Biomedical subjects

A Malinowski

Publications and source records attributed to A Malinowski.

At least 37 records · Page 2Linked to original sources

PubMed2000

[Antiphospholipid autoantibodies in women treated for infertility].

OBJECTIVE: To evaluate an occurrence of selected antiphospholipid antibodies (APL) in infertility women. STUDY DESIGN: An enzyme-linked immunoabsorbent assay (ELISA) has been used to determine a titre of anticardiolipin antibodies (ACA). APTT (activated partial thromboplastin time) and PT (prothrombin time) measurements and direct commercial assay have been also used to study occurrence of LAC (lupus anticoagulant antibodies). The group of 268 observed women has been divided into five subgroups according to the cause of infertility: I-endometriosis, II-tubal occlusion caused by others diseases than endometriosis, III-occurrence of antisperm antibodies (ASA), IV-polycystic ovariorum syndrome (PCOS) and V-unexplained etiology. Results have been compared to 44 healthy controls. RESULTS: Occurrence of ACA has been found statistically more often in patients suffering from infertility than in controls (17.9% vs 4.5%, p < 0.05). Moreover ACA have been statistically more often observed in patients with endometriosis (21 from 44, 47.7%). ACA were more common in patients with other cause of infertility (except PCOS) compared to controls, though statistically this was not significant. Frequency of ACA was also more common than LAC (17.9% vs 13.6%). Compared to controls LAC tests were more often positive in infertile women with endometriosis (I), tubal occlusion (II) and with the occurrence of antisperm antibodies (III) but results were not statistically significant. CONCLUSIONS: Antiphospholipid antibodies are observed more often in patients suffering from infertility compared to women with a regular fertility. This suggests a role of APL in etiology of infertility. The occurrence of anticardiolipin antibodies in almost every second woman suffering from endometriosis suggests existing of autoimmunologic disturbances in this disease.

Adult↗

PubMed2000

[Laparoscopy and laparotomy in the operative treatment of ovarian cysts].

OBJECTIVES: The purpose of our study was to compare operative procedures, histologic types of tumours, and intra- and postoperative complications of patients operated for benign ovarian cysts by laparotomy or laparoscopy. MATERIALS AND METHODS: 257 patients with different types of ovarian cysts underwent operations by laparoscopy (51 cases) or laparotomy (206 cases). Careful selection for operative treatment was made on the basis of clinical findings, ultrasound scans (using colour Doppler), patient's age and history. Operative laparoscopies were performed in patients with "unsuspected" ovarian cysts with diameter < or = 8 cm. During every operation, a histologic examination of tumour was performed. RESULTS: In 42 patients the cysts were found in both ovaries. Remaining 215 women had unilateral ovarian tumours. Adnexectomy was carried out in 142 cases, cystectomy in 131, ovariectomy in 18, and aspiration and electrocoagulation of ovarian cysts in 8 cases. The most common laparoscopic procedures were cystectomy (41) and aspiration and electrocoagulation of ovarian cysts (8); while by laparotomy: adnexectomy (142) and cystectomy (131); p < 0.0001. The histopathological assessment showed as follows: serous cysts in 98 cases, dermoid cysts in 75, endometrial cysts in 63, mucous cyst in 23, and others (mainly haemorrhagic, functional cysts and fibrothecomas) in 40 cases. The incidence of operative complications (3/257--all due to insufficient hemostasis) and postoperative complications (infection--7/257, anaemia--4/257, peritonitis--1/257) was rather low and similar in patients operated by laparoscopy and laparotomy. Patients were generally discharged from the hospital on the fourth (median) postoperative day after laparoscopies and the seventh (median) day after laparotomies (p < 0.0005). CONCLUSIONS: Operative treatment of ovarian benign cysts is connected with a very low risk for intra- and postoperative complications. The operative laparoscopy brings better cosmetic effects and seems to be safe and effective method of treatment of ovarian benign cysts.

Adolescent↗

PubMed2000

[Ovarian cancer. I. Epidemiology, symptoms, FIGO staging].

OBJECTIVES: The purpose of our study was to analyse the epidemiological data, signs and symptoms, FIGO staging in patients operated for the first time for ovarian cancer. MATERIALS AND METHODS: A retrospective review of patients' charts with ovarian cancer operated at the Department of Gynaecological Surgery of Polish Mother's Memorial Hospital-Research Institute in 1990-1999 was conducted. We analysed the data of women operated for the first time for this disease. FIGO staging was performed due to operational and histologic findings. RESULTS: Between January 1990 and December 1999, 107 patients were operated for the first time for ovarian cancer. The mean patients' age was 54 years (range: 25-82); 31.8% of patients were aged from 41 to 50 years, 24.8% 51-60, 27.1% 61-70%, 7.5% above 70 years, and 9.3% were below 40 years. The main symptoms were: abdominal pain (61.7%), increasing abdominal circumference (35.5%), urination and bowel problems (14.0%), weight loss (8.4%), dyspeptic problems (7.5%), slightly elevated temperature (4.7%) and abnormal vaginal bleeding (3.7%). No symptoms were reported by 16.8% of patients (frequency similar in I/II and III/IV stage by FIGO). There were no statistical differences in the incidence of reported symptoms in I/II vs III/IV FIGO stage. FIGO staging was as follows: I--13.1%, II--14.95%, III--59.8%, IV--12.15%. CONCLUSIONS: Our data showed that ovarian cancer is very rare below the age of 40 and above 70 years. There is a great need to improve screening for ovarian cancer because the development of the disease is clinically silent or nonspecific and almost 70% of patients with ovarian cancer is diagnosed in the late stages of illness.

Adult↗

PubMed2000

[Ovarian cancer. II. Procedures, histology, and complications].

OBJECTIVES: The purpose of our study was to analyse the operative procedures and complications in patients operated for the first time for ovarian cancer. MATERIALS AND METHODS: A retrospective review of patients' charts with ovarian cancer operated at the Department of Gynaecological Surgery of Polish Mother's Memorial Hospital-Research Institute in 1990-1999 was conducted. We analysed the data of women operated for the first time for this disease. In every case we tried to perform radical operation consisted of hysterectomy with bilateral adnexectomy, omentectomy, appendectomy (if needed), and additionally optimal debulking in advanced cancer. RESULTS: Between January 1990 and December 1999, 107 patients were operated for the first time for ovarian cancer. FIGO staging was as follows: I--13.1%, II--14.95%, III--59.8%, IV--12.15%. The most frequent findings on histology were serous (39.3%), endometrioid (26.2%), undifferentiated (11.2%) and clear cell cancers (10.7%). In 60.7% of cases we performed hysterectomy with bilateral adnexectomy, in 15.0% bilateral adnexectomy, in 4.7% of patients cytoreductive tumorectomy, and in 19.6% of cases only excisions for histology were taken. 69.0% of patients underwent also omentectomy and 42.6% appendectomy. In 58.9% of patients we performed radical operation; its incidence significantly decreased with the increase of FIGO staging: I--100%, II--87.5%, III--51.6%, IV--15.4% (p < 0.0005). We noted 5 cases of intraoperative complications, all in patients with the stage III, connected with intestinal or urinary bladder lesions. The most common postoperative complication was anaemia (23.4%) and fever (4.7%). Four patients died in 8-27 postoperative day due to circulatory insufficiency. CONCLUSIONS: The most common was serous and endometrioid ovarian cancer. The great majority of patients was diagnosed to late and operated in III and IV stage of the disease, but in almost 60% of cases radical operation was performed.

Adult↗

PubMed2000

[Professors Edward Lubicz-Niezabitowski and Stefan Dabrowski recorded in the memoirs of Ludwik Jaxa-Bykowski].

Ludwik Jaxa-Bykowski, the educator and anthropologist from Poznań, was prosecuted and sentenced to oblivion for both his scientific and political ideas after the Second World War. He was arrested in 1948 and disappeared soon after being released from prison. Most of his scientific output was destroyed or disappeared during the War and after 1948. I found some of his manuscripts in the archives of the Department of Anthropology in Adam Mickiewicz University of Poznań which were about to be recycled. Jaxa-Bykowski' memories of two professors of medicine who worked in the Medical Department of University of Poznań were found among these materials.

Anthropology↗

PubMed1999

Adapting the CAUSN accreditation process for emerging models of nursing education in Canada.

This paper highlights the accreditation issues raised by new and emerging models of baccalaureate nursing education and program delivery in Canada. It suggests ways of adapting the accreditation process to address recent changes. Nursing degree programs now offered by universities include programs at several sites, collaborative programs with partner institutions at multiple sites, and programs offered primarily through distance education. The accreditation program developed by the Canadian Association of University Schools of Nursing (CAUSN) provides a mechanism for monitoring the quality of a nursing education program and promoting the growth of the school that offers the program. Since the decision to undergo accreditation signifies a major commitment on the part of a nursing program, it is essential that the accreditation process be adaptable to meet the needs of evolving nursing education and program delivery models, and that it be fair, equitable, and credible.

Accreditation↗

PubMed1999

Collaborating for breast health education and research. A university, industry, and community agency partnership.

Initiating a collaborative health education program about breast health required talent, expertise, and workload contributions from all involved including university researchers, a regional breast screening agency, and local industries. The credibility and opinions of liaisons or key informants were valued highly, and their support was critical to the success of the project. Participation in any collaborative project is predicated on benefits perceived by each of the partners. The community agency reaped the benefits of greater dissemination of their educational materials through the interventions. The project increased corporate and union awareness of the resources of this agency and in this community. Throughout the project, meetings and telephone conferences were held on a weekly or biweekly basis with the liaisons. Liaisons disseminated updates to management and union representatives.

Adult↗

PubMed1998

[The use of maternal serum cytokines in the predicting of the efficacy of tocolytic therapy in case of the threat of preterm labor].

OBJECTIVES: The purpose of our study was to evaluate the use of maternal serum IL-8, IL-6, IFN-gamma levels in the predicting of the efficacy of tocolytic therapy in preterm labor. MATERIALS AND METHODS: We investigated prospectively the group of 47 women in singleton pregnancies with threatened preterm labor in less than 36 weeks gestation and administered tocolytic therapy. RESULTS: In 19 of them tocolysis failed (group II and they delivered premature newborns (the group I--successful tocolysis consisted of remaining 28 women). The incidence of clinical chorioamnionitis, histologic chorioamnionitis and inherited infection of newborns was significantly higher among women refractory to tocolytic therapy (10.2%, 36.8%, 26.3% versus 0%, 3.6%, 0%, respectively, p < 0.05). Maternal serum IL-8, IL-6, IFN-gamma (by means of ELISA technique) and CRP, WBC, ESR levels were measured at the admission to the study. The mean WBC, ESR and the median (range) IFN-gamma (0 (0-7.1) and 0.9 (0-10.4) pg/ml, respectively) didn't differ in both groups. The concentrations of serum IL-8, IL-6, CRP were significantly higher in the group of failed tocolysis (median (range): IL-8: 22.7 (6.3-83.2) vs 3.0 (0-26.0) pg/ml; IL-6: 7.4 (0-21.0) vs 0 (0-11.3) pg/ml; CRP: 1.8 (0.6-7.0) vs 0.6 (0.6-3.9) mg/dl; p < 0.05). Serum IL-8 determinations (definition of abnormal test: > 8 pg/ml) were found the most reliable in the prediction of tocolysis failure with a sensitivity 87.5%, specificity 81.8%, positive predictive value 77.8%, negative predictive value 90% and accuracy 84.2%. Also reliable were IL-6 determinations (IL-6 > 6 pg/ml had a sensitivity 75%, specificity 90.9%, positive predictive value 85.7%, negative predictive value 83.3% and accuracy 84.2%) and CRP determinations (CRP > 1.2 mg/dl had a sensitivity 75%, specificity 81.8%, positive predictive value 75%, negative predictive value 81.8% and accuracy 78.9%). The efficacy of IFN-gamma, WBC and ESR was significantly lower. CONCLUSIONS: Our data revealed that the maternal serum IL-8, IL-6 and CRP determinations are very useful in the predicting of the efficacy of tocolytic therapy in women with threatened preterm labor. The use of IFN-gamma, WBC, ESR was significantly lower.

Cytokines↗

PubMed1998

[The cost of laparoscopy in the diagnosis of female infertility].

DESIGN: The aim of the study was to estimate the usefulness of laparoscopy in diagnostics of women's infertility. MATERIALS AND METHODS: This study is a retrospective review of the notes of 133 infertile women who had undergone laparoscopic procedures--in 88 (66.2%) patients the reason of their infertility was unknown (study group I) and in 45 (33.8%) pelvic pathology (PCO syndrome-37 cases, endometriosis-6 cases and tubal inpatency-2 cases) was supposed (study group II). RESULTS: In 96 (72.2%) patients (in 51 from group I and in 45 from group II) pelvic pathology was estimated (p < 0.0001 in comparison with diagnostic estimation before laparoscopy). Most frequent pathology in women with unexplained infertility was seen: endometriosis, adhesions and tubal inpatency. During laparoscopy procedure we changed totally preoperative diagnosis in 43.6% patients (58 cases--51 from group I and 7 from group II) and in 9.8% women additional pelvic abnormalities were detected. CONCLUSION: In authors opinion the laparoscopic procedure is very helpful in infertile women and ought to be included in diagnostic standard in cases of unexplained infertility.

Adult↗

PubMed1998

[Maternal serum cytokines concentrations during normal pregnancy and labor].

OBJECTIVES: The purpose of our study was to determine maternal serum concentrations of IL-8, IL-6, IFN-gamma during normal pregnancy and labor. MATERIALS AND METHODS: Maternal serum IL-8, IL-6 and IFN-gamma levels were measured by means of ELISA technique in 41 healthy pregnant women in 22-42 week gestation and 15 healthy women in labor at term. All newborns and afterbirths had no signs of infection. RESULTS: IL-8 values for pregnant women ranged from 1.98 to 35.2 pg/ml with the median value 10.24 pg/ml, and the 95th percentile 24.5 pg/ml. IL-8 values for women in labor at term ranged from 3.96 to 54.8 pg/ml with the median 10.4 pg/ml. No statistically significant changes in serum IL-8 concentration were observed during pregnancy or in labor. Serum IL-6 concentrations in pregnant women ranged from 0 to 21.7 pg/ml with the median value 0 pg/ml, and the 95th percentile 15.5 pg/ml. Serum IL-6 concentrations in women in labor at term were significantly higher (p < 0.05): ranged from 0 to 39.2 pg/ml with the median 10.1 pg/ml and 95-th percentile 33.5 pg/ml. Maternal serum IFN-gamma concentrations in pregnant women ranged from 0 to 9.8 pg/ml with the median value 3.9 pg/ml, the 95th percentile 9.2 pg/ml and didn't differ during labor at term: range from 0 to 14.5 pg/ml, median 1.9 pg/ml. CONCLUSIONS: Our data revealed that maternal serum IL-8 concentrations didn't changed during the course of pregnancy and in labor. Women in labor had significantly elevated serum IL-6 concentrations compared to those in pregnancy. We didn't observed such changes in serum IFN-gamma levels.

Adult↗

PubMed1998

Body structure of female-to-male transsexuals.

31 female-to-male transsexuals treated in the Department of Plastic Surgery, Medical University of Lódź, were examined. Anthropometric measurements were carried out according to Martin's technique. 23 measured characteristics of the examined transsexuals were studied; they were compared with identical characteristics in males and females of the control group. The results indicate that the somatic characteristics in transsexual women are between the values typical for man and women.

Adult↗

PubMed1998

[Aberration of somatic karyotype in normozoospermic males from infertile couples].

During the complex investigation of couple infertility, a group of 40 normozoospermic males having low density of semen was selected. Cytogenetic analysis revealed 2 cases of somatic karyotype aberrations: 47,XYY and 46,XY,t(14;19), and 2 cases of chromosomal polymorphisms: 46,XYq+ i 46,XY,14p+. In the article the mechanism of fertility disturbances evoked by these findings is discussed in aspects of the function of spermatozoa and its genetic material content.

Adult↗

PubMed1998

[Intrauterine infections. I. The role of C-reactive protein, white blood cell count and erythrocyte sedimentation rate in pregnant women in the detection of intrauterine infection after preliminary rupture of membranes].

UNLABELLED: The purpose of our study was to analyze the efficacy of serum C-reactive protein (CRP), white blood cell count (WBC) and erythrocyte sedimentation rate (ESR) serial evaluations in the prediction of chorioamnionitis in cases of premature rupture of membranes (PROM). MATERIALS AND METHODS: A group of 80 patients with PROM before 35 weeks' gestation were evaluated prospectively and managed expectantly. We applied the expectant management with the permanent use of tocolysis, antibiotics, steroids, amnioinfusions of artificial amniotic fluid and intravaginal chemotherapeutics. Patients were monitored with frequent vital signs, fetal heart rate evaluation and everyday blood tests as follows: CRP, WBC and ESR. All afterbirths were examined to establish the presence of histologic chorioamnionitis (gold standard of intrauterine infection). RESULTS: 59 (73.7%) patients had significant chorioamnionitis on histopathology and only 15 of them had clinical chorioamnionitis. Serum CRP serial determinations (definition of abnormal tests: 1) > 1.2 mg/dl; 2) > 2.0 mg/dl; 3) > 1.2 mg/dl and increasing in two consecutive days) were found the most reliable with a sensitivity 1) 91.5%; 2) 85%; 3) 88%, specificity 57%; 76%; 86%, positive predictive value 86%; 90%; 94.5%, negative predictive value 70.5%; 64%; 72% and accuracy 82.5%; 82.5%; 87.5% respectively. The efficacy of WBC (abnormal tests: > 12500/mm3; > 15000/mm3; > 12500/mm3 and increasing in two consecutive days) and ESR (abnormal tests: > 60 mm/h; > 60 mm/h and increasing in two consecutive days) serial evaluations was significantly lower. Moreover, in cases of chorioamnionitis CRP increased above the upper limit of normal 3 days earlier than WBC or ESR. CONCLUSIONS: CRP was found the most reliable indicator of histologic chorioamnionitis and indicated the presence of intrauterine infection earlier than WBC or ESR.

Adult↗

PubMed1998

[Intrauterine infection. II. The effect of intravenous dexamethasone on the results of C-reactive protein, white blood cell count and erythrocyte sedimentation rate during the expectant management of premature rupture of membranes].

UNLABELLED: The purpose of this study was to evaluate the influence of dexamethasone administration on selected markers of infection during the expectant management of premature rupture of membranes (PROM). MATERIALS AND METHODS: A group of 80 patients with PROM before 35 weeks' gestation were evaluated prospectively and managed expectantly. All patients were managed in the hospital. All pregnancies had ultrasonographic evaluations to confirm gestational age, rule out lethal anomalies, and document oligohydramnios. We applied the expectant management with the permanent use of tocolysis, antibiotics, steroids (4 mg of dexamethasone every 8 hr for 2 days, every week), amnioinfusions of artificial amniotic fluid and intravaginal chemotherapeutics. Patients were monitored with frequent vital signs, fetal heart rate evaluation and everyday blood tests as follows: C-reactive protein (CRP), white blood cell count (WBC) and erythrocyte sedimentation rate (ESR). After completing 25 weeks antenatal fetal surveillance included a nonstress test at least once a day. All afterbirths were examined to establish the presence of histologic chorioamnionitis. In order to eliminate the influence of intrauterine infection we analyzed only the results obtained of patients without histologic chorioamnionitis (n = 24). RESULTS: WBC raised significantly in the first day of steroidotherapy (mean: 14,895/mm3), was elevated in the second day (15,716/mm3) and the day after (15,100/mm3), and decreased to the normal limit in the second day after steroids (12,316/mm3); p < 0.001. There were no statistically significant differences in the results of CRP and ESR connected with the administration of dexamethasone. CONCLUSIONS: Dexamethasone administration caused the independent of infection and temporary elevation of WBC. We did not observe such influence on the results of CRP and ESR.

Adult↗

PubMed1998

Immunological characteristics of nonpregnant women with unexplained recurrent spontaneous abortion who underwent paternal lymphocytes immunization.

The purpose of this study was to analyze the immunological characteristics of nonpregnant women with recurrent spontaneous abortions (RSA) of unknown etiology. We analyzed how differences of the immunological state of individual groups of women with RSA and various types of RSA (primary vs. secondary aborters) might influence on results of paternal lymphocytes immunization. In this prospective study the immunological characteristics of 117 nonpregnant women with unexplained RSA in comparison to 44 healthy, nonpregnant multigravid women, were analyzed. The following immunological parameters were studied: peripheral blood lymphocyte subpopulations (CD3+, CD4+, CD8+, CD3+/HLA-DR+), lymphocyte proliferative response to phytohaemaglutynin (PHA) and allogenic lymphocytes (in mixed lymphocyte reaction--MLR), the effect of women's sera on MLR, neutrophil chemiluminescence and anticardiolipin (ACA) as well as antinuclear (ANA) antibodies titers. We found that in nonpregnant RSA women the CD8+ lymphocytes percentage was lower (20.2% vs. 23.9%) and the CD4+/CD8+ ratio higher (2.37 vs. 1.9) as compared to the controls. In comparison with normal multigravidas in recurrent aborters an absence of serum factors suppressing MLR (blocking antibodies) and a high incidence of autoantibodies was observed (ACA: 53.8% vs. 9.1%; ANA: 42.7% vs. 6.8%). The pregnancy success ratio was significantly lower for alloimmunized women with medium/high titers of ACA than for those without ACA (64% vs. 96%, p < 0.001). It was proved there were no significant differences in the estimated immunological parameters between groups of women suffering from either primary or secondary abortions. It was also shown that there is an equally high efficiency of paternal lymphocyte immunization in preventing future abortions both in primary (88%) and secondary (86%) aborters. In conclusion it can be assumed that considering the immunological conditions of nonpregnant women with recurrent spontaneous abortion of unexplained etiology differ from healthy and fertile women. These differences are mainly connected to the humoral immunity and manifested in absence of blocking antibodies in sera of women with RSA and in frequent occurrence of antinuclear and anticardiolipin antibodies. Among autoantibodies, only ACA at medium and high levels are the ones that can negatively influence on the pregnancy outcome in women with RSA who underwent paternal lymphocytes immunization. The clinical classification of women with RSA into primary and the secondary aborters is reflected neither in immunological results nor in efficacy of paternal lymphocytes immunization.

Abortion, Habitual↗

PubMed1997

Clinical and immunological condition of newborns of mothers treated for recurrent spontaneous abortions with paternal lymphocytes immunization.

OBJECTIVE: The aim of this study was to evaluate the clinical condition at birth and some laboratory parameters in newborns of mothers treated for recurrent spontaneous abortion (RSA) of unknown etiology with paternal lymphocytes immunization. STUDY DESIGN: The study comprised 104 newborns delivered by 102 women with RSA, who underwent alloimmunization and 90 randomly chosen control newborns. The following parameters were analysed in two groups of newborns: general condition at birth, physical development, course of adaptation period, values of hematological and immunological (percentage of CD3, CD4, CD8, CD19 and CD3/CD25 lymphocytes, chemiluminescence of neutrophils at rest and stimulated with opsonized zymosane) parameters in umbilical arterial blood. RESULTS: No statistically significant differences were noted between the two groups of newborns as to the duration of pregnancy, birth weight, general condition at birth, occurrence of complications in the adaptation period and values of studied hematological and immunological parameters. CONCLUSION: These results suggest that immunization with paternal lymphocytes in women with RSA of unknown etiology not only creates better prognosis for the outcome of the pregnancy, but is also safe for the fetus and the newborn.

Abortion, Habitual↗

PubMed1997

[Efficiency of paternal lymphocyte immunization in prevention of unexplained recurrent spontaneous abortion. I. Clinical prognostic factors].

Prognostic value of some clinical factors on the course of subsequent pregnancy in 117 women with unexplained recurrent spontaneous abortion undergoing immunization with paternal lymphocytes were evaluated in the study. The results allow to conclude that high efficiency of alloimmunization in preventing consecutive abortions (87.2% in our own study) does not seem to depend significantly on: the woman's and her partner's age, number, type (primary vs. secondary), and time of previous miscarriages, coexistence of subfertility, time from immunization to the fertilization and the number of lymphocytes used for the procedure (as far as it concerns the number of lymphocytes isolated from 100 ml of blood). In our results, alloimmunization is most effective in preventing a missed abortion (in comparison with "live" spontaneous abortion).

Abortion, Habitual↗

PubMed1997

[Efficiency of lymphocyte immunization by the partner in prevention of unexplained recurrent spontaneous abortion. II. Immunologic prognostic factors].

The prognostic value of some immunological parameters on the course of subsequent pregnancy in 117 women with recurrent spontaneous abortion of unknown etiology subjected to paternal lymphocytes immunization, were estimated. We conclude that neither antinuclear (ANA) nor low titers of anticardiolipin antibodies (ACA), nor mixed lymphocyte reaction--blocking antibodies (MLR-BAbs) have any significant influence on alloimmunization efficiency. However medium or high ACA titers significantly diminish changes for successful alloimmunization and are connected with most complications of subsequent pregnancy.

Abortion, Habitual↗