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Premature rupture of membranes
Guothová, Júlia ; Měchurová, Alena (advisor)
Premature rupture of membranes is one of the most important causes of preterm delivery. PROM complicates 5-15 % pregnancies and relates with 18-20 % perinatal mortality according various literary sources. The main cause of PROM is GBS-infection. PROM in Czech republic is about 3,7 %. Physical examination, clinical symptoms, positivity of amnionic fluid and ultrasound imaging are basic technique for PROM's diagnosis. The week of gestation is the most important in management of PROM's therapy. In the case of positivity GBS- colonisation in lower genitourinal tract, there's recommended Penicillin's prophylaxis.
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Sleep-dicordered Breathing at Risk Pregnancies
Hudecová, Jana ; Slouka, David (advisor) ; Slípka, Jaroslav (referee) ; Měchurová, Alena (referee)
The aim of this thesis is to highlight the severity of sleep-disordered breathing at risk pregnancies, as these disorders have a high share on the occurrence of cardiovascular problems at a later age. In the group of high-risk pregnant patients, breathing disorders in sleep lead to higher morbidity of patient as well as newborns. Currently, there are increasing risk factors in the population of pregnant women. Risk factors for the development of OSAS, which are examined in detail in this thesis in pregnant women, include BMI, age, pregestational and gestational hypertension and diabetes mellitus. The theoretical part of the thesis contains the findings of the risk pregnancies. The most serious unit is preeclampsia. For that reason, the greatest attention within high- risk pregnancies is aimed to the incidency, ethiopathogenesis, diagnosis and treatment of preeclampsia. Furthermore, the theoretical part includes findings related to sleep- disordered breathing and focuses on OSAS and its health complications. In the special part of the thesis, there is an assessment of results regarding risk pregnant women with the presence of OSAS and without present OSAS. Keywords Preeclampsia, hypertension, OSAS, pregnancy, risk factors
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The Use of Immune Markers in the Managament of Preterm Birth
Korečko, Vladimír ; Novotný, Zdeněk (advisor) ; Roztočil, Aleš (referee) ; Měchurová, Alena (referee)
Structured summary Aim of the study: To compare the diagnostic reliability, accuracy, and safety of amniocentesis and amniotic fluid Interleukin-6 testing in the diagnosis of intrauterine inflammation of patients with preterm premature rupture of membranes. Type of study: Prospective cohort study Name and location of study site: Department of Gynaecology and Obstetrics, Faculty of Medicine, Charles University in Pilsen Set and methodology: We prospectively examined patients with pPROM between the 23rd and 34th week of gestation in 2014 - 2017. All of them underwent amniocentesis and determination of IL-6 levels in amniotic fluid, leukocytes and bacteria in amniotic fluid as well as maternal blood examination for inflammation parameters. The results were compared to histological examination of the placenta after delivery for the presence of chorioamnionitis. Based on the values mentioned above the sensitivity, specificity, negative and positive predictive value, false positive and negative predictive value and accuracy of the test were determined together with an assessment of statistical significance. Furthermore, the feasibility and incidence of perioperative complications as well as the risk of secondary infection when pregnancy continued were evaluated by serial aniocenteses at weekly intervals. The...
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Changes of lipid metabolism caused by pregnancy
Kokrdová, Zuzana ; Košťál, Milan (advisor) ; Měchurová, Alena (referee) ; Pařízek, Antonín (referee)
As evidenced by recent literature, adverse pregnancy outcomes such as pre-eclampsia, gestational diabetes, preterm delivery, and intrauterine growth restriction are risk factors for maternal metabolic and vascular diseases in later life. The second half of a normal pregnancy is accompanied by glucose intolerance, hyperlipidaemia and an increase in coagulation factors. This physiological response to pregnancy represents a transient excursion into a metabolic syndrome. Approximately 3-4% of all pregnant women are diagnosed with gestational diabetes that usually reverts to normal after delivery. However, gestational diabetes may predict the development of type 2 diabetes later in life. It is not yet known if changes similar to carbohydrate metabolism occur in the lipid metabolism and weather a certain degree of hyperlipidaemia in the last trimester could predict the appearance of an overt non-gestational hyperlipidaemia in the future. Our study describes antepartum and postpartum changes of lipoprotein lipids in 26 healthy pregnant women, 11 women with gestational diabetes, 10 women with type 1 diabetes, and in 9 women with metabolic syndrome in gestation weeks 12, 32 - 34 and 6 and 24 months postpartum. The results are compared to measurements in 30 nonpregnant controls not taking oral contraceptives,...
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Possible use of doppler flowmetry in the detection of discordant growth of twins
Musilová, Ivana ; Rešlová, Taťána (advisor) ; Měchurová, Alena (referee) ; Ľubušký, Marek (referee)
Objective: To evaluate the efficiency of selected doppler parameters as a test for the prediction of twin growth discordancy (GD) and to compare it with the efficiency of routinely used ultrasound biometrical parameters. Design: Prospective clinical study. Methods: Set was formed by 63 twin pregancies. Intertwin differences in Doppler parameters (umbilical artery - AU, middle cerebral artery - MCA, cerebroplacental ratio - CPR) and biometrical parameters (biparietal diameter - BPD, abdominal circumference - AC, femur length - FL, estimated fetal weight - EFW) were studied. Simultaneously, uterine arteries impedance was assessed. GD was identified by the birth weight difference from 20%. The efficiency of intertwin differences in studied parameters were evaluated using ROC analysis. Results: Biometrical measurements performed within three weeks antepartum were in prediction of GD more accurate than doppler parameters (AUC for EFW 0.99; for AU 0.56; for CPR 0.71). Three to six weeks antepartum, the efficiency of biometrical and doppler parameters was comparable (AUC for EFW 0.79; for AU 0.81; for CPR 0.81). In interval more than six weeks antepartum, biometrical parameters were not effective, DG was predictable only using CPR (AUC for EFW 0.62; for AU 0.56; for CPR 0.77). No significant differences...
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Premature ruptura of membranes
Pastoráková, Katarína ; Měchurová, Alena (advisor)
As a topic for her thesis I chose premature rupture amniotic fluid , because this topic is obstetric constant current research and studies in both risk factors , new diagnostic methods , and novel therapeutic approaches . Premature rupture of membranes must be kept in mind during the duration throughout pregnancy until delivery by the due date , as may occur in any of its phases. Immediately there is a threat to the further course pregnancy , the fetus and the mother's life . Approximately 30% of the cause of premature childbirth and thus contributes significantly to perinatal and infant morbidity and mortality. In my work I have therefore decided zkompletizovat currently valid and the clinical use of knowledge relating to the issue and to both in terms of etiology, risk factors , appropriate treatments adding to it the newest and compare them with the knowledge foreign to Based on studies relating mainly to some diagnostic and therapeutic methods and their use.
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Premature ruptura of membrans
Diblíčková, Michaela ; Měchurová, Alena (advisor)
Premature rupture of membranes is still current obstetric tématem.Je cause about 30% of all premature births and has such a significant proportion of perinatal morbidity and mortalityand thus thus on the future status generací.Je be calculated with at any stage of pregnancy. I will not conceal that the choice of thesis topic is For me, more important than personal, because I myself was this condition during their intrauterine development ohrožena.Proto I chose this topic a little more carefully study and complete information on this topic accessible.
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Premature rupture of membranes
Guothová, Júlia ; Měchurová, Alena (advisor)
Premature rupture of membranes is one of the most important causes of preterm delivery. PROM complicates 5-15 % pregnancies and relates with 18-20 % perinatal mortality according various literary sources. The main cause of PROM is GBS-infection. PROM in Czech republic is about 3,7 %. Physical examination, clinical symptoms, positivity of amnionic fluid and ultrasound imaging are basic technique for PROM's diagnosis. The week of gestation is the most important in management of PROM's therapy. In the case of positivity GBS- colonisation in lower genitourinal tract, there's recommended Penicillin's prophylaxis.
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