first study to evaluate the incidence of thyroid dysfunction for the whole population of pregnant women in Slovenia using a retrospective analysis. Thyroid dysfunction adversely affects pregnancy and pregnancy outcome but to a lesser extent than presented in previous studies. An evaluation of thyroid function in the women who experience menstrual cycle irregularities, infertility, and complications during pregnancy, labor and delivery would be advisable.
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Affiliation(s)
- Bor Antolic
- Medical Faculty, University of Ljubljana, Slovenia.
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