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Patients and obstetricians attitudes associated with caesarean section on maternal request
Paltiel, Monica ; Křepelka, Petr (advisor)
Medicine is changing, especially in obstetrics. We now have to involve patients in decision making. In this partnership we have to try to educate women about risks and benefits for both her and her child for both vaginal and cesarean sections. Women today want avoid risks and decrease uncertainty. There is no guarantee that a woman will deliver without complications before the onset of labor, and many feel that they decrease the risks and uncertainty by opting for a cesarean section. But cesarean sections have their own risk profile. Many studies have shown that a planned antepartum cesarean section has less risk than intrapartum cesarean sections. Some would say that a planned cesarean section is as risky as a vaginal delivery, but the risk profiles are different. Different countries have different approaches towards allowing cesarean sections on maternal request. In Italy a woman has the right to choose, while in Norway the woman has only the right to decide together with the physician. This is also reflected in the numbers of cesarean sections in the different populations. Some countries deliver babies with help of mid wives and other places obstetricians have to deliver the baby. In the world we live in time is of the essence and there is no exception when it comes to obstetricians. If the obstetrician...
Patients and obstetricians attitudes associated with cesarean delivery on maternal request
Baxová, Anna ; Křepelka, Petr (advisor) ; Černá, Milena (referee)
Cesarean delivery on maternal request is one of the most discussed questions among obstetricians all around the world. It is a situation when mother wishes to have cesarean delivery although no indications for this surgery are presented. The aim of this diploma paper is to provide important facts about epidemiology, indications and complications of cesarean section and discuss obstetricians' and professional associations' opinion on cesarean delivery on maternal request, its' health, psychological, social and ethic aspects. In the practical part the results of the questionnaire survey are provided, in which we asked about the attitudes of patients and obstetricians towards cesarean delivery on maternal request and other associated questions.
Women's Free Will in the Caesarean Section Indication
Křepelka, Petr ; Payne, Jan (advisor) ; Šimek, Jiří (referee) ; Calda, Pavel (referee)
Currently, Caesarean section is the most commonly indicated procedure. The proportion of caesarean deliveries continues to rise and the spectrum of surgical indications has broadened dramatically. This contemplation focuses on the ethical dilemmas arising during the indication of a Caesarean section: a refusal of a Caesarean section by a pregnant woman when there is a rationally-empirical indication and an enforced Caesarean section. The importance of the woman free will in the process of operating indication closely relates to the issue of the Caesarean section upon request. The assessment of the ethical acceptability of the individual surgical indications is performed on the grounds of confrontation of the pregnant woman's dignity and the dignity of human fetus and subsequently by reflections on theoretical duties and resulting parental responsibilities on the one hand and the right to self-determination of a pregnant women on the other. The fetal dignity is given by its value, attributed to it by the pregnant woman and by the human society. It has always been inferior to the dignity of a pregnant woman. Determining of specific positive duties a pregnant woman has towards the fetus is a very controversial issue and it is impossible to codify them legally despite the unquestionable social character of a...
Ethical issues of assisted reproduction with emphasis cryopreservation methods
Zajíčková, Markéta ; Haškovcová, Helena (advisor) ; Křepelka, Petr (referee) ; Teplá, Olga (referee)
Human infertility is not a new phenomenon, but it is as old as humanity itself. Currently in most developed countries, the number of couples who have a problem with childbearing is growing. This is due, among other things, to the lifestyle associated with career development and postponement of parenthood. While in the past infertile couples usually had only two options to deal with their sterility - childlessness and a substitute life program, or adopting a child. Today, infertile couples have a third option and this is the treatment of infertility using assisted reproduction methods. This year, exactly forty years have elapsed since the birth of the first child by means of extracorporeal fertilization. Already then the assisted reproduction was considered a method that is ethically problematic. Numerous specialists, such as physicians, biologists, lawyers, philosophers, theologians, and others, have been involved in the quest for ethical issues. Not only there has been no solution to some problems during the whole lifetime of assisted reproduction on which most experts and the general public would agree, but with the gradual development of this treatment method new problems have arisen. Today's stage of development of artificial insemination techniques and procedures together with modern...
Ethical issues of assisted reproduction with emphasis cryopreservation methods
Zajíčková, Markéta ; Haškovcová, Helena (advisor) ; Křepelka, Petr (referee) ; Teplá, Olga (referee)
Human infertility is not a new phenomenon, but it is as old as humanity itself. Currently in most developed countries, the number of couples who have a problem with childbearing is growing. This is due, among other things, to the lifestyle associated with career development and postponement of parenthood. While in the past infertile couples usually had only two options to deal with their sterility - childlessness and a substitute life program, or adopting a child. Today, infertile couples have a third option and this is the treatment of infertility using assisted reproduction methods. This year, exactly forty years have elapsed since the birth of the first child by means of extracorporeal fertilization. Already then the assisted reproduction was considered a method that is ethically problematic. Numerous specialists, such as physicians, biologists, lawyers, philosophers, theologians, and others, have been involved in the quest for ethical issues. Not only there has been no solution to some problems during the whole lifetime of assisted reproduction on which most experts and the general public would agree, but with the gradual development of this treatment method new problems have arisen. Today's stage of development of artificial insemination techniques and procedures together with modern...
The biomechanical effects of levator ani muscle laceration injuries after vaginal delivery
Křepelka, Petr ; Šifta, Petr (advisor) ; Otáhal, Jakub (referee)
Title: The biomechanical effects of levator ani muscle laceration injuries after vaginal delivery Objectives: The aim of this thesis is to sum up current knowledge about the normal structure and function of levator ani muscle and findings about dysfunctions of a pelvic floor. By means of biomechanical instruments to analyse how the lower part of levator ani muscle closes (puborectalis muscle) during unilateral avulsion lesion. On the basis of computer simulation of biomechanical properties of the pelvic floor during avulsion lesion to describe the theoretical solutions for the therapy of the main types of dysfunctions of the pelvic floor. Methods: Biomechanical analysis was used with a help of computer model of muscular pelvic floor with a help of the ABAQUS model. This model with matched properties of muscular tissue was influenced by the standard pressure which influences the pelvic floor for a person of 80 kilos standing at rest. This model simulated unilateral avulsion lesion and biomechanical variables were observed during compensatory activation of uninjured parts of levator with the activity 100%, 50% and 10%. The map of the muscular tone and the rate of movement of the muscles of the pelvic floor were evaluated. Results: Only minimal movement is observed in the intact pelvic floor during...
Patients and obstetricians attitudes associated with cesarean delivery on maternal request
Baxová, Anna ; Křepelka, Petr (advisor) ; Černá, Milena (referee)
Cesarean delivery on maternal request is one of the most discussed questions among obstetricians all around the world. It is a situation when mother wishes to have cesarean delivery although no indications for this surgery are presented. The aim of this diploma paper is to provide important facts about epidemiology, indications and complications of cesarean section and discuss obstetricians' and professional associations' opinion on cesarean delivery on maternal request, its' health, psychological, social and ethic aspects. In the practical part the results of the questionnaire survey are provided, in which we asked about the attitudes of patients and obstetricians towards cesarean delivery on maternal request and other associated questions.
Patients and obstetricians attitudes associated with caesarean section on maternal request
Paltiel, Monica ; Křepelka, Petr (advisor)
Medicine is changing, especially in obstetrics. We now have to involve patients in decision making. In this partnership we have to try to educate women about risks and benefits for both her and her child for both vaginal and cesarean sections. Women today want avoid risks and decrease uncertainty. There is no guarantee that a woman will deliver without complications before the onset of labor, and many feel that they decrease the risks and uncertainty by opting for a cesarean section. But cesarean sections have their own risk profile. Many studies have shown that a planned antepartum cesarean section has less risk than intrapartum cesarean sections. Some would say that a planned cesarean section is as risky as a vaginal delivery, but the risk profiles are different. Different countries have different approaches towards allowing cesarean sections on maternal request. In Italy a woman has the right to choose, while in Norway the woman has only the right to decide together with the physician. This is also reflected in the numbers of cesarean sections in the different populations. Some countries deliver babies with help of mid wives and other places obstetricians have to deliver the baby. In the world we live in time is of the essence and there is no exception when it comes to obstetricians. If the obstetrician...

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3 Křepelka, Pavel
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