[Intrapartum prophylaxis against group B Streptococcus infection--own experience]. / Sródporodowa profilaktyka zakazefn paciorkowcami grupy B--doswiadczenia wlasne.

INTRODUCTION: Group B Streptococcus (GBS) infection is a leading cause of neonatal complications. OBJECTIVES: The aim of the following work was to assess the efficacy of the intrapartum antibiotic prophylaxis (IAP) of the GBS infection, together with the diagnostic and therapeutic management of the newborn, based on the type and frequency of neonatal complications in the children of GBS carriers. MATERIAL AND METHODS: 2212 patients, who gave birth at the 1st Department of Obstetrics and Gynecology Medical University of Warsaw, between January 2007 and March 2008, were included in the study. In accordance with current recommendations, all patients were screened for GBS colonization and carriers were qualified for IAR In the end, the study group consisted of 250 GBS-positive parturients and their children (253). Retrospective analysis of the chosen variables and statistical analysis were performed. RESULTS: GBS colonization rate in the studied population reached 11.4%. 199 parturients were qualified for IAP (79.56% of 250 women). Optimal chemoprophylaxis was administered in 87.9% of GBS carriers. Intrauterine infection was diagnosed in 13.04% of 253 newborns. In 2 cases (0.8%) GBS was the etiological factor of the infection. The neonatal infection rate was significantly lower among children of GBS-positive mothers who received IAP in comparison to those not qualified for prophylaxis (11.05% vs. 21.56%; p = 0.036). The rate of intrauterine infection was also lower among newborns of mothers who had received prophylaxis with ampicillin in comparison to macrolides administration (8.2% vs. 37.5%; p = 0.001). CONCLUSIONS: Optimal intrapartum antibiotic prophylaxis of GBS infection in carriers does not eliminate GBS-related neonatal complications. Intrapartum penicillin administration seems to be more efficient than macrolides administration in GBS infection prophylaxis.

The polymorphism in insulin receptor substrate-1 gene and birth weight in neonates at term.

BACKGROUND: The mutation of the IRS-1 gene is one of the genetic risk factors which, it is speculated, is associated with insulin resistance or predisposition to type 2 diabetes. The aim of our study was to evaluate the association between the Gly972Arg polymorphism in the IRS-1 gene and birth weight in newborn children with adequate gestational age. MATERIAL AND METHODS: 100 newborn children with adequate gestational age (38-42 weeks), whose mother had no disorders during pregnancy, were studied. Genomic DNA was extracted from umbilical cord blood leukocytes, and Gly972Arg polymorphism in the IRS-1 gene was genotyped using the PCR-based method. RESULTS: Birth weight was significantly lower in the newborn with the IRS-1 Gly972Arg polymorphism compared with a control group (3161.75 +/- 380.86 g vs. 3427.92 +/- 468.86 g). Body length and head circumference at birth were also lower in the neonates with that polymorphism (54.38 +/- 3.13 cm vs. 52.69 +/- 2.91 cm, and 34.08 +/- 1.47 vs. 33.63 +/- 0.81, respectively). CONCLUSIONS: The results suggest that the Gly972Arg genotype is associated with lower birth weight, body length and head circumference in neonates with adequate gestational age.

Decreased human milk concentration of epidermal growth factor after preterm delivery of intrauterine growth-restricted newborns.

BACKGROUND AND AIM: The aim of the study was to compare epidermal growth factor (EGF) concentration in 81 colostrum samples collected from mothers of newborns in the following growth categories: preterm appropriate for gestational age (AGA), preterm small for gestational age (SGA), and full term (FT). RESULTS: Significantly higher concentrations of EGF were found in the colostrum of mothers who delivered premature AGA infants at less than 32 weeks of gestation compared with mothers who delivered premature SGA babies at the same gestational age. CONCLUSIONS: We concluded that the maternal compensatory mechanism accelerating the development of immature breast-fed infants may be disturbed when gestation is complicated by intrauterine growth retardation.

[Mediastinal tumor as a cause of fetal hydrops]. / Guz sródpiersia przyczyna uogólnionego obrzeku plodu.

Unusual case of fetal hydrops was presented. In a stillborn infant an Rh incompatibility was suspected as a cause of hydrops, although prentally an immunologic source of the illness was excluded. Post-mortem a large polycystic mediastinal teratoma with cardiac and pulmonary hypoplasia was stated as a main cause of the hydrops. Additionally, histopathological examination proved this diagnosis. The mediastinal tissue contained immature epithelial, mesenchymal and blastemal elements. The congenital teratomas should be taken for account in problematic diagnosis of complicated cases.