Psycho-emotional state of women with intrahepatic cholestasis of pregnant women after the use of assisted reproductive technologies

2020 ◽  
pp. 31-35
Author(s):  
O.G. Boychuk ◽  
◽  
T.V. Kolomiichenko ◽  
N.E.N. Ebae ◽  
◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pregnant Women ◽  
Intrahepatic Cholestasis ◽  
Comparison Group ◽  
Assisted Reproductive Technologies ◽  
Reproductive Technologies ◽  
Intrahepatic Cholestasis Of Pregnancy ◽  
Psychoemotional State ◽  
Cholestasis Of Pregnancy

We can assume a deterioration in the psychoemotional state and a decrease in the quality of life in women after assisted reproductive technologies (ART) with intrahepatic cholestasis of pregnancy (ICP), but no scientific information was found on this issue. The objective: to assess the psychoemotional state of pregnant women with ICP after using ART. Materials and methods. We examined 40 pregnant women after ART with the manifestations of ICP (main group) and 40 – without the manifestations of ICP (comparison group). The presence of vegetative dysfunction syndrome was assessed (according to A.M. Wayne); quality of sleep, especially falling asleep and waking up (A.M. Vein, Yu.I. Levin); anxiety level using the test Spielberg in the modification by Hanin, the presence and severity of depression on the Beck scale; quality of life according to the questionnaire SF-36. The data were processed by methods of variation statistics. Results. In pregnant women after ART with ICP, the total number of points on the A.M. Vein questionnaire is 3.5 times higher than the threshold value of 15 points (median 52 [45, 60] points versus 36 [28; 45] points in the absence of ICP, p<0.05). 80.0% of these women reported sleep disorders. The incidence of significant sleep quality disturbances is 37.5%. Patients demonstrate a higher median level of both personal and situational anxiety. Manifestations of depression were noted in 55.0% patients against 27.5% in the comparison group (p<0.05). Women with ICP have lower ratings for their quality of life, both on physical and psychological health scales. The decrease in the integral indicator of physical health (70 [58; 89] versus 84 [75; 92], p<0.05) is a reflection of the physical discomfort associated with ICP. Conclusions. After using ART, women with ICP need to assess the vegetative and psychoemotional state, correct the revealed disorders to normalize the quality of life, and achieve positive perinatal outcomes. Keywords: assisted reproductive technologies, intrahepatic cholestasis of pregnancy, vegetative dysfunction syndrome, anxiety, depression, quality of life.

scholarly journals Enterosorption as concomitant therapy for early toxicosis in pregnant women after assisted reproductive technologies against the background of constipation

2021 ◽  
pp. 42-46
Author(s):  
Iu.V. Davydova ◽  
◽  
A.Y. Lymanskaya ◽  
Keyword(s):  
Quality Of Life ◽  
Pregnant Women ◽  
Rating Scale ◽  
Assisted Reproductive Technologies ◽  
Severe Heart Failure ◽  
Well Being ◽  
Reproductive Technologies ◽  
Active Surface Area ◽  
Significant Deterioration

The aim is to evaluate the effectiveness of the drug «Atoxil Plus» use in the group of pregnant women after assisted reproductive technologies (ART) with early mild toxicosis against the background of constipation. Materials and methods. The effectiveness of the drug «Atoxil Plus» (Orisil-Pharma) in 37 pregnant women with early mild toxicosis on the background of constipation was studied. The pregnant women in the study had no other comorbidities (pathology of the gastrointestinal tract, severe heart failure, infectious diseases, etc.). Taking into account that the definition of the quality of life indicator is an integral indicator of the effectiveness of treatment, the quality of life of pregnant women was assessed according to the «Gastrointestinal Simptom Rating Scale» (GSRS), a special questionnaire, before and after complex treatment of early toxicosis using the drug «Atoxil Plus». GSRS includes 15 questions to assess the following domains: the presence of abdominal pain, heartburn, constipation, diarrhea and signs of dyspepsia. The lower the results for the studied domains, the better. All pregnant women used the «Atoxil Plus» (2 g 3 times/day) for 10–14 days. Any general or local laxatives were excluded from the treatment regimen. Results. Treatment of early pregnancy toxicosis is important, given the loss of electrolytes, microelements, water and significant deterioration in the quality of life. High sorption capacity of Atoxil Plus in relation to microorganisms and bacterial toxins, the possibility of moderate therapeutic doses use due to the large active surface area, the increased binding rate of bacteria and their toxins provide quick therapeutic effect. Against the background of the «Atoxil Plus» enterosorbent use, not only does the constipation frequency not increase, which is very important during pregnancy, but the number of bowel movements is normalized due to the presence of lactulose in the medication, especially given the significant amount of gestagens pregnant women receive after ART. Conclusions. The non-invasive nature of the use of Atoxil Plus, its oral administration, high efficacy in pregnant women with early toxicosis, which manifests itself in improving the quality of life and general well-being, a high safety profile make it possible to recommend this drug as a treatment for early mild toxicosis against the background of constipation in pregnant women after ART. The study was conducted in accordance with the principles of the Declaration of Helsinki. The research protocol was approved by the Local Ethics Committee of the institution mentioned in the work. Informed consent of women was obtained for the research. The authors declare no conflict of interest. Key words: pregnant women, assisted reproductive technologies, constipation, treatment, sorbents.

scholarly journals Characterization of gut microbiota associated with clinical parameters in intrahepatic cholestasis of pregnancy

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Rong Li ◽  
Xuehai Chen ◽  
Zhongzhen Liu ◽  
Yan Chen ◽  
Chuan Liu ◽  
...  
Keyword(s):  
Gut Microbiota ◽  
Pregnant Women ◽  
Intrahepatic Cholestasis ◽  
Premature Delivery ◽  
Clinical Parameters ◽  
Intrahepatic Cholestasis Of Pregnancy ◽  
Control Groups ◽  
And Control ◽  
Cholestasis Of Pregnancy

Abstract Background Intrahepatic cholestasis of pregnancy (ICP) is a liver disorder that specifically occurs in pregnancy. Elevated levels of liver transaminases aspartate aminotransferase, alanine aminotransferase and serum bilirubin levels are common biochemical characteristics in ICP. The disorder is associated with an increased risk of premature delivery and stillbirth. The characterization of the potential microbiota in ICP could go a long way in the prevention and treatment of this pregnancy disease. Methods A total of 58 patients were recruited for our study: 27 ICP patients and 31 healthy pregnant subjects with no ICP. The V3 and V4 regions of the 16S rDNA collected from fecal samples of both diseased and control groups were amplified. 16S rRNA gene amplicon sequencing was then performed on gut microbiota. Sequencing data were analyzed and the correlation between components of microbiota and patient ICP status was found. Related metabolic pathways, relative abundance and significantly different operational taxonomic units (OTUs) between ICP and controls were also identified. Results Elevated levels of total bile acid, ALT, AST, Dbil and Tbil were recorded or observed in ICP subjects as compared to the control. Gut microbiota in pregnant women was dominated by four major phyla and 27 core genera. PCoA analysis results indicated that there was no significant clustering in Bray–Curtis distance matrices. Our results showed that there was a correlation between specific OTUs and measured clinical parameters of pregnant women. Comparison at the different taxonomy levels revealed high levels of abundance of Blautia and Citrobacter in ICP patients. At the family level, Enterobacteriaceae and Leuconostocaceae were higher in ICP patients. 638 KEGG Orthologs and 138 pathways significantly differed in the two groups. PLS-DA model with VIP plots indicated a total of eight genera and seven species were key taxa in ICP and control groups. Conclusions Our research indicated that although there was no significant clustering by PCoA analysis, patients with ICP have increased rare bacteria at different phylogenetic levels. Our results also illustrated that all 638 KEGG Orthologs and 136 in 138 KEGG pathways were less abundant in ICP patients compared to the controls.

Association of ABCB4 and ABCB11 nucleotide variants with intrahepatic cholestasis of pregnancy

2019 ◽  
Vol 88 (4) ◽  
pp. 209-217
Author(s):  
Milena Gruszczyńska-Losy ◽  
Adrianna Mostowska ◽  
Łukasz Adamczak ◽  
Paweł Jagodziński ◽  
Ewa Wender-Ożegowska ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Intrahepatic Cholestasis ◽  
Clinical Symptoms ◽  
Melting Curve ◽  
Liver Disorder ◽  
Melting Curve Analysis ◽  
Control Group ◽  
Intrahepatic Cholestasis Of Pregnancy ◽  
Increased Risk ◽  
Cholestasis Of Pregnancy

Background: Intrahepatic cholestasis of pregnancy (ICP) is the most common liver disorder during gestation. The exact pathogenesis of ICP is multifactorial and still unclear. Therefore, our study aimed to check whether the selected ABCB4and ABCB11nucleotide variants are associated with an increased risk of ICP. Methods:ICP was diagnosed based on clinical symptoms characteristic of this disease and confirmed by increase in serum bile acids and transaminases, spontaneous resolution of clinical symptoms and normalization of laboratory tests after delivery. The total of 86 pregnant women meeting the criteria were included into the study. Healthy pregnant women with uncomplicated pregnancy served as control group (n=310). Sixcommon nucleotide variants in theABCB11and ABCB4genes were genotypedwith the use of high-resolution melting curve analysis. Conclusion:Our study did not show any significant association of analysed ABCB4and ABCB11nucleotide variants with the increased risk of intrahepatic cholestasis of pregnancy.

scholarly journals Comparative Proteomics Analysis of Placenta from Pregnant Women with Intrahepatic Cholestasis of Pregnancy

PLoS ONE ◽  
2013 ◽  
Vol 8 (12) ◽  
pp. e83281 ◽  
Author(s):  
Ting Zhang ◽  
Yueshuai Guo ◽  
Xuejiang Guo ◽  
Tao Zhou ◽  
Daozhen Chen ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Intrahepatic Cholestasis ◽  
Comparative Proteomics ◽  
Intrahepatic Cholestasis Of Pregnancy ◽  
Proteomics Analysis ◽  
Cholestasis Of Pregnancy

scholarly journals Perinatal outcomes and intrahepatic cholestasis of pregnancy: a prospective study

2019 ◽  
Vol 8 (3) ◽  
pp. 1177
Author(s):  
Sangeeta Parihar ◽  
Swatantar Singh
Keyword(s):  
Pregnant Women ◽  
Intrahepatic Cholestasis ◽  
Postpartum Haemorrhage ◽  
Preterm Labour ◽  
Perinatal Outcomes ◽  
P Value ◽  
Maternal Outcomes ◽  
Intrahepatic Cholestasis Of Pregnancy ◽  
Fetal Outcomes ◽  
Cholestasis Of Pregnancy

Background: Women with intrahepatic cholestasis of pregnancy (ICP) have an increased risk for postpartum haemorrhage, dyslipidaemia, preterm labour and operative interference. Fetus in ICP has been associated with an increased incidence of preterm labour, preterm prelabour rupture of membrane, fetal distress, abnormal CTG, meconium staining, spontaneous intrauterine death. The present study was done to evaluate the perinatal outcomes – maternal outcomes and fetal outcomes of ICP.Methods: This was a prospective observational study carried out in a tertiary care teaching hospital. Total 1100 pregnant women were screened during the study period. Patients with ICP were identified in maternity care units after eliciting history about itching. Pregnancies with pregnancy induced hypertension and other liver diseases in pregnancy were excluded.Results: 62 pregnant women with prevalence rate of 5.64% have been found to be suffering from ICP. The most frequently affected (22, 35.48%) age-group with ICP were belong to age > 35 years. A majority of pregnant women with intrahepatic cholestasis of pregnancy was of multipara. ICP was highly significantly associated with small for gestational age (SGA, p-value: 0.0003); abnormal cardiotocography (CTG, p-value: 0.0002); and meconium stained liquor (p-value: 0.0001). Caesarean section as mode of delivery found significantly associated (p-value: 0.0033) with ICP. Insomnia (p-value: 0.0045); dyslipidemia (p-value: 0.0011); and postpartum haemorrhage (p-value: 0.0122) were also found significantly with ICP.Conclusions: ICP can adversely affect fetal as well as maternal pregnancy outcomes. Maternal outcomes have good prognosis, but fetal outcomes can be improved by timely and effective intervention.

Comprehensive approach to treatment of early toxicosis in pregnant after use of ART

2018 ◽  
pp. 34-38
Author(s):  
A.V. Kaminskiy ◽  
◽  
T.V. Kolomiichenko ◽  
I.V. Rogava ◽  
◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pregnant Women ◽  
Autonomic Dysfunction ◽  
Birth Asphyxia ◽  
Reproductive Technologies ◽  
Nausea And Vomiting ◽  
Ginger Extract ◽  
Adequate Treatment ◽  
Complex Therapy

Obstetricians-gynecologists do not always pay sufficient attention to nausea and vomiting of pregnancy (NVP), sometimes its severity is underestimated and adequate treatment is not prescribed. The objective: to investigate the efficacy and safety of the complex therapy of NVP in pregnant women after ART, including a preparation of ginger extract with pyridoxine and psychotherapy. Materials and methods. Sixty pregnant women were examined after applying VRT, with mild manifestations of NVP. The main group consisted of 30 women, with Emegest (ginger and pyridoxine extract) and psychotherapy used in NVP therapy, and a comparison group of 30 women who only adhered to recommendations on changes in diet and life. The presence of the syndrome of autonomic dysfunction was established using the A.M.Veyn questionnaire. For self-assessment of the level of reactive and personal anxiety, testing was carried out according to the method of Ch.D. Spilberger, Yu.L. Khanin. The quality of life was assessed using the SF-36 questionnaire. Results. The use of recommended NVP therapy in pregnant women after ART makes it possible to improve the condition of women already for 2–3 days, and in 2 weeks of treatment it is essential to reduce or even eliminate the symptoms of NVP. Complex therapy reduces the severity of the syndrome of autonomic dysfunction and the level of personal and situational anxiety, which, against the background of improving the overall condition, positively affects the quality of life. The applied therapy had no side effects or complications, positively influenced the further course of pregnancy and the condition of the fetus and the newborn, in particular, the frequency of preeclampsia is decreased by half and the birth asphyxia by 1.5. Conclusion. The safety and efficacy of Emegest in the complex therapy of nausea and vomiting of pregnancy allows us to recommend its use in pregnant women after ART. Key words: nausea and vomiting of pregnancy, Emegest, auxiliary reproductive technologies, psychotherapy.

scholarly journals Characterization of Gut Microbiota Associated with Clinical Parameters in Intrahepatic Cholestasis of Pregnancy

2020 ◽  
Author(s):  
Rong Li ◽  
xuehai chen ◽  
Zhongzhen Liu ◽  
Yan Chen ◽  
Chuan Liu ◽  
...  
Keyword(s):  
Gut Microbiota ◽  
Pregnant Women ◽  
Intrahepatic Cholestasis ◽  
Premature Delivery ◽  
Clinical Parameters ◽  
Intrahepatic Cholestasis Of Pregnancy ◽  
Control Groups ◽  
And Control ◽  
Cholestasis Of Pregnancy

Abstract Background: Intrahepatic cholestasis of pregnancy (ICP) is a liver disorder that specifically occurs in pregnancy. Elevated levels of liver transaminases aspartate aminotransferase, alanine aminotransferase and serum bilirubin levels are common biochemical characteristics in ICP. The disorder is associated with an increased risk of premature delivery and stillbirth. The characterization of the potential microbiota in ICP could go a long way in the prevention and treatment of this pregnancy disease.Methods: A total of 58 patients were recruited for our study: 27 ICP patients and 31 healthy pregnant subjects with no ICP. The V3 and V4 regions of the 16S rDNA collected from fecal samples of both diseased and control groups were amplified. 16S rRNA gene amplicon sequencing was then performed on gut microbiota. Sequencing data were analyzed and the correlation between components of microbiota and patient ICP status was found. Related metabolic pathways, relative abundance and significantly different OTUs (Operational Taxonomic Units) between ICP and controls were also identified.Results: Elevated levels of total bile acid, ALT, AST, Dbil and Tbil were recorded or observed in ICP subjects as compared to the control. Gut microbiota in pregnant women was dominated by four major phyla and 27 core genera. PCoA analysis results indicated that there was no significant clustering in Bray-Curtis distance matrices. Our results showed that there was a correlation between specific OTUs and measured clinical parameters of pregnant women. Comparison at the different taxonomy levels revealed high levels of abundance of Blautia and Citrobacter in ICP patients. At the family level, Enterobacteriaceae and Leuconostocaceae were higher in ICP patients. 638 KEGG Orthologs and 138 pathways significantly differed in the two groups; ICP patients and control group and PLS-DA model with VIP plots indicated a total of eight genera and seven species were key taxa in ICP and control groups.Conclusions: Our research indicated that although there was no significant clustering by PCoA analysis, patients with ICP have increased rare bacteria at different phylogenetic levels. Our results also illustrated that all 638 KEGG Orthologs and 136 in 138 KEGG pathways were less abundant in ICP patients compared to the controls.

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