Search PubMed⌕ Search

Biomedical subjects

B Nalbanski

Publications and source records attributed to B Nalbanski.

At least 55 records · Page 3Linked to original sources

[The echographic diagnosis of a rare congenital uterine anomaly (uterus unicornis with a rudimentary noncommunicating horn)].

A correct diagnosis of a unicornuate uterus with rudimentary noncommunicating horn, complicated with haematometra in a 12-year-old patient, was established after a detailed sonographic examination. The diagnosis was confirmed by diagnostic laparoscopy and surgical excision the rudimentary horn was undertaken. The case is interesting with the fact that several months before the patient's referral to our hospital laparotomy was performed because of persistent and progressive abdominal pain and suspicion for acute appendicitis. The uterine anomaly present was described as uterus duplex. It may be concluded that: The diagnosis of uterine anomalies may be extremely difficult for the inexperienced operator even at laparotomy. This is important since the management of congenital uterine anomalies depends on their type and differs a lot. Any mistakes in this aspect may be fatal for the patient in her further life. The ultrasound examination performed by an experienced sonographer may give precise information about the nature of the defect thus making the task of the operator easier. The final diagnosis of the uterine anomalies is based on the combined interpretation of the data from the patient's history, the sonographic examination, the diagnostic laparoscopy and other methods of investigation if necessary.

Child↗

[Diagnostic laparoscopy in female sterility].

Over a three-year period (1990-1993), a total of 410 diagnostic laparoscopies are performed. The series includes female patients with a minimum one year longstanding of sterility. Diagnostic laparoscopy is taken to be a routine method of making exact diagnosis in female sterility cases, and as a filtering procedure in forthcoming reconstructive operation or in the event of poor outlooks of eventual conception. The commonest finding is endometriosis (in 58.2 per cent), next ranking adhesions free of endometriosis (31.4 per cent) and bilateral obstruction of the uterine tubes (38.5 per cent). Endometriosis is usually located in the uterine body 27.5 per cent, uterine tubes 26.1 per cent and pelvic peritoneum 14.9 per cent.

Adult↗

[Quadruplet pregnancy--the difficulties in its diagnosis and management with a case report].

The authors describe one case of quadruplet pregnancy create difficulties in diagnosis and conclude with unfavourable outcome. One of fetuses have hydrops foetus generalisatus, another foetus is malformative and the rest two fetuses are normal anatomy. Multifetal pregnancies require very early and exactly diagnosis and make up behaviour with goal is favour able outcome. In the end the authors recommended this cases must be turn to hospitals which are better possibilities for antenatal and intensive neonatal care.

Abortion, Incomplete↗

[The effect of the woman's age on the course of pregnancy and labor in breech presentation].

The influence of woman's age on pregnancy outcome and delivery of 362 cases of pregnancies in breech presentation was studied retrospectively. The cases are distributed in 6 interval groups of 5 years each and are compared to the data of vertex presentation. The rate of antedated and pregnancy induced diseases are the same in breech and vertex presentation and do not depend on the type of presentation. There is an increase of premature breech deliveries with the decrease of woman's age. The frequency of Cesarean sections is increased with the woman's age, especially after the thirties. The ruptures of the soft birth canal and the need of oxytocin stimulation are increases with woman's age. In case of selected and successive breech labor the state of the newborn does not depend on the woman's age.

Adult↗

[The effect of fetal maturity and the delivery method on fetal status in breech presentation].

In a retrospective study of 363 pregnancies with one foetus in breech presentation is evaluated the effect of foetal maturity and the route of delivery on the state of the newborn, assessed by the 5 min. Apgar score. The cases are allocated in subgroups according the foetal weight and height, gestational week and the route of delivery. The results show 37% small for gestational age in the subgroup with low birth weight (1500-2500 g). From the group with low weight SGA sustain better the labor and delivery than the eutrophic. The term newborn in breech presentation are with higher Apgar score than delivered by cesarean section. In the group of newborn with low weight the route of delivery has not effect on the Apgar score. The estimated weight and gestational week should be taken in account than managing breech labor.

Adult↗

[The side effects of the prevention of blood loss in the placental period].

On the base of 192 retrospective and 144 prospective cases are evaluated the side of routine prophylactic of the blood loss at the third period of labor. The control group consist of 50 labouring women with expective management of placental period. In normotensive women the methergine does not increase the blood pressure. The use of oxytocic drugs after the delivery of the head shorten the time of placental separation but make more difficult the cord traction method for the delivery of the placenta. The active management of the placental period decrease the rate of instrumental revision of the uterine cavity and the supplemental administration of oxytocic in the early postpartum period. This investigation confirms and justify the routine use of oxytocic after the delivery of the head as a prophylactic of the blood loss in the placental period.

Analysis of Variance↗

[Blood loss in the placental period in relation to the type of prophylaxis].

The aim of this study is to asses the blood loss in third period of labor according the method of its prophylactic. The material consist of 144 prospective and 192 retrospective cases. The blood loss is assessed visually and after that it is weighted. Up to the delivery of placenta the visually assessed blood loss is insignificantly greater than the weighted one. All cases are subdivided in three groups according the management of third period: -with methergin, with oxytocin and without uterostonic. The blood loss associated with the separation and delivery of the placenta is not different in the groups, but the early postpartum haemorrhage is significantly greater in the cases without uterostonics for the delivery of placenta. In premature labors the blood loss associated with the separation of placenta is significantly greater that in term labor.

Analysis of Variance↗

[The ultrasonic diagnosis of an early abnormal pregnancy].

During the period of January 1993 to February 1994, 70 pregnant women had an ultrasonic diagnosis of abnormal pregnancy. 111 ultrasound examinations were made--mean 1.6 of each woman. The ultrasonic diagnosis up to 70 women was: missed abortion--35 women (50%), blighted ovum--30 women (42.9%), other diagnosis--5 women (7.1%). Histological examination of material was made with 64 women (91.4%). Comparing the ultrasonic diagnosis to histological results, authors do not recommend a final diagnosis before eight gestation week.

Abortion, Missed↗

[The treatment of endometriosis in women with sterility. A prospective study over a 2-year period].

Presented are the results of a 2-year prospective study in patients with no other causes than endometriosis proved by laparoscopy between Jan. 1991 and June 1992. Fifty five patients completed 6-9 months of therapy of Orgametril alone and 15 women were pregnant (27.27%). Forty one patients had electro surgery of endometriosis by the time of laparoscopy and 21 patients of them received Orgametril. After electro surgery alone 5 women were pregnant (25%) and of 21 women with complex therapy 10 were pregnant (47.6%). Control group of 79 patients without therapy had pregnancy rates for 6 patients (7.59%). No differences were observed between three groups of patients with treatment. Pregnancy rates were statistically lower in group without therapy. This study reported conception rates for 18 months after laparoscopy.

Adnexal Diseases↗

[The incidence of clinical forms of female endocrine sterility in 1990-1993 at the III Gynecological Clinic of the Maternity Home of the State Institutional Hospital].

The high frequency of the female endocrine sterility and the favorable therapy results are showing categorically the importance of the endocrine sterility as a medical and a social problem. For the period 1990-1993 in Third Gynaecological clinic--Sector of Gynaecological Endocrinology, were observed 584 patients with proved endocrine sterility. The present research has the goal to discuss the frequency of the different clinical forms of the endocrine sterility. The most frequent one is PCO--30.59%, followed by corpus luteum insufficiency--23.58%, and hyperprolactinaemia--20.05%. The results are interpreted on the basis of similar research for the period 1976-1985 with analog contingent. Conclusions are made for the essential directions of the diagnostic and therapy process in the clinic.

Bulgaria↗

[The laparoscopic picture of endometriosis in women with sterility].

It is the purpose of this study to document the variegated appearance of endometriosis at laparoscopy, and select suitable cases indicated for microsurgery. Three-hundred and four patients undergo diagnostic laparoscopy between January 1991 and June 1992. Endometriosis diagnosed during laparoscopy is staged according to the classification of the American Fertility Society. Findings are established as follows: endometriosis--203 patients (66.77 per cent), adhesions without endometriosis--57 (18.75 per cent), Fitz-Hugh-Curtis syndrome--23 (7.56 per cent), leiomyomata--10 (3.28 per cent), ectopic pregnancy--3 (0.98 per cent). In eight women (2.63 per cent) there no peritoneal changes. Peritoneal endometriosis is characterized by the following morphological patterns: peritoneal pockets--38 patients (18.62 per cent), clear vesicles--26 (12.74 per cent), scarred white lesions--24 (11.76 per cent), raised red lesions--21 (10.29 per cent), flat red lesions--21 (10.29 per cent), black-purple lesions--20 (9.3 per cent), polypoid red lesions--10 (4.9 per cent), scarred black lesions--6 (2.44 per cent), and yellow-brown patches--4 (1.96 per cent).

Endometriosis↗

[Comparative study of 4 combined hormonal contraceptive preparations with reduced hormonal levels].

The authors do clinic-laboratory investigation of the affect of four hormonal contraceptive preparations: Minisston, Gravistat 125, Rigevidon, Anteovin, on 179 patients in reproductive age for the period of 895 menstrual cycles. The investigation is specified with respect of investigation of 10 clinic indexes, which are considered as side effects in the reception of hormonal contraception, as well as with respect to reconstruction of ovary function after reception breaking in first, second and third month. The received results demonstrate high effectiveness of the experimented preparations with respect to pregnancy prevention, good acceptance - the appearance of side effects is under the accidentally error limit, as well as good reproductive ability of ovaries after tablet reception breaking. Especially to Anteovin preparation the authors accept that it is with minimum side effects. They considered that this is due to increasing dose of gestagen during the second phase of the menstrual cycle, which appears stabilizing factor with respect to the good acceptance of the preparation without difference in age and fertile realization of the investigated patients.

Adolescent↗

[Intrauterine pessaries and acute genital inflammation in women].

The performed clinic-statistical investigation has covered generally 2182 patients, 946 patients of common group make use of intrauterine contraceptive pessaries and 1236 patients have been included on the other occasion. Generally 14 832 menstrual cycles were followed up. There were used multivariational method and analysis for investigation of three and more risk factors at once. The essential connection between the presence of intrauterine pessary and increased risk of sharply inflammation of the genital apparatus had been established. The uterus was the most often affected--endometritis in sharp and chronic from in 31.39% of cases, and in 3 cases pelvioperitonitis was diagnosed. The appearance of genitals inflammation under the pessary presence is connected also with the age, parity, the application time and the pessary use.

Adult↗

[Surgical laparoscopy--our experience].

Fifty-two of 304 infertile women were surgically treated by the time of diagnostic laparoscopy. Table 1 represents surgical treatment via laparoscopy. Forty-one (78.84%) patients had electrosurgery or laser surgery of endometriosis. Salpingo-ovariolysis was performed in 6 patients (11.53%). Salpingostomy was performed in 2 patients. Fimbrioplasty was performed by incising the peritoneal band surrounding the terminal end of the fallopian tube in 2 patients. Bleeding of vascular adhesions was followed by electrocautery. No patient required laparotomy for control of bleeding. In two patients (3.84%) with ectopic pregnancy had light arterial bleeding along the salpingostomy incision and was controlled by bipolar cautery. In three patients (5.76%) cysts up to 7 cm in diameter were treated. The capsule were dissected and removed how possible. Any residual capsule was vaporized.

Adnexal Diseases↗

[Pelvioscopy in pediatric gynecology and gynecological endocrinology].

The authors perform diagnostic-operative pelvioscopy on 32 patients with primary and secondary amenorrhea--87.5% and 12.5% respectfully. The follow-up included a comparison of the results from the gynaecologic examination, ultrasound evaluation of the ovaries, sex chromatin and histologic results from the gonadal biopsy material. No ovarian structures were scanned in 28.13% of the cases. In 15.63% of the cases 46XY karyotype was diagnosed and in 4 other cases--46 X iso Xq. The histologic results from ovarian biopsy are as follow: in 37.5% only primordial follicles, in 18.75%-fibrous tissue and in 6.25%-presence of testicular tissue. From the analysis of the results the authors conclude that pelvioscopy combined with gonadal biopsy in cases a distinct place in the diagnostic plan of evaluation.

Adolescent↗