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.

[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.

[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.

[Diagnostic and therapeutic dilemmas in pregnant woman with pulmonary embolism]. / Dylematy diagnostyczne i terapeutyczne u cizarnej z zatorowoscia plucna.

Hypercoagulable state during pregnancy and puerperium is associated with an increased risk of venous thromboembolic disease. Pulmonary embolism (PE) is the leading cause of maternal death in the developed world. Clinical assessment of PE may be difficult due to nonspecific signs and symptoms, especially in pregnant women. Diagnostic procedures using ionizing radiation may be harmful for the fetus while aggressive anticoagulation may expose the mother to bleeding complications The aim of this paper was to present a case of a 27-year-old pregnant woman with high-risk PE.

[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.

[Expression of metalloproteinase MMP-9 and tissue inhibitor of metalloproteinase TIMP-2 in placenta of pregnant women with intrauterine growth restriction]. / Ekspresja metaloproteinazy MMP-9 oraz tkankowego inhibitora metaloproteinazy TIMP-2 w lozyskach u ciezarnych z wewnatrzmacicznym ograniczeniem wzrastania plodu.

INTRODUCTION: The development of pregnancy depends on many factors, among other the implantation and the development of the placenta and placental vascularity The correct course of these processes depends on the proper activity of the enzymes degradating elements of extracellular matrix and basal membrane - metalloproteinases. OBJECTIVES: Assessment of the expression of MMP-9 and TIMP-2 in the placenta of women with intrauterine fetal growth restriction. MATERIAL AND METHODS: Two study groups were distinguished - with untreated IUGR and with IUGR treated with the acetylsalicylic acid and L-arginine and the control group with correct fetal growth and course of pregnancy Marked microscope preparations from placental samples were made with specific antibodies for MMP-9 and TIMP-2. RESULTS: The greatest intensity of the reaction and the villous TIMP-2 expression was characteristic of the group with untreated IUGR. Strongest expression MMP-9 was observed in the control group. The smallest surface of the trophoblast with positive MMP-9 reaction appeared in the group with untreated IUGR. CONCLUSIONS: High MMP-9 activity in the placenta correlates with its correct structure and function. Application of IUGR treatment reduces the expression of TIMP-2 in the placental villi.

[Analysis of delivery types in women after previous cesarean section]. / Analiza sposobu zakonczenia ciazy u kobiet po przebytym cieciu cesarskim.

OBJECTIVE: The study was undertaken to analyze the course of pregnancy and delivery in women after previous cesarean section. MATERIAL AND METHODS: The study group consisted of 1272 pregnant women after one cesarean section, who delivered at the 1st Department of Gynecology and Obstetrics, Medical University of Lodz between 1st January 2007 and 31st December 2010. RESULTS: Among patients after previous cesarean section, the most numerous group constituted women whose pregnancy was resolved with an elective repeat cesarean section, without the attempt to deliver vaginally - 58,96% whereas the remaining 41,04% of the women were qualified to make an attempt at vaginal delivery 48,28% of them succeeded to gave birth vaginally and 51,72% underwent repeat cesarean section. CONCLUSIONS: Proper qualification of patients after previous caesarean section for a natural vaginal birth allows a successful vaginal delivery. A critical analysis of the indications for surgical delivery needs to be performed in order to lower the rate of cesarean sections.

[Intrauterine contraceptive device in an appendix--a case report]. / Wkladka wewnatrzmaciczna w wyrostku robaczkowym--opis przypadku.

The application of an intrauterine contraceptive device can perforate the uterus and migrate to adjacent organs such as the bladder or small bowel. The main symptoms are painful insertion of the intrauterine contraceptive device and missing IUD strings. The diagnosis of perforation and transuterine migration of the IUD is made on the basis of an ultrasound examination and an abdominal X-ray. The proper management is such case is immediate removal of the IUD. The aim of this paper was to present a case of a 34-year-old woman with a copper IUD found during a caesarean section.

[Pregnancy and delivery in a patient with non-Hodgkin lymphoma--a case report]. / CiAza i poród u pacjentki z chloniakiem nieziarniczym--opis przypadku.

INTRODUCTION: Neoplasmatic diseases during pregnancy are relatively rare, with the incidence of approximately 1/1000 pregnancies. The symptoms of neoplasmatic processes are unspecific and often mirror physiological changes during pregnancy Chemotherapy is the main therapeutic management of non-Hodgkin lymphomas. The strategy of the treatment and its influence on the course of pregnancy remain controversial. AIM: The aim of this study was to present the case of a pregnant woman with non-Hodgkin lymphoma. CASE REPORT: We described the case of a 27-year-old pregnant nullipara with anemia, breathlessness, cough and general weakness with diagnosed diffused large B-cell lymphoma. During pregnancy the patient received six cycles of CHOP chemotherapy without any serious complications. On 37 week of gestation the caesarean section was performed. CONCLUSIONS: Coexisting non-Hodgkin lymphomas and pregnancy are seldom the case and the treatment requires complex chemotherapy.

[The analysis of selected biochemical parameters concentration in pregnant women with idiopathic edema of the lower limbs--preliminary report]. / Ocena stezenia wybranych parametrów biochemicznych u ciezarnych z idiopatycznymi obrzekami konczyn dolnych--doniesienie wstepne.

INTRODUCTION: Pregnancy causes changes in the hormonal balance, musculoskeletal, cardiovascular and lymphatic systems. The swelling of the lower limbs may also be one of the consequences of the enlarging uterus that increases body weight during pregnancy Determination of the serum concentrations of myeloperoxidase - MPO, extracellular matrix metalloproteinase - MMP, and intreleukine-6 - IL-6 allows for the assessment of inflammation. MPO belongs to the group of peroxidase enzymes with strong antibacterial and anti viral action. It is produced and released from the granules of neutrophils in inflammatory reactions, degenerative changes and neoplasmatic diseases. IL-6 is the main mediator of the inflammation in the live organism, released by monocytes and macrophages stimulated by interleukin-1. OBJECTIVE: To assess the levels of inflammatory mediators: MMP MPO and IL-6 in women in the third trimester of pregnancy both healthy and those who experienced idiopathic edema of the lower limbs. MATERIAL AND METHODS: We analyzed the changes in the concentration of biochemical parameters as: MMP-1, MPO and IL-6 in the serum of 20 healthy pregnant women between 36 and 40 weeks of gestation, and 8 pregnant women who developed idiopathic edema of the lower limbs. The R&D Systems Elisa tests were used to perform the measurement. The Quantikine Human IL-6 Immunoassay was used to measure the concentration of IL-6. The concentration was expressed in pg/ml. MMP-1 was measured using The Quantikine Human Pro -MMP-1. The value of MMP-1 concentration was expressed in ng/ml. MPO was measured using The Quantikine Human MPO Immunoassay and expressed in ng/ml. RESULTS: The mean concentration of IL-6 was higher in the group of pregnant women with swelling of the lower limbs (group II) in comparison to healthy pregnant women (group I) and it was approximately 3,01 pg/ml, SD = 2,64, and 2,3 pg/ml, SD = 1,92, respectively. No statistical difference was found (p = 0,436). Parity has no influence on IL-6 concentration. The mean concentration of MPO in group I was 1797,04 ng/ml, SD = 1378,89, in II group it was 1702,54 ng/ml, SD = 1289,64. (p = 0,866). Parity has also no influence on MPO concentration. The mean concentration of MMP-1 in group I was 7,61 ng/ml, SD = 4,6, in group II it was 10,46 ng/ml, SD = 4,03. (p = 0,137). Significantly higher results were observed in primiparas with lower limbs swelling- 11,36 ng/ml when compared to multiparas - 9,57 ng/ml. CONCLUSIONS: 1. There are no significant differences in the concentrations of the studied inflammatory mediators between the groups of healthy pregnant women and those with idiopathic edema observed in the lower limbs. The significance of these differences requires further confirmation. 2. There was a statistically significant difference between the concentrations of MPO in the group of primiparas with a multiparas with lymphatic edema.

[Analysis of the indications for the caesarean section delivery for very low birthweight neonates (< 1500 g) delivered in I department gynecology and obstetrics, Medical University in Lodz in 2006-2010]. / Analiza wskazan do porodu droga ciecia cesarskiego noworodków ze skrainie niska masa urodzeniowa (< 1500 g) urodzonych w latach 2006-2010 w I Katedrze Ginekologii i Poloznictwa UM W Lodzi.

UNLABELLED: Despite better care pregnant women receive nowadays, preterm birth and prematurity remain to be the reason of many complications and high mortality of neonates. OBJECTIVE: The goal was to analyze the indications for cesarean sections delivery for very low birthweight (<1500 g) newborns delivered in the I Department Gynecology and Obstetrics, Medical University in Lodz. MATERIAL: The data from 560 preterm caesarean sections were analyzed. Detailed analysis referring to 120 cesarean sections resulting in deliveries of very low birthweight neonates was performed. Maternal age, parity neonatal weight and gestational age were assessed. The authors also assessed the number of cesarean sections performed for extremely low birthweight newborns, in particularly years and the rate of the indications in the groups of gestational age. RESULTS: The greatest number of the cesarean sections was done between 26-35 years of age of the patients (68,4%) in 28-32 weeks of gestation (53,3%). The rate of cesarean section performed for very low birthweight neonates was 2,3% of preterm caesarean sections. Fetal growth restriction (IUGR) and the symptoms of intrauterine hypoxia were the indications for cesarean sections in 33,4%, multiple pregnancy in 17,5%, abnormal fetal presentation in 15,8%, intrauterine infection in 13,3% and placental abruption in 11,7% of cases. The rate of the other indications was 11,7% of cases. CONCLUSIONS: In our material the most frequent indication for the cesarean section for very low birthweight neonates was fetal growth restriction with the symptoms of intrauterine hypoxia.

[Body mass changes during pregnancy and concentration of insulin and neuropeptide Y in women with regard to the BMI]. / Zmiany masy ciala podczas ciazy oraz stezenie insuliny 1 neuropeptydu Y u kobiet ciezarnych w zaleznosci od BMI.

INTRODUCTION: Obesity poses a serious problem to human population as it increases the risk of diabetes, hypertension, metabolic syndrome. In pregnancy obesity increases the frequency of its complications. AIM: The main aim of the study was to estimate the increase of body mass and insulin and neuropeptide Y concentrations in pregnant women. MATERIAL AND METHODS: The changes of body mass and BMI in women before pregnancy and before delivery and the concentrations of insulin and neuropeptide Y in blood were estimated. RESULTS: The increase of body mass and BMI during the pregnancy period was higher in the group with high body mass and I stage obesity and increase of insulin concentration depended on increase of the body mass. Higher concentration of NPY was found in the group of women with normal body mass and obese if compared to stages II and III of obesity No correlation between insulin increase and concentration of NPY was found. CONCLUSIONS: In most pregnant women body mass gain is excessive and leads to obesity of different stages. Insulin concentration increases as BMI increases. Neuropeptide Y concentration in the obese women group was lower than in the normal weight group.

[The role of physiotherapy in selected gynecological disorders]. / Znaczenie zabiegów z zakresu fizjoterapii w wybranych schorzeniach ginekologicznych.

Physical training is a method supporting pharmacological and surgical treatment by shortening the time of recovery and effectiveness of the entire treatment. Many kinds of such methods, despite their availability remain unpopular and unused. The aim of the following study was to present possibilities of aiding the processes of curing by means of new physical methods. Guidelines for the treatment of adnexitis and rehabilitation after operative treatment were presented.

[Concentration of selected biochemical parameters in blood of pregnant women infected by HPV 16 and 18]. / Ocena stezenia wybranych parametrów biochemicznych w surowicy kobiet ciezarnych z zakazeniem HPV 16 i 18.

UNLABELLED: Asymptomatic HPV infection in pregnant women may be connected with changes of pro-inflammatory cytokines and proteolytic enzymes which may condition the persistence of infection during pregnancy. AIM: The main aim of the study was to evaluate the concentration of interleukin-1, TNF-alpha and alpha-1 antitrypsin in pregnant women infected by oncogenic types HPV. MATERIALS AND METHOD: The study was conducted in 2008-2009 at the Department of Obstetrics and Gynecology Medical University Lodz, on pregnant women in the third trimester of pregnancy The study group consisted on 19 pregnant women HPV-16, -18 infected. The control group consisted on 34 pregnant women at the same gestational age, HPV-negative. The concentration of interleukin-1, TNF-alpha and alpha-1 antitripsin was estimated in blood. RESULTS: The results of concentration interleukin-1, TNF-alpha and alpha-1 antitrypsin were similar in both groups of pregnant women. CONCLUSIONS: High risk HPV infection has no influence on the concentration of pro- inflammatory cytokines. In HPV infection during pregnancy the anti proteolytic defense did not decrease.

[Physiotherapy in obstetrics]. / Fizjoterapia w poloznictwie.

Physical activity during pregnancy, active preparation for the delivery and rehabilitation after delivery are factors that can influence the quality of life of a woman at those stages of life. Treatment and prevention of leg edemas decreases the risk of hospitalization. Kinezytherapy helps pregnant women to prevent obesity and stay in good physical condition. Physiological changes in skeleton and muscle system may be the reason of pain during pregnancy and physiotherapy may effectively prevent it. Preparation for the delivery by physical activity, kinezytheraphy and respiratory exercises increase awareness and help a pregnant woman to participated more actively in the act of the delivery.