Longitudinal evaluation of markers of hemostasis in pregnancy.

OBJECTIVE: The aim of this study was to establish the physiologic changes in hemostasis during pregnancy and to find the association between the factor V Leiden mutation and adverse pregnancy outcome. METHODS: We investigated blood samples of 148 pregnant women during each trimester of pregnancy. We measured their serum concentrations of factors I, II, V, VII, VIII, IX, X, XI, XII, D-dimers, prothrombin time, INR, aPTT, activity of protein C and S, antithrombin III and platelet count. The pregnancy outcome of women with factor V Leiden mutation was compared to those without congenital thrombophilia. RESULTS: Prothrombin time, INR and aPTT were significantly shorter. We found significantly higher plasma concentrations of fibrinogen and d-dimers and higher levels of activity of factor VII and X in the third trimester. No significant difference was found in protein C and antithrombin III activity. The protein S activity was lower in the second trimester and it increased in the third trimester. Although most of the clotting factors were rising during the pregnancy, there was no evidence of fibrinolytic overactivation. In our study, the carriership of factor V Leiden mutation did not affect the incidence of preeclampsia, eclampsia, intrauterine fetal death and venous thromboembolism. Placental abruption was rare. CONCLUSION: Hemostatic changes in pregnancy are significant and essential, and have the potential to cause adverse pregnancy outcome. In addition, hypercoagulable state during pregnancy is considered to be physiological (Tab. 4, Ref. 36).

Ultrasound diagnosis of macrosomia.

Over the last two to three decades, there has been a 15-25 % increase in many countries in the number of women giving birth to large infant. Fetal macrosomia is associated with an increased risk of complications both for the mother and the newborn. In current obstetrics, the macrosomic fetus represents a frequent clinical challenge. The early detection and identification of the risks associated with fetal macrosomia is important to managing the pregnancies and at last the timing and mode of delivery. This article provides possibilities of ultrasound diagnosis throughout the pregnancy and investigates the effectiveness of fetal measurements in identifying the large fetus (Tab. 1, Ref. 24).

HIV prevalence and clinical care for HIV-positive pregnant women in Slovakia.

OBJECTIVE: To evaluate clinical care for HIV positive pregnant women who delivered in Slovakia from 1985 till 2008. BACKGROUND: National guidelines for the prevention of mother-to-child transmission of HIV have not yet been established. METHOD: Retrospective analysis of 14 HIV-infected pregnant women and their infants. Factors examined include maternal social, demographic, immunological and virological characteristics, method of HIV testing, antiretroviral therapy during pregnancy, delivery and puerperium, mode of delivery, mode of infant feeding, pregnancy outcomes and HIV status of infants. CONCLUSIONS: Due to the increase in cases of HIV-infected pregnant women within the last several years, it would be advisable to create National Guidelines for PMTCT (Prevention of Mother-to-Child Transmission) in order to consolidate the care management in all HIV/AIDS care centers around Slovakia (Fig. 4, Ref. 7).

[Supplementation of swine feed rations with zeolite during cage rearing]. / Obohatenie krmnej dávky prasiat zeolitom pri klietkovom odchove.

The effect of the addition of zeolite to pig feed ration was studied in the cage rearing system under production conditions. Zeolite was mixed in the COS I and COS II feed mixtures directly in the feed plant, the mixing ratio being 100 kg feed mixture + 5 kg zeolite. The feed mixture was administered in granular form ad libitum. The test group had 648 weanlings and the control group 674 weanlings; the piglets, kept in two-story cages in four sections, were arranged so that the test group could be a mirror-like reflection of the control group. The trial lasted 45 days. The piglets given the fortified feed ration had daily weight gains higher by 0.017 kg and feed consumption lower by 0.234 kg per 1 kg of gain, as compared with the control animals. The costs of the feed ration required for producing a kilogram of gain were 8.55 Cz. crowns in the zeolite group and 9.422 crowns in the control group.

[Interruption of gravidity as a cause of premature labour (author's transl]. / Interrupcia gravidity ako prícina predcasného pôrodu

PIP: A survey was conducted in which 625 women who gave birth prematurely and an equal number whose pregnancies were full-term were examined to find out whether an earlier legal interruption of pregnancy (LIP) causes premature births. The results showed that in the premature birth cases 15.3% had had an LIP whereas this was the case for only 6.3% of the control group. It is obvious that the interruption of pregnancy can be 1 of the causes of premature births.^ieng