Diana Ramasauskaite

Vilnius University · Clinic of Obstetrics and Gynaecology

Background: Sentinel lymph node (SLN) biopsy is recommended over systematic lymphadenectomy in early-stage endometrial cancer due to its lower morbidity and comparable detection rate. The objective of this study was to identify clinical factors associated with unsuccessful mapping. Methods: Between April 2020 and June 2024, 120 patients over the ag...

Necukrinis diabetas – tai retas endokrininės sistemos sutrikimas, nulemtas antidiuretinio hormono nepakankamumo ir pažeidžiantis vandens bei elektrolitų pusiausvyrą organizme. Straipsnyje pateikiamas centrinio necukrinio diabeto nėštumo laikotarpiu klinikinis atvejis, rodantis galimą nėštumo įtaką minėtam sutrikimui ir taikomą gydymą. Taip pat, rem...

Purpose To investigate the association of sonographic features and clinical symptoms of adenomyosis. Methods This was a prospective observational study. Only reproductive age women who underwent standardized transvaginal ultrasound examination were included. The diagnosis of adenomyosis was based on sonographic features proposed by Morphological U...

Objective: We aimed to identify the incidence and risk factors of perianal pathology during pregnancy and the postpartum period. Methods: A prospective cohort study was conducted in three institutions in Lithuania. A total of 190 patients were examined and interviewed three times (<12, 18–20 weeks of gestation, and during the first 2 months after d...

Background: Sentinel lymph node (SLN) biopsy in early-stage endometrial cancer is recommended over systematic lymphadenectomy due to reduced morbidity and comparable detection rates. The main objective of this study was to compare the overall and bilateral detection rates of SLN in early-stage endometrial cancer using three techniques. Methods: a p...

Background Pregnancy-related infections are important contributors to maternal sepsis and mortality. We aimed to describe clinical, microbiological characteristics and use of antibiotics by source of infection and country income, among hospitalized women with suspected or confirmed pregnancy-related infections. Methods We used data from WHO Global...

Background Improving noninvasive antenatal diagnosis of fetal inflammatory response syndrome (FIRS) can assist in the evaluation of prenatal risk and reduce perinatal outcomes. This study aimed to determine whether soluble urokinase-type plasminogen activator receptor (suPAR) in vaginally collected amniotic fluid is significant in identifying FIRS...

The aim of the study To investigate the health literacy and associated factors of women giving birth at the Vilnius Perinatology Centre. Material and methods The study was conducted between June 2022 and September 2022 at the Vilnius University Hospital in Lithuania. Five hundred and eight women who had delivered healthy newborns were surveyed. Th...

Osteogenesis imperfecta (OI), also known as brittle bone disease, belongs to a rare heterogeneous group of inherited connective tissue disorders. In experienced prenatal centers, severe cases of OI can be suspected before birth from the first trimester prenatal ultrasound screening. In this article, we describe a case report of OI suspected at the...

Elective cesarean delivery on maternal request is a challenging topic of discussion for patients, their families, and clinicians. Efforts to reduce the rate of cesarean deliveries should include the proportion of cesarean deliveries at term that occur solely due to maternal request rather than a maternal or fetal indication. Additionally, clinician...

INTRODUCTION Maternal health literacy is a social skill that is relevant to successful postnatal newborn adaptation, neonatal feeding, and neonatal health outcomes, given the importance of maternal health literacy in newborn healthcare. The study aims to identify and assess the associations between maternal health literacy, neonatal health, and bre...

Endometrial-factor induced infertility remains one of the most significant pathology among all fertility disorders. Stem cell-based therapy is considered to be the next-generation approach. However, there are still issues about successfully retrieving human endometrium-derived mesenchymal stem/stromal cells (hEnMSCs). Moreover, we need to establish...

Background. Improving noninvasive antenatal diagnosis of fetal inflammatory response syndrome (FIRS) can assist in the evaluation of prenatal risk and reduce perinatal outcomes. This study aimed to determine whether soluble urokinase-type plasminogen activator receptor (suPAR) in vaginally collected amniotic fluid is significant in identifying FIRS...

Background: Unexplained infertility (UI) can be a frustrating and challenging diagnosis for doctors and couples as it can be difficult to understand why they are unable to conceive despite increasing diagnostic tools. Assisted reproductive technology (ART) procedures have been successfully applied to many couples aiming to overcome UI. However, the...

Background. Infertility can negatively affect mental health. Conversely, it is also hypothesized that psychological imbalance may exert a damaging influence on reproductive function. Unfortunately, until now it has been difficult to objectively explain these relations. Certain researchers suggest that genetic and epigenetic mechanisms could be fact...

Acute abdomen during pregnancy is rare. Despite advances in diagnostic imaging, preoperative diagnosis in the pregnant population due to anatomical and physiological changes can pose difficulties. Diagnosis and surgery delays increase the risk of adverse outcomes for both maternal and fetal health. In symptomatic cases, explorative surgery might be...

Santrauka. Daugėjant pagalbinio apvaisinimo procedūrų, didėja akušerinių bei perinatalinių komplikacijų dažnis. Jos dažniausiai susijusios su daugiavaisiu nėštumu po pagalbinio apvaisinimo. Siekiant išvengti su daugiavaisiu nėštumu susijusių komplikacijų, kai kuriose šalyse pradėta taikyti vieno embriono perkėlimo į gimdą politika. Nuo 2009 m. daug...

Tyrimo tikslas: įvertinti ankstyvojo ir vėlyvojo nėščiųjų diabeto (ND) baigtis motinai, vaisiui, naujagimiui. Tyrimo metodai. Į prospektyvinį tyrimą, atliktą Vilniaus Universiteto ligoninės Santaros klinikose (VULSK), 24-28 nėštumo savaitę įtrauktos 242 nėščiosios, kurios buvo konsultuojamos VULSK gydytojo endokrinologo iki gimdymo ir gimdė VULSK....

Pagalbinis apvaisinimas – tai procedūros, kurios pasitelkiamos nevaisingumui gydyti. Procedūrų metu atliekamos manipuliacijos su kiaušialąstėmis ir spermatozoidais ne žmogaus organizme, kurių tikslas – moters nėštumas. Šiuo metu tiek Europoje, tiek JAV daugiau nei 2 proc. naujagimių gimsta po pagalbinio apvaisinimo procedūrų. Skaičiuojama, jog kasm...

The efficiency of endometrial stromal cells (ESC) decidualization is a critical player in successful embryo implantation and further pregnancy development. Epigenetic mechanisms strictly regulate massive changes that affect endometrium in each cycle, so investigating epigenetic patterns could help identify endometrial targets for infertility treatm...

Choriokarcinoma – gestacinei trofoblastinei ligų grupei priskiriamas didelio piktybiškumo navikas. Choriokarcinoma diagnozuojama 1 iš 40 000 nėštumų atvejų ir 1 iš 40 pūslinės išvisos atvejų. Didelis ligos piktybiškumas pasireiškia ankstyva invazija į kraujagysles ir greitu metastazavimu. Ligai būdinga įvairi klinika, todėl ankstyva diagnostika ir...

Introduction: Late-onset intrauterine fetal growth restriction (IUGR) is a common pregnancy complication diagnosed in 5-10% of pregnant women worldwide. Under the impact of hypoxia, the fetus develops a protective mechanism of adaptive changes occurring in the cerebral circulation ("brain-sparing effect"). Materials and methods: We conducted det...

Background. Endometrial-factor induced infertility remains one of the most significant pathology among all fertility disorders. Stem cell-based therapy is considered to be the next-generation approach. However, at this point there are still issues about successfully retrieving human endometrium derived stem cells (hEnSCs). Moreover, we also need t...

Uterus transplantation (UTx) is the only treatment method for women with absolute uterine infertility. Currently, the number of grafts retrieved from deceased donors is increasing; hence, prolonged cold ischemia time is inevitable. Thus, this study was designed to assess the effect of the novel relaxin (RLN)- or erythropoietin (EPO)-supplemented Cu...

Ilgėjant gyvenimo trukmei, dėl socialinių priežasčių atidedant nėštumo planavimą, tobulėjant medicinos technologijoms, vis daugiau moterų renkasi pastoti vyresniame amžiuje, naudodamosi pagalbinio apvaisinimo technologijomis. Nors ilgus metus reprodukcinis moters amžius ribojo nėštumo ir gimdymo galimybę, pastarųjų dešimtmečių pažanga leidžia tuo p...

Vaisiaus rezus (Rh) imunizacija – būklė, kai pakartotinai imunizuotos Rh neigiamos nėščios moters kraujyje esantys antikūnai patenka į Rh teigiamo vaisiaus kraujotaką ir hemolizuoja jo eritrocitus. Straipsnyje aprašomas klinikinis atvejis apie nėščiąją, kuriai buvo diagnozuota vaisiaus Rh imunizacija, sukėlusi komplikacijas vaisiui. Nurodomi šių ko...

Objective To determine the significance of tumor necrosis factor‐α (TNF‐α) and matrix metalloproteinase‐8 (MMP‐8) in vaginally obtained amniotic fluid predicting fetal inflammatory response syndrome (FIRS) after preterm premature rupture of membranes (PPROM). Methods In this prospective case–control study, TNF‐α and MMP‐8 concentrations were evalu...

Background and Objectives The most effective treatment of infertility is in vitro fertilization (IVF). IVF with Preimplantation Genetic Testing (PGT) allows to identify embryos with a genetic abnormality associated with a specific medical disorder and to select the most optimal embryos for the transfer. PGT is divided into structural rearrangement...

Ovulatory disorders are common causes of amenorrhea, abnormal uterine bleeding and infertility and are frequent manifestations of polycystic ovary syndrome (PCOS). There are many potential causes and contributors to ovulatory dysfunction that challenge clinicians, trainees, educators, and those who perform basic, translational, clinical and epidemi...

Research question Would a properly designed educational programme offered to young women improve their awareness and basic knowledge of menstrual pain and endometriosis? Design A multinational cross-sectional study using a pen-and-paper questionnaire among women aged 19–24 years was conducted between 2017 and 2019 to assess basic knowledge of mens...

Successful uterus transplantation, a potential treatment method for women suffering from absolute uterine infertility, is negatively affected by ischemia–reperfusion injury (IRI). The aim of this study is to investigate the protective effect of relaxin (RLX) or/and erythropoietin (EPO) on experimental uterus IRI. Eighty rats, randomly assigned into...

Infertility is one of the most rapidly increasing global health concerns of the 21st century. Embryo quality and endometrial thickness and receptivity are the main factors for successful embryo implantation and pregnancy development. Nevertheless, until now, there has been a lack of understanding about the regulation of human endometrium function a...

( Int J Gynecol Obstet . 2021;152:155–164) A country’s maternal mortality ratio (MMR) is the number of women per 100,000 live births who die from pregnancy related causes. These women may die while pregnant or within 42 days of pregnancy completion. The four most common reasons for MMR in high-income countries are severe preeclampsia, postpartum he...

Abstract Background To compare specific dietary and behavioral recommendations for hemorrhoids prevention during pregnancy. Methods This was a randomized, single-blind, multicenter trial conducted in three different clinical centers. Patients were randomly allocated into two groups in a ratio of 1:1. Intervention consisted of specific dietary and b...

Background and objectives. Gestational diabetes mellitus is an increasingly diagnosed metabolic disorder during pregnancy with unknown pathological pathways. Taking into account the growing numbers of women who are conceiving after assisted reproductive technologies, they comprise an engaging target group for gestational diabetes mellitus etiopatho...

Background. The effect of COVID-19 disease during pregnancy is still under investigation, however scientific studies have shown that pregnant women with COVID-19 infection are at increased risk for severe illness or complications [1]. Risk factors for severe disease and death in pregnancy include maternal age (especially ≥35 years), obesity, preexi...

Background and Objectives: Pregnancy and delivery in patients with congenital heart disease (CHD) and pulmonary arterial hypertension (PAH) carry a very high risk for maternal and foetal complications and are contraindicated according to the guidelines. In the last decades, when an available modern PAH-targeted medication therapy and a new manageme...

Preterm premature rupture of membranes (PPROM) interrupts normal lung development, resulting in neonatal respiratory morbidity. Although post-PPROM risks have been researched, only a few studies have investigated noninvasively obtained amniotic fluid (AF) to predict neonatal outcomes. In this study, we aimed to determine whether epidermal growth fa...

Nėštumo laikotarpiu šlapimo takų infekcija yra viena dažniausių infekcinių ligų. Tiek Lietuvos, tiek tarptautinėse gairėse rekomenduojama patikra dėl besimptomės bakteriurijos, o ją nustačius – antibakterinis nėščiųjų besimptomės bakteriurijos gydymas. Lietuvos „Nėščiųjų besimptomės bakteriurijos diagnostikos ir gydymo metodikoje“ nekomplikuotos be...

Human endometrium derived mesenchymal stem cells (hEndSCs) offer a great promise for regenerative medicine and reproductive system disorders treatment methods based on cell therapy due to their broad differentiation potential and highly efficient proliferation. In our study, we investigated the characteristics of hEndSCs that were isolated from two...

Introduction and importance Obesity is a major health problem. Obese women have an increased risk of pregnancy-related complications. Weight loss before conception is associated with improved fertility rates and pregnancy outcomes. Bariatric surgery (BS), such as laparoscopic adjustable gastric banding (LAGB), was a popular option for obese women p...

COVID-19 įtaka nėštumui vis dar tiriama, tačiau moksliniuose tyrimuose pastebima, kad infekcija didina nepalankios nėštumo eigos ir baigties riziką. Sisteminėse apžvalgose pastebėta, kad COVID-19 ir HELLP sindromo klinika bei laboratorinių tyrimų rezultatai gali būti labai panašūs ir kartais sunkiai atskiriami. Straipsnyje pristatomas klinikinis va...

Įgimta naujagimių Herpes simplex infekcija pasireiškia itin retai, nors virusas tarp suaugusiųjų yra labai paplitęs. Šis straipsnis apžvelgia klinikinį naujagimio atvejį, kai po normalaus nėštumo ir gimdymo, motinai, neturint infekcijos simptomų, naujagimis gimė su Herpes simplex infekcija. Ligos pradžioje naujagimiui infekcija pasireiškė nespecifi...

Chorioamnionitas – tai vaisiaus dangalų ir placentos infekcija, sukelianti gyvybei pavojingų komplikacijų naujagimiui ir motinai. Nėštumo laikotarpiu chorioamnionitas gali būti diagnozuojamas remiantis klinikiniais kriterijais, taikant mikrobiologinius ir biocheminius tyrimo metodus. Šio straipsnio tikslas – apžvelgti ir palyginti skirtingus antena...

Background and Objectives: Intrauterine growth restriction (IUGR) is the term used to describe a fetus whose estimated weight is less than the 10th percentile of its age growth curve. IUGR is the second most common cause of perinatal death. In many cases there is a deficiency in the standardization of optimal management, prenatal follow-up and timi...

Background The neutrophil-lymphocyte ratio (NLR) is easily calculated blood test parameter, which can be used as marker to predict many inflammatory disorders. The aim of this study was to assess and compare the NLR in maternal blood with the white blood cell (WBC) count and C-reactive protein (CRP) concentration for the prediction of histological...

Ischemia/reperfusion injury (IRI) remains a significant problem to be solved in uterus transplantation (UTx). Melatonin and glycine have been shown to possess direct cytoprotective activities, mainly due to their antioxidative and anti-inflammatory properties. The aim of this study was to investigate the protective effects of melatonin and glycine...

Introduction: This study was conducted to evaluate soluble Toll-like receptor 2 (sTLR-2) and soluble Toll-like receptor 4 (sTLR-4) levels in vaginally obtained amniotic fluid and investigate their value in the prediction of histological chorioamnionitis (HCA). Material and methods: This prospective case-control study included patients who had be...

Purpose of the review: To provide the latest evidence and treatment advances of multiple sclerosis in women of childbearing age prior to conception, during pregnancy and postpartum. Recent findings: Recent changes permitting interferon beta (IFN-β) use in pregnancy and breastfeeding has broadened the choices of disease modifying treatments (DMTs...

Purpose To evaluate the agreement of wet smear microscopy with Gram stain microscopy and to assess whether it is possible to predict Mycoplasmas/Ureaplasmas when analysing vaginal secretion with Gram stain and wet smear microscopy. Methods Women with complaints of the abnormal vaginal discharge were invited to participate. A sample of vaginal secr...

When looking for the causes and treatments of infertility, much attention is paid to one of the reproductive tissues—the endometrium. Therefore, endometrial stem cells are an attractive target for infertility studies in women of unexplained origin. Menstrual blood stem cells (MenSCs) are morphologically and functionally similar to cells derived dir...

Vaisiaus kraujagyslių pirmeiga (VKP) yra labai reta patologija, kurios nediagnozavus laiku, dėl didelės naujagimių hipoksijos ir nukraujavimo rizikos smarkiai sumažėja naujagimių išgyvenamumas. Prenatalinė VKP diagnozė ir tinkamai pasirinktas cezario pjūvio operacijos laikas yra būdas išvengti nepalankios nėštumo baigties. Šiuo metu nėra pakankamai...

Vėjaraupiai – tai ūminė virusinė liga, kurios sukėlėjas yra žmogaus herpes virusas, vadinamas Varicella zoster virusu (VZV) ir priklausantis Herpes viridae šeimai [1]. Didžiausią pavojų šis virusas sukelia nėščiosioms ir asmenims, kurių imunitetas nusilpęs. Nustatyta, kad nėštumo laikotarpiu vėjaraupiais suserga 2–3 iš 10 000 nėščiųjų [2]. Nėščiosi...

Tyrimo tikslas. Įvertinti, kokią įtaką žindymo sunkumams turi išnešioto naujagimio gimimo svoris. Tyrimo metodai. Tyrimas buvo atliekamas Vilniaus universiteto ligoninės Santaros klinikų Akušerijos skyriuje nuo 2019 m. rugsėjo 1 d. iki 2020 m. balandžio 1 d. Tyrime dalyvavo 342 gimdyvės, pagimdžiusios sveikus išnešiotus naujagimius ir po gimdymo ga...

Background. Earlier chorioamnionitis diagnosis is crucial to improve maternal and neonatal health outcomes. This study was conducted to evaluate the inlerleukin-6 (IL-6), tumor necrosis factor α (TNF-α), and matrix metalloproteinase 8 (MMP-8) levels in vaginally obtained amniotic fluid to investigate their prognostic value and to determine the most...

Background There are little up-to-date data available on the duration of exclusive breastfeeding in Lithuania. The aim of our study was to examine the factors that could influence exclusive breastfeeding during the first 6 months of life. Methods In 2016, a survey was conducted at the Obstetrics and Gynecology Clinic of Vilnius University Hospital...

This good clinical practice paper provides an overview of the current evidence around second stage care, highlighting the challenges and the importance of maintaining high‐quality, safe, and respectful care in all settings. It includes a series of recommendations based on best available evidence regarding length of second stage, judicious use of ep...

Publication of the Intergrowth‐21st and WHO growth charts raises the question of which growth data prenatal providers should use in clinical practice. Is it better to use a universal chart applied globally, or metrics based on local or regional growth patterns? And what about customized charts versus local charts? FIGO has reviewed the different gr...

Šioje literatūros apžvalgoje įvertinta sudėtinių kontraceptinių tablečių (SKT) įtaka emocinei sveikatai skirtingose moterų amžiaus grupėse: paauglių (10–18 metų), jaunų moterų (19–35 metų). Taip pat aprašytas SKT poveikis moterims, vartojančioms kontraceptines tabletes pirmaisiais metais po gimdymo, pateikiami galimi sąveikos tarp SKT ir depresijos...

Background. Preimplantation genetic testing (PGT) is a genetic testing procedure that is performed before the implantation of embryos for the identification of genetic abnormalities. It is commonly performed when one or both expecting parents have such abnormalities and are at a high risk of passing them to their offspring. The aim of this case rep...

Intrauterine infection, a dangerous condition for a pregnant woman and her fetus, increases the risk of neonatal death and the incidence of severe diseases like cerebral palsy, chronic lung illnesses and psychomotor disorders. Better prediction of intrauterine infection would support the choice of an appropriate treatment plan during pregnancy and...

Pregnant women and their fetuses are among the vulnerable populations that can be severely affected by communicable diseases. As such, some vaccines such as the influenza and the Tdap (tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis) vaccines are strongly recommended in each pregnancy, with generally safe profiles. Other vaccines...

Uterus transplantation (UTx) is the first and only available treatment for women with absolute uterine factor infertility. However, clinical application is limited by the lack of organs, ischemia/reperfusion injury, as well as immunosuppression after UTx. Several different preservation solutions are used in experimental and clinical UTx, including...

The aim of this study was to assess if ureaplasmas are associated with pregnancy complications and diseases in newborns. Pregnant women with complaints and threatening signs of preterm delivery were included. A sample, taken from the endocervical canal and from the surface of the cervical portion, was sent to the local microbiology laboratory for D...