Effect of systemic enzymotherapy on Cesarean section scar healing.

OBJECTIVES: The aim of our study was to monitor changes in the healing of Caesarean section scars in patients using systemic enzymotherapy in comparison with patients not treated with systemic enzymotherapy (Wobenzym). METHODS: A prospective cohort study was conducted in 60 primiparous women delivered by CS. We compared the following outcomes: scar thickness after the Caesarean section, dehiscence risk coefficient (DRC), severity of the Caesarean section scar defect, uterine cavity dilation, post-operative pain, C-reactive protein level and febrility. RESULTS: The scar thickness 6 weeks after CS was significantly greater in the group of patients taking Wobenzym (7.1±0.9 mm; mean ± SD) than in the patients without Wobenzym (5.3±0.7 mm) (p = 0.01). Severe Caesarean section scar defects were observed in 1/30 (3.3%) Wobenzym users and in 5/30 (16.7%) patients who did not use Wobenzym, with no statistically significant difference (p = 0.195). CONCLUSION: Despite the percentage of patients with a severe CS scar defect being apparently lower in the group treated with Wobenzym, the difference did not reach statistical significance due to the small size of the study population.

Prenatal diagnosis of pentalogy of Cantrell in the third trimester.

We report about the prenatal diagnosis of pentalogy of Cantrell in the third trimester. In this case sonographic evaluation revealed mild form of ectopia cordis, severe omphalocele, small meningomyelocele, mild hydrocephalus, severe polyhydramnios and allantoic cyst of the umbilical cord. The pregnancy was terminated by a caesarean section at 35 weeks of pregnancy because of severe polyhydramnios. The neonate died shortly after delivery and the obduction confirmed the diagnosis of pentalogy of Cantrell. We discuss the reason of the late prenatal diagnosis in this case, the importance of early prenatal diagnosis and the options of pregnancy management.

[Fetal thymic involution on ultrasound]. / Involuce fetálního thymu v ultrazvukovém obraze.

OBJECTIVE: The purpose of this study was to summarize the published data on the fetal thymus, the fetal thymic involution and the possible use of the measurement of the fetal thymus in the clinical practice. DESIGN: Review. SETTING: Department of Obstetrics and Gynecology Medical Faculty Charles University Hradec Kralove. METHODS: We summarized published data on the fetal thymic involution and relationship between the sonographic fetal thymus size and the presence of an intrauterinne infection in patiens with preterm labor or preterm prelabour rupture of membranes. CONCLUSION: The present review summarizes the results of clinical and experimental research on the fetal thymic involution.