PubMed Health⌕ Search

Biomedical subjects

S Bozhinova

Publications and source records attributed to S Bozhinova.

At least 19 recordsLinked to original sources
PubMed2006

[Ethical aspects of preliminary sex selection of the fetus].

With the emergence of preimplantation genetic diagnosis the perpetual trial of people to select their children's sex has become a scientific reality. This paper aims at making overview of the arguments for and against every social application of sex selection. More than 50 articles on the topic were reviewed, of which 19 that encompass different view points were chosen. The concept of family balancing itself is questionable. There are many arguments against. The predominant opinion in the profession, for the moment, is against every social application of sex selection technologies unless in cases of sex-linked diseases. As medicine and genetics develop further and further more complex ethical dilemmas arise. As individuals and members of society we need to think about what values our choices reflect and what consequences they are likely to have.

Choice Behavior↗
PubMed2005

[Treatment of iron deficiency anaemia in pregnant, puerperal and gynaecological patients--different drugs, different approaches].

UNLABELLED: According to WHO about 50 per cent of women of fertile age have iron deficiency anaemia (IDA). Iron loss > 80 mg per month, with menstruation in 22 per cent of women cause a negative iron balance in the course of time. About 40 per cent of women have data of prelatent iron deficiency still before conception, and if the demands of occured pregnancy are added, IDA is quickly reached. Over 30 per cent of puerperal women are affected by anaemia. PURPOSE: To make a pharmacoeconomic assessment of peroral antianaemic drugs used for treatment of IDA in pregnant, puerperal and gynaecologically ill women. MATERIALS: There are presented- daily intake of drugs, number of drug package taken, the price of a drug package, value of treatment a month, reimbursement of the drugs below: Ferro Gradumet, Maltofer Fol, Sorbifer Durules, Tot'hema, Legofer, Ferro-Folgamma, Tardiferon. RESULTS: The survey made and the data of own studies show that the most important in treatment of IDA are the choice of iron- containing drug and the correct therapeutic approach. The choice of peroral iron- containing therapy is determined by: high "patient compliance"--good tolerance, independence on food intake, once daily intake, low frequency of adverse effects and treatment with low price (economic effect). CONCLUSION: The most suitable for treatment of IDA in pregnant and puerperal women are Maltofer Fol and Sorbifer Durules. Maltofer Fol is with the best correlation price: "patient compliance". Tot'hema and Legofer have a good tolerance, a few adverse effects, but they are with high price. Ferro folgamma has not a high "patient compliance" and it has comparatively high price. Ferro gradumet has a low price and low "patient compliance".

Anemia, Iron-Deficiency↗
PubMed2005

[Sectio caesarea in extremely low birth weight newborn babies--modern tendency or objective necessity].

UNLABELLED: Obstetrician-gynecologists in a team with neonatologists contributed to saving of many children with extremely low birth weight /ELBW/, increasing many times SC frequency, considering it to be a sparing method for successful delivery, favorably influencing the outcome for the newborn. Many authors put emphasis on the better results however others point out reasons for a certain level of skepticism, assuming that survivability should not be the only criteria. Thus our objective was to find out the role of the abdominal delivery on the favorable outcome for ELBW newborn babies. MATERIAL AND METHODS: The study is retrospective, including 40 deliveries of children weighing from 500 to 999 g, at the Clinic in Obstetrics at Dr. Georgi Stranski University Hospital--Pleven, for a period of 5 years /2000-2004/. The newborn babies were divided into two groups depending on the method of delivery: I group--per vias naturales /PN/--31 cases--77.5% II group--per SC--9 cases--22.5%. RESULTS AND DISCUSSION: Attention was paid in our study to the most frequently asked question about the survivability of the newborn babies until their discharge, neonatal diseases and mortality rate, respectively. Survivability rate in the first group was 32.2% compared to 66.6% for the newborn babies per SC. The main reasons for mortality in the newborn babies are massive brain hemorrhages--70% of the cases, respiratory insufficiency--25% and extreme immaturity--5%. CONCLUSIONS: 1. Operative delivery is an objective necessity as a method improving the final favorable outcome for ELBW newborn babies. 2. The intensive neonatal cares accompanied by precise application of surfactant sharply increase the survivability rate and reduce diseases and mortal rate of ELBW newborn babies. 3. The preventive cares in the maternity consultation rooms could become a landmark for reducing the number of pre-term deliveries.

Bulgaria↗
PubMed2004

[Ferro-Folgamma--a drug for treatment and prophylaxis of iron deficiency anemia in pregnant women].

The problem of iron deficiency anaemia (IDA) in pregnant women is not a new one, but the flashback to it is justified because of the fact that its significance is not appreciated properly. The growing foetus has increased needs of different active for blood formation substances such as iron (Fe), folic acid, vit. B12, which are taken away from the mother. If her supplies are not enough, an anaemic syndrome can be promoted. The only suitable way in the presence of iron deficiency is the administration of drugs for equilibration of iron balance. We used Ferro-Folgamma--a new medicine for our pharmaceutical market, for treatment of IDA in 42 pregnant women and we rendered an account of the results of its administration. All pregnant women had starting data of Hb<110 g/l and Hct<0.33 L/L. One capsule of Ferro-Folgamma contains 100 mg iron sulfate siccatum (that corresponds to 37 mg Fe), folic acid - 5 mg, cyancobalamine 10 mg. It is administered a capsule 3 times daily in 1 to 3 courses of treatment and a course has 20 days duration. After a treatment course was carried out the starting data of Hb were increased with 8.73 g/l, and of Hct with 0.02. In 8 pregnant women after the first therapeutic course, a 20-days - treatment was conducted too and Hb rose with 18.14 g/l in comparison with the starting data, and of Hct - with 0.037. The authors recommend the utilization of Ferro-Folgamma for treatment and prophylaxis of IDA in pregnant women, because of its good gastric acceptance, a few side undesired reactions, and the supplement of Folic acid and vit B12 increases the iron resorbtion.

Anemia, Iron-Deficiency↗
PubMed2004

[How to avoid a haemotransfusion which is not lifesaving? (our experience with administration of intravenous iron to pregnant women and young mothers)].

PURPOSE: To study the effect of intravenous administration of the iron-containing medicine Venofer to pregnant women and young mothers with anaemic syndrome. MATERIAL AND METHODS: A 2-year prospective study was conducted to 50 pregnant women and young mothers, which were treated for iron deficiency anemia in First Obstetrical Clinic of University Hospital - Pleven. There were 27 pregnant women (gestational age 24-39 g. w.) and 23 young mothers. A treatment with Venofer was conducted following 5 ampules regimen of administration--1st day 3 amps and 2d day--2 amps. Venofer is a stabile iron-sucrose complex designed for intravenous application. It is a structural analogue of feritine. Control studies of haemoglobin (Hb) and erythrocytes (Er) were made on 6-7 day after the therapy. RESULTS AND COMMENT: The pregnant women had average starting Hb-data of 90.74 g/l and after the therapy--106.19 g/l. The increase was of 15.74 g/l. Young mothers had Hb-data before the therapy 88.04 g/l and after the therapy 104.5 g/l. The mean increase of Hb was of 16.46 g/l. Undesired side reactions were observed only in one pregnant woman and that necessitated the stop of therapy. Intravenous administration of iron contributed to the good, normal course of pregnancy and fetal growth, and the effect to young mothers consisted of quick and certain recovery of their general state without accomplishing haemotransfusion. CONCLUSION: Therapy with iron-containing medicine gives a good opportunity to avoid the risk of haemotransfusional infections, incopatible haemotransfusions and immunocompromizing effect of allogene haemotransfusion. It is also economically more beneficial.

Anemia, Iron-Deficiency↗
PubMed2004

[Clinical aspects of the issue "pregnancy complicated by syphilis"].

UNLABELLED: Syphilis is a disease with many social, cultural and ethico-moral implications. During the course of pregnancy it may lead to serious fetal disorders and eventually to its intrauterine death. With timely diagnosis, contemporary treatment is uttermost effective. AIM: Analysis of the frequency of syphilis among pregnant women, undergone treatment in the Quarantine Isolation Sector (QIS) with the Clinic "High risk pregnancy", at the University Multifunctional Hospital for Active Treatment (UMBAL) - Pleven Ltd., for a 5 year period (01.01.1999 - 31.12.2003) and an assessment of the effect of the disease on the fetus and the neonate. METHODS: Anamnesis, clinical investigation, serology, ultrasound of the fetus, cardiotocography, path morphology and statistical analysis. RESULTS: The retro- and prospective investigation made gives an idea of a slight tendency of increased frequency of pregnant women with positive serological probes, necessitating active treatment during pregnancy and after delivery (1999 - 0,32%, 2000 - 0,28%, 2001 - 0,51%, 2002 - 0,54% and 2003 - 0,65%). The most often inflicted contingent is among the illiterate population with a low social status. Frequency of obstetrical complication is not greater than with the seronegative women. Pronounced pathology in neonates is observed in newly diagnosed untreated cases. Frequency of operative delivery is independent of the accompanying disease. Higher among the diseased women is the incidence of premature, born-dead and death in the early neonatal period. CONCLUSION: From our results and data from literature we conclude as follows: 1. Wide screening of the sexually active population which covers the socially poor structures is necessary; 2. In timely started treatment with sufficient dose of Penicillin prophylaxis pevents complications to the fetus and the neonate; 3. Pertinent is the use of wide spectrum serological probes with pregnant women; 4. Changes in the health system have inferred a reduced efficacy of mass screening during pregnancy.

Adult↗
PubMed2004

[Delivery and perinatal aspects of pregnant women with pre-eclampsia-eclampsia].

UNLABELLED: Hypertension is the most important cause of disease in the expectant mother and the fetus, and it unfavorably affects the perinatal morbidity and mortality. AIM: To determine the method of delivery of a pregnant women with Praeeclampsia-Eclampsia (PE-E) depending upon the severity, continuity and term of appearance of hypertensive disease during pregnancy and its impact on perinatal morbidity and mortality. MATERIAL AND METHODS: The study covers a two year period (2002-2003), during which 84 pregnant women are treated and deliver with PE-E in the Ist and IInd Obstetrics clinics. Of them 64 (76.20%) are with mild form of PE, 10 (11.90%) with mid severe form and 10 (11.90%) severe form of which 3 had Eclampsia. The pregnancies were followed using echography and cardiotocographic monitoring. RESULTS AND DISCUSSIONS: With the severe forms of PE-E the disease started between 25-30 gestational weeks (60%), while with the mid severe the appearance was between 31-36 g.w. (50%). Persistence of PE > 4 g.w. was observed with severe PE, whereas in mild forms continuity of < 3 g.w. (73.44%) prevailed with its onset after 37 g.w. (57.81%). Normal delivery was attained with 41 pregnancies (48.81%), Caesarean section (CS) with 40 (47.62%), vacuum extraction with 1 (81.19%) and 2 (2.38%) had incomplete aborts. Frequency of CS with the severe forms of PE-E is 80%, with mid severe 50%, and with the mild forms is 42.19%. The most frequent indication of CS is fetal distress--11 (27.50%) and complicated obstetric anamnesis--9 (22.50%). With severe PE-E the most frequent indication is aggravation of symptoms and its non responsiveness to treatment. Born dead are 3 fetuses with severe retardation and body weight < 800 gm. Early gestational age hasn't given us the reason for premature delivery. Death of 1 child, born by CS with 750 gm weight is recorded. The higher rate of CS (3 times more than the median for the clinic--15.16%) can be explained to a degree by the fact that operative delivery by CS in pregnancies with PE-E reduces complications and has an aim to prevent complications to the fetus as well as the mother.

Bulgaria↗
PubMed2002

[Current position on the treatment and prevention of pre-eclampsia-eclampsia with magnesium sulfate].

The study was retrospective, encompassing 2 years period of time (2000-2001), as it was carried out at the First and the Second Clinics of Obstetrics at the Higher Institute of Medicine-Pleven. Fifty pregnant women and women in-child-birth having Praeeclampsia-Eclampsia (PE-E) were treated during this period, as 26 of them were administered Cormagnesin (first group) and 24 (second group) were not treated with magnesium preparations. In the first group 6 pregnant women had severe PE and 4-E, total 10 (38.4%). All E pregnant women and the PE cases with RR > or = 180/120 were treated with Cormagnesin. In the second group there were 4 pregnant women with severe PE (16.67%) but proteinuria was predominant (> or = 5 g/l) as RR was not higher than 160/110, so we did not have the reason to administer them Cormagnesin. The highest total dose MgS was 100 g and it was applied only in 1 E case (20g /daily for the duration of 5 days). In the remaining E cases the total dose was 60, 48, 2 g, respectively, as the number of applications was from 1 to 4 times daily, and the duration from 1 to 4 days. Cormagnesin gave excellent results in 80% of the cases with severe PE-E. The frequency rate of s.c. in the first group was 57.69%, in the second group--25%. The authors made the conclusion that the severity of PE-E and mainly the high values of RR and the other accompanying symptoms determined treatment with MgSO4. Cormagnesin application scheme was strictly individual. MgSO4 application allowed the possibility for conducting the delivery under more favourable conditions when convulsions were under control and RR was stabilised.

Eclampsia↗
PubMed2002

[Pros and cons of magnesium sulfate as a tocolytic].

Magnesium sulphate (MgSO4) is with a proved effectiveness in cases of praeclampsia/eclampsia, but its use as a tocolytic is discussed in the last few years. That is why we had for an object to study its effect as a tocolytic in cases of abortions and premature labours. The study is prospective and if is made in I-st obstetric clinic of High Medical School--Pleven. Treatment with Cormagnesin was carried out to pregnant women for suppressing the uterine activity. Cormagnesin 200 (1 amp-10 ml) contains 1000 mg MgSO4, and Cormagnesin 400 (1 amp-10 ml) contains 2000 mg MgSO4. The medicine was administered in dosage of 4 or 5 g for 30 min, and after that if there were any uterine contractions the infusion was carried on with additional 5 g MgSO4 for 6 to 12 h. The total dosage was from 4 to 60 g MgSO4. The authors reported on very good effect in cases with pains and increased uterine tone--18 (36.73%), as well as in cases with pains and irregular uterine contractions 5 (10.21%), while the treatment was without any effect in cases with uterine contractions on 15-20 min, increased uterine tone, bleeding and Pelvic score 1-3 points in spite of high dosages of MgSO4 and longer duration of treatment. The authors made the conclusion, that the subjective complaints should not be accepted as an indication for administration of MgSO4, and MgSO4 should be administered in cases with increased uterine tone and irregular uterine contractions. Every genital bleeding and suspicion for placental abruption should be defined more precisely, because lately diagnosed placental abruption and unjustified expectation for suppression of uterine activity by MgSO4, may lead to increase of perinatal morbidity and mortality. In spite of the controversial data about MgSO4 as a tocolytic, its administration is justified and necessary.

Abortion, Spontaneous↗
PubMed2001

[Rational method for prostaglandin use in cases with postpartal uterine hypotonia].

The authors aim is to find out the most common dosages, roads of administration and the effect of 15-Methyl PgF2a (Prostin 15 M) during the treatment of postpartal uterine hypotony 1 to 3 amp. Of Prostin 15 M-1 ml. (250 mg Carboprost) were used deeply muscular, intracervical or intramyometrial, by 51 patients with postpartal hypotony. The most common risk factors associated with the development of postpartal haemorrhage are PIH, prolonged labour, the general anaesthesis and higli multiparity. The adequate treatment with Prostin 15 M woned reduse the life threatening complication in the Labour room. The most efficient is the intracervical way of administration, a good effect could be achieved even with 1 amp. Prostin 15 M when it is applied after the conventional methods and manipulations. The lacu of effect grow Prostin 15 M (in 5.88% in this study) shows that there is another pathology responsible for postpartal hemorrhage and life threatening hemorrhage and this usually requires Laparotomy. We offer every Obstetric Clinic to have 3 amp. Prostin 15 M available and these would spare a lot of negative feelings or emotions and it wont supply a better obstetric outcomes.

Carboprost↗
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↗
PubMed2001

[Hormone replacement therapy and uterine leiomyomas].

UNLABELLED: The purpose of the authors is to survey the effect that HRT has on uterine fibromas. METHODS: It was made a very prospective one-year study on 25 women with uterine fibromas, 33-55 years old (the majority of them had subserose uterine fibromas with normal sizes). We are used the HRT with Climent and Cyclo-proginova (Schering A.G.). According to the kind of the treatment that was used, two groups were formed: the 1st had treated with Climent (n = 18) and the 2nd--with Cyclo-proginova (n = 7). The changes in the growth of the fibromas were observed with echography at the 1st, 3rd, 6th and 12th months. RESULTS: The significant changes in the growth are absent in the 1st group, while in the 2nd group in 6 of the 7 cases showed a little increasing in the size of the fibromas (to 25 mm). However, in 2 of all women who had bleeding, were treated with abrasio residuorum, and the histological result is a simple glandular hyperplasia. The missing of important changes in the size of the fibromas can be explained with the progestogens compartment, which decreased of estrogen receptors and with the stimulating effect of the 17 beta-OH-steroiddehydrogenasis, which reduced the estradiol in the cells. CONCLUSION: HRT could be used at women having fibromas without significant changes in the growth, under very strict control by echograpry.

Adult↗
PubMed2001

[Dostinex - the most effective medicine for inhibition of postpartal lactation].

The aim of the authors is to confirm the efficiency of the Dostinex for prevention an inhibition of the puerparal Lactation. Dostinex is a dopamine ergoline derivation that strongly decrease the Prolactin secretion and has a long-lasting effect. 20 parturients were treated with Dostinex and the most common indication was: death fetus (12 cases), disorders of the nipples (2 cases) and 1 occasion with epilepsy, thrombophlebitis and thromboembolic disease of the V. ileofemoralis, polymastia and polythelia and fetal malformations and in 2 women with hypergalactemy was given for inhibition of the lactation (1/2 table. For 4 days). The treatment is based on two tablets daily in the first 24 h. after delivery in 6 cases and for the other--2 x 1/2 table. daily for 2 days. Our conclusion is that Dostinex is the most effective agent for prevention of the postpartal lactation given once a day (2 table.) in the first 24 h. post delivery. We read good effect when the medicine was taken twice daily x 1/2 table. for 2 days. Dostinex shows vary good compliance and low rate of relapse of the Lactation.

Cabergoline↗
PubMed2001

[For and against non-obstetrical indications for cesarean section].

The authors have made a retrospective study on the nonobstetrical indications for SC from 1996-2000 year, with the help of special documents belonging to VMI, Obstetric Clinic, Pleven. There have been 10,465 deliveries in the same period, 1096 with SC (10.47%). The main indications in 56 cases (5.11%) were non-obstetrical complications of pregnancy and delivery. The most frequent non-obstetrical indications were: ophthalmological in 18 (32.14%), orthopedical in 10 (17.86%), cases CNS diseases in 5 (8.93%) and cancer in 3 (5.36%). We have included: Condylomata accuminata--5 (8.93%), acute thrombophlebitis and thromboembolic diseases--5 (8.93%), a condition after plastic repairs of the perineum, virgin and vulvae--3 (5.36%). Special interest was taken on another group of patients with some rare diseases about the other specialist recommended SC. The ovarian age of the patients was 20-29 years--in 36 (64.28%). The SC has been performed in 30 cases (53.57%) in the first stage, in 14 (25.00%) in the second stage of delivery and in 12 (21.43%) cases was emergency. The conclusions of the authors is that the Obstetricians, who manage the delivery, may not always been comparted with that of the other specialist. This comes from the fact that the responsibility is mainly for him.

Adult↗
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↗
PubMed2000

[The treatment of bacterial vaginosis with Dalacin V cream].

UNLABELLED: To asses the efficiency of the 2% clindamycin phosphate creme given in 3 and 7 daily courses officially designer for the treatment of bacterial vaginosis (BV). METHODS: The study includes 65 patients who have microbiological data for BV 11 of the women are pregnant (18.46%). The microbiological study includes there agent: Streptococcus agalactiae, E. colli, Gardnerella vaginalis, Peptostreptococcus species, Prevotella species, Mobiluncus species, Staphylococcus epidermidis et Enterococcus fecalis. The controls visit was assessed on the 7'] and 28'] day after the therapy. RESULTS: There were successful results on the 84.3% of the patients after 7 day course but in the 3-day course the good results were showed in 73.91% of the women. After the 28"] day there were only few successful results 43%. CONCLUSIONS: The clindamycin phosphate is more preferable method for the treatment of BV.

Adult↗
PubMed2000

[Acute appendicitis and pregnancy].

The authors summarize the special characteristics of the acute appendicit and the pregnancy. He pays attention on the symptoms, which made the diagnosis, laboratory analyses and differences with the most common obstetrics-gynaecological diseases. We have studied the main surgical techniques for make operation during Caesarean section. In the cases when there are noncomplicated delivery and acute appendicitis, we have to make an operation and the delivery occurs normal vaginal.

Acute Disease↗