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Biomedical subjects

P Bozhinov

Publications and source records attributed to P Bozhinov.

7 recordsLinked to original sources
PubMed2001

[Hormonal contraception and epilepsy].

Attempts to optimize quality of life in woman with epilepsy should include a reliable method for birth control, including oral contraceptives (OC). One of these methods is hormonal oral contraception. The classic antiepileptic drugs (AEDs)--Phenytoin, Phenobarbital, Ethosuximide and Carbamazepine induce hepatic microsomal enzymes and decrease the production of estradiol and progesterone, that may be compromise the effects of OC. Recommendation for women taking OC include possible use of noninducing AEDs (Valproic acid), new AEDs--Lamotrigine, Gabapentin, Topiramate, Tiagabine or for patients taking inducing AEDs use of an OC containing > or = 50 micrograms. estrogen. Patients should be warned that midcycle bleeding indicates possible OC failure and that the absence of such bleeding is not an indication of OC effectiveness. Additional contraceptive methods are also advised. The authors report their own experience in 12 women taking AEDs and OC.

Anticonvulsants↗
PubMed2000

[Current management in pregnancy and epilepsy].

Modern treatments make possible uneventful pregnancy and successful delivery for most of the epileptic women. Major risks however remain the teratogenic effects of some antiepileptic drugs and the obstetric complications they may cause. This implies careful planning of pregnancy for women with epilepsy and alertness for possible unwanted or undiagnosed (in the early stages) pregnancy in epileptic women during their reproductive years. The authors summarize current opinions in drug selections, specific treatment regimens and the obstetrics problems during pregnancy and delivery in epileptic women.

Epilepsy↗
PubMed1998

[The course of pregnancy and labor in patients with epilepsy].

For a 10-year period we studied the effects of epilepsy on the course of pregnancy, delivery, and perinatal complications among 27 women with epilepsy; 70.37% had epilepsy for 10 years. Before pregnancy, 74.08% of the patients had grand mal seizure. During pregnancy, grand mal characteristics were observed in 14.18% of patients, which mandated better titration of AED therapy. Two thirds of the pregnant women received therapy with carmabazepins and valproate. Delivery was normal in 81.48%, by forceps in 7.41% due to fetal distress, and by cesarean section in 11.11%. In only 1 patient was epilepsy the primary indication for cesarean section. In all cases, perinatal outcome was good and no fetal malformations were noted. We conclude that epilepsy does not lead to any significant complications during pregnancy and delivery except in those with tonic-clonic characteristics, which are difficult to control conservatively.

Anticonvulsants↗
PubMed1998

[Epilepsy and pregnancy].

Presented is a case of a 22-year-old pregnant woman in the ninth lunar month of pregnancy and with epilepsy from 10 years of age. The patient had been on therapy with barbiturates and carbamazepines for over ten years. She was hospitalized in the neurology department after having 5 grand mals in one day. After hospitalization she was observed to have Jackson-type feats of the left limbs that later on became generalized. In-between the feats she had left-sided reflector hemiparesis, and EEG data of an epileptic focus in the sensomotor region of the right hemisphere. The CT with contrast medium showed no pathologic changes. Sonography and cardiotocographic studies revealed no gross anomalies of the fetus, and adequate biometric data. Therapy was instituted with carbamazepin 0.200 t.i.d. valproate 0.200 t.i.d. and mannitol i.v. l/kg body weight. On the seventh day of therapy emergency c.s. was performed and a viable fetus weighing 2020 grams and in length 43 cm. was extracted. For three days after the operation the patient was on artificial ventilation. She was discharged on the twentieth day in a relatively good state and on maintenance therapy. The authors believe that the effect of pregnancy on epilepsy cannot always be foreseen. A precise titration of anticonvulsants to necessary for optimal control of epileptic feats during pregnancy.

Adult↗
PubMed1995

[Prostaglandin E2--an effective alternative for the induction of labor].

The authors aimed at studying the local application of PgE2 as a method of labor induction. 50 pregnant women divided into 3 groups were studied: I with Prostin E2 - vaginal tablets of 3 mg. Dinoprostone. II with Prepidil gel - 0.5 mg. Dinfprostone, applied intracervically and III with additional stimulation with Oxytocin - 5 E as an i.v. infusion. The criteria used were: parity, gestational age, Bishop score indications for induction. Success is considered as normal delivery by the 24th hour. Indications for PgE2 application are prematurity praeeclampsia, fetal malformations, fetal death, grave obstetrics history, RH incompatibility. It was discovered that with Prostin E2, the active phase of labor is reduced thus leading to reduction of labor. The frequency of operative deliveries also reduced and there were better fetal outcome. Two important advantages were discovered--simple application and physiologic advantages--the woman in labor is mobile and thus not traumatised. The authors stress that PgE2 application can be considered an effective method for labor induction.

Administration, Intravaginal↗
PubMed1994

[Adolescent pregnancy and the development of pre-eclampsia--eclampsia].

The authors aim to investigate the incidence and severity of pre-eclampsia--eclampsia in adolescent pregnancies (age under 17 years) and to evaluate the outcome of pregnancy and birth in this patients. With this purpose we compare obstetric and neonatal results in 528 adolescents aged between 13 and 17 years with the results of a control group of mothers aged between 20 and 24 years. We used clinical observation, laboratory findings, instrumental diagnostics and scoring systems. Data were computer-processed. Pre-eclampsia and eclampsia was diagnosed in 17 cases (3.22%), with mild forms prevailing (2.46%). Eclampsia developed in 4 pregnant (0.76%)-an incidence differing from that cited in the literature. We are impressed by the outmost severity of eclampsia in the adolescents, with 1 case of fatal outcome. Seven of the newborns were retarded. The most frequent indications to caesarean section were placental ablation and foetal distress syndrome. Operative delivery was performed in 41.18%. One case of foetal antenatal death and one death in the early neonatal period were observed, both in mothers with eclampsia. The authors conclude that the incidence of pre-eclampsia and eclampsia in adolescents is lower than in general obstetric population, but if eclampsia develops, it is fulminant and in some cases is fatal for the mother or the foetus. This grave prognosis may be related to inappropriate antenatal care in this patient group.

Adolescent↗