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
[Treatment of anaemia of prematurity with SS-R-Hu-erythropoietin and significance of hypoxia-inducible factor].
The main cause of anaemia of prematurity is low erythropoietin levels. A few years ago hypoxia-inducible factor/HIF/gene transcriptor was established, regulating not only the synthesis of erythropoietin /EPO/, but also other growth factors as well as enzymes of anaerobic glycolysis, activated by hypoxia. ⋯ The presence of hypoxia at low levels of Hb and Ht leads to more rapid activation of erythropoiesis. Nevertheless, these babies need more red blood cell transfusions due to clinical symptoms of hypoxia. Normoxia after red blood cell transfusion leads to decrease of reticulocytes count by 30% and platelets by 35% in spite of treatment. The presence of relative hypoxia with Hb 110-120 g/l u Ht 31-32% is optimal for starting treatment with EPO--levels, low enough for activation of HIF and high enough to avoid blood transfusions.
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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.