[Cervical pregnancy--conservative treatment; case report]. / Próba zachowawczego leczenia ciazy szyjkowej--opis przypadku.

Cervical pregnancy is a rare form of ectopic pregnancy. This disorder appears with frequency 1 to 10 cases of ectopic pregnancy. For the sake of high risk of unexpected massive haemorrhage from cervical vessels, the cervical pregnancy is a life threatening state. Total hysterectomy was the only one method applied in this case recently. Since this procedure led to infertility, many clinical centers try to apply conservative treatment in nowadays. Haemostasis after evacuation of fetus from the cervix and early diagnosis of cervical pregnancy are the key to success of conservative treatment. In our study we present case of 24 years old woman with diagnosed early cervical pregnancy and subjected to conservative treatment.

[Fetal pulmonary artery blood flow depending on fetal lung maturity]. / Analiza przeplywu krwi w tetnicy plucnej w zaleznosci od stopnia dojrzalosci pluc plodu.

The ultrasonographic assessment of fetal lung maturity by evaluating the elasticity of lung tissue, Dynamic Lung Score (DLS) has been being performed since 1986 in ObGyn Department in Tychy (Medical University of Silesia). The lung elasticity is evaluated on the cross sections of fetal thorax, on the level of heart ventricles. The result of the evaluation is given as the three degree scale, in which I degree indicates the lack of elasticity and fetal lung immaturity, II degrees indicates partially expressed elasticity, corresponding with incomplete maturity of lung tissue, and III degrees represents full elasticity and indicates complete maturity of fetal lungs. This study was designed to compare fetal pulmonary artery blood flow with the maturity of fetal lung tissue evaluated during the ultrasonographic assessment of fetal lung tissue elasticity. The examination was performed on pregnant women, beginning on 27th week gestation. During the examination the mean Pulsatility Index was decreased, particularly in fetuses with II degrees lung maturity. The Resistance Index (RI) was found to be stable and independent of gestational age. In the group with I degree lung maturity (DLS I), the mean PI = 2.643 (+/- 0.229), mean RI = 0.879 (+/- 0.036), in DLS II group PI = 2.039 (+/- 0.262), RI = 0.868 (+/- 0.037), and in DLS III group PI = 2,500 (+/- 0.100), RI = 0.900 (+/- 0.100). Comparing the ultrasonographic evaluation of fetal lung maturity with fetal pulmonary artery blood flow allows more accurate assessment of fetal lung maturity. Fetal lung maturity can not be evaluated univocally on the basis of blood flow assessment. Because of the divergence of blood flow parameters further studies including bigger population seem to be necessary for verification of the results and for establishing the reference values.

[Usefulness of selected ultrasonographic methods for evaluation of fetal weight in twins]. / Przydatnosc wybranych metod ultrasonograficznych w ocenie masy ciala plodów blizniaczych.

Evaluation of three mathematical methods, based on ultrasound examination, in order to estimate foetal weight in twins and compare them with actual birth weight. Retrospective analysis of ultrasonicly assessed 27 pairs of twin babies, who were born within 10 day of ultrasound examination and then outcome's comparison with newborn weight, measured just after the delivery. The ultrasonic measurements were performed to calculate estimated foetal weight using mathematical models of Shepard, McCallum and Hadlock. All outcomes were compared to birth weight. Statistical analysis, employed in our research, was percentage error according to formula: % = (EFW - BW) x 100/EFW (EFW - estimated foetal weight, BW - birth weight). The mean foetal weight calculated according to Shepard's method was 2605.9 g and 2651.6 g, relatively for the first (I) and second (II) twin baby. By using McCallum's method outcomes were as follows: (I) -2558.4 g (II) -2655.4 g and for Hadlock's method: (I) -2480.9 g and (II) -2540.3 g. Actual birth weight came to 2664.1 g for (I) and 2639.6 g for (II). Percentage error was found -2.23, using Shepard's method, -4.13, using McCallum's method and -7.38, using Hadlock's method, for the first twin-baby. Relatively, for the second twin-baby, values were found as follows: 0.45, 0.59, -3.91. Shepard's method is the most helpful in prediction of birth weight in twin pregnancy. Separate evaluation of each of twin babies can be more significant indicator in prognosis of appearance in intrauterine growth retardation (IUGR), comparatively to evaluation of weight's discordance between both twin-foetuses.