[Pruritic urticaria-related papules and plaques of pregnancy: a case report]. / Rzadki przypadek zapalenia pokrzywkowo-grudkowo-plamistego skóry ciezarnych.

Rarely met pruritic urticarial papules and plaques of pregnancy usually are connected with multiply pregnancy. Disease begins in the third trimester of pregnancy, doesn't react on treating and disappear after delivery. In the reported case massive skin changes disappeared in a few days after caesarean section.

[Maternal serum cytokines in labor, pregnancy and chorioamnionitis]. / Wyniki oznaczen wybranych cytokin w surowicy ciezarnych oraz rodzacych przedwczesnie i o czasie.

UNLABELLED: The purpose of our study was to compare maternal serum levels of interleukin-6, interleukin-8, tumor necrosis factor-alpha and interferon-gamma in gravidities, during spontaneous term and preterm labor and their relation to histologic chorioamnionitis. METHODS: We investigated 61 women: 10 in preterm labor, 36 in term labor and 15 healthy pregnant nonlabouring controls. Venous bloods for cytokines determinations were obtained during the first stage of labor and during routine screening tests. Titers of cytokines were measured by means of ELISA technique. All births after preterm deliveries were examined to establish histologic chorioamnionitis. RESULTS: Serum levels of IL-6 and IL-8 were significantly elevated both in term (mean: IL-6: 17.5 +/- 58 pg/ml; IL-8: 148 +/- 215 pg/ml) and preterm labor (IL-6: 23 +/- 44 pg/ml; IL-8: 332 +/- 389 pg/ml) when compared to nonlabouring gravidities (IL-6: 5 +/- 7 pg/ml; IL-8: 14 +/- 11 pg/ml). IL-6 and IL-8 titers were statistically similar in term and preterm labors and in patients with and without histologic chorioamnionitis. TNF-alpha and IFN-gamma were not statistically analyzed because only a few patients had detectable serum levels of these cytokines. CONCLUSION: Serum levels of IL-6 and IL-8 in both: term and preterm labor are elevated in comparison to nonlabouring gravidities. The elevated levels of these cytokines are not connected with coexisting chorioamnionitis.

[The role of peripheral blood lymphocyte subpopulations in differentiation between preeclampsia and transient hypertension]. / Znaczenie oznaczen subpopulacji limfocytów krwi obwodowej w róznicowaniu pomiedzy preeklampsja a nadcisnieniem przemijajacym w ciazy.

OBJECTIVES: Hypertension is the most frequent complication of pregnancy after 24th week of gestation, occurring in 8% of pregnancies and being the main cause of perinatal mortality and morbidity. It is classified as preeclampsia (PE) or transient hypertension (TH). According to some statements PE and TH are distinct syndromes of different pathogenesis. There are even opinions emphasizing that in most cases TH is in fact undiagnosed chronic hypertension. The role of immunological system in pathogenesis of PE is well known but the hypothesis that immunological events are engaged in pathogenesis of chronic hypertension has not been proved so far. Assuming that TH is closer in its pathogenesis to chronic hypertension than to PE it would be possible to differentiate between TH and PE using some immunological tests. If PE and TH are the same, the differences would be insignificant. DESIGN: The aim of this study was to check the hypothesis that peripheral blood lymphocyte subsets analysis is an useful tool in differentiation between PE and TH and confirmation of their distinct origin. MATERIALS AND METHODS: The study groups consisted of 19 pregnant women with PE (mean age 25.5 +/- 2.5 years, mean gestational age 32.5 +/- 2.5 weeks, 84.2% primiparae) and 14 pregnant women with TH (mean age 27.0 +/- 3.0 years, mean gestational age 33.5 +/- 3.0 weeks, 100% primiparae) diagnosed between 30-37 week of gestation. All women were matched according to gestational age and race. They had no renal diseases or chronic hypertension prior to pregnancy neither had any features of them during the study. Exclusion criteria were: uterine contractions, infection and therapy with steroids before blood sampling. PE and TH were defined according to USA National Health Institute criteria. Peripheral blood was obtained by venipuncture. Standard immunofluorescent marking techniques for whole blood with one-step monoclonal antibodies were performed. Lymphocyte subsets (CD19+, CD3+, CD4+, CD8+, CD3-/CD16+/CD56+, CD3+/CD16+/CD56+, CD8+/CD28+, CD4+/CD45RA+, CD4+/CD45RO+, CD3+/CD69+) analysis was done with flow-cytometer FACSCalibur with 488 nm argon laser. The lymphocyte cells region was chosen with LeucoGATE and analysis performed with SimulSET v.3.1 programme. Statistical analysis was based on Student T test. RESULTS: The differences in peripheral blood lymphocyte subsets composition between PE and TH were insignificant. CONCLUSION: Is that on the basis of peripheral blood lymphocyte subsets analysis PE and TH despite different clinical symptoms seem to have common pathogenesis. However there is possibility that changes observed in peripheral blood are not significantly different in PE and TH because of their low importance for immunopathogenesis.

[The role of cytokines in Th1/Th2 balance in pregnant women with transient hypertension]. / Rola wybranych cytokin w równowadze Th1/Th2 u ciezarnych z nadcisnieniem przemijajacym w ciazy (NP).

OBJECTIVES: There is growing evidence that Th1/Th2 imbalance in cytokine network may play role in immunopathology of preeclampsia (PE). Normal pregnancy is "Th2 phenomenon" while PE is believed to be caused by Th1-shift. There is few data concerning Th1/Th2 imbalance in transient hypertension of pregnancy (TH). DESIGN: The aim of this study was to check the hypothesis that changes in IFN-gamma and IL-2 (Th1 cytokines) levels are accompanied with deficit in TGF-beta (anti-Th1 cytokine) production in TH. MATERIALS AND METHODS: The study group consisted of 10 pregnant women with TH diagnosed between 30-37 week of gestation (mean age 27.0 +/- 3.0 years, mean gestational age 33.5 +/- 3.0 weeks) and 10 women with uncomplicated pregnancy (mean age 26.0 +/- 3.5 years, mean gestational age 35.5 +/- 1.5 weeks). All women were primigravidae matched according to gestational age and race. They had no diabetes mellitus and renal diseases prior to pregnancy neither had any features of them during the study. They had no hypertension before pregnancy. Exclusion criteria were: uterine contractions, infection and therapy with steroids before blood sampling. TH was defined according to USA National Health Institute criteria. Peripheral blood lymphocytes (PBL) were cultured for 72 hours in standard 1640 RPMI medium enriched with 20% FCS, L-glutamine, antibiotics (Sigma) and mitogen phytohemaglutynine (PHA) (Sigma). Cytokine levels were estimated in culture supernatants by using standard ELISA kits according to the indications of the producer (R&D). Statistical analysis was performed with Student-T test. RESULTS: In TH group the levels of IL-2 were higher compared with control group but the differences did not reach statistical significance (4.5 vs. 1.56 pg/ml, t = -1.00, p < 0.1). The same referred to IFN-gamma levels (754.0 vs. 771.0 pg/ml, t = -0.04, NS). However, TGF-beta levels were significantly lower in TH group compared with control group (2459.2 vs. 4156.4 pg/ml, t = -1.47, p < 0.05). Conclusion is that there is a significant deficit of TGF-beta production in peripheral blood lymphocytes of women with TH studied "in vitro". This may contribute to Th1-shift seen in TH similarly to PE.

[Twin pregnancy complicated by intrauterine death of one twin]. / Ciaza blizniacza powiklana obumarciem wewnatrzmacicznym jednego plodu.

In twin pregnancies single intrauterine death of one fetus is associated with significant morbidity and mortality of the surviving infant. The aims of our retrospective study were to review conditions of twin pregnancies complicated with SIUD in Polish Mother's Memorial Hospital in Lódz between 1989-1999 and to assess the fetal outcome when conservative management had undergone. In this study we reviewed 30 twin gestations involving the intrauterine death of one fetus. The incidence of preterm delivery among pregnancies with fetal death was 83.3%; Caesarean section was the method of delivery in 53.3% cases. Monochorionic placentation was found in 60%. Conservative management until there is no risk for the fetus is apt.

[Risk of preterm birth in twin pregnancy]. / Ryzyko porodu przedwczesnego w ciazy blizniaczej.

The aim of the study was to analyze the selected risk factors in twin pregnancies. Retrospective analysis was carried out in the Research Institute Polish Mother's Memorial Hospital (ICZMP) in Lodz and covered data from the period of time between 1989-1999. Out of 38,066 deliveries which had place in the ICZMP 538 twin pregnancies were enrolled in the study. We evaluated usual risk factors for preterm birth such as body mass index, short cervical length, beta-mimetics admission, presence of bleeding and contractions as well as socio-demographical characteristics such as age, parity, martial status and educational level. Univariate analysis and ?2 test were preformed. Odds ratios and 95% confidence intervals were calculated. For multivariate analysis logistic regression model was used. Most of the risk factors for preterm birth were not significantly associated with spontaneous preterm birth of twins.

[Twin pregnancy with intrauterine death of one fetus]. / Ciaza blizniacza z obumarlym wewnatrzmacicznie jednym plodem.

A case of twin pregnancy with congenital malformations and intrauterine death of one fetus in the 27th week of pregnancy has been discussed. The pregnancy was continued with special care of the mother and the alive fetus. During all stay of the pregnant in the clinic no coagulation disturbances were observed. In the 33rd week of pregnancy spontaneous labour occurred, which was conducted by vaginal delivery. Simultaneously a macerated dead fetus and an alive premature newborn were born. The alive one was charged home in good condition in the 38th day of staying in the Neonatal Ward.