Fetus arrest of development at prematurely born pregnancy: diagnostics and prophylaxis of perinatal pathology

2017 ◽  
pp. 124-126
Author(s):  
V.I. Boyko ◽  
◽  
O.I. Butenko ◽  

The objective: to reduce the frequency of perinatal complications at pregnant women with a fetus arrest of development the pregnant at prematurely born pregnancy by improvement of the main diagnostic and treatment-and-prophylactic actions. Patients and methods. prospective research was conducted, we surveyed 120 patients, among which 90 pregnant women with syndrome of an arrest of development of a fetus who were divided by method of casual choice into two groups. Results. The use of the proposed treatment and preventive methods in pregnant women with premature birth at FGR allowed to significantly reduce the incidence of threatened abortion and placental dysfunction 1.3 times, genital tract disorders microbiocenosis 1.4 times, premature rupture of membranes by 1.4 times, the severity FGR syndrome 1.6 times, fetal distress is 1.3 times, 1.2 times of the COP, severe asphyxia in 3 times, intra-amniotic infection is 1.5 times, to change the structure of preterm birth (to prevent early preterm birth in 22–28 weeks). The overall incidence of infants in the early neonatal period, these pregnant women was significantly reduced by 1.3 times (p<0.05), but there were no perinatal loss. Conclusion. The received results: when using the technique of complex correction developed by us the dizadaptation of disturbances in fetoplacental complex at women who received algorithm offered by us, all structural mechanisms of adaptation of placenta which allow to keep morphometric and diffuse indicators of vorsine tree at level with firmness compensations that is the most important adaptive agent which allows to support vital activity of fetus turn on and to prevent development of serious degree of delay of its development. Key words: fetus arrest of development, prematurely born pregnancy, diagnostics, prophylaxis.


2018 ◽  
pp. 7-79
Author(s):  
S.Yu. Vdovichenko ◽  
◽  
T.D. Fakhrutdinova ◽  

The objective: depression of obstetric and perinatal complications at pregnant women with pathological increase of body weight during pregnancy on the basis of studying of clinical-functional, endocrinologic, metabolic, morphological features of condition of fetoplacental complex and development of advanced algorithm of treatment-and-prophylactic actions. Materials and methods. We conducted examination of 264 patients who consisted on the account concerning pregnancy in female consultations of Kiev. By a method of selection of 178 women were included in retrospective research and 86 – in prospective. The main group was made by 39 pregnant women with whom led individual discussions, control – 142 women, that received traditional references in female consultation. Results. Use of the algorithm improved by us allows to improve obstetric (decrease of frequency of a preeclampsia by 12.3%; anomalies of a patrimonial deyalnost for 8.4%) and perinatal outcomes (depression of level of an asphyxia at a delivery for 9.4% and post-natal adaptation for 7.8%) deliveries of women with an excessive increase of body weight during pregnancy. Conclusion. The received results grant the right to recommend the algorithm improved by us for wide use in practical health care. Key words: obstetric and perinatal pathology, pathological increase of body weight, prophylaxis.



2021 ◽  
Vol 2 ◽  
pp. 32-36
Author(s):  
O.V. Laba

The obstetrician-gynaecologist practitioners consider a woman’s health from her reproductive potential support standpoint, and the problem of miscarriage is considered as one of the most important health problems in the world. The difficulty in solving the premature birth problem is the presence of many factors and preconditions that determine the risks of miscarriage. The article provides an overview of current international guidelines for assessing the root causes and preconditions for preterm birth. The problem of preterm birth risks is discussed, taking into account both the socio-economic living conditions of pregnant women and the factors that accompany the formation of the pathogenesis of preterm birth (placental dysfunction). There were examination and evaluation of the clinical significance of the factors that can lead to dysfunction of the fetoplacental complex (partial placental abruption, low placentation, placental dysfunction, premature placental maturation, placental malnutrition/hypertrophy, polyhydramnios/dehydration, placental abruption syndrome and growth retardation syndrome, fetal-placental blood flow, acute/chronic fetal distress). It was noted that hemodynamic disorders in the placenta depend on both the nature and duration of adverse factors. Those factors are pregnancy in unfavourable terms for the birth of children (up to 18 and after 40 years), high frequency of extragenital pathology, complicated reproductive history, genital infectious diseases (chlamydial infections, trichomoniasis, urogenital mycoplasmosis), smoking during pregnancy, the impact of environmental and economical character.Attention is paid to the hemodynamic disorders assessment (vascularization of the lower uterus) in pregnant women and determination of their role in the fetoplacental dysfunction development. The role of the hemodynamic disorders in the placenta is considered as the morphological and biochemical adaptive reactions abnormality. 



2017 ◽  
pp. 41-46
Author(s):  
Yu.P. Vdovychenko ◽  
◽  
N.F. Alipovа ◽  

The objective: A study of features of the course of pregnancy and perinatal outcomes in women with thyroid dysfunction. Analysis of the risk prediction of gestational and perinatal complications, depending on the level of antibodies to thyroid peroxidase (AB-TPO). Patients and methods. A retrospective study of 526 histories and stories birth of generations of women-carriers of antibodies to thyroid peroxidase and 489 of their newborns The group of comparison was formed of 40 stories birth somatically healthy women without the elevated levels of AB-TPO and 40 stories of their newborns. The analysis of the course of pregnancy and perinatal outcomes, evaluation of risk prediction of gestational and perinatal complications, depending on the level of AB-TPO. Results. Established that women carriers of AB-TPO age has the older category; among extragenital diseases most often identified diseases of otolaryngology and neurocirculatory dystonia. Obstetric anamnesis burdened by the pregnancy miscarriage and perinatal losses. In the structure of gestational and perinatal complications, the principal place is the threatened miscarriage, preeclampsia, fetal distress, asphyxia of newborns. Discovered the effect of the starting threshold level of AB-TPO on the risk of occurrence impendence interruption of pregnancy (AB-TPO=315 IU/ml); the risk of miscarriage (AB-TPO=339.8 IU/ml); the risk of fetal distress (AB-TPO = of 247.5 IU/ml); the risk of neonatal asphyxia (AB-TPO=234.8 IU/ml). Didn’t discovere influence of starting threshold level of AB-TPO on the risk of preeclampsia and pathological birht. Conclusion. Women carriers of the AB-TPO constitute a group of high risk of obstetric and perinatal pathology. Discovered the influence of the starting threshold level of AB-TPO on the risk of gestational complications. Key words: pregnancy, level of antibodies to thyroid peroxidase, miscarriage, gestational and perinatal complications.



2021 ◽  
Vol 74 (10) ◽  
pp. 2585-2587
Author(s):  
Vitaliy V. Maliar

The aim: To study the features of the course of gestation and perinatal outcomes of delivery in women with vitamin D lack. Materials and methods: The article presents the results of studies of the characteristics of the course of pregnancy and delivery outcomes in 50 patients with vitamin D lack compared with a group of 50 somatically healthy pregnant women with normal level of 25 (OH) D. In order to establish a lack of vitamin D in pregnant women in the 10-12, 20-22, 30-32 weeks of gestation electrochemiluminiscence method by using a test system EURIMMUN (Germany) in the blood serum level of 25-hydroxycalciferol (25 (OH) D) in pregnant women. Results: When analyzing the structure of complications in women with vitamin D lack during pregnancy and childbirth we found out that risk of premature birth and premature births dominated among all the complications, respectively (58.0% and 36.0%) against (12.0% and 16.0%), p <0.05. Vitamin D lack in pregnant women is often associated with a wide range of obstetric and perinatal complications, namely: preeclampsia, gestational diabetes, bacterial vaginosis , premature rupture of membranes, placental abruption, abnormal labor activity, fetal distress that required delivery by Caesarean section. Conclusions: An analysis of the course of pregnancy and childbirth in women of thematic groups proved the expediency of an individual approach to the therapy of obstetric pathology among women with vitamin D lack. Despite the level of 25 (OH) D in the blood serum of a pregnant woman of 30 ng / ml and below, it is advisable to prescribe vitamin D for prophylaxes and treatment of Vitamin D deficiency in mother and fetus.



2016 ◽  
Vol 32 (sup2) ◽  
pp. 56-61 ◽  
Author(s):  
G. Chistyakova ◽  
I. Gazieva ◽  
I. Remizova ◽  
L. Ustyantseva ◽  
V. Lyapunov ◽  
...  


World Science ◽  
2019 ◽  
Vol 2 (9(49)) ◽  
pp. 4-8
Author(s):  
V. V. Lazurenko ◽  
I. B. Borzenko ◽  
D. Yu. Tertyshnik

The purpose of the study is to evaluate the effect of placental dysfunction caused by gestational endotheliopathy on the course of labor and the condition of the newborn. The first group consisted of 70 patients with placental dysfunction with gestational endotheliopathy confirmed by laboratory-instrumental findings in the first trimester of pregnancy. The control group included 30 pregnant women with physiological gestational course. PD secondary to GE leads to preterm birth, fetal distress, increases the percentage of caesarean section, contributes to the delay of fetal growth and birth weight, poor infant status and perinatal complications.



2018 ◽  
pp. 14-18
Author(s):  
V.V. Kaminskyi ◽  
◽  
O.I. Zhdanovich ◽  
T.V. Kolomiychenko ◽  
A.D. Derkach ◽  
...  

The endpoint of the negative impact of adverse processes in the mother’s body with influenza is the formation of placental insufficiency, the basis of which is a violation of the uteroplacental blood flow. The objective: to study the features of the course of pregnancy, the state of the fetus and the newborn after the influenza in the first trimester of pregnancy. Materials and methods. 120 women who had the influenza in the first trimester of pregnancy were examined. In 68 (56.7%) pregnant women signs of feto-placental dysfunction were observed, 2 groups were distinguished: the main group - 68 patients with feto-placental dysfunction, the comparison group – 52 pregnant women without signs of feto-placental insufficiency. Results. 3 times more often than women without manifestations of placental insufficiency (42.6% versus 15.4%; p<0.05) a severe course of influenza was observed, it accompanied by a high frequency of clinical manifestations, including in almost all patients (95.6% versus 67.3%; p<0.05), body temperature rose to 38 °C and higher, and in 61.7% of women it stayed for 4–6 days (versus 11.5%; p<0.05). Among the complications of influenza: bronchitis (25.0% versus 9.3%; p<0.05), pneumonia (17.6% versus 5.7%; p<0.05), sinusitis (17.6% versus 7.7%; p<0.05). The threat of abortion was noted in 57.4% of cases, the threat of preterm birth was observed in 39.7% of women. Most often, placental dysfunction was associated with fetal distress (76.5% versus 13.5%; p<0.05) and growth retardation (54.4% versus 3.8%; p<0.05). 32.4% versus 13.5% of women had preeclampsia (p<0.05). The frequency of both polyhydramnios (17.6%) and low water (10.3%) is significantly higher. By cesarean section, 35.3% women were delivered (versus 15.4%, (p<0.05). Delivery was preterm in 17.6% of women versus 7.7% (p<0.05). Premature discharge of amniotic fluid (17.6%) and pathological blood loss during childbirth (16.2%), fetal distress during childbirth (48.5% versus 9.6%; p<0.05) were noted. Maternal placental dysfunction, fetal distress, prematurity (17.6%) and malnutrition (22.1%) led to a high incidence of birth asphyxia (46.5% versus 19.2%, p <0.05). Half (51.5%) of children had disadaptation syndromes, most often neurological disorders (32.4% versus 11.5%; p<0.05) and respiratory disorders (27.9% versus 7.7%; p<0.05). Conclusion. Influenza in early pregnancy with a severe course and a high frequency of complications is associated with a high frequency of feto-placental dysfunction and other obstetric and perinatal complications, which requires a more detailed study to determine risk factors and develop tactics for managing this category of pregnant women. Keywords: pregnancy, influenza, feto-placental dysfunction, obstetric and perinatal complications, newborn.



2016 ◽  
pp. 58-64
Author(s):  
O.B. Malanchuk ◽  
◽  
V.P. Lakatosh ◽  
O.U. Kostenko ◽  
M.I. Antonuk ◽  
...  

In Ukraine, each year born about 1,000 children ELBW, representing 0.3% of all newborns. The survival of infants with ELBW in our country has a slow upward trend and does not exceed 50%. Infants with ELBW have the highest risk of death and are the group most at risk for the development of chronic diseases of the respiratory and nervous systems and sensory apparatus and associated disability. Considering the growth of the number of children at private ELBW on the background PPROM, high perinatal morbidity and infant mortality, reduced health and reproductive capacity of women becoming urgency tactics of pregnancy and labor with premature rupture of membranes. The objective: perynatalniyh reduce complications in terms of 22-28 weeks of pregnancy complicated by premature rupture of membranes based on developing the tactics of pregnancy and childbirth. Patients and methods. To reduce perinatal complications analyzed the effect of different methods of pregnancy and childbirth on the state of newborns in gestational age 22-28 weeks against the backdrop of premature discharge of amniotic fluid. The control group consisted of 56 women who had less than a day anhydrous term. In the study group applied expectant tactics of anhydrous long term. Depending on the length of the term of anhydrous main group was divided into 2 subgroups. Sub-IA amounted to 86 pregnant women with anhydrous period of 5 days, and IP subgroup totaled 64 pregnant women with anhydrous period of 25 days. Statistical analysis of the results was performed using Microsoft Excel. Probability difference calculated by Student’s t-criterion. Results. Аnalyzing the structure and frequency of obstetric and perinatal complications in women in the period 22-28 weeks of pregnancy with different duration waterless terms, different terms of delivery proved the effectiveness of the tactics of delivery, which is used in perinatal centers m. Kyiv. This correlates with clinical data - statistical analysis of indicators of neonatal mortality and morbidity. Conclusion. Оf the research found that the rates of neonatal mortality and morbidity affecting: duration of anhydrous interval, gestational period, methods of delivery. Long expectant tactics leads to a real reduction of RDS, but an increase in the incidence of chorioamnionitis and neonatal infection. Therefore, wait-recommended tactics for 5 days, followed by delivery of women. At 22-27 weeks of pregnancy delivery path has no impact on rates of neonatal morbidity. The advantage in the delivery of women in the period 27-28 weeks, especially in the immature cervix and pelvic peredlezhenni fetal provided cesarean section. Key words: born too soon preterm birth, preterm premature rupture of membranes, pregnancy, method of delivery, birth with extremely low body weight.



2017 ◽  
pp. 54-55
Author(s):  
O.V. Zhovtenko ◽  

The objective: depression of frequency of obstetric and perinatal pathology at women who transferred before pregnancy a conservative myomectomy із on the basis of studying the clinical-ekhografical, hemodynamic, endocrinologic, metabolic and morphological features a condition of fetoplacental complex, and also improvement of algorithm of diagnostic and treatment-and-prophylactic actions. Patients and methods. Features of a clinical course of pregnancy and labors at 266 women with a hysteromyoma (in the anamnesis there was no expeditious treatment), which were divided into two groups depending on the sizes of myomatous knots are studied. Features of a clinical course of pregnancy and labors at 126 women who transferred a conservative myomectomy before pregnancy are studied. Pregnant women were divided into two groups from a technique of the performed operation and tactics of conducting pregnancy. Results. Results of the conducted researches testify to high risk of development of perinatal pathology at women with a hysteromyoma who were operated before pregnancy in volume of a conservative myomectomy. Conclusion. Use of the algorithm of diagnostic and treatment-and-prophylactic actions added with us allows to improve perinatal outcomes of a delivery of women of group of high risk. Key words: hysteromyoma, reconstructive operations, pregnancy, labors.



2016 ◽  
pp. 79-81
Author(s):  
A.S. Mandrykova ◽  

The objective: the study of morphofunctional changes of the fetoplacental complex at 28–33 weeks of gestation in women with early preterm delivery after the application of ART. Patients and methods. We have examined 130 patients whose pregnancy occurred after the use of ART. This is the woman who gave birth at 28–33 weeks of gestation. Of these, 80 women had early premature births in the background premature rupture of fetal membranes, 50 – patients with early preterm delivery and timely rupture of fetal membranes (control group 2). The main group included 4 groups of 20 women with regard to the duration of anhydrous interval: 1.1 – anhydrous interval 5–6 hours (main group 1); 1.2 – anhydrous span 24 hours; 1.3 – anhydrous interval 45–48 hours; 1.4 – anhydrous period 5 days after PRFM. Results. Thus, the results of the research indicate that the main cause of early preterm birth in women after using ART are structural dezorhanization changes of collagen fibers of the connective tissue amnion and chorionic which lead to the appearance of microscopic defects – delamination its surface, causing premature rupture of fetal membranes the launch stage localized focal immediate type hypersensitivity reactions and restructuring epithelial cell membranes. Neutrophil macrophage properties in this case reduced and programmed to perform a cycle of incomplete phagocytosis, which increases the synthesis of inflammatory cytokines in the area of rupture of fetal membranes. Сonclusion. Reduced activity of neutrophils increases the effect of abuse and cytokine balance in favor predictor of early spontaneous labor at 28-33 weeks of gestation. Key words: morphological changes of the fetoplacental complex, early preterm birth, expectant tactics of childbirth.



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