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Case Reports 2017; 37(8): 535-539 PubMed PMID: 28326748 Citation  Keywords:  Adult, Appendiceal Neoplasms:diagnosis, Carcinoid Tumor:diagnosis, Female, Follow-Up Studies, Humans, Parturition:physiology, Pregnancy, Pregnancy Complications, Neoplastic:diagnosis, Prognosis, Receptors, Somatostatin:metabolism, Treatment Outcome,.   

: Neuroendocrine neoplasms are detected very rarely in pregnant women. The following is a case report of carcinoid tumor of the appendix diagnosed in 28 year-old woman at 25th week of gestation. The woman delivered spontaneously a healthy baby at the 38th week of gestation. She did not require adjuvant therapy with somatostatin analogues. The patient remained in remission. There are not established standards of care due to the very rare incidence of carcinoid tumors in pregnancy. A review of the literature related to management and prognosis in such cases was done....

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Case Reports 2016; 37(Suppl 1): 9-12 PubMed PMID: 28263524 Citation  Keywords:  Adult, Asphyxia:complications, Brain Diseases:etiology, Female, Fetal Diseases, Humans, Infant, Newborn, Infant, Premature, Pregnancy, Sympathetic Nervous System,.   

: The aim of the study was to analyse case report of prenatally unknown asphyxia of the foetus (a preterm newborn from the second pregnancy delivered by urgent caesarean section in 31st gestational week; birth weight 850 grams, birth length 41 cm, value of Apgar score 7/8) with signs of respiratory insufficiency immediately after birth with hypotonicity. The authors present the case of postnatal at the 1st day of life assessed cystic malformation in the brain of premature newborn. They emphasize the importance of detailed prenatal investigation as most important in preventing prenatal asphyxia and consequent complications. Central nervous system and especially white matter of the brain of the newborn is most vulnerable area of the brain. Together with oxidative stress after exceeding of antioxidant capacity belong among main factors that play an important role in the pathogenesis of hypoxic-ischemic encephalopathy.

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Case Reports 2016; 37(7): 473-477 PubMed PMID: 28326740 Citation  Keywords:  Abortion, Habitual:therapy, Adult, Enoxaparin:administration & dosage, Female, Humans, Pregnancy, Pregnancy Outcome, Sildenafil Citrate:administration & dosage, Treatment Outcome,.   

OBJECTIVES: Does addition of Intralipid to sildenafil and enoxaparin immunotherapy improve pregnancy outcome?

MATERIALS AND METHOD: Report of a striking case of a patient with history of 4 recurrent pregnancy losses (RPL) and IVF failures.

RESULTS: Adding of Intralipid resulted in giving birth to a healthy male baby in the 3th IVF cycle.

CONCLUSION: Combination therapy that includes Intralipid may generate successful IVF outcome, although this problem merits further study, especially regarding safety issues....

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Journal Article 2016; 37(4): 295-300 PubMed PMID: 27857046 Citation  Keywords:  Adolescent, Adult, Case-Control Studies, Endometriosis:surgery, Female, Fertility, Follow-Up Studies, Humans, Laparoscopy, Ovarian Cysts:surgery, Ovarian Diseases:complications, Ovarian Neoplasms:surgery, Peritoneal Diseases:complications, Pregnancy, Preg.   

OBJECTIVES: The golden standard in treatment benign ovarian cysts is laparoscopic cystectomy, but it may also influence women's fertility. The aim of the study was to compare women's fertility after laparoscopic cystectomy of endometrioma versus other benign ovarian tumors.

MATERIALS AND METHODS: Out of the 123 patients operated because of benign ovarian tumor (OT), 66 underwent laparoscopic cystectomy of endometrioma (endometrioma group) and 57 underwent laparoscopic cystectomy of other benign ovarian tumor like: functional cyst, hemorrhagic cyst, yellow body cyst or mature teratoma (reference group). OT-related data were obtained from medical documentation (diagnostic tests, medical reproductive and surgical history, clinical status during OT surgery). Follow-up data were collected by means of a telephone interview. The survey included questions focused on women's fertility during a 24-month period following the surgical treatment of OT (conception, subsequent pregnancies, recurrence of OT).

RESULTS: A 24-month follow-up period revealed that the cumulative pregnancy rate was significantly higher in reference group (RG) as compared to endometrioma group (EG), i.e. 52.6% vs. 32.3%. Lower pregnancy risk was demonstrated in a EG group vs. other benign ovarian tumors, HR=0.57 (CI 0.33-0.99; p=0.049), log-rank test p=0.045. Benign OT returned in 19.3% vs. EG 36.3%, HR= 2.5 (CI 1.16-5.55 ; p=0.019) log-rank test: p=0.0136. The EG was divided on two subgroups: women with solitary endometrioma and women with endometrioma and coexistent peritoneal endometriosis. The study showed insignificantly lower risk of pregnancy in a group of advanced endometriosis vs. solitary endometrioma group (HR= 0.79 (CI 0.34-1.83; log-rank test p=0.57; pregnancy rate 29.3% vs. 40.0%). Statistically nonsignificant higher pregnancy rate occurred in a group of women with tumor ≤50mm in size among patients with benign ovarian tumor and solitary endometrioma vs. group of women with tumor >50mm (30% vs. 61%; p=0.09).

CONCLUSIONS: There is a low pregnancy rate after laparoscopic cystectomy of benign OT. Moreover, pregnancy rate after cystectomy of endometrioma is significantly lower and the percentage of reccurence of endometrioma is significantly higher. That is why, the decision about surgical treatment among childbearing women must be well-considered because of the risk of subsequent surgery in the future....

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Journal Article 2016; 37(1): 70-77 PubMed PMID: 26994389 Citation  Keywords:  Adult, Autonomic Nervous System:physiology, Blood Pressure:physiology, Cardiography, Impedance, Case-Control Studies, Electrocardiography, Female, Heart Rate:physiology, Hemodynamics:physiology, Humans, Pregnancy:physiology, Pregnancy Trimesters:physiolog.   

OBJECTIVE: The purpose of this research was to assess the dynamics of autonomic nervous system(ANS) and hemodynamic activity changes during uncomplicated pregnancy.

METHODS: We enrolled 36 pregnant women (mean age 29 ± 4.8 years) and a control group of 10 non-pregnant women (mean age 25.9 ± 0.88 years). The examination was performed in the 1st, 2nd, and 3rd trimester. Continuous registration of BP, ECG, and cardioimpedance was performed with Task Force Monitor 3040i. ANS activity was measured using the following parameters: HRV, BPV, BRS at rest, and in response to autonomic tests.

RESULTS: Compared to the 1st trimester, an increase in HR (73 vs. 92 bpm; p < 0.001) and mean BP (80 vs. 85 mmHg, p < 0.01) was observed in the 3rd trimester. In the 1st trimester, the BRS of pregnant women was insignificantly higher than in the controls (24.8 vs. 22.3 ms/mmHg); subsequently, it decreased significantly, to 13.4 ms/mmHg in the 3rd trimester (p = 0.0004). An increase in nLF (39.57 ± 13.75 vs. 58.73 ± 15.55; p = 0.001) and LF/HF ratio (1.03 ± 0.76 vs. 1.85 ± 0.8; p < 0.00002) was revealed in HRV analysis conducted in the 3rd trimester, as compared to the 1st tri- mester, along with a decrease in nHF (60.43 ± 13.71 vs. 41.26 ± 15.55; p < 0.001). An increase in LF/HF-sBPV (1.05 ± 0.48 vs. 1.58 ± 0.44; p = 0.01) was recorded in BPV analysis at rest in the 3rd trimester as compared to the respective 1st trimester value.

CONCLUSION: Our findings suggest that pregnancy is associated with dynamic changes in autonomic balance, namely doubled dominance of the sympathetic component. Hypervolemia seems the major factor responsible for autonomic and hemodynamic changes observed during pregnancy, as it causes an increase in BP and simultaneous decrease in BRS....

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Journal Article 2016; 37(1): 53-58 PubMed PMID: 26994386 Citation  Keywords:  Adolescent, Adult, Fear, Female, Health Knowledge, Attitudes, Practice, Humans, Maternal Age, Parity, Posture, Pregnancy, Pregnancy Trimester, Third:physiology, Sexual Behavior:physiology, Surveys and Questionnaires, Young Adult,.   

OBJECTIVE: Pregnancy is usually associated with significant regression in genito-genital intercourse frequency, sexual desire and satisfaction. The aim of the study was to determine women's sexual habits during the third trimester of gestation and to compare their sexual activity before the current pregnancy and during previous pregnancies in case of multiparas.

MATERIAL AND METHODS: The study material consisted of women in the third trimester of pregnancy, recruited from the Outpatient Clinic of the 1st Department of Obstetrics and Gynecology, Medical University of Warsaw between January 2013 and February 2014, who filled out a self-prepared questionnaire. The questionnaire consisted of three parts: demographic data, sexual activity prior to current pregnancy and during gestation, including sexual positions and sources of knowledge regarding the subject. The survey involved 25 questions and was distributed among 220 patients, out of which 165 were returned and 149 properly filled out and analyzed.

RESULTS: The average age of the respondents was 29.6 ± 4.85 years; the majority (78.8%) were in an uncomplicated pregnancy. The decrease in sexual activity was evident in all age groups--the majority usually had sex 1 to 3 times a month in contrast to 1-2 times a week prior to conceiving. Sexual activity decreased significantly with increasing age. The main reasons for abandoning sexual activity included: decreased libido (35.5%), the doctor's suggestion (29%) and fears concerning child's health (29%). During pregnancy the frequency of vaginal intercourse significantly decreased (100% prior to vs. 86.6% during pregnancy; p < 0.001); as did oral sex (44.3% vs. 29.5%; p = 0.043) and anal sex (12% vs. 5.4%; p = 0.02). 54% of the respondents declared reduced satisfaction with sexual life during pregnancy in comparison with the previous period; almost half (43.5%) felt less attractive while pregnant. The same claim was related to libido--it decreased in 58.8% of respondents. Multiparas tended to have sexual intercourses less often in consecutive pregnancies (41.2%) or with an equal frequency (35.3%). The main source of knowledge about sexual life during pregnancy listed by women included internet and other media (63.5%), while medical staff was mentioned by 30%.

CONCLUSIONS: Sexual activity decreases during gestation, however, it often result from an increased fear for the child and lack of possibilities to confront and broaden the knowledge on this subject. The role of medical staff in consulting sexual activity problems is insufficient....

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Journal Article 2016; 37(1): 1-8 PubMed PMID: 26994378 Citation  Keywords:  Environment, Female, Genetic Predisposition to Disease, Humans, Infant, Newborn, Parturition:physiology, Pregnancy, Prevalence, Risk Factors, Schizophrenia:epidemiology, Substance-Related Disorders:complications,.   

: Schizophrenia is a severe mental disorder that affects approximately one percent of the general population. The pathogenesis of schizophrenia is influenced by many risk factors, both environmental and genetic. The environmental factors include the date of birth, place of birth and seasonal effects, infectious diseases, complications during pregnancy and delivery, substance abuse and stress. At the present time, in addition to environmental factors, genetic factors are assumed to play a role in the development of the schizophrenia. The heritability of schizo- phrenia is up to 80%. If one parent suffers from the condition, the probability that it will be passed down to the offspring is 13%. If it is present in both parents, the risk is more than 20%. The opinions are varied as to the risk factors affecting the development of schizophrenia. Knowing these factors may greatly contribute to prevention of the condition....

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Case Reports 2015; 36(5): 410-413 PubMed PMID: 26707038 Citation  Keywords:  Adult, Antidiuretic Agents:therapeutic use, Deamino Arginine Vasopressin:therapeutic use, Diabetes Insipidus:diagnosis, Female, Humans, Pregnancy, Pregnancy Complications:diagnosis,.   

: Gestational diabetes insipidus is a very rare complication. However, undiagnosed and untreated may lead to serious complications in both mother and fetus. In this study, a case of 34-year-old female patient with diabetes insipidus associated with pregnancy was reported. We discussed process of diagnosis and treatment with particular emphasis on the monitoring of water-electrolyte imbalance during labor....

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