[Diabetes mellitus complicating pregnancy]. / Cukrzyca wiklajaca ciaz e.

Of the total 25381 delivered in our Department, in the time from January 1987 to December 1993, 175 (0,69%) were from pregnancies with complicated by diabetes mellitus. 171 of that number ended with healthy babies (172), which is a relatively satisfactory outcome. Only 4 patients lost their babies. They were 3 patients admitted to our programme late in their pregnancy period. Already during their first medical examination the diagnosis was a) nonviable pregnancy in 1 case and b) multiple, congenital defects in the remaining 2 cases. 1 baby was died three days after delivery (congenital heart disease). All patients attended classes of special diabetes mellitus education in the Pathology Ward. Each patient underwent programmed control visits by obstetrician and diabetologist; metabolic therapy reached the level of near normoglycemia. In each case the time of delivery was selected individually. As result of such approach majority of patients gave natural birth. Only in 29 cases (16,6%) caesarean operation was performed. The reason for caesarean operation in 12 of the 29 cases was a previous operation of this kind. In the other 5 cases natural birth was impossible, because of the big foetus. Observation of the newborn babies during their first days of life showed that most of them suffered from the following complications: hypoglycaemia (39,8%), hyperbilirubinemia (25,1%), anaemia (12,9%) and hypocalcaemia (7%). All the babies being in generally good condition were discharged from the hospital on the 5th-10th day together with their mothers. It seems that such good results could obtained owing to special programme, which could by applied also in Regional Gynecological-Obstetrical Ward with help of a local diabetologist.

[Concentration of lipids and lipoproteins in serum of pregnant women with primary hypertension]. / Stezenia lipidów i lipoprotein w surowicy kobiet ciezarnych z nadcisnieniem tetniczym krwi pierwotnym.

The tests have been conducted on 44 women in 3rd trimester of pregnancy. 30 of them were the women with a normal course of pregnancy, and 14 were the ones with the primary hypertension. The blood serum has been tested for the concentration of triglycerides, phospholipids, total cholesterol, HDL and LDL- cholesterol, alpha, beta and pre-beta lipoprotein fractions. The results have been calculated statistically. It has been found that the increase in the concentration of triglycerides (p < 0.001), and the beta lipoprotein fraction (p < 0.004) was essentially higher in the women with the primary hypertension in 3rd trimester of complicated pregnancy in comparison to those values observed in the healthy pregnant women. At the same time a lower concentration of alpha lipoproteins (p < 0.02) has been observed in the group of the pregnant with the primary hypertension. Differences between the concentration of other parameters have not obtained statistical significance.

[Concentration of lipids and lipoproteins in serum of women with pregnancy induced hypertension]. / Stezenia lipidów i lipoprotein w surowicy kobiet z nadcisnieniem tetniczym krwi indukowanym przez ciaze.

The tests have been carried out on 64 women in 3rd trimester of pregnancy. 30 of them were the women with a normal course of pregnancy, and 34 were the ones with hypertension induced pregnancy (PIH). Their blood serum has been tested for the concentration of TG, phospholipids, total cholesterol, HDL- and LDL-cholesterol, alpha, beta and pre-beta lipoprotein fractions. The results have been calculated statistically. It has been found that the increase in the concentration of TG (p < 0.001), phospholipids (p < 0.02), total cholesterol (p < 0.01), the beta lipoprotein fraction (p < 0.001) was essentially higher in the women with PIH, in 3rd trimester of pregnancy, in comparison to those values observed in the healthy pregnant women. At the same time a lower concentration of alpha lipoproteins (p < 0.01) has been observed in the group of the pregnant with pregnancy induced hypertension.

[Evaluation of a seven year period of managing pregnancies complicated by diabetes mellitus]. / Ocena siedmioletniego okresu prowadzenia ciaz powiklanych cukrzyca.

The authors have evaluated seven years' period of the intensive care of pregnant women suffering from diabetes mellitus. In the analysed period 175 patients suffering from diabetes gave birth to babies, and that was 0.69% of all the labours. The most frequent type of diabetes was gestational diabetes mellitus (53.7%), and diabetes of B type (23.5). Diabetes of G-1 type occurred in as many as 44% of the examined women. In the tested group of women the indication to conducting a cesarean section occurred in 16.6% of cases. It was found that the babies born by the mothers suffering from diabetes had in their early neonatal period the following biochemical disorders: hypoglycemia--37.7%, hyperbilirubinemia--17.4%, anemia--8.7% and hypocalcemia--5.8% of cases. Monitoring of pregnancy, the time and the way of its termination should be selected individually for each women suffering from diabetes mellitus.

[An analysis of indications for performing cesarean section from material of the Obstetric-Gynecologic Wards I and II of the District General Hospital in Radom in 1985-1993]. / Analiza wskazan do ciecia cesarskiego w materiale Oddzialów Polozniczo-Ginekologicznych I i II Wojewódzkiego Szpitala Zespolonego w Radomiu w latach 1985-1993.

In 1985-1993 there were 37,046 deliveries in the Maternity and Gynaecological Ward of District General Hospital in Radom. In 4873 (13.15%) cases the caesarean section (c.s) was performed. Primiparas constituted 39.3% and the repeated c.s. was carried out on 1160 (39.2%) patients. In the analysed period the increase in percentage of the c.s. was observed from 11.79% in 1985 to 14.81% of the total number of deliveries in 1993. The most frequent indications to perform the c.s. were the imminent intrauterine asphyxia of the fetus--25.36%, the abnormal position of the fetus--17.73% and the nonprogressive labour--9.89%. In all these groups the operations were performed in over 70% of primiparas. In the case of multiparas the indications to operate were: prolapse of the loop of umbilical cord--71%, placenta previa in 85.8% and the prematurely detached placenta in 72.2% of cases. In 4.45% of cases the c.s. was performed as the result of other than obstetric indications.

[Kidney function in pregnant women with arterial hypertension]. / Czynnosc nerek u kobiet ciezarnych z nadcisnieniem tetniczym krwi.

In a group of 80 women in their 3rd trimester of pregnancy (29-36 weeks) 50 of whom were with hypertension and 30 healthy, the blood serum was studied for concentrations of urea, uric acid, creatinine, total proteins and electrolytes: sodium and potassium. The results were calculated statistically. In the serum of women with hypertension increased concentrations of urea and uric acid were found. Total protein concentration was lower in the studied group, especially those with primary arterial hypertension. Whereas concentration values of electrolytes Na+ and K+ did not seem to be affected by hypertension.

[The effect of hypertension severity in pregnant women and during birth on renal function]. / Wplyw stopnia ciezkosci nadcisnienia tetniczego krwi u kobiet w ciazy oraz ich rodnosci na funkcje nerek.

In a study of 50 women in their 3rd trimester of pregnancy complicated by hypertension of different etiology, the blood serum was examined for concentrations of urea, uric acid, creatinine, total proteins, sodium and potassium. The results were calculated statistically. It was found that the degree of hypertension severity increases concentrations of uric acid, with no significant changes in the values the remaining parameters. There were no differences found in biochemical tests of renal efficiency between primiparous and multiparous pregnancies complicated by hypertension.

[Internal endometriosis from personal material]. / Endometrioza wewnetrzna w materiale wlasnym.

The authors have presented one hundred cases of internal endometriosis of the uterus--adenomyosis recognized by means of the histopathological examination. The coexistence of pathological changes in the reproductive organs of the patients with internal endometriosis has been evaluated. In the tested material in 58% of cases adenomyosis coexisted with the uterine myomas and in 31% of cases with the polycystic ovaries. In the 19 cases the internal endometriosis was concomitant with the malignant pathological changes, which in 8 cases were diagnosed as the endometrial carcinoma. In the histopathological evaluation of the endometrium of the women with internal endometriosis the most frequently found changes were the proliferative ones (29%). In 20 cases the endometrial hyperplasia was recognized, in 3 of them there occurred the adenomatosis type.

[Evaluation of the usefulness of enzymatic determination of estriol in urine and placental lactogen in serum of pregnant women with threatened preterm labor]. / Ocena przydatnosci oznaczania poziomu estriolu w moczu i laktogenu lozyskowego w surowicy krwi u ciezarnych z porodem przedwczesnym zagrazajacym.

The authors studied 60 pregnant women in the pregnancy period from 29-37 weeks with threatened preterm labor. The control group formed 40 healthy pregnant women in the same pregnancy period. In all pregnant women the values of oestriol in 24-hour urine and placental lactogen in the serum was measured. Statistically significantly lower values of placental lactogen were found in the serum of pregnant women with threatened preterm labor. The values of oestriol in 24-hour urine were also lower, but the differences were not statistically significant. In 40 pregnant women in the pregnancy period from 16 to 28 weeks with threatened in the serum is a useful method of monitoring of pregnancy with threatened preterm labor. Determination of oestriol was without any greater diagnostic significance in the case threatened preterm labor.

[Evaluation of usefulness of enzymatically determining estriol in urine and placental lactogen in serum of pregnant women with threatened preterm labor]. / Ocena przydatnosci oznaczania poziomu estriolu w moczu i laktogenu lozyskowego w surowicy krwi u ciezarnych z porodem niewczesnym zagrazajacym.

In 40 pregnant women in the pregnancy period from 16 to 28 weeks with threatened preterm labor diagnosed after clinical investigations and recording of cardiotocogram the values of oestriol in 24-hour urine and placental lactogen in the serum was measured. These values were compared to analogous determinations in a group 40 healthy women with similar duration of pregnancy. Statistically significantly lower values of placental lactogen were found in the serum of pregnant women with threatened preterm labor. The values of oestriol in 24-hour urine were also lower, but the differences were not statistically significant. In conclusion the authors state that enzymatically determined placental lactogen in the serum is a useful method of monitoring of pregnancy with threatened preterm labor. Determination of oestriol was without any greater diagnostic significance in the case of threatened preterm labor.