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Background: In order to determine the appropriate dose of anti-D immunoglobulin to be administered as a preventive measure against hemolytic disease of the fetus/newborn in the subsequent pregnancy it is necessary to assess the number of fetal red blood cells that infiltrate/penetrate into the maternal circulation as a result of fetomaternal hemorrhage (FMH). One of the quantitative methods of FMH analysis is based on flow cytometry (FACS) which makes use of monoclonal antibodies to RhD antigen (anti-D test). The aim of the study was to further develop the method, evaluate its sensitivity and reproducibility and to compare it with the test based on the detection of fetal hemoglobin (HbF)., Material and Methods: The FACS study involved 20 RhD negative pregnant women and 80 RhD negative women after delivery. The following monoclonal antibodies were used: BRAD 3 FITC (anti-RhD antigen), CD45 PerCP (anti leukocyte antigen CD45), and anti-HbF PE., Results: The fluorescence intensity of cells incubated with BRAD 3 FITC was demonstrated to depend on the RhD antigen expression, though the anti-D test also detects the weak D variant. The CD45 PerCP antibodies increased the sensitivity of anti-D test since they eliminated the leukocytes which non-specifically bind anti-D from the analysis. The presence of anti-D antibodies in maternal plasma does not affect the quantitative assessment of the fetal RhD positive fetal cells with BRAD 3 FITC. In case of FMH, the results of the anti-D test were similar to those with anti-HbF antibodies., Conclusions: The flow cytometric test with anti-D and anti-CD45 is useful in the assessment of the fetomaternal hemorrhage in RhD negative women. The sensitivity of the test is estimated at 0.05%.

Objective: To compare the influence of vaginal micronized progesterone and oral dydrogesterone supplementation on uteroplacental circulation in early pregnancy that is complicated by threatened abortion., Design: Randomized, parallel group, double-blind, double dummy-controlled study., Setting: Tertiary care university hospital., Patient(s): Fifty-three patients with threatened abortion and a living embryo., Intervention(s): Three hundred milligrams of micronized vaginal progesterone or 30 mg of oral dydrogesterone daily supplementation for 6 weeks, serial transvaginal Doppler ultrasound measurement of pulsatility index, resistance index, and systolic/diastolic ratio of the spiral arteries, the uterine arteries, and the intrachorionic area., Main Outcome Measure(s): Uteroplacental blood flow., Result(s): The study demonstrated that vaginal progesterone administration, but not oral dydrogesterone treatment, results in the decrease in the spiral artery pulsatility and resistance index and systolic/diastolic ratio. Insignificant decrease in pulsatility index and resistance index of the uterine artery was observed at >9 weeks and was not associated with treatment regimen. Dydrogesterone treatment was only accompanied by the decrease in the uterine artery systolic/diastolic ratio., Conclusion(s): Vaginal progesterone and oral dydrogesterone supplementation have a different influence on the uteroplacental circulation in early pregnancy that is complicated by threatened abortion.

The indications, outcomes and complications of genetic amniocentesis in a group of 358 women were undeped. The most frequent indication for amniocentesis was maternal age over 35 years. Chromosomal abnormalities were identified in 21 cases (5.8%)--most of them were chromosomal inversions. There were no neural tube defects. In 6 (1.6%) cases the cell culture of amniotic fluid was unsuccessful. The level of alpha-fetoprotein was lower in fetuses with chromosomal abnormalities. 2 (0.5%) patients lost pregnancy after procedure, 4 (1.1%) had amniotic fluid leakage and 1 (0.2%) had pain in hypogastrium after amniocentesis.

Following the first successful cord blood transplantation in 1988, several hundreds of patients were treated using same protocol. The main limitation of the wide use of cord blood as a source of haematopoietic cells is the number of available units of this tissue. To make possible selection of HLA-matched cells for individual patient, several thousands of cord blood samples must be collected and stored in liquid nitrogen. The network of cooperating cord blood banks with join accessible database is necessary. In this paper the activity of Jose Carreras memorial Cord Blood Bank established in Warsaw was described. Since the middle of January the collection of cord blood units for clinical purposes was started. During first three months 80 samples of cord blood was collected. Collections were obtained from normal full-term deliveries after the third stage of labour. For the banking the collection over 60 ml or contain over 4 x 10(8) of mononuclear cells were qualified. Whole blood samples and plasma samples obtained following volume reduction were used for HLA and bacteriology tests. After volume reduction the number of nucleated cells (WBC), mononuclear cells (MNC) and hematopoietic cells (CD34+) were evaluated. After processing the cord blood samples were frozen using control freezer and were stored in liquid nitrogen storage tanks. According to results of cord blood transplantation hundred percent of banked samples are suitable for recipients weighing 10 kg and only 7 percent for these weighing 50 kg.

The investigations covered 33 women in the III trimester of pregnancy with diagnosed, insulin-dependent diabetes mellitus, and 108 healthy women in the control group. The alpha-amylase activity was measured in the blood-serum and urine samples using the Caravay technique. An increased activity was demonstrated in the blood-serum samples in the examined group. The values were not related to the levels of glycemia. The urinary alpha-amylase activity was similar to that in the control patients. No coincidence between the activity and glycemia or acetone levels could be demonstrated.

Twenty-five samples obtained by amniocentesis were studied in 25 pregnant women between 35 and 40 weeks of pregnancy with hypertension. The following biochemical investigations were done in the samples: total protein, beta-lipoproteins, cholesterol, uric acid, urea, creatinine, AlAT and AspAT, total alkaline phosphatase and its thermostable isoenzyme, ceruloplasmin and alpha-amylase. The results were analysed in relation to the development of the respiratory distress syndrome in the newborn and were subjected to statistical analysis. In the amniotic fluid of hypertensive mothers in whose children the respiratory distress syndrome developed, reduction was found in the concentrations of beta-lipoproteins and cholesterol. This may have a prognostic significance in the prediction of respiratory distress in early neonatal period.

The study was carried out in 45 samples of amniotic fluid taken by amniocentesis from 21 hypertensive mothers (study group) and 24 healthy mothers (control group). In these samples the concentrations were determined of total oestrogens and human placental lactogen. In the evaluation of the state of the newborns the following was considered: 1) length and body weight, 2) status in the 1st minute of life (Apgar score). The results were subjected to statistical analysis. In hypertensive mothers during pregnancy HPL and total oestrogen concentrations were decreased. In the study group reduction of body weight and length was found. The general condition of the newborns in the 1st minute was similar in both groups.

Twenty-five samples of amniotic fluid obtained by amniocentesis from 25 pregnant women with hypertension in the 35 to 40 weeks of pregnancy were studied. The following biochemical determinations were done in the samples: acid-base equilibrium (pH, pO2, pCO2, base deficit, standard HCO3- and total CO2), concentrations of potassium and sodium ions, total and ionised calcium and inorganic phosphorus. The results were analysed depending on the presence of the respiratory distress syndrome in the newborn, and were subjected to statistical analysis. It was found that determination of acid-base equilibrium and concentrations of K+, Na+, total and ionised Ca++ and inorganic phosphorus in the amniotic fluid of hypertensive women are probably without prognostic significance with respect to the development of the respiratory distress syndrome in newborns.