Translation and cross-cultural adaptation of the Get Active Questionnaire for Pregnancy (kwestionariusz "Badz Aktywna w Ciazy") to support physical activity among pregnant women in Poland.

INTRODUCTION: Physical activity during pregnancy is established to derive clinically meaningful improvements in pregnancy, childbirth, and postpartum health outcomes. Evidence-based pre-screening tools have been developed to support the implementation of physical activity programmes, and enhance communication between health care providers, exercise professionals and pregnant women. The Get Active Questionnaire for Pregnancy (GAQ-P) and the Health Care Provider Consultation Form for Prenatal Physical Activity (HCPCF) empower pregnant women to identify whether they require additional counselling from their obstetric health care provider in terms of physical activity. However, these tools are not available in Polish. This work details the process taken to translate the GAQ-P and HCPCF into Polish. MATERIAL AND METHODS: We followed the translation process outlined by the Translation and Cultural Adaptation International Society for Pharmacoeconomics and Outcomes Research (ISPOR) guidelines between August 2022 and August 2023. We formed an expert group that included representatives of the Polish Society of Sports Medicine, The Polish Society of Gynaecologists and Obstetricians, practitioners, and scientists in physical activity during pregnancy. We implemented 9 of the 10 steps recommended by ISOPR in the translation process. At the Cognitive Debriefing stage, we collected opinions on the Polish version of GAQ-P and HCPCF from 70 stakeholders on the clarity and cultural appropriateness of the translation. RESULTS AND CONCLUSIONS: Target users have positively evaluated the Polish version of GAQ-P and HCPCF. Thanks to the ISPOR methodology, we obtained a trustworthy, evidence-based screening tools, which can reduce the barriers for most women to be physically active during pregnancy.

Serum S100B Protein Concentrations in SGA/FGR newborns.

OBJECTIVES: Fetal growth restriction is associated with chronic fetal hypoxia, poor perinatal outcome and increased perinatal mortality. There are no reliable methods to detect cell damage in the central nervous system (CNS) in these patients. The findings of increased an acidic calcium-binding protein (S100B) concentration in biological fluids of infants after brain injury have supported the use of S100B as a biochemical marker of CNS damage. The purpose of the study was to assess blood S100B concentrations in small for gestational age (SGA) and appropriate for gestational age (AGA) newborns and to evaluate the usefulness of S100B for early detection of hypoxia. MATERIAL AND METHODS: The investigation was carried out between November 2011 and April 2014. Serum S100B protein level was assessed in cord blood collected from newborns after birth. Medical records of mothers of neonates studied were reviewed for pregnancy induced hypertension (PIH), preeclampsia, maternal smoking during pregnancy and abnormalities in umbilical artery (UA) Doppler ultrasound examination. RESULTS: The study was carried out in 88 SGA neonates and 80 AGA neonates. The median value of S100B protein concentration in the SGA study group was significantly higher than in AGA controls (p < 0.001). Cord blood serum S100B concentration in SGA neonates with prenatal normal UA Doppler ultrasound findings (n = 32) did not differ from that SGA neonates with abnormal prenatal UA Doppler findings (n = 25) (p = 0.74), but was significantly higher than in AGA newborns (p < 0.001). CONCLUSIONS: Elevated S100B protein levels in cord blood collected from SGA newborns may be helpful in detecting infants at higher risk of postnatal neurologic disturbances at an early stage.

Use of alternative methods in the treatment of anemia in pregnant women - prospective observational study.

O BJECTIVES: Anemia in pregnant women is a common condition, diagnosed when the concentration of hemoglobin falls below 11 g/dL. Taking into consideration the accounts of nephrologists about good results of treatment of secondary anemia using erythropoietin in patients with renal failure, we tried to use EPO to cure anemia in pregnant women. The aim of the study was to evaluate the results of EPO treatment on pregnant women diagnosed with iron deficiency anemia, as well as possible side effects. MATERIAL AND METHODS: The study consisted of 25 patients: Group I - treated with iron supplement administered parenterally - Ferrum Lek every two days intramuscularly. Group II - treated with recombinant human erythropoietin - 1000 j intravenously every three days, with oral iron sup- plements. RESULTS: After a week of treatment the positive response was higher in the second group (92.3% in II, vs 33.3% in I, p < 0.005). The average increase of hemoglobin and RBC was significantly higher in II group. An increase in hemoglobin did not correlate with the age of women (r = 0.07) or with the duration of pregnancy (r = 0.08). However, a negative correlation was found between basic hemoglobin level and its increase after treatment (r = 0.602). CONCLUSIONS: EPO administered with the oral dose of iron in pregnant women with anemia caused by iron deficiency shows higher effectiveness than the use of iron preparations parenterally. The usage of EPO during pregnancy is not related to any dangerous side effects for the mother or fetus.

Evaluation of soluble concentration Fas and Fas ligand in maternal and cord blood 3rd trimester of pregnancy.

OBJECTIVES: The the study was to estimate the concentrations of antiapoptotic sFas and pro-apoptotic FasL in the serum of pregnant women in the third trimester of pregnancy and in the cord blood serum of neonates from vein and arteries separately. The correlation could be crucial for evaluation of apoptosis process intensity in placenta and the role of fetal blood circulation system on distribution of sFas and FasL. MATERIAL AND METHODS: The study group consisted of 28 pregnant women in physiological pregnancy, between 38- 41 weeks. Vein blood was taken from maternal elbow vein and umbilical cord, separately from vein and arteries. The research was done by sets for sFas and FasL from R&D Systems Elisa kit. RESULTS: In arterial and vein cord blood there were much more lower concentrations of sFas than in maternal blood-arterial cord blood 3351.78 pg/mL, vein cord blood 3351.78 pg/mL versus maternal blood 5769.62 pg/mL (p < 0.001). No differ-ence was found in sFas concentrations between cord arterial and vein blood sera. Statistical difference was found between mean concentration of Fas ligand in maternal blood serum (71.36 pg/mL) and arterial cord blood serum (164.57 pg/mL) p < 0.05 (p = 0.001). Cord arterial blood serum showed much higher concentrations of FasL than maternal blood serum. No difference was found between cord arterial and vein blood sera concentrations of FasL: 164.57 pg/mL vs. 170.00 pg/mL (p = 0.701). CONCLUSIONS: Obtained results suggest no influence of sFas and FasL production on fetal organism apoptosis. Lowering of sFas concentration in fetal blood could mean the increase of apoptosis in fetal organism compared to maternal. Higher concentration of FasL in cord blood than in mothers suggests higher apoptosis intensification in fetal circulation and no influence of blood flow across placenta on its concentration.

Evaluation of tissue metalloproteinase inhibitor TIMP-1 and Survivin levels during third trimester pregnancy - a preliminary report.

OBJECTIVES: A proper implantation of trophoblastic cells and an appropriate metalloproteinases activity is required to cause disintegration of basal membranes of cells. The activity of tissue matrix metaloproteinases can be inhibited by their matrix inhibitors - TIMP-s. Survivin is a member of inhibitor of apoptosis proteins family (IAP), that suppresses caspase activation, influences VEGF expression and promotes proliferative action of endothelial cells. MATERIAL AND METHODS: The aim of the study was to assess concentrations of two independent anti-apoptotic factors. TIMP-1 and survivin in serum of women in their third trimester of pregnancy and in umbilical cord blood of neonates - drawn separately from veins and arteries. The study group consisted of 29 pregnant women in physiological pregnancy and with correct fetal development, in gestational age between 37 to 40 weeks of gestation. Blood used in the study was collected from maternal cubital fossa veins and from neonatal umbilical cords (from veins and from arteries separately). The research was conducted using TIMP-1 and Survivin ELISA kits from R & D Systems according to manufacturers' recommendations and protocols. RESULTS: The concentrations of TIMP-1 were similar and independent of the source of blood samples. Arterial values of TIMP-1 in umbilical cord compared to maternal and fetal veins were slightly lower, but no statistical difference was found. The mean concentrations of Survivin were comparable but we found that in some cases the results in cord blood serum in both vessels-vein and arteries were almost negative. Arterial values of Survivin in umbilical cord compared to maternal blood were higher, but no statistical difference was found. CONCLUSIONS: In III-rd trimester of pregnancy parameters of Timp-1 and Survivin - anti-apoptotic substances concentration were similar in maternal and cord blood in both artery and vein. We found no increased activity of selected antiapoptotic factors.

Assessment of the frequency of genetic alterations (LOH/MSI) in patients with intraepithelial cervical lesions with HPV infection: a pilot study.

In the present study, we analyzed (1) the type of HPV infection and (2) the frequency of loss of heterozygosity and microsatellite imbalance (LOH/MSI) in normal cytology and cervical intraepithelial neoplasia (CIN1-3). The cytological material included: low-grade squamous intraepithelial lesions (CIN1, n = 11), high-grade lesions (CIN2 and CIN3, n = 13), and cytologically normal cells from non-neoplastic cervical samples (n = 8). HPV genotyping was done using RealLine HPV 16/18 kit. We used 20 microsatellite markers from: 1p31.2, 3p14.3, 3p21.3, 3p22.2, 3p24.2, 3p25.3, 7q32.2, 9p21.3, 11p15.5, 12q23.2, and 16q22.1. LOH/MSI was correlated with clinicopathological parameters. The presence of HPV DNA was revealed in 78.13 % samples, including normal cytology. LOH/MSI was the most frequent for: 3p25.3 (39 %), 3p22.2 (20.83 %), 3p24.2 (20 %), and 3p14.3 (16.67 %). It was demonstrated that D3S1234 (FHIT; 3p14.3), D3S1611 (MLH1; 3p22.2), D3S1583 (RARB; 3p24.2), D3S1317 and D3S3611 (VHL; 3p25.3) could differentiate patients with CIN2/CIN3 versus CIN1, showing significantly higher frequency in CIN2/CIN3. LOH/MSI frequency for other than 3p markers was lower, 10-22.2 %. The simultaneous occurrence of LOH/MSI for several markers (OFAL) was higher in CIN2/CIN3. Significant differences in OFAL were found between samples with versus without HPV infection. In HPV-positive patients, significant differences in OFAL were found between normal cytology, CIN1 and CIN2/CIN3. HPV infection influences the increase in LOH/MSI frequency, especially in tumor suppressor gene loci. Several studied microsatellite markers seem to be useful for CIN grading. Hopefully, the obtained results, if confirmed on larger patient cohort, would allow creating a panel of markers supporting clinical diagnosis in patients with HPV infection.

[Evaluation of tissue metaloproteinases inhibitors TIMP-2 and TIMP-4 in III-rd trimester of pregnancy]. / Ocena stqein tkankowych inhibitorów metaloproteinaz TIMP-2 i TIMP-4 w III trymestrze ciazy.

INTRODUCTION: To achieve physiological pregnancy development proper implantation and placental development is needed to establish good exchange between mother and fetus. Metaloproteinases of extracellular matrix are responsible of its degradation, their action is decreased by metaloproteinases inhibitors - TIMPs. OBJECTIVES: Assessment of the concentrations soluble extracellular matrix metaloproteinases inhibitors TIMP-2 and TIMP-4 in blood of pregnant healthy women in III-rd trimester and in umbilical cord blood separately from arteries and umbilical cord vein. MATERIAL AND METHOD: The study was conduced in High Risk Pregnancy Clinic, Medical University Lodz. The study group consisted from 29 women in normal, eutrophic pregnancy between 37 and 40 weeks of pregnancy TIMP-2 and TIMP-4 were measured in blood samples from maternal blood and umbilical cord vessels - separately from arteries and vein. RESULTS: Mean TIMP-2 concentration in maternal blood was 101,27 ng/ml, from umbilical artery 108,88 ng/ml, and from vein 108,28 ng/ml. Mean concentration of TIMP-4 in maternal blood was 726,73 pg/ml in umbilical artery was 529,95 pg/ml, in umbilical vein - 537,87 pg/ml. Comparing obtained results of TIMP-4 statistical difference between maternal blood and umbilical cord blood was found. CONCLUSIONS: The lack of increase of TIMP-2 synthesis in III-rd trimester of physiological pregnancy may be result of stabile vascularisation process. Observed decrease of TIMP-4 concentration may be the result of normal blood vessels development and the lack of increase angiogenesis process in both mother and fetus.

[Comparison of carbetocin and oxytocin effectiveness for prevention of postpartum hemorrhage after caesarean delivery]. / Porównanie skutecznosci dzialania karbetocyny i oksytocyny w profilaktyce krwotoku poporodowego po cieciu cesarskim.

OBJECTIVES: The aim of the study was to compare the effectiveness of carbetocin and oxytocin for prevention of postpartum hemorrhage (PPH) after caesarean section. MATERIAL AND METHODS: We analyzed data from 279 patients who received 100 µg of carbetocin intravenously or 10 IU of oxytocin into the uterine muscle as a rudimentary treatment for prevention of PPH. RESULTS: Blood loss was statistically significantly higher (p=0.0136) in the entire study group as compared to the oxytocin group, and in cases when additional uterotonics were administered (p=0.0090). Also, we observed a statistically significantly correlation between the need for additional treatment and patient BMI. Patients with pre-pregnancy BMI of ≥25 more often required additional medicaments after administration of carbetocin as compared to oxytocin (p=0.0077). We noted a statistically significantly higher rate of using additional treatment (p<0.05) after administering oxytocin into the uterine muscle as compared to intravenously given carbetocin (75% vs. 33%, respectively). CONCLUSIONS: 1. Carbetocin is more effective than oxytocin in the prevention of PPH and significantly reduces the necessity to administer therapeutic uterotonics during caesarean delivery. 2. Higher rates of additional treatment with uterotonics after the administration of carbetocin as compared to oxytocin in a group of patients after2 or more cesarean sections and women with BMI of ≥25 require further studies in a target-selected larger sample size. 3. Based on our findings, it is not possible to conclude that 100 µg of intravenous carbetocin is more effective than 10 IU of oxytocin given to the uterine muscle during caesarean delivery to prevent PPH.

[Evaluation of the expression of selected pro- and anti-apoptotic factors in syncytiotrophoblasts of human placenta and changes observed after vitamin supplementation]. / Ocena ekspresji wybranych czynników pro- i antyapoptotycznych w syncytiotrofoblascie lozysk ludzkich oraz ich zmian pod wplywem suplementacji witaminowej.

AIM: The main aim of the study was to estimate expression of Bcl-2 and Bax proteins in syncytiotrophoblast in placenta obtained from pregnancies complicated by hypertension and to compare results with group supplemented by antioxidants. MATERIAL AND METHOD: The study was performed in High Risk Department of Medical University Lodz. 3 groups of pregnant women were compared: I-pregnancy complicated by hypertension, II pregnancy complicated by hypertension treated by oral administration of antioxidants--vitamin C and vitamin E.III-rd group consisted of healthy women. After delivery incision from central part of placenta was taken on obtained slides due to immunohistochemical reactions the character intensity surface affected by reaction and expression of two proteins involved into process of apoptosis was measured- anti-apoptotic Bcl-2 and pro-apoptotic Bax. In every slide ten of random choosen fields were evaluated in 200x zoom using semi-quantative method. RESULTS: Highest value of Bcl-2 character was found in I-st group, the lowest in III-rd group- healthy women. The lowest intensity surface affected and expression of the reaction was found in II group- treated by antioxidants. The highest value of Bax reaction character and intensity was found in III group comparing to others. The lowest mean surface of syncytiotrophoblast affected by Bax reaction was found in II group. In III-rd group expression of reaction was higher than in both other groups. CONCLUSIONS: In the base of Bcl-2 reaction in syncytiotrophoblast no influence of antioxidants supplementation on apoptosis process that occurs by this path was found. Antioxidants supplementation decrease Bax activity in syncytiotrophoblast, that suggests restriction of apoptosis process despite of changes connected to hypertension.

Assessment of interleukin-6, interleukin-8 and interleukin-18 count in the serum of IUGR newborns.

AIM: Aim of this study was to assess concentrations of interleukin-6 (IL-6), interleukin-8 (IL-8) and interleukin-18 (IL-18) in the serum of newborns with diagnosed intrauterine growth restriction (IUGR) in comparison to concentrations in serum of newborns with weight appropriate for gestational age (AGA). MATERIALS: Research was conducted at the Lodz Medical University Clinic of Neonatology during 2010-2011. Surveyed group consisted of 50 hypotrophic full-term infants of single pregnancies (average weight: 2329 ± 287 g); control group, enclosing 50 infants AGA (average weight: 3544 ± 2161 g). Both groups received average Apgar score of 9 points. Concentrations of analysed cytokines were marked between 4-6 hours after birth. The enzyme-linked immunosorbent assay (ELISA) test was used to determine interleukins concentrations. Study was prospective. Statistics on the data were conducted with the Kolmogorov-Smirnov test. Significance level: p < 0.05. RESULTS: Concentrations of IL-6 and IL-18 were elevated in the IUGR group in a statistically significant manner in comparison to the control group. CONCLUSIONS: An elevated level of IL-6 and IL-18 in the IUGR group, comparing to control group, signifies the existence of inflammation in the process of developing IUGR, therefore, screening tests estimating levels of interleukins as IL-6 and IL-18 might be clinically useful in predicting the occurrence of IUGR and help preventing it.

[Evaluation of the usefulness of endoglin level as a predictor of preeclampsia in pregnant women with hypertension]. / Ocena przydatnosci stzenia rozpuszczalnej endoglny jako czynnika predykcyjnego wystapienia stanu przedrzucawkowego u ciezarnych z nadcisnieniem tetniczym.

INTRODUCTION: Preeclampsia is a pregnancy-specific syndrome that occurs after the 20 weeks of pregnancy and is characterized by hypertension and proteinuria. It complicates approximately 5-6% of all pregnancies and is a major factor in fetal and neonatal mortality OBJECTIVES: The aim of this study was to evaluate serum concentration of soluble endoglin (sEng) as the predictor of preeclampsia in pregnant women with hypertension. MATERIAL AND METHODS: The study was conducted at the Department of Pathology of Pregnancy (Department of Gynecology and Obstetrics, Medical University of Lodz), and the clinical ambulatory of the WSSz--M. Madurowicz (at present, WSSz--M. Pirogow) in Lodz, between 2008-2012. The Committee of Bioethics, Medical University of Lodz approved of the research (RNN/106/08/KE, May 20, 2008). The study included 86 pregnant women, between 25 and 40 weeks of pregnancy The subjects were divided into 3 groups: - Group HA--33 pregnant women with hypertension arterialis (> 140/90 mmHg) without proteinuria, --Group P--21 pregnant women with hypertension arterialis (>140/90 mmHg) with proteinuria, --Group K--32 pregnant women with normal blood pressure (< 140/90 mmHg) without proteinuria. Markings were determined with the ELISA method, using Quantikine kit. RESULTS: A significantly higher value of endoglin levels were found in pregnant women with preeclampsia syndrome (P) than in women with hypertension (HA) and the control group (K). Levels of endoglin in the P group was 29.70 pg/ml, 19.54 pg/ml in the HA group and 12.99 pg/ml in the K group. CONCLUSIONS: Elevated serum concentration of soluble endoglin (SENG) in pregnant women constitutes a risk factor for preeclampsia.

[The role of vitamin D deficiency in the etiology of polycystic ovary syndrome disorders]. / Rola niedoboru witaminy D w patofizjologii zaburzen wystepujacych w zespole policystycznych jajników.

Vitamin D deficiency connected with insufficient production in the skin and limited alimentation delivery disrupts the function of all systems of the body and increases the risk of chronic diseases. Many studies have reported associations between low serum 25-hydroxyvitamin D [25(OH)D] level and symptoms of the polycystic ovary syndrome (PCOS) - insulin resistance, hirsutism, and infertility associated with both, ovulatory disorders and abnormal endometrial receptivity. The beneficial effects of vitamin D supplementation on insulin resistance, ovarian follicles maturation, ovulation and menstrual regularity were confirmed. Due to limited evidence, the additional randomized trials are required to establish the correct dose of vitamin D and confirm the effectiveness of vitamin D treatment in PCOS disorders. However; it seems evident that correct supplementation of vitamin D is beneficial in the management of women with PCOS and low 25(OH)D serum levels, and that it could be helpful in improving the effects of PCOS treatment.

[Assessment of neuropeptide Y, leptin and leptin-receptor concentrations in teenagers suffering from anorexia nervosa]. / Ocena wartosci stezen neuropeptydu Y, leptyny oraz receptora leptyny u nastolatek chorych na anoreksje.

INTRODUCTION: Anorexia nervosa (AN) is the third most common chronic disorder affecting adolescents and is associated with high mortality risk. The predominant symptom of anorexia nervosa is persistent and intentional striving to achieve weight loss initiated and/or sustained by the patient, leading to cachexia. Until now the cause of the condition remains unknown, but seems to be multifactoral. Patients with AN develop multi-organ complications and endocrine disorders affecting multiple disturbances of energy metabolism. Neuropeptide Y and leptin can be found between chemical substances regulating feelings of hunger and satiety. Neuropeptide Y plays the main role in the regulation of energetic homeostasis of the organism, feeding customs, sexual and reproductive functions. Concentration of neuropeptide Y increases during starvation and decreases after feeding. In anorexia nervosa the concentration of neuropeptide Y increases and, by doing that, decreases the excrection of gonadoliberines and gonadotropines. Leptin influences the feeling of hunger and its synthesis takes part, among others, in adiposal tissue. It also influences the menstruation disturbances. Rising leptin concentrations, with accompanying increasing adiposity is known to be the main factor influencing the puberty and the reverse of the malfunction of hypothalamic-pituitary-gonadal axis in malnourished persons. During hunger and low calorie intake, leptin concentration decreases, independently of adiposity. AIM: The main aim of the study was to assess concentrations of neuropeptide Y, leptin and leptin receptor in teenagers treated for anorexia nervosa. MATERIALS AND METHODS: The study was conducted between 2007- 2011 in a group of 45 female teenagers with anorexia nervosa and a control group consisting of 59 healthy regularly menstruating female age peers. Concentrations of leptin, leptin receptor and neuropeptide Y (NPY) have been determined by using immunoenzymatic tests. Blood samples were obtained in fasting state. The Ethics Committee of the Medical University of Lodz approved of the study. RESULTS: There were statistically significant differences between mean values of BMI (14.6 vs. 19.83), median value of leptin concentration (3.79 vs. 12.09), proportions of LEP/BMI (0.1986 vs. 0.5701) in the study group when compared to controls. Higher values were found in the study group if compared to the percentage of body mass insufficiency--(23.09 vs. 3.97), neuropeptide Y concentration--(0.33 vs. 0.19), proportions of NPY/BMI--(0.023 vs. 0.0095), concentration of leptin receptor--(30.25 vs. 19.45), proportions of LR/BMI--(2.1048 vs. 0.9744). CONCLUSIONS: Low concentrations of leptine correlate to high concentrations of leptin receptor. A positive correlation between low body mass index and leptin receptor concentration and proportions of LR to BMI was found. A negative correlation was found between body mass loss and leptin concentration. The increasing concentration of neuropeptide Y, correlated to body mass deficency with existing high concentrations of leptin, could suggest disturbances of their regulatory axis.

[The influence of vitamin C and E use on concentration of endothelin-1 and lipid peroxides in the serum of pregnant women with arterial hypertension]. / Wplyw przyjmowania witaminy C oraz E na stezenie endoteliny-1 oraz nadtlenków lipidów w surowicy kobiet ciezarnych z nadcisnieniem tetniczym.

INTRODUCTION: Hypertension occurs in 6 to 10 percent of pregnancies. It remains one of the most common disorders in pregnancy and the leading causes of maternal and fetal morbidity The changes in blood vessel endothelium have impact on the pathogenesis of hypertension and preeclampsia. AIM: The aim of this study was to establish endothelin- 1 and lipids peroxides content in blood during hypertension and the influence of vitamin C and E supplementation on the concentration of both parameters. MATERIALS AND METHODS: Two study groups (pregnancy complicated with hypertension, pregnancy complicated with hypertension treated with vitamins C and E) and a control group with uncomplicated pregnancies were distinguished. Blood samples from maternal peripheral venous circulation were collected and ET-1 and lipids peroxides levels were determined from the blood samples. RESULTS: Concentration of endothelin-1 in the group with hypertension and with vitamin supplementation was INCREASED (66.18 +/- 26.66 pg/ml) in comparison with normal pregnant (36.50 +/- 13.25) and hypertension group (41.02 +/- 15.98). The difference was significant. Lipid peroxides concentrations were significantly higher in the group with hypertension (1.18 +/- 0.69) in comparison with both groups - controls (0.73 +/- 0.35) and the group with hypertension and vitamin supplementation (0.77 +/- 0.42). CONCLUSIONS: No significant differences in the endothelin- 1 level between healthy pregnant and pregnant women with hypertension were found. Vitamin supplementation decreases the concentrations of lipid peroxides.

[A comparative analysis of selected parameters of vascular angiogenesis in placentas from dizygotic twin pregnancies]. / Analiza porównawcza wybranych parametrów angiogenezy naczyniowej w lozyskach pochodzacych z ciaz blizniaczych dwuzygotycznych.

INTRODUCTION: Most of preIntroduction: Most pregnancies after assisted reproduction techniques are dizygotic twin gestations. There is a close relationship between the development and functioning of the placenta and the growth of both fetuses in dizygotic twin pregnancies. Angiogenesis is the process of creating new capillaries. OBJECTIVES: The aim of the study was to compare the expression of vascular endothelial growth factor (VEGF) and endothelial nitric oxide synthase (eNOs) between placentas of dizygotic twins, taking into account their birth weight. MATERIALS AND METHODS: The study included 35 women in dizygotic twin pregnancies, resolved after 30 completed weeks of gestation by a caesarean section. The patients were divided into two groups: twins whose weight did not differ by more than 20% (group 1) and twins whose weight differed by more than 20% (group 2). Twins with higher and lower birth weight were classified as A and B, respectively A comparative analysis of the placentas of twins A and B with regard to the selected parameters of angiogenesis, i.e. VEGF and eNOs, was performed. RESULTS: A strong expression of VEGF was observed in twins with lower birth weight in group 1, as well as a strong expression of eNOs in twins with higher weight in group 2, and with lower weight in group 1. CONCLUSIONS: Neovascularization is more expressed in the placentas of twins with lower birth weight (in the group with no significant differences in weight), possibly reflecting the existence of efficient mechanisms of compensation. High expression of e-NOS may indicate an increased risk of ischemia with intact endothelium.