[Risk factors for fetal macrosomia].

AIM: To determine the influence of some of the risk factors on fetal macrosomia. MATERIALS AND METHODS: A retrospective study was provided at the Department of Obstetrics and Gynecology, Medical University, Pleven, from January, 1, 2001 to December, 31, 2002 over 625 deliveries: 225 cases of fetal macrosomia--fetal birth weight (FBW) more than 4000 g and/or over 90. percentile (macrosomic group--MG) and 400 cases of singleton term newborns--with FBW between 10. and 90. percentile (nonmacrosomic group--NMG). Analysis included influence of: maternal age, height, prepregnant weight, BMI, weight gain and weight before delivery, previous delivery of macrosomic infant, maternal diabetes mellitus, fetal sex and gestational age. RESULTS: A comparative analysis of data for both of groups was performed. It was found significant correlation (p = 0.001) for influence of maternal age (r = 0.34); height (r = 0.33); prepregnant weight (r = 0.42); BMI (r = 0.32); weight before delivery (r = 0.49); weight gain (r = 0.34); previous delivery of macrosomic infant (r = 0.41); maternal diabetes mellitus (r = 0.54); fetal sex (r = 0.37) and gestational age (r = 0.39). Correlations are different in both of groups. CONCLUSION: Positive correlations between analysed factors and delivering of macrosomic infants and differences in both of groups suggest that analysed factors can't explain completely fetal macrosomia.

[Indications for third and more than three cesarean sections--analysis and pattern of practice]. / Indikatsii za treto i poveche ot tri tsezarovi secheniia--analiz, nasoki za povedenie.

PURPOSE OF THE STUDY: Authors aimed to analyse indications for third and more than three times cesarean sections (c. s.), as well as, to make an assessment of the adequacy of the taken decisions. METHODS AND MATERIALS: It was conducted a retrospective study for third and more than three times cesarean, including period 1991-2003 in the Department of Obstetrics and Gynaecology, Medical University, Pleven. During that time 28645 births has taken place, 2971 of which are by cesarean section. 2,5% from the last, has been third and more than three times cesarean. Using expert judging, indications for the last were divided into three groups-right, disputable and wrong. RESULTS: In the cases with only one mentioned indication "Re-re c.s." 37,8% (28 patients), ratio between right, disputable and wrong was 2:1:1 and the same ratio in the cases with indication "Re-re c.s.+ other indications" 58,1% (43 patients), was 5:1:1. In 4,3% of the cases (3 patients) no indication "Re-re c.s." was mentioned. CONCLUSION: Reduction of third and more than three times cesarean can be achieved by more careful judgement of indications in second, "disputable", group and erradication of the "wrong", which most commonly are jatrogenic reasons. This will result in diminishing the increasing frequency of abdominal births, as well as, preventing possible complications for mother, connected with operation.

[Leiomyomatosis and chronic pelvic pain]. / Leiomiomatoza i khronichna tazova bolka (predvaritelno suobshtenie).

UNLABELLED: Leiomyomatosis is one of the major gynaecological diseases, which cause the onset of chronic pelvic pain /CPP/. PURPOSE OF THE STUDY: To build up a pain profile of patients with leiomyoma by the use of quantitative and qualitative characteristics. METHODS AND MATERIALS: The study was conducted through the period of 01.01.2004-01.07.2004 in the Clinic of Gynaecology of the Department of Obstetrics and Gynaecology, Medical University-Pleven. During that period 94 patients with leiomyomatosis were admitted in the clinic, and they filled in an inquiry form, containing also a pain calendar and pain map. Clinical and pathohistological data, verifying type, localization and clinical manifestation were used too. RESULTS AND DISCUSSION: Forty-eight /51.1%/ of 94 patients with leiomyomatosis admitted in the clinic had been experiencing CPP. CPP had been the reason for diagnosing leiomyomas. A dependency was determined between quantitative value of CPP and: localization of leiomyomas, presence of another accompanying myoma gynaecological pathology, body mass index, histological changes, time of the onset of CPP, chronological appearance according to day and menstrual cycle. Pain qualitative characteristics were mainly defined by localization of leiomyomas, histological changes in them and eventually a presence of another accompanying myoma gynaecological pathology. CONCLUSION: Building up a specific for leiomyomatosis pain profile helps to provide a faster and more accurate diagnostic assessment and therapeutic management.

[Sex behavior and contraception among the population of Romany origin]. / Seksualno povedenie i kontratseptsiia sred naselenieto ot romski proizkhod.

The modern and reliable methods for contraception are not sufficiently used in our country, especially among the Gypsy population, where the abortions and the births are relatively higher. Through a standardised interview information about the fertility and the familial status of the Gypsy population of Sofia, Pleven [correction of Eleven] and Sliven regions was gathered. The aim of the study is analysis of the sexual behaviour of the population in the given regions and the need of adequate contraception avoidance of unwanted gravidity. The results show that only 12% of the population know how to protect themselves of sexually transmitted diseases, 55% of the women have not knowledge about their own gravidity, 57.3% of them give birth of their first child at the age of 15-17, 78.1% do not use contraceptive means and 3.6% use harmful "protective" methods.

[A histological study of the experimentally damaged ligamentous apparatus of the joints in rabbits treated with celeston]. / Khistologichno prouchvane na eksperimentalno uvreden vruzkov aparat v stavi na zaitsi, tretirani s tseleston.

A histological study was made on experimentally damaged ligament apparatus of the ankle joint of rabbits, treated with celestone, divided into three groups: celestone was administered immediately after the damage in the first group. Morphological changes were manifested slightly. Celestone was administered on the 20th day after the damage in the second group. A manifested chronic productive inflammatory process with hyalinization was established morphologically. The most manifested changes were found in the control group of rabbits, which were not treated with celestone. Intraarticular, administration of celestone in ligament damages immediately after trauma prevents occurrence of severe fibrous changes and contributes for functional recovery of the ligament apparatus.