Ceska Gynekologie-Czech Gynaecology最新文献

Objective: Review of recent literature dealing with the effect of antipsychotic use during pregnancy on early postpartum adaptation of exposed infants and the development of congenital malformations.

Results: The use of antipsychotics during pregnancy does not appear to lead to significantly higher risk of congenital malformations but may pose a greater risk for the early adaptation of the newborn (especially the risk of preterm birth and intensive care unit admission). The study to date face methodological limitations - lack of information on exact doses of antipsychotics, lack of control groups of women with psychiatric problems but not taking antipsychotics and failure to control for confounding factors.

Conclusion: The available data suggest the relative safety of antipsychotics during pregnancy, provided that potential risks are known, and the woman and her baby are carefully monitored.

Pure uterine lipomas are extremely rare benign uterine tumors. This paper presents the case of a 68-year-old patient with symptomatic leiomyoma-like fundus formation on ultrasound. A hysterectomy was performed with anterior vaginal plastic surgery as a treatment option for concomitant cystocele grade II. Histological diagnosis of pure uterine lipoma with S-100 positive immunohistochemical staining was confirmed. This case shows us that uterine lipoma clinically and diagnostically mimics myoma very well. We believe that surgery as a therapeutical approach is justified in symptomatic patients.

The uterine tube, belonging to the female internal reproductive organs, is the only tubular organ in the human body that has, under physiological conditions, a transport function occurring in two opposite directions. It transports the picked-up oocyte released during ovulation and early embryo towards the uterine cavity. At the same time, it can transport spermatozoa towards the abdominal opening of the fallopian tube. Moreover, the uterine tube has many other vital functions as sperm selection (one of the crucial factors preventing polyspermy) and the production of tubal fluid. This unique secretion is essential not only for the process of fertilization but also for sperm activation and the nourishment of the early embryo during its transport into the uterine cavity. The first part of our review is focused on the historical introduction to the topic in which the reader will become familiar with the views and understanding of these peculiar organs by famous anatomists of the 16th and 17th centuries, namely Gabriele Falloppio and Renier de Graaf. The following section will cover the overview of the latest anatomical, embryological, and histological knowledge, which are also crucial for a better understanding of pathological processes affecting the fallopian tube, such as tubal infertility or tubal pregnancy. Interestingly, recent years have been very fruitful regarding uterine tube morphology, e. g. the discovery of an unique mechanism of lymphatic flow within the uterine tube mucosa, the first description of immunologically-active intraepithelial suppressor T-lymphocytes, or the observation of pacemaker cell population - telocytes - in the muscle layer.

The aim of this article is to acquaint the gynaecological public with our experience with the use of computed tomography in the diagnosis of fluid collections in women with clinical suspicion of complicated pelvic inflammation or a complication after gynaecological surgery. We present diagnostic dilemmas that radiologists deal with, including differential diagnoses. We also deal with the benefits for the referring gynaecologist, and we also discuss the possible discrepancy between his expectations and the result of the examination.

Objectives: The aim of the presented work is to summarize the current knowledge about the pathophysiology of preterm birth in connection with premature amniotic fluid.

Methods: To analyze current knowledge and our own experiences regarding of preterm prelabour rupture of membranes.

Conclusion: The most important factor influencing neonatal morbidity and mortality is gestational age. Early neonatal sepsis occurs with high risk after premature amniotic fluid outflow, associated with inflammatory complications.

New recombinant gonadotropin-follitropin delta produced on human cell lines PER.C6 shows the same glycosylation profiles as human follicle stimulating hormone in comparison with recombinant gonadotropins produced on animal cell lines. The aim of the article is to summarize published data.

Introduction: Small and large bowel obstruction secondary to volvulus on the background of intestinal malrotation is a very rare occurrence, especially in pregnancy. This can be associated with significant feto-maternal morbidity and mortality.

Case report: We report a case of a pregnant lady who developed symptoms of subacute intestinal obstruction during the 2nd trimester of pregnancy and was subsequently dia-gnosed with intestinal malrotation on imaging. Though she had symptoms of abdominal pain and constipation persisting for 9 long weeks during pregnancy, there was no evidence of definite intestinal obstruction or volvulus on her abdominal magnetic resonance imaging. She underwent a caesarean section at 34 weeks of pregnancy due to worsening abdominal pain. Postnatally, she was dia-gnosed with midgut volvulus on a computer tomography scan, leading to obstruction of both small and large bowels and needed an emergency laparotomy and right hemicolectomy.

Conclusion: The case highlights the importance of timely dia-gnosis and prompt management of intestinal obstruction in pregnancy with a multidisciplinary team approach.

Background: Examination for the presence of diastasis of the rectus abdominis muscle and examination of the entire posture is very important in postpartum women. Currently, examination by 2D ultrasound, caliper and palpation is used. It is examined at rest and during stress tests.

Methods: Case study of a patient with diastasis of the direct abdominal muscle after a first spontaneous uncomplicated delivery at the age of 32 years. Examination to confirm diastasis of the rectus abdominis muscle - the width of linea alba was measured with a 2D linear probe by ultrasound 4.5 cm above the umbilicus, in the region of the umbilicus and 4.5 cm below the umbilicus. Lying on the back at rest, and with elevation of the lower limbs. The degree of severity was classified into four grades. A standard physiotherapy postural examination was performed. A part of the intervention was individual exercise with activation of the m. transversus abdominis to reduce diastasis of the direct abdominal muscles. The exercise program included postural adjustment, modification of breathing stereotype and quality, and activation of pelvic floor muscles. Exercises to reduce pain in the ligamentous apparatus and training in correct ergonomics were also performed. The dosage of exercise was 15 min per day in the 1st week of treatment, 2-4 week of treatment 20 min per day, 5-12 week of treatment 30 min per day, 5 days per week, for 12 weeks.

Conclusion: The effect of exercise with activation of m. transversus abdominis on the reduction of diastasis of the direct abdominal muscle in the postpartum patient was objectively proven by the above mentioned objectification methods.

Objective: Currently, there is a rapid increase in studies on assisted oocyte activation, which can significantly improve the process of in vitro fertilization. Fertilization of oocytes by conventional methods and by intracytoplasmic sperm injection can be affected by insufficient activation of the oocyte. The reason is mainly deviations in the enzymatic equipment of sperm or oocytes or a non-functional activation cascade. In many cases, fertilization can be achieved using artificial oocyte activation by applying calcium ion donors to the oocytes after sperm microinjection. However, opinions on the safety and reliability of this method are not uniform. The aim of the thesis is to present current knowledge about assisted oocyte activation and its impact not only on in vitro fertilization, but also on subsequent embryonic and fetal development.

Methodology: Research of relevant literature in Web of Science, PubMed/Medline and Scopus databases.

Results and conclusions: Based on the literature data and the authors' own experience, it follows that this method is effective and safe from the point of view of further development of the embryo, fetus and postnatal development. Extensive meta-analyses focused on this method were carried out, which did not find a negative impact not only on the embryonic and fetal development of the individual, but this method did not have associated with a negative impact on the psychosomatic development of the children.