scholarly journals FEATURES OF THE COURSE OF PREGNANCY AND GENERA IN PATIENTS WITH OBESITY

2019 ◽  
Vol 6 (2) ◽  
pp. 94-97
Author(s):  
E. V Timokhina ◽  
Mariam G. Saakyan ◽  
N. V Zafiridi ◽  
I. M Bogomazova
Keyword(s):  
Arterial Hypertension ◽  
Pregnant Women ◽  
Fetal Growth ◽  
Growth Retardation ◽  
Pregnancy Complications ◽  
High Frequency ◽  
Placental Insufficiency ◽  
Chronic Hypertension ◽  
Fetal Growth Retardation ◽  
Fetal Hypoxia

The aim of the study was to assess the course of pregnancy and childbirth in patients with varying degrees of obesity.Material and methods of research. A retrospective study of pregnant women with different body mass index (BMI), the delivery of which occurred in the period 01.01.2018-06.30.2018, was conducted. The results of the study. In the study, the largest proportion - 53% were pregnant women with a BMI above 30 kg/m2, the proportion of women with premorbid obesity - 47%. The incidence of diseases that complicate the course of pregnancy (chronic hypertension, gestational hypertension and preeclampsia) was highest in women with a BMI higher than 30 kg/m2. In the study groups, gestational arterial hypertension was the most common - 14%. Pregnancy complications, namely, fetal growth retardation/placental insufficiency, occurred with a frequency of 8% in the group with premorbid obesity. In pregnant women with a BMI of more than 30 kg/m2, acute/chronic fetal hypoxia was observed, the frequency of which in total was 10%. Complications of the fetus in the studied women showed that the risk of fetal hypoxia in pregnant women with a BMI above 30 kg/m2 is very high. Large fruit was found in 15% of cases of the total number of women studied, in groups with a BMI of more than 30 kg/m2, with a frequency equal to 10% of the total number. The number of births through the birth canal in women with a BMI of more than 30 kg/m2 was 28%, and the frequency of cesarean section operations was 24%. Conclusion. Women with a BMI above 30 kg/m2 have a high frequency of pregnancy complications (gestational arterial hypertension, preeclampsia, chronic arterial hypertension). A high frequency of perinatal pathology was revealed - acute/chronic fetal hypoxia, placental insufficiency, fetal growth retardation, macrosomia. Pregnant women with a high BMI should be closely monitored by an obstetrician-gynecologist, observe proper nutrition, monitor weight gain, and timely treat chronic diseases, in particular hypertension.

Predictive value of hyperhomocysteinemia in pregnant women with chronic hypertension

2011 ◽  
Vol 17 (4) ◽  
pp. 379-383
Author(s):  
V. S. Chulkov ◽  
N. K. Vereina ◽  
S. P. Sinitsin
Keyword(s):  
Pregnant Women ◽  
Fetal Growth ◽  
Growth Retardation ◽  
Prognostic Significance ◽  
Placental Insufficiency ◽  
Chronic Hypertension ◽  
Fetal Growth Retardation ◽  
Group 2 ◽  
Insufficiency Syndrome ◽  
Design And Methods

Objective. To investigate homocysteine ​​levels in pregnant women with chronic hypertension in different terms of pregnancy, and to evaluate the prognostic significance of hyperhomocysteinemia in the development of preeclampsia, placental insufficiency syndrome and fetal growth retardation. Design and methods. It is a cohort prospective study. Pregnant women were divided into 2 groups: group 1 was formed by women with chronic hypertension (n = 80), group 2 consisted of 40 women without hypertension. Results. Pregnant women with chronic hypertension had higher homocysteine ​​levels throughout the pregnancy compared to those without hypertension. Homocysteine ​​level was higher in pregnancy complicated by preeclampsia, placental insufficiency and fetal growth retardation syndrome. Conclusion. Homocysteine ​​levels above 5,8 mmol/l in the III trimester of pregnancy may be used as a prognostic risk factor for preeclampsia development.

Clinical significance of predictive and diagnostic indices of fetal pathology associated with placental insufficiency in women with endometriosis

2021 ◽  
Vol 70 (5) ◽  
pp. 37-48
Author(s):  
Igor S. Lipatov ◽  
Yury V. Tezikov ◽  
Mikhail S. Amosov
Keyword(s):  
Pregnant Women ◽  
Growth Retardation ◽  
Pregnancy Complications ◽  
Placental Insufficiency ◽  
Information Value ◽  
Placental Alkaline Phosphatase ◽  
Fetal Hypoxia ◽  
Ovarian Endometriosis ◽  
Group I ◽  
Fetal Pathology

BACKGROUND: Modern achievements of pharmacology, surgery and reproductive medicine have determined an increase in the implementation of reproductive function in endometriosis of various localization. The onset of pregnancy in presence of impaired endometrial receptivity and progesterone resistance, pro-inflammatory and pro-thrombotic status, abnormal functioning of the immune system, structural changes in the reproductive organs leads to impaired formation of the embryo (feto) placental system, early reproductive losses, complicated pregnancy and adverse perinatal outcomes. In this regard, the endometriosis and pregnancy issue requires close study and specific proposals to optimize pregnancy management. AIM: The aim of this study was to develop predictive (PIs) and diagnostic (DIs) indices of placenta-associated fetal pathology in pregnant women with endometriosis, to determine their prognostically and diagnostically significant parameters. MATERIALS AND METHODS: This prospective study in the dynamics of gestation included a comprehensive clinical and laboratory examination of 175 pregnant women with endometriosis (100 subjects with adenomyosis and 75 subjects with ovarian endometriosis). To develop PIs and DIs, two comparison groups with fetal pathology due to placental insufficiency were retrospectively identified, depending on the location of endometriosis. Group I consisted of 49 pregnant women with adenomyosis and placental insufficiency isolated from other pregnancy complications, accompanied by growth retardation and/or chronic fetal hypoxia; Group II comprised 29 pregnant women with ovarian endometriosis and placental insufficiency isolated from other pregnancy complications, accompanied by growth retardation and/or chronic fetal hypoxia. The control group (Group III) included 30 healthy pregnant women with a normal course of gestation. The examination was performed at 10-14 weeks, 20-24 weeks, and 28-34 weeks of gestation and included an assessment of placental insufficiency markers such as placental growth factor (PlGF), placental -1-microglobulin (PAMG-1), tumor necrosis factor (TNF), lymphocytes with membrane receptor FasR (L CD95+), C-reactive protein, placental alkaline phosphatase (PAPh), and fetal hemoglobin (HbF). The information value of individual parameters and indices was determined by ROC analysis, odds ratio, and clinical epidemiology tests. RESULTS: Pregnancy in presence of endometriosis in 100% of cases was complicated by placental insufficiency of varying severity (with fetal pathology in 81.5% of cases), the frequency of which had statistically significant differences between the groups of pregnant women with adenomyosis and ovarian endometriosis (2 = 4.06, p = 0.04). To predict growth retardation and / or chronic fetal hypoxia, we have developed PI I (PlGF / TNF 100) and PI II (PAMG-1 / PlGF 100), which characterize the state of placental angio-and vasculogenesis depending on systemic inflammatory response level. For early diagnosis of fetal pathology, we have proposed DI I (CRP / PAPh 100), DI II (HbF / PlGF 100) and DI III (L CD95+ / PAPh 100), which allow for diagnosing placental alterations with impaired placental energy supply due to an increase in inflammatory status. Evaluation of prognostic and diagnostic significance of PIs and DIs showed that the most informative tools are PI I (Se = 86.1%, Sp = 80.5%) and DI I (Se = 88.3%, Sp = 83.7%). CONCLUSIONS: The use of PIs allows for risk stratification of pregnant women from the 1st trimester of gestation to address the issue of the prevention method. The clinical capabilities of DIs optimize obstetric tactics for the timely prescription of therapy for placental insufficiency and targeted diagnosis of fetal pathology. Pregnant women with endometriosis should be classified as a high perinatal risk group, and therefore the proposed PIs and DIs should be included in the dynamic examination complex.

Assessment of risk factors for fetal growth retardation

2020 ◽  
pp. 50-53
Author(s):  
Kh. Alirzayeva ◽  
Keyword(s):  
Risk Factors ◽  
Body Weight ◽  
Arterial Hypertension ◽  
Pregnant Women ◽  
Fetal Growth ◽  
Gestational Age ◽  
Growth Retardation ◽  
Deficiency Anemia ◽  
Fetal Growth Retardation ◽  
History Of

The objective: to determine the risk factors for the development of ESRD in pregnant women with preeclampsia and anemia. Materials and methods. 97 pregnant women with preeclampsia with iron-deficiency anemia were monitored. The first group included 46 pregnant women with diagnosed ZRD, the second group-51 pregnant women who gave birth to children with normal body weight. Criteria of FGR is to reduce body weight and length of newborn at birth (less than 10 percentile of assessment tables in comparison with due to gestational age), morphological maturity index (a lag of 2 weeks or more from the true gestational age), disproportionate body, the signs of malnutrition and trophic disorders of the skin and mucous membranes. Results. A step-by-step elimination of the factors that contributed the least to the development of ARI in a combination of preeclampsia and anemia was performed. The results of multivariate analysis showed that in General, the following factors had the strongest influence on the development of RR in preeclampsia and anemia: arterial hypertension (RR= 2.055 [95% CI 1.31-3.20]), overweight/obesity (RR=1.646 [95% CI 1.03-2.62]), anemia in the anamnesis (RR=2.591[95% CI 1.56-4.28]),complicated labor in the anamnesis (RR=1.886 [95% CI 1.29-2.74]), habitual miscarriage (RR=1.850 [95% CI 1.21-2.82]), a history of preeclampsia (RR= 1.922 [95% CI 1.31-2.80]), a history of RR (RR=3.502 [CI 2.37-5.16]). Conclusions. The most significant clinical and anamnestic risk factors for the development of RRT are: arterial hypertension, overweight/obesity, anemia in the anamnesis, pre-eclampsia in the anamnesis, complicated labor in the anamnesis, habitual miscarriage, RRT in the anamnesis. Keywords: pregnancy, preeclampsia, anemia, fetal growth retardation, risk factors.

scholarly journals Blood pressure variability in pregnant women with risk factors of preeclempsia

2019 ◽  
Vol 100 (3) ◽  
pp. 426-433 ◽  
Author(s):  
S D Mayanskaya ◽  
A V Ganeeva ◽  
R I Gabidullina
Keyword(s):  
Blood Pressure ◽  
Pregnant Women ◽  
Fetal Growth ◽  
Growth Retardation ◽  
Blood Pressure Variability ◽  
Placental Insufficiency ◽  
Fetal Growth Retardation ◽  
Second Trimester ◽  
Short Term

Aim. To assess the short-term and long-term variability of blood pressure in women, starting from early pregnancy, to predict the development of complications of gestation, including preeclempsia. Methods. In 131 pregnant women, systolic blood pressure, diastolic blood pressure, as well as short-term (intra-visit) and long-term (inter-visit) blood pressure variability were assessed during the gestation period and 6 weeks after delivery. At the end of gestation period, depending on the identified complications, all study participants were divided into four groups: group 1 - control (healthy); group 2 - pregnant with preeclempsia; group 3 - with placental insufficiency; group 4 - with chronic arterial hypertension. In patients with placental insufficiency the indices of fetal growth retardation were also analyzed. Results. In group 4, starting from the second trimester, higher values of short-term blood pressure variability were demonstrated, which increased as pregnancy progressed. Long-term blood pressure variability increased in groups 2 and 4, starting from the second trimester. In pregnant women with fetal growth retardation in the first trimester, blood pressure variability was higher than in pregnant controls and in the second trimester it was higher than in the group with the subsequent development of preeclempsia. Thus, during pregnancy complicated by preeclempsia or placental insufficiency with fetal growth retardation, high long-term blood pressure variability was observed. At the same time, the highest values were observed in the third trimester. Conclusion. The assessment of long-term blood pressure variability from the early gestation seems to be an effective tool for detecting preclinical changes in the body of a pregnant woman, preceding the development of preeclempsia and fetal growth retardation, and in the presence of risk factors of preeclampsia allows narrowing the group of patients for target follow-up and prevention.

scholarly journals Features of prevention of fetal growth retardation in pregnant women with chronic hypertension

2019 ◽  
pp. 44-48
Author(s):  
O. V. Deinichenko ◽  
Yu. Ya. Krut ◽  
N. G. Izbytska ◽  
O. M. Slinko ◽  
N. V. Gaidai ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Acetylsalicylic Acid ◽  
Pregnant Women ◽  
Fetal Growth ◽  
Growth Retardation ◽  
Chronic Hypertension ◽  
Fetal Growth Retardation ◽  
Clinical Protocols ◽  
Group A ◽  
Group B

The lack of effective methods to prevent the development of fetal growth retardation in high-risk pregnant women remains a significant problem of modern obstetrics, which determines the relevance of the study. The aim of the study was to examine the effectiveness of monoprophylaxis of fetal growth retardation using aspirin at a dose of 150 mg, starting at 12-13 weeks of gestation, pregnant women with chronic hypertension. In order to apply and implement the proposed prevention of fetal growth retardation, all pregnant women with chronic hypertension were divided into two groups. The patients were divided into groups randomly. To prevent the development of fetal growth retardation, patients in group A received acetylsalicylic acid at 150 mg/day, patients in group B received acetylsalicylic acid at 100 mg/day. Primary examination of pregnant women in a prospective study was performed during pregnancy 11-12 weeks in all groups, which included: history taking, general clinical examination, blood pressure measurement, obstetric and gynecological examination according to clinical protocols of the Ministry of Health of Ukraine № 417 from 15.07.2011, № 676 dated 31.12.2004. Clinical and instrumental examination was performed: blood pressure and ECG monitoring, Doppler examination. Childbirth and initial assessment of the condition of newborns were performed in accordance with the current orders of the Ministry of Health of Ukraine with the assessment of the condition on the Apgar scale and the result of anthropometry (determination of mass and growth rate). It was found that the age characteristics of the group of pregnant women did not differ statistically significantly: the average age of patients in group A reached 27.3±1.6 years, group B – 28.1±1.8 years. According to the obstetric and gynecological history, the women did not differ. It should be noted that statistically significant differences between the main group and the comparison group by the degree of chronic hypertension (grade 1 and 2) were not detected: 30 % of women in group A and 35 % of group B had chronic hypertension grade 1, 70 % and 65 %, respectively – chronic arterial hypertension of 2 degrees. Among the concomitant lesions in pregnant women were determined: obesity 8 women of group A (26.7 %), 8 people (25.8 %) of group B; varicose veins in 3 women (10.0 %) of group A, 4 people (12.9 %) of group B; pathology of the urinary system – in 2 cases (6.6 %) in group A and in 2 people (6.45 %) of group B; pathology of the thyroid gland – 2 women (6.6 %) of group A, and 1 person (3.22 %) of group B, anemia of pregnant women – in 4 women (13.3 %) of group A, and 4 people (12.9 %) of group B; chronic viral hepatitis C in remission in 1 woman of group B (3.22 %). As a result of the analysis of pregnancies and complications of childbirth, we found that the appointment of acetylsalicylic acid in addition to standard treatment of chronic arterial hypertension in accordance with clinical protocols at a dose of 150 mg/day helped reduce the incidence of disorders of uteroplacental and fetal circulation by 2.7 times, fetal growth retardation – by 8,8 times and small to gestational age fetus – 4.8 times compared with the results of patients who received acetylsalicylic acid at a dose of 100 mg/day.

Fetal growth retardation and hemorheological predictors of oxygen delivery in hypertensive vs normotensive pregnant women

2019 ◽  
Vol 71 (4) ◽  
pp. 387-396
Author(s):  
Jean-Frédéric Brun ◽  
Emmanuelle Varlet-Marie ◽  
Pierre Boulot ◽  
Bénédicte Marion ◽  
Céline Roques ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Fetal Growth ◽  
Growth Retardation ◽  
Oxygen Delivery ◽  
Fetal Growth Retardation

scholarly journals Antiphospholipid antibodies, genetic thrombophilia and fetal growth retardation

2022 ◽  
Vol 15 (6) ◽  
pp. 695-704
Author(s):  
E. A. Orudzhova
Keyword(s):  
Pregnant Women ◽  
Fetal Growth ◽  
Growth Retardation ◽  
Antiphospholipid Antibodies ◽  
Controlled Trial ◽  
Factor V Leiden ◽  
Control Group ◽  
Fetal Growth Retardation ◽  
Group 2 ◽  
Group 1

Aim: to study the role of antiphospholipid antibodies (AРA) and genetic thrombophilia as a potential cause of the development or a component in the pathogenesis of early and late fetal growth retardation (FGR).Materials and Methods. There was conducted a prospective randomized controlled trial with 118 women enrolled. The main group consisted of 83 patients, whose pregnancy was complicated by FGR degrees II and III, stratified into two groups: group 1 – 36 pregnant women with early FGR, group 2 – 47 pregnant women with late FGR. Women were subdivided into subgroups according to the FGR severity. The control group consisted of 35 pregnant women with a physiological course of pregnancy. АРА were determined according to the Sydney antiphospholipid syndrome criteria by enzyme immunoassay (ELISA): against cardiolipin, β2 -glycoprotein 1, annexin V, prothrombin, etc. (IgG/IgM isotypes); lupus anticoagulant – by the three-stage method with Russell's viper venom; antithrombin III and protein C levels – by chromogenic method; prothrombin gene polymorphisms G20210A and factor V Leiden – by polymerase chain reaction; homocysteine level – by ELISA.Results. AРA circulation (medium and high titers), genetic thrombophilic defects and/or hyperhomocysteinemia were detected in 40 (48.2 %) patients with FGR, which was significantly higher than that in the control group (p < 0.05): in group 1 (41.7 % of women) AРA (30.6 %) and AРA with genetic thrombophilia or hyperhomocysteinemia (11.1 %) were revealed; in group 2 (51.1 % of women) AРA (21.3 %), AРA with hyperhomocysteinemia (4.3 %), genetic thrombophilia (25.5 %), and due to hyperhomocysteinemia (2.1 %) were found. No differences in prevalence of thrombophilia rate in patients were observed related to FGR severity, but a correlation between the FGR severity and AРA titers was found.Conclusion. Testing for the presence of AРA, genetic thrombophilia and hyperhomocysteinemia should be recommended for patients with FGR (including those with FGR in medical history), especially in the case of its early onset. It is recommended to determine the full AРA spectrum.

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