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SummaryBackgroundThis study was designed to evaluate maternal levels of leptin and interferon-gamma (IFN-gamma) in pregnancy complicated with hypertension and to assess the role of cytokines in predicting the risk of cesarean section.Material/MethodsThis was a cohort study with a prospective follow-up. After proportional sampling procedure, the study included the follow-up of 40 women with hypertensive disorders of pregnancy (pregnancy-induced hypertension [PIH] or preeclampsia [PE]) and 40 uncomplicated pregnancies. Women were followed from the time of admission to the delivery. Levels of leptin and interferon-gamma were measured in serum samples from all women. A p-value <0.05 was considered as significant.ResultsSignificant increase in IFN-gamma and leptin concentration in women with pre-eclampsia was observed. We found a significant 1.4-fold increase in the risk of birth by cesarean section associated with the increase of the IFN-gamma concentration by 0.1 pg/ml and almost 3-fold increase in the risk associated with the increase of the leptin concentration.ConclusionsIFN-γ and leptin might be risk markers of cesarean section in hypertension disorders of pregnancy, but further studies supporting this evidence are needed.

Objectives: Induction of labour is a part of an active prenatal care nowadays and the ideal method of that procedure still remains to be identified. The purpose of this study was to evaluate effectiveness of misoprostol vaginal insert as compared to dinoprostone gel for delivery induction in pregnant women without any comorbidities. Material and methods:It was a retrospective cohort study of 240 pregnant women. The primary study outcome was successful delivery. Other analysed parameters included time to delivery of a baby, time to the beginning of the first stage of labour, time to vaginal delivery, and duration of all delivery stages. We compared both methods regarding maternal complications during and after delivery. We also reviewed neonatal outcomes such as birth weight, birth length and 1-minute Apgar scores. Results:The patients' basic characteristics were similar regarding their age, gravidity, parity, height, weight and Bishop score. Time to any delivery and to the onset of a labour in the misoprostol group versus in the dinoprostone group was 14.5 vs 35.6 h (p < 0.001) and 9.9 h vs 25.3 h (p < 0.001) respectively. The chance of the beginning of labour and the baby's delivery over time has been observed to be approximately two times higher for misoprostol as compared to dinoprostone. Conclusions:Our study showed that using misoprostol vaginal insert in comparison to dinoprostone seems to shorten the time to beginning of the first stage of labour as well as the time to the delivery itself. Some lower Apgar scores observed in the misoprostol group requires further investigation.

Objectives:The aim of the study was to evaluate whether the presence of the disease in pregnancy influences the effectiveness and safety of delivery preinduction with prostaglandins: misoprostol vaginal insert and dinoprostone vaginal gel. Material and methods:This is a retrospective cohort study conducted of 560 pregnant women.The concomitant diseases mainly recorded were diabetes mellitus, hypertensive diseases, intrahepatic cholestasis of pregnancy, asthma, thrombocytopenia, and hypothyroidism. The 2 primary study outcome was a successful vaginal delivery. The study above others evaluates the time from treatment implementation to the beginning of a labor and to a final delivery, the rate of Cesarean sections, and the presence of delivery complications.Results: Among women with a concomitant disease, Caesarean section was observed more frequently in the misoprostol group. In the dinoprostone group, mothers with the concomitant disease as compared to healthy mothers required more time to the delivery and to achieve the beginning of labor. There were no differences in postpartum complications regardless of the prostaglandins, comorbidities or mothers' age. Neonates of mothers ≥ 35 years old with concomitant disease had lower average Apgar scores. Conclusions:Our study showed that comorbidities seem to increase the caesarean section risk in the misoprostol preinduction group but in the dinoprostone group they prolong the time needed to achieve an active labour phase and a delivery.

Hypertensive disease during pregnancy is a crucial perinatal problem. Preeclampsia is associated with complications for pregnant women and fetuses, so it is important to find causative factors. All over the world multiple researches are held among others on the subject of genetic conditioning of preeclampsia and gestational hypertension. Genes encoding the elements of the renin-angiotensin system, which regulates blood pressure, are the most commonly studied, especially the polymorphisms: ACE I/D and AGT M235T. In this case-control study 168 pregnant patients were randomly enrolled from the patients hospitalized in the Perinatology and Obstetrics Department of the University Hospital in Cracow (Poland). In the study there were 104 normotensive pregnant women, 29 patients with preeclampsia and 35 patients with gestational hypertension. Genomic DNA was extracted from peripheral blood leukocytes and polymorphisms of ACE I/D and AGT M235T were genotyped from all patients. The genotypes distribution and allele frequencies of polymorphisms and its association to perinatal outcome in all groups were analyzed. A p-value <0.05 was considered as significant. Clinical evaluation included the duration of the pregnancy, a method of the delivery, the birth weight, the birth length and the Apgar score. The risk of preeclampsia and gestational hypertension was evaluated. The CC genotype of AGT M235T polymorphism increases the risk of gestational hypertension. Genotype DD of the I/D polymorphism of the ACE gene is associated with the risk of lower birth weight percentile, but not with the increased risk of a fetal hypotrophy. The study shows the probable impact of ACE I/D and AGT M235T polymorphisms on pregnancy, but further studies on larger groups are needed.