Pavel Calda | Charles University, Prague (original) (raw)
Papers by Pavel Calda
Ceska gynekologie / Ceska lekarska spolecnost J. Ev. Purkyne
The most frequent congenital developmental defect in the orofacial region are, no doubt, facial c... more The most frequent congenital developmental defect in the orofacial region are, no doubt, facial clefts which are a serious stress for health professionals and the population. Depending on the type of cleft, the prevalence is between 1 : 1000-2800 births. According to contemporary views in the etiology of orofacial clefts participate genetic as well as environmental factors. That means that specific genetic factors create a certain "sensitivity" for specific factors of the external environment which act as a trigger mechanism and combined they produce the cleft. Cleft lip can be diagnosed already during the 13th week of gestation, while a cleft palate is not necessarily apparent till after the 18th week of gestation as the maxilla is in the process of joining. Presentation of the foetal face and its profile is thus important in particular during the second trimester of gestation and should be part of ultrasonographic screening between the 18th and 20th week of gestation. As more than 8% of facial clefts are associated with chromosomal abnormalities, in all affected foetuses karyotyping is done. The prognosis of satisfactory cosmetic and functional repair in cleft lip and in cleft lip and palate is favourable. In case of associated malformations all depends on the type and severity of these associated defects or on the diagnosis of the syndrome. If median clefts are extensive or associated with cerebral anomalies, the prognosis is as a rule poor. Prenatal diagnosis and management of defects of the orofacial area calls for collaboration of the obstetrician, neonatologist and plastic surgeon already in the stage when the defect is detected to give the expectant mother an opportunity to obtain accurate and unbiased information on possible treatment and prognosis for the foetus.
Pregnancy Hypertension: An International Journal of Women's Cardiovascular Health, 2011
American Journal of Obstetrics and Gynecology, 2012
Prenatal Diagnosis, Sep 1, 2009
Fetal Diagnosis and Therapy
Ceska gynekologie / Ceska lekarska spolecnost J. Ev. Purkyne
To evaluate, which of selected anamnestic, laboratory and ultrasonographic (USG) parameters could... more To evaluate, which of selected anamnestic, laboratory and ultrasonographic (USG) parameters could contribute to the prediction of prematurity. Prospective, observational, clinical study. Department of Obstetrics and Gynecology, 1st Faculty of Medicine and the General Faculty Hospital, Charles University, Prague. 349 women with the singleton pregnancy were followed from the half of the 2nd trimester until the end of gestation. At each woman the anamnestic (age, parity, pregravid BMI, weight gain until 20th week, significant risk from patient's history, cigarette smoking, risk pregnancy symptoms until 20th week), laboratory (maternal serum concentration of AFP, hCG, and uE3/triple test/at 16th week, the blood count and ferritin concentration at 18th-20th week, bacteriological cultivation of the smear from the cervix at 34th-36th week), and USG (transvaginal cervicometry and doppler flowmetry of the uterine arteries at 18th-20th week) data were established. With the aid of one-dimensional and multi-dimensional analysis the dependence of completed gestational age and preterm delivery (before completed 37th week) on above mentioned parameters was tested. 314 women completed the study. We proved a significant dependence of prematurity on the following markers: risk pregnancy symptoms until 20th week (RR 2.94), abnormal triple test (RR 4.63), cultivation of pathogens from the cervix (RR 5.49), USG established cervical length (P < 0.0001), abnormal result of cervicometry (RR 19.02), both doppler parameters (RI of uterine arteries: P < 0.0001; presence of early diastolic notch: RR 2.84). The results of multi-dimensional analysis confirmed superiority of USG cervicometry in prediction of both measured outcomes. The predictive value of some of selected anamnestic, laboratory, and USG markers of premature delivery was proved at random population of women with singleton pregnancy. The abnormal result of transvaginal USG cervicometry was the most significant predictor of prematurity. We recommend a routine performing of cervicometry (as a part of USG screening at 18th-20th week) for early selection of women with significantly increased risk of prematurity.
Ceska gynekologie / Ceska lekarska spolecnost J. Ev. Purkyne
In the foetus in utero predominates a considerable percentage of immunologically so-called naive ... more In the foetus in utero predominates a considerable percentage of immunologically so-called naive lymphocytes of the T and B series. The objective of the presented work was to assess by means of flow cytometry and labelled monoclonal antibodies quantitative changes in cell sub-populations of the foetal immune system before the foetus is altered by severe heamolysis as a result of Rh(D) isoimmunization. The authors obtained by intrauterine puncture of the umbilical cord peripheral blood from 10 foetuses with isoimmunization during the 23rd-35th week of gestation, confirmed by the direct Coombs test and with a mean haematocrit value of 30.8% +/- 8.02. These findings were compared with values in the peripheral blood stream in a control group of 35 foetuses during the 18th-39th week of pregnancy with normal intrauterine development (haematocrit 34.2% +/- 5.87). The authors assessed the haemogram and CD signs in the lymphocyte population. In the peripheral bloodstream of foetuses with erythrocyte isoimmunization the authors did not detect, as compared with the control group (p > 0.01), a lower haemoglobin level (10.6 +/- 2.77 g/dl vs. 11.9 +/- 2.03 g/dl) a lower haematocrit (30.8% +/- 8.02 vs. 34.2% +/- 5.87) and fewer leucocytes 5.1 +/- 2.39 x 10(9)/l versus 6.97 +/- 3.29 x 10(9)/l. In foetuses with Rh(D) isoimmunization the authors found a higher percentage of T(CD3+) lymphocytes (79.0% +/- 11.23 vs. 73.7% +/- 12.79, but did not prove an increase of activated T lymphocytes (%DR+ from CD3+) (1.0% +/- 0.52 vs. 1.3 +/- 0.58). The percentage ratio of T helper cells (CD+) was higher than in the control group (61.0% +/- 10.25 vs. 56.1% +/- 12.45). In foetuses with Rh(D) isoimmunization there was no difference in the ratio of CD8 positive cells (24.1% +/- 8.23 vs. 23.6% +/- 7.26). Suppressor T cells (CD8+CD11b+) were fewer (4.1% +/- 1.24 vs. 7.5 +/- 11.23) than in the control group. The number of NK cells in foetuses with Rh(D) isoimmunization was 5.1% +/- 3.26 vs. 6.9% +/- 3.86, in isoimmunized foetuses there is a higher ratio of so-called naive T helper cells Th1 (CD4+ CD45 RA+) 49.3% +/- 12.71 vs. 43.0% +/- 12.88. When assessing naive B1 cells (CD19+CD5+), the authors did not find a difference between the two groups (10.4% +/- 6.20 vs. 9.06% +/- 12.1). The ratio of CD4: CD8 in the group with isoimmunization was higher than in the control group (3.1 +/- 1.39 vs. 2.5 +/- 1.13). In isoimmunized foetuses in the initial stages of haemolysis no detactable immune response with significant changes in the lymphocyte sub-populations was found.
![Research paper thumbnail of [Primary prevention of congenital anomalies and the role of folic acid]](https://attachments.academia-assets.com/48465827/thumbnails/1.jpg)
](Congenital anomalies are an important diagnostic group in the perinatal healthcare. Only some of ... more Congenital anomalies are an important diagnostic group in the perinatal healthcare. Only some of these anomalies have an individual cause (complex anomalies accompanying chromosomal aberrations, congenital anomalies with monogenic inheritance, typical anomalies caused by strong teratogens etc.). The majority of cases of congenital ano-malies is caused by multiple and complex factors that are hard to identify. Therefore – the so called primary prevention of congenital anomalies becomes much more important during last years. Primary prevention of congenital anomalies itself is composed of various guidelines and recommendations that should prevent the formation of the anomaly. Specific role in the primary prevention has the folic acid supplementation that is world-wide recommended as the prevention of neural tube defects.
Review article about preeclampsia (PE), analysis and summarization of cutting-edge knowledge abou... more Review article about preeclampsia (PE), analysis and summarization of cutting-edge knowledge about this adverse pregnancy outcome based on the study of existing literature. A relatively new trend is the prediction possibility of the development of PE in early gestation and appropriate management of high risk pregnancies. ln this pa per we accord special attention to this important aspect. On the other hand possibilities and efficiency of prevention of PE are discussed. Prediction. prevention, early diagnosis and appropriate treatment of PE are important goals of the modem obstetrics.
Recommendations and guidelines for routine ultrasound examinations in pregnancy. Czech Society fo... more Recommendations and guidelines for routine ultrasound examinations in pregnancy. Czech Society for Ultrasound in Obstetrics and Gynecology (www.csupg.cz)
http://www.actualgyn.com/pdf/en\_2014\_122.pdf
![Research paper thumbnail of [Accuracy of placenta accreta ultrasound prediction in clinical work]](https://attachments.academia-assets.com/48465836/thumbnails/1.jpg)
](Ceska gynekologie / Ceska lekarska spolecnost J. Ev. Purkyne
Objective: To evaluate accuracy of placenta accreta ultrasound prediction in own group of patiens... more Objective: To evaluate accuracy of placenta accreta ultrasound prediction in own group of patiens. Design: Retrospective analysis.Setting: Departement of Obstetrics and Gynaecology, 1st Faculty of Medicine, Charles University and General Faculty Hospital, Prague.Methods: We retrospectively evaluated a group of 12 patients, that had undergone ultrasound examination during pregnancy at our department and afterwards had been diagnosed during caesarean section (CS) with placenta accreta (years 2010-2011).Results: 11 out of 12 women in our group had at least one of the risk factors (placenta praevia, previous SC, history of uterine surgery). During US examination, suspicion of placenta accreta was raised at 7 out of 12 women. In 5 cases we have performed elective CS and in 7 cases CS was done after onset of the labour (in 4 cases the reason was severe bleeding). The peripartal blood loss ranged from 500 ml to 7000 ml. Due to life threatening bleeding in 5 cases (42%), abdominal hysterect...
Prague medical report, 2009
Intestinal dilatation and hyperechogenic bowel, some typical ultrasonographic features of anorect... more Intestinal dilatation and hyperechogenic bowel, some typical ultrasonographic features of anorectal malformation, were found in the 21st week of a singleton pregnancy. These findings were associated with unilateral renal agenesis and a single umbilical artery. All prenatally diagnosed anomalies were confirmed postpartum. Development of the sonographic appearance of the anorectal malformation, prenatal and neonatal management are described and discussed.
![Research paper thumbnail of [Preeclampsia in pregnancy - prediction, prevention and further management]](https://attachments.academia-assets.com/48465840/thumbnails/1.jpg)
](Ceská gynekologie / Ceská lékarská spolecnost J. Ev. Purkyne, 2014
Review article about preeclampsia (PE), analysis and summarization of cutting-edge knowledge abou... more Review article about preeclampsia (PE), analysis and summarization of cutting-edge knowledge about this adverse pregnancy outcome based on the study of existing literature. A relatively new trend is the prediction possibility of the development of PE in early gestation and appropriate management of high risk pregnancies. In this paper we accord special attention to this important aspect. On the other hand possibilities and efficiency of prevention of PE are discussed. Prediction, prevention, early diagnosis and appropriate treatment of PE are important goals of the modern obstetrics. preeclampsia, screening, prediction, PlGF, sFlt-1, prevention, Aspirin.
![Research paper thumbnail of [Accuracy of placenta accreta ultrasound prediction in clinical work]](https://attachments.academia-assets.com/48465854/thumbnails/1.jpg)
](Ceská gynekologie / Ceská lékarská spolecnost J. Ev. Purkyne, 2012
To evaluate accuracy of placenta accreta ultrasound prediction in own group of patients. Retrospe... more To evaluate accuracy of placenta accreta ultrasound prediction in own group of patients. Retrospective analysis. Department of Obstetrics and Gynaecology, 1st Faculty of Medicine, Charles University and General Faculty Hospital, Prague. We retrospectively evaluated a group of 12 patients, that had undergone ultrasound examination during pregnancy at our department and afterwards had been diagnosed during caesarean section (CS) with placenta accreta (years 2010-2011). 11 out of 12 women in our group had at least one of the risk factors (placenta praevia, previous SC, history of uterine surgery). During US examination, suspicion of placenta accreta was raised at 7 out of 12 women. In 5 cases we have performed elective CS and in 7 cases CS was done after onset of the labour (in 4 cases the reason was severe bleeding). The peripartal blood loss ranged from 500 ml to 7000 ml. Due to life threatening bleeding in 5 cases (42%), abdominal hysterectomy was performed. Placenta accreta was suc...
![Research paper thumbnail of [Prenatal intracranial hemorrhagie--diagnosis and follow-up]](https://attachments.academia-assets.com/48465829/thumbnails/1.jpg)
](Ceská gynekologie / Ceská lékarská spolecnost J. Ev. Purkyne, 2009
We present a case of difficult prenatal diagnosis and follow-up of severe fetal intracranial hemo... more We present a case of difficult prenatal diagnosis and follow-up of severe fetal intracranial hemorrhage. With an analysis of the available literature that is related to this topic, we would like to bring attention to the necessity of accurate evaluation of fetal brain morphology even during routine ultrasound examination in the late third trimester. Case report. Department of Obstetrics and Gynecology, General Faculty Hospital and 1st Faculty of Medicine, Charles University, Prague. Four cases of prenatal intracranial hemorrhage are presented. All cases were diagnosed during ultrasound examination during the third trimester of pregnancy and the findings were clarified using nuclear magnetic resonance imaging. The etiology of the hemorrhage was determined in only two cases. Postnatal follow-up of the affected children over a range of one to two years of age shows a very severe prognosis of the described hemorrhagic conditions. Prenatally diagnosed fetal intracranial hemorrhage is a r...
Ceska gynekologie / Ceska lekarska spolecnost J. Ev. Purkyne
The most frequent congenital developmental defect in the orofacial region are, no doubt, facial c... more The most frequent congenital developmental defect in the orofacial region are, no doubt, facial clefts which are a serious stress for health professionals and the population. Depending on the type of cleft, the prevalence is between 1 : 1000-2800 births. According to contemporary views in the etiology of orofacial clefts participate genetic as well as environmental factors. That means that specific genetic factors create a certain "sensitivity" for specific factors of the external environment which act as a trigger mechanism and combined they produce the cleft. Cleft lip can be diagnosed already during the 13th week of gestation, while a cleft palate is not necessarily apparent till after the 18th week of gestation as the maxilla is in the process of joining. Presentation of the foetal face and its profile is thus important in particular during the second trimester of gestation and should be part of ultrasonographic screening between the 18th and 20th week of gestation. As more than 8% of facial clefts are associated with chromosomal abnormalities, in all affected foetuses karyotyping is done. The prognosis of satisfactory cosmetic and functional repair in cleft lip and in cleft lip and palate is favourable. In case of associated malformations all depends on the type and severity of these associated defects or on the diagnosis of the syndrome. If median clefts are extensive or associated with cerebral anomalies, the prognosis is as a rule poor. Prenatal diagnosis and management of defects of the orofacial area calls for collaboration of the obstetrician, neonatologist and plastic surgeon already in the stage when the defect is detected to give the expectant mother an opportunity to obtain accurate and unbiased information on possible treatment and prognosis for the foetus.
Pregnancy Hypertension: An International Journal of Women's Cardiovascular Health, 2011
American Journal of Obstetrics and Gynecology, 2012
Prenatal Diagnosis, Sep 1, 2009
Fetal Diagnosis and Therapy
Ceska gynekologie / Ceska lekarska spolecnost J. Ev. Purkyne
To evaluate, which of selected anamnestic, laboratory and ultrasonographic (USG) parameters could... more To evaluate, which of selected anamnestic, laboratory and ultrasonographic (USG) parameters could contribute to the prediction of prematurity. Prospective, observational, clinical study. Department of Obstetrics and Gynecology, 1st Faculty of Medicine and the General Faculty Hospital, Charles University, Prague. 349 women with the singleton pregnancy were followed from the half of the 2nd trimester until the end of gestation. At each woman the anamnestic (age, parity, pregravid BMI, weight gain until 20th week, significant risk from patient's history, cigarette smoking, risk pregnancy symptoms until 20th week), laboratory (maternal serum concentration of AFP, hCG, and uE3/triple test/at 16th week, the blood count and ferritin concentration at 18th-20th week, bacteriological cultivation of the smear from the cervix at 34th-36th week), and USG (transvaginal cervicometry and doppler flowmetry of the uterine arteries at 18th-20th week) data were established. With the aid of one-dimensional and multi-dimensional analysis the dependence of completed gestational age and preterm delivery (before completed 37th week) on above mentioned parameters was tested. 314 women completed the study. We proved a significant dependence of prematurity on the following markers: risk pregnancy symptoms until 20th week (RR 2.94), abnormal triple test (RR 4.63), cultivation of pathogens from the cervix (RR 5.49), USG established cervical length (P < 0.0001), abnormal result of cervicometry (RR 19.02), both doppler parameters (RI of uterine arteries: P < 0.0001; presence of early diastolic notch: RR 2.84). The results of multi-dimensional analysis confirmed superiority of USG cervicometry in prediction of both measured outcomes. The predictive value of some of selected anamnestic, laboratory, and USG markers of premature delivery was proved at random population of women with singleton pregnancy. The abnormal result of transvaginal USG cervicometry was the most significant predictor of prematurity. We recommend a routine performing of cervicometry (as a part of USG screening at 18th-20th week) for early selection of women with significantly increased risk of prematurity.
Ceska gynekologie / Ceska lekarska spolecnost J. Ev. Purkyne
In the foetus in utero predominates a considerable percentage of immunologically so-called naive ... more In the foetus in utero predominates a considerable percentage of immunologically so-called naive lymphocytes of the T and B series. The objective of the presented work was to assess by means of flow cytometry and labelled monoclonal antibodies quantitative changes in cell sub-populations of the foetal immune system before the foetus is altered by severe heamolysis as a result of Rh(D) isoimmunization. The authors obtained by intrauterine puncture of the umbilical cord peripheral blood from 10 foetuses with isoimmunization during the 23rd-35th week of gestation, confirmed by the direct Coombs test and with a mean haematocrit value of 30.8% +/- 8.02. These findings were compared with values in the peripheral blood stream in a control group of 35 foetuses during the 18th-39th week of pregnancy with normal intrauterine development (haematocrit 34.2% +/- 5.87). The authors assessed the haemogram and CD signs in the lymphocyte population. In the peripheral bloodstream of foetuses with erythrocyte isoimmunization the authors did not detect, as compared with the control group (p > 0.01), a lower haemoglobin level (10.6 +/- 2.77 g/dl vs. 11.9 +/- 2.03 g/dl) a lower haematocrit (30.8% +/- 8.02 vs. 34.2% +/- 5.87) and fewer leucocytes 5.1 +/- 2.39 x 10(9)/l versus 6.97 +/- 3.29 x 10(9)/l. In foetuses with Rh(D) isoimmunization the authors found a higher percentage of T(CD3+) lymphocytes (79.0% +/- 11.23 vs. 73.7% +/- 12.79, but did not prove an increase of activated T lymphocytes (%DR+ from CD3+) (1.0% +/- 0.52 vs. 1.3 +/- 0.58). The percentage ratio of T helper cells (CD+) was higher than in the control group (61.0% +/- 10.25 vs. 56.1% +/- 12.45). In foetuses with Rh(D) isoimmunization there was no difference in the ratio of CD8 positive cells (24.1% +/- 8.23 vs. 23.6% +/- 7.26). Suppressor T cells (CD8+CD11b+) were fewer (4.1% +/- 1.24 vs. 7.5 +/- 11.23) than in the control group. The number of NK cells in foetuses with Rh(D) isoimmunization was 5.1% +/- 3.26 vs. 6.9% +/- 3.86, in isoimmunized foetuses there is a higher ratio of so-called naive T helper cells Th1 (CD4+ CD45 RA+) 49.3% +/- 12.71 vs. 43.0% +/- 12.88. When assessing naive B1 cells (CD19+CD5+), the authors did not find a difference between the two groups (10.4% +/- 6.20 vs. 9.06% +/- 12.1). The ratio of CD4: CD8 in the group with isoimmunization was higher than in the control group (3.1 +/- 1.39 vs. 2.5 +/- 1.13). In isoimmunized foetuses in the initial stages of haemolysis no detactable immune response with significant changes in the lymphocyte sub-populations was found.
Congenital anomalies are an important diagnostic group in the perinatal healthcare. Only some of ... more Congenital anomalies are an important diagnostic group in the perinatal healthcare. Only some of these anomalies have an individual cause (complex anomalies accompanying chromosomal aberrations, congenital anomalies with monogenic inheritance, typical anomalies caused by strong teratogens etc.). The majority of cases of congenital ano-malies is caused by multiple and complex factors that are hard to identify. Therefore – the so called primary prevention of congenital anomalies becomes much more important during last years. Primary prevention of congenital anomalies itself is composed of various guidelines and recommendations that should prevent the formation of the anomaly. Specific role in the primary prevention has the folic acid supplementation that is world-wide recommended as the prevention of neural tube defects.
Review article about preeclampsia (PE), analysis and summarization of cutting-edge knowledge abou... more Review article about preeclampsia (PE), analysis and summarization of cutting-edge knowledge about this adverse pregnancy outcome based on the study of existing literature. A relatively new trend is the prediction possibility of the development of PE in early gestation and appropriate management of high risk pregnancies. ln this pa per we accord special attention to this important aspect. On the other hand possibilities and efficiency of prevention of PE are discussed. Prediction. prevention, early diagnosis and appropriate treatment of PE are important goals of the modem obstetrics.
Recommendations and guidelines for routine ultrasound examinations in pregnancy. Czech Society fo... more Recommendations and guidelines for routine ultrasound examinations in pregnancy. Czech Society for Ultrasound in Obstetrics and Gynecology (www.csupg.cz)
http://www.actualgyn.com/pdf/en\_2014\_122.pdf
Ceska gynekologie / Ceska lekarska spolecnost J. Ev. Purkyne
Objective: To evaluate accuracy of placenta accreta ultrasound prediction in own group of patiens... more Objective: To evaluate accuracy of placenta accreta ultrasound prediction in own group of patiens. Design: Retrospective analysis.Setting: Departement of Obstetrics and Gynaecology, 1st Faculty of Medicine, Charles University and General Faculty Hospital, Prague.Methods: We retrospectively evaluated a group of 12 patients, that had undergone ultrasound examination during pregnancy at our department and afterwards had been diagnosed during caesarean section (CS) with placenta accreta (years 2010-2011).Results: 11 out of 12 women in our group had at least one of the risk factors (placenta praevia, previous SC, history of uterine surgery). During US examination, suspicion of placenta accreta was raised at 7 out of 12 women. In 5 cases we have performed elective CS and in 7 cases CS was done after onset of the labour (in 4 cases the reason was severe bleeding). The peripartal blood loss ranged from 500 ml to 7000 ml. Due to life threatening bleeding in 5 cases (42%), abdominal hysterect...
Prague medical report, 2009
Intestinal dilatation and hyperechogenic bowel, some typical ultrasonographic features of anorect... more Intestinal dilatation and hyperechogenic bowel, some typical ultrasonographic features of anorectal malformation, were found in the 21st week of a singleton pregnancy. These findings were associated with unilateral renal agenesis and a single umbilical artery. All prenatally diagnosed anomalies were confirmed postpartum. Development of the sonographic appearance of the anorectal malformation, prenatal and neonatal management are described and discussed.
Ceská gynekologie / Ceská lékarská spolecnost J. Ev. Purkyne, 2014
Review article about preeclampsia (PE), analysis and summarization of cutting-edge knowledge abou... more Review article about preeclampsia (PE), analysis and summarization of cutting-edge knowledge about this adverse pregnancy outcome based on the study of existing literature. A relatively new trend is the prediction possibility of the development of PE in early gestation and appropriate management of high risk pregnancies. In this paper we accord special attention to this important aspect. On the other hand possibilities and efficiency of prevention of PE are discussed. Prediction, prevention, early diagnosis and appropriate treatment of PE are important goals of the modern obstetrics. preeclampsia, screening, prediction, PlGF, sFlt-1, prevention, Aspirin.
Ceská gynekologie / Ceská lékarská spolecnost J. Ev. Purkyne, 2012
To evaluate accuracy of placenta accreta ultrasound prediction in own group of patients. Retrospe... more To evaluate accuracy of placenta accreta ultrasound prediction in own group of patients. Retrospective analysis. Department of Obstetrics and Gynaecology, 1st Faculty of Medicine, Charles University and General Faculty Hospital, Prague. We retrospectively evaluated a group of 12 patients, that had undergone ultrasound examination during pregnancy at our department and afterwards had been diagnosed during caesarean section (CS) with placenta accreta (years 2010-2011). 11 out of 12 women in our group had at least one of the risk factors (placenta praevia, previous SC, history of uterine surgery). During US examination, suspicion of placenta accreta was raised at 7 out of 12 women. In 5 cases we have performed elective CS and in 7 cases CS was done after onset of the labour (in 4 cases the reason was severe bleeding). The peripartal blood loss ranged from 500 ml to 7000 ml. Due to life threatening bleeding in 5 cases (42%), abdominal hysterectomy was performed. Placenta accreta was suc...
Ceská gynekologie / Ceská lékarská spolecnost J. Ev. Purkyne, 2009
We present a case of difficult prenatal diagnosis and follow-up of severe fetal intracranial hemo... more We present a case of difficult prenatal diagnosis and follow-up of severe fetal intracranial hemorrhage. With an analysis of the available literature that is related to this topic, we would like to bring attention to the necessity of accurate evaluation of fetal brain morphology even during routine ultrasound examination in the late third trimester. Case report. Department of Obstetrics and Gynecology, General Faculty Hospital and 1st Faculty of Medicine, Charles University, Prague. Four cases of prenatal intracranial hemorrhage are presented. All cases were diagnosed during ultrasound examination during the third trimester of pregnancy and the findings were clarified using nuclear magnetic resonance imaging. The etiology of the hemorrhage was determined in only two cases. Postnatal follow-up of the affected children over a range of one to two years of age shows a very severe prognosis of the described hemorrhagic conditions. Prenatally diagnosed fetal intracranial hemorrhage is a r...