[Socio-demographic characteristics and vitamin D status in women born before 32 weeks'].

UNLABELLED: Deficiency of vitamin D (25-OHD) is a health problem among prematurely born women and their newborns independently of the geographical location of the country. OBJECTIVES: To study serum levels of vitamin D in patients born before 32 weeks and their newborns at birth. To analyse the socio-demographic factors, complications of pregnancy and their relationship with vitamin D status of women. PATIENTS AND METHODS: The study has been carried out in the University hospital "Maichin dom" Sofia for the period August 2013-January 2014. 35 women who gave birth before 32 gestational week and their 41 newborns with birth weight < 1500g have been investigated. The serum level of vitamin D (25-OH D) in mother-infant pairs at birth and 8 weeks of age in infants has been investigated. The ECLIA method has been used. Serum levels of vit D (25-OHD) have been estimated as sufficient:(> 30 ng/ml), insufficient (21-29ng/ml) and deficient (< 20 ng/ml). RESULTS: At delivery according to their vit D (25- OHD) serum levels 63% of the mothers are defficient /12.61 ± 4.8 ng/ml/, 28.5% are insufficient/26.66 ± 2.59/and only 8.5%/40.4 ± 8.48/sufficient with normal levels of vitamin D. For newborns data are respectively 32%/ 20.08 ± 3.69/-deficient, 49%/27.39 ± 2.70/- insufficient and 19 %- sufficient/41.6 + 10/ There is a positive correlation between mother's and children's serum levels of vitamin D (25- OHD). Statistical significant differences are observed in the levels of vitamin D and the presence of infection and preeclampsia in the mothers. During the period of the study there were no seasonal variations in vit D (25-OHD) serum levels of mother-baby pairs. All newborns received Vit D3 1334 IU/daily from 20th day of age. At eight weeks of age sufficient levels of vitamin D have 70% of the children, but 30% of the newborns remains with inadequate supplementation/27.09 ng/ml/. CONCLUSION: 91.5% of mothers are with insufficient serum levels of vitamin D (25OHD) at birth, and a deficit is present in 63% of all women. Only in 8.5% of the women had normal values. This implies more effective monitoring and vitamin D prophylaxis during pregnancy.

[Nonspecific immunomodulation in obstetrics and gynecology with Ecomer preliminary report].

UNLABELLED: The article gives a brief description of "Ecomer", preparation containing shark liver oil. Main immunoactive ingredient of the shark liver oil are the alkylglycerols. The main characteristics of alkylglycerols are noted together with their mechanism of action. There is also a list of indications for Ecomer administration. There is a summary of the authors' experience with Ecomer, its efficacy in ObGyn being the main aim of this study. METHODS AND MATERIALS: For the purpose of the study Ecomer is given to two main groups of patients: I-pregnant women between 27 and 36 weeks of gestation having two subgroups: 1--with 8 women with naso-pharyngeal complaints and 2--with 13 patients with urinary tract complaints, suggestive of cysto-pyelitic disorders and II main group of patients operated for cervical cancer in different stages with two subgroups--1 with 17 patients with Ecomer intake started at the beginning of the radiation therapy, and 2 with 6 patients who began taking Ecomer before the beginning of the radiation therapy, after having a histologically proved diagnose. The I group took two capsules of Ecomer three times a day for 15 days or less if asymptomatic earlier; in the II group Ecomer was taken two capsules three times a day for 2 months, then one capsule three times a day for a month, followed by a repetition of the scheme. RESULTS: In the pregnant women group, improvement was noticed in 75% in the first subgroup and in 76% in the second subgroup. In the second main group the interpretation of results is hindered by the insufficient time interval. Nevertheless, fewer side effects of the radiation therapy was noticed in both groups. Improvement in the survival rate is yet to be followed up. CONCLUSIONS: Administration of Ecomer in pregnant women with naso-pharyngeal problems led to improvement in their general condition and less frequent need to prescribe antibiotics. In pregnant women with urinary tract problems, Ecomer resulted in easing the pain faster and lowered the recurrence risk. In women with cervical cancer, the treatment is quite aggressive and the opportunity to diminish the side effects by administration of a natural and harmless preparation should not be omitted.

[Vitamin D levels in maternal--VLBW infants pairs].

UNLABELLED: Normal foetal growth depends on sufficient mother's vit D intake. Premature birth interrupts vit D and mineral mother-to-foetus transfer and leads to vit D deficiency and disturbs newborn mineral bone metabolism. OBJECTIVES: To determine vit. D plasma levels in mothers and their very low birth weight- (VLBW) newborns and the prevalence of vit D deficiency in this population, to investigate seasonal variation and analyse babies' vit D levels from birth to the 8 postnatal week. PATIENTS AND METHODS: The study has been carried out in the University hospital "Maichin dom" Sofia for the period 09.2011-01.2012 and there have been investigated 32 women and their 39 VLBW infants as a target group. 25-OHD level has been measured in maternal and newborn cord blood samples. The ECLIA method has been used. 25-OHD level has been tested second time at eight weeks of age in 34 infants. According to the maternal vit D levels the patients have been divided into 3 groups: Group. 1--vit D reference range level (> 30 ng/ml); Group. 2--vit D insufficiency (21-29 ng/ml), Group. 3--vit D deficiency (< 20 ng/ml). RESULTS: Low Vit. D levels have been estimated in 62.5% of mothers' group. Nevertheless, only 38.6% of all babies have been Vit. D deficient. In 61.4% of them vit D has been in normal range (32.4-35.7 ng/ml). A significant positive correlation between maternal and infants' vit D level at birth has been established (r = 0.516; p = 0.002). There have been found a significant seasonal dependence of vit D level at birth in the group too: vit D plasma levels have been estimated higher in September-October group compared to those in November-January group. Most of the blood samples in winter months showed lower vit. D levels than the autumn group. At 8 weeks of age 67.6% of the babies have been with vit D insufficiency. There has been a significant positive correlation between 25-OHD levels at birth and at weeks (r = 0.425; p = 0.012). CONCLUSION: Vit. D insufficiency has been found in 62.5% of the mothers at birth. Maternal vit. D deficiency is a significant risk factor for neonatal vit D deficiency. There is a clear seasonal dependency with a significantly lower 25-OHD level in the mothers and their VLBW babies in winter months.

[Fetal meconium pseudocyst secondary to in utero perforation of colon transversum and meconium peritonitis].

Fetal bowel intrauterine perforation causes sterile inflammation of the peritoneum, known as meconium peritonitis. In some cases the perforation closes spontaneously, thus forming a meconium pseudocyst between the intestinal loops and the omentum. Meconium peritonitis, complicated by pseudocyst formation, should always be considered when a fetal abdominal mass with diverse echogenicity and hyperechogenic calcifications is observed on prenatal ultrasound. Usually, this is associated with ascites and/or polyhydramnios. The differential diagnosis necessitates exclusion of all other fetal abdominal tumors. We present a case report of meconium pseudocyst diagnosed prenatally at 32 weeks of gestation which was successfully treated by surgery after birth.

[Antenatal ambroxol administration for prevention of respiratopry distress syndrome in preterm infants: preliminary report].

UNLABELLED: The rate of preterm births has remained unchanged for the recent years despite of the persistent attempts to diminish it. Preterm births are responsible for about 70% of neonatal morbidity and mortality. One of the main problems of preterm newborns is their lung immaturity. The aim of this study is to assess the effect of Ambroxol, given prenatally on the rate and severity of neonatal respiratory distress syndrome (NRDS) in preterm infants and its potential to replace the corticosteroid prophylaxis in cases where steroids are contraindicated or undesirable. MATERIALS AND METHODS: The trial consisted of 33 pregnant women between 27 and 32 week of gestation. 17 of them represented our work group and were given Ambroxol syrup 15 mg/ml, per os 30 ml in three intakes, for 7 days. 16 were controls and were not given any kind of NRDS prophylaxis. RESULTS: severe NRDS was diagnosed in 2.5 times more cases in the control group compared to the work group. All infants in the control group had clinical signs of NRDS, while 23.5% of the infants in the work group were asymptomatic. Bronchopulmonary dysplasia was diagnosed in 25% of the infants in the control group, compared to none diagnosed in the work group. Newborns with no antenatal NRDS prophylaxis had to be kept in intensive care units for an average period of time twice longer than the newborns to mothers who had received Ambroxol. CONCLUSIONS: Antenatal Ambroxol administration diminishes the rate of NRDS, decreases the duration, scope and price of the intensive care, lessens the duration of assisted ventilation and oxygen needs and hence improves the long-term outcome. Ambroxol and steroids have cumulative effect on fetal lung maturation and therefore should both be a part of the preterm delivery therapeutic scheme.