Obstetric and perinatal outcomes in women with threatened interruption of pregnancy, living in the armed conflict zone

2020 ◽  
pp. 21-24
Author(s):  
I.Yu. Romanenko ◽  

The objective: was to evaluate the course of pregnancy, childbirth and perinatal outcomes of delivery of women with threatened interruption of pregnancy (TIP), living in the Lugansk region, to improve treatment and preventive measures and prevent obstetric and perinatal complications in such women. Materials and methods. A prospective clinical and statistical analysis of the course of pregnancy and childbirth of 86 pregnant women in first and second trimesters of pregnancy were hospitalized regarding TIP in the hospitals located in the Luhansk region was performed (group I). The control group consisted of 64 pregnant women with non-complicated obstetric anamnesis and physiological course of pregnancy with similar gestational period of pregnancy and place of residence (group II). Results. In women of group I, a history of female genital inflammatory diseases was significantly more frequent, and a complicated course of pregnancy and childbirth was registered. The number of cases of acute respiratory viral infection (ARVI) was in 4, isthmic-cervical insufficiency (ICI) was in 3 times more often than in healthy pregnant women, asymptomatic bacteriuria, recurring TIP, gestational pyelonephritis and ureaplasma infection were found only in pregnant women of group I, the number of cases of anemia there was no significant difference. 13 (15.12%) of women of group I and 3 (4.69%) of group II (p=0.041) had spontaneous preterm birth at 33–37 weeks of gestation; operative delivery was registered in 23 (26.74%) and 8 (12.50%) cases, respectively (p=0.033). It was established that recurrent TIP, ARVI during this pregnancy, ICI, gestational pyelonephritis are statistically significant risk factors for preterm delivery and operative delivery. Premature rupture of the membranes was found in 1.58, weakness of labor – in 2.2, premature detachment of a normally located placenta – in 6, fetal distress – in 1.9 times more often in women of group I, central placenta previa was noted only in group I. Conclusions. The complicated course of the first and second trimesters of pregnancy, in particular, recurrent TIP, ARVI during this pregnancy, ICI, gestational pyelonephritis, had a direct effect on frequency increase of premature termination of pregnancy and operative delivery in patients of the main group compared with women of the control group. The presence of a history of chronic female genital inflammatory diseases, sexually transmitted infections, ARVI during this pregnancy, TIP in the first and second trimesters, allows pregnant women to be at high risk of developing gestational complications in order to conduct timely treatment. Key words: pregnancy, the threat of abortion, childbirth, the condition of newborns.

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.


2017 ◽  
pp. 10-15
Author(s):  
I.A. Usevych ◽  
◽  
V.L. Kolesnik ◽  

Psychological problems during pregnancy and childbirth for today is a little studied subject of modern obstetrics. The possibilities for solving psychological problems that arise in cases of emergency obstetric situations are almost not used by Ukrainian specialists through the marriage of knowledge and skills to provide crisis psychological help to obstetric patients. The objective: to determine the level of psychoemotional load in pregnant and parturient women, depending on the category of urgency of cesarean section. Material and methods. The main group of the study was presented: 1 group - pregnant women, who had planned a cesarean section operation according to the ІV category of urgency and who had already had a caesarean section in the anamnesis; ІІ group – pregnant women who planned an operation according to the IV category of urgency and who had no previous caesarean section in their history; ІІІ group – pregnant and parturient women who underwent surgery, respectively, in the I–III category of urgency; Control group – 30 pregnant women in the period of 37–41 weeks of pregnancy. A survey was conducted using the questionnaires of J.Teylor, Ch.Spielberger and SAN-test. Results. On the eve of labor in pregnant women there is an increase in the psychoemotional load, which can be determined using the above questionnaires. There is a direct dependence on the category of urgency of cesarean section and the level of psychoemotional load. Also revealed the correlation dependence of the voltage of the adaptation reserves of the pregnant woman on the presence of a history of caesarean section. Conclusion. Almost 50 percent of pregnant women, in cases of cesarean section, respectively, 1–3 categories of urgency in the preoperative period have the maximum level of psychoemotional load according to the questionnaires used. Pregnant women who have undergone a caesarean section in anamnesis are more adapted and have less psycho-emotional stress than women who have a cesarean section for the first time. Key words: cesarean section, psychoemotional state, pregnancy, childbirth, scale J. Teylor, scale Ch. Spielberger, SAN-test.


Author(s):  
Kh. M. Omarova ◽  
E. S.-А. Ibragimova ◽  
T. Kh.-M. Khashaeva ◽  
I. Kh. Magomedova ◽  
R. G. Omarova ◽  
...  

Objective. To assess the condition of newborns from women of the late reproductive period (LRP), depending on the parity of births.Material and methods. The authors examined 130 pregnant women and their 130 newborns. Group I consisted of 60 primiparous women of late reproductive period and their 60 newborns, Group II included 40 multiparous women of the late reproductive period and their 40 newborns, Group III (control group) consisted of 30 healthy pregnant women aged from 18 to 25 years and their 30 newborns. The authors performed a retrospective analysis of the gestation course and perinatal outcomes. Ultrasound and neurosonography were used among the instrumental research methods.Results. Women of the late reproductive period gave birth to children in a state of asphyxia twice more often, who develop neurological disorders 1,5 times more often and complex postnatal adaptation and disorders of the perinatal period are twice more likely. Among women of the late reproductive period, primiparous women gave birth to children with the most severe disorders.Conclusion. The high incidence of neurological diseases in children born from women of the late reproductive period is associated with age-related changes in their germ cells, the implementation of assisted reproductive technologies, and the intake of hormonal drugs in early pregnancy. The data obtained should be taken into account by obstetricians in the course of pregnancy in women of late reproductive age; they should be included in the group of high risk of developing neurological disorders in children.


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.


2010 ◽  
Vol 4 ◽  
pp. CMRH.S5835
Author(s):  
M.N. EL-Gharib ◽  
T.M. Elhawary ◽  
S.H. Elshourbagy ◽  
M.A. Morad

Objective To determine the role of anti-annexin V antibodies (a-A5) as an etiologic factor in recurrent pregnancy failure. Study design Prospective observational study. Material and methods The study included ninety first trimester pregnant women who had a history of unexplained recurrent miscarriage (group I) with ninety well-matched pregnant women with a history of normal reproductive outcome allocated as control group (GII) and another ninety nonpregnant women (GIII). Sera from all women controls were analyzed for anti-annexin antibody measured by Elisa. Results The mean value of a-A5 was 11.37 ± 6.78, 7.7 ± 1.40 and 6.20 ± 0.95 ng/ml in groups I, II and III respectively. There was a significant increase in the mean value a-A5 among women with a history of recurrent miscarriage, compared with controls. The mean value was 13.92 ± 2.42 ng/ml among patients with unfavourable outcome, compared with a corresponding value of 6.95 V 0.58 ng/ml among women with favourable outcome. The receiver operator characteristic curve revealed that the cutoff value of a-A5 was 8.61 ng/ml. Conclusion This study emphasizes the relationship between anti-annexin V antibodies and recurrent miscarriage.


2017 ◽  
Vol 23 (2) ◽  
Author(s):  
A Hoshovska ◽  
I Byrchak ◽  
V Hoshovskyi

The study involved 36 pregnant women with inflammatory diseases of female genital organs and 40 placentas of women with the physiological course of pregnancy and childbirth. Immunohistochemical and histological methods were used.  It has been established that pregnant women with urogenital infections compared to those with physiological pregnancy had a lower concentration of the placental lactogen hormone and more active proapoptic protein of the BAX against the background of the unchanged concentration of the anti-apoptotic protein Bcl-2 in the cytoplasm of the invasive cytotrophoblast of the basal lamina.


2020 ◽  
Vol 16 (28) ◽  
pp. 6-11
Author(s):  
N.Yu. Sakvarelidze ◽  
S.G. Tsakhilovа ◽  
V.S. Muradova ◽  
N.V. Zharkov ◽  
A.S. Zikova ◽  
...  

Purpose. To study placental angiogenesis in pregnant women with preeclampsia (PE), based on a comparison of the results of a clinical examination and a morphometric study of sequins with this pathology. Material and methods. In the present work, we studied 30 pregnant women with PE, whose average age was 29 ± 1.4 years. The pregnant women were divided into two groups. Group I (n = 21) consisted of pregnant women with PE, among whom 10 patients were within 34 weeks of gestation, and 11 – at 34–39 weeks. Group II (n = 9) – control group, with physiological pregnancy. The inclusion criteria were: singleton pregnancy, the presence of preeclampsia according to the ICD-10 classification, the patient's voluntary informed consent to the study. Exclusion criteria: extragenital pathology, multiple births, congenital malformations of the fetus. There were no significant differences in somatic and gynecological status among pregnant women in the surveyed groups. Results. Vascular endothelial growth factor (VEGF) and its receptors, VEGF R1 and VEGF R2, are of priority importance in the development of placental angiogenesis. The balance of interaction between VEGF and R1 and R2 receptors leads to adequate vascularization of the villi in the early stages of trophoblast invasion into the spiral arteries of the uterus. Conclusion. As a result of the morphological study, it can be assumed that hemodynamic parameters according to Doppler and angioarchitectonics of the placentas are an important factor in the pathogenesis of placental insufficiency and fetal growth retardation. In the absence of disturbances in uteroplacental-fetal hemodynamics, endothelial dysfunction should be considered as compensated, in which favorable perinatal outcomes are expected. Structural changes in the fetoplacental complex with impaired blood flow in the uterine arteries and umbilical cord arteries in PE are regarded as subcompensated and decompensated forms of placental insufficiency


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.


2019 ◽  
Vol 68 (4) ◽  
pp. 19-26
Author(s):  
Olga V. Lavrova ◽  
Elena A. Shapovalova ◽  
Yulia R. Dymarskaya ◽  
Dmitry S. Sudakov ◽  
Anna V. Paliychuk

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.


Author(s):  
L.E. Tumanova ◽  
◽  
E.V. Kolomiets ◽  

Purpose — to study the indicators of quality of life in pregnant women with a history of different types of infertility. Materials and methods. The study of quality of life indicators was carried out in 127 women aged 20 to 49 years, 97 of whom had a history of infertility of various origins and 30 pregnant women who had it. The distribution of pregnant women into groups was based on the factor of infertility: Group I — 35 pregnant women with a history of endocrine infertility, Group II — 37 pregnant women with a history of inflammatory infertility, Group III — 25 pregnant women with a history of combined infertility of inflammatory genesis with endocrine, Group IV (control) — 30 healthy pregnant women who did not have a history of infertility. The method of assessing quality of life was the WHOQOL-BREF Short Questionnaire. Results. The indicators of quality of life and general health, according to the subjective assessment of the patients, were the lowest in group III — 2.5±0.10 points and 2.1±0.05 points. In group I patients, the score was 3.1±0.15 points and 3.2±0.20 points and in group II — 3.2±0.10 points and 3.3±0.07 points, respectively. It should be noted that the most positive assessment of these indicators took place in the control group of pregnant women — 5.0±0.3 points. Thus, the physical functioning was assessed by the patients of group III at 16.7±1.1 points, and self+perception — at 20.5±1.6 points. A patient of groups I and II with a history of infertility assessed these indicators — 18.2±1.3 points; 23.4±1.5 points and 19.5±1.4 points; 22.6±1.6 points, respectively. The women in the control group had higher scores — 24.7±1.8 points; 25.7±1.7 points. Microsocial support in groups I, II, III was assessed 8.2±0.3 points; 9.3±0.5 points; 7.7±0.2 points, but in the control group — 13.7±0.1 points. The indicators of social well+being were 22.4±1.8 points; 23.5±1.9 points; 20.6±1.5 in groups I, II, III, and in the control group — 36.4±2.1 points. Conclusions. In women who became pregnant after long-term treatment of infertility in anamnesis, there was a significant deterioration in quality of life indicators compared with healthy women, which is explained by the high incidence of obstetric complications in them. Determination of quality of life indicators in women with a history of infertility is an integral part of monitoring during pregnancy, which allows adequate assessment and timely correction of physical, social and psycho-emotional functions in the interests of the mother and the fetus. 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 these Institutes. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: short WHO questionnaire, quality of life assessment, pregnancy after infertility.


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