[Gestational hypertension (GH) and a1166c polymorphism of angiotensin II type 1 receptor]. / Nadcisnienie ciazowe (GH) a polimorfizm A1166C receptora typu 1 angiotensyny II (AT1).

INTRODUCTION: Recent studies have suggested an association between genetic background of renin-angiotensin system (RAS) and the pathogenesis of pregnancy induced hypertension (PIH). However, the role of the gene coding for angiotensin II receptor (AT1) polymorphism in PIH is not fully understood, thus the aim of the present study was to determine the frequency of A1166C mutation in women with gestational hypertension (GH) and to establish the role of this polymorphism on the susceptibility to the PIH development. PATIENTS & METHODS: We have analysed 88 women with PIH and 113 healthy pregnant women as a controls. Genomic DNA was extracted from leucocytes using polymerase chain reaction (PCR) followed by restriction fragment length polymorphism (RFLP). RESULTS: We have detected overrepresentation of mutated homozygous genotypes in the PIH group (11.4% in the PIH versus 2.7% in the controls). Homozygous wild-type genotypes were underrepresented in the PIH group (48.9% in PIH and 56.6% in controls). The frequency of heterozygotes was similar in both groups. Statistically significant overrepresentation of allele with mutation in the PIH group (31.3% in the women with PIH, and 23.0% in the controls) (O.R. = 1.5, p = 0.04) was observed. CONCLUSION: We suggest that presence of A1166C mutation is a risk factor for the development of PIH.

[Cesarean section for the second twin during the course of delivering twins]. / Ciecie cesarskie na drugim plodzie w przebiegu porodu ciazy blizniaczej.

We have analysed 6 cases of twin pregnancies with vertex presentation of the first foetus. In this cases after delivery of the first twin by vaginal route caesarean, section was made. Caesarean section of the second twin was made because of: transversal presentation with fetal distress syndrom (four cases), umbilical cord drop (one case), and premature placenta ablation (one case). We have determined acid base balance and Apgar score. We have noted worse results for the second twin, independently too of the time between deliveries both twins. Caesarean section of the second twin is the rarely clinical situation, but in motivated situation is accepted and reasonable solution.

[The efficiency of goiter prevention due to iodine deficiency in pregnant women]. / Skutecznosc profilaktyki wola z niedoboru jodu u kobiet ciezarnych.

The iodine is indispensable element for life that is also fundamental substract for thyroid hormone synthesis which make very important influence on protein's lipid's, carbohydrate's and highly caloric substances metabolism and are a requisite of proper man development. The pregnant women are one of population group which is the most sensitive on iodine's deficiency. The results of researches indicate on insufficient iodine intake in pregnant women diet, whose take food even according to diet's recommendation given by physician. The wide iodine's prophylaxis which was provided as yet is insufficient in case of pregnant and nursing women. It is confirmed the necessity of additional iodine supplementation. A set of control tests should be done in requires cases that inform physician about changes in function and size of thyroid gland and make possible the individualization of treatment. The supplementation doses of iodine about 150 micrograms are safe and there was not observed any side effects during their taking.

[The use of color Doppler ultrasonography in the diagnosis of benign breast tumors]. / Zastosowanie techniki koloroweo Dopplera w diagnostyce Lagodnych schorzen gruczolu sutkowego.

The paper describes Color Doppler Velocity (CDV) technique with clinical implications in examinations of patients with benign breast lesions. Results suggest that CDV might be useful in differentiation of the breast lesions in routine clinical work.

[The diagnostic value of anti-CMV and anti-HPV-B19 antiviral antibodies in studies on causes of recurrent abortions]. / Wartosc diagnostyczna przeciwcial przeciwwirusowych anty-CMV i anty-HPV-B19 w dochodzeniu przyczyn nawracajacych poronien.

Presence of serum anti-cytomegalovirus (CMV) and anti-parvovirus B19 (HPV-B19) antibodies was studied in 11 women within the first day after consecutive spontaneous abortion in the second trimester of pregnancy and in the control group, consisting of 15 women in the second trimester of a normal pregnancy. Most of studied women manifested presence of serum IgG class anti-CMV antibodies (IgG-anti-CMV) and levels of the antibodies proved significantly higher in women following spontaneous abortions. The patients frequently demonstrated in parallel presence of serum IgG class anti-HPV-B19 antibodies. In one patient a generalised nonimmunological hydrops fetalis was disclosed and her serum contained IgM and IgG class antibodies against CMV as well as against HPV-B19. The results suggest that in majority of the studied women the spontaneous abortion might have resulted from fetal infection due to reactivation of chronic CMV infection in the course of pregnancy.

[Evaluation of using the B-mode color system in sonomammography with computer analysis of images compared with conventional gray scale modalities]. / Ocena zastosowania systemu B-mode color w sonomammografii wraz z komputerowa analiza obrazów uzyskiwanych w tym systemie w porównaniu z konwencjonalna skala szarosci.

The paper describes B-mode color and B-tag modalities with clinical implications in breast examinations. New color techniques show increased sensitivity of the human eye to color pictures compared to gray scale levels. Computer analysis of pictures obtained in color mode and gray scale supports these findings.

[Ectopic cervical pregnancy--conservative treatment with methotrexate]. / Ciaza ektopowa szyjkowa--leczona zachowawczo methotrexatem.

Ectopic pregnancy regardless its localization always remains difficult diagnostic and therapeutical problem. Special attention is paid to cervical pregnancy because of its rare incidence and poor prognosis (even in this day and age maternal death rate is 40-45%). In this paper there has been reported the case of 38 years old patient, admitted to Dept of Gynecological Oncology with suspicion of alive cervical pregnancy. Diagnostic procedures have been described as well as positive results of conservative treatment with Methotrexate (under careful monitoring--ultrasound, beta hCG levels). Also there has been presented detailed description of endocervix curettage after fetal death confirmed ultrasonographically. Current conservative therapy methods for cervical pregnancy have been discussed.

In utero surfactant administration to preterm human fetuses using endoscopy.

Our purpose was to assess the feasibility of the endoscopic delivery of surfactant directly to the fetus during active preterm labor. A gas-sterilized intraoperative fiberscope was introduced through the cervical canal into the amniotic cavity after spontaneous rupture of membranes during preterm labor in 3 patients. The flexible fiberscope was inserted under constant endoscopic visual control to avoid possible trauma to the fetus and the mother. Surfactant was injected into the mouths of 3 preterms fetuses through a catheter placed through the biopsy channel of the fiberscope. Fetal heart rate tracings as well as neonatal and maternal outcome are reported for each case. In utero surfactant placement was successful in each case. The fetal heart rate remained normal throughout the procedure. No maternal or neonatal complications/infections were detected. Our preliminary experience indicates that in utero endoscopic delivery of surfactant to a preterm human fetus is feasible. The usefulness of intrapartum endoscopy in the prophylactic administration of surfactant directly to the fetus, prior to the first breath, has to be assessed in a prospective controlled study.

[Predictive value of absent or reverse end-diastolic blood flow in the umbilical artery in the diagnosis of fetal distress]. / Wartosc prognostyczna zaniku lub odwrócenia koncowo-rozkurczowego przeplywu krwi w tetnicy pepowinowej w diagnostyce zagrozenia plodu.

To examine the significance of the absence of reverse of end-diastolic (ARED) velocity in umbilical artery, outcome of pregnancy in 24 women with this complication was evaluated. Acute or chronic hypoxia was evident in 87.5% fetuses with ARED. Such situation is a definable high-risk state that demands intensive surveillance.

[Evaluation of the clinical value in doing complex analysis of blood flow velocity parameters of the umbilical artery for determining prognosis of fetal status]. / Ocena wartosci klinicznej kompleksowej analizy parametrów przeplywu krwi w tetnicy pepowinowej w prognozowaniu stanu plodu.

Complex analysis of the clinical value of the doppler flow indices was undertaken. A/B, RI and PI were compared separately and in different combinations with fetal status and neonate's condition. Statistical analysis revealed that complex and detailed analysis of few quality indices is of greater clinical value and increases sensitivity, specificity and positive predictive value of the doppler technique in the sense of prognosis of fetal distress and neonate's condition.

[Levels of thyroid hormones during pregnancy and in the perinatal period. II. Levels of iodothyronine in blood serum during cesarean section and puerperium]. / Stezenie hormonów tarczycy podczas ciazy oraz w okresie økoloporodowym. Czesc II. Stezenie jodotyronin w surowicy krwi podczas ciecia cesarskiego i w pologu po cieciu cesarskim.

Analysis of T4, T3 and rT3 concentration in blood serum of 27 women during and after caesarean section was performed. Estimation of hormones using RIA was done. Changes of levels of analysed hormones differed from this found during normal delivery. Periferral conversion of T4 is discussed as a potential source of different levels of T3 and rT3.

[Partial excision of the anterior uterine wall for placenta accreta]. / Wyciecie czesciowe przedniej sciany macicy z powodu wrosnietego lozyska.

Rapid accumulation of blood from placental separation site during cesarean delivery for placenta accreta obscures the surgical field and quickly leads to deterioration of the patient's vital signs. In turn, these conditions such as uterine rupture, placenta previa, placenta accreta, increase the risk of hysterectomy, blood transfusions and prolonged hospital stay. We used the following technique in one case of intractable bleeding during cesarean for placenta accreta. Following failure to control the bleeding by suture at the placental separation site via the lower segment cesarean incision, the lower uterine segment with the abnormal adherence of placenta to myometrium, was excised. Our experience suggests that this technique could reduce the use of hysterectomy in cesarean for some cases of placenta accreta.

[Perinatal infections. Intraamniotic infections]. / Zakazenia perinatalne. Zakazenia wewnatrzowodniowe.

Intraamniotic infections is achieved in ascendent way and presents, for the pregnant woman and her fetus, the most common and also the most dangerous kind of perinatal infections. On the ground of our own clinical findings and medical literature, we have discussed epidemiology, pathogenesis, symptomatology and treatment procedure in the case of intraamniotic infections.

[Perinatal infections. Infection as etiological factor of preterm labor]. / Zakazenia perinatalne. Udzial zakazen w etiologii porodu przedwczesnego.

On the ground of contemporary medical literature and our own observations, we have tried to estimate the participation of microorganism infection in preterm labor. In this article, we present mechanism, currently recognized as the most probable, that are leading to preterm labor under condition of perinatal infections. One of them seems to be the production of enzymes by pathological strains. Those enzymes are considered to stimulate decidual and amniotic cells to arachidonic acid metabolism and prostaglandins synthesis. Coexisted with chorionamnionitis the migration of leukocytes that are able to induce prostaglandins synthesis releasing interleukin, can also be an important factor of preterm labor.

[Perinatal infections. Fetal and newborn immunology in perinatal infection]. / Zakazenia perinatalne. Mechanizmy odpornosciowe skierowane przeciwko drobnoustrojom patogennym w okresie okoloporodowym.

Specificity of neonatal immunologic system we have discussed. Bacterial, viruses (especially HSV), fungal infections and immunologic answer in mentioned cases was presented in this article, on the ground of medical literature. Immunoglobulins production, lymphocyte T activation, production of lymphokines, complement system and phagocytosis in infected fetus and newborn was discussed.