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Pregnancy induced hypertension and pre-eclampsia, defined as hypertension and proteinuria after 20 weeks of pregnancy with no history of such symptoms, are a great challenge in the field of perinatology They are a serious threat to the mother and the child. Regardless of numerous studies on the subject, the pathogenesis of pregnancy-induced hypertension and pre-eclampsia is still unknown, although a crucial role of genetic factors combined with environmental factors has been confirmed. New theory based on genetic analysis of Renin-Angiotensin System and its impact on blood pressure in pregnant women, has been subject to much debate recently Numerous genes have been studied but angiotensinogen remains to be the best known. Little is known about angiotensin receptor type 1 and 2. This paper presents the knowledge about selected genes of RAS and their impact on pregnancy

Objective: In current literature, the immune-inflammatory theory of atherosclerosis is widely discussed. The role of how adhesion molecules contribute to the development of atheromatic plaques is especially underlined., Material and Methods: 120 females in menopausal age were included in the study between 2004 and 2009. All the women were of menopausal age (51±3 years), from southern Poland, with FSH levels above 30 mIU/ml, and complaining of menopausal symptoms that disturbed normal daily activity. The study was conducted over a 6 month period. Three groups of 40 randomized patients were selected. The control group consisted of 40 volunteers, who were also from southern Poland, in good health, without menopausal symptoms, or menstrual periods in the last 6 months. Control subjects were match according to age and weight, with FSH levels above 25 mIU/ml and normal TSH and prolactin values. All patients, in the treatment and control groups were seronegative for Chlamydia pneumonia throughout the duration of the study., Results: After 6 months, hormonal therapy was found to significantly reduce levels of sICAM-1 and sVCAM-1 in all treated groups compared to the control group and the results were statistically significant. Alternatively, in the latter group, we observed increased levels of the investigated adhesion molecules (group I: 37.5 µg/24h transdermal estradiol + dydrogesteron; group II 50 µg/24h transdermal estradiol + medroxyprogesteron; group III 1mg of oral estradiol + noretisteron sICAM-1 and control group; using paired Wilcoxon test)., Conclusion: All of the investigated estrogen therapy schemas have a favorable impact on the blood levels of sICAM-1 and sVCAM-1 in postmenopausal women without cardiovascular risk factors, reducing their concentration.

The management of thyroid disorders during pregnancy is one of the most frequently disputed problems in modern endocrinology. It is widely known that thyroid dysfunction may result in subfertility, and, if inadequately treated during pregnancy, may cause obstetrical complications and influence fetal development. The 2007 Endocrine Society Practice Guideline endorsed with the participation of the Latino America Thyroid Association, the American Thyroid Association, the Asia and Oceania Thyroid Association and the European Thyroid Association, greatly contributed towards uniformity of the management of thyroid disorders during pregnancy and postpartum. Despite the tremendous progress in knowledge on the mutual influence of pregnancy and thyroid in health and disease, there are still important areas of uncertainty. There have been at least a few important studies published in the last 3 years, which influenced the thyroidal care of the expecting mother. It should also be remembered that guidelines may not always be universally applied in all populations with different ethnical, socio-economical, nutritional (including iodine intake) background or exposed to different iodine prophylaxis models. The Task Force for development of guidelines for thyroid dysfunction management in pregnant women was established in 2008. The expert group has recognized the following tasks: development of the coherent model of the management of thyroid dysfunction in pregnant women, identification of the group of women at risk of thyroid dysfunction, who may require endocrine care in the preconception period, during pregnancy and postpartum - that is in other words, the development of Polish recommendations for targeted thyroid disorder case finding during pregnancy, and the development of Polish trimester-specific reference values of thyroid hormones. Comprehensive Polish guidelines developed by the Task Force are to systematize the management of the thyroid disorders in pregnant women in Poland.

Objective: Verify that resistance to aspirin may have an impact on pregnancy and neonatal outcome., Methods: We enrolled 43 pregnant women, aged 30.7 ± 4.0 years regularly taking 75 mg of aspirin daily and 32 (aged 30.8 ± 4 years) pregnant women not receiving aspirin who served as control group. Laboratory tests were performed at 18 to 22 weeks of gestation, 28 to 32 weeks of gestation and 16 to 32 weeks after delivery. Resistance to aspirin was defined as urinary 11-dehydrothromboxane B2 (u11-dTXB2) concentrations in the highest quartile and additionally, as the resistance index (RI) calculated for each woman, defined as the difference between u11-dTXB2 concentration of each woman treated with aspirin and the median value at the same time point measured in the control group., Results: Women taking aspirin in the highest quartile of u11-dTXB2 delivered prematurely (35.8±3.4 vs 38.1±1.7 weeks, p=0.02). Delivery of small for gestational age (SGA) newborns (p=0.003) as well as fetal distress (p=0.014) and preeclampsia (p=0.003) occured more frequently in aspirin-resistant women. Resistance to aspirin based on the RI value was also associated with higher prevalence of preeclampsia (p=0.02) and SGA newborns delivery (p=0.01). The two groups resistant to ASA designed on the basis of both (RI and u11-dTXB2 urine levels) methods compared with ASA sensitive group differed in frequency of SLE prevalence., Conclusion: Aspirin resistance may be associated with increased risk of adverse pregnancy outcomes including preeclampsia, premature delivery and delivery of SGA newborns.

The development of operative laparoscopy in gynecology and obstetrics has greatly increased in the past decade. The Authors attempt to show the most important applications of the laparoscopic procedures in the diagnostics and therapy of gynecological diseases.

Uterine leiomyomata are the commonest neoplasms of the female reproductive system in the procreative age. In these cases operation is still a treatment of choice. The procedure's range depends on: number, size and localisation of the myomas, patient's age and possession of children. Currently uterine leiomyomata are removed more frequent by endoscopic operations. We present the technique of laparoscopic myomectomy taking into consideration very important problem--patients' qualification this procedure. We pay attention to necessity of precise closing the wound in layers after removed myoma, which seems to prevent uterine rupture during pregnancy and labour. We also present some controversial aspects of using GnRH analogues. In summary we emphasise benefits of laparoscopic myomectomy particularly for women in the procreative age, who are planning pregnancy.

Uterine leiomyomas are benign tumours that arise from the smooth-muscle cells of the human uterus. They are clinically apparent in up to 20% of women and cause significant morbidity, including prolonged and heavy menstrual bleeding, pelvic pressure or pain and reproductive dysfunction. Surgery has been the mainstay of fibroid treatment and various minimally invasive procedures have been developed in addition to hysterectomy and abdominal myomectomy, but formation of new leiomyomas after these conservatives therapies remains a substantial problem. The pathophysiology of myomas is not well understood. We present some views of epidemiological, reproductive and environmental factors, which may stimulate myomas formation. We also present a brief survey of the literature about genetic predisposition, mutations, steroid hormone and growth factors concentration, which seems to pay an important role in fibrotic processes and angiogenesis observed during formation and growth of these tumours. New research into the basic biology of these neoplasms may add new treatment options for the future as the role of growth factors and genetic mutations in these tumours are better understood.

Preterm delivery is still one of the most important problems of the modern obstetrics. In our country frequency of preterm delivery is 7.2-8.4% of all deliveries. Although preterm birth is the leading cause of perinatal morbidity and mortality, the diagnosis and appropriate treatment of preterm labor remains an unresolved clinical problem. A growing body of evidence supports the view that preterm labor is a syndrome with multiple causes and the urogenital infections play a very important role in the pathogenesis of preterm birth. The study analyses relationship between results of microbiological examination of cervical smear and preterm rupture of membranes.

The Authors present a delivery of conjoined twins--thoracopagus, of an 18 years old primigravida. A pregnant woman was admitted to delivery room with full cervical dilation. She underwent ultrasonography examination which showed bigeminal pregnancy--two fetus in breech presentation with the suspicion of conjoined twins. Ultrasonography measurements of fetus corresponded to gestational age of 23 weeks. The heart rate of the first fetus was about 40 per minute, the heart rate of the second fetus was undetectable. She underwent delivery through manual extraction of the fetuses. Both fetuses were female, without any signs of life. The result of the autopsy was: Hemithoracogastropagus holoacardius immaturus.

Intrauterine device (IUD) is a widely used method of contraception in the world. The aim of our study was to examine infectious cases due to a prolonged use of IUD. We present four patients who had carried IUD for about seventeen years. On admission, all cases were presenting symptoms of acute adnexitis. On further examination, we diagnosed tubo-ovarian abscess in two patients. In our article, we carefully describe all cases and focus attention on side effects of abnormally extended period of using IUD. We conclude that the only proper way of informing patients how to use IUD and good gynecological care while using IUD may protect against severe infectious complications of the genital tract.

Introduction: Proper diet during pregnancy is one of the conditions of correct fetal development and maintenance of good health of pregnant women. Increased demand for energy and nutritial substances is connected with growth of mother's tissue mass and also with growth of fetals mass and afterbirth. During pregnancy, quality composition of ailment is not only important, but also the quantity and regularity in taking meals., Aim: The aim of this study was to investigate nutrician status of pregnant women hospitalized in Department of Obstetrics and Gynaecology Collegium Medicum of The Jagiellonian University., Methods: There were 96 women, hospitilized for complications during pregnancy, from 1.11.2002 to 28.02 2003, in Department of Obstetrics and Gynaecology Collegium Medicum of The Jagiellonian University, asked for filling up the questionnaire about their diet during pregnancy., Results: Medium age of patients was 28.3 years. 47% of women were multiparas. Average body mass before pregnancy was 60 kg and BMI (Body Mass Index) was 21.95. 46% examined women had highschool education. In 96 of questioned women 50% took informations about proper diet during pregnancy from the pass, only 12.5% from the obstetricians. None of the questioned women defined their nutritian condition as bad or mild, for 72% it was good and for 28% very good. Most of them (69%) applied common diet without modifications, only 6% of women had good digestive diet. Alcohol was consumed occasionally by 22% of women, rest of them did not consume it at all. Majority of women, 90.5% did't smoke cigarettes, 6.5% smoked occasionally and 3% up to 10 cigarettes per day., Conclusions: 1. Obtained data suggests that nutrition habits don't change significantly during pregnancy. 2. Pregnant women are not enough informed about healthy diet during pregnancy by doctors which leads to irregularity in taking meals. 3. General nutritial status of pregnant women could be considered satisfactory in the most of cases.