[Diagnostic utility of RHD-gene detection in maternal plasma in the prophylaxis of feto-maternal Rh-incompatibility]. / Diagnostyczna przydatnosc detekcji genu RHD w osoczu ciezarnych w profilaktyce konfliktu matczyno-plodowego na tle antygenu D z ukladu Rh.

OBJECTIVES: The aim of the study was analytical validation of prenatal noninvasive fetal RHD detection in maternal plasma and the preliminary assessment of its clinical utility Introduction of this noninvasive test into routine diagnostic use is important for more rational and safe immunoprophylaxis. MATERIAL AND METHODS: RHD gene was detected using real-time PCR. Primers and probes complementary to sequence on exons 7 and 10 were chosen. Samples with RHD-negative results were examined with additional tests to confirm the proper isolation of cell-free fetal DNA (cffDNA). For male fetuses, the presence of fetal DNA was confirmed by detection of the male genetic marker (SRY gene) using Quantifiler Duo kit. In the case of SRY-negative result we used mini SGM test, which is based on the detection of short-tandem repeat polymorphism differences between maternal and fetal DNA. RESULTS: Diagnostic accuracy of RHD test was 96.82%, while diagnostic value of SRY determination was lower (87.50%). Mini SGM test was able to confirm the presence of fetal DNA in 77% of the cases. CONCLUSIONS: Effectiveness of the proposed procedure of prenatal noninvasive RHD determination and cffDNA confirmation is high, on condition proper control samples and suitable verifying tests are used.

Pregnancy coexisting with a uterine abscess in a double uterus: a case report and review of literature.

A 20 year old primigravida with a double uterus was admitted with a viable fetus in the right uterus and pus oozing from the left one. Management consisted of a regimen of intravenous antibiotics and intravaginal antibiotic tablets. Tocolysis was used to arrest imminent preterm labor. In the course of pregnancy IUGR was diagnosed. At 38 weeks of pregnancy a SGA baby boy of 2,440 g was delivered by cesarean section. The mother and the baby were discharged from the hospital in good general condition.

Pregnancy in a woman with treated bladder extrophy, split pelvis and hypoplasia of ischial bones. Case report.

We present a case of a pregnancy in a 24 year old woman who was born with ectopia vesicae, split pelvis and hypoplasia of ischial bones. From childhood to adulthood she had undergone reconstructive surgeries of the abdomen and perineum, as well as urine diversion surgery. During pregnancy she experienced recurrent urinary tract infections which were treated with antibiotics. In spite of tocolysis, she delivered by cesarean section a premature baby boy at 35th week of gestation due to premature uterine contractions. The postoperative period was uneventful and they were discharged from the hospital in a good general condition.