Personality type influence the gestational weight gain.

Pregnancy is frequently followed by the development of obesity. Aside from psychological factors, hormonal changes influence weight gain in pregnant women. We attempted to assess the potential association between personality type and the extent of gestational weight gain. The study group involved 773 women after term delivery (age 26.3 ± 3.9 years, body mass before pregnancy 61.2 ± 11.1 kg). Weight gain during pregnancy was calculated by using self-reported body mass prior to and during the 38th week of pregnancy. Personality type was assessed using the Polish version of the Framingham Type A Behavior Patterns Questionnaire (adapted by Juczynski). Two hundred forty-six (31.8%) study subjects represented type A personalities, 272 (35.2%) type B and 255 (33.0%) an indirect type. Gestational weight gain was related to the behavior patterns questionnaire score and age. In women <30 years with type A personality, the weight gain was higher than in women with type B behavior of the same age. In women >30, the gestational weight gain was larger for type B personalities. Type A personality and increased urgency in younger pregnant women increases the risk of developing obesity during pregnancy in women below 30 years old. A higher level of competitiveness demonstrates a risk factor of excessive weight gain during pregnancy regardless of age.

[Hypertension in the course of primary aldosteronism during pregnancy]. / Nadcisnienie tetnicze w przebiegu pierwotnego hiperaldosteronizmu u kobiet w ciazy

Hypertension is one of the most common cardiovascular diseases during pregnancy. Primary hyperaldosteronism (PHA) is the most frequent endocrinological, secondary cause of hypertension, rarely diagnosed in pregnant women. In the available literature about 50 cases of PHA in pregnant women have been described. PHA is often a cause of resistant hypertension. PHA can cause life-threatening complications both for the pregnant woman and the fetus. Diagnosis of PHA in pregnancy is difficult due to the antagonistic effect of progesterone on aldosterone, physiological increase of aldosterone release during gestation and frequent normokalaemic clinical course. Typical pharmacological treatment of PHA is limited due to the anti­androgenic effect of spironolactone, lack of data concerning the safety of eplerenone and limited access to amiloride in Poland. Surgical treatment is a therapeutic option only in early pregnancy. This paper presents the current state of knowledge on diagnostic methods and treatment of PHA in pregnant women and a systematic review of cases described in the literature.

[Pheochromocytoma in pregnancy]. / Guz chromochlonny w ciazy.

Pheochromocytoma occurs with a frequency estimated at 2-7 per 100,000 pregnant women. Unrecognized, and thus untreated pheochromocytoma is associated with very high (40-50%) maternal and fetal mortality. Pheochromocytoma occurs sporadically or as a family trait. Its presence should be suspected in women with paroxysmal or established hypertension, especially before the 20th week of pregnancy, accompanied by headaches and palpitations, and excessive sweating, muscle tremors, vomiting, anxiety, vasomotor disturbances and blurred vision. The variety of clinical presentations and rarity are the cause of not including the disease in differential diagnosis of hypertension in pregnancy. Biochemical tests are essential in the diagnosis of pheochromocytoma, and involving the assessment of methoxycatecholamine urinary excretion. The second step in the diagnostics is magnetic resonance imaging of adrenal glands. Adrenalectomy is the treatment of choice for pheochromocytoma with adrenal location, which depends on the timing of the tumor diagnosis. Conservative treatment for 10-14 days with pharmacological blockade of alpha-adrenergic receptors should precede the surgery. Early diagnosis and properly planned treatment of pheochromocytoma significantly reduces the risk to the mother and fetus.

Live birth of monochorionic triamniotic triplets after in vitro fertilization and blastocyst transfer: case report and review of the literature.

UNLABELLED: Monozygotic triplet pregnancies are very rare, even after in vitro fertilization (IVF). We present a case of a live birth of triplets from a monochorionic triamniotic pregnancy after blastocyst transfer. A 29-year-old woman underwent intracytoplasmic sperm injection (IVF-ICSI). Her medical history included a 4-year infertility treatment with ovarian stimulation, three cycles of intrauterine insemination, hysteroscopy and an unsuccessful attempt at IVF. During the second IVF attempt, the patient underwent ovulation simulation according to the long GnRH agonist protocol. Eleven metaphase II (MII) oocytes were injected with spermatozoa, resulting in four expanded blastocysts. In the end, two blastocysts (4AA) were transferred into the uterine cavity. Ultrasound examination performed at 7 weeks of gestation showed an ongoing triamniotic triplet pregnancy. Regular uterine contractions began at 33 weeks of gestation and a cesarean section was performed, resulting in a birth of three healthy girls, weighing 2060g (Apgar 7), 1860g (Apgar 6), 2000g (Apgar 6). After 13 days of hospitalization the infants and the mother were discharged home. CONCLUSION: The causes of monozygotic multiple gestations in spontaneous and ART pregnancies are poorly understood. They seem to occur more often after IVF. Any definitive relationship between particular stages of the IVF procedure and monozygotic multiple pregnancies remains controversial.

Immunolocalization of ABC drug transporters in human placenta from normal and gestational diabetic pregnancies.

OBJECTIVES: ABC transporters, P-gp, MDR3, BCRP and MRP1, can bind both endo- and exogenous ligands. The latter include immunosuppressive, anticancer sedative, anticonvulsant, antiparasitic and cardiovascular drugs, as well as HIV protease inhibitors and antibiotics. Protein transporters are also involved in tissue distribution of orally administered medicines in combination therapy for gestational diabetes mellitus (GDM) and could be used during GDM treatment. The distribution depends on transporter specificity its expression and subcellular localization. THE AIM: The aim of the study was to compare P-gp, MDR3, BCRP and MRP1 localization in placental tissues from normal and GDM diabetic pregnancies. MATERIAL AND METHODS: Tissue samples were taken from 10 normal and 10 GDM placentas. Immunohistochemical reactions were performed with the use of adequate monoclonal antibodies. Avidin-biotin-peroxidase complex method was used for the visualization of antigen-antibody complexes. RESULTS: P-gp, MDR3 and BCRP were found in all parts of normal human placenta i.e. the amniotic epithelium, cytotrophoblast, syncytiotrophoblast and decidual cells. P-gp and BCRP, but not MDR3 and MRP1, were also localized on the endothelial cells of fetal blood vessels in the chorionic plate, as well as stem and tertiary villi. MRP1 expression was observed in the cytotrophoblast and the syncytiotrophoblast. Its expression was very low or undetectable in the amniotic epithelium and the majority of decidual cells. Immunohistochemical reactions within the syncytiotrophoblast showed apical (P-gp, BCRP), apical and basal (MRP1) or diffuse (MDR3) distribution. The main changes observed in GDM placentas included weaker MRP1 and MDR3 positive reactions in the syncytiotrophoblast, slightly lower expression of P-gp in the decidual and amniotic epithelial cells, and MDR3 in the amniotic epithelium. CONCLUSIONS: Our results indicate that GDM-related changes in the environment of placental cells do not substantially influence tissue and subcellular location of ABC transporters. Nevertheless, the expression of P-gp, MDR3 and MRP1 may be lower in comparison to normal placentas. Basal syncytiotrophoblast transporters, MRP1 and MDR3, seem to be more sensitive to the influence of GDM than apical proteins, what may result in altered biodisposition of endogenous substrates and drugs.

Application of fuzzy inference systems for classification of fetal heart rate tracings in relation to neonatal outcome.

OBJECTIVES: Fetal monitoring based on the analysis of the fetal heart rate (FHR) signal is the most common method of biophysical assessment of fetal condition during pregnancy and labor Visual analysis of FHR signals presents a challenge due to a complex shape of the waveforms. Therefore, computer-aided fetal monitoring systems provide a number of parameters that are the result of the quantitative analysis of the registered signals. These parameters are the basis for a qualitative assessment of the fetal condition. The guidelines for the interpretation of FHR provided by FIGO are commonly used in clinical practice. On their basis a weighted fuzzy scoring system was constructed to assess the FHR tracings using the same criteria as those applied by expert clinicians. The effectiveness of the automated classification was evaluated in relation to the fetal outcome assessed by Apgar score. MATERIAL AND METHODS: The proposed automated system for fuzzy classification is an extension of the scoring systems used for qualitative evaluation of the FHR tracings. A single fuzzy rule of the system corresponds to a single evaluation principle of a signal parameter derived from the FIGO guidelines. The inputs of the fuzzy system are the values of quantitative parameters of the FHR signal, whereas the system output, which is calculated in the process of fuzzy inference, defines the interpretation of the FHR tracing. The fuzzy evaluation process is a kind of diagnostic test, giving a negative or a positive result that can be compared with the fetal outcome assessment. The present retrospective study included a set of 2124 one-hour antenatal FHR tracings derived from 333 patients, recorded between 24 and 44 weeks of gestation (mean gestational age: 36 weeks). Various approaches for the research data analysis, depending on the method of interpretation of the individual patient-tracing relation, were used in the investigation. The quality of the fuzzy analysis was defined by the number of correct classifications (CC) and the additional index QI - the geometric mean of the sensitivity and specificity values. RESULTS: The effectiveness of the fetal assessment varied, depending on the assumed relation between a patient and a set of her tracings. The approach, based on a common assessment of the whole set of tracings recorded for a single patient, provided the highest quality of automated classification. The best results (CC = 70.9% and QI = 84.0%) confirmed the possibility of predicting the neonatal outcome using the proposed fuzzy system based on the FIGO guidelines. CONCLUSIONS: It is possible to enhance the process of the fetal condition assessment with classification of the FHR records through the implementation of the heuristic rules of inference in the fuzzy signal processing algorithms.

[Effects of the cigarette smoking on the newborn clinical parametrs and the accumulation of cadmium and lead in the placenta of women from Upper Silesia]. / Wplyw palenia papierosów na parametry noworodka oraz na kumulacje kadmu i olowiu w lozysku kobiet z Górnego Slaska.

AIM: The aim of the study was to determine the content of cadmium and lead in different parts of the placenta and fetal membranes of women who were exposed to cigarette smoke. The correlation between the two chemical elements and the impact of the Cd and Pb accumulation on newborn parameters were established. MATERIALS AND METHODS: The study material was collected immediately after delivery from 40 patients of the Department of Obstetrics and Gynecology Katowice. The marginal and central parts of the placenta and fetal membranes (amnion) were taken. The women were divided into two groups: smokers and non-smokers. Metal concentration in placenta was determined by flame atomic absorption spectrometry (FAAS). Bioethical Commission approved of the study RESULTS: In both studied groups, smokers and non-smokers, the presence of cadmium and lead was detected. Smokers turned out to have accumulated more of the investigated heavy metals in the placenta and fetal membranes. In the analyzed groups of women of smokers and non-smokers, differences in the content of the studied metals were found, but they were not statistically significant. Differences in newborn parameters in the two groups of women occurred, but again they lacked statistical significance. The level of lead increases along with the increase in the amount of cadmium, which proves the existence of a statistically significant correlation between them (p = 0.000). CONCLUSIONS: The number of smoked cigarettes increases cadmium content in maternal placenta and fetal membranes. No significant differences in newborn parameters of either smoker or non-smokers were observed, which may indicate women's adaptation to the environment containing cigarette smoke. The placenta and fetal membranes are biomarkers of the level of toxic exposure for the developing baby.

Expression and co-expression of surface markers of pluripotency on human amniotic cells cultured in different growth media.

OBJECTIVES: Despite constant advances in the field of biology and medical application of human embryonic stem cells, the molecular mechanism of pluripotency remains largely unknown. So far, definitions of pluripotent stem cells (SC) have been based on a limited number of antigenic markers and have not allowed for unambiguous determination of the homogeneity of each subpopulation. Moreover, the use of some crucial pluripotency markers such as SSEA-3 and SSEA-4 has recently been questioned due to the possibility that the pattern of surface glycans may be changed depending on the content of the cell culture medium. AIM: Quantitative analysis of amniotic SC subpopulations cultured in different media, based on the following pluripotency surface markers: SSEA-3, SSEA-4, TRA- 1-60 and TRA- 1-81 expression and co-expression. MATERIAL AND METHODS: Immunofluorescence and fluorescence microscopy were used to identify and localize SC within a normal human placenta at term. The number of SSEA-4+, SSEA-3+, TRA-1-60+ and TRA-1-81+ cells and cells with co-expression of the above mentioned markers, cultured in media containing different protein supplements of animal origin, was counted by flow cytometry RESULTS AND CONCLUSIONS: Cells with characteristics of embryonic SC were identified in the amniotic epithelium and the chorion, but not in the decidua basalis. Amniotic epithelium contained various types of SC, with SSEA-4+ as the most numerous. Disproportion in the number of SSEA-4+, SSEA-3+, TRA-1-60+ and TRA-1-81+ cells and cells characterized by co-expression of these antigens, as well as lack of quantitative differences between SC subpopulations cultured in different media, was observed. In conclusion, the amniotic epithelium is composed of SC at different stages of the development but human amnion might become an alternative source of SSEA-4+ embryonic-like SC. The composition of the evaluated media, characterized by different content of animal-derived proteins, does not influence the number of cells identified within the SC subpopulations.

[The statement of Polish Society's Experts Group concerning diagnostics and methods of endometriosis treatment]. / Stanowisko Zespolu Ekspertów Polskiego Towarzystwa Ginekologicznego dotyczace diagnostyki i metod leczenia endometriozy.

Endometriosis is defined by endometrial glands and stroma outside of the endometrial cavity Three types of endometriosis have been described: peritoneal endometriosis, ovarian endometriosis and deep infiltrating endometriosis. Endometriosis afflicts 6-15% of women population. It occurs mainly in the group of women in reproductive age, but also in the group of minors and approximately 3% of women after menopause. Within the group of women suffering from infertility the frequency of endometriosis increased to 35-50% of cases. Endometriosis is associated with pain symptoms which can bear the character of pain occurring periodically and altering into constant pain, dysmenorrhea, dyspareunia, dysuria and dyschezia. The correlation between the stage of endometriosis and intensity of pain symptoms not always has to be proportionate. Laparoscopy can be perceived as a standard procedure in endometriosis diagnostics as it allows simultaneous treatment. Profound interview as well as visual diagnostics (USG, MRI) should precede laparoscopy Treatment of endometriosis can be divided into pharmacological and surgical treatment, which can be invasive or non-invasive. The type of treatment depends on patient's age and her procreation plans, occurring ailments and endometriosis type. Important role is played by adjuvant treatment such as appropriate diet and lifestyle. Treatment of advanced endometriosis should be conducted in reference centres that are appointed with adequate equipment and have the possibility of interdisciplinary treatment. Presented standards can digest and outline the order of proceedings both in diagnostics and endometriosis treatment. The research group believes that the above compilation will facilitate undertaking appropriate decision in diagnosis and treatment of the disease, which will subsequently contribute to therapeutic success.

The spatial and temporal reconstruction of a medieval moat ecosystem.

Moats and other historical water features had great importance for past societies. The functioning of these ecosystems can now only be retrieved through palaeoecological studies. Here we aimed to reconstruct the history of a stronghold's moat during its period of operation. Our spatio-temporal approach allowed mapping of the habitat changes within a medieval moat for the first time. Using data from four cores of organic deposits taken within the moat system, we describe ecological states of the moat based on subfossil Chironomidae and Ceratopogonidae assemblages. We found that over half (57%) of the identified dipteran taxa were indicative of one of the following ecological states: limnetic conditions with or without periodic water inflow, or marshy conditions. Samples representing conditions unfavourable for aquatic insects were grouped in a separate cluster. Analyses revealed that the spatio-temporal distribution of midge assemblages depended mostly on depth differences and freshwater supply from an artificial channel. Paludification and terrestrialization did not happen simultaneously across the moat system, being greatly influenced by human activity. The results presented here demonstrate the importance of a multi-aspect approach in environmental archaeology, focusing not only on the human environment, but also on the complex ecology of the past ecosystems.

The analysis of receptor-binding cancer antigen expressed on SiSo cells (RCAS1) immunoreactivity within the microenvironment of the ovarian cancer lesion relative to the applied therapeutic strategy.

RCAS1 is involved in generating the suppressive profile of the tumor microenvironment that helps cancer cells evade immune surveillance. The status of the cells surrounding the cancer nest may affect both the progression of the cancer and the development of metastases. In cases of ovarian cancer, a large number of patients do not respond to the applied therapy. The patient's response to the applied therapy is directly linked to the status of the tumor microenvironment and the intensity of its suppressive profile. We analyzed the immunoreactivity of RCAS1 on the cells present in the ovarian cancer microenvironment in patients with the disease; these cells included macrophages and carcinoma-associated fibroblasts. Later we analyzed the immunoreactivity levels within these cells, taking into consideration the clinical stage of the cancer and the therapeutic strategy applied, such as the number of chemotherapy regiments, primary cytoreductive surgery, or the presence of advanced ascites. In the patients who did not respond to the therapy we observed significantly higher immunoreactivity levels of RCAS1 within the cancer nest than in those patients who did respond; moreover, in the non-responsive patients we found RCAS1 within both macrophages and carcinoma-associated fibroblasts. RCAS1 staining may provide information about the intensity of the immuno-suppressive microenvironment profile found in cases of ovarian cancer and its intensity may directly relate to the clinical outcome of the disease.

[Anti-Müllerian hormone and fertility disturbances in obese women and women with polycystic ovary syndrome]. / Hormon anty-Müllerowski a zaburzenia plodnosci u otylych kobiet i kobiet z zespolem policystycznych jajników.

Anti-Müllerian hormone (AMH) belongs to a family of growth and differentiation factors beta (TGF-beta). In male fetuses AMH induces regression of Müller's ducts whereas in female ones this hormone plays an important role during adolescence and reproductive period. AMH participates in regulation of folliculogenesis by inhibiting the recruitment of prenatal and antral follicles. The aim of the present study was to summarize the current knowledge of the role of AMH in menstrual and fertility disturbances in obese women and those with polycystic ovary syndrome.

[Risk factors of pelvic organ prolapsed in women qualified to reconstructive surgery--the Polish multicenter study]. / Czynniki ryzyka defektów dna miednicy u kobiet zakwalifikowanych do operacji rekonstrukcyjnych--polskie badanie wieloosrodkowe.

AIM OF STUDY: To evaluate the prevalence rate of various pelvic floor disorders among patients treated in 8 academic centers in Poland due to pelvic organ prolapse (POP). MATERIAL AND METHODS: The study group consisted of 717 women scheduled for reconstructive surgery due to POP. Risk factors, functional abnormalities along with symptoms affecting quality of life, were assessed by means of disease specific questionnaire. The stage of the disease was assessed after gynecological examination using POP-Q score. RESULTS: The mean age of affected women with POP was 61,25 years (median 61), and mean BMI--27.62 (median--27.29). 80% of women were menopausal. Mean time of symptoms related to disease was 65,6 months; whereas the time relapsed from first doctor diagnosis of POP to hospital admission was 50.6 months. 97.4% affected women were multiparous. Only 1.21% women with POP were nulliparous. Family history of prolapse was found in 13.4% of patients, whereas familial positive history of urinary incontinence was 10%. Lower urinary tract symptoms (LUTS) among the analyzed group were as follows: frequency--almost 50%, urgency 32.2%, feeling of improper voiding -29,6% and voiding difficulty -17.7%. Functional disorders of lower bowel were found in 43% of patients and the most prevalent symptom was constipation (31%), followed by empting difficulty (12%), dyschesia (9%), and urge stool empting (7.7%). Cardiovascular diseases were found among 43% of respondents, whereas pulmonary diseases with chronic coughing were present in 20% of the analyzed population. Subjective POP symptoms reported by women were as follows: feeling of heaviness in lower abdomen--378%, perineal pain--27.8%, lumbosacral pain-34.2%, and abdominal pain--28.4%. Female sexual disorders were reported by 9,8% women and dyspareunia was found in 7.6% of responders. POP was the main reason for sexual abstinence only in 1 out of 10 patients. More than 30% of patients from the study group underwent previously pelvic surgery due to various reasons. POP related quality of life measured by VAS (Visual Analogue Scale) was 61.4 points (median--60). The most common finding during gynecological examination was cystocele--96.5%, followed by rectoenterocele--92.7%, and central defect--79%. Mean POP quantification was stage III in POP-Q scale. LUTS symptoms (urinary incontinence, urgency and voiding difficulties) were present among 81% of patients whereas lower gastrointestinal disorders (constipation, fecal incontinence, dyschesia) were found in 43% of women affected by POP. CONCLUSIONS: Mean delay time from objective POP diagnosis until decision concerning surgical treatment was more than 5 years. The most common risk factors associated with POP were: multiparity with vaginal deliveries, obesity and aging. The most common defect found among patients with POP was cystocele, followed by rectoenterocele and central defect however most patients presented with advanced combined defects.

Successful treatment of placental site trophoblastic tumor in twin pregnancy without hysterectomy.

To the best of the authors' knowledge, no case of placental site trophoblastic tumor (PSTT) pertinent to twin pregnancy has yet been published. There are only few case reports concerning patients with PSTT who were successfully treated by fertility-sparing methods. A 29-year-old nulliparous woman was admitted to hospital in the 36th week of a twin pregnancy due to symptoms of preterm labor. She underwent a cesarean section, during which a 4-cm uterine mass was found and resected. Histopathology revealed PSTT. Eighteen weeks after the delivery an ultrasound scan displayed another intrauterine mass, 2 cm in size. In the material resected in hysteroscopy there was necrotic decidual tissue. Another 30 months of observation revealed no abnormalities. Even though PSTT is rarely diagnosed, it may cause significant diagnostic and therapeutic problems.

[Changes of mRNAs encoding alternatively spliced variants of procollagen C-endopeptidase in leiomyomas uteri depending on the phase of menstrual cycle and in postmenopausal women]. / Zmiany mRNA wariantów alternatywnego skladania C-endopeptydazy prokolagenu w miesniakach macicy w zaleznosci od fazy cyklu miesiecznego i u kobiet w okresie klimakterium.

UNLABELLED: Leiomyoma uteri is a monoclonal tumour of the uterus muscle layer. It is characterized by excessive, abnormal growth of extracellular matrix. The collagen types I and III are the major components of extracellular matrix. Removal of the C-propeptides in procollagens type I, II, and III by procollagen C-endopeptidase leads to spontaneous self-assembly of collagen fibrils. Thus, the procollagen C-endopeptidase is a key regulator of extracellular matrix production, its quality, and other developmental processes including angiogenesis. OBJECTIVE: The objective of this study was to analyze the three alternatively spliced variants of the BMP1 gene product including the procollagen C-endopeptidase, in leiomyoma uteri tumors in comparison to normal myometrium in women being in first or second menstrual phase or in time of climacterium. MATERIAL AND METHODS: In the study we analyzed samples from the control and cancerous tissues from 52 women. Expression of the three alternatively spliced variants of BMP1 gene transcript were assayed by RT-PCR, following densytometric analysis. Statistical significance (p < or = 0,05) of the observed differences was assessed with the use of Anova test, Least Significance Different Test, and Student's T-test. RESULTS: Analysis of RT-PCR products revealed the presence of all alternatively spliced variants of BMP-1 mRNA and the changes in their alternative splicing intensity, depending on the phase of menstrual cycle or postmenopausal state. In the second phase of the cycle, in control tissue, the expression level of BMP-1 variant decreased when compared to women in I phase of the cycle or postmenopausal women. In the tumour, postmenopausal women showed increased expression of BMP-1at, when compared with women in the second phase of the cycle. The presence of mTLD in the tumour tissue at II phase of the cycle and in postmenopausal state was less strong when compared to women at I phase of the cycle. In control tissue this type of change was not observed. The BMP-1/HIS was present at higher level in control tissue, during II phase of the menstrual cycle and in postmenopausal state, whereas in the tumour tissue its lowest level was at II phase of the cycle. CONCLUSIONS: Regulation of alternative splicing of mRNA for procollagen C-endopeptidase in leiomyomas and myometrium depends mainly on the hormonal status of women.

[Prognostic value of chosen parameters of mechanical and bioelectrical uterine activity in prediction of threatening preterm labour]. / Wartosc wybranych parametrów mechanicznej i bioelektrycznej aktywnosci miesnia macicy w przewidywaniu zagrozenia porodem przedwczesnym.

OBJECTIVES: To record and analyse bioelectrical activity of the uterine muscle in the course of physiological pregnancy, labour and threatening premature labour; to define which parameters from the analysis of both electrohysterogram and mechanical activity signal allow us to predict threatening premature labour. MATERIAL AND METHODS: Material comprised 62 pregnant women: Group I--27 patients in their first physiological pregnancy, Group II--21 patients in their first pregnancy with symptoms of threatening premature labour, and Group III--14 patients in the first labour period. The on-line analysis of the mechanical (TOCO) and electrical (EHG) contraction activity relied on determination of quantitative parameters of detected uterine contractions. RESULTS: The obtained statistical results demonstrated a possibility to differentiate between Group I and II through the amplitude and contraction area for EHG signal, and only the contraction amplitude for TOCO signal. Additionally, significant differentiating parameters for electrohysterogram are: contraction power and its median frequency. Analyzing Group I and III, significant differences were noted for contraction amplitude and area obtained both from EHG and TOCO signals. Similarly, the contraction power (from EHG) enables us to assign the contractions either to records from Group I or to labour type. There was no significant difference noted between Group II and III. CONCLUSIONS: Identification of pregnant women at risk of premature labour should lead to their inclusion in rigorous perinatal surveillance. This requires novel, more sensitive methods that are able to detect early symptoms of the uterine contraction activity increase. Electrohysterography provides complete information on principles of bioelectrical uterine activity. Quantitative parameters of EHG analysis enable the detection of records (contractions) with the symptoms of premature uterine contraction activity.

Symptomatic uterine fibroids in pregnancy - wait or operate? Own experience.

OBJECTIVES: Uterine fibroids are one of the most common benign tumors of the female genital tract. The major complication of myomas in pregnancy is a recurrent pain, however the misscariage is the main threat. The negative impact of myomas on the course of pregnancy may also result in i.e. uterine bleeding, higher incidence of a maternal-fetal incommunicability, an incorrect position of the fetus and its deformities. MATERIAL AND METHODS: The patient aged 31 was admitted to Mother and Child Health Center in Zabrze due to the threatened miscarriage. The primigravid at 19 weeks' gestation was previously diagnosed with myoma. On admission the ultrasonography revealed one alive fetus in the uterus and a nodular change on the right side of the uterine fundus, 13 x 11 cm in size and non-homogenous echo. RESULTS: The patient was qualified to the conservative myomectomy. 11 days after the enucleation of 25 cm in diameter myoma, patient in good condition, with the maintained, alive foetus was discharged from the hospital. Patient at 34 weeks' gestation was re-admitted due to the beginning of uterine contraction. After one week of observation within the ward, with tocolytic drugs and steroids administered, at 35th week of pregnancy the patient gave birth to a live daughter via the Ceasarian section. CONCLUSIONS: Prenatal myomectomy can be safely performed in the first and second trimester of pregnancy, however it is recommended to deliver the baby via Caesarean section, due to fear of intrauterine rupture of the uterus.

Sexual Functioning in Pregnant Women.

Sexual activity during pregnancy is determined by emotional, psychosocial, hormonal, and anatomical factors and varies during trimesters. This work aimed to establish women's sexual activity during each trimester of pregnancy. A total of 624 women were included in the study and filled in the questionnaire three times, once during each trimester of pregnancy. The first part of the survey included questions about socio-demographic characteristics, obstetric history, and medical details of a given pregnancy. The second part was the Polish version of the female sexual function index (FSFI) questionnaire. Comparison of the mean scores for the overall sexual function of each trimester revealed clinically relevant sexual dysfunction in the second and third trimesters (mean values 25.9 ± 8.7 and 22.7 ± 8.7, respectively; p < 0.01). Women were most sexually active during their second trimester. In the first trimester of pregnancy, women were most likely to choose intercourse in the missionary position. Women with vocational education were characterized by the lowest and homogenous FSFI values. Total FSFI score depended on the martial status-the highest value pertained to married women (25.2 ± 6.9; p = 0.02).

The possible biological role of metallothionein in apoptosis.

Metallothioneins (MTs) are a family of low molecular weight proteins with a high affinity for divalent metals. Metallothionein has been shown to have a protective role in apoptosis. Specifically, it controls the cellular zinc ion levels. The proper intracellular Zn2+ level maintains the fragmentation of DNA associated with caspase-3 activity. In cancer nests, MT has been identified in the peripheral regions and associated with higher cell proliferation rates and fewer positive apoptotic cells. The expression of MT in the stroma has been linked with tumor spread. The tumor stroma may respond to tumor growth and aggressiveness by the expression of MT, thus protecting itself from and developing a resistance to apoptosis. Multistep carcinogenesis is related to a breakdown in immune response that enables tumor progression and dissemination. This breakdown is a crucial for tumor survival. The evaluation of MT expression in cancer and its stroma seems to correlate with the level of immune system inhibition in cancer-adjacent stroma.