Ceská gynekologie / Ceská lékarská spolecnost J. Ev. Purkyne
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To evaluate effectiveness and safety of hypogastric artery branches embolization in the treatment of postpartum hemorrhage, hemorrhage associated with cesarean section and termination of pregnancy. ⋯ Embolization of hypogastric arteries decreases length of hospital stay in patients with obstetric hemorrhage and should be done soon if routine methods of bleeding control fail.
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Case Reports
[Gitelman syndrome in pregnancy--a severe hypokalemia with favorable perinatal prognosis].
Gitelman syndrom is a rare congenital tubulopathy characterized by hypokalemia, hypomagnesemia, metabolic alkalosis and hypocalciuria. We report a case of a 32-year-old patient admitted for asymptomatic hypokalemia and hypomagnesemia in the 30th week of gestation. A diagnosis of Gitelman syndrom was made and intravenous administration of potassium chloride in high doses combined with spironolactone was started. ⋯ A summary of 22 so far published cases of Gitelman syndrome in pregnancy is presented. The analysis of published case studies suggests a need for ion supplementation, reduction of urinary potassium wasting, monitoring of fetal well-being and amniotic fluid levels. Pregnancy has a very favorable perinatal prognosis despite critical serum levels of potassium and magnesium throughout the pregnancy.
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Review
[Urinary tract infections in pregnancy: when to treat, how to treat, and what to treat with].
Urinary tract infections (UTI) in pregnant women are a relatively frequent occurrence and the spectrum of these infections ranges from lower urinary tract disease (asymptomatic bacteriuria, acute cystitis) to upper urinary tract disease (acute pyelonephritis). Anatomical and functional changes in the urinary tract in pregnancy result in significantly higher susceptibility to progression of the infection from asymptomatic bacteriuria to the stage of acute pyelonephritis. Untreated asymptomatic bacteriuria in pregnancy leads, in as much as 40%, to the development of acute pyelonephritis with all the subsequent negative effects not only for the woman herself, but particularly for the fetus. ⋯ The article provides an overview of medications that can be safely used throughout the pregnancy or only in certain stages of pregnancy. The selection of an appropriate antibiotic should always be preceded by the result of urine culture. The article presents the principles and rules for treating asymptomatic bacteriuria, acute cystitis and acute pyelonephritis in pregnant women.
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Analysis of births after previous caesarean section (SC) at Department of Obstetrics and Gynaecology, Masaryk University, Brno. Determination of successful vaginal deliveries after previous SC (complete vaginal birth) and the factors that influence success. Risk identification and determination of the frequency of complications. Comparison of vaginal births after previous SC (VBAC) with elective repeat caesarean section (ERCS). ⋯ Vaginal birth after previous caesarean section is a safe way of delivery in selected groups of mothers. An essential requirement is careful monitoring during labor to the exclusion of excessive uterine activity and protracted labor.