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Biomedical subjects

Z Stembera

Publications and source records attributed to Z Stembera.

At least 19 recordsLinked to original sources
PubMed1992

[Development of indications for cesarean section in the Czech Republic and certain developed countries].

The author analyzes the reasons for the rapid increase of pregnancies terminated by caesarean section; in some countries (USA, Canada and others) the frequency is as high as 20%. The main reason was a change of indication for caesarean section: not only hazard to the mother, but above all hazard to the foetus. It seems however that there is no relationship between the frequency of caesarean and the level of perinatal mortality. On the contrary, in many instances caesarean section increases the risk of mother and foetus and the neonate. In the Czech Republic the rate of caesarean sections was 7.8%: the main indications were the hazard of foetal hypoxia and an unfavourable presentation of the foetus. Some non-obstetric indications play a part: in particular orthopaedic and ophthalmological ones: they are the indication for every tenth caesarean section. In multiple pregnancies (in our country 42% are terminated by caesarean section), in particular pathological presentations of the foetus are involved. So far efforts of the international obstetric organization to reduce the use of caesarean section did not prove very successful.

Cesarean Section↗
PubMed1991

When is it possible to meet the wish of a woman to terminate her labour by caesarean section?

The authors have evaluated 311 answers of Czech obstetricians to the questionnaire concerning their attitude towards pregnant women that want to terminate their labour by caesarean section. The questionnaire contained six model situations: (1) normal delivery; (2) previous caesarean section; (3) breech presentation; (4) previous delivery of an injured baby; (5) protracted labour and (6) caesarean section apparently indicated by another obstetrician. In each situation the obstetrician was encouraged to choose from five different answers. The results have revealed the lack of unanimity in some cases, 3, 4 and 5. Here we feel that the obstetrician should meet the wish of the woman. However, in those situations that are clear from the medical point of view and where there is no professional indication for a caesarean section, it is in accordance with the Czechoslovak rule of law not possible to meet the wish of the woman.

Cesarean Section↗
PubMed1990

Prospects for higher infant survival.

Studies on trends in infant mortality and its constituent elements of early neonatal, late neonatal and postneonatal death, in developed and developing countries, point to ways of making further progress towards the target of infant mortality rates not exceeding 50/1000 live births in all countries by the year 2000.

Forecasting↗
PubMed1990

[Evaluation of the suitability of labor induction using the oxytocin stress test].

The authors elaborated an oxytocin loading test with a continual increase of oxytocin, which was used not with regard to the antepartal threat to the foetus but at the same time also for assessing whether induction of labour is advisable. This criterion was not mentioned in the literature so far. For evaluation of the sensitivity of the uterus the mutual association of the index of the uterine cervix, the number of days before childbirth and the necessary dose of oxytocin was used. If the required three contractions developed within the time interval of 10 mins. after the smallest oxytocin dose, the sensitivity of the uterine muscle was evaluated as good, after the double dose as medium, after the largest dose of oxytocin as weak sensitivity. The results of the thus arranged oxytocin loading test are above the borderline of the screening test and pass into the zone of a diagnostic method. To verify this important fact it is necessary to test according to epidemiological criteria the results attained in this so-called "preliminary" group in a more extensive "test" group.

Female↗
PubMed1989

Countrywide perinatal surveillance in Czechoslovakia.

Countrywide perinatal surveillance in four 10-year periods of Maternal Child Health (MCH) care development in Czechoslovakia is described. During this time maternal mortality decreased from 137 to 17/100,000 live births, and perinatal mortality (PMR) from 51 to 12/1000. On the basis of study results, countrywide intervention strategies concerning organization as well as medical measures were gradually drawn up. The greatest decrease in PMR was found through basic perinatal care for all; greatest efficiency followed employment of a risk approach.

Czechoslovakia↗
PubMed1988

Countrywide analysis of perinatal outcome.

The computer laboratory of the Research Institute for the Care of Mother and Child in Prague performs annually a countrywide analysis of perinatal outcome in order to obtain a background for the preparation of the optimal strategy for improving perinatal care in CSR in the future. The total as well as weight specific perinatal mortality rate further sub-divided into early neonatal death rate and late fetal death rate and differentiated according to the birthweight, was correlated with the incidence of different factors influencing the perinatal mortality rate both countrywide and for each of the eight provinces of CSR. This way a correlation was found between some of the mentioned perinatal outcomes and e.g. instrumental equipment of obstetrical departments and neonatal intensive care units, frequency of caesarean sections, or transport of LBW newborns in incubators or "in utero" etc. The results of this analysis have proved that there still remain in some provinces opportunity for further decrease in perinatal mortality due to the incomplete observance of the two intervention strategies "Risk approach" and "New technology" which were introduced in the whole country during the last 10 years.

Birth Weight↗