Objectives: The objective of the study is to determine efficacy of the Primary Prevention Program of Neural Tube Defects in Polish women with higher education in 5-year interval.
Material and methods:Survey research was conducted twice (in 2008 and 2013) in 630 female students of universities: 305 female medical students and 325 female non-medical students. The survey was also done among women aged 27--35 who graduated from medical or non-medical universities and have at least one child. Questions concerned knowledge about prophylaxis and periconceptional folic acid intake. Chi square test was used to assess the significance. There was no significant difference in preconceptional folic acid intake among mothers with medical and non-medical education (53.3% vs. 45% p = 0.4). However, the highest folic acid intake was among mothers -medical doctors who treat children with neural tube defect.
Conclusions:Difference between medical and non-medical students shows that better educational programs may improve knowledge about prophylaxis. Aside from knowledge, compliance with recommendations of Primary Prevention Program of Neural Tube Defects is unsatisfactory.
Congenital diaphragmatic hernia (CDH) is a malformation with a diverse clinical picture. Its severity can be assessed prenatally using the lung area to head circumference ratio (LHR). LHR lower than 1 as associated with high mortality is an indication for prenatal treatment involving occlusion of fetal trachea. Before such treatment other congenital malformations must be excluded. Assessment of circulatory system in these patients is difficult. Heart is compressed by viscera in the thorax that decreases blood return to the left atrium, and structures of the left heart may be smaller than in healthy fetuses. The echocardiographic picture may be similar to some congenital defects of the left heart. Differentiation between structural and functional cardiac abnormalities is difficult but essential for diagnostic and therapeutic decisions in the most severe type of CDH. The authors present problems with interpretation of hemodynamic disturbances in a neonate with prenatally diagnosed and treated severe CDH.
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