Biomedical subjects
Publications and source records attributed to Marian Semczuk.
There are special troubles to diagnose ectopic and intrauterine simultaneous pregnancies. The intrauterine pregnancy usually releases from coexisting ectopic pregnancy diagnosis. Diagnostic difficulties were analysed.
The pregnancy in women with epilepsy is associated with an increased risk of complications and especially with an increased incidence of congenital malformations in offspring. Currently, anti-epileptic drugs (AEDs) are concerned to be a major etiologic factor of abnormal fetal development. The most of AEDs may cross the placenta and reach pharmacologically concentrations in the fetus. Although the pathomechanism of teratogenicity of AEDs is complex and not well understood, a AEDs--dependent folate deficiency is thought as crucial. The reasons may also theoretically include a primary effect of AEDs on placental function and morphology. In the own study on perfused human placental cotyledon, only toxic concentrations of valproic acid caused morphological changes in placental tissue, including microvascular degeneration of cytoplasm, atrophy of syncytiotrophoblast, colliquative necrosis of some mesenchymal cells. The toxic but not therapeutic dose of valproic acid influenced also hormonal function of placenta by lowering of chorionic gonadotrophin concentration in perfusate. Although a knowledge about an influence of AEDs on the placenta and fetus is not complete, the use of these drugs during pregnancy may be more safe. If a dosage of AEDs in pregnant women with epilepsy is reduced to a reasonable minimum and the monotherapy is preferred, the risk of congenital malformations in their offspring can be minimized.
OBJECTIVES: The analysis of stress in patients with high risk pregnancies. DESIGN: The purpose of this research was analysis of stress level and structure in patients awaiting the baby from high risk pregnancies. MATERIALS AND METHODS: 50 married couples were recruited to the study: 14 with threatened abortion, 18 with impending preterm delivery and 18 with a chronic disease (preeclampsia or diabetes). Trauma Symptoms Inventory (J. Briere) was implemented in this research. RESULTS: Women exhibited higher levels of anxious arousal (AA). They revealed more frequently lowered mood and depression (D), as well as anger and irritability (AI). The clinical type of the threat seems to be the factor modifying the level of experienced stress. The highest level of stress occurred in those couples in which the women suffered from a chronic disease (preeclampsia, diabetes). CONCLUSIONS: Threatened pregnancy is a trigger for psychological stress in parents. Both women and men reveal increased behaviours directed to reduction of emotional tension. The level of experienced stress is most heavily affected by the type of threat. The symptoms of stress are similar in both parents in a group with a particular diagnosis.
Caesarean section is one of the most frequently performed surgical procedures in current obstetric practice. There are several reasons for this upward tendency, including well developed hemotherapy, anesthesia, antibiotic treatment and skilled doctors. Despite such risks as uterine rupture, necessity of blood transfusion or the possibility of the necessity of ending the delivery by means of surgery, it is possible, in justified cases, to attempt spontaneous labor. A decision jointly made by the patient and her doctor, based on careful consideration of benefits and risks, as well as positive attitude on the woman's part may lead to positive outcome of labor. Taking the above factors into account we have decided to present a study of a difficult, operational labor after two Caesarean sections.
OBJECTIVES: The pregnancy in women with epilepsy is associated with an increased incidence of congenital malformations in offspring. Currently, anti-epileptic drugs (AEDs) are concerned to be a major etiologic factor of abnormal fetal development but the pathomechanism of teratogenicity of AEDs is complex and not well understood. The purpose of this study was to evaluate an influence of one of the AED-valproic acid (VPA) on placental metabolism (glucose consumption and lactate production). MATERIAL AND METHODS: Term human placental cotyledons were perfused in vitro using a recycling perfusion of maternal and fetal circulations. A total 18 placentas were perfused either with 75 micrograms/ml of VPA (therapeutic dose) or with 225 micrograms/ml of VPA (toxic dose). Eight placentas were perfused with a medium without VPA and served as controls. During 2.5 h of experiment, both maternal and fetal glucose consumption and lactate production were measured every 30 minutes. RESULTS: The introduction of different concentrations of VPA into the perfusion system did not effect placental glucose consumption and lactate production rates in both maternal and fetal compartments. CONCLUSIONS: The teratogenic effect of valproic acid is not associated with metabolic disturbances of glucose or lactate in the placental tissue.
OBJECTIVES: Recent data emphasize relationship between antiphospholipid antibodies (APA) and increased natural killer cell activity in women with recurrent spontaneous abortion (RSA). Therefore, it has been proposed that final common mechanism involved in the pathogenesis of RSA is associated with auto- and alloimmunity. DESIGN: The aim of this study was to present our data concerning diagnosis and treatment of women with RSA. MATERIALS AND METHODS: Sixty nonpregnant women with the history of RSA were studied, among them 41 were screened at the beginning of their next pregnancy. We investigated the existence of inherited (deficiencies of protein C, protein S, antithrombin III, a resistance to the activated protein C-including Leiden V mutation) or acquired thrombophilia (APA-anticardiolipin antibodies, antiphosphatidylserine antibodies, lupus anticoagulant). Natural killer cell activity was measured using flow cytometry. In addition, the following lymphocytes surface antigens: CD3, CD4, CD8, CD16, CD56 were studied using flow cytometry. We also studied the existence of autoimmunity: antinuclear antibodies (ANA), antithyroid antibodies (ATA). According to presence of auto- or alloimmunity, we introduce immunotherapy: intravenous immunoglobulin, alloimmunization, heparin/aspirin, aspirin alone, steroids or combine therapy. RESULTS: We determined the existence of thrombophilia in 17 women, ANA in 5 women, ATA in 5 women, increased number of NK cells in 16 women and increased NK cell activity in 14 women. Forty-one women were pregnant and followed up during pregnancy, among them 33/41 delivered normal healthy baby, 7/41 experienced the next abortion and 1/41 had ectopic pregnancy. Therefore, overall success of immunotherapy was 80.5%. CONCLUSIONS: Immunotherapy seems to be effective treatment for women with the history of RSA and combined immune abnormalities. Regulation of immune system activity may underlie possible effect of such therapy.
OBJECTIVES: Hypertensive disorders in pregnancy are one of the major mortality risk factors for mother and fetus. Although pathomechanisms of hypertension are extreme complex, the involvement of kidneys usually occurs. N-acetyl-beta-D-glucosaminidase (NAG) is a lysosomal enzyme which is located in renal tubular cells. Therefore an elevation of urinary NAG activity serves as a marker of tubular cell damage. AIM: Evaluation of renal tubular damage in pregnant women with different types of hypertension by determination of urinary NAG activity. MATERIAL AND METHODS: The study comprised 84 pregnant women in third trimester, divided according to type of hypertension into 3 subgroups: pregnancy induced hypertension (n = 58), preeclampsia (n = 13) and chronic hypertension (n = 13). The control group comprised 36 healthy pregnant women. Urinary NAG activity was measured in the second morning urine samples by colorimetric method and the results were expressed as NAG/creatinine ratios (NAG/Cr). RESULTS: The highest NAG/Cr ratios were found in women with preeclampsia (median-1.520 U/mmol) and in women with pregnancy induced hypertension (median-0.874 U/mmol) and both results differed significantly from those in controls (median-0.782 U/mmol). There was slight positive correlation between NAG/Cr ratios and systolic blood pressure (r = 0.225, p < 0.05). CONCLUSIONS: Hypertension in pregnancy may lead to renal tubular damage, however clinical significance of this phenomenon requires further studies.
The purpose of the study was the analysis of regulatory (region 5 gen) and encoding sequences of RAR-alpha receptor in cervical dysplasia and invasive cancer associated with HPV infection. A PCR method with the use of specific primers was applied to amplify and detect DNA sequence of various HPV types. A PCR-SSCP method was used to analyse the sequence of RAR--a receptor. The study revealed changes in structure of regulatory and encoding sequences of the investigated RAR receptor. Utmost changes were found in DNA isolated from tissues with diagnosis of adenocarcinoma colli uteri.
OBJECTIVES: The main unfavourable effects observed in gestosis include: increased vascular peripheral resistance and increased blood pressure with a defective uteroplacental flow. The above mentioned changes may result from disorders in prostacyclin PGI2/thromboxane A2 balance. DESIGN: The aim of the studies presented was to compare the effects of, labetalol on the fetal vascular resistance induced by U 46,619--stable analogue of thromboxane A2 an experimental bilateral perfusion of the human placental lobule. MATERIALS AND METHODS: The researchers used the experimental model described by Schneider. 12 perfusions of the human placental lobules were performed. The control and labetalol groups consisted in 6 placental lobule perfusions lasting 120 min each. Having obtained constant increase in perfusion pressure from the 60th min of the experiment, labetalol was administered along with thromboxane A2 analogue into the fetal circulation. The perfusion pressure was steadily recorded on the kymograph tape. RESULTS: The stable increase of perfusion pressure was observed from the 60th minute with the average of 185% of the initial pressure. This value represented the reference standard in the second stage of the studies in which the effects of labetalol on the experimentally increased perfusion pressure was evaluated. CONCLUSIONS: Labetalol did not significantly affect the hemodynamics of fetoplacental vessels.
Preterm delivery is still a major medical and social problem in perinatology. Despite many efforts the appliance of efficient prevention methods is still not possible. The treatment and inhibition of uterine contractions is widely used in clinical practice. The use of tocolytic agents in arresting premature labor is justified by gaining time which is necessary for applying antibiotics and steroids. Short-term tocolysis, ordinarily used between 22 and 34 weeks gestation, prolongs pregnancy and usually delays the delivery by about 48 hours. There are two prevailing options to follow successful inhibition of preterm contractions. The first one recommends intravenous treatment in cases with recurrent premature contractions, the other recommends long-term tocolysis even in cases with no any threatening symptoms. In such cases many obstetricians apply oral beta-Adrenergic agonists, although most of literature data and clinical practice do not confirm good results in preventing premature labor long-term tocolytic therapy does not improve fetal condition and does not prolong the pregnancy. It is also not meaningless that during this therapy maternal adverse effects may occur. Taking the above into consideration long-term tocolysis cannot be recommended as the routine treating procedure.
Preterm birth is one of the major problems in perinatology today. It is associated with increased risk of neonatal infection and related neonatal mortality. In this study we evaluated some perinatal risk factors for neonatal injection. We found an association of neonatal infection with low gestational age, low birth weight, low Apgar score, intraamniotic injection, maternal leukocytosis, prolonged ruptured membranes and antenatal use of steroids and tocolysis. We conclude, that appropriate diagnosis, treatment and prophylaxis of intrauterine infections may reduce the incidence of infections among preterm babies.