[CALCIUM LEVELS IN URINE SAMPLE IN PREGNANT WOMEN WITH PREECLAPMSIA].

Hypertensive disorders during pregnancy are still leading cause for maternal and perinatal death. Calcium metabolism is impaired significantly in women with preeclampsia. Measurement of calcium levels in 24 hours urine sample is easy, modern, fast and not expensive predictive test to reveal women in high risk of developing preeclampsia in late pregnancy. The severity of condition strongly correlates with decrease level of calcium excretion in urine.

[The vitamin D deficiency--an independent risk factor for developing preeclampsia].

Increasing number of studies during the last years reveal that steroid hormone vitamin D not only regulate calcium metabolism but it influences and other biological processes like glucose metabolism, neural function, cardio-vascular and reproductive systems. More and more clinical data suggests that normal plasma vitamin D levels are required for physiological pregnancy. Vitamin D deficiency is considered as an independent risk factor for developing preeclampsia. Specific pathophysiological mechanisms are not established yet.

[The effect of vitamin D on pregnancy].

Vitamin D is a steroid hormone which plays an essential role in regulation of calcium metabolism. Many recent studies suggest that vitamin D is taking part in regulation of numerous physiological processes-glucose and neural metabolism, cardiovascular and sexual systems. Normal plasma levels of Vitamin D3 are needed for physiological development of pregnancy, normal skeletal mineralization of the fetal skeleton and lactation. Deficiency of vitamin D during pregnancy is associated with increased risk of serious complications like gestational diabetes and preeclampsia.

[The use of carboprost tromethamole for prevention and treatment of postpartal haemorrhage].

All around the world as well as in Bulgaria postpartal haemorrhage is a main reason of maternal death. The treatment of postpartal haemorrhage of which approximately 70% is caused by hypotony of the uterus is still a challenge for physician-obstetrician. In the following study we have used prostaglandin-Carboprost tromethamole (Prostin 15M) for treatment of this important obstetric pathology. One year investigation which includes 82 patients with hypotony during vaginal delivery or cesarian section. Results showed that the use of Carboprost tromethamole (Prostin 15M) in treatment of hypotony leads to fast and extended contraction of the uterus as well as significantly decreases blood loss and the necessity of haemotrasfusion.

[The use of Dinoproston for induction of delivery].

For the past decades induction of delivery is more often put in practice of modern obstetric. During the last couple of years it exceeds 20% of the vaginal deliveries. In the following study we have use Dinoprostone (Prepidil gel) as a remedy which stimulates labor. In 6 months 92 patients were selected. A 92 deliveries were stimulated with Prepidil gel. The results were satisfactory. Dinoprostone represents to be effective, safe and easy to use for induction of delivery.

[Ovarian cancer with metastatic lesion in the vagina (foetus papiraceus)].

Ovarian cancer spreads primarily by intraperitoneal implantation of exfoliated cancer cells, by lymphatic dissemination, and by haematogenous spread. Very rarely it metastasizes to cervix, vulva and vagina; this type of metastases present a diagnostic challenge to the gynecologist and pathologist. We present a case of ovarian cancer with initial clinical manifestation-lesion of the vagina.

[Use of yasmin in the treatment of women with polycystic ovary syndrome].

AIM OF STUDY: To prove the clinical efficiency over hyperandrogenism in women with PCOS after the application of the combined oral contraceptive Yasmin containing 30 mcg ethynilestradiol and 2 mg drospirenone. METHODS: Prospective open study over 15 women taking Yasmin for six months. At the beginning and at the end of the study the following values have been checked--the Ferriman-Gallwey /F-G/ index, BMI, the waist/hip ratio (WHR), some hormonal and biochemical indexes--testosterone, SHBG, immune reactive insulin (IRI), glucose, as well as the values of free androgenic index (FAI) and insulin resistance (HOMA). RESULTS: All fifteen women completed 6 months of therapy. The drug has been accepted very well. At the end of the study there was a significant improvement of hirsutism, expressed in the decrease of F-G index, accompanied by an increase of testosterone and SHBG values. The carbohydrate parameters haven't changed significantly. CONCLUSION: Yasmin is an effective drug in the treatment of hyperandrogenism in women with PCOS with few side effects and no significant influence over insulin resistance.

[Medical abortion using methotrexate and misoprostol. Efficacy and tolerability].

UNLABELLED: Medical abortion means interruption of early pregnancy (usually before 9-th gestational week) as a result of administration of abortifacient drugs without surgical intervention. OBJECTIVE: To investigate the efficacy and tolerability of methotrexate plus misoprostol regimen as a method for early medical abortion < 49 days L.M.P. MATERIAL AND METHOD: 50 mg methotrexate was administered orally to 20 women < 49 days L.M.P. followed by 800 mcg misoprostol vaginal and oral administration 3-7 days after the methotrexate. RESULTS: 19 Successful medical abortions (95%). One woman chose vacuum aspiration for termination of the abortion on day 3 of the induced bleeding. No serious side effects were observed after administration of the drugs. CONCLUSION: Medical abortion with methotrexate and misoprostol is safe and effective and can be offered to practicing gynecologists.

[Treatment of recurrent vulvovaginal candidosis with mycosyst (fluconazole)].

The authors treat 15 women with recurrent vulvovaginal candidosis with 3 sequential oral 150-mg doses of fluconazole (Mycosys, Gedeon Richter), each dose administered 72 hours after the first dose. Candida albicans was isolated in 14 women and Candida glabrata--in one. 14 days later all women had no clinical signs of vulvovaginal candidosis. Three months after the treatment only 11 women consulted for a checking exam--and all of them without clinical complaints, though in three of them (73.3%) C. albicans was isolated from the vaginal discharge. The authors discuss the difficulties in the treatment of recurrent vulvovaginal candidosis and the advantages of the sequential type of therapy with fluconazole.

[The case of secondary abdominal pregnancy in 14th week of gestation]. / Sluchai na vtorichna abdominalna bremennost v 14-ta gestatsionna sedmitsa.

The authors report on a rare case of secondary abdominal pregnancy after tubal rupture of a 40-year-old woman.

[Delivery after cesarean section based on the data of the Obstetrical-Gynecological Clinic of the Higher Medical Institute in Plovdiv for the period of 1984-1988]. / Razhdane sled tsezarevo sechenie po material na Akushero-ginekologichna klinika pri VMI--Plovdiv, za period 1984--1988 g.

The authors studied the history of delivery of all women, who delivered for the period of 1984-1988. For this period 8981 deliveries took place, 849 of which (9.45%) by cesarean section. For the same period 193 women were admitted to the clinic after undergone cesarean section. 161 out of 193 women (83.4%) were delivered by repeated section. 113 women delivered by elective repeated section. Trial of labour was carried out on 80 women. 32 out of 80 women delivered vaginally. Trial of labour was unsuccessful in the remaining 48 women and delivery ended by cesarean section. The causes for failure in the trial of labour are discussed as well as the possible ways for increasing its efficiency.