Biomedical subjects

Grzegorz Breborowicz

Publications and source records attributed to Grzegorz Breborowicz.

6 recordsLinked to original sources

PubMed2004

Triplet pregnancies in women aged 40 or older: a matched control study.

OBJECTIVE: To determine, in triplet pregnancies, if maternal age is associated with adverse outcome in terms of birth weight characteristics. STUDY DESIGN: We analyzed a nationwide cohort of live-born triplets compiled by Matria Healthcare (Marietta, Georgia). We compared all 171 mothers > or = 40 years old with randomly selected and matched-for-parity mothers aged 25-29 and 35-39 years. The main outcome measures were length of gestation and individual and total triplet birth weight. All the subjects had private health insurance. The sample size was adequate to detect 5% differences at a power of 80%. RESULTS: Birth weights for infants A, B and C were significantly higherfor mothers > or = 40 years (P = .016, .01, and .03, respectively); total triplet birth weight was significantly higher as compared with that in the younger controls (P =.01). Gestational ages were similar in the 3 groups. In addition, the frequencies of births at < 28 weeks and of < 1,000 g were reduced by one-third or more in women aged 40 or older as compared to the younger controls (2.3% vs. 6.4% and 4.5% vs. 7.0%, respectively). CONCLUSION: Older mothers of triplets have better outcomes than do their younger counterparts in terms of total triplet birth weight.

Adult↗

PubMed2003

[Fetal brain blood flow velocity monitoring in high risk pregnancies].

OBJECTIVES: Blood velocity in the fetal vein of Galen and straight sinus is normally even and without fluctuation. Transverse sinus blood velocity pattern shows a characteristic triphasic shape. The aim of this study was to establish whether blood flow velocity pulsations in the Galen vein, straight sinus and transverse sinus velocimetry in high-risk pregnancies are related to an adverse outcome. MATERIALS AND METHODS: The Galen vein, straight sinus and transverse sinus were located by color Doppler ultrasound in 110 pregnancies complicated by pregnancy-induced hypertension and intra-uterine growth retardation with blood velocity recorded by pulsed Doppler. The incidences of blood velocity pulsations in Galen vein and straight sinus as well as peak systolic velocity, lowest diastolic velocity and resistance index (RI) from transverse sinus were correlated to pregnancy outcome, including emergency operative intervention and/or neonatal distress. Umbilical artery and venous and uterine and middle cerebral artery blood velocity was also recorded at the same time. RESULTS: Pulsating blood velocity in the Galen vein and transverse sinus was found in 40 and 10 cases, respectively. Signs of brain sparing in the middle cerebral artery were seen in 23 fetuses. Abnormal values for RI, peak systolic velocity and lowest diastolic velocity from transverse sinus were found in 20.6 and 18 cases, respectively. Galen vein pulsations were highly significantly related to adverse outcome of pregnancy and significantly more frequent in the present study than in the umbilical vein. Parameters studied in straight sinus and transverse sinus showed poor correlation with outcome of pregnancy. CONCLUSIONS: Venous pulsations in the Galen vein are significantly correlated to adverse outcome of high-risk pregnancy. Straight sinus and transverse sinus velocimetry was not associated with perinatal outcome and might not be useful in predicting fetal distress.

Blood Flow Velocity↗

PubMed2002

Fetal superior mesenteric artery blood flow velocimetry in normal and high-risk pregnancy.

THE AIM: To record blood flow velocimetry in the fetal superior mesenteric artery in normal pregnancy and to evaluate if blood flow recordings in the vessel might predict adverse outcome in high-risk pregnancy. METHODS: The fetal superior mesenteric artery blood velocimetry was recorded in a cross sectional manner in 75 normal pregnancies between 27 and 41 weeks of gestation. Reference curves were performed for pulsatility and resistance indices. The superior mesenteric artery was also located in 48 singleton pregnancies complicated by pregnancy-induced hypertension and/or intra-uterine growth retardation. Middle cerebral artery, umbilical artery and vein and uterine artery velocimetry were also recorded. RESULTS: Superior mesenteric artery PI and RI values expressed an increase in resistance to blood flow with gestational age after 32 weeks of gestation. In all except eight high-risk pregnancies the fetal mesenteric artery PI values were within normal range. Among the pregnancies with absent or reversed blood flow in the umbilical artery, all had abnormal mesenteric artery pulsatility index (PI) (> 97.5th percentiles), one fetus died intrauterine and two others died after delivery due to prematurity, growth retardation and necrotizing enterocolitis. In the remaining fetuses with increased mesenteric artery PI, necrotizing enterocolitis was diagnosed in three cases. CONCLUSIONS: Increased vascular resistance in the mesenteric artery might be a late sign of fetal circulation redistribution and frequently related to necrotizing enterocolitis in the newborn.

Blood Flow Velocity↗

PubMed2002

[The incidence of ovarian tumors in the third trimester of pregnancy].

METHOD AND RESULTS: Between 1993 and 2000, 7529 patients underwent cesarean section (24.3% of 31,798 delivering women) at University Hospital in Poznań. There were 52 cases of simultaneous adnexal surgery among them because of ovarian tumors (1 case/144 abdominal deliveries; 1 case/612 pregnancies). In 43 cases tumor was accidentally diagnosed at time of operative delivery (1/174 abdominal deliveries). The average age of all delivering women was 27 +/- 7 yrs, among abdominally delivering 28 +/- 7 yrs. The respective value for patients with ovarian tumor was significantly higher--30 +/- 7 yrs. The mean diameter of the tumor was 4.8 +/- 4.7 cm, but the largest 30 cm. In 9 cases adnexectomy was performed, remaining patients were treated conservatively. Benign cyst teratoma was diagnosed in 26.9%, cystis simplex in 21.2%, fibroma in 15.4%, endometriosis and luteal cyst every in 9.6%. There were two cases of malignant tumors, both diagnosed earlier: dysgerminoma and adenocarcinoma. CONCLUSIONS: 1. incidence of ovarian tumors of pregnant women was previously probably underestimated, 2. the risk of malignant ovarian tumor is relatively low.

Adult↗

PubMedDate not supplied

Triplet pregnancies and their aftermaths. Part I: Basic considerations.

Until recently, triplets were an infrequent occurrence. With the development of ovulation-inducing medications and then assisted reproductive technology (ART), the triplet birth rate in maternal age ranges over 24 years has multiplied three- to fiftyfold. The first review of the clinical aspects of triplet pregnancies was published in 1988. Since then, more data reported on such births have revealed a consistent triad of preterm delivery, low birth weight, and very low birth weight, plus increased maternal risks. This article details comparative risks to mothers and children using population-based data comparing differential outcomes in singletons, twins, and triplets; an extensive review of recent triplet publications is provided in the references.

Birth Rate↗

PubMedDate not supplied

Triplet pregnancies and their aftermaths II. Risks of older mothers and plurality.

There is no literature that accurately reports the risks inherent to the woman over age 40 who carries a triplet pregnancy. Extrapolating the singleton literature does not provide solid evidence, since risks are described variously by different authors and may relate to maternal age or parity as independent factors, which affect both maternal and fetal outcome data. On the other hand, recent population-based surveys strongly suggest that plurality is a more important risk factor than maternal age, for it affects both maternal and fetal outcomes.

Adult↗