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Article ; Online: Prediction of adverse maternal outcomes of early severe preeclampsia.

Mirkovic, Ljiljana / Tulic, Ivan / Stankovic, Sanja / Soldatovic, Ivan

2020 Volume 22, Page(s) 144–150

Abstract: Objectives: Assess soluble FMS-like tyrosine kinase-1/placental growth factor ratio (sFlt-1/PlGF) diagnostic accuracy for predicting adverse maternal outcome in patients with early severe preeclampsia, and whether its predictive performance is superior ... ...

Abstract	Objectives: Assess soluble FMS-like tyrosine kinase-1/placental growth factor ratio (sFlt-1/PlGF) diagnostic accuracy for predicting adverse maternal outcome in patients with early severe preeclampsia, and whether its predictive performance is superior to full preeclampsia integrated estimate of risk score (PIERS). Study design: Prospective study enrolled patients with early severe preeclampsia (defined by American College of Obstetricians and Gynaecologists 2013 guidelines) admitted to the Clinic for Obstetrics and Gynaecology, Clinical Center of Serbia intensive care unit. Patients underwent delivery to terminate preeclampsia within 48 h of admission. PIERS was generated and blood samples taken at admission. Multiple pregnancies and gestational ages outside 24-34 weeks were excluded. sFlt-1 and PlGF serum concentrations were measured using Elecsys® assays and cobas e 601 analyser. Maternal complications were recorded for seven days post-delivery. Main outcome measures: Diagnostic accuracy (sensitivity and specificity), and predictive performance (receiver operating characteristic area under curve [AUC]) vs. PIERS, of sFlt-1/PlGF for predicting adverse maternal outcome. Results: Of 89 patients enrolled, 61 were evaluable. Median frequency of adverse maternal outcomes within seven days of delivery was two. Median sFlt-1/PlGF and PIERS were 521·0 and 5·0%, respectively. sFlt-1/PlGF showed greater correlation with complication number than PIERS (Spearman's rho: 0·728 [p < 0·001] and 0·134 [p = 0·304], respectively). AUC for sFlt-1/PlGF and PIERS were 0·853 and 0·628, respectively. A 377·0 sFlt-1/PlGF cut-off was optimal for predicting complications (75·0% sensitivity; 92·3% specificity). Conclusions: sFlt-1/PlGF correlated more closely with number of adverse maternal outcomes than PIERS, and was a superior predictor of maternal complications.
MeSH term(s)	Adult ; Biomarkers/blood ; Female ; Humans ; Middle Aged ; Placenta Growth Factor/blood ; Pre-Eclampsia/blood ; Pre-Eclampsia/physiopathology ; Predictive Value of Tests ; Pregnancy ; Prospective Studies ; Risk Assessment ; Serbia ; Severity of Illness Index ; Vascular Endothelial Growth Factor Receptor-1/blood
Chemical Substances	Biomarkers ; Placenta Growth Factor (144589-93-5) ; Vascular Endothelial Growth Factor Receptor-1 (EC 2.7.10.1)
Language	English
Publishing date	2020-09-17
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2584464-7
ISSN	2210-7797 ; 2210-7789
ISSN (online)	2210-7797
ISSN	2210-7789
DOI	10.1016/j.preghy.2020.09.009
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Article: Management of cervical dysplasia in patient with Müllerian anomaly: diagnostic and therapeutic challenges.

Sparic, R / Dotlic, J / Kovac, J / Babovic, I / Buzadzic, S / Mirkovic, L / Nejkovic, L / Stamenkovic, J

European journal of gynaecological oncology

2018 Volume 38, Issue 3, Page(s) 469–472

Abstract: Purpose: The study aim was to report diagnostic and therapeutic challenges in treatment of a patient with cervical dysplasia and con- genital uterine anomaly.: Case report: A 53-year-old women with Müllerian anomaly - uterus duplex (bicorporal ... ...

Abstract	Purpose: The study aim was to report diagnostic and therapeutic challenges in treatment of a patient with cervical dysplasia and con- genital uterine anomaly. Case report: A 53-year-old women with Müllerian anomaly - uterus duplex (bicorporal septate uterus) and Y-shaped endocervical canal was referred due to repeated abnormal Pap smears. She underwent endocervical curettage of both canals and the endocervical septum biopsy which revealed presence of cervical intraepithelial neoplasia (CIN) III. Cervical conization was considered technically unfeasible because of abnormal cervical anatomy (lesions deep in the cervical canal on the cervical bifurcation where the cervical wall is the thickest). Classical open abdominal hysterectomy was performed. Patient had two almost equally-sized, symmetrical uterine bodies connected in the isthmico-cervical region, with normal left and obstructed right hemi-vagina. Postoperative histopathological findings confirmed that dysplasia was located in the region where two endocervical canals conjoined. Conclusion: Diagnostic and therapeutic approach to patients with uterine anomalies has to be individualized, based on anomaly type, patient's age, reproductive history, and patient's preferences.
MeSH term(s)	Cervical Intraepithelial Neoplasia/therapy ; Female ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Mullerian Ducts/abnormalities ; Uterine Cervical Dysplasia/diagnostic imaging ; Uterine Cervical Dysplasia/pathology ; Uterine Cervical Dysplasia/therapy ; Uterine Cervical Neoplasms/therapy
Language	English
Publishing date	2018-04-20
Publishing country	China
Document type	Case Reports ; Journal Article
ZDB-ID	604589-3
ISSN	0392-2936
ISSN	0392-2936
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Article: Asymptomatic isthmico-cervical uterine perforation with IUD - our experience and literature review.

Sparic, R / Dotlic, J / Mirkovic, L / Stamenkovic, J / Kotlica, B Kastratovic / Nejkovic, L / Babovic, I / Malvasi, A / Tinelli, A

Clinical and experimental obstetrics & gynecology

2018 Volume 43, Issue 6, Page(s) 896–898

Abstract: Purpose: The study aim was to report an unusual case of a misplaced IUD in isthmico-cervical region causing partial uterine perforation and discuss literature data regarding such a condition.: Case report: A 50-year-old women was referred to the ... ...

Abstract	Purpose: The study aim was to report an unusual case of a misplaced IUD in isthmico-cervical region causing partial uterine perforation and discuss literature data regarding such a condition. Case report: A 50-year-old women was referred to the present institution for IUD extraction. She was diagnosed with spontaneously misplaced IUD located in isthmico-cervical region of the uterus causing partial perforation. The time of dislocation was unknown, as she was completely asymptomatic for ten years after IUD application. More-over, she had no risk factors for device misplacement. The removal of IUD was uneventful. Conclusion: Isthmico-cervical misplacement of IUD, although rare, can occur at any time and can be asymptomatic. Thus, women with IUD should be annually checked-up in order to prevent possible IUD complications.
MeSH term(s)	Asymptomatic Diseases ; Female ; Humans ; Intrauterine Devices/adverse effects ; Middle Aged ; Risk Factors ; Uterine Perforation/etiology
Language	English
Publishing date	2018-06-22
Publishing country	China
Document type	Case Reports ; Journal Article ; Review
ZDB-ID	754459-5
ISSN	0390-6663
ISSN	0390-6663
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Article: Epidemiology of Uterine Myomas: A Review.

Sparic, Radmila / Mirkovic, Ljiljana / Malvasi, Antonio / Tinelli, Andrea

International journal of fertility & sterility

2015 Volume 9, Issue 4, Page(s) 424–435

Abstract: Myomas are the most common benign tumors of the genital organs in women of childbearing age, causing significant morbidity and impairing their quality of life. In our investigation, we have reviewed the epidemiological data related to the development of ... ...

Abstract	Myomas are the most common benign tumors of the genital organs in women of childbearing age, causing significant morbidity and impairing their quality of life. In our investigation, we have reviewed the epidemiological data related to the development of myomas in order to homogenize the current data. Therefore, a MEDLINE and PubMed search, for the years 1990-2013, was conducted using a combination of keywords, such as "myoma," "leiomyoma," "fibroids," "myomectomy," "lifestyle," "cigarette," "alcohol," "vitamins," "diet," and "hysterectomy". Randomized controlled studies were selected based upon the authors' estimation. Peer-reviewed articles examining myomas were sorted by their relevance and included in this research. Additional articles were also identified from the references of the retrieved papers and included according to authors' estimation. Many epidemiologic factors are linked to the development of myomas; however, many are not yet fully understood. These factors include age, race, heritage, reproductive factors, sex hormones, obesity, lifestyle (diet, caffeine and alcohol consumption, smoking, physical activity and stress), environmental and other influences, such as hypertension and infection. Some of the epidemiological data is conflicting. Thus, more research is needed to understand all the risk factors that contribute to myoma formation and how they exactly influence their onset and growth.
Language	English
Publishing date	2015-12-23
Publishing country	Iran
Document type	Journal Article ; Review
ZDB-ID	2570865-X
ISSN	2008-0778 ; 2008-076X
ISSN (online)	2008-0778
ISSN	2008-076X
DOI	10.22074/ijfs.2015.4599
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Article: Obstetric complications of placenta previa percreta.

Sparić, Radmila / Mirković, Ljiljana / Ravilić, Uroš / Janjić, Tijana

Vojnosanitetski pregled

2015 Volume 71, Issue 12, Page(s) 1163–1166

Abstract: Introduction: Placenta previa is related to severe maternal and fetal morbidity. The increasing incidence of cesarean delivery rate causes a marked increase in abnormally invasive placenta over the past decades. The abnormally invasive placenta is ... ...

Abstract	Introduction: Placenta previa is related to severe maternal and fetal morbidity. The increasing incidence of cesarean delivery rate causes a marked increase in abnormally invasive placenta over the past decades. The abnormally invasive placenta is becoming the foremost cause of obstetric hemorrhage and postpartum hysterectomy, causing a significant maternal and fetal morbidity and even mortality. Maternal morbidity in such cases also comprise politransfusion, development of disseminated intravascular coagulation, uterine rupture, cystostomy, fistula formation, ureteral stricture, intensive care unit admission, infection, and prolonged hos- pitalization, adult respiratory distress syndrome, renal failure, septicemia and even death. Case report: A 38-year-old gravida 3, para 2, was admitted to our hospital at 27 weeks of gestation as an emergency due to vaginal bleeding, previously diagnosed with an anterior placenta previa. Following tocolytic therapy, bleeding stopped. The patient was informed on the diagnosis and the possibility of life-threatening hemorrhage necessitating preterm delivery. She was given corticosteroids to enhance fetal lung maturity. At 28 weeks of gestation, she experienced massive vaginal bleeding, and a decision was made to perform emergency cesarean section. We made a corporeal transverse uterine incision well above the uterovesical fold and tortuous vessels, at the same time avoiding the superior edge of the placenta. The placenta was found to be densely adherent to the lower uterine segment, penetrating through it and infiltrating the posterior wall of the urinary bladder. An attempt to remove the placenta resulted in injury to the bladder wall and the uterine rupture at a previous cesarean scar. The decision was made to perform total abdominal hysterectomy with placenta left in situ. At present, both mother and the baby are well. Conclusion: Anticipation and the surgeon's judgment are leading factors for surgery, from the choice of uterine incision type to the decision to proceeding to hysterectomy in order to reduce maternal morbidity.
MeSH term(s)	Adult ; Cesarean Section ; Female ; Humans ; Hysterectomy ; Infant, Newborn ; Male ; Placenta Previa/diagnosis ; Placenta Previa/therapy ; Pregnancy ; Pregnancy Outcome ; Tocolysis
Language	English
Publishing date	2015-01-28
Publishing country	Serbia
Document type	Case Reports ; Journal Article
ZDB-ID	123795-0
ISSN	0042-8450
ISSN	0042-8450
DOI	10.2298/vsp1412163s
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Article: Complications during cesarean delivery in a patient with two previous myomectomies.

Sparić, Radmila / Berisavac, Milica / Buzadzić, Snezana / Mirković, Ljiljana

Acta chirurgica Iugoslavica

2014 Volume 60, Issue 1, Page(s) 99–100

Abstract: Introduction: Myomas are associted with numerous pregnancy-related maternal and fetal complications, including high rate of cesarean deliveries.: Case outline: We present a woman with huge posterior myoma who had two previous myomectomies. During the ...

Abstract	Introduction: Myomas are associted with numerous pregnancy-related maternal and fetal complications, including high rate of cesarean deliveries. Case outline: We present a woman with huge posterior myoma who had two previous myomectomies. During the cesarean section, the anatomy was found to be grossly distorted. Thus it was necessary to make an inverted T-incision on the uterus, which facilitated delivery of the fetus. The patients postoperative recovery was uneventful. Conclusion: This case illustrates the difficulties that may arise during cesarean section in the presence of uterine myomas in women with previous myomectomies. Clinicians should be prepared to manage those difficulties with inverted T-incision in order to prevent fetal injuries. Such operations should be performed by an experienced obstetrician.
MeSH term(s)	Adult ; Cesarean Section ; Female ; Humans ; Intraoperative Complications/etiology ; Leiomyoma/surgery ; Pregnancy ; Pregnancy Complications, Neoplastic/surgery ; Uterine Myomectomy/adverse effects ; Uterine Neoplasms/surgery
Language	English
Publishing date	2014-03-25
Publishing country	Serbia
Document type	Case Reports ; Journal Article
ZDB-ID	428721-6
ISSN	0354-950X ; 0001-5474
ISSN	0354-950X ; 0001-5474
DOI	10.2298/aci1301099s
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Article ; Online: Lipids and Adipokines in Cord Blood and at 72 h in Discordant Dichorionic Twins.

Milenković, Svetlana / Jankovic, Borisav / Mirković, Ljiljana / Jovandaric, Miljana Z / Milenković, Dušan / Otašević, Biljana

Fetal and pediatric pathology

2017 Volume 36, Issue 2, Page(s) 106–122

Abstract: Background: Intrauterine growth restriction (IUGR) is a risk factor for developing metabolic syndrome later in life. We explored whether adipokine concentrations in cord blood (CB) and on day 3 (D3) were related to impaired fetal growth and lipids in ... ...

Abstract	Background: Intrauterine growth restriction (IUGR) is a risk factor for developing metabolic syndrome later in life. We explored whether adipokine concentrations in cord blood (CB) and on day 3 (D3) were related to impaired fetal growth and lipids in IUGR twins. Patients and methods: Thirty-six discordant (birth weight [BW] discordance ≥20% calculated in relation to the heavier co-twins) and 42 concordant (BW discordance ≤ 10%) twin pairs were included. Results: In IUGR twins, both adiponectin/BW and triglyceride (TG) levels were significantly higher, while total cholesterol, high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol were lower in CB. On D3, both leptin and HDL-C levels were significantly lower and TG levels were significantly higher in IUGR twins. In the discordant group, the alterations in lipids were not related to any adipokine. Conclusions: IUGR is related to lower leptin level and proatherogenic lipid profile (higher TG and lower HDL-C), which are not influenced by adipokine at birth.
Language	English
Publishing date	2017-04
Publishing country	England
Document type	Journal Article
ZDB-ID	2165508-X
ISSN	1551-3823 ; 1551-3815 ; 1522-7952
ISSN (online)	1551-3823
ISSN	1551-3815 ; 1522-7952
DOI	10.1080/15513815.2016.1242675
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Article: [Morbidity and mortality of patients suffering from gestational trophoblastic diseases at the Clinic of Gynecology and Obstetrics, Clinical Center of Serbia in the period from 2000 to 2007].

Lazović, Biljana / Milenković, Vera / Mirković, Ljiljana

Medicinski pregled

2012 Volume 64, Issue 11-12, Page(s) 579–582

Abstract: Introduction: Gestational trophoblastic disease is a heterogenous group of diseases with malignant potential. The aim of this retrospective study was to evaluate potential risk factors in pathogenesis of gestational trophoblastic disease, its morbidity ... ...

Abstract	Introduction: Gestational trophoblastic disease is a heterogenous group of diseases with malignant potential. The aim of this retrospective study was to evaluate potential risk factors in pathogenesis of gestational trophoblastic disease, its morbidity and mortality as well as treatment results. Method: We investigated 82 patients who were treated at the University Clinic of Gynecology and Obstetrics Clinical Center of Serbia from Jan 1st 2000 to Dec 31st 2007. The data were collected from their hospital charts and referred to gynecological anamnesis, diagnosis, protocols of operated patients, diagnosis, histopathological findings, decisions of expert team for trophoblastic disease and hospital discharge. Results: The incidence was 1.5 per 1000 deliveries. The most frequent finding was hydatiform mole (59.8%). The patients were treated by chemotherapy and surgery. All patients survived. Conclusion: The maternal age and a larger number deliveries and abortions are risk factor for gestational trophoblastic disease. The incidence in our clinic is approximately equal to the incidence in western countries in this period.
MeSH term(s)	Adult ; Female ; Gestational Trophoblastic Disease/diagnosis ; Gestational Trophoblastic Disease/epidemiology ; Gestational Trophoblastic Disease/therapy ; Humans ; Pregnancy ; Serbia/epidemiology
Language	Serbian
Publishing date	2012-01-24
Publishing country	Serbia
Document type	English Abstract ; Journal Article
ZDB-ID	131108-6
ISSN	0025-8105
ISSN	0025-8105
DOI	10.2298/mpns1112579l
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Article: Brain metastases of choriocarcinoma--a report on two cases.

Milenković, Vera / Lazović, Biljana / Mirković, Ljiljana / Grujicić, Danica / Sparić, Radmila

Vojnosanitetski pregled

2013 Volume 70, Issue 10, Page(s) 968–971

Abstract: Introduction: Gestational trophoblastic diseases (GTD) are a spectrum of tumors with a various of biological behavior and potential for metastases. It consists of hydatiform mole, invasive mole, choriocarcinoma and placental site trophoblastic tumor. ... ...

Abstract	Introduction: Gestational trophoblastic diseases (GTD) are a spectrum of tumors with a various of biological behavior and potential for metastases. It consists of hydatiform mole, invasive mole, choriocarcinoma and placental site trophoblastic tumor. Choriocarcinoma presents a very aggressive tumor with high malignant potential. Case report: We presented the two cases of choriocarcinoma with brain metastases. The first one was manifested by neurological deterioration as the first sign of metastasis, while the second patient had firstly metrorrhagia and in the further couse neurological disturbances that suggested the presence of brain tumor. In both cases we applied a combined treatment of surgery, chemotherapy and radiation therapy. Both patient survived with high quality of life. Conclusion: A successful outcome of brain metastases of choriocarcinoma was obtained by the use of a combined treatment of surgery, chemotherapy and radiation therapy. In cases of young women with brain metastases, gynecological malignancy should be always considered.
MeSH term(s)	Adult ; Antineoplastic Agents/administration & dosage ; Brain/pathology ; Brain/surgery ; Brain Neoplasms/diagnostic imaging ; Brain Neoplasms/physiopathology ; Brain Neoplasms/secondary ; Brain Neoplasms/therapy ; Choriocarcinoma, Non-gestational/pathology ; Choriocarcinoma, Non-gestational/physiopathology ; Choriocarcinoma, Non-gestational/therapy ; Combined Modality Therapy ; Female ; Humans ; Neurosurgical Procedures/methods ; Radiography ; Radiotherapy, Adjuvant/methods ; Treatment Outcome ; Uterine Neoplasms/pathology ; Uterine Neoplasms/physiopathology ; Uterine Neoplasms/therapy
Chemical Substances	Antineoplastic Agents
Language	English
Publishing date	2013-09-05
Publishing country	Serbia
Document type	Case Reports ; Journal Article
ZDB-ID	123795-0
ISSN	0042-8450
ISSN	0042-8450
DOI	10.2298/vsp1310968m
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Article: Radicality of surgical treatment for cervical cancer.

Mirković, L / Petković, S / Mirković, D / Jeremić, K / Milenković, V / Maksimović, M

European journal of gynaecological oncology

2008 Volume 30, Issue 2, Page(s) 190–192

Abstract: Analyses were carried out on 545 Wertheim-Meigs radical hysterectomies performed at the Institute of Gynecology and Obstetrics of the Clinical Center of Serbia during a four-year period from 2002 to 2006. More than ten lymphatic glands in 84.4% of ... ...

Abstract	Analyses were carried out on 545 Wertheim-Meigs radical hysterectomies performed at the Institute of Gynecology and Obstetrics of the Clinical Center of Serbia during a four-year period from 2002 to 2006. More than ten lymphatic glands in 84.4% of patients were removed. The apical part of the vagina was removed in 77.8% of cases, and 77.6% of patients had the right part of the vagina removed. Distribution of surgical radicality according to FIGO stage of disease has been demonstrated. Comparison of research results in the period from 1996 to 2000 shows a significantly more radical approach concerning the number of lymphatic glands removed during this period.
MeSH term(s)	Fallopian Tubes/surgery ; Female ; Humans ; Hysterectomy ; Lymph Node Excision ; Ovariectomy ; Pelvic Bones ; Uterine Cervical Neoplasms/pathology ; Uterine Cervical Neoplasms/surgery ; Vagina/surgery
Language	English
Publishing date	2008-09-16
Publishing country	China
Document type	Journal Article
ZDB-ID	604589-3
ISSN	0392-2936
ISSN	0392-2936
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