Our study demonstrates reduced kisspeptin levels in pregnancies with diabetes, H, PE, and placental dysfunction. In patients with PE and placental dysfunction, decreased kisspeptin levels were associated with adverse perinatal outcome. Larger studies are needed to investigate the role of kisspeptin as a potential marker of placental dysfunction and adverse perinatal outcome.

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. Moreover, 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.

Ultrasound is the screening modality of choice for the fetal imaging. However, there are circumstances in which an alternative imaging technique is needed for additional information regarding fetal anatomy and pathology as well as different maternal conditions. Magnetic resonance imaging (MRI) is being increasingly used as correlative imaging modality in pregnancy because it uses no ionizing radiation, provides excellent soft-tissue contrast, and has multiple planes for reconstruction and large field of view, allowing better depiction of anatomy in fetuses with large or complex anomalies. In this review, we attempted to identify strengths and weaknesses of each modality both from the literature and our own working experience, and to propose to some practical recommendations on when to use which imaging modality. Both ultrasonography and MRI are operator-dependant and neither technique obviates the need for thorough knowledge of normal and abnormal anatomy. In early pregnancy, and where repeated assessment is needed, ultrasound has the obvious advantage. In circumstances where ultrasound examination is difficult, as in the obese patient or severe oligohydramnion, better images might be obtained by MRI examination. MRI might also identify early fetal ischemic lesions after an insult, such as maternal trauma or death of a monochorionic co-twin. From the published literature, it would appear that MRI may provide additional diagnostic information to that given by ultrasound in 25 to 55% of cases, which in turn may have influence on parental counseling and/or management of affected pregnancies. Individual circumstances and expertise influence the accuracy of both modalities. Ultrasound and MRI should be performed to the highest possible standard, and the final diagnosis should be made in a multidisciplinary setting.

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Back ground: Ce sar ean myomectomy (CM) is a con tro ver sial is sue, even rel a tively con tra in dicated in ob stet ric prac tice. Re cent re ports showed that CM is not as so ci ated with in creased mor bidity, but those are lack ing the data about risks of in ten sive care unit (ICU) treat ment. Aim: The authors eval u ated the fac tors af fect ing the du ra tion of ICU treat ment in pa tients af ter CM. Ma te rial and Meth ods: The study in cluded 57 women who under went CM and were post op er a tively ad mit ted and treated in ICU. Cor re la tion anal y sis was used to es timate the ef fect of var i ous pa ram e ters on the du ra tion of ICU treat ment. Re sults: There was a highly sig nif icant cor re la tion be tween du ra tion of ICU treat ment and num ber of post op er a tive trans fu sions (p=0.001), du ra tion of sur gery (p=0.007), intraoprative hem orrhage (p=0.008) and myoma di am e ter (p=0.009). Dura tion of ICU treat ment was also cor re lated with gesta tional age, hy per ten sive syn drome in preg nancy, pre op er a tive hematocrit and he mo glo bin val ues, number of intraoperative trans fu sions, post op er a tive hemor rhage and re peated myomectomy. Con clu sions: In our re port, lon ger ICU tretment was re quired in cases of perioperative hem or rhage, pro longed sur ger ies and those re quir ing perioperative trans fu sion. Pa tients who have had pre vi ous myomectomy, with lower preop er a tive hemoglobine and hematocrit vaues and bigger myomas are at risk of pro longed ICU treat ment. Key words: Ce sar ean myomectomy; myomectomy; ce sar ean sec tion; com pli ca tions; in ten sive care unit. IN TRO DUC TION A high per cent age of ce sar ean sec tion (CS) in women with myomas is well doc u mented; how ever, the cesar ean myomectomy (CM) is still a con tro ver sial is sue, even rel a tively con tra in di cated in ob stet ric ex pe ri ence 1-3. Con versely, many re ports showed that CM was not as soci ated with in creased mor bid ity 2-6. Now a days, CM is consid ered to be an in ter ven tion with more fa vor able