[Results of gestational trophoblastic neoplasia treatment in the Slovak Republic in the years from 1993 to 2012]. / Výsledky liecby gestacnej trofoblastovej neoplázie v Slovenskej republike v rokoch 1993 az 2012.

OBJECTIVE: Analysis and epidemiology of gestational trophoblastic neoplasia treatment in the Slovak Republic in the years 1993-2012. DESIGN: Retrospective epidemiological national study. SETTING: Centre for gestational trophoblastic disease Ministry of Health the Slovak Republic, Bratislava. METHODS: Retrospective analysis results of gestational trophoblastic neoplasia treatment according to prognostic scoring and staging system FIGO/WHO in Centre for gestational trophoblastic disease Ministry of Health the Slovak Republic Bratislava in the years 1993-2012. RESULTS: The treatment of gestational trophoblastic neoplasia (GTN) in the Czech and Slovak Republics started in 1955 and lasted till 1993. After the split of the former Czechoslovakia the Centre for gestational trophoblastic disease was created in Slovakia. 75 patients were treated in this Centre in the years 1993-2012. According to prognostic scoring and staging system FIGO/WHO 56 (75%) patients had low-risk gestational trophoblastic neoplasia and 19 (25%) of patients had high-risk gestational trophoblastic neoplasia. There were 41 patients (55%), 2 (3%), 24 (32%) and 8 (11%) in stage I., II., III. and IV. respectively. Total curability rate was 94.7% and mortality rate was 5.3%. Curability rate 100% was achieved in stage I & II and all placental site trophoblastic tumours (PSTT), 98.3% in stage III and 50% stage IV. In the years 1993-2012 the incidence of choriocarcinoma was one in 76 273 pregnancies and one in 53 203 deliveries. The incidence of other gestational trophoblastic neoplasia in the same years was for PSTT one in 533 753 pregnancies and one in 372 422 deliveries, invasive mole one in 145 611 pregnancies and one in 101 569 deliveries, and persistent GTN one in 40 043 pregnancies and one in 27 932 deliveries. 225-241 patients were treated in the same period of time in the Czech Republic with curability rate 98.2-98. 3%. CONCLUSION: Early detection and treatment in the centre for trophoblastic disease are crucial points in the manage-ment of gestational trophoblastic neoplasia, because the effective therapy of gestational trophoblastic neoplasia with high curability rate is available.

[DNA analysis in gestational trophoblastic disease]. / DNA analýza gestacnej trofoblastovej choroby.

OBJECTIVE: DNA analysis of different forms of gestational trophoblastic disease. DESIGN: Retrospective clinical study. SETTING: Slovak Center of Trophoblastic Disease, Bratislava, Slovak Republic. METHODS: In the period of September 1993 to April 2003, eighty-nine cases of gestational trophoblastic disease were analysed. There were 22 cases of partial hydatidiform moles, 58 cases of complete hydatidiform mole, 5 cases of invasive mole and 4 cases of gestational choriocarcinomas. Southern hybridization and polymerase chain reaction were used for DNA analysis. RESULTS: From 22 analyzed cases of partial hydatidiform moles 19 (86.4%) were triploid and 3 (13.6%) diploid ones. There were 58 cases of complete hydatidiform mole and out of them 29 (50%) were homozygous, 28 (48.3%) heterozygous, and in one case (1.7%) both paternal and maternal genome was detected. In 8 cases of heterozygous and in one case of homozygous complete hydatidiform mole occurred a malignant transformation to gestational choriocarcinoma. CONCLUSIONS: Molecular analysis can determine the nuclear DNA origin of complete hydatidiform mole and allow us to define the patients with higher risk of malignant transformation usually to gestational choriocarcinoma.

Management of intracavitary left atrium tumors during pregnancy - two case reports.

OBJECTIVE: Authors documented an individual management of intracavitary left atrium tumors diagnosed during pregnancy. SUBJECT: Two case reports were presented. Brain embolisation was supposed in the case one of intracavitary left atrium tumor. An urgent cardiosurgery at 24 weeks' gestation was performed on the cardiopulmonary bypass. In case two (multiple pregnancy - twins) cardiac tumor in left atrium was detected in third trimester of pregnancy. The mother was without any serious cardiac and systemic complications during the last trimester. Surgical approach was different - removal of tumor after delivery. CONCLUSION: The surgical approach should be determined by clinical behavior of left atrial cardiac tumors.

[Fertility after chemotherapy of gestational trophoblastic disease]. / Fertilita po chemoterapii pre gestacnú trofoblastovú chorobu.

OBJECTIVE: To evaluate subsequent pregnancy experience in patients following chemotherapy for malignant form of gestational trophoblastic disease. DESIGN: Retrospective clinical study. SETTING: Slovak Center of Trophoblastic Disease, Bratislava, Slovak Republic. METHODS: There were evaluated subsequent pregnancy experiences in 38 patients after chemotherapy for malignant form of gestational trophoblastic disease registered in Slovak center of gestational trophoblastic disease. Histological and cytogenetical analysis of all placentas after deliveries and material from curettage specimens after miscarriages, abortions and ectopic pregnancies were performed. RESULTS: 11 women conceived following successful chemotherapy of gestational trophoblastic disease became pregnant a total 19 times. Out of them there were 9 full-term deliveries, 2 spontaneous abortion, 1 ended in ectopic pregnancy and 7 pregnancies were terminated in therapeutic abortion. Cytogenetical analysis was successful in 7 to 10 reproductive losses with normal karyotype in all analysed cases. CONCLUSION: Patients after successful chemotherapy of gestational trophoblastic disease have a normal reproductive outcome.

[Laparoscopic findings in women with chronic pelvic pain]. / Laparoskopické nálezy u zien s chronickou panvovou bolest'ou.

Chronic pelvic pain afflicts 5-10% of women. The diagnosis of its cause is predominantly assessed by means of laparoscopy which in 60-70% reveals various organic causes of pain. The retrospective study analyses the results of 43 laparoscopic examinations indicated due to chronic pelvic pain. The average age of patients was 29.97 years. Organic findings on internal genitals were found in 36 cases (83.7%). Endometriosis was diagnosed in 11 cases (25.6%). According to the criteria of American Fertility Society, 4 patients (36.4%) suffered from stage I, 6 patients (54.5%) suffered from stage II, and only one case (9.1%) was caused by stage III. Chronic inflammatory process was diagnosed in 12 cases (18.6%), adhesions without any other pathologic findings in 8 cases (18.6%), and ovarial cysts in 3 cases (7.0%). Varicose pelvic veins and uterine myoma occurred in one case (2.3%), respectively. In 7 cases, no pathological change was revealed. Laparoscopy in coincidence with chronic pelvic pain is a significant examination which helps to reveal the organic origin of disturbance. An early decision of applying this invasive examination contributes to fast assessment of the diagnose and commencement of treatment. (Tab. 2, Fig. 1, Ref. 32.)