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Biomedical subjects

R Debski

Publications and source records attributed to R Debski.

10 recordsLinked to original sources

[Diagnosis of fetal hemolytic disease and therapeutic possibilities].

The possibility of fetal blood sampling and direct blood transfusion into fetal circulation began the new direction in diagnostics and treatment of fetal haemolytic disease. Early diagnostics and possibilities of intrauterine treatment of the fetus enabled effective treatment also in severe hydrops cases. In the article diagnostic and therapeutic scheme introduced in the I Department of Obstetrics and Gynaecology and Central Rh-disease Unit in Warsaw was presented.

Blood Transfusion, Intrauterine

[Ultrasonographic assessment of changes in the location of the lower border (termed migration) of the placenta].

Ultrasonographic assessment of the so called placental migration was done in 136 patients in whom the preliminary diagnosis was made between 18th and 34th week of pregnancy. It was found that placental migration was a commonly observed phenomenon in patients with preliminary diagnosis of low-located marginal placenta previa while in the case of central placenta previa it occurred sporadically only in the second trimester of pregnancy. The lower placental border migration rate was higher in the second than in the third trimester of pregnancy.

Female

Enhancement of plasma corticotropin-releasing hormone in pregnancy-induced hypertension.

The role of a high CRH level in normal pregnancy remains unknown. Therefore we evaluated the concentrations of CRH and the related hormones in patients with pregnancy-induced hypertension. Fourteen women with pregnancy-induced hypertension, aged 20-39, at 30-39 gestational week, were investigated. The control group consisted of 20 healthy pregnant women matched according to gestational age. Plasma CRH beta-endorphin-like immunoreactivity, cortisol, and human placental lactogen were measured by radioimmunoassay, ACTH by an immunoradiometric method. It was found that in hypertensive patients the mean CRH concentration was significantly higher (4257 +/- 840 (SEM) ng/l) than that in healthy pregnant women (1083 +/- 227 ng/l, p less than 0.001). The concentration of ACTH, however, was only slightly higher 65.0 +/- 6.0 vs 50.7 +/- 2.5 ng/l p less than 0.025, whereas the differences in beta-endorphin, cortisol and human placental lactogen were not significant. In both groups there was no correlation between the CRH level and those of the related hormones. In healthy pregnant women the CRH level closely correlated with gestational age (r = 0.76, p less than 0.001), whereas in patients with hypertension no such correlation was present (r = 0.29). We assume that the marked enhancement of plasma CRH in pregnancy-induced hypertension is probably caused by its decreased breakdown in ischemic placental tissue, but its increased synthesis in the placenta and its indirect counterregulatory hypotensive role must also be considered.

Adult

A study of circadian rhythms of estriol secretion in the third trimester of gestation complicated by gestosis and intra-uterine growth retardation (IUGR).

The circadian changes in serum estriol concentration in the case of gestosis (at 30-36 weeks gestation) and intra-uterine growth retardation-IUGR (at 28-36 weeks) were examined. The control group consisted of pregnant patients without placental insufficiency at 26-34 weeks gestation. No circadian rhythms of estriol secretion was found in patients with gestosis and IUGR, whereas such a rhythm was confirmed in normal pregnancies. The evaluation of circadian changes in estriol concentration in the third trimester of gestation may be useful when diagnosing chronic placenta insufficiency.

Circadian Rhythm

Albumin and packed red blood cells in the treatment of severely isoimmunised pregnancies.

The most effective method of treatment of severe cases of fetal haemolytic disease are intrauterine intravascular transfusions. In some hydroptic cases however, the administration of only packed red blood cells produces unsuccessful results. We found that albumin supplementation paralleled with PRBC injection significantly increases the effectiveness of intravascular treatment.

Albumins

[Intrauterine blood transfusions in the treatment of severe serologic conflict].

Efficacy of the intraperitoneal and intravenous blood transfusions guided ultrasonographically was evaluated in severe cases of fetal hemolytic disease due to Rh conflict. It was shown, that survival rate of fetuses without generalized edema is two-fold higher in the group treated with intraperitoneal blood transfusions in comparison with the control group. It was found, that the proportion of erythrocytes containing HbA in umbilical blood of newborn is related to the number of intraperitoneal transfusions. One has to underline the failure of such a treatment in features with generalized edema. In such case intravenous blood transfusion is a method of choice.

Blood Transfusion, Intrauterine