Rubavičiūtė, Ieva

ABSTRACT Title: Characterisation of Perinatal Autopsies in 2016-2021 at LUHS Pathological Anatomy Department. Author: Ojaswi Gupta Aim: Perinatal Mortality(PM) is classified into stillbirth and neonatal death, and years of studies conducted in the field of PM have found a wide range of conclusions about the causes and the complications leading to PM with similar results about the prevalence of PM according to particular gestational age (GA) and gestational weight (GW) during the time of the birth of a newborn. The study aims to determine the most frequent cause of death and complications for stillborns and newborns with autopsies performed at Lithuanian University of Health Sciences (LUHS) Kaunas Clinics, pathological anatomy department 2016 - 2021.  Methods: 291 clinical cases were selected from the archive of the pathological department, Kaunas Clinics, LUHS. These cases were recorded after a post-mortem of each unfortunate fetus in the 5 years of 2016 to 2021. PM cases were selected based on the GA and underlying causes from these perinatal autopsies. The study’s results are based on the retrospectively collected data, translated from Lithuanian to English, categorised according to the suitable criteria, analysed according to the objectives of the study using Microsoft Excel Software, and then discussed with the reviewed collected information.  Results: The five-year retrospective study of 291 selected perinatal autopsy cases concluded that Perinatal Asphyxia (PA, n=186, 33.8%,rs=0.75, p (2-tailed)=0.08594) is the leading cause of PM in Kaunas, Lithuania. Prematurity(n=178, 32.3%,rs=0.23191, p=0.65837) and Infections(n=129,23.4%, rs=-0.42647, p=0.39908) were the next frequent causes associated with PM. The other causes include Congenital Multiple Malformation (CMM, n=35, 6.4%,rs= 0.35294, p=0.49257), sepsis(n=15, 2.7%, rs =-0.50752, p=0.30408) and Genetical Disorders (GD, n=6, 1.2%). Placental Damage/abnormalities(PD, n=173,rs=0.5523, p=0.25579) and Umbilical Cord Abnormalities(UCA, n=92,rs=0.46382, p=0.35416) were found to be the true underlying causes of PM. Co-morbidities concerning PM are the various organ system disorders such as neurological, respiratory, circulatory, hepatic and nephrological systems present due to the development of CMM and GD. The maximum risk of stillbirth is recorded at 38 and 40 weeks of gestation. The least PM cases among the selected were noted at the GA of 26 weeks. 36.3% of newborns were small-for-gestational-age(SGA,n=103 out of 29,rs=0.16176, p=0.75947), which is recorded as the other most common complication in PM cases along with the aspiration of amniotic fluid(n=113 out of 29,rs=0.81168, p=0.04986). Multiple pregnancies (56.5%,rs=0.35294, p=0.49257) and maternal factors(19.6%) pose the highest stillbirth risk.  Conclusion: In Kaunas, multiple number of prematurity cases (<37 weeks) are studied, which are most prevalent at the GA of 22-27 weeks; however, most perinatal death's GA is estimated to be nearly full-term, which corresponds to the primary leading cause - PA, which observes the maximum number of deaths at the GA of 38-40 weeks as well along with congenital malformations. Other trends include the prevalence of infections at the GA of 25 weeks. Most co-morbidities in various organ systems appear around the GA of 22 to 27 weeks. The maximum number of GW cases is recorded on a scale of 500 to 1000 grams averaging at the GA of 27 weeks. SGA infants due to a PD harbour the preponderance when the inadequacy of GW according to the GA is considered. In each case of PM studied during this study, there was more than just one cause of death present. However, based on the primary cause leading up to PM, PA and prematurity predominate this retrospection as they appear to occur at the term simultaneously. Placental and umbilical abnormalities refer to the necessity of antenatal sustenance. CMM and GD are associated with dysgenesis of organ tissues, while PA leads to neurological and hepatic injuries in most PM cases. Key words: Perinatal Mortality, Gestational Age, Gestational Weight, Stillbirth, Newborn, Prematurity, Asphyxia, Placenta, Infant, Fetal Death.

Urinary bladder cancer is a heterogeneous disease with a variable natural history. The morphological type, stage and grade of these tumors vary within surgical specimens and have an impact on prognosis, treatment and further progression on the malignancy. According to recent scientific research data, correlation between the gender, age and other demographic features,tumor characteristics and therapy success as well as incidence of bladder cancer is identified, but the results are still inconclusive. Early and accurate diagnostic and prognostic criteria are essentially important not only for diagnosis, but also for individualized treatment planning and strategise therefore, accurate characterization of progression, prevalence, and distribution of bladder cancer according to socio-demographic characteristics requires more detail and standardized research. This study will focus on the distribution of morphological types, stage (first reported diagnosis) and other tumor characteristics in relation to the patients socio-demographic features