Aim. This study was undertaken to determine the prevalence of Trichomonas vaginalis infection in women of reproductive age from Kosovo. Methodology. The study was carried out in the Obstetrics and Gynecology Clinic of the Faculty of Medicine, University of Pristine, Kosovo, between April and July 2022. The study population consisted of a total of 207 women. Sexually active women aged at least 20 years old were included in the study. A semi-structured questionnaire was distributed to the participants to seek for information such as age, marital status, occupation and pregnancy status. Every woman’s informed consent was sought before the collection of specimens by qualified medical personnel. The specimens were carefully and aseptically collected from the high vaginal area using well-labeled, sterile, non-abrasive high vaginal swab sticks. A few drops of normal saline were added to each swab stick, and a wet mount examination was performed within less than half an hour of collection in order to get optimal results. The wet preparation of the vaginal discharge was made by applying a drop from the sample to a small area of a clean glass slide with a cover slip in order not to trap air bubbles. The wet smear was examined microscopically for motile T. vaginalis with a low-power objective (x10) and then with a high-power objective (x40). The vaginal secretion was characterized by the presence of epithelial cells, white blood cells and red blood cells. The T. vaginalis trophozoite was identified by its oval, flagellated and distinctive motility (jerky movement). Results. An overall prevalence rate of 12.56% was found in Kosovo. The prevalence of T. vaginalis infection differed from place to place. It varied as well among age groups, showing the highest prevalence in the age group of 30-39 years old (13.63%), and the lowest in the age group of 20-29 years old (5.70%). The prevalence varied with marital groups, being the highest in divorced women (30.76%) and the lowest among singles (6.74%). The prevalence rate was also observed to be highest among the employed (19.71%) and lowest among students (14.81%) and unemployed (7.33%). T. vaginalis infection was observed in non-pregnant women in a prevalence rate of 15.20%. Conclusions. T. vaginalis infection is prevalent in women of reproductive age, as evident in our country. The infection is common in sexually active female participants, especially in those with multiple sex partners. Proper personal hygiene, faithfulness to one sexual partner, and massive public awareness on the prevention and control of T. vaginalis are advised to reduce its prevalence among women of reproductive age in our country.
Background and aim. The worldwide rise of caesarean section (CS) is a major public health concern and a cause of significant debate due to potential maternal and perinatal risks, cost issues and inequity in access. In the Republic of Moldova, in recent years, the incidence of CS has increased by 7.7% (from 12.08% in 2007 to 20.5% in 2019); however, perinatal mortality rates haven’t changed (10.3‰ in 2007, and 9.7‰ in 2019). In order to understand the factors that determine the increasing trend of CS and to approach new strategies to reduce unnecessary caesarean sections, a standardized tool is needed to assess and compare CS rates. Methodology. A single-center, cross-section study was conducted in the period of January-December 2019. Data were collected from medical charts of women who gave birth in the Department of Obstetrics and Gynecology of the “Gheorghe Paladi” Municipal Clinical Hospital, Chişinău, and classified using the ten-group classification system according to Robson, to determine the CS rate in each group, the absolute and relative contribution made by each group to the overall caesarean section rate. Results. A total of 4279 deliveries were analyzed, and of these, 836 (19.5%) cases were delivered by caesarean section. The most representative group of our population was Group 3 (42.4%), followed by Group 1 (32.1%) and Group 5 (7.5%). The greatest contributors to the overall CS rate were Group 5 (33.8%), Group 2 (14.7%) and Group 1 (11.4%). There was also a high rate of pre-labor caesarean sections in Group 2, Group 4 and Group 10. Conclusions. The obtained results indicate that the greatest contributor to CS rate are women with previous caesarean section, followed by nulliparous women with full-term, cephalic pregnancy. An important step in reducing the total CS rate is to focus our efforts on decreasing the caesarean section rate in primary patients. We found that the Robson classification is clinically relevant and it is an effective tool for analyzing the caesarean section rate in our population.
Leiomyoma is one of the most common tumors of mesenchymal origin, being detected in 70% of women of reproductive age. Vaginal leiomyoma (VL) refers to quite rare tumors. To date, about 300 cases of VL have been published in the English language specialized literature. We present the case of a 25-year-old patient, complaining of vaginal discomfort and periodic pains of varying intensity. Ultrasonography examination revealed a 21.9x17.6 mm hypoechoic mass on the anterior vaginal wall, normal-sized uterus, and normal bilateral adnexa. MRI examination determined a 25x18x22 mm isointense solid tumor in the fornix (the left side of the cranial part of the vagina), clearly dissociated from the surrounding tissues. Surgical enucleation was performed. Histopathology testing of the specimen revealed that it was a leiomyoma of the vagina. A clinical examination at a follow-up consultation, after 14 months, showed that her vagina was normal. We also present a brief review of the English language literature on the features of diagnosis and treatment methods for vaginal leiomyoma.
Disseminated intravascular coagulation (DIC) represents a major challenge in obstetrics. The prognosis is influenced by the severity of the coagulopathy and its underlying condition. Early recognition of DIC, if possible, is important because of the potential for end-organ microvascular thrombosis and/or major blood loss. Obstetric DIC manifests mainly with bleeding. In order to facilitate the diagnosis and management of disseminated intravascular coagulation, a pregnancy-specific DIC score was developed. The therapy aims at treating the condition that triggers DIC, the hemorrhagic complications and the coagulopathy.
Preinvasive cervical lesions have a long period of evolution towards cervical cancer, therefore their early detection and treatment, along with anti-HPV vaccination, are a necessity in preventing the occurrence of invasive cervical cancer. Genital HPV infection is the most common sexually transmitted infection. The objective of the study was to establish the prediction of the cervicovaginal cyto-tumor examination and the colposcopic examination for cervical dysplastic lesions and the histopathological examination of the fragments obtained by cervical biopsy, as well as the reevaluation of the histopathological diagnosis of certainty of dysplastic lesions, in the context of the increased incidence of cervical cancer in our country. Cervicovaginal cyto-tumor examination and colposcopic examination had a good correlation with the histopathological diagnosis of the biopsied cervical fragment in cases where they were concordant. In case of discordant cytological and colposcopic results, cervical biopsy with histopathological examination establishes the diagnosis of certainty. Since the incidence of cervical cancer is high in our country, the biopsy with histopathological examination is necessary to establish the diagnosis of dysplastic lesions and the subsequent therapeutic behavior.
