scholarly journals FEATURES OF THE COURSE OF MULTIPLE PREGNANCY AGAINST THE BACKGROUND OF FETAL GROWTH RETARDATION

2020 ◽  
Vol 8 (4) ◽  
pp. 433-438
Author(s):  
A.B. Sukharev ◽  
T.V. Kopytsia ◽  
V.I. Boyko
Keyword(s):  
Pregnant Women ◽  
Fetal Growth ◽  
Multiple Pregnancy ◽  
Placental Insufficiency ◽  
Multiple Births ◽  
Growth Delay ◽  
Control Group ◽  
Multiple Pregnancies ◽  
Group I

In most European countries in recent years, the frequency of multiple births ranges from 11 to 14 per 1000. These pregnancies have a high number of complications. Perinatal mortality in multiple births is more than 6 times higher than in singleton pregnancies. Severe neurological abnormalities under the age of 1 year have from 10% to 25% of twins. According to most researchers, the main cause of perinatal losses in multiple births is deep prematurity and severe fetal growth delay. It has now been proven that placental insufficiency is the main reason of developmental delay, discordant fetal growth, antenatal death of one of the fetuses. A fetus that develops and is born in conditions of chronic placental insufficiency is more vulnerable and at high risk of developing perinatal pathology. The purpose of the research was to study the frequency and structure of complications of the pregnancy and labor of women with multiple pregnancies, complicated uteroplacental insufficiency and fetal discordance. The study was carried out at the city clinical maternity house during 2013–2019. The information was gathered from literature and by interviewing pregnant women with twins. 20 pregnant women (group I) with dichorionic, diamnionic twins with the presence of placental insufficiency and fetal discordance of more than 20%. Group II consisted of 20 pregnant women with twins but fetal discordance did not exceed 20%. However, the control group ІІІ consisted of 30 women without complications and ended in physiological labor. The general, somatic, obstetric and gynecological anamnesis, especially the course of pregnancy, childbirth, the state of the cervix by vaginal and ultrasound examination were studied. The results of the study show that in the anamnesis of pregnant women with fetal discordance, take place in vitro fertilization and infections of the respiratory and urinary tract. Multiple pregnancies which were accompanied by fetal discordance exceeding 20% ​​is accompanied by impaired uteroplacental circulation. Labor with twins complicated by impaired uteroplacental circulation occurs in a large number of complications. The results can be applied to the using various medications for the correction of disorders of the uteroplacental circulation.

scholarly journals Perinatal outcomes of multiple births conceived through in vitro fertilization compared with spontaneous multiple births

2018 ◽  
Vol 51 ◽  
pp. 02008
Author(s):  
Irisa Zile ◽  
Inga Jefremova ◽  
Iveta Gavare
Keyword(s):  
In Vitro Fertilization ◽  
Congenital Anomalies ◽  
Perinatal Outcomes ◽  
Perinatal Period ◽  
Population Based ◽  
Multiple Births ◽  
Control Group ◽  
Multiple Pregnancies ◽  
Vitro Fertilization

Pregnancies that occur after assisted reproduction procedures constitute high-risk pregnancies. There is a lack of sufficient epidemio-logically based data on this issue in Latvia. The aim of this study was to compare the maternal and perinatal outcomes of multiple pregnancies conceived by in vitro fertilization (IVF) in comparison with spontaneous multiple pregnancies. This retrospective cohort study (2007–2014) analysed data from population-based Medical Birth Register (MBR). There is a statistically significant increase of multiple births from IVF pregnancies – an average 2% per year (p< 0.01). Newborns of IVF multiple births have higher odds of low birth weight (OR = 1.2) and congenital anomalies (OR = 1.6). Maternity characteristics showed that mothers in the IVF group were significantly older than those in the control group (≥35 years) (OR = 2.1) and primipara births (OR = 4.1). Multiple births conceived by IVF have similar outcomes as spontaneously conceived multiples in the perinatal period, although the rates of congenital anomalies after IVF are just slightly higher than in control group.

Prevention and treatment of iron deficiency anemia in multiple pregnancy

2020 ◽  
pp. 51-56
Author(s):  
T.G. Romanenko ◽  
◽  
O.V. Morozova ◽  
O.M. Sulimenko ◽  
◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Pregnant Women ◽  
Iron Deficiency Anemia ◽  
Multiple Pregnancy ◽  
Erythrocyte Membranes ◽  
Deficiency Anemia ◽  
Multiple Pregnancies ◽  
Group I ◽  
Group Ii

The objective: to reduce the frequency and severity of iron deficiency anemia (IDA) in multiple pregnancies by optimizing its prevention, treatment and proving the effectiveness and safety of the therapy. Materials and methods. 90 pregnant women were under observation. The control group (CG) consisted of 30 pregnant women with one fetus, group I – 30 women with multiple pregnancies who did not use the recommended therapy, group II – 30 women with multiple pregnancies, conducted according to our proposed method. The effectiveness of therapy was evaluated weekly by subjective evaluation of improvement and according to laboratory parameters of peripheral blood. General clinical methods included clinical, general blood analysis and determination of serum iron, quantitative determination of the concentration of sulfhydryl groups and lipoproteins in erythrocyte elements of peripheral blood, studied the surface architecture of erythrocyte membranes. Results. There was a significant reduction in the frequency and severity of IDA in pregnant women of group II in 1.6 times.Diagnosed with a significant increase in the number of discocytes (group I 67.340.81; group II 84.531.04; p<0.05), a decrease in the number of ellipses (group I 0.990.05; group II 0.600.05; p<0.05); flat disks (group I 0.870.07; group II 0.560.03; p<0.05); dome-shaped (I group 2.410.14; ІІ group 1.820,11; р<0.05) and spherical erythrocytes (І group 4.110.12; ІІ group 2.440, 13; p<0.05). Significant decrease in the number of transitional forms (group I 3.410.31%; group II 2.530.21; p<0.05); pre hemolytic (I group 2.410.14%; ІІ group 1.440.11%; р<0.05) and degenerative forms (І group 1.180.14%; ІІ group 0.520.03; p<0.05), as well as the ratio of the inner and outer diameters of erythrocytes (group I 66.710.91; group II 45.810.63; p<0.05). There was a significant increase in the ratio of sulfhydryl groups and lipoproteins in erythrocyte membranes. Conclusions. The complex composition of the drug Fersinol and Fersinol-Z, taking into account the effective antianemic action, can be considered optimal for the prevention and treatment of iron deficiency in multiple pregnancies and recommended for use in practical health care. Keywords: multiple pregnancy, iron deficiency anemia, prevention, treatment, Fersinol ampoules, Fersinol-Z capsules.

Arginine and аrginase levels in the blood serum of pregnant women with intrauterine growth retardation

2016 ◽  
pp. 97-99
Author(s):  
A.V. Basystyi ◽  
Keyword(s):  
Blood Serum ◽  
Pregnant Women ◽  
Fetal Growth ◽  
Growth Retardation ◽  
Intrauterine Growth Retardation ◽  
Main Group ◽  
Control Group ◽  
Fetal Growth Retardation ◽  
Intrauterine Growth ◽  
Group I

The objective: to determine arginine and arginase levels in the blood serum of pregnant women with intrauterine growth retardation of different severity. Patients and methods. The study included 100 pregnant women (from 23 to 40 weeks of gestation). The main group consisted of 80 pregnant women with intrauterine growth retardation. The control group consisted of 20 women with physiological course of pregnancy. The patients of the main group were divided into three clinical groups regarding intrauterine growth retardation staging. Group I included 38 pregnant women with stage I IUGR, 22 pregnant women with stage II IUGR were in group II and 20 pregnant women with stage III IUGR – in group III. L-arginine concentration was determined in the blood serum by the method of T.L. Aleinikova et al [1], arginase activity – by the method of J.W. Geyer, D. Dabich [4]. The statistical analysis was performed by using standard computer programs: STATISTICA 6.0, Microsoft Excel, ANOVA. Statistically significant difference was considered at p<0.05. Results. In the study the reduced level of free arginine in the main group of pregnant women with intrauterine growth retardation of different severity was determined if compared with the control group. Fetomaternal gradient of arginine is reduced significantly due to increasing activity of the enzyme arginase, which competitively uses amino acid. Conclusions. The level of reduced free arginine in the blood serum of pregnant women with intrauterine growth retardation is directly proportional to the severity of fetal growth retardation: the more severe fetal growth retardation, the more marked arginine deficiency. For correcting metabolic disorders in pregnant women with intrauterine growth retardation it is recommended to administer L-arginine containing drugs. Key words: L-arginin, arginase, blood serum, pregnant women with intrauterine growth retardation.

Opting for Twins in In Vitro Fertilization

2016 ◽  
Author(s):  
Bonnie Steinbock
Keyword(s):  
Learning Disabilities ◽  
Multiple Pregnancy ◽  
Reproductive Technology ◽  
Multiple Births ◽  
Fertility Treatment ◽  
Ethical Question ◽  
Multiple Pregnancies ◽  
Vitro Fertilization ◽  
Twin Pregnancies

Multiple births are an unfortunate consequence of assisted reproductive technology, causing risks to both fetuses and pregnant women. The central ethical issue raised by multiple pregnancy is the conflict between the fertility patient’s desire to get pregnant and the increased risks to offspring. Although extreme cases in which many embryos are transferred to the woman’s uterus are very rare—and represent negligence—twin pregnancies are still common. Many women undergoing fertility treatment reportedly express a preference for twin pregnancies to reduce the costs and risks of the procedure while increasing their opportunities for having more than one child. However, risks to the offspring are significant and underappreciated, including prematurity, low birth weight, cerebral palsy, and learning disabilities. Even though many multiple pregnancies result in good outcomes, the ethical question is whether the risks are justifiable in order to improve the chances of pregnancy when transfer of a singleton embryo is an available alternative.

scholarly journals Fetoplacental Angiogenesis in Preeclampsia. Clinical and Morphological Aspects

2020 ◽  
Vol 16 (28) ◽  
pp. 6-11
Author(s):  
N.Yu. Sakvarelidze ◽  
S.G. Tsakhilovа ◽  
V.S. Muradova ◽  
N.V. Zharkov ◽  
A.S. Zikova ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Structural Changes ◽  
Perinatal Outcomes ◽  
Placental Insufficiency ◽  
Trophoblast Invasion ◽  
Morphometric Study ◽  
Control Group ◽  
Singleton Pregnancy ◽  
Placental Angiogenesis ◽  
Group I

Purpose. To study placental angiogenesis in pregnant women with preeclampsia (PE), based on a comparison of the results of a clinical examination and a morphometric study of sequins with this pathology. Material and methods. In the present work, we studied 30 pregnant women with PE, whose average age was 29 ± 1.4 years. The pregnant women were divided into two groups. Group I (n = 21) consisted of pregnant women with PE, among whom 10 patients were within 34 weeks of gestation, and 11 – at 34–39 weeks. Group II (n = 9) – control group, with physiological pregnancy. The inclusion criteria were: singleton pregnancy, the presence of preeclampsia according to the ICD-10 classification, the patient's voluntary informed consent to the study. Exclusion criteria: extragenital pathology, multiple births, congenital malformations of the fetus. There were no significant differences in somatic and gynecological status among pregnant women in the surveyed groups. Results. Vascular endothelial growth factor (VEGF) and its receptors, VEGF R1 and VEGF R2, are of priority importance in the development of placental angiogenesis. The balance of interaction between VEGF and R1 and R2 receptors leads to adequate vascularization of the villi in the early stages of trophoblast invasion into the spiral arteries of the uterus. Conclusion. As a result of the morphological study, it can be assumed that hemodynamic parameters according to Doppler and angioarchitectonics of the placentas are an important factor in the pathogenesis of placental insufficiency and fetal growth retardation. In the absence of disturbances in uteroplacental-fetal hemodynamics, endothelial dysfunction should be considered as compensated, in which favorable perinatal outcomes are expected. Structural changes in the fetoplacental complex with impaired blood flow in the uterine arteries and umbilical cord arteries in PE are regarded as subcompensated and decompensated forms of placental insufficiency

scholarly journals Peculiarities of circulation of interleukins of different classes in multiple pregnancy depending on the method of fertilization and the term of gestation

2021 ◽  
Vol 1 ◽  
pp. 44-48
Author(s):  
I.V. Poladich ◽  
S.O.  Avramenko ◽  
O.B.  Malanchuk ◽  
O.Yu.  Kostenko
Keyword(s):  
Multiple Pregnancy ◽  
Multiple Births ◽  
Control Group ◽  
Perinatal Morbidity ◽  
Multiple Pregnancies ◽  
Prevention And Treatment ◽  
Recommended Therapy ◽  
Cytokine Imbalance ◽  
Micronized Progesterone ◽  
Pro Inflammatory Cytokines

The article is devoted to the detection of interleukin circulation of different classes in women with multiple pregnancies depending on the method of fertilization and gestational age.The study found that the concentration of pro-inflammatory cytokines IL-1 (126.8 pg/mg) and IL-8 (176.4 pg/mg), determined in the 22nd week of pregnancy in the serum of patients with multiple pregnancies due to using ART, probably exceeded the control group (48.7 and 39.3 pg/mg) and spontaneous multiple pregnancy (49.3 and 40.6 pg/mg). Concentrations of cervical IL-1 and IL-8 were also elevated in pregnant women receiving ART compared with women with spontaneous multiple births and controls. These changes were observed in the dynamics of pregnancy. Under the influence of our recommended therapy, there was a gradual decrease in IL-1 and IL-8, which no longer differed from those of women with spontaneous multiple pregnancies and the control group. Administration of natural micronized progesterone for immunosuppression (normalization of the cytokine profile) to patients with multiple pregnancies due to the use of ART, reduced the incidence of preterm birth (from 83.3 to 43.7%), weakness of labor (33.3 and 21.9%, respectively), PRPO (22.2 and 12.5%, respectively), to reduce perinatal morbidity from 45.5 to 19.7% and mortality from 43.1 to 9.5%, which was not detected in patients with spontaneous fertility.Determining the features of cytokine imbalance in women with multiple pregnancies depending on the method of fertilization provides new approaches to the prevention and treatment of miscarriage, which will benefit mothers in different clinical situations.

scholarly journals Changes of the sleep in pregnant women with intrauterine fetal growth restriction

2018 ◽  
Vol 22 (1) ◽  
pp. 160-162
Author(s):  
A.M. Berbets
Keyword(s):  
Pregnant Women ◽  
Sleep Disorders ◽  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Intrauterine Growth Restriction ◽  
Placental Insufficiency ◽  
Growth Restriction ◽  
Control Group ◽  
Intrauterine Growth ◽  
Intrauterine Fetal Growth Restriction

Objective – to study the reasons of appearance, terms of manifestation and types of the sleep disorders in pregnant women with intrauterine growth restriction of fetus. 80 pregnant women with placental insufficiency, manifesting as intrauterine fetal growth restriction (IUGR) of II–III degree in the 3rd pregnancy trimester (study group) and 30 women with normal clinical flow of pregnancy (control group) were questioned. They were asked about pregnancy term when the complains of the sleep disorders were firstly expressed, as well as about types of the sleep disorders and their frequency (in times per week). Questioning showed that pregnant women with IUGR in 86% cases experience the sleep disorders starting from pregnancy term 12–22 weeks (healthy pregnant women — mostly after 30 weeks, 57% cases), more commonly wake up 2 or more times per night (71% of positive answers, in control group – 23%), and 3 or more times per week (78% of positive answers, in control group – 17%). Thus, sleep disorders in pregnant women with IUGR appear earlier and seem to be more expressed then in pregnant women with normal fetal growth. Expression of the complains of insomnia, in our opinion, might be considered as an early diagnostic sign of forming of placental insufficiency, which is later realized as IUGR.

scholarly journals Significance of pregnancy-associated plasma protein a (PAPP-a) concentration determination in the assessment of final outcome of pregnancy

2013 ◽  
Vol 70 (1) ◽  
pp. 46-50 ◽  
Author(s):  
Dragan Loncar ◽  
Mirjana Varjacic ◽  
Slobodan Arsenijevic
Keyword(s):  
Pregnant Women ◽  
Fetal Growth ◽  
Plasma Protein ◽  
Gestational Age ◽  
Fetal Growth Restriction ◽  
Protein A ◽  
Growth Restriction ◽  
Control Group ◽  
Group I ◽  
Significant Difference

Background/Aim. Pregnancy-associated plasma protein A (PAPP-A) is high molecular matrix metalloproteinase originally isolated in the serum of pregnant women. The aim of this study was to analyze the values of concentration of PAPP-A in assessment of progress and outcome of pregnancy in pregnant women diagnosed with threatening preterm delivery, preeclampsia and fetal growth restriction in relation to physiological pregnancy of the same gestational age. Methods. The study included 60 pregnant women that were divided into three groups according to gestational age and the diagnosis of imminent premature birth upon reception, preeclampsia and fetal growth restriction as follows: the group I from 28 to 32 weeks of gestation, a total of 25 pregnant women, the group II from 33 to 36 weeks of gestation, a total of 23 pregnant women, and the group III from 37 to 41 weeks of gestation, a total of 12 pregnant women. The control group consisted of 60 pregnant women without complications of pregnancy that were identically divided into three groups according to gestational age as in the sample. We performed quantitative determination of PAPP-A from the venous blood of patients by using commercial tests of the company Diagnostics Product Corporation (DPC), Los Angeles, California, USA. Results. There was a statistically significant difference in PAPP-A values in the examined groups in all gestational ages (p < 0.01). The value of the PAPP-A concentration in different gestational ages with equal statistical significance indicated the possibility of complications, which was examined during pregnancy in relation to the control group of pregnant women with physiological pregnancies. This study confirmed that there was a statistically significant difference in fetal body weight at birth (p < 0.05), Apgar score in 5 min after birth (p < 0.05), and gestational age at birth (p < 0.05), as parameters of the outcome of pregnancy course, between the examined groups of pregnant women in relation to the value of PAPP-A concentration. The age of pregnant women was not statistically different in the examined groups (p > 0.05). Conclusion. Differences in PAPP-A concentration should point out to the obstetrician the need for more intensive antepartum fetal surveillance in order to increase the chances of favorable perinatal outcome, regardless gestational age.

Anamnestic factors that shape reproductive health of women with repeated unsuccessful popygamy in vitro fertilization

2016 ◽  
pp. 140-143
Author(s):  
N.V. Cotsabin ◽  
◽  
O.M. Makarchuk ◽  
Keyword(s):  
High Risk ◽  
Risk Group ◽  
Polycystic Ovary ◽  
High Risk Group ◽  
Stress Factors ◽  
Control Group ◽  
Fertilization In Vitro ◽  
Infertile Women ◽  
Group I

The proportion of patients with multiple unsuccessful attempts of assisted reproductive technology (ART) is about 30% of all patients treated with the use of ART. Women with history of unsuccessful ART attempts - a special category of patients who require emergency attention and a thorough examination at the stage of preparation for superovulation stimulation,the selection of embryos and endometrium preparation for embryo transfer. The objective: to distinguish high-risk group of unsuccessful attempts based on a detailed analysis of anamnestic and clinical data of infertile women with repeated unsuccessful ART attempts that requires more in-depth study of hormonal features, ovarian reserve and condition of the endometrium. Materials and methods. For better understanding of the problem of repeated unsuccessful ART attempts and сreation of efficient infertility treatment algorithms for these couples we conducted a thorough analysis of anamnestic data of three groups of infertile women (105 patients), which were distributed by age: group I – younger than 35, the II group – from 35 to 40, the III group - over 40 years. These groups of patients were compared with each other and with the control group of healthy women (30 persons). Results. Leading stress factors in the percentage three times prevailed in the group of infertile women and had a direct connection with the fact of procedure «fertilization in vitro» and chronic stressors caused by prolonged infertility. Primary infertility was observed significantly more frequent in patients younger than 35 years (p <0.05), secondary infertility - mostly in the second and third experimental groups (p <0.05). Noteworthy significant percentage of wellknown causes of infertility and idiopathic factor in all groups, and the prevalence of tubal-peritoneal factor in the second and third experimental groups, and endocrine dysfunction in the I experimental group. The most common disorder among this category of woman was polycystic ovary syndrome. Frequency of usual miscarriage among patients of I ana II groups was two times higher than in the third group (p <0.05). Among the experimental groups the leading place belongs urinary tract infection, respiratory tract diseases, pathologies of the cardiovascular system. Data of the stratified analysis show an increase likelihood of repeated unsuccessful ART attempts under the influence of constant chronic stress (odds ratio OR=2.06; 95% CI: 0.95–3.17; p<0.05). Conclusions. Among infertile patients with repeated unsuccessful ART attempts must be separated a high risk group of failures. The identity depends on the duration of infertility, female age and leading combination of factors. Key words: repeated unsuccessful ART attempts, anamnesis, infertility, high risk.

scholarly journals Comparative Evaluation of Fracture Resistance of Endodontically Treated Teeth Restored with Resin Fiber Post and Stainless Steel Post: An In Vitro Study

2015 ◽  
Vol 03 (02) ◽  
pp. 080-084
Author(s):  
Vijay Singh ◽  
Poonam Bogra ◽  
Saurabh Gupta ◽  
Navneet Kukreja ◽  
Neha Gupta
Keyword(s):  
Stainless Steel ◽  
Fracture Resistance ◽  
Testing Machine ◽  
Compressive Force ◽  
Control Group ◽  
Fiber Post ◽  
Endodontically Treated Teeth ◽  
Group I ◽  
Significant Difference

AbstractFracture resistance of endodontically treated teeth restored with post. Aims: This study aims to compare the fracture resistance of endodontically treated teeth restored with resin fiber and stainless steel post. Commercially available prefabricated resin fiber post(Dentsply Maillefer Easy Post), prefabricated stainless steel post(Coltene/Whaledent Parapost) were used. Methods and Material: Forty five maxillary central incisors were obturated and divided into 3 groups: Control Group (Group I) without any post (n = 15), Resin Fiber Post Group (Group II) (n = 15) and Stainless Steel Post Group (Group III) (n = 15). In all Groups except control group, post space was prepared; a post was cemented, and a core build-up was provided. All the specimens were subjected to compressive force under a universal testing machine until fracture. Statistical analysis used: The results were analyzed using the variable analysis test (ANOVA). Results: One-way analysis of variance revealed significant difference among test groups. The control group demonstrated highest fracture resistance (925.2183 N), followed by the resin fiber post group (486.7265 N) and stainless steel post group (423.539N). Conclusions: Teeth restored with resin fiber post showed higher fracture resistance values than prefabricated stainless steel post.

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