[Reproductive problems in women with PCOS, the impact of PAL-1 CARRIERS OF 4G PAI -1 polymorphism and BMI].

Approximately 7-12% of women in reproductive age are affected by PCOS[2] and 40 to 70 percent of them are overweight contributing to the clinical picture of PCOS and increased reproductive and metabolic disorder. In order to investigate the role of PAl-1 as a possible risk factor for the development of PCOS a group of 67 women with polycystic ovarian disease and 70 healthy controls were investigated for levels of PAI-1 and carriage of the promoter polymorphism 675 4G/5G in gene of PAl-1. The results of the DNA analysis showed a high carriage of polymorphism 675 4G/4G in promoter of PAI-1 gene in women with PCOS but not as significant (OR = 1.6645, p = 0.141). Serum levels of PAI-1 were significantly higher in total group of patients compared to controls. The levels of PAI-1 is correlated with carriage of 675 4G/5G polymorphism in the gene for PAI-1 (R = 0.534, p = 0.03) as well as wih BMI, like correlation coefficients were higher in the group with PCOS (0.572, p = 0.04). Data from the disease history showed a higher percentage of women with reproductive problems: 61.5% (early pregnancy loss and infertility) significantly higher in the group with PCOS (70.1% compared to 54.1%). The carriers of polymorphism 4G are at greater risk for early pregnancy loss than those with 5G (61.45% as compared to 36.8%), which confirms that carriage of the polymorphism 4G/5G 675 gene PAI-1 has a specific in multifactorial pathogenesis and expression of PCOS.

[Reproductive problems in women with PCOS, the impact of PAI-1 carriers of 4G PAI-1 polymorphism and BMI].

Approximately 7-12% of women in reproductive age are affected by PCOS[2] and 40 to 70 percent of them are overweight contributing to the clinical picture of PCOS and increased reproductive and metabolic disorder. In order to investigate the role of PAl-1 as a possible risk factor for the development of PCOS a group of 67 women with polycystic ovarian disease and 70 healthy controls were investigated for levels of PAl-1 and carriage of the promoter polymorphism 675 4G/5G in gene of PAI-1. The correlation with BMI was checked. The results of the DNA analysis showed a high carriage of polymorphism 675 4G/4G in promoter of PAl-1 gene in women with PCOS but not significant (OR = 1.655; p = 0.141), as well in the total group of the patient (OR =1.474; p>0.05). Serum levels of PAI-1 were significantly higher in total group of patients compared to controls. The levels of PAI-1 is correlated with carriage of 675 4G/5G polymorphism in the gene for PAI-1 (r=0.534; p=0.03) as well as with BMI, like correlation coefficients were higherin the group with PCOS (0.572; p=0.04). Data from the disease history showed a higher percentage of women with reproductive problems: early pregnancy loss 48.5% and infertility 23.2%, significantly higher in the group with PCOS (58.1% compared to 32.4%). The carriers of polymorphism 4G are at greater risk for early pregnancy loss than those with 5G (61.45% as compared to 36.8%), which confirms that carriage of the polymorphism 4G/5G 675 gene PAl-1 has a specific in multifactorial pathogenesis and expression of PCOS.

[Sclerosing stromal ovarial tumor--a case report and review].

Sclerosing stromal tumor (SST) is a rare benign ovarian neoplasm of stromal origin with less than 100 cases reported in the literature. Unlike the other stromal tumors, the comas and fibromas, which tend to occur in the fifth and sixth decades, sclerosing stromal tumors predominantly affect females in the second and third decades. Several unique histologic features including pseudolobulation, sclerosis and prominent vascularity of the tumor are clearly reflected at ultrasonography. We present a case of SST of the ovary in a 26-year-old female, and describe the ultrasound findings with pathologic correlation.

[For and against non-obstetrical indications for cesarean section]. / Za i protiv neakysherskite indikatsii za sectio caesarea.

The authors have made a retrospective study on the nonobstetrical indications for SC from 1996-2000 year, with the help of special documents belonging to VMI, Obstetric Clinic, Pleven. There have been 10,465 deliveries in the same period, 1096 with SC (10.47%). The main indications in 56 cases (5.11%) were non-obstetrical complications of pregnancy and delivery. The most frequent non-obstetrical indications were: ophthalmological in 18 (32.14%), orthopedical in 10 (17.86%), cases CNS diseases in 5 (8.93%) and cancer in 3 (5.36%). We have included: Condylomata accuminata--5 (8.93%), acute thrombophlebitis and thromboembolic diseases--5 (8.93%), a condition after plastic repairs of the perineum, virgin and vulvae--3 (5.36%). Special interest was taken on another group of patients with some rare diseases about the other specialist recommended SC. The ovarian age of the patients was 20-29 years--in 36 (64.28%). The SC has been performed in 30 cases (53.57%) in the first stage, in 14 (25.00%) in the second stage of delivery and in 12 (21.43%) cases was emergency. The conclusions of the authors is that the Obstetricians, who manage the delivery, may not always been comparted with that of the other specialist. This comes from the fact that the responsibility is mainly for him.

[The effect of tobacco smoking on maternal weight gain and the neonatal results]. / Vliianie na tiutiunopusheneto vurkhu maichinoto naddavane na teglo i neonatalnite rezultati.

UNLABELLED: Our aim was to investigate the effects of smoking till term on maternal weight increase and on the foetus after delivery. The study is prospective and includes a group of 238 pregnant smokers consulted at the Antenatal clinics of the 3rd county polyclinic, Pleven. 115 of them smoked regularly until term at least 5 cigarettes weekly (48.32%), while 123 stopped smoking prenatally (45.9%). Utilizing a special test these two groups were compared based on their pre-delivery weight and the weight of their foetuses. RESULTS: The women who stopped smoking increased in weight with 16.6 kgs (SD-14.5), while those who smoked till term thrived with 13.2 kgs (SD-11.7) (Pt 0.001). This greater increase in maternal weight is connected with a 3.1 times more frequent delivery of babies weighing more than 4000 gr. All neonates with LBW were in the group of smokers, as well as those with foetal demise (perinatal deaths = 12.76%. CONCLUSION: In the studied group stoppage of smoking is connected with less risk of inadequate increase of weight, LBW and their foetuses more frequently weigh more than 4000 gr.

[The Materna preparation as an agent for iron prophylaxis and treatment in pregnancy disorders]. / Preparatut "Materna" kato sredstvo za zheliazoprofilaktika i lechenie na niakoi narusheniia prez bremennostta.

Quality proteins, salts and minerals are necessary for the well development of the foetus and the pregnant woman, one of the ways of supplementing or supplying these is via multivitamins. One of these is Materna, a preparation of 21 vitamins, minerals in a well-balanced formula. We used Materna for ferroprophylaxis during pregnancy recorded ist effects on the subjective feelings of the patients. This type of prophylaxis was used on 46 patients divided into 3 groups depending on the gestational week, in which the prophylaxis was commenced. We measured hemoglobin, hematocrit and serum iron concentration before++, during and after ingestion of Materna. We found a good effect of the preparation on the subjective feelings of the patients and also an effective ferroprophylaxis. We also discovered that for an effective ferroprophylaxis a long and intermittent use of the preparation is necessary in all and not some pregnancies. The authors believe that pending the current conditions in our country supplementary therapy with preparations such as Materna is essential.