Thrombin generation, D-dimer and protein S in uncomplicated pregnancy

2015 ◽  
Vol 53 (12) ◽  
Author(s):  
Mirjana K. Kovac ◽  
Sanja Z. Lalic-Cosic ◽  
Jelena M. Dmitrovic ◽  
Valentina J. Djordjevic ◽  
Dragica P. Radojkovic
Keyword(s):  
Pregnant Women ◽  
Reference Values ◽  
Gestational Age ◽  
Protein S ◽  
First Trimester ◽  
Second Trimester ◽  
Third Trimester ◽  
The Third ◽  
D Dimer ◽  
Protein S Activity

AbstractGestational age-specific reference values are essential for the accurate interpretation of haemostatic tests during pregnancy.Our 1-year prospective study included 40 healthy pregnant women with a median age of 30 (range 22–40) years; the subjects were followed in order to establish the gestational age dependent values for endogenous thrombin potential (ETP), D-dimer and protein S (activity and free).During the first trimester 50% of studied women had ETP >100% (reference values out of pregnancy); in the second trimester an ETP over 100% was observed in all women; ETP values remained unchanged during the third trimester. In the first trimester, the median D-dimer concentration of 0.30 mg/L, in the second 0.91 mg/L and in the third of 1.45 mg/L were observed. During the first trimester 14/40 subjects had protein S activity below reference range (<59%, out of pregnancy); the median value of 61.35; interquartile range (IQR) 20.38; in the second 21/37; the median value of 53.1 (IQR 15.65); in the third trimester 28/37 had low level of protein S activity with the median value of 49.0 (IQR 18.8). Free protein S showed a slight decrease from the first trimester; it remained almost stable during the rest of pregnancy, with the equal number of pregnant women with reduced free protein S.Related to the gestational age, a significant increase of ETP and D-dimer, from the second trimester was observed; the decrease of protein S was observed already from the early pregnancy, with more pronounced variability of protein S activity.

scholarly journals The course of ankylosing spondylitis during pregnancy: intermediate data of a prospective follow-up

2019 ◽  
Vol 13 (2) ◽  
pp. 61-72 ◽  
Author(s):  
O. A. Krichevskaya ◽  
Z. M. Gandaloeva ◽  
A. B. Demina ◽  
T. V. Dubinina
Keyword(s):  
Back Pain ◽  
Ankylosing Spondylitis ◽  
Disease Activity ◽  
Pregnant Women ◽  
Functional Status ◽  
Gestational Age ◽  
First Trimester ◽  
Second Trimester ◽  
Third Trimester ◽  
The Third

The onset of ankylosing spondylitis (AS) more frequently occurs at the end of the third decade of life, which corresponds to the time of marriage and the birth of the first child and determines the relevance of a study of the interaction of AS and pregnancy.Objective: to describe the clinical presentations of AS and its therapy during pregnancy and to study AS activity dynamics and the patients' functional status during gestation.Patients and methods. The investigation enrolled 19 pregnant women who met the 1984 modified New York AS criteria. The mean age of the women was 32.2±1.1 years; their mean age at the onset of AS was 22.6±3.1 years; the duration of the disease was 147±20.7 months. The patients visited their physician at 10–11, 20–21, and 31–32 weeks of pregnancy. The investigators determined AS activity by the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Ankylosing Spondylitis Disease Activity Score (ASDAS) and functional status by the Bath Ankylosing Spondylitis Functional Index (BASFI) and the Bath Ankylosing Spondylitis Metrology Index (BASMI). The Maastricht Ankylosing Spondylitis Enthesitis Score (MASES) was used to assess enthesitis.Results and discussion. At the time of conception, 78.9% of the patients had inflammatory back pain with an intensity of 2.2±0.4 on a numerical rating scale; during pregnancy, 95% of the pregnant women experienced pain, its intensity increased by the second trimester (4.6±0.7) and remained at this level in the third trimester (p<0.05 between the month of conception and the second and third trimesters). By the third trimester, the nature of the pain changed: 55.5 and 61.1% of the patients reported reduced pain at rest and after exercise, respectively. The frequency and severity of enthesitis increased with gestational age: the MASES scores were higher in the third trimester (2.3±0.5) than that in the first-trimester (0.4±0.22; p<0.05). The frequency of extra-axial and extra-skeletal manifestations did not increase during gestation. Coxitis was detected in 27.8% of the pregnant women.The BASDAI increased from the time of conception (1.7±0.3) to the second trimester (3.3±0.5; p<0.05) and remained at this level in the third trimester. Multiple regression analysis revealed that the predictors of BASDAI levels in the third trimester were BASDAI scores (R2 =0.7) and back pain (R2 =0.9) at the time of conception, the use of biological agents 3 months before gestation (R2 =0.7) with their cumulative impact. Throughout pregnancy, the BASDAI was determined by a set of factors: the severity of pain in the back (β=0.6) and entheses (β=0.3) and weakness (β=0.6). By the end of the first trimester, the increased BASDAI scores were provided mainly by the higher level of general weakness (by 68.5%) and back pain (by 24.1%). In the second trimester, the higher BASDAI was due to the increased severity of enthesitis (by 30.7%) and back pain (by 27%).There were no changes in ASDAS-C-reactive protein (ASDAS-CRP), but there was its upward tendency in the second trimester as compared with the beginning of pregnancy. The BASMI did not change significantly (1.3±0.9; 1.8±0.2; 2.1±0.3, respectively, for trimesters). The BASFI increased by the third trimester (3.9±0.7) versus the first trimester (1.4±0.3; p<0.05).In the third trimester, this rise was due to difficulties in performing the actions related to both AS activity and pregnancy (forward bends; questions 1, 2, and 4).According to the trimesters, 31.6, 73.7, and 66.7% of the pregnant women took nonsteroidal anti-inflammatory drugs. The need for glucocorticoids was noted in 22% of patients in the second trimester and in 53% in the third trimester.Conclusion. The clinical activity of AS is increased by the second trimester of pregnancy and remains moderate and high until the end of gestation. The activity of AS at the time of conception can determine the activity of the disease throughout pregnancy. In the third trimester, mechanical back pain becomes concurrent in half of the patients. Functional impairments increase with gestational age, and this is due to both the activity of AS and pregnancy itself in the third trimester. 

Gestation specific reference intervals for thyroid function tests in pregnancy

2016 ◽  
Vol 54 (8) ◽  
Author(s):  
Süleyman Akarsu ◽  
Filiz Akbiyik ◽  
Eda Karaismailoglu ◽  
Zeliha Gunnur Dikmen
Keyword(s):  
Pregnant Women ◽  
Thyroid Function ◽  
First Trimester ◽  
Reference Intervals ◽  
Specific Reference ◽  
Thyroid Function Tests ◽  
Second Trimester ◽  
Third Trimester ◽  
The Third ◽  
Function Tests

AbstractThyroid function tests are frequently assessed during pregnancy to evaluate thyroid dysfunction or to monitor pre-existing thyroid disease. However, using non-pregnant reference intervals can lead to misclassification. International guidelines recommended that institutions should calculate their own pregnancy-specific reference intervals for free thyroxine (FT4), free triiodothyronine (FT3) and thyroid-stimulating hormone (TSH). The objective of this study is to establish gestation-specific reference intervals (GRIs) for thyroid function tests in pregnant Turkish women and to compare these with the age-matched non-pregnant women.Serum samples were collected from 220 non-pregnant women (age: 18–48), and 2460 pregnant women (age: 18–45) with 945 (39%) in the first trimester, 1120 (45%) in the second trimester, and 395 (16%) in the third trimester. TSH, FT4 and FT3 were measured using the Abbott Architect i2000SR analyzer.GRIs of TSH, FT4 and FT3 for first trimester pregnancies were 0.49–2.33 mIU/L, 10.30–18.11 pmol/L and 3.80–5.81 pmol/L, respectively. GRIs for second trimester pregnancies were 0.51–3.44 mIU/L, 10.30–18.15 pmol/L and 3.69–5.90 pmol/L. GRIs for third trimester pregnancies were 0.58–4.31 mIU/L, 10.30–17.89 pmol/L and 3.67–5.81 pmol/L. GRIs for TSH, FT4 and FT3 were different from non-pregnant normal reference intervals.TSH levels showed an increasing trend from the first trimester to the third trimester, whereas both FT4 and FT3 levels were uniform throughout gestation. GRIs may help in the diagnosis and appropriate management of thyroid dysfunction during pregnancy which will prevent both maternal and fetal complications.

scholarly journals Maternal Serum Levels of Alpha Tumour Necrotic Factor, Interleukin 10, Interleukin 6 and Interleukin 4 in Malaria Infected Pregnant Women Based on Their Gestational Age in Southeast, Nigeria

2020 ◽  
pp. 64-70
Author(s):  
Obeagu, Emmanuel Ifeanyi ◽  
Esimai, Bessie Nonyelum ◽  
Ekelozie, Ifeoma Stella ◽  
Asogwa Eucharia Ijego ◽  
Amaeze Augustine Amaeze ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Gestational Age ◽  
First Trimester ◽  
Interleukin 10 ◽  
Interleukin 4 ◽  
Second Trimester ◽  
Third Trimester ◽  
Tnf Α ◽  
Significant Difference ◽  
Tumour Necrotic Factor

Malaria has been reported as a condition caused by infestation with Plasmodium parasite species, is a major public health problem globally especially in developing countries like Nigeria. This study was carried out in Federal Medical Centre Umuahia in Abia State, Nigeria. A study was done to determine the maternal serumlevels of alpha tumour necrotic factor, interleukin 10, interleukin 6and interleukin 4 in malaria infected pregnant women based on their gestational age in Southeast, Nigeria. A total of 150 subjects between the ages of 18-45 years were recruited for the study comprising of fifty (50) subjects each of the 3 trimesters. Commercial ELISA Kit by MELSIN Medical Co Limited was used to measure all the cytokines. The results of Table 1 showed no significant difference of TNF-α (p=0.346), IL-10 (p=0.059), IL-6 (p=0.811) and IL-4 (p=0.257) of malaria infected pregnant women at first trimester and second trimester respectively. The results of Table 2 showed no significant difference of TNF-α (p=0.642), IL-10 (p=0.678), IL-6 (p=0.551) and IL-4 (p=0.280) of malaria infected pregnant women at first trimester and third trimester respectively. The results of Table 2 showed no significant difference of TNF-α (p=0.062), IL-10 (p=0.016), IL-6 (p=0.352) and IL-4 (p=0.914) of malaria infected pregnant women at first trimester and third trimester respectively. The study showed no changes in the cytokines studied among the malaria infected pregnant women based on gestational ages except when IL-10 was compared between the subjects on second trimester and third trimester. This study shows that malaria infection does not changes these cytokines in pregnant women based on gestational ages except the il-10 when compared at second trimester and third trimester but changes when compared at other trimesters.

scholarly journals Assessment of D-Dimer Levels in Southwestern Nigerian Pregnant Women

2020 ◽  
pp. 60-68
Author(s):  
E. O. Bamisaye ◽  
M. A. Okungbowa ◽  
D. T. Alade ◽  
O. Brown- West ◽  
G. T. Oluwasuji
Keyword(s):  
Pregnant Women ◽  
Teaching Hospital ◽  
First Trimester ◽  
Elevated Concentration ◽  
Third Trimester ◽  
Southwestern Nigeria ◽  
Blood Samples ◽  
The Third ◽  
The Mean ◽  
D Dimer

Aim: This study evaluated D-dimer level in pregnant and non-pregnant women in Southwestern Nigeria in order to provide more information on the concentration and liable risks in this region. Study Design: This is a cross sectional study where convenience sampling method was applied in sample collection. Place and Duration of Study: Blood samples were collected from pregnant women             attending the antenatal clinics of Federal Teaching Hospital Ido-Ekiti (FETHI), Ekiti; Federal                Medical Centre (FMC), Owo; and LAUTECH Teaching Hospital (LTH), Osogbo in Southwestern Nigeria. Methodology: Exactly three hundred pregnant (300) and one hundred and fifty (150) apparently healthy non pregnant women were recruited for this study. The blood samples were analysed for haematocrit (HCT) and platelet count using Sysmex KX-2IN (Japan); prothrombin time (PT) and activated partial thromboplastin time (APTT) by Diagen reagents (Diagnostic Ltd., UK); the international normalized ratio (INR) was calculated from the PT results; and D-dimer quantitative assay using Tina Quant Gen 2 on Cobas C111 (Roche). Data analysis was performed using IBM-SPSS version 25.0; mean and standard deviation was used to summarize continuous variables and descriptive and Inferential statistical tests were employed with level of statistical significance was determined at p<0.05. Results: The mean D-dimer levels were significantly higher in the pregnant women (0.87 ± 1.00 ugFEU/ml) than in controls (0.31 ± 0.22 ugFEU/ml) with 42% of the pregnant population having elevated concentration while the mean PT, INR and HCT were significantly higher in controls than the subjects (p<0.05).Furthermore, the HCT, platelet, PT and INR were observed to be highest at first trimester; 36.04±5.09 (L/L), 182.72±35.11 (x109/L), 11.80±1.86 (seconds) and 0.35±0.15 respectively, decreasing across the second and the third trimester. On the other hand, the D-dimer and APTT increased exponentially from the first trimester; 0.42±0.18 (ugFEU/ml) and 30.80±3.30 (seconds), through the second and third trimesters respectively (p>0.05). Conclusion: This study shows a significant increase in D-dimer in the pregnant subjects when compared with the control and an exponential increase in the third trimester, also a significant reduction in some other baseline coagulation profile hence depicting D-dimer as a notable significant marker of coagulation and fibrinolysis. This therefore emphasizes the hypercoagulable state of pregnancy and a need for adequate monitoring.

scholarly journals Lipid Profile of Healthy Women During Normal Pregnancy

2009 ◽  
Vol 28 (3) ◽  
pp. 152-160 ◽  
Author(s):  
Margarita Diareme ◽  
Petros Karkalousos ◽  
Georgos Theodoropoulos ◽  
Stefanos Strouzas ◽  
Nikos Lazanas
Keyword(s):  
Pregnant Women ◽  
Lipid Profile ◽  
Gestational Age ◽  
First Trimester ◽  
Normal Pregnancy ◽  
Second Trimester ◽  
Third Trimester ◽  
Predisposing Factor ◽  
Healthy Women ◽  
C 30

Lipid Profile of Healthy Women During Normal PregnancyThe four basic lipid indexes (Chol, Trig, HDL-C and LDL-C) increase during pregnancy, following different rates of increase. Among the four analytes triglycerides show the largest increase and HDL-C the smallest. All analyte values are raised during the 40 weeks of pregnancy, except HDL-C which is stabilized during the second trimester. After delivery the values decrease, except LDL-C which remains steady (for some weeks) before starting to fall following the others. In this study the relations between the four lipid indexes and some predisposing factors (age, gestational age, nationality, body mass index, profession, smoking and diabetes during pregnancy) were investigated. The sample consisted of 413 pregnant women, mainly Greeks and Albanians. After regression analysis it was proved that the only common predisposing factor was the gestational age. Triglycerides and total cholesterol are also influenced by the women's age. The lipid indexes showed no important difference between the pregnant women in the first trimester and the non-pregnant women. On the contrary, there was a statistical difference between the pregnant women in the second and third trimester and between them and the women in the first trimester. The percentages of increase between first and second trimester were: Chol: 38%, Trig: 115%, HDL-C: 30%, LDL-C: 33%. The percentages of increase between first and third trimester were: Chol: 65%, Trig: 208%, HDL-C: 26%, LDLC: 64%.

scholarly journals FOR HIGHLY PATHOGENIC INFLUENZA A(H1N1) IN PREGNANCY AND IMPACT ON BIRTH OUTCOMES

2018 ◽  
Vol 23 (3) ◽  
pp. 119-125
Author(s):  
M. G. Avdeeva ◽  
O. R. Gafurova
Keyword(s):  
Nervous System ◽  
Pregnant Women ◽  
Influenza A ◽  
Intrauterine Infection ◽  
First Trimester ◽  
Second Trimester ◽  
Third Trimester ◽  
Highly Pathogenic ◽  
The Third ◽  
Influenza A H1n1

The purpose of this study was to improve the diagnosis of influenza A (H1N1) in pregnant women and to determine the risk of developing various types of pathology in newborns, depending on the gestation period at which the infection influenza occured. Materials and methods. A total of 94 pregnant women, an average age of 28.7 ± 0.48, who were on treatment with influenza diagnosis in the Specialized Infectious Disease Clinical Hospital of the Ministry of Health of the Krasnodar Territory during the epidemic rise of influenza A (H1N1) from December 2015 to February 2016. The diagnosis of influenza A (H1N1) was confirmed in all cases by the isolation of RNA of influenza A (H1N1) virus by PCR in a nasopharyngeal scrap. Patients applied for medical care on average 2.74 ± 0.16 days of illness. Pregnancy at the gestational age corresponding to the first trimester was in 20 (21.3%), in the term of the second trimester - in 36 (38.3%), and in the third trimester - in 38 (40.4 %) of women. The results of the laboratory examination were evaluated. Pregnancy outcomes were traced in 94 women, a telephone questioning of women was conducted 3-6 months after childbirth, the state of children at birth was analyzed based on the results of a retrospective analysis of 91 neonatal card in the maternity hospital. Results. Highly pathogenic influenza A (H1N1) in pregnant women during early treatment and prescription of antiviral therapy was mainly in medium-heavy form (96.81%). In the first day of the disease, subfebrile fever predominated - 63.3%, febrile fever subsequently developed in 53.33%, headache, and other intoxication manifestations were less than in the case of epidemical influenza A. Catarrhal syndrome is not bright, often characterized by early joint cough. The main complication of influenza, determining the severity of the patient state, was pneumonia, developed in one third of patients. Early antibacterial and antiviral therapy in most cases prevented the formation of severe lung lesions and abortion. Pregnancy ended with urgent deliveries in 89 women (94.68%); in three cases, in women who had influenza at 6, 15 and 29 weeks of gestation, abortion with fetal death (3.19%) occurred. Premature delivery at 28 and 33 weeks of gestation with the birth of a viable child occurred in two cases (2.13%). The development of influenza in the first trimester resulted in complications in 42% of cases, increasing the risk of abortion and developmental anomalies, mainly from the cardiovascular system (26.31%). Infection of pregnant women with influenza in the second trimester led to a different pathology of newborns in 49% cases. Among them, acute intranatal asphyxia prevailed (14.29%), pathology of the nervous system (11.43%), less frequently developed intrauterine infection, pneumonia (5.71%). Special attention is required by women with influenza in the third trimester of pregnancy, in this group, the pathology of the newborns was noted in 54% of cases, mainly in the form of acute intranatal asphyxia (29.73%) against the background of intrauterine infection, pneumonia (16.22%), central nervous system pathology (8.11%). The conclusion. Despite the medium-heavy course, the woman’s influenza had an adverse effect on the formation of the fetus and the condition of the newborn at birth. On the background of influenza infection, the degree and nature of exposure depended on the gestation period.

Midwifery Care for Pregnant Women With Back Pain Discomfort in Trimester III Pregnancy at the Karunia Birth Clinic, Sidoarjo.

Academia Open ◽  
2021 ◽  
Vol 5 ◽  
Author(s):  
Anggraeni Kriswidya Putri ◽  
Hanik Machfudloh
Keyword(s):  
Back Pain ◽  
Data Collection ◽  
Pregnant Women ◽  
Gestational Age ◽  
Analysis Data ◽  
Second Trimester ◽  
Third Trimester ◽  
Midwifery Care ◽  
The Third ◽  
Maternity Clinic

Pregnancy is a process that begins with the unification of spermatozoa with ovum called fertilization and then continued with implantation. Normal pregnancies generally last for 9 months, and are divided into the first 3 trimesters 1-12 weeks, the second trimester 13-27 weeks, the third trimester 28-40 weeks. Various complaints felt by pregnant women, one of which is back pain that causes pregnant women discomfort. This aerikel was written taken from the place of Maternity Clinic Karunia Sidoarjo on January 05, 2020. The way of data collection is by means of anamnesa, examination of analysis, data then documenting by comparing between the data that has been obtained with existing theories. Mrs. .m 40 weeks gestational age, with complaints of physiological back pain with good maternal and fetal conditions.

Haemostatic reference intervals in pregnancy

2010 ◽  
Vol 103 (04) ◽  
pp. 718-727 ◽  
Author(s):  
Maja Jørgensen ◽  
Anna Klajnbard ◽  
Malene Andersen ◽  
Nina Colov ◽  
Steen Stender ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Gestational Age ◽  
Total Protein ◽  
Protein C ◽  
Protein S ◽  
Coagulation Factors ◽  
Reference Intervals ◽  
Specific Reference ◽  
D Dimer ◽  
Protein S Activity

SummaryHaemostatic reference intervals are generally based on samples from non-pregnant women. Thus, they may not be relevant to pregnant women, a problem that may hinder accurate diagnosis and treatment of haemostatic disorders during pregnancy. In this study, we establish gestational age-specific reference intervals for coagulation tests during normal pregnancy. Eight hundred one women with expected normal pregnancies were included in the study. Of these women, 391 had no complications during pregnancy, vaginal delivery, or postpartum period. Plasma samples were obtained at gestational weeks 13–20, 21–28, 29–34, 35–42, at active labor, and on postpartum days 1 and 2. Reference intervals for each gestational period using only the uncomplicated pregnancies were calculated in all 391 women for activated partial thromboplastin time (aPTT), fibrinogen, fibrin D-dimer, antithrombin, free protein S, and protein C and in a subgroup of 186 women in addition for prothrombin time (PT), Owren and Quick PT, protein S activity, and total protein S and coagulation factors II, V, VII, VIII, IX, X, XI, and XII. The level of coagulation factors II, V, X, XI, XII and antithrombin, protein C, aPTT, PT remained largely unchanged during pregnancy, delivery, and postpartum and were within non-pregnant reference intervals. However, levels of fibrinogen, D-dimer, and coagulation factors VII, VIII, and IX increased markedly. Protein S activity decreased substantially, while free protein S decreased slightly and total protein S was stable. Gestational age-specific reference values are essential for the accurate interpretation of a subset of haemostatic tests during pregnancy, delivery, and puerperium.

scholarly journals Headaches during pregnancy in women with a prior history of menstrual headaches

2005 ◽  
Vol 63 (4) ◽  
pp. 934-940 ◽  
Author(s):  
Eliana Melhado ◽  
Jayme A. Maciel Jr ◽  
Carlos A.M. Guerreiro
Keyword(s):  
Pregnant Women ◽  
International Headache Society ◽  
First Trimester ◽  
Prior History ◽  
Second Trimester ◽  
Third Trimester ◽  
The Third ◽  
Ihs Classification ◽  
History Of ◽  
Structured Questionnaire

OBJECTIVE: To evaluate the presence of menstrual headaches prior to pregnancy according to the International Headache Society (IHS) classification criteria, 2004, and also study the outcome (frequency and intensity) of these pre-existing headaches during the gestational trimesters. METHOD: This study involved 1,101 pregnant women (12 to 45 years old). A semi-structured questionnaire was used to interview the women during the first, second and third gestational trimesters as well as after delivery. All the interviews were conducted by one of the researchers by applying the IHS Classification (IHSC-2004). RESULTS: A 1,029 women out of the 1,101 women interviewed presented headaches prior to gestation, which made it possible to study headaches in 993 women during the gestational trimesters. Menstrually related headaches were presented by 360 of the 993 women. Migraine was reported by 332/360 women (92.22%) with menstrual headaches and 516/633 women (81.51%) without menstrual headaches, respectively, prior to gestation. The majority of the women with menstrual migraine presented a headache improvement or disappearance during gestation (62.22% during the first trimester; 74.17% during the second trimester; 77.78% during the third trimester). CONCLUSION: Most of the pregnant women with menstrual or non-menstrual headaches prior to gestation presented migraine, which either improved or disappeared during pregnancy. Women who suffered from non-menstrual headaches improved during pregnancy but not as much as women with menstrual headaches.

scholarly journals FOR HIGHLY PATHOGENIC INFLUENZA A(H1N1) IN PREGNANCY AND IMPACT ON BIRTH OUTCOMES

2018 ◽  
Vol 23 (3) ◽  
pp. 119-125
Author(s):  
M. G. Avdeeva ◽  
O. R. Gafurova
Keyword(s):  
Nervous System ◽  
Pregnant Women ◽  
Influenza A ◽  
Intrauterine Infection ◽  
First Trimester ◽  
Second Trimester ◽  
Third Trimester ◽  
Highly Pathogenic ◽  
The Third ◽  
Influenza A H1n1

The purpose of this study was to improve the diagnosis of influenza A (H1N1) in pregnant women and to determine the risk of developing various types of pathology in newborns, depending on the gestation period at which the infection influenza occured. Materials and methods. A total of 94 pregnant women, an average age of 28.7 ± 0.48, who were on treatment with influenza diagnosis in the Specialized Infectious Disease Clinical Hospital of the Ministry of Health of the Krasnodar Territory during the epidemic rise of influenza A (H1N1) from December 2015 to February 2016. The diagnosis of influenza A (H1N1) was confirmed in all cases by the isolation of RNA of influenza A (H1N1) virus by PCR in a nasopharyngeal scrap. Patients applied for medical care on average 2.74 ± 0.16 days of illness. Pregnancy at the gestational age corresponding to the first trimester was in 20 (21.3%), in the term of the second trimester - in 36 (38.3%), and in the third trimester - in 38 (40.4 %) of women. The results of the laboratory examination were evaluated. Pregnancy outcomes were traced in 94 women, a telephone questioning of women was conducted 3-6 months after childbirth, the state of children at birth was analyzed based on the results of a retrospective analysis of 91 neonatal card in the maternity hospital. Results. Highly pathogenic influenza A (H1N1) in pregnant women during early treatment and prescription of antiviral therapy was mainly in medium-heavy form (96.81%). In the first day of the disease, subfebrile fever predominated - 63.3%, febrile fever subsequently developed in 53.33%, headache, and other intoxication manifestations were less than in the case of epidemical influenza A. Catarrhal syndrome is not bright, often characterized by early joint cough. The main complication of influenza, determining the severity of the patient state, was pneumonia, developed in one third of patients. Early antibacterial and antiviral therapy in most cases prevented the formation of severe lung lesions and abortion. Pregnancy ended with urgent deliveries in 89 women (94.68%); in three cases, in women who had influenza at 6, 15 and 29 weeks of gestation, abortion with fetal death (3.19%) occurred. Premature delivery at 28 and 33 weeks of gestation with the birth of a viable child occurred in two cases (2.13%). The development of influenza in the first trimester resulted in complications in 42% of cases, increasing the risk of abortion and developmental anomalies, mainly from the cardiovascular system (26.31%). Infection of pregnant women with influenza in the second trimester led to a different pathology of newborns in 49% cases. Among them, acute intranatal asphyxia prevailed (14.29%), pathology of the nervous system (11.43%), less frequently developed intrauterine infection, pneumonia (5.71%). Special attention is required by women with influenza in the third trimester of pregnancy, in this group, the pathology of the newborns was noted in 54% of cases, mainly in the form of acute intranatal asphyxia (29.73%) against the background of intrauterine infection, pneumonia (16.22%), central nervous system pathology (8.11%). The conclusion. Despite the medium-heavy course, the woman’s influenza had an adverse effect on the formation of the fetus and the condition of the newborn at birth. On the background of influenza infection, the degree and nature of exposure depended on the gestation period.

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