[Correlation between cordocentesis performed during pregnancy and premature delivery]. / Zwiazek wykonanej podczas ciazy kordocentezy z porodem przedwczesnym.

OBJECTIVES: Cordocentesis is a procedure used to obtain fetal blood sample or to perform an intrauterine therapy. The cordocentesis is performed to determine the blood group, blood cell counts, fetus karyotype, intrauterine infection, level of 17-OH progesterone and fetus renal secretion. Access to the umbilical vein is possible from the 16-18th week of gestation. DESIGN: The aim of our study was to determine the impact of cordocentesis on the premature delivery. MATERIAL AND METHODS: Authors have analysed the course of gestation and delivery in all the cases with at least one cordocentesis carried out in the Department of Obstetrics in Gdansk in 1991-2002. The group of 145 pregnant women was analysed. In this group 199 cordocenteses were performed. In 31 cases there was a premature delivery which was not a complication of cordocentesis. The duration of pregnancies in each group was compared to the control group--a total of 1657 patients who gave births in the Institute of Obstetrics and Gynecology in 1998. For statistical analysis of the results the T-Student test was used with the significance level p = 0.05. RESULTS: The mean duration of pregnancy in the control group was 40 +/- 2.47 weeks (from 23 to 45), in the group of patients after cordocentesis--33.97 +/- 4.68 weeks (from 23 to 42)--no statistical difference was found. In the group of patients with lethal malformation of foetus the induction of delivery was performed in the 30.97 +/- 4.66 week of gestation (from 23rd to 41st)--statistical difference to the group of all patients after cordocentesis. In cases with only diagnostic cordocentesis the delivery took place in 36.85 +/- 2.60 weeks of gestation and in the group with fetal blood transfusions the mean duration of pregnancy was 35.36 +/- 3.72 weeks. The incidence of the premature deliveries in the control group was 7.18% and in the group of patients after cordocentesis--72.46%--there is significant difference between these two groups. The cesarean section was performed in the control group in 23.60% and in 36.23% in the group of patients with performed cordocentesis. CONCLUSIONS: The intrauterine transfusions during cordocentesis do not influence the term of delivery. The term of delivery after the diagnostic and therapeutic cordocenteses does not statistically differ from the term of delivery in the control group. The cordocentesis (the result of blood tests) allows to determine the need of induction of delivery. It gives better prognosis for the newborn.

[Intestinal obstruction during pregnancy]. / Niedroznosc mechaniczna jelita cienkiego w ciazy.

We report a rare case of intestinal obstruction during first pregnancy. 35-year old patient at the 16th week of her first pregnancy was admitted to the hospital due to hyperemesis gravidarum. After differential diagnosis the patient underwent successful surgical procedure followed by the intensive obstetrical care. The case history and a review of current literature are presented. We underline the importance of early diagnosis and interdisciplinary care.

[Isolated metastases of cervical cancer to the abdominal wall--a case report]. / Nietypowa lokalizacja przerzutów raka plaskonablonkowego szyjki macicy do powlok brzusznych--opis przypadku.

We described an unusual case of skin metastases of the uterine cervix in 63 year old woman. Previously, she was found having a Stage IIa squamous carcinoma of the cervix. She underwent bilateral salpingo-oophorectomy, total abdominal hysterectomy and pelvic node dissection. Then the patient was treated by external and intracavitary radiation. Within the next six months she was readmitted to the hospital because of abdominal pain and urinary stress incontinence after irradiation. The examination revealed three firm, freely-movable, solid subcutaneous nodules on the abdominal wall, umbilical site and urinary fistula. No other significant physical phenomena were noted. Radical excision of all the lesions was conducted and followed by four courses of adjuvant chemotherapy. Histopathological examination of the excised nodules revealed nests of squamous cell carcinoma, which were histologically identical to the previous carcinoma of the cervix. After successful treatment, the patient was continued for three months now, without any clinical evidence of recrudescence, and with good results from the urinary fistula treatment. Moreover, in these case-report we presented a review of current literature about new techniques and treatment methods of the cervical carcinomas.

[Coexistence of ovarian carcinoma with pregnancy--case report]. / Zlosliwy nowotwór jajnika wspólistniejacy z ciaza.

OBJECTIVE: Ovarian tumors during pregnancy are a rare event. More ovarian tumors are detected accidently during ultrasonography examination or caesarean section at term. STUDY DESIGN: Ovarian tumor was recognized at the 36 years old patient during 21 weeks of pregnancy and was observed and treated during caesarean section. RESULTS: During caesarean section the mesonephroid ovarian carcinoma at IA stage has been diagnosed and unilateral cystectomy after meticulous surgical exploration was done.

[Neoadjuvant chemotherapy in the treatment of advanced cervical cancer]. / Zastosowanie chemioterapii indukcyjnej przed operacyjnym leczeniem zaawansowanego raka szyjki macicy.

UNLABELLED: Neoadjuvant chemotherapy (NAC) has been used for treatment of advanced cervical cancer by some institutions for several years. PURPOSE: We investigated the value of NAC for patients with IIb cervical cancer. MATERIALS AND METHODS: Eight patients treated at the 2nd Department of Obstetrics and Gynecology Medical University of Gdansk between 1999 and 2000 for stage IIb cervical cancer were enrolled into the study. The drugs infused were: cisplatin 50 mg/m(2) and vincristine 1 mg/m(2) for 1 day and bleomycin 25 mg/m(2) for 3 days, for three cycles. NAC was followed by radical Wertheim-Meigs hysterectomy. All patients were evaluated for response and toxicity. RESULTS: In all eight patients partial responses were obtained. Despite previous data there was no severe toxicity in our study group. Hematological toxicity was mild and there was no need for modifying chemotherapy due to side effect of NAC. CONCLUSION: NAC followed by radical Wertheim-Meigs hysterectomy is an effective approach to stage IIB cervical cancer. Further larger prospective study is necessary. Preoperative imaging studies (CT and/or MR) might be consider as selection criteria for future study.