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Z Hájek

Publications and source records attributed to Z Hájek.

At least 19 recordsLinked to original sources
PubMed2006

[Diagnosis and management of infection and its role in preterm labor].

OBJECTIVE: Analysis of contemporary knowledge of infection and its role in etiology and pathogenesis of preterm labor. DESIGN: Review article. SETTING: Department of Gynecology and Obstetrics, 1st Faculty of Medicine, Charles University, Prague. METHODS: An overview of published data. CONCLUSION: Infection is considered the most significant cause of preterm labor. The current research tend towards searching for local cervicovaginal markers of infection. An important role in the prenatal care is played by cervical ultrasonography which together with cervicovaginal markers can sort out the group of women with high risk of the preterm labor. Cervicovaginal markers can reveal microbial invasion into higher parts of the birth canals during the intrapartal care and justify the administration of antibiotics especially to women with the premature rupture of membranes. The routine administration of antibiotics was reevaluated in the management of preterm labor. The question of optimal antibiotics remains open.

Bacterial Infections↗
PubMed2006

[Intrapartal fetal monitoring, sensitivity and specificity of methods].

OBJECTIVE: To evaluated sensitivity and specificity of presently used methods for intrapartal monitoring (CTG, FpO2 a STAN S-21) and their mutual comparison. TYPE OF STUDY: A prospective study. SETTING: Gynecological-Obstetrical Clinic, 1st Medical Faculty, Charles University and general Teaching Hospital, Prague. METHOD: In 114 pregnant women with high-risk or pathological course of pregnancy the authors evaluated the capability of individual methods to predict intrapartal hypoxia, determined on the basis of postnatal evaluation of parameters observed (Apgar score in 1st minute, pH from umbilical artery, lactate levels in fetal blood, base excess (BE) and postpartum condition of fetus evaluated by a neonatologist). Each method was categorized according to its importance. The quality of individual methods was evaluated by means of their sensitivity and specificity as well as by the area under ROC (Receiver Operating Characteristic), i.e. AUC (Area under Curve). A similar or different prediction of the condition of the newborn by these individual methods was evaluated by the McNamara test of symmetry. In 50 deliveries performed by Cesarean section and 24 forceps deliveries the authors evaluated postnatal pH from umbilical artery and evaluation by Chi-square test. The women in childbed were infused with a tocolytic drug (hexoprenalin) before Cesarean section. All tests were performed at 5% level of significance. RESULTS: Low level of Apgar score in the 1st minute and less) always indicated CTG, but also a large proportion of normal newborns. STAN, in contrast, well indicates all newborns with a normal point evaluation. The best balanced evaluation of the newborns is provided by FpO2 and there was a significant difference between CTG and FpO2. In evaluating pH from the umbilical artery (pH < 7.20), TCG proved to be most sensitive again but displayed low specificity. STAN was the best predictor of newborns with normal pH. In evaluating high levels of lactate (> 3.7mmol/L) and BE (> -10) and related demonstration of metabolic acidosis STAN proved to be the best predictor. The condition of the newborn evaluated by a neonatologist immediately after birth (medium or heavy depression) was best predicted by FpO2. In deliveries performed by Cesarean section and after the administration of tocolysis the postnatal pH was higher then in forceps deliveries without acute tocolysis. The occurrence of emergencies in the course of a pathological delivery in individual methods is as follows: CTG, FpO2 and STAN. CONCLUSION: Even though CTG displays a very low specificity, this method should not be rejected, since it draws attention of the obstetrician very early to the possibility of developing hypoxia. FpO2 or STAN gives more precision to the situation and demarcates a correct moment for ending the delivery for the indication of fetus hypoxia intra partum. STAN is the best predictor for conditions of developing metabolic acidosis, evaluated postnatally by the level of lactate and BE in fetal blood.

Apgar Score↗
PubMed2005

[Analysis of present diagnostic methods of intrapartum fetal hypoxia].

OBJECTIVE: To evaluate specificity of present diagnostic methods of intrapartal fetal hypoxia (cardiotocography--CTG, fetal pulse oxymetry--FpO2, ST-ECG analysis). DESIGN: A prospective study. SETTING: Gynecology-Obstetrics Clinic, 1st Medical Faculty and General Faculty Hospital in Prague. METHODS: The results of synchronic fetus monitoring by means of CTG, FpO2 and STAN-ST 21 were followed in 53 mothers with a risk and pathological delivering of birth in the period of April 2003 to March 2004. The study investigated, which of the methods provided the best prediction of the intrapartal fetal hypoxia. The statistical evaluation (p-mark test and Mc Namara test) was based on the assessment of correct or incorrect prediction of the Apgar score values in the first minute after birth, pH in umbilical artery and the lactate level. We also investigated results of three methods during postpartum depression, turbid or mushy amniotic fluid and the way the individual methods were made useful in indication for ending the delivery. RESULTS: In comparison with CTG there was a statistically significantly higher specificity in FpO2 and STAN in the evaluation of Apgar score in the newborn in the first minute after birth, FpO2 (p=0.007) and STAN-ST (p<0.001), in the determination of pH (a) from umbilical blood FpO2 (p=0.029) and STAN (p=0.001) and the occurrence of postpartum depression of the newborn in minute 30-60 after birth FpO2 (p=0.019) and STAN (p=0.0005). The changes in lactate level in umbilical blood were better predicated by STAN (p=0.001). FpO2 evaluated the changes in the same way as CTG. The threatening hypoxia in strongly turbid or even mushy amniotic fluid was correctly evaluated by STAN only (p=0.002). The FpO2 evaluation was not statistically significant. There was not any statistically significant difference in the indication of operation for ending the delivery among the individual methods. CONCLUSIONS: The results univocally demonstrated that the used of other method for diagnosis on intrapartal fetus hypoxia--Fetal pulse oxymetry and ST--analysis of ECG of the fetus give more precision to the diagnosis. The introduction of these methods requires a correct interpretation and the effort of the obstetrician to use these methods in clinical practice.

Adult↗
PubMed2005

[Foetal ECG in the prediction of intrapartum hypoxia].

Intrapartum foetal hypoxia represents one of the most frequent causes of the hypoxia-ischemia CNS injury in newborns and it can result in the development of a permanent handicap. It often results from the underestimation of the development of the delivery by the obstetrician who conducts delivery and who is responsible for it. That is why the contemporary obstetrics is using new instruments, enabling to evaluate objectively the development of the intrapartum foetal hypoxia. The praxis consequently introduced cardiotocography (CTG), foetal pulse oximetry (FpO2) and recently new methods for evaluation of ST interval in foetal ECG- STAN. The last method has the highest specificity for prediction of the foetal hypoxia and it properly signalises the development of the metabolic foetal acidosis, which threatens the foetus during delivery and which can impair the vital organs. Foetal myocardium sensitively responds to the release of stress hormones, to the development of anaerobic metabolism and to the increase of potassium levels. The development of hypoxia manifests in ECG as a subsequent rise of T wave, elevation of T/QRS segment and as a significantly biphasic ST interval. The last sign indicates serious state of the foetus in utero accompanied with metabolic acidosis.

Cardiotocography↗
PubMed2005

[Delivery of a healthy child from pregnancy after IVF complicated hyperstimulation syndrome, phlebothrombosis and resection of uterine horn. Case report].

OBJECTIVE: To evaluate the negative effect of uterine horn resection for heterotopic pregnancy in the uterine horn in the first trimester on the course of pregnancy and labor. To point out the increased incidence of other complications in pregnancy after IVF+ET (ovarian hyperstimulation syndrome, phlebothrombosis of the pelvic veins). DESIGN: Case study. SETTING: Department of Obstetrics and Gynecology, 1st Faculty of Medicine, Charles University and General Faculty Hospital, Prague. METHODS: In this study, the authors analyze their experience with the course of pregnancy of a patient who had uterine horn resection for a heterotopic uterine horn pregnancy after IVF+ET. The course of pregnancy was associated with further complications such as ovarian hyperstimulation syndrome and the resulting occurence of thrombosis in the 2nd trimester of pregnancy. The pregnancy was terminated by caesarean section for the indication of prior uterine surgery-resection of the uterine horn in the first trimester. A healthy infant was delivered. CONCLUSION: This case study demonstrates the multiple occurrence of serious complications in pregnancy after IVF+ET, which are associated with ovarian hyperstimulation and the transfer of multiple embryos. The pregnancy was terminated with the delivery of a healthy term infant.

Adult↗
PubMed2005

[Threatening uterine rupture in pregnancy after previous laparoscopic myoma enucleation. Case report].

OBJECTIVE: To evaluate the negative effect of uterine myoma enucleation forcompact structure of the uterus. DESIGN: Case report. SETTING: Department of Obstetrics and Gynecology, 1st Faculty of Medicine, Charles University and General Faculty Hospital, Prague, Pronatal Sanatoruim, Prague METHODS: In this study, the authors analyze their experience of the course of pregnancy in a patient who had uterine myoma enucleation with penetration to the uterine cavity and large coagulation. The pregnancy was terminated by caesarean section for the indication of prior uterine surgery and the risk of uterine rupture in 38 week of pregnancy. CONCLUSION: This case report demonstrates the risk of uterine rupture in pregnancy after laparoscopy myoma enucleation.

Adult↗
PubMed2005

[Pregnancy and labor after combined pancreas-kidney transplantation in Czech Republic].

OBJECTIVE: To inform about the first own experiences and to present opinion on leading pregnancy and delivery after a combined pancreas and kidney transplantation. DESIGN: Case report and review article. SETTING: Department of Obstetric and Gynecology, 1st Medical Faculty of the Charles University and General Faculty Hospital, Prague. RESULTS AND CONCLUSIONS: Pregnancies and deliveries after the transplantation of solid organs are not common. Mostly there are experiences with women after kidney transplantation, smaller or no experiences are with women after transplantation of other solid organs. About 25 pancreas transplantation per year are performed in the Czech republic. Two women after the combined kidney and pancreas transplantation were the first in Czech republic to get pregnant spontaneously and delivered by using a chronic immunosupressive. therapy (Prograf, Imuran, Prednison) in 2002 and 2003. These single pregnancies were led as a high-risk pregnancy in Regional Perinatology Center in collaboration with Transplant and Diabetic Center. Both pregnancies were termined from the obstetrical indication before the term by cesarean section. Both children were healthy. The pregnancy of both patients has not affected the function of the transplanted organs and development of both children has been normal.

Adult↗
PubMed2005

[Vaginal infections screening in pregnancy].

Preterm birth before the 37th gestational week is most frequently caused by infection. The agents are aerobic and anaerobic bacteria. Infection usually ascends from the vagina. Microorganisms entering the choriodecidual space induce pro-inflammatory cytokines, which trigger prostaglandin synthesis and contraction activity of the uterus. Cytokines can also release proteases, which cause premature outflow of the amnionic fluid. Screening of vaginal infections is indicated in all cases of imminent preterm parturition and in the group of risk pregnancies. Screening on Streptococcus B is indicated to all pregnant women in the gravidity weeks 35 to 37. Beside streptococcus infections with the risk of disease of the neonate being 2 to 3 per 1000 of vital newborns, bacterial vaginosis caused by Gardnerela vaginalis is frequently diagnosed. Effective treatment of symptomatic cases of the advanced pregnancy is five days long administration of Metronidazol or Clindamycin--vaginal crème. Another frequent cause of the preterm birth is chlamydial infection. The best contemporary treatment is Azitromycine for five days. Therapy of women without symptoms of the imminent preterm parturition does not decrease its occurrence. It is therefore not recommended as well as is not recommended the therapy of pregnant women with asymptomatic bacterinuria. Beside the classical cultivations, detection of antibodies, DNA analysis and serum infection markers (leucocytes, C-reactive protein), detection of pro- inflammatory cytokines in the serum and in the vaginal secret (IL-6, IL-8, TNFalpha etc.) are used to diagnose vaginal infections.

Female↗
PubMed2003

[Pregnancy in myelodysplastic syndrome].

OBJECTIVE: Evaluation of the influence of myelodysplastic syndromee (MDS) on the course of pregnancy and delivery. DESIGN: Case report. SETTING: Gynecological and Obstetric Department 1st Medical Faculty Charles University and General Faculty Hospital, Prague. SUBJECTS AND METHODS: The authors analyze their experience with the course of pregnancy and delivery in a patient with MDS and refractory anaemia who was treated on account of the disease for several years before pregnancy in the Institute of Haematology and Blood Transfusion. Pregnancy was not associated with progression of the basic disease and complications which developed during pregnancy were not associated with MDS. Pregnancy was terminated in this patient on account of preeclampsia gravis per sectionem caesarean by delivery of a healthy foetus. CONCLUSION: The example draws attention to a serious haematological disease while during pregnancy and delivery deterioration of the basic disease was not observed.

Adult↗
PubMed2003

[The May-Hegglin anomaly in pregnancy. 2 case reports].

TYPE OF STUDY: Case report. SETTING: Obstetrics and Gynecology Department, 2nd Medical Faculty Charles University and Faculty Hospital Motol, Department of Hematology and blood transfusion, Obstetrics and Gynecology Department, 1st Medical Faculty Charles University and General Faculty Hospital, Prague. METHODS: The authors present two cases of pregnant women with May-Hegglin anomaly. This rare hereditary trombocytopenia is characterized with the presence of megathrombocytes and typical basophilie inclusions (Dahli's inclusions) in granulocyte cytoplasma in blood count. Clinically, there are possible haemmorrhagic manifestations in this anomaly [13]. The course of pregnancy was uncomplicated in both cases. The values of thrombocytes fluctuated between 22-34 x 10(9)/l and 17-27 x 10(9)/l respectively. The response on the corticosteroid administration was minimal. The pregnancy was terminated with caesarean section in general anesthesia in both cases. The indication in the first case was, after the neonatologist consultation with hematologist on duty, the anomaly itself. In the second case it was primarily decided to conduct the labor vaginally. It was necessary to start the induction of labor for the development preeclamptic signs. This prostaglandin induction was unsuccessful and therefor was the labor also terminated with s.c. Both delivered neonates were in good condition without clinical or lab signs of the disease. The neonate in the second case was of borderline trophicity. The s.c. were secured with transfusions of thrombocytes and carried out without any complications in both cases. The blood losses were 400 and 700 ml without necessity of erythrocyte transfusions. The postoperative course was also uncomplicated in both cases. Both women with their children were released from hospital on the 6th postoperative day. CONCLUSION: There are about 20 published papers of authors describing pregnancy with this rare anomaly. The efforts of haemmorrhage are very rare, the course of pregnancy is usually not disturbed [7, 8, 9, 11]. Some authors alert on possible higher risk intrauterine growth restriction [4]. The risk of fetal hemorrhage is from all available, data also small and there is no need of prenatal invasive investigation (cordocentesis) [11]. The mode of delivery depends only on the obstetrics and indications, vaginal labor is not associated with higher risk for the fetus [2, 3, 5, 6, 10]. The treatment with corticosteroids or immunoglobulins in cases when the clinical symptomatology appear is only little effective, administration of thrombocytes transfusions are useful [8, 9]. When the anesthesia is necessary, general anesthesia is preferred because of higher risk of local haemmorrhage complications in cases of epidural or spinal analgesia [10, 14].

Adult↗
PubMed2003

[Successful postponement of delivery in twin pregnancy].

OBJECTIVE: Description of twin pregnancy after IVF preterm rupture of membranes of fetus A in 22nd gestational week. Abortion of fetus A and successful delayed delivery of twin B. DESIGN: Case report. SETTING: Obstetrics and Gynecology Department, 2nd Medical Faculty Charles University and Faculty Hospital Motol, Obstetrics and Gynecology Department, 1st Medical Faculty Charles University and General Faculty Hospital, Prague. METHODS: Patient A. S. 34 years old, admitted to the hospital in 23rd gestational week with preterm rupture of membranes of fetus A, after appearing spontaneous uterine contractions terminated the abortion of fetus A. The uterine contractions stopped with toxolytics and after one week of expectation interval the cerclage suture of cervix was performed. The following course of pregnancy was protected with antibiotics and 48 hours toxolysis with beta mimetics. The pregnancy continued without any serious complications till 37th gestational week, when infectious markers elevated. Cerclage suture was taken away and after 12 hours interval the labor started. The labor was terminated with s.c. because of imminent fetal hypoxia. CONCLUSION: After the abortion of twin A we succeeded to delay delivery interval for 4 months. The borderline mature neonate was born in good clinical condition and survived without any serious complications.

Abortion, Spontaneous↗
PubMed2002

[Massive pulmonary embolism after delivery by cesarean section].

OBJECTIVE: To give an overview of the preventive and therapeutic measures in thromboembolic disease in association with pregnancy and delivery. SUBJECT: Case report. SETTING: Department of Obstetrics and Gynaecology, First Faculty of Medicine, Charles University and General Faculty Hospital, Prague. SUBJECT AND METHOD: The surgical treatment of massive pulmonary embolism in a patient after delivery by caesarean section. CONCLUSION: Surgical embolectomy still has its place in the treatment of pulmonary embolism in the early phase of critical cases, when thrombolysis is contraindicated, and mechanical disintegration with the catheter is unsuccessful. In such cases it is the only one possibility of saving the patient. However, prevention of thromboembolic disease remains of primary importance.

Adult↗
PubMed2002

[Prediction of premature labor--multifactorial analysis of a prospective clinical study].

OBJECTIVE: To evaluate, which of selected anamnestic, laboratory and ultrasonographic (USG) parameters could contribute to the prediction of prematurity. DESIGN: Prospective, observational, clinical study. SETTING: Department of Obstetrics and Gynecology, 1st Faculty of Medicine and the General Faculty Hospital, Charles University, Prague. METHODS: 349 women with the singleton pregnancy were followed from the half of the 2nd trimester until the end of gestation. At each woman the anamnestic (age, parity, pregravid BMI, weight gain until 20th week, significant risk from patient's history, cigarette smoking, risk pregnancy symptoms until 20th week), laboratory (maternal serum concentration of AFP, hCG, and uE3/triple test/at 16th week, the blood count and ferritin concentration at 18th-20th week, bacteriological cultivation of the smear from the cervix at 34th-36th week), and USG (transvaginal cervicometry and doppler flowmetry of the uterine arteries at 18th-20th week) data were established. With the aid of one-dimensional and multi-dimensional analysis the dependence of completed gestational age and preterm delivery (before completed 37th week) on above mentioned parameters was tested. RESULTS: 314 women completed the study. We proved a significant dependence of prematurity on the following markers: risk pregnancy symptoms until 20th week (RR 2.94), abnormal triple test (RR 4.63), cultivation of pathogens from the cervix (RR 5.49), USG established cervical length (P < 0.0001), abnormal result of cervicometry (RR 19.02), both doppler parameters (RI of uterine arteries: P < 0.0001; presence of early diastolic notch: RR 2.84). The results of multi-dimensional analysis confirmed superiority of USG cervicometry in prediction of both measured outcomes. CONCLUSION: The predictive value of some of selected anamnestic, laboratory, and USG markers of premature delivery was proved at random population of women with singleton pregnancy. The abnormal result of transvaginal USG cervicometry was the most significant predictor of prematurity. We recommend a routine performing of cervicometry (as a part of USG screening at 18th-20th week) for early selection of women with significantly increased risk of prematurity.

Adult↗
PubMed2002

[The fetal ECG--ST analysis in the diagnosis of fetal hypoxia].

OBJECTIVE: Clinical tests of a new apparatus STAN S21 evaluating the foetal ECG--ST section in the diagnosis of foetal hypoxia. DESIGN: Retrospective analysis. SETTING: Gynaecological and Obstetric Clinic, First Medical Faculty Charles University and General Faculty Hospital, Prague. METHOD: Within the framework of clinical tests 27 analyses were made on a apparatus STAN S21 manufactured by Swedish firm Neoventa. Contrary to hitherto implemented and published studies, in all monitored deliveries the CTG curve was evaluated as well as FpO2 and STAN. After each delivery in the neonate the Apgar score and acid-base equilibrium from the umbilical artery was evaluated. ST analysis was included mainly in case of abnormal CTG records, risk and pathological deliveries. Evaluation was divided into two groups: in one delivery was terminated by the vaginal route, in the second one by Caesarean section. For evaluation of the CTG curve the FIGO terminology was selected (intermediary-suspect) and (abnormal-pathological). For evaluation of the FpO2 pathology 30% saturation for 10 minutes was used. In STAN analysis important phenomena were evaluated by computer (increase of T wave, increase of T/QRS complex and biphasic character of ST). RESULTS: In reduced values of the Apgar score (during the 5th minute < 8 points) and the acid-base balance from umbilical artery (pH < 7.2, BE > -8) pathological CTG records and FpO2 were present in 25%. STAN had in these instances pathological records in 50%). CONCLUSION: ST analysis is another very effective link in the diagnosis of interpartial foetal hypoxia. Initial experience indicates, that STAN will have probably a higher diagnostic specificity than CTG and FpO2.

Apgar Score↗
PubMed2002

[Disseminated intravascular coagulation syndrome and protein C].

Disseminated intravascular coagulation (DIC) is characterized by systemic activation of the haemostasis. In many instances the release of inflammatory cytokines and tissue factor trigger the system in septic or traumatic conditions. Initially, the increased activation of haemostasis can be compensated by natural inhibitor systems. As release of the triggers persists, inhibitors (e.g. antithrombin and protein C) will be consumed leading to intravascular clotting. In this process many coagulation factors, most notably fibrinogen and platelets are consumed too, resulting in a failure of haemostasis system and in a diffuse bleeding (decompensated DIC). Fresh frozen plasma, blood transfusion, and fibrinogen concentrate correct the bleeding, if needed, in the case of traumatic (obstetric) DIC. Arrest of the activated haemostasis by heparin and natural anticoagulants (antithrombin or/and protein C) is recommended, mainly in septic conditions with systemic inflammatory reactions. A case of stercoral sepsis usefully treated by recombinant human activated protein C is reported.

Disseminated Intravascular Coagulation↗
PubMed2000

[The spectrum of lipids in the intrauterine growth retarded fetus and in the parents].

OBJECTIVE: The aim of this study was to determine the relationship between the parameters of individual serum lipids and the degree of intrauterine growth retardation (IUGR) of the fetus. The lipid levels were compared in fetuses with IUGR and in eutrophic fetuses and it was determined in which studied variable IUGR newborns differ from healthy newborns. METHODS: The group under study consisted of 53 pregnant women in whom IUGR of the fetus was diagnosed by ultrasound during pregnancy. The control group consisted of 26 women who gave birth to eutrophic newborns. The cases in the control group were chosen by the method of matched control so that the results could be statistically evaluated in both groups at the same gestational age and at the same maternal age. In both groups blood samples from the umbilical cord were taken after delivery and the whole spectrum of lipid levels were evaluated (cholesterol-CH, triglycerides-TGA, high-density lipoprotein--HDL, low-density lipoprotein--LDL, Lp(a) lipoprotein, and apolipoproteins-ApoB, ApoAI, ApoE). The same parameters were evaluated in maternal and paternal blood samples. In several cases, intrauterine lipid levels of the fetus were determined by cordocentesis. The incidence of hyperlipoproteinemia in the families of both groups was surveyed. SETTING: Department of Obstetrics and Gynaecology, 1st medical Faculty, Charles University, Prague. RESULTS: There was a significant incidence of hyperlipoproteinemia in the families of the mothers in the group studied (chi-square test: p < 0.001). In the mothers of the groups studied, there were statistically significant higher levels of HDL, LDL, and Lp(a) in comparison to the mothers in the control group. A significant dependence was determined between the levels of ApoAI and Lp(a) of the mothers and newborns. In the regression analysis of the dependence of lipid levels on the birth weight of the newborns, a statistical correlation was determined for the values of ApoB and Lp(a). CONCLUSION: The more increased the intrauterine growth retardation of the fetus and the lower its birth weight in relation to its gestational age, the higher its lipid levels, specifically apolipoproteins. Apolipoproteins are under genetic control and present a genetic risk for changes in the metabolism of cholesterol, hemocoagulation, and cardiovascular disease in adulthood.

Adult↗
PubMed2000

[Perinatal outcome of twin pregnancies after fertilization in vitro and after spontaneous conception].

OBJECTIVE: To compare the obstetric outcome of twin pregnancies after IVF with spontaneously conceived twins and thus determine whether IVF twins require greater care. TYPE OF STUDY: A retrospective study. SETTING: The Department of Obstetrics and Gynaecology, 1st Faculty of Medicine of Charles University, Prague. METHODS: Statistical evaluation of obstetric outcome between the group of 46 twin pregnancies after IVF and 85 spontaneously conceived twins. We evaluated the following parameters: signs of abortion and premature delivery, bleeding in pregnancy, premature rupture of membranes, performed cerclage, incidence of praeclampsia, gestational diabetes mellitus and hepatopathy of the mother. Pathological ultrasound findings were also evaluated--disturbances in foetal growth and the amount of amniotic fluid. In these parameters we also evaluated the time of the first signs of their development. Further, we evaluated the type of delivery, the gestational age at delivery, birth weight, birth weight discordance and perinatal mortality. RESULTS: We found statistically significant differences in the method of delivery--more cesarean sections in the IVF group (71.7%) than in spontaneous ones (44.7%). Another difference was the gestational age at which cerclage were performed--earlier in the IVF group (average 22.8 weeks) than in spontaneous ones (average 25.7 weeks). In the other evaluated parameters we did not find any statistically significant differences between the two groups. CONCLUSION: In our retrospective analysis of twin pregnancies, deliveries and neonatal outcome, except for the method of delivery and time of performing cerclage, we did not find any important significant differences between the IVF and spontaneously conceived twins. However, it is necessary to remember the generally worse obstetric outcome of twin compared to singleton pregnancies.

Adult↗