[Utero-ovarian flow velocity waveforms in patients after renal transplantation]. / Przeplyw krwi w krazeniu maciczno-jajnikowym u pacjentek po przeszczepieniu nerki.

The aim of this study was to estimate the utero-ovarian flow velocity waveforms in patients after renal transplantation. The study material consisted of 24 women aged 28-44 years which underwent renal transplantation and 26 healthy controls. All women had normal menstrual cycles. Using transvaginal approach PSV, RI and PI were measured both in uterine and intraovarian arteries. There were no differences in PSV in both groups. The group of ranal transplants had significantly decreased PI and RI measurements on the side of renal placement when compared to the other side or controls. We conclude that renal transplantation influences blood flow in pelvic vessels by lowering resistance on the side of transplantation.

[Testicular artery Doppler flow evaluation in men with degenerative changes of seminiferous tubules]. / Ocena przeplywów naczyniowych w tetnicy jadrowej u mezczyzn ze zmianami zwyrodnieniowymi kanalików kretych jader.

AIM: The aim of this study was to assess the eventual impact of degenerative changes of seminiferous tubules on Doppler flow parameters in testicular vessels. MATERIAL AND METHODS: There were 12 men with degenerative changes of seminiferous tubules (diagnosed by testicular biopsy) in study group and 24 healthy men with normal semen parameters in control group. Patients' age in both groups was respectively 32.22 +/- 5.31 and 29.64 +/- 3.17 (ns). Sonographic biometry of testes volume was performed and the values of qualitative flow indices in terminal section of testicular artery were evaluated. The both groups results were compared with themselves by T-test. Also the values of qualitative flow parameters in testis after biopsy and contralateral one were compared. Additionally the correlation between vascular flow parameters and selected hormone levels (FSH, LH, T, E2 and Prl) was determined. RESULTS: The mean testes volume in the study group was 10.81 +/- 3.77 cm3 and in the control one 14.42 +/- 5.42 cm3 (ns). The values of particular flow indices in both study and control group were respectively: S:D 3.20 +/- 0.95 and 2.92 +/- 0.96 (ns), PI 1.46 +/- 0.46 and 1.23 +/- 0.41 (ns), RI 0.69 +/- 0.09 and 0.66 +/- 0.08 (ns). There were no differences between flow parameters in testis after biopsy and contralateral one. Testosterone was the only hormone correlating with analyzed flow indices (S:D, PI, RI) and the correlation coefficient value was respectively 0.51, 0.49 and 0.52 (p < 0.05). CONCLUSIONS: The significant influence of degenerative changes of seminiferous tubules on vascular flow in testicular artery was not observed. There were no differences between flow parameters in testis after biopsy and contralateral one. The testosterone was the only hormone significantly correlating with analyzed flow indices.

[Feto-maternal immunization and fetal hemolytic disease: invasive diagnostics and therapy in the Warsaw center of serological collision in years 1992-1999]. / Immunizacja matczyno-plodowa i choroba hemolityczna plodu--inwazyjna diagnostyka i terapia w stolecznym osrodku konfliktu serologicznego w latach 1992-1999.

OBJECTIVE: The objective of this study was the assessment of intrauterine procedures, which are performed during the diagnostic phase and therapy of fetal hemolytic disease in the Warsaw Center of Serological Collision. MATERIALS AND METHODS: The study covered 146 women, who were patients of the Center from 1992 to 1999. Analyzed were the time of commencement of diagnostic and treatment, type of operations, duration of therapy, time and manner of delivery after the past intrauterine procedures, the medical condition of infants born as a result of these deliveries and the necessity for blood treatment in the early neonatal stage. RESULTS: 451 intrauterine procedures were carried out, of which 159 were diagnostic punctures of the umbilical vessel and 292 were fetal transfusions. The diagnostics and treatment was performed between the 19 and 38 week of pregnancy. The number of punctures for each patient ranged from 1 to 4, and 1 to 10 for intrauterine transfusions. The therapy, which on average lasted 42 days, significantly improved the fetal blood morphology results. During the therapy 5 intrauterine demises were noted--3 as a result of advanced fetal hemolytic disease and 2 related to operation complications. The average pregnancy duration in the analyzed group was 36.4 for treated women and 37.4 weeks for diagnosed women. 52.7% of deliveries were vaginal, 47.3% were performed by cesarean section. The general condition of 87% of infants was good. However, 77% of infants required blood treatment during the early neonatal period. CONCLUSIONS: Invasive methods of fetal hemolytic disease diagnostics and intrauterine therapy assure high efficiency in the guiding of serological collision and fetal hemolytic disease conflicted pregnancies. At the same time, these methods are safe and carry a low risk of complications.

[Computer-assisted analysis of cardiotocographic recordings in the course of fetal hemolytic disease]. / Komputerowa analiza zapisów kardiotokograficznych w ciazy powiklanej choroba hemolityczna plodu.

OBJECTIVES: The aim of this study was to assess the usefulness of computerized cardiotocography in the diagnostics of fetal hemolytic disease. STUDY DESIGN: 50 invasive diagnostic and therapeutic procedures proceeded by computer assisted CTG recording were analysed. The values of particular parameters of CTG were compared with adequate values obtained in uncomplicated pregnancy. The correlation between both cardiotocographic and hematological parameters was estimated. The common relationship between all analyzed features was examined using multidimensional analysis of variancy. RESULTS: The most significant correlation was determined in case of short-term variation and hematocrite of fetal blood. The five-feature algorhythm, containing short- and long-term variation, number of accelerations, fetal movements and gestational age, was established for the prognosing of the most probable level of fetal hematocrite. CONCLUSION: Computerized cardiotocography seems to be the useful diagnostic method which enable to decrease the number of invasive intrauterine procedures in case of fetal hemolytic disease.

Albumin and packed red blood cells in the treatment of severely isoimmunised pregnancies.

The most effective method of treatment of severe cases of fetal haemolytic disease are intrauterine intravascular transfusions. In some hydroptic cases however, the administration of only packed red blood cells produces unsuccessful results. We found that albumin supplementation paralleled with PRBC injection significantly increases the effectiveness of intravascular treatment.