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D Borowski

Publications and source records attributed to D Borowski.

10 recordsLinked to original sources
PubMed2000

[Fetal fibronectin as a predictor of preterm delivery in patients with preterm contractions and cervical changes].

OBJECTIVE: The purpose of the study was to assess the clinical value of fetal fibronectin assay in the group of women presenting with preterm contractions and cervical changes. STUDY DESIGN: We prospectively evaluated 82 patients between 23-34 weeks of gestation presenting with signs and symptoms of preterm labor, intact membranes and cervical dilatation < 3 cm. In all cases cervico-vaginal samples were collected and assayed for the presence of fetal fibronectin. The primary outcome was delivery < or = 28 days from examination. RESULTS: The rate of preterm delivery (< 37 weeks) was 25.6% (21/82) and 17.1% (14/82) of the patients delivered < or = 28 days from the examination. The mean Bishop score was significantly higher in patients delivered < 28 days (5.9 +/- 1.2 vs 4.7 +/- 1.4; p = 0.004). Positive result of fFN (> 0.05 mg/ml) was found in 71.4% of patients that were delivered < or = 28 days and in 7.4% delivered > 28 days (p < 0.001). For predicting delivery < or = 28 days the positive fFN testing had sensitivity of 71.4%, specificity of 92.7%, PPV of 66.7% and NPV of 94%. The cutoff value for Bishop's score > or = 5 had sensitivity of 85.7% and specificity of 48.5%. Performing fFN testing only in patients with Bishop score > or = 5 resulted in the sensitivity of 71.4%, specificity of 95.6%, PPV of 76.9% and NPV of 94.2%. CONCLUSIONS: Fetal fibronectin is a very good predictor of imminent preterm delivery. It needs further research whether performing of the fFN assay can be limited only to the patients with the estimated Bishop's score > or = 5.

Abortion, Spontaneous↗
PubMed2000

[Serial amniocentesis in TTTS].

AIM OF THE STUDY: The aim of our study was to estimate the efficacy of serial amniocentesis in cases of acute polyhydramnion in TTTS. We analyzed the time and the route of delivery, as well as the status of newborns. MATERIAL AND METHODS: The study group consisted of 13 twins with confirmed hydramnios. In each case thorough examination allowed to make the diagnosis of TTTS. After the examination patients were prepared for amnioreduction. During the procedure the excess of amniotic fluid was removed through the punction needle. RESULTS: The therapy of TTTS was based mainly on serial amniocentesis. In 2 cases, due to an extremely high amniotic volume, the therapy was started with placing the catheter to provide continuous amniotic drainage. The volume of AF removed during the single amniocentesis varied between 700-3000 ml and depended on AFI and the gestational age. In one case maternal treatment with indomethacin was introduced beside amniocentesis and in 3 pregnancies the Digoxin therapy was implemented together with amniocentesis. In all cases the deliveries were preterm. The mean donor weight was 730 +/- 290 g and the mean recipient weight was 1145 +/- 435 g (the difference was approximately 37%). In 7 cases we observed an intrauterine demise of one fetus. The 5th min Apgar score was 1 pt (median). When the analysis was performed after exclusion of stillborns, the median Apgar score for donors and recipients was 4 and 2 pt respectively. CONCLUSIONS: 1. Acute TTTS is a rare pathology occurring in monochorionic twin gestations. 2. The concomitant pathologies include: acute hydramnios, preterm labor and delivery, intrauterine growth restriction, cardiac failure. 3. Serial amniocentesis are effective in significant prolongation of gestation (the mean interval between diagnosis and delivery 24 days). 4. The improvement of perinatal outcomes in twin gestations complicated by TTTS can be achieved by the combination of serial amniocentesis and the laser ablation of anastomoses.

Adult↗
PubMed2000

[Doppler evaluation as a predictor of asphyxia in fetuses with intrauterine growth retardation (IUGR)].

Many papers showed that the pulsatility index of the fetal middle cerebral artery decreases during gestation. We observed equalization of the PI in MCA and PI in UMB in the perinatal period (after 38 weeks of gestation). We observed the increase the diastolic cerebral flow through the brain in cases of hypoxia. We interpreted that situation as a vasomotor response to fetal hypoxia (for example in IUGR). This phenomenon, is called in the literature as brain sparing effect. The aim of our study was estimation of application Doppler technique in diagnosis of changes in circulatory system in pregnancies complicated by intrauterine growth restriction (IUGR). We included 66 fetuses with IUGR and sonographic signs of the brain sparing effects, without any congenital malformation, oedema and genetic abnormalities to the study group. We included 1730 foetuses from normal, physiological pregnancies to the control group. In all cases time of gestation were calculated from Naegele's rule and were confirmed in sonographic examination before 16 weeks of gestation. SGA fetuses were defined on the basis of ultrasonographic measurements of BPD, HC, AC, FL and weight below 10th percentile of our reference curve. Sonographic examination were performed on Acuson 128 XP/10 with transducers (2.5 MHz-5 MHz). We performed Doppler examinations in MCA and UMB. Redistribution (brain sparing effect) was diagnosed when CPR (cerebroplacental ratio) was less than 1. We analysed the way and time of delivery and neoanatal follow up. Obtained in advance of researches results made possible expression of following conclusions: 1. Use of Doppler techniques in pregnancies complicated by IUGR makes possible diagnosis of hypoxia that helps in settlement of continuing or ending of pregnancy. 2. Changes in Doppler flows in foetus resoluteness outdistance irregular other values of biophysical methods of foetus monitoring.

Adult↗
PubMed1998

[The significance of cardiography in the diagnosis of cardiac ectopia of the fetus].

Retrospective analysis of echocardiographic examinations of 7 fetuses with ectopia cordis was presented. The majority of abnormalities were found in low risk pregnancies. There was only one case of isolated ectopia cordis with normal heart anatomy and no extracardiac malformations. There was no survival. Theoretically the prenatal diagnosis of isolated ectopia cordis may help to choose the proper term, place and method of delivery and also to plan the optimal care of newborn. Parents should be counseled about the prognosis in such cases, at the tertiary center, after detailed fetal echocardiography.

Adult↗
PubMed1997

Reversal of diastolic flow in the middle cerebral artery of the fetus during the second half of pregnancy.

This study obtained data on 22 fetuses in whom reversal of diastolic flow in the middle cerebral artery (MCA) was seen. In 59% of cases there was normal heart function and in 28% there was isolated tricuspid valve regurgitation. The majority (73%) of cases presented with normal fetal anatomy and most (82%) had a normal amniotic fluid index and normal fetal growth. In all cases, Doppler results of the umbilical artery and vein were normal. Of the women, 65% were on no medication and 73% did not smoke during pregnancy. The reversal of diastolic flow in the MCA was seen temporarily in the majority of cases (for 2-30 min); however, in one case with rhesus factor disease and a rim of ascites, it was observed for a longer period (about 2 h) and on the following day, intrauterine demise was recorded. In most of the cases without structural malformations, the neonatal outcome was normal. We conclude that reversed diastolic flow in the MCA is a rare and usually transient event. In one of our cases prolonged reversed flow preceded intrauterine demise. Therefore, this may be an ominous sign and careful fetal surveillance should be undertaken when this observation is made. There are a few possible pathomechanisms of reversed diastolic flow in the MCA. In the majority of cases the cause of the observed phenomenon remains unknown, but an increased pressure in the right ventricle and possible tricuspid regurgitation should be considered.

Blood Flow Velocity↗
PubMed1996

[Prenatal echocardiography of aortic stenosis].

UNLABELLED: Between 1991-1995 five cases of fetal critical aortic stenosis were diagnosed by fetal echocardiography at the Polish Mother's Memorial hospital. The main cause for referral for fetal ECHO was fetal ascites detected during routine obstetrical ultrasound scan in four cases and positive family history in one case. Pregnant women had fetal echocardiography monitoring as in-patients. During the first examination, the mean aortic valve size was 3.9 mm, mean shortening fraction of LV was 15.8%, mean heart/chest area ratio was 0.51. In one case pharmacological treatment with digoxin (due to fetal congestive heart failure) and steroids (to stimulate fetal lung maturity) was introduced. Amniocentesis due to severe polyhydramnios and fetal ascites drainage were also performed in this case. The were 2 fetal demises at 26 and 28 weeks of pregnancy, 3 cesarean section due to fetal distress during the first period of labour. The pH of umbilical blood was > 7.2. The newborns died between days 2-4 of life. CONCLUSIONS: Aortic valve stenosis can be diagnosed prenatally. This type of fetal heart defect has a poor prognosis.

Aortic Valve Stenosis↗
PubMed1985

Genetic analysis of Tn7 transposition.

The purpose of this work was to localize the DNA regions necessary for the transposition of Tn7. Several deletions of Tn7 were constructed by the excision of DNA fragments between restriction sites. The ability of these deleted Tn7s to transpose onto the recipient plasmid RP4 was examined. All the deleted Tn7s isolated in this work had lost their transposing capability. The possibility of complementing them was studied using plasmids containing all or part of Tn7. Two deleted Tn7s could not be complemented by an entire Tn7 indicating that a DNA sequence greater than the 42 bp terminal sequence is needed for recognition of the transposon by a transposition function. Four other deleted Tn7s could be complemented by Tn7. One of these was studied intensively in complementation experiments using different parts of Tn7 to obtain transposition. The results obtained allow us to propose that all genes needed for transposition of Tn7 onto plasmids are contained in a DNA segment of between 6.0 and 7.4 kb. Furthermore, one essential function must be contained in a DNA fragment longer than 2.5 kb on the right-hand end of Tn7. The classification of Tn7 with regard to the other transposable elements is discussed.

Base Sequence↗
PubMed1985

Tn7-encoded proteins.

Proteins encoded by Tn7 have been studied in Escherichia coli maxicells harbouring either various deleted ColE1::Tn7 plasmids or Tn7 fragments cloned in pBR322. Six Tn7-encoded proteins were detected and named p18, p32, p40, p54, p85-a and p85-b according to their apparent molecular weight. Protein p18 is dihydrofolate reductase type I and p32 is probably the protein conferring resistance to streptomycin/spectinomycin. Both genes map on the left-hand part of Tn7. The genes for the four other proteins are located on the right-hand part of Tn7. We propose that they fully cover a 6.9 kb DNA fragment without any overlapping. Starting from the right-hand end towards the middle of the transposon, these four genes are in the following order: p85-a, p54, p40 and p85-b. Transposition of Tn7 onto E. coli plasmids requires the proteins p85-a, p85-b, p54 and p40. However, transposition onto the chromosome does not require the p85-b and p40 products.

Bacterial Proteins↗
PubMedDate not supplied

Diagnostic and perinatal management of fetal extrasystole.

Fifty fetuses referred to the Polish Mother's Memorial Hospital for fetal echocardiography between January 1, 1991 and June 1, 1995 were evaluated. The mean fetal gestational age at the time of diagnosis of arrhythmia was 34.1 weeks, and the mean gestational age at the time of delivery was 38.7 weeks. Checkup echocardiographic examinations were performed every 10-14 days, for a mean 2.4 studies per fetus. In most cases (48/50, 96%), premature atrial contractions were present during the first echocardiography examination. The fetal heart study was normal in 30 cases; in 7 (14%) there was tricuspid valve regurgitation, in 7 (14%) an atrial septal aneurysm, in 4 congenital heart defects, in 1 myocardial hypertrophy, and in 1 disproportion in the four-chamber view. Of the 50 fetuses, 43 underwent regular echocardiographic monitoring alone; in 7 cases, based on the presence of additional echocardiographic findings, pharmacotherapy was applied (digoxin, verapamil, or both). Three neonates died after delivery owing to malformations in two cases (one critical aortic stenosis, one spina bifida plus hygroma colli) and due to myocarditis in one case. In six of seven newborns treated in utero, myocarditis was diagnosed after birth (including the one with neonatal demise). Most of the newborns were in good condition after birth, their mean Apgar score being 8.6 and the mean birth weight 3259 g. We concluded that most extrasystoles represent an isolated anomaly, not affecting the fetal condition. Their presence should not influence the obstetric care and may require only echocardiographic monitoring. In most of our cases the premature contractions subsided after birth, although sometimes they preceded fetal supraventricular tachycardia or appeared after congenital myocarditis.

Anti-Arrhythmia Agents↗