Results and effects in the diagnosis and treatment of diseases received in medical practice from "Complex medical expert" (CME).
BACKGROUND: Most authors agree that the twin pregnancies have a higher risk of complications compared to singleton pregnancies. However, there is no unanimity as to whether the risk of complications in twin pregnancies resulting from in vitro fertilization is higher than in twin pregnancies resulting from spontaneous conception.
OBJECTIVE: The aim of this study was to estimate the frequency rates of complications in the second and third trimester of dichorionic-diamniotic twin pregnancies resulting from IVF (group I) compared to dichorionic-diamniotic and monochorionic-diamniotic twin pregnancies resulting from spontaneous conception (group II and III).
RESULTS: The rate of cesarean section and cervical cerclage was significantly higher in the group I. Polyhydramnios occurred less frequently in group I than in group III. The discordant growth of fetuses occurred significantly more frequently in the group I. The frequency of other complications did not differ in the studied groups. The Apgar score was similar in the group I and II but significantly lower in the group III compared to the group I.
CONCLUSIONS: 1) The frequency of complications in twin pregnancies after IVF is similar to those in the twin pregnancies conceived spontaneously. 2) In the twin pregnancies after IVF it is necessary to expect only a higher frequency of caesarean sections, cervical incompetence and a discordant growth of the twins when comparing with twin pregnancies conceived spontaneously. 3) In the twin pregnancies after IVF the intrauterine fetal demise and polyhydramnios occurred less frequently than in monochorionic-diamniotic pregnancies after spontaneous conception....
OBJECTIVE: Parasitic diseases, particularly the congenital form of toxoplasmosis, can negatively affect the mortality and morbidity of newborns and infants.
METHODS: The authors examined 152 samples of umbilical blood in 152 women who had experienced premature delivery with or without PROM. The samples were examined for the titre of antibodies - the CFR, levels of immunoglobulins IgA and IGM (toxoplasmosis) and for titres of antibodies against toxocariasis.
RESULTS: No presence of IGM was demonstrated in association with the congenital form of toxoplasmosis. The values of titres of antibodies against toxocariasis were negative. There was only one case of a titre in a newborn higher than that in the mother. There was no clinical manifestation of the disease.
CONCLUSION: In spite of the negative result, the authors point out the possibility of a timely diagnosis of these parasitic diseases....
BACKGROUND: Reactive oxygen species (ROS) may cause peroxydation of lipids, proteins and deoxyribonucleic acids with subsequent cell damage. The hydroxyl radical (OH*) represents a measure of global oxidative stress. Hydroxyl radicals are short-lived; they form an important part of radical chemistry nonetheless. The measure of total antioxidant system (TAS) can give useful information about the extent of defence capable of counteracting the oxidative damage. Pregnancy is an important condition that favors oxidative stress in the fetus. Clinical studies indicate a protective mechanism against O2 toxicity in the human feto-placental unit.
AIM: This study reports the OH* and TAS concentrations in mother and fetus at birth to evaluate the role of the placenta against fetal oxidative stress.
METHODS: Blood samples were collected at delivery from 45 healthy women at term and from their newborns. The maternal and neonatal OH* and TAS concentrations were compared by paired Student t-test.
RESULTS: OH* was higher in maternal blood than in cord blood (573.75+/- 170.0 UCarr/l vs 40.08+/-33.37 UCarr/l) (p<0.01); TAS concentrations did not differ between the two groups (1.11+/-0.09 mmol/l vs 1.17+/-0.12 mmol/l). Multiple regression analyses: maternal and neonatal OH* decreases with maternal age; only maternal TAS and OH* are related to gestational age in a nonlinear fashion. Female infants showed higher values of maternal and neonatal TAS as compared to male infants.
CONCLUSION: TA protective role of the placenta against oxidative damage is in keeping with a large enough gradient of ROS (between mother and fetus) and the passage of TAS from mother to fetus....
OBJECTIVE: The effect leptin on fetal growth in healthy and infected newborns is not well known. This study is aimed at: 1) evaluating serum leptin concentration in full term and preterm, healthy and infected newborns, according to their gender, birth asphyxia, intrauterine and neonatal infections, and 2) assessing the correlation between serum leptin levels and anthropometric parameters among healthy and infected newborns.
MATERIALS AND METHODS: The study involved 146 newborns: 73 full-term and 73 preterm, 86 male and 60 female, 56 healthy and 90 infected, aged from 2nd to 4th day of life. Anthropometric parameters, including: birth weight, length, head and chest circumference, and serum leptin concentration were measured in all the subjects. Intrauterine and neonatal infections were diagnosed by the standard criteria.
RESULTS: In this study, it was found that both healthy and infected, but full-term newborns had significantly higher mean leptin concentration than the premature ones (p<0.05). Statistically significant (p<0.05), positive correlations were found between serum leptin level and gestational age, birth weight, head and chest circumference, both in healthy, and in infected newborns.
CONCLUSIONS: Findings of this study suggest that the serum leptin concentration in full term newborns is higher than in the preterm ones, and in females it is higher than in males, 2) among both healthy and infected newborns, there is a positive, linear correlation between the serum leptin concentration and anthropometric parameters, 3) intrauterine and neonatal infections do not have a significant influence on serum leptin concentration. The role of leptin in fetal growth deserves further research....
OBJECTIVES: This work follows up with our already published results concerning consequences of lead on prenatal and postnatal development of child in connection with the rise of hyperkinetic syndrome (ADHD). This disease has in children increasing tendency all over the world.
METHODS: In our work we used a set of histological and histochemical methods, method of scanning electron microscopy, infrared spectroscopy and statistical evaluation.
RESULTS: Our new method for proof of lead in placenta enabled us to show how lead is cumulated in syncytiotrophoblast. We have found release of lead from mother's erythrocytes in the intervillous space and receipt of lead by erythrocytes of fetus in the vessels of the villi of placenta. This finding enriches knowledge about relation between mother's erythrocytes, lead, calcium that is lead carrier, syncytiotrophoblast, and erythrocytes of fetus in the vessels of placental villi. We have proved that syncytiotrophoblast is the most frequent place for cumulation of lead deposits. We verified our ecomorphologic results by means of infrared spectroscopy in cooperation with physicists and statistically evaluated occurrence of ADHD in particular age categories what helps to fill gaps in knowledge of ADHD etiology.
CONCLUSIONS: Our finding of lead in umbilical cord blood immediately after the child birth is forewarning against the possible rise of the ADHD. This finding facilitates early diagnostics and means preventing step against the rise, development and consequences of this disease. The obtained results give evidence about the serious influence of mother's dwelling in environment polluted with neurotoxic metal - lead on the prenatal and postnatal development of child....
: Ovarian function with regular menstrual cycles is usually restored in women of reproductive age after solid organ transplantation. The number of pregnancies reported in these patients increases gradually. Pregnancy is always considered high risk, and not properly planned may lead to serious complications. The best for the patient is to conceive in a period of good general health and good stable graft function, after appropriate preparation and not later than five years after transplantation. Immunosuppressive regimen should be modified before conception. Sirolimus and mycophenolate mofetil should be excluded. The blood levels of immunosuppressive agents should be regularly controlled during the whole pregnancy. The rate of successful pregnancies isn approximately 95% in graft recipients. Increased incidence of preterm labor, anemia and intrauterine growth restriction is observed compared with general population. Organ transplantation itself is not an indication for cesarean section and vaginal delivery is recommended as the best for the patient, the graft and the newborn. Breast feeding is believed to be contraindicated in women on immunosuppressive therapy, however no adverse effects were reported in children of graft recipients who decided to breast feed. The rate of congenital malformations in newborns is approximately 3-4% and does not differ from the rate seen in general population. The rate of perinatal deaths decreased beneath 0.8% in recent reports. Jaundice, hyperglycemia and hyperkalemia, observed more frequently in newborns of graft recipients, are mild and in most cases do not have any clinical implications....
OBJECTIVE: To determine whether amniotic fluid levels of interleukin-8 (IL-8) are of value in the antenatal diagnosis of acute histological chorioamnionitis (HCA) in preterm premature rupture of membranes (PPROM).
SETTING: Department of Obstetrics and Gynaecology, Charles University, Medical School and University Hradec Kralove, Czech Republic.
METHODS: We compared amniotic fluid IL-8 levels in twenty-nine pregnant women with preterm premature rupture of membranes between 24th and 36th gestational weeks with presence and absence acute histological chorioamnionitis or/and microbial invasion in the amniotic cavity using nonparametric tests (Mann-Whitney test), given the non-normal distribution of analyte. Comparisons of proportions were performed with Shapiro-Wilk normality test.
RESULTS: Patients with HCA had a significantly higher median amniotic fluid IL-8 concentration than patients without the histological signs of chorioamnionitis (1867 pg/mL, 826-5577 versus 1045 pg/mL, 60-4133, p=0.013). Patients with MIAC had a significantly higher median amniotic fluid level than patients without invasion (1888 pg/mL, 519-5577 versus 1225 pg/mL, 60-2766, p= 0.017). Women with HCA and MIAC had a significantly higher median amniotic fluid IL-8 level than women without histological signs of chorioamnionitis and microbial invasion (3117 pg/mL, 826-5577 versus 1468 pg/mL, 394-2766, p=0.034).
CONCLUSIONS: HCA or/and MIAC are associated with a significant increase of amniotic fluid interleukin-8 levels. Amniotic fluid IL-8 seems to be a marker of intraamniotic inflammation....