Placental disfunction at pregnant women with concomitant pathology of cardiovascular system

2017 ◽  
pp. 88-92
Author(s):  
E.N. Gopchuk
Keyword(s):  
Pregnant Women ◽  
Clinical Laboratory ◽  
Vascular System ◽  
Varicose Veins ◽  
Peripheral Resistance ◽  
Placental Perfusion ◽  
Cardiovascular Pathology ◽  
Pregnancy And Childbirth ◽  
Placental Dysfunction ◽  
And Control

The objective: study of the effect of Tivomax on the parameters of utero-placental-fetal blood circulation in patients with placental dysfunction and concomitant extragenital pathology of the vascular system. Patients and methods. The study included 60 pregnant women diagnosed with the diagnosis «placental dysfunction», after 22 weeks of gestation and concomitant extragenital pathology of the vascular system, including varicose veins, thrombophlebitis and endarteritis. All patients were randomly divided into the main (30 patients) and control (30 patients) epidemically equivalent groups. During the survey, clinical, laboratory and instrumental (ultrasound) methods of examination were used. Observation of patients was carried out both during pregnancy and in the postpartum period. Results. The study of the efficacy of Tivomax, 4.2% solution for infusions, against the background of the generally accepted regimen for the treatment of placental dysfunction showed that under the influence of the proposed therapy, dopplerogram normalization occurs by decreasing peripheral resistance in the microvascular bed of the placenta, increasing placental perfusion, and optimizing blood flow in the vessels. The conclusion. The purpose of the drug Tivomax contributes to the normalization of the dopplerogram by reducing the peripheral resistance in the microvascular bed. The drug Tivomax has no adverse reactions, negative changes in laboratory blood counts. Timely correction of management of pregnancy and childbirth, drug therapy, conducted in accordance with dopplerometric indicators, can reduce perinatal morbidity and mortality. Key words: Tivomax, L-arginine, endothelium, obstetrics and gynecology, placental disfunction, cardiovascular pathology, extragenital pathology.

scholarly journals Risk factors of gestational hypertension development

2017 ◽  
Vol 30 (2) ◽  
pp. 65-68
Author(s):  
Olga Bulavenko ◽  
Oksana Vaskiv
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Clinical Laboratory ◽  
Gestational Hypertension ◽  
Varicose Veins ◽  
Pregnancy Termination ◽  
Control Group ◽  
Post Secondary ◽  
Hypertension Development ◽  
Instrumental Methods

Abstract The problem of gestational hypertension (GH) remains to be of current concern in obstetric practice. The purpose of this study, therefore, was to determine the risk factors for GH development. We examined 53 pregnant women and allocated them to 2 groups: the main group - pregnant women with gestational hypertension (n = 30) and the control group - pregnant women without the pathology (n = 23). The selection of persons for the study was carried out on the basis of detailed history taking, examination and complaints, using standard clinical, laboratory and instrumental methods of investigation. The data was processed on a PC (standard statistical package Statistica 6.0). Our results show that the gestational hypertension development is closely linked with such risk factors as: age ≤ 18 years old and over 35 years old, unmarried status, living in a city/town, post-secondary education, unemployment, obesity, first labor in consecutively pregnant women, the threat of pregnancy termination, cardiovascular system diseases, urinary tract pathology, varicose veins, as well as ABO-sensibilization.

scholarly journals COMPARATIVE ASPECTS OF PLACENTAL DYSFUNCTION IN WOMEN USING DIFFERENT METHODS OF CONTRACEPTION IN ANAMNESIS

2020 ◽  
Vol 5 ◽  
pp. 34-40
Author(s):  
Oleksandra Lubkovska
Keyword(s):  
Pregnant Women ◽  
Clinical Laboratory ◽  
Risk Groups ◽  
Oral Contraception ◽  
Pregnancy And Childbirth ◽  
Diagnostic Measures ◽  
Perinatal Pathology ◽  
Satisfactory Condition ◽  
Fetoplacental Complex ◽  
History Of

The aim. To reduce the incidence of perinatal pathology in women who have used various methods of contraception, based on the study of the functional state of the fetoplacental complex (FPS), as well as improving diagnostic measures and tactics of pregnancy. Materials and methods. 140 pregnant women were studied with their division into control and 3 test groups depending on the method of contraception in the anamnesis, using clinical, laboratory and instrumental research methods during pregnancy and childbirth. Results. The study found that women with a history of intrauterine contraception (IUC), in contrast to combined oral contraception (COC) and combined oral contraception containing folate (COC+F), had a higher incidence of complications during pregnancy and childbirth, as well as fewer newborns with a satisfactory condition at birth. Assessment of folic acid levels at 6-8 weeks of gestation showed significantly better results among women with a history of COC+F, compared with IUC and COC. In the group of women with IUC in the anamnesis, significantly worse mean endocrinological values prevailed, and there was also a greater number of pregnant women with disorders of fetal-placental blood flow. More pronounced dystrophic changes in the placentas of women in this group were pathomorphologically confirmed. Conclusions. The presence in the anamnesis of IUC is accompanied by a high proportion of pregnant women with various pathological conditions and is a risk factor for FPS dysfunction. The use of COC+F in the anamnesis is the best option for women of different risk groups.

Features of course of pregnancy at women with varicose phlebectasia of genitals

2019 ◽  
pp. 43-45
Author(s):  
L.V. Manzhula ◽  
Keyword(s):  
Cesarean Section ◽  
Pregnant Women ◽  
Pregnancy Complications ◽  
Clinical Laboratory ◽  
Premature Births ◽  
Key Words Pregnancy ◽  
Placental Dysfunction ◽  
Group 2 ◽  
Laboratory Tool ◽  
Atypical Localization

The objective: to study features of course of pregnancy at women with varicose phlebectasia of genitals. Materials and methods. For the solution of a goal was the assessment of a clinical current of a gestation at 200 women with сliniсal-laboratory signs of varicose illness of the bottom extremities and genitals (the main 1 group) and 50 women of similar age and parity without clinical-laboratory signs of varicose illness (group 2 control) is carried out. In the main group we in addition allocated a subgroup of 1.1 – 42 women with varicose illness and varicose phlebectasia of genitals, respectively the subgroup 1.2 was made by 158 women with a varicose phlebectasia of only the bottom extremities. The complex of the conducted researches included clinical, laboratory, tool and statistical methods. Results. The obtained data testify that atypical localization varicose expanded veins of genitals is observed at 21.0% of women with varicose illness. The main complications of pregnancy at women with a varicose phlebectasia of genitals are not incubation threat in І a trimester – 53.3%; placental dysfunction – 33.3% and threat of premature births – 31.3%. Abortion frequency in І a trimester made 5 cases (11.9%), and premature births – respectively 3 (7.1%). Pregnant women with varicose phlebectasia of genitals in most cases (39 з 42 – 92.9%) were delivery by way of operation of Cesarean section. Conclusion. The obtained data needs to be considered when developing tactics of pregnancy and labors at women with a varicose phlebectasia of genitals. Key words: pregnancy, complications, varicose phlebectasia of genitals.

scholarly journals Comparative assessment of fetal blood flow and cardiac system status of pregnant women with mitral valve pathology

2019 ◽  
Vol 23 (4) ◽  
pp. 645-651
Author(s):  
A.P. Dnistryanska ◽  
Yu. Konovalenko ◽  
N.A. Godlevskaya ◽  
N.G. Burtyak ◽  
L.S. Baida
Keyword(s):  
Blood Flow ◽  
Mitral Valve ◽  
Pregnant Women ◽  
Mitral Valve Prolapse ◽  
Volume Ratio ◽  
Mitral Valve Insufficiency ◽  
The Body ◽  
Cardiovascular Pathology ◽  
Pregnancy And Childbirth ◽  
Valve Insufficiency

Annotation. The aim of this work is to analyze the course of pregnancy in women with mitral pathology, the task is to identify preclinical criteria for worsening cardiovascular pathology that can lead to the development of complications of pregnancy and functioning of the fetal CVS, to evaluate the effectiveness of preventive measures. The article presents the analysis of changes in ultrasound characteristics of fetoplacental blood flow in women with mitral valve prolapse and mitral valve insufficiency, as well as cardiovascular status in these women. Statistical processing was performed by calculating Student coefficients (+) using the Microsoft Excel PC program. Doppler examination of fetal umbilical cord blood flow during pregnancy was studied. The correlation between the level of maternal blood flow compensation and pathological changes in the fetoplacental complex was established. As a result of our work, the prevalence of the disease was estimated. As of 2018, it was found that of the total number of extragenital pathology in 1676 pregnant women with CVSD; respectively for 2017 — 1699, for 2016 — 1925, 2015 — 1857 in the region. Of these, 331 (2018), 313 (2017), 326 (2016), 306 (2015) had mitral valve defects, including prolapse. A retrospective assessment of pregnancy and childbirth indicates the possibility of complications of pregnancy and childbirth. In the group of patients with mitral valve prolapse and mitral valve insufficiency, compared to the control group, they did not show significant changes in the dynamics of the Doppler metrics of cardiovascular pathology, which indicates the compensation of the cardiovascular system against the background of changes in the valve. At the same time, the tendency to decrease of CF in women with mitral valve prolapse and insufficiency of the mitral valve against the background of increasing pregnancy is revealed, indicates a violation of CVD adaptation to changes inherent in pregnancy, which provoke hemic and hemodynamic changes in the body, which will cause pregnancy and fetal status. FPC status in women with mitral valve prolapse and mitral valve insufficiency worsens in the third trimester of pregnancy, especially indicators such as the ratio of systolic volume ratio (SVR) to diastolic volume ratio (DVR) and IR. The administration of 40 mg of ƅ-blockers for a 2-week period improved the FPC, was safe and effective.

scholarly journals Peculiarities of micronutrient metabolism in obese pregnant women (literature review)

2021 ◽  
Vol 23 (3) ◽  
Author(s):  
I. A. Zhabchenko ◽  
O. R. Sudmak ◽  
I. S. Lishchenko ◽  
O. M. Bondarenko
Keyword(s):  
Pregnant Women ◽  
Nutritional Deficiencies ◽  
Obese Women ◽  
Urgent Problem ◽  
Minimum Effective Dose ◽  
Pregnancy And Childbirth ◽  
Placental Dysfunction ◽  
Women Literature ◽  
Iron And Folic Acid ◽  
Special Risk

Here we summarize uptodate data on the influence of the most significant micro, macroelements, and vitamins, such as magnesium, vitamin D, iron, and folic acid, on the course of pregnancy and childbirth in obese women. The paper considers both domestic and foreign recommendations for correcting nutritional deficiencies to prevent the development of complications from the pregravid stage to the end of lactation. Nowadays, the deficiency of micro-, macroelements and vitamins is an extremely urgent problem, especially in a group of special risk, i.e. overweight and obese women, whose number is steadily growing simultaneously with an increase of the number of pregnant women of 35+ years of age. It is important to consider a woman's body mass index to prescribe the minimum effective dose of the necessary drugs. Timely preventive personalized correction of the micronutrient state can reduce the risks of such major obstetric syndromes as preeclampsia, premature birth, fetal growth retardation, miscarriage, and placental dysfunction.

scholarly journals Prevention of complications of pregnancy and childbirth of patients with a burdensome gynecological anamnesis

2021 ◽  
Vol 6 ◽  
pp. 56-60
Author(s):  
T. P. Andriichuk
Keyword(s):  
Pregnant Women ◽  
Fetal Distress ◽  
The Body ◽  
Prevention Measures ◽  
Perinatal Complications ◽  
Pregnancy And Childbirth ◽  
Placental Dysfunction ◽  
Treatment And Prevention ◽  
Prophylactic Measures ◽  
The Mean

The objective: determination of the effectiveness of prevention and medicinal correction of placental dysfunction in pregnant women with chronic salpingo-oophoritis.Materials and methods. The study included 100 pregnant women (basic group) with chronic salpingo-oophoritis, of these, I group (50 women) included patients who received proposed treatment and prevention approach, II group (50 women) received a common set of treatment and prevention measures. The proposed treatment-and-prophylactic approach included prophylactic administration to pregnant women with chronic salpingo-oophoritis from the 8th to the 10th and from the 16th to the 18th week inclusive of natural micronized progesterone at a dose of 100 mg intravaginally twice a day for two weeks. Venotonik and angioprotector were prescribed prophylactically at dose 600 mg from 18 weeks to 37-38 weeks of pregnancy. For therapeutic purposes (blood flow disorders in the uterine arteries and vessels of the umbilical cord that are determined by Doppler), the drug was prescribed at dose 600 mg twice a day for 3–4 weeks.Results. A lower frequency of obstetric and perinatal complications was found in the women in I group than in the patients in the II group. Thus, the rate of placental dysfunction was 6.0±3.36% vs. 34.0±6.7%, respectively, oligohydramnios – 6.0±3.36% and 12.0±4.59%, polyhydramnios – 10.0±4.24% and 22.0±5.86%, fetal distress during childbirth – 6.0±3.36% and 14.0±4.91%, cesarean section – 12.0±4.6% and 24.0±4.27%. In the group of patients with treatment-and-prophylactic approach, the mean of the body weight of newborns was 3486.7±312.71 g, and in women who received a common set of treatment-and-prophylactic measures – 3099.8±295.69 g. The mean of the assessment of the condition of newborns by the Apgar scale at the 1st minute – 7.92±1.54 and 6.81±1.16 points, respectively.Conclusions. The use of micronized natural progesterone and the drug diosmin 600 mg in pregnant women with a history of chronic salpingo-oophoritis reduces the rate of obstetric and perinatal complications during pregnancy.

Is it possible the prediction of placental dysfunction?

2016 ◽  
pp. 23-27
Author(s):  
S.I. Zhuk ◽  
◽  
Yu.M. Melnik ◽  
N.V. Pehnio ◽  
◽  
...  
Keyword(s):  
Growth Factor ◽  
Pregnant Women ◽  
Dynamic Control ◽  
Clinical Signs ◽  
Control Group ◽  
Morphological Examination ◽  
Endothelin 1 ◽  
Pregnancy And Childbirth ◽  
Placental Dysfunction ◽  
Complicated Pregnancy

The purpose of the study: the study of the initiating mechanisms of development of violations of the fetal-placental relationship to develop prognostic criteria, tactics of pregnancy and delivery in women at high risk. Materials and methods. In the period from 2013 to 2015 a comprehensive examination of 334 pregnant women, which depending on the peculiarities of pregnancy and childbirth were divided into groups. The control group consisted of 236 pregnant women with uncomplicated gestational period, no morphological signs of placental dysfunction. The main group (OG) included 98 patients with a complicated pregnancy who had revealed violations of the fetal-placental relationship, which was confirmed by morphological examination of the placenta immediate postpartum period. Depending on options of course of gestation period pregnant OG were divided into subgroups: subgroup I – 31 pregnant signs of preeclampsia of different severity; subgroup II – 33 pregnant women with clinical and morphological signs of placental dysfunction, subgroup III – 34 pregnant women with threatened miscarriage and premature birth. In addition, to evaluate the effectiveness of prediction and diagnosis of disorders of fetal-placental relationship was highlighted in the comparison group (GP), which included 32 pregnant women with risk factors for placental dysfunction, which carried out the monitoring of the pregnancy by the proposed algorithm. Results. Due to the datas of high-frequency dopplerometry was determined that decline of cerebro-placental index can be the sign of placental dysfunction (p<0.05). At women with placental insufficiency the reliable increase of endothelin-1 (p<0.05), decline of vascular endothelial growth factor (p<0.05) and placental growth factor (p<0.05), increase of interleukin-1b maintenance (p<0.05) and interleukin-3 reduction (p<0.05) were set. It was proven that during placental dysfunction with an absence of high variableness episodes and STV value less than 4,0 points immediate delivery was necessary. Conclusion. It was developed the monitoring, that based on the prognostic markers determination and dynamic control of pregnancy and it allowed to predict placental dysfunction and decrease its clinical signs during pregnancy in 2,5 time and unfavorable delivery outcomes in 1,7 times. Key words: placental dysfunction, prediction, endothelin-1, growth factor, interleukin, dopplerometry, cardiotocography.

scholarly journals Differential diagnosis of thrombocytopenia during pregnancy: clinical and diagnostic algorithms

2021 ◽  
pp. 28-40
Author(s):  
O.M. Naumchik ◽  
◽  
Iu.V. Davydova ◽  
A.Yu. Limanska ◽  
◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Pregnant Women ◽  
Immune Thrombocytopenia ◽  
Clinical Laboratory ◽  
Treatment Algorithm ◽  
Laboratory Data ◽  
Diagnostic Algorithm ◽  
State Institution ◽  
Perinatal Complications ◽  
Pregnancy And Childbirth

Purpose — to create an algorithm for early diagnosis and differential diagnosis of conditions accompanied by thrombocytopenia (TP) during pregnancy, as well as an algorithm for the treatment of immune thrombocytopenia during pregnancy based on analysis of clinical, laboratory data and obstetric and perinatal results of such pregnant women. Materials and methods. We analyzed 155 histories of pregnancy and childbirth of women with TP, who underwent inpatient treatment and/or gave childbirth in the obstetric clinic of the State Institution «Institute of Pediatrics, Obstetrics and Gynecology named after Academician O.M. Lukyanova NAMS of Ukraine» from January 2008 to August 2018. According to the inclusion criteria, 111 histories were selected for further analysis. Pregnant women are divided according to the etiological principle of TP into three groups: with gestational thrombocytopenia, immune thrombocytopenia, secondary thrombocytopenia. The first group included 32 women (28.8%), the second — 65 (55.6%), the third — 14 (12.6%). During the selected period of time there were 99 births, 100 babies were born, 1 twin birth. Results and conclusions. The number of platelets progressively decreases during pregnancy with a minimum in childbirth. The algorithm of examination, the decision on the initiation or intensification of treatment, the choice of monitoring tactics for TP during pregnancy, the calculation of obstetric and perinatal risks, preparation for childbirth and the choice of method depend on the cause of TP and differ significantly. Developed «Algorithm for diagnosis and differential diagnosis in the detection of thrombocytopenia during pregnancy» and «Algorithm for the treatment of immune thrombocytopenia during pregnancy» are aimed at the prevention of obstetric and perinatal complications in pregnant women with thrombocytopenia. The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local Ethics Committee of an participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: thrombocytopenia, pregnancy, diagnostic algorithm, treatment algorithm.

scholarly journals Operative delivery in pregnant women with asthma

2019 ◽  
Vol 68 (4) ◽  
pp. 19-26
Author(s):  
Olga V. Lavrova ◽  
Elena A. Shapovalova ◽  
Yulia R. Dymarskaya ◽  
Dmitry S. Sudakov ◽  
Anna V. Paliychuk
Keyword(s):  
Cesarean Section ◽  
Pregnant Women ◽  
Allergic Diseases ◽  
First Trimester ◽  
Control Group ◽  
Operative Delivery ◽  
Common Chronic Disease ◽  
Pregnancy And Childbirth ◽  
Asthma Patients ◽  
And Control

Hypothesis/aims of study. Asthma is the most common chronic disease of the respiratory system in women during pregnancy. Numerous studies show an increased frequency of all complications of pregnancy and delivery by cesarean section in women with asthma. Such delivery is reported to be observed more often in patients with severe asthma and asthma exacerbations during gestation. There are conflicting data showing that the use of asthma medication increases the risk of complications of pregnancy and childbirth. This study aimed at analyzing the frequency of cesarean section in patients with asthma, depending on the severity, course, and control of the disease. Study design, materials and methods. This retrospective study involved data of 170 patients with varying severity and control of asthma, who were under the supervision of a pulmonologist from the first trimester of pregnancy. According to the severity of asthma, patients were divided into subgroups with mild intermittent, mild persistent, and moderate and severe course of the disease. The control group was represented by 30 patients who did not suffer from any pulmonary and allergic diseases. Results. The cesarean delivery rate in patients with asthma in the whole group was significantly higher than in patients of the control group. Exacerbation of asthma during pregnancy significantly increases the frequency of abdominal operative delivery, and the use of modern drugs to achieve control of asthma during pregnancy has a positive effect and is associated with a lower birth rate by cesarean section. Conclusion. The active simultaneous management of pulmonary problems in pregnant women allows timely and adequate therapeutic measures aimed to achieve control of asthma during pregnancy, thereby reducing obstetric and perinatal risks, including those associated with the method of delivery.

STUDIES ON THE AROMATISATION OF NEUTRAL STEROIDS IN PREGNANT WOMEN

1970 ◽  
Vol 65 (1) ◽  
pp. 69-83 ◽  
Author(s):  
H. Vokal ◽  
D. F. Archer ◽  
N. Wiqvist ◽  
E. Diczfalusy
Keyword(s):  
Pregnant Women ◽  
Placental Perfusion ◽  
Homogeneous Form ◽  
Urine Specimens

ABSTRACT The following steroids, [7α-3H]5-androstene-3β,16α,17β-triol and [4-14C] 5-androstene-3β,16β,17β-triol were biosynthesized and their metabolism was studied in two subjects at midgestation, following placental perfusion in situ. Among the metabolites isolated in a radiochemically homogeneous form, exclusively 3H-labelled 16α,17β-dihydroxy-4-androsten-3-one was isolated from the extracts of placentas and perfusates. Exclusively 14C-labelled 16β,17β-dihydroxy-4-androsten-3-one was isolated from the placentas and perfusates and 16-epioestriol (1,3,5(10)-oestratriene-3,16β,17β-triol) from the placentas, perfusates and urine specimens. The following compounds contained both 3H and 14C-label: oestriol (placentas and urine specimens) and 5β-androstane-3α,16α,17β-triol (urine specimens). The 3H/14C-ratio of oestriol isolated from the urine specimens was much lower than that of urinary 5β-androstane-3α,16α,17β-triol, or that of the oestriol isolated from the placentas. The 3H/14C-ratio of the oestriol isolated from the urine 2–4 days following the perfusion was lower than that of the perfused material. It is concluded that a considerable amount of the 16-epioestriol secreted by the placenta is gradually converted to oestriol by the maternal organism. A limited conversion occurs also in the placenta.

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