Rosita Aniuliene - Department of Obstetrics and Gynecology, Kaunas University of Medicine, Lithuania

Rosita Aniuliene, MD, Ph D.

Administrator of Obstetrics and Gynecology Department
Eiveniu 2, 3007 Kaunas, Lithuania (Lietuva)
Tel. + 003707 731994 / + 003707 733832
Fax. + 003707 331498 / + 003707 733832

Chief: Prof. Vida - Marija Chigriejiene

The department started in 1973. There are 160 beds and work 55 doctors gynaecologysts.

The department is divided in 5 units:

Delivery
High risk pregnancy
Pregnancy pathology
Gynaecology
Antenatal care (out - patient)

The gynaecological department has the following specialised units:

Oncogynaecology (chief. prof. V.M.CHIGRIEJIENE)
Reproductive function (chief. doc. V.Kruminis)
Endoscopic and plastic (chief. Dr. V.Kozeniauskas)
Unit of infectious complications in obstetrics and gynecology (chief. doc. R.Nadishauskiene)

There are 3000 deliveries per year, 1500 typical gynaecological operations, 400 endoscopic surgery and 100 cases of diagnostic laparoscopy per year.

The medical university and our department organize bi-annual training courses in:

colposcopy
fetal monitoring
gynaecologycal endocrinology
ultrasonography
diagnostic and operative laparoscopy and hysteroscopy
pregnancy and extragenital diseases

The following projects and research works are being carried out in our clinic:

Theme 1: Optimizing pregnancy and delivery care in case of existing perinatal pathology.

"Care of women with gestational diabetes (GD)" by doc. D. Baliutaviciene.

An analysis performed on women with GD who delivered between years 1997 and 1998 showed that centralized care of such patients as well as intensive insulin therapy markedly diminishes perinatal mortality (PM). Perinatal mortality among women with GD treated at the Diabetes Center was 6 times lower than among those who were treated at non specialized hospitals. Moreover, after excluding cases of GD with accompanying congenital anomalies PM appeared to be 12 times as low.

"Ultrasonographic diagnosis of intrauterine congenital anomalies (CA)" by doc. V. Kruminis.

One hundred and seventy nine pregnancy outcomes were analyzed, where ultrasonographic fetal anomalies were suspected in utero. Antenatal diagnosis by ultrasound was successful in 50.8% of all CAs; unfortunately, only 34.1% of cases were diagnosed prior 12 weeks of gestation. Predominantly CNS abnormalities were found (51.7%), less commonly urinary system abnormalities (18.7%) and 11% of cases were due to multiple anomalies. It is obvious that about half of all CAs can be diagnosed antenatally. In order to diagnose CAs as early as possible, it is imperative to perform ultrasound examination for all women at risk before 21st week of gestation at a specialized center.

"Diagnosis of cardiophysiologic state of the fetus" by assist. V. Gintautas.

Two groups of pregnant women were included in the study: 1) 216 women with suspected fetal distress and 2) 123 women with uncomplicated pregnancy and delivery. It was found that the duration of fetal heart electromechanical intervals is dependent on FHR and gestational age. It was also determined that changes in cardiac contractility are direct proportional to severity of fetal distress.

"Influence of Immune system on pregnancy" by chief assist. G. Siupsinskas.

Seventy eight pregnant women with various gestational pathologies were included in the trial. Those are: Recurrent spontaneous abortions; intrauterine fetal death of unknown origin; severe preeclampsia and high degree fetal growth retardation. Anticardiolipin antibodies (ACA) were found in 18 women (23%). According to literature ACA among population is lower than 5-6%. In conclusion, a big deal of perinatal pathologies, caused by placental functional abnormalities, are due to autoimmune disorders (antiphospholipid syndrome). It would be rational to perform prepregnancy examination of ACA in women at risk and, if needed, prescribe appropriate treatment during pregnancy.

"Intrauterine infection and pregnancy outcome" by chief assist. D. Vaitkiene.

The trial consisted of recovering amniotic microflora during normal pregnancy and in cases of premature rupture of membranes (PROM). The aim was to study the influence of that microflora on pregnancy arrest and other perinatal pathologies. A thesis was maintained on "Intrauterine infection and pregnancy outcome in cases of PROM".

Theme 2: Influence of sexual behavior on women’s health.

"Problems and methods of family planning in Kaunas region" by Prof. V. Sadauskas.

Data are collected according to a standardized questionnaire and the trial consists of 2 groups of women: 1) Women who had previous induced abortions and 2) women who are using contraceptive methods. 400 women are already inquired but we are expecting to reach 600. The aim is to determine the reason why women decide to have induced abortion, why they use contraception and what kind of methods they do or do not prefer. Results would be valuable in both medical and demographic concerns.

"Infertility diagnosis and treatment" by doc. R. Janickiene.

Years 1996 to 1998, 86 artificial inseminations were performed with washed sperm for 38 infertile women. Husband’s sperm was used for this purpose. 8 of them conceived (21%). Frequency of conception according to menstrual cycle was 8.9%. Three women were prepared for artificial insemination with donor’s sperm at Tartu University Clinic and two of them conceived and had term deliveries. Eleven women were prepared for IVF at Tartu University Clinic. It is necessary to establish IVF laboratory at Kaunas University Clinics in order to solve problems of infertile couples.

"Significance of conscious maternity and paternity" by doc. M. Butylkina.

The trial relied on an anonymous questionnaire filled up by 12-17 year-old teenagers: 546 girls and 392 boys. Almost all girls and 2/3 of boys checked the necessity of lessons on sexuality, preferably between ages 12 and 14. According to the data collected 53.6% would remain friends and only 15.5% would become parents. This shows the need to have centers for counseling on family matters, where teenagers could get the necessary and qualified information about concerning matters.

"Human papilloma virus (HPV) prevalence among women of Kaunas" by doc. R.J. Nadisauskiene.

Four groups were included in the trial: 1) Women on regular gynecologic visits; 2) women with gynecologic complaints; 3) patients hospitalized for venereal diseases and 4) oncologic patients. A questionnaire was used for this trial. HPV was determined by molecular hybridization. 532 women were studied. One third of them had antibodies characteristic to high risk of malignancy. High risk HPV was found more frequently in smoking women, women who had more than one sexual partner during the last year period and women who had earlier sexually transmitted disease. A conference on HPV and cervical cancer was organized.

Publications