[Fetal macrosomia--risks for the mother and the infant during vaginal delivery].

UNLABELLED: Fetal macrosomia represents a continuing challenge in obstetrics. The delivery of macrosomic infant has potentially serious consequences for the infant and the mother. AIM: To determine the influence of fetal macrosomia (FM) on some of maternal and fetal complications during vaginal delivery. MATERIALS AND METHODS: A five-year retro- and prospective study was conducted at the Department of Obstetrics and Gynecology, Medical University, Pleven (2001-2005). It included 524 vaginal deliveries: 286 cases of delivery of macrosomic infant--fetal birth weight (FBW) more than 4000 g and/or over 90-th percentile (Large for gestational age) and 238 cases of delivery of eutrophic infant at term--FBW between 10-th and 90-th percentile (Appropriate for gestational age). Analysis included: rate of episio- and perineotomy, perineal trauma, postpartum haemorrhage and fetal injury. RESULTS: It was found significant correlation (p < 0.05) for influence of FM on the rate of episio- and perineotomy, perineal trauma and haemorrhage (chi2 = 182.10; R = 0.14), fetal injuries (chi2 = 114.52; R = 0.19). CONCLUSION: FM is associated with a higher risk for the mother and the infant during vaginal delivery compared to infants with normal birth weight.

[Diagnostic approach to Allen-Masters syndrome].

UNLABELLED: In the basic appearance of chronic pelvic pain /CPP/, it is often found the symptomatology of Allen-Masters syndrome /AMS/, especially having in mind pelvic congestion syndrome /PCS/. PURPOSE OF INVESTIGATION: To determine the diagnostic approach to AMS on the basis of CPP and factors conducive to development of AMS. METHODS AND MATERIALS: A nine-year retro- and prospective study (in the period 1996-2004) was conducted in Gynaecological Clinic at the Department of Obstetrics and Gynaecology, Medical University - Pleven. Forty patients with verified AMS were included in it. A documentary and inquiry methods were used for the investigation purposes. The following conducive factors were studied: age, body mass index /BMI/, blood group belonging, deliveries, including that of macrosomic foetuses, abortions and other gynaecologic interventions. It was rendered an account of the beginning of CPP, its qualitative and quantitative characteristics, localization and irradiation, its dynamics according to menstrual cycle and day. Excel and Statgraphics plus for Windows were used for the statistical processing of the data obtained from the investigation. RESULTS: Major conducive factors to AMS are BMI, number of pregnancies (deliveries and abortions), weight/ body mass of baby born. CPP is clinically manifested with dysmenorrhoea, dyspareunia and postcoital ache. CONCLUSION: The determined specific pain profile and the presence of proved etiological factors, parallel with laparoscopic method, are auspicious means for diagnosing AMS.

[Fetal macrosomia: mode of delivery]. / Fetalna makrozomiia: nachin na rodorazreshenie.

This study was provided among 1847 deliveries from January, 1 to December, 31, 2003. The aim of the study was to examine the correlation between antenatal diagnosis "fetal macrosomia" and the mode of delivery. We found that among the cases with birth weight > or = 4000 g and antenatal diagnosis "fetal macrosomia" the rate of cesarean section was fourfold higher than among the cases without such a diagnosis. There weren't statistically significant correlation between the cases with antenatal diagnosis "fetal macrosomia " and the cases with estimated birth weight < or = 3999g in reference to the mother's age and weight, parity, fundal height and abdominal circumference. There are insignificant differences between both of groups in reference to gestacional age and birth.