Antifosfolipidový syndrom (APS) je autoimunitně podmíněné onemocnění s celou řadou potenciálně život ohrožujících manifestací. Vyskytuje se samostatně v primární podobě nebo jako sekundární doprovázející řadu chorobných stavů (autoimunitní, nádorová onemocnění atd.). Diagnostická kritéria zahrnují jak klinickou, tak laboratorní složku. Mezi klinické manifestace patří výskyt trombóz arteriálních či žilních a dále komplikace v těhotenství. Laboratorně musí být opakovaně prokázána přítomnost antifosfolipidových protilátek v minimálním odstupu 12 týdnů. Klinická manifestace APS může být velmi pestrá a často vyžaduje multidisciplinární přístup. Obávanou, ale vzácnou komplikací je tzv. katastrofický APS spojený s vysokou morbiditou a mortalitou. Včasná diagnóza spolu s terapií výrazně ovlivňuje prognózu pacientů s APS. Klíčová slova: antifosfolipidový syndrom – systémový lupus erythematodes, Antiphospholipid syndrome (APS) is an autoimmune disorder characterized by various potentially serious and life‑threatening manifestations. APS occurs in a primary form with no associated conditions, or in a secondary form associated with various other illnesses (autoimmune, neoplastic and others). APS is diagnosed according to clinical and laboratory criteria. It is characterized by recurrent arterial or venous thrombosis and/or pregnancy‑related complications and laboratory findings of antiphospholipid antibodies in a minimum time interval of 12 weeks between individual laboratory tests. Clinical manifestations of APS can vary and a multidisciplinary approach is needed. Catastrophic APS is a very serious and life‑threatening condition associated with high mortality and morbidity, although it is rare. An early diagnosis with proper therapy has a serious impact on the prognosis of patients with APS. Keywords: antiphospholipid syndrome – systemic lupus erythematosus, and Ciferská H.
Ilona Hromadnikova, Lenka Dvorakova, Katerina Kotlabova, Andrea Kestlerova, Lucie Hympanova, Veronika Novotna, Jindrich Doucha, Ladislav Krofta and Literatura
Based on survey of 257 women with nondeveloping pregnancies of various geneses, it was shown that the level of apoptosis marker P53 in the decidual tissue is increased, and antiapoptotic protein Bcl2 simultaneously is reduced, compared with similar data of women with physiological pregnancies. The morphological and histochemical investigation of apoptotic changes during NDP, by means of Bcl2 and P53, must consider the main marker in early manifestations of the dynamics of the pathological processes., Dilnoza Saidjalilova, and Literatura
Ruptured pregnancy in the rudimentary horn of women who have had a vaginal delivery is rare and unpredictable. However, when undiagnosed, this condition could lead to maternal morbidity and mortality. We report a pregnancy at 19 weeks gestation presented with acute abdomen and hypovolemic shock. She was initially thought to have an intrauterine pregnancy with the provisional diagnosis of a ruptured uterus. Intraoperatively, a ruptured non-communicating right rudimentary horn with ex utero pregnancy was discovered., Che Hasnura Che Hassan, Abdul Kadir Abdul Karim, Nor Azlin Mohamed Ismail, Mohd Hashim Omar, and Literatura 6
Cíl studie: zhodnocení efektivity cerkláže dle McDonalda ve Fakultní nemocnici Ostrava v období 1/2007 – 3/2014. Typ studie: retrospektivní studie Název a sídlo pracoviště: Porodnicko–gynekologická klinika, Fakultní nemocnice Ostrava Metodika: retrospektivní analýza provedených cerkláží ve Fakultní nemocnici Ostrava a rozbor výsledků takto ošetřených gravidit. Kritériem úspěšnosti byl stanoven porod po ukončeném 34. týdnu gravidity. Závěr: ve sledovaném období bylo indikováno devět cerkláží – 7 terapeutických a 2 záchranné. Výkony byly provedeny mezi 18. a 25. týdnem gravidity. Tři pacientky již měly v minulosti cerkláž provedenu. 57 % takto ošetřených těhotných porodilo po ukončeném 34. týdnu gravidity. Pouze v jednom případě (11,1 %) byla cerkláž neúspěšná a těhotenství skončilo potratem. Průměrná doba mezi provedením cerkláže a porodem činila 69 dnů., Objective: To evaluate the efficacy of cerclage according to McDonald at the University Hospital Ostrava in the period 1/2007 - 3/2014. Design: A retrospective study Obstetrics and Gynecology: Obstetrics - Gynecology, University Hospital Ostrava Methods: A retrospective analysis of cerclage performed at the University Hospital Ostrava and analysis of the results thus treated pregnancies. The criterion for success was determined after childbirth completed 34 weeks of preg - nancy. Conclusion: In the reporting period, nine indicated cerclage - 7 of therapeutic and 2 emergency. The procedures were performed between the 18th and 25th week of pregnancy. Three patients have had in the past cerclage performed. 57% of the treated pregnant women gave birth after 34 completed weeks of gestation. Only in one case (11.1 %) cerclage was unsuccessful and the pregnancy ended in a miscarriage. The average time between performing cerclage and delivery was 69 days., Petr Vašek, Igor Michalec, and Literatura
We measured plasma concentrations, adipose tissue and placental mRNA expression of hepatokines fetuin A, fetuin B and fibroblast growth factor 21 (FGF21) in 12 healthy pregnant women (P group), 12 pregnant women with gestational diabetes (GDM) and 10 healthy non-pregnant women (N group) to explore their potential role in the etiopathogenesis of GDM. GDM and P group had comparable BMI, C-reactive protein (CRP) and glycated hemoglobin levels while IL-10 and TNF-α levels were higher in GDM group. Fetuin A and fetuin B levels were higher in pregnancy as compared to N group and decreased after delivery with no apparent influence of GDM. In contrast, the pattern of changes of circulating FGF21 levels differed between GDM and P group. Fetuin A concentrations positively correlated with CRP, TNF-α mRNA expression in adipose tissue and IL-6 mRNA expression in placenta. Fetuin B positively correlated with CRP. FGF21 levels correlated positively with IFN-γ mRNA in adipose tissue and inversely with IL-8 mRNA in the placenta. Taken together, fetuin A and fetuin B levels were increased during pregnancy regardless of the presence of GDM. In contrast, FGF21 patterns differed between healthy pregnant women and GDM patients suggesting a possible role of this hepatokine in the etiopathogenesis of GDM., P. Šimják, A. Cinkajzlová, K. Anderlová, J. Kloučková, H. Kratochvílová, Z. Lacinová, P. Kaválková, H. Krejčí, M. Mráz, A. Pařízek, M. Kršek, M. Haluzík., and Obsahuje bibliografii
Smoking during pregnancy presents health risks for both the mother and her child. In this study we followed changes in the production of steroid hormones in pregnant smokers. We focused on changes in steroidogenesis in the blood of mothers in their 37th week of pregnancy and in mixed cord blood from their newborns. The study included 88 healthy women with physiological pregnancies (17 active smokers and 71 nonsmokers). We separately analyzed hormonal changes associated with smoking according to the sex of newborns. In women with male fetuses, we found higher levels of serum cortisone, dehydroepiandrosterone (DHEA), 7α-OH-DHEA, 17-OH pregnenolone, testosterone, and androstenedione in smokers at the 37th week compared to non-smokers. In women with female fetuses, we found lower serum levels of 7β-OH-DHEA and higher androstenedione in smokers at the 37th week. We found significantly higher levels of testosterone in newborn males of smokers and higher levels of 7α-OH-DHEA in female newborns of smokers. Smoking during pregnancy induces changes in the production of steroids in both the mother and her child. These changes are different for different fetal sexes, with more pronounced changes in mothers carrying male newborns as well as in the newborn males themselves., K. Adamcová, L. Kolátorová, T. Chlupáčová, M. Šimková, H. Jandíková, A. Pařízek, L. Stárka, M. Dušková., and Obsahuje bibliografii