Bevezetés: A habituális vetélés a nők 1%-át érintő rendellenesség, amelynek hátterében genetikai, endokrin, méhűri anatómiai, immunológiai, mikrobiológiai és hematológiai, valamint andrológiai zavarok mutathatók ki mint kocká-zati tényezők, de az esetek felében ismeretlen ok miatt alakul ki. Célkitűzés: A habituális vetélés kockázati tényezőinek kutatása során a szerzők arra a kérdésre kerestek választ, vajon a magyar lakosságban milyen gyakran fordul elő a méhüreget érintő anatómiai rendellenesség. Módszer: Retrospektív módon dolgozták fel 152 habituális vetélő adatait. Az esetleges méhűri eltérés tisztázására 132 betegben vagy diagnosztikus hiszteroszkópia, vagy a méhüreg 3 dimenziós ultrahangvizsgálata, 16 esetben hysterosalpingographia, 4 esetben hysterosalpingo-sonographia történt. Eredmények: Megállapították, hogy a habituális vetélők 15,8%-ában méhűri rendellenesség mutatható ki. A rendellenességek közül septum uteri 6,5%-ban, endometriumpolypus 2,6%-ban, uterus arcuatus 2%-ban, uterus bicornis 2%-ban, submucosus myomagöb 1,3%-ban és méhűri synechiák 1,3%-ban fordultak elő. Következtetések: A szerzők megfi gyelése arra utal, hogy habituális vetélésben szenvedő nőkben a méhüreg morfológiai rendellenessége gyakori. Ilyen esetekben javasolt a méhüreg anatómiai vizsgálata. Orv. Hetil., 2015, 156(27), 1081-1084. Kulcsszavak: habituális vetélés, méhűri rendellenesség Uterine anomalies in women with recurrent pregnancy lossIntroduction: One percent of couples trying to have children are affected by recurrent miscarriage. These pregnancy losses have different pathogenetic (genetic, endocrine, anatomic, immunologic, microbiologic, haematologic and andrologic) backgrounds, but recurrent miscarriage remains unexplained in more than half of the affected couples. Aim: To explore risk factors for recurrent pregnancy loss the authors studied the incidence of anatomic disorders of the uterine cavity occur in Hungarian women with recurrent miscarriage. Method: Medical records of 152 patients with recurrent miscarriage were analyzed retrospectively. In order to explore disorders of the uterine cavity hysteroscopy or 3-dimensional sonography in 132 women, hysterosalpingography in 16 and hysterosalpingo-sonography in 4 patients were used. Results: Incidence of anomalies in the uterine cavity was found in women with recurrent miscarriage to be 15.8%. A variety of the uterine anomalies was found including uterine septum in 6.5%, endometrial polyp in 2.6%, arcuate and bicornuate uteri both in 2% and 2%, submucosal myoma in 1.3 %, and intrauterine synechiae in 1.3%. Conclusions: These fi ndings suggest that morphologic disorder of the uterine cavity is frequent in Hungarian women with recurrent miscarriage. Therefore, assessment of the uterine anatomy is recommended in such patients.
Viral infections during pregnancy raise several clinical challenges, including birth defects in the offspring. Thus, this systematic review and meta-analysis aims to prove and highlight the risk of birth defects after first-trimester maternal influenza infection. Our systematic search was performed on 21 November 2022. Studies that reported maternal influenza infection in the first trimester and non-chromosomal congenital abnormalities were considered eligible. We used odds ratios (OR) with 95% confidence intervals (CIs) to measure the effect size. Pooled ORs were calculated with a random effects model. Heterogeneity was measured with I² and Cochran’s Q tests. We found that first-trimester maternal influenza was associated with increased odds of developing any type of birth defects (OR: 1.5, CI: 1.30–1.70). Moreover, newborns were more than twice as likely to be diagnosed with neural tube defects (OR: 2.48, CI: 1.95–3.14) or cleft lip and palate (OR: 2.48, CI: 1.87–3.28). We also found increased odds of developing congenital heart defects (OR: 1.63, CI: 1.27–2.09). In conclusion, influenza increases the odds of non-chromosomal birth defects in the first trimester. The aim of the present study was to estimate the risk of CAs in the offspring of mothers affected by first-trimester influenza infection.
The DCR Budapest-Nashville was developed by adopting a differentiated concept of the ‘full disease entity’. The so-called small disease entity is a preliminary stage in the search for more complicated disease entities. In its present form, the DCR is a diagnostic method for identifying small disease entities in the spectrum of reactive (i.e. psychogenic) and functional (i.e. endogenous) psychoses. The nosological concept of the DCR can be characterized by thirteen paradigms: (1) a nonkraepelinian clinical classificatory system given by Leonhard; (2) the index-psychosis paradigm as opposed to the end-state paradigm; (3) conceptual differentiation of the disease entities as opposed both to the full disease entity paradigm and to the only-one-psychosis (or no disease entity) paradigm, respectively; (4) an aristotelian distinction between content (meaning) and form as opposed to the paradigm of ideas; (5) three-aspect approach to the psychopathological phenomena instead of choosing only one or two of the aspects of experience, of the behavior and of the achievement as special paradigm; (6) gestalt paradigm specified in different ways, as completing the associationist paradigm; (7) structural paradigm, especially concerning the delusions; (8) method of understanding in contrast to the method of causal explanation in distinguishing reactive (i.e psychogenic) psychoses from functional (i.e. endogenous) psychoses; (9) behavioral symptoms overrule experiential symptoms in the decision-tree process concerning schizophrenias; (10) erosive psychotic phenomena (‘minus symptoms’) overrule productive phenomena (‘plus symptoms’) in the decision-tree process concerning hebephrenias in the group of systematic schizophrenias; (11) three-dimensional (polarity, rhythmicity, deterioration) assessment of course of illness; (12) sociological paradigm in reformulation of types of ‘defect’; (13) psychosis paradigm concerning the operationalization of applicability of DCR to patients. Some empirical investigations are mentioned concerning the validity of the DCR.
Objective: The role of maternal age in the development of non-chromosomal congenital anomalies (NCAs) is under debate. Therefore, the primary aim of this study was to identify the age groups at risk for NCAs. The secondary aim was to perform a detailed analysis of the relative frequency of various anomalies. Design: National population-based study. Setting: The Hungarian Case-Control Surveillance of Congenital Anomalies (CAs) between 1980 and 2009. Population or Sample: A cohort of 31 128 cases with confirmed NCAs was compared with Hungary's total of 2 808 345 live births. Methods: Clinicians prospectively reported cases after delivery. Data were analysed by non-linear logistic regression. Risk-increasing effect of young and advanced maternal age was determined by each NCA group. Main outcome measures: These were the total number of NCAs: cleft lip and palate, circulatory, genital, musculoskeletal, digestive, urinary, eye, ear, face, and neck, nervous system, and respiratory system anomalies. Results: The occurrence of NCAs in our database was lowest between 23 and 32 years of maternal age at childbirth. The relative risk (RR) of any NCA was 1.2 (95% CI 1.17-1.23) and ) in the very young and advanced age groups, respectively. The respective results for the circulatory system were RR = 1.07 (95% CI 1.01-1.13) and RR = 1.33 (95% CI 1.24-1.42); for cleft lip and palate RR = 1.09 (95% CI 1.01-1.19) and RR = 1.45 (95% CI 1.26-1.67); for genital organs RR = 1.15 (95% CI 1.08-1.22) and RR = 1.16 (95% CI 1.04-1.29); for the musculoskeletal system RR = 1.17 (95% CI 1.12-1.23) and RR = 1.29 (95% CI 1.14-1.44); and for the digestive system RR = 1.23 (95% CI 1.14-1.31) and RR = 1.16 (95% CI 1.04-1.29). Conclusion: Very young and advanced maternal ages are associated with different types of NCAs. Therefore, screening protocols should be adjusted for these risk groups.
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