Evaluation of the results of planned open surgical interventions in primary chronic vein disease in pregnant women

2020 ◽  
pp. 51-56
Author(s):  
V.М. Аntonyuk-Kysil ◽  
◽  
І.Y. Dziubanovskyi ◽  
V.М. Yenikeeva ◽  
S.І. Lichner ◽  
...  
Keyword(s):  
Pregnant Woman ◽  
Pregnant Women ◽  
Postoperative Period ◽  
Postpartum Period ◽  
Clinical Manifestations ◽  
Lower Extremities ◽  
Vascular Surgeon ◽  
Surgical Interventions ◽  
Perinatal Center ◽  
Vein Disease

The objective: to evaluate the results of planned open surgical interventions (POSI) in pregnant women with primary symptomatic chronic vein disease (PSCVD). Materials and methods. The study included 457 pregnant women operated on a routine basis with PSCVD. The patients underwent ultrasound duplex angioscanning (USDA) of the veins of the lower extremities, inguinal canals, and iliac veins. The severity of the clinical manifestations of PSCVD was evaluated on a VCSS scale. With the help of the circadian visual-analog scale, the dynamics after the operative pain were studied. The effect of POSI on uterine tone and cardiac function of the fetus was investigated using cardiotocography. When forming the results for POSI, data from USDA, the severity of clinical and cosmetic manifestations of PCVD, the need for active prevention of thrombophlebetic, thromboembolic and hemorrhagic complications, minimization of surgical childbirth were taken into account. The results of treatment were studied in 2 groups of patients. Patients of the first group were treated with conservative therapy, the second group – POSI. Parametric indicators, which were presented as mean and standard error M(SD), were used for statistical data processing of the study, and their reliability was estimated using Student’s t-test. The species was determined to be significant at p<0.05. Results. 495 POSI were performed at 28-38 weeks gestation in an obstetric hospital (perinatal center), by a vascular surgeon from the staff of the center, who was familiarized with the peculiarities of working with this contingent of patients. Surgery was performed under local anesthesia in 346 (75.49%) pregnant women at one extremity, in 111 (24.51%) – at two in one session. According to the results of the study, it was noted that in the first group 33.7% of patients had a positive clinical result due to the reduction of pain syndrome, while 67.5% of patients had an increase and spread of varicose transformation in the area of saphenous and/or non-saphenous veins with spread of pathological venous reflux in the distal direction. 78% of patients had the need to administer prophylactic doses of low molecular weight heparins, both during pregnancy and in postpartum period. Out of 126 pregnant women with pronounced varicose veins of the external genital organs and perineum in 36 (28.6%) deliveries were performed by caesarean section. In 9 (3%) patients there was an acute thrombophlebitis of the subcutaneous veins of the lower extremities, which required 5 pregnant women to undergo urgent surgery when the inflammatory process had spread to the middle and above along the femoral vein of the large subcutaneous vein. Pregnant women of the second group with PSCVD on the basis of obstetric hospital (perinatal center) POSI were performed in the organization, which laid the ideology of the FTS program, strictly individual indications for intervention in the optimal terms of pregnancy, multidisciplinary management of patients, due to this in 93% of operated patients regression of clinical manifestations of the disease was noted, whch contributed to the correct and safe delivery of pregnancy with 100% absence of preterm birth, abnormalities in fetal development, pregnancy course, negative impact on obstetric and somatic condition of the pregnant woman. No hemorrhagic, thrombophlebic, thromboembolic complications were noted. Patients in the postoperative period did not require medical support, as during the period of pregnancy, during delivery and in the postpartum period. There were no indications for surgical delivery. 2.4% of patients experienced complications of post-operative wounds in the form of cheese, which had no effect on pregnancy and was eliminated before delivery. In the postoperative period, if necessary, it was recommended to use elastic compression class garments 1–2. Conclusion. POSI made at PSCVD in optimal terms of pregnancy in a specialized obstetric hospital by a vascular surgeon in strictly individual indications is safe, both for the fetus and the pregnant woman. It is promising to further study the results of POSI in pregnant women with PSCVD to introduce it into the arsenal of treatment of this pathology. Key words: FTS ideology, planned open surgical interventions in pregnant women.

scholarly journals Clinical Features and Maternal-fetal Results of Pregnant Women in COVID-19 Times

2021 ◽  
Vol 43 (05) ◽  
pp. 384-394
Author(s):  
Ana Paula Nogueira Godoi ◽  
Gilcelia Correia Santos Bernardes ◽  
Leilismara Sousa Nogueira ◽  
Patrícia Nessralla Alpoim ◽  
Melina de Barros Pinheiro
Keyword(s):  
Pregnant Women ◽  
Vertical Transmission ◽  
Postpartum Period ◽  
Scientific Literature ◽  
Respiratory Infections ◽  
Clinical Manifestations ◽  
Fetal Distress ◽  
Medical Subject Headings ◽  
Substantial Evidence ◽  
The Subject

Abstract Objective Coronavirus disease 2019 (COVID-19) is a disease caused by a newly discovered coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which usually leads to non-specific respiratory symptoms. Although pregnant women are considered at risk for respiratory infections by other viruses, such as SARS and Middle East respiratory syndrome (MERS), little is known about their vulnerability to SARS-CoV-2. Therefore, this study aims to identify and present the main studies on the topic, including the postpartum period. Methods In this narrative review, articles were searched in various databases, organizations, and health entities using keywords compatible with medical subject headings (MeSH), such as: COVID-19, pregnancy, vertical transmission, coronavirus 2019, and SARS-CoV-2. Results The review of the scientific literature on the subject revealed that pregnant women with COVID-19 did not present clinical manifestations significantly different from those of non-pregnant women; however, there are contraindicated therapies. Regarding fetuses, studies were identified that reported that infection by SARS-CoV-2 in pregnant women can cause fetal distress, breathing difficulties and premature birth, but there is no substantial evidence of vertical transmission. Conclusion Due to the lack of adequate information and the limitations of the analyzed studies, it is necessary to provide detailed clinical data on pregnant women infected with SARS-CoV-2 and on the maternal-fetal repercussions caused by this infection. Thus, this review may contribute to expand the knowledge of professionals working in the area as well as to guide more advanced studies on the risk related to pregnant women and their newborns. Meanwhile, monitoring of confirmed or suspected pregnant women with COVID-19 is essential, including in the postpartum period.

scholarly journals ТHE PLACE OF ENDOVASCULAR SURGICAL INTERVENTIONS IN PATIENTS WITH CRITICAL ISCHEMIA OF THE LOWER EXTREMITIES

2020 ◽  
pp. 94-98
Author(s):  
V. B. Goshchynsky ◽  
O. B. Lugovyj ◽  
S. O. Lugovyj ◽  
U. M. Herasimets
Keyword(s):  
Balloon Angioplasty ◽  
Postoperative Period ◽  
Lower Extremities ◽  
The Elderly ◽  
Endovascular Surgery ◽  
Critical Ischemia ◽  
Surgical Interventions ◽  
Ischemia Of The Limbs ◽  
Analysis Of Results ◽  
Late Postoperative Period

Summary. The purpose of the study. To determine the possibility of endovascular surgical interventions and their effectiveness in patients with critical ischemia of the limbs. Materials and methods. The object of research was 209 patients with critical ischemia of the limbs, ages 53 to 71 years, which made endovascular surgical interventions. The results. Analysis of results of endovascular surgery witness that balloon angìoplasty with stenting zone for reconstruction and balloon angìoplasty with paclitaxel give the smallest percentage of reocclusion and restenosis in the early and late postoperative period than balloon angìoplasty. Conclusions. 1. The use of endovascular surgical interventions is a promising method of treatment of critical ischemia of the lower extremities, especially in the elderly and senile. 2. In case of critical ischemia of the limbs should be used balloon angìoplasty with stenting or balloon angìoplasty with paclitaxel, based on the results of early and late postoperative period.

scholarly journals Evaluation of the condition of the eye surface in patients with burdened general somatic history. Early diagnosis, treatment and prevention methods

2020 ◽  
pp. 56-62
Author(s):  
I.E. Shvailikova ◽  
◽  
E.I. Belikova ◽  
Keyword(s):  
Dry Eye ◽  
Postoperative Period ◽  
Inflammatory Responses ◽  
Clinical Manifestations ◽  
Additional Treatment ◽  
Dry Eye Syndrome ◽  
Comprehensive Treatment ◽  
Inflammatory Reactions ◽  
Surgical Interventions ◽  
Somatic Status

Introduction. Modern computerisation, frequent use of contact correction, surgical interventions on the visual organ and long-term drug installations often lead to the formation and further progression of dry eye syndrome (DES) with subsequent increased sensitivity and inflammatory symptoms on the conjunctiva and cornea. Purpose. Evaluation of the condition of the eye surface in patients with a burdened general somatic history. Development of measures for prevention, diagnosis and comprehensive treatment of this condition. Material and methods. A retrospective analysis of disease histories and medical records of 108 patients (108 eyes) with phacoemulsification of uncomplicated cataract with IOL implantation was carried out. Patients were divided into three main groups based on the presence of burdening factors of somatic status and the course of the postoperative period: I group included patients with unburdened somatic status and no complications during the course of the postoperative period; II group included patients with burdened general somatic history with complications during the course of the postoperative period; 3rd group included patients with burdened general somatic history with complications during the course of the postoperative period. 3rd group of patients used a special scheme to prevent and treat inflammatory reactions from the eye surface. Results. 1st group patients were less likely to complain and had no clinical manifestations of conjunctival and corneal inflammatory responses. Accordingly, this group of patients did not require additional treatment, which is indicative of the low incidence of complications in this category of patients. II group patients who had been identified as predisposing factors for conjunctival and corneal inflammatory reactions and did not receive additional treatment were more likely to experience complaints and the frequency of clinical manifestations was 20% higher than III group patients. Patients in III group required additional treatment in the postoperative period. Conclusion. Prolonged prescription of high doses of drugs of different groups with different preservative and auxiliary substances content in patients after surgical intervention in some cases leads to damage to the conjunctival and corneal epithelium, which in turn causes an aggravation of symptoms of SSG with the development of inflammatory reaction of the conjunctiva and cornea. The application of preventive measures before and after the surgery leads to a significant reduction in the objective manifestations of the eye surface complications and, as a result, a reduction in the number of complaints from patients about discomfort in the postoperative period. Key words: ocular surface, dry eye syndrome, cataract, allergies, tear film stability.

scholarly journals Technique for Spleen Resection Using Radiofrequency Ablation

2021 ◽  
pp. 1-7
Author(s):  
Ionkin Dmitry ◽  
Ionkin Dmitry ◽  
Stepanova Yulia Aleksandrovna ◽  
Alimurzaeva Maksalina Zakaryaevna ◽  
Vishnevsky Vladimir Aleksandrovich
Keyword(s):  
Comparative Analysis ◽  
Radiofrequency Ablation ◽  
Blood Loss ◽  
Postoperative Period ◽  
Surgical Intervention ◽  
Clinical Manifestations ◽  
Spleen Tissue ◽  
Surgical Interventions ◽  
National Medical ◽  
A New Technique

From modern positions, removal of the spleen is undesirable due to the risk of post-splenectomy syndrome development, where first of all, the clinical manifestations of the syndrome of suppressive post-splenectomy infections are taken into account, which justifies either performing organ-preserving surgical interventions on the spleen, or heterotopic autotransplantation of spleen tissue. Spleen resection is accompanied by significant blood loss, both during the intervention and in the postoperative period. The various methods of prevention of bleeding (clips, coagulation instruments, local hemostatics, etc.) are not always effective. Currently, there have been reports of the possibility of using radiofrequency ablation (RFA) in interventions on the spleen. The literature data and own 10 observations of spleen resection with the use of RFA in patients with focal organ lesions are presented. All described in literature technologies use the Rita® device for RF destruction and the corresponding attachment, which consists of 4 needle active electrodes. The spleen parenchyma is "burned" blindly, and the organ parenchyma is divided in the middle, between the treated injections. A new technique for performing spleen resection using radiofrequency ablation has been proposed at A.V. Vishnevsky National Medical Research Center of Surgery. The essence of our proposed method for minimizing blood loss during spleen resection is as follows: RFA-exposure is carried out along the zone of organ ischaemia under the control of ultrasound. For RFA, we used a Radionics Cool-Tip® Ablation System and a set of water-cooled electrodes (MEDTRONIC, USA). The features of the surgical intervention are noted. No bleeding was noted either intraoperatively or in the postoperative period in any case. A comparative analysis of the results of various methods of organ-saving surgical treatment is presented.

scholarly journals Spontaneous Intra-leiomyoma Hemorrhage during Second Trimester of Pregnancy

2020 ◽  
Vol 2 (6) ◽  
Author(s):  
Khong Jac Mun ◽  
Zalina Nusee ◽  
Riduan Tahar
Keyword(s):  
Abdominal Pain ◽  
Pregnant Woman ◽  
Pregnant Women ◽  
Uterine Fibroid ◽  
Conservative Management ◽  
Postpartum Period ◽  
Hypovolemic Shock ◽  
Second Trimester ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture

Uterine fibroid affects 0.3-2.6% of pregnant women and it is usually asymptomatic during pregnancy [1]. In about 10% of these patients will have complications such as miscarriage, fetal malpresentation, premature rupture of membranes, placenta abruptio, preterm delivery, abdominal pain due to fibroid torsion or degeneration [2]. Bleeding into the uterine fibroid is extremely rare and patient can present with acute abdomen [11]. Up to date, there were only two cases reported and both occur in postpartum period. We present a case of a pregnant woman with huge uterine fibroid with spontaneous intra-leiomyoma bleeding causing hypovolemic shock at 22 weeks of gestation. Because of failure of conservative management, we performed fibroid resection at 22 weeks of gestation with preservation of the pregnancy.

scholarly journals THE PATIENT HAS LISTERIOSIS MENINGITIS AT 33-34 WEEKS OF PREGNANCY. THEMULTIDISCIPLINARY SOLUTION

2018 ◽  
Vol 23 (1) ◽  
pp. 30-39
Author(s):  
Larisa G. Sozaeva ◽  
V. B Tetova ◽  
R. E Kuznetsov ◽  
V. Y Samorukov ◽  
L. B Tumgoeva ◽  
...  
Keyword(s):  
Pregnant Woman ◽  
Mortality Rate ◽  
Pregnant Women ◽  
High Mortality ◽  
Clinical Case ◽  
Rapid Development ◽  
Newborn Infants ◽  
Clinical Manifestations ◽  
Elderly Persons ◽  
Clinical Awareness

In connection both with the continuing prevalence of the listeriosis disease, and polymorphism of clinical manifestations, as well as the high lethality rate, it is necessary to better understand this problem. Listeriosis infection often affects patients with the weakened immunity, the elderly persons, pregnant women, and newborns. In particular, in pregnant women, the risk of infection with listeriosis is 18 times higher than in the general population. This feature is due to cell-mediated immune suppression in pregnant women and placental tropism of the causative agent of listeriosis L. monocytogenes. The problem of listeriosis during pregnancy includes the maternal, fetal and neonatal disease. Listeriosis in a pregnant woman is usually characterized by a sharp onset, rapid development, and a high incidence, and often it does not take much trouble. Along with this, there are cases of asymptomatic, complicated and atypical variants of the disease, which requires a high degree of clinical awareness of various specialists and the implementation of adequate screening. Fetal listeriosis is characterized by the high mortality rate amounting to up 25-35%, depending on the gestational age at the time of the onset of infection. Clinical manifestations of listeriosis in newborn infants depend on the time and pathway of infection (antenatal or intranatal infection). Neonatal listeriosis can manifest as sepsis or meningitis with severe consequences and high mortality rate (up to 20%). The appropriate treatment of maternal listeriosis is aimed at preventing the fetal disease, it also has important therapeutic value for newborn babies. The empirical use of antibiotics may appear to be ineffective for listeria. Amoxicillin or ampicillin are at the first line of the treatment in pregnant women, alone or in the combination with gentamycin, followed by trimethoprim /sulfamethoxazole. The aim of the work is to summarize the available knowledge about the problem of listeriosis, including the features of the course of the disease during pregnancy, with presenting the example of a clinical case. The article reports a clinical case demonstrating the clinical problem of listeriogenic meningitis in a pregnant woman aged 35 years. Data showing different treatment strategies are also presented.

PATHOPHYSIOLOGICAL AND PATHOMORPHOLOGICAL ASPECTS OF RELAPSE OF VARICOSE VEINS AFTER ENDOVASCULAR LASER VEIN COAGULATION

2020 ◽  
Vol 73 (11) ◽  
pp. 2468-2475
Author(s):  
Volodymyr B. Goshchynsky ◽  
Bogdan O. Migenko ◽  
Svitlana S. Riabokon
Keyword(s):  
Endothelial Dysfunction ◽  
Postoperative Period ◽  
Varicose Vein ◽  
Varicose Veins ◽  
Lower Extremities ◽  
Venous System ◽  
Circulating Endothelial Cells ◽  
Electron Microscopic ◽  
Deep Venous System ◽  
Vein Disease

The aim: With the help of biochemical and morphological methods of investigation to identify the causes of a false postoperative recurrence of varicose veins after the EVLC. Materials and methods: In 173 patients with varicose veins of the lower extremities, the level of markers of endothelial dysfunction was determined: P-selectin, E-selectin, tissue plasminogen activator, endothelin-1, adhesion molecules of type 1 vascular endothelium (sVCAM-1-soluble vascularcellularmolecula), circulating endothelial cells (CEC) before surgery (EVLC), on the 10th and 60th day of the postoperative period.At the same time, a morphological and electron microscopic examination of the state of the deep venous system in 31 patients with varicose vein disease of the lower extremities who died from acute heart failure, was performed. Results: Increased values of markers of endothelial dysfunction in patients with varicose veins of the lower extremitiesbefore surgery of EVLC were established. We found that, despite the operation, the parameters of endothelial dysfunction decrease, but in the remote postoperative period do not come to the norm. Morphological and electron microscopic studies of the deep vein wall revealed pathomorphological changes in all of their layers, especially the endothelial layer. At the heart of the development of endothelial dysfunction in the postoperative period, the leading role belongs to changes in mitochondria. Conclusions: 1. Based on our research, we can state that there are significant pathomorphological and pathophysiological changes in the deep venous system of the lower extremities in conditions of varicose vein disease. 2. The initiator of postoperative relapse of varicose veins are structural changes in the wall of deep veins with a violation of the integrity of the endothelial lining, contributing to the absorption of plasma and leukocyte contents from the blood stream in the interstitium, with the following pathological changes in the layers of deep veins.Such changes are the basis for the manifestations of endothelial dysfunction in the postoperative period.

scholarly journals Malaria in pregnancy in Hodiedah, Republic of Yemen

2002 ◽  
Vol 8 (2-3) ◽  
pp. 245-253
Author(s):  
A. M. Assabri ◽  
A. A. Muharram
Keyword(s):  
Plasmodium Falciparum ◽  
Pregnant Woman ◽  
Pregnant Women ◽  
Causative Agent ◽  
Clinical Manifestations ◽  
Malaria In Pregnancy ◽  
Laboratory Investigations ◽  
The Republic ◽  
In Pregnancy ◽  
Structured Questionnaire

In the Republic of Yemen, Plasmodium falciparum is the predominant causative agent of malaria and is associated with adverse consequences for pregnant women and their babies. The prevalence and clinical manifestations of malaria among 500 pregnant [260] and non-pregnant [240] women were compared. Clinical examinations, laboratory investigations and a structured questionnaire were used to collect data. The prevalence of malaria was higher among pregnant women [55%] than non-pregnant women [20%]. Anaemia was significantly more prevalent among pregnant woman than non-pregnant women and also more prevalent in pregnant women with malaria than non-pregnant women with malaria.

scholarly journals Improvement of surgical treatment of patients with critical ischemia of the lower extremities

2017 ◽  
Vol 4 (2) ◽  
pp. 455
Author(s):  
Shavkat Karimov ◽  
Akmal Irnazarov ◽  
Uktamkhon Askarovich Asrarov ◽  
Ulugbek Alijanov ◽  
Abdurasul Yulbarisov ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Carotid Endarterectomy ◽  
Clinical Manifestations ◽  
Lower Extremities ◽  
Limb Ischemia ◽  
Critical Ischemia ◽  
Actual Problem ◽  
Surgical Interventions ◽  
Associated Lesions ◽  
Reconstructive Operations

Background: The choice of tactics of surgical treatment in patients with lesions of the femoral-popliteal-tibial segment with the CILE is the actual problem, which is far from being solved. Aim of the study was to found improved treatment of patients with critical ischemia of the lower extremities by improving the surgical approach.Methods: 79 patients with critical ischemia of the lower extremities with lesions of the carotid and coronary arteries were observed and surveyed. To determine the tactics of treatment of these patients, we used non-invasive methods of imaging vessels, and only with probable therapeutic purposes used the contrasting of the vessels.Results: The used treatment allowed reducing the number of complications to a minimum. Among observable patients, in one case was determined acute myocardial infarction. 19 (24%) patients with stenosis and CILE managed to achieve regress of clinical manifestations of lower limb ischemia with medical therapy. In 12 (63.1%) patients were completed the installation of long catheter for intra-arterial catheter therapy, after that we performed carotid endarterectomy. Of these, 9 (47.3%) patients at 7 days underwent reconstructive operations on arteries of the lower extremities. In 5 (26.3%) patients after carotid endarterectomy, endovascular interventions implemented at ALE.Conclusions: The suggested diagnostic low and stages of surgical interventions significantly increase the detection of associated lesions of other arterial basins and expands the indications for surgical treatment with the use of combined interventions.

Clinical case of periostitis in pregnant women complicated by sepsis

2020 ◽  
pp. 61-63
Author(s):  
S. Sh. Kakvaeva ◽  
M. A. Magomedova ◽  
A. N. Dzhalilova
Keyword(s):  
Pregnant Woman ◽  
Multiple Organ Failure ◽  
Pregnant Women ◽  
Organ Failure ◽  
Clinical Case ◽  
Clinical Observation ◽  
Infectious Agent ◽  
Modern Medicine ◽  
Multiple Organ ◽  
Number Of Patients

One of the most serious problems of modern medicine is sepsis. The number of patients undergoing this complication is 20–30 million (WHO) annually and has no tendency to decrease. Sepsis is characterized by severe multiple organ failure due to a violation of the response of the macroorganism to an infectious agent. Moreover, it is dangerous with high mortality. Sepsis often develops in patients with immunodeficiency conditions, which primarily include pregnant women. The article presents a clinical observation of a case of periostitis in a pregnant woman complicated by a septic state.

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