Biomedical subjects
Publications and source records attributed to A Dimitrov.
We compared the results of oxygen delivery and oxygen consumption measurements in 11 preeclamptic patients and report of the oxygen transport in severe preeclampsia. Measurements were performed between 28-36 weeks of gestation.
UNLABELLED: The aim of this prospective study is to assess the effect of non indicated supplementation with Materna during normal pregnancy on some parameters of the neonate and the process of delivery. The material includes 98 women who had been taking Materna during the pregnancy and 27 cases without any medications. The criteria for inclusion are: normally progressing clinically and paraclinically pregnancy and delivery after completing 37th w.g. (95% confident interval 39.0-40.5). RESULT: Most of the pregnant women take Materna for 3 to 5 months (95% CI) during pregnancy. The supplementation with Materna lead to increase of the BIP from the control group of 94.4 mm to 96.5; the occipitofrontal circumference from 33.9 to 35.1 and the high of the neonate from 50.2 to 51.1 respectively. The impression of the obstetricians engage in the study is that the scull bones are more solid and the molding of the head after the delivery is very small or even missing. CONCLUSION: Unjustified supplementation of normal pregnancy with multivitamins and multiminerals lead to increase in the occipitofrontal circumference and to the decrease of the molding capacity of the fetal head wherefore the labor prolongs and the rate of CS and the operative vaginal deliveries increase.
The postnatal development of renal function was compared in 29 infants with a gestation age (GA) of 26-30 weeks mean 28.5 680-1,450 g means 1080 g and in 31 infants with a gestation age of 31-33-weeks, means 31.5, 950-2000 g means 1580 g. Observation were made during the 1st, 5th and 10th day. From 1st to 10th day the creatinine clearance increased but it was significantly lower in GA 26-30 that in GA 31-33. During the first 10 days of life diuresis was lower in GA 26-30 that in GA 31-33 but thereafter was the same in both groups. Urinary sodium excretion was high at 1st and 5th day in both groups and decreased with increasing postnatal age. Na excretion was slightly higher in GA 26-30 that in GA 31-33 at 1st and 5th day but not at 10th day. UK/UNa was below 1 in both groups during the 1st, 5th day and increased with postnatal age. FeNa% was high in both groups but in GA 26-30 was significantly hither then in GA 31-33. We conclude that the postnatal development of renal function is retarded in all preterm infants and is slightly slower in infants with a GA below 31 weeks than in infants with GA 31-33 weeks.
A rare case of successful pregnancy and delivery of a patient with Hereditary angioedema is described. The complications of the disease during pregnancy are described as well as the possibilities for their prevention. The delivery was accomplished without complications and the preoperative preparations are listed. The treatment of HAE in general is divided into two groups: short-term (Fresh frozen plasma) and long-term prophylaxis (antifibrinolytic agents, androgen therapy) and acute treatment (epinephrine, steroids, antihistamines, eventually tracheotomy).
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A survey is made on physiology of lipid metabolism and its variations during pregnancy. The mechanisms leading to an increase in triglycerides and cholesterol during pregnancy are explained. These changes induce increased aterogenic risk, higher risk for developing pathologic 1 changes in blood vessels on microcirculation level on the basis of endothelial disfunction. A multiorgan pathology may possibly be provoked--kidneys, pancreas or occurrence of praeeclampsia.
Bacterial vaginosis is one of the most widespread disturbances of the normal state of the vagina of women of reproductive and menopausal age. This condition is highly disregarded due to its moderate and not always clear clinical manifestation. The disturbed proportion of microorganisms in vagina is shown in the strong decrease or lack of lactobacilli and a spread of associated with bacterial vaginosis microorganisms. G. vaginalis, Mobiluncis spp., Bacteroides spp. (without B. fragilis), Peptostreptococcus spp., Mycoplasma hominis, Ureaplasma urealyticum. The condition is a predisposition to a disturbance of natural defense mechanisms and to a spread of infectious agents towards the upper female genital tract. This is a predisposition for the development of tubal patency and motility disorders, ovarian function disturbances, endometrites. The treatment of this condition as an important step in female sterility prophylaxis is commented.
The probiotics or biotherapeutical agents are microorganisms that have an antagonistic activity regarding pathogens in vivo. Therapeutic application of these microorganisms is mostly in cases of infections of non-sterile mucous surfaces--vagina and large intestines. With the help of the probiotic L. acidophilus bacterial vaginosis can be treated successfully in a natural way. The lack of systemic side effects makes it a drug of choice in the treatment of pregnant women. More studies in this direction and development of new strategies for treatment of bacterial vaginosis in pregnant and non-pregnant women are needed.
Umbilical cord blood transplantation has many potential advantages over Bone Marrow Transplantation using other donor sources to patients in need of allogeneic hematopoietic stem cell transplantation. Collecting of Umbilical cord blood is a technically simple procedure that poses no foreseeable health risks to the mother or the fetus. The results achieved during the last 10 years of the European Transplantation Centers define this new technology as vanguard and perspective, alternative treatment of the patients obtained oncological disorders.
Allogeneic Hematopoietic Stem Cells Transplantation is a therapy for wide variety of malignant and nonmalignant disorders. Cord blood as an alternative source of hematopoietic stem cells was utilized and these transplantations.
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The aim of the study is to investigate the alterations in fetal oxygen saturation during right lateral, supine and left lateral maternal position. Thirty six women at term are included--during the first stage of normally progressing labour. Simultaneous monitoring is carried out of fetal heart rate, uterine contractions, fetal oxygen saturation and maternal arterial blood pressure for a certain period of time in different maternal positions. It was established, that fetal oxygen saturation values are lowest in the supine position, still remaining in physiological ranges--47.1 +/- 10.2. If supine syndrome develops, fetal oxygen saturation values decrease significantly: 23%, 25%.
The purpose of this prospective and case controlled study is to determine the effectiveness and safety of antibiotic prophylaxis with Tercef (ceftriaxone) in women undergoing cesarean section and to compare the results with those of 24 hours regiment of Cefazolin and also with a group without prophylaxis. The study includes 122 cases of elective and emergency CS: 41 with a single intravenous dose of 1.0 g Tercef after clamping of the umbilical cord; 41 cases of antibiotic prophylaxis with Cefazolin three times 2.0 g for 24 hours and 40 low infectious risk CS without antibiotic prophylaxis. We take in account the existing before the CS risk factors for postoperative infectious complications as: hours of PROM; length of labor, number of vaginal examinations before CS, previous sections, duration of the operation, anemia, bacteriuria and diabetes. For post CS infection-related complications we take: febrile morbidity, endometritis, wound infections, infection of urinary tract. The results show infection complication in the three groups as follow: 14.6% for tercef, 17.1% for cefazolin and 20.0% for the group without antibiotic. There is not statistically significant difference. According our study in cases of CS with increased risk of post-operative infectious complications the antibiotic prophylaxis reduce the rate of infection-related complications even below that of CS with low infectious risk. The single dose of 1 g tercef i.v. is effective and suitable in comparison with 24 hours regiment of cefazolin.
The aim of the study is to establish the possibility for reconstructing episiotomies with a continuous uninterrupted suture. In a prospective study are included 54 women with a lateral episiotomy without further lacerations. As sewing material were used Cat-gut or Vicryl Rapide. Reconstruction of vagina, perineum and skin is done by a continuous suture with a single thread. The technical accomplishment does not provide problems to the surgeon. What is more, it reduces the durability of the intervention by achieving a good haemostasis and anatomic adaptation. All episiotomies heal per priman. An important advantage for women from a psychoemotinal point of view is the lack of the necessity to remove threads.
This is a retrospective study on the rate of inborn defects of neural tube in University Hospital of Obstetrics and Gynaecology--Sofia for two 5-years-long periods of time: from 1986 to 1990 and from 1993 to 1997. The results show an increasing rate of inborn NTD during the second period of time which can be partly explained by the fact that the hospital is National Perinatal Centre where high risk pregnancies and deliveries are concentrated. Most disturbing is the fact that more than half of life-born and still-born infants with NTD are at an age of gestation higher than 34 g.w. This is a result of late perinatal diagnosis of these defects and brings up serious psychological, social and economical problems.
The aim of the study is to provide preliminary assessment of the possibilities of fetal pulse oximetry as a method for monitoring of fetal pulse rate and oxygen saturation during labour. The study includes 65 pregnant women during active labour at term--all with one fetus and ruptured membranes. A system for fetal pulse oximetry is used, consisting of monitor Nellcor-N 400; oxygen sensor FS-14 and printer P-400 (Nellcor Puritan Bennett incorporation). Sensor is applied by mean dilatation of cervical channel 6.5 +/- 1.9 cm. Mean duration of monitoring of the pregnant woman is 104 +/- 68 minutes, range 30 to 180 min. The time of reliable signal quality is 83% for first stage of labour and 70% for second stage of labour. Mean SpO2 values are 47.1 +/- 9.8%. The conclusion is made that fetal pulse oximetry is an easy method to use, without side effects for mother and fetus. Mean SpO2 values are tower than in adults and vary inside wider range 35-55%.
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The authors report the results of application of low molecular weight heparin during pregnancy, delivery and after birth to counter placental insufficiency in case of primary antiphospholipid syndrome. The patient had been treated with Fraxiparin for 126 days. No systemic or local side effects were spotted. There were no genital bleeding and tromboembolic accidents during pregnancy. A Caesaerean section was carried out under spinal anaesthesia. Fraxiparin treatment was not halted during the section, which was accompanied by a normal blood loss. The pregnancy yielded an eutrophic newborn and no complications were demonstrated during the neonatal period.