Pregnancy after influenza in the first trimester

The endpoint of the negative impact of adverse processes in the mother’s body with influenza is the formation of placental insufficiency, the basis of which is a violation of the uteroplacental blood flow. The objective: to study the features of the course of pregnancy, the state of the fetus and the newborn after the influenza in the first trimester of pregnancy. Materials and methods. 120 women who had the influenza in the first trimester of pregnancy were examined. In 68 (56.7%) pregnant women signs of feto-placental dysfunction were observed, 2 groups were distinguished: the main group - 68 patients with feto-placental dysfunction, the comparison group – 52 pregnant women without signs of feto-placental insufficiency. Results. 3 times more often than women without manifestations of placental insufficiency (42.6% versus 15.4%; p<0.05) a severe course of influenza was observed, it accompanied by a high frequency of clinical manifestations, including in almost all patients (95.6% versus 67.3%; p<0.05), body temperature rose to 38 °C and higher, and in 61.7% of women it stayed for 4–6 days (versus 11.5%; p<0.05). Among the complications of influenza: bronchitis (25.0% versus 9.3%; p<0.05), pneumonia (17.6% versus 5.7%; p<0.05), sinusitis (17.6% versus 7.7%; p<0.05). The threat of abortion was noted in 57.4% of cases, the threat of preterm birth was observed in 39.7% of women. Most often, placental dysfunction was associated with fetal distress (76.5% versus 13.5%; p<0.05) and growth retardation (54.4% versus 3.8%; p<0.05). 32.4% versus 13.5% of women had preeclampsia (p<0.05). The frequency of both polyhydramnios (17.6%) and low water (10.3%) is significantly higher. By cesarean section, 35.3% women were delivered (versus 15.4%, (p<0.05). Delivery was preterm in 17.6% of women versus 7.7% (p<0.05). Premature discharge of amniotic fluid (17.6%) and pathological blood loss during childbirth (16.2%), fetal distress during childbirth (48.5% versus 9.6%; p<0.05) were noted. Maternal placental dysfunction, fetal distress, prematurity (17.6%) and malnutrition (22.1%) led to a high incidence of birth asphyxia (46.5% versus 19.2%, p <0.05). Half (51.5%) of children had disadaptation syndromes, most often neurological disorders (32.4% versus 11.5%; p<0.05) and respiratory disorders (27.9% versus 7.7%; p<0.05). Conclusion. Influenza in early pregnancy with a severe course and a high frequency of complications is associated with a high frequency of feto-placental dysfunction and other obstetric and perinatal complications, which requires a more detailed study to determine risk factors and develop tactics for managing this category of pregnant women. Keywords: pregnancy, influenza, feto-placental dysfunction, obstetric and perinatal complications, newborn.

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LABOR COURSE AND CONDITION OF NEWBORNS IN WOMEN WITH PLACENTAL DYSFUNCTION DUE TO GESTATIONAL ENDOTHELIOPATHY

World Science ◽

10.31435/rsglobal_ws/30092019/6704 ◽

2019 ◽

Vol 2 (9(49)) ◽

pp. 4-8

Author(s):

V. V. Lazurenko ◽

I. B. Borzenko ◽

D. Yu. Tertyshnik

Keyword(s):

Birth Weight ◽

Preterm Birth ◽

Caesarean Section ◽

Fetal Growth ◽

Fetal Distress ◽

First Trimester ◽

Control Group ◽

Perinatal Complications ◽

Placental Dysfunction ◽

First Trimester Of Pregnancy

The purpose of the study is to evaluate the effect of placental dysfunction caused by gestational endotheliopathy on the course of labor and the condition of the newborn. The first group consisted of 70 patients with placental dysfunction with gestational endotheliopathy confirmed by laboratory-instrumental findings in the first trimester of pregnancy. The control group included 30 pregnant women with physiological gestational course. PD secondary to GE leads to preterm birth, fetal distress, increases the percentage of caesarean section, contributes to the delay of fetal growth and birth weight, poor infant status and perinatal complications.

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Drug-induced cytolytic syndrome in pregnancy: clinical and biochemical diagnostic criteria

Journal of obstetrics and women s diseases ◽

10.17816/jowd65628-35 ◽

2016 ◽

Vol 65 (6) ◽

pp. 28-35

Author(s):

Irina V Borisova

Keyword(s):

Pregnant Women ◽

Hormone Therapy ◽

Clinical Manifestations ◽

First Trimester ◽

Gamma Glutamyl Transpeptidase ◽

Drug Induced ◽

Planning Stage ◽

Protein Levels ◽

First Trimester Of Pregnancy ◽

In Pregnancy

The aim of the study was evaluation of clinical and laboratory manifestations of drug-induced cytolytic syndrome in pregnancy. In the research group included 62 pregnant women with drug-induced liver injury (DILI) in the first trimester of pregnancy. These pregnant women received hormone therapy at the planning stage and/or during pregnancy for the prevention and treatment of miscarriage and had clinical and biochemical manifestations of cytolytic syndrome. Pregnancy after IVF and ovulation induction was in 60.8% of cases. Hormone therapy for pregnant patients received long-term, 85% of pregnant women used estrogen and progestin drugs. DILI during pregnancy characterized by low-symptom or asymptomatic clinical manifestations. DILI manifested cytolytic biochemical syndrome, in which there is isolated increase of transaminase levels, in some cases accompanied by increased level of gamma glutamyl transpeptidase, liver glutamate dehydrogenase and decreased total protein levels, in the first place due to the albumin fraction.

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Clinical and Pathogenetic Causes of Developing Complications in Multiple Pregnancy

Galician Medical Journal ◽

10.21802/gmj.2020.1.6 ◽

2020 ◽

Vol 27 (1) ◽

pp. E202016

Author(s):

Iryna Nikitina ◽

Volodymyr Boiko ◽

Tetiana Babar ◽

Natalia Kalashnik ◽

Nataliia Ikonopistseva ◽

...

Keyword(s):

Growth Factor ◽

Pregnant Women ◽

Multiple Pregnancy ◽

First Trimester ◽

Placental Growth Factor ◽

Enzyme Linked Immunosorbent Assay ◽

Full Time ◽

Singleton Pregnancy ◽

Placental Dysfunction ◽

First Trimester Of Pregnancy

To assess the role of the placental growth factor in the development of gestational complications during multiple pregnancy, there was conducted a study of this indicator in serum of 320 pregnant women with multiple pregnancy in the first trimester and 40 pregnant women with singleton pregnancy (the control group). The objective of the research was to study the effect of placental growth factors on the gestational process in multiple pregnancy. Materials and Methods. There was conducted a prospective study of pregnancy and childbirth in 320 females with multiple pregnancy (the main group) and 40 healthy women with singleton pregnancy. The level of serum placental growth factor was determined by enzyme-linked immunosorbent assay using monoclonal antibodies in the first trimester of pregnancy. The indicators of the hemostasis system (vascular, platelet and coagulation components) were evaluated according to generally accepted methods. Doppler ultrasound of the placental and fetal blood flow was performed in the uterine arteries, the umbilical artery and vein, the fetal middle cerebral artery. Results. Women with multiple pregnancy were at high risk of developing gestational complications such as preterm deliveries (67.8%, p<0.01), placental dysfunction, pre-eclampsia (17.5%, p<0.05). The disorders of the vascular platelet and coagulation hemostasis in the first trimester of pregnancy were the main risk factors for early termination of pregnancy. Low level of serum placental growth factor in pregnant women with multiple pregnancy in case of preterm delivery, placental dysfunction and pre-eclampsia (111.23 ± 8.4, 203.24 ± 6.4 and 305.86 ± 7.4 pg/ml), in comparison with the corresponding indicators in singleton pregnancy (418.2 ± 10.4 pg/ml), was proven to be a prognostic marker for the development of gestational complications. Conclusions. Timely correction of gestational complications in multiple pregnancy with micronized progesterone, low molecular weight heparins, angio-protective agents allowed us to prolong pregnancy with monochorionic placentation type for 3.2 weeks (up to 34.2 ± 2.4 weeks) and provide full-time delivery of dichorionic twin pregnancy.

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

Reproductive health of woman ◽

10.30841/2708-8731.6.2021.244380 ◽

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.

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Antenatal thyroid screening and its clinical correlation

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20171938 ◽

2017 ◽

Vol 6 (5) ◽

pp. 1864

Author(s):

Juhi Sisodia ◽

Meena Samant

Keyword(s):

Pregnant Women ◽

Perinatal Outcome ◽

Fetal Distress ◽

First Trimester ◽

Control Group ◽

Intrauterine Death ◽

Perinatal Complications ◽

Maternal Complications ◽

Serum Tsh ◽

In Pregnancy

Background: The study of hypothyroidism in pregnancy was done with the aim of determining the effect of hypothyroidism on maternal and perinatal outcome. This study also aimed to decide whether universal screening of pregnant women for hypothyroidism is justified.Methods: A prospective observational study was done over a period of 1 year from October 2011 to September 2012, on pregnant women attending the OPD of Obs and Gynae department. Serum TSH is the most convenient and best test to diagnose hypothyroidism in pregnancy in first trimester. Ideal serum TSH level during pregnancy is 0.5-2.5µIU/ml in first trimester and 0.5-3µIU/ml in second and third trimester. First trimester booking visit is the ideal time for initial evaluation. Thereafter serum TSH should be measured at 6 weeks interval for necessary dose adjustments. Levothyroxine is the drug of choice. It should be started at 1.6-2µg/kg/day. If serum TSH is raised but fT4 is normal, treatment can be started with 25-75µg/day.Results: Inadequately treated hypothyroid pregnant women had higher incidence of maternal complications in comparison to adequately treated hypothyroid patients, like threatened abortion (11.1% vs 1.5%), antepartum hemorrhage (7.4% vs 1.5%), premature rupture of membrane (14.8% vs 3.0%), preterm labour (18.5% vs 1.5%), postpartum hemorrhage (9.3% vs 4.5%), anemia (16.7% vs 9.1%) and intrauterine death (9.3% vs 0%). Perinatal complications were also higher like fetal distress (33.3% vs 13.6%) and low birth weight (16.7% vs 4.5%).Incidence of caesarean section was higher in hypothyroid women in comparison to control group (29.2% vs 19.2%).Conclusions: This study shows that there is an association between inadequately treated hypothyroidism and adverse maternal and perinatal outcome. Those who were detected early and adequately treated had outcome similar to control group.

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BASIC CLINICAL AND PATHOGENETIC ASPECTS OF DEVELOPING THE COMPLICATIONS DURING MULTIPLE PREGNANCIES

Wiadomości Lekarskie ◽

10.36740/wlek201901110 ◽

2019 ◽

Vol 72 (1) ◽

pp. 52-55

Author(s):

Volodymyr I. Boiko ◽

Alla V. Boychuk ◽

Irina M. Nikitina ◽

Tetyana V. Babar ◽

Alesya V. Boiko ◽

...

Keyword(s):

Growth Factor ◽

Pregnant Women ◽

Solid Phase ◽

First Trimester ◽

Enzyme Analysis ◽

Control Group ◽

Multiple Pregnancies ◽

Placental Dysfunction ◽

First Trimester Of Pregnancy ◽

A Prospective Study

Introduction: In order to evaluate the value of the Placenta Growth Factor (PlGF) in the developing the gestational complications during multiple pregnancies, a study of this indicator in serum of 320 pregnant women with multiple pregnancies in the first trimester, as well as 40 pregnant women with single pregnancy, constituted a control group. The aim: of the study is to investigate the effect of the placental growth factors on gestational process during multiple pregnancies. Materials and methods: A prospective study of maternity pregnancy in 320 females with multiple pregnancies was conducted, which comprised the main group of the subjects and 40 healthy women with unipolar pregnancy. The level of PlGF in serum was determined by solid phase enzyme analysis using monoclonal antibody sets in the first trimester of pregnancy. Indicators of the hemostasis system (vascular thrombocyte and coagulation link) were evaluated according to generally accepted methods. Dopplerometry of placental and fetal blood flow was performed in uterine arteries, arteries and umbilical cord veins, middle cerebral artery of the fetus. Results: Women with multiple pregnancies are at the risk of gestational complications - premature births in 67.8% (p <0.01), feto placental dysfunction, pre eclampsia - in 17.5% (p <0.05) cases. The revealed violations of the vascular thrombocyte and coagulation homeostasis in the first trimester of pregnancy are the main risk factors for early premature abortion. It has been shown that the low level of placental growth factor in serum of pregnant women with multiple pregnancies in the case of premature labor, feto placental dysfunction and pre-eclampsia (111.23 ± 8.4, 203.24 ± 6.4 and 305.86 ± 7.4 pg / ml) compared with the corresponding indicators for single-pregnancy (418.2 ± 10.4 pg / ml) is a prognostic marker for the development of gestational complications. Conclusions: Timely medical correction of gestational complications during multiple pregnancies with the use of micronized progesterone, low molecular weight heparins, angio protectants allowed prolonging the pregnancy with mono choric type of placentation by 3.2 weeks (up to 34.2 ± 2.4 weeks), and in the case of dichoric twins - to full-term pregnancy.

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Hyperglycosylated chorionic gonadotropin – prognostic criteria development of complications of pregnancy

HEALTH OF WOMAN ◽

10.15574/hw.2017.121.82 ◽

2017 ◽

pp. 82-85

Author(s):

N.V. Pehnyo ◽

Keyword(s):

Pregnant Women ◽

Chorionic Gonadotropin ◽

Human Chorionic Gonadotropin ◽

Prognostic Significance ◽

Neonatal Morbidity ◽

First Trimester ◽

Trophoblast Invasion ◽

Placental Dysfunction ◽

Hyperglycosylated Human Chorionic Gonadotropin ◽

First Trimester Of Pregnancy

The objective: to assess the prognostic significance of the level of serum hyperglycosylated human chorionic gonadotropin (gHCG) reative to the development of pregnancy complications that lead to impaired fetal conditions. Materials and methods. 382 pregnant women were examined who were on the register, were hospitalized in case of complications of pregnancy and gave birth to KCMH №2 (Kiev). All pregnant women were evaluated serum gCGG in the period of 8-10 weeks gestation, evaluated the course and result of pregnancy. Results. Reduction in the level of gHCG is a marker of insufficient trophoblast invasion, which is likely to lead to the formation of placental dysfunction and the development of a variety of obstetric pathology complicating the course of pregnancy and a risk factor for antenatal loss and neonatal morbidity. The conclusion. Determination of the level of hyperglycosylated human chorionic gonadotropin in the first trimester of pregnancy will make it possible to identify pregnant women at risk for the formation of placental dysfunction and propose a set of monitoring activities aimed at early detection of violations of pregnancy and their timely removal. This helps prevent the formation of severe pathological conditions during pregnancy in both the mother and the fetus, which corresponds to the current trends in the development of medical care, namely: prediction, prevention and individual approach. Key words: hyperglycosylated chorionic gonadotrophin, complications of pregnancy, disturbed fetal condition.

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The use of drugs in the first trimester of pregnancy: pharmacoepidemiologic study

Vladikavkaz Medico-Biological Bulletin ◽

10.12737/17245 ◽

2015 ◽

Vol 21 (31) ◽

pp. 45-47

Author(s):

Арчегова ◽

E. Archegova ◽

Болиева ◽

Laura Bolieva

Keyword(s):

Pregnant Women ◽

Medical Records ◽

High Frequency ◽

First Trimester ◽

Descriptive Study ◽

Pharmacoepidemiological Study ◽

First Trimester Of Pregnancy ◽

Drugs Prescription ◽

Real Practice ◽

North Ossetia

The article presents the results of pharmacoepidemiological study the main goal of which was to analyze the real practice of drugs prescription to the pregnant women during the first trimester of pregnancy in hospitals of North Ossetia-Alania. A retrospective descriptive study based on medical records of patients (n=284) admitted to hospitals in 2012 was performed. According to the obtained data the main problems were: high frequency of prescribing drugs in pregnancy; great number of drugs prescribed to every pregnant women at the same time; high percent of drugs, when the reliable information of safety is lacking during the pregnancy.

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

HEALTH OF WOMAN ◽

10.15574/hw.2016.111.160 ◽

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.

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Antibiotic Prescriptions among China Ambulatory Care Visits of Pregnant Women: A Nationwide Cross-Sectional Study

Antibiotics ◽

10.3390/antibiotics10050601 ◽

2021 ◽

Vol 10 (5) ◽

pp. 601

Author(s):

Houyu Zhao ◽

Mei Zhang ◽

Jiaming Bian ◽

Siyan Zhan

Keyword(s):

Pregnant Women ◽

Ambulatory Care ◽

National Level ◽

Mainland China ◽

Antibiotic Use ◽

First Trimester ◽

Cross Sectional Study ◽

Cross Sectional ◽

Fetal Safety ◽

First Trimester Of Pregnancy

Background: Antibiotic use in pregnant women at the national level has rarely been reported in China. Objectives: We aimed to investigate antibiotic prescriptions during pregnancy in ambulatory care settings in China. Methods: Data of 4,574,961 ambulatory care visits of pregnant women from October 2014 to April 2018 were analyzed. Percentages of Antibiotic prescriptions by different subgroups and various diagnosis categories and proportions of inappropriate antibiotic prescriptions for different subgroups were estimated. Food and Drug Administration (FDA) pregnancy categories were used to describe the antibiotic prescription patterns. The 95% confidence intervals (CIs) were estimated using the Clopper––Pearson method or Goodman method. Results: Among the 4,574,961 outpatient visits during pregnancy, 2.0% (92,514 visits; 95% CI, 2.0–2.0%) were prescribed at least one antibiotic. The percentage of antibiotic prescriptions for pregnant women aged >40 years was 4.9% (95% CI, 4.7–5.0%), whereas that for pregnant women aged 26–30 years was 1.5% (95% CI, 1.4–1.5%). In addition, percentages of antibiotic prescriptions varied among different trimesters of pregnancy, which were 5.4% (95% CI, 5.3–5.4%) for the visits in the first trimester of pregnancy and 0.5% (95% CI, 0.4–0.5%) in the third trimester of pregnancy. Furthermore, the percentages of antibiotic prescriptions substantially varied among different diagnosis categories and nearly three-quarters of antibiotic prescriptions had no clear indications and thus might be inappropriate. In total, 130,308 individual antibiotics were prescribed; among these, 60.4% (95% CI, 60.0–60.8%) belonged to FDA category B, 2.7% (95% CI, 2.1–3.5%) were classified as FDA category D and 16.8% (95% CI, 16.2–17.4%) were not assigned any FDA pregnancy category. Conclusions: Antibiotic prescriptions in ambulatory care during pregnancy were not highly prevalent in mainland China. However, a substantial proportion of antibiotics might have been prescribed without adequate indications. Antibiotics whose fetal safety has not been sufficiently illustrated were widely used in pregnant women.

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