Akusherstvo i ginekologii͡a
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Akush Ginekol (Sofiia) · Jan 2010
[Guidelines for parenteral nutrition in high risk newborn babies].
High risk newborn babies, admitted and treated at the Intensive care units often have to be started on intravenous nutrition--total or partial. The guidelines which we propose are adapted to the specific needs of the various groups of critically ill newborns--daily intake of liquids and essential nutritional substances according the day of life and the birth weight, as well their variations depending on the clinical condition and the morbidity of the baby.
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Akush Ginekol (Sofiia) · Jan 2010
[Doppler velocimetry for timing of delivery in intrauterine growth-restricted (IUGR) fetuses].
The aim of this study was to find a relationships between umbilical artery (UA) and MCA Doppler, ductus venosus (DV) Doppler and perinatal outcome in preterm, intrauterine growth-restricted (IUGR) fetuses. UA Doppler is a placental function test that provides important diagnostic and prognostic information in preterm IUGR. DV Doppler effectively identifies those preterm IUGR fetuses that are at high risk for adverse outcome (particularly stillbirth) at least 1 week before delivery, independent of the UA waveform. Relationships between perinatal outcome, arterial and venous Doppler status and gestational age require ongoing observational research effort.
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Akush Ginekol (Sofiia) · Jan 2009
[Effect of small-doses ketamine on postoperative pain management with combinations morphine/ketoprofen or lidol/ketoprofen after major gynecological surgery] [corrected].
We examine the potential beneficial effect of small-doses ketamine on postoperative pain management with combinations morphine/ketoprofen or lidol/ketoprofen after major gynecological surgery. After patient written consent, 50 healthy women, which were scheduled for abdominal gynecological surgery were randomly allocated into two groups depending of postoperative analgesic technique--morphine/ ketoprofen or lidol/ketoprofen. ⋯ Using ketamine during the anesthesia improve quality of postoperative analgesia in accordance with less opioid consumption for the combination morphine/ ketoprofen, but not for the combination lidol/ketoprofen. Adding small doses ketamine to combination morphine/ketoprofen improve postoperative analgesia; reduce morphine consumption and incidences of morphine-related side effects after major gynecological surgery.
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Akush Ginekol (Sofiia) · Jan 2009
[Survival, prognostic factors and modern tendencies in adjuvant treatment of diagnosed endometrial cancer patients with or without lymph node dissection].
Our aim was to research and evaluate very big clinical material for 22 years period (1987-2009) at the National Cancer Center, Gynaecological clinic and Medical University--Departement of Obstetrics and Gynaecology-Varna. We studied some of the most important prognostic factors in patients with endometrial cancer, radically operated with or without lymph node dissection. We compared our results with the results of other authors working in this field. Our aim was by examining the prognostic factors and the survival rate to define and help the choice of the most suitable radical surgical treatment, as well as the application of most suitable adjuvant therapy. ⋯ The radical surgical treatment with lymph node dissection (pelvic and/or paraaortal) gives a better survival rate in intermediate and high risky groups. The extent of the lymph node dissection is an independent prognostic factor. In stage IA and IB, grade 1 and 2, a simple total hysterctomy has the same significance for the survival of patients as the radical hysterectomy with lymph node dissection. In stage IIB endometrial cancers the most suitable treatment is radical hysterctomy with lymph node dissection. The lymph node dissection is of benefit for endometrial cancers grade 3, stage IC, stage II, serous and clear cell carcinomas.
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Vasa previa are umbilical vessels which run along the fetal membranes over or near the internal cervical os. Unprotected by the umbilical cord or placenta these vessels most often originate from velamentous insertion, low-lying and/or bilobated placenta. ⋯ In this review we present two cases of prenatally diagnosed vasa previa with successful perinatal outcome. An outline of the major sonographic markers and criteria used in the ultrasound diagnosis and differential diagnosis, as well as a step-by-step algorithm of the ultrasound examination in cases with suspected vasa previa is proposed.