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Impacts of COVID-19 Pandemic on the Mental Health of Pregnant Women in the Czech Republic
Venclů, Viktorie ; Pařízek, Antonín (advisor) ; Richtárová, Adéla (referee)
This bachelor thesis examines the impact that the COVID-19 pandemic had on the mental health of pregnant women in the Czech Republic. The theoretical part includes the fundamental information essential for understanding the context of the topic. It focuses on the disease itself, the emergence and development of its pandemic in the Czech Republic, and its course in pregnant women. Additionally, it delves into the psychology of pregnant women and into mental health in general. The thesis also summarizes the results of some Czech studies investigating the impact of the pandemic on the mental health of the Czech population. The research section investigates the influence of the pandemic on the mental health of pregnant women through regression analysis. The numbers of births among women who required a certain form of psychiatric intervention during pregnancy, or within six months after childbirth are examined. The analysed dataset was obtained from the national registers NRRZ and NRHZS and includes records from January 2015 to December 2021. A regression log- log model was created for analysis, which did not show a statistically significant impact of the pandemic on the number of births for these women. Possible reasons for the different results between this research and mentioned studies are discussed...
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Steroid metabolome and multiple pregnancy
Černý, Andrej ; Pařízek, Antonín (advisor) ; Hubka, Petr (referee) ; Kiss, Imrich (referee)
Steroid hormones can be divided into 2 groups - intracellular and extracellular, depending on location of their activity. Intracellular ones influence expression of genes while acting as transcription factors. This so-called genomic effect is very slow. Extracellular (non-genomic) steroids bind to neurotransmitter receptors located on the cytoplasmic cell membrane and thus affect ionic channels permeability. Their effect is faster. We refer to them as neuroactive steroids (produced in different body tissues or administered externally) or neurosteroids (synthetized in nervous system cells). Some neuroactive steroids and their metabolites (e.g. progesterone) are crucial in stabilizing the pregnancy. Other steroid disorders play their role in wide spectre of pregnancy complications, such as preterm labor, preeclampsia, intrahepatic cholestasis in pregnancy etc. Our scientific interest in collaboration with the Department of Steroids and Proteofactors of the Institute of Endocrinology in Prague is focused on investigation of multiple pregnancies in term of steroid metabolome. Studies conducted so far have not provided a comprehensive analysis of steroidome within mothers and fetuses of multiple pregnancies. The aim of our research is to clarify the relationship between fetuses and mother from the point...
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Ultrasonographic Markers of Infection-Related Complications in Preterm Prelabour Rupture of Membranes
Špaček, Richard ; Kacerovský, Marian (advisor) ; Pařízek, Antonín (referee) ; Hruban, Lukáš (referee)
Preterm prelabour rupture of membranes (PPROM) represents a serious pregnancy complication associated with approximately 30% of preterm deliveries. PPROM might be complicated by the presence of microorganisms and/or their nucleic acids in amniotic fluid termed microbial invasion of the amniotic cavity (MIAC), and the elevation of various inflammatory mediators in the amniotic fluid referred to as intra-amniotic inflammation (IAI). Based on their presence or absence, four subgroups of PPROM can be defined: i) intra-amniotic infection (presence of both MIAC and IAI), ii) sterile IAI (IAI alone), iii) colonisation of the amniotic cavity (MIAC alone), and iv) absence of both MIAC and IAI. Although gestational age at delivery is the most important factor affecting the risk of neonatal morbidity and mortality, the presence of MIAC and/or IAI might worsen neonatal outcomes. Therefore, precise assessment of the intra-amniotic environment seems essential for ideal personalised management of PPROM pregnancies. Modern ultrasound machines allow a very detailed examination of the foetus. The effort to identify surrogate ultrasound markers of MIAC and/or IAI represents a logical research step in this field. One of the most promising results has been found on doppler assessment on blood flow in the foetal splenic...
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The influence of assisted vaginal delivery on newborn's adaptation
Michálková, Tereza ; Pařízek, Antonín (advisor) ; Vojtěch, Jiří (referee)
The aim of the bachelor's thesis is to introduce assisted vaginal delivery and to relate the end of delivery by the extraction method to the condition of the newborn immediately after delivery. The thesis is divided into theoretical and practical parts. The theoretical part is focused on defining the concepts on the topic of childbirth and birth mechanism. Furthermore, it deals with the characteristics of vaginal operative delivery and the characteristics of different extraction equipment methods - technique of execution, indications, contraindications and complications. Furthermore, the thesis is focused on defining basic concepts about the newborn, both general and more specific to the topic of the thesis. An important chapter in the neonatal section is the postpartum adaptation and injury of the newborn. The practical part is conceived as a research part and analytical data collection from medical records and the hospital information system Medea was used for this purpose. The research was conducted at the Gynaecology and Obstetrics Clinic of the 1st Faculty of Medicine of Charles University and the General University Hospital in Prague. The collected data were processed in the web application for medical research data collection - REDCap. The aim of the practical part of the bachelor thesis was...
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Cardiotocography in midwifery practice
Bartusková, Simona ; Pařízek, Antonín (advisor) ; Přáda, Jan (referee)
The subject matter of this bachelor thesis has been to create a research identifying the knowledge of the CTG interpretation according to FIGO 2015, both in the theoretical field as well as in the framework of practical skills. Cardiotocography is an integral part of midwife daily routine and a useful method to identify and interpret the lack of oxygenation of the fetus. Therefore, it is a great benefit in terms of reducing the prenatal morbidity and mortality. The work aims at the employment of this method in a deeper and more complex way. The theoretical part focuses on the relevant knowledge up to now, the analysis of CTG, on the recommended processes in the evaluation of the antepartal and intrapartal fetal heart rate monitoring (as it puts emphasis mainly on the changes introduced by the new FIGO 2015 recommendations), on the pathophysiology of fetal hypoxia and last but not least on the nursing care of the midwives in pursuance of FHR monitoring. Using the anonymous questionnaires we tested the theoretical knowledge and practical techniques in the interpretation of CTG by the new guidelines at the Clinic of Gynecology and Obstetrics. Three groups of respondents were addressed, female students of 3rd year bachelor studies (Midwife branch of study), midwives working in delivery rooms and young...
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Prediction of spontaneous preterm labor - role of midwife
Plojharová, Tereza ; Pařízek, Antonín (advisor) ; Přáda, Jan (referee)
This bachelor thesis focuses on the issue of premature birth prediction. Premature delivery is one of the most serious problems in obstetrics and the cause of many perinatal complications. The incidence in the Czech Republic today is around 7,2 %. The problem of prediction of this serious pathology is false negativity or converselyfalse positivity. Regarding the latter, women are unnecessarily hospitalized and treated. It is very important to find a method that could detect as many impending premature births as possible and at the same time show the lowest possible false positivity. However, this is very difficult. Premature birth is caused multifactorial effects. The aim of the study was to determine the premature birth prediction using vaginal ultrasound cervicometry in combination with the examination of fetal fibronectin levels in the transvaginal fluid and the effectiveness of the QUIPP algorithm in predicting the premature birth. These goals were accompanied by 6 hypotheses that helped to fulfill the goals. From January 2019 to March 2020, asymptomatic women with a high risk of premature birth in the week of pregnancy 22+0 to 25+6 were examined. Also, women who then gave birth at the Department of Gynecology and Obstetrics of the First Faculty of Medicine and General Teaching Hospital in...
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The effect of maternal smoking on the homeostasis of the fetoplacental unit
Adamcová, Karolína ; Pařízek, Antonín (advisor) ; Miovský, Michal (referee) ; Procházka, Martin (referee)
Maternal smoking causes serious health danger for a mother but especially for a baby. Cigarette smoking produces complex steroidogenesis changes during the whole life of a woman. To study the influence of smoking on fetoplacental unit focusing on steroid hormons it was important first to concentrate on changes of the chosen steroids around the delivery. The first part of the thesis is dedicated to observe some chosen steroid hormons in peripartal period (37th week of the pregnancy, first stage of labor of mothers and mixed umbilical blood of their neonates) and to look for relations to the age of mother, the increase of the weight during the pregnancy, the type of the delivery and the sex of the baby. It was interesting to compare steroids in the relation to the type of the delivery: vaginal delivery versus planned caesarean section. Non-smoking women who delivered a boy spontaneously had significantly higher level of 17-OH-pregnenolone, progesterone, cortisol, corticosterone and significantly lower level of estradiol in comparison with non-smoking women who delivered a boy by a planned Caesarean section. In the maternal blood in the 37th week of the pregnancy there were found differences between steroids in accordance to the sex of the fetus but they were not found in the neonates' case. The age...
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Midwifery of Period Called Pobelohorska Infanticide
Surá, Alexandra ; Říhová, Milada (advisor) ; Čechura, Jaroslav (referee) ; Pařízek, Antonín (referee)
I initially explored historic figures of European accoucheur of the 17. and 18. century. Beyond this I focused on a period called "Pobělohorská" in Czech countries. I summarized the health conditions of the population during this period, and described medical professions, midwifery and emergency Christening ceremonies. One chapter discusses partnerships and considers women who hid their pregnancy to avoid the prospect of caring for their children in the future. For this reason I present questions relating to how women hid their pregnancy during the Early Modern period. In the next chapter I discuss aspects of the process of giving birth, the locations where women gave birth and the moments thereafter. I present the circumstances of the death of the baby and the possible causes of death. The process of investigation of the scene, an assessment of the body and the search for the mother of the baby (as a potential murderer) are all considered. The assessment of the body was in the hands of the regional physiciusurgeon and a midwife. In my work I describe how the body was assessed, how they judged the maturity of the newborn baby and if the baby was born dead or alive. Further chapters explain the treatment of the umbilical cord, the inquisition of the witnesses and the suspect, and the next steps of...
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Identification of biomarkers involved in the pathophysiology of gestational diabetes mellitus.
Šimják, Patrik ; Pařízek, Antonín (advisor) ; Karásek, David (referee) ; Novotný, Zdeněk (referee)
Identification of biomarkers involved in the pathophysiology of gestational diabetes mellitus ABSTRACT Gestational diabetes mellitus is a disorder of glucose metabolism that occurs in pregnancy and resolves after delivery. Increasing production of pregnancy-related hormones leads to insulin resistance which is not adequately compensated by increased insulin secretion. Since obesity is an important risk factor for gestational diabetes and is also associated with adipose tissue dysfunction and increased peripheral insulin resistance, the question arises as to what extent is the adipose tissue involved in the development of gestational diabetes. The first part of the thesis focuses on the identification of changes in plasma concentration and mRNA expression of adipokines fetuin A, fetuin B and FGF21. In our study we did not show that the presence of gestational diabetes significantly influenced the plasma concentration of fetuin A, fetuin B and FGF21 during pregnancy. An important finding was that women who had pregnancy complicated with gestational diabetes had a significantly higher concentration of FGF21 several months after delivery in comparison to healthy pregnant women. We have been able to demonstrate the production of fetuin A in the placenta and fetuin B in perineal and subcutaneous tissue. However,...
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The influence of high performance sports on pregnancy, delivery and puerperium
Novotná, Adéla ; Pařízek, Antonín (advisor) ; Přáda, Jan (referee)
The bachelor thesis deals with the impact of high performance sports on pregnancy, delivery and puerperium. Theoretical part is focused on the changes in the organism of a pregnant woman, especially on her diet and the impact of either excessive or deficient physical activity. This part also evaluates the suitability of individual sport activities in terms of intensity and specificity during the period of pregnancy. It also addresses the influence of sport anamnesis on the delivery during each birth periods. The thesis also seeks the theoretical basis for returning to a high performance field or maintaining an adequate physical activity during the period of puerperium and lactating. The purpose of the practical part is to compare the population of professional athletes with the average population in both qualitative and quantitative features. Data from Obstetrics-gynecology clinic are used for the quantitative part of the research and are compared with a control group of the average population. The qualitative part is processed in the form of semi-structured interviews. Interwiews were conducted eith respondents who performer top-level sport and with respondents who had never pursued top-level sport. The respondents were acquainted with the topic of bachelor thesis and using their data. They were...
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