|
|
Preeclamsia and selected immunogenetic factors
Hradecký, Libor ; Ulčová-Gallová, Zdeňka (advisor) ; Madar, Jindřich (referee) ; Oborná, Ivana (referee)
Preeclampsia and selected immunogenetic factors Our objective was to evaluate plasma levels of the eight most common antiphospholipid antibodies (antiphosphatidylserine, antiphosphatidylethanolamine, antiphosphatidylinositol, antiphosphatidylglycerol, antiphosphatidic acid, antiannexin V, anticardiolipin and anti 2-glycoprotein I antibodies) by ELISA method and selected inherited thrombophilia (F V- Leiden mutation, FII mutation G20210A, C677T and A1298C variants of the gene for methylene tetrahydrofolate reductase-MTHFR) by DNA analysis of peripheral blood lymphocytes using the real-time PCR in fifty-five women with preeclampsia in the period immediately before urgent termination of pregnancy. Fifty-five healthy women without preeclampsia was considered as a controll group. Entered data were examined using a non-parametric Wilcoxon's test, univariate analysis were perfomed using the Fisher's exact test and statistical dependence between variables was assessed using Spearman's rank correlation coefficient. We demonstrated that women with preeclampsia had significantly higher levels of anticardiolipin antibodies in the isotope IgG (p <0.01) and IgM (p <0.01), elevated levels of antiphosphatidylserine antibodies in the isotope IgG(p <0.01) and antiethanolamine antibodies in the isotope IgM (p <0.01) when...
|
|
|
Prevention of complications in pregnancy after laparoscopic myomectomy
David, Martin ; Kučera, Eduard (advisor)
Gynecology and obstetrics monitor many clinical areas, which are very complex and not only medical side of things. Uterine myomatóza between such areas undoubtedly belongs. In the last time monitor several important phenomena occurring at the same time, giving rise to many questions. In recent years we have witnessed not only the rising birth rate but also shift to higher fertility age groups. According to data from 2007 significantly increased the number of pregnancies after twenty-fifthyear of age (> 70%) and rapidly increases the fertility of women between 30 and 34year (35%) [1]. In this age group is also a high incidence of uterine fibroids. We speak a very frequent clinical finding - fibroid is the most commongynecological tumor. It is therefore of considerable morbidity originator. So there is a growing group of women in roughly the same age, at where there is a fibroid, which are planning pregnancy andpregnant more often not. Symptomatic myoma is obviously an indication for its removal through various treatment modalities including surgical therapy. The result is a subgroup of patients who need to predict subsequent course of pregnancy, including mode of delivery, to analyze
|
|
| |
|
|
Exercise for Women after Giving Birth by Cesarean Section
SEJPKOVÁ, Zuzana
The theme of the bachelor thesis is women´s exercise after the caesarean section. The exercise helps women to recover after the caesarean section and also speeds up the process of healing and lowers the bad outcome. The work is divided into a theoretical and practical part. In theoretical part, based on scholarly literature, we describe the history, indications for Caesarean section, methods of the operation, kinds of anaesthesia and possible complications after the Cae-sarean section (C-section). Then the work deals with the role of a midwife in pre-operational and postoperative care for a woman. The exercises in hospital are described and suitable exercises for home care are suggested. At the end we describe the postoper-ative care of the scar, such as massage using animal fat but also more modern trends like silicone stickers and plasters, laser treatment or taping. The aim of this bachelor thesis was to find out if women have enough infor-mation about the importance of exercising after C-section and also to find out which sources they use when searching information on exercising. The final aim of this thesis was to explore possibilities of exercising after C-section at the hospital puerperium ward. To reach our goals we used three hypotheses which were verified by a statistical test. Hypothesis 1: Women have enough information about the importance of exercising after C-section. Hypothesis 2: Women find necessary information about exercising after C-section mostly on the Internet. Hypothesis 3: Women on the puerperium ward exercise only with the physiotherapist. In the bachelor thesis we have chosen the quantitative research method, data col-lection was done by a questionnaire which had been distributed electronically. The sam-ple group consisted of women placed in the puerperium ward of hospital in Klatovy and in České Budějovice . The sample group consisted of 138 respondents. The evaluation of the research has proved that women have enough information about the importance of exercising (73%), this statement is also supported by the fact that only 8 respondents did not know what kind of exercise to choose in the days imme-diately after C-section. Hypothesis 1 was confirmed by the statistical test. The question-naire has also showed that women find information about exercise after C-section most-ly from their doctors or from the Internet, but also from the midwives at the ward. Other important sources of information are the physiotherapists. On the base of these results hypothesis 2 was not confirmed. The exercises at the puerperium ward are organised mostly by a physiotherapist but sometimes some women exercise on their own or with the help of their midwife. A physiotherapist is then not the only person with whom the women exercise this is the reason why the statistical test had not validated the hypothesis 3. We have also found out from the questionnaire that among the women who had attended birth classes only 12 % of them were informed about exercising after C-section. The research has showed that it is necessary to motivate women more towards exercising because even when having access to necessary information about exercising after C-section only 38 % of the women carried on exercising in home care, though, except of one person, all of those women had chosen the right exercises. The questionnaire has proved that when it comes to scar treatment after C-section 74% of women were informed about the care, the women are mostly educated by their doctor, midwife or a physiotherapist. The Internet as a source for information plays an unimportant role here. We have found out that women are aware of the new and more modern trends in scar treatment but they still mostly prefer to use massage with animal fat. The questionnaire has also suggested that 40 respondents did not care about any kind of scar treatment. Women themselves mostly gave to the amount of information about postoperative scar treatment average mark 3.
|
|
|
Needs of women with multiple pregnancy
BLAŽKOVÁ, Barbora
In the last 15 years, the number of multiple pregnancies has climbed way up, in the Czech Republic. Natural factor for their emergence is gradually increasing maternal age. The occurence of multiple pregnancy is largely influenced by the wide choices of IVF programs in curable infertility. This bachelor thesis introduces readers with the multiple pregnancy topic not only theoretically but as well practically. We used experiences of mothers expecting twins. Theoretical part is devided into three phases in which are systematically listed stages of pregnancy, labour and the time after birth. To better orientation in this issue, each period is described in terms of medical and nursing care. The first part of the thesis defines issues of multiple pregnancies classification of multiple pregnancy, its diagnosis, nursing care in the prenatal period, during labour and after birth, furthermore it discussed associated complications and presented theory of needs. The needs of women with multiple pregnancy are specified in the last chapter. The practical part focuses on the biopsychosocial needs of women in all three periods - during pregnancy, during childbirth and after birth period. The research was conducted at the Institute for Mother and Child in Prague - Podolí. The aim of this thesis was to analyze these needs and to identify differences in the experience of pregnancy, childbirth and the after birth period. The method of qualitative research through case studies was chosen. Stated objective was realized on the basis of three research questions - what are the psychosocial needs of women with multiple pregnancies during pregnancy, during delivery and in the postpartum period. Two women were approached for the purpose of this research - primipara (first delivery) and woman who is pregnant for the second time (sekundipara). In the practical part of bachelor thesis was found that multiple pregnancy woman experiences very much like woman with singleton pregnancies. Based on the analysis of interviews with women show that the gestation period of a multiple pregnancy does not have to be more challenging than in women with singleton pregnancy. The needs of women with multiple pregnancies are in many respects identical, pregnant women most commonly reported problems with fatigue, back pain, and increased urge to urinate. More difficult for women is breathing, increased joint pain, limited adopting of a suitable position and the associated discomfort while sleeping. This is due to greater spatial complexity and weight of the fetus. In the question of the need, case reports have shown that respondents have concerns about the course of multiple pregnancy, caesarean section and managing the care for the twins. During all three stages of pregnancy, they felt the greatest need for sufficient information and for communication with the medical staff. The actual delivery of twins women perceive as well as a birth of one child and the needs of women in this stage are similar. Case reports describe two cases of women after caesarean section. Postpartum period is the same as for singleton pregnancies. The fundamental difference is in the care of a newborn and breastfeeding. The answers of the respondents show that education is very important in this area. The research shows how important is quality nursing care, empathy, listening and communication between the medical staff and the client. It is important to work on a positive relationship between the two parties. It's not just about performing routine nursing care of clients, but also about a human approach, warmth and empathy. The conclusion contains highlighted differences between singleton and multiple pregnancies. The results of this work could be useful for the medical staff (midwives and neonatal nurses) for the basic orientation and for the better perspective on the issue. This is mainly because the multiple pregnancy is not so common.
|
|
|
Activation the deep stabilization of the spine in women after gynecologic operations
JIRÁNKOVÁ, Tereza
The theme of this bachelor work is the deep stabilizing spinal system activation of women after undergone gynecological operations. The deep stabilizing spinal system is the system which involves muscles participating in spinal stabilization in all daily life movements. The participation of these muscles is automatical,unconscious.Right coactivation is responsible for high quality setting and optimal pressure in particular spinal joints. Deep stabilizing system dysfunction is one of possible causes of vertebraegenic problems or wrong posture. We speak about pelvis bottom muscles,diaphragm,nucha deep ones,m.mulitifidii and m.transversus abdomonis. In spite of the fact that gynecological operations are carried out very carefully (abdominal way), they leave some changes on musculoskeletal system. I have chosen two most carried gynecological operations for my bachelor work/abdominal hysterectomy and Caesarean section. I have divided my work into two parts. The theoretical one is aimed at mapping available information about deep stabilizing system and gynecological operations. The research one is the core of the work. It is about practical research of deep stabilizing spinal system activation of women after gynecological operations and their profound analysis. The aim of the theoretical part of my bachelor work was mapping of available information about mentioned matter and the description of deep stabilizing spinal system. You can find there the description of particular parts of deep stabilizing system from the point of view anatomy and their function. Then there are described the possibilities of its examination and the last but least the methods used in activation. After the explanation what the deep stabilizing system is the theoretical part follows which is aimed at gynecological operations. I have tried to describe their indications, course and their possible complications. One part is about female sexual organs anatomy. The main aim of the bachelor work research part was brief description of the musculoskeletal system changes during therapy. I have applied the qualitative research method. Two women of different age and diagnosis have been chosen for my research. Therapy was carried out at their home environment in the period of 5 and 8 weeks. The research results were worked out in the casuistry forms which contain input and output kinesiological analysis, therapy course, short-term and long-term rehabilitation plan. The therapy was carried out once a week under the therapist supervision. Then the patients were instructed and trained in the right exercise set and they were given exercise plan for every day. After gynecological operations there were some changes in musculoskeletal system particularly in abdomen area exactly in the location of the cut. This area was not active entirely. There was not abdominal breathing. Activity of abdominal muscles was taken over by musculus rectus abdominis. Lateral groups of abdominal muscles (musculus obliquus internus abdominis,musculus obliquus externus abdominis and musculus transversus abdominis) were not activated entirely. Both patients learnt the right breathing sterotype and their deep stabilizing system was activated. Realizing their own body and how to operate with it was the result of the therapy. The therapy was finished with the form of output kinesiological analysis containing appropriate examination. The research proved the efficiency of activating deep stabilizing spinal system after gynecological operations not only from the point of view physiology, but from the point of view psychic too.
|
|
|
Aftercare awareness of women after Caesarean section
MAŘÍKOVÁ, Monika
The thesis focuses on a very hot topic, which is the aftercare awareness of women after cesarean section. The theoretical part is divided into three areas. The first area deals with the history of caesarean section and presents the main topics and concepts that are associated with caesarean sections. The second area focuses on the role of midwives in the preoperative care and the last is devoted to the role of midwives in the post-operative care.The research was conducted with the quantitative method, using standardized anonymous questionnaires. The questionnaires were distributed to women after caesarean section in the Gynecology and Obstetrics Clinic of the University Hospital in Plzen. Questionnaires were distributed during the months of January, February and March 2012. The aim of the explorative research was to find out the extent of the aftercare awareness of women after caesarean section. The given aim was fulfilled. The results of the explorative research show that the extent of the aftercare awareness of women after caesarean section in the Gynecology and Obstetrics Clinic of the University Hospital in Plzen is at good level.
|
|
| |
|
|
The economic profitability of current obstetric facilities in the Czech Republic
Kobliha, Pavel ; Ševčík, Miroslav (advisor) ; Antonín, Pařízek (referee)
The aim of the thesis is to analyze the economic profitability of current obstetric facilities in the Czech Republic. The theoretical part deals with economic aspects of health such as health determinants and their effect on human health, the specific of health care and role of the state in health care. Further work is focused on exploring different types of health systems, the principles of financing Czech healthcare system and its development in recent years. Despite the increasing role of direct financing of health care and higher patient participation, the public sector still plays the most important role, which follows from the Charter of Fundamental Rights and Freedoms. Based on available data on infant mortality the efficiency of functioning of the Czech and American health care system will be compared. Infant mortality in the Czech Republic is very low and our country in this regard is placed on the top places in the world. The practical part deals with analysis of the costs of planned caesarean section, including the total time a mother spends in hospital. Furthermore, the practical part deals with the future of obstetrics in the Czech Republic in terms of plans for the closing of small hospitals with low numbers of births and infant homes replacing foster care. The final part deals with births at home as a substitute for births in hospitals. This topic is now getting into media interest when it is discussed to ensure adequate care in childbirth and health risks for mother and newborn.
|
|
|
Nursing care of women after operative deliveries
KREJCAROVÁ, Jana
Nursing Care in Women after an Operative Delivery The bachelor thesis focuses on nursing care in women after an operative delivery terminating pregnancy. The theoretical part describes the individual surgical procedures (forceps delivery, vacuum extraction, cesarean section), nursing care and educational activity accompanying them. Further, it also includes a brief history of these methods. In the practical part, four basic goals and hypotheses were stated. The goal of the work was to identify differences in taking care of women after operative deliveries, to find out whether the care is conducted in the form of a nursing process, whether the care follows nursing and obstetrical standards in the selected delivery wards. With the view of these goals the following hypotheses were formulated: nursing care in women after operative deliveries differs in selected delivery wards and that midwives use a nursing process meeting the nursing and obstetrical standards in care of women. The research was conducted by a quantitative method. Data were collected through the use of anonymous questionnaires. These questionnaires were given to midwives in selected delivery wards (České Budějovice, Plzeň and Písek). The respondents were nurses working in delivery rooms, puerperium wards and gynecologic intensive care unit. The goals of the work were fulfilled. The hypothesis regarding the differences in care between individual delivery wards was confirmed. The second hypothesis that the care in women after operative deliveries is conducted in the form of a nursing process was proved in 72% cases. The third hypothesis confirms using of nursing standards in this care in 92% and the fourth hypothesis reveals that obstetrical standards are met in 75%. The results for the analyzed set of cases as a whole show certain definite tendencies, however the care differs among individual places and even among various wards within one institution. Therefore it would be useful to asses the organization of work, technical conditions and possible modifications that could improve the nursing care.
|
guest ::
