Wpływ znieczulenia zewnątrzoponowego na przebieg i rodzaj porodu oraz stan urodzeniowy noworodków – badanie retrospektywne

Objectives: to evaluate the impact of epidural analgesia (EA) on labor, delivery and neonatal status. Material and methods: retrospective, observational, cohort study comprising 5593 pregnant women who met the inclusion criteria (singleton pregnancy, cephalic presentation, 37-42 weeks of gestation). Out of them, 2496 had EA and 3097 constituted the control group. Main outcome measures: incidence of labor complications and operative deliveries in women who received EA, neonatal status assessed by Apgar score in 1- and 5-minute, and cord pH values. Results: Labor complications were more frequently observed in the epidural group, with an almost 1.5-fold higher incidence in nulliparous (16.32% vs. 11.29%) and 1.4-fold in multiparous women (9.86% vs. 7.08%). Stepwise logistic regression confirmed that EA is a significant risk factor for labor complications in nulliparous women (OR 1.27, 95% CI 1.03-1.58) and for forceps delivery in multiparous women (5.20, 95% CI 3.31-8.17). Also, EA is an important risk factor for both, low cord arterial pHCel: Ocena wpływu znieczulenia zewnątrzoponowego (ZO) na przebieg porodu oraz stan urodzeniowy noworodków. Materiał i metody: Retrospektywnej analizie poddano 5593 pacjentek spełniających kryteria włączenia do grupy badanej: ciąża pojedyncza, położenie płodu podłużne główkowe, wiek ciążowy ≥37tyg oraz brak stwierdzanych prenatalnie i postnatalnie anomalii rozwojowych. W tej grupie u 2496 ciężarnych zastosowano znieczulenie zewnątrzoponowe porodu, natomiast 3097 stanowiło grupę kontrolną. Oceniane parametry: Częstość występowania powikłań porodowych oraz porodów operacyjnych w grupie pacjentek rodzących w ZO, stan urodzeniowy noworodków oceniony na podstawie skali Apgar (w 1 i 5 minucie) oraz pH krwi pępowinowej. Wyniki: W analizie regresji wieloczynnikowej wykazano, że znieczulenie zewnątrzoponowe jest niezależnym czynnikiem ryzyka powikłań porodowych tylko w grupie pierworódek (IS 1,27, 95% CI 1,03-1,58), natomiast w grupie wieloródek wpływa na zwiększenie odsetka porodów kleszczowych (5,20, 95% CI 3,31-8,17). ZO jest również istotnym czynnikiem ryzyka wystąpienia niskiego pH

Pathogenesis and genetics of neural tube defects

Abstract After congenital heart defects neural tube defects (NTDs) is the second most prevalent congenital malformation among birth defects. The average rate of isolated NTDs is 1.4-2.0 per 1000 live births worldwide. The etiology of isolated (nonsyndromic) NTDs is believed to be the result of a combination of genetic predisposition and environmental factors. Over 80 genes believed to be engaged in the neurulations have been identified during the investigation and research of the mouse models. Despite exhaustive research efforts, now spanning several decades, little is known about the actual genetic mechanisms governing the primary events involved in neural tube closure (NTC)

Prevalence of uterine malformations and their impact on fertility

Aim: Uterine malformations belong to the most common congenital abnormalities within the female reproductive system. Their mean prevalence in the general population is 2-4%. The incidence of uterine malformation leads to impaired fertility and a number of obstetric complications such as threatening preterm delivery, pelvic and transverse presentation, premature departure of amniotic fluid, intrauterine growth restriction, threatening rupture of the uterus, caesarean section. The aim of this review is to analyze the influence of an individual uterine malformation on female fertility. Material and methods: The study involved 124 women hospitalized at Research Institute of the Polish Mother’s Memorial Hospital in Lodz between the years 1994-2007. The patients were divided into 6 groups on the basis of the diagnosed defect. Results and conclusion: In our study, the most common defect was uterus bicornis, diagnosed in 46,7% of cases. The worst obstetric outcome was found among patients with septate uterus. The highest number of miscarriages and fertility problems occurs among those women. Nevertheless, there are positive data on the treatment of this defect. It would be recommendable to extend the diagnosis of the uterine malformations, especially in women with fertility problems, because early diagnosis and appropriate treatment allow to obtain satisfactory obstetric outcomes

West Nile Virus infection in perinatology

West Nile Virus causes one of the so-called emerging infectious diseases and is considered to be one of the major epidemic problems in many countries. Most of the WNV-infected-people do not develop clinical symptoms. Nevertheless, Infection with WNV can lead to severe neurological diseases, classically associated with West Nile fever. Among several neurological manifestations that have been observed, encephalitis is the most typical presentation. Transplacental passage is one of the confirmed transmission ways, but neonatal infection by breast feeding is also probable. Congenital WNV infection has been accompanied by bilateral chorioretinitis and severe malformation of the fetal central nervous system. At present, due to the lack of sufficient data, possibilities to conclude on the nature of the relationship between WNV infection and fetal malformations are limited

Free radicals properties of gamma-irradiated penicillin-derived antibiotics : piperacillin, ampicillin, and crystalline penicillin

The aim of this work was to determine the concentrations and properties of free radicals in piperacillin, ampicillin, and crystalline penicillin after gamma irradiation. The radicals were studied by electron paramagnetic resonance (EPR) spectroscopy using an X-band spectrometer (9.3 GHz). Gamma irradiation was performed at a dose of 25 kGy. One- and two-exponential functions were fitted to the experimental data, in order to assess the influence of the antibiotics’ storage time on the measured EPR lines. After gamma irradiation, complex EPR lines were recorded confirming the presence of a large number of free radicals formed during the irradiation. For all tested antibiotics, concentrations of free radicals and parameters of EPR spectra changed with storage time. The results obtained demonstrate that concentration of free radicals and other spectroscopic parameters can be used to select the optimal parameters of radiation sterilization of β-lactam antibiotics. The most important parameters are the constants τ (τ 1(A),(I) and τ 2(A),(I)) and K (K 0(A),(I), K 1(A),(I), K 2(A),(I)) of the exponential functions that describe free radicals decay during samples storage

Seroprevalence of cytomegalovirus infection in the population of Polish pregnant women

Objectives: Human cytomegalovirus is a common etiological agent of infections and is the most common cause of intrauterine infections. Due to the scale and importance of infections during pregnancy, in this study we investigated the incidence of specific IgG and IgM antibodies directed against HCMV in population of Polish pregnant women. Material and Methods: The retrospective study included 1332 pregnant women who were hospitalized at the DFMMG in Lodz between 1999 and 2009. In this group, 117 women had serological features of acute cytomegalovirus infections (study group) and 51 women were seronegative for IgG, IgM and IgA antibodies (control group). HCMV infections in pregnant women were diagnosed by serological assays (IgG, IgM, IgA, IgG avidity) and clinical symptoms. Results: Seroprevalence of CMV IgG was estimated to be 76.7% (n=985). Anti-HCMV immunoglobulin M antibodies were detected in 13% of pregnant women (n = 179). Conclusions: There was no significant correlation between the prevalence of IgG and IgM antibodies and factors such as maternal age, parity, a number of births, place of residence and marital status