The doctoral dissertacion is focused on the role of inflammation in the pathogenesis of preterm labor. In the first part, we describe the current view on pathophysiology of preterm labor. In the second part, we evaluated the relationship of specific markers of inflammation and endothelial dysfunction to preterm birth and fetal inflammatory response. The most important findings of our study was that we found decreased levels of MMP-2 and decreased levels of sRAGE in women with preterm labor in comparison with the control group of pregnant women. Similarly, we found decreased levels of MMP-2 in women with subsequent diagnosed fetal inflammatory response. sRAGE is currently ranked among patttern recognition receptors. In the case of sRAGE we followed the results of our pilot project, it can be assumed that the its low level are connected with tissue damage. We confirmed that it can play an important role in the pathogenesis of preterm labor. We assume abnormal regulatory mechanisms of the production of MMP-2. In both cases, however, further studies are required to elucidate the functional significance of our results.

The thesis deals with psychosocial aspect of premature birth, to which our society does not still pay the attention they would deserve. The aim of the thesis is to emphasise the need to provide specialized psychosocial care to families with prematurely born children within a neonatology ward and to evaluate the possibilities to apply the role of a social worker to provision of such care. The thesis is conceived as a qualitative research. The techniques of semi-structured interview and data content analysis were applied on data collection. The research sample consisted of 11 specialists of various professions involved in the care about prematurely born children and their families. The work partly continues in the research of 2007 where I dealt with the psychosocial issues of premature births from the point of view of parents of prematurely born children. The research results definitely confirmed that striving for creating a conception of specialist psychology care forming a link between health care staff and parents is necessary. Such care should be based on the following forms of assistance so as it supports family function and child{\crq}s healthy development: provision of crisis intervention, support of early relation between the mother (parents) and the child, support and strengthening parent competences, advisory on care about a prematurely born child or perhaps a handicapped child, social law counselling, mediation of related services, support of sharing experience among parents. A social worker is fully competent to provide such care. As the research shows no unified legislation dealing with his/her activities within a multidisciplinary team of a neonatology ward exists. The Social Service Act defines the conditions for the profession; separate activity would probably be subject to special regulations dealing with the activity of a social worker in hospitals. The work may be useful to all professionals pushing for rendering complex care about families of prematurely born children, i.e. care naturally involving specialist psychological care.

This work observes the relation between mother-child early contact immediately after birth and emotional tune of mothers in relation to their child. The theoretical part deals with the situation of labor, further development after birth, with an emphasis on very early contact and ways to establish the relationship between a mother and a child. In the end of the theoretical part, the quality of the relationship between a mother and a child and the interactions between them is described. The empirical part examines if the early contact immediately after birth or a general contact between mothers and babies in the hospital, influence emotional tune of a mother to her child. The research was based on interviews with mothers who were describing their child. It was assumed that the emotional tune of mothers is associated with the choice of adjectives describing their child or the whole situation. However, research does not show a significant relation of early contact and emotional tune of a mother to her child. Based on the research results, the conclusion is that the immediate early contact after birth does not have a significant effect on the quality of the relationship between a mother and her child.

Page 1 of 2 Abstract The diploma thesis deals with the topic of autonomy of the mother's will during childbirth. The main goal of the work is to analyze the legal regulation concerning the provision of healthcare in connection with childbirth and the limits of the autonomy of the patient's will in this situation. The aim of the thesis is to examine the issue of the autonomy of the patient's will according to the valid and effective legal regulation in the Czech Republic, with respect to gradual enforcement of the principle of patient and healthcare provider equality, this issue being related to a relatively specific area of childbirth. There is general legal regulation, relating to the position of the patient, healthcare provider and their mutual relationship outlined in this thesis. This legislation is then subsequently used for the provision of healthcare in relation to childbirths. The case law of both domestic courts and the European Court of Human Rights is then applied to specific problems in this area. One of the described problems is the legal nature of the delivery plan as one of the basic means of expressing the autonomy of the patient's will. In particular, the legal nature of the birth plan is handled as institute which is not regulated by law. Possible legal consequences of the delivery plan as...

PRENATAL AND PERINATAL LOSS ENTANGLED IN CZECH INSTITUTIONS Marie Hintnausová ABSTRACT An ethnographic research among women who experienced a loss of child during pregnancy or postpartum aims to expose contexts and backgrounds in which prenatal and perinatal loss emerges in the Czech Republic. This life event is delineated not only by unique biographies of affected mothers, but also by the societal understanding of prenatal life and institutional definitions of human reproduction. This thesis highlights various notions and meanings entangled in the event of prenatal and perinatal death and shows which trajectories women follow in the terrain of societal expectations and governmental and biomedical institutions when they lose a promised assurance of raising a new child.

The dissertation aims at the issue of transcultural care in the practice of midwives with a specific focus on Mongolian women, who currently represent the fifth largest group in terms of the number of births of foreigners in the Czech Republic. The theoretical framework of the text consists of chapters on nursing with subsequent differentiation of the field with regard to specialized care in the field of gynecology-obstetrics, as well as the divided subdiscipline of transcultural nursing care. An integral part of the theoretical part of the work are the basic general information about Mongolia and the Mongols. The practical part of the work is represented by my own qualitative and quantitative research. Qualitative research was carried out in the field through in-depth interviews with Mongolian women living in the Czech Republic and having experience with their own childbirth in a Czech maternity hospital. The aim of the research was to uncover possible peculiarities and requirements that a midwife may encounter from Mongolian women in the provision of transcultural care related to pregnancy, childbirth and the postnatal period. Additional quantitative research was conducted in the form of a questionnaire survey among Prague midwives and was focused on finding out the awareness, previous experience...

This thesis deals with framing of homebirths in the Czech Republic. It is focused on the interpretation of homebirths in the Czech mass and alternative media. The goal of this paper is find out what kind of discourse dominate about homebirths in public discussion, against which attitude to childbirth it is in conflict and if this interpretation correspond with "real" practise of homebirths. I used discourse analysis for uncover discourses in Czech media and the in-depth interview with mothers for detecting the process, risks and experience of homebirth (was compared with the experience of childbirths in hospital). The secondary goal of the thesis is to discover how much are reflected the people involved in this issue. Theoretically, the paper is based on framing theory and the concept of human rights. The sources of analysis are composed of the Czech media articles (2014-2017) and the statements of mothers interviewed.

The doctoral dissertacion is focused on the role of inflammation in the pathogenesis of preterm labor. In the first part, we describe the current view on pathophysiology of preterm labor. In the second part, we evaluated the relationship of specific markers of inflammation and endothelial dysfunction to preterm birth and fetal inflammatory response. The most important findings of our study was that we found decreased levels of MMP-2 and decreased levels of sRAGE in women with preterm labor in comparison with the control group of pregnant women. Similarly, we found decreased levels of MMP-2 in women with subsequent diagnosed fetal inflammatory response. sRAGE is currently ranked among patttern recognition receptors. In the case of sRAGE we followed the results of our pilot project, it can be assumed that the its low level are connected with tissue damage. We confirmed that it can play an important role in the pathogenesis of preterm labor. We assume abnormal regulatory mechanisms of the production of MMP-2. In both cases, however, further studies are required to elucidate the functional significance of our results.

The thesis is aimed at perinatal factors affecting the emotional bond between a mother and a child (boding) during the first weeks postpartum. The literature review is divided into three chapters. The first chapter discusses the childbirth, the experience of childbirth and the factors affecting a subjective evaluation of the childbirth by a parturient. The second chapter follows up with an overview of findings concerning the initial afterbirth moments, and the interaction between a mother and a child during early contact. The third chapter introduces the concept of bonding. It describes its manifestations, possible measuring methods, and factors influencing its quality. The research part analyzes perinatal factors affecting bonding on a sample of 1108 mothers with the use of generalized linear regression. The independent variables are: mode of birth, the evaluation of childbirth experience by mother, and the process of early contact between a mother and a child. The results show that bonding during the first weeks postpartum was not affected by the mode of birth or by the parturient's evaluation of the childbirth experience. A significant effect was found in the occurrence of early contact between a mother and a child; mothers who had contact with the child during the first postpartum hour reported...

Introduction: Multiple sclerosis (MS) is an autoimmune disorder of the CNS that typically affects young women of childbearing age. Due to the international published data, safety for pregnant women with MS can be assumed. However, no study has been published in the Czech Republic to address the effect of MS on pregnancy and perinatal outcomes. Objective: Analysis of the clinical course of patients with MS during and after pregnancy, and perinatal outcomes in comparison with healthy pregnant women. Methods: A single centre prospective observational study in the period 2006-2015 was conducted. Complete data from 68 patients with MS were analyzed (85 deliveries) and were compared with a control cohort of 68 age- and parity - matched healthy pregnancies. Results: The comparison between relapse rate and EDSS before, during and after delivery showed no statistically significant difference (relapse in 7.4% and 9.5%, EDSS 1.27 and 1.49). Perinatal outcomes were comparable in both cohorts. The weight of newborns differed by 159 g, (p = 0.295), complications in pregnancy were represented in 16.2% in the group with MS and in 27.9% in controls (p = 0.295), caesarean section was performed in 16.2% in patients with MS and in 23.5% of controls (p = 0.629), 79.4% of patients with MS were breast-feeding. In the MS...