1
|
Kozar N, Kovač V, Reljič M. Correction to: Can methods of artificial intelligence aid in optimizing patient selection in patients undergoing intrauterine inseminations? J Assist Reprod Genet 2021; 38:2503. [PMID: 34184180 PMCID: PMC8490544 DOI: 10.1007/s10815-021-02264-4] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Correction to this paper has been published: 10.1007/s10815-021-02264-4
Collapse
Affiliation(s)
- Nejc Kozar
- Department of Reproductive Medicine and Gynaecological Endocrinology, Clinic for Gynaecology and Perinatology, University Medical Centre Maribor, Ljubljanska 5, 2000, Maribor, Slovenia. .,Faculty of Medicine, University of Maribor, Taborska ulica 8, 2000, Maribor, Slovenia.
| | - Vilma Kovač
- Department of Reproductive Medicine and Gynaecological Endocrinology, Clinic for Gynaecology and Perinatology, University Medical Centre Maribor, Ljubljanska 5, 2000, Maribor, Slovenia.,Faculty of Medicine, University of Maribor, Taborska ulica 8, 2000, Maribor, Slovenia
| | - Milan Reljič
- Department of Reproductive Medicine and Gynaecological Endocrinology, Clinic for Gynaecology and Perinatology, University Medical Centre Maribor, Ljubljanska 5, 2000, Maribor, Slovenia.,Faculty of Medicine, University of Maribor, Taborska ulica 8, 2000, Maribor, Slovenia
| |
Collapse
|
2
|
Kozar N, Serdinšek T, Tašner T, Reljič M, Gavrić Lovrec V, Kovač V. Diagnosis and management of rudimentary horn pregnancy rupture, misinterpreted as bicornuate uterus in the 14th week of pregnancy. J Obstet Gynaecol Res 2020; 47:843-846. [PMID: 33271628 DOI: 10.1111/jog.14586] [Citation(s) in RCA: 1] [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] [Received: 07/12/2020] [Revised: 10/08/2020] [Accepted: 11/19/2020] [Indexed: 11/29/2022]
Abstract
We present a 26-year-old primigravida with rudimentary horn pregnancy rupture at 14 weeks of pregnancy. Uterine anomaly was first diagnosed at the time of nuchal translucency scan and was presumed to be a bicornuate uterus with normal intrauterine pregnancy in the right horn. One day later, she was admitted to our department with abdominal pain, shortly leading to massive hemoperitoneum and hypovolemic shock. Uterine rupture was confirmed ultrasonically, followed by immediate laparotomy. Ruptured rudimentary horn with already expulsed pregnancy was encountered during surgery. Despite significant advances in ultrasonography, diagnosis of prerupture stage remains controversial. However, high mortality of the condition should ensure low threshold for surgical exploration.
Collapse
Affiliation(s)
- Nejc Kozar
- Department of Reproductive Medicine and Gynaecologic Endocrinology, Clinic for Gynaecology and Perinatology, University Medical Centre Maribor, Maribor, Slovenia.,Faculty of Medicine, University of Maribor, Maribor, Slovenia
| | - Tamara Serdinšek
- Faculty of Medicine, University of Maribor, Maribor, Slovenia.,Department of General Gynaecology and Gyanecological Urology, Clinic for Gynaecology and Perinatology, University Medical Centre Maribor, Maribor, Slovenia
| | - Tanja Tašner
- Department of Reproductive Medicine and Gynaecologic Endocrinology, Clinic for Gynaecology and Perinatology, University Medical Centre Maribor, Maribor, Slovenia
| | - Milan Reljič
- Department of Reproductive Medicine and Gynaecologic Endocrinology, Clinic for Gynaecology and Perinatology, University Medical Centre Maribor, Maribor, Slovenia.,Faculty of Medicine, University of Maribor, Maribor, Slovenia
| | - Vida Gavrić Lovrec
- Department of Reproductive Medicine and Gynaecologic Endocrinology, Clinic for Gynaecology and Perinatology, University Medical Centre Maribor, Maribor, Slovenia.,Faculty of Medicine, University of Maribor, Maribor, Slovenia
| | - Vilma Kovač
- Department of Reproductive Medicine and Gynaecologic Endocrinology, Clinic for Gynaecology and Perinatology, University Medical Centre Maribor, Maribor, Slovenia.,Faculty of Medicine, University of Maribor, Maribor, Slovenia
| |
Collapse
|
3
|
Serdinšek T, Reljič M, Kovač V. Medical management of first trimester missed miscarriage: the efficacy and complication rate. J OBSTET GYNAECOL 2019; 39:647-651. [PMID: 30917727 DOI: 10.1080/01443615.2018.1535577] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 10/27/2022]
Abstract
Our aim of the study was to evaluate the efficacy and complication rate of our inpatient medical management protocol for missed miscarriages. Three-hundred and ninety women hospitalised at our tertiary centre because of a missed miscarriage/anembryonic pregnancy in 2012-2013 were included in this retrospective study. The women underwent either a low (until 9 + 0 weeks of gestation) or high gestational age (from 9 + 1 until 15 + 6 weeks of gestation) management protocol. The success rate, curettage in the first 48 hours after the procedure, the complication rate and the factors that might influence these outcomes were evaluated. The overall success rate was 83.3%. The curettage in the first 48 hours after the procedure was performed in 7.4% of the patients and was more often in the high gestational age protocol. Complications that required another outpatient visit or hospitalisation occurred in 9% of the patients. Higher beta-hCG values 14 days after the procedure and the absence of evacuation of products of conception during hospitalisation were associated with a higher complication rate. IMPACT STATEMENT What is already known on this subject? As much as 10-20% of clinically recognised pregnancies end in a spontaneous abortion. A missed miscarriage and a blighted ovum represent a form of spontaneous abortion, which has long been treated with surgical evacuation. However, nowadays, medical management represents a well-established alternative with very high success rates and is considered as an equivalent and safe method that is also very well accepted by patients. What do the results of this study add? According to our results, a medical management of a first trimester missed miscarriage and a blighted ovum is very effective with an overall success rate of 83.3% and a very low percentage of curettage in the first 48 hours after the procedure (7.4%). Our study was also able to identify higher beta-hCG values 14 days after procedure and absence of evacuation of products of conception during hospitalisation as risk factors for complication occurrence. What are the implications of these findings for clinical practice and/or further research? Our study helps to identify patients who are at greater risk for developing complications after the medical management of a first trimester missed miscarriage.
Collapse
Affiliation(s)
- Tamara Serdinšek
- a Clinic for Gynaecology and Perinatology , University Medical Centre Maribor , Maribor , Slovenia
| | - Milan Reljič
- b Department of Reproductive Medicine and Gynaecological Endocrinology, Clinic for Gynaecology and Perinatology , University Medical Centre Maribor , Maribor , Slovenia
| | - Vilma Kovač
- b Department of Reproductive Medicine and Gynaecological Endocrinology, Clinic for Gynaecology and Perinatology , University Medical Centre Maribor , Maribor , Slovenia
| |
Collapse
|
4
|
Kovač V, Reljič M, Bizjak T. Causes of Massive Vulvar Edema in Patients with Severe Ovarian Hyperstimulation Syndrome: A Case Report and Literature Review. Am J Case Rep 2019; 20:238-241. [PMID: 30796195 PMCID: PMC6396704 DOI: 10.12659/ajcr.913149] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Patient: Female, 31 Final Diagnosis: Severe ovarian hyperstimulation syndrome Symptoms: Ascites • chest discomfort • vulvar edema Medication: — Clinical Procedure: Expectant with local treatment • paracenthesis Specialty: Obstetrics and Gynecoiogy
Collapse
Affiliation(s)
- Vilma Kovač
- Department of Reproductive Medicine and Gynecological Endocrinology, University Medical Centre Maribor, Maribor, Slovenia
| | - Milan Reljič
- Department of Reproductive Medicine and Gynecological Endocrinology, University Medical Centre Maribor, Maribor, Slovenia
| | - Tina Bizjak
- University Medical Centre Maribor, Maribor, Slovenia
| |
Collapse
|
5
|
Reljič M, Knez J, Kovač V, Kovačič B. Endometrial injury, the quality of embryos, and blastocyst transfer are the most important prognostic factors for in vitro fertilization success after previous repeated unsuccessful attempts. J Assist Reprod Genet 2017; 34:775-779. [PMID: 28386815 PMCID: PMC5445053 DOI: 10.1007/s10815-017-0916-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [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: 01/04/2017] [Accepted: 03/29/2017] [Indexed: 11/29/2022] Open
Abstract
Purpose The purpose of this study was to find out the most important prognostic factors for achieving a pregnancy after in vitro fertilization (IVF) in women with history of repeated unsuccessful IVF attempts. Methods We analyzed factors affecting pregnancy rate in a retrospective study including 429 IVF/ICSI cycles performed in women younger than 40 years with at least three previous consecutive failed IVF/ICSI attempts. Results Clinical pregnancy was observed in 140/429 (32.6%) cycles. Clinical pregnancy rate (CPR) was significantly higher in cycles with LEI compared to cycles without LEI before embryo transfer (44.4 vs 26.54%, p = 0.007). The CPR was also higher in cycles with day 5 blastocyst- compared with day 3 cleavage-stage embryo transfers (45.51 vs 26.54%, p < 0.001). In multivariate logistic regression model, only transfer of at least one good quality embryo (OR = 4.32, 95% CI 2.41–7.73), local endometrial injury (OR = 1.73, 95% CI 1.02–2.92), and transfer on day 5 (OR = 3.02, 95% CI 1.53–5.94) remained important independent prognostic factors for clinical pregnancy. Conclusions These results suggest that hysteroscopy with local injury to the endometrium prior to ovarian stimulation for IVF/ICSI can improve implantation and pregnancy rates in women experiencing recurrent IVF failure. However, large studies are needed to confirm these findings.
Collapse
Affiliation(s)
- Milan Reljič
- Department of Reproductive Medicine and Gynecologic Endocrinology, Clinic for Gynecology and Perinatology, University Medical Centre Maribor, Ljubljanska 5, 2000, Maribor, Slovenia.
| | - Jure Knez
- Department of Reproductive Medicine and Gynecologic Endocrinology, Clinic for Gynecology and Perinatology, University Medical Centre Maribor, Ljubljanska 5, 2000, Maribor, Slovenia
| | - Vilma Kovač
- Department of Reproductive Medicine and Gynecologic Endocrinology, Clinic for Gynecology and Perinatology, University Medical Centre Maribor, Ljubljanska 5, 2000, Maribor, Slovenia
| | - Borut Kovačič
- Department of Reproductive Medicine and Gynecologic Endocrinology, Clinic for Gynecology and Perinatology, University Medical Centre Maribor, Ljubljanska 5, 2000, Maribor, Slovenia
| |
Collapse
|
6
|
Knez J, Kovač V, Batistić JP, Bizjak T, Reljič M. Efficacy of hysteroscopy with local endometrial injury in patients with recurrent implantation failure. Eur J Obstet Gynecol Reprod Biol 2016. [DOI: 10.1016/j.ejogrb.2016.07.019] [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]
|
7
|
Knez J, Kovač V, Batistić JP, Bizjak T, Reljič M. Efficacy of hysteroscopy with local endometrial injury in patients with recurrent implantation failure. Eur J Obstet Gynecol Reprod Biol 2016. [DOI: 10.1016/j.ejogrb.2016.07.178] [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]
|
8
|
Kovač V, Vlaisavljević V, Reljič M. Evaluation of coagulation abnormalities among women with vaginal bleeding in the first trimester of pregnancy. Int J Gynaecol Obstet 2012; 118:202-4. [PMID: 22727417 DOI: 10.1016/j.ijgo.2012.04.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2011] [Revised: 04/05/2012] [Accepted: 05/22/2012] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To compare blood coagulation parameters between pregnant women with vaginal bleeding in the first trimester of pregnancy and pregnant women with normal pregnancy in the first trimester. METHODS A prospective controlled study of 98 women in the first trimester of vital pregnancy was conducted at the University Medical Centre Maribor, Slovenia. The study group comprised women with vaginal bleeding (n=50) while the control group women with normal pregnancy, admitted for artificial abortion (n=48). Prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen concentration, number of platelets, hemogram, coagulation factor VIII (FVIII) and von Willebrand factor (VWF) activity were compared between the 2 groups. RESULTS No significant between-group differences were detected in mean PT, fibrinogen concentration, FVIII, and VWF activity. Mean aPTT was significantly higher in the control group than the study group (32.47 versus 30.46 seconds; P<0.05). The mean number of platelets was significantly lower in the study group than the control group (181.69 versus 203.52×10(9)/L; P<0.05). All measured coagulation parameters, except VWF activity, were within normal ranges. CONCLUSION Coagulation abnormalities are rarely the cause of vaginal bleeding in the first trimester of pregnancy among women with no previous symptoms of bleeding disorders.
Collapse
Affiliation(s)
- Vilma Kovač
- Department of Reproductive Medicine and Gynecological Endocrinology, University Medical Centre Maribor, Maribor, Slovenia.
| | | | | |
Collapse
|
9
|
Erčulj N, Kovač V, Hmeljak J, Dolžan V. The influence of platinum pathway polymorphisms on the outcome in patients with malignant mesothelioma. Ann Oncol 2012; 23:961-7. [DOI: 10.1093/annonc/mdr324] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
10
|
Vlaisavljević V, Kovač V, Sajko MČ. Impact of insulin resistance on the developmental potential of immature oocytes retrieved from human chorionic gonadotropin–primed women with polycystic ovary syndrome undergoing in vitro maturation. Fertil Steril 2009; 91:957-9. [DOI: 10.1016/j.fertnstert.2007.12.062] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2006] [Revised: 12/13/2007] [Accepted: 12/19/2007] [Indexed: 10/22/2022]
|
11
|
Reljič M, Vlaisavljević V, Kovačič B, Gavrić Lovrec V, Čižek Sajko M, Kovač V. The Impact of Motile Sperm Concentration on the Outcome of ICSI in Natural Cycles. Fertil Steril 2005. [DOI: 10.1016/j.fertnstert.2005.07.536] [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]
|
12
|
|