The levels of calcium, magnesium and iron in amniotic fluid and serum taken from women during first half of pregnancy were compared. The relationship between these levels and vitamin-mineral supplementation was also estimated. There was similar calcium and magnesium concentration in the serum and amniotic fluid. The concentration of iron in serum was four times as large as in amniotic fluid. Any influence of supplementation on concentration of studied minerals was noted.

The present article discusses potential mechanisms by which lipid peroxidation might contribute to the pathogenesis of hypertensive disorders of pregnancy.

The aim of this study was to analyse some aspects and methods use to evaluate the quality of obstetric care, and their implementation into obstetric practice. Assurance of proper quality of services in obstetrics becomes today a key -problem in Poland. The article describes the evaluation of structures, processes, and results as methods of quality assurance and control. Authors suggest that special attention should by paid to correct leader- ship, medical records analysis and later formulating constructive conclusions and quality improvement. Audit and quality improvement at the national level seems to be very important. Monitoring of quality is not only necessary, but also continuous management and improvement. It is also necessary to remember that the process of quality improvement once begun should be continued.

International Journal of Gynecology & ObstetricsVolume 70, Issue S1 p. A83-A84 Birthing Vaginal birth after previous cesarean section J. Leibschang, J. LeibschangSearch for more papers by this authorA. Swiatack, A. SwiatackSearch for more papers by this authorJ. Kesicka, J. KesickaSearch for more papers by this authorB. Chazan, B. ChazanSearch for more papers by this author J. Leibschang, J. LeibschangSearch for more papers by this authorA. Swiatack, A. SwiatackSearch for more papers by this authorJ. Kesicka, J. KesickaSearch for more papers by this authorB. Chazan, B. ChazanSearch for more papers by this author First published: 09 December 2003 https://doi.org/10.1016/S0020-7292(00)82765-4AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume70, IssueS12000Pages A83-A84 RelatedInformation

The aim of this multicentre prospective study was assessing the effectiveness of intravaginal treatment of vaginal candidiasis with Pimafucin 100 mg ovule. Success was obtained among 81% pregnant and 86% nonpregnant women. The negative predictive factors were intensive patients complains: pruritus or soreness.

The aim of this study was to evaluate women’s attitudes towards cigarette smoking and to determine their preferences and socioeconomic characteristics. The participants were a representative group of 1385 women aged 15–49 in three areas of Poland. Each woman filled in a standardized questionnaire in the presence of the interviewer.

PROBLEM:Premature birth and hospitalisation of a child in the first weeks of life may have a potentially adverse effect on the relationship between the parents and the child.AIM:The aim of this paper is to describe: 1) emotional reactions of parents of babies born prematurely, 2) parental processes of coping, and 3) psychological intervention in the context of tertiary care hospital ward.DESCRIPTION:The author presents data from relevant literature and her clinical experiences of co-operation with the Clinical Department of Neonatal Pathology and Intensive Care of the National Research Institute of Mother and Child in Warsaw.CONCLUSIONS:Parents of premature neonates experience a whole range of emotional reactions and use different ways of coping. Psychological intervention in the post-partum period is aimed at preventing disorders of bonding and attachment.

Prenatal and postnatal health care at counselling centres and hospitals in Poland involves tobacco control efforts during a number of visits. At the first visit of an expectant mother, background information is obtained, and the woman is given information about the consequences of cigarette smoking and assistance is she has stopped smoking. Women at high risk are given assistance and are monitored. At subsequent visits, assistance and advice is given to women who have stopped smoking. Those who have not are advised of the importance of involving their partners and close friends in helping them to quit. They are given information and shown the embryo’s movements on ultrasound monitors. During the visit at the third trimester or in hospital, their anti- smoking attitude is consolidated and they are given assistance in coping with stress and provided with information about the harmful effects of tobacco smoke.

The role of vascular endothelial cell dysfunction and damage in pathogenesis of preeclampsia have been discussed in this paper.

In pregnancy complicated by the cigarette smoking the risk of oxidative damage depends not only on the amount of physiologically enhanced free oxygen species but may be affected by intoxication with tobacco smoke radicals. In the presented studies oxidative damage was estimated through measurement of lipid peroxidation, level of total antioxidant activity and selected antioxidants in plasma and erythrocytes of non-smoking and smoking pregnant women. No differences were found between those two groups in the level of lipid peroxidation and antioxidant activity. Plasma concentration of vitamin A was lower by 15% in smoking than in non-smoking women but vitamin E level did not change. In erythrocytes of the smoking group, concentration of reduced glutathione was 35% higher than in the non-smoking group but activity of glutathione peroxidase and concentration of vitamin E were the same. The observed changes indicate that protection of erythrocytes against free radicals may be sufficient to prevent lipid peroxidation and may manifest local and adaptive response of metabolism for tobacco smoking by pregnant women.

Maternal phenylketonuria (M-PKU) is a syndrome of embryo- and fetopathy observed in the offsprings of mothers with increased blood level of phenylalanine. These women fall into two groups: phenylketonuria (PKU) and mild hyperphenylalaninemia (MHP). The Phe--level safe for the fetus is 4-6 mg%. Typical for M-PKU syndrome is: microcephalia, mental retardation, intrauterine growth retardation, congenital heart diseases and other anomalies like esophageal atresia, meningocoele, Pierre-Robin syndrome, cataract. The only way to prevent this syndrome is Phe--restricted diet that should be initiated before conception. We reviewed updated literature on the pathogenesis of this syndrome, clinic, possibility of prophylaxis and treatment. We present also 5 pregnancies of 3 patients with PKU, treated in National Research Institute of Mother and Child in Warsaw. On that ground we propose the scheme of prevention of maternal PKU syndrome.

This paper sums up the results of treatment with laparoscopy the patients suffering from infertility of unknown reason. Laparoscopy was performed in 75 patients and only in 21.3% of cases the reason of infertility remained unclear. In most of infertile women (90%) different factors of infertility were revealed--among them the most important turned out adhesions in the adnexal area (37%) and polycystic ovaries (32%). The most often performed procedures during laparoscopy were adhesiolysis and electrical cauterization ("drilling") of ovaries. 20% of patient become pregnant and delivered successfully. In operated patients only 2 complications were noted (one of anesthetic origin). The results confirmed that laparoscopy is essential element in infertility diagnostics and treatment.

Antiretroviral therapy decreases rates of maternal-infant HIV transmission when given ante and intrapartum to the pregnant women and post partum to the infant. The use of zidovudine (AZT) in pregnant women and newborn is well tolerated and reduces the maternal-infant transmission of HIV even though the complete protocol has not been used. Combination therapy leads to a sustained undetectable viral load in mother blood and does not have detrimental effects on the newborn. The use of combination antiretroviral therapy is now recommended in pregnancy, although limited data currently exists on the impact of this regimen on newborns. In future, there is a clear need to assemble larger population-based cohorts of HIV+ parturients and their offspring to explore the safety of antiviral therapy in pregnancy.

1. The main causes of direct obstetrical deaths were; (1) haemorrhage 34,5% (rate 3,91), (2) sepsis 27,3% (rate 3,08), (3) gestosis or pregnancy induced hypertension 18,9 % (rate 2,14), (4) embolism 19,3 % (rate 2,18).2, The most common causes of haemorrhage were: placenta praevia; premature separation of placenta, rupture of uterus, post partum haemorrhage (uterine atony), other placental complications and haemorrhage of unknown origin.3, Maternal deaths were mostly avoidable. Despite the fact, that maternal mortality rate decreased in Poland during last 45 years considerably (from 50 in 1950 to 11,2 in 1995 per 100 000 live births), we believe, that better organization of antenatal care and emergency obstetrical surveillance, readiness of blood and laboratory services should lead to significant improvement in this field.

Postterm pregnancy remains constantly a difficult and controversial problem in modern obstetrics. The aim of this study is to discuss the definition of the postterm pregnancy, complications for both the foetus (macrosomia associated with birth trauma and shoulder dystocia, oligohydramnios, meconium aspiration, postmaturity syndrome) and mother (increase rate of caesarean births). We discussed also the antepartum surveillance and the management of the postterm gestation (time and way of delivery). The management of postterm pregnancy should be individualised and based on the above findings. Treatment includes active methods (induction of labour, elective caesarean section) or conservative way (strict foetal antenatal surveillance).