Ceskoslovenska gynekologie最新文献

By intracervical administration of 0.75 mg PGE2, using a butterfly needle, the authors preinduced 32 patients with an immature portio vaginalis cervicis (CS 5 points) who had indications for termination of a full-term pregnancy. Slow administration lasted cca 6 hours. Maturation of the portio vaginalis cervicis occurred in 93.5%, in 71% regular uterine contractions started. The length of labour stages, the loss of blood, frequency of injuries during labour and foetal hypoxia were similar as in spontaneous deliveries. Side-effects were recorded in 20.7%. The described method is a suitable alternative to administration of gel substances, in particular because it is cheaper because it is well tolerated by the patients and is simple.

The paper deals with the genetic risk of advanced age of women assessed on the basis of prenatal cytogenetic analysis during the second trimester of gestation. The examined group comprised 614 pregnant women older than 35 years. The cells for chromosomal analysis were obtained by transabdominal amniocentesis during the 16th to 18th week of gestation. Cytogenetic examination revealed that the general risk of an aneuploid foetus in women of more advanced age is 2.12% and the most frequently encountered chromosomal aberration was trisomy 21 which was confirmed in 1.30 cytogenetically examined foetuses.

The objective of the work was to evaluate the importance of antenatal examination of amniotic fluid and foetal blood in case of suspected Rh isoimmunization of the foetus. In 1991-1992 in 16 patients with a rise of the titre of anti-D antibodies to > 1:8 between the 24th and 36th week of gestation 32 punctures of the umbilicus by means of a 22 gauge needle were made under continual ultrasonic control. In two instances intraumbilical transfusion was indicated. The authors revealed that with the rising titre of anti-D antibodies in maternal blood the foetal haematocrit value in the umbilical blood declines. With the rising bilirubin level the haematocrit declines. In foetuses with a haematocrit of < 31% severe forms of jaundice are encountered more frequently with the necessity of long-term phototherapy and exchange transfusion. The authors did not find a correlation between the haematocrit of foetal blood and the bilirubinoid concentration in amniotic fluid, assessed by Liley's method. Foetuses with a haematocrit higher than 31% are not threatened by severe forms of jaundice and therefore the authors do not use transfusions in these foetuses. Based on hitherto assembled experience, the authors confirmed that cordocentesis is associated with a comparable risk as amniocentesis but provides more accurate information on the state of the foetus.

The authors describe the frequency, incidence, number of deaths and mortality from malignant tumours of the uterine corpus in the Czech Republic in 1961-1988. The mean incidence of 13.06 during the five-year period 1961-1965 rose to a mean incidence of 25.12 during the five-year period 1984-1988, while during this period a paradoxical decline of the mortality from 9.00 to 6.7 occurred. This implies a decline of the lethality during 1961-1965 from 76.56% to 28.98%, i.e. to 37.85% of the original value. The reasons of the decline in lethality may be earlier detection of the disease and possibly a rise in the incidence of less aggressive forms of hormone-dependent carcinomas only, because therapy did not change essentially during the mentioned period.