ABSTRACT
THE PURPOSE OF THE RESEARCH: Analysis of the course of pregnancy and labor in patients qualified for the prenatal diagnostic tests program in Opole Region. MATERIAL AND METHODS: 2513 pregnant women participated in the program. There were 1763 (70.1%) patients above 35 years of age, out of whom 515 women (20.5%) were qualified for amniocentesis and 394 of them (15.6%) decided to undergo the test. Within the group of patients who underwent amniocentesis, 39 karyotypes (9.8%) were found. Analysis of the number of amniocenteses carried out and the number of detected fetal defects showed that initially the number of invasive tests was rising. However since 2007, i.e. since the introduction of biochemical diagnostic tests based on Kryptor technology a significant decrease of amniocenteses tests has been observed, while the rate of detected chromosome aberrations in fetuses has not changed. The course of pregnancy and labor in patients above 35 years of age, who gave birth to children in Gynecology and Obstetrics Hospital in Opole, has also been analyzed. The investigated group comprised 106 patients who underwent amniocentesis, and 138 patients who did not consent to having the invasive test. Apart from a small difference in average birth weight, the analysis of infant condition and their biophysical parameters after the labor has not shown any significant differences. In both groups gestational diabetes was the most frequent disease, and statistically it was diagnosed more often in patients who had not undergone amniocentesis. No statistically significant differences in the frequency of occurrence of other pregnancy complications have been found. CONCLUSIONS: 1. Amniocentesis carried out due to genetic indications between 150th and 20th week of pregnancy may be considered to be a procedure which is safe both for a mother and a fetus. 2. Amniocentesis does not affect the course of pregnancy or the mode of delivery in any significant way. 3. Proper genetics counseling service based on biochemical research enables to decrease the number of amniocenteses tests, while the rate of detected chromosome defects in fetuses remains unchanged.
Subject(s)
Amniocentesis/statistics & numerical data , Chromosome Disorders/diagnosis , Chromosome Disorders/epidemiology , Genetic Testing/statistics & numerical data , Maternal Age , Pregnancy Complications/diagnosis , Prenatal Diagnosis/statistics & numerical data , Adult , Diabetes, Gestational/diagnosis , Diabetes, Gestational/epidemiology , Female , Humans , Hypertension, Pregnancy-Induced/diagnosis , Hypertension, Pregnancy-Induced/epidemiology , Obstetric Labor, Premature/diagnosis , Obstetric Labor, Premature/epidemiology , Poland/epidemiology , Pregnancy , Pregnancy Complications/epidemiology , Pregnancy Outcome/epidemiology , Risk Factors , Women's Health , Young AdultABSTRACT
The central neuronal systems associated with cardiovascular regulation in haemorrhagic shock can be functionally divided into two groups. The first one includes opioid peptides, which inhibit the activity of cardiovascular centre neurones and initiate the sympathoinhibitory phase of regulation in hypovolaemia. The second group consists of non-opioid systems demonstrating anti-shock properties, such as the melanocortinergic. cholecystokininergic, thyreoliberinergic, cholinergic and histaminergic systems. In the present paper, we review recent data concerning the role of the melanocortins in cardiovascular regulation in haemorrhagic shock. Melanocortin peptides, proopiomelanocortin (POMC)-derived peptides which have His-Phe-Arg-Trp sequence, are secreted in large amounts in the sympathoinhibitory phase of cardiovascular regulation in shock. Exogenous melanocortins. such as melanocyte-stimulating hormones (MSHs). adrenocorticotropic hormone (ACTH) and many ACTH fragments induce a long-lasting pressor effect with an increase in the survival rate in haemorrhage-shocked rats. The mechanisms of their action include centrally mediated activation of the sympathetic nervous system and the "cholinergic anti-inflammatory pathway". which leads to an increase in the peripheral resistance and suppression of the transcription nuclear factor appaB-dependent systemic inflammatory response. respectively. Moreover, acting peripherally, the melanocortins stimulate secretion of glucocorticoids, normalise the blood levels of nitric oxide and inhibit free radical generation in haemorrhagic shock. Further clinical studies are needed to confirm the usefulness of the melanocortins in the treatment of haemorrhagic shock in humans.
