Informative application of the instrumental diagnosis of scar integrity in the experimental model of the uterine cavity

2021 ◽  
Vol 69 (6) ◽  
pp. 17-22
Author(s):  
Anastasia Yu. Alekseeva ◽  
Marina N. Mochalova
Keyword(s):  
Clinical Trials ◽  
Experimental Model ◽  
Information Content ◽  
Uterine Cavity ◽  
Birth Canal ◽  
Early Postpartum Period ◽  
Early Postpartum ◽  
Natural Birth ◽  
Manual Examination ◽  
Uterine Scar

Currently, the frequency of deliveries by cesarean section is steadily increasing. Independent childbirth in women with a uterine scar is one of the mechanisms of its reduction. Meanwhile, the delivery of this category of patients through the natural birth canal requires the development of a safe and effective method for assessing scar integrity in the early postpartum period. For this purpose, a new instrumental diagnostics method has been developed, with its information content compared to manual examination data in an experimental model of the uterus. Each model was made of a bovine heart and had three defects with diameters less than 0.5 cm, 0.5-0.8 cm and 0.8-1.2 cm. Defects with diameters less than 0.5 cm were not detected by any of the methods studied. Defects with a diameter of 0.5-0.8 cm were detected using the developed device in 90 % (45/50) of cases and using manual examination in 44 % (22/50) of cases (2 = 23.93, p 0.001), defects with a diameter of 0.8-1.2 cm being detected in 100% (50/50) and 98% (49/50) of cases, respectively (2 = 1.01, p = 0.32). The information content of the instrumental model exceeds that of the manual study by 1.34 times (RR = 1.34, 95 % CI 1.09-1.65, p 0.05). Therefore, the possibility of testing this device in clinical trials needs to be considered.

The value of vaginal lactobacilli in the restoration of vaginal microbiocenosis in women in the early postpartum period, depending on the method of delivery

2021 ◽  
Vol 70 (4) ◽  
pp. 15-23
Author(s):  
Dzhamilya G. Dadayeva ◽  
Olga V. Budilovskaya ◽  
Anna A. Krysanova ◽  
Tatyana A. Khusnutdinova ◽  
Alevtina M. Savicheva ◽  
...  
Keyword(s):  
Vaginal Delivery ◽  
Postpartum Period ◽  
Vaginal Discharge ◽  
Vaginal Microbiota ◽  
Clinical Material ◽  
Birth Canal ◽  
Early Postpartum Period ◽  
Vaginal Microflora ◽  
Early Postpartum ◽  
Before And After

BACKGROUND: Despite numerous studies of the vaginal microbiota, there is still a lack of knowledge regarding its restoring dynamics in the early postpartum period. The condition of the vaginal microflora during pregnancy plays a key role in maintaining the physiological microbiocenosis of the birth canal and creating conditions for the normal course of pregnancy, the establishment of an infants intestinal microbiota, and the further development of the child. AIM: The aim of this study was to estimate the role of certain types of lactobacilli in restoring the vaginal microbiota in women in the early postpartum period, depending on the method of delivery. MATERIALS AND METHODS: We examined 150 women at 38-41 weeks of gestation. The clinical material for the study was vaginal discharge before and after delivery. To determine the species of lactobacilli and other microorganisms in the clinical material, we used quantitative real-time PCR. RESULTS: Before delivery, lactobacilli were found in vaginal discharge in 144 out of 150 women (96.0%), their number in the majority being more than 106 GE. In the postpartum period, lactobacilli were found in 66/128 (51.5%) cases, while prevailing in women after vaginal delivery in 50/65 (76.9%) cases (4.61.6, p = 0.000000). Among the dominant species of lactobacilli was L. crispatus, found in vaginal discharge before delivery, which most often affects the recovery of the vaginal microbiota in the postpartum period (29 out of 61 women, 47.5%). L. iners detected in the lochia predisposes to the violation of uterine involution in the early postpartum period (p = 0.03). CONCLUSIONS: Normal vaginal microbiota in the postpartum period is restored more quickly in women after vaginal delivery. Our study confirms that L. crispatus and L. iners play a major role in restoring the vaginal microbiota in the postpartum period.

A Device for Diagnosis of Uterine Scar Integrity in the Early Postpartum Period

2020 ◽  
Vol 54 (3) ◽  
pp. 159-162
Author(s):  
M. N. Mochalova ◽  
V. A. Mudrov ◽  
A. Yu. Mironenko
Keyword(s):  
Postpartum Period ◽  
Early Postpartum Period ◽  
Early Postpartum ◽  
Uterine Scar

The Effective and Safety Use of the Epidural Analgesia at Vaginal Delivery in the Women with the Uterine Scar

10.12737/9077 ◽  
2015 ◽  
Vol 22 (1) ◽  
pp. 50-56
Author(s):  
Виноградов ◽  
V. Vinogradov ◽  
Густоварова ◽  
T. Gustovarova ◽  
Боженков ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Epidural Analgesia ◽  
Vaginal Delivery ◽  
Epidural Anesthesia ◽  
Apgar Score ◽  
Negative Effects ◽  
Birth Canal ◽  
Clinical Hospital ◽  
Natural Birth ◽  
Uterine Scar

The frequency of the Cesarean section leads to increase number of the patients with the scar on the uterus. In the Clinical hospital № 1 (Smolensk, Russia) the childbirth is carried out through natural birth canal on the women having a reliable scar on the uterus. The analysis of the vaginal delivery and labour outcomes in 69 patients with the scar on the uterus is carried out. The childbirth in 38 patients was conducted with the epidurals, in 31 patients – without this type of anesthesia. The efficiency and safety of the epidural anesthesia are shown. The obtained results confirm that the epidural anesthesia doesn´t complicate the labour, doesn´t increase the hospitalization term, doesn´t influence the bleeding and negative effects on the fetus condition and the newborn assessment according to Apgar score. The possibility of using epidural anesthesia at childbirth on the women with uterine scar during the dystocia is shown.

Pregnancy management in patients with uterine fibroids. Case report

GYNECOLOGY ◽  
2021 ◽  
Vol 23 (5) ◽  
pp. 448-453
Author(s):  
Iuliia E. Dobrokhotova ◽  
Sonia Zh. Danelian ◽  
Ekaterina I. Borovkova ◽  
Elena A. Nagaitseva ◽  
Dzhamilia Kh. Sarakhova ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Uterine Fibroids ◽  
Uterine Cavity ◽  
Pain Syndrome ◽  
First Trimester ◽  
Reproductive Age ◽  
Node Degree ◽  
Birth Canal ◽  
Large Size ◽  
Natural Birth

Uterine fibroids (UF) are the most common tumor in women of reproductive age. The growth of myomatous nodes during pregnancy is non-linear and mainly occurs in the first trimester. In most cases, UF do not burden the course of pregnancy. Large size (5 cm), retroplacental location, and/or deformity of the uterine cavity by the myomatous node are associated with increased risks of spontaneous miscarriage, placental abruption, bleeding, preterm birth, and cesarean section. Myomectomy during pregnancy is undesirable, with the development of pain syndrome, the use of acetaminophen is safe. Indications for cesarean section in UF are the presence of a large size of fibroids that prevent delivery through the natural birth canal, red degeneration of myomatous nodes, torsion of the subserous myomatous node (degree 2C).

Myomectomy or conservative management of uterine fibroids: effects on reproductive potential

2021 ◽  
Vol 70 (5) ◽  
pp. 95-104
Author(s):  
Alexandra I. Shapovalova ◽  
Eduard N. Popov ◽  
Elena V. Mozgovaya
Keyword(s):  
Caesarean Section ◽  
Comparison Group ◽  
Uterine Fibroids ◽  
Main Group ◽  
Uterine Myoma ◽  
Laparoscopic Myomectomy ◽  
Inclusion Criteria ◽  
Birth Canal ◽  
Natural Birth ◽  
Uterine Scar

AIM: The aim of this study was to analyze reproductive function, pregnancy and labor in women after laparoscopic myomectomy and in women with unoperated myoma. MATERIALS AND METHODS: The main group consisted of 60 patients aged 25-46 years with a scar on the uterus who had laparoscopic myomectomy. Inclusion criteria were full-term pregnancy, uterine scar after laparoscopic myomectomy for subserosal or intramural uterine myoma (3-10 cm), and myomatous nodules (one to three). The comparison group included 30 women aged 25-46 years who were not surgically treated. Inclusion criteria were full-term pregnancy, subserosal or intramural uterine myoma (3-10 cm), and myomatous nodules (one to three). All patients in the main group underwent laparoscopic myomectomy. In all cases, the myomatous nodule was removed intracapsularly, leaving the leiomyoma pseudocapsule, which, with a deep arrangement of the transmural myomatous nodules, avoided opening the uterine cavity; myomatous nodule morcellation being used. With a deep intramural arrangement of the leiomyoma, the myometrial defect was sutured layer by layer with the application of several rows of endosutures. RESULTS: Six months after myomectomy, the patients underwent MRI of their pelvic organs with contrast. In 95% of cases, the uterine scar had no anatomical insolvency. In assessing the anamnesis, gynecological diseases occurred two times more often in women in the main group: 22 (36.7%) patients resorted to the use of the in vitro fertilization method for pregnancy, while among the patients in the comparison group, there were only two (6.7%) of them (2 = 12.8; р 0.001). In the main group, moderate preeclampsia and gestational diabetes mellitus were twice as common. In the main group, all patients were delivered by caesarean section, of which 83.3% were planned and 16.7% were emergency. In the comparison group, 73.3% of patients were delivered through the natural birth canal and 26.7% by caesarean section (2 = 149, p 0.0001). The most unfavorable signs predisposing to obstetric complications and operative delivery were the presence of multiple nodules (OR = 5.96 (1.09-32.72), p 0.05), the location of the nodule or scar in the uterine bottom (OR = 2.52 (1.00-6.33), p 0.05), and their combination with IVF (OR = 9.09 (2.42-34.07), р 0.01). CONCLUSIONS: In 95% of women, the scar on the uterus after myomectomy was consistent, but all these pregnant women were delivered by cesarean section, mainly for combined indications. However, they carried out the pregnancy safely, with a good outcome for the fetus. In women with uterine myoma and its conservative management, there was a lower rate of aggravated gynecological history and obstetric complications, and 73.3% of them were delivered through the natural birth canal. Despite the increased risk of caesarean section, the presence of uterine fibroids, even of a large size (more than 4 cm), should not be considered as a contraindication to vaginal delivery.

scholarly journals INTEGRATED PREPARATION OF PREGNANT WOMEN WITH A UTERINE SCAR TO VAGINAL PARTURITION

2019 ◽  
Vol 6 (1) ◽  
pp. 38-42
Author(s):  
E. P Shevtsova ◽  
Anatoly E. Miroshnikov ◽  
Yu. A Shatilova ◽  
N. A Zharkin
Keyword(s):  
Cesarean Section ◽  
Pregnant Women ◽  
Vaginal Delivery ◽  
Previous Cesarean Section ◽  
Birth Canal ◽  
Natural Birth ◽  
Uterine Scar ◽  
Previous Cesarean

Attempts of vaginal delivery in cases with a scar on the uterus after a previous cesarean section are more successful after appropriate psycho-prophylactic preparation during pregnancy. The purpose of the study is to reduce the frequency of repeated cesarean section operations. A comparison was made of the methods of delivery for pregnant women with a scar on the uterus after comprehensive training on an improved program and unprepared pregnant women. A total of 158 women were included in the study. Among them were those who had a cesarean section in history, but not trained for the current childbirth, only 5% gave birth independently. At the same time, women trained under the improved program had independent deliveries in 45.6% of cases (OR 5.813; 95% CI 0.826-40.885). The results confirm the effectiveness of the proposed improvements in the preparation of pregnant women with a scar on the uterus. The intention of such women to give birth through the natural birth canal, formed as a result of preparation, is an important factor for successfully overcoming the difficulties of the delivery process.

scholarly journals Exclusive Breastfeeding Is Not Associated with Maternal–Infant Bonding in Early Postpartum, Considering Depression, Anxiety, and Parity

Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1184
Author(s):  
Naoki Fukui ◽  
Takaharu Motegi ◽  
Yuichiro Watanabe ◽  
Koyo Hashijiri ◽  
Ryusuke Tsuboya ◽  
...  
Keyword(s):  
Mental Health ◽  
Path Analysis ◽  
Exclusive Breastfeeding ◽  
Postpartum Period ◽  
Depression Scale ◽  
Anxiety And Depression ◽  
Women’S Mental Health ◽  
Women's Mental Health ◽  
Early Postpartum Period ◽  
Early Postpartum

It is important to clarify how the breastfeeding method affects women’s mental health, and how women’s mental health affects the breastfeeding method in the early postpartum period when major depression and other psychiatric problems are most likely to occur. This study aimed to examine this bidirectional relationship in the early postpartum period. Participants were 2020 postpartum women who completed the Hospital Anxiety and Depression Scale (HADS) and Mother-to-Infant Bonding Scale (MIBS). We obtained data for participants’ breastfeeding method for four weeks after childbirth. We performed a path analysis with factors including breastfeeding method (exclusive breastfeeding or non-exclusive breastfeeding), parity (primipara or multipara), the two HADS subscales (anxiety and depression), and the two MIBS subscales (lack of affection and anger and rejection). The path analysis showed that breastfeeding method did not significantly affect depression, anxiety, and maternal–infant bonding in the early postpartum period. Women with higher anxiety tended to use both formula-feeding and breastfeeding. Our study suggests that exclusive breastfeeding is not associated with maternal-fetal bonding in early postpartum, considering depression, anxiety, and parity.

scholarly journals Effects of Intrauterine Infusion of a Chitosan Solution on Recovery and Subsequent Reproductive Performance of Early Postpartum Dairy Cows with Endometritis: A Pilot Field Trial

Animals ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 197
Author(s):  
Hiroaki Okawa ◽  
Missaka M.P. Wijayagunawardane ◽  
Peter L.A.M. Vos ◽  
Osamu Yamato ◽  
Masayasu Taniguchi ◽  
...  
Keyword(s):  
Dairy Cows ◽  
Reproductive Performance ◽  
Polymorphonuclear Leukocytes ◽  
Prostaglandin F2α ◽  
Chitosan Solution ◽  
Control Group ◽  
Control Groups ◽  
Early Postpartum Period ◽  
Early Postpartum ◽  
And Control

This study investigated the efficacy of intrauterine infusion of a chitosan solution (CHT) on uterine recovery in early postpartum dairy cows with or without endometritis, and their subsequent reproductive performance. In Experiment 1, cows with endometritis at 3 weeks postpartum were administered CHT (n = 5) and prostaglandin F2α (PGF2α) (n = 4). Untreated cows (n = 7) served as the control group. In Experiment 2, 18 cows with a normally recovered uterus at the fresh cow check (mean, 35 days postpartum) were assigned to the CHT (n = 10) and control (n = 8) groups, and intrauterine infusion was conducted in the CHT group. Overall, in Experiment 1, the percentage of polymorphonuclear leukocytes significantly declined in the CHT group (32.3 ± 10.2 to 5.5 ± 2.4, p < 0.05) from week 3 to week 5, but no decline occurred in the PGF2α and control groups. In Experiment 2, the CHT and control groups showed no significant differences in reproductive parameters, suggesting the absence of adverse effects of CHT on fertility. These results suggest that intrauterine infusion of CHT in the early postpartum period effectively accelerates uterine recovery from endometritis and might be a suitable replacement for PGF2α administration.

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