[Comparative evaluation of efficiency and tolerance of two alternative methods for premature uterine contractions suppression using fenoterol and nitroglycerin]. / Ocena porównawcza skutecznosci i tolerancji dwóch alternatywnych metod hamowania przedwczesnej czynnosci skurczowej macicy za pomocy fenoterolu i nitrogliceryny.

In the Obstetrics and Gynaecological Department of the National Research Institute of Mother and Child between January 1998 and December 1998, sixty women with premature uterine contractions were treated. 30 women were treated using transdermal nitroglicerin (Nitroderm) and 30 using Fenoterol. There was no difference between age, parity and gestational age at the beginning of this study. The authors compared the efficiency, tolerance and safety of transdermal nitroglicerin and beta-mimetics used for premature uterine contraction suppression. The frequency and intensity of adverse effects were also evaluated.

[Uterine wall perforation as a complication of the intrauterine Spiran contraceptive device]. / Przebicie sciany macicy jako powiklanie stosowania wewnatrzmacicznej wkladki antykoncepcyjnej typu "Spiran".

A case of asymptomatic perforation of uterine wall as a complication of polish IUD " Spiran " application was demonstrated. Underlying rareness of this complication hypothesis of its mechanism in this case are discussed.

[Clinical value of the fetoplacental ratio]. / Ocena wartosci klinicznej wskaznika poplodowo-plodowego.

Scientific interest in the placenta derives not only from its enormous diversity of form and function but also from the unique metabolic, endocrine and immunologic properties. The steady increase in size and weight of the placenta throughout pregnancy has been investigated in the large number of studies. The data obtained from weighing the placenta vary considerably, depending upon how the placenta is prepared. If membranes and mass of the cord are left attached and adherent maternal blood clot is not removed, the weight is increased by nearly 50 percent. In our study we tried to asses the value of the feto-placental ratio and to correlate the weight of placenta with the other data obtained during pregnancy and labour and with outcome of pregnancy. A group of 1010 patients was assessed. The data obtained these patients were correlated with the length of pregnancy, the body weight of the baby and the status of the newborn estimated by Apgar score in 1 and 5 min. The feto-placental ratio was significantly affected by the length of pregnancy and the status of the newborn. Another comparisons were made with the medical illnesses during pregnancy, i. g. H--Gestosis, renal diseases and the cholestasis of pregnancy.

[Inhibition of premature uterine contractions]. / Hamowanie przedwczesnej czynnosci skurczowej macicy.

Various drugs used to stop premature uterine contractions are discussed in the paper. Particular attention is paid to beta-mimetic drugs. The results of ming Partusisten, one of beta-mimetic drugs, is presented on the material of 104 patients with threatening immature and premature labour. Partusisten was administered in the form of intravenous drip infusion or tablets. During treatment monitoring of the uterine contractility and of foetal heart rate took place. Inhibition of the uterine contraction activity was successful in 100 per cent of cases. In 60,9 per cent in the group of threatening immature labour and in 38,1 per cent in the group threatening premature labour, the delay of delivery was more then 28 days. The delay of delivery by 48 hours was 87 per cent and 84 per cent in both groups respectively. Tachycardia was one of the first side effects observed in 15,2 per cent of cases. There is also presented an example of pregnancy when delivery was delayed by 21 days in spite of premature outflow of amniotic fluid (at a high rupture of membrane). The authors are of the opinion that Partusisten is very effective and gives little side effects, preventing premature uterine contractions. Dosage should be individualized according to the case and labour advancement, and should be based on topographic evaluation of uterine contraction. Negative influence of the drug on foetuses was not observed.

[Prenatal monitoring of fetal heart activity and the course of labor and the state of the newborn infant]. / Przedporodowe monitorowanie czynnosci serca plodu a przebieg porodu i stan noworodka.

In the paper practical importance of cardiotocographic interpretation of records carried out during pregnancy is discussed as well as the importance of antepartum monitoring of foetal heart rate. 1944 records of 663 pregnant women were analysed. Observations of basic frequency of foetal heart rate, oscillation and heart rate response to foetal movements and uterine contractions were made. Taking into consideration these criteria the records were classified as: reactive, nonreactive and combined (reactive and nonreactive) patterns. Among 663 cases there were 544 reactive patterns, 73 combined with predominance of reactive ones, 34 combined with predominance of nonreactive ones and 12 nonreactive patterns. Comparison of separate types of records with Apgar test in the 1 st, 3 rd, and 5 th minute shows that low Apgar score (below 7) is mainly related to the group of nonreactive and combined records with predominance of nonreactive patterns. Apgar score is above 7 in the group of reactive and combined patterns with predominance of reactive pattern. Comparison of the types of records to the kinds of delivery termination shows that in predominately nonreactive pattern there was 50-55% of operational deliveries in predominately reactive pattern groups however 24%. Therefore repeating reactive pattern in antepartum monitoring records is the evidence of good foetal state and this state most probably will not be disturbed during labour. Repeating nonreactive pattern with decreasing oscillation is the evidence of increased foetal distress.