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Systematic lupus erythematosus and antiphospholipid syndrome - importance for gravidity
Kešeláková, Katarína ; Andělová, Kateřina (advisor)
This thesis deals with pregnancy complicated by the presence of systemic rheumatic disease, systemic lupus erythematosus. Further analyzes and antiphospholipid syndrome in pregnancy, which can be separately, when we talk about the primary antiphospholipid syndrome, or may be associated with a magnifying glass to the system - secondary antiphospholipid syndrome. The work seeks to provide an overview of new knowledge about diagnosis and treatment, but most focus on the relationship of these units to pregnancy, development of the fetus, birth and postpartum complications and also the question of how pregnancy affects theactivity systemic lupus erythematosus
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The Placenta and Antiphospholipid Antibodies in Etiology of Recurrent Abortions
Martincová, Petra ; Andělová, Kateřina (advisor)
Antiphospholipid syndrome is characterized by arterial and venous thrombosis, recurrent pregnancy loss, and intrauterine growth restriction (IUGR). It is associated with antiphospholipid antibodies, which are subdivided to anti-cardiolipin antibodies, lupus anticoagulant antibodies, and antibodies against proteins. Anti-2GPI is the best known antibody against proteins. 2GPI binds to negatively charged phospholipids, like cardiolipin, phosphatidylserine, and phosphatidylinositol. Antiphospholipid antibodies influence several processes, such as hemostasis and cell and complement activation. Complement is the main mediator of tissue injury in the placenta. Initially, the classical pathway of complement activation is induced via C1, then, at the level of C3, the alternative pathway joins and amplifies the damage. It has been shown that interactions between complement anaphylatoxin C5a and its receptors play a key role in causing injury. The murine model has shown that by inhibition of the complement pathway at this level, pregnancies can be rescued. The etiology of placental injury involves three important molecules; these molecules first initiate a proinflammatory state which then allows subsequent induction of the prothrombotic state. The prothrombotic state is the best known complication of antiphospholipid...
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New trends in antiphospholipid syndrome in pregnancy treatment
Kroupová, Monika ; Andělová, Kateřina (advisor)
Antiphospholipid syndrome is a systemic autoimmune disease characterised by presence of the antiphospholipid antibodies in serum. The diagnosis of APS including aPL measured in solid-phase immunoassays (ELISA) as anticardiolipin antibodies or detected in phospholipid dependent clotting tests as lupus anticoagulans. Positiv APS is characterised by prolonged coagulation times. In Pregnancy is APS characterised by placental insufficiency, pre-term delivery, pre-eclampsia and intrauterine growth retardation. He interferes in trofoblast growth and invasion and hampers in trofoblast function. At present is used low-molecular-weight heparin in combination with low-dose aspirin. Non-pregnant patiens with history of thrombosis are usually treated by warfarin to keep an APTT between 2-3.
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Glucose-metabolism pathology during pregnancy
Lišková, Michala ; Andělová, Kateřina (advisor)
Pregnancy of patients with DM is risk. Mother may be threatened by the development of acute and chronic complications of diabetes, hypertension, frequent occurrence of infectious diseases and maternal mortality. Risks for the fetus are premature birth or abortion, diabetic embryopathy, including congenital malformations, and diabetic fetopathy with fetal macrosomia and postnatal hypoglycaemia. The risk for later development of diabetes in children of diabetic mothers is 1.3%. The pre-conception care is insist on planning pregnancy to term of good compensation. Diabetes care in pregnancy include insulin therapy or insulin's pump. Diet is not different from the diet before pregnancy, it is possible higher energy intake in the 2nd and 3 trimester. The most serious complications of pregnancy with DM consequences for the fetus and mother are diabetic retinopathy and diabetic nephropathy. Diabetic nephropathy (DN) develops on the basis of protein glycation glomerulus basement membrane, other factors are hypertension and hyperfiltration. Creatinine clearance less than 125 micromol / l diastolic pressure below 85 mm Hg prognosis of pregnancy is good. At present pre-conception significantly altered renal function, a pregnancy is not recommended. The most common disabilities in the fetal complications as premature...
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Oral hypoglycemics for the treatment of gestational diabetes mellitus
Tesaříková, Jana ; Andělová, Kateřina (advisor)
This thesis submits retrospective analytic study Evaluating and peroperation early postoperation Complications of laparoscopically assisted vaginal hysterectomy (LAVH). The aim of this thesis was to find out: ? what peroperation and early postoperation Complications of LAVH Occur on patient file ? to analyze individual Types of Complications on patient file ? Compare to the results of retrospective study with national Indications (with the help of national register of Complications of Gynaecological laparoscopy) ? Possible discuss prevention of the most severe Complications of LAVH The text part is Devoted to Indications and contraindications of laparoscopic operation, and Complications That May Occur During Describes the operation and execution of laparoscopically assisted vaginal hysterectomy. The Necessary information for the thesis is based on operation records of Patients operated in the years 2000 - 2004 in ÚPMD. Data Shown are processed with the aim to answer to the questions mentioned above. Further in the thesis there Presented are the results of the study and Their Evaluation. I ANALYZED peroperation and early postoperation Complications of LAVH in the file of 394 Patients operated in the year 2000 to 2004 in ÚPMD. The peroperation or early postoperation Complications occurred in cases of 154...
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Antiphospholipid syndrome and recurrent abortions
Oleinikov, Kira ; Andělová, Kateřina (advisor)
Recurrent abortions prevalent in around 1% of couples. Although in majority of cases the ethiology remains unknown, antiphospholipid syndrome is cause that can be prevented. The antiphospholipid antibody syndrome (APS) is characterized by arterial and venous thrombosis and pregnancy complications in association with antiphospholipid (aPL) antibodies. In addition to recurrent abortions and fetal death, pregnancy complications in women with APS include preeclampsia, placental insufficiency, and fetal growth restriction . The pathogenic mechanisms that lead to injury in vivo are incompletely understood and therapy for pregnant women with APS, currently aimed at preventing thrombosis, is only partially successful in averting pregnancy loss. As it was already mentioned before - for any therapeutic intervention to be successful it would appear that treatment needs to be applied early in pregnancy, if not before, and it therefore depends on the identification of women at risk of aPL-associated pregnancy complications before they conceive. Before the introduction of heparin therapy for management of pregnant patients with APS, the fetal loss rate was more than 50%; currently, it is less than 20%. Therefore both diagnostical and therapeutic methods should be considered in prevention of recurrent abortions.
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Antiphospholipid syndrome and complications during pregnancy
Vaněčková, Eva ; Andělová, Kateřina (advisor)
Antifosfolipidový syndrom je autoimunitní onemocnění charakterizované středními až vysokými hladinami antifosfolipidových protilátek v krvi a rekurentními venózními nebo arteriálními trombózami. V souvislosti s těhotenstvím byl APS definován jako jedna z příčin opakovaných těhotenských ztrát, ke kterým může dojít kdykoli v průběhu těhotenství. Na rozdíl od sporadických těhotenských ztrát, ke kterým nejčastěji dochází v období pre-embryonálním a embryonálním, u žen s APS je pozorována neobvyklá proporce těhotenských ztrát v období fetálním. Těhotenství žen s pozitivními antifosfolipidovými protilátkami jsou navíc komplikována placentární insuficiencí, předčasným porodem, preeklampsií a intrauterinní růstovou retardací. Tyto důsledky vyplývají z rozmanitého působení antifosfolipidových protilátek, jejichž nejčastějšími mechanismy jsou navození hyperkoagulačního stavu systémově nebo lokálně v uteroplacentární jednotce a zasahování do procesu invaze trofoblastu, jeho růstu a funkce. Opakované těhotenské ztráty jsou v současnosti považovány za léčitelnou komplikaci spojenou s antifosfolipidovým syndromem. Jeho diagnostika, která je založena na klinických a laboratorních kritériích, je velmi důležitá, neboť při vhodně zvolené léčbě většina žen dosáhne úspěchu. Jak se shoduje většina odborníků, efektivní...
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Thyroid dysfunction during pregnancy in women with diabetes mellitus type 1
Galandáková, Iva ; Andělová, Kateřina (advisor)
It is known, that autoimmune disease of the thyroid gland during pregnancy and postpartum period is more often in women with diabetes mellitus type 1 than in general population. Both diseases negative influence developing of the foetus and health of the mother. Therefore is important timely diagnosis and good compensation both in diabetes and in thyroid gland. Women with diabetes mellitus type 1 should plan their pregnancy and always should be the thyroid gland investigate, measurement TSH, FT4 and thyroid antibodies.
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