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Journal Article 2011; 32(6): 885-888 PubMed PMID: 22286793 Citation  Keywords:  Adult, Body Weight, Diabetes, Gestational:etiology, Female, Fertilization in Vitro:adverse effects, Glucose Tolerance Test, Humans, Polycystic Ovary Syndrome:complications, Pregnancy, Pregnancy Outcome, Pregnancy Trimesters, Retrospective Studies, Risk Fa.   

OBJECTIVE: Increasing number of pregnancies resulting from In vitro Fertilisation (IVF) combined with increased awareness of Gestational Diabetes Mellitus (GDM) - related morbidity calls for research on possible differences in pregnancy outcomes between IVF and non-IVF GDM complicated pregnancies. The aim of this study was to compare GDM - affected pregnancies, both resulting from IVF and conceived without medical intervention with regards to maternal data, fetal biometry and neoanatal outcomes.

METHODS: We used our Clinic's databases to retrospectively identify 36 women who had successful IVF and developed GDM during the course of their singleton pregnancy (IVF group) and 137 non-IVF women with GDM (non-IVF group). They were matched according to age, pre-pregnancy BMI and none had the history of diabetes mellitus before their pregnancies. We compared the maternal characteristics, course of pregnancy and neonatal outcome.

RESULTS: The weight gain until the diagnosis of GDM in both non-IVF and IVF groups of women was not significantly different (9.81±4.37 vs 10.0±4.8 kg, p=0.8 respectively) with similar time at which they came under the specialist GDM care (29±4.0 vs 28±4.5 wks, p=0.42,). When analyzing first trimester fasting glucose levels we found it to be significantly higher in IVF group (89±16.2 vs 83±11.3 mg/dl, p=0.04). Second trimester oral glucose tolerance test (OGTT) results and glucose levels during GDM treatment did not differ between the groups. No changes were noted in investigated fetal and neonatal variances: 3rd trimester AC, it's percentile and neonatal birth weight (3 460±641 vs 3 200±440 g, p=0.22).

CONCLUSIONS: GDM among women after in vitro fertilisation is characterised by higher first trimester fasting glucose levels. Early diagnostic intervention in IVF pregnancies is specially needed....

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Comment 2011; 32(4): 369-370 PubMed PMID: 21876514 Citation  Keywords:  Aspirin:pharmacology, Female, Humans, Platelet Aggregation Inhibitors:pharmacology, Pregnancy, Pregnancy Outcome,.   

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Case Reports 2009; 30(4): 450-452 PubMed PMID: 20010490 Citation  Keywords:  Adult, Albumins:therapeutic use, Cordocentesis, Female, Fetal Therapies, Humans, Hydrops Fetalis:diagnosis, Infant, Newborn, Paracentesis, Pregnancy, Pregnancy Outcome, Premature Birth,.   

BACKGROUND: Nonimmune hydrops fetalis (NHF) is an abnormal accumulation of fluid - especially serous - in visceral cavities and soft tissues. This condition may be caused by: cardiovascular diseases, chromosomal disorders, infections, lung, stomach, intestinal, kidneys, urinary tract and blood diseases, metabolic disorders and tumors. NHF may by diagnosed by an ultrasound scan. THE AIM of the study was to present diagnostic and therapeutic difficulties as well as management with reference to NHF.

CASE STUDY: An abnormal accumulation of fluid in visceral cavities and subcutaneous tissue of two fetuses was diagnosed by an ultrasound scan. Despite a detailed and specific diagnostic proceeding which included: infections, congenital malformations, chromosomal abnormalities etc. it was impossible to establish the cause of NHF. The symptomatic therapy was performed: periodic cordocentesis with an injection of human albumin solutions. In case of the first fetus therapeutic thoracocentesis was performed. The fetuses were delivered in 32nd and 31st week of pregnancy. Both neonates survived but even after the delivery it was impossible to establish the cause of NHF.

CONCLUSIONS: Multidirectional diagnostic approach is essential for the implementation of causal treatment of NHF. In case of idiopathic NHF the only management is symptomatic therapy, fetal monitoring and preterm delivery....

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Case Reports 2009; 30(2): 192-194 PubMed PMID: 19675518 Citation  Keywords:  Cesarean Section, Female, Fibroma:complications, Humans, Meigs Syndrome:complications, Ovarian Neoplasms:complications, Pregnancy, Pregnancy Complications, Neoplastic:pathology, Pregnancy Outcome, Virilism:etiology, Young Adult,.   

BACKGROUND: A half of virilizing ovarian tumors in pregnancy are malignant. The risk of cancer increases with ascites and hydrothorax. Our case shows that such tumor can be benign with good outcome.

CASE: Primigravida in 30 weeks with advanced hirsutism (from 15 weeks), vomiting, epigastric pain, dyspnoea, ascites, hydrothorax, ovarian mass and high level of serum testosterone was operated. After the tumorectomy (fibrothecoma) we performed cesarean section (placental abruption suspected). The female fetus had no signs of virilization. In mother all symptoms and effusions resolved.

CONCLUSION: Meigs' syndrome in pregnancy leads to acute clinical symptoms and needs the surgical intervention with the risk of placental abruption. Virilization of mother was the first symptom of ovarian tumor but the female fetus was protected of hyperandrogenism....

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Case Reports 2008; 29(6): 871-873 PubMed PMID: 19112397 Citation  Keywords:  Abscess:complications, Anti-Bacterial Agents:therapeutic use, Cesarean Section, Female, Humans, Pregnancy, Pregnancy Complications, Infectious:drug therapy, Pregnancy Outcome, Treatment Outcome, Uterine Diseases:complications, Uterus:abnormalities, Young .   

: A 20 year old primigravida with a double uterus was admitted with a viable fetus in the right uterus and pus oozing from the left one. Management consisted of a regimen of intravenous antibiotics and intravaginal antibiotic tablets. Tocolysis was used to arrest imminent preterm labor. In the course of pregnancy IUGR was diagnosed. At 38 weeks of pregnancy a SGA baby boy of 2,440 g was delivered by cesarean section. The mother and the baby were discharged from the hospital in good general condition....

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Clinical Trial 2004; 25(5): 373-380 PubMed PMID: 15580173 Citation  Keywords:  Adolescent, Adult, Anti-Bacterial Agents:therapeutic use, Combined Modality Therapy, Female, Gestational Age, Humans, Obstetric Labor, Premature:therapy, Pregnancy, Pregnancy Outcome, Tocolysis, Treatment Outcome,.   

OBJECTIVE: The aim of this study was to determine: a) to what extent application of antibiotics enhances efficiency of tocolysis; b) whether the duration of antibiotic treatment influences its efficacy; c) what criterion is decisive for efficacy of tocolysis assisted by antibiotic therapy.

MATERIALS AND METHODS: 223 successive women with unifetal pregnancies, aged 17 to 42 (average age 27.3), admitted to the Department of Gynecology and Obstetrics of the JU Medical College in the period from January 1, 1999 to September 9, 2001, were enrolled in the study. Using clinical methods such as: assessment of contractile activity of the uterus, of uterine cervix and membranes, presence of bleeding and other clinical symptoms, these women were diagnosed with imminent preterm labour.

CONCLUSIONS: Antibiotic treatment enhances the efficacy of tocolysis, influencing the time of prolonging pregnancy in imminent preterm delivery. This synergistic effect is clinically crucial as in this way significantly larger number of children will be born at term and also a number of premature neonates who survive may be increased....

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Clinical Trial 2004; 25(4): 302-306 PubMed PMID: 15361822 Citation  Keywords:  Adolescent, Adult, Biomarkers, C-Reactive Protein:metabolism, Cystinyl Aminopeptidase:blood, Female, Humans, Isoenzymes:blood, Middle Aged, Predictive Value of Tests, Pregnancy, Pregnancy Outcome, Pregnancy Trimester, Third, Premature Birth:blood, Prenata.   

OBJECTIVES: Preterm deliveries represent still one of the most important problems in contemporary obstetrics. They are associated with prematurity and higher rate of perinatal mortality and morbidity. During the last few years, the role of C-reactive protein (CRP) in prediction of threatening preterm delivery was emphasized. CRP is produced mainly inside the liver as a response to acute and chronic inflammatory processes.

AIM: The aim of this study was to assess relations between C-reactive protein, oxytocinase, izooxytocinase and vaginal culture in prediction of preterm delivery.

METHODS: This study was performed in the years 2000-2004 in the Department of Septic Obstetrics and Gynecology of Collegium Medicum of the Jagiellonian University. Some 389 patients hospitalized because of threatening preterm delivery or preterm delivery in tractu were enrolled into the trial.

CONCLUSION: C-reactive protein is a useful marker of threatening preterm delivery, overtaking the results of vaginal culture. CAP1 and CAP2 are effective biochemical markers in pregnancy monitoring....

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