Correction of bleeding in the early stages of gestation depending on the status of the embryo and extraembryonic structures

2017 ◽  
pp. 22-24
Author(s):  
E.V. Kravchenko ◽  
Keyword(s):  
Pregnant Women ◽  
Ultrasonic Inspection ◽  
Clinical Signs ◽  
First Trimester ◽  
Fibrin Clot ◽  
Main Group ◽  
Control Group ◽  
Early Stages ◽  
The Status ◽  
Hemostatic Therapy

The objective: the study of the status of the embryo and extraembryonic structures for bleeding that is not associated with the detachment of the chorion in the first trimester of gestation. Patients and methods. Were examined 34 patients in the gestational age 6-9 weeks (main group) with bleeding from the genital tract, in which, at the primary ultrasonic inspection revealed no detachment of the chorion. The control group included 30 women with uncomplicated course And trimester of gestation. The average age of the pregnant women of the main group was 25.3±3.1 years in the control group 26.4±4.3 years. All women underwent standard clinical and laboratory examination. Results. Studies have shown that prognostic markers of unfavorable development of the embryo in the early stages of pregnancy bleeding not related to chorion detachment was not detected. For the purpose of hemostasis in pregnant of the main group of prescribed drugs traneksamic acid 0.25 mg 3-4 times a day for 3 days. Traneksam – antifbrinolytic tool is able to block not only plasminogen, and plasmin that has already formed. It also stimulates the synthesis of collagen, through which increases the elasticity of the fibrin clot. Pregnant women in both groups received vitamin E 1 capsule per day magnesium products, Magnicum 1 tablet 3 times a day, folic acid 400 micrograms per day. Assessing clinical signs of disease in dynamics of treatment, it should be noted that the hemostasis in the main group was achieved in an average of 2.3±0.7 days. Conclusion. Bleeding in early gestation, not connected with the detachment of the chorion, the use of Traneksam provides fast absolute hemostasis, which in turn contributes to the normalization of tone of the uterus and the physiological course of placentation. Key words: bleeding in early pregnancy, the chorion detachment, hemostasis, hemostatic therapy, Traneksam.

scholarly journals DISTURBANCE OF 20α-HYDROXYSTEROID DEHYDROGENASE ACTIVITY IN VILLOUS CHORION SYNCIOTHYTHROPHOBLAST AT REACTIVATION OF CYTOMEGALOVIRUS INFECTION DURING PREGNANCY

2017 ◽  
Vol 1 (65) ◽  
pp. 50-53
Author(s):  
Инна Довжикова ◽  
Inna Dovzhikova ◽  
Михаил Луценко ◽  
Mikhail Lutsenko ◽  
Ксения Петрова ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Dehydrogenase Activity ◽  
Cytomegalovirus Infection ◽  
Hydroxysteroid Dehydrogenase ◽  
First Trimester ◽  
Main Group ◽  
Control Group ◽  
Reaction Products ◽  
Igg Antibody ◽  
Antibody Titers

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.

scholarly journals Shifts in Female Facial Attractiveness during Pregnancy

2020 ◽  
Vol 17 (14) ◽  
pp. 5176
Author(s):  
Dariusz P. Danel ◽  
Kasper Kalinowski ◽  
Natalia Nowak-Szczepanska ◽  
Anna Ziomkiewicz-Wichary ◽  
Anna Apanasewicz ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Physical Attractiveness ◽  
Physiological State ◽  
Facial Attractiveness ◽  
Temporal Changes ◽  
Heterosexual Men ◽  
Control Group ◽  
Early Stages ◽  
The Status

It has been proposed that women’s physical attractiveness is a cue to temporal changes in fertility. If this is the case, we should observe shifts in attractiveness during pregnancy—a unique physiological state of temporal infertility. The aim of this study was to examine how women’s facial attractiveness changes during the subsequent trimesters of pregnancy and how it compares to that of nonpregnant women. Sixty-six pictures of pregnant women (22 pictures per trimester) and 22 of nonpregnant women (a control group) were used to generate four composite portraits, which were subsequently assessed for facial attractiveness by 117 heterosexual men. The results show considerable differences between facial attractiveness ratings depending on the status and progress of pregnancy. Nonpregnant women were perceived as the most attractive, and the attractiveness scores of pregnant women decreased throughout the course of pregnancy. Our findings show that facial attractiveness can be influenced by pregnancy and that gestation, even at its early stages, affects facial attractiveness. Considerable changes in women’s physiology that occur during pregnancy may be responsible for the observed effects.

scholarly journals The efficiency of treatment of vaginal infections in women with a history of 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
Keyword(s):  
Bacterial Vaginosis ◽  
Pregnant Women ◽  
First Trimester ◽  
Main Group ◽  
Control Group ◽  
Vaginal Infections ◽  
Pregnancy And Childbirth ◽  
Vaginal Microflora ◽  
History Of ◽  
Threatened Abortion

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.

Effectiveness of tranexamic acid in the therapy of bleeding in the first trimester of pregnancy

2018 ◽  
pp. 59-62
Author(s):  
T.G. Romanenko ◽  
◽  
O.M. Sulimenko ◽  
Keyword(s):  
Tranexamic Acid ◽  
Pregnant Women ◽  
Inpatient Treatment ◽  
Comparison Group ◽  
First Trimester ◽  
Main Group ◽  
Primary Group ◽  
First Trimester Of Pregnancy ◽  
Bed Days ◽  
Hemostatic Therapy

The objective: to study the effectiveness of hemostatic therapy with tranexamic acid in pregnant women with miscarriage that started. Materials and methods: The study group included 110 pregnant women with a miscarriage that began with the onset of retrochoric hematoma, from 5 to 22 weeks of gestation. The main group was 60 pregnant women who received hemostatic therapy with the drug tranexamic acid Vidanol in a daily dose of 1000–1500 mg until stopping the bleeding. The comparison group consisted of 50 pregnant women who received standard hemostatic therapy with etamsylatum. On ultrasound, retrochorionic / retroplacental hematomas were noted in 27 women of the main group (45%) and 22 patients in the comparison group (44%), extramembrane hematomas were diagnosed in 8 (13.3%) and 9 (18%) women, respectively. Placenta presentation was observed in 7 (11.7%) and 8 (16%) women of both groups, respectively. In the rest of pregnant women there was a bloody discharge from the genital tract as a result of detachment of the chorion / placenta or membranes without formation of hematoma. The obtained data are processed by the statistical method using the Microsoft Excel computer program. Results. Stopping bleeding with the use of tranexamic acid averaged over 2 days from the start of therapy, the duration of bleeding was 2.1±0.2 days, whereas in the comparison group, the duration of bleeding was significantly higher than 5.7±0.3 (p<0,01). The need for inpatient treatment was in the main group of 9.7±0.8 bed-days and 15.6±2.7 bed-days, respectively (p<0.05). When using the drug tranexamic acid, the organization and resorption of hematomas in the uterus occurred in a shorter time – 19 of 35 (54.3%) women in the primary group and 10 in 31 (32.3%) women in the comparison group. The total absence of hematoma is noted in the main group for 1.2±0.4 weeks, in the comparison group for 4.8±0.5 weeks (p<0.05). Conclusion. The use of tranexamic acid, as hemostatic therapy in pregnant women with a miscarriage, significantly reduces the duration of bleeding, promotes the accelerating the organization and resorption of intrauterine hematomas, reduces the duration of inpatient treatment. Key words: pregnancy, miscarriage, risk of miscarriage, retrochorionic hematoma, bleeding in the first trimester of pregnancy.

scholarly journals The course of pregnancy, childbirth and the postpartum period in patients after ovarian apoplexy

2021 ◽  
Vol 2 ◽  
pp. 42-46
Author(s):  
O.M. Ishak
Keyword(s):  
At Risk ◽  
Surgical Treatment ◽  
Pregnant Women ◽  
Postpartum Period ◽  
Main Group ◽  
Control Group ◽  
Time Interval ◽  
Early Stages ◽  
Reproductive Loss ◽  
History Of

The objective: to study the features of the course of pregnancy, childbirth and the postpartum period in women with a history of surgical treatment of ovarian apoplexy.Materials and methods. The study involved 62 women in labor (main group, n=62), who were operated on for ovarian apoplexy before pregnancy, and 60 patients in the control group (n=60), who did not have this pathology in the anamnesis. The average age of women was 26,1±2,3 years, the time interval from an episode of ovarian apoplexy to pregnancy was 5,44±2,7 years. Re-apoplexy was observed in 2 cases (3,22%).Results. The study found that the main complication in the first trimester of pregnancy was reproductive loss, mainly in the form of a stillborn pregnancy. In the early stages of gestation, the threat of abortion was 3 times more often observed in the main group than in the control group. In the second trimester draws attention to several facts of complications that are characteristic of patients in the main group: the widespread prevalence of acute or chronic infectious pathology in the acute stage (51,6% vs. 11,7% in the control group), the development of preeclampsia 2 times more often among pregnant women with ovarian apoplexy (38,7% vs. 20,0%), as well as mild anemia (40,3% vs. 21,6%).The results of the study indicate a high frequency of premature ejaculation of amniotic fluid in pregnant women with ovarian apoplexy (29,0% vs. 13,3%), rapid labor (16,1% vs. 1,7%), umbilical cord entanglement (33,9% vs. 15,0%), hypotonic bleeding in the early postpartum period (14,5% vs. 1,67%). The frequency of cesarean section did not differ significantly in both groups (p>0,05). The assessment of newborns on the Apgar scale had no statistically significant differences.Conclusion. Pregnant women who have a history of surgical treatment of ovarian apoplexy are at risk for developing early miscarriage, complicated gestation, childbirth and the postpartum period. Analysis of the reproductive function of women in the study groups reflected the problems of gestation mainly in the early stages in the form of reproductive loss or symptoms of miscarriage, in the late stages of pregnancy complications were mainly due to extragenital pathology. The data obtained during the study in practice should contribute to the development of rehabilitation measures and pre-pregnancy training, which are aimed at restoring reproductive health and prevention of complications of pregnancy and childbirth in women at risk.

scholarly journals CHANGES OF HORMONAL STATUS IN PREGNANT WOMEN WITH MISCARRIAGE IN EARLY GESTATION TERMS

2020 ◽  
Vol 10 (4(38)) ◽  
pp. 35-40
Author(s):  
K. Lisova ◽  
I. Kalinovska ◽  
P. Tokar
Keyword(s):  
Pregnant Women ◽  
Chorionic Gonadotropin ◽  
Main Group ◽  
Placental Lactogen ◽  
Control Group ◽  
Hormonal Status ◽  
Early Stages ◽  
Fetoplacental Complex ◽  
Arterial Blood ◽  
The Impact

Introduction. The article represents the results of the study of the placental hormone level during the early stages of gestation (5-20 weeks). The aim of the study. To analyze the level of hormones of the fetoplacental complex in pregnant women with miscarriage, along with the dynamics of changes in these indicators. To evaluate the features of the hormonal status of women during law-risk pregnancy and  miscarriage in history and the impact of these features on the functional state of the fetoplacental complex and the subsequent course of pregnancy. Material and methods. We examined 30 somatically healthy women with a physiological course of pregnancy (the control group) and 30 pregnant women with a miscarriage in history (the main group). Research results. It was found that the content of estradiol, chorionic gonadotropin and placental lactogen in the blood plasma of pregnant women of the main group was significantly lower during the entire gestational period compared to the control group. Estradiol levels in pregnant women with miscarriage were 4.2 times lower than in healthy pregnant women. Placental lactogen levels in the main group of pregnant women were 6.1 times lower, and chorionic gonadotropin - 3.7 times lower compared with the control group. There was also a significant backlog in the growth of hormone levels as the pregnancy progressed. In its turn it indicates the development of placental dysfunction in women with a miscarriage in history in the early stages of gestation. Conclusions. As a result of the described changes there is a violation of the first wave of cytotrophoblast invasion and, as a consequence, incomplete gestational remodeling of segments of spiral arteries. The walls of blood vessels are not completely replaced by fibrinoid and the formed placental vessels do not provide a constant flow of arterial blood into the intervillous space. As a result, the uterine-placental area and the formed placenta are not ready to meet the needs of the developing fetus. In the future, this can lead to perinatal losses.

Preeclampy prevention issues in women with obesity

2020 ◽  
pp. 61-66
Author(s):  
S.P. Posokhova ◽  
◽  
S.V. Nikolaeva ◽  
K.O. Nitoсhko ◽  
◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Growth Factor ◽  
Pregnant Women ◽  
Prophylactic Treatment ◽  
First Trimester ◽  
Main Group ◽  
Placental Growth Factor ◽  
Control Group ◽  
Positive Trend ◽  
Obese Women

The objective: evaluation of the effectiveness of the prevention of preeclampsia in pregnant women with obesity using L-arginine during pregnancy Materials and methods. Materials and methods. The main group consisted of 38 obese women (1st century – 15th, 2nd century – 12th, 3rd century – 11), who were prescribed complex prevention of preeclampsia: from 12 weeks of pregnancy 150 mg of aspirin once a day, and from 16 weeks the solution L-arginine (Тivortin aspartate) 5 ml (1 g) 4 times a day for 2 months. The comparison group included 30 pregnant women with obesity of the II-III stage who did not receive preventive treatment. The control group consisted of 30 healthy pregnant women. By the beginning of prophylactic treatment and in the dynamics of all obese pregnant women, the level of pregnancy-associated plasma protein A (PAPP-A), placental growth factor (PlGF), arginine and leptin was determined in blood serum. Results. In pregnant women with obesity, already in the first trimester a significantly higher level of leptin is observed compared to the main group and the level of placental growth factor is significantly lower, which are significant triggers for the development of preeclampsia and other gestational complications. After the prophylactic treatment of pregnant women of the main group with L-arginine for 2 months (at 16–24 weeks), the following trends were observed: the level of L-arginine did not change, was constant. Leptin levels differed depending on the degree of obesity, but did not have a high critical value. A positive trend was the growth of placental growth factor in women of the main group, which indicated normal placentation and the prevention of early preeclampsia. Conclusions. Thus, in pregnant women of the main group, after comprehensive prevention of the development of preeclampsia with aspirin and L-arginine (Тivortin) for 2 months, the incidence of severe severe preeclampsia decreased by 4.4 times, which is a favorable factor in maintaining a woman’s health and reducing perinatal losses. Additional L-arginine in the diet reduced the frequency of preeclampsia in pregnant women with obesity, contributing to vasodilation due to increased production of nitric oxide, may be one of the positive factors of pathogenetic treatment. Keywords: pregnancy, obesity, preeclampsia, leptin, nitric oxide, L-arginine.

Optimisation of tactics of conducting pregnancy and labours at women after auxiliary reproductive technologies

2016 ◽  
pp. 160-164
Author(s):  
D.N. Maslo ◽  
Keyword(s):  
Pregnant Women ◽  
Resistance Index ◽  
First Trimester ◽  
Reproductive Technologies ◽  
Premature Delivery ◽  
Control Group ◽  
Uterine Arteries ◽  
Placental Dysfunction ◽  
Placental Blood ◽  
Two Stages

The objective: frequency decrease perinatal pathologies at women after ART on the basis of studying clinical-ehografical, endocrinological, biochemical, dopplerometrical, cardiotokografical and morphological researches, and also improvement of algorithm of diagnostic and treatment-and-prophylactic actions. Patients and methods. The work basis is made spent by us from 2012 on 2015 by complex inspection of 300 pregnant women from which 250 were after ART and 50 – firstlabours which pragnency without ART, and also their newborns. For the decision of an object in view of research spent to two stages. At 1 stage spent prosperctive research which included 150 pregnant women: з them 100 women pregnancy at which has come out ART (1 group) and 50 healthy women (control group). At 2 stage spent prospective randomization in which result of patients after ART have divided on two equal groups by therapy principle: 2 basic group - 75 pregnant women after ART at which used the algorithm improved by us; 3 group of comparison - 75 pregnant women after ART which have been spent on the standard treatment-and-prophylactic actions. Results. The results suggest that women after using ART is a high frequency of reproductive losses in the first trimester (10.0%), 3.0% of spontaneous abortion from 16 to 22 weeks, and 3.0% "early" premature delivery (22 to 28 weeks of pregnancy). The frequency of violations of the functional state of placenta in women after using IVF is 63.0%, which is the main cause of high levels of perinatal losses (40.0 ‰), and delivery by cesarean section (96.0%). Placental dysfunction in women after using ART characterized by retrohorialnyh hematoma (21.0%); size mismatch fruit (30.0%) and hypertonicity of the uterus (73.0%) against changes in fruit-placental blood flow - increased resistance index in umbilical artery and increased vascular resistance in the uterine arteries. Endocrinological and biochemical changes in placental dysfunction in women after using IVF starting from 28 weeks of pregnancy and are in significant reduction in progesterone, placental b1-microglobulin, B2-microglobulin of fertility and trophic в-glycoprotein. Conclusion. The received results: use of the algorithm of diagnostic and treatment-and-prophylactic actions improved by us allows to lower frequency of spontaneous interruption of pregnancy till 22 weeks – from 13.0% to 5.7%; «early» premature birth – from 3.0% to 1.0%; placentary dysfunction from 63.0% to 40.6%; cesarean sections – from 96.0% to 56.5%, and also perinatal losses – from 40.0‰ to 16.2‰. Key words: pregnancy, childbirth, auxiliary reproductive technologies.

New opportunities of drug delivery in oncology

2018 ◽  
pp. 120-127
Author(s):  
А.В. Бойко ◽  
Н.Д. Олтаржевская ◽  
В.И. Швец ◽  
Л.В. Демидова ◽  
Е.А. Дунаева ◽  
...  
Keyword(s):  
Clinical Signs ◽  
Supportive Therapy ◽  
Main Group ◽  
Radiation Proctitis ◽  
Control Group ◽  
Vaginal Mucosa ◽  
Zone Method ◽  
Radiation Cystitis ◽  
Grade Ii ◽  
Grade Iii

Цель исследования. Разработка методов сопроводительной терапии для защиты нормальных органов и тканей, входящих в зону облучения. Методы. В исследование включено 112 больных раком шейки и тела матки после комбинированного или самостоятельного лучевого лечения с 2012 по 2016 гг. У 71 пациентки основной группы в качестве терапии сопровождения применяли гидрогель с деринатом и у 41 больной группы контроля - традиционные методы профилактики (масло оливковое, подсолнечное, метилурациловая мазь). Для профилактики эпителиита слизистой влагалища и шейки матки в основной группе использовали гидрогель в виде аппликаций с первого дня облучения. Для профилактики лучевого ректита гидрогель вводили в прямую кишку 1 раз в день с первого дня облучения. Инстилляции гидрогеля в мочевой пузырь начинали только при развитии первых признаков клинической картины цистита. Пациенткам контрольной группы для профилактики лучевых реакций проводились масляные, мазевые аппликации во влагалище, масляные микроклизмы в прямую кишку с первого дня облучения. Лечение лучевого цистита проводили с помощью растительных диуретиков, уросептиков. Результаты. Применение гидрогеля с деринатом позволило провести курс лучевой терапии без перерыва у 84,5% (60/71) больных, в контрольной группе - лишь у 48,8% (20/41). Лучевые циститы возникали в 2,5 раза реже (25,3% ± 3,3 против 63,4% ± 2,7, р<0,01). Анализ степени выраженности лучевого цистита по RTOG в двух группах показал, что у 75% больных основной группы наблюдалась I степень, у 25% - II степень, III и IV степени не отмечено, тогда как в контрольной группе лучевой цистит I степени развился у 44% пациенток, II - 40% и III - 16% больных. Применение гидрогеля снизило частоту лучевых ректитов в 2 раза (26,7% ± 3,3 против 53,7% ± 3,2 р<0,1).При использовании ежедневных аппликаций гидрогеля с деринатом со стороны слизистой оболочки влагалища и шейки матки преобладали эпителииты I степени (53,5%), II степень наблюдалась у 29,5% и III степень лучевой реакции - лишь в 16,9% случаев, IV степень реакции не отмечена. В контрольной группе эти показатели составили 26,8%, 24,3%, 31,7% и 17,2% соответственно. Разработаны цитологические критерии оценки течения лучевых реакций слизистой влагалища. Выделены три степени изменения цитограммы, которые коррелировали с клинической картиной. В основной группе лучевые изменения I степени зафиксированы в 4,5 раза чаще (52 ± 9,9% против 11,5 ± 6,3%, р<0,002), а III степень представлена в 3,8 раза реже, чем в контрольной группе (12 ± 6,5% против 46,1 ± 9,8%, р<0,003). Заключение. Применение гидрогелевого материала с деринатом в качестве препарата сопроводительной терапии во время курса облучения позволяет уменьшить частоту и степень выраженности лучевых повреждений со стороны слизистой влагалища, мочевого пузыря и прямой кишки, провести курс лучевой терапии без перерыва и улучшить качество жизни пациенток. Objective. Development of methods for accompanying therapy to protect normal organs and tissues in the irradiation zone. Method. The study included 112 patients with cervical and endometrial cancer after combined or independent radiotherapy from 2012 to 2016. In 71 female patients of the main group, Derinat with hydrogel was applied as a supportive therapy and in 41 patients of the control group, conventional prevention methods (olive oil, sunflower oil, methyluracyl ointment) were applied. For prevention of vaginal mucosal and cervical epitheliitis in the main group, hydrogel was used as applications from the first radiation day. For prevention of radiation proctitis, hydrogel was injected into the rectum once daily from the first radiation day. Hydrogel instillations into the bladder were started only with the first clinical signs of cystitis. For prevention of radiation reactions, vaginal oil and ointment and rectal oil micro-enema were administered to patients of the control group from the first day of irradiation. Radiation cystitis was treated with vegetable diuretics and uroseptic drugs. Results. Using the hydrogel with Derinat allowed to administer a course of radiotherapy without interruption in 84.5% (60/71) of patients and only in 48.8% (20/41) in the control group. Radiation cystitis occurred 60% less frequently (25.3% ± 3.3 versus 63.4% ± 2.7, p <0.01). Analysis of radiation cystitis severity in two groups (according to RTOG) showed that 75% of patients in the main group had grade I and 25% had grade II. Grade III and grade IV did not occur. At the same time, in the control group, grade I radiation cystitis developed in 44% of patients, grade II - in 40%, and grade III - in 16% of patients. The hydrogel treatment halved the frequency of radiation proctitis (26.7% ± 3.3 vs. 53.7% ± 3.2 p <0.1). With daily application of the hydrogel with Derinat, grade I epitheliitis (53.5%) predominated in vaginal and cervical mucosa, grade II was observed in 29.5%, and grade III radiation reaction - only in 16.9% of cases; grade IV reaction was not observed. In the control group, these proportions were 26.8%, 24.3%, 31.7%, and 17.2%, respectively. Cytological criteria were developed to evaluate the course of radiation reactions in the vaginal mucosa. Three degrees of change in the cytogram were identified, which correlated with clinical picture. In the main group, incidence of grade I radiation-induced changes was increased by more than 350% (52 ± 9.9% vs. 11.5 ± 6.3%, p <0.002), and incidence of grade III was decreased by more than 70% compared to the control group (12 ± 6.5% vs. 46.1 ± 9.8%, p <0.003). Conclusion. Using the hydrogel material with Derinat as an accompanying therapy during the course of irradiation allows to reduce frequency and severity of radiation injuries of the vaginal mucosa, bladder, and rectum, administer an uninterrupted course of radiotherapy, and improve the quality of life of patients.

scholarly journals Modern view on the problem of optimization of therapy in pregnant women with functional cervical insufficiency

2018 ◽  
Vol 22 (1) ◽  
pp. 173-177
Author(s):  
V. F. Oleshko
Keyword(s):  
Blood Serum ◽  
Pregnant Women ◽  
Main Group ◽  
Control Group ◽  
Cervical Insufficiency ◽  
Progesterone Concentration ◽  
Therapeutic Dosage ◽  
Hormonal Balance ◽  
Magnesium Orotate ◽  
Micronized Progesterone

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.

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