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Ectopic pregnancy and blood loss during its surgical treatment
Kolářová, Nikola ; Kužel, David (advisor) ; Hudeková, Lucia (referee)
The bachelor's thesis deals with ectopic pregnancy and blood loss during its surgical treatment. The work is divided into a theoretical part and a research part. The first part deals with the anatomy of the female genital tract, types of ectopic pregnancies and procedures for their treatment. The research part was conducted in the form of quantitative research. The data was drawn from the Medea system of the Department of Gynecology and Obstetrics of the 1st Faculty of Medicine of Charles University and the General University Hospital in Prague in the time from 2016 to 2021. The aim of the research was to find out whether various criteria affect blood loss during the surgical treatment of ectopic pregnancies. Examples of the examined criteria include parity, miscarriage or abortion, age of patients and other critera, using descriptive statistical analysis of data calculated on the basis of arithmetic mean. Keywords: ectopic pregnancy, laparoscopy, blood loss, salpingotomy and salpingectomy, transvaginal ultrasonography
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Urinary incontinence and sexuality during pregnancy and after delivery
Záhumenský, Josef ; Zvěřina, Jaroslav (advisor) ; Kužel, David (referee) ; Weiss, Petr (referee)
Results and conclusion. We found the statistically significant increase in the occurrence of urinary incontinence during pregnancy. We found no significant relation between prevalence of urinary incontinence during pregnancy and either BMI before pregnancy or weight gain during pregnancy. All females of age 36 and more suffered from urinary incontinence during the third trimester. There is a decrease in frequency of sexual intercourses, a decrease in female orgasm sensation and a decrease in satisfaction with the sexual life during pregnancy. Frequency of sexual dysfunctions increases: dyspareunia, insufficient lubrication and hypogastrium pain. Females with significant dyspareunia before pregnancy have higher risk of extensive injury to the vaginal wall during labour. 10% of women do not have full comfort of life due to birth injury six months after the labour. 24% of women start with sexual life less than six weeks after the first labour; 7% of women have no sexual intercourse six months after the delivery. 38% of females declare that the sexual life six months after the delivery is still not as highquality as prior to pregnancy. In the comparison of the way of labour (Caesarean section vs. vaginal delivery) we found no difference in frequency of sexual intercourses six months after the labour, in orgasm...
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The significance of thrombophilic and immunologic factors in human reproduction
Šubrt, Ivan ; Ulčová-Gallová, Zdeňka (advisor) ; Kužel, David (referee) ; Šantavý, Jiří (referee)
The aim of presented study was to compare frequencies of eight antiphospholipid antibodies (aPL) in serum and assorted genetic thrombophilic factors and their mutual relation in patients with recurrent pregnancy loss (RPL) and controls. Enzyme-linked immunosorbent assay was used for detection of aPL against phosphatidyl-L-serine, phosphatidylethanolamine, phosphatidylinositol, phosphatidyl- DL-glycerol, phosphatidic acid, annexin V, cardiolipin, and beta2-GPI. Thrombophilic mutations factor V Leiden (F5 G1691A), F II G20210A, and MTHFR C677T and A1298C variants were determined using a melting curve analysis of the PCR amplification product detected by the fluorescence resonance energy transfer (FRET). PAI1 (-675)4G/5G, PROZ intron F G79A, PROZ A(-13)G and PROZ R255H variants were determined using standard PCR-RFLP method. Genotypes distribution and allelic frequencies were calculated. Correlation between aPL and thrombophilic factors was tested by chi-square and Fisher exact test. Our results showed significantly increased prevalence of aPL against phosphatidylinositol (17 - 19.6 % dependent on number of spontaneous miscarriages) and against phosphatidyl-L-serine (18-25 %). aPL in IgG prevailed. In 96 % of studied group we found at least one risk factor (either aPL positivity or thrombophilic factor). Both...
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Risks and limits of laparoscopy in the treatment of gynecological cancers
Charvát, Martin ; Robová, Helena (advisor) ; Kužel, David (referee) ; Mlynček, Miloš (referee)
The thesis evaluates the results of experimental protocol involving the fertility sparing treatment procedure in early stage cervical carcinoma (LAP I protocol). Sentinel lymph node detection and experimental extirpation of afferent channels using laparoscopy and its technical aspects were analysed in prospective group of 85 women. The oncologic results and early/late morbidity show that established surgical procedures can be considered safe with minimal morbidity, provided that the indication criteria are met. The second part analyses the results of 148 women with no further pregnancy plans suffering from cervical tumors less than 2 cm in size with invasion less than half of the stroma (LAP II protocol). The oncological results in our defined group are very good and comparable to 'standard' procedure of modified radical hysterectomy type B or C with lower morbidity. In the separate section the thesis analyses the possibilities of laparoscopy in endometrial cancer treatment including the potentials of use of sentinel lymph node detection and technical aspects of laparoscopy in obese women. Currently the biggest controversy is the use of laparoscopy in malignant ovarian tumors. Our oncogynaecological study group at FN Motol prefers the laparotomic approach and we chose to include the set of advanced...
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Inhibins in reproduction
Babčová, Katarína ; Ulčová-Gallová, Zdeňka (advisor) ; Kužel, David (referee) ; Crha, Igor (referee)
Inhibin A and B participate to regulation of gametogenesis. We investigated their applicability as a marker of gametogenesis of men fertility disorders. We monitored the levels of inhibins during the treatment. We interested in their paracrine activity, relationship in sera, follicular fluid and seminal plasma depending on cause of fertility failure. We studied the levels of inhibin B in serum and seminal plasma from 355 men treated for fertility failure, in the context of their andrological and immunological findings (quality of spermiogrammes and acrosome area). We monitored concentration of levels of inhibin A and B in serum and follicular fluids depending on cause of fertility failure, on course and treatment outcome. We took blood samples in the time of the oocytes collection, of the embryotransfer and early pregnancy. The follicular fluids were obtained during the oocytes collection. The levels of both of inhibins were measured by ELISA in all medium (serum, follicular fluid, seminal plasma). We confirm, that inhibin B is useful marker of spermatogenesis in men, but is necessary to examine patient in complex with determination of immunology profile or quality of acrosome. Seminal plasma is, in some indicated cases, more suitable diagnostics material. Similarly inhibin B in women seems to be...
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Th1/Th2 cytokine gene polymorphisms in patients with urine fibroid
Sosna, Ondřej ; Kužel, David (advisor) ; Živný, Jan (referee) ; Novotný, Zdeněk (referee)
Background: Uterine fibriod (UF) or leiomyoma is the most frequent benign tumour upon lower genital tract and represents the most frequent indication for hysterectomy. The aetiology remains still unknown. The genetic factors contributing for the development of UF are being intensively investigated. The aim of our study was to look for possible genetic markers which could be used as prognostic tools for evaluation of an increased risk for development of UF. Methods: The study group enrolled 102 patients diagnosed with UF and 145 healthy controls. Ultrasonographic examination of the pelvis was performed and a single blood sample was taken in all women. Histological verification followed the surgery in the patient group. The principal of the cytokine gene polymorphisms detection is based on PCR reaction with sequence-specific primers. Results: A large spectrum of Th1/Th2 cytokine gene polymorphisms in patients with uterine fibroid was compared with control group. The frequencies of the majority of tested cytokine gene SNP in the patient cohort were not statistically different from the cytokine SNP in the control group. However, an intriguing association between polymorphisms of the IL-4 gene promotor at positions -590 C/T and -33 C/T, and the risk of leiomyoma was observed. The CC genotype of IL-4 at position...
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Risks and limits of laparoscopy in the treatment of gynecological cancers
Charvát, Martin ; Robová, Helena (advisor) ; Kužel, David (referee) ; Mlynček, Miloš (referee)
The thesis evaluates the results of experimental protocol involving the fertility sparing treatment procedure in early stage cervical carcinoma (LAP I protocol). Sentinel lymph node detection and experimental extirpation of afferent channels using laparoscopy and its technical aspects were analysed in prospective group of 85 women. The oncologic results and early/late morbidity show that established surgical procedures can be considered safe with minimal morbidity, provided that the indication criteria are met. The second part analyses the results of 148 women with no further pregnancy plans suffering from cervical tumors less than 2 cm in size with invasion less than half of the stroma (LAP II protocol). The oncological results in our defined group are very good and comparable to 'standard' procedure of modified radical hysterectomy type B or C with lower morbidity. In the separate section the thesis analyses the possibilities of laparoscopy in endometrial cancer treatment including the potentials of use of sentinel lymph node detection and technical aspects of laparoscopy in obese women. Currently the biggest controversy is the use of laparoscopy in malignant ovarian tumors. Our oncogynaecological study group at FN Motol prefers the laparotomic approach and we chose to include the set of advanced...
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Inhibins in reproduction
Babčová, Katarína ; Ulčová-Gallová, Zdeňka (advisor) ; Kužel, David (referee) ; Crha, Igor (referee)
Inhibin A and B participate to regulation of gametogenesis. We investigated their applicability as a marker of gametogenesis of men fertility disorders. We monitored the levels of inhibins during the treatment. We interested in their paracrine activity, relationship in sera, follicular fluid and seminal plasma depending on cause of fertility failure. We studied the levels of inhibin B in serum and seminal plasma from 355 men treated for fertility failure, in the context of their andrological and immunological findings (quality of spermiogrammes and acrosome area). We monitored concentration of levels of inhibin A and B in serum and follicular fluids depending on cause of fertility failure, on course and treatment outcome. We took blood samples in the time of the oocytes collection, of the embryotransfer and early pregnancy. The follicular fluids were obtained during the oocytes collection. The levels of both of inhibins were measured by ELISA in all medium (serum, follicular fluid, seminal plasma). We confirm, that inhibin B is useful marker of spermatogenesis in men, but is necessary to examine patient in complex with determination of immunology profile or quality of acrosome. Seminal plasma is, in some indicated cases, more suitable diagnostics material. Similarly inhibin B in women seems to be...
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The significance of thrombophilic and immunologic factors in human reproduction
Šubrt, Ivan ; Ulčová-Gallová, Zdeňka (advisor) ; Kužel, David (referee) ; Šantavý, Jiří (referee)
The aim of presented study was to compare frequencies of eight antiphospholipid antibodies (aPL) in serum and assorted genetic thrombophilic factors and their mutual relation in patients with recurrent pregnancy loss (RPL) and controls. Enzyme-linked immunosorbent assay was used for detection of aPL against phosphatidyl-L-serine, phosphatidylethanolamine, phosphatidylinositol, phosphatidyl- DL-glycerol, phosphatidic acid, annexin V, cardiolipin, and beta2-GPI. Thrombophilic mutations factor V Leiden (F5 G1691A), F II G20210A, and MTHFR C677T and A1298C variants were determined using a melting curve analysis of the PCR amplification product detected by the fluorescence resonance energy transfer (FRET). PAI1 (-675)4G/5G, PROZ intron F G79A, PROZ A(-13)G and PROZ R255H variants were determined using standard PCR-RFLP method. Genotypes distribution and allelic frequencies were calculated. Correlation between aPL and thrombophilic factors was tested by chi-square and Fisher exact test. Our results showed significantly increased prevalence of aPL against phosphatidylinositol (17 - 19.6 % dependent on number of spontaneous miscarriages) and against phosphatidyl-L-serine (18-25 %). aPL in IgG prevailed. In 96 % of studied group we found at least one risk factor (either aPL positivity or thrombophilic factor). Both...
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Th1/Th2 cytokine gene polymorphisms in patients with urine fibroid
Sosna, Ondřej ; Kužel, David (advisor) ; Živný, Jan (referee) ; Novotný, Zdeněk (referee)
Background: Uterine fibriod (UF) or leiomyoma is the most frequent benign tumour upon lower genital tract and represents the most frequent indication for hysterectomy. The aetiology remains still unknown. The genetic factors contributing for the development of UF are being intensively investigated. The aim of our study was to look for possible genetic markers which could be used as prognostic tools for evaluation of an increased risk for development of UF. Methods: The study group enrolled 102 patients diagnosed with UF and 145 healthy controls. Ultrasonographic examination of the pelvis was performed and a single blood sample was taken in all women. Histological verification followed the surgery in the patient group. The principal of the cytokine gene polymorphisms detection is based on PCR reaction with sequence-specific primers. Results: A large spectrum of Th1/Th2 cytokine gene polymorphisms in patients with uterine fibroid was compared with control group. The frequencies of the majority of tested cytokine gene SNP in the patient cohort were not statistically different from the cytokine SNP in the control group. However, an intriguing association between polymorphisms of the IL-4 gene promotor at positions -590 C/T and -33 C/T, and the risk of leiomyoma was observed. The CC genotype of IL-4 at position...
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