[Terminated pregnancy following prenatal diagnosis of congenital anomalies--a part of register of congenital anomalies].

UNLABELLED: The most of European registries of congenital anomalies (CA) collected information of CA in livebirths, stillbirths and terminated pregnancies following prenatal/ultrasound diagnosis. OBJECTIVES: to assess terminated pregnancies after prenatal/ ultrasound diagnosis of CA as a part of register of CA performed in University Hospital-Pleven. Among 21 202 births monitored during the study period (1996-2005), 679 CA were detected. The total prevalence of CA was 32/ 1000 births. The outcome of pregnancy for all cases of selected CA by register was 620 livebirths (91.3%), 36 stillbirths (5.3%), 23 terminated pregnancies (TP) (3.4%). The percentage of pregnancy termination was higher in the case of isolated anomalies, mainly lethal and CA associated with a low survival rate (61%), than with multiple ones. The most common CA detected after prenatal/ ultrasound diagnosis were neural tube defects (NTD) - the main reason for TP (52% of cases). The low proportion of these CA in TP (1/3) compared to their proportion in livebirths (50%) demonstrated an insufficiency of prenatal diagnosis of NTD as a part of register of CA performed in University Hospital-Pleven. Prenatal diagnosis of CA allows an early genetic counseling of mother presenting information on neonatal prognosis and recurrence risk for subsequent pregnancies. It helps family to take an adequate decision for termination of pregnancy with bad prognosis about heavy fetal CA.

[Treatment of tubal pregnancy with methotrexate in gynecological clinic of MBAL-Pleven during five year period].

The authors presented a short survey for application of Methotrexate for treatment of intact ectopic pregnancy and its usage in Gynecological clinic of MBAL-Pleven during the last five years. There was made a prospective study, and for the studied five years' period in the clinic there were treated 149 women with ectopic pregnancy, 33 of which were hospitalized with intact tubal pregnancy. Methotrexate was used by plan for 6 patients as for 3 of them the treatment was successful. The authors also described two of these cases according to the diagnosis, way and usage period of the cytostatic and the result from the disorder. In conclusion there was emphasized that the treatment of intact tubal pregnancy with Methotrexate has a place in gynecological practice in view of the fact that it decreased physical pain, psycho-emotional stress and bed staying of the patient, but the cases must be strongly selected.

[Laparoscopic fenestration of the ovaries in sterility and the Stein-Leventhal syndrome--is it a modern fad or correct procedure]. / Laparoskopsa fenestratsiia na iaichnitsite pri sterilitet i sindrom na Stein-Leventhal--moderno uvlechenie ili pravilna taktika.

The treatment of the sterility due to the Stein-Leventhal syndrome has been always object of many discussions. Sometimes, the approach towards this disease in the different departments is diametrically different. Some offer only conservative therapy other-only surgical interventions and some-combination between the two. The authors of this study present the results of operative laparoscopy in the treatment of sterility and polycystic ovary syndrome, in the department of gynaecology to the Higher Medical Institute, Pleven. Object of observation were 33 women in whom was performed laparoscopic fenestration of the ovaries and 20 women in whom was made resectio cuneiformis ovariorum. Comparative analysis of the results for one year period after the surgical interventions was made. The conclusion of the authors is that after failure of the conservative approach, the laparoscopic fenestration of the ovaries remains the only right therapeutic intervention.