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Objective: Whether epidural analgesia (e.a.) have influence on the way of delivery, indications to cesarean section (c.s.) and neonatal outcome., Material and Methods: We have analysed 8784 deliveries. We excluded women with plural pregnancy, pre-term parturitions, elective c.s., still births. Finally we studied 339 parturitions with e.a. versus 6868 the others and theirs newborns., Results: More frequent c.s. was in women with e.a. (18.6% vs 7.9%; p < 0.001) or forceps (f.d.) (7.7% vs 3.5%; p < 0.005). Among those with e.a. the most frequent indications to c.s. were labour with no progression (23.4% vs 4.0%; p < 0.001) and the others as hypoxia fetus (68.7% vs 82.6%; p < 0.01). The lost of blood with oblique to transfusion was more frequent at f.d. at comparison to c.s. and spontaneous delivery (26.9% vs 3.2% and 6.8%; p < 0.001). The condition of neonates at 1 min. according Apgar score was the worse after f.d. in comparison to spontaneous delivery (7.38 +/- 2.22 vs 8.79 +/- 1.41 points; p < 0.005) and after c.s. (7.38 +/- 2.22 vs 8.55 points; p < 0.05). In comparison the state at 5 min. was the similar after f.d. (9.11 +/- 1.24 vs 9.53 +/- 0.81 points; p = 0.05) and (9.11 +/- 1.24 vs 9.48 +/- 0.83 points; p = 0.09)., Conclusions: Women with epidural analgesia more frequent were ending the delivery by cesarean section or forceps. The forceps delivery was related with worse neonatal outcome at first minutes of live, and bigger lost of blood during labour. Epidural analgesia predisposed to cesarean section delivery caused of partus without progress and relatively deminished caused by fetus hypoxia.

Objective: Our purpose was to determine the incidence, risk factors and pregnancy outcome among women with vaginal growth of Candida species., Materials and Methods: In the period from January 1, 1994 to December 31, 1997 inoculation results have been assessed of vaginal secretions collected on a standard Sabouraud base and demographic data has been collected of 10,825 pregnant women delivering in single and full-term pregnancy in the Municipal Hospital in Bydgoszcz., Results and Conclusions: Positive inoculation results for Candida sp. has been noted by 2248 women, which constitutes 20.77% from the delivering women meeting the above mentioned conditions. Properties correlated with positive inoculation results were: living in the country (23.55%), age--below 20 years (24.56%), civil status--widow or divorced (23.88%), vocation (22.66%) or primary education (22.44%), unemployment (22.82%), third or further birth (21.26%) and earlier pregnancy complications (22.46%). An analysis of two simultaneously occurring factors has disclosed a very high percentage of positive inoculation results--in the group of women attending school and residing in the country (37.50%) and women below 20 years of age that have had earlier pregnancy complications (42.31%).

Objective: The rates of Candida species and susceptibility to nystatin were evaluated., Materials and Methods: In the period from January 1, 1998 to December 31, 1998 mycological tests have been carried out for identification of yeast species in the group of pregnant and delivering women hospitalized in the Obstetrics-Gynecological Departments of the Municipal Hospital in Bydgoszcz. We used two commercial media: Albicans ID and CHROMagar Candida. Noted have been 389 positive inoculation results for Candida from vaginal secretions., Results and Conclusions: From the total number of 416 differentiated fungus strains decidedly dominant was the species Candida albicans--constituting 81.97% of all strains. The second frequently occurring fungus species was Candida glabrata--11.06%. Further species were C. krusei--2.16%, C. tropicalis--1.20% and C. guilliermondii--1.20%. In 10 cases (2.41%)--in spite of carrying out the laboratory activities that are necessary in such a situation--the species type of tested strains could not be determined. The simultaneous occurrence of two Candida species has been noted in material originating from 27 women (6.94% of cases). Defining the drug-resistance of 93 Candida species strains against nystatin by means of the disk-diffusion method--it has been started that this drug is highly effective--81.72% of sensitive strains.

Objective: The purpose of the study was to analyses the sensitivity of 73 randomly selected Candida albicans strains isolated from the vagina of pregnant and delivering women against seven basic antimycotics., Materials and Methods: The microtest FUNGITEST (Sanofi Diagnostics Pasteur) was applied in assessing the sensitivity of 5-fluorocytosin, amphotericin B, ketoconazol, fluconazol, itraconazol and miconazol and the disk-diffusion method with the use of a Casitone base for nystatin., Results and Conclusions: Variations in the sensitivity against drugs have been noted between individual strains of Candida albicans species. The largest number of strains was resistant against ketoconazol--56.16%, and only 10.96% was resistant against nystatin.

Objective: To evaluate the effects of leaving the visceral peritoneum open and hysterotomy closing by a one-layer continuous locked., Materials and Methods: The analysis of 868 women underwent caesarean section had been performed. All operated patients were divided into three compared groups. 268 women operated between 01.05.96 and 31.01.97, belonged into I group, which had the visceral peritoneum sutured during caesarean section, in comparison to the II group operated between 01.05.97-31.01.98 (n = 280), which had only one modification in surgical procedure--the visceral peritoneum was left unsutured and to the group operated between 01.05.98-31.01.99 (n = 320) with second modification--the hysterotomy was closed by a one-layer continuous locked., Results: The average operating time was significantly shorter at group II and III. After surgery we have not observed significant differences in frequency of febrile morbidity (6.34% in I group, 8.93% in second group and 8.44% in third group) and postoperative complications (respectively 9.33; 11.07 and 10.63%)., Conclusions: Non-closure of the visceral peritoneum and closure of the hysterotomy by a one-layer continuous locked has no influence on the number of the post surgical complications. Modifications method of cesarean section showed significantly decreased operative time and chirurgical materials use.

Objective: The analysis occurrence of developmental defects of newborns in the City Hospital in Bydgoszcz during the period 1995-1999., Materials and Methods: Over the period of 5 years, 14,943 newborns delivered in City Hospital in Bydgoszcz. The group of 358 (2.40%) with developmental anomalies was analysed retrospectively. The subject of the study was to estimate the types of malformations and their frequency., Results: In our material cardiovascular anomalies (29.05%), reproductive system anomalies (20.11%) and muscosceletal anomalies (18.72%) were most frequent. Breech-presented or transverse lie fetuses had double the risk of any anomalies. In addition, pre-term delivery were not positively associated with any newborn defects. The frequency of occurrence cesarean sections was positively correlated with presence of congenital malformations.

Changes in the fibrinolytic system of parturient women have so far been only partially documented. Our main questions were whether and how the concentration of tissue plasminogen activator (tPA) and plasminogen activator inhibitors of type 1 (PAI-1) and type 2 (PAI-2) change in the plasma throughout normal labor. The study group consisted of 38 women with normal pregnancy, delivering at term. The concentration of antigens tPA, PAI-1 and PAI-2 in plasma was tested by enzyme-linked immuno-sorbent assay method, and the activity of PAI-1 by plasmin method. Results were analysed statistically. During labor the level of tPA antigen increases over two times: from 9.3 +/- 4.3 ng/ml before labor, to 23.3 +/- 9.6 ng/ml in the second stage of labor. Changes of PAI-1 antigen as well as its activity though noticeable, were not statistically significant. PAI-2 antigen level increased significantly in the third stage (146.3 +/- 58.7 ng/ml before labor, and 212.2 +/- 75.0 ng/ml after placenta expulsion). In summary the more significant change in the fibrinolytic system during labor is an increase of the level of tPA and PAI-2 antigens, but their peaks appear in different stages of labor. The predominance of PAIs over tPA is maintained throughout the whole labor, though on a lower level as can be inferred from the tPA/PAIs ratio.

The hysterosalpingography was performed with 191 women with primary sterility. Pathologic transformations in oviducts were found among the 46 (45.5%) women besides pathology of the uterus which concerned 16 (15.9%) women. Impatency of uterine tube (the right oviduct--13.0%, the left--12.9%) and peritubal adhesions (9.0% on the right side and 12.9% on the left) were the most frequent changes. Hysterosalpingography is a precious diagnostic method in primary sterility and it should be perform comparatively early in the quality of screening examination. A pathology which was affirmed or suspicion of the pathology should be next diagnose with the most invasive methods.

Lead in organic and inorganic compounds is a health risk factor leading after high-grade exposure to poisoning. It can accumulate in the organism and exert toxic effects, especially on the haemopoietic system and nervous system. Its action includes damage to cell membranes and disorders of the oxidoreductive processes in the cells. Hypothyroidism occurring in subjects with occupational exposure to lead may evidence a negative effect of the element on thyroid function.