scholarly journals Features of the exchange of connective tissue and certain microelements in pregnant women with a risk of postterm pregnancy

2020 ◽  
Vol 0 (51) ◽  
pp. 37-41
Author(s):  
І. А. Жабченко ◽  
І. С. Ліщенко ◽  
В. В. Буран
2019 ◽  
Vol 3 (3) ◽  
pp. 12
Author(s):  
Betzabhé Pico Franco ◽  
Olga Pamela Cadena Orellana ◽  
Víctor Miguel Castro Bravo ◽  
Nicole Elizabeth Puga Miranda ◽  
Gustavo Iván Zambrano Intriago ◽  
...  

  El embarazo en adolescentes es un problema de salud pública mundial que altera la salud física, emocional, la condición educativa y económica de los futuros padres; asimismo, frecuentemente se afecta también al producto de la gestación. La investigación fue de tipo retrospectiva, correlacional y cuantitativa. La muestra fue 461 embarazadas adolescentes atendidas en el Hospital “Verdi Cevallos Balda” de la ciudad de Portoviejo durante el 2016. Los resultados de este estudio mostraron que la mayor tasa de embarazo en adolescentes se produjo en primigestas (88,72 %) de 18 años. La desproporción céfalo-pélvica fue el factor materno-fetal que ocupó el primer lugar como causa de cesárea, seguida de factores fetales como distocia de presentación y ruptura prematura de membranas.   Palabras clave: Parto espontáneo, cesárea, pretérmino, postérmino, embarazo.   Abstract Teenage pregnancy is a global public health problem that alters the physical, emotional, educational and economic condition of future parents; likewise, the gestation product is frequently affected. The research was retrospective, correlational and quantitative. The sample was 461 adolescent pregnant women treated at the Hospital "Verdi Cevallos Balda" of the city of Portoviejo during 2016. The results of this study showed that the highest rate of adolescent pregnancy occurred in first-time pregnant women (88.72 %) of 18 years. Cephalopelvic disproportion was the maternal-fetal factor that ranked first as a cause of caesarean section, followed by fetal factors such as presenting dystocia and premature rupture of membranes.   Keywords: Spontaneous delivery, cesarean section, preterm, postterm, pregnancy.


Author(s):  
V. Yu. DOBRIANSKA ◽  
S. M. HERYAK ◽  
L. M. MALANCHUK ◽  
M. I. SHVED ◽  
I. V. KORDA

Among the visceral manifestations of NDST in pregnant women most often diagnosed mitral valve prolapse (20-25%) that accompanied by more cardiovascular and obstetric complications during pregnancy. It demonstrates the high clinical significance of the problem of connective tissue dysplasia with mitral valve prolaps for pregnancy and requires adequate treatment programs for prevention of complications and management of pregnant women with connective tissue dysplasia. Aim. Determination of the frequency of pregnancy pathology in women with clinical signs of NDST and MVP complicated by extrasystolic arrhythmia. Materials and methods. 138 pregnant women with MVP and concomitant signs of NDST and 54 healthy pregnant women were selected for analysis. Clinical manifestations of NDST, different variants of arrhythmias and the total number of complications of pregnancy and childbirth were evaluated. Results. In pregnant women with clinical signs of NDST and MVP complicated by extrasystolic arrhythmia, cases of frequent sinus extrasystole were significantly more often compared to frequent ventricular arrhythmia (47.8% vs. 18.1%, p<0.001) and cases of combination of frequent sinus extrasystole and ventricular arrhythmia (13.3 % vs. 1.5%, p <0.05). They significantly more often identified both symptoms of arrhythmological nature and symptoms that indicated a violation of autonomic status. The presence of NDST syndrome is more often accompanied by the development of complications of pregnancy and childbirth. These pregnant women have genetic and phenotypic risk factors for the development of pathological pregnancy and childbirth, birth trauma, disability of mother and newborn, which justifies such patients in a separate risk group for individualized programs of the prevention and treatment of visceral (cardiac) manifestations of NDST and possible complications of pregnancy and childbirth. Conclusions. 3.1% of pregnant women are diagnosed with phenotypic signs (stigma) of undifferentiated connective tissue dysplasia, and the most common visceral cardiac manifestation is mitral valve prolapse. The presence of mitral valve prolapse and extrasystolic arrhythmia in pregnant women with NDST is accompanied by significantly more frequent development of pregnancy and childbirth complications in these patients.


Author(s):  
Tat'iana Sergeevna Fadeeva

The work raises questions of predicting the complications of pregnancy and childbirth and adverse conditions in the fetus in the presence of UCTD in the expectant mother, who also need to be studied, especially from the standpoint of mathematical modeling of the disease. It is also necessary to develop a common tactic for providing medical and social assistance and treatment and diagnostic services to pregnant women suffering from UCTD, which will make the outcome of childbirth more favorable and improve the subsequent prognosis for mother and newborn. In the literature there is practically no assessment of the course of pregnancy and the outcome of childbirth, depending on the severity of UCTD. Little is known about the role of a connective tissue metabolism marker - hydroxyproline, trace elements (magnesium) and vitamins (D3) in pregnant women suffering from UCTD, and the medical tactics regarding such patients are not clearly defined. Despite numerous successes in the study of the causes of complications during pregnancy and childbirth in women suffering from UCTD, a unified approach to their management during the prenatal stage has not yet been developed. Therefore, the search for possible predictors for the timely prediction of adverse pregnancy and childbirth outcome in such patients is becoming increasingly important. This will make it possible to develop an optimal organizational and methodological base and subsequently improve the prognosis for women and their offspring. Thus, in contrast to the existing standard approach, we have proposed a comprehensive management of patients suffering from UCTD, including the timely identification of patients from the risk group, clarification of their condition using such markers as magnesium and hydroxyproline, additional intake of magnesium and vitamin D preparations. Optimal plan managing the period of gestation, childbirth, and a pathogenetically reasoned set of treatment and preventive measures for women with UCTD, will not only improve the outcomes of pregnancy and childbirth, but also contribute to the health of the future generation. 1. UCTD affects the course of pregnancy, childbirth and the condition of the newborn. The degree of exposure is largely determined by the severity of the underlying disease. In severe UCTD, the prevalence of spontaneous miscarriage and preterm labor was significantly higher, and endometritis and severe anemia were more common in the postpartum period. Severe asphyxia on the Apgar scale at the 1st and 5th minutes, congenital heart defects, morphofunctional immaturity, conjugation jaundice and convulsive syndrome were more common in the fetus. 2. A low content of magnesium and hydroxyproline is associated with the occurrence of complications during childbirth and a decrease in the anthropometric characteristics of the newborn. Taking magnesium preparations reliably affects the concentration of this trace element and hydroxyproline in the blood of pregnant women suffering from UCTD. 3. Therapy with magnesium preparations is an effective tool in patients suffering from UCTD, as it helps to improve well-being during pregnancy, improves the course of the postpartum period and reduces the prevalence of chronic fetal hypoxia. 4. Vitamin D and magnesium supplements have a beneficial effect on pregnancy and the fetus, reducing the prevalence of pre-eclampsia and chronic intrauterine hypoxia of the fetus, reducing the incidence of morphofunctional immaturity and conjugation jaundice of the newborn. 5. The created computer program “STEP DST” can be applied in the clinical practice of obstetrician-gynecologists and health care organizers. The obtained individual forecast of the probability of development of complications of reproduction allows us to outline the optimal plan for managing the period of gestation, childbirth and the postpartum period, to prescribe a pathogenetically based set of therapeutic and preventive measures for women suffering from UCTD.


2020 ◽  
pp. 42-51
Author(s):  
Z.M. Dubossarska ◽  
◽  
Yu.O. Dubossarska ◽  
Ye.O. Puzii ◽  
◽  
...  

The problem of premature rupture of membranes (PROM) is unfortunately still relevant in modern obstetrics and perinatology, especially in preterm pregnancy, and leads to 20% of all cases of perinatal loss. Among the possible causes, a lot of attention has recently been paid to disorders of connective tissue structure of genetic origin. The article provides an overview of current medical literature on the causes and diagnosis of PROM. Preliminary own data on the positive effect of the advanced algorithm for detecting undifferentiated connective tissue dysplasia (UCTD) on obstetric and perinatal outcomes are also given. The objective: to clarify the causes of PROM, the role of the severity of connective tissue dysplasia to predict risk factors for preterm birth, especially when combined in pregnant women with anemia. Materials and methods. A total of 60 pregnant women with IDF were examined. During the survey, laboratory and instrumental methods were used. Results. Quality of life in women with NDTT had an inverse mean relationship between the patients’ well-being and the number of PST phenotypic manifestations (r = 0.653; p> 94%). In addition, a high constitutionally determined level of personal anxiety was established. Quality of life depends on the number and severity of phenotypic abnormalities, ie the more signs of connective tissue dysplasia (joint hypermobility, scoliosis, nephroptosis, increased bleeding, myopia, pronounced varicose veins, etc.), the lower this indicator. As pregnancy progressed, worsening of health and decrease in quality of life in patients with NDST was observed. Conclusion. The advanced algorithm has demonstrated the positive effects in pregnant women with undifferentiated connective tissue dysplasia on obstetric and perinatal delivery, and the findings suggest that it is practiced in health care. Key words: premature rupture of membranes, preterm pregnancy, undifferentiated connective tissue dysplasia.


Author(s):  
D. M. Zhelezov ◽  
T. O. Savenko

The aim of the study – to evaluate the role of expression of specific connective tissue proteins in the formation of the scar on the uterus. Materials and Methods. The study was performed on the basis of the regional perinatal center and KU PB No. 5 during 2017–2019. 426 women with a scar on the uterus were examined, including 115 (27.0 %) with two or more scars. The mean age of the subjects was (33.4±1.1) years. The results of sonographic studies were analyzed. For pathomorphological examination, three cases of intranatal rupture of the uterine wall along the “old” scar after cesarean section from middle-aged women with a gestational age of 33 to 40 weeks are presented. The expression of collagen types 1 and 3 and the protein of the intermediate filaments of the muscle tissue of desmin was determined using a semi-quantitative method with the calculation of H-score. Results and Discussion. Analysis of ultrasound data showed that the average assessment of the degree of insolvency of the scar on the uterus was in the examined women X=(1.3±0.2) points, a high level of insolvency was found in 114 (26.8 %) pregnant women. At the same time, 225 (52.8 %) pregnant women showed no signs of scar failure at all. In 87 (20.4 %) one sign of uterine scar failure was found, in 76 (17.8 %) – two signs, in 20 (4.7 %) – three signs, and in 18 (4.2 %) – four signs. Subsequently, 44 (10.3 %) women were born operatively, the rest gave birth per via naturales. Local myometrial defect after ultrasound delivery was detected in 25 of 182 (13.7 %) women who gave birth independently. Conclusions. A high level of scar failure risk is found in 26.8 % of pregnant women. H-score valuesfor collagen types 1 and 3 averaged (212±24) and (188±22), for desmin – (193±17). Thus, reparative processes at the site of previous surgery on the uterine wall are by incomplete regeneration (substitution) and compensatory hyperplasia of structural tissue elements.


2021 ◽  
Vol 74 (4) ◽  
pp. 880-883
Author(s):  
Tunzala V. Ibadova ◽  
Volodymyr V. Maliar ◽  
Vitalii V. Maliar ◽  
Vasyl V. Maliar

The aim: Study of the relationship between cervical insufficiency and dysplastic stigma in miscarriages. Materials and methods: 80 pregnant women were examined at 23-27 weeks of gestation.) Group I included 40 pregnant women with the threat of premature birth, with habitual miscarriage and correction of cervical insufficiency (CI) by using pessary in the anamnesis. Group II consisted of 20 pregnant women with the threat of premature birth and correction of CI by using pessary without the burden of habitual miscarriage, the control group of 20 almost healthy pregnant women. Results: The studies revealed phenotypic signs of dysplastic stigmatization in 39 (97.5 + 2.5%) pregnant women of group I, in 18 (90.0 + 6.9%) group II and in 4 (20.0 + 9.2%) control, which indicates a high prevalence of connective tissue dysplasia in women with CI, which also has a laboratory reflection in the form of increased excretion per day of oxyproline and a decrease in total glycosaminoglycans in both groups at risk of preterm birth. Conclusions: The most common gestational complication in women with connective tissue dysplasia is the risk of premature birth. Improving existing and finding new diagnostic and therapeutic measures for women with UDСTD will reduce the risk of preterm birth.


2018 ◽  
Vol 6 ◽  
pp. 30-36
Author(s):  
Sadrudin Magomedov ◽  
Iryna Zhabchenko ◽  
Viktor Oleshko ◽  
Larysa Polishchuk ◽  
Nellia Korniets ◽  
...  

The preterm deliveries are the leading cause of the perinatal morbidity and represent important mortality indicators. Functional cervical insufficiency, which is a phenotypic manifestation of undifferentiated connective tissue dysplasia, plays the main role in the development of pregnancy complications in primigravidas (women pregnant for the first time) and primiparas (women giving birth for the first time). Aim of the research: to study the indicators of connective tissue metabolism and basic microelements in order to determine the role of undifferentiated connective tissue dysplasia in the pathogenesis of functional cervical insufficiency during pregnancy. Methods. The 101 pregnant women (the main group) at the 22–32 week gestation period which were diagnosed with “Functional cervical insufficiency” were examined, as well as 34 pregnant women with the physiological obstructive function of the cervix (the control group). Utilizing immunoenzyme analysis we measured in blood serum the concentration of Total P1NP the amino-terminal propeptide of procollagen type I a marker of synthesis, and β-CrossLaps resorptions marker of the connective tissue. Utilizing the automatic analyzer of electrolytes and a set of reagents for their determination we estimated the content of microelements Na+, K+, Mg2+, Ca2+ and total Ca and P. Results. The functional cervical insufficiency in pregnant women was indicated by cervical shortening up to 22.88±1.02 mm, and the majority of women (76.2 %) had phenotypical manifestations of undifferentiated connective tissue dysplasia. We found a significant increase in the concentration of marker of synthesis Total P1NP, whereas the concentration of resorption marker β-CrossLaps remains normal, and strong reverse correlation (r=–0.7362) between the index of cervix length and concentration of marker of connective tissue synthesis Total P1NP. We detected a significant increase in the concentration of total and ionized calcium, total phosphorus, deficiency of ionized magnesium, potassium and sodium that lead to changes in the structure of connective tissue and reduction of cervical obstructive function.


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