Features of vaginal biotope of pregnant women with obstructive failure of the cervix functions and the ways of its correction

2016 ◽  
pp. 59-63
Author(s):  
I.A. Zhabchenko ◽  
◽  
V.F. Oleshko ◽  
E.M. Bondarenko ◽  
T.M. Kovalenko ◽  
...  

The article presents the investigation results of the vaginal biotope of pregnant women with incompetence of cervix obstructive function. The frequency growth of this complication in nulliparous women, the absence of significant differences in pregnancy outcomes without regard to the correction methods, the increase of number of obstructed and pathological labors among these women, were the basis for the factors analysis that deteriorate the prognosis for the mother and fetus. The vaginal microbiocenosis pathology plays one of the leading roles in the premature birth development) in women with incompetence of cervix obstructive function. The objective: to study the vaginal biotope in pregnants with incompetence of cervix obstructive function in order to improve the antenatal care tactics and increase the effectiveness of non-surgical treatment modality of this pathology. Patients and methods. 63 pregnants at term 22–32 weeks who had been treated at the department of pathology of pregnancy and childbirth of SE «IPAH NAMS of Ukraine» with the verified incompetence of cervix obstructive function (main group) were examined. The control group was formed by 34 pregnants with physiological state of cervix obstructive function. Results. The predominance of alkaline or slightly alkaline vaginal biotope’s reaction expressed leukocyte reaction, high desquamated epithelium content and a sharp decline in the numbers of Lactobacillus spp. at the background of mostly associated coccal microflora, Gram-negative microorganisms and Candida albicans fungi is typical for the main group of pregnants. The association of anaerobic microorganisms from bacterial-viral and bacterial-chlamydial urogenetal infections is typical for every third main group of pregnant women. Conclusion. The pathogenetically justified antibiotic therapy with a long-term correction of vaginal microbiocenosis dysbiotic disorders before the introduction of the perforated silicone cervical pessary provides the absence of discomfort which is associated with vaginal secret overproduction and allows stabilizing the leukocyte vagina microbiocenosis reaction within the physiological one and reducing the risk of preterm labor in these pregnants. Key words: the incompetence of cervix obstructive function, cervix, microbiocenosis, pregnancy, miscarriage.

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.


2018 ◽  
pp. 104
Author(s):  
N.Y. Skripchenko ◽  
◽  
O.M. Pavlova ◽  
T.M. Mazur ◽  
◽  
...  

The objective: to study the features of the endocrinological status and the fetoplacental complex in pregnant women with adenomyosis, the course of pregnancy and childbirth in these women, to develop new, systematize and improve the existing methods of diagnosis, treatment and prevention of complications and reproductive losses. Materials and methods. We examined 90 pregnant women who were divided into groups: 30 healthy women – control group, a comparison group of 30 women with adenomyosis receiving classic progesterone therapy and the main group of 30 women with adenomatosis who received advanced preserving, metabolic therapy and diet therapy. The condition of the feto-placental complex, the frequency of IUGR, hemodynamic disturbances on the part of the fetus, and the level of estriol, progesterone, cortisol, chronic gonadotropin (CGL), placental lactogen were evaluated. Results. The main complication in pregnant women with adenomyosis was placental dysfunction (the comparison group was 60.0% and the main group was 33.3%), whose structure was performed by compensated (58.2%) and subcompensated forms (35.8%). The frequency of preterm labor threat was 20.0% in comparison group and 13.3% in main one, while in the control group – 1 case, which is 3.3%. Frequency of SCR was in the comparison group – 20.0% and in the main – 3.3%. Low levels of estriol, progesterone, HHG, placental lactogen, increased cortisol levels in comparison and main groups were determined, and after treatment the indicators of the main group significantly improved. Conclusions. With timely correction of violations, prevention of fetoplacental insufficiency and complex treatment with the use of advanced classical progesterone therapy in combination with metabolic and diet therapy we can significantly reduce the frequency of various complications in pregnant women with adenomyosis. Key words: adenomyosis, pregnancy, non-pregnancy, diet therapy, metabolic therapy, preservation therapy, preventive care.


2019 ◽  
Vol 72 (2) ◽  
pp. 175-180
Author(s):  
Viacheslav M. Husiev ◽  
Daria S. Khapchenkova

Introduction: The article presents information about the peculiarities of the course of pregnancy and childbirth in women with a syphilitic infection in the anamnesis. The peculiarities of the state of newborn babies born from mothers who have suffered syphilis are described. To date, the incidence of syphilis in Ukraine has a clear tendency to decline, but still remains quite high. The maximum incidence of syphilis is observed in women aged 15-20 years. The combination of pregnancy and syphilitic infection in an anamnesis is an unfavorable factor in regard to high risk of perinatal complications, the frequency of which does not tend to decrease. The aim - study the features of the course of pregnancy and childbirth in women with a syphilitic infection in the anamnesis, the evaluation of the state of newborns. Materials and methods: A prospective examination of 57 healthy women and their newborns (control group) and 60 pregnant women with a history of syphilitic infection (the main group) had been conducted. All pregnant women had undergone ultrasound examination, including feto- and placentometry, an estimate of the amount of amniotic fluid. The effect of the transferred syphilis on the state of the newborn had been assessed in accordance with the results of the clinical examination of an anthropometric data, including an Apgar score. Results: It is stated that the incidence of latent (41,66%) and forms with a prolonged course (20,00%) of syphilitic infection. The threat of premature childbirth was almost 3,5 times higher than in women with syphilis, cases of an anemia in pregnant women – 2 times, hypertensive disorders of pregnant women were 2,4 times more common in women of the main group, fetal development retardation syndrome 6,4 times, while a greater percentage of this disorder was recorded among women in the main group who were ill with latent forms and suffered secondary recurrent syphilis (35%). In 20% of the cases, pregnancy in women with syphilis has been completed by the cesarean section, an abnormality of the contractile capacity of the uterus was significantly higher – 23,33%. The adaptive capacity of the newborns in the main group has been significantly lower, compared to the control group. Conclusions: Syphilitic infection in the anamnesis complicates the course of pregnancy with numerous pathological conditions. Syphilitic infection, borne before pregnancy, affects not only the course of pregnancy, but also the course of childbirth and the postpartum period. The pathological conditions in infants are due to a decrease in resistance to birth stress, early depletion of adaptive resources of newborns under the influence of a syphilitic infection of the mother. In children who have experienced chronic intrauterine hypoxia, the risk of hemorrhagic syndrome is significantly higher due to increased permeability of the vascular wall. Such children have a tendency to develop neurological disorders and respiratory system lesions.


2018 ◽  
Vol 22 (1) ◽  
pp. 173-177
Author(s):  
V. F. Oleshko

A functional cervical insufficiency plays an important role in the etiology of miscarriage and premature birth. The aim of research was to estimate the hormonal balance indexes during the course of pregnancy in pregnant women with functional cervical insufficiency and to correct the revealed violations in order to prevent obstetric complications. 101 pregnant women with confirmed diagnosis of a functional cervical insufficiency in term of gestation 22–32 weeks of pregnancy (the main group) and 34 pregnant women and women in labor with physiological condition of the cervix (the control group) were examined. The content of estradiol, progesterone, cortisol and prolactin was examined in the blood serum. On the second stage of examination 63 pregnant women obtained general basic therapy (I main group) and 38 pregnant women (II main group) received a developed treatment complex which included progesterone support by the micronized progesterone 200–400 mg twice a day up to 34–35 weeks of pregnancy, magnesium support by the magnesium orotate dehydrate in the therapeutic dosage and arginine glutamate in the therapeutic dosage. The correction of cervical insufficiency was performed with the help of a cervical pessary (according to indications). The examination of hormonal balance revealed an accurate decease of progesterone concentration on the background of high concentration of estradiol and increased levels of stress-associated hormones. Propitious influence of the developed therapy is proved by increase of progesterone concentration in the blood serum, normalization in stress-associated hormones balance according to gestational age. All this provideded the decrease of specific weight of threatened preterm labors, placental dysfunction, vaginitis, bacterial vaginosis and delay the labors up to 38–39 weeks of gestation in 97,4% of pregnant women (82,5% in the I main group). Prescription of micronized progesterone, magnesium orotate dehydrate, arginine glutamate to pregnant women with a cervical insufficiency is reasonable and effective one comparing with general and traditional therapy.


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.


2020 ◽  
Vol 8 (T2) ◽  
pp. 196-199
Author(s):  
Stang Stang ◽  
Debora Selin ◽  
Suriah Suriah ◽  
Sumarni Marwang ◽  
Hasanuddin Ishak

BACKGROUND: Each pregnancy and childbirth has complication risks. These complications are accompanying pathological incidences that might cause maternal mortality. AIM: This research aims to determine the effect of educational media development in increasing knowledge and attitudes about complications of pregnancy and childbirth in pregnant women. METHODS: This research method passed through several stages as follows: First stage consisted of the development of educational media (leaflets), and second stage consisted of development test with leaflet media using a quasi-experimental research design. The samples were Trimester I to Trimester III pregnant women who visited Sayang Rakyat Hospital Makassar, which consisted of 30 people as intervention group and 30 people as control group. The intervention group was provided leaflets while the control group was provided books on maternal and child health. Data analysis used Wilcoxon Signed Ranks Test and Mann–Whitney test. RESULTS: The results showed that there are differences in case of knowledge and attitudes of pregnant women regarding complications of pregnancy and childbirth before and after being provided with leaflet intervention with a value of p = 0.000. Likewise, there are differences in the case of knowledge and attitudes of pregnant women regarding pregnancy and childbirth complications between the intervention and control groups with p = 0.041 and 0.001, respectively. CONCLUSION: Educational media on knowledge and attitudes about complications of pregnancy and childbirth has a positive effect in pregnant women at Sayang Rakyat Hospital in Makassar.


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.


2011 ◽  
Vol 18 (1) ◽  
pp. 3-9
Author(s):  
S P Mironov ◽  
Nikolay Petrovich Omel'yanenko ◽  
O V Kozhevnikov ◽  
V K Il'ina ◽  
A V Ivanov ◽  
...  

First results of application of cultivated autologous stromal bone marrow cells for the stimulation of distraction bone regenerates' reparative regeneration in 8 patients aged from 3.7 to 16 years with congenital lower extremity length discrepancy (main group) are presented. In 24 children with similar pathology aged from 2.5 to 14 years (control group) no cellular technology was used. In the main group duration of treatment reduces to 4.5-6.5 months versus 7.5- 11 months in the control one. That enabled to avoid potential complications related to the long-term fixation of the extremity in the distraction apparatus.


Author(s):  
V. H. Korniienko ◽  
A. S. Fitkalo

According to modern data, the cardiovascular system is a kind of indicator of the organism's adaptive activity, and the structure of the heart rhythm carries information about the development of adaptive reactions in response to irritating factors of the external and internal environment.The aim of the study – to investigate the functional state of the autonomic nervous system in pregnant women who have harmful habits by evaluating and analyzing the parameters of heart rate variability in order to prevent complications of non-delivery of gestational process.Materials and Methods. The study involved 73 pregnant women, 53 of them were pregnant (the main group) who had malignant habits in history. Before studying adaptive reactions in pregnant women, a study of cardiac rhythm variability was performed in practically healthy non-pregnant women of reproductive age (25.3±2.2) years). The control group consisted of 20 pregnant women without any harmful habits. Determination of heart rate variability was performed on the basis of peripheral heart rate recording, which included measuring the sequence of RR intervals for 5 minutes, followed by mathematical analysis using the PlsMntr software product.Results and Discussion. It was established that in the main group, in the complicated failure to pass the gestational process, violations of cardiac rhythm variability were detected in 59.7 % of cases. There is an increase in the frequency of very low frequency (VL F) waves (43.5 % relative to control, p<0.05), indicating a predominance of humoral and metabolic rate of regulation of the cardiac rhythm. At the threat of premature births, a decrease in the particle (LF) is observed at 36.6 %, a decrease in the share of high-frequency waves (НF) by 30.8 %. Taking into account the results of the study, one can speak of a decrease in the tone of the sympathetic and parasympathetic nervous system, reducing the influence of the reflexive vegetative level of regulation, which, in turn, indicates the depletion of regulatory mechanisms and the lack of an adaptive protective effect of n.vagus on the heart.Conclusions. Our innovative low-invasive method of evaluating the adaptive reactions of the organism through the determination and analysis of indicators of cardiac rhythm variability in pregnant women with the existing harmful habits offers us the opportunity to observe manifestations of functional stress of regulatory systems of pregnant women, preceding the development of complication of non-delivery of gestational process.


Author(s):  
Инна Довжикова ◽  
Inna Dovzhikova ◽  
Михаил Луценко ◽  
Mikhail Lutsenko ◽  
Ксения Петрова ◽  
...  

The aim of the work is to assess the effects of cytomegalovirus infection on the 20α-hydroxysteroid dehydrogenase activity in the villous chorion syncytiotrophoblast in the first trimester of pregnancy. The materials for the study included 48 villous chorions samples taken during spontaneous abortions at 8th–10th weeks of gestation from women with reactivation of cytomegalovirus infection (the main group). The control group included 35 villous chorions samples from pregnant women with chronic cytomegalovirus infection in the latent stage taken at medical abortions at the same stage of gestation. The results of women’s examination were studied taken into account the activity of cytomegalovirus infection by immunoassay by detection of IgM antibodies or by 4 times and more increase of IgG antibody titers in the paired serums in dynamics in 10 days. The activity of 20α-hydroxysteroid dehydrogenase was assessed by the histochemical method. Quantitative evaluation of the reaction products was carried out on sections under the microscope MT (Japan) connected to software-hardware complex «SCION Corporation» (USA). At histochemical specimen of villous chorion of pregnant women who had a reactivation of cytomegalovirus infection during pregnancy (main group), there was a decrease of cytophotometric parameter of 20α-hydroxysteroid dehydrogenase activity till 30.1±2.12 pixels/μm2 (p<0.001) compared with the control group. The decrease in the reaction activity in syncytiotrophoblast indicated a decrease in the contents of 20α-dihydroprogesterone in placenta, which contributed, in our opinion, to spontaneous abortion.


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