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Objective: Implementation of minimally invasive selective ischemization of uterine leiomyomas at fertile age women., Design: Pilot study., Settings: Gynecological institute GynCentrum, Prague., Subject and Methods: Ultrasound guided laparoscopic electro-coagulation of myoma's vascular stalk was carried out at consecutive 48 women during June 2000-June 2002., Results: Significant reduction of the original size of the leiomyoma was achieved at 98% of women during 3 months after the surgery. No surgery complications were observed as well as any obstetrical complications at five patients getting pregnant after the procedure., Conclusion: In addition to good therapeutic effect this minimally invasive technique brings more rapid recovery, smaller visible incisions and reduced complication, particularly during consequent pregnancy.

Objective: Proposal of antenatal Down syndrome screening protocol using integration of first and second trimester results., Design: Review., Setting: Antenatal screening centre GENNET, Prague., Methods: Search of relevant articles, software analysis and pilot implementation., Results: Screening of Down syndrome (DS) is divided into two phases: at first phase combined DS risk is calculated using pregnancy plasma protein-A (PAPP-A) at 9th-11th gestational week and ultrasound fetal nuchal translucency (NT) at 11th-13th week with risk cut-off 1/100 (about 2 per cent of screened). Positive mothers are counselled immediately after NT measurement: First phase negative mothers continue to second phase where PAPP-A and NT values are integrated with second trimester screening results. Protocol is supported with special software (Obstetrician's Screening Guide-OSG)., Conclusion: At proposed protocol the information on significant first trimester DS risk is not withheld to second trimester and mother can choose early prenatal diagnosis. Expected detection rate is near 90 per cent at 5 per cent false positive rate.

Objective: Elaboration of a maximally safe and comfortable technique of collection of amniotic fluid (AMC)., Design: For practice., Setting: Gyncentrum Ltd., Hloubĕtínská 3, Praha 9, Dept. of Medical Genetics GENNET, Klimentská 1, Praha 1., Method: In 81 patients AMC was performed using a needle with an external diameter of 0.53 mm, by the sampling system Vacutainer of Becton-Dickinson Co., Conclusion: The method elaborated by the authors appears to be perspective for use in invasive procedures in the sphere of prenatal diagnosis.

The authors investigated within the framework of non-specific immunity reactions proteins of the acute phase during spontaneous delivery and Caesarean section up to the 5th day after delivery and on the 1st, 5th and 10th day after delivery in forty women, half of them healthy and half suffering from late gestoses. Half the women had spontaneous deliveries, half had deliveries by Caesarean section. The proteins of the acute phase reacted sensitively to the stress of childbirth during spontaneous delivery and their activation was inhibited by general anaesthesia in deliveries by Caesarean section. After spontaneous delivery the elevated proteins of the acute phase returned to baseline values by the 5th day, after operation their levels rose further up to the 5th day, orosomucoid to the 10th day after operation. In late gestoses with spontaneous delivery or by Caesarean section there were significantly elevated alpha-1-antitrypsin and alpha-2-macroglobulin and orosomucoid levels, whole in patients with late gestoses in the prealbumin levels were reduced. The elevated levels of proteinase inhibitors in late gestoses support the view on a possibly impaired coagulation equilibrium in late gestoses, and the high ceruloplasmin levels suggest an enhanced catecholamine breakdown during the stress alarm reaction.

Within the framework of the stress theory the authors investigated total cortisol levels in the maternal serum during spontaneous delivery and 24 hours after delivery in 20 women half of whom had a non-complicated pregnancy and half had an EPH gestosis. They investigated also cortisol levels in 20 women during delivery by Caesarean section; half of them had a normal pregnancy and half had suffered from gestosis. At the onset of delivery and operation resp. women with gestosis had significantly elevated cortisol levels, as compared with healthy women. During spontaneous delivery the levels of this hormone had a rising trend with the peak during delivery of the foetus and return to pre-delivery values after 24 hours. During Caesarean section the cortisol levels rose only insignificantly and in gestoses they declined already at the end of the operation. In the discussion the authors draw attention to the activation of the stress axes during delivery and attempt to explain the elevated cortisol levels during delivery and in late gestoses.

The effects of terguride on the uterotonic activity of rat's uterine stria were investigated by means of a standardized isometric method of measuring in vitro the contractility of uterine muscles. The uterotonic activity of the given preparation depends on its concentration and on the phase of uterine cycle. The uterotonic activity makes 71.4 U.mg-1 in the range of terguride concentrations from 10(-7) to 10(-5) mg per ml. Used at higher concentrations, the uterotonic activity of terguride is very low. Spontaneous contractions are moderated and the tone of uterus is decreased by terguride administration.

The isometric method of assessment of the contractility of uterine strips in vitro makes it possible to follow up systematically the response of smooth uterine musculature to oxytocin and to test the effect of selected preparations on this process. In the submitted work the author investigated the effect of methyloxytocin, magnesium sulphate, seduxene, phenergan, plegomazine and DH-ergotoxin on the uterine contractions of strips of rat and human uteri ted. Based on the results of model experiments in vitro, the author discusses the effect of the mentioned substances on the spasmogenic activity of oxytocin.

Using a standard isometric method, the authors investigated the effect of some cations and nifedipine on the contractility of isolated strips of the human uterus in vitro. Evidence was provided that the contractility depends on the extracellular surface concentration of the calcium cation. Under the experimental set-up used intracellular calcium does not play any part and the contractions of the uterine strip depend on the state of the calcium channels.