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M Kudela

Publications and source records attributed to M Kudela.

At least 37 records · Page 2Linked to original sources
PubMed2003

[Celiac disease and fertility disorders in women].

OBJECTIVE: To determine incidence of subclinical forms of celiac disease in women with decreased fertility. DESIGN: Screening test. SETTING: Department of Gynecology and Obstetrics, University Hospital, Palacký University, Olomouc. METHODS: 137 patients with fertility problems were included to the study. There were divided into two groups, patients with infertility and patients with repeated pregnancy loss. Screening test for celiac disease, serum level of antibodies tissue transglutaminase (tTGA) were performed in all of them. Positive test was confirmed by serological level of anti endomysium antibodies (EmA) and final diagnosis of silent celiac disease was done by enterobiopsy. RESULTS: Celiac disease was found in two infertile patients (1.67%). In one patient the silent form was diagnosed by enterobiopsy. The second disease was latent form. In patients with repeated pregnancy loss we did not observe positive screening test. CONCLUSION: We confirmed higher incidence of celiac disease in women with impaired fertility.

Celiac Disease↗
PubMed2003

[Occurrence of gene mutations in factor V Leiden, prothrombin and methylenetetrahydrofolate reductase in patients with pre-eclampsia].

OBJECTIVE: The aim of the study was to detect the incidence of thrombophilia FV Leiden, prothrombin G20210A, MTHFR C677T, resistance to activated protein C, and deficiency of protein C and S in pregnant or puerperal women with preeclampsia and control group. DESIGN: Case-control study. SETTING: Department of Obstetrics and Gynecology, Department of Hemato-oncology, Medical Faculty, Palacký University, Olomouc. METHODS: The group of 38 women with confirmed diagnosis of preeclampsia were examined for resistance to activated C protein. (Coatest, APC resistence Chromogenix), levels of C and S protein. For the detection of FV:Q506, prothrombin G20210A and MTHFR C677T allels was done by PCR test. The control group had 50 women, chosen randomly. The statistical evaluation was performed by the STATISTICA program. For the analyzing of the continuous variables the Student's T-test was used. Values below p < 0.01 were considered to be statistically significant. RESULTS: Women who suffered from preeclampsia came to mean age of 32.8 +/- 4.3 (years), mean gestational age 33.6 +/- 2.8 (weeks), mean systolic pressure 163 +/- 21 mmHg, diastolic pressure 108 +/- 8 mmHg. All of the results were rendered to be statistically significant in comparison the control group. On the other hand, the results in observed haematologic parameters were not significant (Preeclampsia/controls). FV Leiden--heterozygous subjects 4/3, prothrombin G20210A 1/0, C677T heterozygous subjects 12P10, C677T 2/0, protein C and S deficiency 2(0. Resistance to activated C protein was found in 14 (37%) patients, in comparison to 6 (12%) in the control group (p = 0.0073). CONCLUSION: We didn't find any difference in the prevalence of genetic mutations in patients with preeclampsia compared to the control group. The prevalence of APC resistance was statistically higher in preeclamptic patients compared to the control group.

Activated Protein C Resistance↗
PubMed2003

[Matrix metalloproteinases, embryo implantation and tumor invasion].

OBJECTIVE: To summarise which metalloproteinases and specific inhibitors have been already described, their regulatory mechanisms, the connection with implantation and in cases of tumour invasion. In conclusion we would like to point to the possibilities of practical use of this information. DESIGN: A literature review. SETTING: Department of Obstetrics and Gynecology, Medical Faculty, Palacký University, Olomouc. ABSTRACTS: Metalloproteinases are important for many biological processes including for instance cell proliferation, differentiation and remodelation of extracellular matrix (ECM) or vascularisation and cell migration. These events are in progress during organogenesis both in the normal development and in tumour progression. Mechanisms of activity of metalloproteinases during these processes include proteolysis of growth factors which in this way become available to cells. The motion of cells through tissues and fission of signal receptors made possible by degradation of the ECM is vital for cell migration. The majority of these processes requires a balanced equilibrium between the activity of matrix metalloproteinases (MMP) and their natural tissue inhibitors (TIMP). It is precisely this equilibrium between metalloproteinases and their tissue inhibitors that is decisive for the site and extent trophoblast invasion during embryo implantation and as well as for the cell invasion during tumour progression. In our literary review we would like to shortly summarize which metalloproteinases and specific inhibitors have been already described and what are their regulatory mechanisms. Which of them were detected in tissues in connection with implantation and which are most often expressed in cases of tumour invasion. In conclusion we would like to point to the possibilities of practical use of this information.

Animals↗
PubMed2003

[Uterine myomatosis--abdominal hysterectomy, vaginal hysterectomy or laparoscopic-assisted vaginal hysterectomy?].

OBJECTIVE: To evaluate the way of the surgical treatment of uterine fibroids in two 5 year long periods. In the first period (1987-1991) the operative procedures--hysterectomies--were performed usually by the classical abdominal approach. In the second period (1997-2001) the modern trend of minimal invasive surgery was applied. Through analysis of three surgical procedures used (AHY, VHY, LAVHY) the conclusions concerning the advantages, disadvantages and correct indications for the selection of hysterectomy in cases of uterine fibroids are presented. STUDY DESIGN: Retrospective study. STUDY SETTING: Department of Obstetrics and Gynecology, Medical Faculty and University Hospital, Palacký University, Olomouc. METHODS: The total of 1172 patients (604 in the first period and 568 in the second period) were operated by abdominal hysterectomy (AHY), vaginal hysterectomy (VHY) or laparoscopically assisted vaginal hysterectomy (LAVHY). The factors influencing the mode of hysterectomy (body mass, weight of uterus, parity, adnexal finding, previous surgery) were analyzed. The type of anesthesia and per and postoperation complications (blood loss, conversion of vaginal to abdominal approach, inflammatory complications and administration of antibiotics) were also evaluated. RESULTS: Each of the chosen surgical procedures has advantages and disadvantages. Abdominal hysterectomy as the most invasive procedure is indicated only in extremely unfavourable findings. The least invasive procedure is VHY, which therefore is the optimal solution for the patient. LAVHY represents the operation which combines advantages of both AHY and VHY and fulfills also the criteria for minimal invasive surgery. CONCLUSION: The choice of the optimal surgical procedure in patients with uterine fibroids depends on the complex assessment of the preoperative finding, the technical possibilities of the setting and the experience of the surgeon. The goal is to chose the safest but at the same time least invasive surgical procedure.

Female↗
PubMed2003

[Early maternal and neonatal morbidity after spontaneous and surgically-assisted vaginal delivery].

OBJECTIVE: To evaluate the differences in early maternal and neonatal morbidity after spontaneous delivery, forceps delivery and vacuum-extraction. DESIGN: Retrospective clinical study. SETTING: Department of Obstetrics and Gynecology, University Hospital, Palacký University, Olomouc. METHODS: The database of 8196 deliveries at our department in the time period from January 1995 till September 2000 revealed 183 of forceps deliveries and 217 of vacuum-extractions. The control group included 200 randomly selected parturients with spontaneous vaginal delivery. The early maternal morbidity was evaluated according to the following parameters: perineal tears of the IIIrd + IVth degree, duration of hospitalization, average blood loss, the need of analgetics, dehiscence of episiotomy requiring resuture, febrilies and administration of antibiotics. The early neonatal morbidity evaluation was based on the incidence of cephalhematomas, the incidence of hyperbilirubinaemia, duration of hospitalization, signs of fetal hypoxia (pH, Apgar score), gestational age, birthweight and the presence of intracranial and retinal bleeding. The statistical significance of the differences in the frequency of the above parameters was evaluated. RESULTS: Spontaneous deliveries were associated with lower maternal morbidity according to the most of studied parameters. Vacuum-extraction had a lower frequency of maternal postpartum complications compared to forceps deliveries. Statistically valid differences were however found only at perineal tears of the IIIrd + IVth degree and at administration of analgetic and antibiotics. The use of vacuum-extraction seems to be connected with a higher risk of cephalhematomas (p = 0.0051) and longer duration of hospitalization. CONCLUSIONS: From the point of view of early maternal morbidity the assisted vaginal delivery by vacuumextraction gives better results than by forceps. However vacuum-extraction increases the risk of cephalhematomas at newborn.

Extraction, Obstetrical↗
PubMed2003

[Significance of matrix metalloproteinases in pregnancy].

OBJECTIVE: To summarise which metalloproteinases and specific inhibitors have been already described, their regulatory mechanisms in obstetric complications. DESIGN: A literature review. SETTING: Department of Gynecology Obstetric and University Hospital, Palacký University, Olomouc. ABSTRACTS: The invasion of extravillous trophoblast cells into the maternal endometrium is one of the key events in human placentation. The ability of these cells to infiltrate the uterine wall and to anchor the placenta to it as well as their ability to infiltrate and adjust utero-placental vessels to pregnancy depends, among other things, on their ability to secrete enzymes that degrade the extracellular matrix. Most of these enzymes belong to the family of matrix metalloproteinases. In the literature review, we focus on the role of these proteases in normal pregnancy as well as on their importance in the development of some pregnancy complications.

Animals↗
PubMed2003

[Lymphangiogenesis and new markers for lymphatic endothelium].

OBJECTIVE: To summarise recent knowledge about lymphangiogenesis, markers of the lymphatic endothelium and their importance to the tumor dissemination. DESIGN: A literature review. SETTING: Department of Gynecology and Obstetrics, Medical Faculty, Palacký University, University Hospital, Olomouc. ABSTRACTS: Clinicopathological data suggest that the lymphatics are an initial route for the spread of solid tumors. Detection of sentinel lymph nodes by biopsy provides significant information for staging and designing therapeutic regimens. The role of angiogenesis (formation of new blood vessels) in facilitating the growth of tumors has been well established, but the presence of lymphatic vessels and the relevance of lymphangiogenesis (formation of new lymphatics) to tumor spread are less clear. Growth factors involved in lymphangiogenesis during embryogenesis have been recently identified and showed to be able to induce formation of intratumoral lymphatics and thus facilitate metastatic spread to lymph nodes. The development of approaches to block tumor lymphangiogenesis and treat lymphedema would benefit from the availability of markers specific for lymphatic endothelium.

Animals↗
PubMed2002

[Risks in hysteroscopy in patients with endometrial carcinoma--a prospective clinical study].

OBJECTIVE: The evaluation of the risk of hysteroscopy (HSC) in patients with endometrial carcinoma with regard to the dissemination of disease and the deterioration of its prognosis. DESIGN: A prospective multicentric study. SETTING: Department of Obstetrics and Gynaecology and Institute of Pathology of the Palacky Univerzity Medical School and University Hospital, Olomouc; Obstetrical and Gynecological Departments of collaborating hospitals. METHODS: Two groups of patients with endometrial carcinoma were compared on the basis of cytological examinations from the peritoneal cavity. The study group (n = 156) consisted of patients whose diagnosis was made on the base of HSC and targeted biopsy. The control group (n = 71) included patients with the classical D&C. Both groups were comparable as to the distribution of clinical stages of the disease (P < 0.05). Cytological examinations were performed from the fluid obtained by the puncture of the cul de sac at the end of the HSC procedure and from the peritoneal lavage at the beginning of the following operation. Results of both groups were compared and statistically evaluated. RESULTS AND CONCLUSIONS: The comparison of the cytological findings from the punctures of the cul de sac after the HSC and from the lavages at the following operation did not show an increased penetration of malignant cells from the uterus into the abdominal cavity. Similarly, the comparison of cytological findings from the peritoneal lavages after HSC and probatory curettage did not show a statistically significant difference between both groups. We assume that HSC does not increase the risk of dissemination of tumour cells into the peritoneal cavity and does not deteriorate the prognosis of the disease.

Carcinoma↗
PubMed2002

The circalunar cycle of salivary testosterone and the visual-spatial performance.

BACKGROUND: A circalunar cycle is thought to be female sex specific. Results of studies observing the relationship of testosterone and spatial abilities are controversial. OBJECTIVE: To describe the infradian variations of testosterone and the correlations between salivary testosterone levels and spatial abilities in young healthy volunteers of both sexes. SUBJECTS AND METHODS: Testosterone levels in saliva were determined in 53 young adult male and female subjects (mean age--20.89 +/- 0.91 years). The samples of saliva were collected either once (22 subjects) or daily during a period of 30 days (31 subjects). Salivary testosterone was analyzed by RIA. Both groups of subjects were tested on their visual-spatial performance (mental rotation and spatial visualization). All important data about the menstrual cycle of female subjects were also collected. This data and the results of the visual-spatial tests as well as the circalunar cycle in their relationship to the testosterone levels were analyzed. RESULTS: In this study a circalunar rhythm of testosterone related to the menstrual cycle with a maximum peak in the periovulatory phase was confirmed in women and an analogical circalunar cycle in men was described. A positive correlation of the salivary testosterone levels and the performance in visual-spatial tests in women and a negative dependence in men was found. The outcomes showed a significant statistical difference between the results of the test during the high-testosterone and the low-testosterone phase in both sexes. CONCLUSIONS: The levels of testosterone between the high female and low male range seem to be associated with the best spatial ability performance in adults. A male circalunar rhythm similar to the female one is very likely. Recognizing of the infradian fluctuations in women as in men should have many various clinical implications. (Tab. 2, Fig. 7, Ref. 143.)

Adult↗
PubMed2002

[Antepartal cardiotocography and doppler flowmetry in the diagnosis of fetal hypoxia ].

OBJECTIVE: To evaluate by analysis of the most serious obstetric cases during a five-year period the contribution of ante-partum CTG and Doppler flowmetry in the diagnosis of foetal risk and to assess the part of risk factors of hypoxia during pregnancy. DESIGN: Retrospective epidemiological analysis. SETTING: Gynaecological and Obstetric Clinic Medical Faculty Palacký University and Faculty Hospital Olomouc. METHOD: In a retrospective analysis based on 6494 deliveries during a five-year period (1996-2000) the authors evaluate a selected sample of 1087 most serious conditions with the diagnosis of imminent foetal hypoxia. In the evaluated group 90.3% of the women had a cardiotocographic examination, 50.8% Doppler flowmetry with assessment of umbilical RI and PI indexes. The diagnosis of neonatal hypoxia was based on evaluation according to Apgar score < 7 and pH of arterial blood < 7.20. The authors compare both diagnostic methods with a common gold standard as regards their ability to predict hypoxia. In the logistic regression model they evaluate risk factors of pregnancy in relation to foetal hypoxia. RESULTS: Clinical manifestations of hypoxia were recorded in 114 neonates (10.5%). Perinatal deaths occurred in 46 infants, 16 were stillborn. Pathological ante-partum CCTG findings are associated with more active approaches (earlier termination of pregnancy, SC, preinduction by prostaglandins). Pathological ante-partum CTG and flowmetry was paradoxically more frequently associated with a better condition of the neonate. Pathological findings of ante-partum CTG were significantly less frequent in neonates with hypoxia than those without it (27%) vs. (40.9%), (relative risk 0.56 [95% CL 0.36-0.88], P = 0.01) while pathological findings of umbilical flowmetry were insignificantly more frequent (34.9%) vs. (33%), (relative risk 1.08 [95% Cl 0.59-1.97], P = 0.9). Both examinations were made in 547 (50.3%) women of the whole group, in 43 (7.9%) hypoxia of the foetus developed. Sensitivity: CTG 32.6%, Doppler 34.9%, Specificity: CTG 51.4%, Doppler 67.3%. Falsely positive CTG 48.6%, Doppler 32.7%. Analysis of risk factors of pregnancy in relation to foetal hypoxia defines by retrospective elimination as significant risks haemorrhage during pregnancy (n = 76, OR 2.35 [95% Cl 1.31-4.23], P = 0.01) and premature delivery (n = 258, OR 2.02 [95% Cl 1.34-3.05], P = 0.0004). CONCLUSION: The value of ante-partum CTG and Doppler flowmetry in the prognosis of neonatal hypoxia is low. The lower rate of pathological findings in affected neonates is probably associated with the fact that part of the hypoxias develop during delivery and cannot be predicted before delivery. The high number of falsely positive findings may by due by the adaptational abilities and reserves of the infant, by a more active approach when there are signs of danger and incorrect interpretation of findings. Premature delivery and haemorrhage are significant risks of neonatal hypoxia.

Adult↗
PubMed2002

[Activated protein C resistance and deep venous thrombosis in pregnancy].

OBJECTIVE: The aim of the study was to detect the incidence of resistance to activated protein C in pregnant or puerperal women with confirmed diagnosis of deep venous thrombosis or pulmonary embolism. DESIGN: Case-control study. SETTING: Dept. of Obstetrics and Gynaecology, Dept. of Haemato-oncology, Medical Faculty, Palacky University, Olomouc. METHODS: The group of 33 women with confirmed deep venous thrombosis were examined for resistance to activated C protein. The levels of C and S proteins, antithrombin III., prothrombin, heparin II cofactor and plasminogen were measured. Patient with APC ratio below 1.86, were tested by PCR analysis for the detection of the FV:Q506 allele. The control group had 51 pregnant women, chosen randomly. The statistical evaluation was performed by STATISTICA program. For the analyzing of the continuous variables the Students' T-test was used. For the categorical variables the chi 2 test was used (for comparison of 2 relative values). Values below P < 0.01 were considered to be statistically significant. RESULTS: Women who have shown to suffer from deep venous thrombosis (DVT) came to the mean age of 31 +/- 3.1 years, weight 75.3 +/- 7.9 kg and BMI 28.7 +/- 4.3. All of the results above were rendered to be statistically significant. 54.5% of thrombosis occurred in the 3rd trimester, 61% were localised to the left iliofemoral vein. APC resistance appeared in 17 (51%) women with DVT, in comparison to 5 (9.8%) women in the control group (i.e. statistically significant). Factor V appeared in II (33.3%) women, in comparison to 3 (5.9%) women in the control group. CONCLUSION: APC resistance and factor V. Leiden represent as important factors in the aetiology of deep venous thrombosis in pregnancy.

Activated Protein C Resistance↗
PubMed2001

[A shortened exposure of oocytes to sperm in standard in vitro fertilization].

OBJECTIVE: To find out if the shortened exposure of oocytes to sperm can influence the embryo quality and the implantation and pregnancy rate of the classical IVF also in Centre for Assisted Reproduction. DESIGN: A prospective study including 104 patients undergoing the classical IVF procedure. SETTING: Centre for Assisted Reproduction, Clinic of Gynaecology and Obstetrics, Palacký University Medical School and the University Hospital in Olomouc. METHODS: In the study group with the shortened exposure (54 patients) the oocytes were washed one hour after the insemination and transferred into the fresh medium. In the control group (50 patients) the classical procedure (e.g. transfer into the fresh medium 17 to 20 hours after insemination) has been used. The following parameters have been evaluated in both groups: the stimulation protocol, sterility cause, number of previous IVF cycles, age, serum estradiol level on the day of hCG application, number of retrieved oocytes, fertility rate (FR), embryo quality, pregnancy rate (PR) and the implantation rate (IR) expressed as the number of gestational sacs with heart action related to the number of transferred embryos. T-Test, Mann-Whitney Test and chi 2 were used for statistical evaluation. RESULTS: There were no statistically significant differences between the study and the control group in any of the parameters compared. CONCLUSION: In our study group the shortened exposure of oocytes to sperm did not influence the results of the classical IVF.

Adult↗
PubMed2001

[Ascitic fluid puncture in the treatment of severe forms of ovarian hyperstimulation syndrome].

OBJECTIVE: Evaluate the contribution and complications of ascitic fluid puncture in the treatment of severe ovarian hyperstimulation syndrome. DESIGN: Retrospective analysis of 18 patients. SETTING: Department of Gynaecology and Obstetrics, University Hospital, Palacky University, Olomouc. METHODS: 18 patients with the diagnosis of severe ovarian hyperstimulation syndrome admitted to intensive care unit from January 1996 to June 2000 were analysed. As a part of the therapy of severe OHSS 11 punctures of ascitic fluid was performed. In 3 patients the reinfusion of the ascites into the blood circulation was performed. RESULTS: The transabdominal paracentesis under the ultrasound control in 11 patients was performed. In 6 patients the puncture had to be repeated. The amount of removed ascitic fluid in single procedure was between 600-3750 ml. Total amount of fluid in different patients was between 1500-17,300 ml. Sterility of ascites and high contents of proteins was proved. In 3 patients with the refractory ascites the reinfusion of the ascitic fluid to the circulation was performed. No serious complications of the punctures were observed, 4 patients had a slight rise of body temperature, which fell down without antibiotics therapy. CONCLUSION: Puncture of the ascitic fluid is a save and effective part of the therapy of severe OHSS. In the treatment of the refractory ascites the reinfusion of the ascitic fluid should be used.

Ascites↗
PubMed2001

[Preoperative ultrasound evaluation of myometrial invasion in patients with endometrial carcinoma].

OBJECTIVE: To evaluate the diagnostic accuracy of preoperative transvaginal sonography in the detection of myometrial invasion in endometrial cancer patients classified by the grade of disease. DESIGN: Prospective multicenter study. SETTING: Department of Obstetrics and Gynaecology, Medical Faculty, Palacky University, Olomouc, Czech Republic. METHODS: In the period 1998-2001, 195 patients from 10 cooperating centers in the Czech Republic were enrolled in the RHOCE (risk of hysteroscopy in endometrial cancer) study. Sixteen patients did not meet the vaginal sonography study criteria (insufficient surgical staging, missing ultrasound examination). Sonographic results in 179 patients were categorized as M0--absence of infiltration (n = 97), M1--infiltration less than 1/2 myometrial depth (n = 61), M2--infiltration greater than 1/2 myometrial depth (n = 21). The final histopathology report of myoinvasion was used as a golden standard. RESULTS: We proved lower accuracy of vaginal sonography in detecting myometrial invasion in patients with higher grade of disease. CONCLUSION: Based on these data, the value of preoperative vaginal sonography as the sole criterion in the decision to perform extensive surgical procedures is questionable and warrants further evaluation.

Carcinoma↗
PubMed2001

Is there a real risk in patients with endometrial carcinoma undergoing diagnostic hysteroscopy (HSC)?

OBJECTIVE: The penetration of distention medium into the peritoneal cavity as well as directly into the bloodstream via injured endometrial vessels occurs in a great proportion of patients at hysteroscopy (HSC). This may cause potential risk of dissemination of the malignant cells of endometrial cancer patients. To evaluate the real risk of a poorer prognosis of these patients a prospective multicentric study was started in 1998. MATERIAL AND METHODS: Two groups of patients with endometrial carcinoma have been compared. The diagnosis was made in the study group by HSC and targeted biopsy, while in the control group by classical D&C. At the end of the HSC procedure puncture of the cul de sac was performed and the fluid obtained was cytologically examined. In both groups peritoneal lavage was performed at the beginning of the subsequent operation and the collected fluid was again cytologically examined. In the first phase of the study the cytology findings in both groups were compared. In the second phase which is planned for the next five years. the results of follow-up of both groups of patients will be evaluated. RESULTS: The results were evaluated in 134 patients with HSC and in 61 patients with D&C. In the study group a positive finding of malignant cells from the cul de sac was found in four patients (5.3%), a suspect finding in eight patients (10.7%), and a negative finding in 63 patients (84%). In the remaining 59 patients with HSC no peritoneal fluid was obtained. In the fluid from lavage at the beginning of the operation in the same group of HSC patients, a positive finding of malignant cells was found in 12.1%, a suspect finding in 18.2%, and a negative finding in 69.7%. In the control group (after D&C) the fluid from lavage contained malignant cells in eight patients (13.6%), suspect cells in 12 patients (20.3%), and no malignant cells in 39 patients (66.1%). Both groups were comparable for clinical stages of disease. CONCLUSIONS: Our results suggest that HSC does not increase the risk of penetration of tumour cells into the peritoneal cavity more than estimates in D&C.

Carcinoma↗
PubMed2000

[Embryo transfer after 5 days of culture].

OBJECTIVE: To find out whether: 1) the blastocysts transfer rises the successfulness of IVF and ET (G/ET) and 2) the 2-blastocyst transfer lowers the incidence of multiple pregnancies (IR). DESIGN: Prospective study of 46 patients involved in a prolonged 5-day cultivation of IVF and ET programme. SETTING: Centre for Assisted Reproduction, Clinic of Gynecology and Obstetrics, Teaching Hospital and Palacky University in Olomouc. METHODS: Patients with at least 5 acquired embryos were included in the group. The cultivation in media commercially produced by Scandinavian IVF Science took 5 days. RESULTS: In 91% of patients in the observed group (n = 46) morulas or blastocysts were acquired. The IVF and ET success rate after 5-day cultivation and subsequent transfer of two embryos was 37% pregnancies per a started cycle (G/cycle), 40% pregnancies per an embryotransfer (G/ET) and the implantation rate (IR) was 31%. Relatively high percentage of double pregnancies (53%) is alarming. Following parameters were assessed: age, sterility cause, number of previous IVF cycles, stimulation scheme, E2 level on the day of hCG application, number of acquired oocytes and pronuclear stages, percentage of grown blastocysts, the quality of transferred embryos and endometrium thickness on the day of transfer. The only statistically significant difference was found in E2 level on the day of hCG application. Pregnant patients had lower levels of estradiol (average value 11.8 +/- 4.8 nmol/l) compared to patients who did not become pregnant (18.6 +/- 11.9 nmol/l). CONCLUSION: In selected groups of patients who refuse multiple pregnancies only one blastocyst should be transferred.

Adult↗
PubMed2000

[Cervix length measured by transvaginal ultrasonography in women with twin pregnancy--prospective study].

OBJECTIVE: To evaluate cervical length in twin pregnancies measured by transvaginal ultrasonography. DESIGN: A prospective clinical study. SETTING: Department of Obstetrics and Gynecology, Medical Faculty of Palacky, Olomouc, Czech republic. METHODS: Clinical data of cervical length in twin pregnancies measured by transvaginal ultrasonography were summarized. RESULTS: 69% of patients delivered after 36th week of gestation, mean gestational age at the time of delivery was 35.5 week. Mean cervical length measured bi-weekly from the 16th till 34th week was 34.9, 34.6, 33.8, 33.2, 29.7, 28.7, 29.1, 28.4, 23.6, 22.8 mm. The creation of the funneling was recorded in more than 80% of patients with preterm delivery at the mean gestational age 23 week. Mean cervical length in patients delivered before 36th week was in the 23rd week of gestation 21.5 mm, while in woman delivered near term was average cervical length 33.1 mm. Genital infection in patients with preterm labours was present in 27%. CONCLUSION: Transvaginal ultrasonography seems to be a useful method in antenatal care of risk pregnancies with twins.

Cervix Uteri↗