Biomedical subjects
Publications and source records attributed to I Kozovski.
A case of severe HELLP sd. Was associated with cerebral oedema, anuria, retinal ablation, ascites and hydrothorax. The mother survived after intensive care and therapy, including 10 times haemodialysis. The acute fatty liver of pregnancy (M. Sheehan II) with a much poorer prognosis should be excluded. A diagnostical corticosteroids and prompt delivery is pointed out.
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The authors present the results of 31 consecutive cycles of ICSI. Fertilization occurred in 251 /88%/ of 279 oocytes which resulted in 8 clinical pregnancies /27% per transfer/--3 singleton, 2 multiple uterine pregnancies, 2 abortions and 1 ectopic pregnancy.
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In this article the authors discuss some problems in ART:COH, stimulation protocols, culture media, transfer of embryos, luteal phase support, ethical, financial, religious and legal problems etc. Tha main complications are discussed, toosyndrom and pseudosyndrom of the empty follicle, OHSS, multiple pregnancy. In these cases the prophylactic and therapeutical measures are pointed out. Finally the main perspectives and developments of ART in the new millennium are outlined.
The author discusses the problem Caesarean section in present day obstetrics and points out that the percentage of Caesarean births has been unnecessarily increased. This justifies the term "Caesarean epidemy". In spite of discussions and recommendations it turns out impossible to cope with this problem, i.e. reducing the rate to 15% in these countries where it is higher. Methods of infections morbidity prophylaxis are discussed too, especially the peri- and intraoperative antibiotic application (PAP, IAL) as well as the inaugurated by the author in 1987 postoperative intermittent intrauterine antibiotic lavage (PIAL). PIAL should be applied in very high risk cases, e.g. severe chorionamnionitis or vulvovaginitis combined with PAP and IAL. The use of these methods renders hysterectomy as ultra ratio prophylactic measure unnecessary. It is explicitly stressed that there is no prophylactic method to compensate defective surgical skills or flaws in aseptics and antiseptics.
UNLABELLED: The aim of the present multicentre study was to examine the therapeutic possibilities of the wide-spectrum medicament MACMIROR & MACMIROR COMPLEX for the treatment of the vaginal infections. MATERIALS AND METHODS: The study included 159 nonpregnant women among 15 and 54 years (middle age 35.6) with different by kind and intensity colpitis complaints. The following microbiological characteristic was established: in 26 cases Gardnerella vaginalis, in 46 Candida spp., and in the rest 87-mixed aerobic bacterial flora, with a combination of Gardnerella, yeast and Trichomonas. The treatment of the patients was done in combined scheme: peroral and vaginal administration, simultaneously with local treatment of the partner. The control examination was performed bistagely: on 7-10 day and on 30-40 day. RESULTS: The good clinical and microbiological influence of the treated patients was established, for the first control examination the effect was found in 88.1% and 86.8% and for the second--respectively in 81.1% and 82.4%. CONCLUSIONS: The received results give us a cause to approve, that the combination "Nifuratel and Nystatin" (Macmiror & Macmimor complex) has the good possibilities to influence the mixed forms of vaginal infection.
The authors present 3 cases of OHSS in 85 patients (3.5%), treated with long stimulation protocol. They propose an original grading of the severity of the syndrome as well as prophylactic and therapeutic measures.
After a review of the literature the author discusses methods, results and risks of the multifetal pregnancy reduction and shares his experience. Prophylactic measures are proposed too. Embryocide in twin or triplet pregnancy is not recommended except for malformation.
Shoulder dystocia occurred in 98 women (0.9%) among 10,695 deliveries during the period of 1986-1988. The most frequent cause was overweight and strangulated umbilical cord. The following maneuvers were used: pressure on the uterine fundus, strong flexion of legs (maneuver of Knebel-Macroberts-Korokawa) and in 12 cases--extraction of the posterior hand. The head should be rotated to the opposite thigh of the parturient in cases with incorrect rotation of the head--the most frequent cause for low shoulder dystocia. Prophylactic measures are of special significance: cesarean section in women with large fetus, estimated by ultrasound, or with fetus with thoracic diameter larger than biparietal diameter with 1.5 sm. The delivery should be managed by the most experienced obstetricians and should not be protracted or precipitate without indications.
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Studies were carried out on 167 pregnant women, divided into 4 groups in accordance with the values of human chorionic gonadotropin (HCH). Fetal death was established by ultrasound in 41 of the pregnant women including all cases with HCG under 5000 IU, but it was also found in 19.18% of women with values of HCG over 10,000 IU. Pregnancy advanced unfavourably in other 16 pregnant women of altogether in 34.13%. Prognosis was unfavourable in the presence of decidual hematoma. The gestational sac was enlarged on the average. 1.3 mm per day in normal development. Treatment was made in two groups: with hormones, spasmolytics and vitamins and only with spasmolytics and vitamins. The results showed that progesterone preparations, used singly or in combination with estradiol, did not improve the results.
Abruptio placentae was established in 202 pregnancies out of 43,678 pregnancies (0.48%). Pre-eclampsia was diagnosed in 76 women as well (37.6%). Caesarean section was performed in 109 women as vital maternal indications were found in 43 of them. 139 children were born alive (67.8%), but the perinatal mortality was 43.9% (90 children). The maternal mortality was 1.98% (4 women). Caesarean section should be made only in women with alive infant, but obligatory in all cases with severe separation, if preconditions for quick management of delivery by vaginal way lack. Vaginal delivery is recommended in all milder cases and dead fetus, but the duration of delivery should not surpass 6 hours. Total hysterectomy and tamponade of the operative field and vagina should be performed in women with persistent bleedings, but in grave cases a ligature of the hypogastric arteries as well. All interventions should be done after application of intensive infusion, transfusion and other reanimation. The authors propose a scheme for medicamentous treatment.
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Explore the source record for details and available documents.