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Biomedical subjects

L Pilka

Publications and source records attributed to L Pilka.

At least 37 records · Page 2Linked to original sources
PubMed1996

[An active approach in membrane rupture before the 32nd week of pregnancy and perinatal results].

During the period from Jan. 1, 1991 to Dec. 31, 1994 at the Second Department of Gynaecology and Obstetrics in Brno 125 patients were delivered of babies after premature rupture of membranes (PROM) before the 32nd week of gestation. After verification of PROM the active approach involved the following steps administration of antibiotics, corticoids, tocolysis, monitoring of markers of inflammation, of the foetoplacental unit and side-effects of treatment. Unless the patient had a spontaneous delivery within three days, the pregnancy was terminated, if the portio uteri was mature, by induction, if it was not mature, by Caesarean section. The latter was performed in cases of a pathological position of the foetus, multiple pregnancy, foetal hypoxia, metrorrhagia or associated complications. The perinatal results were evaluated in four weight categories (500-749, 750-999, 1000-1249, 1250-1499). The early neonatal mortality rate in the different groups was 750/1000, 420/1000, 217/1000, and 90/1000, RDS IV 37%, 36%, 21%, 12% and adnatal infection 25%, 11%, 34% and 21%. According to the authors results an active approach in case of PROM before the 32nd week of gestation is another factor which reduces the perinatal mortality and morbidity.

Delivery, Obstetric↗
PubMed1996

[Labor induction with extra-amnial administration of PGE2 vaginal tablets].

UNLABELLED: During the period between Jan. 1 1992 and Dec. 31, 1995 at the Second Department of Gynaecology and Obstetrics in Brno labour was induced in 1159 patients by extraamnial fractionated administration of PGE2 vaginal tablets. After assessment of the indication and the baseline examination (NST, amnioscopy, US biometry and cervical score) according to the CS to the patient the first dose of PGE2 was administered into the extraamnial space beyond the inner os uteri (CS 5-8:1.0 mg PGE2, CS > 8 : 0.5 mg PGE2). After two hours the patient was examined again and if regular uterine contractions had started or the finding on the os uteri was larger than 2 cm, the amniotic sac was disrupted. If not, another dose was administered. After two hours the patient was re-examined and if the os was larger than 2 cm, and there were regular uterine contractions, the amniotic sac was disrupted. If the changes did not take place, the induction was considered a failure. RESULTS: there were 1007 successful inductions (95.5%), the mean period from the onset of induction to the onset of uterine contractions was < 120 mins-269 (24.6%), 120-180 mins.: 501 (45.9%) and > 180 mins.: 322 (29.5%). The mean period of the first stage of labour was 228 mins., stage II 10 mins., stage III 8 mins. Five times uterine hypertonus was recorded and a blood loss greater than 500 ml occurred in four patients. Forty-nine Caesarean sections were made (4.2%) and 51 (4.4%) forceps deliveries. The rate of epidural analgesia was 27 (2.3%). Revision of the uterine cavity was made in 39 patients (3.4%) and manual lysis of the placenta in 30 (2.6%). The Apgar score was inferior to 6 in 10 neonates (0.9%). The protocol of induction of labour described by the authors is effective and associated with a minimum of side-effects, safe for the mother and foetus, well tolerated by patients and cost-effective.

Dinoprostone↗
PubMed1996

[Programmed labor--beneficial for the mother and fetus or an obstetrical hazard?].

During the period between Jan. 1, 1992 and Dec. 31, 1995 at the Second Department of Gynaecology and Obstetrics 482 full-term pregnancies were terminated by elective induction of labour. Labour was induced by extraamnial administration of PGE2 (Prostin UPJOHN 3.0 mg tablets vag). Depending on the maturity of the portio uteri a maximum of two doses after two hours were administered: 0.5 mg PGE2 when the cervical score was > 8 and 1.0 mg PGE2 when the score was 5-8 points. The results were compared with 278 non-risk pregnant women who were delivered of babies between Jan. 1 and June 30, 1995. The first stage of labour was longer in patients with spontaneous labour. The second stage of labour was longer in patients with induced labour. From the results ensues that an elective induction of labour does not increase the perinatal risk for mother and foetus, and conversely if all conditions are respected it is better for the mother, her family and the staff of the labour ward.

Dinoprostone↗
PubMed1996

[Preinduction priming of the cervix. Comparison of the intracervical administration of PGE2 gel and vaginal administration of estradiol].

During the period between Jan.1, 1994 and May 31, 1996 at the Second Department of Gynaecology and Obstetrics in Brno preinduction was performed in 40 patients by means of PGE2 gel (Prepidil Upjohn) and in 38 patients by means of an estradiol gel (Biotika). The inclusion criteria in the group were: singleton pregnancy, 38 or more weeks of gestation, cephalic presentation, unripe cervix (Bishop score less than 5) and reactive NST. The gel was introduced into the cervical canal and left in situ for 12 hours. If maturation of the cervix occurred, induction was implemented by extraamnial administration of PGE2. In the group of patients preinduced with Prepidil there was a significantly greater increase of Bishop score and the first stage of labour was shorter during subsequent induction of delivery. As to other investigated parameters, the two methods did not differ significantly.

Administration, Intravaginal↗
PubMed1995

[Intracytoplasmic sperm injection--a possible therapy for male subfertility].

The authors describe a new method of assisted fertilization, i.e. intercytoplasmic injection of spermatozoa. They submit an account of their technical equipment and the initial experience with this method on the degenerated human oocyte as well as on the blastocyst of cattle. Before this method can be introduced into clinical practice, it must be approved by the ethical commission.

Female↗
PubMed1995

[Dilatation of the cervical canal with Dilapan before induced abortion in the first trimester of pregnancy in primigravidas].

During the period between Oct. 1, 1993 and June 30, 1994 the authors inserted by the intracervical route in 32 primogravidae with unwanted pregnancies before abortion with pregnancies shorter than 8 weeks a hydrophil dilator Dilapan. After 12 hours the rod was removed under general anaesthesia and the pregnancy terminated by vacuum aspiration. In three instances after Dilapan insertion slight haemorrhage occurred which, however, did not call for removal of the rod. Apart from slight tenderness in the hypogastrium, similar as during menses, no side-effects were observed. In two instances during Dilapan extraction the rod was disrupted and the residue had to be removed by means of Kocher's forceps. In all patients the dilation of the cervical canal was sufficient for a 6 mm suction curette and further dilation of the cervix by means of metal dilators was not necessary. On examination after menstruation the patients did not report more massive bleeding nor febrile complications or residues. Based on the described results, the authors are of the opinion that gradual dilation of the cervix before abortion in the first trimester should be part of the procedure and all women who must face this situation should be given this opportunity.

Abortifacient Agents↗
PubMed1995

[Induction of cervical maturation using vaginal administration of estrogens].

During the period between September 1, 1993 and September 1, 1994 the authors preinduced 38 pregnant women in term by oestrogen administered by the vaginal route. The group comprised patients with a single pregnancy, PPH, CS 5n and reactive NST. For preinduction 150 mg oestradiol in a viscous gel were used which along with a pessary was inserted 24 hours before the planned induction of delivery by the vaginal route on the portio uteri. After removal of the pessary the CS was evaluated and then delivery was induced by intracervically administered prostaglandin. The preinduction was successful in 32 patients (84.3%), in 6 patients uterine contractions started during preinduction, delivery by forceps was used twice (5.3%) and Caesarean section six time (15.8%). In the course of preinduction there were no side-effects, no irregularities in the course of parturition were observed. The described method can be recommended as the method of choice for the treatment of an immature portio uteri before planned induction of delivery.

Administration, Intravaginal↗
PubMed1995

[Induction of cervical maturation using hydrophilic Dilapan rods in term pregnancy].

During the period between July 1, 1993 and July 31, 1994 the authors preinduced 52 pregnant women in term using the cervical dilator Dilapan. The group comprised patients with single pregnancies > or = 38 weeks, vertex presentation, cervical score < 5 and reactive NST. They introduced into the cervical canal 4 Dilapan rods for 12-18 hours and after extraction of the rods, depending on the finding, the patients were induced with Prostin e.a. or oxytocin i.v. The preinduction was successful in 46 patients (88.5%), in 16 patients (30.8%) uterine contractions were induced by Dilapan alone. Forceps delivery was performed 4 times (7.7%) and Caesarean section 12 times (23.1%). Apart from pain in the hypogastrium resembling menstruation pain, no side-effects were recorded. There were no irregularities such as the length of labour stages, blood loss due to injury during labour and the incidence of neonatal hypoxia. Based on the described experience Dilapan can be recommended as a preinduction method for maturation of the portio uteri.

Administration, Intravaginal↗
PubMed1995

[Treatment of post-partum atonic hemorrhage with prostaglandin F2 alpha analogs].

In the authors' group of patients with haemorrhage during childbirth, in 1990-1994 a total of 28 atonic haemorrhages were recorded, 15 of them were controlled by uterotonic treatment, in the remaining 13 cases haemostasis using PG F2 alpha was applied after ruling out post-partum injury. Some patients were given moreover saline infusions. According to initial results and consistent with the literature analogues of PG F2 alpha are effective uterotonic preparations of a new generation. With regard to their simple and rapid administration they are becoming the drug of first aid in the treatment of acute atonic haemorrhage.

Dinoprost↗
PubMed1994

[Hysteroscopic sterilization using Ovabloc].

The authors give an account on 29 sterilizations made by the hysteroscopic route, using the preparation OVABLOC. It is a reversible block of the oviducts by occlusive material. Under hysteroscopic control into the inner orifice of the oviduct by means of a special injecting device under pressure a two-component mixture of silicone and a catalyst is instilled which causes within 5 min. hardening of the mass and the formation of an elastic relief filling of the entire oviduct. In 25 of the women (86.2%) the procedure was accomplished without complication, in the 3 (10.3%) the procedure failed on account of technical difficulties and in one case (3.5%) during hysteroscopy the uterine wall was perforated. On X-ray check-up after three months of 25 successfully operated women in 24 the position of the tubal occlusion was unaltered (the material is due to dispersed silver particles contrasting on X-ray); in one case it was loosened. The advantages of the method are that it is sparing, well tolerated and easily reversible, the disadvantage is that it is relatively laborious and expensive.

Female↗
PubMed1994

[Hysteroscopic resection of myomas].

The authors give an account of their initial experience with hysteroscopic resection of myomas. During the investigation period (January 1991-August 1992) 34 of these operations were performed. In all instances at the same time laparoscopy was performed. The operation was free from complications in 26 patients (76.5%), in three instances (8.8%) peroperative haemorrhage developed, in 4 (11.8%) postoperative haemorrhage and in one instance (2.9%) perforation of the uterine wall. In 29 (85.3%) thus operated patients the menstrual cycle became normal within three months, after this period of time amenorrhoea persisted in three patients (8.8%). Two women (5.9%) reported irregular bleeding after the operation. To improve the success of the operation accurate indication is necessary, preferably based on previous diagnostic hysteroscopy, and improvement of the surgical technique.

Female↗
PubMed1994

[Anti-anemia therapy with prophylactic administration of Fe2+ in normal pregnancy and its effect on prepartum hematologic parameters in the mother and neonate].

Eighty-four non-anaemic pregnant women were treated, starting between the 20th-24th week of Pregnancy, with Actiferrin Compositum--1 capsule per day--from the 36th with 2 capsules per day up to childbirth. The group was compared with the results in 57 non-anaemic not treated pregnant women. Haematological parameters were recorded before the onset of treatment, during the first stage of labour and in neonates on the first day after delivery. By means of the non-paired t-test no significant differences were disclosed between the groups; nevertheless the percentage values of haemoglobin, haematocrit, erythrocytes and serum iron were higher in the treated group, as compared with the non-treated one. Also the ferritin values in neonates of the non-treated group were lower, as compared with the treated group. The paired t-test was highly significant in the Actiferrin treated patients as regards haemoglobin, haematocrit and transferrin values. The results provide evidence that it is indicated to administer as a routine measure Actiferrin Compositum to all pregnant women as prevention of pre-partum anaemia of the mother and low ferritin levels in the neonate.

Anemia, Hypochromic↗
PubMed1994

[Lateral pathologic flow in the uterine artery in the 3rd trimester of pregnancy and the fetal status].

From a total of 2,312 Doppler examinations made in 1992 at the Gynaecological Department of the University Clinic in Zürich in 34 patients in the 3rd trimester of pregnancy a lateralized pathological blood flow in the uterine artery on the non-placental side was found. As a control group the authors selected a group of 34 patients comparable as to age, gestation period, time when the Doppler examination was made and the type of delivery. The results of the investigation are not statistically significant in view of the low percentage incidence of lateralized pathology, however, it may be stated that the finding may be the first symptom of incipient foetal hypoxia.

Apgar Score↗
PubMed1993

[Ripening the cervix using intracervical administration of PGE2 with a butterfly needle in terminating pregnancy].

By intracervical administration of 0.75 mg PGE2, using a butterfly needle, the authors preinduced 32 patients with an immature portio vaginalis cervicis (CS 5 points) who had indications for termination of a full-term pregnancy. Slow administration lasted cca 6 hours. Maturation of the portio vaginalis cervicis occurred in 93.5%, in 71% regular uterine contractions started. The length of labour stages, the loss of blood, frequency of injuries during labour and foetal hypoxia were similar as in spontaneous deliveries. Side-effects were recorded in 20.7%. The described method is a suitable alternative to administration of gel substances, in particular because it is cheaper because it is well tolerated by the patients and is simple.

Cervix Uteri↗