Ceská gynekologie / Ceská lékarská spolecnost J. Ev. Purkyne
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Amniotic fluid embolism is a rare but mortal pregnancy complication. Presentations may vary from subtle clinical events to sudden cardiac arrest or death. Amniotic fluid embolism is one of the most common cause of maternal mortality in developed countries. Basic principle is amniotic fluid and its particles gaining access to maternal circulation. It is supposed, that these particles trigger immune-based mechanism. This results into wide spectrum of clinical symptoms, especially cardiovascular, respiratory and haematological. Treatment of these symptoms needs an acute interdisciplinary cooperation. AFE mortality is decreasing in recent times. It is mainly because of increase of quality of intensive care and inclusion of less severe episodes in perinatal pathology registries. ⋯ amniotic fluid embolism, anaphylactic shock, sepsis.
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Preterm prelabor rupture of membranes is responsible for approximately one third of all preterm deliveries. The most common complications associated with this pregnancy pathology are microbial invasion of the amniotic cavity, intraamniotic inflammation, intraamniotic infection and histological chorioamnionitis. This article explains these complicatioss and their relation to the optimal management of preterm prelabor rupture of membranes. ⋯ Inflammatory complications of preterm prelabor rupture of membranes are associated with risk of development of early onset sepsis. Nevertheless, gestational age is a main confounder affecting neonatal morbidity and mortality.
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TRALI is a major cause of serious morbidity and mortality associated with a blood transfusion. It is clinically manifested by acute respiratory distress within 6 hours of completion of transfusion. Neutrophils have the key role in the pathogenesis. ⋯ TRALI is a clinical diagnosis based on hypoxemia and positive finding on lung X-ray examination. The treatment is only supportive and the mortality is about 5% to 10%. The major preventive measure is transfusing blood products from donors without leukocyte antibodies.
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To assess women's satisfaction with psychosocial aspects of perinatal care provided in Czech maternity hospitals, to identify areas that need improvement and to compare satisfaction with maternity care between selected subgroups of parturients. ⋯ Despite its rather high quality, the Czech perinatal care suffers from several shortcomings as regards its psychosocial aspects. These shortcomings include lack of respect and empathy shown by caregivers, poor communication of information and low involvement of parturients in decision-making. Improving the quality of care at the Czech maternity hospitals requires empowerement of parturients in the system of perinatal care and development of psychological and psychosocial compteneces of health care providers.