The influence of human papillomavirus infection on pregnant women defence systems

This study analyses the impact of HPV infection for antioxidative state of pregnant woman, and the response of local immunity to this infection. In order to achieve this aim the following goals were: to determine HPV infection in pregnant women; to determine it’s types; to compare infection between first and third trimesters of pregnancy; to study the antioxidative system state during pregnancy due to HPV infection; to study interleukins (IL-10 and IL-12), which show local immunity, concentration changes during pregnancy due to HPV infection. Considering a high morbidity and mortality from cervical cancer in Lithuania, our established HPV infection in pregnant women and identified types of this virus enabled us to determine changed of HPV infection during pregnancy in high risk cervical cancer population. Also there is possibility to compare obtained data with that from authors in other countries. It is established, that women develop oxidative stress during pregnancy, and that its level did not depend on HPV infection. Changes of IL-10 and IL-12 concentrations in cervicovaginal washing fluid (local immunity) are related to Th1 and Th2 lymphocytes function, and depend on HPV infection

ŽIV infekuotų nėščiųjų antioksidacinės sistemos būklė.

All pregnant women were compared with non-pregnant women to confirm the influence of pregnancy on the MDA level. In the first trimester, this parameter for pregnant women was close to that of non-pregnant women, while with the developing pregnancy the MDA level increased 1.6 times. No significant difference in the parameter was determined for pregnant women with HPV infection. Conclusions. A decrease of GSH concentration and an increase of MDA level in blood plasma with the development of pregnancy confirmed the presence of a general oxidative stress. The lower levels of GSH and GSH + GSSG in the cervicovaginal washing fluid, if to compare the two trimesters of pregnancy, can be considered as markers of a local oxidative stress. HPV infection depressed the antioxidative system in general and did not affect it at the local level. Systemic oxidative stress, rather than HPV infection, influenced the lipid peroxidation process during pregnancy. The level of MDA is recommended to be tested also during a normal pregnancy, although this parameter should not be considered as an additional biomarker of cervical carcinoma risk. Changes of the antioxidative system variables could induce a deep oxidative imbalance during a pathological pregnancy, and oxidative stress might cause a persistent HPV infection, suggesting the importance of the additional screening of HPV-infected women after delivery

Meckel’s diverticulum as a cause of small bowel obstruction complicated with gangrene in the third trimester of pregnancy: a case report

Acute abdomen during pregnancy is rare. Despite advances in diagnostic imaging, preoperative diagnosis in the pregnant population due to anatomical and physiological changes can pose difficulties. Diagnosis and surgery delays increase the risk of adverse outcomes for both maternal and fetal health. In symptomatic cases, explorative surgery might be essential for correct diagnosis and patient treatment. Here, we present Meckel’s diverticulum as an unusual cause of small bowel obstruction complicated with gangrene in a 34-week pregnant patient. The diagnosis was only apparent during explorative surgical laparotomy

Širdies vožtuvinė liga nėštumo metu: klinikinis atvejis ir literatūros apžvalga

Background. As a result of improved diagnostic and reparative techniques, congenital heart diseases are becoming a significant problem for women of childbearing age. Nowadays, more pregnant women in the West are being diagnosed with an acquired heart disease because of the tendency to delay childbearing and increasing age-related risk of developing complications of hypertension, diabetes, obesity and other diseases. According to the Lithuanian Health Information Centre, the incidence of cardiovascular diseases in pregnancy is decreasing in Lithuania, from 1.4% in 2014 to 1% in 2016 (1). Heart diseases can aggravate maternal adaptive capabilities and complications that pose a threat to mother and foetus can occur. Management of such conditions presents a serious therapeutic challenge to multidisciplinary team. The aim of this article is to discuss the course of pregnancy and peculiarities of maternal and foetal care in a woman with hemodynamically significant heart disease. Materials and methods. We present a clinical case of a 30-year-old nuliparous woman who was diagnosed with mitral valve disease with critical stenosis, grade II/III mitral valve insufficiency, moderate-severe pulmonary hypertension, heart failure stage C, and NYHA functional class II. Results and conclusions. Pregnancy in conjunction with heart disease is a complicated condition that requires multidisciplinary prenatal care (consisting of an obstetrician gynaecologist, cardiologist, anaesthesiologist). Low molecular weight heparins should be the first choice medication for antithrombotic prophylaxis. Since pregnancy can aggravate a heart disease, preconception counselling and evaluation of the heart function are recommended

Predictors of exclusive breastfeeding in the first six months: four consecutive surveys in a tertiary hospital in Lithuania

Background: There are little up-to-date data available on the duration of exclusive breastfeeding in Lithuania. The aim of our study was to examine the factors that could influence exclusive breastfeeding during the first 6 months of life. Methods: In 2016, a survey was conducted at the Obstetrics and Gynecology Clinic of Vilnius University Hospital, Santaros Klinikos. Women in postnatal wards were opportunistically offered questionnaires and later followed up by telephone interviews at 6 weeks, 3 months, and 6 months postpartum. We used binary logistic regression to determine the factors that impacted exclusive breastfeeding during the first 6 months following childbirth. Results: Of 475 eligible women that were approached, a total of 447 women were recruited, with response rates of 76.1, 71.4 and 67.0% at 6 weeks, 3 months, and 6 months postpartum, respectively. The prevalence of exclusive breastfeeding through the 6 month postpartum period was 39.8%. Exclusive breastfeeding during days 2 to 4 postpartum was positively influenced by factors such as a natural childbirth, the practice of breastfeeding on demand and maternal self-confidence in breastfeeding. Subsequently, exclusive breastfeeding on demand in the immediate postpartum period and exclusive breastfeeding for up to 3 months were associated with successful exclusive breastfeeding up to 6 months. However, the adverse factors that limited the success and duration of exclusive breastfeeding included free samples of human milk substitutes or advertising at primary healthcare centers 6 weeks after childbirth, pacifier use 6 months after childbirth, as well as amniotomy for labor induction. Conclusions: Our research demonstrated that exclusive breastfeeding is impacted in both directions by a range of factors during particular periods after delivery. One of the novel findings was the adverse influence of amniotomy for labor induction on exclusive breastfeeding rates. Taking into account diverse factors influencing exclusive breastfeeding and the absence of a single way to promote it, there is a crucial need to increase the incidence of exclusive breastfeeding until infants reach the age of 6 months