Objective: To evaluate the differences in early maternal and neonatal morbidity after spontaneous... more Objective: To evaluate the differences in early maternal and neonatal morbidity after spontaneous delivery, forceps delivery and vacuum-extraction. Design: Retrospective clinical study. Setting: Department of Obstetrics and Gynecology, University Hospital, Palacký University, Olomouc. Methods: The database of 8196 deliveries at our department in the time period from January 1995 till September 2000 revealed 183 of forceps deliveries and 217 of vacuum-extractions. The control group included 200 randomly selected parturients with spontaneous vaginal delivery. The early maternal morbidity was evaluated according to the following parameters: perineal tears of the IIIrd + IVth degree, duration of hospitalization, average blood loss, the need of analgetics, dehiscence of episiotomy requiring resuture, febrilies and administration of antibiotics. The early neonatal morbidity evaluation was based on the incidence of cephalhematomas, the incidence of hyperbilirubinaemia, duration of hospitalization, signs of fetal hypoxia (pH, Apgar score), gestational age, birthweight and the presence of intracranial and retinal bleeding. The statistical significance of the differences in the frequency of the above parameters was evaluated. Results: Spontaneous deliveries were associated with lower maternal morbidity according to the most of studied parameters. Vacuum-extraction had a lower frequency of maternal postpartum complications compared to forceps deliveries. Statistically valid differences were however found only at perineal tears of the IIIrd + IVth degree and at administration of analgetic and antibiotics. The use of vacuum-extraction seems to be connected with a higher risk of cephalhematomas (p = 0.0051) and longer duration of hospitalization. Conclusions: From the point of view of early maternal morbidity the assisted vaginal delivery by vacuumextraction gives better results than by forceps. However vacuum-extraction increases the risk of cephalhematomas at newborn.
The study was aimed at (1) the determination of the incidence of abnormalities of the urinary tra... more The study was aimed at (1) the determination of the incidence of abnormalities of the urinary tract in newborn infants detected by postnatal ultrasound screening, and (2) the evaluation of the diagnostic accuracy of postnatal ultrasound screening for detecting surgical urinary tract abnormalities. The prospective study was of full-term neonates born in the University Hospital of Olomouc in 2005-2008 who underwent renal ultrasound screening after 72 h of life. Significant findings were recorded. Subsequent diagnostic and therapeutic procedures were recorded and evaluated in a group of children with detected renal pelvic dilatation (RPD). (1) A total of 6,088 newborn infants was examined. The absolute and relative RPD incidence rates (anteroposterior diameter, APD) were as follows: 5-7 mm, 146 (2.4%); 7-10 mm, 70 (1.15%); 10-15 mm, 13 (0.21%), and 15 mm or more, 5 (0.08%). Of those, 16 children were operated on for abnormalities of the urinary tract, of which nine (56%) had been detected by prenatal screening. Other findings: six cases of unilateral renal agenesis, four cases of multicystic renal dysplasia, four of renal dystopia, one of polycystic kidney disease and one of renal hypoplasia. (2) A group of 224 children with postnatally detected RPD was examined, of whom 40 (17.9%) underwent voiding cystourethrography and/or scintigraphy and 16 (7.1%) were treated surgically. The receiver operating characteristic curves were analyzed, and the areas under the curves were calculated. Postnatal renal ultrasound screening is probably a suitable test for detecting significant urinary tract abnormalities.
Hypoxicko-ischemicka encefalopatie zůstava významnou přicinou mortality a pozdni morbidity donose... more Hypoxicko-ischemicka encefalopatie zůstava významnou přicinou mortality a pozdni morbidity donosených novorozenců. Lecebna opatřeni byla donedavna omezena pouze na obecně podpůrnou a symptomatickou terapii. Lecebna hypotermie je proto vitanou možnosti, jak pozitivně ovlivnit osud novorozenců s hypoxicko-ischemickou encefalopatii. Sděleni přinasi zakladni informace o použiti metody v teto indikaci.
Moro reflex je samozřejmou a důležitou soucasti neurologickeho vysetřeni novorozence a maleho koj... more Moro reflex je samozřejmou a důležitou soucasti neurologickeho vysetřeni novorozence a maleho kojence. Od jeho popisu uplynulo100 let – byl popsan v praci Ernsta Moro v roce 1918 (Umklammerungsreflex). Ernst Moro (1874–1951) byl významnou osobnosti lekařskevědy pocatku 20. stoleti, jednou z důležitých postav rozvijejiciho se dětskeho lekařstvi s velmi sirokým odborným zaběrem. Jeho profesnikariera i životni osud byl vzhledem k židovskemu původu jeho ženy negativně ovlivněn politickou situaci v nacistickem Německu.
Lehka poraněni hlavy u děti jsou velmi castým klinickým problemem. Větsinou nejsou spojena se zav... more Lehka poraněni hlavy u děti jsou velmi castým klinickým problemem. Větsinou nejsou spojena se zavažným nitrolebnim poraněnim. Problemem je rozpoznat mezi těmito pacienty ty, kteři jsou ohroženi zavažnou komplikaci, a zaroveň omezit zbytecnou zatěž ostatnich (zobrazovaci vysetřeni, hospitalizace). Autor v souhrnu uvadi přehled teto problematiky s důrazem na aktualni poznatky.
Objective: To describe the incidence of developmental impairments (DI) among very low birth weigh... more Objective: To describe the incidence of developmental impairments (DI) among very low birth weight (VLBW) infants at 24 months' corrected age, born in perinatal centers in 1997-2007, and evaluate their changing prognosis of intact development. Design: Prospective epidemiological study. Setting: Follow-up clinics of neonatal centers level III. Methods: Live birth rate, in-hospital mortality, neonatal morbidity, DI and quality of survival were assessed. Neonatal morbidity was analyzed in periods 2000/2, 2003/5, and 2006/7 by the data of Institute of Health Informatics and Statistics. DI and quality of survival were evaluated in cohorts of VLBW infants born in 1997/9 (period I), 2000/2 (period II), 2003/5 (period III) and 2006/7 (period IV). Results: Live birth rate of VLBW newborns in 1997-2007 increased in total of 39.5%, in-hospital mortality decreased, significantly in 1997-9 (fall of 10%). Neonatal morbidity, except infections, also declined. Significant decrease in DI-CP and visual impairment, was observed after period II, in category 1000-1499 g of 7/1.5%, in infants <1000 g of 8/7% resp. After period II, the prevalence of impaired children 1000-1499 g decreased of 5%, whereas in category < 1000 g only small decrease of 2% occurred in period III. Number of children without impairment increased gradually in both categories. Conclusions: The study showed significant increase in surviving VLBW infants, especially in category <1000 g. Increased survival rate at concurrent fall in severe neonatal morbidity (except infections) was not accompanied with worsened prognosis of an intact development.
PrĂĄce se zabĂ˝vĂĄ standardizacĂ americkĂS ĹĄkĂĄly Neurobehavioral Assessment of the Preterm Inf... more PrĂĄce se zabĂ˝vĂĄ standardizacĂ americkĂS ĹĄkĂĄly Neurobehavioral Assessment of the Preterm Infant (NAPI), kterĂĄ slouŞà k hodnocenĂneurobehaviorĂĄlnĂho chovĂĄnĂ pĹedAasnA narozenĂ˝ch dAtĂ od 32. gestaAnĂho tĂ˝dne do doby pĹŻvodnĂho termĂnu porodutj. 38. – 40. gestaAnĂho tĂ˝dne. SouAĂĄstĂ standardizace tĂSto ĹĄkĂĄly bylo vytvoĹenĂ AeskĂS verze vyĹĄetĹovacĂho protokolu ĹĄkĂĄly NAPIa porovnĂĄnĂ neurobehaviorĂĄlnĂho vĂ˝voje AeskĂ˝ch pĹedAasnA narozenĂ˝ch dAtĂ s americkĂ˝mi pĹedAasnA narozenĂ˝mi dAtmi(normativnĂ data ĹĄkĂĄly NAPI).
Objective: To evaluate the differences in early maternal and neonatal morbidity after spontaneous... more Objective: To evaluate the differences in early maternal and neonatal morbidity after spontaneous delivery, forceps delivery and vacuum-extraction. Design: Retrospective clinical study. Setting: Department of Obstetrics and Gynecology, University Hospital, Palacký University, Olomouc. Methods: The database of 8196 deliveries at our department in the time period from January 1995 till September 2000 revealed 183 of forceps deliveries and 217 of vacuum-extractions. The control group included 200 randomly selected parturients with spontaneous vaginal delivery. The early maternal morbidity was evaluated according to the following parameters: perineal tears of the IIIrd + IVth degree, duration of hospitalization, average blood loss, the need of analgetics, dehiscence of episiotomy requiring resuture, febrilies and administration of antibiotics. The early neonatal morbidity evaluation was based on the incidence of cephalhematomas, the incidence of hyperbilirubinaemia, duration of hospitalization, signs of fetal hypoxia (pH, Apgar score), gestational age, birthweight and the presence of intracranial and retinal bleeding. The statistical significance of the differences in the frequency of the above parameters was evaluated. Results: Spontaneous deliveries were associated with lower maternal morbidity according to the most of studied parameters. Vacuum-extraction had a lower frequency of maternal postpartum complications compared to forceps deliveries. Statistically valid differences were however found only at perineal tears of the IIIrd + IVth degree and at administration of analgetic and antibiotics. The use of vacuum-extraction seems to be connected with a higher risk of cephalhematomas (p = 0.0051) and longer duration of hospitalization. Conclusions: From the point of view of early maternal morbidity the assisted vaginal delivery by vacuumextraction gives better results than by forceps. However vacuum-extraction increases the risk of cephalhematomas at newborn.
The study was aimed at (1) the determination of the incidence of abnormalities of the urinary tra... more The study was aimed at (1) the determination of the incidence of abnormalities of the urinary tract in newborn infants detected by postnatal ultrasound screening, and (2) the evaluation of the diagnostic accuracy of postnatal ultrasound screening for detecting surgical urinary tract abnormalities. The prospective study was of full-term neonates born in the University Hospital of Olomouc in 2005-2008 who underwent renal ultrasound screening after 72 h of life. Significant findings were recorded. Subsequent diagnostic and therapeutic procedures were recorded and evaluated in a group of children with detected renal pelvic dilatation (RPD). (1) A total of 6,088 newborn infants was examined. The absolute and relative RPD incidence rates (anteroposterior diameter, APD) were as follows: 5-7 mm, 146 (2.4%); 7-10 mm, 70 (1.15%); 10-15 mm, 13 (0.21%), and 15 mm or more, 5 (0.08%). Of those, 16 children were operated on for abnormalities of the urinary tract, of which nine (56%) had been detected by prenatal screening. Other findings: six cases of unilateral renal agenesis, four cases of multicystic renal dysplasia, four of renal dystopia, one of polycystic kidney disease and one of renal hypoplasia. (2) A group of 224 children with postnatally detected RPD was examined, of whom 40 (17.9%) underwent voiding cystourethrography and/or scintigraphy and 16 (7.1%) were treated surgically. The receiver operating characteristic curves were analyzed, and the areas under the curves were calculated. Postnatal renal ultrasound screening is probably a suitable test for detecting significant urinary tract abnormalities.
Hypoxicko-ischemicka encefalopatie zůstava významnou přicinou mortality a pozdni morbidity donose... more Hypoxicko-ischemicka encefalopatie zůstava významnou přicinou mortality a pozdni morbidity donosených novorozenců. Lecebna opatřeni byla donedavna omezena pouze na obecně podpůrnou a symptomatickou terapii. Lecebna hypotermie je proto vitanou možnosti, jak pozitivně ovlivnit osud novorozenců s hypoxicko-ischemickou encefalopatii. Sděleni přinasi zakladni informace o použiti metody v teto indikaci.
Moro reflex je samozřejmou a důležitou soucasti neurologickeho vysetřeni novorozence a maleho koj... more Moro reflex je samozřejmou a důležitou soucasti neurologickeho vysetřeni novorozence a maleho kojence. Od jeho popisu uplynulo100 let – byl popsan v praci Ernsta Moro v roce 1918 (Umklammerungsreflex). Ernst Moro (1874–1951) byl významnou osobnosti lekařskevědy pocatku 20. stoleti, jednou z důležitých postav rozvijejiciho se dětskeho lekařstvi s velmi sirokým odborným zaběrem. Jeho profesnikariera i životni osud byl vzhledem k židovskemu původu jeho ženy negativně ovlivněn politickou situaci v nacistickem Německu.
Lehka poraněni hlavy u děti jsou velmi castým klinickým problemem. Větsinou nejsou spojena se zav... more Lehka poraněni hlavy u děti jsou velmi castým klinickým problemem. Větsinou nejsou spojena se zavažným nitrolebnim poraněnim. Problemem je rozpoznat mezi těmito pacienty ty, kteři jsou ohroženi zavažnou komplikaci, a zaroveň omezit zbytecnou zatěž ostatnich (zobrazovaci vysetřeni, hospitalizace). Autor v souhrnu uvadi přehled teto problematiky s důrazem na aktualni poznatky.
Objective: To describe the incidence of developmental impairments (DI) among very low birth weigh... more Objective: To describe the incidence of developmental impairments (DI) among very low birth weight (VLBW) infants at 24 months' corrected age, born in perinatal centers in 1997-2007, and evaluate their changing prognosis of intact development. Design: Prospective epidemiological study. Setting: Follow-up clinics of neonatal centers level III. Methods: Live birth rate, in-hospital mortality, neonatal morbidity, DI and quality of survival were assessed. Neonatal morbidity was analyzed in periods 2000/2, 2003/5, and 2006/7 by the data of Institute of Health Informatics and Statistics. DI and quality of survival were evaluated in cohorts of VLBW infants born in 1997/9 (period I), 2000/2 (period II), 2003/5 (period III) and 2006/7 (period IV). Results: Live birth rate of VLBW newborns in 1997-2007 increased in total of 39.5%, in-hospital mortality decreased, significantly in 1997-9 (fall of 10%). Neonatal morbidity, except infections, also declined. Significant decrease in DI-CP and visual impairment, was observed after period II, in category 1000-1499 g of 7/1.5%, in infants <1000 g of 8/7% resp. After period II, the prevalence of impaired children 1000-1499 g decreased of 5%, whereas in category < 1000 g only small decrease of 2% occurred in period III. Number of children without impairment increased gradually in both categories. Conclusions: The study showed significant increase in surviving VLBW infants, especially in category <1000 g. Increased survival rate at concurrent fall in severe neonatal morbidity (except infections) was not accompanied with worsened prognosis of an intact development.
PrĂĄce se zabĂ˝vĂĄ standardizacĂ americkĂS ĹĄkĂĄly Neurobehavioral Assessment of the Preterm Inf... more PrĂĄce se zabĂ˝vĂĄ standardizacĂ americkĂS ĹĄkĂĄly Neurobehavioral Assessment of the Preterm Infant (NAPI), kterĂĄ slouŞà k hodnocenĂneurobehaviorĂĄlnĂho chovĂĄnĂ pĹedAasnA narozenĂ˝ch dAtĂ od 32. gestaAnĂho tĂ˝dne do doby pĹŻvodnĂho termĂnu porodutj. 38. – 40. gestaAnĂho tĂ˝dne. SouAĂĄstĂ standardizace tĂSto ĹĄkĂĄly bylo vytvoĹenĂ AeskĂS verze vyĹĄetĹovacĂho protokolu ĹĄkĂĄly NAPIa porovnĂĄnĂ neurobehaviorĂĄlnĂho vĂ˝voje AeskĂ˝ch pĹedAasnA narozenĂ˝ch dAtĂ s americkĂ˝mi pĹedAasnA narozenĂ˝mi dAtmi(normativnĂ data ĹĄkĂĄly NAPI).
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