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Biomedical subjects

M Pervulov

Publications and source records attributed to M Pervulov.

31 records · Page 2Linked to original sources
PubMed2004

Indication of myomectomy during pregnancy from Doppler ultrasonography.

Myomas during pregnancy must be evaluated carefully, especially in relation to possible premature delivery or spontaneous miscarriage. We wanted to find out whether the addition of Doppler assessment could help in the management of these cases. We found that from all cases of myomas during pregnancy, the most common association with impairment of the fetoplacental unit flow was found in the cases with submucous myomas and the subgroup of those with intramural myomes which show etc. growth during pregnancy. However myomectomy is generally not considered to be indicated to prevent pregnancy complications except for women with a history of myoma-related complications. In pregnancies with myomas, preserving the pregnancy is one goal but different risk factors have to be taken into account at the same time.

Adult↗
PubMed2004

The importance of Doppler ultrasound in delivery planning.

With respect to the power of nature and the fact that it can still surprise us, even with all anticipated measures of safety, it is necessary to expand a range of true indications for surgical delivery. Thus complications of the delivery itself and conditions of increased morbidity can be reduced. By following Doppler flow with a biophysical profile, cardiotocography and pH metry of the head (if available), indications for cesarean section can be expanded in time so the morbidity and mortality of the newborn population can be decreased. It is a fact that controlled vaginal delivery leads to additional maturation of the fetus. By provoking contractions, acts of hypoxia crisis under the influence of stress hormones cause larger and faster surfactant production. However, the danger of walking on a tightrope is decreased if it is anticipated that delivery can not be accomplished per vias naturalis and that it is more advisable and safer to perform cesarean section.

Cardiotocography↗
PubMed2004

Early diagnosis of trophoblast produced capillary hypertension (pregnancy-induced hypertension).

A clinical study was initiated to demonstrate that blood pressure in the capillaries increases long before there is a rise in arterial blood pressure. Thus the diagnosis of capillary hypertension can be made much earlier, even before gross tissue edema is observed. Bearing in mind the pathogenetic mechanism of the development of pregnancy-induced hypertension (PIH) complicating the clinical picture, analyzed hematocrit had great statistical significance. Also, by following the diagnostic sequence, after hematocrit, Acidum uricum shows pathologic and protein loss values. Clinical application of this study would be in timely albumin administration and fast oncotic pressure regulation in order to avoid hypertension complications.

Capillaries↗
PubMed1996

Intra-amniotic Chlamydia trachomatis infection.

Chlamydia trachomatis is one of the most prevalent genital pathogens in pregnant women. Ascending, transcervical infection may reach fetal membranes creating chorioamnionitis or amniotic fluid infection. The aim of this study was to examine amniotic fluids obtained during cesarean section for the presence of chlamydial IgM- and IgG-specific antibodies, and for the presence of C. trachomatis antigen. Five of 52 (9.6%) amniotic fluid samples were seropositive. Two of 52 (3.8%) amniotic fluid samples had C. trachomatis antigen in the epithelial cells of the amnion. In conclusion, our data indicate that there is a high rate of transmission of C. trachomatis from mother to infant and that the pathogen can be identified in the amniotic fluid.

Adolescent↗
PubMed1994

Ceftriaxone in prevention of complications after cesarean section and its influence on the newborn.

The study included 303 patients subjected to elective cesarean section. Thirty two (11%) patients were classified in group A (with prophylactic ceftriaxone administration), 28 (87.5%) of whom had uneventful postoperative courses and 4 (12.5%) who had complications. Group B (with therapeutical application of ceftriaxone) was composed of 135 (45%) patents, 127 (94.1%) with uneventful postoperative courses and 8 (5.9%) with complications. Group C (in whom other antibiotics were used) consisted of 95 (31%) patients, 72 (75.8%) with uneventful postoperative courses and 23 (24.2%) with complications. Group D (no antibiotics used) was composed of 41 (13%) patients, 31 (75.6%) with uneventful postoperative courses and 10 (24.4%) with complications. Statistical analysis revealed highly significant differences in distribution of complications according to whether any, and which one of the antibiotics was used (X2 = 17.81, p < 0.005). This difference mainly resulted from lower incidence of complications associated with ceftriaxone use than in patients with no antibiotic therapy (X2 = 11.66; p < 0.005) as well as in patients using other antibiotics (X2 = 15.95; p < 0.005). Significant difference was also noted when patients given antibiotics other than ceftriaxone were compared with patients receiving no antibiotics other than ceftriaxone were compared with patients receiving no antibiotic therapy (X2 = 4.45; p < 0.05). Group A of newborns included 17 (89.5%) with high Apgar score, while 2 children (10.5%) had the score below 8. Group B had 2 children (11.7%) with Apgar score below 8, while 15 (88.3%) children had higher scores.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

Doppler ultrasound as an additional parameter for the evaluation of myomas and the indication of myomectomy during pregnancy.

OBJECTIVE: Pregnancies with myomas are known to have an increased risk for complications such as abruptio placentae, dysfunctional labor, growth of the tumor, necrosis and delivery problems, but prediction is still difficult based on clinical and real-time ultrasound evaluations alone. METHODS: We evaluated 15 patients with submucosal, intramural and subserous myomas, respectively. RESULTS: We found that in the submucosal myomas, the resistance index in the spiral and radial arteries decreased from 0.80-0.95 to 0.60-0.75 when choriogonadin and aspirin were given. In 3 cases in whom the resistance index increased before delivery, intrauterine growth retardation and the need for surgical delivery occurred. In 9 cases with intramural myomas, a normal decrease in the resistance indexes was seen, but 6 cases had a sharper drop related to necrosis. In 3 of the 5 cases with myomectomies, there were not only signs of necrosis but also of sarcomatous degenerations on histology. The cases with subserous myomas had no complications and the classical physiologic conversion pattern on Doppler evaluations. CONCLUSION: We feel that the Doppler results helped us with the management issues and gave insights into the typical pathophysiologic sequences, but the clinical role of Doppler flow analysis in pregnancies with myomas needs to be further evaluated.

Blood Flow Velocity↗
PubMedDate not supplied

[Determination of alpha acid glycoprotein in normal and pathologic pregnancy].

By the immunochemical method the authors determined alpha 1 acid glycoprotein in 20 pregnant women with normal pregnancy and 60 pregnant women with diabetes mellitus, EPH gestosis, and imminent abortion. In women with normal pregnancy no statistically significant changes between individual trimesters were recorded. Pregnant women with diabetes mellitus showed a statistically significant increase in all three trimesters, those with EPH gestosis in the first and the second trimester, and those with imminent abortion only in the first trimester. In the authors' opinion, the test could be a useful parameter in following up pathologic pregnancies.

Abortion, Threatened↗
PubMedDate not supplied

[Etiological factors in sterility and infertility as risk factors in future pregnancies].

An analysis was made of 1420 patients with threatened spontaneous or habitual abortions and pre-term deliveries, concerning the incidence of some etiological factors of infertility that might have been risk factors in the actual pregnancy. The number of pregnant women over 35 years of age in the treated series was significantly higher than in the control group. History data on sterility in the former group showed the incidence of 4.37% and in the control group 1.10%, the difference being highly significant (P less than 0.001). In the investigated series 154 patients (10.85%) had already had previous pre-term deliveries, while in the control group pre-term deliveries amounted to 3.20%, the difference being statistically highly significant (P less than 0.001). History data on spontaneous abortions in the first group showed the incidence of 69.57% (846 patients) and in the control group 16.20% (P less than 0.001). Uterine malformations were recorded in 69 gravidae (4.86%) in the treated group and in 1.20% in the control group, the difference being statistically highly significant (P less than 0.001). In addition to etiological factors, a high incidence of the following anomalies was also revealed: uterine hypoplasia and myoma, cervical laceration, cervico-isthmical insufficiency, and perinatal deaths in the history of the treated group. The importance of antenatal care of pregnant women with previous sterility and infertility is emphasized, as well as the need for considering the prophylactic use of beta-sympathomimetics.

Abortion, Spontaneous↗
PubMedDate not supplied

[Hypocorticism, pregnancy, labor and the newborn infant].

The authors followed up a pregnant woman with Addison's disease. Prior to, and throughout pregnancy, she received hydrocortisone in daily doses of 20 mg. The basic disease did not deteriorate during pregnancy. The pregnancy was terminated in the 41st week of gestation by induced labour. The infant's birth weight was below the 10th centile for the gestational age. Apgar score was 6. During the puerperium, the maternal basic disease got worse, requiring the increased substitution therapy. Both the mother and child discharged in good condition, on the 11th postpartal day.

Addison Disease↗
PubMedDate not supplied

[The effect of pre-eclampsia on thyroid gland function].

The prospective study involved 183 pregnant women with disorders of the thyroid gland, who were regularly followed up and delivered at the Department of Gynaecology and Obstetrics, University Clinical Centre, Belgrade, over a period of 10 years (1981-1990). There were 15 euthyroid patients in whom development of pre-eclampsia was diagnosed in the last trimester of pregnancy, and 20 healthy pregnant women with normal pregnancies and termed deliveries. The incidence of pre-eclampsia was analyzed depending on the basic disease, therapy and pregnancy metabolic status, as well as on their influence on the function. A statistically significant higher incidence of pre-eclampsia (p < 0.001) was observed in pregnant women with hyperthyroidism (26.0%) and hypothyroidism (26.8%). On the other hand, in euthyroid patients with pre-eclampsia the authors found that the concentration of total and free thyroxine was somewhat lower, while that of thyroid-stimulating hormone was a little higher comparing to the healthy pregnant women in the last trimester of pregnancy. Similar changes were noticed in patients with hypothyroidism. In pregnant women with hyperthyroidism and pre-eclampsia it was established that the concentration of thyroxine and triiodothyronine was somewhat higher, and that concentration of thyroid-stimulating hormone was a little lower comparing to all examined women in the equal metabolic condition. In the authors' opinion diseases of the thyroid gland represent a predisposing factor, i.e. a risk factor for the development of pre-eclampsia. The aim of further investigation is to observe mutual influences, pathogenetic mechanisms of further development of pre-eclampsia in patients with thyroid disorders, i. e. the influence of pre-eclampsia on thyroid disorders.

Female↗