Background: Global access to social media has supposedly changed women’s awareness about the phar... more Background: Global access to social media has supposedly changed women’s awareness about the pharmacological and alternative methods of pain relief during vaginal delivery. The purpose of the study was to analyze changes in women’s preference and opinion about different forms of labor analgesia over the past decade. Materials and methods: The study was designed as an anonymous survey with questions about women’s knowledge and preference of different forms of pain relief in labor. The survey was conducted in 2010 and 2020, with data collected from 1175 women in 2010 and 1033 in 2020. Results: There were no differences between 2010 and 2020 in the proportion of women who wanted to receive analgesia in labor, at, respectively 67.9% of women in 2010 and 73.9% in 2020. About 50% of women chose epidural analgesia as the only efficacious method of pain relief in labor both in 2010 and 2020. There were no differences between the two time-points in the distribution of chosen methods of pain ...
Background and Objectives: The maternal preference of mode of delivery is an important problem in... more Background and Objectives: The maternal preference of mode of delivery is an important problem in respect of patient’s autonomy and shared decision-making. The objective of the study was to obtain information about women’s preferences of the mode of delivery and knowledge about the cesarean section and its’ consequences. Materials and Methods: The study was based on a survey filled in by 1175 women in 2010 and 1033 women in 2020. Respondents were asked about their preference of mode of delivery, possible factors influencing their decision and their knowledge about risks and benefits of cesarean section. Results: There was a significant increase in the rate of women who declared cesarean section as their preferred mode of delivery, from 43.97% in 2010 to 56.03% in 2020 (p < 0.05). In 2010 26.51% of women thought that choice of mode of delivery should be their autonomic decision, 46.36% preferred decision-sharing with their obstetrician, 25.64% thought that cesarean section should ...
OBJECTIVES Delayed or insufficient breast milk production, as well as low milk supply, is still a... more OBJECTIVES Delayed or insufficient breast milk production, as well as low milk supply, is still a challenging problem to overcome, particularly in the case of preterm delivery. Herbal galactagogues might be a good way to increase milk supply, however, there is a lack of clinical studies confirming their efficacy and safety. The aim of this study was to verify the safety and effectiveness as a galactagogue of the unique galactagogue composition based on barley malt with β -glucan and lemon balm. MATERIAL AND METHODS The study included 117 mothers of preterm infants randomly divided into the Galactagogue Group given galactagogue and the Placebo Group. A complete data set was obtained for 80 participants, divided equally between two groups. Volume of milk expressed by mothers during the first two weeks after delivery was the primary outcome and safety of the product was the secondary outcome. RESULTS Volume of milk recorded on participants' last visit in the Galactagogue Group was ...
The immunomodulatory effects of a recently synthesized adamantane derivative of aminopyridine – 2... more The immunomodulatory effects of a recently synthesized adamantane derivative of aminopyridine – 2-(1-adamantylamino)-6-methylpyridine (AdAMP) – were tested on normal and neoplastic cells in vitro. When incubated with TNF-a gene-transduced mouse melanoma cells (B78/TNF), AdAMP significantly enhanced basal production of TNF-a by these cells, both by ‘‘high’’ and ‘‘moderate’’ TNF-a-producer cells. A similar TNF-a production-enhancing effect was observed in cultures of human ovarian carcinoma cells (CAOV1) which spontaneously produce TNF-a but not in cultures of tumour cells incapable of TNF-a secretion. RT-PCR analysis showed that the enhancement of TNF-a production by AdAMP was associated with an increase in TNF-a mRNA expression in the treated cells. The results of an electrophoretic mobility shift assay (EMSA) showed that AdAMP significantly activated nuclear factor jB (NF-jB) in both CAOV1 and B78/ TNF cells. The role of NF-jB in enhancement of TNF-a production was confirmed in exp...
Shoulder dystocia remains an obstetric emergency. Maternal diabetes is considered to be one of th... more Shoulder dystocia remains an obstetric emergency. Maternal diabetes is considered to be one of the major risk factors for shoulder dystocia. The aim of this study was to analyze antepartum and peripartum risk factors and complications of shoulder dystocia in diabetic and non-diabetic women. We performed a retrospective analysis of 48 shoulder dystocia cases out of 28,485 vaginal deliveries of singleton, live-born infants over a 13 year period: 13 cases were diagnosed in diabetic women and 35 cases in non-diabetic women. The study was conducted in the 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland, from January 2000 to December 2012. Compared to non-diabetic women, diabetic patients had significantly higher pre-pregnancy body weight (83.4±23.8 kg vs. 62.5±10.9 kg, p=0.002), higher pre-pregnancy BMI (30.2±6.8 kg/m2 vs. 22.9±4.3 kg/m2, p=0.0003), and lower gestational weight gain (11.4±6.2 kg vs. 16.0±4.7 kg, p=0.01). Diabetic women with shoulder dyst...
Intrahepatic Cholestasis of Pregnancy (ICP) constitutes the most common, reversible liver disease... more Intrahepatic Cholestasis of Pregnancy (ICP) constitutes the most common, reversible liver disease closely connected with pregnancy and spontaneously resolving in puerperium. ICP usually reoccurs in consecutive pregnancies (45-90%), often in a more intensified form. Many compounds (hormones, cytokines, medicines, endotoxins) can impair transport in the hepatocyte, disturb the intracellular transport and increase the permeability of the intercellular connections. As a result, the elements of bile may appear in the peripheral blood. Gestational cholestasis constitutes a classic example of intrahepatic cholestasis. The etiology of ICP is multifactorial with hormonal, genetic and environmental factors participating in the process. The diagnosis is based on the presence of pruritus, elevated values of bile acids in the blood serum and of aminotransferases (aspartic, aminopropionic and gamma-glutamylotranspeptydase (AspAt, AlAt, GGTP)), as well as spontaneous remission in the second or thi...
Cardiotocography (CTG) is routinely used in obstetric units to monitor fetal well-being during pr... more Cardiotocography (CTG) is routinely used in obstetric units to monitor fetal well-being during pregnancy and labor Nevertheless the use of CTG is limited in cases of fetal arrhythmia, because it truncates the FHR if faster than 210 bpm and slower than 50 bpm. In fetal arrhythmias, with the heart rate between 50 bpm and 210 bpm, CTG may be nonconclusive, difficult to interpret and should not be taken into consideration when making the decision to end the pregnancy especially when it is premature. Until now the usefulness of CTG in the fetal arrhythmia has not been sufficiently described. The following study evaluates typical cases of fetal arrhythmia diagnosed by fetal echocardiography with corresponding cardiotocography and reviews the decision that had been made in each case.
To assess myocardial performance index (Tei index) for left and right ventricle in fetuses at 11.... more To assess myocardial performance index (Tei index) for left and right ventricle in fetuses at 11.0 to 13.6 week of gestation. Flow velocity waveforms of mitral, tricuspid, aortic and pulmonary valves were obtained. The Tei index for the left ventricle (Tei LV) was calculated in 55, and for the right ventricle (Tei RV) in 27 fetuses. The value of Tei LV ranged from 0.28 to 0.59, mean 0.41 +/- 0.08, and for Tei RV from 0.23 to 0.56, mean 0.37 +/- 0.11. There was no statistically important correlation either between Tei index and both ventricles or gestational age and fetal heart rate. The possibility to measure Tei index increased with the progress of the pregnancy. There remains a significant correlation between Tei LV and Tei RV values. Tei index may be useful for the assessment of fetal myocardial performance in the first trimester of pregnancy. Tei index is independent of gestational age and fetal heart rate. It is easier to measure the Tei index for the left ventricle than for th...
Epidural analgesia provides the most effective pain control during labor. Of great concern is its... more Epidural analgesia provides the most effective pain control during labor. Of great concern is its influence on the course of delivery and perinatal complications. The aim of the study was to assess the effect of epidural analgesia on the course of delivery and perinatal outcome. 609 deliveries among 1334 (323 women with epidural analgesia (53%) and 548 without epidural analgesia (47%)) met the following criteria: primipara, singleton, live pregnancy, > =37 weeks' gestation, cephalic presentation of a fetus, lack of contraindication for vaginal delivery. The incidence of instrumental deliveries and fetal distress, duration of the first, second and third stage of labor, perinatal outcome, perinatal complications and perinatal blood loss and were analyzed. The incidence of fetal distress during second stage of labor was significantly higher in the epidural group (12.69 vs. 6.99%, P=0.02). The incidence of fetal distress during first stage of labor did not differ in both groups (...
The aim of the study was to assess mother and fetal outcome in gestational diabetic women. The st... more The aim of the study was to assess mother and fetal outcome in gestational diabetic women. The study covered 689 patients with gestational diabetes mellitus. All women had been taken care of II Department of Obstetrics and Gynecology Warsaw Medical University in 1997-2001 years. The following parameters were analyzed: the patients ages, past obstetric experience, gestational age of GDM diagnosis, pregnancy complications, delivery course and neonatal outcomes. Among study group 11.9% patients required insulin to maintain blood glucose concentration in normal range. GDM was mostly (44.1%) diagnosed between 29 and 34 weeks of pregnancy. At the recommended gestational age of screening tests--24-28 weeks--there were detected only 33.4% GDM. The most frequent pregnancy complication was imminent preterm delivery (16.7%). Delivery at term occurred of 89.1% of cases. Percentage of preterm deliveries was 10.9%. Spontaneous vaginal deliveries were the most frequent (72.5%). 23.2% women were de...
Background: Global access to social media has supposedly changed women’s awareness about the phar... more Background: Global access to social media has supposedly changed women’s awareness about the pharmacological and alternative methods of pain relief during vaginal delivery. The purpose of the study was to analyze changes in women’s preference and opinion about different forms of labor analgesia over the past decade. Materials and methods: The study was designed as an anonymous survey with questions about women’s knowledge and preference of different forms of pain relief in labor. The survey was conducted in 2010 and 2020, with data collected from 1175 women in 2010 and 1033 in 2020. Results: There were no differences between 2010 and 2020 in the proportion of women who wanted to receive analgesia in labor, at, respectively 67.9% of women in 2010 and 73.9% in 2020. About 50% of women chose epidural analgesia as the only efficacious method of pain relief in labor both in 2010 and 2020. There were no differences between the two time-points in the distribution of chosen methods of pain ...
Background and Objectives: The maternal preference of mode of delivery is an important problem in... more Background and Objectives: The maternal preference of mode of delivery is an important problem in respect of patient’s autonomy and shared decision-making. The objective of the study was to obtain information about women’s preferences of the mode of delivery and knowledge about the cesarean section and its’ consequences. Materials and Methods: The study was based on a survey filled in by 1175 women in 2010 and 1033 women in 2020. Respondents were asked about their preference of mode of delivery, possible factors influencing their decision and their knowledge about risks and benefits of cesarean section. Results: There was a significant increase in the rate of women who declared cesarean section as their preferred mode of delivery, from 43.97% in 2010 to 56.03% in 2020 (p < 0.05). In 2010 26.51% of women thought that choice of mode of delivery should be their autonomic decision, 46.36% preferred decision-sharing with their obstetrician, 25.64% thought that cesarean section should ...
OBJECTIVES Delayed or insufficient breast milk production, as well as low milk supply, is still a... more OBJECTIVES Delayed or insufficient breast milk production, as well as low milk supply, is still a challenging problem to overcome, particularly in the case of preterm delivery. Herbal galactagogues might be a good way to increase milk supply, however, there is a lack of clinical studies confirming their efficacy and safety. The aim of this study was to verify the safety and effectiveness as a galactagogue of the unique galactagogue composition based on barley malt with β -glucan and lemon balm. MATERIAL AND METHODS The study included 117 mothers of preterm infants randomly divided into the Galactagogue Group given galactagogue and the Placebo Group. A complete data set was obtained for 80 participants, divided equally between two groups. Volume of milk expressed by mothers during the first two weeks after delivery was the primary outcome and safety of the product was the secondary outcome. RESULTS Volume of milk recorded on participants' last visit in the Galactagogue Group was ...
The immunomodulatory effects of a recently synthesized adamantane derivative of aminopyridine – 2... more The immunomodulatory effects of a recently synthesized adamantane derivative of aminopyridine – 2-(1-adamantylamino)-6-methylpyridine (AdAMP) – were tested on normal and neoplastic cells in vitro. When incubated with TNF-a gene-transduced mouse melanoma cells (B78/TNF), AdAMP significantly enhanced basal production of TNF-a by these cells, both by ‘‘high’’ and ‘‘moderate’’ TNF-a-producer cells. A similar TNF-a production-enhancing effect was observed in cultures of human ovarian carcinoma cells (CAOV1) which spontaneously produce TNF-a but not in cultures of tumour cells incapable of TNF-a secretion. RT-PCR analysis showed that the enhancement of TNF-a production by AdAMP was associated with an increase in TNF-a mRNA expression in the treated cells. The results of an electrophoretic mobility shift assay (EMSA) showed that AdAMP significantly activated nuclear factor jB (NF-jB) in both CAOV1 and B78/ TNF cells. The role of NF-jB in enhancement of TNF-a production was confirmed in exp...
Shoulder dystocia remains an obstetric emergency. Maternal diabetes is considered to be one of th... more Shoulder dystocia remains an obstetric emergency. Maternal diabetes is considered to be one of the major risk factors for shoulder dystocia. The aim of this study was to analyze antepartum and peripartum risk factors and complications of shoulder dystocia in diabetic and non-diabetic women. We performed a retrospective analysis of 48 shoulder dystocia cases out of 28,485 vaginal deliveries of singleton, live-born infants over a 13 year period: 13 cases were diagnosed in diabetic women and 35 cases in non-diabetic women. The study was conducted in the 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland, from January 2000 to December 2012. Compared to non-diabetic women, diabetic patients had significantly higher pre-pregnancy body weight (83.4±23.8 kg vs. 62.5±10.9 kg, p=0.002), higher pre-pregnancy BMI (30.2±6.8 kg/m2 vs. 22.9±4.3 kg/m2, p=0.0003), and lower gestational weight gain (11.4±6.2 kg vs. 16.0±4.7 kg, p=0.01). Diabetic women with shoulder dyst...
Intrahepatic Cholestasis of Pregnancy (ICP) constitutes the most common, reversible liver disease... more Intrahepatic Cholestasis of Pregnancy (ICP) constitutes the most common, reversible liver disease closely connected with pregnancy and spontaneously resolving in puerperium. ICP usually reoccurs in consecutive pregnancies (45-90%), often in a more intensified form. Many compounds (hormones, cytokines, medicines, endotoxins) can impair transport in the hepatocyte, disturb the intracellular transport and increase the permeability of the intercellular connections. As a result, the elements of bile may appear in the peripheral blood. Gestational cholestasis constitutes a classic example of intrahepatic cholestasis. The etiology of ICP is multifactorial with hormonal, genetic and environmental factors participating in the process. The diagnosis is based on the presence of pruritus, elevated values of bile acids in the blood serum and of aminotransferases (aspartic, aminopropionic and gamma-glutamylotranspeptydase (AspAt, AlAt, GGTP)), as well as spontaneous remission in the second or thi...
Cardiotocography (CTG) is routinely used in obstetric units to monitor fetal well-being during pr... more Cardiotocography (CTG) is routinely used in obstetric units to monitor fetal well-being during pregnancy and labor Nevertheless the use of CTG is limited in cases of fetal arrhythmia, because it truncates the FHR if faster than 210 bpm and slower than 50 bpm. In fetal arrhythmias, with the heart rate between 50 bpm and 210 bpm, CTG may be nonconclusive, difficult to interpret and should not be taken into consideration when making the decision to end the pregnancy especially when it is premature. Until now the usefulness of CTG in the fetal arrhythmia has not been sufficiently described. The following study evaluates typical cases of fetal arrhythmia diagnosed by fetal echocardiography with corresponding cardiotocography and reviews the decision that had been made in each case.
To assess myocardial performance index (Tei index) for left and right ventricle in fetuses at 11.... more To assess myocardial performance index (Tei index) for left and right ventricle in fetuses at 11.0 to 13.6 week of gestation. Flow velocity waveforms of mitral, tricuspid, aortic and pulmonary valves were obtained. The Tei index for the left ventricle (Tei LV) was calculated in 55, and for the right ventricle (Tei RV) in 27 fetuses. The value of Tei LV ranged from 0.28 to 0.59, mean 0.41 +/- 0.08, and for Tei RV from 0.23 to 0.56, mean 0.37 +/- 0.11. There was no statistically important correlation either between Tei index and both ventricles or gestational age and fetal heart rate. The possibility to measure Tei index increased with the progress of the pregnancy. There remains a significant correlation between Tei LV and Tei RV values. Tei index may be useful for the assessment of fetal myocardial performance in the first trimester of pregnancy. Tei index is independent of gestational age and fetal heart rate. It is easier to measure the Tei index for the left ventricle than for th...
Epidural analgesia provides the most effective pain control during labor. Of great concern is its... more Epidural analgesia provides the most effective pain control during labor. Of great concern is its influence on the course of delivery and perinatal complications. The aim of the study was to assess the effect of epidural analgesia on the course of delivery and perinatal outcome. 609 deliveries among 1334 (323 women with epidural analgesia (53%) and 548 without epidural analgesia (47%)) met the following criteria: primipara, singleton, live pregnancy, > =37 weeks' gestation, cephalic presentation of a fetus, lack of contraindication for vaginal delivery. The incidence of instrumental deliveries and fetal distress, duration of the first, second and third stage of labor, perinatal outcome, perinatal complications and perinatal blood loss and were analyzed. The incidence of fetal distress during second stage of labor was significantly higher in the epidural group (12.69 vs. 6.99%, P=0.02). The incidence of fetal distress during first stage of labor did not differ in both groups (...
The aim of the study was to assess mother and fetal outcome in gestational diabetic women. The st... more The aim of the study was to assess mother and fetal outcome in gestational diabetic women. The study covered 689 patients with gestational diabetes mellitus. All women had been taken care of II Department of Obstetrics and Gynecology Warsaw Medical University in 1997-2001 years. The following parameters were analyzed: the patients ages, past obstetric experience, gestational age of GDM diagnosis, pregnancy complications, delivery course and neonatal outcomes. Among study group 11.9% patients required insulin to maintain blood glucose concentration in normal range. GDM was mostly (44.1%) diagnosed between 29 and 34 weeks of pregnancy. At the recommended gestational age of screening tests--24-28 weeks--there were detected only 33.4% GDM. The most frequent pregnancy complication was imminent preterm delivery (16.7%). Delivery at term occurred of 89.1% of cases. Percentage of preterm deliveries was 10.9%. Spontaneous vaginal deliveries were the most frequent (72.5%). 23.2% women were de...
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