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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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Midwife's care of a woman at risk of imminent preterm birth
BUBENÍČKOVÁ, Veronika
This bachelor thesis deals with the topic of care for a pregnant woman with impending preterm birth. The bachelor thesis is divided into theoretical and practical parts. In the theoretical part, the is described preterm birth, its incidence in the Czech Republic, causes of preterm birth, diagnostic methods, therapeutic procedures in preterm birth, the needs of pregnant women with this diagnosis, and the care of midwives for women at risk of preterm birth. Qualitative survey research was used to develop the practical part. The first research group consisted of 10 women with a diagnosis of preterm birth, who answered questions in a semi-structured interview. The second research group consisted of 7 midwives at the Risk Pregnancy Station. The research was conducted during April and July 2021. Participation in the research was entirely voluntary. Before the start of the interview, the participants of the interview were informed about the topic of the bachelor's thesis and about the protection of personal data. The interviews were conducted anonymously and, after approval by the informants, recorded on a mobile phone. To maintain anonymity, the informants were marked with numbers I1 to I10 and P1 to P7. After that, the interviews were literally transcribed, analyzed, and processed using coding, the paper and pencil method. For the research of this bachelor thesis, two research questions were determined to find out how women perceive the care of a midwife in case of imminent preterm birth and how midwives perceive the care of a woman with a diagnosis of preterm birth. Based on the research survey, it was found that all informants were satisfied with the care of midwives. Research has shown that there were several factors for women's satisfaction with the care of midwives during hospitalization. These factors included the approach of midwives to their willingness and ability to communicate with women. Even though all informants were satisfied with the care and communication from the midwives, the research showed the dissatisfaction of women with the communication with the attending physicians. Dissatisfaction was expressed by informants I1, I3, and I6 when information from doctors seemed to be insufficient to them. Research has further shown that midwives are aware of the importance of their empathic approach in the care of women hospitalized with a diagnosis of preterm birth and also perceive the changing needs of women during hospitalization, which need to be taken into account during care. This work points out the importance of a kind and empathic approach of a midwife to a woman with a diagnosis of preterm birth because that approach of a midwife is one of the most important aspects for a woman to overcome hospitalization at the Risk Pregnancy Station of the gynecology and obstetrics department. The work also shows the influence of the communication of doctors to patients on the female psyche and the experience of hospitalization. The results within this bachelor's thesis can be used as feedback on the work of midwives at the Risk Pregnancy Station of the Gynecology and Obstetrics Department to improve the care of midwives for women with imminent premature birth and increase client satisfaction in the medical facility.
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Stress in women with impending preterm birth
Šplíchalová, Barbora ; Slabá, Šárka (advisor) ; Tisová, Markéta (referee)
This bachelor's thesis deals with the issue of premature birth and the stress associated with it. Although health care in the field of obstetrics is improving, the incidence of preterm birth remains constant worldwide. Preterm birth is a serious perinatological problem and it is therefore important to continue to address this topic. In obstetrics, then, we must not forget the psychological issue, which is an integral part of this branch of medicine and plays an important role in it. Therefore, this thesis also focuses on the psychological part of the issue and discusses in detail the connection between stress and premature birth. The thesis is conceived as a theoretical-practical one. The theoretical part consists of an obstetric part and a psychological part. The obstetric part deals with the issue of premature birth. It deals with its causes, diagnosis, prevention, treatment and management. The psychological part deals with the problem of stress. It deals with types of stress, stressors, consequences of stress and describes the stages of the adaptation syndrome as well as psychological mechanisms of coping with stress. It then goes on to describe the psychological and obstetric issues, discussing the link between stress and preterm birth and describing the emotions that can be observed in women...
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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 Use of Immune Markers in the Managament of Preterm Birth
Korečko, Vladimír ; Novotný, Zdeněk (advisor) ; Roztočil, Aleš (referee) ; Měchurová, Alena (referee)
Structured summary Aim of the study: To compare the diagnostic reliability, accuracy, and safety of amniocentesis and amniotic fluid Interleukin-6 testing in the diagnosis of intrauterine inflammation of patients with preterm premature rupture of membranes. Type of study: Prospective cohort study Name and location of study site: Department of Gynaecology and Obstetrics, Faculty of Medicine, Charles University in Pilsen Set and methodology: We prospectively examined patients with pPROM between the 23rd and 34th week of gestation in 2014 - 2017. All of them underwent amniocentesis and determination of IL-6 levels in amniotic fluid, leukocytes and bacteria in amniotic fluid as well as maternal blood examination for inflammation parameters. The results were compared to histological examination of the placenta after delivery for the presence of chorioamnionitis. Based on the values mentioned above the sensitivity, specificity, negative and positive predictive value, false positive and negative predictive value and accuracy of the test were determined together with an assessment of statistical significance. Furthermore, the feasibility and incidence of perioperative complications as well as the risk of secondary infection when pregnancy continued were evaluated by serial aniocenteses at weekly intervals. The...
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Maternal stress and premature birth
Kokešová, Nikola ; Černý, Andrej (advisor) ; Laštůvka, Zdeněk (referee)
This bachelor thesis is studying the influence of maternal stress on premature birth. Premature birth is a very serious perinatal complication, the incidence of which remains consistent, although health care is constantly improving. In the Czech Republic, the incidence of premature birth is around 8 %. The work has theoretical and practical part. The theoretical part of the thesis is focused on preterm birth, what are its causes, how it can be prevented, what is the diagnosis and management of premature birth. Last but not least the thesis discusses stress as a risk factor for preterm birth. In 2020, a pandemic of COVID-19 hit the world. In March 2020, the first cases appeared in the Czech Republic. A completely new and extraordinary situation has brought many changes and limitations in everyday life of the society, and thus caused an excessive level of stress in the population. Therefore, in the practical part, we focus on the impact of the COVID-19 pandemic on pregnancy and premature births. The aim of the work was to find out whether this new stressful situation affected the frequency of premature births at the Department of Obstetrics and Gynaecology of the First Faculty of Medicine and General Teaching Hospital in Prague. We have also studied whether the frequency of premature births has...
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Pregnancy proteins - molecular biological and biochemical analysis
Muravská, Alexandra ; Kalousová, Marta (advisor) ; Černá, Marie (referee) ; Průša, Richard (referee)
The aim of this thesis was to establish methods for selected PAPP-A (Pregnancy- Associated Plasma Protein A) gene polymorphisms analysis and to study genetic background of PAPP-A and biochemical background of PAPP-A and PlGF (Placental Growth Factor) in relation to risk pregnancy. Secondly, the aim was to establish method for two-dimensional (2D) electrophoresis of amniotic fluid. Methods for analysis of ten PAPP-A gene polymorphisms were established. These polymorphisms, PAPP-A and PlGF levels were studied in together 165 women in third trimester pregnancies complicated with threatening preterm labor (n=98), preeclampsia (n=35), IUGR (Intrauterine Growth Restriction) (n=34) and ICP (Intrahepatic Cholestasis of Pregnancy) (n=15). 114 healthy pregnant women served as controls. The method for 2D electrophoresis of amniotic fluid was established. Preeclamptic patients had significantly higher frequency of TT genotype of Cys327Cys (C/T) PAPP-A gene polymorphism compared to controls. Patients with ICP had increased serum levels of PAPP-A compared to controls, in patients with threatening preterm labor PAPP-A levels were rather decreased. PlGF levels did not differ from control group in patients with ICP and threatening preterm labor. Positive correlation was found between PAPP-A and PlGF in group of...
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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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Nursing care of the women with imminent premature labour
Trtková, Eliška ; Endlicherová, Jana (advisor) ; Šmatláková, Lenka (referee)
The bachelor thesis focuses on the problem of premature labour and the nursing care of the woman at risk of premature labour. The thesis consists of a theoretical and clinical part. In the introduction of this work, the progress of pregnancy, causes, risks, diagnosis and the therapy of premature labour and the characteristics of premature newborns are described. The last chapter of the theoretical part is focused on the psychology of pregnant woman with imminent premature labour. The clinical part is done in the form of case reports and the method of the nursing process according to Marjory Gordon for its processing is used. The study also deals with the emergence of the nursing process, its history and determining nursing diagnoses. The characteristics of the nursing model of health and domains used in this study is also described. In the casuistry, the history of the pregnant woman, the course of hospitalization and the assessment of current and potential nursing diagnoses are mentioned. In the conclusion of the thesis, the process of the delivery and the status of the newborn are described. Keywords: nursing care, premature labour, pregnancy, premature newborn
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