RESUMO
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.
Assuntos
Angiotensina II/genética , Expressão Gênica/genética , Hipertensão/genética , Polimorfismo de Fragmento de Restrição , Complicações Cardiovasculares na Gravidez/metabolismo , Receptores de Angiotensina/genética , Adolescente , Adulto , Análise Mutacional de DNA , Feminino , Humanos , Mutação Puntual/genética , Reação em Cadeia da Polimerase , GravidezRESUMO
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.
Assuntos
Cesárea , Doenças em Gêmeos/prevenção & controle , Sofrimento Fetal/prevenção & controle , Gêmeos , Equilíbrio Ácido-Base , Adulto , Índice de Apgar , Feminino , Humanos , Apresentação no Trabalho de Parto , Gravidez , Resultado da GravidezRESUMO
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.
Assuntos
Bócio/terapia , Iodo/deficiência , Iodo/uso terapêutico , Complicações na Gravidez/terapia , Gravidez/fisiologia , Adulto , Feminino , Humanos , Tireotropina/biossínteseRESUMO
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.
Assuntos
Neoplasias da Mama/diagnóstico por imagem , Ultrassonografia Doppler em Cores , Feminino , Humanos , GravidezRESUMO
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.
Assuntos
Aborto Habitual/diagnóstico , Anticorpos Antivirais/análise , Citomegalovirus/imunologia , Imunoglobulina G/imunologia , Parvovirus B19 Humano/imunologia , Gravidez/imunologia , Aborto Habitual/imunologia , Doença Crônica , Infecções por Citomegalovirus/imunologia , Feminino , Humanos , Complicações Infecciosas na Gravidez/imunologia , Segundo Trimestre da Gravidez , RecidivaRESUMO
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.
Assuntos
Processamento de Imagem Assistida por Computador , Ultrassonografia Mamária/métodos , Adulto , Idoso , Feminino , Humanos , Pessoa de Meia-Idade , Ultrassonografia Doppler em CoresRESUMO
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.
Assuntos
Metotrexato/uso terapêutico , Gravidez Ectópica/tratamento farmacológico , Adulto , Colo do Útero , Feminino , Morte Fetal , Humanos , Gravidez , Gravidez Ectópica/diagnóstico , Ultrassonografia Pré-NatalRESUMO
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.
Assuntos
Endoscopia/métodos , Feto/efeitos dos fármacos , Surfactantes Pulmonares/administração & dosagem , Adulto , Vias de Administração de Medicamentos , Feminino , Humanos , Recém-Nascido , Trabalho de Parto Prematuro/tratamento farmacológico , Gravidez , Síndrome do Desconforto Respiratório do Recém-Nascido/prevenção & controle , Fatores de TempoRESUMO
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.
Assuntos
Sofrimento Fetal/diagnóstico por imagem , Hipóxia Fetal/diagnóstico por imagem , Ultrassonografia Pré-Natal , Artérias Umbilicais/diagnóstico por imagem , Adulto , Velocidade do Fluxo Sanguíneo , Feminino , Humanos , Valor Preditivo dos Testes , Gravidez , Resultado da Gravidez , Volume Sistólico/fisiologia , Ultrassonografia Doppler , Artérias Umbilicais/fisiologiaRESUMO
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.
Assuntos
Sofrimento Fetal/diagnóstico por imagem , Ultrassonografia Pré-Natal , Artérias Umbilicais/diagnóstico por imagem , Adulto , Velocidade do Fluxo Sanguíneo , Estudos de Avaliação como Assunto , Feminino , Humanos , Recém-Nascido , Valor Preditivo dos Testes , Gravidez , Prognóstico , Sensibilidade e Especificidade , Ultrassonografia DopplerRESUMO
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.
Assuntos
Cesárea , Trabalho de Parto/sangue , Período Pós-Parto/sangue , Hormônios Tireóideos/sangue , Adulto , Feminino , Humanos , Gravidez , Radioimunoensaio , Tri-Iodotironina/sangueRESUMO
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.
Assuntos
Placenta Acreta/cirurgia , Útero/cirurgia , Cesárea , Feminino , Humanos , GravidezRESUMO
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.
Assuntos
Líquido Amniótico/microbiologia , Chlamydia trachomatis/isolamento & purificação , Corioamnionite/epidemiologia , Corioamnionite/microbiologia , Mycoplasma/isolamento & purificação , Neisseria gonorrhoeae/isolamento & purificação , Complicações Infecciosas na Gravidez , Streptococcus/isolamento & purificação , Ureaplasma urealyticum/isolamento & purificação , Antibacterianos/uso terapêutico , Corioamnionite/tratamento farmacológico , Feminino , Humanos , Polônia/epidemiologia , GravidezRESUMO
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.
Assuntos
Candida albicans/patogenicidade , Chlamydia trachomatis/patogenicidade , Corioamnionite/etiologia , Gardnerella vaginalis/patogenicidade , Neisseria gonorrhoeae/patogenicidade , Complicações Infecciosas na Gravidez , Simplexvirus/patogenicidade , Ureaplasma urealyticum/patogenicidade , Líquido Amniótico/microbiologia , Candida albicans/isolamento & purificação , Chlamydia trachomatis/isolamento & purificação , Corioamnionite/microbiologia , Feminino , Gardnerella vaginalis/isolamento & purificação , Humanos , Neisseria gonorrhoeae/isolamento & purificação , Gravidez , Simplexvirus/isolamento & purificação , Ureaplasma urealyticum/isolamento & purificaçãoRESUMO
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.