BACKGROUND: Adolescent pregnancy, defined as a pregnancy in girls aged 10 to 19 years. Adolescent mothers are at high risk for maternal and neonatal complications. AIM: To compare maternal, perinatal and neonatal outcomes in adolescents and adult women aged 20-24 years. MATERIAL AND METHODS: This retrospective cohort study included all singleton pregnancies during a three-year period (January 2016-December 2018) who gave birth in a Clinical Hospital in Tetovo, Republic of Macedonia. After exclusion criteria, a total of 932 cases were reviewed and divided into two groups: one of the teenage mothers (< 19 years old) (115 women) and the other of adult mothers (20-24 years old) (817 women). RESULTS: Of the total number of 5643 births, 128 (2.27%) were from adolescent pregnancies. Of them, nulliparous adolescent women were 115 (2.04%). Adolescents compare to adult mothers had a higher rate of urinary tract infections (33% vs. 22%), increased rate of maternal anemia (26% vs. 15%), preterm birth, small for gestational age newborns (25.2% vs. 17.1%), lower high school attendance (0 vs. 21.9%) and inadequate prenatal care. Spontaneous labour was more common in adolescents (73% vs 63.5%), while Caesarean sections were less common than in women aged 20-24 years (25.2% vs 33.5%). The rate of other perinatal outcomes was not significantly different between the 2 groups. CONCLUSIONS: The results of the study showed that the frequencies of some maternal, perinatal and neonatal complications were considerably higher in adolescent mothers. nal and perinatal complications were considerably higher in adolescent mothers.

BACKGROUND:Primary fallopian tube carcinoma (PFTC) is a rare tumour of the female genital tract with an incidence of 0.1-1.8% of all genital malignancies, and it is very difficult to diagnose preoperatively, because of its non-specific symptomatology. In most cases, it is an intraoperative finding or a histopathological diagnosis. It is a tumour that histologically and clinically resembles epithelial ovarian cancer.CASE PRESENTATION:We are reporting a case of a 62-year-old, postmenopausal women with primary fallopian tube carcinoma of the right fallopian tube in stage IA. The patient has lower abdominal pain, watery vaginal discharge and repeated episodes of bleeding from the vagina. The clinical and radiological findings suggested a right adnexal tumour with elevated CA-125 levels. Total abdominal hysterectomy, bilateral salpingo-oophorectomy, omentectomy and peritoneal washing were performed. Pathologic confirmation of primary serous cystadenocarcinoma of the right fallopian tube was made. Peritoneal washings were negative for malignancy. FIGO stage was considered as IA, and the patient received no courses of chemotherapy and postoperative radiation because she refused it. Ten months after initial surgery, the patient is alive and in good condition.CONCLUSION:Cytoreduction surgery followed by adequate cycles of chemotherapy is an important strategy to improve patients’ prognosis.

BACKGROUND: Ovarian fibrothecoma is a rare, benign, sex cord-stromal neoplasm, with a typically unilateral location in the ovary, characterized by mixed features of both fibroma and thecoma. Ovarian fibrothecoma is uncommon tumor of gonadal stromal cell origin accounting for 3-4% of all ovarian tumours. CASE PRESENTATION: We presented a rare case of a 46-year-old patient with recurrent menorrhagia in the past two years with no previous medical, surgical or gynecological history. She underwent two times curettage procedures. At the admission to hospital ultrasonography showed a homogenous solid right ovarian mass of size 2.5 cm x 3.5 cm. Endometrial curettage revealed simple hyperplasia of the endometrium. Diagnostic evaluation and surgical management are discussed along with a brief review of the literature. Total abdominal hysterectomy with bilateral salpingo-oophorectomy was carried out. Histopathology confirmed fibrothecoma of the ovary, proliferative endometrium with hyperplasia without atypia and multiple uterine fibroids. CONCLUSION: In all patients presenting with recurrent menorrhagia and adnexal tumor the possibility of a granulosa cell tumor must be kept in mind during evaluation.

Objectives: Atrial fibrillation (AF) is one of the main cardiovascular complications associated with type 2 diabetes mellitus (T2DM). Echocardiography-derived total atrial activation time (PA-TDI duration) which reflects electrical and structural changes to the atria, consistently and accurately predicts new-onset AF. In this study, we aimed to determine the value of PA-TDI duration in T2DM patients. Methods:  A total of 40 consecutive patients with T2DM, mean age 51.5 ± 14.3 years, and 40 age and gender-matched healthy volunteers were evaluated. Conventional and tissue Doppler echocardiography were performed. Additionally, we determined the PA-TDI duration as the time interval from the onset of the P-wave in lead II of the ECG to the peak A’-wave on the tissue Doppler tracing. Results: Left atrial (LA) diameter and LA volume index were significantly higher in T2DM patients (3.36 ± 0.5 cm vs.3.10 ± 0.45cm, p=0.037; 30.8 ± 30ml/m2 vs. 29.0 ± 3.4ml/m2, p=0.03 respectively). Mitral A velocity was significantly higher in T2DM patients (69.72 ± 10.16 cm/s vs. 64.75 ± 10.64 cm/s, p=0.029).  Doppler E/A ratio was lower in T2DM patients.  Tissue Doppler E’/A’ ratio for left ventricular lateral annulus was significantly lower in the diabetic group (1.28±0.33 vs. 1.49±0.40, p=0.024) and E/E’ was significantly higher in the diabetic group (7.33±2.5 vs. 6.45±1.1, p=0.038). PA-TDI duration was significantly higher in the T2DM patients when compared with the controls (134.2±6.0ms vs. 124.3±9.4ms p<0.001). Conclusions: Our results showed that PA-TDI duration is significantly increased in patients with T2DM as compared with healthy volunteers. PA-TDI duration measurement, using transthoracic echocardiography can serve as an easy and non-invasive method of detecting patients with T2DM at risk of atrial fibrillation.