[Unsolved issues of pregnancy in liver cirrhosis].

Pregnancy in patients with liver cirrhosis and portal hypertension occurs very rare, because of their significantly derailed reproductive functions. Тhe risks for the mother and the fetus are connected with worsening of the portal hypertension, progression of decompensated liver cirrhosis and development of its complications: liver failure, ascites, hepatorenal syndrome, hepatic encephalopathy and variceal hemorrhage, and with increased incidence of spontaneous abortions and abnormal uterine bleeding. The decision for continuation of the pregnancy in cirrhotic patients must be based on individual approach and a multidisciplinary team consisting of obstetricians, hepatologists, anesthesiologists, surgeons and hematologists must participate in the therapy.

[Preplacentation pregnancy loss in cases of angiotensin-converting enzyme insertion/deletion polymorphism].

The balance between coagulation and fibrinolysis processes is critical for establishment and development of early pregnancy. Angiotensin-converting enzyme (ACE) is related with plasminogen activator inhibitor-1 activity which is a key regulator in embryo implantation. Therefor polymorphisms in ACE gene and variation in ACE activity could be associated with an early pregnancy wastage risk.

[A weak association of 677 C>T polymorphism in MTHFR with recurrent embryonic loss].

Early (embryonic) pregnancy loss before 10 week of gestation (wg) could also be related with endometrial receptivity as well as with gene expression regulation in developed embryo. Methylation of genome is a key process in the gene expression. Because the methylenetetrahydrofolate reductase (MTHFR) have had significant role in methionine metabolism polymorphisms into the gene could be related with early embryonic development.

[Platelet intregrin beta3 A1/A2 polymorphism in women with stillbirth].

Maternal thrombophilia was recently discussed as possible cause for pregnancy complication, although the roles of some coagulation factors have not been clarified. Carrier status for platelet integrin beta3 polymorphism A1/A2 (PL A1/A2) was considered as possible risk factor for pregnancy complication. Seventy women with one or more stillbirth (intrauterine fetal death after 20 week of gestation) and 100 healthy control subjects were evaluated for PL A1/A2 to assess the impact of polymorphism for late pregnancy loss.

[Inherited thrombophilic factors in women with secondary infertility].

Because of the presence of additional confounding factors, such as cervical incompetence or uterine infections, the impact of inherited thrombophilia in women with second infertility has been hard to assess. The evaluation of the significance of the most common inherited thrombophilic factors - Factor V Leiden (FVL), prothrombin gene mutation 20210 G > A (FII), polymorphism (PL) 677 C > T in MTHFR, PL A1/A2 in platelet glycoprotein IIb/IIIa and PAL-1 PL 4G/5G in 35 women with two or more secondary (who have given birth to at least one child) recurrent pregnancy loss (RPL) before 14 weeks of gestation compared to 70 healthy women with no history of RPL and at least one uncomplicated full-term pregnancy, has been performed. Eight out of 35 women with secondary RPL (25.

[Combined thrombophilic factors among women with late recurrent spontaneous abortions].

The aim of this study was to assess the role of combined thrombophilic factors carrier status for development of late recurrent pregnancy loss (RPL). The polymorphism 4G/5G (PL 4G/5G) - genotype 4G/4G in plasminogen activator inhibitor type 1 (PAI-1), Factor V Leiden (FVL) and prothrombin (FII) gene mutation 20210 G>A in 52 women with recurrent pregnancy loss between 10 and 20 weeks of gestation and in 125 healthy women with at least one uncomplicated full-term pregnancy was investigated. Combined carrier status for thrombophilic factors was more pronounce among women with RPL (7.

[Plasminogen activator inhibitor type 1 activity in women with unexplained very early recurrent pregnancy loss].

The aim of the study was to assess the independent role of polymorphism 4G/5G (PL 4G/5G)--genotype 4G/4G in plasminogen activator inhibitor type 1 (PAI-1) in the development of very early recurrent pregnancy loss (RPL)--before 10 weeks of gestation of pregnancy. The polymorphism 4G/5G as well as Factor V Leiden (FVL), prothrombin (FII) gene mutation 20210 G > A and polymorphism 677 C > T in methylentetrahydrofolat reductase (MTHFR) gene was investigated in 110 women with recurrent pregnancy loss before 10 weeks of gestation and in 97 healthy women with at least one uncomplicated full-term pregnancy. A significant prevalence of PL 4G/5G in women with RPL was found in comparison to prevalence of the polymorphism in controls (41.

Polymorphism A1/A2 in the cell surface integrin subunit β3 and disturbance of implantation and placentation in women with recurrent pregnancy loss.

Polymorphism A1/A2 in the β3 subunit of integrins αIIb/β3 and αV/β3 is implicated in the risk of development of embryonic and fetal recurrent pregnancy loss (RPL). In 191 women with RPL, polymorphism A1/A2 was statistically significantly associated with RPL at <10 weeks of gestation (29.3% versus 16.

[Inherited thrombophilic factors in women with unexplained intrauterine fetal deaths].

The aim of the study was to investigate a relationship between carrier status for factor V Leiden (FVL), prothrombin gene mutation 20210 G>A (PTM 20210 G>A) and development of unexplained intrauterine fetal deaths (UIFD). Thirty three women with one or more UIFD and stillbirths were investigated for carriers status for FVL and PTM 20210 G>A. Women with multiple pregnancies, congenital anomalies, intrauterine infection or chorioamnionitis were excluded from the study.

[Herpes simplex virus infection in pregnancy and transmission to neonatal].

Herpes simplex virus (HSV) infection is the most common sexually transmitted viral disease. According epidemiological studies almost one quarter of the adult population in Bulgaria is seropositive for HSV-2. High prevalence of infection, asymptomatic course and limited diagnostic resources increased risk of neonatal acquisition of HSV from pregnant women.

[Genetic variant C677T in the MTHFR in women with recurrent early fetal loss].

The aim of this study was to evaluate correlation of carrier status for thrombophilic gene mutation--C677T in the methylenetetrahydrofolate reductase (MTHFR) and recurrent early pregnancy loss. Recently inherited thrombophilia was discussed as a predisposed factor for early recurrent fetal loss (ERFL). We investigated carrier status for C677T genetic variant in 54 women with ERFL before 10 week of gestation and 67 women with one or more successful pregnancy.

[Risk of thrombophilia in carriers of thrombophilic genetic factors in unsuccessful assisted reproduction].

The aim of this study was to evaluate an association of carrier status of common inherited thrombophilic genetic mutations and implantation failure after assisted reproduction (ART): IVF and ICSI. Sixty seven women with failure of embryo implantation and ninety six controls--women without obstetric complication were investigated for carriage of factor V Leiden (FVL), G20210A prothrombin gene mutation, genetic variant C677T in methylentetrahydrofolate reductase gene (MTHFR) and polymorphism A2 in platelet glycoprotein IIb/IIIa (GIPr IIb/IIIa). A significantly higher prevalence of polymorphism A2 in GIPr IIb/IIIa was found in women with implantation failure in ART compared to controls (respectively 26.

Recombinant factor VIIa in the management of postpartum bleeds: an audit of clinical use.

Background: This paper presents an analysis of 25 patient cases in which recombinant factor VIIa was used in the management of postpartum hemorrhage, including severe and/or life-threatening bleeds. Anecdotal experiences in the empirical use of this agent are described and dosing regimens, effects on bleeding, and safety data are presented.

Methods: Data were extracted from the international, internet-based, voluntary registry, haemostasis.

[Herpes simplex virus infection in the newborn].

Herpes simplex virus (HSV) infection is a rare disease, but with serious sequelae in the newborn. Despite active treatment with high dose Acyclovir, prognosis on psychomotor development remains unfavorable. A short review of the recent literature about clinical forms, diagnosis, treatment, and disease prophylaxis is presented.

[Treatment of life-threatening bleeding in obstetrics and gynaecology --NovoSeven (recombinant factor VIIa)].

The study offers the results from the application of recombinant factor VIIa (NovoSeven) in 19 patients with obstetric or gynaecological problems showing severe haemorrhage of non-surgical origin, which could not be controlled by standard therapy (surgery and resuscitation). Haematological and haemostaseological values as well as final outcome are being monitored. The role of the drug and its special indications in complex urgent treatment of life-threatening bleeding are being discussed.

Beneficial effects of spin-labelled nitrosourea on CCNU-induced oxidative stress in rat blood compared with vitamin E.

This study was carried out to determine the effects of a recently synthesized 1-ethyl-3-[4-(2,2,6,6-tetra-methylpiperidine-1-oxyl)]-1-nitrosourea (SLENU), compared with vitamin E as a positive control, on 1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea (CCNU)-induced oxidative stress in rats. We determined plasma malonyl dialdehyde (MDA) levels and the activities of erythrocyte superoxide dismutase (SOD) and catalase (CAT). Forty two white albino healthy rats were treated once daily for 30 days with oral preparations of CCNU (12.

[Dermatoses in pregnancy].

A number of immunological, endocrine, metabolic and vascular changes with various influences on the skin occur in the organism during pregnancy. The specific dermatoses of pregnancy are a heterogenous group of diseases with a different impact on both mother and child. Their clinical characteristics, diagnostic criteria and therapeutic options are discussed in the present review.

Influence of antigen stimulation on the oxidative stress parameters in outbred and inbred rabbits.

The influence of antigen stimulation on the oxidative stress parameters in two groups of rabbits-inbred and outbred were explored by evaluation of the level of lipid peroxidation products (MDA) in the plasma membrane, and the activity of erythrocyte antioxidant defense enzymes superoxide dismutase (SOD) and catalase (CAT). There was not a significant difference between levels of MDA in inbred and outbred rabbits before immunization. However, SOD activity in inbred rabbits was significantly increased in comparison with that of outbred (p = 0.

Immunomodulatory effects of C3bgp on the antibody response to hemocyanin in outbred rabbits and the F1 generation of breeding with siblings.

Dynamics and quantitative analyses of monospecific antibody during the primary and secondary humoral responses were determined in outbred rabbits and in the F1 generation of breeding with siblings. The antibody response in rabbits immunized with Keyhole Limpet Hemocyanin (KLH) was studied during a 4-month immunization period. ELISA determination of anti-KLH Ig and anti-KLH IgG alone, in preimmune and immune rabbit sera, was performed.

[Emergency contraception with levonorgestrel in adolescents].

Objective: The aim of the study was to asses effectiveness and adverse reactions in adolescent girls received Postinor (0.75 mg Levonorgestrel) for emergency contraception.

Method: Forty-two teenage girls with established regular menstrual cycles for 24 months period and 128 intercourses are included.