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Kosinski P, Borowski D, Brawura-Biskupski-Samaha R, Cnota W, Debska M, Drews K, Grzesiak M, Jaczynska R, Janiak K, Kaczmarek P, Lipa M, Litwinska M, Luterek K, Olejek A, Polczynska-Kaniak E, Preis K, Szaflik K, Szymkiewicz-Dangel J, Swiatkowska-Freund M, Wegrzyn P, Wielgos M, Wloch A, Zamlynski J, Zamlynski M, Sieroszewski P. Fetal therapy guidelines of the Polish Society of Gynecologists and Obstetricians - Fetal Therapy Section. Ginekol Pol 2024; 95:285-315. [PMID: 38632880 DOI: 10.5603/gpl.100108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Accepted: 04/03/2024] [Indexed: 04/19/2024] Open
Affiliation(s)
- Przemyslaw Kosinski
- Department of Obstetrics, Perinatology and Gynecology, Medical University of Warsaw, Poland.
| | - Dariusz Borowski
- Clinic of Obstetrics and Gynecology, Provincial Combined Hospital, Kielce, Poland
| | | | - Wojciech Cnota
- Chair and Department of Gynecology and Obstetrics, Faculty of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Marzena Debska
- National Medical Institute of the Ministry of the Interior and Administration in Warsaw, Poland
| | - Krzysztof Drews
- Department of Perinatology and Women's Diseases, Poznan University of Medical Sciences, Poland
| | - Mariusz Grzesiak
- Department of Perinatology, Obstetrics and Gynecology, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland
- 2nd Chair and Department of Gynecology and Obstetrics, Medical University of Lodz, Poland
| | - Renata Jaczynska
- Department of Obstetrics, Perinatology and Gynecology, Medical University of Warsaw, Poland
| | - Katarzyna Janiak
- Department of Gynecology, Reproductive, Fetal Therapy and Infertility Diagnosis and Treatment, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland
| | - Piotr Kaczmarek
- Department of Gynecology, Reproductive, Fetal Therapy and Infertility Diagnosis and Treatment, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland
| | - Michal Lipa
- National Medical Institute of the Ministry of the Interior and Administration in Warsaw, Poland
| | - Magdalena Litwinska
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
| | - Katarzyna Luterek
- Department of Obstetrics, Perinatology and Gynecology, Medical University of Warsaw, Poland
| | - Anita Olejek
- Department of Gynecology, Obstetrics and Oncological Gynecology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | | | - Krzysztof Preis
- Department of Gynecology and Obstetrics, Medical University of Gdansk, Poland
- Department of Obstetrics, Gynecology and Gynecological Oncology, Provincial Multi-specialist Hospital in Torun, Poland
| | - Krzysztof Szaflik
- Department of Gynecology, Reproductive, Fetal Therapy and Infertility Diagnosis and Treatment, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland
| | - Joanna Szymkiewicz-Dangel
- Department of Perinatal Cardiology and Congenital Defects, Centre of Postgraduate Medical Education, Warsaw, Poland
| | | | - Piotr Wegrzyn
- Department of Obstetrics, Perinatology and Gynecology, Medical University of Warsaw, Poland
| | - Miroslaw Wielgos
- National Medical Institute of the Ministry of the Interior and Administration in Warsaw, Poland
- Medical Faculty, Lazarski University, Warsaw, Poland
| | - Agata Wloch
- Chair and Department of Gynecology and Obstetrics, Faculty of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Jacek Zamlynski
- Department of Gynecology, Obstetrics and Oncological Gynecology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Mateusz Zamlynski
- Department of Gynecology, Obstetrics and Oncological Gynecology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Piotr Sieroszewski
- 1st Department of the Gynecology and Obstetrics, Medical University of Lodz, Poland
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Sieroszewski P, Bomba-Opon D, Czajkowski K, Drews K, Grzesiak M, Leszczynska-Gorzelak B, Scholz A, Kalinka J, Kosinka-Kaczynska K, Kwiatkowski S, Mierzynski R, Preis K, Ropacka-Lesiak M, Swiatkowska-Freund M, Wielgos M, Zimmer M, Huras H. Guidelines of the Polish Society of Gynecologists and Obstetricians on the diagnosis and management of pregnancies complicated by prelabor rupture of the membranes. Ginekol Pol 2024:VM/OJS/J/98339. [PMID: 38506477 DOI: 10.5603/gpl.98339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 11/28/2023] [Indexed: 03/21/2024] Open
Affiliation(s)
- Piotr Sieroszewski
- 1st Department of Gynaecology and Obstetrics, Medical University of Lodz, Poland
| | - Dorota Bomba-Opon
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
| | - Krzysztof Czajkowski
- 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
| | - Krzysztof Drews
- Department of Perinatology and Women's Diseases, Poznan University of Medical Sciences, Poznan, Poland
| | - Mariusz Grzesiak
- Department of Perinatology, Obstetrics and Gynaecology, Polish Mother's Memorial Hospital Research Institute in Lodz, Poland
| | | | - Anna Scholz
- 1st Department of Obstetrics and Gynecology, CMKP in Warsaw, Poland
| | | | - Katarzyna Kosinka-Kaczynska
- Department of Obstetrics, Perinatology and Neonatology, Center of Postgraduate Medical Education in Warsaw, Poland
| | - Sebastian Kwiatkowski
- Department of Obstetrics and Gynecology, Independent Public Clinical Hospital No 2, Medical University in Szczecin, Poland
| | - Radzislaw Mierzynski
- Chair and Department of Obstetrics and Perinatology, Medical University of Lublin, Poland
| | - Krzysztof Preis
- The Academy of Applied Medical and Social Sciences Elblag, Poland
| | - Mariola Ropacka-Lesiak
- Department of Perinatology and Gynaecology, Poznan University of Medical Sciences, Poznan, Poland
| | | | | | - Mariusz Zimmer
- 2nd Department of Gynecology and Obstetrics, Wroclaw Medical University, Poland
| | - Hubert Huras
- Department of Obstetrics and Perinatology Collegium Medicum Jagiellonia University Cracow, Poland
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Stefańska K, Kurkowiak M, Piekarska K, Chruściel E, Zamkowska D, Jassem-Bobowicz J, Adamski P, Świątkowska-Stodulska R, Abacjew-Chmyłko A, Leszczyńska K, Zieliński M, Preis K, Zielińska H, Tymoniuk B, Trzonkowski P, Marek-Trzonkowska NM. High maternal-fetal HLA eplet compatibility is associated with severe manifestation of preeclampsia. Front Immunol 2023; 14:1272021. [PMID: 38022600 PMCID: PMC10655094 DOI: 10.3389/fimmu.2023.1272021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 10/09/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Preeclampsia is responsible for more than 70 000 and 500 000 maternal and fetal deaths, respectively each year. Incomplete remodelling of the spiral arteries in placenta is the most accepted theory of preeclampsia pathogenesis. However, the process is complexed with immunological background, as pregnancy resembles allograft transplantation. Fetus expresses human leukocyte antigens (HLA) inherited from both parents, thus is semiallogeneic to the maternal immune system. Therefore, induction of fetal tolerance is crucial for physiological outcome of pregnancy. Noteworthy, the immunogenicity of discordant HLA antigens is determined by functional epitopes called eplets, which are continuous and discontinuous short sequences of amino acids. This way various HLA molecules may express the same eplet and some HLA incompatibilities can be more immunogenic due to different eplet combination. Therefore, we hypothesized that maternal- fetal HLA incompatibility may be involved in the pathogenesis of gestational hypertension and its progression to preeclampsia. We also aimed to test if particular maternal-fetal eplet mismatches are more prone for induction of anti- fetal HLA antibodies in gestational hypertension and preeclampsia. Methods High resolution next-generation sequencing of HLA-A, -B, -C, -DQB1 and -DRB1 antigens was performed in mothers and children from physiological pregnancies (12 pairs) and from pregnancies complicated with gestational hypertension (22 pairs) and preeclampsia (27 pairs). In the next step HLA eplet identification and analysis of HLA eplet incompatibilities was performed with in silico approach HLAMatchmaker algorithm. Simultaneously maternal sera were screened for anti-fetal HLA class I, class II and anti-MICA antibodies with Luminex, and data were analyzed with HLA-Fusion software. Results We observed that high HLA-C, -B, and DQB1 maternal-fetal eplet compatibility was associated with severe preeclampsia (PE) manifestation. Both quantity and quality of HLA epletmismatches affected the severity of PE. Mismatches in HLA-B eplets: 65QIA+76ESN, 70IAO, 180E, HLA-C eplets: 193PL3, 267QE, and HLA-DRB1 eplet: 16Y were associated with a mild outcome of preeclampsia if the complication occurred. Conclusions High HLA-C, HLA-DQB1 and HLA-B eplet compatibility between mother and child is associated with severe manifestation of preeclampsia. Both quantity and quality of maternal-fetal HLA eplet mismatches affects severity of preeclampsia.
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Affiliation(s)
- Katarzyna Stefańska
- Department of Gynecology and Obstetrics Medical University of Gdansk, Gdańsk, Poland
| | - Małgorzata Kurkowiak
- International Centre for Cancer Vaccine Science (ICCVS), University of Gdańsk, Gdańsk, Poland
| | - Karolina Piekarska
- Laboratory of Immunology and Clinical Transplantology, University Clinical Centre in Gdańsk, Gdańsk, Poland
- Department of Medical Immunology, Medical University of Gdansk, Gdańsk, Poland
- Laboratory of Immunoregulation and Cellular Therapies, Department of Family Medicine, Medical University of Gdansk, Gdańsk, Poland
| | - Elżbieta Chruściel
- International Centre for Cancer Vaccine Science (ICCVS), University of Gdańsk, Gdańsk, Poland
| | - Dorota Zamkowska
- Department of Gynecology and Obstetrics Medical University of Gdansk, Gdańsk, Poland
| | | | - Przemysław Adamski
- Department of Gynecology and Obstetrics Medical University of Gdansk, Gdańsk, Poland
| | | | - Anna Abacjew-Chmyłko
- Department of Gynecology and Obstetrics Medical University of Gdansk, Gdańsk, Poland
| | - Katarzyna Leszczyńska
- Department of Gynecology and Obstetrics Medical University of Gdansk, Gdańsk, Poland
| | - Maciej Zieliński
- Department of Medical Immunology, Medical University of Gdansk, Gdańsk, Poland
| | - Krzysztof Preis
- Department of Gynecology and Obstetrics Medical University of Gdansk, Gdańsk, Poland
| | - Hanna Zielińska
- Laboratory of Immunology and Clinical Transplantology, University Clinical Centre in Gdańsk, Gdańsk, Poland
- Department of Medical Immunology, Medical University of Gdansk, Gdańsk, Poland
| | - Bogusław Tymoniuk
- Department of Immunology and Allergy, Medical University of Łódź, Łódź, Poland
| | - Piotr Trzonkowski
- Department of Medical Immunology, Medical University of Gdansk, Gdańsk, Poland
| | - Natalia Maria Marek-Trzonkowska
- International Centre for Cancer Vaccine Science (ICCVS), University of Gdańsk, Gdańsk, Poland
- Laboratory of Immunoregulation and Cellular Therapies, Department of Family Medicine, Medical University of Gdansk, Gdańsk, Poland
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Strzelecka I, Sylwestrzak O, Murlewska J, Węgrzynowski J, Leszczyńska K, Preis K, Respondek-Liberska M. Fetal Cardiac Hemodynamic and Sonographic Anomalies in Maternal COVID-19 Infection Depending on Vaccination Status-Polish Multicenter Cohort Study. J Clin Med 2023; 12:5186. [PMID: 37629228 PMCID: PMC10456038 DOI: 10.3390/jcm12165186] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 07/31/2023] [Accepted: 08/06/2023] [Indexed: 08/27/2023] Open
Abstract
Most obstetrical studies have focused on maternal response to the SARS-CoV-2 virus but much less is known about the effect of COVID-19 on fetal physiology. We aimed to evaluate the effect of the maternal SARS-CoV-2 infection on the fetal homeostasis with the use of detailed ultrasonography and echocardiography and consideration of the effect of vaccination. This was a multi-center study of fetuses who had prenatal detailed ultrasound and echocardiographic examinations performed by fetal cardiology specialists. The subjects were divided based on the COVID vaccination status (vaccinated women who did not have COVID-group V, unvaccinated women who had COVID-group UV, and unvaccinated women who did not have COVID-control group). We evaluated the ultrasound and echocardiography results obtained. The study group included 237 gravidas from four prenatal cardiology centers. In the group of fetuses with normal heart anatomy, normal cardiovascular function had 147 (81%) fetuses and functional cardiovascular anomalies were present in 35 (19%) cases. Functional cardiovascular anomalies were present in 11 (16%) fetuses in the V group, 19 (47%) fetuses in the UV group and 5 (8%) fetuses in the control group (p < 0.01). There were 56 (24%) fetuses with extracardiac anomalies. Extracardiac anomalies were present in 20 (22%) fetuses in the V group, 22 (45%) fetuses of the UV group and in 14 (14%) fetuses in the control group (p < 0.01). Our study has proved that maternal COVID-19 infection can affect the fetal physiology and mild cardiac and extracardiac markers detected by fetal ultrasonography and echocardiography. Moreover, maternal vaccination results in lower occurrence of these findings in fetuses.
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Affiliation(s)
- Iwona Strzelecka
- Department of Fetal Malformations Diagnosis and Prevention, Medical University of Łódź, 90-419 Lodz, Poland
| | - Oskar Sylwestrzak
- Department of Prenatal Cardiology, Polish Mother’s Memorial Hospital Research Institute in Łódź, 93-338 Lodz, Poland
| | - Julia Murlewska
- Department of Prenatal Cardiology, Polish Mother’s Memorial Hospital Research Institute in Łódź, 93-338 Lodz, Poland
- Private Gynecology and Obstetrics Clinic, 60-502 Poznań, Poland
| | - Jerzy Węgrzynowski
- Department of Obstetrics and Gynecology, Zdroje Hospital, 70-780 Szczecin, Poland
| | | | - Krzysztof Preis
- Department of Obstetrics, Gynecological Diseases and Oncological Gynecology of the Regional Hospital in Toruń, 87-100 Toruń, Poland
| | - Maria Respondek-Liberska
- Department of Fetal Malformations Diagnosis and Prevention, Medical University of Łódź, 90-419 Lodz, Poland
- Department of Prenatal Cardiology, Polish Mother’s Memorial Hospital Research Institute in Łódź, 93-338 Lodz, Poland
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Jańczewska I, Preis-Orlikowska J, Domżalska-Popadiuk I, Preis K, Jańczewska A. Children with corpus callosum anomalies: clinical characteristics and developmental outcomes. Neurol Neurochir Pol 2023:VM/OJS/J/92935. [PMID: 37078131 DOI: 10.5603/pjnns.a2023.0026] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 03/09/2023] [Accepted: 03/13/2023] [Indexed: 04/21/2023]
Abstract
INTRODUCTION Corpus callosum abnormalities are complex, aetiologically diverse, and clinically heterogeneous conditions. Counselling parents regarding their causes and associated syndromes, and predicting the neurodevelopmental and seizure risk prognosis, is challenging. MATERIAL AND METHODS We describe the clinical characteristics, associated anomalies, and neurodevelopmental outcomes of children with agenesis of corpus callosum (ACC). Fifty-one neonates with ACC/hypoplasia of the corpus callosum were identified over a 17-year period, and their medical records were retrospectively reviewed. RESULTS Patients were classified into two groups depending on the presence or absence of associated abnormalities. The first group (17 patients, 33.4%) presented with isolated callosal anomalies. The second group included 34 patients (66.6%) with associated cerebral and extracerebral anomalies. We achieved an identifiable genetic aetiology in 23.5% of our cohort. Magnetic resonance imaging was performed in 28 patients (55%), and of these 39.3% had additional brain anomalies. During the study period, five patients died early in the neonatal period and four were lost to follow up. Of the 42 followed patients, 13 (31%) showed normal neurodevelopment, 13 (31%) showed mild delay, and 16 (38%) had a severe delay. Fifteen (35.7%) had epilepsy. CONCLUSIONS AND CLINICAL IMPLICATIONS We have confirmed that callosal defects are frequently accompanied by brain and somatic anomalies. Additional abnormalities were shown to be significantly associated with developmental delay and increased risk of epilepsy. We have highlighted essential clinical features that may provide diagnostic clues to physicians and we have given examples of underlying genetic disorders. We have provided recommendations about extended neuroimaging diagnostics and widespread genetic testing that may impact upon daily clinical practice. Paediatric neurologists may therefore use our findings to help base their decisions regarding this matter.
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Affiliation(s)
- Iwona Jańczewska
- Department of Neonatology, Faculty of Medicine, Medical University of Gdansk, Gdansk, Poland.
| | - Joanna Preis-Orlikowska
- Department of Neonatology, Faculty of Medicine, Medical University of Gdansk, Gdansk, Poland
| | | | - Krzysztof Preis
- Department of Gynaecology and Obstetrics, Faculty of Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Alicja Jańczewska
- Intern doctor at University Clinical Centre in Gdansk, Gdansk, Poland
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Słodki M, Copel JA, Rizzo G, Araujo Junior E, Axt-Fliedner R, Abuhamad A, Simpson LL, Lee W, DeVore G, Bahado-Singh R, Preis K, Respondek-Liberska M. Fetal Cardiology: Is It Time to Establish a Separate Independent Medicine Subspeciality? Pediatr Cardiol 2022; 43:1676-1677. [PMID: 35606573 DOI: 10.1007/s00246-022-02936-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 05/16/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Maciej Słodki
- Department of Prenatal Cardiology, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland.
| | - Joshua A Copel
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT, USA
| | - Giuseppe Rizzo
- Department of Obstetrics and Gynecology, Università' Roma Tor Vergata, Rome, Italy
| | - Edward Araujo Junior
- Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo, São Paulo, Brazil
| | - Roland Axt-Fliedner
- Department of Obstetrics and Gynecology, Justus-Liebig University, Giessen, Germany
| | - Alfred Abuhamad
- Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, VA, USA
| | - Lynn L Simpson
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, USA
| | - Wesley Lee
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA
| | - Greggory DeVore
- Department of Obstetrics and Gynecology, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
| | - Ray Bahado-Singh
- Department of Obstetrics and Gynecology, Oakland University William Beaumont School of Medicine, Royal Oak, MI, USA
| | - Krzysztof Preis
- Department of Obstetrics, Medical University of Gdańsk, Gdańsk, Poland
| | - Maria Respondek-Liberska
- Department of Prenatal Cardiology, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland
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Stefańska K, Tomaszewicz M, Dębska-Zielkowska J, Zamkowska D, Piekarska K, Sakowska J, Studziński M, Tymoniuk B, Adamski P, Jassem-Bobowicz J, Wydra P, Leszczyńska K, Świątkowska-Stodulska R, Kwiatkowski S, Preis K, Trzonkowski P, Marek-Trzonkowska N, Zieliński M. KIR- Ligand Interactions in Hypertensive Disorders in Pregnancy. Front Immunol 2022; 13:868175. [PMID: 35911739 PMCID: PMC9336683 DOI: 10.3389/fimmu.2022.868175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 06/16/2022] [Indexed: 12/03/2022] Open
Abstract
Hypothesis The activity of natural killer (NK) cells is considered an important factor for the tolerance of the fetus during pregnancy. The complications of pregnancy, such as hypertensive disorders (HDP), may be therefore associated with this immune compartment. Methods The current study included 41 pregnant women diagnosed with HDPs (Gestational Hypertension; GH or Preeclampsia; PE) and 21 healthy women. All the patients were under continuous obstetric care during the pregnancy and labour. The number of mother-child mismatches within killer immunoglobulin-like receptors (KIRs), their ligands [MM], and missing KIR ligands [MSLs] was assessed. KIRs and their ligands were assessed with Next Generation Sequencing (NGS) and Polymerase Chain Reaction Sequence-Specific Oligonucleotide (PCR-SSO) typing. The subsets of NK cells were assessed with multicolor flow cytometry and correlated to the number of MSLs. Results The number of MSLs was significantly higher in HDP patients when compared to healthy non-complicated pregnancy patients. Some MSLs, such as those with 2DS2 activating KIR, were present only in HDP patients. The percentage of CD56+CD16-CD94+ NK cells and CD56+CD16-CD279+ NK cells correlated with the number of MSLs with inhibiting KIRs only in healthy patients. In HDP patients, there was a correlation between the percentage of CD56-CD16+CD69+ NK cells and the number of MSLs with inhibiting and activating KIRs. As compared to the healthy group, the percentage of CD56+CD16-CD279+ NK cells and CD56-CD16+CD279+ NK cells were lower in HDP patients. HDP patients were also characterized by a higher percentage of CD56+CD16+perforin+ NK cells than their healthy counterparts. Conclusions Patients with HDP were characterized by a higher number of MSLs within the KIRs receptors. It seemed that the number of MSLs in the healthy group was balanced by various receptors, such as CD94 or inhibitory CD279, expressed on NK cells. Conversely, in HDP patients the number of MSLs was associated with the activation detected as the increased level of CD69+ NK cells.
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Affiliation(s)
- Katarzyna Stefańska
- Division of Gynecology and Obstetrics, Medical University of Gdansk, Gdańsk, Poland
| | - Martyna Tomaszewicz
- Department of Medical Immunology, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
- *Correspondence: Martyna Tomaszewicz,
| | - Joanna Dębska-Zielkowska
- Department of Medical Immunology, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Dorota Zamkowska
- Division of Gynecology and Obstetrics, Medical University of Gdansk, Gdańsk, Poland
| | - Karolina Piekarska
- Department of Medical Immunology, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Justyna Sakowska
- Department of Medical Immunology, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Maciej Studziński
- Department of Medical Immunology, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Bogusław Tymoniuk
- Department of Immunology and Allergy, Medical University of Lodz, Łódź, Poland
| | - Przemysław Adamski
- Division of Gynecology and Obstetrics, Medical University of Gdansk, Gdańsk, Poland
| | - Joanna Jassem-Bobowicz
- Department of Neonatology, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Piotr Wydra
- Department of Medical Immunology, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | | | - Renata Świątkowska-Stodulska
- Department of Endocrinology and Internal Medicine, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Sebastian Kwiatkowski
- Department of Obstetrics and Gynecology, Pomeranian Medical University of Szczecin, Szczecin, Poland
| | - Krzysztof Preis
- Division of Gynecology and Obstetrics, Medical University of Gdansk, Gdańsk, Poland
| | - Piotr Trzonkowski
- Department of Medical Immunology, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Natalia Marek-Trzonkowska
- International Centre for Cancer Vaccine Science Cancer Immunology Group, University of Gdansk, Gdańsk, Poland
- Laboratory of Immunoregulation and Cellular Therapies, Department of Family Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Maciej Zieliński
- Department of Medical Immunology, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
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Minowski P, Swiatkowska-Freund M, Preis K. Influence of Entonox (mixture of 50% nitrous oxide and 50% oxygen) on physiological labor and neonatal outcome in own material. Ginekol Pol 2022:VM/OJS/J/88431. [DOI: 10.5603/gp.a2022.0039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 03/06/2022] [Accepted: 03/07/2022] [Indexed: 11/25/2022] Open
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Kittel-Schneider S, Leutritz A, van Braam L, Preis K, Gehrmann A, Fiedler K, Deckert J, Unterecker S, Scherf-Clavel M. Antidepressants in pregnancy – focus on therapeutic drug
monitoring. PHARMACOPSYCHIATRY 2022. [DOI: 10.1055/s-0042-1747654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- S. Kittel-Schneider
- Department of Psychiatry, Psychotherapy and Psychosomatics, University
Hospital of Würzburg, Würzburg, Germany
- Department of Psychiatry, Psychotherapy and Psychosomatics, University
Hospital of Frankfurt, Frankfurt, Germany
| | - A.L. Leutritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, University
Hospital of Würzburg, Würzburg, Germany
| | - L. van Braam
- Department of Psychiatry, Psychotherapy and Psychosomatics, University
Hospital of Würzburg, Würzburg, Germany
| | - K. Preis
- Department of Psychiatry, Psychotherapy and Psychosomatics, University
Hospital of Frankfurt, Frankfurt, Germany
| | - A. Gehrmann
- Department of Psychiatry, Psychotherapy and Psychosomatics, University
Hospital of Würzburg, Würzburg, Germany
| | - K. Fiedler
- Department of Psychiatry, Psychotherapy and Psychosomatics, University
Hospital of Frankfurt, Frankfurt, Germany
| | - J. Deckert
- Department of Psychiatry, Psychotherapy and Psychosomatics, University
Hospital of Würzburg, Würzburg, Germany
| | - S. Unterecker
- Department of Psychiatry, Psychotherapy and Psychosomatics, University
Hospital of Würzburg, Würzburg, Germany
| | - M. Scherf-Clavel
- Department of Psychiatry, Psychotherapy and Psychosomatics, University
Hospital of Würzburg, Würzburg, Germany
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10
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Pęksa M, Kamieniecki A, Gabrych A, Lew-Tusk A, Preis K, Świątkowska-Freund M. Loss of E-Cadherin Staining Continuity in the Trophoblastic Basal Membrane Correlates with Increased Resistance in Uterine Arteries and Proteinuria in Patients with Pregnancy-Induced Hypertension. J Clin Med 2022; 11:jcm11030668. [PMID: 35160120 PMCID: PMC8836559 DOI: 10.3390/jcm11030668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 01/26/2022] [Indexed: 11/17/2022] Open
Abstract
Pregnancy-induced hypertension (PIH), especially when complicated with pre-eclampsia (PE), could be a life-threatening complication of pregnancy. Pre-eclampsia is one of the leading causes of perinatal morbidity and mortality in women. Pre-eclampsia is mainly characterized by hypertension and kidney damage with proteinuria. Abnormal placentation and altered structure of the placental barrier are believed to participate in the pathogenesis of pregnancy-induced hypertension, leading to PE. In the current study, we aimed to analyze the immunohistochemical expression pattern of E-cadherin and p120, two markers of epithelial–mesenchymal transition, in placental samples derived from a group of 55 patients with pregnancy-induced hypertension, including pre-eclampsia and 37 healthy pregnant controls. The results were correlated with the presence of an obtained early uterine artery flow notching during diastole on Doppler ultrasound. We observed a higher frequency of discontinuous E-cadherin staining in the basement membrane of syncytiotrophoblast in patients with PIH/PE compared to controls (p < 0.001, Fisher’s exact test). Moreover, the loss of continuity of E-cadherin expression correlated with the presence of a bilateral early diastolic notch on Doppler ultrasound (p < 0.001, Fisher’s exact test) and the presence of proteinuria (p = 0.013, Fisher’s exact test). These findings suggest that E-cadherin contributes to the integrity of the placental barrier, and its loss could be an immunohistochemical marker of PE.
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Affiliation(s)
- Marta Pęksa
- Department of Obstetrics, Medical University of Gdańsk, 7 Debinki Street, 80-211 Gdansk, Poland; (K.P.); (M.Ś.-F.)
- Correspondence: ; Tel.: +48-58-584-4100
| | - Alexandra Kamieniecki
- Department of Pathomorphology, Medical University of Gdańsk, 7 Debinki Street, 80-211 Gdansk, Poland;
| | - Anna Gabrych
- Department of Pediatrics, Hematology, and Oncology, Medical University of Gdansk, 7 Debinki Street, 80-211 Gdansk, Poland;
| | - Anna Lew-Tusk
- Department of Neonatology, St. Adalbert’s Hospital, 80-462 Gdansk, Poland;
| | - Krzysztof Preis
- Department of Obstetrics, Medical University of Gdańsk, 7 Debinki Street, 80-211 Gdansk, Poland; (K.P.); (M.Ś.-F.)
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11
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Sieroszewski P, Haus O, Zimmer M, Wielgos M, Latos-Bielenska A, Borowiec M, Borowski D, Cnota W, Czuba B, Dubiel M, Jakubowski L, Janiak K, Kaczmarek P, Kwiatkowski S, Nowakowska B, Pietryga M, Piotrowski K, Preis K, Ropacka-Lesiak M, Sasiadek MM, Swiatkowska-Freud M, Wegrzyn P, Wloch A, Moczulska H. Recommendations for prenatal diagnostics of the Polish Society of Gynaecologists and Obstetricians and the Polish Society of Human Genetics. Ginekol Pol 2022; 93:427-437. [PMID: 35315029 DOI: 10.5603/gp.a2021.0255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 12/31/2021] [Indexed: 11/25/2022] Open
Affiliation(s)
- Piotr Sieroszewski
- Department of Fetal Medicine and Gynaecology, Medical University of Lodz, Poland
| | - Olga Haus
- Department of Clinical Genetics, Faculty of Medicine, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, Poland
| | - Mariusz Zimmer
- Department of Gynaecology and Obstetrics, Wroclaw Medical University, Poland
| | - Miroslaw Wielgos
- 1 st Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
| | - Anna Latos-Bielenska
- Chair and Department of Medical Genetics Poznan University of Medical Sciences, Poland
| | - Maciej Borowiec
- Department of Clinical Genetics, Medical University of Lodz, Poland, Poland
| | - Dariusz Borowski
- Department of Perinatology, Gynaecology and Gynaecologic Oncology, Collegium Medicum, Nicolaus Copernicus University in Bydgoszcz, Poland
| | - Wojciech Cnota
- Chair and Department of Gynaecology and Obstetrics, Faculty of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Bartosz Czuba
- Chair and Department of Gynaecology and Obstetrics, Faculty of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Mariusz Dubiel
- Department of Obstetrics, Gynecology and Gynecological Oncology, Faculty of Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Lucjusz Jakubowski
- Department of Genetics, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland
| | - Katarzyna Janiak
- Department of Gynecology, Fertility and Fetal Therapy, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland
| | - Piotr Kaczmarek
- Department of Perinatology, Obstetrics and Gynecology, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland
| | - Sebastian Kwiatkowski
- Department of Obstetrics and Gynecology, Pomeranian Medical University of Szczecin, Poland
| | - Beata Nowakowska
- Department of Medical Genetics, The Institute of Mother and Child, Warsaw, Poland
| | - Marek Pietryga
- Department of Gynecology, Obstetrics and Gynecologic Oncology, Poznan University of Medical Sciences, Poznan, Poland
| | | | - Krzysztof Preis
- Department of Obstetrics, Medical University of Gdansk, Poland
| | - Mariola Ropacka-Lesiak
- Department of Perinatology and Gynecology, Poznan University of Medical Sciences, Poland
| | - Maria M Sasiadek
- Department of Genetics, Wroclaw Medical University, Wroclaw, Poland
| | | | - Piotr Wegrzyn
- Department of Obstetrics, Perinatology and Gynecology, Medical University of Warsaw, Poland
| | - Agata Wloch
- Chair and Department of Gynaecology and Obstetrics, Faculty of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Hanna Moczulska
- Department of Clinical Genetics, Medical University of Lodz, Poland, Poland.
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12
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Jassem-Bobowicz JM, Klasa-Mazurkiewicz D, Żawrocki A, Stefańska K, Domżalska-Popadiuk I, Kwiatkowski S, Preis K. Prediction Model for Bronchopulmonary Dysplasia in Preterm Newborns. Children (Basel) 2021; 8:children8100886. [PMID: 34682151 PMCID: PMC8534367 DOI: 10.3390/children8100886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 09/27/2021] [Accepted: 09/27/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVE: To develop a multifactorial model that allows the prediction of bronchopulmonary dysplasia (BPD) in preterm newborns. MATERIALS AND METHODS: A single-center retrospective study of infants born below 32 + 0 weeks gestational age. We created a receiver operating characteristic curve to assess the multifactorial BPD risk and calculate the BPD risk accuracy using the area under the curve (AUC). BPD risk was categorized using a multifactorial predictive model based on the weight of the evidence. RESULTS: Of the 278 analyzed preterm newborns, 127 (46%) developed BPD. The significant risk factors for BPD in the multivariate analysis were gestational age, number of red blood cell concentrate transfusions, number of surfactant administrations, and hemodynamically significant patent ductus arteriosus. The combination of these factors determined the risk of developing BPD, with an AUC value of 0.932. A multifactorial predictive model based on these factors, weighted by their odds ratios, identified four categories of newborns with mean BPD risks of 9%, 59%, 82%, and 100%. CONCLUSION: A multifactorial model based on easily available clinical factors can predict BPD risk in preterm newborns and inform potential preventive measures.
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Affiliation(s)
- Joanna Maria Jassem-Bobowicz
- Department of Neonatology, Medical University of Gdańsk, 80-214 Gdańsk, Poland;
- Correspondence: ; Tel.: +48-58-584-41-48
| | - Dagmara Klasa-Mazurkiewicz
- Department of Gynaecology and Oncological Gynaecology, Medical University of Gdańsk, 80-214 Gdańsk, Poland;
| | - Anton Żawrocki
- Department of Pathology, Specialist Hospital in Wejherowo, 84-200 Wejherowo, Poland;
| | - Katarzyna Stefańska
- Department of Obstetrics, Medical University of Gdańsk, 80-214 Gdańsk, Poland; (K.S.); (K.P.)
| | | | - Sebastian Kwiatkowski
- Department of Obstetrics and Gynecology, Pomeranian Medical University of Szczecin, 70-111 Szczecin, Poland;
| | - Krzysztof Preis
- Department of Obstetrics, Medical University of Gdańsk, 80-214 Gdańsk, Poland; (K.S.); (K.P.)
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13
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Dziennik A, Preis K, Swiatkowska-Freund M, Rebala K. Potential of DNA zygosity tests for non-invasive evaluation of risk of complications in twin pregnancies. Ginekol Pol 2021:VM/OJS/J/76173. [PMID: 34541652 DOI: 10.5603/gp.a2021.0158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 07/19/2021] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES To evaluate and compare the potential of DNA analysis and ultrasound examination for diagnosis of high-risk and low-risk twin pregnancies. MATERIAL AND METHODS Chorionicity of 42 twin pregnancies was determined by routine high-resolution sonographic examination between 10 and 14 weeks of gestation. Zygosity was analysed in umbilical cord blood samples collected immediately after the birth by genotyping of 22 autosomal short tandem repeats used in human identity testing. RESULTS Routine ultrasound imaging in the first trimester of twin gestations revealed 21 low-risk dichorionic (50%) and 21 high-risk monochorionic pregnancies (50%). DNA typing of umbilical cord blood showed 23 twin pairs with different genotypes (low-risk dizygotic pregnancies, 55%) and 19 twin pairs with identical genotypes (high-risk monozygotic pregnancies, 45%). We found four pregnancies (10%), which were diagnosed sonographically as monochorionic diamniotic, but were identified as dizygotic in postnatal DNA testing. They constituted 19% of all high-risk monochorionic pregnancies detected by ultrasound imaging. CONCLUSIONS Our results indicate high potential of prenatal DNA testing of zygosity in identification of low-risk and high-risk twin gestations requiring different prenatal care, especially in cases when chorionicity and zygosity cannot be reliably determined by ultrasound examination and as a supplementary test able to detect gestations misdiagnosed as monochorionic, resulting from fusions of dizygotic placentas. In such cases, dizygosity detected prenatally eliminates the need for frequent prenatal visits typical for monochorionic pregnancies. If chorionicity cannot be unequivocally determined and a prenatal DNA test detects monozygotic twins, a more pessimistic variant of monochorionic pregnancy should always be assumed.
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14
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Stefańska K, Zieliński M, Jankowiak M, Zamkowska D, Sakowska J, Adamski P, Jassem-Bobowicz J, Piekarska K, Leszczyńska K, Świątkowska-Stodulska R, Kwiatkowski S, Preis K, Trzonkowski P, Marek-Trzonkowska N. Cytokine Imprint in Preeclampsia. Front Immunol 2021; 12:667841. [PMID: 34248946 PMCID: PMC8261231 DOI: 10.3389/fimmu.2021.667841] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 05/31/2021] [Indexed: 11/23/2022] Open
Abstract
The hallmark of preeclampsia (PE) is a shift toward persistent inflammatory response, accompanied by endothelial dysfunction. The driving forces in PE are proinflammatory cytokine and growth factors, in parallel with reduced functionality of anti-inflammatory effectors, like regulatory T cells are observed. Unfortunately, no conclusive mechanism underlying preeclampsia has been identified. For this reason, research on preeclampsia is needed to provide a state of the art understanding of the pathophysiology, identification of new diagnostics tools and the development of targeted therapies. The 68 patients were divided into three groups: gestational hypertension (GH) group (n = 19) and PE group (n = 28) and a control group (n = 21). We have tested a set of 53 cytokines, chemokines and growth factors in preeclampsia and gestational hypertension, and then compared them with normal pregnancies. Using a diagnostic test assessment characteristic parameters (IL-22, MDC/CCL22, IL-2/IL-4 ratio) have been identified and cut-off values have been proposed to diagnose preeclampsia. All parameters had high negative or positive predictive values, above 80%. In conclusion, we have proposed a potential set of immune parameters to diagnose preeclampsia.
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Affiliation(s)
| | - Maciej Zieliński
- Department of Medical Immunology, Medical University of Gdańsk, Gdańsk, Poland
| | - Martyna Jankowiak
- Department of Medical Immunology, Medical University of Gdańsk, Gdańsk, Poland
| | - Dorota Zamkowska
- Department of Obstetrics, Medical University of Gdańsk, Gdańsk, Poland
| | - Justyna Sakowska
- Department of Medical Immunology, Medical University of Gdańsk, Gdańsk, Poland
| | | | | | - Karolina Piekarska
- Department of Medical Immunology, Medical University of Gdańsk, Gdańsk, Poland
| | | | | | - Sebastian Kwiatkowski
- Department of Obstetrics and Gynecology, Pomeranian Medical University of Szczecin, Szczecin, Poland
| | - Krzysztof Preis
- Department of Obstetrics, Medical University of Gdańsk, Gdańsk, Poland
| | - Piotr Trzonkowski
- Department of Medical Immunology, Medical University of Gdańsk, Gdańsk, Poland
| | - Natalia Marek-Trzonkowska
- International Centre for Cancer Vaccine Science Cancer Immunology Group, University of Gdansk, Gdańsk, Poland
- Laboratory of Immunoregulation and Cellular Therapies, Department of Family Medicine, Medical University of Gdańsk, Gdańsk, Poland
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15
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Stefanska KA, Zielinski M, Jassem-Bobowicz J, Zamkowska D, Adamski P, Piekarska K, Jankowiak M, Leszczynska K, Swiatkowska-Stodulska R, Preis K, Trzonkowski P, Marek-Trzonkowska N. Perinatal and neonatal outcome in patients with preeclampsia. Ginekol Pol 2021; 93:VM/OJS/J/70312. [PMID: 34105747 DOI: 10.5603/gp.a2021.0101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 02/21/2021] [Accepted: 01/04/2021] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES Preeclampsia (PE) affects 2-5% of pregnant women. Hypertensive disorders of pregnancy are associated with adverse maternal and perinatal outcomes. MATERIAL AND METHODS This study included 88 women showing gestational hypertension (GH) or PE symptoms, and their newborns. RESULTS The rate of FGR was 43% for mothers with PE, compared to 8% with GH. The association was significant, p = < 0.001 but with moderate strength, Cramer's V = 0.40. The risk of FGR increased nine times when PE occurred, as the odds ratio was 9.25 (CI: 2.46-34.83), p = 0.001. PE was associated with FGR risk if delivery time was less than 34 weeks compared to a delivery time of more than 34 weeks. This was 82% of FGR cases for < 34 weeks, compared with 35% of cases in > 34 group, (p = 0.001; Cramer's V = 0.50). PE was also associated (p = 0.01, Cramer's V = 0.27) with the type of delivery, as the caesarean section rate was 74%, compared to 50% in the GH group. This made it three times higher the likelihood of delivery by caesarean section, as the odds ratio was 3.10 (CI: 1.24-7.75), p=0,02. Delivery time was significantly (p < 0.001) shortened to 38 weeks (27-41), compared to 40 weeks (38-42) GH mothers. There was no distinction in median age for PE and GH mothers (p = 0.124). The overall clinical status of neonates was proportional despite the mother's PE. The sum of Apgar points in the first, and then the second to third minute, did not differ significantly, p = 0.370 and 0.560, respectively. The number of peripheral blood platelets and leucocytes was not reduced (p = 0.821 and 0.534) in infants when the mother suffered from PE. CONCLUSIONS The prediction of adverse maternal outcomes from hypertensive diseases of pregnancy is key to optimal management, including the timing of delivery and planning for the most appropriate place of care.
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Affiliation(s)
| | - Maciej Zielinski
- Department of Medical Immunology, Medical University of Gdansk, Poland
| | | | | | | | | | - Martyna Jankowiak
- Department of Medical Immunology, Medical University of Gdansk, Poland
| | | | | | - Krzysztof Preis
- Department of Obstetrics, Medical University of Gdansk, Poland
| | - Piotr Trzonkowski
- Department of Medical Immunology, Medical University of Gdansk, Poland
| | - Natalia Marek-Trzonkowska
- International Centre for Cancer Vaccine Science Cancer Immunology Group, University of Gdansk, Poland
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16
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Swiatkowska-Freund M, Traczyk-Łos A, Partyka A, Obara K, Damdinsuren A, Preis K. Perinatal outcome in preterm premature rupture of membranes before 37 weeks of gestation. Ginekol Pol 2020; 90:645-650. [PMID: 31802465 DOI: 10.5603/gp.2019.0109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 09/23/2019] [Accepted: 10/03/2019] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES The aim of this study was to assess the maternal and neonatal outcome in patients with preterm prematurerupture of membranes between 22 to 37 weeks of gestation in comparison to preterm birth patients. MATERIAL AND METHODS Group of PPROM patients consisted of 127 women, the control group counted 141 women whodelivered prematurely. The control group was formed by matching patient with the same gestational age at deliveryand neonatal birth weight to every woman from study group. In both groups speculum and ultrasound examinationswere performed, microbiological swabs were taken. In unclear cases of PPROM tests detecting amniotic proteins, suchas PAMG-1 or IGFBP-1, were performed. According to gestational age at delivery, neonates were divided into subgroups:extremely premature infants (< 27 weeks 6 days), moderate premature infants (from 28 weeks 0 days to 33 weeks 6 days),late premature infants (from 34 weeks 0 days to 37 weeks 0 days). RESULTS In the study group, median gestational age of delivery was 34 weeks 1 day and the same in control group - 34 weeksand 5 days (p > 0.05). Parameters of inflammatory status were more often reported in the PPROM group than in the pretermbirth group, even if they weren't statistically significant (positive culture of cervical swab, increased leukocytosis, CRP above 5).The rate of neonate survival was similar in both groups (93.7% and 94.1%). Congenital infection was more often diagnosed ingroup of neonates from PPROM pregnancies than in neonates from control group; (36% and 21.2% respectively; p = 0.009). CONCLUSIONS Our research appears to be consistent with theory of inflammatory etiology of PPROM. Optimal managementof infection in PPROM patients seems to be the most important in efforts to prolong pregnancy.
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Affiliation(s)
| | | | - Anna Partyka
- Department of Obstetrics, Medical University of Gdansk, Poland
| | - Kamil Obara
- Department of Obstetrics, Medical University of Gdansk, Poland
| | | | - Krzysztof Preis
- Department of Obstetrics, Medical University of Gdansk, Poland
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17
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Dębska-Ślizień A, Gałgowska J, Bułło-Piontecka B, Bzoma B, Chamienia A, Król E, Lichodziejewska-Niemierko M, Lizakowski S, Pankrac Z, Preis K, Renke M, Rutkowski P, Śledziński Z, Zdrojewski Z. Pregnancy After Kidney Transplantation With Maternal and Pediatric Outcomes: A Single-Center Experience. Transplant Proc 2020; 52:2430-2435. [PMID: 32444125 DOI: 10.1016/j.transproceed.2020.01.122] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Accepted: 01/26/2020] [Indexed: 10/24/2022]
Abstract
Outcomes of pregnancies after kidney transplantation were evaluated. Thirty-one pregnancies in 26 women were noted. The mean maternal age at pregnancy was 31 ± 5 years (range, 23-44 years). The interval between transplantation and conception was 54 ± 51 months (range, 7-213 months). The mean serum creatinine concentration before conception was 1.28 ± 0.4 mg/dL (range, 0.8-2.45 mg/dL), and mean estimated glomerular filtration rate (Chronic Kidney Disease Epidemiology Collaboration) was 62 ± 18 mL/min/1.73 m2 (range, 27-106 mL/min/1.73 m2). There were no maternal deaths. There was 1 case of suspected acute rejection after delivery. There was 1 case of graft loss during pregnancy. Maternal complications included edema (6/26), hypertension (7/26), increase of (2/26) or appearance of proteinuria (5/26), and preeclampsia (4/26). Mean creatinine increase during pregnancy was 0.02 mg/dL. Mean creatinine 1 year after pregnancy was 1.54 mg/dL (±0.8 mg/dL). There were 19 cesarean sections. Fetal outcomes included 25 live births, 4 abortions, and 2 stillbirths. Out of 25 live births, 22 children were considered healthy, 2 children had congenital defects, and there were 2 deaths at neonatal age. Mean pregnancy age was 35 ± 4 weeks (range, 24-40 weeks). The rate of premature deliveries was 15 of 25. Mean neonate birth weight was 2363 ± 1029 grams (range, 490-4100 grams). The rate of babies small for gestational age was 19%. During follow-up (range, 0.5-30 years) 5 of 26 patients lost grafts (between 3 and 15 years after pregnancy); most (20) of the children previously considered healthy had good long-term development. Our results confirm that risk of pregnancy in kidney transplant recipients can be accepted, and children considered healthy at delivery develop well.
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Affiliation(s)
- Alicja Dębska-Ślizień
- Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdańsk, Poland
| | - Joanna Gałgowska
- Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdańsk, Poland.
| | - Barbara Bułło-Piontecka
- Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdańsk, Poland
| | - Beata Bzoma
- Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdańsk, Poland
| | - Andrzej Chamienia
- Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdańsk, Poland
| | - Ewa Król
- Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdańsk, Poland
| | | | - Sławomir Lizakowski
- Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdańsk, Poland
| | - Zofia Pankrac
- Department of Obstetrics, Medical University of Gdańsk, Poland
| | - Krzysztof Preis
- Department of Obstetrics, Medical University of Gdańsk, Poland
| | - Marcin Renke
- Department of Occupational and Internal Medicine, Medical University of Gdańsk, Poland
| | - Przemysław Rutkowski
- Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdańsk, Poland
| | | | - Zbigniew Zdrojewski
- Department of Internal Medicine, Connective Tissue Diseases and Geriatrics, Medical University of Gdańsk, Poland
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18
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Kittel-Schneider S, Preis K, van Braam L, Unterecker S. 13 Therapeutic drug monitoring in pregnancy and post-partum period – antidepressant substances. PHARMACOPSYCHIATRY 2020. [DOI: 10.1055/s-0040-1710121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- S Kittel-Schneider
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Center of Mental Health, University Hospital of Würzburg
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital of Frankfurt, Goethe University
| | - K Preis
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital of Frankfurt, Goethe University
| | - L van Braam
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Center of Mental Health, University Hospital of Würzburg
| | - S Unterecker
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Center of Mental Health, University Hospital of Würzburg
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19
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Leszczynska K, Meyer-Szary J, Chojnicki M, Haponiuk I, Preis K, Stefanska K, Gierat-Haponiuk K, Swiatkowska-Freund M. Assessment of cardiac function in donor and recipient fetuses during a 7-day follow-up after selective laser photocoagulation of communicating vessels due to TTTS. Ginekol Pol 2020; 90:189-194. [PMID: 31059111 DOI: 10.5603/gp.2019.0034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Revised: 03/17/2019] [Accepted: 02/12/2019] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES The aim of the study was to analyze the changes in cardiac function and myocardial contractility of donor and recipient fetuses with twin-to-twin transfusion syndrome (TTTS) subjected to selective laser photocoagulation of the communicating vessels (SLPCV), between and after the procedure. Finally, we verified if fetuses with Quintero's stage I TTTS presented with early impairment of myocardial contractility. MATERIAL AND METHODS We selected 77 consecutive women with twin pregnancies, whose both fetuses survived at least seven days post-SLPCV. Myocardial contractility of both fetuses was evaluated ultrasonographically, and their myocardial performance indices (Tei-Index values) and shortening fractions (SF) were determined. RESULTS In donor fetuses, the Tei-Index values for both right and left ventricle remained within the respective reference ranges both before the procedure and during a 7-day follow-up. A significant change in shortening fraction values for the left ventricle in recipient fetuses and the right ventricle of in the donors was observed during a 7-day follow-up. CONCLUSIONS Comparison of the cardiac parameters of donors and recipients revealed significant differences in Tei-indices during the entire follow-up period. The group with Quintero's I stage TTTS included 74% of recipient fetuses with abnormal Tei-Index values for the right ventricle (mean 0.53).
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Affiliation(s)
| | - Jaroslaw Meyer-Szary
- Medical University of Gdansk, Department of Pediatric Cardiology and Congenital Heart Diseases, Gdansk, Poland
| | - Maciej Chojnicki
- Copernicus Hospital in Gdansk, Department of Pediatric Cardiac Surgery, Gdansk, Poland
| | - Ireneusz Haponiuk
- Copernicus Hospital in Gdansk, Department of Pediatric Cardiac Surgery, Gdansk, Poland.,Gdansk University of Physical Education and Sport, Chair of Physiotherapy, Gdansk, Poland
| | - Krzysztof Preis
- Medical University of Gdansk, Department of Obstetrics, Gdansk, Poland
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Maliszewska K, Świątkowska-Freund M, Bidzan M, Preis K. Relationship, social support, and personality as psychosocial determinants of the risk for postpartum blues. Ginekol Pol 2018; 87:442-7. [PMID: 27418222 DOI: 10.5603/gp.2016.0023] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 06/30/2016] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES The purpose of the study was to identify factors increasing or decreasing the risk for postpartum blues. MATERIAL AND METHODS A total of 101 women in their first week postpartum were included in the study. The Edinburgh Postnatal Depression Scale, questions concerning their medical and social status, and psychological tests (the Personality Inventory NEO-FFI, The Mieczysław Plopa and Jan Rostowski Marriage Questionnaire, and the Berlin Social Support Scales) were used. RESULTS The probability of postpartum blues was detected in 16.8% of the respondents. The risk decreased with higher satisfaction with intimacy (OR = 0.81), partner similarity (OR = 0.78), and the overall satisfaction with the relationship (OR = 0.94), while higher disappointment elevated that risk (OR = 1.12). As far as social support is concerned, further inde-pendent factors included perceived available social support (OR = 0.31), perceived instrumental social support (OR = 0.24), need for support (OR = 2.74), and protective buffering support (OR = 3.41). High level of neuroticism as well as fear of childbirth increased the risk for postpartum blues (OR = 2.17 and OR = 1.30, respectively). High level of extraversion and better quality of sleep constituted protective factors (OR = 0.74 and OR = 0.60, respectively). CONCLUSIONS Maternal disappointment with marriage/relationship, neuroticism and introversion, poor quality of sleep, fear of childbirth, and seeking social support are among the factors signaling the need for careful observation for signs of possible postpartum mood disorders both, during hospitalization and the follow-up visits.
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Maliszewska K, Bidzan M, Świątkowska-Freund M, Preis K. Personality type, social support and other correlates of risk for affective disorders in early puerperium. Ginekol Pol 2018; 87:814-819. [PMID: 28098932 DOI: 10.5603/gp.2016.0094] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2016] [Revised: 10/19/2016] [Accepted: 11/07/2016] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES The purpose of this study was to assess the prevalence of risk for postpartum mood disorders in mothers during the early postnatal period and to search for coexisting conditions. MATERIAL AND METHODS We studied 546 women in the first week after delivery. The subjects filled out a questionnaire concerning their health, social and demographic status, the Edinburgh Postnatal Depression Scale, the Patient Health Questionnaire, the NEO-FFI Personality Inventory and the Berlin Social Support Scales. RESULTS Probable mood disorders affected 15.85% of these patients. The risk increased with a current cesarean section (ORa = 2.54), a higher level of neuroticism (ORa = 1.65), greater fear of childbirth (ORa = 1.18), a lower level of extraversion (ORa = 0.77) and greater need for social support (ORa = 2.68). CONCLUSIONS High level of neuroticism and introversion, as well as higher fear of delivery and the need of social support are among factors increasing the probability of mood disturbances in early postpartum period. A cesarean section might elevate the risk similarly. The mental health of such patients should be carefully examined.
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Czajkowski K, Helwich E, Preis K, Grzesiak M, Krekora M, Gulczyńska E, Kornacka K, Zeman K, Maroszyńska I, Respondek-Liberska M. Recommendations “Cardio-Prenatal 2017” From Poland. Prenatal Cardiology 2018. [DOI: 10.1515/pcard-2018-0001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
On 27.10.2017, in the course of the CARDIO-PRENATAL Conference at the Polish Mother’s Memorial Institute and Health Centre in Lodz, we presented, among others, the following problems:
classification of prenatal heart defects, fetal hemodynamic status evaluation in the third trimester, expected neonate’s clinical condition, planned procedures to be conducted just after birth and also planned medical staff to be present in the delivery room. Here are our main recommendations following the meeting and discussion.
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Affiliation(s)
| | - Ewa Helwich
- National Consultant in Charge of Neonatology, Łódź , Poland
| | - Krzysztof Preis
- Provincial Consultant in Charge of Gynaecology & Obstetrics, Gdańsk , Poland
| | - Mariusz Grzesiak
- Provincial Consultant in Charge of Gynaecology & Obstetrics, Łódź , Poland
| | - Michał Krekora
- Deputy Head of the Clinics of Obstetrics & Gynaecology of the Polish Mother’s Memorial Hospital in Łódź , Poland
| | - Ewa Gulczyńska
- Provincial Consultant in Charge of Neonatology, Łódź , Poland
| | | | - Krzysztof Zeman
- Provincial Consultant in Charge of Immunology, Łódź , Poland
| | - Iwona Maroszyńska
- Chairwoman of the Łódź Branch of the Polish Society of Neonatology, Łódź , Poland
| | - Maria Respondek-Liberska
- President of Association for the Development of Prenatal Cardiology, Head of Prenatal Cardiology of the Polish Mother’s Memorial Hospital in Łódź, Head of Fetal Malformations Department, Medical University of Lodz , Poland
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Maliszewska KM, Bidzan M, Świątkowska-Freund M, Preis K. Socio-demographic and psychological determinants of exclusive breastfeeding after six months postpartum — a Polish case-cohort study. Ginekol Pol 2018; 89:153-159. [DOI: 10.5603/gp.a2018.0026] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 02/19/2018] [Accepted: 02/22/2018] [Indexed: 11/25/2022] Open
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Leszczyńska K, Chojnicki M, Stefańska K, Preis K, Gierat-Haponiuk K, Haponiuk I. Prenatalnie zdiagnozowana złożona wrodzona wada serca z zespołem Cri du chat i wieloma przeciwwskazaniami do leczenia kardiochirurgicznego — opis przypadku. Folia Cardiologica 2017. [DOI: 10.5603/fc.2017.0099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Mazur-Kominek K, Romanowski T, Bielawski K, Kiełbratowska B, Preis K, Domżalska-Popadiuk I, Słomińska-Frączek M, Sznurkowska K, Renke J, Plata-Nazar K, Śledzińska K, Sikorska-Wiśniewska G, Góra-Gębka M, Liberek A. Association between uridin diphosphate glucuronosylotransferase 1A1 (UGT1A1) gene polymorphism and neonatal hyperbilirubinemia. Acta Biochim Pol 2017; 64:351-356. [PMID: 28399191 DOI: 10.18388/abp.2016_1450] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 01/17/2017] [Accepted: 02/07/2017] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To assess the prevalence of UGT1A1*28 and UGT1A1*60 polymorphisms of UGT1A1 gene and their association with hyperbilirubinemia. STUDY DESIGN The study was performed at a single centre - at the Department of Obstetrics of the Medical University of Gdansk in Poland. DNA was isolated from Guthrie cards of 171 infants. Only full term newborns (gestational age 38-42 weeks) were included in the study. Fluorescent molecular probes were used for UGT1A1 promoter variation analysis. The presence of UGT1A1*28 polymorphism was detected with a dual-probe system, and UGT1A1*60 with a SimpleProbe™. RESULT Homozygous UGT1A1*28 and UGT1A1*60 genotypes were detected in 14.6% and 20.5% of the newborns, respectively. Homozygous (G/G) genotypes of UGT1A1*60 polymorphism were found in all of the UGT1A1*28 (i.e. (TA)7/(TA)7) homozygotes. More than 80% (55/66) of the children with "wild" type UGT1A1*28 genotype (where no polymorphism was detected) (i.e. (TA)6/(TA)6) carried the "wild" (T/T) genotype of UGT1A1*60 as well. The UGT1A1*28 polymorphism was detected more often among neonates with elevated bilirubin. Hyperbilirubinemia was diagnosed more frequently in boys. CONCLUSION Polymorphisms of the UGT1A1 gene frequently co-exist in neonates. The presence of UGT1A1*28 polymorphism and male gender seem to predispose to neonatal hyperbilirubinemia.
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Affiliation(s)
- Katarzyna Mazur-Kominek
- Department of Biotechnology, Intercollegiate Faculty of Biotechnology, University of Gdansk and Medical University of Gdansk, Gdańsk, Poland
| | - Tomasz Romanowski
- Department of Biotechnology, Intercollegiate Faculty of Biotechnology, University of Gdansk and Medical University of Gdansk, Gdańsk, Poland
| | - Krzysztof Bielawski
- Department of Biotechnology, Intercollegiate Faculty of Biotechnology, University of Gdansk and Medical University of Gdansk, Gdańsk, Poland
| | | | - Krzysztof Preis
- Department of Obstetrics, Medical University of Gdansk, Gdańsk, Poland
| | | | - Magdalena Słomińska-Frączek
- Department of Pediatrics, Pediatric Gastroenterology, Hepatology and Nutrition, Medical University of Gdansk, Gdańsk, Poland
| | - Katarzyna Sznurkowska
- Department of Pediatrics, Pediatric Gastroenterology, Hepatology and Nutrition, Medical University of Gdansk, Gdańsk, Poland
| | - Joanna Renke
- Department of General and Medical Biochemistry, University of Gdansk, Gdańsk, Poland
| | - Katarzyna Plata-Nazar
- Department of Pediatrics, Pediatric Gastroenterology, Hepatology and Nutrition, Medical University of Gdansk, Gdańsk, Poland
| | - Karolina Śledzińska
- Department of Pediatrics, Pediatric Gastroenterology, Hepatology and Nutrition, Medical University of Gdansk, Gdańsk, Poland
| | - Grażyna Sikorska-Wiśniewska
- Department of Pediatrics, Pediatric Gastroenterology, Hepatology and Nutrition, Medical University of Gdansk, Gdańsk, Poland
| | - Magdalena Góra-Gębka
- Department of Pediatrics, Pediatric Gastroenterology, Hepatology and Nutrition, Medical University of Gdansk, Gdańsk, Poland
| | - Anna Liberek
- Faculty of Health Sciences with Subfaculty of Nursing, Medical University of Gdansk, Gdańsk, Poland
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Abstract
Uterine cervix is a part of the uterus responsible for maintaining pregnancy till term. As long as the cervix remains long and firm and its internal orifice (os) is closed, it can withstand enlargement of the uterine contents and resultant growing pressure. Mechanical properties of the cervix change during pregnancy; the cervix ripens prior to delivery, then effaces and dilates with contractions of the uterus. Ripening of the cervix can be assessed using the Bishop score and ultrasonographically determined length of the cervical canal and internal os. Consistency is one of the cervical properties that change during the course of the maturation process. Until recently, cervical consistency has been assessed only manually, but in 2007, the first report on elastographic imaging of the cervix during pregnancy has been published. Elastography presents the ability of a tissue to deform under pressure. The softer the tissue, the easier it changes its shape. Different methods of elastography are used – static, when tissue displacement in response to manual compression or physiological movements of vessels is measured, or dynamic, when the speed of shear wave propagation is determined. Irrespective of the method, elastography provides information on the internal os stiffness; this parameter, impossible for manual assessment, was shown to correlate with pregnancy outcome and is a strong predictor of preterm delivery or successful labor induction. Although elastography seems to be a highly promising diagnostic option, still no consensus has been reached regarding an optimal method for uterine cervix assessment, and virtually all previous studies of various elastographic methods produced highly satisfactory results. Future studies need to identify the most promising and objective elastographic method which may serve as a novel tool for pregnancy management, preventing adverse events, such as preterm delivery and unsuccessful labor induction.
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Affiliation(s)
| | - Krzysztof Preis
- Department of Obstetrics, Medical University of Gdańsk, Gdańsk, Poland
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Leszczyńska K, Preis K, Respondek-Liberska M, Słodki M, Wood D, Weiner S, Gembruch U, Rizzo G, Achiron R, Pruetz JD, Sklansky M, Cuneo B, Arabin B, Blickstein I. Recommendations for Fetal Echocardiography in Twin Pregnancy in 2016. Prenatal Cardiology 2016. [DOI: 10.1515/pcard-2016-0001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Progress in the fields of fetal cardiology and fetal surgery have been seen not only in singleton pregnancies but also in multiple pregnancies. Proper interpretation of prenatal echocardiography is critical to clinical decision making, family counseling and perinatal management for obstetricians, maternal fetal medicine specialists, neonatologists and pediatric cardiologists. Fetal echocardiography is one of the most challenging and time-consuming prenatal examinations to perform, especially in multiple gestations. Performing just the basic fetal exam in twin gestations may take an hour or more. Thus, it is not practical to perform this exam in all cases of multiple gestations. Therefore our review and recommendations are related to fetal echocardiography in twin gestation.
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Affiliation(s)
| | - Krzysztof Preis
- 1. Department of Obstetrics, Medical University of Gdansk, Poland
| | - Maria Respondek-Liberska
- 2. Department of Diagnoses and Prevention Fetal Malformations, Medical University of Lodz, Poland
- 3. Department of Prenatal Cardiology, Polish Mother’s Memorial Hospital Research Institute, Lodz, Poland
| | - Maciej Słodki
- 3. Department of Prenatal Cardiology, Polish Mother’s Memorial Hospital Research Institute, Lodz, Poland
- 4. Institute of Health Sciences, The State School of Higher Professional Education in Płock, Poland
| | - Dennis Wood
- 5. Department of Obstetrics and Gynecology, Thomas Jefferson University, Philadelphia, Pennsylvania, United States of America
| | - Stuart Weiner
- 6. Thomas Jefferson University and Hospitals, Philadelphia, Pennsylvania, United States of America
| | - Ulli Gembruch
- 7. Department of Obstetrics and Prenatal Medicine, University Bonn Medical School, Bonn, Germany
| | - Giusseppe Rizzo
- 8. Department of Obstetrics and Gynecology, Università Roma Tor Vergata, Ospedela Fatebenefratelli Isola Tiberina, Rome, Italy
| | - Reuven Achiron
- 9. Department of Obstetrics and Gynecology, The Chaim Sheba Medical Center Tel-Hashomer, Sackler School of Medicine, Tel-Aviv University, Israel
| | - Jay D Pruetz
- 10. Division of Pediatric Cardiology, Children’s Hospital Los Angeles, Los Angeles, CA, United States of America ; Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America
| | - Mark Sklansky
- 11. Division of Pediatric Cardiology, Department of Pediatrics, David Geffen School of Medicine, Los Angeles, California, United States of America
| | - Bettina Cuneo
- 12. Department of Pediatric Cardiology, Then Fetal Heart Program, Colorado Fetal Care Center, Colorado Institute for Maternal Fetal Health, Children’s Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado, United States of America
| | - Birgit Arabin
- 13. Center for Mother and Child, Philipps University, Marburg, Germany
| | - Isaac Blickstein
- 14. Department of Obstetrics and Gynecology, Kaplan Medical Center, 76100 Rehovot and the Hadassah-Hebrew University School of Medicine, Jerusalem, Israel
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Chodkowski M, Swiatkowska-Freund M, Preis K. [Estimation of fetal middle cerebral artery peak systolic velocity at 18-39 weeks of gestation in Polish population]. Ginekol Pol 2016; 86:806-10. [PMID: 26817311 DOI: 10.17772/gp/59537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES The aim of this paper was to establish normal values of fetal middle cerebral artery peak systolic velocity (MCA-PSV) between 18-39 weeks' gestation in the Polish population and to compare the results with values published by other authors, for different populations seeking the discrepancies between them. MATERIAL AND METHODS 280 healthy pregnant women from the Polish population underwent ultrasound examination. The cross-sectional data were obtained based on the measurements of fetal middle cerebral artery peak systolic velocity A chart of normal MCA-PSV values as a function of the gestational age was constructed. RESULTS Normal ranges for MCA-PSV in the Polish population were established. The results were compared with values published by other authors, for different populations. CONCLUSIONS The use of MCA-PSV measurements has proven itself to be a reliable method in diagnosis of fetal anemia. Differences in normal values of MCA-PSV in the Polish population compared with other nations have been observed.
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Adamski P, Ciach K, Kiełbratowska B, Szczerkowska Z, Preis K. DNA profiling as a metod of zygosity determination in multiple pregnancy. Ginekol Pol 2016; 87:222-5. [DOI: 10.17772/gp/61989] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 04/13/2016] [Indexed: 11/12/2022] Open
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Regitz-Zagrosek V, Jaguszewska K, Preis K. Pregnancy-related spontaneous coronary artery dissection. Eur Heart J 2015; 36:2273-2274. [PMID: 26594680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
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Leszczyńska K, Chojnicki M, Haponiuk I, Preis K, Ciach K, Gierat-Haponiuk K, Łajkowski Z. [Analysis of pregnancy, labor and neonatal course in babies with prenatally-diagnosed complete atrioventricular heart block]. Ginekol Pol 2015; 86:366-71. [PMID: 26117975 DOI: 10.17772/gp/2424] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Complete heart block (third-degree atrioventricular block) is a defect of the conduction system of the heart, in which the impulse generated in the sinoatrial node does not propagate to the ventricles, and thus the latter contract independently of the atria. A third-degree atrioventricular block can be either congenital or acquired. In 60-70% of the cases, the congenital heart block results from destruction of the conduction system of the fetal heart by anti-Ro/SSA and anti-La/SSB antibodies present in maternal serum. The antibodies are synthesized in the course of autoimmune maternal conditions, most often systemic lupus erythematosus or rarer rheumatoid arthritis, dermatomyositis or Sjögren's syndrome. The complete block can occur as an isolated defect or be associated with structural anomalies of the fetal heart. MATERIAL AND METHODS A total of five patients whose fetuses were diagnosed with the third-degree atrioventricular block have been hospitalized at the Department of Obstetrics, Medical University of Gdansk between 2012 and 2014. RESULTS We present the data of the five patients, hospitalized at the Department of Obstetrics, Medical University of Gdansk, whose fetuses were diagnosed prenatally with the complete heart block. The cases differ in terms of etiology clinical outcome, and postnatal treatment. All data are presented in Table I. CONCLUSIONS We emphasize the role of appropriate pregnancy management and careful monitoring of the fetal condition. From obstetrical perspective, it is important to monitor the condition of fetuses with the third-degree atrioventricular block ultrasonographically and echocardiographically; in turn, cardiotocography is less useful in this setting. Therefore, a non-reactive cardiotocographic tracing should not constitute an indication for a preterm delivery. An affected fetus should be delivered in a tertiary center for perinatal care that cooperates with a pediatric cardiology center. An efficient program for cardologic prenatal care and close cooperation between obstetricians, neonatologists, pediatric cardiologists, and cardiac surgeons constitute the key to a successful outcome.
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Zabul P, Wozniak M, Slominski AT, Preis K, Gorska M, Korozan M, Wieruszewski J, Zmijewski MA, Zabul E, Tuckey R, Kuban-Jankowska A, Mickiewicz W, Knap N. A Proposed Molecular Mechanism of High-Dose Vitamin D3 Supplementation in Prevention and Treatment of Preeclampsia. Int J Mol Sci 2015; 16:13043-64. [PMID: 26068234 PMCID: PMC4490485 DOI: 10.3390/ijms160613043] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Revised: 05/31/2015] [Accepted: 06/01/2015] [Indexed: 12/02/2022] Open
Abstract
A randomized prospective clinical study performed on a group of 74 pregnant women (43 presenting with severe preeclampsia) proved that urinary levels of 15-F(2t)-isoprostane were significantly higher in preeclamptic patients relative to the control (3.05 vs. 2.00 ng/mg creatinine). Surprisingly enough, plasma levels of 25-hydroxyvitamin D3 in both study groups were below the clinical reference range with no significant difference between the groups. In vitro study performed on isolated placental mitochondria and placental cell line showed that suicidal self-oxidation of cytochrome P450scc may lead to structural disintegration of heme, potentially contributing to enhancement of oxidative stress phenomena in the course of preeclampsia. As placental cytochrome P450scc pleiotropic activity is implicated in the metabolism of free radical mediated arachidonic acid derivatives as well as multiple Vitamin D3 hydroxylations and progesterone synthesis, we propose that Vitamin D3 might act as a competitive inhibitor of placental cytochrome P450scc preventing the production of lipid peroxides or excess progesterone synthesis, both of which may contribute to the etiopathogenesis of preeclampsia. The proposed molecular mechanism is in accord with the preliminary clinical observations on the surprisingly high efficacy of high-dose Vitamin D3 supplementation in prevention and treatment of preeclampsia.
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Affiliation(s)
- Piotr Zabul
- Department of Obstetrics & Gynecology, the Sw. Wojciech Specialist Hospital, Independent Public Complex of Integrated Health Care Units in Gdansk, 50 Al. Jana Pawła II St., Gdansk 80-462, Poland; E-Mail:
| | - Michal Wozniak
- Department of Medical Chemistry, Medical University of Gdansk, 1 Debinki St., Gdansk 80-211, Poland; E-Mails: (M.W.); (M.G.); (J.W.); (A.K.-J.); (W.M.)
| | - Andrzej T. Slominski
- Department of Dermatology, University of Alabama at Birmingham, VA Medical Center, Birmingham, AL 35294, USA; E-Mail:
| | - Krzysztof Preis
- Department of Obstetrics & Gynecology, Medical University of Gdansk, 1A Kliniczna St., Gdansk 80-402, Poland; E-Mail:
| | - Magdalena Gorska
- Department of Medical Chemistry, Medical University of Gdansk, 1 Debinki St., Gdansk 80-211, Poland; E-Mails: (M.W.); (M.G.); (J.W.); (A.K.-J.); (W.M.)
| | - Marek Korozan
- Department of Obstetrics & Gynecology, the Sw. Wojciech Specialist Hospital, Independent Public Complex of Integrated Health Care Units in Gdansk, 50 Al. Jana Pawła II St., Gdansk 80-462, Poland; E-Mail:
| | - Jan Wieruszewski
- Department of Medical Chemistry, Medical University of Gdansk, 1 Debinki St., Gdansk 80-211, Poland; E-Mails: (M.W.); (M.G.); (J.W.); (A.K.-J.); (W.M.)
| | - Michal A. Zmijewski
- Department of Histology, Medical University of Gdansk, 1 Debinki St., Gdansk 80-211, Poland; E-Mail:
| | - Ewa Zabul
- Department of Anesthesiology & Intensive Care, Medical University of Gdansk, 1 Debinki St., Gdansk 80-211, Poland; E-Mail:
| | - Robert Tuckey
- School of Chemistry and Biochemistry, the University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia; E-Mail:
| | - Alicja Kuban-Jankowska
- Department of Medical Chemistry, Medical University of Gdansk, 1 Debinki St., Gdansk 80-211, Poland; E-Mails: (M.W.); (M.G.); (J.W.); (A.K.-J.); (W.M.)
| | - Wieslawa Mickiewicz
- Department of Medical Chemistry, Medical University of Gdansk, 1 Debinki St., Gdansk 80-211, Poland; E-Mails: (M.W.); (M.G.); (J.W.); (A.K.-J.); (W.M.)
| | - Narcyz Knap
- Department of Medical Chemistry, Medical University of Gdansk, 1 Debinki St., Gdansk 80-211, Poland; E-Mails: (M.W.); (M.G.); (J.W.); (A.K.-J.); (W.M.)
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Kielbratowska B, Kazmierczak M, Michalek J, Preis K. Temperament and the mother-infant dyad: associations with breastfeeding and formula feeding with a bottle. Infant Ment Health J 2015; 36:243-50. [PMID: 25973840 DOI: 10.1002/imhj.21508] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Breastfeeding supports the formation of an emotional bond between mothers and their children. The feeding method is associated with both the child's temperament and the mother's perception of herself and the child. Therefore, the present study focuses on the feeding method, mothers' reaction during feeding, and infants' temperament traits. Ninety-eight mothers with children aged 3 to 5 months participated in the study. Children were assessed with the Children Development Scale (A. Matczak et al., 2007) to measure their temperament. Mothers completed the Mother and Baby Scale (D. Wolke & I. St James-Roberts, 1987, as cited in T.B. Brazelton & K. Nugent, 1995), which measures mothers' evaluation of their children's behaviors during feeding and their overall experiences with their children's care. The results show that breastfed newborns, as compared to bottle-fed newborns, demonstrate higher vigor, which includes activity and the intensity of reaction. Bottle-fed children demonstrate higher regularity than do breastfed children. Mothers who bottle-feed their children perceive themselves to be less confident in the feeding domain than do mothers who breastfeed. Our results indicate that children's temperament might be an important factor in the decision regarding the feeding method. The study supports the idea of promoting knowledge of children's behaviors during feeding among mothers even before their children are born, such as during antenatal classes.
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Sielicka A, Pelikant-Malecka I, Kaniewska E, Olkowicz M, Pankrac Z, Swiatkowska-Freund M, Preis K, Gorska M, Slominska EM, Smolenski RT. Effect of nitrosative stress on extracellular nucleotide metabolism in endothelial cells. Nucleosides Nucleotides Nucleic Acids 2015; 33:342-6. [PMID: 24940691 DOI: 10.1080/15257770.2014.898069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Mechanisms of free radical injury involve chemical modification of proteins, lipid derivatives and nucleic acids and consequent loss of its function. However, specific targets and exact sequence of events has not been fully clarified. We determined whether extracellular enzymes that are involved in adenosine formation such as ecto-5'nucleotidase (e5N) and removal such as extracellular form of adenosine deaminase (eADA) could be affected by peroxynitrite. We used intact cell assay system that involves exposure of cultured HMEC-1 cells to substrates followed by HPLC analysis of conversion of substrates into products. We found that e5N and ADA activities decreased by 20-40% after incubation for 20 or 60 minutes with 30 μM peroxynitrite. Decrease of cellular ATP and NAD was also observed. We conclude that besides other cytotoxic effects modification of extracellular enzymes of nucleotide metabolism could be important target for free radical injury.
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Affiliation(s)
- A Sielicka
- a Department of Biochemistry , Medical University of Gdansk , Gdansk , Poland
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Szaryńska M, Myśliwski A, Myśliwska J, Kmieć Z, Preis K, Zabul P. Cytokine profiles during delivery affect cord blood hematopoietic stem and progenitors cells. Cell Immunol 2015; 293:137-41. [DOI: 10.1016/j.cellimm.2015.01.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Revised: 01/09/2015] [Accepted: 01/10/2015] [Indexed: 01/10/2023]
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Marciniak A, Owczuk R, Wujtewicz M, Preis K, Majdyło K. The influence of intravenous ondansetron on maternal blood haemodynamics after spinal anaesthesia for caesarean section: a double-blind, placebo-controlled study. Ginekol Pol 2015; 86:461-7. [DOI: 10.17772/gp/2405] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Dębska-Ślizień A, Gałgowska J, Chamienia A, Bułło-Piontecka B, Król E, Lichodziejewska-Niemierko M, Lizakowski S, Renke M, Rutkowski P, Zdrojewski Z, Preis K, Śledziński Z, Rutkowski B. Pregnancy After Kidney Transplantation: A Single-Center Experience and Review of the Literature. Transplant Proc 2014; 46:2668-72. [DOI: 10.1016/j.transproceed.2014.08.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Leszczyńska K, Preis K, Swiatkowska-Freund M, Pankrac Z. Comparison of fetal myocardial contractility before and after laser photocoagulation of communicating vessels in twin-to-twin transfusion syndrome. Ginekol Pol 2014; 85:283-6. [PMID: 24834706 DOI: 10.17772/gp/1724] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES To evaluate changes in myocardial contractility that occur after selective laser photocoagulation of communicating vessels (SLPCV) in fetuses from pregnancies complicated with twin-to-twin transfusion syndrome (TTTS). METHODS The study included 51 pregnant women between 16 and 26 weeks of gestation who underwent SLPCV due to TTTS. Ultrasonography was performed before SLPCV and on postoperative day 1, 3(4) and 7. Fetal heart contractility in both fetuses was evaluated by determining the shortening fractions of the left and right ventricles (FS LV and FS RV), and the myocardial performance index (Tei-Index). RESULTS There was a significant increase in postoperative FS LV and FS RV in recipients (from 35.7% to 44%, P = 0.037 and from 27.6% to 32.9%, P = 0.021, respectively). Pre-operative Tei-Index values for both the left (0.55) and right ventricle (0.6) were above normal. The mean postoperative Tei-Index for the left ventricle decreased significantly to 0.49 (P = 0.011), while no significant change was observed in the right ventricle (0.57). No significant differences between pre- and postoperative FS and Tei-Index values were noted in the donors. CONCLUSIONS SLPCV is reflected by a significantly increased myocardial contractility in recipients.
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Ciach K, Swiatkowska-Freund M, Preis K. Influence of place of residence on indications for genetic amniocentesis in the Pomeranian region of Poland before and after introduction of the Prenatal Screening Program in 2008. Med Sci Monit 2014; 20:720-4. [PMID: 24785299 PMCID: PMC4015648 DOI: 10.12659/msm.890159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Background The aim of the study was to analyze differences in the indications for amniocentesis in patients living in urban and rural areas before and after introduction of the Prenatal Screening Program by Polish National Health Insurance agency in the Pomeranian region in 2008. Material/Methods Indications for 2578 amniocenteses performed in the Department of Obstetrics of the Medical University of Gdansk between 1996 and 2010 were recorded. Results Advanced maternal age accounted for 69% of women in urban areas and 61% of women in rural areas being referred for amniocentesis (p<0.001). There was also a significant difference between locations in chromosomal abnormality in previous pregnancy, accounting for 4% of referrals for amniocentesis in urban areas compared with 7% of referrals in rural areas. In urban areas, advanced maternal age accounted for 73% of referrals between 1996–2007 compared with 60% of referrals for amniocentesis between 2008 and 2010 (p=0.004), and in rural areas it was 66% and 54%, respectively (p<0.001). Abnormal result of biochemical screening surprisingly accounted for 13% of referrals for amniocenteses between 1996–2007 in urban areas compared with 28% after 2008 (p<0.001). In rural areas this indication accounted for 12% referrals before 2008 and for 28% from 2008 onward (p<0.001). Conclusions The results of the study suggest that in both urban and rural areas there was a significant decrease in advanced maternal age as a reason for referral for amniocentesis, but a significant increase in abnormal results of biochemical screening as an indication for amniocentesis after 2008.
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Affiliation(s)
- Katarzyna Ciach
- Department of Obstetrics, Medical University of Gdańsk, Gdańsk, Poland
| | | | - Krzysztof Preis
- Department of Obstetrics, Medical University of Gdańsk, Gdańsk, Poland
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Stukan M, Kruszewski WJ, Dudziak M, Kopiejć A, Preis K. [Appendicitis and gall bladder diseases as acute abdominal conditions in pregnancy]. Ginekol Pol 2014; 84:1045-50. [PMID: 24505953 DOI: 10.17772/gp/1678] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Appendicitis (APP) and gall bladder diseases (GBD) are the most frequent non-obstetric indications for urgent surgery among pregnant women. The aim was to present the diagnosis, treatment and potential complications of APP and symptomatic GBD. We searched the literature for APP and GBD during pregnancy and presented the results in the form of a review article. APP symptoms among pregnant women are comparable to these in the general population. Typical clinical symptoms are present in 50-75% of cases. Laboratory tests are useful for a differential diagnosis. The imaging of choice is an ultrasonography scan, but magnetic resonance is of the highest accuracy The final diagnosis is difficult. When the surgery is delayed, the risk of appendix perforation increases and thus complications are more frequent. GBD symptoms and signs are comparable to those in the general population. The best imaging is an ultrasonography scan, and laboratory tests are important in a jaundice differential diagnosis. In cases with symptomatic GBD, a delay in surgery is associated with an increased risk of complications (pancreatitis, abortion, intrauterine death). The treatment method of choice for APP and symptomatic GBD is surgery both laparotomy and laparoscopy (preferred), which are considered relatively safe, though laparoscopy compared to laparotomy for APP can be associated with a higher risk of abortion. Untreated or delayed APP and symptomatic GBD treatment during pregnancy increases the risk of complications, both for the woman and the fetus. Diagnosis is difficult and should be based on a multidisciplinary approach to the patient. Surgery by laparotomy or laparoscopy is relatively safe.
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Affiliation(s)
- Maciej Stukan
- Szpital Morski im. PCK, Gdyńskie Centrum Onkologii, Oddział Ginekologii Onkologicznej, Gdynia, Polska.
| | | | - Mirosław Dudziak
- Szpital Morski im. PCK, Gdyńskie Centrum Onkologii, Oddział Ginekologii Onkologicznej, Gdynia, Polska
| | - Arkadiusz Kopiejć
- Szpital Specjalistyczny w Kościerzynie, Oddział Chirurgii, Kościerzyna, Polska
| | - Krzysztof Preis
- Gdański Uniwersytet Medyczny, Klinika Połoznictwa, Gdańsk, Polska
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Szaryńska M, Kmieć Z, Preis K, Zabul P. The presence of a supporting person during delivery affects cord blood haematopoietic stem cells. J OBSTET GYNAECOL 2014; 34:245-7. [DOI: 10.3109/01443615.2013.844111] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Świątkowska-Freund M, Traczyk-Łoś A, Preis K, Łukaszuk M, Zielińska K. Prognostic value of elastography in predicting premature delivery. Ginekol Pol 2014; 85:204-7. [DOI: 10.17772/gp/1714] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Świątkowska-Freund M, Pankrac Z, Preis K. Intra- and inter-observer variability of evaluation of uterine cervix elastography images during pregnancy. Ginekol Pol 2014; 85:360-4. [DOI: 10.17772/gp/1740] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Abstract
OBJECTIVE To identify demographic and clinical variables differentiating pregnant Polish women who decided to terminate the pregnancy in the case of lethal fetal malformation from those who preferred to continue the pregnancy in such a situation. STUDY DESIGN Cross-sectional study. RESULTS The group of women who decided to abort contained a higher fraction of multiparas than the group of patients who chose to continue their pregnancies, and was characterized by significantly lower mean gestational age at diagnosis of lethal fetal malformation. The only demographic variable approaching statistical significance was the presence of siblings, which was significantly more frequent amongst women who decided to terminate the pregnancy. CONCLUSIONS As the decision-making process on pregnancy termination is multimodal, pregnant women require particular support in the case of detecting lethal malformation in their fetuses.
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Affiliation(s)
- Anna Michalik
- Department of Obstetrical and Gynecological Nursing, Medical University of Gdansk , Gdansk , Poland and
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Ciach K, Swiatkowska-Freund M, Preis K. Evolution of the indications for genetic amniocentesis after the introduction of the prenatal screening program by the national health insurance in Poland. Ginekol Pol 2013; 84:418-21. [PMID: 24032258 DOI: 10.17772/gp/1598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE In 2008, the Prenatal Screening Program was introduced by the National Health Insurance in the Pomeranian region of Poland. As of then, biochemical and ultrasound screening was offered to women eligible for amniocentesis according to the earlier policy. The aim of the study was to investigate the evolution of the indications for amniocentesis after the introduction of the Program. MATERIAL AND METHODS In total, 2579 women referred for amniocentesis to the Department of Obstetrics, Medical University of Gdansk, were included in the study They were divided into two groups: 1705 women referred between 1996 and 2007 (group A) and 874 women referred between 2008 and 2010 (group B). Indications for amniocentesis were compared between the groups. RESULTS A significant difference in the indications for amniocentesis was found between the groups (Kruskal-Wallis test; p < 0.001). Maternal age, fetal malformation in the previous pregnancy and anxiety were less frequent in group B (p < 0.0001, p = 0.0008 and p = 0.0156, respectively). In contrast, a higher frequency of positive biochemical screening and abnormal ultrasound results as indications for amniocentesis was found in group B (p < 0.0001 and p = 0.0008, respectively). CONCLUSIONS The introduction of the Prenatal Screening Program by the National Health Insurance shifted the proportion of indications for amniocentesis from maternal age to positive results in biochemical and ultrasound screenings, and increased the number of invasive testing. Further observation of the trend and its influence on the detection rate is imperative to confirm that the proposed Program is adequate and does not require adjustments.
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Affiliation(s)
- Katarzyna Ciach
- Department of Obstetrics, Medical University of Gdansk, Poland.
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Abstract
This is a review of literature concerning intestinal obstruction in pregnant women. Approximately 50-90% and 30% of pregnant women, respectively suffer from nausea and vomiting, mostly during the first trimester. There is also increased risk of constipation. During the perioperative period, the administration of tocolytics should be considered only in women showing symptoms of a threatening premature delivery. Intensive hydration should be ordered to sustain uterine blood flow. The incidence of intestinal obstruction during pregnancy is estimated at 1:1500-1:66431 pregnancies and is diagnosed in II and III trimester in most cases. However, it can also occur in the I trimester (6%) or puerperium. Symptoms of intestinal obstruction in pregnancy include: abdominal pains (98%), vomiting (82%), constipation (30%). Abdominal tenderness on palpation is found in 71% and abnormal peristalsis in 55% of cases. The most common imaging examination in the diagnosis of intestinal obstruction is the abdominal X-ray. However ionizing radiation may have a harmful effect on the fetus, especially during the first trimester. X-ray is positive for intestinal obstruction in 82% of pregnant women. Ultrasonography and magnetic resonance imaging are considered safe and applicable during pregnancy. Intestinal obstruction in pregnant women is mostly caused by: adhesions (54.6%), intestinal torsion (25%), colorectal carcinoma (3.7%), hernia (1.4%), appendicitis (0.5%) and others (10%). Adhesive obstruction occurs more frequently in advanced pregnancy (6% - I trimester 28% - II trimester; 45% - III trimester 21% - puerperium). Treatment should begin with conservative procedures. Surgical treatment may be necessary in cases where the pain turns from recurrent into continuous, with tachycardia, pyrexia and a positive Blumberg sign. If symptoms of fetal anoxia are observed, a C-section should be carried out before surgical intervention. The extent of surgical intervention depends on the intraoperative evaluation. Intestinal torsion during pregnancy mostly occurs in the sigmoid colon and cecum. Small bowel torsion secondary to adhesions is diagnosed in 42% of pregnant women with intestinal obstruction. The risk of intestinal torsion is higher in the 16-20 and 32-36 weeks of pregnancy and during puerperium. Intestinal torsion results in vessel occlusion which induces more severe symptoms and makes urgent surgical intervention necessary. The overall prognosis is poor--during II and III trimester the fetal mortality rate reaches 36% and 64%, respectively while the risk of maternal death is 6%. Acute intestinal pseudoobstruction can be diagnosed during puerperium, especially following a C-section. Diagnosis is made on the basis of radiological confirmation of colon distension at the cecum as > 9cm, lack of air in the sigmoid colon and rectum, exclusion of mechanical obstruction. In most cases, the treatment is based on easing intestine gas evacuation and administering neostigmine. The authors point out the need for multi-specialty cooperation in the diagnostic-therapeutic process of pregnant women suspected with intestinal obstruction, since any delay in making a correct diagnosis increases the risk of severe complications, both for the woman and the fetus.
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Affiliation(s)
- Maciej Stukan
- Szpital Morski im. PCK, Gdyńskie Centrum Onkologii, Oddział Ginekologii Onkologicznej, Gdynia, Polska.
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Abstract
Background The authors performed a long term outcome analysis of minimal brain damage in children delivered in breech presentation, and related the results to the mode of delivery (vaginal or by cesarean section). Material/Methods In the Department of Obstetrics at the Medical University of Gdansk (Poland), 917 breech deliveries took place between 1981 and 1990. Excluding stillbirths and multiple pregnancies, 874 deliveries were analyzed. We received positive responses from 232 mothers, who provided us with considerable information about the children’s further development and problems that had arisen during their school years. All the respondents were contacted by telephone, and 83 of them agreed to visit our Department with their children to undergo a psychological examination – the following tests were performed: 1) the Bender-Kopitz Test (BKT), and 2) the Benton Visual Retention Test (BVRT). Results The mode of delivery for all groups and subgroups had no influence on the incidence of organic brain disorders in later childhood, assessed by the Benton Visual Retention test and by the Bender-Kopitz test. Conclusions Vaginal breech deliveries are safe in both primiparous and multiparous mothers.
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Affiliation(s)
- Krzysztof Preis
- Department of Obstetrics, Medical University of Gdansk, Gdansk, Poland
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Arndt M, Duchoslav J, Preis K, Samek L, Stifter D. Nanoscale surface analysis on second generation advanced high strength steel after hot dip galvanizing. Anal Bioanal Chem 2013; 405:7119-32. [DOI: 10.1007/s00216-013-6801-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2012] [Revised: 01/16/2013] [Accepted: 01/25/2013] [Indexed: 11/30/2022]
Affiliation(s)
- M Arndt
- Zentrum für Oberflächen- und Nanoanalytik und Christian Doppler Labor für mikroskopische und spektroskopische Materialcharakterisierung, Johannes Kepler Universität Linz, Altenbergerstraße 69, 4040 Linz, Austria.
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Abstract
Malignant neoplasm of the head and neck is rare disease of pregnant woman. The most common localization of this tumors are larynx, thyroid, melanoma and lymphoma. Many diagnostic and therapeutic procedures (routinely used in patients with cancer) are contraindicated in the presence of pregnancy. The authors presents a case of a 28-year-old female with malignant tumor of nasal cavity during the 37 week of pregnancy. We performed caesarean section and radical surgery (lateral rhinotomy) with removing of the tumor. The histological examination result was: esthesioneuroblastoma. 5-weeks after surgery radiotherapy was realized. During the 6-year follow-up no recurrence was observed.
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Skrzypczak J, Rajewski M, Wirstlein P, Goździewicz T, Breborowicz G, Leszczyńska-Gorzelak B, Ludwikowski G, Preis K, Wołczyński S, Zimmer M. [Incidence of hereditary thrombophilia in women with pregnancy loss in multi-center studies in Poland]. Ginekol Pol 2012; 83:330-336. [PMID: 22708328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
AIM The aim of this study was to estimate the prevalence of factor V Leiden and prothrombin gene G20210A mutation among women with pregnancy loss in Poland. MATERIAL AND METHODS we analyzed a group of 396 women (mean age of 30.4 (+/- 4.6) years), who experienced at least one pregnancy loss. Patients were recruited from 6 academic centers (Poznań, Białystok, Lublin, Wrocław Bydgoszcz, Gdańsk), and were divided into the following groups: 122 patients with 3 episodes of early recurrent pregnancy loss (group 1), 87 patients with late pregnancy loss (group 2) and 46 patients with intrauterine pregnancy loss (group 3). Patients who did not fulfill the above inclusion criteria were divided into additional groups. 50 healthy women (mean age of 29.2 (+/- 4.5) years), having at least one child, constituted the control group. Factor V Leiden mutation and prothrombin G20210A gene mutation were examined in all 396 women with pregnancy loss and 50 controls. For molecular analysis peripheral blood was tested. Genome DNA isolation from lymphocyte was performed with commercial assay QIAampDNA Blood Mini Kit. RESULTS Among 396 women with unexplained loss of at least one pregnancy 36 (9.1%) were carriers of inherited thrombophilia. Factor V Leiden mutation was present in 29 women (73%), prothrombin gene mutation G20210A in 6 (1.5%) and in 1 (0.3%) patient both mutations were detected. No coagulation defects were found in the control group. Factor V Leiden mutations was the most common disorder (21.7%) in patients with intrauterine demise and was significantly higher than in the group of women with early recurrent and late losses, p<0.011 and p<0,006 respectively The frequency of G20210 A prothrombin gene mutation did not differ substantially between the examined groups; the highest number (2.6%) was found in women with early and late pregnancy losses, and the lowest number (0.8%) was seen in women with early recurrent miscarriages. CONCLUSION Factor V Leiden screening should be performed, regardless of negative history of thrombosis, in patients who experienced intrauterine fetal demise or recurrent early miscarriages.
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Affiliation(s)
- Jana Skrzypczak
- Klinika Rozrodczości, Katedry Ginekologii, Połoznictwa i Ginekologii Onkologicznej Uniwersytetu Medycznego w Poznaniu, Polska.
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