Biomedical subjects

Piotr Wegrzyn

Publications and source records attributed to Piotr Wegrzyn.

At least 19 recordsLinked to original sources

PubMed2006

[Doppler flow characteristic in inferior vena cava between 22-42 weeks in intrau-terine growth restriction and normal pregnancies].

UNLABELLED: Uterine blood flow restriction and placental insufficiency can cause intrauterine grow restriction. Permanent hypoxia triggers compensatory mechanisms to pro-tect vital organs. Increased placental resistance and constriction of the fetal pe-ripheral vessels, as evidenced by blood redistribution and increased right ven-tricular afterload and end-diastolic pressure lead to increased pulsality in pre-cordial veins. Doppler flow analysis of the IVC allows the indirect estimation of the fetal heart function. OBJECTIVE: The aim of the study was to compare the Doppler indices in IVC in growth restricted and normal fetuses. RESULTS: The authors found that for the normal group PVIV, PIV and S/D de-creased with advancing gestation. However in comparision in IUGR group these parameters were substantially higher. CONCLUSIONS: The improvement of maternal and fetal Doppler techniques allows us to distinguish the subgroups of IUGR fetuses with the uteroplacental insufficiency that will have an increased perinatal morbidity and mortality. Alterations in the venous blood velocity waveforms have a more precise relationship with the risk of adverse perinatal outcome than changes in the arterial blood flow usually recognized relatively early in placental function disorders.

Adolescent↗

PubMed2006

[Multiple pregnancy at 11+0 - 13+6 weeks].

Chorionicity, rather than zygosity, is the main factor determining pregnancy outcome. In monochorionic twins the rates of miscarriage, perinatal death, preterm delivery, fetal growth restriction and fetal abnormalities are much higher than in dichorionic twins. High mortality confined to monochorionic pregnancies is the consequence of severe early-onset TTTS. Death of a monochorionic fetus is associated with a high chance of sudden death or severe neurological damage in the co-twin. Sonographic examination provides reliable distinction between dichorionic and monochorionic pregnancies. Reduction of the excess fetal loss in twins, can only be achieved through early identification of monochorionic pregnancies by ultrasound examination at 11+0 - 13+6 weeks, close surveillance and appropriate treatment in those that develop severe TTTS. In multiple pregnancies, compared to singletons, prenatal diagnosis of chromosomal abnormalities is complicated because, firstly, the techniques of invasive testing may provide uncertain results or may be associated with higher risks of miscarriage and, secondly, the fetuses may be discordant for an abnormality.

Chorion↗

PubMed2006

[The role of a family delivery in the modern obstetrics].

UNLABELLED: The aim of the study were the comparison of a course of delivery and the baby's condition between family delivery and traditional mode of labour, and the analysis of factors influencing the choice for a particular delivery option. MATERIAL AND METHODS: retrospective analysis of the medical records of healthy pregnant women at term hospitalised in 2001-2003 in the Department of Perinatology and Gynecology, Zabrze, Poland. Patients were divided into two groups depending on a delivery mode basis: group I (n = 520) were those attended by a family member, group II involved patients who were not (n = 1480). RESULTS: In the analysed period of time the rate of family deliveries has risen from 14% only in 2001 till 26% in 2002 and 36% in 2003. Younger patients, particularly occupationally active primigravidae with at least secondary education were more likely to choose the family delivery. This group of patients revealed two times lower rate of caesarean section or abnormal foetal heart rate. At the same time longer the first and the second stage of labour were noted. Duration of the III stage did not differ. CONCLUSIONS: Support by a family member during delivery could significantly elongate time spent in the delivery room as well as decrease the number of invasive procedures during and after the delivery.

Adult↗

PubMed2005

[First trimester diagnosis of chromosomal defects].

Fetal nuchal translucency thickness at the 11(+0) - 13(+6) weeks scan has been combined with maternal age to provide an effective method of screening for trisomy 21; for an invasive testing rate of 5%, about 75% of trisomic pregnancies can be identified. When maternal serum free B-human chorionic gonadotropin and pregnancy-associated plasma protein-A at 11(+0) - 13(+6) weeks are also taken into account, the detection rate of chromosomal defects is about 85-90%. In 60-70% of fetuses with trisomy 21 the nasal bone is not visible at the 11(+0) - 13(+6) weeks scan and examination of the nasal bone can increase the detection rate of screening by the first trimester scan and serum biochemistry to more than 95%.

Adult↗

PubMed2005

[Changes to the periodontium in postmenopausal women].

Few up to date studies on the influence of hormonal replacement therapy (HRT) on periodontium has been conducted on small groups of patients and the conclusions made may require further investigation on a larger population. It has been widely accepted that decreased estrogen levels in postmenopausal women are associated with a gradual loss of a bone density and increased risk of a dental loss. Much less stress is put however on the fact that the same phenomenon, especially suboptimal levels of estradiol, may deteriorate periodontal tissue condition. The authors made a literature search on the influence of HRT on periodontium.

Age Factors↗

PubMed2005

[Fetal nuchal translucency thickness and risk for chromosomal defects].

In normal pregnancy fetal nuchal translucency (NT) thickness increases with gestation, in trisomy 21 and other major chromosomal defects fetal NT is increased. The risk for trisomies can be derived by multiplying the a priori maternal age and gestation related risk by a likelihood ratio, which depends on the degree of deviation in fetal NT measurement from the normal median for that crown-rump length. In a pregnant population with a mean maternal age of 28 years, using the risk cut-off of 1 in 300 to define the screen positive group would detect about 80% of trisomy 21 fetuses for a false positive rate of 5%. It was estimated that, for a 5.4% false positive rate, 90% of trisomy 21 fetuses could be detected. Prospective studies have demonstrated that such results are achievable by screening with fetal NT and maternal serum free b-hCG and PAPP-A in the first-trimester. It is therefore essential that, in screening, attention is paid to the provision of high quality sonographic and biochemical services for early diagnosis of chromosomal defects.

Adult↗

PubMed2005

[Fetal nuchal translucency].

In addition to its role in the assessment of risk for trisomy 21, increased nuchal translucency (NT) thickness can also identify a high proportion of other chromosomal defects and is associated with major abnormalities of the heart and great arteries, and a wide range of genetic syndromes. In the first trimester, the term translucency is used to describe the accumulation of fluid behind the fetal neck, irrespective of whether it is septated or not and whether it is confined to the neck or envelopes the whole fetus. During the second trimester, the translucency usually resolves and, in a few cases, it evolves into either nuchal edema or cystic hygromas with or without generalized hydrops. Increased NT is associated with trisomy 21, Turner syndrome and other chromosomal defects as well as many fetal malformations and genetic syndromes. The incidence of these abnormalities is related to the thickness, rather than the appearance, of NT The ability to achieve a reliable measurement of NT is dependent on appropriate training and adherence to a standard technique in order to achieve uniformity of results among different operators. Furthermore, the success of a screening program necessitates the presence of a system for regular audit of results and continuous assessment of the quality of images.

Abnormalities, Multiple↗

PubMed2005

[Why do we observe a high concentration of CA125 in mother's serum during pregnancy?].

INTRODUCTION: CA125 was evaluated in a group of 100 pregnant women in the first trimester, at term and during puerperium to find out its main source at those stages. OBJECTIVES: Findings were analysed against history and symptoms of an imminent abortion in the first trimester. In patients with a history of vaginal spotting or bleeding regardless of the time of their duration, serum levels of CA125 were significantly higher in those who miscarried later. No such relation was noticed in those presenting with other symptoms only (e.g. abdominal pain) where CA125 titres did not depend on the outcome of the present pregnancy. MATERIAL AND METHODS: CA125 was evaluated in a group of 100 pregnant women at term to find out its main source in pregnancy. CA125 levels was evaluated with Roche Cobas Core CA125 II EIA. RESULTS: In every study group patients with a history of previous miscarriages revealed significantly higher levels of serum CA125 regardless of a number of previous abortions. Mean value of CA125 in a 3rd stage of labour was significantly higher than in a 2nd day of puerperium, when it dropped to the levels similar to that of nonpregnant women. These values were significantly higher in women admitted to the hospital in the early pregnancy on an imminent abortion basis. In patients who had caesarean section CA125 levels were significantly lower in respective period of delivery and puerperium. CONCLUSIONS: Maternal serum CA125 levels did not depend on other maternal, placental nor foetal factors evaluated in the study.

Abortion, Spontaneous↗

PubMed2005

[Doppler flow characteristics in ductus venosus between 22-42 weeks in intrauterine growth restriction and normal pregnancies].

OBJECTIVES: The ductus venosus plays an important role in the oxygenated blood supply from the placenta directly to the fetal heart. Uterine blood flow restriction and placental insufficiency can cause intrauterine grow restriction. Permanent hypoxia triggers compensatory mechanisms to protect vital organs. Increased placental resistance and constriction of the fetal peripheral vessels, as evidenced by blood redistribution and increased right ventricular afterload and end-diastolic pressure lead to increased pulsatility in precordial veins. Doppler flow analysis of the DV allows the indirect estimation of the fetal heart function. Because it is not always possible to achieve correct ultrasound beam insonation there have been attempts to use angle-independent indices. The aim of the study was: to compare the Doppler indices in DV in growth restricted and normal fetuses. MATERIAL AND METHODS: 208 women were analyzed: 89 women between 22-42 weeks of pregnancy complicated by IUGR and 119 with normal pregnancy as a control group. Ultrasound examination using pulse and color Doppler was performed and PVIV, PIV, PLI and S/D ratio were estimated. RESULTS: The authors found that for the normal group PVIV, PIV, PLI and S/A decreased with advancing gestation. However in comparison in IUGR group these parameters were substantially higher. CONCLUSIONS: The improvement of maternal and fetal Doppler techniques allows us to distinguish the subgroups of IUGR fetuses with the uteroplacental insufficiency that will have an increased perinatal morbidity and mortality. Alterations in the venous blood velocity waveforms have a more precise relationship with the risk of adverse perinatal outcome than changes in the arterial blood flow usually recognized relatively early in placental function disorders.

Adult↗

PubMed2005

[Sonographic features of chromosomal defects at 11(+0) to 13(+6) weeks of gestation].

Each chromosomal defect has its own syndromal pattern of detectable abnormalities. The authors describe the sonographic features of trisomy 21 and other major chromosomal defects in the first trimesters of pregnancy. At 11(+0) - 13(+6) weeks, all major chromosomal defects are associated with increased NT thickness. In trisomies 21, 18 and 13 the pattern of increase in NT is similar and the average NT in these defects is about 2.5 mm above the normal median for crown-rump length. In Turner syndrome, the median NT is about 8 mm above the normal median. In addition to increased NT there are sonographic features that are often seen in some affected fetuses at 11(+0) - 13(+6) weeks. In trisomy 21 fetuses have absent nasal bone, short maxilla and abnormal Doppler waveforms in the ductus venosus. In trisomy 18, there is early onset fetal growth restriction, a tendency for bradycardia, exomphalos, absent nasal bone and single umbilical artery. In trisomy 13, there is tachycardia, early onset fetal growth restriction, megacystis, holoprosencephaly and exomphalos. In Turner syndrome, there is tachycardia and early onset fetal growth restriction. In triploidy, there is early onset asymmetrical fetal growth restriction, bradycardia, holoprosencephaly, exomphalos, posterior fossa cyst and molar changes in the placenta.

Adult↗

PubMed2005

[Clinical significance of the doppler evaluation in ductus venosus, hepatic veins and pulmonary veins].

Doppler evaluation of the fetal venous system at present improves assessment of fetal well-being in many conditions. Actually, analysis of ductus venosus waveforms seems to be the most important. It place role in detection of genetic abnormalities (in low pregnancies), prediction of outcomes growth-restricted fetuses, assessment of severity of heart failure due to congestive heart anomalies, fetal infections, hydrops fetalis. Hepatic veins are known rather as an additional parameter (for ductus venosus) in the severely compromised fetus. Doppler evaluation of pulmonary veins may be useful in prediction of fetal lung maturity and in detection some difficult circulatory anomalies.

Female↗

PubMed2005

[Increased nuchal translucency with normal karyotype].

Increased fetal NT thickness is a common phenotypic expression of trisomy 21 and other chromosomal abnormalities, but it is also associated with fetal death and a wide range of fetal malformations, deformations, dysgenesis, and genetic syndromes. This paper reviews the outcome of chromosomally normal fetuses with increased NT On the basis of these data it is possible to estimate, for each NT group, the chances of intrauterine survival and delivery of a healthy baby with no major abnormalities. These data are useful in counselling parents of pregnancies with increased fetal NT and in planning the appropriate follow-up investigations. In normal fetuses NT thickness increases with fetal crown-rump length (CRL). The median and 95th centile of NT at a CRL of 45 mm are 1.2, and 2.1mm and the respective values at CRL of 84mm are 1.9 and 2.7 mm. The 99th centile does not change significantly with CRL and it is about 3.5 mm. Increased NT, refers to a measurement above the 95th centile and the term is used irrespective of whether the collection of fluid is septated or not and whether it is confined to the neck or envelopes the whole fetus. After 14 weeks, increased NT usually resolves but in some cases it evolves into nuchal edema or cystic hygromas.

Abnormalities, Multiple↗

PubMed2005

[Risk assessment for preterm delivery in pregnant women with active periodontitis].

INTRODUCTION: Premature labor has been regarded as a highly problematic clinical event not only due to its relation with perinatal mortality but also in the light of the remote results of the prematurity. Therefore many ongoing studies concentrate on evaluation of potentially avoidable risk factors of premature labor. Relatively few studies have suggested chronic periodontitis as such a determinant. OBJECTIVES: Prospective evaluation of periodontium changes in the course of otherwise normal pregnancy. Assessment of potential influence of periodontium pathology, and its severity, on the obstetrical complications. The authors have made literature search on the relation of active periodontitis and premature labor. MATERIALS AND METHODS: Study involved 120 randomized gravidae attending electively dental clinic for a routine control. INCLUSION CRITERIA: single pregnancy, no preterm delivery in a history, mother's age 18 to 35 years, gestational age 10 to 20 weeks based on a last menstrual period date--confirmed on ultrasound. Every patient underwent dental examination twice--at the inclusion date and 48 hours after delivery. Patients were divided into three groups. Group I (n = 25)--healthy patients. Group II (n = 61)--patients with mild or moderate periodontitis. Group III (n = 39) patients with a severe periodontitis. Progression of lesions was recognized if the post-delivery dental assessment revealed increase of the pockets depth higher than 2mm and in at least 4 places compared with the initial findings. RESULT: In the course of otherwise normal pregnancy women with signs of inflammation within periodontium revealed progression of this pathology proportional to its severity in early pregnancy. This increase was associated with 4-fold higher rate of preterm deliveries in Group II and 12-fold in Group III compared with healthy patients. CONCLUSION: Active and severe periodontitis should be regarded as independent and highly influential risk factor of the preterm delivery.

Adult↗

PubMed2005

[Sonographic features of chromosomal defects in the second trimester of pregnancy].

Each chromosomal defect has its own syndromal pattern of detectable abnormalities. The authors describe the sonographic features of trisomy 21 and other major chromosomal defects in the second trimesters of pregnancy. It is recommended that, when an abnormality/marker is detected at routine ultrasound examination, a thorough check is made for the other features of the chromosomal defect known to be associated with that marker; should additional abnormalities be identified, the risk is dramatically increased. In the case of apparently isolated abnormalities, the decision whether to carry out an invasive test depends on the type of abnormality. Minor fetal abnormalities or soft markers are common and they are not usually associated with any handicap, unless there is an underlying chromosomal defect. Routine karyotyping of all pregnancies with these markers would have major implications, both in terms of miscarriage and in economic costs. It is best to base counseling on an individual estimated risk for a chromosomal defect, rather than the arbitrary advice that invasive testing is recommended because the risk is 'high\ The estimated risk can be derived by multiplying the a priori risk (based on maternal age, gestational age, history of previously affected pregnancies and, where appropriate, the results of previous screening by NT and/or biochemistry in the current pregnancy) by the likelihood ratio of the specific abnormality or marker.

Adult↗

PubMed2005

[Pregnancy complications and pregnancy outcome in women under 18 and above 35 years old in highly industrialized urban complex of Upper Silesia].

OBJECTIVES: There is a considerable effort done by many researchers towards identification factors that are responsible for increase in risk of adverse perinatal outcome. Maternal age is one of the most obvious but also one of the most difficult to proper interpretation. MATERIAL AND METHODS: The authors analyzed major complications in pregnancy and labour in women under 18 above 35 years old in highly industrialized urban complex of Upper Silesia. RESULTS: Extremes of reproductive age, adolescence and age above 35 years have an impact on biological, social, cultural and economic conditions that significantly affects obstetrical results. CONCLUSIONS: Teenage mothers and the mothers above 35 years old are regarded to be in increased risk of instrumental delivery and caesarean section. These factors are also associated with augmented incidence of complication such as preterm labour, intrauterine growth restriction etc.

Adolescent↗

PubMed2004

[Doppler measurements of blood flow velocity and waveforms in fetal venous circulation].

Ultrasonic velocimetry of the fetal circulation became a very useful method in assessment of fetal well-being, especially in high risk pregnancies. There are many papers concerning on distribution and regulation of blood flow in umbilical artery, middle cerebral artery, and much less dealing with flow velocity waveforms in inferior vena cava and ductus venosus and their clinical significance. Fetal compromise is associated with significant alterations in the fetal arterial and venous circulation. Changes in venous Doppler waveforms develop due to increased afterload and perhaps myocardial failure in deterioration after arterial redistribution is established. Doppler investigation of the fetal venous circulation may play an important role in monitoring the redistribution and may help to determine the optimal time for delivery.

Blood Flow Velocity↗

PubMed2004

[Etiology of intrauterine growth retardation. Part I: placental-fetal interrelationship disorder].

Intrauterine growth retardation (IUGR) increases a risk of perinatal complications and may carry a negative influence on a later baby's mental and physical development. Poorer function revealed by many vital organs seems to be the effect of their lower mass and their relative immaturity. In the first part of a paper the authors discuss two groups of factors thought to be responsible for IUGR. The first one has been related to the fetal status-genetic anomalies, other primary developmental defects and different growth patterns.

Embryonic and Fetal Development↗

PubMed2004

[Etiology of intrauterine growth retardation. Part II: maternal disorders].

The second part of discussion incorporates maternal conditions influencing the risk of intrauterine growth retardation. Special attention was paid to the systemic abnormalities, and those pregnancy related, known for their links with affected placenta-uterine barrier or otherwise related to abnormal fetal growth. Both social and environmental groups of factors potentially influencing prenatal development have been discussed.

Embryonic and Fetal Development↗