Birth Of Healthy Child Research Articles

Full-term abdominal pregnancy case

The article gives account of the case offull-term abdominal pregnancy with comparatively favourable course that led to diagnostic mistakes and complications, but resulted in the birth of healthy child without any signs of asphyxia.

Oligohydramnion in the First Half of Pregnancy in the Fetuses with Congenital Abnormalities: Ultrasound Diagnostics and Obstetric Outcomes

Background.Oligohydramnion in the first half of pregnancy, combined with congenital abnormalities in the fetus has objective difficulties in diagnosis. The morphology features and type of defects associated with oligohydramnion, which manifests in the first half of pregnancy, are not sufficiently studied at the present stage.
 Aims to evaluate the clinical significance of diagnosing oligohydramnion in the first half of pregnancy in women with congenital fetal malformations.
 Materials and methods.The analysis of the course of pregnancy and perinatal outcomes in 77 women with low water content in combination with congenital malformations of the fetus and 72 patients with a normal amount of amniotic fluid and no congenital malformations of the fetus was performed. The patients of the main group were divided into two subgroups depending on the severity of oligohydramnion: the 1st subgroup (n = 54) patients with severe oligohydramnion and the 2nd subgroup (n = 23) patients with moderate oligohydramnion. The amount of amniotic fluid was determined by 3D/4D ultrasound (1321 weeks of gestation) and the structure of fetal abnormalities associated with oligohydramnion was analyzed. We evaluated perinatal outcomes in women with congenital malformations of the fetus in combination with oligohydramnion and the effect of its severity on the outcome of pregnancy.
 Results.In the main group (n = 77), fetal abnormalities were detected in patients: urinary system 39 (50.6%), respiratory system 4 (5.2%), heart 1 (1.3%), chromosomal and genetic abnormalities 14 (18.2%), central nervous system 3 (3.9%), osseous system 3 (3.9%), multiple 13 (16.9%). In the main group (n = 77), pregnancy was terminated for medical indications in 47 (61%) cases, in 6 (7.8%) spontaneous miscarriage occurred, in 5 (6.5%) antenatal fetal death. 19 (24.7%) children were born alive, and surgical treatment in the neonatal period was required in 8 (10.4%) cases. In the 1st subgroup (n = 54) in 53 (98.1%) cases, there was a loss of the fetus, in 1 (1.9%) the newborn died on the 9th day. In the 2nd subgroup (n = 23), fetal death occurred in 5 (21.7%) cases, 18 (78.3%) children were born alive, and 8 (44.4%) newborns were operated on in the neonatal period. In the control group, all pregnancies ended with the birth of healthy children. A decrease in ultrasound imaging of internal organs in the fetus was observed when a pregnant woman was obese (BMI more than 35).
 Conclusions.Oligohydramnion in the first half of pregnancy in combination with fetal malformation should be considered an extremely unfavorable clinical sign for the prognosis of pregnancy and the health of the fetus and newborn. 3D/4D ultrasound scanning allows you to reliably determine oligohydramnion in the first half of pregnancy, and the degree of its severity to assume the nature of complications.

All you need to know about sperm RNAs.

Spermatogenesis generates a small and highly specialised type of cell that is apparently incapable of transcription and translation. For many years, this dogma was supported by the assumption that (i) the compact sperm nucleus, resulting from the substitution of histones by protamine during spermatogenesis, renders the genome inaccessible to the transcriptional machinery; and (ii) the loss of most organelles, including endoplasmic reticulum and ribosomes, limits or prevents translational activity. Despite these observations, several types of coding and non-coding RNAs have been identified in human sperm. Their functional roles, particularly during fertilisation and embryonic development, are only now becoming apparent. This review aimed to summarise current knowledge of the origin, types and functional roles of sperm RNAs, and to evaluate the clinical benefits of employing these transcripts as biomarkers of male fertility and reproductive outcomes. The possible contribution of sperm RNAs to intergenerational or transgenerational phenotypic inheritance is also addressed. A comprehensive literature search on PubMed was conducted using the search terms 'sperm' AND 'RNA'. Searches focussed upon articles written in English and published prior to August 2020. The development of more sensitive and accurate RNA technologies, including RNA sequencing, has enabled the identification and characterisation of numerous transcripts in human sperm. Though a majority of these RNAs likely arise during spermatogenesis, other data support an epididymal origin of RNA transmitted to maturing sperm by extracellular vesicles. A minority may also be synthesised by de novo transcription in mature sperm, since a small portion of the sperm genome remains packed by histones. This complex RNA population has important roles in paternal chromatin packaging, sperm maturation and capacitation, fertilisation, early embryogenesis and developmental maintenance. In recent years, additional lines of evidence from animal models support a role for sperm RNAs in intergenerational or transgenerational inheritance, modulating both the genotype and phenotype of progeny. Importantly, several reports indicate that the sperm RNA content of fertile and infertile men differs considerably and is strongly modulated by the environment, lifestyle and pathological states. Transcriptional profiling has considerable potential for the discovery of fertility biomarkers. Understanding the role of sperm transcripts and comparing the sperm RNA fingerprint of fertile and infertile men could help to elucidate the regulatory pathways contributing to male factor infertility. Such data might also provide a molecular explanation for several causes of idiopathic male fertility. Ultimately, transcriptional profiling may be employed to optimise ART procedures and overcome some of the underlying causes of male infertility, ensuring the birth of healthy children.

Reproductive aspects of long-term consequences of ovarian apoplexy

The objective: to determine the long-term consequences of surgical treatment of ovarian apoplexy, taking into account the risk factors of this urgent pathology. Materials and methods. The study included 112 women (main group, n=112), who underwent surgery for ovarian apoplexy, and 40 patients in the control group (n=40), who had no history of this pathology. All patients underwent a comprehensive examination using clinical, instrumental and laboratory research methods. The groups were homogeneous in age (mean age was 23,6±4,2) and statistically comparable. Results. Based on the analysis of clinical and anamnestic data of patients who underwent surgical treatment of ovarian apoplexy, we identified the main risk factors for this pathology: chronic diseases of the urinary, respiratory and digestive systems, genital infantilism, ovarian retention cysts, chronic salpingo-oophoritis, menstrual disorders by type of hyperpolymenorrhea and/or algodysmenorrhea, family thrombophilic history, bleeding of various localizations in the anamnesis, artificial abortions, weight loss, smoking. Our proposed comprehensive two-stage rehabilitation system included treatment and prevention measures from the acute period of ovarian apoplexy to the time of reproductive function. The first stage of the treatment complex (early postoperative period) helped to eliminate the effects of ovarian injury, pain relief and hypercoagulable changes in the blood coagulation system, improving the quality of life during inpatient treatment. The second stage (2 months after surgery) provided the restoration of ovarian function and balance of the hemostasis system, thus preparing a woman’s reproductive system for future pregnancy and childbirth. In the remote postoperative period, the complex stage of rehabilitation in 23 treated patients resulted in the birth of healthy children and the absence of obstetric complications in 22 of them. Conclusion. Identification and structuring of risk factors for ovarian apoplexy is an important step for comprehensive treatment and prevention of recurrence of this disease. Eliminating or reducing the impact of these factors will help restore the reproductive system and improve quality of life. A comprehensive assessment of the state of the whole organism in the remote postoperative period indicates the need for rehabilitation measures aimed at increasing the natural resistance of the macroorganism and the effective restoration of reproductive function.

P–564 Analysis of efficiency and outcomes of assisted reproductive technology (ART) programs after embryo transfer with a low-level of mosaicism

Abstract Study question How does embryo transfer with a low-level of mosaicism affect the success of ART programs, pregnancy, and live birth in comparison with euploid embryo transfer? Summary answer The transfer of mosaic embryos results in the delivery of a healthy baby however significantly decreases the outcome of ART programs and live birth rate. What is known already Present methods of preimplantation genetic testing of aneuploidy (PGT-A) allow detecting a mixture of euploid and aneuploid cells at the blastocyst stage with high accuracy. Such embryos are classified as mosaics with varying levels according to the guidelines of the International Society for Preimplantation Genetic Diagnosis (PGDIS). Numerous sources describe that number of mosaic embryos can vary from 4 to 22%. Several publications report that mosaic embryos can lead to successful pregnancies and healthy childbirth, but with a lower frequency and higher rates of pregnancy loss compared to euploid embryos. Nevertheless, the effect of mosaicism on ART outcomes remains controversial. Study design, size, duration It has been analyzed 2506 embryos from 648 patients undergoing the ART program with PGT-A at the Institute of Reproductive Medicine for 2018 - 2019. Embryos after PGT-A were classified as euploid, aneuploid, and having mosaicism of less than 40% as low level and more than 40% as high level following PGDIS guidelines. Patients of (group A) were transferred 467 single euploid embryos, and 43 patients (group B) underwent single low-level mosaic embryo transfer. Participants/materials, setting, methods The embryos on day 5 or 6 were graded by Gardner Scoring System. Approximately 5–10 TE cells were biopsied from good quality blastocysts and subsequently vitrified. PGT-A was performed utilizing an array comparative genomic hybridization (aCGH) (Agilent). The transfer of mosaic embryos was performed in the absence of an alternative, only after medical genetic counseling with a risk explanation and the subsequent signing of an informed agreement. Statistical tests processed by Pearson’s chi-squared test. Main results and the role of chance Of all analyzed embryos, the proportion of euploid embryos was 48.6% (n = 1002), the total number of mosaics was 18.6% (n = 384) and aneuploid ones were 32.8% (n = 676). Depending on the level of mosaicism, the ratio between embryos with low-level mosaicism (≤40%) / high-level (≥40%) was 38.3% / 61.7%, respectively. According to the study, there was a significant decrease in the indicator of clinical pregnancy rate after embryo transfer with a low-level of mosaicism of 44.1% versus 63.2% transferred euploid embryo (р<0,01), however, despite an increase losses pregnancy in the group B (26.3%) there was no significant difference (p = 0.16) in comparison with the control group (15.4%). The live birth rate (LBR) significantly decreased (p < 0.001) after the transfer of the mosaic embryo by 32.5%, while in the control group the indicator was 53.9%. In all cases, after the transfer of the mosaic embryo, healthy babies were born. There were 2 cases of high-level mosaic embryo transfer as a result of which pregnancy did not occur. According to the survey, about 70% of patients agree to replant mosaic embryos, 20% are ready to go to the new program, and 10% cannot make a decision. Limitations, reasons for caution The number of patients in group B was significantly lower than in group A. Not enough cases of embryo transfer with a high-level of mosaicism. Wider implications of the findings: The current study might help to develop and to select a more appropriate strategy for transfer mosaic embryos. The next series of studies should focus on obstetric and neonatal outcome data from mosaic embryo transfer to gain a better understanding of the chromosomal and physiological health of children. Trial registration number Not applicable

Reproducing fear: the effect of birth stories on nulligravid women\u2019s birth preferences

ObjectivePreference for caesarean birth is associated with higher fear and lower self-efficacy for vaginal birth. Vicarious experience is a strong factor influencing self-efficacy in nulligravid women, and is increasingly accessible via digital and general media. This study assessed the effect of exposure to different birth stories on nulligravid women’s childbirth preferences and the factors mediating these effects.MethodsNulligravid women (N = 426) were randomly allocated to one of four conditions exposing them to written birth stories. Stories varied by type of birth (vaginal/caesarean) and storyteller evaluation (positive/negative) in a 2 × 2 design. Childbirth preference, fear of labour and vaginal birth, and self-efficacy for vaginal birth were measured before and after exposure via a two-way between groups analysis of covariance. Hierarchical regression models were used to determine the mediating effects of change in childbirth fear and childbirth self-efficacy.ResultsVariations in type of birth and storyteller evaluation significantly influenced childbirth preferences (F (1, 421) = 44.78, p < 0.001). The effect of vaginal birth stories on preference was significantly mediated by fear of labour and vaginal birth and self-efficacy. Effects of exposure to caesarean birth stories were not explained by changes in fear or self-efficacy.ConclusionsChildbirth preferences in nulligravid women can be significantly influenced by vicarious experiences. For stories about vaginal birth, the influence of birth stories on women’s fear and self-efficacy expectancy are partly responsible for this influence. The findings highlight the importance of monitoring bias in vicarious experiences, and may inform novel strategies to promote healthy childbirth.

Long-term consequences of surgical treatment of ovarian apoplexy

The objective: to determine the long-term consequences of surgical treatment of ovarian apoplexy, taking into account the risk factors of this urgent pathology.Materials and methods. The study included 112 women (main group, n=112), who underwent surgery for ovarian apoplexy, and 40 patients in the control group (n=40), who had no history of this pathology. All patients underwent a comprehensive examination using clinical, instrumental and laboratory research methods. The groups were homogeneous in age (mean age was 23,6±4,2) and statistically comparable.Results. Based on the analysis of clinical and anamnestic data of patients who underwent surgical treatment of ovarian apoplexy, we identified the main risk factors for this pathology: chronic diseases of the urinary, respiratory and digestive systems, genital infantilism, ovarian retention cysts, chronic salpingo-oophoritis, , menstrual disorders by type of hyperpolymenorrhea and/or algodysmenorrhea, family thrombophilic history, bleeding of various localizations in the anamnesis, artificial abortions, weight loss, smoking.Our proposed comprehensive two-stage rehabilitation system included treatment and prevention measures from the acute period of ovarian apoplexy to the time of reproductive function. The first stage of the treatment complex (early postoperative period) helped to eliminate the effects of ovarian injury, pain relief and hypercoagulable changes in the blood coagulation system, improving the quality of life during inpatient treatment. The second stage (2 months after surgery) provided the restoration of ovarian function and balance of the hemostasis system, thus preparing a woman’s reproductive system for future pregnancy and childbirth. In the remote postoperative period, the complex stage of rehabilitation in 23 treated patients resulted in the birth of healthy children and the absence of obstetric complications in 22 of them.Conclusion. Identification and structuring of risk factors for ovarian apoplexy is an important step for comprehensive treatment and prevention of recurrence of this disease. Eliminating or reducing the impact of these factors will help restore the reproductive system and improve quality of life.A comprehensive assessment of the state of the whole organism in the remote postoperative period indicates the need for rehabilitation measures aimed at increasing the natural resistance of the macroorganism and the effective restoration of reproductive function.

Broader driver of disrespectful maternity care: power dynamics

Understanding the dynamics under which women experiences birth and disrespectful care is important. It recognizes the relegation women experiences within a subjugated relationship between women and health care practitioners arising from power disparities. When power dynamics are acknowledged and everyone’s expertise respected, women have positive and healthy childbirth with respect to human’s fundamental right. This is the kind of care women want and need.

Die Humangenetische Beratung in der DDR

In recent years, the history of human genetic counseling has increasingly become the subject of research in the history of medicine and science. In this article, I examine the establishment and design of human genetic counselling in the GDR from the 1960s until the fall of the Berlin Wall in 1989, based on archive material and medical literature of the time. The initiative for the establishment of a genetic counselling service in the GDR originated in the 1960s and can be traced back to scientists with different political backgrounds who were concerned with human genetic problems. In the 1970s and 80s, a nationwide network of human genetic counseling centers was established. They were located at either university institutions or district hospitals. Despite the centralized control, there was a considerable difference between the individual districts. Both biologists and doctors practiced genetic counselling in the GDR. With their focus on single individuals or families and their rejection of any kind of coercion, human geneticists set themselves apart from the eugenic practices of the Nazi era. Nevertheless, they did not completely ignore population-genetic objectives, as was the case in the FRG. Human genetic counseling in the GDR did not differ from other, even non-socialist, states in its objectives, namely to prevent the birth of handicapped children and to promote the birth of healthy children. This intent was not prescribed by the state, but it reflected a social attitude that equated disability with suffering.

The Importance Of A Healthy Lifestyle In Achieving Physical Perfection

A healthy lifestyle is the process of forming a person striving for maturity, able to overcome the most dangerous and harmful influences, factors affecting active work, strong physical and mental state. In order to conduct effective socio-political and spiritual and educational work among young people, trainings have been introduced in each educational institution aimed at increasing medical knowledge about a healthy lifestyle, personal hygiene, family spirituality, and the negative impact of harmful influences. Diseases from healthy childbirth. It plays an important role in shaping the principles of a healthy lifestyle in the minds of our youth. This article scientifically examines the importance of healthy living in the development of society and the achievement of physical maturity.

Correction of the functional stateof children with children’s cerebral paralysis 10-12 years old

Abstract. This article presents the results of the functional state of children with cerebral palsy at the age of 10–12 years based on the indicators of the hardware-software complex Varicard 2.51. A special set of mini-football exercises for children with infantile cerebral palsy at the age of 10–12 years will improve the functional state. Relevance. Every year, 800 thousand people get disability, one fourth of them are the category of people able to work. Over the past few years, there has been a noticeable increase in the indicators of disability increased by 8-10%, including the category of children. Medical experts say that by 2021, the birth of healthy children could be reduced by 15-20% of the total number of children. Problem. Goal. Tasks. To determine the effectiveness of the use of special mini-football exercises in children with cerebral palsy (CP) 10–12 years old for the correction of the functional state. Research materials and Methods. The study involved pupils of the Boarding School No. 5 of the city of Togliatti at the age of 10–12 years with infantile cerebral palsy with spastic form, who were divided into the main group and the comparison group. Results and its discussion. As a result of using a special set of mini-football exercises in the main group, there was a positive dynamic in the level of the functional state of children with cerebral palsy. Conclusions and conclusion. The data obtained in the study is of practical interest primarily for adaptive physical culture teachers. A special set of mini-football exercises helps to correct the functional state in a positive way.

Effectiveness of self-developed informational booklet regarding birth preparedness and complication readiness (BPCR) on knowledge of antenatal women and assessment of competencies of ASHAs regarding BPCR-A pilot study

Introduction: A healthy childbirth experience is absolutely vital for an antenatal woman, as it can greatly influence not only her health but also that of the newborn. Birth preparedness and complication readiness is an approach which significantly helps to increase the capacities of the woman, her partner, her family and also the health care providers to ensure appropriate care for a safe delivery. Materials and Methods: One group pre-test post-test design was used to assess the effect of self-developed informational booklet regarding BPCR on knowledge of antenatal women whereas a cross-sectional study design was used for assessment of competencies of Accredited social health activists (ASHA). Results: The mean post-test knowledge score (21.52) of antenatal women after administration of informational booklet regarding BPCR was significantly higher than their mean pre-test knowledge score (10.48) with t-calculated value of 22.307 (p value Conclusion: The self-developed informational booklet regarding BPCR is significantly effective in increasing the knowledge of antenatal women. Further rounds of training of ASHAs regarding BPCR are essentially required to enhance their competencies. Keywords: Informational booklet, Birth preparedness and complication readiness (BPCR), Accredited social health activist (ASHA).

Pregnancy and Healthy Childbirth in a 37 Year-Old Patient with Diverticular Disease

Aim.To describe a clinical case of pregnancy and healthy labour in a young female patient with uncomplicated diverticular disease (DD).Key points.In recent years, DD is more frequently observed in younger patients. A 37-yo woman manifested the symptoms of periodic intense abdominal pain and constant abdominal discomfort. Colonic DD was diagnosed with irrigoscopy. A high-fibre diet, rifaximin-α at 400 mg twice a day for one week, once a month for six months, and topical anti-inflammatory therapy were prescribed. Clinical symptoms were eradicated upon the treatment. Unaware of pregnancy, the patient had another course of rifaximin-α at the second week of gestation, after which the therapy was stopped. Rifaximin-α, which has a poor intestinal absorption, did not affect the foetal development. A caesarean childbirth was healthy, the newborn was delivered on term with no complications (Apgar score 8).Conclusion.DD should be included in differential diagnosis for patients with non-specific symptoms (abdominal pain, bloating and discomfort), regardless of young age. No protocols are currently accepted for the DD management during gestation. In the clinical case reported, a patient having diverticular disease and a rifaximin-α therapy at an early term of gestation proceeded without complications for herself and the foetus.

Analysis of Factors Affecting the Selection of Midwives and Shaman Labor Workers in Haria State Saparua District

Maternal mortality ratio (MMR) is an important indicator of a country’s public health. MMR is currently thehighest number in Southeast Asia. The coverage of childbirth in 2018 Haria State is 66.67%, still far fromthe Target Of Central Maluku Regency in 2018 which is 76.27%. There are 14 active child shamans who aretrained shamans and there are still many wild shamans who do maternity assistance, while only 3 midwives.The purpose in this study is to analyze the factors that influence the selection of midwives and shamanlaborers in Haria State saparua sub-district. This research is quantitatively descriptive using cross sectionaldesign. The population in this study was mothers who performed childbirth, either stillborn or born alive inthe working area of Porto Haria public health center saparua sub-district in 2018. The sampling used totalsampling, namely all mothers who did childbirth helped by midwives as many as 62 respondents and shamansas many as 31 respondents in Haria State in 2018. Data analysis uses univariate and bivariate analysis. Theresults showed no influence between the number (parity) of children on the selection of maternity helpersin Haria State saparua sub-district (p value=0.769), There is a work influence (p value = 0.012), knowledge(p value = 0.000) and attitude (p value = 0.000) on the selection of labor helpers in Haria State saparua subdistrict.It is important to improve the mother’s knowledge of healthy childbirth and instill a positive attitudetowards health workers so that the mother will choose a healthcare person as a helper in childbirth.

History of perinatal loss: A study of psychological outcomes in mothers and fathers after subsequent healthy birth

BackgroundThe loss of an expected child is a psychologically difficult and potentially traumatic life event. While most women will become pregnant again within a year following the loss, data are limited regarding the mental health of parents with a history of perinatal loss, especially in the period following the birth of a subsequent healthy child. This study, therefore, investigated the relation between perinatal loss and mothers’ and fathers’ psychological symptoms and parenting stress 6-months after the birth of a healthy child. MethodsA community sample of 92 mother-father dyads living in a Canadian city and having a 6-month-old biological infant were asked to complete questionnaires measuring their history of perinatal losses (55 parents reporting at least one loss) and their psychological symptoms and parenting stress. ResultsMothers and fathers who have experienced a perinatal loss reported more psychological symptoms and parenting stress. Mothers were more likely to report psychological symptoms and parenting stress compared to fathers, but the magnitude of the relation between perinatal losses and psychological outcomes were comparable for mothers and fathers. LimitationsLimitations of the study include the use of a small community sample with low generalizability and low levels of psychological symptoms and stress. ConclusionsThe results suggest that the experience of a perinatal loss might have negative consequences on the psychological wellbeing of parents even after the birth of a healthy child.

Clinical Features of CVT in Women and Effect on Subsequent Pregnancy: A Follow-Up Study in a Chinese National Comprehensive Hospital

Background and objectiveCerebral venous thrombosis (CVT) is not rare in women of childbearing age. Chinese couples have been encouraged to have two children by the new family-planning policy. Concerns have been raised about the effect of CVT on subsequent pregnancies, but few studies have focused on the Chinese population. We aimed to analyze the clinical features of Chinese female CVT patients of childbearing age and study the outcome of their subsequent pregnancies after CVT. MethodsWe retrospectively analyzed the clinical data of female patients at fertile age (15–45 years) diagnosed with CVT in our hospital between January 2009 and January 2019. Information on recurrence of venous thrombotic events as well as obstetrical outcomes of subsequent pregnancies was obtained and evaluated during follow-up. ResultsA total of 72 patients were enrolled, mean age at CVT onset was 29.4 ± 7.9 years. The main risk factors included autoimmune system disease (27.8%), pregnancy or puerperium (12.5%), and inherited thrombophilia (11.1%). Furthermore, 58 patients were followed up for a mean time of 63.1 ± 31.4 months and 17 new pregnancies occurred in 13 women. Among the 17 pregnancies, one CVT (5.9%) recurred in a patient with antiphospholipid syndrome. Overall, 10 (58.8%) pregnancies resulted in the birth of healthy children, including 8 full-term and 2 preterm births; 7 were terminated, including 3 (17.6%) spontaneous abortions. All patients with spontaneous abortions had antiphospholipid syndrome or Behcet's disease. ConclusionsAutoimmune system disease was the most common risk factor in Chinese female CVT patients. Recurrent pregnancy-associated CVT was infrequent in women with prior CVT, but attention should be paid during subsequent pregnancies.

Parameters of interferon system, matrix metalloproteinases and related tissue inhibitors in women with papillomavirus infection during preconceptional preparation

Pregravid or preconceptional preparation comprises one of important aspects in planing pregnancy and labor that includes a set of diagnostics as well as vurative and preventive measures aimed at ensuring conception and birth of healthy children. Currently, preconceptional preparation is viewed crucial for successful conception, both provided by a woman as well as a man. Virus-associated infection is one of the main causes resulting in impaired reproductive function. Host immune response in the urinary tract is often manifested as bacterial vaginosis (BV) underlying sufficient enviroinment for developing ascending inflammatory process that accounts for its intensity and duration and lead to reproductive disorders. Our study provides the data on interferon system, matrix metalloproteinases and related tissue inhibitors in women with STDs and/or papillomavirus infection. The aim of the study was to assess level of interferons, components of matrix metalloproteinases and related tissue inhibitors in women with papillomavirus infection during preconceptional preparation. There were examined 73 patients for infection with sexually transmitted diseases (STDs) in accordance with standard protocol. All patients were divided into three groups: Group I (n = 32) – STDs with papillomavirus infection (PVI); Group II (n = 27) – STDs without papillomavirus infection and Group III – Control, consisting of 14 apparently healthy female volunteers. The average age of the patients and control subjects was 26.3±3.2 and 29.5±2.2 years, respectively. Blood serum IFN, MMP and TIMP levels were measured by using specific reagents (RD Diagnostics Inc., USA) with sandwich ELISA, according to the manufacturer’s instructions, on Multiskan immunoassay analyzer (Finland), presented as pg/ml and ng/ml. SPSS v. 20 software was used for the statistical analysis with non-parametric method. Disturbances in type 1, 2 and 3 interferons were found in women with papillomavirus infection. An increased amount of MMP-2,8,9 and related tissue inhibitors TIMP-1 and TIMP-3 in women with PVI was revealed. Long-term HPV persistence leads to developing chronic systemic inflammatory response manifested as immune-inflammatory syndrome accounting for tissue morphological changes making impossible onset of pregnancy.

The Evolution of Transplantation From Saving Lives to Fertility Treatment: DUETS (Dallas UtErus Transplant Study).

We report the results of the first 20 uterus transplants performed in our institution. Uterus transplantation (UTx) aims at giving women affected by absolute uterine-factor infertility the possibility of carrying their own pregnancy. UTx has evolved from experimental to an established surgical procedure. The Dallas Uterus Transplant Study (DUETS) program started in 2016. The uterus was transplanted in orthotopic position with vascular anastomoses to the external iliac vessels and removed when 1 or 2 live births were achieved. Immunosuppression lasted only for the duration of the uterus graft. Twenty women, median age 29.7 years, enrolled in the study, with 10 in phase 1 and 10 in phase 2. All but 2 recipients had a congenital absence of the uterus. Eighteen recipients received uteri from living donors and 2 from deceased donors. In phase 1, 50% of recipients had a technically successful uterus transplant, compared to 90% in phase 2. Four recipients with a technical success in phase 1 have delivered 1 or 2 babies, and the fifth recipient with a technical success is >30 weeks pregnant. In phase 2, 2 recipients have delivered healthy babies and 5 are pregnant. UTx is a unique type of transplant; whose only true success is a healthy child birth. Based on results presented here, involving refinement of the surgical technique and donor selection process, UTx is now an established solution for absolute uterine-factor infertility.

First experience in two successful consecutive pregnancies after simultaneous liver-kidney transplantation with reno-portal transposition

The paper presents the world’s first clinical case of two full-term successive pregnancies in a patient following simultaneous liver-kidney transplantation with reno-portal transposition. Both pregnancies ended with the birth of healthy children and favorable course of postpartum and long-term periods. The features of management and childbirth are highlighted. Literature review on this problem is presented.

Gestação e exercício físico:recomendações, cuidados e prescrição

Com o avanço do conhecimento científico acerca dos benefícios da prática de exercício físico para a população humana, vem aumentando cada vez o número de praticantes em todas as faixas etárias e populações em diversos estados clínicos ou situações. As atividades físicas vêm sendo amplamente procuradas por indivíduos do sexo feminino como garantia de longevidade, manutenção da saúde e melhora da qualidade de vida. Tais benefícios somente são pronunciados quando a atividade física é realizada de forma regular, contínua e ao longo da vida, portanto é comum mulheres em período gestacional manterem-se ativas para melhor adaptação fisiológica e preparo geral para o parto saudável. A gestação é uma fase de adaptações morfofuncionais e psicoemocionais para a mulher. Dentro da perspectiva científica obteve-se a seguinte pergunta norteadora: Quais as adaptações inerentes ao organismo da mulher grávida e os principais benefícios da atividade física e exercício físico durante este processo? Portanto, o objetivo deste estudo foi revisar na literatura conceitos sobre a atividade física e condição gestacional. Utilizou-se como método a revisão de literatura narrativa consultando livros e artigos científicos, sintetizando resultados e respondendo perguntas através de leitura exploratória, e finalmente encontrando resultados e validade das conclusões. Foram descritas as adaptações morfofuncionais durante a gestação, os benefícios da atividade física e exercício físico, bem como as principais recomendações e cuidados na prescrição e supervisão de programas de condicionamento físico para mulher que vivencia esta fase da vida.