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OBJECTIVE: The aim of this study was to evaluate the usefulness of maternal serum and vaginal fluid C-reactive protein (CRP) determinations in the prediction of neonatal congenital infection. STUDY DESIGN: Fifty women between 24 and 36 weeks gestation, complicated by preterm premature rupture of membranes (pPROM), were divided into two groups according to the presence (n=14) or absence (n=36) of early-onset newborns' infection. RESULT: Maternal serum and vaginal fluid CRP concentrations were comparable between both groups. Serum CRP levels ≥10 and ≥15 mg l(-1) predicted neonatal infection with a sensitivity of 47 and 47%, specificity of 63 and 76%, positive predictive value (PPV) of 38 and 47%, and negative predictive value (NPV) of 72 and 76%, respectively. The cutoff value of vaginal CRP ≥2.4 mg l(-1) predicted infection with a sensitivity of 71%, specificity of 47%, PPV of 34%, and NPV of 81%. Receiver-operating characteristic curve analysis revealed that the predictive performance of CRP was poor. CONCLUSION: Maternal serum and vaginal fluid CRP determinations after pPROM are of poor predictive value in neonatal early-onset infection prediction.

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OBJECTIVES: To compare the usefulness of evaluating cervico-vaginal concentrations of proinflammatory cytokines (interleukin [IL]-1alpha, IL-1beta, IL-6 and IL-8) and procalcitonin (PCT), as well as serum levels of C-reactive protein (CRP), leucocytosis and band form granulocytes in the prediction of preterm delivery (PTD). METHODS: A total of 65 pregnant women experiencing preterm labor (PTL) were enrolled in the study. Concentrations of the studied markers in women who delivered prematurely and in women who, after treatment, delivered at term were compared. Receiver operator characteristic (ROC) curve analysis was used for all study parameters. RESULTS: Cervico-vaginal IL-6 and procalcitonin as well as serum CRP concentrations were higher in women who delivered prematurely than in those who delivered near term. A cervico-vaginal IL-6 level greater than 660 pg/ml was the best predictive value of preterm delivery (sensitivity, 50%; specificity 90%; positive predictive value [PPV], 85%; NPV, 62%; likelihood ratio, 5.17). Moreover, the area under the ROC curve of 0.75 for cervico-vaginal IL-6 was greater than for other markers. CONCLUSION: Although cervico-vaginal concentrations of procalcitonin and serum concentration of CRP are higher in women who deliver prematurely, only cervico-vaginal concentration of IL-6 is a good predictor of preterm delivery.

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576 patients with preterm deliveries that occurred between the 22nd to 37th gestation weeks were undergone clinical analysis. The material was collected in the years 1995 to 1999 at Clinic of Obstetric and Perinatology of Pomeranian Academy of Medicine in Szczecin. In our study the rate of preterm delivery was 10.5%. Special attention was paid to mother's age, obstetrics history, socioeconomic, medical and psychogenic conditions of pregnant women, condition of infants, infant mortality and their birth-weight. The rate of premature preterm rupture of fetal membranes was 52.7%. The frequency of caesarean sections in our study in preterm births was about 50% like in other publications and the most important indication for them was amnionitis. In almost 40% the general state of infants was poor and medium. Almost 25% of preterm deliveries is connected with other systemic diseases during pregnancy.

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The way of termination of pregnancy was retrospectively analysed in 95 pregnant women with heart and/or great vessels diseases, hospitalised in years 1989-1991 and 1995-1996 in the Department of Obstetrics and Perinatology of Pomeranian Medical Academy. The condition of cardiovascular system was assessed according to NYHA classification on admission and just before delivery with participation of an experienced cardiologist. Kind of heart disease, mode and period of delivery, perinatal cardiovascular symptoms, duration of delivery and duration of hospitalisation, weight and clinical condition of the newborns were taken under consideration. In more than half of cases (60%) cesarean sections were performed. Among the indications for elective cesarean section cardiological indications formed the dominant group (29.5%). During perinatal period deterioration of circulatory system sufficiency associated with increase of number of cesarean sections were observed.

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Diagnostic and therapeutic management in pregnant woman with severe arterial hypertension in course of glomerulonephritis proliferativa chronica at kidney insufficiency stage was presented. Ultrasonic biometry, biophysical fetal profile and Doppler ultrasound velocimetry were performed for antenatal fetal surveillance. Relation between a degree of fetal compromise (abnormal qualitative Doppler velocimetry indices and pre-pathological or even pathological NST) and a long-drawn increase of both diastolic and systolic blood pressure was stated. Doppler ultrasound examination gave possibility of monitoring and evaluation of fetal distress and verification of its treatment efficacy, what would allow to prolong the pregnancy for 12 days and was a definite contribution to its successful outcome.

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Characteristics of uterine contraction curve was evaluated from recordings obtained by means of external topography in imminent premature delivery, as well as from comparative analysis of changes of the said characteristics in the course of tocolytic therapy. The study covered 19 pregnant women with imminent premature delivery symptoms and 12 giving birth "at term", in whom respectively 433 and 142 uterine contractions were recorded topographically. After digital processing of the records with the aid of original software, 10 features of curves for changes in the uterine wall tonus, registered in the course of tocolytic therapy by using magnesium sulphate, salbutamol and fenoterol, were subjected to retrospective computer analysis. It has been disclosed that fenoterol caused the earliest and most strikingly expressed changes in the area of analyzed features of the uterine contraction curves, while applying higher doses there was a significant shortening of overall contraction length, and of the time at respective levels of amplitude. Contractions registered in patients with imminent premature pregnancies before the onset of tocolytic treatment were characterized by higher values of features reflecting changes in intrauterine pressure, but by lower values of features associated with the duration of contraction in confrontation with the recordings, accomplished for comparison purposes, of delivery "at term" in the latent phase.

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Analysed were the dependencies between the single and total weight of lifted objects and disturbed equilibrium of working women's uterus. The examined population covered 167 women working in standing position, lifting objects of different single and total mass during their workday. The analysis involved: workers' age, type of menstruation, childbirth, urine incontinence and equilibrium of the uterus and vagina. The percentage of women with the descent of uterus and vagina, uterus displacement and effort urine incontinence was found to increase with age, length of employment and number of deliveries, particularly high percentage being the one relating to women lifting, just once, heavy objects. No correlation was found between the incidence rate of the health disturbances and the total weight of the objects lifted during the workday.

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