Biomedical subjects

Monika Przybyłkowska

Publications and source records attributed to Monika Przybyłkowska.

4 recordsLinked to original sources

PubMed2005

[Conjoined twins--diagnostic problems, difficult decisions in choosing the most optimal management in one of the rarest pathologies of pregnancy].

Conjoined twins are the rarest type of monozygotic, monochorionic, monoamniotic twins--incidence about 1:50000 - 1:100000. A conjoined twin pregnancy is a very special pathology in obstetrics and usually ends prematurely. 40% of twins are stillborn, while 35% die within 24 hours after delivery. The development of ultrasonography and in the last years also MRI, allows earlier detection and diagnosis of fetal malformation and enables precise evaluation of the anatomy, type of malformation and how the twins are conjoined. Chances of survival and way of delivery depends on the degree of fusion of the organs and possibilities of surgical separation. Obstetric care for a women with conjoined twins does not differ from that in a normal twin pregnancy, but the newborns require special medical care after delivery. We would like to stress the diagnostic problems and the difficult decisions that we encountered. The degree of conjoinment in this case excluded surgical separation of the twins. A multidisciplinary team of experts decided to end the pregnancy at 31 wks by cesarean section. Delivery at a later term could increase the risk of uterine rupture and surgical complications.

Abnormalities, Multiple↗

PubMed2005

[Subsequent pregnancy (twin) in woman with autoimmunological hepatitis].

Autoimmunological hepatitis is a long lasting disease with periods of recurrences and remissions. There is a limited knowledge on this subject during the pregnancy. We present a case of a subsequent pregnancy (twin) in woman with autoimmunological hepatitis. The patient's condition between both pregnancies was so severe that she was assigned for organ transplantation. However after treatment with prednisolone and azathioprine patient's outcome improved. The patient got pregnant in a short time after remission. Pregnancy did not have any negative influence on symptoms of the disease in this case; moreover we observed complete remission of the disease.

Adult↗

PubMed2004

[Case report of 18 weeks delayed delivery of the second twin after the miscarriage of the first fetus at the 17th week of pregnancy].

Delayed delivery of the second twin after the miscarriage of the first foetus is very rare. Delayed second-twin delivery gives the opportunity for corticoid and antibiotics administration--procedures that decrease the infant morbidity and mortality. We report a case of the second twin's retention after miscarriage of the first at 17th week of pregnancy. The delay time was of 126 days (18 weeks). Pregnancy like this is at increased risk for all maternal complications, in particular intrauterine infection. Parents consent have to be obtained after informing them about advantages and risk of such procedure. The patient was treated with tocolysis, antibiotics, corticosteroids but not previous cervix cerclage has been performed. On regards of our experience and the data from literature we conclude that when observing fetal status and maternal condition, it is possible to delay the second twin's delivery long time after the miscarriage or birth of the first one thus giving the chance to the second twin to grow more mature. The main problem is imminent infection which defines the prognosis. Cerclage does not seem to be essential for better outcome.

Abortion, Spontaneous↗

PubMed2004

[Cervical pregnancy].

Until quite recently the diagnosis of cervical pregnancy was an indication for hysterectomy, because of mortality among patients with cervical pregnancy, coming up to 60%. During last 15 years methods of conservative therapy has developed in order to avoid the necessity of hysterectomy and to keep patient's fertility. Among these the most promising method is using of methotrexate (MTX), which is now the most commonly used agent in case of conservative forms for the treatment of cervical pregnancies. It should be stressed successful in treatment of cervical pregnancy in women, who wish to remain fertile, depends on early and proper diagnosis. MTX can be administered up to 13 weeks of gestation, with the highest efficacy between 6-8 weeks of pregnancy. We reported a case of cervical pregnancy treated successfully with methotrexate therapy combined with curettage of the cervical canal and uterine cavity. Serial beta HCG serum determination and ultrasonography were used to diagnose the pregnancy and to monitor therapy. Treatment was effective and the patient reproductive capability was preserved.

Abortifacient Agents, Nonsteroidal↗