scholarly journals Peculiarities of micronutrient metabolism in obese pregnant women (literature review)

2021 ◽  
Vol 23 (3) ◽  
Author(s):  
I. A. Zhabchenko ◽  
O. R. Sudmak ◽  
I. S. Lishchenko ◽  
O. M. Bondarenko
Keyword(s):  
Pregnant Women ◽  
Nutritional Deficiencies ◽  
Obese Women ◽  
Urgent Problem ◽  
Minimum Effective Dose ◽  
Pregnancy And Childbirth ◽  
Placental Dysfunction ◽  
Women Literature ◽  
Iron And Folic Acid ◽  
Special Risk

Here we summarize uptodate data on the influence of the most significant micro, macroelements, and vitamins, such as magnesium, vitamin D, iron, and folic acid, on the course of pregnancy and childbirth in obese women. The paper considers both domestic and foreign recommendations for correcting nutritional deficiencies to prevent the development of complications from the pregravid stage to the end of lactation. Nowadays, the deficiency of micro-, macroelements and vitamins is an extremely urgent problem, especially in a group of special risk, i.e. overweight and obese women, whose number is steadily growing simultaneously with an increase of the number of pregnant women of 35+ years of age. It is important to consider a woman's body mass index to prescribe the minimum effective dose of the necessary drugs. Timely preventive personalized correction of the micronutrient state can reduce the risks of such major obstetric syndromes as preeclampsia, premature birth, fetal growth retardation, miscarriage, and placental dysfunction.

scholarly journals Features of Pregnancy and Characteristics of Obstetric Pathology in Women with Obesity of Various Degrees and Physiological Weight

2020 ◽  
Vol 5 (6) ◽  
pp. 182-187
Author(s):  
K. V. Tarasenko ◽  
Keyword(s):  
Body Weight ◽  
Pregnant Women ◽  
Statistical Significance ◽  
Asymptomatic Bacteriuria ◽  
Fetal Distress ◽  
Control Group ◽  
Obese Women ◽  
Social Significance ◽  
Obstetric Hemorrhage ◽  
Placental Dysfunction

The medical and social significance of obesity in pregnant women lies in the high frequency of obstetric complications: miscarriage, preeclampsia, placental dysfunction, abnormal labor, obstetric hemorrhages, infectious and extragenital diseases in offspring that are programmed in utero. The purpose of the research was to analyze the course of pregnancy and to characterize obstetric pathology in women with obesity of various degrees and physiological body weight. Material and methods. To achieve this goal, we surveyed 369 pregnant women. Pregnant women with obesity were divided into three experimental groups: the first one consisted of 149 women with obesity of the 1st degree; the second group included 73 women with the 2nd degree obesity; the third group had 46 women with the 3rd degree obesity. The control group consisted of 101 women with physiological body weight (BMI = 18.5-25 kg/m2). Results and discussion. In the early term of pregnancy, the risk of miscarriage in women with obesity of different degrees was reliably higher by 2.1-2.9 times compared to the control group (p˂0.05). The risk of late miscarriage in groups of women with obesity of different degrees was 1.7-2.4 times higher than in the control group, although these differences were unreliable. There was also a clear tendency for the risk of preterm labor to increase by 1.4-1.7 times (p˃0.05) in obese women. There was a significant increase in the frequency of placental dysfunction in pregnant women with obesity of varying degrees, which was 1.3-1.8 times higher than the control values. An increase in the incidence of placental dysfunction in obese pregnant women manifested as an increase in the number of cases of fetal distress during pregnancy, the frequency of which increased in accordance with the severity of obesity. There was an increase in the incidence of early preeclampsia without statistical significance in women with the 2nd and 3rd degree obesity. Regarding preeclampsia, a significant increase in its frequency should be noted in obese pregnant women depending on the severity. Only women with 2nd and 3rd degree obesity had obstetric hemorrhage caused by premature detachment of the normally situated placenta. This complication was not observed in pregnant women of the control group and with the I degree obesity. Anemia of pregnancy was 1.5 times more common in women with I degree obesity and 1.4 times in women with the 2nd degree obesity, compared to the control group. In obese pregnant women, the frequency of asymptomatic bacteriuria increased in the 1st degree obesity by 1.6 times, in the 2nd and 3rd degrees by 1.2 and 1.4 times respectively compared to the control group. Conclusion. Thus, obesity is an aggravating factor of pregnancy, as evidenced by the increasing frequency of the most threatening complications for the mother and fetus such as miscarriage, placental dysfunction, preeclampsia, and obstetric hemorrhage compared to pregnant women with physiological body weight

scholarly journals Nutritional support in pregnancy: possibilities for the prevention of obstetric complications

2021 ◽  
pp. 67-74
Author(s):  
O. I. Mikhailova ◽  
D. D. Mirzabekova ◽  
N. E. Kan ◽  
V. L. Tyutyunnik
Keyword(s):  
Folic Acid ◽  
Pregnant Women ◽  
Nutritional Support ◽  
Pantothenic Acid ◽  
Nutritional Deficiencies ◽  
Perinatal Complications ◽  
Beneficial Effects ◽  
Iron And Folic Acid ◽  
Guidelines And Recommendations ◽  
In Pregnancy

This review focuses on the causes and consequences of nutritional deficiencies in the pregnant woman’s diet, as well as on the possibilities of its supplementation. It has been shown that inadequate intake of vitamins and minerals during pregnancy is accompanied by a lack of nutrient supply to the fetus, which can cause growth retardation, low birth weight and other obstetric and perinatal complications.According to the analysed guidelines and recommendations, the body’s need for vitamins and minerals increases at least twice as much during pregnancy. Adverse effects of the environment, a number of gastrointestinal and liver diseases, chronic diseases, antibiotic therapy, etc. increase this need.However, adequate nutritional support of the fetus is the result of several steps. These include the frequency of maternal food intake, the availability of nutrients in the food and the ability of the placenta to transport substrates effectively to the fetus.The most recommended vitamin for consumption in pregnancy is folic acid, alone or in combination with other B vitamins, as its deficiency leads to birth defects in the child.The authors of this review have reviewed a number of large studies conducted over the past decade that recommend iron and folic acid for pregnant women, regardless of dietary intake, as they have proven beneficial effects on the course and outcome of pregnancy. Folic acid, according to current recommendations, must be prescribed to every pregnant woman in the form of 400 mcg tablets daily regardless of her diet. Other most important and necessary vitamins for pregnant women are: vitamins A, C, D, E, K, B1, B2, B6, B12, PP, pantothenic acid, biotin.

scholarly journals Prevention of complications of pregnancy and childbirth of patients with a burdensome gynecological anamnesis

2021 ◽  
Vol 6 ◽  
pp. 56-60
Author(s):  
T. P. Andriichuk
Keyword(s):  
Pregnant Women ◽  
Fetal Distress ◽  
The Body ◽  
Prevention Measures ◽  
Perinatal Complications ◽  
Pregnancy And Childbirth ◽  
Placental Dysfunction ◽  
Treatment And Prevention ◽  
Prophylactic Measures ◽  
The Mean

The objective: determination of the effectiveness of prevention and medicinal correction of placental dysfunction in pregnant women with chronic salpingo-oophoritis.Materials and methods. The study included 100 pregnant women (basic group) with chronic salpingo-oophoritis, of these, I group (50 women) included patients who received proposed treatment and prevention approach, II group (50 women) received a common set of treatment and prevention measures. The proposed treatment-and-prophylactic approach included prophylactic administration to pregnant women with chronic salpingo-oophoritis from the 8th to the 10th and from the 16th to the 18th week inclusive of natural micronized progesterone at a dose of 100 mg intravaginally twice a day for two weeks. Venotonik and angioprotector were prescribed prophylactically at dose 600 mg from 18 weeks to 37-38 weeks of pregnancy. For therapeutic purposes (blood flow disorders in the uterine arteries and vessels of the umbilical cord that are determined by Doppler), the drug was prescribed at dose 600 mg twice a day for 3–4 weeks.Results. A lower frequency of obstetric and perinatal complications was found in the women in I group than in the patients in the II group. Thus, the rate of placental dysfunction was 6.0±3.36% vs. 34.0±6.7%, respectively, oligohydramnios – 6.0±3.36% and 12.0±4.59%, polyhydramnios – 10.0±4.24% and 22.0±5.86%, fetal distress during childbirth – 6.0±3.36% and 14.0±4.91%, cesarean section – 12.0±4.6% and 24.0±4.27%. In the group of patients with treatment-and-prophylactic approach, the mean of the body weight of newborns was 3486.7±312.71 g, and in women who received a common set of treatment-and-prophylactic measures – 3099.8±295.69 g. The mean of the assessment of the condition of newborns by the Apgar scale at the 1st minute – 7.92±1.54 and 6.81±1.16 points, respectively.Conclusions. The use of micronized natural progesterone and the drug diosmin 600 mg in pregnant women with a history of chronic salpingo-oophoritis reduces the rate of obstetric and perinatal complications during pregnancy.

Is it possible the prediction of placental dysfunction?

2016 ◽  
pp. 23-27
Author(s):  
S.I. Zhuk ◽  
◽  
Yu.M. Melnik ◽  
N.V. Pehnio ◽  
◽  
...  
Keyword(s):  
Growth Factor ◽  
Pregnant Women ◽  
Dynamic Control ◽  
Clinical Signs ◽  
Control Group ◽  
Morphological Examination ◽  
Endothelin 1 ◽  
Pregnancy And Childbirth ◽  
Placental Dysfunction ◽  
Complicated Pregnancy

The purpose of the study: the study of the initiating mechanisms of development of violations of the fetal-placental relationship to develop prognostic criteria, tactics of pregnancy and delivery in women at high risk. Materials and methods. In the period from 2013 to 2015 a comprehensive examination of 334 pregnant women, which depending on the peculiarities of pregnancy and childbirth were divided into groups. The control group consisted of 236 pregnant women with uncomplicated gestational period, no morphological signs of placental dysfunction. The main group (OG) included 98 patients with a complicated pregnancy who had revealed violations of the fetal-placental relationship, which was confirmed by morphological examination of the placenta immediate postpartum period. Depending on options of course of gestation period pregnant OG were divided into subgroups: subgroup I – 31 pregnant signs of preeclampsia of different severity; subgroup II – 33 pregnant women with clinical and morphological signs of placental dysfunction, subgroup III – 34 pregnant women with threatened miscarriage and premature birth. In addition, to evaluate the effectiveness of prediction and diagnosis of disorders of fetal-placental relationship was highlighted in the comparison group (GP), which included 32 pregnant women with risk factors for placental dysfunction, which carried out the monitoring of the pregnancy by the proposed algorithm. Results. Due to the datas of high-frequency dopplerometry was determined that decline of cerebro-placental index can be the sign of placental dysfunction (p<0.05). At women with placental insufficiency the reliable increase of endothelin-1 (p<0.05), decline of vascular endothelial growth factor (p<0.05) and placental growth factor (p<0.05), increase of interleukin-1b maintenance (p<0.05) and interleukin-3 reduction (p<0.05) were set. It was proven that during placental dysfunction with an absence of high variableness episodes and STV value less than 4,0 points immediate delivery was necessary. Conclusion. It was developed the monitoring, that based on the prognostic markers determination and dynamic control of pregnancy and it allowed to predict placental dysfunction and decrease its clinical signs during pregnancy in 2,5 time and unfavorable delivery outcomes in 1,7 times. Key words: placental dysfunction, prediction, endothelin-1, growth factor, interleukin, dopplerometry, cardiotocography.

Placental disfunction at pregnant women with concomitant pathology of cardiovascular system

2017 ◽  
pp. 88-92
Author(s):  
E.N. Gopchuk
Keyword(s):  
Pregnant Women ◽  
Clinical Laboratory ◽  
Vascular System ◽  
Varicose Veins ◽  
Peripheral Resistance ◽  
Placental Perfusion ◽  
Cardiovascular Pathology ◽  
Pregnancy And Childbirth ◽  
Placental Dysfunction ◽  
And Control

The objective: study of the effect of Tivomax on the parameters of utero-placental-fetal blood circulation in patients with placental dysfunction and concomitant extragenital pathology of the vascular system. Patients and methods. The study included 60 pregnant women diagnosed with the diagnosis «placental dysfunction», after 22 weeks of gestation and concomitant extragenital pathology of the vascular system, including varicose veins, thrombophlebitis and endarteritis. All patients were randomly divided into the main (30 patients) and control (30 patients) epidemically equivalent groups. During the survey, clinical, laboratory and instrumental (ultrasound) methods of examination were used. Observation of patients was carried out both during pregnancy and in the postpartum period. Results. The study of the efficacy of Tivomax, 4.2% solution for infusions, against the background of the generally accepted regimen for the treatment of placental dysfunction showed that under the influence of the proposed therapy, dopplerogram normalization occurs by decreasing peripheral resistance in the microvascular bed of the placenta, increasing placental perfusion, and optimizing blood flow in the vessels. The conclusion. The purpose of the drug Tivomax contributes to the normalization of the dopplerogram by reducing the peripheral resistance in the microvascular bed. The drug Tivomax has no adverse reactions, negative changes in laboratory blood counts. Timely correction of management of pregnancy and childbirth, drug therapy, conducted in accordance with dopplerometric indicators, can reduce perinatal morbidity and mortality. Key words: Tivomax, L-arginine, endothelium, obstetrics and gynecology, placental disfunction, cardiovascular pathology, extragenital pathology.

scholarly journals Early prediction of placental insufficiency in obese women

2021 ◽  
Vol 8 (1) ◽  
pp. 40-47
Author(s):  
Natalya S. Datsenko ◽  
Igor O. Marinkin ◽  
Tat’yana M. Sokolova ◽  
Tat’yana V. Kiseleva ◽  
Anna V. Yakimova
Keyword(s):  
Pregnant Women ◽  
Placental Insufficiency ◽  
Reproductive Age ◽  
Control Group ◽  
Obese Women ◽  
Growth State ◽  
Pregnancy And Childbirth ◽  
Paired Samples ◽  
Fetoplacental Complex ◽  
Prevalence Of Obesity

Obesity is one of the most important problems in modern health care. The high prevalence of this pathology also affects women of reproductive age, which leads to an increase in the prevalence of obesity in pregnant women. Purpose of the work ‒ analysis of the effect of adipokine indicators on predicting the development of placental insufficiency in obese women. Materials and methods. 225 women were examined who were subdivided by such a parameter as obesity into 4 groups: 3 main and 1 control. The control group consisted of 55 pregnant women with an initially normal BMI value (18.5‒24.9 kg/m2). Group 1st included 109 pregnant women with grade I obesity (BMI 31.88 1.4 kg/m2), group 2nd ‒ 34 pregnant women with grade II obesity (BMI 36.6 1.1 kg/m2), group 3rd ‒ 31 pregnant women with grade III obesity (BMI 42.2 1.9 kg/m2). We studied the data of the anamnesis of pregnant women (somatic and obstetric-gynecological), indicators of adiponectin and omentin, peculiarities of the course of pregnancy and childbirth (data of cardiotocography (CTG), ultrasound markers of disturbances in the formation and functioning of the fetoplacental complex), indicators of labor activity, parameters of newborns (mass-growth, state on the Apgar scale, ponderal index, fetal-placental ratio) and the course of the postpartum period. When conducting statistical analysis in the case of comparing two dependent (paired) samples of parameters, the paired Students t-test was used. The results were considered statistically significant if the р was less than 0.05. With this indicator, the value of the probability of difference between the compared categories was more than 95%. Results. The possibility of predicting the development of placental insufficiency depending on the concentrations of omentin and adiponectin was confirmed. The development of placental insufficiency is most likely with omentin values in the range of 177.6‒191.2 g/ml and adiponectin in the range of 16.0‒22.5 g/ml. Conclusion. Determination of adipokine levels at 8‒9 weeks gestation may be practically significant in predicting the development of placental insufficiency in obese women.

Decompensation placental dysfunction: diagnostics and delivery tactics

2017 ◽  
pp. 66-68
Author(s):  
V.I. Boyko ◽  
◽  
S.A. Tkachenko ◽  
Keyword(s):  
Pregnant Women ◽  
Key Words ◽  
Retrospective Analysis ◽  
Control Group ◽  
Present Stage ◽  
Placental Dysfunction ◽  
Perinatal Pathology ◽  
Delivery Times ◽  
Case Rate ◽  
Major Factors

The objective: depression of frequency of perinatal pathology at women with decompensation form of placental dysfunction by improvement of the main diagnostic and treatment-and-prophylactic actions. Patients and methods. 154 pregnant women in gestation term from 22 to 40 weeks were surveyed. Depending on features of course of pregnancy and families of all surveyed it was divided into 4 groups. The group of the retrospective analysis was made by 45 pregnant women with decompensation placental dysfuction, the group of prospective research included 109 pregnant women of whom the main group was made by 38 women with decompensation form of placental dysfunction, the group of comparison included 47 pregnant women with the compensated form of placental dysfunction. The control group was made by 24 pregnant women with the uncomplicated course of pregnancy and labors. The complex of the conducted researches included clinical, ehografical, dopplerometrical, laboratory, morphological and statistical methods. Results. Use of advanced algorithm of diagnostic and treatment-and-prophylactic actions allows to increase efficiency of diagnostics of decompensation form of placental dysfunction for 33.3%, and rational tactics of a delivery leads to depression of perinatal pathology for 22.7%. Conclusion. Decompensation placental dysfuction is one of the main reasons for perinatal mortality and a case rate at the present stage. Use of the algorithm of diagnostic and treatment-and-prophylactic actions improved by us allows major factors of risk of this complication and the indication for change of tactics and delivery times. Key words: decompensation placental dysfunction, diagnostics, delivery tactics.

Optimisation of tactics of conducting pregnancy and labours at women after auxiliary reproductive technologies

2016 ◽  
pp. 160-164
Author(s):  
D.N. Maslo ◽  
Keyword(s):  
Pregnant Women ◽  
Resistance Index ◽  
First Trimester ◽  
Reproductive Technologies ◽  
Premature Delivery ◽  
Control Group ◽  
Uterine Arteries ◽  
Placental Dysfunction ◽  
Placental Blood ◽  
Two Stages

The objective: frequency decrease perinatal pathologies at women after ART on the basis of studying clinical-ehografical, endocrinological, biochemical, dopplerometrical, cardiotokografical and morphological researches, and also improvement of algorithm of diagnostic and treatment-and-prophylactic actions. Patients and methods. The work basis is made spent by us from 2012 on 2015 by complex inspection of 300 pregnant women from which 250 were after ART and 50 – firstlabours which pragnency without ART, and also their newborns. For the decision of an object in view of research spent to two stages. At 1 stage spent prosperctive research which included 150 pregnant women: з them 100 women pregnancy at which has come out ART (1 group) and 50 healthy women (control group). At 2 stage spent prospective randomization in which result of patients after ART have divided on two equal groups by therapy principle: 2 basic group - 75 pregnant women after ART at which used the algorithm improved by us; 3 group of comparison - 75 pregnant women after ART which have been spent on the standard treatment-and-prophylactic actions. Results. The results suggest that women after using ART is a high frequency of reproductive losses in the first trimester (10.0%), 3.0% of spontaneous abortion from 16 to 22 weeks, and 3.0% "early" premature delivery (22 to 28 weeks of pregnancy). The frequency of violations of the functional state of placenta in women after using IVF is 63.0%, which is the main cause of high levels of perinatal losses (40.0 ‰), and delivery by cesarean section (96.0%). Placental dysfunction in women after using ART characterized by retrohorialnyh hematoma (21.0%); size mismatch fruit (30.0%) and hypertonicity of the uterus (73.0%) against changes in fruit-placental blood flow - increased resistance index in umbilical artery and increased vascular resistance in the uterine arteries. Endocrinological and biochemical changes in placental dysfunction in women after using IVF starting from 28 weeks of pregnancy and are in significant reduction in progesterone, placental b1-microglobulin, B2-microglobulin of fertility and trophic в-glycoprotein. Conclusion. The received results: use of the algorithm of diagnostic and treatment-and-prophylactic actions improved by us allows to lower frequency of spontaneous interruption of pregnancy till 22 weeks – from 13.0% to 5.7%; «early» premature birth – from 3.0% to 1.0%; placentary dysfunction from 63.0% to 40.6%; cesarean sections – from 96.0% to 56.5%, and also perinatal losses – from 40.0‰ to 16.2‰. Key words: pregnancy, childbirth, auxiliary reproductive technologies.

Early predictors of placental dysfunction

2016 ◽  
pp. 25-28
Author(s):  
J.M. Melnik ◽  
◽  
A.A. Shlyahtina ◽  
Keyword(s):  
Vascular Endothelial Growth Factor ◽  
Growth Factor ◽  
Pregnant Women ◽  
Umbilical Artery ◽  
Placental Growth Factor ◽  
Vascular Endothelial ◽  
Endothelin 1 ◽  
Placental Dysfunction ◽  
Early Predictors ◽  
Endothelial Growth Factor

The article presents the predictors of placental dysfunction on the early stage of pregnancy. The objective: the search for prognostic markers and criteria for the occurrence of placental insufficiency in the early stages of the gestational process to optimize the pregnancy and labor with improved perinatal outcomes. Patients and methods. To solve this goal in the period from 2013 to 2015 were conducted a comprehensive survey of 334 pregnant women, which depending on the peculiarities of pregnancy and childbirth were divided into groups. The control group consisted of 236 pregnant women with uncomplicated gestational period, no morphological signs of placental dysfunction. The study group included 98 patients with a complicated pregnancy who had revealed violations of the fetal-placental relations, which was confirmed by morphological examination of the placenta in the postpartum period. Results. It was found that pregnant women with placental insufficiency in the first trimester of pregnancy have higher levels of interleukin-1B (IL-1v) and interleukin-3 (IL-3) in comparison with physiological pregnancy, as well as there is a direct significant correlation between IL-1v and pulsative index (PI) in the spiral (r=0.84) and uterine artery (r=0.77), and the inverse correlation between the level of IL-3 and PI in the terminal branches of the umbilical artery (r=-0.69). Verified an inverse relationship between the concentration of endothelin-1, the level of vascular endothelial growth factor (r=-0.87) and placental growth factor (r=-0.73), and also a direct link between the content of endothelin-1 and PI in spiral arteries (r=0.89), uterine artery (r=0.83) and the terminal branches of the umbilical artery (r=0.79). Conclusion. Thus, it is proven that early predictors of placental dysfunction can be considered the concentration of endothelin-1, vascular endothelial growth factor, placental growth factor, interleukin-1, interleukin-3, and the indices of pulsative index. Key words: placental dysfunction, predictors, endothelin-1, vascular endothelial growth factor, placental growth factor, interleukin, pulsative index.

Epidemiological Characterization of the Infection by Treponema Pallidum in Pregnant Women in Beira City, Sofala, Mozambique

2020 ◽  
Vol 2 (2) ◽  
Author(s):  
Nchowela Guido
Keyword(s):  
Pregnant Women ◽  
Congenital Syphilis ◽  
Health Centre ◽  
Treponema Pallidum ◽  
Timely Manner ◽  
Pregnancy And Childbirth ◽  
Epidemiological Characterization ◽  
Active Syphilis ◽  
Structured Questionnaire

Introduction: Syphilis is one of several diseases that can be transmitted during pregnancy and childbirth, which can lead to complications during pregnancy and in the newborn. This is especially so when the pregnant woman is not diagnosed or treated properly and in a timely manner. Methodology: Data from 262 pregnant women prospectively included, aged 18-41years, attended at the Ponta Gêa Health Centre for antenatal clinics has been analyzed from January to September of 2016. In the prospective study, a rapid treponemal and a non-treponemal test were performed. A structured questionnaire was used to collect socio demographic and clinical variables, which was developed from the literature review. Results: The prevalence of active syphilis was 11.8%; the majority of reactive pregnant women were aged 18-25years (55.4%), (61.3%) of pregnant women were treated with doses below those recommended; only a small number of the partners were treated successfully. The highest seroprevalence of syphilis was found in housewives (77%), in those who attended primary education (71.6%) in those who had a monthly income of 1000- 3000 MZN (70.3%), in those with two or more pregnancies (55.7%) and living with someone has husband and wife (63.5%). The syphilis/HIV co-infection rate was high. Conclusion: According to the results obtained in this study, urgent measures are needed to assess the problems encountered and to improve the screening approach, treatment and monitoring of syphilis during pregnancy in order to prevent the cases of congenital syphilis.

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