[Anti-Mullerian hormone: a gonadal hormone with multiple diagnostics resources].

Anti-Mullerian hormone (AMH) is a gonadal hormone synthesized by granulose cells of the ovary and Sertoli cells of the testis. Anti-Mullerian hormone is used to facilitate the evaluation of intersex disorders and as a marker in some ovarian tumors or ovarian reserve assessment in the infertility cases. Serum levels of AMH hold objective information, which is useful in the clinical practice. Therefore it is necessary to decimate the normal and the abnormal levels of AMH.

[Prognostic value of some hormonal and ultrasound ovarian reserve tests]. / Prognostichni vuzmozhnosti na niakoi khormonalni i ultrazvukovi testove za otsenka na ovarialniia rezerv.

OBJECTIVE: To determine the predictive value of basal estradiol, FSH and inhibin B levels, antral follicle count and mean ovarian diameter of ovarian response in controlled ovarian hyperstimulation (COH), in outcome with normal FSH concentration in early follicular phase of menstrual cycle. MATERIALS AND METHODS: Twenty nine patients undergoing IVF treatment. Blood samples were collected and transvaginal ultrasound was performed on early follicular phase of unstimulated cycle. Controlled ovarian hyperstimulation (COH) was performed on the base of long protocol. RESULT(S): Mean women age and basal FSH levels were significantly higher in cancelled cycles than in the control group, whereas basal inhibin B, mean ovarian diameter and antral follicle count was significantly higher in the latter. Mean basal E2 concentration was similar in both groups. CONCLUSION(S): In women with normal basal FSH level the determination of E2 has no prognostic value of poor response outcome. However, inhibin B, antral follicles count and mean ovarian diameter tests when applied separately are with good prognostic values.

[Poor ovary response to the controlled ovarian hyperstimulation]. / Nezadovolitelen ovarialen otgovor (HOO) pri lechenie na sluchai chrez kontrolirana ovarialna khiperstimuliatsiia (COH).

One of the greatest challenges in clinical reproductive endocrinology is assessment of patients who respond badly to exogenous gonadotropins in controlled ovarian hyper stimulation (COH). Low response is a result of diminished ovarian reserve. Identifying potential low responders is of critical clinical importance. This paper will review varies form of "poor response" definition and a series of tests to analyses in order to discover a patient's ovarian functional reserve.

[Pregnancy, delivery and perinatal outcome in adolescent pregnancy]. / Bremennost, razhdane i perinatalen izkhod pri adolestsentni bremenni.

Retrospectively 398 adolescent primiparas have been analyzed in respect of the process of pregnancy, antenatal complications, mode of delivery and perinatal outcome. The researched contingent was divided into 2 age groups--up to 15 years and between 16-18 years. The results obtained were compared to a control group of 398 primiparas at the age of 20-24 years. The results indicate that the process of adolescent pregnancy is related to a substantially higher relative share of some complications like anemia, premature rupture of the membranes and preeclampsia. The frequency of pre-term labor has essentially increased. A basic model of birth-giving is the vaginal delivery, and the duration of delivery of the adolescent does not differ from that of the adult primiparas. There is not a significant difference between the adolescent and the adult pregnant in the placental and in the early puerperal period. An increased frequency of the fetal retardation is missing at the adolescent pregnancy.

[The use of cefotetan for the prevention of infectious postoperative complications in gynecology]. / Prilozhenie na tsefotetan za profilaktika na infektsioznite postoperativni uslozhneniia v ginekologiiata.

The study presents the results from the use of cefotetan for perioperative prophylaxis in 43 gynaecology patients compared with 29 controls without perioperative antibiotic prophylaxis with similar diseases and operations. Both groups show equal percentage of the cases with smooth postoperative period (70 and 72% respectively). 13 of the patients on cefotetan prophylaxis received additional antibiotic treatment (9 because of temperature up to 37.5 degrees and 4 because of temperature from 37.6 to 38.5 degrees). Mo major infections postoperative complications occurred among the patients on cefotetan prophylaxis. 8 of the non-prophylacted patients needed antibiotic treatment postoperatively including 4 with temperature above 38.5 degrees. Two infections of the operative wounds also occurred in the same group. The conclusion is that cefotetan effectively prevents the major infection postoperative complications in gynaecology. The administration of additional antibiotic treatment is most often not warranted.

[The ultrasonic diagnosis of an early abnormal pregnancy]. / Ultrazvukova diagnoza na ranna abnormalna bremennost.

During the period of January 1993 to February 1994, 70 pregnant women had an ultrasonic diagnosis of abnormal pregnancy. 111 ultrasound examinations were made--mean 1.6 of each woman. The ultrasonic diagnosis up to 70 women was: missed abortion--35 women (50%), blighted ovum--30 women (42.9%), other diagnosis--5 women (7.1%). Histological examination of material was made with 64 women (91.4%). Comparing the ultrasonic diagnosis to histological results, authors do not recommend a final diagnosis before eight gestation week.