scholarly journals Psychological сomponents of miscarriage. Ways to overcome

2021 ◽  
Vol 23 (3) ◽  
pp. 348-355
Author(s):  
A. A. Zhyvetska-Denysova ◽  
V. B. Tkachenko ◽  
I. I. Vorobiova

Habitual miscarriage is a stressful condition and a significant factor of frustration for married couples. The psycho-emotional state of the pregnant woman affects the course of the subsequent pregnancy and its outcome. Correction of the psychological component of habitual miscarriage is a promising direction for preventing reproductive losses. The aim of the work is to study the psychological components of miscarriage and determine the ways of their correction. Materials and methods. The level of chronic stress was studied in pregnant women with symptoms of miscarriage and a history of habitual reproductive losses (main group) based on indicators of psychoemotional state, the condition of the autonomic nervous system, and the degree of activation of stress-implementing systems. The results were evaluated with the scale PSS, PSM-25 as adapted by N. Ye. Vodopianova, Spielberger–Khanin inventory and the scale by L. D. Malkova, Baevsky index, cortisol content in the blood and urine. The pregnant women with a physiological course of pregnancy and uncomplicated history were included in the control group. Based on the fact that the etiology of habitual miscarriage is multifactorial, and the psychological component is amenable to correction, stress-protective therapy was included in the treatment complex of habitual miscarriage. To assess the effectiveness of treatment, the main group was divided into subgroups: 1 – with psychotherapy, 2 – without psychotherapy. Results. A high level of personal perception of stress, anxiety and asthenia determine the psycho-emotional state of the main group pregnant women, among whom two dominant psycho types were identified: A – a high level of anxiety and low neuropsychic resistance; B – poise and good adaptive ability against the background of stress. Non-drug stress-protective therapy in the complex of miscarriage treatment contributes to: a decrease in psycho-emotional stress in pregnant women with psycho type A – 2.6 times, anxiety level – 1.7 times, asthenia level – 2.3 times; and also: a decrease in similar indicators in pregnant women with psycho type B – 1.6 times, 3.9 times and 2.5 times, respectively (P < 0.05); a decrease in the frequency of premature termination of pregnancy by more than 11 %. Conclusions. The psychological component of miscarriage is a high level of personal perception of stress, anxiety and asthenia. Stress-protective therapy in combination with pathogenetic therapy of miscarriage improves pregnancy outcomes for the mother and the fetus. It is advisable to conduct pregravid training with the participation of a psychologist in women with a history of reproductive losses in order to overcome the psychological component of stress perception, expand adaptive potential, increase neuropsychic stability, and form a positive orientation toward pregnancy and motherhood.

2018 ◽  
pp. 118-121
Author(s):  
L.M. Vygivska ◽  
◽  
I.A. Usevych ◽  
I.V. Maidannyk ◽  
V.F. Oleshko ◽  
...  

The article represents the results of a prospective clinical and paraclinical examination of women with a history of infertility, pregnancy in which occurred as a result of the assisted reproductive technologies application. The objective: was to study the dynamics of pregnancy features of the psycho - emotional state and the concentration of stress-associated hormones in the serum of pregnant women after the application of assisted reproductive technologies in order to improve the tactics of antenatal care and prevention of obstetric and perinatal complications. Materials and methods. The main group consisted of 80 pregnant women with endocrine infertility, in which pregnancy occurred as a result of therapeutic cycles of ART, control – 50 first-pregnant women with spontaneous fertilization, taken in an arbitrary order of clinical, statistical and laboratory and instrumental studies. In pregnant women of the study groups, in order to determine the psycho emotional state in the screening mode, a clinical interview was conducted by filling out questionnaires that contained the Spilberger test questions in modification of Y.L. Hanina and «Test of relationof pregnant» by the method of I.V. Dobryakova. In the dynamics of pregnancy, the concentration of prolactin (PRL) and cortisol (K) was determined by the enzyme immunoassay on the Reader-MSR-1000 apparatus using test systems manufactured by Hema-Medicament (Russia). Results. Pregnant women with infertility in past history were characterized by a state of chronic stress. According to the results of the Spielberger test in modification Y .L. Hanina every second pregnant of main group had a high level of reactive and every fourth personal anxiety. Almost 90.0% of pregnant women after art are characterized by the presence of pathological PKGD, among which an alarming and depressive type was registered in every sixth and twelfth pregnant woman, respectively. The obtained data are confirmed by the results of the study of the level of K and PRL. For women with a history of infertility and pregnancy, which is the result of therapeutic cycles of ART, inherent in increasing concentrations of stress-associated hormones – cortisol and prolactin, which is one of the reasons for the complicated course of pregnancy and requires reasonable pathogenetic correction. Conclusion. For women who are pregnant as a result of the use of therapeutic cycles of art characterized by a high level of personal and reactive anxiety and PKGD, which confirm the presence of neuropsychiatric and afferent disorders. Increasing the concentration of stress-associated hormones is one of the causes of complicated pregnancy and requires a reasonable pathogenetic correction. Key words: pregnancy, infertility, assisted reproductive technologies, psychological status, cortisol, prolactin.


2019 ◽  
Vol 72 (4) ◽  
pp. 562-567
Author(s):  
Volodymyr K. Likhachov ◽  
Yanina V. Shymanska ◽  
Yulia S. Savelieva ◽  
Viktoriya L. Vashchenko ◽  
Ludmyla М. Dobrovolska

Introduction: During pregnancy in the body of a healthy woman there are physiological and psychological changes that contribute to the bearing a child and prepare the female for future labour and motherhood. In women who experience failure at the stage of fertilization or during pregnancy, as a result of prolonged negative emotional states, psycho-emotional stress develops. The aim of the research was to study the psycho-emotional state of women with infertility in history, whose pregnancy resulted from extracorporal fertilization (IVF), and to develop methods for reducing their anxiety. Materials and methods: At the first stage, the initial psycho-emotional state of 60 women in the second trimester, whose pregnancy resulted from IVF (Group I), was studied; the control group consisted of 20 healthy women with a physiological course of pregnancy (Group II). At the second stage, 10 art therapy exercises with a requestioning of pregnant women from Group I were conducted for improving their psycho-emotional state. Results: Women of Group I had a high level of both situational anxiety (SA) and the personal one (PA). The prevalent type of the psychological component of gestational dominant was anxiety and euphoric types (58.3%). In one third of women with burdened gynecological history examined mild or masked depression was diagnosed. 43 pregnant women from Group I used a method of psychocorrection – art therapy, which included colouring “antistress” pictures of perinatal topic, making flowers from paper and creating a collage of dreams. Conclusions: After the art therapy course, a high level of SA (from 46.5% to 7.0%) and OA (from 48.8% to 32.6%) decreased, the index of the optimal type of the psychological component of gestational dominant increased from 25.6% to 53.5%. The number of women without depression increased from 62.8% to 93%.


2020 ◽  
Vol 5 ◽  
pp. 5-10
Author(s):  
T. P. Andriichuk ◽  
A. Ya. Senchuk ◽  
V. I. Chermak

The objective: to study the features of pregnancy, childbirth, postpartum period, fetal status and newborns in patients with a history of chronic salpingo-оophoritis.Materials and methods. Conducted a retrospective study of 150 birth histories and neonatal development maps. All patients were divided into two groups. The main group includes 100 patients with chronic salpingo-оophoritis, for which they received anti-inflammatory treatment from 1 to 3 times before pregnancy. The control group included 50 pregnant women who did not suffer from chronic salpingo-оophoritis.Results. Our analysis of pregnancy, childbirth, fetal and neonatal status in women with chronic salpingo-оophoritis indicates that such patients have a complicated obstetric and gynecological and somatic history, which forms an unfavorable basic condition of organs and systems, imperfect adaptation to pregnancy, high risk of failure of adaptive reactions. The result is a violation of the formation and development of the mother-placenta-fetus system and, as a consequence, a high level of complications during pregnancy, childbirth and perinatal pathology.Conclusion. Patients suffering from chronic salpingo-oophoritis should be considered at high risk of possible complications during pregnancy and childbirth. This category of women needs quality preconception training and careful monitoring during pregnancy.


2017 ◽  
pp. 35-37
Author(s):  
S.I. Zhuk ◽  
◽  
O.D. Shchurevskaya ◽  

Preeclampsia is a clinical manifestation of the physiological and psychological maladaptation in the pregnant woman. The objective: to determine the characteristics of the psychoemotional status of pregnant women with pre-eclampsia based on the results of psychological testing using questionnaires using the Spielberger-Khanin technique and studying the psychological component of the gestational dominant (PCGD) Dobryakov [3]. Materials and methods. The subject of this study was the results of clinical-laboratory and psychological testing of 90 women in the III trimester of pregnancy. In 50 women, moderate and severe preeclampsia was diagnosed and they were included in the main group, and 40 women with a physiological pregnancy were included in the control group. Results. Pathological subtypes of the psychological component of the gestational dominant are revealed by the method of IV. Dobryakova and an increase in anxiety level by the Spielberger-Khanin technique. The high level of anxiety, the absence of a dominant pregnancy or the presence of its pathological subtypes in the case of gestosis is both a reflection of the maladaptation of the whole organism and the woman's unwillingness to transform her stereotypes of behavior in accordance with the needs of a new condition-pregnancy and forthcoming births, Have long-term consequences even from offspring [5]. The conclusion. The necessity of psychological counseling of pregnant women and correction of the revealed violations of the period of gestation is proved. Key words: pregnancy, delivery, preeclampsia, perinatal psychology, anxiety, gestational dominant.


Author(s):  
E. N. Nenashkina

Introduction. The presence of somatic diseases during pregnancy leaves a serious imprint on the emotional state of a woman, significantly worsens the quality life indicators and affects the clinical characteristics of pregnancy. One of these diseases is chronic pyelonephritis. There are a fairly large number of recommendations for the treatment of this pathology. However the focus is mainly on drug therapy. At the same time the existing restrictions on the number of drugs using during pregnancy, the problem of polypragmasia, and the increase in the number of allergic complications of drugs using dictate the need to search alternative methods of treatment, primarily non-drug ones. Moreover, the problems of pregnant women life quality with chronic pyelonephritis during complex drug therapy are often not given due attention.The goal of research — to assess the impact of osteopathic correction on the psycho-emotional state and life quality of pregnant women with concomitant pathology of the urinary system.Materials and methods. A prospective controlled randomized study was conducted in the period 03.2016– 01.2018 on the basis of medical clinics of LLC «Mokhov Institute of osteopathy» and LLC «Vasileostrovskaya clinic of reproduction and genetics». There were observed work 48 pregnant women with chronic pyelonephritis aged 25–45 years, with a gestation period 13–27 weeks. During the processing of the clinical material, 8 patients were eliminated. As a result of the selection process, a group of 40 people was formed. All pregnant women with chronic kidney disease, depending on the used treatment method, were divided into two groups using a simple randomization method with a random number generator. There was formed the main group (20 people), and the control group (20 people). Patients of the main group received medication and osteopathic correction (3 procedures with an interval of 7–10 days). Patients in the control group received only traditional drug therapy. All pregnant women with chronic pyelonephritis had an osteopathic examination before and after treatment with forming an osteopathic conclusion, and the assessment of the pain syndrome severity by a visual analog scale (VAS), the general psycho-emotional state (the method of rapid assessment of health, activity and mood — HAM), and the level of life quality (Questionnaire Medical Outcomes Study — Short Form).Results. Pregnant women with chronic pyelonephritis were characterized by a weak pain syndrome, a psychoemotional state violations in the categories «well-being» and «activity», and a decrease in both the physical and mental components of life quality. After the complex treatment including the additional to traditional drug therapy osteopathic correction methods, the statistically significant decrease of the pain severity degree (p=0,001), increase of psychoemotional state rates in the category of «activity» (p=0,05) and the increase of physical and mental components of life quality (p=0,02) were observed in the main group compared with the control.Conclusion. Chronic pathology of the kidneys during pregnancy affects the emotional state of a woman, significantly worsens life quality indicators. The use of osteopathic correction as a part of the complex therapy of pregnant women with chronic pyelonephritis can improve the emotional state and life quality; reduce the pain severity, and so can be used to improve medical care for this population category. 


2021 ◽  
Vol 66 (8) ◽  
pp. 485-488
Author(s):  
A. V. Kust ◽  
N. Y. Sotnikova ◽  
A. I. Malyshkina ◽  
D. N. Voronin

To determine the level of CD20 + IL-10 + B-lymphocytes in pregnant women with the threat of termination of pregnancy at 5-12 weeks and recurrent miscarriage in history and compare the data obtained with the end of gestation. A survey of 65 women at a gestational age of 5-12 weeks was carried out. The main group consisted of 33 women with a threatening recurrent miscarriage at the time of the examination, the comparison group consisted of 10 pre-pregnant women with a threatening sporadic miscarriage at the time of the examination, the control group consisted of 22 pregnant women without signs of a threatening miscarriage. The main group, depending on the outcomes of pregnancy, is divided into 2 subgroups: subgroup A - pregnancy ended in undeveloped pregnancy or miscarriage (9 women), subgroup B - pregnancy ended in childbirth (24 women). The relative content of CD20 + IL-10 + B-lymphocytes was determined by flow cytometry on FACSCanto II (Becton Dickinson, USA). Women in the main group had a significantly lower level of CD20 + IL-10 + B-lymphocytes in comparison with the rest of the surveyed. A retrospective analysis revealed that among women of subgroup A there was a sharp decrease in CD20 + IL-10 + cells compared with subgroup B. Prediction of a non-developing pregnancy and spontaneous miscarriage up to 22 weeks of gestation in pregnant women with threatened spontaneous miscarriage and a history of recurrent miscarriage is possible with the relative content of CD20 + IL-10 + equal to or less than 4.5% (sensitivity 100%, specificity 82.6%, accuracy 87.9%).


2021 ◽  
Vol 70 (4) ◽  
pp. 73-79
Author(s):  
Anna I. Malyshkina ◽  
Natalia Y. Sotnikova ◽  
Dmitriy N. Voronin ◽  
Alena V. Kust

BACKGROUND:The frequency of recurrent miscarriage is up to 5 % of all desired pregnancies and is mainly due to immunological disorders. Dysfunction in the regulation of the functional activity of B lymphocytes is the pathogenetic link in multiple obstetric complications, including habitual miscarriage. AIM:The aim of this study was to characterize the regulation of the functional activity of peripheral B lymphocytes in pregnant women with threatened spontaneous miscarriage and a history of habitual miscarriage. MATERIALS AND METHODS:We examined 88 women aged 18-40 years at a gestation period of 5-12 weeks. The main group consisted of 36 patients with threatened spontaneous miscarriage at the time of examination and a history of habitual miscarriage. The control group included 28 women with uncomplicated pregnancy. The comparison group consisted of 24 primary pregnant patients with threatened spontaneous abortion at the time of examination. BAFF and APRIL levels in the blood serum were determined by enzyme immunoassay. The content of CD19+BAFFR+B lymphocytes in the lymphocyte gate was evaluated in the peripheral blood by flow cytometry using monoclonal antibodies. Akt mRNA expression was assessed using real-time reverse-transcription quantitative polymerase chain reaction. CD19+В lymphocytes were isolated by direct magnetic separation. RESULTS:In the main group, there was an increase in expression of BAFF receptors on peripheral CD19+B lymphocytes and a decrease in the serum BAFF concentration compared to the parameters in the other study groups. We also found a pronounced trend towards a decrease in the serum APRIL level in the main and comparison groups of patients compared to healthy pregnant women. Besides, Akt mRNA expression in peripheral CD19+B lymphocytes was increased in the main group. CONCLUSIONS:Threatened habitual abortion is associated with the deficit of the regulatory influence of BAFF and APRIL, which is expressed in the disruption of B cell homeostasis and the weakening of humoral effector mechanisms.


Author(s):  
Antonina Kotenok ◽  
Liliya Vygivska ◽  
Іgor Maidannyk ◽  
Viktor Оleshko

                                  The issue of preserving the reproductive health of the nation in Ukraine is very acute. The psycho-emotional state of a woman is of particular importance for the prolongation of pregnancy and the normal course of labor. Violation of adaptive mechanisms which are aimed at restructuring the functional systems of the body during pregnancy and on the eve of childbirth, as well as the state of chronic stress contribute to the increase in the of obstetric and perinatal complications frequency and have an adverse effect on the course of pregnancy. The aim of the reaserch was to study the dynamics of psycho-emotional state features in pregnant women after assisted reproductive technologies (ART) application in order to improve the tactics of antenatal surveillance. To achieve this goal, 299 pregnant women were comprehensively examined in the dynamics of prospective observation, which were distributed as follows – the main group included 249 women whose pregnancy occurred as a result of the ART application. The control group consisted of 50 pregnant women with spontaneous pregnancy and its physiological course, which were registered for pregnancy at 6-8 weeks. The women of main group whose pregnancy occurred as a result of ART application were divided into three groups, depending on the factor that caused infertility. The first group included 94 women with tubal-peritoneal factor of infertility, the second group was formed by 87 women with endocrine factor of infertility, the third group included 68 women whose infertility was caused by the male factor. Pregnant women of the study groups by age, marital and social status, place of residence were representative, which allowed further to judge the differences caused by etiological factors of infertility. In order to determine the psycho-emotional state of pregnant women in the study groups in the screening mode, a clinical interview was conducted by filling out questionnaires that contained the constituent questions of the STAI tests in the modification of Yu. L. Khanin and the "Pregnant Attitude Test" by the method of I. V. Dobryakov. The obtained test results indicate that the average score of reactive anxiety in pregnant women of the main group exceeded the same indicator of the control group and was: 49 - pregnant women with tubal-peritoneal type of infertility, 56 - pregnant women with endocrine type of infertility, 44 - pregnant women with male factor of infertility, 24 - control group. According to the results of testing, a significant difference was revealed in the indicators of personal anxiety. The values of indicators of personal anxiety were: 51 - pregnant women with tubal-peritoneal type of infertility, 54 - pregnant women with endocrine type of infertility, 31  -pregnant women with male factor of infertility, 31 - control group. Low level of personal anxiety was observed in 26 (27,6%) pregnant women of I group, 29 (33,3%) pregnant women of II group, which is significantly less in comparison with the indicator of pregnant women of the control group – 33 (66,0%) and III group - 33 (48,5%) (p < 0,05). Moderate type of personal anxiety was observed in 46 (48.9%) pregnant women of group and 40 (45.9%) pregnant women of II group compared to the indicator of the control group – 11 (22, 0%) (p < 0,05). Moderate type of personal anxiety was determined in 25 (36,7%) cases in pregnant women of III group and did not differ significantly from the indicators of I, II and control groups (p > 0,05). A high level of personal anxiety was observed in 22 (23,5%) pregnant women of group I, 18 (20,8%) pregnant women of group II, which is significantly higher in comparison with the indicator of pregnant women of the control group – 6 (12,0%) (p < 0,05). Thus, the study of the psycho-emotional state of pregnant women after the application of ART deviations in the level of personal and reactive anxiety and pathological types of gestational dominant, which are inherent in pregnant women of the main group. Taking into account the above, we consider it appropriate to involve a psychologist to work with the examined pregnant women in order to correct the identified abnormalities.


2019 ◽  
Vol 68 (5) ◽  
pp. 63-74
Author(s):  
Anna A. Siniakova ◽  
Elena V. Shipitsyna ◽  
Olga V. Budilovskaya ◽  
Vyacheslav M. Bolotskikh ◽  
Alevtina M. Savicheva

Hypothesis/aims of study. The problem of vaginal infections during pregnancy is of high importance in obstetric practice. To predict the risks and reduce the frequency of pregnancy and childbirth complications, it is necessary to dynamically assess the vaginal microflora and treat its disorders. The aim of the study was to investigate the vaginal microflora and evaluate the effectiveness of treating vaginal infections in pregnant women with a history of miscarriage. Study design, materials and methods. The study included 153 pregnant women in the first trimester. The main group (group I) consisted of 99 women with a history of miscarriage, 35 of whom had signs of threatened abortion (subgroup IA) and 64 did not (subgroup IB). The control group (group II) comprised 54 women without a history of miscarriage and signs of threatened abortion. The vaginal microflora was examined using microscopic, bacteriological and quantitative real-time PCR methods. All patients with an established vaginal infection (bacterial vaginosis, aerobic vaginitis, and vulvovaginal candidiasis) received etiotropic therapy, depending on the microorganisms identified and their sensitivity to antimicrobial drugs. After treatment, in order to assess the effectiveness of the therapy, the vaginal microflora was examined in the second trimester and the outcomes and complications of present pregnancy were evaluated. Results. In women of subgroup IA, vulvovaginitis and bacterial vaginosis were detected 3.5 times more often compared to the control group, and 1.6 times more often compared to subgroup IB (66% and 19%, respectively, p 0.001; 66% and 42%, respectively, p 0.05). Aerobic vaginitis was the most frequent vaginal infection in the first trimester of pregnancy in women of the main group (p 0.05). After treatment, the frequency of the vaginal infections in the second trimester in women of the main group significantly decreased: by 1.9 times in subgroup IA and by 1.5 times in subgroup IB (p 0.05). There were no significant differences in the frequency of adverse pregnancy outcomes in women with bacterial vaginosis or vulvovaginitis as compared to women with normal vaginal microflora. Nevertheless, pregnancy and childbirth complications were diagnosed 4 times more frequently in the main group (23% and 6%, respectively, p 0.05), with the complications occurring significantly more often in the cases of vulvovaginitis or bacterial vaginosis and signs of threatened abortion in the first trimester (p 0.05). Conclusion. Etiotropic therapy of vaginal infections diagnosed in the first trimester of pregnancy in women with a history of miscarriage was highly effective. In 40% of women, vaginal microbiocenosis normalized, and the clinical symptoms of vaginosis/vaginitis disappeared. Differences in the frequency of adverse pregnancy outcomes in women with vulvovaginitis or bacterial vaginosis in the first trimester and in women with normal vaginal microbiocenosis were not significant. However, the treatment of vaginal infections in the group of pregnant women with a history of miscarriage did not significantly affect the frequency of pregnancy and childbirth complications.


2020 ◽  
pp. 16-20
Author(s):  
Ірина Володимирівна Малишева

Introduction. The article considers the features of the psycho-emotional state of pregnant women with drug addiction.Aim. To study the features of the psycho-emotional state of pregnant women with drug addiction using the Hospital Anxiety and Depression Scale HADS and SWLS Life Satisfaction Scales.Materials and methods. The study included 156 pregnant women, including 96 women with drug addiction (main group). The control group included 60 pregnant women.Results. A higher frequency of subclinically expressed anxiety and depression in pregnant women with drug addiction 62.5% (60 women) compared with women of the control group 8.3% (5 women). Life satisfaction in women the main group was at a low level, namely almost dissatisfied with life 40.6% (39 women) or dissatisfied with life 50% (48 women).Conclusions. The study showed the presence of psycho-emotional changes areas in the form of increased anxiety and depression, as well as decreased levels life satisfaction in pregnant women with drug addiction.


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