[Dosage of acetylsalicylic acid in the prevention and therapy of intrauterine growth retardation]. / Dávkování kyseliny acetylsalicylové v prevenci a terapii nitrodelozní rustové retardace.

The authors recommend, based on their own experience, an optimal dose of acetylsalicylic acid in treatment of IUGR. The therapeutic effect was not proved conclusively and views are controversial. Based on a retrospective group from the years 1993, 1994 and 1995 the authors assume that treatment of IUGR by acetylsalicylic acid is indicated and they recommend a dose of 100 mg per day (e.g. one tablet of Anopyrin).

[Intrauterine growth retardation of the fetus and the pregnancy]. / Nitrodelozní rustová retardace plodu a tehotenství.

IUGR (intrauterine growth retardation) is a serious complication of pregnancy. The author compared in the submitted paper different diagnostic and therapeutic possibilities in a six-year retrospective group of 181 hypotrophic foetuses. Based on the results he emphasizes the necessity of magnesiotherapy and prevention of IUGR by acylpyrin. It is impossible to monitor and treat adequately a pregnant woman with a hypotrophic foetus without Doppler sonography. Combination of indexes from various areas (brain, umbilicus) is useful. Even the somewhat obsolete method of assessment of estriol in the urine of pregnant women should not be refuted. Even during the present period of transformation of health services IUGR therapy under ambulatory conditions is not recommended. The author emphasizes the comprehensive character of evaluation of all diagnostic methods for the detection of IUGR.

[Klimonorm and precanceroses of the endometrium]. / Klimonorm a prekancerózy endometria.

In the prospective study the authors administered for one year the preparation Klimonorm (Jenapharm) to 90 women divided into three groups. Of 90 patients at the onset 30 women suffered from precancerous endometriosis confirmed by histological and cytological examination. The remaining 60--half with and half without menstrual bleeding--all had climacteric complaints. The authors evaluated by statistical methods various parameters, in particular Kuppermann's index, the thickness of the endometrial mucosa in the uterine cavity by ultrasound, the oncological endometrial cytology by a cytobrush and subsequent lavage of the uterine cavity during 4 check-up examinations after three-month intervals. At the onset of the investigation and after one year the hormonal serum levels (FSH, LH, 17-beta oestradiol) were assessed and in the patients with precancerous conditions also the histology of the endometrium. The results are promising, in particular the significant drop of Kuppermann's index already after three months to one third of the baseline value in all three groups of patients; complete reversal to the negative side as regards the cytological finding on the endometrium, correlating with the histological finding; unaltered body weight; change of the thickness of the endometrium in the group of precanceroses to more favourable values. Based on these results the authors hold the view that hormonal therapy (oestrogen-gestagen) in the climacteric and in endometrial precanceroses is fully justified. Klimonorm (Jenapharm) proved a very useful preparation as the patients' subjective complaints improved and also with regard to the favourable effect on endometrial precanceroses which can be monitored without active abrasion only by a cytobrush.

[Lateral pathologic flow in the uterine artery in the 3rd trimester of pregnancy and the fetal status]. / Lateralizovaný patologický prutok v a. uterina ve III. trimestru gravidity a stav plodu.

From a total of 2,312 Doppler examinations made in 1992 at the Gynaecological Department of the University Clinic in Zürich in 34 patients in the 3rd trimester of pregnancy a lateralized pathological blood flow in the uterine artery on the non-placental side was found. As a control group the authors selected a group of 34 patients comparable as to age, gestation period, time when the Doppler examination was made and the type of delivery. The results of the investigation are not statistically significant in view of the low percentage incidence of lateralized pathology, however, it may be stated that the finding may be the first symptom of incipient foetal hypoxia.

[An unusual tumor of the oral cavity in a fetus and prenatal ultrasonography--case report]. / Neobvyklý tumor ústní dutiny plodu a prenatální ultrasonografie--kazuistika.

OBJECTIVE: The tumours and pseudotumours of the foetal face are very rare diseases. Basic method for their prenatal diagnosis is ultrasound. The authors describe the case of diagnosed orofacial pseudotumour--sublingual cyst. DESIGN: Case report introduces some rules for ultrasound investigation of foetal face. SETTING: Department of Clinical Genetics and Foetal Medicine, University Hospital Olomouc. SUBJECT AND METHOD: The cyst of oral cavity was diagnosed by ultrasound in second trimester of gestation. It was repeatedly punctured during pregnancy and the content was cytologically examined. Exstirpation was performed after delivery. Histological etiology--dysontogenetic cyst--was established. CONCLUSION: Prenatal ultrasonographical diagnosis of the oral pseudotumour was completed by puncture procedures. This invasive way verifies anatomical conditions, enables histological investigation and warrants the swallowing act which is the prevention of polyhydramnion.

[Preinduction priming of the cervix. Comparison of the intracervical administration of PGE2 gel and vaginal administration of estradiol]. / Preindukcní zrání cípku. Srovnání intracervikální aplikace PGE2 gelu s vaginální aplikací estradiolu.

During the period between Jan.1, 1994 and May 31, 1996 at the Second Department of Gynaecology and Obstetrics in Brno preinduction was performed in 40 patients by means of PGE2 gel (Prepidil Upjohn) and in 38 patients by means of an estradiol gel (Biotika). The inclusion criteria in the group were: singleton pregnancy, 38 or more weeks of gestation, cephalic presentation, unripe cervix (Bishop score less than 5) and reactive NST. The gel was introduced into the cervical canal and left in situ for 12 hours. If maturation of the cervix occurred, induction was implemented by extraamnial administration of PGE2. In the group of patients preinduced with Prepidil there was a significantly greater increase of Bishop score and the first stage of labour was shorter during subsequent induction of delivery. As to other investigated parameters, the two methods did not differ significantly.

[Anti-anemia therapy with prophylactic administration of Fe2+ in normal pregnancy and its effect on prepartum hematologic parameters in the mother and neonate]. / Antianemická lécba fyziologických tehotných a její vliv na prepartální hematologické parametry matky a novorozence profylaktickým podáním Fe2+.

Eighty-four non-anaemic pregnant women were treated, starting between the 20th-24th week of Pregnancy, with Actiferrin Compositum--1 capsule per day--from the 36th with 2 capsules per day up to childbirth. The group was compared with the results in 57 non-anaemic not treated pregnant women. Haematological parameters were recorded before the onset of treatment, during the first stage of labour and in neonates on the first day after delivery. By means of the non-paired t-test no significant differences were disclosed between the groups; nevertheless the percentage values of haemoglobin, haematocrit, erythrocytes and serum iron were higher in the treated group, as compared with the non-treated one. Also the ferritin values in neonates of the non-treated group were lower, as compared with the treated group. The paired t-test was highly significant in the Actiferrin treated patients as regards haemoglobin, haematocrit and transferrin values. The results provide evidence that it is indicated to administer as a routine measure Actiferrin Compositum to all pregnant women as prevention of pre-partum anaemia of the mother and low ferritin levels in the neonate.

[New approaches in the treatment of hypotrophic fetuses]. / Nový prístup v terapii hypotrofického plodu.

Hypotrophy or intrauterine growth retardation of the foetus associated with placental insufficiency still remains a serious obstetric problem. In the submitted paper the authors compare hypotrophic foetuses treated in 1989 and 1990 at the authors' clinic by conventional methods only (biometry, bed rest, CTG oestriol, glucose and possibly heparin) with a group of hypotrophic foetuses treated in 1991 and 1992 with magnesium and where the therapeutic effect was followed up by Doppler flowmetry. Based on the results, the demand to improve placental insufficiency by pharmacological induction and stimulation of specific placental enzymes is met perfectly by concomitant parenteral and oral magnesium administration to pregnant women.

[Personal experience with labor induction using prostaglandins 1985-1987]. / Nase zkusenosti s indukcemi porodu prostanglandiny v letech 1985-1987.

The authors evaluate 56 Labors induced with Enzaprost and 141 with Prostin. The main indication for induction was a postdate pregnancy (33%), rupture of the amniotic sac 24 hours previously without contractions (24.5%) and a planned confinement (23%). An initial dose of 1 microgram of Enzaprost per min. was administered or 1 tablet of Prostin in increasing doses after 30 mins. up to three tablets. There were 87.5% successful Enzaprost inductions and 96.5% successful Prostin inductions. The difference is significant at the 5% level.

[Induction of cervix ripening with hydrophilic Dilapan rods in pregnancy at term]. / Induktion der Zervixreifung mit hydrophilen Dilapan -Stäbchen bei einer Terminschwangerschaft.

During the period between July 1, 1993 and July 31, 1994 the authors preinduced 52 pregnant women in term using the cervical dilatator Dilapan. The group comprised patients with single pregnancies > 38 weeks, vertex presentation, cervical score < 5 and reactive NST. They introduced into the cervical canal 4 Dilapan rods for 12-18 hours and after extraction of the rods, depending on the finding, the patients were induced with Prostaglandin e.a. or oxytocin i.v. The preinduction was successful in 46 patients (88.5 per cent), in 16 patients (30.8 per cent) uterine contractions were induced by Dilapan alone. Forceps delivery was performed 4 times (7.7 per cent) and Caesarean section 12 times (23.1 per cent). Apart from pain in the hypograstrium resembling menstruation pain, no side-effects were recorded. There were no irregularities such as the length of labour stages, blood loss due to injury during labour and the incidence of neonatal hypoxia. Based on the described experience Dilapan can be recommended as a preinduction method for maturation of the portio uteri.