scholarly journals OBSTETRIC AND PERINATAL OUTCOMES IN PREGNANCY WITH DIFFERENT SEVERITY AND TIME OF THE MANIFESTATION OF PREECLAMPSIA

2018 ◽  
pp. 110-113
Author(s):  
M. B. Amor ◽  
O. P. Gnatko ◽  
N. G. Skuriatina
Keyword(s):  
Pregnant Women ◽  
Fetal Growth ◽  
Growth Retardation ◽  
Severe Disease ◽  
Asymptomatic Bacteriuria ◽  
Clinical Manifestations ◽  
Perinatal Outcomes ◽  
Medical Documentation ◽  
Fetal Growth Retardation ◽  
Perinatal Complications

The aim of the study – to conduct a retrospective analysis of the course of pregnancy and delivery to determine the nature of obstetric and perinatal complications in preeclampsia. Materials and Methods. The analysis was based on the results of the evaluation of the medical documentation (individual medical records of the pregnant woman, birth histories, developmental histories of the newborn) in 224 pregnant women with preeclampsia and 80 pregnant women without preeclampsia. In addition to the results of the clinical and laboratory examination, the analysis included the severity of preeclampsia and the time of clinical manifestations. The results of the study were statistically processed by methods of mathematical analysis with the determination of the mean values ​​(M ± m), Student's t-test and significance factor (р˂0.050 difference was statistically significant. Results and Discussion. According to the results of the analysis, mild preeclampsia was found in 32.6 % of cases, modera­te PE – in 37.5 %, severe PE – in 29.9 % of cases. The early onset of PE (up to 34 weeks) was observed in 35.7 % of pregnant women, and later onset (after 34 weeks) in 64.7 %. The analysis of the incidence of early and late PE cases at various severity levels showed that, in the case of early PE, severe disease was 2.9 times more frequent, and the moderate disease was 2.7 times more frequent than the mild disease. In the late PE, the mild PE was 1.9 times more frequent than the severe PE and 1.2 times more frequent than the moderate PE. In addition to PE, 31.7 % of women had other complications of pregnancy. The most common complications include asymptomatic bacteriuria (16.9 %), abnormal placental location (14.1 %), placental dysfunction (32.4 %), and fetal growth retardation (21.1 %). Term delivery occurred in 81.6 % of cases, premature births were in 18.3 %. Complications include premature rupture of membranes, anomalies of labor, premature detachment of the normally located placenta, postpartum hemorrhage. Among perinatal complications, fetal growth retardation, hemodynamic disorders, fetal distress, newborn asphyxia have been observed. The adverse outcome for a child in severe PE was 3 times higher than for mild PE. Conclusion. The analysis showed that obstetric and perinatal outcomes in preeclampsia are associated with the time of this pregnancy complication and its severity.

Hemostasis changes in pregnant women with fetal growth retardation

2020 ◽  
Author(s):  
Н.К. Вереина ◽  
В.Ф. Долгушина ◽  
Ю.В. Фартунина ◽  
Е.В. Коляда
Keyword(s):  
Pregnant Women ◽  
Fetal Growth ◽  
Growth Retardation ◽  
Perinatal Outcomes ◽  
Intrauterine Infection ◽  
Control Group ◽  
Pathological State ◽  
Fetal Growth Retardation ◽  
Thrombotic Risk ◽  
Smoking During Pregnancy

Введение: Задержка роста плода (ЗРП) занимает второе место в структуре причин перинатальной смертности, а ее наличие имеет длительное неблагоприятное влияние на здоровье ребенка. Оценка степени активации системы гемостаза при ЗРП в сопоставлении с клиническими исходами имеет важное значение в понимании патогенеза, улучшении прогнозирования и профилактики этого патологического состояния. Цель исследования: оценить состояние гемостаза у беременных с ЗРП в сравнении с женщинами с физиологическим течением беременности. Материалы и методы: Тип исследования: поперечный срез на базе когортного. В исследование включено 52 беременных. Основная группа — 32 пациентки с ЗРП, выявленной при ультразвуковой фетометрии; контрольная группа — 20 практически здоровых женщин без отягощенного акушерско-гинекологического анамнеза, с физиологически протекавшей беременностью, завершившейся неосложненными родами. Оценку состояния системы гемостаза проводили на сроке 24-32 нед гестации. Результаты: Среди факторов тромботического риска у беременных с ЗРП чаще выявлялось табакокурение во время беременности. Наличие ЗРП было значимо связано с маловодием, генитальной и внутриматочной инфекцией, преэклампсией, нарушениями маточно-плацентарно-плодового кровотока. У женщин с ЗРП обнаружен более высокий уровень фибриногена, а также повышение скорости роста сгустка, больший размер сгустка, более частое формирование спонтанных сгустков в сравнении с контрольной группой. Заключение: У беременных с ЗРП имеется протромботическая готовность плазмы, что может служить основанием для дальнейшей разработки антитромботической коррекции с целью улучшения перинатальных исходов. Background: Fetal growth retardation (FGR) is the second leading cause of perinatal mortality, has a long-term adverse effect on child health. Assessment of hemostasis activation in FGR in comparison with clinical outcomes is important for understanding pathogenesis, improving the prognosis and prevention of this pathological state. Objectives: to assess hemostasis state in pregnant women with FGR compared to women with physiological pregnancy. Patients/Methods: Type of study: crosssectional based on cohort. The study included 52 pregnant women. The main group consisted of 32 patients with FGR diagnosed by ultrasound fetometry; the control group consisted of 20 practically healthy women without burdened obstetric-gynecological history, with physiological pregnancy that ended in uncomplicated childbirth. Hemostasis assessment was carried out at 24-32 weeks of gestation. Results: Smoking during pregnancy as a factor of thrombotic risk was more common in pregnant women with FGR. FGR was significantly associated with oligohydramnios, genital and intrauterine infection, preeclampsia, and placental insufficiency. Women with FGR showed a higher level of fibrinogen, as well as an increased rate of clot growth, clot larger size, and more frequent formation of spontaneous clots in comparison with the control group. Conclusions: Pregnant women with FGR are characterized by prothrombotic state that may be the basis for further development of antithrombotic correction for improving perinatal outcomes.

scholarly journals Prediction of perinatal outcomes in pregnant women with fetal growth retardation

2021 ◽  
Vol 20 (4) ◽  
pp. 4-11
Author(s):  
V. F. Dolgushina ◽  
N. K. Vereina ◽  
Ju. V. Fartunina ◽  
T. V. Nadvikova
Keyword(s):  
Pregnant Women ◽  
Fetal Growth ◽  
Growth Retardation ◽  
Perinatal Outcome ◽  
Perinatal Outcomes ◽  
Intrauterine Infection ◽  
First Trimester ◽  
Fetal Growth Retardation ◽  
Adverse Perinatal Outcomes ◽  
Group 2

Introduction. An important problem of modern obstetrics is the development and improvement of methods for predicting fetal growth retardation (FGR) and pregnancy outcomes in this pathology, since there are no proven effective treatments for FGR. Purpose of the study — to develop prediction criteria for newborn hypotrophy and cumulative adverse perinatal outcome in pregnant women with FGR. Objective. To identify key predictive factors for adverse perinatal outcomes in pregnancy complicated by FGR. Material and methods. A case-control, cohort-based study was conducted that included 155 pregnant women with FGR, who were divided into two groups after delivery: Group 1 included 90 patients with neonatal hypotrophy and Group 2 included 65 patients without neonatal hypotrophy. A comprehensive analysis of clinical and anamnestic, laboratory and instrumental data, peculiarities of the course of pregnancy and perinatal outcomes was performed. FGR was determined on the basis of ultrasound fetometry. Results. Factors associated with neonatal hypotrophy and unfavorable perinatal outcome were: impaired blood flow in the uterine arteries and/or umbilical artery, early preeclampsia and scarcity of water. Protective factors were antibacterial therapy for intrauterine infection, administration of low-molecular-weight heparin in the first trimester, and acetylsalicylic acid starting from the 12th to 16th weeks of gestation. Conclusion. The most promising measures in the prevention of FGR and adverse perinatal outcomes in this pathology may be timely prescription of antithrombotic correction and treatment of genital infections.

Fetal growth retardation and hemorheological predictors of oxygen delivery in hypertensive vs normotensive pregnant women

2019 ◽  
Vol 71 (4) ◽  
pp. 387-396
Author(s):  
Jean-Frédéric Brun ◽  
Emmanuelle Varlet-Marie ◽  
Pierre Boulot ◽  
Bénédicte Marion ◽  
Céline Roques ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Fetal Growth ◽  
Growth Retardation ◽  
Oxygen Delivery ◽  
Fetal Growth Retardation

Clinical and statistical analysis of obstetrics and perinatal complications in singleton and multiple pregnancy after assisted reproductive technology

2018 ◽  
pp. 67-73
Author(s):  
T.G. Romanenko ◽  
◽  
O.M. Sulimenko ◽  
S.O. Ovcharenko ◽  
◽  
...  
Keyword(s):  
Statistical Analysis ◽  
Fetal Growth ◽  
Growth Retardation ◽  
Assisted Reproductive Technologies ◽  
Multiple Pregnancy ◽  
Fetal Distress ◽  
Reproductive Technologies ◽  
Fetal Growth Retardation ◽  
Multiple Pregnancies ◽  
Perinatal Complications

The objective: conduct a comparative clinical and statistical analysis of obstetric and perinatal complications in singleton and multiple pregnancies after assisted reproductive technologies (ART) according to archival documents (pregnancy observation data and birth history) and identify features of multiple pregnancy. Materials and methods. During the period 2017–2019, 522 women gave birth in maternity hospital «Leleka» after assisted reproductive technologies, 331 women were observed in the maternity hospital «Leleka». 445 women gave birth with a singleton pregnancy and 77 with a multiple pregnancy. A clinical and statistical analysis of 150 pregnancy and childbirth histories was performed. All pregnant women were divided into two groups: Group I – 75 pregnant women with singleton pregnancies after ART; Group II – 75 pregnant women with multiple pregnancies after ART. The selection criteria for comparative clinical and statistical analysis were women whose pregnancies occurred as a result of ART, namely by in vitro fertilization (IVF) using five-day frozen embryos. Mathematical research methods were performed in accordance with the recommendations of O.P. Minzer (2013). The reliability of the cancellation of the mean pairs was calculated using the Student’s and Fisher’s criteria. Graphs were designed using the program «Microsoft Excel». Results. Complications of early pregnancy in multiple pregnancies were: anemia (47.8% vs. 22.9%; p<0.01), placental dysfunction (43.3% vs. 22.9%; p<0.01), the threat of abortion (41.8% vs. 28.6%; p<0.01). Complications of the second half of pregnancy: preeclampsia (52.7% vs. 20.6%; p<0.01), fetal growth retardation (20.0% vs. 7.4%; p<0.01), gestational anemia (76,4% vs. 32.4%; p<0.01), placental dysfunction (47.3% vs. 22.1%; p<0.05). Complications in childbirth in women with multiple pregnancies were as follows: premature rupture of membranes (30.9% vs. 10.3%; p<0.05), anomalies of labor activity (16.4% vs. 5.9%; p>0.05), fetal distress (29.1% vs. 14.7%; p<0.05), premature placental abruption (3.6% vs. the absence of this indicator in group I). In patients of group II with multiple pregnancies 3.7 times more often the pregnancy ended prematurely compared with singleton (21.8% vs. 5.9%; p<0.05). Early preterm births predominated, of which births occurred in 3.6% of cases at 22–28 weeks, 7.3% at 28–32 weeks, and 6.4% at 32–34 weeks. Significant increase in the frequency of 32.7% of abdominal births in multiple pregnancies against 11.8% of patients in pregnancy with a single fetus (p<0.01). The structure of indications in patients of group II was as follows: severe preeclampsia 27.8%, development of fetal growth retardation and fetal distress of 11.1%, respectively, premature placental abruption 16.7%, the following single indications (pelvic presentation of the fetus, transverse or oblique position of the fetus, clinically narrow pelvis, abnormalities of labor, scar on the uterus) – 33.3%. Significant increase in the total frequency of neonatal asphyxia of varying severity in multiple pregnancies (35.0% vs. 5.9%; p<0.05), fetal growth retardation (27.3% vs. 11.8%; p<0.01). Conclusions. Multiple pregnancies are a high risk factor for gestational anemia, preeclampsia, placental dysfunction, early fetal growth retardation, and fetal distress during pregnancy and childbirth. This causes a high level of abdominal delivery. Therefore, further research to predict and prevent obstetric and perinatal complications in multiple pregnancies after ART is relevant today. Keywords: obstetric and perinatal complications of pregnancy, multiple pregnancy, assisted reproductive technologies.

scholarly journals Antiphospholipid antibodies, genetic thrombophilia and fetal growth retardation

2022 ◽  
Vol 15 (6) ◽  
pp. 695-704
Author(s):  
E. A. Orudzhova
Keyword(s):  
Pregnant Women ◽  
Fetal Growth ◽  
Growth Retardation ◽  
Antiphospholipid Antibodies ◽  
Controlled Trial ◽  
Factor V Leiden ◽  
Control Group ◽  
Fetal Growth Retardation ◽  
Group 2 ◽  
Group 1

Aim: to study the role of antiphospholipid antibodies (AРA) and genetic thrombophilia as a potential cause of the development or a component in the pathogenesis of early and late fetal growth retardation (FGR).Materials and Methods. There was conducted a prospective randomized controlled trial with 118 women enrolled. The main group consisted of 83 patients, whose pregnancy was complicated by FGR degrees II and III, stratified into two groups: group 1 – 36 pregnant women with early FGR, group 2 – 47 pregnant women with late FGR. Women were subdivided into subgroups according to the FGR severity. The control group consisted of 35 pregnant women with a physiological course of pregnancy. АРА were determined according to the Sydney antiphospholipid syndrome criteria by enzyme immunoassay (ELISA): against cardiolipin, β2 -glycoprotein 1, annexin V, prothrombin, etc. (IgG/IgM isotypes); lupus anticoagulant – by the three-stage method with Russell's viper venom; antithrombin III and protein C levels – by chromogenic method; prothrombin gene polymorphisms G20210A and factor V Leiden – by polymerase chain reaction; homocysteine level – by ELISA.Results. AРA circulation (medium and high titers), genetic thrombophilic defects and/or hyperhomocysteinemia were detected in 40 (48.2 %) patients with FGR, which was significantly higher than that in the control group (p < 0.05): in group 1 (41.7 % of women) AРA (30.6 %) and AРA with genetic thrombophilia or hyperhomocysteinemia (11.1 %) were revealed; in group 2 (51.1 % of women) AРA (21.3 %), AРA with hyperhomocysteinemia (4.3 %), genetic thrombophilia (25.5 %), and due to hyperhomocysteinemia (2.1 %) were found. No differences in prevalence of thrombophilia rate in patients were observed related to FGR severity, but a correlation between the FGR severity and AРA titers was found.Conclusion. Testing for the presence of AРA, genetic thrombophilia and hyperhomocysteinemia should be recommended for patients with FGR (including those with FGR in medical history), especially in the case of its early onset. It is recommended to determine the full AРA spectrum.

The rs5918 polymorphism in the ITGB3 gene increases the risk for preeclampsia in pregnant women with fetal growth retardation

GYNECOLOGY ◽  
2021 ◽  
Vol 23 (4) ◽  
pp. 330-334
Author(s):  
Oleg V. Golovchenko ◽  
Irina V. Ponomarenko ◽  
Mikhail I. Churnosov
Keyword(s):  
Pregnant Women ◽  
Fetal Growth ◽  
Growth Retardation ◽  
Genetic Variant ◽  
Fetal Growth Retardation ◽  
Dna Motifs ◽  
Polymorphic Loci ◽  
Relationship Of ◽  
The Relationship ◽  
I Gene

Aim. To assess the relationship of rs5918 ITGB3, rs1126643 ITGA2 and rs5985 F13A1 polymorphic loci with the risk for preeclampsia (PE) in pregnant women with fetal growth retardation (FGR). Materials and methods. The study included 272 pregnant women, of which 76 had a combination of PE and FGR and 196 had FGR. In the studied groups, genetic testing was carried out for three polymorphic loci of candidate genes for hereditary thrombophilia (rs5918 ITGB3, rs1126643 ITGA2, and rs5985 F13A1). Results. The rs5918 genetic variant in the ITGB3 gene is associated with the development of PE in pregnant women with FGR: C allele of rs5918 ITGB3 increases the risk for this complication of pregnancy by 1,8 times (OR 1.761.77, p0.036, pperm0.038). The rs5918 polymorphism determines an increase in the affinity of DNA motifs for seven transcription factors (BDP1, ELF1, IRF, NRSF, Pax-5, Sp1, and Zfx), is a missense mutation and causes the Leu59Pro amino acid substitution in the 3 subunit of integrin, is multidirectionally associated with the expression of five genes (EFCAB13, TBKBP1, NPEPPS, MRPL45P2, THCAT158) and alternative splicing of two genes (EFCAB13, MRPL45P2), is located in the region of functionally important DNA regions (promoters and enhancers) in cell cultures and organs which are pathogenetically important for the formation of PE and FGR. Conclusion. The rs5918 polymorphism in the ITGB3 gene increases the risk for PE in pregnant women with FGR.

Assessment of risk factors for fetal growth retardation

2020 ◽  
pp. 50-53
Author(s):  
Kh. Alirzayeva ◽  
Keyword(s):  
Risk Factors ◽  
Body Weight ◽  
Arterial Hypertension ◽  
Pregnant Women ◽  
Fetal Growth ◽  
Gestational Age ◽  
Growth Retardation ◽  
Deficiency Anemia ◽  
Fetal Growth Retardation ◽  
History Of

The objective: to determine the risk factors for the development of ESRD in pregnant women with preeclampsia and anemia. Materials and methods. 97 pregnant women with preeclampsia with iron-deficiency anemia were monitored. The first group included 46 pregnant women with diagnosed ZRD, the second group-51 pregnant women who gave birth to children with normal body weight. Criteria of FGR is to reduce body weight and length of newborn at birth (less than 10 percentile of assessment tables in comparison with due to gestational age), morphological maturity index (a lag of 2 weeks or more from the true gestational age), disproportionate body, the signs of malnutrition and trophic disorders of the skin and mucous membranes. Results. A step-by-step elimination of the factors that contributed the least to the development of ARI in a combination of preeclampsia and anemia was performed. The results of multivariate analysis showed that in General, the following factors had the strongest influence on the development of RR in preeclampsia and anemia: arterial hypertension (RR= 2.055 [95% CI 1.31-3.20]), overweight/obesity (RR=1.646 [95% CI 1.03-2.62]), anemia in the anamnesis (RR=2.591[95% CI 1.56-4.28]),complicated labor in the anamnesis (RR=1.886 [95% CI 1.29-2.74]), habitual miscarriage (RR=1.850 [95% CI 1.21-2.82]), a history of preeclampsia (RR= 1.922 [95% CI 1.31-2.80]), a history of RR (RR=3.502 [CI 2.37-5.16]). Conclusions. The most significant clinical and anamnestic risk factors for the development of RRT are: arterial hypertension, overweight/obesity, anemia in the anamnesis, pre-eclampsia in the anamnesis, complicated labor in the anamnesis, habitual miscarriage, RRT in the anamnesis. Keywords: pregnancy, preeclampsia, anemia, fetal growth retardation, risk factors.

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