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Objective: The aim of the study was to evaluate the possibility of conception and the course of pregnancy in women with cervical cancer (FIGO IA and IB1), who underwent fertility-sparing surgical management, i.e. surgical conization or radical vaginal trachelectomy with laparoscopic lymphadenectomy., Material and Methods: A total of 80 patients treated surgically due to cervical cancer constituted the study group. Out of them, 65 (85%) women underwent surgical conization (43--FIGO IA1 and 25--FIGO IA2), and 12 (15%) women underwent radical vaginal trachelectomy with laparoscopic lymphadenectomy (9--FIGO IA2 and 3--FIGO lB1). Cervical cerciage was performed in all patients after trachelectomy., Results: A total of 52 (76.5%) women after surgical conization successfully conceived. Out of them, 3 (5.8)% women miscarried (1 before 12 and 2 between 12-22 weeks of gestation), 2 (3.8%) delivered pre-term (at 26 and 34 weeks of gestation), and 47 (90.4%) delivered at term, including 5 (10.2%) cesarean deliveries, 1 (2.0%) vaginal delivery with the use of the Bracht Manoeuve; and 43 (87.8%) normal vaginal deliveries. Six (50.0%) women after radical vaginal trachelectomy successfully conceived. Out of them, 1 (16.7%) woman miscarried (at 19 weeks of gestation), 2 (33.3%) delivered pre-term (between 22-32 weeks of gestation), and 3 (50%) delivered at term, including 1 (20%) vaginal delivery at 25 weeks of gestation and 4 (80%) cesarean deliveries (1 at 29 weeks of gestation and 3 at term)., Conclusions: Fertility-sparing surgical management in subjects with early-stage cervical carcinoma, provided the patients have been properly qualified for the procedure, allows a significant number of the affected women to conceive, have a normal pregnancy and delivery

Smoking is a significant factor which affects not only reproduction and the process of pregnancy but also the offspring. Endangering for tobacco smoke and nicotine either passive or active has an important influence for shortening the time of pregnancy, the weight of the newborn and the Placenta. The occurrence of complications connected with smoking is probably correlated with the amount of cigarettes smoked per day. The aim of the paper was to analyse the influence of passive and active smoking on the course of pregnancy. The study involved a group of 113 women who gave birth in Gynaecological and Obstetrics Clinical Hospital of the Karol's Marcinkowski University of Medical Sciences in Poznan during the period from January to June 2011. Based on data gained from documentation and mothers three groups were separated: 22 women who were active smokers, 32 passive smokers and 59 women from control group who have never been smoking. There were analyzed selected obstetric data and term of pregnancy, condition and weight of newborn, blood pH and alkaline balance from umbilical vessels. In research there were no correlation between groups and/or results of researches of blood Ph, alkaline balance from umbilical vessels and the assessment of the newborn in Apgar score at 1, 3, 5 minute. In fact passive smoking women were younger (the average 27.84) than actively smoking woman (30.23) and non-smokers (30.25) (p = 0.03). The most of small as for their gestational age infants were in the group of active smoking women (14%). Non-smokers more often did have a miscarriage (84%) in the past than other groups (active smokers 60%, passive 33%) (p = 0.04). Smoking women usually come from countryside or small towns, they were not marriage and they had preterm delivery. In this group there was found the biggest percent of too small newborns for their gestational age--14%.

Objectives: the aim of this retrospective study was to assess if a first trimester subchorionic hematoma (SCH) influences the pregnancy outcome and whether pv bleeding can be a prognostic factor for the pregnancy course., Material and Methods: the study included 185 pregnant women hospitalized due to symptoms of a threatening miscarriage. Patients were divided into 2 groups: 119 women with SCH (study group) and 66 patients with normal prenatal scan (control group), further subdivided into cases with and without pv bleeding, irrespectively of the outcome of the ultrasound scan. Obstetric and neonatal data were analyzed., Results: 1. A pregnancy complicated by SCH is more often associated with a poor outcome -- 23.78% of the study group patients had a miscarriage versus 7.62% of the controls. 2. Pregnancy with SCH is more likely to be lost before 9 weeks of gestation. 3. The "N" ratio, that expresses the maximal length of the hematoma to the maximal length of the fetus, equal to 2.5 or more, is associated with a risk of miscarriage. 4. The surface area of SCH equal to 280mm(2) or more is more likely to reveal with vaginal bleeding. 5. Vaginal bleeding can be a prognostic factor for the mode of delivery -- a higher rate of the Cesarean section is observed in patients with pv bleeding. 6. SCH is a complication that occurs in older women, with the limit of 30 years of age. 7. In this study there were no significant correlations between subchorionic hematoma or pv bleeding and PTL, IUGR, PIH, abnormal volume of the amniotic fluid, parity and order of gestation and delivery, Conclusions: subchorionic hematoma can be associated with poor pregnancy outcome and the "N" index may be a useful predictor of the further course of a pregnancy Pv bleeding may be a prognostic factor for the delivery mode.

The term "miscarriage" refers to the end of pregnancy before the 22nd week of gestation, or taking into account the criterion of foetal weight (less than 500 g). Approximately 15-20% of recognized pregnancies and miscarriage involve spontaneous expulsion of the blastocyst from the uterine cavity. This constitutes about 80% of miscarriages in the first 12 weeks of gestation. The literature lists a number of factors which cause the loss of pregnancies. The most frequently cited causes of abortion are: genetic, anatomical, immunological and hormonal factors, and infections. A large number of miscarriages remain unexplained (idiopathic miscarriages). Clinical signs of miscarriage include bleeding and pain. Bleeding or spotting is the earliest sign of miscarriage. Data from the patient's history, physical examination, ultrasound examination and tests for hCG level can enable diagnosis of bleeding in early pregnancy, help to assess the degree of risk, and implement an appropriate treatment regimen and care for pregnant women adapted to their needs. Loss of pregnancy is an interdisciplinary problem involving obstetrics, epidemiology, public health, psychology, and other specialities. The role of medical personnel in the care of women after the loss of a child, regardless of the week and therapeutic procedures, as well as for giving adequate information regarding the rights of women after pregnancy loss. The obligation to inform women of their rights concerns medical staff, and it is important to promote knowledge in this field among doctors, nurses and midwives who care for women after miscarriage.

Unlabelled: Smoking is a significant factor which affects not only reproduction and the process of pregnancy but also the offspring. Endangering for tobacco smoke and nicotine either passive or active has an important influence for shortening the time of pregnancy, the weight of the newborn and the Placenta. The occurrence of complications connected with smoking is probably correlated with the amount of cigarettes smoked per day., Target: The target of the paper was to analyse the influence of passive and active smoking on the course of pregnancy., Methods and Materials: The study involved a group of 113 women who gave birth in Gynaecological and Obstetrics Clinical Hospital of the Karol's Marcinkowski University of Medical Sciences in Poznan during the period from January to June 2011. Based on data gained from documentation and mothers three groups were separated: 22 women who were active smokers, 32 passive smokers and 59 women from control group who have never been smoking. There were analyzed selected obstetric data and term of pregnancy, condition and weight of newborn, blood pH and alkaline balance from umbilical vessels., Results: in research there were no correlation between groups and/ or results of researches of blood Ph, alkaline balance from umbilical vessels and the assessment of the newborn in Apgar score at 1, 3, 5 minute. In fact passive smoking women were younger (the average 27,84) than actively smoking woman (30,23) and non-smokers (30,25) (p=0,03). The most of small as for their gestational age infants were in the group of active smoking women (14%). Non-smokers more often did have a miscarriage (84%) in the past than other groups (active smokers 60%, passive 33%) (p=0,04)., Conclusion: smoking women usually come from countryside or small towns, they were not marriage and they had preterm delivery. In this group there was found the biggest percent of too small newborns for their gestational age - 14%.

The Aim: The aim of the study was the analysis of antiphospholipid syndrome frequency in Polish women with pregnancy loss., Material and Methods: We analyzed 352 women with average age of 31.4 (+/- 4.3) who experienced one or more pregnancy losses. Patients from 5 University centers: Poznań, Białystok, Lublin, Wrocław and Bydgoszcz were divided into 3 groups. In the 1st group there were 150 women with recurrent early pregnancy losses before 10 weeks gestation, in the 2nd group we included 160 women with late pregnancy losses, in the 3rd group we analyzed 42 women with labor complicated by preeclampsia or placental insufficiency within or before 34 gestational week. All 352 women were screened for the presence of anticardiolipin antibodies (aCL), anti beta2glikoprotein I (abeta2GPI) and lupus anticoagulant (LA). The first two antibodies were investigated with ELISA test and the last one with APPT based test. Only the second positive result qualified patients as antiphospholipid antibody (aPL) positive. Antibodies against cardiolipin and beta2glicoprotein I were analyzed in three classes--IgA, IgG and IgM--where the laboratory criteria of positivity were titers above 40 unitsU/ml or above 99 centile., Results: 13 patients (3.69%) in the screened population of 352 women met the criteria of the antiphospholipid syndrome. The frequency of APS in women with early and late pregnancy losses were 1.33% and 6.25%, respectively. The most common antibody found was lupus anticoagulant (LA). In 3 women with late pregnancy loss all three antibodies were found. In women with premature deliveries complicated with preeclampsia and/or placental insufficiency the frequency of APS was 2.58%., Conclusion: 1. Screening of antiphospholipid syndrome should be routinely performed in women with late pregnancy loss 2. We can conclude that APS is rarely found in women with pregnancy loss before 10 gestational week.

Objectives: The demand for genetic amniocentesis in case of young pregnant women has significantly increased due to various new indications. Moreover, nowadays a growing number of women aged > or =35, who required genetic amniocentesis, get pregnant The aim of the following study has been to compare the course of the pregnancy, the delivery and the condition of the newborn in two groups of patients: 18-34 years old and > or =35 years old., Material and Methods: 783 women underwent the procedure of amniocentesis at the Department of Obstetrics of Medical University of Gdansk in 1996-2003. A group of 540 women, who answered the questionnaire about the course of the pregnancy and the delivery after the procedure, has been isolated., Results: Fetal loss occurred in 2 cases (1.6%) in the group of the younger women and in 8 cases (0.8%) in the group of > or =35 year-olds (p=0.84). There was no statistically significant difference between younger and older patients when comparing complications after the procedure in the first three weeks following amniocentesis: spotting, bleeding, leakage of amniotic fluid. Frequency of late complications such as gestational diabetes mellitus, pregnancy induced hypertension and urinary tract infections were comparable in both age groups women. Cesarean section has been more frequently performed in case of the older women than in the group of younger patients, with statistical difference p=0.003. In most cases (33.9%) it has been an elective cesarean section, performed due to advanced maternal age rather than any obstetric cause. Frequency of pneumonia and the number of respiratory infections in the newborns have been comparable in both groups., Conclusions: Prenatal invasive diagnosis has no influence on frequency of complications during pregnancy and delivery in the group of women less than 35 years old and more than 35 years old.

Objectives: The risk of fetal loss after amniocentesis is 0.2-1%. The aim of the study was to compare the course of pregnancy and delivery and the state of the newborn in patients after genetic amniocentesis and in the control group., Material and Methods: 783 patients who underwent amniocentesis at the Department of Obstetrics of Medical University of Gdansk in 1996-2003 and 221 women who did not undergo amniocentesis., Results: Fetal loss occurred in 8 pregnancies (3.8%) after amniocentesis and in 12 (5.4%) p=0.37 in the control group. There was no significant statistical difference between the amniocentesis group and the control group comparing complications during pregnancy such as gestational diabetes mellitus, pregnancy induced hypertension, urinary tract infections. Cesarean section was more often performed in the amniocentesis group than in the control group, statistical difference p=0.003. Most often (28.09%) there was an elective cesarean section because of advanced maternal age without any obstetrician cause. The frequency of pneumonia, respiratory infections and congenital malformations in the first weeks of life was more frequent in the amniocetesis group., Conclusions: Invasive prenatal diagnosis has no influence of the frequency of complications during pregnancy and delivery.

Objectives: Evaluation of the complications rate, as well as pregnancy outcome, in women who underwent early and mid-trimester amniocentesis., Material and Methods: The study was conducted among 454 patients, including 162 women after the procedure performed before 15 gestational week and 292 patients who underwent classic amniocentesis. All patients were hospitalized in Division of Reproduction of University of Medical Sciences in Poznan between 1999 and 2005. The analysis, based both on clinical observations and questionnaire sent to patients, concerned especially the frequency of following complications: miscarriage, premature rupture of membranes and club foot in newborns., Results: Total pregnancy loss rate due to amniocentesis amounted to 1.2% and 0.3% in early and mid-trimester amniocentesis, respectively, not reaching statistical significance. The frequency of club foot in newborns of mothers who underwent amniocentesis did not differ significantly between the groups, although it was four times higher in early amniocentesis group than in patients in whom mid-trimester amniocentesis had been performed., Conclusions: The safety of early amniocentesis is comparable with safety of mid-trimester amniocentesis.

Thrombophilia these days is a subject of many medical research including obstetric and gynecology where causing feto-maternal complications. In women predispose to venous thromboembolism in high risk situation like pregnancy, puerperium, operation, prolonged bed rest or hormonal treatment. For fetal complication account miscarriages, intrauterine deaths, IUGR, and for maternal account premature placental separation and severe preeclampsia. Diagnostic panel include inherited factors like factor V Leiden and prothrombin mutation, activated protein C resistance and acquired like anticardiolipin antibodies, antibodies against beta2-glicoprotein 1 and lupus anticoagulant. The aim of this paper is estimation ofthrombophilia as a causative factor of pregnancy complications and attempt to establish screening criteria for thrombophilia. Material involved 36 women with pregnancy complications divided into three groups correlating with trimester when pregnancy loss occured. All patients had genetic, hormonal and anatomic tests done on purpose to exclude other possible causes of miscarriages. All women had done both types of tests for inherited and acquired thrombophilia. For factor V and II gene polimorphism we used PCR and RLFP method. Acquired protein C resistance and lupus anticoagulant was tested using chronometric method with the use of time measurement of optical density accompanying coagulation. Anticardiolipin antibodies and antibodies against beta2-glicoprotien 1 were measured in ELISA tests. Our current results present the frequency of at least one thrombophilic factor in 16.6% patients. The highest frequency rate was observed among women with pregnancy loss between 7th and 12th gestational week--19.04%. In this group we also noticed the highest number of miscarriages. In remaining two groups, with pregnancy loss between 12th and 22nd and after 22nd gestational week, one case of thrombophilia occurred in each group.

The majority of connective tissue diseases, with the exception of scleroderma which is usually diagnosed past the age of 40 years, may affect women of reproductive age. Questions concerning the impact of the connective tissue disease upon pregnancy, interactions of pregnancy with the disease, and influence of the disease on fetal development are not easily answered. However, our knowledge on the pathogenesis of connective tissue diseases and the mechanisms of action of various antibodies is increasing, enabling improved disease control and reduction of adverse pregnancy outcomes. Multicenter, prospective clinical studies verified some unproven opinions about the adverse influence of pregnancy on scleroderma or systemic lupus erythematosus, as well as about their unavoidably fatal interactions with pregnancy. Careful pregnancy planning and cooperation of the rheumatologist, obstetrician and neonatologist helps avoid disease exacerbation and fetal misdevelopment. Acetylsalicylic acid and heparin reduce the adverse effect of antiphospholipid antibodies. Still, miscarriage, intrauterine fetal death, intrauterine growth retardation, and prematurity are more often encountered in women with systemic lupus erythematosus. However, the risk of adverse pregnancy outcome in these patients is gradually falling. Active lupus nephritis, hypertension, presence of antiphospholipid antibodies, and history of miscarriage are important risk factors. Pregnancy in women with diffuse type of scleroderma is of worse prognosis, often resulting in prematurity and low birthweight. Establishing the risk of immunosupressive and anti-inflammatory therapies enables better treatment of connective tissue diseases in pregnancy. Currently there is no doubt that pregnancy is contraindicated only in a small group of high-risk patients with connective tissue disease.

Objectives: Systemic lupus erythematosus (SLE) is an autoimmune disease predominantly affecting women of childbearing age, which may negatively influence the pregnancy course and outcomes. The objective of the study was to estimate the risk of fetal loss and prematurity in lupus patients. These data seem to be an important component of family counselling in lupus patients., Design: The pregnancies' course and outcomes in lupus patients and in healthy controls were compared., Material and Methods: 47 lupus patients with pregnancies occurring after the diagnosis of SLE and 108 healthy controls were included in this study. The pregnancies were analysed in terms of delivery term and outcomes (live births/ miscarriage/ neonatal deaths/ congenital defects). The structured review and case histories analysis were used to gather the data., Results: The percentage of spontaneous abortions (24.1%) and preterm deliveries (24.1%) were significantly higher in lupus patients when compared with healthy controls (9.3% and 5.3% respectively)., Conclusions: The caution in pregnancy planning in lupus patients is necessary and the role of physicians' information in patients' awareness of fetal loss and prematurity is vital.

About 10-15% of clinically diagnosed pregnancies end by spontaneous abortion. One of the causes of recurrent abortions is the presence of chromosome aberrations in a parent. The paper presents the results of cytogenetic investigations in 107 couples referred to genetic council clinic because of at least 2 spontaneous abortions. Cytogenetic analysis was performed on peripheral blood lymphocytes after standard 72h PHA-stimulated culture. At least 20 GTG- and CBG-banded metaphases were analyzed in each patient. Fluorescence in situ hybridization technique was used as to precisely define cytogenetic results. Chromosome aberrations were found in 7 couples (6.54%), exclusively in women. Numerical aberration (47,XXX) was present in 1 woman, and balanced structural aberrations in 6 (5.61%). In 3 of them balanced translocations were disclosed: t(7; 19)(p13;p13.3), t(8;16)(q24;q22), and t(3;8)(q21;p21), in 2--inversions: inv(2)(p25q31), inv(17)(p12p13.3), and in 1--der(20). Pericentric inversion of chromosome 9 was found in 3 men. The analysis of nongenetic factors showed that neither age, nor congenital anomalies of uterus could be an important factor causing abortions in analyzed couples with aberrations. However, infections and muta- or teratogenic exposure could contribute to loss of pregnancies in some cases. Authors conclude that karyotype analysis should be an integral part of diagnostics in couples with recurrent abortions.

Wide access to the assisted reproductive technics as a tool in the treatment of infertility arisen many questions regarding the outcome of the pregnancy, its possible complications and the neonatal outcome in women after IVF treatment. We completed the literature search in order to present this subject. It seems that the increased rate of spontaneous abortions and preterm deliveries in this group is caused by such factors as: maternal age, chromosomal, hormonal and uterine abnormalities and immunological factors. The incidence of preterm deliveries in the multiple gestation after IVF group is similar to the one observed in the spontaneous pregnancy group.

Objectives: Although ovarian tumors are rare in pregnancy, they constitute a real diagnostic and therapeutic challenge., Design: The aim of the study was to describe pathomorphological and clinical characteristic of ovarian tumor in pregnancy and to review the effects of diagnostics and treatment., Materials and Methods: The study included 76 pregnant women treated due to ovarian tumors at Department of Gynaecology and Oncology, Collegium Medicum of Jagiellonian University. The age of patients range from 18 to 41 years (mean age 26 years). Diameter of each tumor was more then 5 cm., Results: The symptoms of the tumors occurred in 25% of patients. Most of them were unilateral (96.05% cases). In 88.16% of cases the tumor diameter did not exceeded 10 cm. 71.05% of tumors were detected in first trimester of pregnancy. More then 50% of cystic tumors, that had not been surgically treated directly after detection disappeared during observation. Most common histological type of operated tumors were teratoma adultum (50%) and corpus luteum cyst. The malignant tumor of ovary was detected in 3.12% of cases. Spontaneous abortion after surgical treatment occurred in one patient after, emergency operation due to tumor torsion., Conclusions: Most of the ovarian tumors in pregnancy were benign. Incidence of ovarian malignancies in pregnancy did not exceed 4%. More then 50% of tumors that had not been removed directly after detection disappeared in the course of observation. Spontaneous abortion after operation rarely complicated surgical treatment.

The article describes present knowledge of teratogenicity, which final manifestation are functional disorders, growth retardation, fetal carcinogenesis, malformation and death.

Unlabelled: Apart from the two relatively well documented risk factors for thyroid cancer i.e. iodine deficiency and ionising radiation, the mechanism of carcinogenesis involves a number of biological and environmental factors. The aim of the study was to analyse the selected biological and environmental risk factors in patients with differentiated thyroid cancer in comparison with a reference group in a case-control study., Methods: Both the group of 188 women and 30 men with thyroid cancer including 92 with follicular carcinoma and 126 with papillary carcinoma and the control group of 287 women and 58 men were subjected to the examination. All the study participants were given a standard questionnaire and underwent physical examination including thyroid USG, blood hormone levels and urine iodine concentration. The following risk factors were included in the analysis: family history, sex, age, thyroid morbidity, employment, body weight, hormone replacement therapy in women, cigarette smoking. In both groups with thyroid cancer women predominant with the female to male ratio 6.7 in follicular carcinoma and 6.0 in the papillary variant. In both groups of diagnoses the mean age was high--above 50, higher in men than in women. Over 70% of the patients with thyroid cancer had nodular goitre before the detection of cancer. In the control group the proportion of diagnosed goitre was slightly above 10%. A significantly more frequent hormone replacement therapy and contraception and more frequent miscarriages in women with thyroid cancer were noteworthy. One may assume that initiation, promotion and progression of the neoplastic process in the thyroid is triggered by a number of factors, both biological and environmental, and only multifactorial analysis may provide an insight into the mechanisms of carcinogenesis followed by initiation of preventives measures in appropriate cases.

The aim of the study was the analysis of pregnancy outcome, newborn status, metabolic control and obstetric failure in 365 pregnant diabetic patients treated in Białystok Diabetic-Obstetric Center. Abortions occurred in 1.64% of pregnancies, intrauterine deaths--in 1.1%, and newborns deaths--in 2.47% cases. Macrosomia was observed in 14.8% of children (from 12% in type 1--up to 25% in gestational diabetes class G2). Congenital malformations were seen in 16 newborns of type 1 diabetic women (9.6%), 2 newborns of type 2 diabetics (22.2%), 6 children of mothers with gestational diabetes class G1 (4.2%) and 4 (8.3%)--class G2. The discussion underlines the role of a long duration of the disease as a key factor increasing the risk of complications and the importance of a good metabolic control before and shortly after conception.

The body mass is one of the major indicators which determine the clinical condition of newborns, influence the rate of neonatal mortality and further development of newborns. In order to prevent malformations it is necessary to identify factors which impair the fetus development and cause fetal hypotrophy. The main objective of the study was to find out whether mothers' occupational work affected the body mass of infants born at term. The study covered a group of 1015 women randomly sampled among those who had delivered their babies in the Polish Mother Memorial Hospital in Lódź, during the years 1992-94. In this group the percentage of working women accounted for 69%. The comparison of the body mass in infants born to women employed and not employed during pregnancy did not indicate differences. However, it was found that male infants born to employed mothers showed a lower body mass than those born to not employed mothers. The effect of some factors modifying infants' body mass was different in the case of not employed women than in those employed. In the group of not employed women a significantly lower body mass in infants was observed in the following subgroups: mothers under 24 years of age, spontaneous abortion of one of previous pregnancies, consumption of large quantity of caffeine (equivalent of > two cups of coffee), and poor economic status. Smoking during pregnancy decreased the body mass of infants in both groups of women. In the group of working women, chronic diseases before pregnancy and diseases involving fever during pregnancy proved to be factors affecting the body mass of infants. The indicators of perinatal medical care (the beginning of medical care and the number of visits during pregnancy) in working women were better than in those not working. None of factors characterizing occupational work affected significantly the body mass of infants. Slightly lower infants' body mass was observed only in those born to mothers working overtime (> 9 hrs daily), involved in hard physical work or working in the environment with harmful chemical and physical factors. According to the data obtained, a negative effect of occupational work on the fetus development should not be overestimated. Nevertheless, the performance of occupational work may aggravate a negative effect of woman's bad health condition on the fetus development.

The clinical examinations covered 1710 women. The investigations were performed on 199 women with symptoms of menopause, who were selected and divided into two groups. The first control group (I) included 80 women employed in the Industrial Clothing Factory "Dana" in Szczecin, without contact with carbon disulphide. The second study group (II) comprised 119 women employed in the Synthetic Fibres Factory "Chemitex-Wiskord" and exposed chronically to carbon disulphide in concentration of 9.36-23.4 mg/m3. The microclimate conditions of the production halls in both groups were similar (Tab. 1). Menopause was present in 16.59% of women in the population chronically exposed to carbon disulphide, as compared with 8.05% in the normal population. Mean age at menopause in women of the first group was 48.1 years and 43.9 years in the second group. In the studied group of menopausal women retrospective estimation of menopausal and gestational cycles shows statistically significant increase in abortion and disorders of menstrual cycles (p < 0.001) (Tab. 2). The women chronically exposed to CS2 had significantly more frequently headaches, weight gain and loss of libido (p < 0.001). In the normal group fatigue, palpitations and hot flushes were found significantly more often (p < 0.001) (Tab. 4). The serum concentrations of estrone (p < 0.01), estradiol, progesterone, 17-hydroxyprogesterone were significantly decreased in women chronically exposed to CS2 (p < 0.001). No significant differences in the level of FSH or LH were noted between both groups (Tab. 3). The daily excretion of adrenaline and noradrenaline in urine concentrations of dopamine in plasma of women chronically exposed to CS2, was significantly lower (p < 0.001), but the serum concentrations of serotonin (Tab. 5), testosterone, dehydroepiandrosterone sulphate (DHAS) and prolactin in plasma were significantly higher (p < 0.001). No difference concerning the level in serum of dehydroepiandrosterone and beta-endorfine was found (Tab. 6). Significant negative linear correlations between serotonin and FSH (r = -0.45; p < 0.001), serotonin and daily excretion of adrenaline (r = -0.43; p < 0.01) or noradrenaline (r = -0.58; p < 0.001) were disclosed in the exposed group. In this group a positive correlation was noted between the concentration of serotonin and prolactin (r = 0.45; p < 0.001).

The aim of the paper was to evaluate the results of microsurgical resections of periadnexal adhesions and those within the pelvis, with taking into consideration the index of intraperitoneal adhesions, coexisting endometriosis and possible adhesions within the fimbriae of oviducts with their patency being preserved. Among 40 women operated on, intrauterine pregnancy terminating in delivery occurred in 42.5% of cases, miscarriage in 7.5%, and oviductal pregnancy in 5% of cases. The highest percentage of pregnancies was obtained with the index of adhesion up to 30 points. Above that value the number of obtained pregnancies decreased dramatically. In the group of patients with coexisting endometriosis the percentage of pregnancies was 13.3%, while 33.3% were scored in the group of women, in whom resection of adhesions within fimbriae was carried out. Active endometriosis and changes within fimbriae of oviducts exert unfavourable influence effects of surgical procedure.

In the present study of hospitalization rates during the period 1979-1990 for some of the diseases considered to be related to environmental contamination were analyzed. Selected diagnosis included malignant melanoma and other malignant neoplasm of skin, malignant neoplasm of bladder, myeloid and monocytic leukaemia, aplastic anaemia, chronic obstructive pulmonary disease and asthma, diseases of skin and subcutaneous tissue, spontaneous abortion and congenital anomalies. The performed analysis has shown that in 1979-1990 discharge rates had significant growing trends in the both urban and rural population in the case of malignant neoplasm of bladder, leukaemia, spontaneous abortion and congenital anomalies in infants. There were no significant trends in hospitalization of malignant melanoma and other malignant neoplasm of skin, aplastic anaemia and asthma.

Adverse outcome of the previous pregnancy as a risk factor for the next one has lately been given increased attention. Particular concern has been expressed as to the possible adverse effects of induced abortion on subsequent pregnancy outcome (1, 2, 3, 4, 5, 6). The purpose of the present report was to establish on the basis of population studies whether and to what extent, abnormal outcome of pregnancy increases the risk of abnormal outcome of the next or further pregnancies. Particular attempt was made to evaluate the increased risk of abnormal outcome of pregnancy following spontaneous and induced abortion. A sample of the studied population was originally collected in several Departments of Obstetrics for a study on epidemiology of low birth weight, and its selection was conditioned by that study. The sample included women whose present pregnancy resulted in the delivery of a live born child. This pregnancy was not taken into consideration in the present study except as a basis for selection of 2 study groups of women who previously had at at least 2 pregnancies (except the present one): Group A consisted of 1180 women who gave birth in the recent pregnancy to a full term child weighing over 3000 g and Group B of 1170 women who delivered a low birth weight infant in their previous pregnancy. Mothers of infants weighing between 2500 and 3000 g were also included in this group because the foetal growth tables for Polish newborn infants showed that weight limits at the 5th percentile for full term male infant ranged between 2500-2800 g and below 10th percentile between 2600 and 3000 g. The following outcomes of previous pregnancies were considered: Full term newborn infant (FT) Low birth weight infant (less than or equal to 2500 g) (Pr) Spontaneous abortion (SA) Induced abortion (IA) Other outcomes (O) Contingency tables containing information on the frequency of different outcomes of earlier and later pregnancies were prepared and the effects of the mode of termination of the earlier pregnancy on the later ones were demonstrated. Interrupted pregnancies were not included in the whole number of cases for the calculation of the percent value, as the decision to interrupt is usually arbitrary and very seldom related to the outcome of the previous pregnancy. The differences between the distribution of pregnancy outcomes in various categories of termination of earlier pregnancy were tested by standard Chi square test which was useful also for testing the dependence of the mode of outcome of the preceding and the following pregnancy. The relative risk coefficient was also calculated for two different combinations of outcomes.(ABSTRACT TRUNCATED AT 400 WORDS)