Threat of premature birth: psycho-social aspects

2016 ◽  
pp. 86-89
Author(s):  
S. Zhuk ◽  
◽  
O. Schurevska ◽  
Keyword(s):  
Pregnant Women ◽  
Physical Functioning ◽  
Premature Birth ◽  
Defense Mechanisms ◽  
Subjective Evaluation ◽  
Clinical Signs ◽  
Subjective Assessment ◽  
Psychological Status ◽  
Stress Load ◽  
Mandatory Participation

The objective: to study the psychological characteristics of women’s status in one of the most common complications of pregnancy - the threat of termination of pregnancy, depending on the level of stress load. Patients and methods. We have studied the psychological status (the Holmes-Rahe level of psychosocial stress, the Spielberg-Hanin level of anxiety, V.I.Dobryakov’s related to a pregnancy test, diagnosis of psychological defense mechanisms, assessment of quality of life) 60 pregnant women with threat of premature birth in the third trimester of pregnancy. Surveyed women were divided into 2 groups: group 1 included 30 pregnant women – forced migrant of Donetsk and Lugansk area and 2 group – 30 pregnant women who resided in Kiev. Results. At the same clinical picture of the threat of premature birth we detected discrepancy between the subjective assessment of their condition in women – forced migrants: a high level of situational and personal anxiety, decrease in physical (physical functioning, role-physical functioning) and psychological (social functioning, role emotional functioning) health, doubtful and pathological subtypes of gestational dominant. This creates prerequisites for complications of pregnancy, childbirth and postpartum future period and requires the participation of psychologists in the work with this category of patients. Conclusion. So, revealed a discrepancy between the objective clinical signs similar obstetric pathology (on the example of threatened abortion) in pregnant women with different levels of stress load and their subjective evaluation of their condition that affects their psychological status. This should be reflected in individually tailored therapy and be mainstreamed into the work of obstetricians and gynecologists with these patients, and requires mandatory participation of psychologists in the work with this category of patients. Key words: pregnancy, the threat of premature birth, stress, psychological status.

AB0839 Fibromyalgia Syndrome in Pregnant Women; The Effects on Physical Functioning and Psychological Status

2016 ◽  
Vol 75 (Suppl 2) ◽  
pp. 1190.1-1190
Author(s):  
H. Genc ◽  
M. Atasever ◽  
B. Duyur Cakit ◽  
M. Seval ◽  
A. Koc
Keyword(s):  
Pregnant Women ◽  
Physical Functioning ◽  
Fibromyalgia Syndrome ◽  
Psychological Status

Opportunities for treating opportunistic vaginal infections during pregnancy

GYNECOLOGY ◽  
2017 ◽  
Vol 19 (6) ◽  
pp. 11-15 ◽  
Author(s):  
T E Karapetyan ◽  
V V Muravieva ◽  
A S Ankirskaya ◽  
L A Lyubasovskaya ◽  
T V Priputnevich
Keyword(s):  
Positive Result ◽  
Pregnant Women ◽  
Early Pregnancy ◽  
Premature Birth ◽  
Local Treatment ◽  
Vaginal Infections ◽  
Aerobic Vaginitis ◽  
Early Gestation ◽  
Early Stages ◽  
Intrauterine Infections

The aim of the study was to evaluate the effectiveness of treatment of women with opportunistic vaginal infections during pregnancy. Materials and methods. A prospective cohort study included 330 pregnant women, of whom 151 were diagnosed with bacterial vaginosis (BV), 37 had aerobic vaginitis (AB), 109 had vulvovaginal candidiasis (VC), 20 had a combination of VC + BV. When carrying out antibiotic therapy in the early stages of pregnancy, the principle of local treatment was observed. Results. Most often (46.0%), vaginal infections were detected when women were treated early in pregnancy. In the treatment of BV in the early stages of pregnancy with antiseptic chlorhexidine, a positive result of therapy was noted in 97.6% of women. Therapy with metronidazole or clindamycin BV in women who applied in the II and III trimesters, gave a positive result, respectively, in 90.0% and 89.5% of cases. The course of therapy with chlorhexidine pregnant women with AB was effective in 91.7% of cases with treatment in the first trimester and 92.0% in treatment in the II and III trimesters. In the treatment of VC in early pregnancy, natamycin was effective in 95.0% of women. In the II and III trimesters, econazole treatment was successful in 88.2% and 88.6%, respectively. In the treatment of combination of BV + VC in early gestation, the complex course of chlorhexidine + natamycin was effective in 76.5% of women, in II and III trimesters Neo-Penotran Forte was effective in 93.8% of pregnant women. Relapses of vaginal infections were observed in 34 pregnant women (10.3%). Superinfection with fungi was noted in 9.3% of cases of BV treatment and in 8.1% of pregnant women with AB. Among women observed from early pregnancy, there were no cases of premature birth, manifestations of intrauterine infections were noted in 5.3% of newborns. At treatment in the II and III trimesters, premature birth was in 6.5% and 13.5% of women, and manifestations of intrauterine infections - in 15.3% of newborns. Thus, microbiological monitoring of timely detection and treatment of opportunistic vaginal infections in pregnant at-risk groups showed the advisability of treating these infections in early gestation.

scholarly journals Low Maternal Immunoglobulin G Avidity and Single Parity as Adverse Implications of Human Cytomegalovirus Vertical Transmission in Pregnant Women with Immunoglobulin M Positivity

Viruses ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 866
Author(s):  
Masatoki Kaneko ◽  
Junsuke Muraoka ◽  
Kazumi Kusumoto ◽  
Toshio Minematsu
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Vertical Transmission ◽  
Human Cytomegalovirus ◽  
Multiple Logistic Regression Analysis ◽  
Clinical Signs ◽  
Immunoglobulin M ◽  
Igg Antibody ◽  
Neurological Sequelae ◽  
Previous Pregnancy

Human cytomegalovirus (CMV) is the leading cause of neurological sequelae in infants. Understanding the risk factors of primary CMV infection is crucial in establishing preventive strategies. Thus, we conducted a retrospective cohort study to identify risk factors of vertical transmission among pregnant women with immunoglobulin (Ig) M positivity. The study included 456 pregnant women with IgM positivity. Information on age, parity, occupation, clinical signs, IgM levels, and IgG avidity index (AI) was collected. The women were divided into infected and non-infected groups. The two groups showed significant differences in IgM level, IgG AI, number of women with low IgG AI, clinical signs, and number of pregnant women with single parity. In the multiple logistic regression analysis, pregnant women with single parity and low IgG AI were independent predictors. Among 40 women who tested negative for IgG antibody in their previous pregnancy, 20 showed low IgG AI in their current pregnancy. Among the 20 women, 4 had vertical transmission. These results provide better understanding of the risk factors of vertical transmission in pregnant women with IgM positivity.

Electromyographic and subjective evaluation of a wrist rest for VDT operators

1998 ◽  
Vol 1 (4) ◽  
pp. 239-257
Author(s):  
Erwin Keller ◽  
Helmut Strasser
Keyword(s):  
Experimental Investigation ◽  
Subjective Evaluation ◽  
Subjective Assessment ◽  
Physiological Data ◽  
Physiological Cost ◽  
Working Posture ◽  
Finger Touch ◽  
Muscle Groups ◽  
Vdt Operators ◽  
Objectively Measured

This study assessed the effects of a wrist rest for VDT operators based on an experimental investigation. Muscular strain associated with the working posture was measured continuously via electromyographic activities (EA) of 8 muscle groups which were involved in the working tasks. The electromyographic measurements yielded a clear systematical effect of the wrist rest while entering text using the 10-finger touch system. Values of the EA, as an indicator of physiological cost were essentially lower with the wrist rest. Working without the wrist rest is at least two times more strenuous than working with it. The differences are statistically highly significant. Less positive and less consistent results were found while working on the prefixed mouse pad of the wrist rest. Considering the influence of the working aid on entering text, the results of the subjective assessment after the tests corresponded well with the objectively measured physiological data. Whereas the working aid for entering text was assessed quite positively overall, the integrated mouse pad earned a clearly negative rating.

scholarly journals The presence of lupus nephritis additionally increases the risk of preeclampsia among pregnant women with systemic lupus erythematosus

Lupus ◽  
2021 ◽  
pp. 096120332110047
Author(s):  
Katarina Bremme ◽  
Sonja Honkanen ◽  
Iva Gunnarsson ◽  
Roza Chaireti
Keyword(s):  
Caesarean Section ◽  
Lupus Nephritis ◽  
Pregnant Women ◽  
Lupus Erythematosus ◽  
Premature Birth ◽  
Renal Involvement ◽  
Significant Risk ◽  
Obstetric Outcomes ◽  
Increased Risk ◽  
Renal Lupus

Introduction Pregnant women with systematic lupus erythematosus (SLE) have an increased risk of obstetric complications, such as preeclampsia and premature births. Previous studies have suggested that renal involvement could further increase the risk for adverse obstetric outcomes. Aims: The aim of this study was to compare the obstetric outcomes in a Swedish cohort of patients with SLE with and without lupus nephritis (LN). Patients and methods The study was conducted as a retrospective observational study on 103 women with SLE, who gave birth at the Karolinska University Hospital between the years 2000-2017. Thirty-five women had previous or active LN and 68 women had non-renal lupus. Data was collected from digital medical records. The outcomes that were analysed included infants born small for gestational age (SGA), premature birth, preeclampsia, SLE- or nephritis flare and caesarean section. Results Women with LN, both with previous and with renal flare during pregnancy suffered from pre-eclampsia more often compared to women with non-renal lupus (25.7% vs 2.9%, p = 0.001) and this complication was associated with premature birth (p = 0.021) and caesarean section (p = 0.035). Conclusions Lupus nephritis is a significant risk factor for adverse obstetric outcomes in women with SLE, including preeclampsia. Those patients could benefit from more frequent antenatal controls and more vigorous follow-up.

scholarly journals Sonographic Assessment of Complex Ultrasound Morphology in Pregnant Women with the Use of IOTA Simple Rules Risk and ADNEX Scoring Systems

Diagnostics ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 414
Author(s):  
Artur Czekierdowski ◽  
Norbert Stachowicz ◽  
Agata Smoleń ◽  
Tomasz Kluz ◽  
Tomasz Łoziński ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Risk Model ◽  
Malignant Tumors ◽  
Scoring Systems ◽  
Subjective Assessment ◽  
Risk Level ◽  
Likelihood Ratios ◽  
Predictive Values ◽  
Adnexal Masses ◽  
Simple Rules

Background: To evaluate the accuracy of subjective assessment (SA), the International Ovarian Tumor Analysis (IOTA) group Simple Rules Risk (SRR) and the Assessment of Different NEoplasias in the adneXa (ADNEX) model for the preoperative differentiation of adnexal masses in pregnant women. Methods: The study population comprised 36 pregnant women (median age: 28.5 years old, range: 20–42 years old) with a mean gestation age of 13.5 (range: 8–31) weeks at diagnosis. Tumors were prospectively classified by local sonographers as probably benign or probably malignant using SA. Final tumor histological diagnosis was used as the reference standard in all cases. Logistic regression SRR and ADNEX models were used to obtain a risk score for every case. Serum CA125 and human epidydimis protein 4 (HE4) concentrations were also retrieved and the Risk of Ovarian Malignancy Algorithm (ROMA) value was calculated. The calculated predictive values included positive and negative likelihood ratios of ultrasound and biochemical tests. Results: Final histology confirmed 27 benign and 9 malignant (including 2 borderline) masses. The highest sensitivity (89%) and specificity (70%) were found for the subjective tumor assessment. Although no malignancy was classified as benign using the SRR criteria (sensitivity = 100%), the specificity of this scoring system was only 37%. At the cut-off risk level of >20%, the ADNEX model had a sensitivity of 78% and a specificity of 70%. Serum levels of CA125, HE4 and the ROMA risk model correctly identified adnexal malignant tumors with a sensitivity of 67%, 25% and 25%, respectively. Corresponding specificities were 72%, 100% and 100%, respectively. The highest positive and negative likelihood ratios were found for SA (LR+ = 3.0 and LR− = 0.16, respectively). Overall diagnostic accuracy of all predictive methods used in this study were similar (range: 70–75%) except for SRR (53%). Conclusion: Subjective assessment remains the best predictive method in complex adnexal masses found at prenatal ultrasound in pregnant women. For less experienced sonographers, both the SRR and ADNEX scoring systems may be also used for the characterization of such tumors, while serum tumor markers CA125 and HE4, along with the ROMA algorithm appear to be less accurate.

AAP Code of Ethics for the Use of Fetuses and Fetal Material for Research

PEDIATRICS ◽  
1975 ◽  
Vol 56 (2) ◽  
pp. 304-305
Author(s):  
Horace L. Hodes ◽  
Rowine H. Brown ◽  
Malcolm A. Holliday ◽  
L. Stanley James ◽  
Avrum L. Katcher ◽  
...  
Keyword(s):  
American Academy ◽  
Pregnant Women ◽  
Premature Birth ◽  
Code Of Ethics ◽  
Health Needs ◽  
Genetic Abnormality ◽  
Direct Benefit ◽  
Research Activities ◽  
American Academy Of Pediatrics ◽  
New Knowledge

Research on the fetus and newborn is of the greatest importance in contributing to the health and welfare of the entire population. Such research, motivated by humane concern, should be continued and fostered, subject to adequate and clearly defined safeguards.* The American Academy of Pediatrics recognizes that through research involving previable fetuses, new knowledge may be gained which would ultimately benefit viable infants. The American Academy of Pediatrics also recognizes that some of these areas of research, while not jeopardizing the health and welfare of the fetus, are not of direct benefit to that particular fetus. In such cases express consent should be obtained from the parent. "The whole previable fetus has offered an important opportunity that cannot be obtained in any other way for making observations of great value on the transfer of substances across the human placenta, the reaction of the immature fetus to drugs, and on the endocrinological development of the fetus and the development of the placenta."1 Research activities involving the fetus in utero or pregnant women may be undertaken1 for the purpose of benefiting that particular fetus or to respond to the health needs of the mother,2 as part of the procedure to terminate the pregnancy, and for the purpose of evaluating or improving methods of prenatal diagnosis, methods of prevention of premature birth, or methods of intervention to offset the effects of genetic abnormality or congenital injury or to ascertain the safety and efficacy to the fetus of drugs which might be needed by pregnant women.2

Features of psychoemotional condition and stress-assosiatate hormons bioproduction in pregnant women after application of assisted reproductive technologies

2018 ◽  
pp. 118-121
Author(s):  
L.M. Vygivska ◽  
◽  
I.A. Usevych ◽  
I.V. Maidannyk ◽  
V.F. Oleshko ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Emotional State ◽  
Assisted Reproductive Technologies ◽  
Past History ◽  
Reproductive Technologies ◽  
Main Group ◽  
Psychological Status ◽  
Perinatal Complications ◽  
History Of ◽  
High Level

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.

scholarly journals Prevention of preterm delivery in women with multiple pregnancy

2018 ◽  
Vol 22 (1) ◽  
pp. 126-132
Author(s):  
A.V. Tkachenko
Keyword(s):  
Pregnant Women ◽  
Preterm Delivery ◽  
Rating Scale ◽  
Transvaginal Ultrasound ◽  
Multiple Pregnancy ◽  
Clinical Signs ◽  
Cervical Canal ◽  
Cervical Insufficiency ◽  
Cervical Incompetence ◽  
Vaginal Pessary

The objective — to asses the effectiveness of obstetric pessary for cervical incompetence correction in women with multiple pregnancy and infertility in the anamnesis, treated by ART. 30 ART treated pregnant women with infertility in the anamnesis, with dichorionic diamniotic twins (DCDA) were divided into 3 groups, depending on the gestational age when cervical incompetence was diagnosed and vaginal pessary placed: the I group consisted of 5 pregnant women (17%), whom pessary was inserted at 19–22 gestational weeks, the II group included 18 (60.0%) women with correction of cervical insufficiency from 23 to 27 weeks of gestation, the III — 7 (23%) of the patients with pessary implementation in terms of 28–32 gestational weeks. Diagnosis of cervical incompetence was based on the FMF criterias, the Score Rating Scale (Shtember Scale in the modification of G.M. Savelieva) and cervical indices (CI). The sonographic evaluation of cervical insufficiency considered the cervical length (less than 25 mm), opening of the internal os and / or cervical canal (9 mm or more), ICSC>0.22, IPC>0.18 and the Rating Scale score > 5–6 points. With the aim to treat cervical incompetence during pregnancy, silicone vaginal pessary (ASQ, perforated) was used. The cervical assessment by transvaginal ultrasound probe was performed every 2 weeks and evaluated 1 month after correction. The data obtained were processed statistically, using the Microsoft Excel software. The average age of pregnant women was 27.7±2.8 years (28–38 years). Extragenital pathology was determined in 83.3% of women. All pregnant women had infertility in anamnesis, treated by ART, 18 (60%) by standard IVF procedure and 12 (40%) using ICSI method. The number of primiparous and multiparous women was the same. Within pregnancy duration, there were artificial abortions in 8 (53,3%), miscarriages in 7 (46,7%), prematurity in 3 (20,0%) and term delivery in 2 (13,3%) patients in the anamnesis. The current pregnancy was complicated by threatened abortions in all groups, which clinical signs most often occurred within 8–10 and 14–17 weeks of gestation. The average duration of pessary placement in groups was 15.0±1.8; 12.2±1.6 and 4.7±2.1 weeks, respectively. According to ultrasonography evaluation, the visual lengthening of the cervix from 21.6±3.4 mm to 30.2±3.6 mm (p<0,05) were observed in all groups, during the first week of treatment. Preterm delivery occurred in 6 (20%) women, among them before 32 weeks — 3.3%, 32–34 weeks — 10% and in 35–36 weeks — 6.5% of observations. 16.7% of pregnant women had vaginal delivery, 25 (83.3%) underwent Cesarean Section, 76.7% of them had a planned CS. No cases of antenatal or intranatal fetal death happened, as well as newborns with extremely low body weight were not observed in women of all three groups. Results were obtained testify the role of cervical incompetence in the pathogenesis of perinatal losses in women with multiple pregnancy. Evaluation and diagnosis of cervical insufficiency to predict and prevent premature labor in such group of patients should be based on criteria of Fetal Medicine Foundation (FMF), using the method of transvaginal ultrasound cervicometry. An additional calculation of cervical indices may improve the reliability of the prognostic technique. The safety, accessibility and efficacy of obstetric vaginal pessary usage for non-surgical correction of cervical incompetence, as well as absence of severe complications in women with twin pregnancies, have been demonstrated.

scholarly journals CARDIAL MANIFESTATIONS OF NON-DIFFERENTIATED CONNECTIVE TISSUE DYSPLASIA AND THEIR INFLUENCE ON PREGNANCY

2021 ◽  
pp. 14-22
Author(s):  
V. Yu. DOBRIANSKA ◽  
S. M. HERYAK ◽  
L. M. MALANCHUK ◽  
M. I. SHVED ◽  
I. V. KORDA
Keyword(s):  
Mitral Valve ◽  
Connective Tissue ◽  
Ventricular Arrhythmia ◽  
Pregnant Women ◽  
Mitral Valve Prolapse ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Adequate Treatment ◽  
Pregnancy And Childbirth ◽  
Connective Tissue Dysplasia

Among the visceral manifestations of NDST in pregnant women most often diagnosed mitral valve prolapse (20-25%) that accompanied by more cardiovascular and obstetric complications during pregnancy. It demonstrates the high clinical significance of the problem of connective tissue dysplasia with mitral valve prolaps for pregnancy and requires adequate treatment programs for prevention of complications and management of pregnant women with connective tissue dysplasia. Aim. Determination of the frequency of pregnancy pathology in women with clinical signs of NDST and MVP complicated by extrasystolic arrhythmia. Materials and methods. 138 pregnant women with MVP and concomitant signs of NDST and 54 healthy pregnant women were selected for analysis. Clinical manifestations of NDST, different variants of arrhythmias and the total number of complications of pregnancy and childbirth were evaluated. Results. In pregnant women with clinical signs of NDST and MVP complicated by extrasystolic arrhythmia, cases of frequent sinus extrasystole were significantly more often compared to frequent ventricular arrhythmia (47.8% vs. 18.1%, p<0.001) and cases of combination of frequent sinus extrasystole and ventricular arrhythmia (13.3 % vs. 1.5%, p <0.05). They significantly more often identified both symptoms of arrhythmological nature and symptoms that indicated a violation of autonomic status. The presence of NDST syndrome is more often accompanied by the development of complications of pregnancy and childbirth. These pregnant women have genetic and phenotypic risk factors for the development of pathological pregnancy and childbirth, birth trauma, disability of mother and newborn, which justifies such patients in a separate risk group for individualized programs of the prevention and treatment of visceral (cardiac) manifestations of NDST and possible complications of pregnancy and childbirth. Conclusions. 3.1% of pregnant women are diagnosed with phenotypic signs (stigma) of undifferentiated connective tissue dysplasia, and the most common visceral cardiac manifestation is mitral valve prolapse. The presence of mitral valve prolapse and extrasystolic arrhythmia in pregnant women with NDST is accompanied by significantly more frequent development of pregnancy and childbirth complications in these patients.

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