Antigens HLA-G, sHLA- G and sHLA- class I in reproductive failure.

It can be supposed that relation between HLA-G polymorphism and sHLA-G protein expression are associated with successful embryo implantation and pregnancy maintenance. The aim of the study was the estimation specific differences in expression of sHLA-G and sHLA- class I antigens in women with reproductive failure in comparison with fertile women. The study sample enrolled 80 women, divided into 2 groups. The study group (B) enrolled 60 women with reproductive failure including 20 women with 3 recurrent spontaneous abortions in the first trimester of pregnancy (RSA), 20 women with empty sac (ES) and 20 women with 3 consecutive in-vitro fertilization failures (IVFf). The control group (C) enrolled 20 fertile women with at least 2 children. Soluble HLA- class I antigens (sHLA-I) and soluble HLA-G (sHLA-G) were determined using ELISA test kits from IBio Vendor Labolatory Medicine, Inc. HLA-G allele found in individuals in our study were identified by comparing the obtained bp sequences of exon 2., 3. and 4. with bp sequences of HLA-G antigen published at the Nolan Research Institute website. The highest concentration of sHLA-I is noted among women with HLA-G 10401 allele which differed significantly for the mean sHLA-I concentration calculated for all the remaining alleles (

Kohabitacja jako silny czynnik predykcyjny depresji okołoporodowej

al and methods: 117 pregnant women (at 32-40 weeks of gestation) and 105 postpartum patients (2-5 days after the delivery) were included in the study. The Edinburgh Postnatal Depression Scale (EPDS) was used as a screening test for symptoms of pre- and postnatal depression. The risk of appearance of depressive symptoms was assessed in three groups of pregnant and postpartum patients – married, unpartnered and cohabitating. Results: By means of the EPDS test, symptoms of perinatal depression were found in 17% of pregnant and 10% of postpartum women. In comparison to married women, the risk of appearance of depressive symptoms in unpartnered pregnant patients was almost 10-times higher (OR=9,34; 95% CI 1,42, 201,77), and several hundred times higher in cohabitating pregnant women (OR=975,86; 95% CI 116,73, 19502,00); the risk of depressive symptoms in postpartum unpartnered women was more than 2 times higher (OR=2,4; 95% CI 0,59, 9,72) and more than 20 times higher in cohabitating postpartum mothers (OR=23,2; 95% CI 5,89, 91,51). Conclusions: 1/ the marital status of pregnant and postpartum women has a substantial influence on the risk of the development of perinatal depressive symptoms; this risk is highly increased in a group of cohabitating women compared to patients remaining in a formal partnership as well as women who live unpartnered, 2/ clinical evaluation of women in the perinatal period should include the assessment of their psychosocial status, which can constitute a predicting factor of perinatal depression, 3/ pregnant women living in informal partnership should be put under strict psychological surveillance.Streszczenie Cel pracy: Celem pracy było zbadanie, czy stan cywilny kobiet będących w ciąży lub w połogu, ze szczególnym uwzględnieniem zjawiska kohabitacji, wpływa na częstość występowania objawów depresji okołoporodowej. Materiał i metody: Badaniem objęto 117 kobiet ciężarnych (w wieku ciążowym 32-40 tygodni) i 105 położnic (2-5 dzień połogu). Jako test skriningowy w kierunku obecności objawów depresji przed- i poporodowej zastosowano kwestionariusz EPDS (Edynburska Skala Depresji Okołoporodowej). Oceniono ryzyko wystąpienia objawów depresji w grupach kobiet ciężarnych i położnic - zamężnych, stanu wolnego i w kohabitacji. Wyniki: Przy pomocy testu EPDS objawy depresji okołoporodowej stwierdzono u 17% ciężarnych oraz 10% położnic. W porównaniu z grupa kobiet zamężnych, ryzyko wystąpienia objawów depresji u ciężarnych stanu wolnego było podwyższone blisko dziesięciokrotnie (OR=9,34; 95% CI 1,42, 201,77), natomiast aż kilkusetkrotnie u ciężarnych kohabitujących (OR=975,86; 95% CI 116,73, 19502,00); ryzyko wystąpienia objawów depresji u położnic stanu wolnego było podwyższone ponad dwukrotnie (OR=2,4; 95% CI 0,59, 9,72), natomiast ponad dwudziestokrotnie u położnic kohabitujących (OR=23,2; 95% CI 5,89, 91,51). Wnioski: 1) stan cywilny kobiet ciężarnych i położnic ma istotny wpływ na ryzyko wystąpienia objawów depresji okołoporodowej; ryzyko to zwiększa się wielokrotnie w grupie kobiet kohabitujących w stosunku do kobiet pozostających w związkach formalnych i kobiet wolnych nie żyjących z partnerem, 2) badanie kliniczne kobiet w okresie perinatalnym powinno uwzględniać ocenę ich stanu psychospołecznego, który może być czynnikiem predykcyjnym depresji okołoporodowej, 3) kobiety ciężarne żyjące w związkach nieformalnych powinny być objęte szczególnym nadzorem psychologicznym

Style radzenia sobie w sytuacjach stresowych a Lęk-stan i Lęk-cecha u kobiet z objawami depresji okołoporodowej

Abstract Objectives: The aim of the following study was to establish whether there is any connection between an elevation of anxiety experienced by women during pregnancy or postpartum and their styles of coping with stressful situations, as well as to assess if those factors influence higher risk of incidence of perinatal depressive symptoms. Material and methods: A total of 229 patients admitted to the Department of Foeto-Maternal Medicine, Pomeranian Medical University, Szczecin in 2006-2007, were recruited for the study. By means of the Edinburgh Postnatal Depression Scale (EPDS), a study group of 76 pregnant and postpartum women with high risk of perinatal depression was assigned, as well as a control group of 153 patients without such risk. The level of anxiety and ways of coping in stressful situations were measured by means of the CISS (Coping Inventory for Stressful Situations) and STAI (State-Trait Anxiety Inventory) questionnaires. Results: It has been shown that specific styles of coping in stressful situations and Anxiety-state or Anxiety-trait have substantial influence on higher risk of perinatal depressive symptoms in women. Conclusions: 1). The risk of perinatal depressive symptoms is associated with ways of coping with stressful situations or Anxietystate and Anxiety-trait., 2). the risk of perinatal depression among pregnant women increases with an elevation of emotion-concentrated styles of coping in stressful situations, 3). the risk of perinatal depression among postpartum women increases with an elevation of emotion-concentrated ways of coping in stressful situations and engagement in substitute activities, 4). analysis of undertaken research indicate for suitableness of early diagnosis of specific styles of coping in stressful situations in order to implement proper therapy directed at the reduction of the risk of perinatal depression.Streszczenie Cel pracy: W pracy zbadano, czy istnieje zależność między nasilaniem się lęku doświadczanego przez kobiety w okresie ciąży i połogu a stylami radzeniem sobie przez nie w sytuacjach stresowych, a także czy te czynniki wpływają na zwiększenie ryzyka wystąpienia objawów depresji okołoporodowej. Materiał i metody: W badaniach wzięło udział 229 pacjentek hospitalizowanych w Klinice Medycyny Matczyno-Płodowej Pomorskiej Akademii Medycznej w Szczecinie w latach 2006-2007. Przy użyciu Edynburskiej Skali Depresji Poporodowej (EPDS) wyodrębniono grupę badaną 76 kobiet ciężarnych i położnic z wysokim ryzykiem wystąpienia objawów depresji okołoporodowej oraz grupę kontrolną 153 pacjentek bez takiego ryzyka. Poziom lęku oraz style radzenia sobie w sytuacjach stresowych zmierzono przy użyciu kwestionariuszy CISS (Coping Inventory for Stressful Situations) i STAI (State-Trait Anxiety Inventory). Wyniki: Wykazano znaczący wpływ określonych stylów radzenia sobie w sytuacjach stresowych oraz Lęku-stanu i Lęku-cechy na nasilenie ryzyka wystąpienia objawów depresji okołoporodowej u kobiet. Wnioski: 1.Ryzyko wystąpienia objawów depresji okołoporodowej związane jest ze stylami radzenia sobie w sytuacjach stresowych oraz Lękiem-stanem i Lękiem-cechą. 2. Ryzyko wstąpienia objawów depresji okołoporodowej u ciężarnych wzrasta w przypadku stosowania stylu radzenia sobie w sytuacjach stresowych skoncentrowanego na emocjach. 3. Ryzyko wstąpienia objawów depresji okołoporodowej u położnic wzrasta w przypadku stosowania stylu skoncentrowanego na emocjach i angażowaniu się w czynności zastępcze. 4. Analiza przeprowadzonych badań wskazuje na celowość wdrażania wczesnej diagnostyki stylów radzenia sobie w sytuacjach stresowych u kobiet ciężarnych, celem podjęcia odpowiedniej terapii ukierunkowanej na zmniejszenie ryzyka rozwoju depresji okołoporodowej

Knowledge of the perinatal care standard among women giving birth to children in the hospitals in Szczecin

Introduction: In order to improve the quality of perinatal care in Poland, the Regulation of the Minister of Health of September 20, 2012 introduced the standards of medical treatment when providing medical care from the field of perinatal care to women during the period of physiological pregnancy, physiological childbirth, postpartum and newborn care ( so-called the standards of perinatal care). Although the standards have been in force for several years, there are still problems with their compliance and their low knowledge among women giving birth. Research objective: Assessment of the level of knowledge about the Standards perinatal care and of Patients' Rights and the rights arising from them by women giving birth in the hospitals in Szczecin. Materials and Methods: The study included 335 women who have given birth in the hospitals in Szczecin. The study was performed since January 2016 till March 20158 by means of a diagnostic survey, based on the author’s questionnaire, developed on the basis of the standards of perinatal care 20th September 2012. Results: Among women giving birth vaginally 42% reported knowledge of the standard. 41% of women who have given birth by caesarean section declared that they know the standard. No statistically significant differences were found between the knowledge or lack of knowledge of the standards in terms age, education, and attend or not at antenatal class. We found statistically significant relationship between the knowledge of the standards and having a birth plan. Conclusions: 1. Knowledge of the standards declared more women, in comparison to the research conducted a few years earlier. Despite this their knowledge is still not high. 2. Women in spite of declaring knowledge of the standard are not aware that they were not followed. 3. There is still a need to educate women and staff on the standards of prenatal care and Patients' Rights

Association between HLA-DQA1, HLA-DQB1 alleles and risk of early pregnancy loss

The aim: The aim of the study is to identify HLA-DQA1, HLA-DQB1 allele and to assess the risk of early pregnancy loss of women, couples with reproductive failure in the first trimester of pregnancy in comparison with fertile women, couples. The study group (B) enrolled 61 couples with reproductive failure and the control group (C) enrolled 20 fertile couples with at least 2 children. Method: HLA-DQA1 gene typing was performed using PCR-sequence-specific primer (SSP) on the high resolution level according to established procedure of labeling and using the detection kit (FASTYPETM DQASSP Typing, FASTYPETM DQA „High Resolution” Typing Sheet) purchased from Bio-Synthesis (USA). Results: In female patient the highest risk quotient was associated with alleles HLA-DQA 01101/0105 OR 7,19 (95% CI 1,18-5,23; p=0,03) and HLA-DQB5 OR 3,67 (95% CI =1,11-12,0; p=0,037). The lowest but statistically significant risk of pregnancy failure in this group was related to allele HLA-DQB6 OR 0,48 (95% CI=0,22-1,04; p=0,087). In patient and control couples the significantly increased risk of pregnancy failure was related to the frequency of HLA-DQB5 allele OR 2,3 (95% CI 1,09-4,82; p=0,035) . The lowest risk quotient in the patient couples was associated with HLA-DQ 0302/0303 allele OR 0,44 (95% CI 0,14-1,36; p=ns). Conclusion: HLA-DQA and HLA-DQB allele might influence pregnancy outcome in the Polish population, but further studies are necessary in this regard

Knowledge of nursing students on the subject of pressure ulcers prevention and treatment. What we know about pressure ulcers?

Introduction: Pressure ulcers and their consequences can occur in any patient regardless of the underlying disease, so the knowledge of their prevention and treatment is extremely important. The aim of the study: The aim of the study was to analyze the state of students’ knowledge on pressure ulcers. Material and methods: The research was carried out in the Pomeranian Medical University in Szczecin among students of nursing. The study involved 203 full-time students. Data was collected using a questionnaire consisting of 27 questions. The questions addressed the issues of the formation, prevention and treatment of pressure ulcers. The Kolmogorow-Smirnow, Fisher-Snedecor test, (ANOVA) with Spearman’s correlation and Student’s t-test were applied for statistical analysis. The statistical significance was assumed to be p ≤ 0.05. Results: Over half of the respondents (57.64%) had a sufficient level of knowledge on pressure ulcers prevention and treatment. The level increased with the duration of the study, the highest was in the last few years, both I and II cycle of studies. The better (the higher) subjects assessed their knowledge about prevention and treatment of pressure ulcers, they were characterized by a higher level of knowledge. Conclusions: The knowledge of nursing students on pressure ulcers increases with subsequent years of study. The selfassessment of students’ knowledge about pressure ulcers, their prevention and treatment is accurate. Students of the consecutive years are better prepared to carry out anti-bedsore prevention. Students are aware of the need to have knowledge, as well as practice in the field of prevention and treatment of pressure ulcers

Zmiany stężenia sHLA-I i niektórych cytokin w przebiegu ciąży powikłanej zespołem antyfosfolipidowym

Summary Objectives: To compare the serum concentrations of the selected cytokines from subsequent trimesters of antiphospholipid syndrome complicated pregnancies. Material and Methods: This study included 43 pregnant women (23 patients diagnosed with antiphospholipid syndrome and 20 controls). IL-2R, IL-4, IL-10, INF-γ, TNF-α, and class I sHLA concentrations were analyzed by ELISA in the 1st, 2nd and 3rd trimester. Results: INF-γ levels were below the method detection threshold and therefore were not included in the final analysis. No significant changes in IL-2R, IL-4, IL-10, TNF-α, and class I sHLA concentrations were observed in subsequent trimesters in the group of women with antiphospholipid syndrome. Significant decrease in IL-10 in the 2nd trimester along with significant increase in TNF-α in the 3rd trimester were noted amongst the control subjects. The only significant inter-group difference was observed in the 1st trimester when mean TNF-α level was significantly higher among antiphospholipid syndrome women if compared to controls. Conclusions: The observed lack of significant differences between antiphospholipid syndrome affected and control group pregnancies in their sHLA class I and cytokine concentrations may be related to the fact that the treatment of antiphospholipid syndrome was implemented early and continued throughout all trimesters of the pregnancy.Streszczenie Cel pracy: Porównanie stężeń surowiczych wybranych cytokin w kolejnych trymestrach ciąży powikłanej zespołem antyfosfolipidowym. Materiał i Metoda: Badaniem objęto 43 ciężarne (23 pacjentki z zespołem antyfosfolipidowym i 20 zdrowych kobiet z grupy kontrolnej). Stężenia IL-2R, IL-4, IL-10, INF-γ, TNF-α oraz sHLA klasy I oznaczano metodą ELISA w I, II i III trymestrze ciąży. Wyniki: Wartości INF-γ w badanej grupie znajdowały się poniżej progu detekcji i nie zostały uwzględnione w dalszej analizie. W grupie ciężarnych z zespołem antyfosfolipidowym nie stwierdzono znamiennych różnic pomiędzy stężeniami IL-2R, IL-4, IL-10, TNF-α i sHLA klasy I oznaczanymi w kolejnych trymestrach ciąży. Natomiast w grupie kontrolnej w II trymestrze odnotowano istotny statystycznie spadek stężenia IL-10, a w III trymestrze – znamienny wzrost poziomu TNF-α. Jedyna istotna różnica pomiędzy grupą badaną i kontrolną dotyczyła stężenia TNF-α w I trymestrze, które było znamiennie wyższe wśród ciężarnych z zespołem antyfosfolipidowym. Wnioski: Brak istotnych różnic pomiędzy pacjentkami z zespołem antyfosfolipidowym a ciężarnymi z grupy kontrolnej w zakresie stężenia sHLA klasy I i niektórych cytokin może wynikać z faktu wczesnego rozpoczęcia terapii zespołu antyfosfolipidowego i jej kontynuacji w kolejnych trymestrach ciąży

Amnioinfuzja śródporodowa u pacjentek z obecnością smółki w płynie owodniowym

Abstract Objectives: The aim of the study was to evaluate the effect of intrapartum amnioinfusion in the presence of meconium stained amniotic fluid. Material and methods: 93 women with meconium – stained amniotic fluid were assigned to receive amnioinfusion or no amnioinfusion (128 women). The trials were evaluated for fetal distress syndrome, route of delivery, fetal acidemia, Apgar score at 1 and 5 min., meconium aspiration syndrome, postpartum endometritis and maternal hospital stays. Result: Amnioinfusion in cases of meconium-stained fluid did not improve the number of fetal distress symptoms during fetal heart rate monitoring. Amnioinfusion was associated with a significant decrease of neonatal acidemia although it did not improve Apgar score. In our study amnioinfusion was not associated with reduction in the incidence of neonatal outcome and puerperial complications.Streszczenie Cel: Celem pracy była analiza zasadności wykonywania zabiegu amnioinfuzji śródporodowej w przypadku obecności smółki w płynie owodniowym. Materiał metody: Grup´ badana stanowiły 93 ciężarne, u których przeprowadzono zabieg amnioinfuzji śródporodowej; grupę kontrolną stanowiło 128 pacjentek, bez zabiegu amnioinfuzji. Oceniono wystąpienie objawów zagrożenia płodu, sposób ukończenia porodu, punktację w skali Apgar w 1 i 5 min., wystąpienie kwasicy poporodowej, wystąpienie objawów zespołu aspiracji smółki, potrzebę wsparcia oddechowego noworodka, czas hospitalizacji, wystąpienie objawów połogowego zapalenia błony śluzowej macicy oraz potrzebę antybiotykoterapii. Wyniki: Przeprowadzenie zabiegu amnioinfuzji śródporodowej z powodu obecności smółki w płynie owodniowym nie wiąże się ze zmniejszeniem częstości wystąpienia objawów zagrożenia płodu w zapisie kardiotokograficznym, w sposób statystycznie istotny wpływa korzystnie na wartość pH w tętnicy pępowinowej (

Increased neuroticism aggravates the risk of depressive symptoms pregnant women

The objective of this paper was to present personality traits and the role of personality factors in the pathogenesis of depression, as well as in predicting the incidence of depressive symptoms amongst women in pregnancy. The study involved 134 pregnant women (gestational age between 32 and 40 weeks, 50 ones with perinatal depression symptoms, and 84 Controls). In  creased neuroticism was revealed a factor aggravating the risk of depressive symptoms during pregnancy (OR=1.23). Pregnant women suffering from prenatal depression differed in their self assessment of real psychological needs but not with respect to ideał (expected) self image. These differences demonstrated their lack of self acceptance. In conclusion, some personality traits (such as neuroticism, introversion, a lower score of openness, agre  eableness and conscientiousness) and self assessment of real psychological needs are important psychological factors in the pathogenesis of depression, as well as in the prediction of the incidence of depressive symptoms amongst women in pregnanc