A comparison of the incidence of early postoperative infections between patients using synthetic mesh and those undergoing traditional pelvic reconstructive surgical procedures.

New mesh-related complications such as erosion, etc., can result from abnormal postoperative healing due to surgical site infection. The aim of our study was to compare systemic inflammatory responses and the incidence of early infectious complications after reconstructive surgery using synthetic mesh and after traditional vaginal wall repair. In this prospective observational study 99 women with symptomatic pelvic organ prolapse were included; 55 women underwent traditional repair and 44 repair using mesh. After the procedure infectious complications were monitored. The patients who underwent reconstructive surgery using mesh material were more likely to have febrile morbidity in the postoperative period than the patients who had been treated with traditional repair (p=0.031); there was a higher incidence of combination febrile morbidity with elevated C-reactive protein (CRP) > 50 mg/l; p=0.046, and a higher incidence of CRP increase over 30 mg/l; p=0.005. Reconstructive procedures using synthetic mesh are accompanied by a higher incidence of early post-operative infectious complications.

[Modified classification of microscopic evaluation of vulvovaginal infections]. / Modifikovaná klasifikace mikroskopického hodnocení posevních infekcí.

OBJECTIVE: The objective of the study is to examine the role of microscopy using stained smears for diagnosis of vulvovavaginal infections: DESIGN: Description of different scoring systems. SETTINGS: Department of Gynecology and Obstetrics, First Medical Faculty, Charles University; General Teaching Hospital, Prague; Institute of Clinical Chemistry and Laboratory Medicine; Clinical Microbiology and Antibiotic Center, First Medical Faculty, Charles University. MATERIAL AND METHODS: Presentation of our practical skills in microscopic diagnoses of vulvovaginal infections. CONCLUSIONS: Vulvovaginal infections are a common problem which we encounter in daily gynaecological practice. Microscopic examination represents the gold standard in the diagnosis of vulvovaginal infections. However, providing microscopy in an outpatient setting is very time-consuming. The vaginal smear can be sent to a laboratory to stain and to be microscopically examined under oil immersion. For this purpose we recommend taking two smears for Gram and Giemsa stain and combining microscopical examination with cultures for detecting the presence of Candida species and for Trichomonas vaginalis. Where appropriate, it is also necessary to obtain cervical smears for detection of C. trachomatis and N. gonnorhoeae infection.

[Current possibilities for diagnosis of vulvovaginal infection]. / Soucasné moznosti diagnostiky vulvovaginálních infekcí.

OBJECTIVE OF THE STUDY: The objective of the study was to describe current possibilities of proper diagnosis of vulvovaginal infections. DESIGN: Review article. SETTINGS: Department of Gynecology and Obstetrics, First Medical Faculty, Charles University and the General Teaching Hospital, Prague, Institute of Clinical Chemistry and Laboratory Medicine, Clinical microbiology and antibiotic center, First Medical Faculty, Charles University and General Teaching Hospital in Prague. MATERIAL AND METHODS: Presentation of literature review information and our practical skills in diagnosing vulvovaginal infections. CONCLUSIONS: Vulvovaginal infections are a common problem which we encounter in daily gynaecological practice. Most women with those conditions need only basic investigation and treatment. However, in order to offer the appropriate care for those women it is necessary to understand the basic pathophysiology of vulvovaginal disorders. A fundamental step is to make the correct diagnosis. All too often our decisions are influenced by clinical dogmas which are even found repeatedly in gynaecological textbooks. Microscopic examination represents the gold standard in the diagnosis of vulvovaginal infections.

[A role of prenatal diagnostics in birth defects occurrence in the Czech Republic in 2004]. / Podíl prenatální diagnostiky na výskytu vrozených vad v Ceské republice v roce 2004.

OBJECTIVE: An analysis of prenatal diagnostics of birth defects in the Czech Republic in 2004 and a comparison to data from 1996 - 2003. TYPE OF STUDY: A retrospective analysis of data from a Register of Prenatal Diagnostics of the Czech Republic. METHODOLOGY: Data on birth defects in the Czech Republic from particular departments of medical genetics and prenatal diagnostics from 1996 to 2004 time period was used. An analysis of data on prenatal diagnostics of selected type of birth defects was performed. RESULTS: During 1996 to 2004 period, a total of 4,126 prenatally diagnosed and terminated cases were reported. In 2004, 597 cases were reported, which presents 61.1 cases per 10 000 live births. (The mean rate from the total period under the study was 49.8 per 10 000 live births.) CONCLUSIONS: Current data on birth defects in a 9-year period in the Czech Republic are presented. The role of prenatal diagnostics in decrease of some severe types of birth defects is underlined.

[Infant mortality due to birth defects in the Czech Republic in 1994-2004]. / Mortalita detí v prubehu prvního roku zivota v dusledku vrozených vad v CR v období 1994-2004.

UNLABELLED: AIM AND TYPE OF STUDY: A retrospective data study with an analysis of pre- and postnatal occurrence of selected types of birth defects in the Czech Republic during 1994 to 2004 period. An analysis of infant mortality rate in children with selected types of birth defects during their first year of life is described. METHODOLOGY: Data on prenatal diagnostics were obtained from particular departments of medical genetics. Data on birth defects incidences were obtained from National Health registers - Institute of Health Information and Statistics (National Register of Congenital Anomalies and National Newborns Register) from the 1996-2004 period were used. A case analysis of incidences of 14 types of pre- and postnatally diagnosed birth defects was performed for the period 1994-2004. In postnatally diagnosed cases, an analysis of survival and extinction of particular types of defects during the first year of life was also performed. RESULTS: During 1994-2004, there were 1 030 069 children born in the Czech Republic. Including prenatally diagnosed cases, we registered 305 cases of anencephaly, 454 spina bifida, 156 encephalocele, 528 cases of congenital hydrocephalus, 304 omphalocele and 302 cases of gastroschisis, 241 oesophageal defects, 302 anorectal malformations, 312 cases of diaphragmatic hernia, 518 renal agenesis/hypoplasia cases, 529 cases of cystic kidneys and 1764 Down syndrome cases. Secondary prevention rate was high in neural tube defects (61-100%), abdominal wall defects (60-79%) and Down syndrome (63%). In operable defects, a first-year survival was lowest in congenital hydrocephalus (63%) and neural tube defects -excluding anencephaly - (82%). In abdominal wall defects, diaphragmatic hernia, oesophageal and anorectal malformations, the survival rate was, however, 76-91% of children. CONCLUSIONS: Birth defects present a major contribution to infant mortality and morbidity. Prematurity in a combination with a birth defect prolongs inpatient days and increases a need of a total parenteral feeding in a newborn and it also makes a worse prognosis for the infants with birth defects. An improvement of prenatal diagnostics with an early detection of the most severe types along with the associate ones could decrease incidences of such cases. A progress in surgical techniques and a special neonatal and infant intensive health care would also contribute an improvement of survival.

[Birth defects' occurrence in offspring of mothers taking 1st trimester medication in the Czech Republic in 1996-2004]. / Vrozené vady v Ceské republice v roce 2004 u detí matek uzívajících v I. trimestru gravidity léky.

OBJECTIVE: An analysis of birth defects incidence in offspring of mothers taking 1st trimester medication in the Czech Republic in 1996-2004. TYPE OF STUDY: A retrospective demographical-epidemiological analysis of data from a National Register of Congenital Anomalies of the Czech Republic. METHODOLOGY: Data on birth defects in the Czech Republic from the Institute of Health Information and Statistics--National Register of Congenital Anomalies from the 1996-2004 period and a control group data on healthy children born to mothers taking medications from the same time period. Data on medication were analyzed in relation to particular defects and were also used in international databases. RESULTS: There were 1,125 children born with a birth defect to mothers taking 1st trimester medication making a total of 1,456 particular birth defects. A control group covered 1,321 exposed women giving birth to a child without any birth defect. Some types of congenital heart defects, cleft lip with cleft palate and limb reduction defects. A significantly higher risk was found also in following 5 types of drugs: anticoagulants, antihypertensives, peripheral vasodilatants, urologics and antiepileptics. CONCLUSIONS: A significantly higher risk was found for the following defects: anencephaly, spina bifida, congenital hydrocephalus, anophthalmia/microphthalmia and auricular and limb reduction defects. Although the results are not always unambiguous and are probably influenced by both information and recall bias, they complement data on adverse effects of drugs in pregnancy in the Czech Republic. They also stress the need for a high preliminary caution in drug prescription and for a complex and individual risk assessement by a clinical geneticist.

[Birth defects occurrence and their role in perinatal mortality in the Czech Republic in 2004]. / Výskyt vrozených vad v Ceské republice a jejich podíl na perinatální úmrtnosti v roce 2004.

OBJECTIVE: An analysis of birth defects occurrence in the Czech Republic in 2004 and a comparison to data from 1996-2003. TYPE OF STUDY: A retrospective analysis of data from a National Register of Congenital Anomalies of the Czech Republic. METHODOLOGY: Data on birth defects in the Czech Republic from the Institute of Health Information and Statistics--National Register of Congenital Anomalies from the 1996-2004 period were used. An analysis of incidence of selected type of birth defects was performed along with their contribution to perinatal mortality according to particular types of defects. RESULTS: There were 29 186 children born with a birth defect, out of it were 17,063 boys and 12,116 girls, an undetermined sex was reported in 7 cases. A mean incidence of birth defects 2004 in was 367.9/10,000 live births. Corresponding data from years 2003, 2002 and 2001 were 405.2, 4043 and 407.9/10,000 live births. CONCLUSIONS: Current data on birth defects in 2004 in the Czech Republic are presented with a comparison to a 8-year period. An analysis of temporal and demographic changes in birth defects incidence is given along with data on birth defects contribution to perinatal mortality in selected types of defects.

[Birth defects occurrence in the Czech Republic in 2003]. / Výskyt vrozených vad v Ceské republice v roce 2003.

OBJECTIVE: An analysis of birth defects occurrence in the Czech Republic in 2003 and a comparison to data from 1996-2002. TYPE OF STUDY: A retrospective analysis of data from a National Register of Congenital Anomalies of the Czech Republic. METHODOLOGY: Data on birth defects in the Czech Republic from the Institute of Health Information and Statistics-National Register of Congenital Anomalies from the 1996-2003 period were used and an analysis of incidences of selected types of birth defects was performed. RESULTS: There were 25,593 children born with a birth defect (14,896 boys and 10,690 girls, in 7 cases the sex was undetermined). A mean incidence of birth defects was 405.2/10,000 live births and remains more or less stable compared to the years 2002 and 2001 (4043/10,000 and 407.9/10,000 live births respectively). CONCLUSIONS: Current data on birth defects in 2003 in the Czech Republic are presented with a comparison to a 8-year period. An analysis of temporal and demographic changes in birth defects incidences is given along with data on prenatal diagnostics and its role in birth defects decrease.

[Prenatal diagnostics of birth defects in the Czech Republic--gestational week at the time of diagnosis]. / Prenatální diagnostika vrozených vad v Ceské republice--týdny tehotenství pri diagnostice.

UNLABELLED: AIM AND TYPE OF STUDY: A retrospective study and analysis of data on gestational week at the time of the birth defect diagnoses of both invasive and non-invasive type as well as on gestational week at the time of pregnancy termination in the Czech Republic over the 1996-2003 period. METHODOLOGY: Data on prenatal diagnostics were obtained from particular departments of medical genetics. Data were collected for both birth defects as a total as well as for selected particular types: anencephaly, spina bifida, omfalocele, gastroschisis and Down syndrome. An analysis on gestational weeks at the time of diagnosis and/or pregnancy termination was performed. RESULTS: Mean gestational week at the time of diagnosis was 19.49 for total birth defects and 20.02 for pregnancy termination. Corresponding values (diagnosis x termination) in gestational weeks were as follows: Anencephaly 17.01 and 17.69, spina bifida 19.41 and 19.68, omfalocele 17.64 and 17.99, gastroschisis 17.63 and 1836, Down syndrome 19.81 and 20.43. CONCLUSIONS: Results of aggregate data analysis contribute to a better knowledge of different methods of prenatal diagnosis during different gestational periods. All values of mean gestational week at the time of diagnosis/pregnancy termination slightly decreased during the time of the study in all presented types of birth defects.

[Birth defects in the Czech Republic--expected incidence in the coming years]. / Vrozené vady v Ceské republice--odhady incidencí v prístích letech.

OBJECTIVE: The study was aimed to analyze expected incidence of birth defects as a whole and some selected types of birth defects on the basis of the mean values over the period of 1983-2002 in the Czech Republic. A possible incidence of birth defects in the Czech Republic in the coming years was evaluated. DESIGN: A statistical estimate and analysis of the expected incidence based on retrospective values of incidence of birth defects from the data of the Institute of the Care of Mother and Child (UPMD) and the Institute of Medical Information and Statistics of the Czech Republic (UZIS). METHODS: The estimate of incidence of birth defects as a whole as well as according to individual selected types with the application of exponential adjustment of time series with the time-weighted parameter for individual years of the retrospective period of time. RESULTS AND CONCLUSIONS: The statistical estimate indicates that 1,244,767 children should be born in the Czech Republic over the period of 2003-2015. In this period of time there should be 50,706-67,628 prenatally and postnatally diagnosed cases of birth defects in this republic. These our results represent an estimate of birth defects in the Czech Republic in the coming years and draw attention to the importance of registry of birth defects in the Czech Republic. The epidemiology of birth defects actually represents a multidisciplinary branch, which is primarily aimed at and providing data for the evaluation of quality of prenatal and postnatal care in the Czech Republic.

[The incidence of serious complications in neonates with birth weight < 1,500 g in the Czech Republic (in the period 2000-2002)]. / Incidence závazných komplikací u novorozencu s porodní hmotností < 1500g v CR (období 2000-2002).

OBJECTIVE: To analyse the incidence of serious complications in neonates with birth weight lower than 1,500 g in the Czech Republic in the years 2000-2002. DESIGN: A retrospective epidemiological study. METHODS: Frequency analysis of the data from the National Register of Neonates, administrated by the Institute of Health Information and Statistics of the Czech Republic. RESULTS: The incidence of PIVH of level III-IV in neonates with weight of up to 1,500 g in the Czech Republic in the years 2000-2002 was 6.8-10.3%; the incidence of cPVL reached 6.4-7.6%; the incidence of ROP of level III and of a higher level was 6.6-7.9% and the incidence of NEC was between 4.3 and 5.7% of all live births. Among the surviving neonates, the percentages of those who did not have any of the PIVH, ROP, HIE or meningitis diagnoses in the reference period were as follows (according to their birth weights): 500-749g 50-63.8%; 750-999 g 69.7-74.8%; 1,000-1,499 g 86.8-91.4%; 1,500-1,999g 98-98.2%; 2,000-2,499 g 99.4-99.5%; and in the group with weight above 2,500g, the percentage was 99.9%. CONCLUSION: The incidence of serious complications in neonates with birth weight of up to 1,500 g in the Czech Republic in the years 2000-2002 was comparable with the data stated in the literature, except for cPVL, the incidence of which was higher in the Czech Republic. The proportion of neonates, who were released and did not have any of the complications, which pose a risk to normal neurosensory development, does not virtually change for birth weights higher than 1,500 g and reaches 98 and more percent. However, among the surviving neonates with birth weight of up to 750, their proportion is mere 50-64%.

[Role of prenatal diagnosis in decreasing the incidence of congenital defects in the Czech Republic]. / Podíl prenatální diagnostiky na snizování výskytu vrozených vad v Ceské republice.

OBJECTIVE: An analysis of prenatal diagnostics of congenital malformations in the year 2002 and an analysis of the proportion of prenatal diagnostics in the total incidence of congenital malformations in the Czech Republic in the years 1994-2002. DESIGN: A retrospective study. SETTING: Department of Medical Genetics, Faculty Thomayer Hospital, Prague. MATERIALS AND METHODS: The data were obtained from Dept. of Medical Genetics wards (28 departments)--congenital malformations were detected during prenatal diagnostics, and other data were obtained from the Institute of Medical Information and Statistics of the Czech Republic, the National Registry of Inborn Defects--Congenital Malformations in Newborns. From the available material the authors selected six types of congenital malformations (anencephaly, spina bifida, omphalocoele, gastroschisis, renal agenesis/hypoplasia, Down syndrome) for a more detailed analysis. RESULTS: In the period of 1994-2002 a total of 3,621 pregnancies with congenital malformations were detected and terminated and 1,351 fetuses were prenatally diagnosed, but the pregnancy was not terminated. The prenatal detection of inborn errors is gradually increasing. A detailed analysis of prenatal diagnostics in 2002 indicated that chromosomal aberrations were diagnosed most frequently (307 cases), of which Down syndrome was most frequent (108 cases). The next most frequent defects were those of urinary tract (agenesis or renal hypoplasia 13 times, kidney cystosis 25 times, hydronephrosis 31 times, other congenital malformations 10 times), congenital heart malformations (dealt with in another presentation), defects of neural tube (anencephaly 18 times, encephalocoele 6 times, spina bifida 22 times), congenital malformations of skeletal and muscular system (46 times) and defects of abdominal wall (omphalocoele 10 times, gastoschisis 25 times). A detailed analysis of six types of congenital malformations revealed that prenatal detection of congenital malformations increases with time and prenatal diagnostics significantly participates in the total detection of congenital malformations. The percentage of prematurely terminated pregnancies from the total number of diagnosed malformations is almost 100% in anencephaly, 50-60% in spina bifida, 50-60% in omphalocoele, 70-90% in gastroschisis, 20-30% in renal agenesis/hypoplasia and 60-70% in Down syndrome. CONCLUSION: In the period of observation there were increasing numbers of prenatally diagnosed congenital malformations. A difference develops between the total number of prenatally diagnosed cases and those diagnosed prenatally and terminated. There is an increasing number of non-terminated cases (decision of the pregnant woman, multiple pregnancies, late detection of the congenital malformations). The efficiency of prenatal diagnosis in the observed period was in the range of 50-100% in relation to the type and severity of the congenital malformations.

[Occurrence of congenital defects in the Czech Republic from 1996 to 1999 in the offspring of mothers taking medications during the 1st trimester of pregnancy]. / Výskyt vrozených vad u detí v potomstvu matek uzívajících v 1. trimestru gravidity medikaci v Ceské republice v období 1996-1999.

OBJECTIVE OF STUDY: Elaborate the results of recorded inborn defects in mothers taking drugs during the first trimester of pregnancy. TYPE OF STUDY: Retrospective analysis of data from register of inborn defects in the Czech Republic. METHOD: Elaboration of the incidence of selected types of inborn defects assessed in children born to mothers taking drugs during the first trimester of pregnancy. Data from the nationwide register of inborn defects kept in the Institute for Health Information and Statistics of the Czech Republic in 1996-1999 were used. From this total number 519 cases were recorded in born infants and 31 in foetuses. In born infants there were 215 affected girls and 304 affected boys. Some of the inborn defects were recorded more frequently in our material than in the remaining population. RESULTS: In 1996-1999 in our retrospective analysis a total of 550 cases of inborn defects were recorded in women taking medication during the first trimester of pregnancy. CONCLUSION: The paper presents recent results of the incidence of nationwide registration of inborn defects during a four-year period.

[Occurrence of congenital esophageal defects in the Czech Republic 1961-2000--incidence, prenatal diagnosis and prevalence according on maternal age]. / Výskyt vrozených vad jícnu v CR v období 1961-2000--incidence, prenatální diagnostika a prevalence podle veku matky.

OBJECTIVE: To present incidences of the oesophageal atresia or stenosis and their maternal age distribution. To analyse maternal age as a possible risk factor for the defects studied. DESIGN: Retrospective epidemiological study. SETTING: Institute for Care of Mother and Child, Prague, Czech Republic. METHODS: Retrospective epidemiological study of oesophageal atresia and stenosis using data from the population based register of congenital malformations in the Czech Republic over the 1961-2000 period. The main source of data for this paper is the database of congenital anomalies at the Institute for Care of Mother and Child in Prague (the 1961-1990 period) and the data analysed by the Institute of Health Information and Statistics (the 1987-2000 period). RESULTS: Out of the total number of 5,589,888 births in the Czech Republic in 1961-2000 period, 804 cases of oesophageal atresia and stenosis were registered. Mean incidence of oesophageal atresia and stenosis in the period under the study was 1.51 per 10,000 livebirths. In the 1991-2000 period an increase of incidences of this congenital anomaly was revealed in the Czech Republic. By application of the two-sided 95% CI, statistically significant correlation was found in women of 39 years of age and older. CONCLUSIONS: Statistically significant increase of risk (for age as a risk factor) was found in maternal age groups of 39 years of age and over.

[Routine monitoring of congenital defects in children in the Czech Republic. History and present status]. / Prubezné sledování vrozených vad u detí v Ceské republice. Historie a soucasnost.

OBJECTIVE: Analysis of quarterly incidences of selected types of birth defects in the Czech Republic in 1994-2000. SETTING: Institute for the Care of Mother and Child, Prague; Department of Medical Genetics, Thomayer Hospital, Prague and Institute of Health Information and Statistics, Prague. TYPE OF STUDY: Retrospective analysis of quarterly data from registers of birth defects in the Czech Republic. METHODS: Processing and analysis of incidences of selected birth defects in the Czech Republic in relative numbers (per 10,000 liveborn infants). The ratio of observed/expected values was calculated. RESULTS: During the period between Jan. 1 1994 and Dec. 31 2000 a total of 654 695 liveborn infants were born (for 2000 preliminary data). This number included 18,008 infants with one or more birth defects. The mean incidence of all cases during the observation period was 262.99 per 10,000 liveborn infants. In the analysis the authors discuss in detail also the frequency and its changes of eleven selected types of birth defects. CONCLUSION: Continuous registration and analysis of the incidence of inborn defects are essential as the basis for evaluation of the influence of the mentioned factors on the incidence of inborn defects.

[Survival of children born with selected types of birth defects in Czech Republic]. / Prezívání detí narozených s vybranými typy vrozených vad v Ceské republice.

OBJECTIVE: A retrospective study of data with an analysis of the prenatal and postnatal incidence of selected types of birth defects in the Czech Republic during the period from 1994 to 2003. The objective was also to analyse the percentage of deceased children born with selected types of congenital defects from the total number of deceased children. DATA SOURCE AND METHODS: The data on prenatal diagnostics were obtained from particular department of medical genetics in the Czech Republic. The data on the incidences of birth defects in the born children were obtained from the data of the National Health Registers, the administration of which has been entrusted to the Institute of Health Information and Statistics of the Czech Republic (IHIS CR). Specifically, the data from the National Register of Congenital Defects and the National Register of Neonates were used. The analysis of the frequencies of prenatally and postnatally diagnosed cases of twelve selected types of birth defects was carried out for the Czech Republic for the period from 1994 to 2003. For the cases of postnatally diagnosed defects, an analysis of survival and mortality of the affected individuals during the 1st year of life was carried out for selected types of birth defects. RESULTS: In the period 1994-2003, a total of 932,153 children were born in the Czech Republic. Including the cases of successful prenatal diagnostics, we analysed 268 cases of anencephalia, 384 cases of spina bifida and 80 cases of encephalocele, 425 cases of congenital hydrocephalus, 261 cases of omphalocele and 258 cases of gastroschisis, 225 cases of congenital defects of oesophagus and 279 anorectal malformations; 232 cases of diaphragmatic hernia, 411 cases of agenesis/hypoplasia of kidneys and 438 cystic kidneys; and 1,412 cases of Down's Syndrome. The success rate of secondary prevention was high for the defects of neural tube (55-96%), for the defects of abdominal wall (55-78%) and for the Down's Syndrome (59%). As concerns the defects treatable by surgery, the survival rate in the first year of life of the born children was lowest in the case of congenital hydrocephalus (63%) and in the case of neural tube defects (75-84%). However, in the case of GIT congenital defects (the defects of abdominal wall, diaphragmatic hernia, congenital defects of oesophagus and anorectal malformations), 82 to 91% of the born children survived. CONCLUSION: Immaturity and concurrent incidence of additional birth defects prolong the period of hospitalisation, UPV and total parenteral nutrition in the case of the affected neonates. This deteriorates the prognosis of the children born with birth defects. Possible reduction of the incidence of these cases could be achieved through improvement in prenatal diagnostics, specifically through more timely identification of mainly the serious types of defects with the presence of associated congenital defects. Another possibility to improve the survival rate of children is the development of surgical procedures and specialised neonatal and infant intensive care.

[Diaphragmatic hernia from 1961 to 2000--incidence, prenatal diagnosis and prevalence according to maternal age]. / Diafragmatické hernie v letech 1961-2000--výskyt, prenatální diagnostika a prevalence podle veku matky.

OBJECTIVE: Presentation of diaphragmatic hernia in the CR in 1961-2000. Analysis of prevalence of these defects in different groups by maternal age. DESIGN: Retrospective demographic-epidemiological study. SETTING: Institute for the Care of Mother and Child, Prague. METHODS: The authors used data from nationwide registers of birth defects in neonates kept in the Institute of Health Information and Statistics of the CR during 1995-2000. Epidemiological analysis of the incidence of diaphragmatic hernia in the CR during 1961-2000 in newborn infants. Mathematical statistical analysis of prevalence of these defects by maternal age using the method of 95% confidence interval of probability. RESULTS: In the CR during 1961-2000 1321 cases of diaphragmatic hernia were recorded. The mean incidence of this defect during the entire period was 2.32 per 10,000 live born infants incl. prenatally diagnosed cases and terminated pregnancies. Including those it was 2.37 per 10,000 live born infants. CONCLUSION: The authors elaborated the mean incidence during the investigation period and in individual years in born children as well as prenatally diagnosed cases. Also an analysis of the prevalence of these defects by maternal age was made using the method of 95% confidence interval. The authors found a significantly higher risk of development of this defect in foetuses of women aged 38, 42 years or older as compared with the population average. However an unequiwocally increased risk associated with more advanced age was neither confirmed nor ruled out.

[Congenital renal defects from 1961 to 2000--incidence, prenatal diagnosis and prevalence according to maternal age]. / Vrozené vady ledvin v letech 1961-2000--výskyt, prenatální diagnostika a prevalence podle veku matky.

OBJECTIVE: Presentation of agenesis/hypoplasia of kidneys and cystic kidneys in the Czech Republic during 1961-2000. Analysis of prevalence of these defects in different groups by maternal age. DESIGN: Retrospective demographic-epidemiological study. SETTING: Institute for the Care of Mother and Child, Prague. METHOD: The author used data from the nationwide register of birth defects in neonates, kept by the Institute of Health Information and Statistics in the CR during 1990-2000. Epidemiological analysis of the incidence of agenesis/hypoplasia of the kidneys and cystic kidneys in the CR during 1961 to 2000 in cases diagnosed prenatally and in born children. The authors made a mathematical-statistical analysis of the prevalence of these defects by maternal age, using the method of calculation of the 95% confidence interval of probability. RESULTS: In the CR there were during the period from 1961-2000 1093 registered cases of agenesis/hypoplasia of the kidneys and 1370 cases of cystic kidneys. The mean incidence during the entire period was 1.81 in agenesis/hypoplasia of the kidneys and 2.26 in cystic kidneys per 10,000 live born infants. After adding prenatally diagnosed cases and pregnancies terminated on that account it was 2.05 a 2.58 per 10,000 live born infants. CONCLUSION: The investigation of these inborn defects did not confirm nor rule out statistically a higher risk of women older than the population average.

[Congenital hydrocephalus 1961-2000--incidence, prenatal diagnosis and prevalence based on maternal age]. / Vrozený hydrocefalus v období 1961-2000--výskyt, prenatální diagnostika a prevalence podle veku matky.

OBJECTIVE: Presentation of the incidence of congenital hydrocephalus in the Czech Republic during 1961 to 2000, prenatally and postnatally diagnosed cases with this defect. Analysis of the prevalence of the defect in different groups by maternal age. DESIGN: Retrospective demographic epidemiological study. SETTING: Institute for the Care of Mother and Child, Prague. METHOD: In the investigation data from the nationwide registration of birth defects were used, kept in in the Institute for Health Information and Statistics of the Czech Republic and data on the prenatal diagnosis from different departments of medical genetics. Epidemiological analysis of the incidence of congenital hydrocephalus diagnosed prenatally and postnatally in the Czech Republic in 1961 to 2000. Mathematical and statistical analysis of the prevalence of this defect by maternal age, the method of calculation of the 95% confidence interval was used. RESULTS: In the Czech Republic in 1961-2000 3650 cases of congenital hydrocephalus were recorded. From this total number of notified cases 3415 cases were diagnosed after delivery. Prenatally 235 cases were diagnosed and pregnancy was terminated prematurely. The mean incidence of birth hydrocephalus in the neonatal population in the CR in 1961-2000 was 6.11 per 10,000 liveborn infants, after adding the number of prenatally diagnosed cases the mean incidence was 6.35 per 10,000 liveborn infants. The mean success rate of prenatal diagnosis during the investigation period was 24.30%. CONCLUSION: The authors found a significant decrease of the incidence in the neonatal population of the Czech Republic due to advances in prenatal diagnosis during the last nine years. When evaluating maternal age as one of the risk factors for the development of congenital hydrocephalus a statistically significantly higher risk was recorded in women above 37 years of age.

[Abdominal wall defects from 1961 to 2000--incidence, prenatal diagnosis and prevalence by maternal age]. / Defekty brisní steny v letech 1961-2000--výskyt, prenatální diagnostika a prevalence podle veku matky.

OBJECTIVE: Presentation of defects of the abdominal wall--omphalocele and gastroschisis--in the Czech Republic during 1961 to 2000. Analysis of the prevalence of these defects in different groups by maternal age. DESIGN: Retrospective demographic epidemiological study. SETTING: Institute for the Care of Mother and Child, Prague. METHOD: Data from the nationwide registration of congenital defects were used which are kept in the Institute for Health Information and Statistics of the CR and data on the prenatal diagnosis from different departments of medical genetics. Epidemiological analysis of the incidence of defects of the abdominal wall--omphalocele and gastroschisis, diagnosed pre- and postnatally in the Czech Republic in 1961-2000. For the mathematical and statistical analysis of the prevalence of these defects by maternal age the method of calculation of the 95% confidence interval of probability was used. RESULTS: In the Czech Republic during the period of 1961-2000 a total of 2293 cases of abdominal wall defects were registered. From this total number of notified defects 1915 cases were diagnosed after delivery, prenatal diagnosis was made in 378 cases and pregnancy was therefore terminated prematurely. From the total number of abdominal wall defects there were 1450 cases of omphalocele (incl. 136 prenatally diagnosed cases) and 843 cases of gastroschisis (incl. 242 cases diagnosed prenatally). CONCLUSION: The authors found a significant decrease in the incidence in the neonatal population of the Czech Republic due to the advances of prenatal diagnosis in the recent decade. As regards omphalocele there is a significantly higher risk in women older than 39 years, in the case of gastroschisis there is a higher risk for women under 18 years and women above 39 years.