[The analisys of complications in forceps delivery in Institutute of Obsterics and Women Disease Medical University of Gdansk]. / Analiza powiklan porodów zakonczonych zabiegiem kleszczowym w materiale Instytutu Poloznictwa i Chorób Kobiecych AM w Gdansku.

INTRODUCTION: The forceps are the oldest obstetrics instrument using to quickly finishing delivery in situation of imminent fetal death. Forceps delivery increase the risk of new-born and women complications AIM OF STUDY: The aim of the study was retrospective analysis of 215 forceps deliveries in Institute of Obstetrics and Gynecology, Medical University of Gdansk between years 1991 and 2004. MATERIAL AND METHODS: 26653 deliveries took place in Institute of Obstetrics and Gynecology, Medical University of Gdansk between years 1991 and 2004 and in 215 cases deliveries finished by forceps operations. The fetal and mothers complications were assessed. RESULTS: Percentage of forceps delivery was low 0.81%. About 30% of new-borns were born with different types of birth's complications. 16.7% of new-borns had extravasations of skin and 14.8% had subperiosteal haematoma. More than half of examined women had various injuries of their birth canal and the more common was unilateral rupture of cervix--18.6%. CONCLUSIONS: The risk of complications after forceps delivery in rather high. 37.2% of newborn and 58,1% of women had various complications after forceps delivery. Our results indicate that percentage of forceps deliveries is decreased and in the 14 years periods was only 0.81%.

[The case of spleen's tumor and trombocytopenia in pregnant women]. / Przypadek krwiaka sledziony i maloplytkowosci u ciezarnej--opis przypadku.

The women with spleen's tumor and trombocytopenia was diagnosed and observed during pregnancy, labour and puerperium. The lowest level of thrombocytes (50 K/microl) was detected in 32nd week of pregnancy. Termination of the pregnancy by cesarean section was performed because of a big risk for the mother and child (tumor's crack, haemorrhage, infection). The same time the splenectomy was conducted. The results were successful.

[Pregnancy, delivery and puerperium in patients after liver transplantation]. / Przebieg ciazy, porodu i pologu u kobiet po przeszczepie watroby.

We report two cases of successful pregnancies in women after liver transplantation for end-stage liver dysfunction caused in one case by Wilson disease and in the second one by lupoid hepatitis. For woman with the Wilson disease it was a second pregnancy and for woman with lupoid hepatitis it was the first pregnancy. Mothers continued immunosuppressive therapy during their pregnancies. Labours started spontaneously at 39th and 36th week's of gestation. As a result the healthy two female infants weighing 3600 g and 2420 g respectively were born. The first woman with her baby was discharged from hospital on the third day after delivery and the second one and her baby on the sixth day after delivery. Both were in good condition.

[Co-existence of myoma uteri and pregnancy]. / Ciaza powiklana obecnoscia miesniaków macicy.

OBJECTIVE: Myomas of uterus are the most common mild tumours of uterus. There is often observed the rapid increase of them during the pregnancy and then they could caused complications from 0.3% to 2.6% of pregnancies. DESIGN: The aim of study was the general valuation of the course and delivery means of the pregnancies coexisted with myoma uteri. MATERIALS AND METHODS: We have analysed 11 pregnancies, which we observed during hospitalisation of pregnant women at 2nd Department of Obstetrics and Gynaecology at Medical University of Gdansk. RESULTS: We observed pain in abdomen during pregnancy in 63.6% of analysed group. The 6 (54.5%) pregnant women were pharmacologically treated against symptoms of miscarriages and preterm labors. We investigated in the connection of the complicated pregnancy at women with myomatous uterus. The results confirm the high risk of the pregnancy. Almost 82% of analysed group delivered at time. The frequency of caesarean sections in our study was about 36%, but 2 of them were performed because of myomas. CONCLUSION: We made conclusion that pregnancy complicated by myomas had not significant increase in failure at the end. Myomatous uterus in pregnancy required to be quickly diagnosed and take care to prevent complications.

[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.

[Lymph node metastasis as a prognostic factor in cervical carcinoma]. / Przerzuty do wezlów chlonnych jako czynnik prognostyczny raka szyjki macicy.

MATERIAL AND METHODS: 499 patients with cervical carcinoma at stage I and IIa after radical hysterectomy were included in the study. Diagnosis was based on gynecological examinations and cervical biopsies. Clinical staging was determined by FIGO classification. Pelvic lymph nodes were routinely removed on hysterectomy. RESULTS: Metastatic nodes were observed in 26.3% (131 patients). We found no metastatic nodes at stage Ia. In the group of 410 patients with stage Ib cervical cancer metastases in lymph nodes were found in 24.6% (101 patients). In the group of 78 patients with stage IIa cervical cancer metastatic nodes were observed in 38.5% (30 patients). In our finding metastases were located in one group of lymph nodes in 64.4% (64 patients) with stage Ib and 43.3% (13 patients) with stage IIa. Metastatic involvement of more than one group of lymph nodes was observed in 36.6% (37 patients) of stage Ib and 56.7% (17 patients) of stage IIa. The most frequent pattern of lymph nodes metastatic involvement comprised common iliac and obturatorious nodes. 5 year survival in the group without metastases in lymph nodes was estimated at 82.2%, and in the group with nodal metastases--50.8% (p = 0.005). CONCLUSIONS: 1. Metastases to pelvic lymph nodes are significant prognostic factor of long-term survival in patients with cervical cancer. 2. Patients with metastases in lymph nodes and no subsequent postoperative radiotherapy had significantly worse long-term survival.

[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.

[The prevalence of gestational diabetes mellitus in Polish population]. / Czestotliwosc cukrzycy ciezarnych (GDM) w Polsce w badaniach przesiewowych.

OBJECTIVE: The aim of the study was to determine the frequency of GDM in different parts of Poland and to assess whether 1 h--glucose plasma levels after 50 g glucose tolerance test (50 g OGTT) reflect the risk of GDM. MATERIAL AND METHODS: A total of 5778 pregnant women were screened with 50 g OGTT between 24 and 28 weeks of gestation. All subjects whose post-challenge glucose levels exceeded 140 mg/dl had 75 g OGTT performed according to WHO criteria. RESULTS: The rate of abnormal screening test results ranged from 8.0% to 20.7% for different regions of Poland, respectively. The pathological 50 g OGTT results were from 140 mg/dl to 320 mg/dl. Screening test results within 140 mg/dl to 149 mg/dl were confirmed by positive 75 g OGTT only in 2.9% subjects. All patients whose 1 h--glucose levels at 50 g OGTT were greater than 190 mg/dl had pathological 75 g OGTT results as well. CONCLUSION: The prevalence of GDM in different parts of Poland ranged from 2.0% to 3.8% (the average 3.4%).