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Papers by Dagmara Filipecka-Tyczka

Research paper thumbnail of Risk factors for anxiety and depression among pregnant women during the COVID-19 pandemic

Medicine, 2020

Introduction: The article presents a protocol of a cross-sectional study of mental health of preg... more Introduction: The article presents a protocol of a cross-sectional study of mental health of pregnant women in relation to the coronavirus disease 19 (COVID-19) pandemic. The primary aim is to compare differences in anxiety and depression scores of pregnant women between countries affected by the COVID-19 pandemic. The secondary aim is to assess demographic, economic, and social aspects affecting maternal anxiety and depression scores among pregnant women worldwide in the time of the COVID-19 pandemic. Finally, we will be able to compare differences in perception of the different aspects of the COVID-19 pandemic (social distancing, restrictions related to delivery) between countries and according to the epidemic status (number of infected patients, number of reported deaths). The comparisons will also be done according to the COVID-19 status of the participants. Methods and analysis: It is a web-based anonymous survey of pregnant women living in countries affected by the COVID-19 pa...

Research paper thumbnail of VP42.03: Relation between uterine arteries pulsality index and the occurrence obstetrical complications in twin pregnancies

Ultrasound in Obstetrics & Gynecology, 2020

Research paper thumbnail of P11.09: Relation between uterine arteries pulsatility index and the occurrence of gestational hypertension, pre‐eclampsia and hypotrophy in twin pregnancies

Ultrasound in Obstetrics & Gynecology, 2019

This study measured cervical length (CL) of asymptomatic women with twin pregnancies at 14-16 and... more This study measured cervical length (CL) of asymptomatic women with twin pregnancies at 14-16 and 21-24 weeks of gestation and assessed whether the difference between measurements is predictive of preterm delivery (PTD). Methods: This retrospective, cohort study included patients with two consecutive CL, measured with transvaginal sonography at 14-16 weeks of gestation (CL1) and 21-24 weeks of gestation (CL2). Electronic medical records were reviewed for demographic, medical and delivery data. PTD was defined as delivery prior to 37+0 weeks of gestation. CL1, CL2 and the change between scans were evaluated and correlated with PTD. Results: Among 103 twin gestations, 76 (73.7%) women delivered at term and 27 (26.3.) had PTD. CL1 was not a good predictor of PTD (4.2 ± 0.57 cm in PTD group vs 4.1 ± 0.67 cm in term group P = 0.32). The correlation between CL change and PTD was not significant (0.47 ± 0.09 cm in PTD group VS 0.28 ± 0.08 in TERM groupP = 0.2). The correlation between CL change and delivery after 38 weeks was not significant (0.13 ± 0.07 in 38+ group vs 0.34 ± 0.04 in 37-38 weeks group P = 0.3). Baseline characteristics and perinatal outcomes between term and preterm deliveries were similar. Conclusions: Sonographic measurement of CL at 14-16 weeks gestation and the difference between CL in the first and second scans were not reliable predictors of PTD in asymptomatic women with twin pregnancies and in addition cannot be used to predict delivery after 38 weeks.

Research paper thumbnail of Deep infiltrating endometriosis as a cause of severe urogynecological complications despite invasive treatment – report of two cases from the center of endometriosis surgery

Clinical and Experimental Obstetrics & Gynecology, 2020

Endometriosis involvement of the urological tract may lead to significant disabilities. The invol... more Endometriosis involvement of the urological tract may lead to significant disabilities. The involvement of the urological tract gives rise to severe complications that burden patient health and quality of life. Two cases of patients with severe urogynecological complications after surgery of deep infiltrating endometriosis were analyzed. Last resort radical surgical treatment did not stop the progression of the disease and failed to prevent further deterioration despite concomitant hormone therapy. Careful clinical consideration is recommended to plan an effective therapeutic strategy and the extent of the surgery for this multidisciplinary and complex disease. The treatment should start and be proceed by a dedicated and experienced team. Radical surgery including a total hysterectomy with a salpingo-oophorectomy could be necessary. Although a radical dissection increases the chances of recovery and long-term remission, it is also associated with an increased risk of serious short-term and long-term postoperative complications. In presented cases, the infiltration of the ureter by endometriosis caused non-symptomatic kidney function loss. The radical surgical treatment of deep infiltrating endometriosis did not stop the progression of a disease and was associated with severe urogynecological complications. Screening for pyelocaliectasis in patients with deep endometriosis could be considered as an important part of preoperative examination and postoperative follow-up.

Research paper thumbnail of Emergency cerclage using double-level versus single-level suture in the management of cervical insufficiency (Cervical Occlusion double-level Stitch Application,COSA): study protocol for a multicentre, non-blinded, randomised controlled trial

BMJ Open

IntroductionCervical insufficiency accounts for 15% of recurrent pregnancy losses between 16 and ... more IntroductionCervical insufficiency accounts for 15% of recurrent pregnancy losses between 16 and 28 weeks of gestation. The aim of the study is to verify the effectiveness of emergency double-level cerclage with vaginal progesterone in cervical insufficiency treatment in terms of the prevention of preterm delivery before 34 weeks of gestation.Methods and analysisThis trial is a multicentre, non-blinded, randomised study with 1:1 allocation ratio. The study is conducted at tertiary perinatal care departments in Poland. It will include patients with cervical insufficiency with the fetal membranes visible in the open cervical canal or protruding into the vagina between 16+0 and 23+6 weeks of pregnancy. They will be randomised into two arms: emergency single-level cerclage with vaginal progesterone or double-level cerclage with vaginal progesterone. All will be administered antibiotics and indomethacin. The primary outcome is the rate of deliveries below 34+0 weeks of gestation, while s...

Research paper thumbnail of 361. Effectiveness of cervical cerclage in twin pregnancies

European Journal of Obstetrics & Gynecology and Reproductive Biology, Mar 1, 2022

Research paper thumbnail of Molecular Pathways of Altered Brain Development in Fetuses Exposed to Hypoxia

International Journal of Molecular Sciences

Perinatal hypoxia is a major cause of neurodevelopmental impairment and subsequent motor and cogn... more Perinatal hypoxia is a major cause of neurodevelopmental impairment and subsequent motor and cognitive dysfunctions; it is associated with fetal growth restriction and uteroplacental dysfunction during pregnancy. This review aims to present the current knowledge on brain development resulting from perinatal asphyxia, including the causes, symptoms, and means of predicting the degree of brain damage. Furthermore, this review discusses the specificity of brain development in the growth-restricted fetus and how it is replicated and studied in animal models. Finally, this review aims at identifying the least understood and missing molecular pathways of abnormal brain development, especially with respect to potential treatment intervention.

Research paper thumbnail of Monoamniotic twins pregnancy complicated by a fetal congenital heart defect – a challenge for perinatal decisions

Case Reports in Perinatal Medicine, 2020

Objectives To analyze pregnancy management and postnatal follow-up in monochorionic monoamniotic ... more Objectives To analyze pregnancy management and postnatal follow-up in monochorionic monoamniotic (MCMA) pregnancies complicated by a congenital heart defect (CHD) in one twin and to compare the results with current recommendations concerning time and mode of delivery in MCMA pregnancies. Cases presentation Perinatal medical records of five pairs of monoamniotic twins referred to Fetal Cardiology Department were analyzed. 5 out of 23 MCMA pregnancies (21.7%) were complicated by CHD in one fetus. Cesarean section (CS) was performed between 32 and 35 weeks of gestation (WoG). 9 out of 10 neonates had respiratory failure, including all patients with CHD. Twins without congenital abnormalities spent median 21 days (range 10–40 days) in neonatal units. Patients with CHD were transferred to cardiology departments on average 6th day of life. All were operated on later than term-born neonates, 4 out of 5 required stage surgery and their median stay in the hospital was 75 days (range 48–106 d...

Research paper thumbnail of A unique case of diagnosis of a heterotopic pregnancy at 26 weeks – case report and literature review

BMC Pregnancy and Childbirth, 2021

Background Heterotopic pregnancy (HP) is a rare condition when at least two pregnancies are prese... more Background Heterotopic pregnancy (HP) is a rare condition when at least two pregnancies are present simultaneously at different implantation sites and only one located in the uterine cavity. The majority of cases are diagnosed in the first trimester. Case presentation We present a unique case of HP diagnosed at 26 weeks of spontaneous pregnancy in a patient without any relevant risk factors. We performed an extensive review of HP cases from MEDLINE (PUBMED) published in English between 2005-2019 to prove this case's uniqueness. A 24-year-old woman presented because of threatened preterm birth. Despite treatment, pain aggravated, without progression of labor. An emergency ultrasound exam revealed free fluid in the abdominal cavity. Suspicion of active bleeding prompted the medical team to perform an exploratory laparotomy. The surgery team found a ruptured heterotopic pregnancy. This was an unexpected cause of nontraumatic hemoperitoneum at such advanced gestational age. The post...

Research paper thumbnail of Additional file 1 of A unique case of diagnosis of a heterotopic pregnancy at 26 weeks – case report and literature review

Additional file 1: Table 1. List of case reports of heterotopic pregnancies used in the analysis.

Research paper thumbnail of Ciąża heterotopowa

Ciąża heterotopowa (ang. heterotopic pregnancy, HP) to rzadkie schorzenie, w którym doszło do imp... more Ciąża heterotopowa (ang. heterotopic pregnancy, HP) to rzadkie schorzenie, w którym doszło do implantacji co najmniej dwóch jaj płodowych jednoczasowo w różnych miejscach w organizmie kobiety. Naturalne występowanie HP wynosi 1:30 000, jednak metody rozrodu wspomaganego zwiększają częstość tej patologii do 1:125. HP pozostaje stanem zagrażającym życiu, opisanym głównie w pierwszym i na przełomie pierwszego i drugiego trymestru ciąży. Autorzy przeprowadzili przegląd piśmiennictwa w celu oceny najnowszych czynników ryzyka, sposobów rozpoznawania i leczenia ciąży heterotopowej. Słowa kluczowe: Ciąża heterotopowa, ciąża pozamaciczna, metody rozrodu wspomaganego, ostry brzuch w ciąży

Research paper thumbnail of Medical care for a pregnant woman with a multiple pregnancy

Opieka nad ciężarną w ciąży wielopłowej z uwagi na zwiększone ryzyko wystąpienia powikłań zarówno... more Opieka nad ciężarną w ciąży wielopłowej z uwagi na zwiększone ryzyko wystąpienia powikłań zarówno typowych dla ciąż bliźniaczych (TTTS, TAPS, sIUGR), jak również częstsze występowanie powikłań położniczych, takich jak poród przedwczesny, preeklampsja, cukrzyca i inne, wymaga częstszych wizyt i badań USG. Postępowanie położnicze powinno być nastawione na wczesne wykrywanie powikłań i jak najszybsze wdrożenie odpowiedniego leczenia. Omówione zostały proponowane przez różnych autorów schematy opieki ambulatoryjnej, jak również wskazania do hospitalizacji oraz czas i sposób ukończenia ciąży w zależności od kosmówkowości i owodniowości oraz ilości płodów. Podsumowanie ma na celu ułatwić położnikowi podjęcie szybkiej decyzji klinicznej. W artykule uwzględniono akty prawne obowiązujące w Polsce oraz wytyczne polskich i międzynarodowych towarzystw ginekologiczno-położniczych. Dodatkowo omówiono sposób wykrywania i postępowania w przypadku wystąpienia powikłań specyficzny dla ciąż wielopłodo...

Research paper thumbnail of Large-for-gestational-age or macrosomia as a classifier for risk of adverse perinatal outcome: a retrospective cross-sectional study

The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians, 2021

OBJECTIVE Small for gestational age (SGA) fetuses and neonates are of great interest, while those... more OBJECTIVE Small for gestational age (SGA) fetuses and neonates are of great interest, while those who are too big are much less studied. The aim was to analyze the classifiers described by ACOG "Fetal macrosomia" practice bulletin as predictors of adverse perinatal outcomes for overgrown fetuses and their mothers. MATERIALS From a database of 53,586 singleton term births, appropriate-for-gestational-age (AGA), large for gestational age (LGA), and macrosomic deliveries were selected. AGA served as a control. The crude and adjusted odds ratios (aORs) were calculated for large-for-gestational-age >90th centile, and macrosomia >4000 g, >4250 g, and >4500 g. Patients with and without diabetes were analyzed separately. RESULTS Macrosomia >4000 g performed poorer than other classifiers. LGA performed comparably to other definitions of macrosomia. Diabetes carries a severe risk of complications for overgrown neonates, but those non-diabetic also have increased risk....

Research paper thumbnail of Is growth restriction in twin pregnancies a double challenge? – A narrative review

Background Foetal growth restriction (FGR) complicates about 25–47% of twin pregnancies. One or b... more Background Foetal growth restriction (FGR) complicates about 25–47% of twin pregnancies. One or both foetuses can be restricted. Pregnancies with discordant growth of foetuses are associated with a sevenfold increased risk of neonatal morbidity. Materials and methods This is a narrative or traditional literature review. A literature search was performed to present a comprehensive, critical and objective analysis of the current knowledge on growth restriction in twin pregnancies. Results The definitions of FGR in twin pregnancies and selective FGR (sFGR) differ between international societies. In 2019, the Delphi procedure aimed to unify the definitions of sFGR in twin pregnancies. Several growth charts for twins have been published. However, most societies recommend singleton growth charts as better in detecting hypoxic complications of FGR in twin pregnancies. Discordant growth in twins results from placental insufficiency, congenital anomalies, chromosomal aberrations and TORCH in...

Research paper thumbnail of Foetal goitrous hypothyroidism - easy to recognise, difficult to treat. Is combined intra-amniotic and intravenous L-thyroxine therapy an option?

Endokrynologia Polska, 2018

INTRODUCTION Foetal hypothyroidism negatively impacts somatic and neurological child development ... more INTRODUCTION Foetal hypothyroidism negatively impacts somatic and neurological child development and can be the cause of serious obstetric and perinatal complications. We present a rare case of a large foetal dyshormonogenetic goitre, causing foetal neck hyperexten-sion, oesophageal compression, and cardiac high-output failure. MATERIAL AND METHODS A foetal goitre complicated by cardiomegaly and polyhydramnios was diagnosed at 23 weeks of gestation (WG) on a routine ultrasonographic (US) assessment in a healthy nullipara. Foetal blood sampling was performed and a severe foetal hypothyroid-ism was diagnosed. Treatment was undertaken with an intra-amniotic followed by combined intra-amniotic and intravenous injections of L-thyroxine (L-T4). A total of 11 doses of L-T4 were administered between 24-37 WG to the foetus. RESULTS A complete regression of foetal goitre, cardiomegaly, and polyhydramnios was observed. At 38 WG the patient delivered vagi-nally a male infant with mild hypothyro...

Research paper thumbnail of Fetal Growth Diagnosis and Management among Perinatal Medical Professionals: A Survey of Practice and Literature Review

Introduction: This paper aimed to assess the knowledge of healthcare professionals (obstetric and... more Introduction: This paper aimed to assess the knowledge of healthcare professionals (obstetric and gynecology residents, specialists, and midwives) in the field of perinatal medicine regarding fetal growth diagnosis and management. Methods: A questionnaire was created consisting of a set of questions regarding demographic data, methods of growth assessment, and management. It was a handout survey. The results were analyzed with the use of descriptive statistics and χ2 analysis using the program Statistica. Results: 190 medical professionals have participated in the questionnaire. 86.3% of respondents agreed that pregnancy dating should be modified based on first-trimester ultrasound. 90.9% agreed that III trimester ultrasound has a ±15% margin of error. When asked which growth charts are best fit for assessing growth in a studied population, 10.7% marked standard, 37.4% reference, 26.2% customized, and 26.2% did not know the difference between the three choices. 60.3% stated that the...

Research paper thumbnail of Uterine Artery Doppler Reference Ranges in a Twin Caucasian Population Followed Longitudinally From 17 to 37 Weeks Gestation Compared to That of Singletons

Journal of Ultrasound in Medicine

Research paper thumbnail of Compliance with gestational weight gain recommendations in a cross-sectional study of term pregnancies — how far reality falls from the standard?

Ginekologia Polska

Objectives: During pregnancy, two aspects are critical in the context of adverse perinatal outcom... more Objectives: During pregnancy, two aspects are critical in the context of adverse perinatal outcomes (APO): preconception obesity and gestational weight gain. This study aimed to assess compliance with the 2009 IOM guidelines, compare GWG with and without correcting for gestation duration, and observe the relationship between pre-pregnancy BMI and GWG and neonatal birth weight. Material and methods: This is a cross-sectional study conducted from 2015-2018 at the St. Sophia's Specialist Hospital in Warsaw, Poland. Self-reported pre-pregnancy and predelivery weight were collected. Results: The presented data set amounts to 7820 records. Analysis of weight gain compliance with IOM recommendations showed that only 41-44% (depending on the calculation method) of women had weight gain in accordance with IOM guidelines (22-23%below; 33-37% above). Overweight and obese women with diabetes are more likely to comply with IOM than women without diabetes. In contrast, women with normal-weight and underweight with diabetes are less likely to achieve IOM weight gain in pregnancy than women without diabetes. Women who have GWG below recommendations significantly more often gave birth to SGA neonates, and women who exceeded GWG standards significantly more often gave birth to LGA neonates. Conclusions: Less than half of women had GWG within the recommended norms. Statistically significant differences were found in methods of calculation of GWG, but it was not found clinically significant. Correction for pregnancy duration when calculating GWG reclassifies two percent of patients. We underestimate the risk of crossing the line between overweight and obesity during pregnancy.

Research paper thumbnail of Growth Abnormalities as a Risk Factor of Adverse Neonatal Outcome in Hypertensive Pregnancies—A Single-Center Retrospective Cohort Study

Children

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

Research paper thumbnail of Successful pregnancy in women with inferior vena cava stenosis — case report and discussion

Ginekologia Polska

Objectives: Inferior vena cava syndrome (IVCS) is a heterogenous group of symptoms resulting in o... more Objectives: Inferior vena cava syndrome (IVCS) is a heterogenous group of symptoms resulting in obstruction of the main vein inflow . Common reasons are thrombotic changes and tumors. Incidence of inferior vena cava (IVC) anomalies is 0.3% in general population. Iatrogenic IVC lesions caused by catheter insertion play increasing role. Treatment varies depending on the condition.

Research paper thumbnail of Risk factors for anxiety and depression among pregnant women during the COVID-19 pandemic

Medicine, 2020

Introduction: The article presents a protocol of a cross-sectional study of mental health of preg... more Introduction: The article presents a protocol of a cross-sectional study of mental health of pregnant women in relation to the coronavirus disease 19 (COVID-19) pandemic. The primary aim is to compare differences in anxiety and depression scores of pregnant women between countries affected by the COVID-19 pandemic. The secondary aim is to assess demographic, economic, and social aspects affecting maternal anxiety and depression scores among pregnant women worldwide in the time of the COVID-19 pandemic. Finally, we will be able to compare differences in perception of the different aspects of the COVID-19 pandemic (social distancing, restrictions related to delivery) between countries and according to the epidemic status (number of infected patients, number of reported deaths). The comparisons will also be done according to the COVID-19 status of the participants. Methods and analysis: It is a web-based anonymous survey of pregnant women living in countries affected by the COVID-19 pa...

Research paper thumbnail of VP42.03: Relation between uterine arteries pulsality index and the occurrence obstetrical complications in twin pregnancies

Ultrasound in Obstetrics & Gynecology, 2020

Research paper thumbnail of P11.09: Relation between uterine arteries pulsatility index and the occurrence of gestational hypertension, pre‐eclampsia and hypotrophy in twin pregnancies

Ultrasound in Obstetrics & Gynecology, 2019

This study measured cervical length (CL) of asymptomatic women with twin pregnancies at 14-16 and... more This study measured cervical length (CL) of asymptomatic women with twin pregnancies at 14-16 and 21-24 weeks of gestation and assessed whether the difference between measurements is predictive of preterm delivery (PTD). Methods: This retrospective, cohort study included patients with two consecutive CL, measured with transvaginal sonography at 14-16 weeks of gestation (CL1) and 21-24 weeks of gestation (CL2). Electronic medical records were reviewed for demographic, medical and delivery data. PTD was defined as delivery prior to 37+0 weeks of gestation. CL1, CL2 and the change between scans were evaluated and correlated with PTD. Results: Among 103 twin gestations, 76 (73.7%) women delivered at term and 27 (26.3.) had PTD. CL1 was not a good predictor of PTD (4.2 ± 0.57 cm in PTD group vs 4.1 ± 0.67 cm in term group P = 0.32). The correlation between CL change and PTD was not significant (0.47 ± 0.09 cm in PTD group VS 0.28 ± 0.08 in TERM groupP = 0.2). The correlation between CL change and delivery after 38 weeks was not significant (0.13 ± 0.07 in 38+ group vs 0.34 ± 0.04 in 37-38 weeks group P = 0.3). Baseline characteristics and perinatal outcomes between term and preterm deliveries were similar. Conclusions: Sonographic measurement of CL at 14-16 weeks gestation and the difference between CL in the first and second scans were not reliable predictors of PTD in asymptomatic women with twin pregnancies and in addition cannot be used to predict delivery after 38 weeks.

Research paper thumbnail of Deep infiltrating endometriosis as a cause of severe urogynecological complications despite invasive treatment – report of two cases from the center of endometriosis surgery

Clinical and Experimental Obstetrics & Gynecology, 2020

Endometriosis involvement of the urological tract may lead to significant disabilities. The invol... more Endometriosis involvement of the urological tract may lead to significant disabilities. The involvement of the urological tract gives rise to severe complications that burden patient health and quality of life. Two cases of patients with severe urogynecological complications after surgery of deep infiltrating endometriosis were analyzed. Last resort radical surgical treatment did not stop the progression of the disease and failed to prevent further deterioration despite concomitant hormone therapy. Careful clinical consideration is recommended to plan an effective therapeutic strategy and the extent of the surgery for this multidisciplinary and complex disease. The treatment should start and be proceed by a dedicated and experienced team. Radical surgery including a total hysterectomy with a salpingo-oophorectomy could be necessary. Although a radical dissection increases the chances of recovery and long-term remission, it is also associated with an increased risk of serious short-term and long-term postoperative complications. In presented cases, the infiltration of the ureter by endometriosis caused non-symptomatic kidney function loss. The radical surgical treatment of deep infiltrating endometriosis did not stop the progression of a disease and was associated with severe urogynecological complications. Screening for pyelocaliectasis in patients with deep endometriosis could be considered as an important part of preoperative examination and postoperative follow-up.

Research paper thumbnail of Emergency cerclage using double-level versus single-level suture in the management of cervical insufficiency (Cervical Occlusion double-level Stitch Application,COSA): study protocol for a multicentre, non-blinded, randomised controlled trial

BMJ Open

IntroductionCervical insufficiency accounts for 15% of recurrent pregnancy losses between 16 and ... more IntroductionCervical insufficiency accounts for 15% of recurrent pregnancy losses between 16 and 28 weeks of gestation. The aim of the study is to verify the effectiveness of emergency double-level cerclage with vaginal progesterone in cervical insufficiency treatment in terms of the prevention of preterm delivery before 34 weeks of gestation.Methods and analysisThis trial is a multicentre, non-blinded, randomised study with 1:1 allocation ratio. The study is conducted at tertiary perinatal care departments in Poland. It will include patients with cervical insufficiency with the fetal membranes visible in the open cervical canal or protruding into the vagina between 16+0 and 23+6 weeks of pregnancy. They will be randomised into two arms: emergency single-level cerclage with vaginal progesterone or double-level cerclage with vaginal progesterone. All will be administered antibiotics and indomethacin. The primary outcome is the rate of deliveries below 34+0 weeks of gestation, while s...

Research paper thumbnail of 361. Effectiveness of cervical cerclage in twin pregnancies

European Journal of Obstetrics & Gynecology and Reproductive Biology, Mar 1, 2022

Research paper thumbnail of Molecular Pathways of Altered Brain Development in Fetuses Exposed to Hypoxia

International Journal of Molecular Sciences

Perinatal hypoxia is a major cause of neurodevelopmental impairment and subsequent motor and cogn... more Perinatal hypoxia is a major cause of neurodevelopmental impairment and subsequent motor and cognitive dysfunctions; it is associated with fetal growth restriction and uteroplacental dysfunction during pregnancy. This review aims to present the current knowledge on brain development resulting from perinatal asphyxia, including the causes, symptoms, and means of predicting the degree of brain damage. Furthermore, this review discusses the specificity of brain development in the growth-restricted fetus and how it is replicated and studied in animal models. Finally, this review aims at identifying the least understood and missing molecular pathways of abnormal brain development, especially with respect to potential treatment intervention.

Research paper thumbnail of Monoamniotic twins pregnancy complicated by a fetal congenital heart defect – a challenge for perinatal decisions

Case Reports in Perinatal Medicine, 2020

Objectives To analyze pregnancy management and postnatal follow-up in monochorionic monoamniotic ... more Objectives To analyze pregnancy management and postnatal follow-up in monochorionic monoamniotic (MCMA) pregnancies complicated by a congenital heart defect (CHD) in one twin and to compare the results with current recommendations concerning time and mode of delivery in MCMA pregnancies. Cases presentation Perinatal medical records of five pairs of monoamniotic twins referred to Fetal Cardiology Department were analyzed. 5 out of 23 MCMA pregnancies (21.7%) were complicated by CHD in one fetus. Cesarean section (CS) was performed between 32 and 35 weeks of gestation (WoG). 9 out of 10 neonates had respiratory failure, including all patients with CHD. Twins without congenital abnormalities spent median 21 days (range 10–40 days) in neonatal units. Patients with CHD were transferred to cardiology departments on average 6th day of life. All were operated on later than term-born neonates, 4 out of 5 required stage surgery and their median stay in the hospital was 75 days (range 48–106 d...

Research paper thumbnail of A unique case of diagnosis of a heterotopic pregnancy at 26 weeks – case report and literature review

BMC Pregnancy and Childbirth, 2021

Background Heterotopic pregnancy (HP) is a rare condition when at least two pregnancies are prese... more Background Heterotopic pregnancy (HP) is a rare condition when at least two pregnancies are present simultaneously at different implantation sites and only one located in the uterine cavity. The majority of cases are diagnosed in the first trimester. Case presentation We present a unique case of HP diagnosed at 26 weeks of spontaneous pregnancy in a patient without any relevant risk factors. We performed an extensive review of HP cases from MEDLINE (PUBMED) published in English between 2005-2019 to prove this case's uniqueness. A 24-year-old woman presented because of threatened preterm birth. Despite treatment, pain aggravated, without progression of labor. An emergency ultrasound exam revealed free fluid in the abdominal cavity. Suspicion of active bleeding prompted the medical team to perform an exploratory laparotomy. The surgery team found a ruptured heterotopic pregnancy. This was an unexpected cause of nontraumatic hemoperitoneum at such advanced gestational age. The post...

Research paper thumbnail of Additional file 1 of A unique case of diagnosis of a heterotopic pregnancy at 26 weeks – case report and literature review

Additional file 1: Table 1. List of case reports of heterotopic pregnancies used in the analysis.

Research paper thumbnail of Ciąża heterotopowa

Ciąża heterotopowa (ang. heterotopic pregnancy, HP) to rzadkie schorzenie, w którym doszło do imp... more Ciąża heterotopowa (ang. heterotopic pregnancy, HP) to rzadkie schorzenie, w którym doszło do implantacji co najmniej dwóch jaj płodowych jednoczasowo w różnych miejscach w organizmie kobiety. Naturalne występowanie HP wynosi 1:30 000, jednak metody rozrodu wspomaganego zwiększają częstość tej patologii do 1:125. HP pozostaje stanem zagrażającym życiu, opisanym głównie w pierwszym i na przełomie pierwszego i drugiego trymestru ciąży. Autorzy przeprowadzili przegląd piśmiennictwa w celu oceny najnowszych czynników ryzyka, sposobów rozpoznawania i leczenia ciąży heterotopowej. Słowa kluczowe: Ciąża heterotopowa, ciąża pozamaciczna, metody rozrodu wspomaganego, ostry brzuch w ciąży

Research paper thumbnail of Medical care for a pregnant woman with a multiple pregnancy

Opieka nad ciężarną w ciąży wielopłowej z uwagi na zwiększone ryzyko wystąpienia powikłań zarówno... more Opieka nad ciężarną w ciąży wielopłowej z uwagi na zwiększone ryzyko wystąpienia powikłań zarówno typowych dla ciąż bliźniaczych (TTTS, TAPS, sIUGR), jak również częstsze występowanie powikłań położniczych, takich jak poród przedwczesny, preeklampsja, cukrzyca i inne, wymaga częstszych wizyt i badań USG. Postępowanie położnicze powinno być nastawione na wczesne wykrywanie powikłań i jak najszybsze wdrożenie odpowiedniego leczenia. Omówione zostały proponowane przez różnych autorów schematy opieki ambulatoryjnej, jak również wskazania do hospitalizacji oraz czas i sposób ukończenia ciąży w zależności od kosmówkowości i owodniowości oraz ilości płodów. Podsumowanie ma na celu ułatwić położnikowi podjęcie szybkiej decyzji klinicznej. W artykule uwzględniono akty prawne obowiązujące w Polsce oraz wytyczne polskich i międzynarodowych towarzystw ginekologiczno-położniczych. Dodatkowo omówiono sposób wykrywania i postępowania w przypadku wystąpienia powikłań specyficzny dla ciąż wielopłodo...

Research paper thumbnail of Large-for-gestational-age or macrosomia as a classifier for risk of adverse perinatal outcome: a retrospective cross-sectional study

The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians, 2021

OBJECTIVE Small for gestational age (SGA) fetuses and neonates are of great interest, while those... more OBJECTIVE Small for gestational age (SGA) fetuses and neonates are of great interest, while those who are too big are much less studied. The aim was to analyze the classifiers described by ACOG "Fetal macrosomia" practice bulletin as predictors of adverse perinatal outcomes for overgrown fetuses and their mothers. MATERIALS From a database of 53,586 singleton term births, appropriate-for-gestational-age (AGA), large for gestational age (LGA), and macrosomic deliveries were selected. AGA served as a control. The crude and adjusted odds ratios (aORs) were calculated for large-for-gestational-age >90th centile, and macrosomia >4000 g, >4250 g, and >4500 g. Patients with and without diabetes were analyzed separately. RESULTS Macrosomia >4000 g performed poorer than other classifiers. LGA performed comparably to other definitions of macrosomia. Diabetes carries a severe risk of complications for overgrown neonates, but those non-diabetic also have increased risk....

Research paper thumbnail of Is growth restriction in twin pregnancies a double challenge? – A narrative review

Background Foetal growth restriction (FGR) complicates about 25–47% of twin pregnancies. One or b... more Background Foetal growth restriction (FGR) complicates about 25–47% of twin pregnancies. One or both foetuses can be restricted. Pregnancies with discordant growth of foetuses are associated with a sevenfold increased risk of neonatal morbidity. Materials and methods This is a narrative or traditional literature review. A literature search was performed to present a comprehensive, critical and objective analysis of the current knowledge on growth restriction in twin pregnancies. Results The definitions of FGR in twin pregnancies and selective FGR (sFGR) differ between international societies. In 2019, the Delphi procedure aimed to unify the definitions of sFGR in twin pregnancies. Several growth charts for twins have been published. However, most societies recommend singleton growth charts as better in detecting hypoxic complications of FGR in twin pregnancies. Discordant growth in twins results from placental insufficiency, congenital anomalies, chromosomal aberrations and TORCH in...

Research paper thumbnail of Foetal goitrous hypothyroidism - easy to recognise, difficult to treat. Is combined intra-amniotic and intravenous L-thyroxine therapy an option?

Endokrynologia Polska, 2018

INTRODUCTION Foetal hypothyroidism negatively impacts somatic and neurological child development ... more INTRODUCTION Foetal hypothyroidism negatively impacts somatic and neurological child development and can be the cause of serious obstetric and perinatal complications. We present a rare case of a large foetal dyshormonogenetic goitre, causing foetal neck hyperexten-sion, oesophageal compression, and cardiac high-output failure. MATERIAL AND METHODS A foetal goitre complicated by cardiomegaly and polyhydramnios was diagnosed at 23 weeks of gestation (WG) on a routine ultrasonographic (US) assessment in a healthy nullipara. Foetal blood sampling was performed and a severe foetal hypothyroid-ism was diagnosed. Treatment was undertaken with an intra-amniotic followed by combined intra-amniotic and intravenous injections of L-thyroxine (L-T4). A total of 11 doses of L-T4 were administered between 24-37 WG to the foetus. RESULTS A complete regression of foetal goitre, cardiomegaly, and polyhydramnios was observed. At 38 WG the patient delivered vagi-nally a male infant with mild hypothyro...

Research paper thumbnail of Fetal Growth Diagnosis and Management among Perinatal Medical Professionals: A Survey of Practice and Literature Review

Introduction: This paper aimed to assess the knowledge of healthcare professionals (obstetric and... more Introduction: This paper aimed to assess the knowledge of healthcare professionals (obstetric and gynecology residents, specialists, and midwives) in the field of perinatal medicine regarding fetal growth diagnosis and management. Methods: A questionnaire was created consisting of a set of questions regarding demographic data, methods of growth assessment, and management. It was a handout survey. The results were analyzed with the use of descriptive statistics and χ2 analysis using the program Statistica. Results: 190 medical professionals have participated in the questionnaire. 86.3% of respondents agreed that pregnancy dating should be modified based on first-trimester ultrasound. 90.9% agreed that III trimester ultrasound has a ±15% margin of error. When asked which growth charts are best fit for assessing growth in a studied population, 10.7% marked standard, 37.4% reference, 26.2% customized, and 26.2% did not know the difference between the three choices. 60.3% stated that the...

Research paper thumbnail of Uterine Artery Doppler Reference Ranges in a Twin Caucasian Population Followed Longitudinally From 17 to 37 Weeks Gestation Compared to That of Singletons

Journal of Ultrasound in Medicine

Research paper thumbnail of Compliance with gestational weight gain recommendations in a cross-sectional study of term pregnancies — how far reality falls from the standard?

Ginekologia Polska

Objectives: During pregnancy, two aspects are critical in the context of adverse perinatal outcom... more Objectives: During pregnancy, two aspects are critical in the context of adverse perinatal outcomes (APO): preconception obesity and gestational weight gain. This study aimed to assess compliance with the 2009 IOM guidelines, compare GWG with and without correcting for gestation duration, and observe the relationship between pre-pregnancy BMI and GWG and neonatal birth weight. Material and methods: This is a cross-sectional study conducted from 2015-2018 at the St. Sophia's Specialist Hospital in Warsaw, Poland. Self-reported pre-pregnancy and predelivery weight were collected. Results: The presented data set amounts to 7820 records. Analysis of weight gain compliance with IOM recommendations showed that only 41-44% (depending on the calculation method) of women had weight gain in accordance with IOM guidelines (22-23%below; 33-37% above). Overweight and obese women with diabetes are more likely to comply with IOM than women without diabetes. In contrast, women with normal-weight and underweight with diabetes are less likely to achieve IOM weight gain in pregnancy than women without diabetes. Women who have GWG below recommendations significantly more often gave birth to SGA neonates, and women who exceeded GWG standards significantly more often gave birth to LGA neonates. Conclusions: Less than half of women had GWG within the recommended norms. Statistically significant differences were found in methods of calculation of GWG, but it was not found clinically significant. Correction for pregnancy duration when calculating GWG reclassifies two percent of patients. We underestimate the risk of crossing the line between overweight and obesity during pregnancy.

Research paper thumbnail of Growth Abnormalities as a Risk Factor of Adverse Neonatal Outcome in Hypertensive Pregnancies—A Single-Center Retrospective Cohort Study

Children

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

Research paper thumbnail of Successful pregnancy in women with inferior vena cava stenosis — case report and discussion

Ginekologia Polska

Objectives: Inferior vena cava syndrome (IVCS) is a heterogenous group of symptoms resulting in o... more Objectives: Inferior vena cava syndrome (IVCS) is a heterogenous group of symptoms resulting in obstruction of the main vein inflow . Common reasons are thrombotic changes and tumors. Incidence of inferior vena cava (IVC) anomalies is 0.3% in general population. Iatrogenic IVC lesions caused by catheter insertion play increasing role. Treatment varies depending on the condition.