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Biomedical subjects

Z Malý

Publications and source records attributed to Z Malý.

At least 19 recordsLinked to original sources
PubMed2004

[Classification of twins and their ultrasonographic diagnosis].

OBJECTIVE: Systematic classification of all forms of twins and mechanisms of twinning. DESIGN: Review of published cases. Morphogenesis based on personal experience related to human blastogenesis including observation of anterior twinning in two early human embryos. SETTING: Institute for the Care of Mother and Child, Prague, Department of Gynecology and Obstetrics, 1st Medical Faculty, Charles University, Prague, Department of Medical Genetics, Medical Faculty, Palacký University Olomouc, Institut Unica, Brno. METHODS: Analysis of cases described in literature completed by observed cases. RESULTS: Classification of twins. A) Separated twins: 1. dichorial a) monozygotic (very rare), b) dizygotic (most frequent); 2. monochorial (always monozygotic) a) diamnial, b) monoamnial. B) Conjoined twins (always monozygotic) 1. isopagi (equal conjoined twins) a) originating from peripheral fusions of two germ discs, b) originating from duplications of axial structures; 2. heteropagi (unequal conjoined twins): autosit (main twin), heterosit (parasitic twin). CONCLUSION: The developmental mechanisms of twinning are discussed, special attention is paid to equal conjoined twins and to the possibilities of their early prenatal ultrasonographic diagnostics.

Female↗
PubMed2002

[Comparison of the risk of fetal hypoxia in active and expectant management of post-term delivery].

OBJECTIVE: Evaluation and comparison of risk of intrapartum foetal hypoxia in expectative and active approach after term of delivery. DESIGN: Retrospective analysis. SETTING: Gynaecological and Obstetric Clinic Medical Faculty, Masaryk University Brno. METHODS: The authors compared retrospectively two groups. Group A comprised 1906 deliveries in 1996, group B 2008 deliveries in 1999. In group A 194 deliveries after the 41st week term was applied. In group B there were 373 deliveries with an expectative approach, with inductions after the 42nd week of pregnancy. The authors evaluated the number of surgical and induced deliveries in after-term pregnancy in both groups and analyzed in indications. The post-delivery condition of neonates was evaluated in both groups according to the Apgar score during the 1st, 5th and 10th minute, In group B the authors had for the blood from the umbilical artery. The condition of neonates delivered by a surgical approach in group B was made more accurate by the base excess (BE) blood from the umbilical artery. The statistical significance of results was evaluated by the U-test and chi 2 test. RESULTS: The differences in the condition of neonates after delivery between the two groups are insignificant. In the expectative approach in 1999 there was a significant decline of the total number of induced deliveries and the total number of surgical deliveries. The difference in the number of surgical deliveries on account of imminent foetal hypoxia in group A and B are statistically insignificant. The number of hypoxic neonates is the same in both groups. CONCLUSION: Based on the results of comparison of the two groups it is obvious that the expectative approach is safe and medically justified. It is not associated with a greater risk of intrauterine foetal hypoxia. It does not lead to deterioration of perinatal results and leads to a marked reduction of induced deliveries.

Apgar Score↗
PubMed2002

[Effect of birth weight on neonatal and maternal morbidity in expectant management of post-term pregnancy].

OBJECTIVE: In the retrospective study to evaluate whether the number of newborns over 4000 grams weight is greater under expectative management of post-term pregnancy and explain its influence on perinatal and maternal morbidity and mortality. DESIGN: Retrospective study. SETTING: Gynaecology and Obstetric Clinic, Medical Faculty, Masaryk University, Brno. METHODS: Two groups were compared. Group I includes 1906 women, who delivered in the year 1996 under the active management of the post-term pregnancy with induction of labour in the 41st week. Group II includes 2008 parturients who delivered under the expectative management of the post-term pregnancy with induction of labour at the end of 42nd week. Perinatal mortality, brachial plexus injuries, clavicle fractures, Caesarean section rate for cephalopelvic dysproportion and injuries in mothers were evaluated. Students T test and chi square test were used for statistical purposes. RESULTS: In the group with expectative management of the post-term pregnancy there was significantly higher number of newborns over 4000 grams. Perinatal mortality and morbidity did not differ between the two groups. There is no difference in maternal morbidity as well. CONCLUSIONS: Our results of expectative management in post-term pregnancies with newborns over 4000 grams did not confirm our worries about higher morbidity both in newborns and mothers. There is no need to consider the expectative management of the post-term pregnancies to be dangerous.

Birth Injuries↗
PubMed1999

[Comparison of safety of the vertical and horizontal position for delivery].

The objective of the study was to assess whether vertical positions during childbirth are as safe as horizontal positions. In the course of delivery the authors observed 328 women with normal pregnancies, matched for parity and age, divided into two groups by type of delivery. They compared the course of the delivery, length of stages I and II, birth injuries, haemorrhage of the mother (number of episiotomies and grade III rpt. and blood losses) and the condition of the infant after delivery (Apgar score during the fifth and tenth minute, pH of the umbilical artery). The differences were evaluated by the chi square test and were not statistically significant. In the vertical position no greater risk was found for mother or infant and it can be considered equally safe as the horizontal one but it is more apt for mother and foetus.

Apgar Score↗
PubMed1999

[Fixation of the prolapse vagina to the sacrotuberal ligament].

OBJECTIVE: To present personal experience in the fixation of the vaginal stump to the sacrotuberal ligament. METHOD: Description of the surgery including modified surgical instruments. RESULTS: 32 surgical procedures were performed during a 4-year period. Two relapses were recorded. DISCUSSION: Various surgical procedures including abdominal approach to the fixation are mentioned, complications and prevention of relapses are discussed. CONCLUSION: The method is appropriate for sexually active patients. It preserves the length, axis and volume of the vagina.

Aged↗
PubMed1994

[Comparison of the results of conventional ultrasonography and color doppler analysis in the evaluation of the nature of adnexal tumors. I. Conventional vaginal ultrasound].

The author evaluates the results of ultrasonographic examination of adnex tumours in 317 patients, in correlation with the histological postoperative findings. US evaluation was focused on the quality and quantity of tumour echogenity, tumour size, its boundaries, possible presence of free fluid (ascites) in the abdominal cavity. The author discusses also factors influencing the US finding. It was revealed that the different criteria of conventional vaginal sonography only indicate the "direction of the nature of the tumour". The value of US criteria increases if several positive criteria are present simultaneously.

Female↗
PubMed1994

[Comparison of the results of conventional ultrasonography and color doppler analysis in the evaluation of the nature of adnexal tumors. II. Color duplex doppler ultrasonography].

The author evaluates the possibilities of coloured Doppler vaginosonography for prebioptic evaluation of the nature of ovarian tumours. He investigated the site of vascularization of tumours and qualitatively the blood flow by assessing the vascular resistance (PI, RI) and character of the flow velocity curve. The results revealed a statistically significant (p < or = 0.05) trend of central vascularization of malignant tumours. A new parameter with a 100% sensitivity and 89% specificity proved to be the notch at the beginning of the diastolic part of the velocity curve which was not observed in any carcinomas but was present in 89% of benign lesions. The vascular resistance was significantly lower in malignant tumours. The cut off value of malignity of the pulsatility index PI = 0.7 had a 86% sensitivity and 100% specificity. The cut off value of the resistance index RI is 0.6 with a 100% sensitivity and 75% specificity. Comparison of the predictive values of malignity of conventional and coloured duplex ultrasonography revealed that for evaluation of the nature of ovarian tumours coloured duplex sonography with several parameters is more suitable. PI and RI alone can be considered rather as indicators of active growth.

Adult↗
PubMed1993

[New approaches in the treatment of hypotrophic fetuses].

Hypotrophy or intrauterine growth retardation of the foetus associated with placental insufficiency still remains a serious obstetric problem. In the submitted paper the authors compare hypotrophic foetuses treated in 1989 and 1990 at the authors' clinic by conventional methods only (biometry, bed rest, CTG oestriol, glucose and possibly heparin) with a group of hypotrophic foetuses treated in 1991 and 1992 with magnesium and where the therapeutic effect was followed up by Doppler flowmetry. Based on the results, the demand to improve placental insufficiency by pharmacological induction and stimulation of specific placental enzymes is met perfectly by concomitant parenteral and oral magnesium administration to pregnant women.

Female↗
PubMed1992

[Results of transvaginal ultrasound screening for endometrial carcinoma in women at risk after menopause].

Vaginal sonography was used as a prebioptic examination for screening of endometrial carcinoma in postmenopausal women in a risk group (diabetes, hypertension, obesity) without a history of haemorrhage. The examination was made in 104 women. In 23 patients the ultrasonic finding was suspect and subsequent abrasion revealed in three instances carcinoma of the endometrium (2.88%). The authors consider vaginal sonography as important prebioptic method of endometrial cancer in the risk group of women after the menopause.

Endometrial Neoplasms↗