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Major obstetric complications in women with inherited thrombophilia in comparison to the control group of women
Pechrová, Viktorie ; Koucký, Michal (advisor) ; Čábela, Radek (referee)
Leiden mutation and mutation of the gen for prothrombin are classified as hereditary thrombophilia affecting external cascade's hemocoagulation factors. The higher incidence is in the Europoid. We marked those disorders not only as risk factors for thromboembolism but as risk factors for obstetrics complications as well. This bachelor thesis completes theoretical knowledge of Leiden mutation and mutation of the gen for prothrombin. Afterward, the thesis is focused on obstetrics complications that are associated with those thrombophilias. The analytical part of the thesis is devoted to the association of the mentioned mutations and the higher risk of recurrent pregnancy loss. Meaning that women who carry the such mutation are more likely to have the anamnesis of 2 or more miscarriages compared to women without thrombophilia. First, the hypothesis was set that the women with thrombophilia are going to have more frequent recurrent pregnancy loss compared to the control group without thrombophilia. To verify the hypothesis a retrospective check of the databases was made. The databases were from The Institute of Medical Biochemistry and Laboratory Diagnostics of the General University Hospital and of the First Faculty of Medicine of Charles University, where the group with thrombophilia was taken. The...
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Pregnancy with positive diagnosis of preeclampsia and the role of a midwife.
HUSÁROVÁ, Nela
This bachelor thesis deals with pregnancy and positive diagnosis of pre-eclampsia. The thesis describes the role of a midwife and the needs of pregnant women during hospitalization. The aim of this thesis was to find out how midwives perceive the care of pregnant women diagnosed with pre-eclampsia and a further aim was to find how the needs of women diagnosed with preeclampsia have changed. The thesis is divided into two parts, theoretical and empirical. In the theoretical part the characteristics of pregnancy, hypertension, etiopathogenesis and the role of a midwife with a woman diagnosed with pre-eclampsia are described. Two aims were chosen for the empirical part of this thesis, namely, to find out how midwives perceive the care of pregnant women diagnosed with pre-eclampsia and how the needs of women diagnosed with pre-eclampsia have changed. We were interested in finding out how midwives care for pregnant women diagnosed with pre-eclampsia and the needs of these women during hospitalization. Based on these objectives, two research questions were established. How do midwives perceive the care of pregnant women diagnosed with pre-eclampsia and how have the needs of pregnant women changed during the provision of care. A qualitative research investigation was carried out by means of semi-structured interviews with midwives and women who have experienced the disease during pregnancy. The first research group consisted of five midwives working in the obstetrics and gynecology department. The second research group consisted of eight informants with personal experience of pre-eclampsia and whose delivery took place less than a year ago. The first research question investigated how midwives perceive the care for pregnant women diagnosed with pre-eclampsia. The research survey showed that all the midwives interviewed agreed on increased monitoring of the client's general condition, especially monitoring of blood pressure, swelling, laboratory testing of blood and urine, subjective feelings of the client and further observation of the heart rate of the fetus using a doppler. Furthermore, the midwives emphasized the importance of client education during hospitalization. Most frequently the women were educated about resting regimen, limiting TV and phone screen time, having a semi-dark room, bedrest, signaling devices and getting enough sleep and rest. Only some midwives mentioned educating women about the proper technique of urine collection in 24 hours. Information regarding bowel movement and constipation prevention was mentioned only by midwife PA3. The second research question examined how pregnant women's care needs have changed. The research survey showed that informants most frequently experience disruption of psychosocial needs, namely separation from family and loved ones, fear and concern for their unborn child, homesickness and sadness. Furthermore, the informants reported disruption of sleep due to hospitalization and change of environment. Some informants mentioned limited dietary choices and only informant I8 mentioned a problem of obstipation due to long-term hospitalization and resting regimen. Furthermore, the informants mentioned an information deficit in the area of self-education due to not attending antenatal classes as a result of hospitalization and the previous epidemiological situation. Pregnant women undergoing long-term hospitalization do not have the opportunity to visit antenatal courses outside the medical ward which results in information deficit in the area of self-education. This bachelor thesis has shown that there is a need for more consistent education for women during hospitalization. The findings of this thesis may be used as a source for professional seminars and lectures for midwives.
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Nursing care for a woman with pre-eclampsia, perinatological results in relation to creatinine levels in maternal blood
Šmejkalová, Tereza ; Koucký, Michal (advisor) ; Čábela, Radek (referee)
Pre-eclampsia (PE) is a serious multi-organ disease complicating pregnancy. It occurs in 2-8% of pregnancies worldwide and approximately 50,000 women die from its consequences each year. This bachelor's thesis summarizes the theoretical knowledge of PE, - specifically the etiopathogenesis, classification and symptoms of the disease, treatment management, likely complications and other aspects that are important in nursing care. The practical part of the thesis deals with the use of serum creatinine (S-creatinine) levels to determine the severity of the patient's condition and the likely consequences for the foetus. The main objective of the thesis was to find a correlation between maternal S-creatinine levels prior to delivery and perinatal outcomes. The sub-objective was to monitor serum urea (S-urea) levels in relation to the length of pregnancy. Our hypothesis was that as the mother's antepartum S-creatinine level increases, the length of gestation shortens, newborn birth weight decreases, postpartum adaptation worsens, and the length of maternal hospitalization increases. To perform the research, we retrospectively collected data from pregnant women with a PE diagnosis who gave birth at the Department of Obstetrics and Gynaecology of the First Faculty of Medicine of Charles University and of...
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Detection of extracellular microRNAs in maternal circulation - diagnosis and prognosis of pregnancy related complications
Ondráčková, Markéta ; Hromadníková, Ilona (advisor) ; Daňková, Pavlína (referee)
MicroRNAs (miRNAs) are small noncoding RNAs of length 18 to 25 nucleotides that regulate gene expression posttranscriptionally. Expression of some miRNAs is tissue specific. I assumed that pregnancy induced complications associated with placental insufficiency could be characterized by a unique profil of placental-specific miRNAs in maternal circulation. I measured concentration and gene expression of selected miRNAs (miR-516-5p, miR-517*, miR-518b, miR-520a*, miR-520h, miR-525 and miR-526a) in the plasma of patients with preeclampsia (PE), fetal growth restriction (FGR) and gestational hypertension (GH). The control group consisted of patients with a normal course of pregnancy (FG). I processed 168 plasma samples, the representation of individual diagnosis were as follows: PE 63, FGR 27, GH 23, FG 55. Detection and quantification was carried out by quantitative real-time PCR. I identified three miRNAs with elevated levels in a group of preeclamptic patients: miR-517*, miR-520a* and miR-525. The severity of the PE, which was characterized by a form of the disease (mild or severe PE) and term (before or after the 34th week of pregnancy), did not have a statistically significant effect on the levels of miRNAs. More than a quarter of patients had PE superimposed on previous hypertension. Previous history of...
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Relation between cardiovascular microRNAs and pregnancy-related complications
Dalecká, Linda ; Hromadníková, Ilona (advisor) ; Daňková, Pavlína (referee)
During the pregnancy, there are many complications, which can affect a fetal development and eventually, its or mother's life. Pre-eclampsia is one of these complications. It is a hypertensive disorder, which appears during the pregnancy. Another example of these complications is an intrauterine growth restriction. It is a condition, when the fetus is not able to reach its genetical growth potential. Both of those pathological disorders are accompanied by changes in microRNA gene expression in placenta, for example miR-16, miR-21, miR-210. Knowledge about these changes in gene expression could represent unique instruments in the field of noninvasive prenatal diagnosis of these disorders. This could be benefitial due to the fact, that both of these disorders are responsible for increasing maternal and perinatal morbidity and mortality. This work focused on microRNAs, their expression in aformentioned disorders and benefits, which could bring in diagnostics. In this work these two disorders, characteristics of microRNAs and their biogenesi are described. MicroRNAs are interesting for us as potential biomarkers for noninvasive prenatal diagnostics becouse they are present in body fluids, such as plasma, breast milk or amniotic fluid and they are not subject of rapid degradation. Key words:...
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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...
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Heat shock proteins - - their role in diagnosis and prognosis of pregnancy related complications
Dvořáková, Lenka ; Hromadníková, Ilona (advisor) ; Růžičková, Šárka (referee)
Heat shock proteins increase their gene expression after exposure of cells or organisms to some forms of stress, which may be high temperature, infection, inflammation, hypoxia, lack of nutrients and water. Stressful situations for the body are also pregnancy-related complications associated with placental insufficiency - preeclampsia and IUGR, as well as other pregnancy-related complications such as fetal growth restriction and gestational hypertension. Therefore, I examined whether the occurrence of pregnancy-related complications (preeclampsia, fetal growth retardation, gestational hypertension) affect the gene expression of heat shock proteins. Five hsp systems was detected, namely Hsp27, Hsp60, Hsp70, Hsp90 and HspBP1 in placental tissue samples and whole maternal peripheral blood. Samples came from women with physiological pregnancy and from women with certain pregnancy-related complications (PE, FGR, GH). RNA was isolated from the samples. Detection of hsp expression was performed by using real-time RT-PCR and the comparative Ct method. Changes in gene expression between the test samples and reference sample were examined. To assess the difference between physiological pregnancies and pregnancies with selected pregnancy- related complications, an analysis of variance (ANOVA) was used....
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Markers for the prediction of preeclampsia and their relevance in the first trimester of pregnancy
Šedová, Lenka ; Kestlerová, Andrea (advisor) ; Švandová, Ivana (referee)
Preelampsia is a clinical syndrome found uniquely in a pregnant patient with an incidence 2 - 8 % of pregnancies worldwide. It is defined as the new onset of hypertension and proteinuria after 20 weeks of gestation, resolving with delivery or soon thereafter. Its worst consequences are eclampsia with tonic and clonic seizures and possibly coma. Also pulmonary edema, CNS hemorrhage, anaemia, hepatorenal failure, circulation failure and other complications can occur. In its most severe form, it affects nearly every organ. Preeclampsia remains a major cause of premature delivery and both maternal and neonatal mortality and morbidity. The origin and the cause of the disease remain unknown and therefore the medical treatment focuses only on clinical manifestations. Timely prediction of preeclampsia would enable accurate therapeutic treatment and a decrease of the threat to maternal and fetal health. In this study, the most important predictive biomarkers of PE and their relevance in the first trimester of gestation are presented. Furthermore, a first trimester screening with the best prediction rates is described. Powered by TCPDF (www.tcpdf.org)
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Extracellular microRNAs and their role in pathologies especially in the field of gynecology and obstetrics.
Štěrbová, Monika ; Hromadníková, Ilona (advisor) ; Balušíková, Kamila (referee)
microRNAs (miRNAs) represent a relatively newly discovered group of RNA molecules and they serve to regulate gene expression. In spite of processes of differentiation, proliferation and apoptosis, miRNAs influence the whole biological systems, such as embryogenesis, oncogenesis, and immunity. There have been a number of experiments in recent years concerning diagnoses and predictions of complications during pregnancy, and tumour growth. Extracellular miRNA molecules participating in circulation of patients are used in the non-invasive diagnostics. RNA molecules usually get into the extracellular fluid during the apoptosis process. I chose four diseases, which extracellular miRNA have diagnostic potential - preeclampsia, intrauterine growth retardation, gestational diabetes mellitus and breast cancer - for my work. An aberrant expression of different levels of various extracellular miRNAs has been reported in these diseases but the clinical use of microRNAs in the diagnosis and prediction of those still requires further research and optimization. Keywords: breast cancer, extracellular nucleic acids, fetal growth retardation, gestational diabetes mellitus, microRNA, PCR, preeclampsia
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