S S Sumner MB, CHB, FRCS ED, DOMS.
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UNLABELLED: The aim of the study is to analyze the outcome of pregnancies complicated by Rh-isoimmunization for the period 1996-2001 and to outline the aspects of optimization of the obstetrical conduct. MATERIAL AND METHODS: The current study includes 39 pregnant women with Rh-isoimmunisation to whom amniocentesis and cordocentesis was performed. All cases were analyzed using medical history, serology (indirect Coombs, PAP test), ultrasound examination, amniocentesis, cordocentesis, NST. RESULTS: From 39 pregnancies, complicated by severe Rh-isoimmunization 36 resulted in a live delivery, 2 resulted in intrauterine death of the fetus and 1 in early neonatal death. The titre of the antibodies is of prognostical value only in the first isoimmunised pregnancy. In this case there is a reliable correlation between the condition of the newborn and the zone from the Liley curve, antenatally found. With history of former immune pregnancies with unfavourable perinatal outcome most precise information about the condition of the foetus gives the cordocentesis. CONCLUSION: In all of the discussed cases the Rh-isoimmunization is a result of no andi-D immunoglobulin profilaxis post partum or following abortion. That is why the efforts should be directed towards conduction of proper profilaxis to all Rh-negative pregnant women.
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The aim of this retrospective study is to find the CS rate, which to maintain the perinatal mortality at a lowest possible level in groups of patients with normal and high risk pregnancies. There were 123598 births for a period from 1976 to 2000 years. The CS rate has increased from 4.8% to 24.5% and the PNM has decreased from 27.7@1000 to 11.4@1000. The statistical analysis shows that the for this period the CS rate is one of the factors to decrease the PNM (r = -0.776, p < 0.05). In the group of pregnancies with normal risk the PMN is between 8 and 11@1000 at the CS rate of 15-16% while in the group with high-risk pregnancies the same PNM is achieved with 24-26% CS rate. The antenatal mortality is not influenced by the CS rate and is almost unchanged for 24 years (r = -0.339, p > 0.05).
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