[Intra-uterine fetal death syndrome--not only a gynecologic problem]. / Ciaza obumarla--problem nie tylko ginekologiczny.

Intra-uterine fetal death may seriously affect maternal health and implies considerable risk of maternal death, especially when clotting and septic disorders arise. Management od IUFD should include removal of the triggering mechanism for DIC, antiinfectious prophylaxis and consider prompt evacuation of uterus. Low-dose heparin therapy is safe and offers sufficient protection against coagulopathy associated with IUFD. Treatment with low-dose aspirin, steroids or substitutive ACTH therapy is useful for patients with a poor obstetrical outcome. Etiopathology of IUFD, complications, methods terminating of the pregnancies has also been presented.

[Early diagnosis as a condition for conservative treatment of tubal pregnancy with methotrexate]. / Wczesna diagnostyka jako warunek zachowawczego leczenia ciazy jajowodowej przy uzyciu metotrexatu.

27 women with diagnosed unruptured tubal pregnancy were treated using methotrexate given intravenous. Three patients failed medical therapy and required surgical treatment for tubal rupture. The method was effective in 88,89% of cases. 17 women (63%) were given only one dose of methotrexate, ten others required 2-4 doses. Using the diagnostic algorithm (endovaginal sonography, serial B-hCG determinations and uterine curettage) the presence of an ectopic pregnancy was confirmed. The early and relatively easy to follow diagnosis allowing an increase in the proportion of patients who could undergo the alternative of methotrexate therapy and avoidance of laparotomy. The side effects of therapy were mild and transient. Because rupture of ectopic pregnancy can occur despite low and declining B-hCG levels, efficient monitoring was performed.

[Pregnancy and labor in a pregnant woman with nephrocalcinosis complicated by renal failure]. / Ciaza i poród u ciezarnej z nefrokalcynoza powiklana niewydolnoscia nerek.

The paper presents a case of woman with nephrocalcinosis confirmed 10 years ago. During her third pregnancy a renal failure occurred with increasing urinary retention in the right kidney. Conservative treatment was applied without dialysis, despite of renal biochemical parameters, which balanced on the edge of the indication for this procedure. The pregnancy was managed by the 32-nd week and then cesarean section was performed because of increasing levels of creatinine and urea in the serum and enlargement of hydronephrosis. After the delivery a recovery of renal function was observed. Patient was discharged in good general condition on 9-th day after cesarean section and baby after 52 days of hospitalization in neonatal department when she has reached weight of 3000 g.

[Endemic goiter in the area of Mielec]. / Endemia wola w okolicach Mielca.

The scope of this report is the incidence of goiter in school children living in Mielec and neighbouring villages. We examined a group of 3537 children aged 6-14. The enlargement of thyroid gland was observed in 49.3% of the population. Judging by the results of the research this region can be regarded as endemic. There might be several reasons for a high incidence of goiter in this region. The most important are: insufficient iodine prophylaxis, pollution of the environment including the pollution with radioiodine after the damage of the Chernobyl reactor.