Obstetric and neonatal outcomes in women aged 40 years or older after in vitro fertilization.

PURPOSE OF INVESTIGATION: The aim of this study was to determine the rate of complications in pregnancy and during delivery, as well as neonatal outcomes, in women who underwent in vitro fertilization (IVF) and who are 40 years of age or older. MATERIALS AND METHODS: This was a prospective study. The study group consisted of 29 women who underwent IVF. The control group consisted of women who had a spontaneous pregnancy. RESULTS: Pregnancy complications occurred in 86.21% of women in the study group, an 46.87% of women in the control group. The proportion of cesarean sections (CS) was 84.62% in the study group, and 21.87% in control group. Birth weight < 1,500 grams and < 2,500 grams was present in 17.16% and 22.86% of newborns in the study group, spectively. In the control group, birth weight < 1,500 grams and < 2,500 grams was present in 5.55% and 8.33% of newborns, respectively. Neonatal intensive care unit admissions included 22.86% newborns from the study group and 8.33% from the control group. CONCLUSION: Pregnancy, delivery, and neonatal complications were more frequent in the study (IVF) group.

Carcinosarcoma of the uterus in advanced stage: a case report.

This is the case of an advanced stage carcinosarcoma uteri, in a patient with limited therapy options. Carcinosarcomas (malignant mixed Müllerian tumors) are histologically composed of malignant epithelial and mesenchymal components. Sarcomatous component of this mixed tumor in the present patient was of heterologous-type chondrosarcoma. The primary treatment option for uterine carcinosarcomas is surgery, but adjuvant therapy is always necessary. The optimal treatment is still uncertain, as the histogenesis of this tumor remains controversial.

Uterine tumor resembling ovarian sex cord tumor. Case report and review of literature.

A uterine tumor resembling an ovarian sex cord tumor (UTROSCT) shows a poly phenotypic immunophenotype with coexpression of epithelial, myoid, and sex cord markers, as well as hormone receptors. The authors present a case of a 59-year-old multiparous woman admitted to the Institute of Gynecology and Obstetrics Clinical Centre of Serbia in January 2010 due to prolonged vaginal bleeding and abdominal discomfort. The vaginal ultrasound showed an enlarged uterus size of 100 x 74 x 81 mm, with extended cavity with an unhomogenic content and myomas sized 54 x 69 mm located in fundus with secondary changes. She underwent abdominal hysterectomy with adnexectomy. Microscopic examination revealed submucosal uterine tumor with variabile histological organization that had anastomotic trabeculae with solid cellular grupations. Rare mitotic figures (2/10 HPF) were found. Additional imunohistochemistry showed immunophenotype: the sex cord areas were positive for vimentin(++), aSMA(++), AE1/AE3(+), PR(+), and ER(+). The poly phenotypic immunophenotype can be useful in differential diagnosis from other neoplasms but also suggests an origin of UTROSCT from uncommitted stem cell enabling for multidirectional differentiation.

Optimal dose of an anesthetic in epidural anesthesia and its effect on labor duration and administration of vacuum extractor and forceps.

This study examined the factors that influence the optimal dose of epidural anesthesia (EA), its effect on labor duration, and the frequency of vacuum and forceps administration at the end of delivery. The study group included 100 women who underwent vaginal delivery with EA with administration of 0.125% bupivacaine. A control group included 100 vaginally delivered women, without EA administration. In both groups delivery was stimulated by syntocinon. The level of labor pain influenced the optimal bolus dose of EA more than the body mass. However, the maintenance dose was influenced by both of these factors equally. Labor in the study group was somewhat shorter. In the group with EA the percentage of forceps and vacuum extractor application was twice that in the control group. There was no difference in average value of 5-minute Apgar scor in newborns.