Cíl a metodika: Představit ucelený přehled nových poznatků a aktuálních doporučených postupů týkajících se antifosfolipidových protilátek s důrazem zejména na jejich klinický dopad v těhotenství. Závěr: Antifosfolipidové protilátky představují důležitý rizikový faktor pro rozvoj celé řady těhotenských komplikací. Jejich včasnou diagnostikou a správně zvolenou terapií lze snížit incidenci těhotenských ztrát a závažných těhotenských komplikací.
Aim and methodology: To provide a comprehensive review on new findings and current recommendations regarding antiphospholipid antibodies with particular emphasis on clinical impact on gestation. Conclusion: Antiphospholipid antibodies are an important risk factor for the development of a series of pregnancy-related complications. Early diagnosis and appropriate therapy can reduce the incidence of pregnancy loss and pregnancy-related complications.
- MeSH
- antifosfolipidové protilátky * imunologie klasifikace MeSH
- antifosfolipidový syndrom diagnóza farmakoterapie klasifikace patologie MeSH
- antikardiolipinové protilátky imunologie MeSH
- Aspirin aplikace a dávkování MeSH
- beta-2-glykoprotein I antagonisté a inhibitory imunologie MeSH
- heparin nízkomolekulární aplikace a dávkování MeSH
- hydroxychlorochin aplikace a dávkování MeSH
- komplikace těhotenství * etiologie MeSH
- lidé MeSH
- lupusový inhibiční faktor koagulace imunologie MeSH
- rizikové faktory MeSH
- těhotenství MeSH
- Check Tag
- lidé MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- práce podpořená grantem MeSH
- přehledy MeSH
Prenatálně diagnostikované nitrolební krvácení u plodu je spojeno s širokým spektrem postižení novorozence, od zcela nekomplikovaného fyziologického vývoje až po závažnou tíži neurologického postižení či úmrtí. Incidence čítá 0,6–1/1 000 porodů. Nitrolební krvácení je v závislosti na anatomické lokalizaci klasifikováno na intraventrikulární, intracerebrální, cerebrální, subarachnoidální, subdurální. V kazuistice popisujeme raritní případ spontánního nitrolebního krvácení u plodu sledovaného pro hydrops, těhotenství komplikované pro polyhydramnion. Byla provedena rešerše literatury. V diskuzi prezentujeme diagnostický algoritmus a výsledky provedených vyšetření. Pro ucelení kazuistiky doplňujeme informaci o vedení porodu a časném úmrtí novorozence.
Prenatally diagnosed intracranial hemorrhage in the fetus is associated with a wide range of neonatal disorders, from completely uncomplicated physiological development to severe neurological impairment or death. The incidence is 0.6–1/1,000 births. Intracranial hemorrhage, depending on the anatomical location, is classified as intraventricular, intracerebral, cerebral, subarachnoid, and subdural. In this case report, we describe a rare case of spontaneous intracranial hemorrhage in a fetus monitored for hydrops and pregnancy complicated by polyhydramnios. A literature research was carried out. In the discussion, we present the diagnostic algorithm and the results of the examinations performed. To complete the case report, we add information about the management of childbirth and early death of the newborn.
- MeSH
- dospělí MeSH
- hydrops fetalis * etiologie MeSH
- intrakraniální krvácení * etiologie mortalita MeSH
- kojenecká mortalita MeSH
- lidé MeSH
- paliativní péče metody MeSH
- polyhydramnion etiologie MeSH
- prenatální diagnóza metody MeSH
- subdurální hematom etiologie mortalita MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
Brain injury is a multifaceted condition arising from nonspecific damage to nervous tissue. The resulting cognitive developmental impairments reverberate through patients' lives, affecting their families, and even the broader economic landscape. The significance of early brain injury detection lies in its potential to stave off severe consequences and enhance the effectiveness of tailored therapeutic interventions. While established methods like neuroimaging and neurophysiology serve as valuable diagnostic tools, their demanding nature restricts their accessibility, particularly in scenarios such as small hospitals, nocturnal or weekend shifts, and cases involving unstable patients. Hence, there is a pressing need for more accessible and efficient diagnostic avenues. Among the spectrum of brain injuries, hypoxic-ischemic encephalopathy stands out as a predominant affliction in the pediatric population. Diagnosing brain injuries in newborns presents challenges due to the subjective nature of assessments like Apgar scores and the inherent uncertainty in neurological examinations. In this context, methods like magnetic resonance and ultrasound hold recommendations for more accurate diagnosis. Recognizing the potential of serum biomarkers derived from blood samples, this paper underscores their promise as a more expedient and resource-efficient means of assessing brain injuries. The review compiles current insights into serum biomarkers, drawing from experiments conducted on animal models as well as human brain pathologies. The authors aim to elucidate specific characteristics, temporal profiles, and the available corpus of experimental and clinical data for serum biomarkers specific to brain injuries. These include neuron-specific enolase (NSE), ubiquitin carboxy-terminal hydrolase L1 (UCH-L1), S100 calcium-binding protein beta (S100B), glial fibrillary acidic protein (GFAP), and high-mobility-group-protein-box-1 (HMGB1). This comprehensive endeavor contributes to advancing the understanding of brain injury diagnostics and potential avenues for therapeutic intervention.
Kostní dysplazie jsou širokou, heterogenní skupinou chorob. Thanatoforická dysplazie patří mezi nejčastější letální kostní dysplazie. Základem diagnostiky je kvalitní ultrazvukové vyšetření ve II. trimestru a nejnovější metody genetického testování vč. vyšetření klinického exomu. Znalost správné diagnózy je klíčová pro budoucnost plodu i páru.
Bone dysplasias are a broad, heterogeneous group of diseases. Thanatophoric dysplasia is a rare bone dysplasia, but it is the most common lethal skeletal dysplasias. The major role in diagnostics plays a high-quality ultrasound examination in the 2nd trimester and the latest methods of genetic testing, including clinical exome testing. Knowing the correct diagnosis is crucial for the future of the fetus and the couple.
- MeSH
- dospělí MeSH
- indukovaný potrat MeSH
- lidé MeSH
- nemoci plodu diagnostické zobrazování genetika patologie MeSH
- progrese nemoci MeSH
- sekvenování exomu * MeSH
- těhotenství MeSH
- thanatoforní dysplazie * diagnostické zobrazování genetika patologie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
OBJECTIVES: Postpartum retained products of conception are a relatively rare diagnosis occurring in approximately 1% of cases after spontaneous deliveries and abortions. The most common clinical signs are bleeding and abdominal pain. The diagnosis is based on clinical signs and ultrasound examination. MATERIAL AND METHODS: Retrospective analysis of 200 surgical procedures for the diagnosis of residua postpartum obtained in 64 months. We correlated the method and accuracy of diagnosis with definitive histological findings. RESULTS: During 64 months, we performed 23 412 deliveries. The frequency of procedures for diagnosis of retained products of conception (RPOC) was 0.85%. Most (73.5%) of the D&C were performed within six weeks of delivery. Histologically, the correct diagnosis was confirmed in 62% (chorion + amniotic envelope). There was interestingly lower concordance of histologically confirmed RPOC in post-CS patients (only 42%). In women after spontaneous delivery of the placenta, the diagnosis of RPOC was confirmed by histological correlate in 63%, and the highest concordance occurred in women after manual removal of the placenta in 75%. CONCLUSIONS: Concordance with histological findings of chorion or amnion was seen in 62% of cases; this means that the incidence rate in our study was around 0.53%. The lowest concordance is after CS deliveries, 42%. D&C for RPOC should be performed after adequate clinical evaluation and in the knowledge of 38% false positivity. There is certainly more space for a conservative approach under appropriate clinical conditions, especially in patients after CS.
- MeSH
- komplikace těhotenství * MeSH
- lidé MeSH
- poporodní období MeSH
- retrospektivní studie MeSH
- samovolný potrat * MeSH
- těhotenství MeSH
- zadržená placenta * diagnostické zobrazování chirurgie epidemiologie MeSH
- Check Tag
- lidé MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
OBJECTIVES: The good healing of the hysterotomy after cesarean section is important for subsequent pregnancies. However, the factors which improve this healing have not been completely described, yet. In this study, we focused on factors which may affect healing of hysterotomy within one year after delivery, such as menstruation, breastfeeding, and the use of the contraception. MATERIAL AND METHODS: Following delivery, total of 540 women were invited for three consecutive visits at six weeks, six months, and 12 months postpartum. The presence of menstruation, frequency of breastfeeding and contraception use were recorded. The scar was evaluated by vaginal ultrasound as already described. The impact of menstruation, breastfeeding, and contraception method on presence of niche was evaluated. RESULTS: The presence of menstruation increased odds to have niche by 45% (CI 1.046-2.018, p = 0.026). Secondarily, our results demonstrated a statistically significant protective effect of breastfeeding on the incidence of niche with OR 0.703 (CI 0.517-0.955, p = 0.024). Breastfeeding decreases odds to have niche by 30%. Also, the use of gestagen contraception lowered the odds by 40% and intrauterine device (IUD) or combine oral contraceptive (COC) by 46.5%. The other possibly intervening factors were statistically controlled. CONCLUSIONS: Amenorrhea, breast-feeding and progesterone-contraceptive decreases the risk of uterine niche within one year follow up.
- MeSH
- amenorea * MeSH
- antikoncepce metody MeSH
- císařský řez MeSH
- hysterotomie MeSH
- laktace * MeSH
- lidé MeSH
- ochranné faktory MeSH
- poporodní období MeSH
- retrospektivní studie MeSH
- těhotenství MeSH
- Check Tag
- lidé MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
OBJECTIVES: Pregnant women are among the priority groups to receive influenza vaccines in the Czech Republic since 2011, data on vaccination coverage are not yet available. The aim of the study was to determine the influenza vaccination coverage (IVC) and provide source data for further activities. METHODS: A prospective observational study was performed in a large maternity hospital in Prague. The self-completed questionnaire was distributed to 5,475 pregnant women between September 1, 2020 and August 31, 2021. Questions included maternal sociodemographic characteristics, influenza vaccination status and sources of maternal vaccination recommendations during pregnancy. RESULTS: A total of 4,617 completed questionnaires have been analysed. The median age of study participants (N = 4,592) was 33 years (range: 18-51 years). The majority (69.7%) of women had completed their university education, most women were childless (58.5%) or had one child (32.5%) before the start of the study. Less than 2% of women reported being vaccinated against influenza during their pregnancy (1.5%; 95% CI, 1.1-1.9%). Only 21% of women knew that it's possible to get vaccinated against influenza during pregnancy. Participants considered influenza vaccination in pregnancy as important (3.3%), useful (41.1%) and useless (44.4%). Out of 959 pregnant women who had information about influenza vaccination during pregnancy, only 6.9% were vaccinated, while among those who did not have this information, 0.1% were vaccinated during pregnancy (p < 0.001). The most frequent source of information was Internet, then media and a general practitioner. CONCLUSIONS: The IVC during pregnancy in our study was extremely low. In order to improve IVC among pregnant women, it is necessary to increase awareness of recommendations and vaccination options among the public and professionals and incorporating vaccination recommendation in routine antenatal practice.
- MeSH
- chřipka lidská * epidemiologie prevence a kontrola MeSH
- dospělí MeSH
- infekční komplikace v těhotenství * prevence a kontrola MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- porodnice MeSH
- průzkumy a dotazníky MeSH
- roční období MeSH
- těhotenství MeSH
- těhotné ženy MeSH
- vakcinace MeSH
- vakcíny proti chřipce * terapeutické užití MeSH
- zdraví - znalosti, postoje, praxe MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- pozorovací studie MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika MeSH
OBJECTIVES: This observational study aimed to analyse data from big maternity hospital, determine the vaccination coverage and provide source information for further activities. BACKGROUND: Although vaccination of pregnant women against pertussis is recommended in the Czech Republic, data on vaccination coverage are not available. METHODS: The self-completed questionnaire was distributed to 5,475 pregnant women in the maternity hospital between 2020 and 2021. Questionnaires collected mother's sociodemographic characteristics, pertussis vaccination status and sources of recommendations for vaccinations during pregnancy. RESULTS: A total of 4,617 completed questionnaires were analysed. Pertussis vaccination coverage during pregnancy was 1.6 % (95% confidence interval, 1.3-2.0 %). Only 12.5 % of women knew about the possibility of being vaccinated against pertussis during pregnancy. Women considered pertussis vaccination in pregnancy as important (12.9 %), useful (49.1 %) and useless (24.0 %). Of 579 pregnant women who had information about pertussis vaccination during pregnancy, only 12.1 % were vaccinated, while among those who did not have this information, 0.1% were vaccinated during pregnancy (p < 0.001). The most frequent source of information was Internet, then a general practitioner. CONCLUSION: It is necessary to raise awareness of recommendations for pregnancy vaccination among public and professionals, to emphasize the benefits of such vaccination in order to increase the vaccination coverage (Tab. 3, Ref. 31). Text in PDF www.elis.sk Keywords: pertussis, whooping cough, pregnancy, vaccination, health knowledge, prevention.
- MeSH
- chřipka lidská * prevence a kontrola MeSH
- infekční komplikace v těhotenství * MeSH
- lidé MeSH
- pertuse * prevence a kontrola MeSH
- těhotenství MeSH
- těhotné ženy MeSH
- vakcinace MeSH
- Check Tag
- lidé MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- pozorovací studie MeSH
- Geografické názvy
- Česká republika MeSH
