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Miroslava Gojnic

Publications and source records attributed to Miroslava Gojnic.

3 recordsLinked to original sources

New approach of the treatment of von Willebrand's disease during pregnancy.

AIM: The aim of the study was to analyze the effectiveness of the application of DDAVP (desmopressin) and Hemate P with cryoprecipitate pre- and postpartum in patients with von Willebrand disease. METHODS: We monitored 32 patients with von Willebrand disease during the study period 1993-2003. DDAVP was applied in the 36th/37th week of gestation and cryoprecipitate and fresh frozen plasma were applied 1 day before and 3 days after delivery. DDAVP treatment continued for 4 weeks. Factor VIII (Hemate P) at the day of delivery RESULTS: No complications occurred in the studied population. CONCLUSION: Precipitation of DDAVP, Hemate P, and cryoprecipitate may help in the treatment of pregnant women with von Willebrand disease.

Deamino Arginine Vasopressin↗

Progesterone and pregnancy.

PURPOSE OF REVIEW: Progesterone is an essential hormone in the process of reproduction. Although the pharmacokinetics and pharmacodynamics of progesterone have been well studied, its use in the pathophysiology of pregnancy remains controversial. One of these concerns is the way in which the hormone is administered. RECENT FINDINGS: In obstetrics the most frequent uses of progesterone are in the treatment of threatened abortion, prevention of recurrent miscarriage, or in the support of the luteal phase in assisted reproduction programmes, and in threatened preterm labour. Randomized, controlled trials showed that women who received progesterone were statistically significantly less likely to have recurrent miscarriages before 34 weeks, to have an infant with birth weight of 2.5 kg or lower, or to have an infant diagnosed with intraventricular haemorrhage. There is currently, however, insufficient information to allow recommendations regarding the optimal dose, route and timing of administration of progesterone supplementation. SUMMARY: Progesterone has shown to be efficacious when continuation of pregnancy is hampered by immunological factors, luteinic and neuroendocrine deficiencies and myometrial hypercontractility. This may explain the reduction in the incidence of preterm birth in high-risk pregnant women using high-dosage prophylactic progesterone.

Abortion, Spontaneous↗

[Drugs and pregnancy].

The evidence of the transplacental transfer of most of the drugs administered to the mother has changed the old concept of the invulnerability of the fetus due to the placental barrier protection. The commonly used drugs act on the fetus by means of two different mechanisms: directly after the placental transfer, and indirectly influencing the utero-placental circulation and maternal homeostasis. Fetal effects can be several and they depend on the type of the drug, dosage, route of administration, gestational age in relation to the fetal ontogenesis, and on the amount of drug which reaches the fetus. For example, some drugs are redistributed in the maternal compartment; others remain in the fetal compartment by virtue of their chemical-physical characteristics and/or altered fetal homeostasis, i.e., fetal acidosis results in ionisation of the loco-regional anesthetics, which cannot leave the fetus, and therefore are entrapped in the fetal compartment. The complexity of the fetal-maternal pharmacology has implemented research on the animals, and epidemiologic and clinic studies. In spite of the research performed in the last years, the long-term perinatal effects are still to be clarified for many drugs administered to the mother.

Alcoholism↗