scholarly journals COMPARATIVE ASPECTS OF PLACENTAL DYSFUNCTION IN WOMEN USING DIFFERENT METHODS OF CONTRACEPTION IN ANAMNESIS

2020 ◽  
Vol 5 ◽  
pp. 34-40
Author(s):  
Oleksandra Lubkovska

The aim. To reduce the incidence of perinatal pathology in women who have used various methods of contraception, based on the study of the functional state of the fetoplacental complex (FPS), as well as improving diagnostic measures and tactics of pregnancy. Materials and methods. 140 pregnant women were studied with their division into control and 3 test groups depending on the method of contraception in the anamnesis, using clinical, laboratory and instrumental research methods during pregnancy and childbirth. Results. The study found that women with a history of intrauterine contraception (IUC), in contrast to combined oral contraception (COC) and combined oral contraception containing folate (COC+F), had a higher incidence of complications during pregnancy and childbirth, as well as fewer newborns with a satisfactory condition at birth. Assessment of folic acid levels at 6-8 weeks of gestation showed significantly better results among women with a history of COC+F, compared with IUC and COC. In the group of women with IUC in the anamnesis, significantly worse mean endocrinological values prevailed, and there was also a greater number of pregnant women with disorders of fetal-placental blood flow. More pronounced dystrophic changes in the placentas of women in this group were pathomorphologically confirmed. Conclusions. The presence in the anamnesis of IUC is accompanied by a high proportion of pregnant women with various pathological conditions and is a risk factor for FPS dysfunction. The use of COC+F in the anamnesis is the best option for women of different risk groups.

2017 ◽  
pp. 96-98
Author(s):  
A.L. Kostiuk ◽  

The objective: to study features of obstetric and perinitalny pathology at women with undifferentiated dysplasia of a connecting tissue. Patients and methods. 100 patients with clinical-laboratory signs of an undifferentiated dysplasia of connecting tissue are surveyed. On the basis of the received results of the patient were divided into two groups: the main – 50 women (expression of і6 points) whom regarded as patients with the expressed undifferentiated dysplasia of connecting tissue, and group of comparison – 50 women (expression <6 points) whom regarded as patients without the expressed undifferentiated dysplasia of connecting tissue. Results. Results of the conducted researches testify to the high frequency of obstetric and perinatal pathology at pregnant women with clinical-laboratory and functional signs of an undifferentiated dysplasia of connecting tissue. Conclusion. The received results are the basis for algorithm improvement the diagnostical and treatment-and-prophylactic actions at women with an undifferentiated dysplasia of connecting tissue. Key words: undifferentiated dysplasia of connecting tissue, obstetric and perinatal pathology.


2017 ◽  
pp. 71-73
Author(s):  
N.Yu. Bysaha ◽  

The objective: study of hormonal status in pregnant women with benign cervical pathology (CP) in anamnesis. Patients and methods. Clinical and statistical analysis of the hormonal status of 100 women with a history of benign CP pathology has been performed. According to the revealed symptoms of CP during colposcopic examination, women were divided into two groups: 100 pregnant women, in whom colposcopic and cytologically signs of CP pathology were not detected, were included in the control group; and 100 women who had a pathology of CP, entered the main group. Results. The study examined hormonal relationships in the system mother–placenta–fetus, namely the level of hormones such as estriol, progesterone, human chorionic gonadotropin, placental lactogen. Hormonal changes in pregnant women and contribute to reducing the immunoreactivity unwanted stimulation of existing benign hyperplastic background processes in the cervix. Conclusion. Determining functional state placenta is an important factor in the timely diagnosis of disorders in the functioning of the system mother–placenta–fetus. Key words: hormonal status, placenta, uterine cervix, fetoplacental complex.


2018 ◽  
pp. 7-79
Author(s):  
S.Yu. Vdovichenko ◽  
◽  
T.D. Fakhrutdinova ◽  

The objective: depression of obstetric and perinatal complications at pregnant women with pathological increase of body weight during pregnancy on the basis of studying of clinical-functional, endocrinologic, metabolic, morphological features of condition of fetoplacental complex and development of advanced algorithm of treatment-and-prophylactic actions. Materials and methods. We conducted examination of 264 patients who consisted on the account concerning pregnancy in female consultations of Kiev. By a method of selection of 178 women were included in retrospective research and 86 – in prospective. The main group was made by 39 pregnant women with whom led individual discussions, control – 142 women, that received traditional references in female consultation. Results. Use of the algorithm improved by us allows to improve obstetric (decrease of frequency of a preeclampsia by 12.3%; anomalies of a patrimonial deyalnost for 8.4%) and perinatal outcomes (depression of level of an asphyxia at a delivery for 9.4% and post-natal adaptation for 7.8%) deliveries of women with an excessive increase of body weight during pregnancy. Conclusion. The received results grant the right to recommend the algorithm improved by us for wide use in practical health care. Key words: obstetric and perinatal pathology, pathological increase of body weight, prophylaxis.


2020 ◽  
Vol 5 ◽  
pp. 5-10
Author(s):  
T. P. Andriichuk ◽  
A. Ya. Senchuk ◽  
V. I. Chermak

The objective: to study the features of pregnancy, childbirth, postpartum period, fetal status and newborns in patients with a history of chronic salpingo-оophoritis.Materials and methods. Conducted a retrospective study of 150 birth histories and neonatal development maps. All patients were divided into two groups. The main group includes 100 patients with chronic salpingo-оophoritis, for which they received anti-inflammatory treatment from 1 to 3 times before pregnancy. The control group included 50 pregnant women who did not suffer from chronic salpingo-оophoritis.Results. Our analysis of pregnancy, childbirth, fetal and neonatal status in women with chronic salpingo-оophoritis indicates that such patients have a complicated obstetric and gynecological and somatic history, which forms an unfavorable basic condition of organs and systems, imperfect adaptation to pregnancy, high risk of failure of adaptive reactions. The result is a violation of the formation and development of the mother-placenta-fetus system and, as a consequence, a high level of complications during pregnancy, childbirth and perinatal pathology.Conclusion. Patients suffering from chronic salpingo-oophoritis should be considered at high risk of possible complications during pregnancy and childbirth. This category of women needs quality preconception training and careful monitoring during pregnancy.


2017 ◽  
pp. 10-15
Author(s):  
I.A. Usevych ◽  
◽  
V.L. Kolesnik ◽  

Psychological problems during pregnancy and childbirth for today is a little studied subject of modern obstetrics. The possibilities for solving psychological problems that arise in cases of emergency obstetric situations are almost not used by Ukrainian specialists through the marriage of knowledge and skills to provide crisis psychological help to obstetric patients. The objective: to determine the level of psychoemotional load in pregnant and parturient women, depending on the category of urgency of cesarean section. Material and methods. The main group of the study was presented: 1 group - pregnant women, who had planned a cesarean section operation according to the ІV category of urgency and who had already had a caesarean section in the anamnesis; ІІ group – pregnant women who planned an operation according to the IV category of urgency and who had no previous caesarean section in their history; ІІІ group – pregnant and parturient women who underwent surgery, respectively, in the I–III category of urgency; Control group – 30 pregnant women in the period of 37–41 weeks of pregnancy. A survey was conducted using the questionnaires of J.Teylor, Ch.Spielberger and SAN-test. Results. On the eve of labor in pregnant women there is an increase in the psychoemotional load, which can be determined using the above questionnaires. There is a direct dependence on the category of urgency of cesarean section and the level of psychoemotional load. Also revealed the correlation dependence of the voltage of the adaptation reserves of the pregnant woman on the presence of a history of caesarean section. Conclusion. Almost 50 percent of pregnant women, in cases of cesarean section, respectively, 1–3 categories of urgency in the preoperative period have the maximum level of psychoemotional load according to the questionnaires used. Pregnant women who have undergone a caesarean section in anamnesis are more adapted and have less psycho-emotional stress than women who have a cesarean section for the first time. Key words: cesarean section, psychoemotional state, pregnancy, childbirth, scale J. Teylor, scale Ch. Spielberger, SAN-test.


2017 ◽  
pp. 54-55
Author(s):  
O.V. Zhovtenko ◽  

The objective: depression of frequency of obstetric and perinatal pathology at women who transferred before pregnancy a conservative myomectomy із on the basis of studying the clinical-ekhografical, hemodynamic, endocrinologic, metabolic and morphological features a condition of fetoplacental complex, and also improvement of algorithm of diagnostic and treatment-and-prophylactic actions. Patients and methods. Features of a clinical course of pregnancy and labors at 266 women with a hysteromyoma (in the anamnesis there was no expeditious treatment), which were divided into two groups depending on the sizes of myomatous knots are studied. Features of a clinical course of pregnancy and labors at 126 women who transferred a conservative myomectomy before pregnancy are studied. Pregnant women were divided into two groups from a technique of the performed operation and tactics of conducting pregnancy. Results. Results of the conducted researches testify to high risk of development of perinatal pathology at women with a hysteromyoma who were operated before pregnancy in volume of a conservative myomectomy. Conclusion. Use of the algorithm of diagnostic and treatment-and-prophylactic actions added with us allows to improve perinatal outcomes of a delivery of women of group of high risk. Key words: hysteromyoma, reconstructive operations, pregnancy, labors.


2017 ◽  
pp. 124-126
Author(s):  
V.I. Boyko ◽  
◽  
O.I. Butenko ◽  

The objective: to reduce the frequency of perinatal complications at pregnant women with a fetus arrest of development the pregnant at prematurely born pregnancy by improvement of the main diagnostic and treatment-and-prophylactic actions. Patients and methods. prospective research was conducted, we surveyed 120 patients, among which 90 pregnant women with syndrome of an arrest of development of a fetus who were divided by method of casual choice into two groups. Results. The use of the proposed treatment and preventive methods in pregnant women with premature birth at FGR allowed to significantly reduce the incidence of threatened abortion and placental dysfunction 1.3 times, genital tract disorders microbiocenosis 1.4 times, premature rupture of membranes by 1.4 times, the severity FGR syndrome 1.6 times, fetal distress is 1.3 times, 1.2 times of the COP, severe asphyxia in 3 times, intra-amniotic infection is 1.5 times, to change the structure of preterm birth (to prevent early preterm birth in 22–28 weeks). The overall incidence of infants in the early neonatal period, these pregnant women was significantly reduced by 1.3 times (p<0.05), but there were no perinatal loss. Conclusion. The received results: when using the technique of complex correction developed by us the dizadaptation of disturbances in fetoplacental complex at women who received algorithm offered by us, all structural mechanisms of adaptation of placenta which allow to keep morphometric and diffuse indicators of vorsine tree at level with firmness compensations that is the most important adaptive agent which allows to support vital activity of fetus turn on and to prevent development of serious degree of delay of its development. Key words: fetus arrest of development, prematurely born pregnancy, diagnostics, prophylaxis.


2019 ◽  
Vol 23 (4) ◽  
pp. 652-658
Author(s):  
A.P. Dnistryanska ◽  
O.S. Musienko ◽  
L.V. Yaremchuk

Annotation. In the structure of causes of maternal mortality, extragenital pathology accounts for 25%. Among them, endocrine pathology is 6%, diabetes accounts for 31.9%. 1% of women of childbearing age suffer from type 1 diabetes, and 2–17% has gestational diabetes (GD). The aim is to compare the condition of the fetoplacental complex in the third trimester of pregnancy in 9 pregnant women with type 1 diabetes (group 1) and in 12 women with GD (group 2) who were observed at “Vinnitsa City Clinical Hospital and child” for 2016–2019. The control group included 10 patients with physiological pregnancy. Women with diabetes had a history of gynecological diseases: colpitis (8 patients (88.8%)), cervical erosion (2 (22.2%)), chronic adnexitis (5 (55.5%)). Among the complications of previous pregnancies in the group of patients with diabetes mellitus (5 births) were unauthorized miscarriages (1 (11.1%)), the risk of termination of pregnancy (5 (55%)). In women with a history of GD, colpitis was observed in 3 (24.9%), which is significantly less than in women with type 1 diabetes. There were 2 pregnant women with GD: preterm births (16.6%). Among the complications of pregnancy in 1 patient was the threat of abortion in previous cases. Changes in the indexes of hemodynamics of the uterine-placental complex were evaluated on the basis of cardiotocography, ultrasound on ultrasound machine “Logic-5” with 2D measurement, Doppler, evaluation of the biophysical profile of the fetus (BPF). Statistical data processing was performed by calculating Student coefficients (+) using the Microsoft Excel program. It was established that in the 1st trimester of pregnancy, 5 (55.5%) women with type 1 diabetes were diagnosed with a threat of termination of pregnancy (TTP), and in the 1st (11.1%), they had a retroplacental hematoma. Two (22.2%) women with GD were diagnosed with TTF. In the 2nd trimester, 2 women with GD remained symptomatic of TTF. Six (66.7%) women with type 1 diabetes have symptoms of TTF. In the 1 pregnant woman developed pyelonephritis. Childbirth in 8 (88.8%) women with type 1 diabetes ended through natural birth canal, in 1 woman — a caesarean section. The weight of the child was 4435±2 g. In women with GD the weight of the child was 3756±12. In 7 (77.8%) patients, fetal weight exceeded 4000 g. BPF in the group of patients with diabetes was significantly different from the group with GD at 37–38 weeks of pregnancy. BPF in the 1st group — 7.6±0.2, in the 2nd group — 8.7±0.2, resistance index (RI): 1st group — 0.61±0.01, 2-ha group — 0.57±0.01, CO/K: in the 1st group — 3.2±0.1, in the 2nd group — 3.1±0.1. The correlation between the level of GD compensation and pathological changes in the fetoplacental complex has been established. The data obtained indicate that early screening of this pathology and appropriate compensation for carbohydrate metabolism in the presence of diabetes mellitus should be noted as one of the methods for the prevention of the development of complications in GD.


2019 ◽  
Vol 68 (5) ◽  
pp. 63-74
Author(s):  
Anna A. Siniakova ◽  
Elena V. Shipitsyna ◽  
Olga V. Budilovskaya ◽  
Vyacheslav M. Bolotskikh ◽  
Alevtina M. Savicheva

Hypothesis/aims of study. The problem of vaginal infections during pregnancy is of high importance in obstetric practice. To predict the risks and reduce the frequency of pregnancy and childbirth complications, it is necessary to dynamically assess the vaginal microflora and treat its disorders. The aim of the study was to investigate the vaginal microflora and evaluate the effectiveness of treating vaginal infections in pregnant women with a history of miscarriage. Study design, materials and methods. The study included 153 pregnant women in the first trimester. The main group (group I) consisted of 99 women with a history of miscarriage, 35 of whom had signs of threatened abortion (subgroup IA) and 64 did not (subgroup IB). The control group (group II) comprised 54 women without a history of miscarriage and signs of threatened abortion. The vaginal microflora was examined using microscopic, bacteriological and quantitative real-time PCR methods. All patients with an established vaginal infection (bacterial vaginosis, aerobic vaginitis, and vulvovaginal candidiasis) received etiotropic therapy, depending on the microorganisms identified and their sensitivity to antimicrobial drugs. After treatment, in order to assess the effectiveness of the therapy, the vaginal microflora was examined in the second trimester and the outcomes and complications of present pregnancy were evaluated. Results. In women of subgroup IA, vulvovaginitis and bacterial vaginosis were detected 3.5 times more often compared to the control group, and 1.6 times more often compared to subgroup IB (66% and 19%, respectively, p 0.001; 66% and 42%, respectively, p 0.05). Aerobic vaginitis was the most frequent vaginal infection in the first trimester of pregnancy in women of the main group (p 0.05). After treatment, the frequency of the vaginal infections in the second trimester in women of the main group significantly decreased: by 1.9 times in subgroup IA and by 1.5 times in subgroup IB (p 0.05). There were no significant differences in the frequency of adverse pregnancy outcomes in women with bacterial vaginosis or vulvovaginitis as compared to women with normal vaginal microflora. Nevertheless, pregnancy and childbirth complications were diagnosed 4 times more frequently in the main group (23% and 6%, respectively, p 0.05), with the complications occurring significantly more often in the cases of vulvovaginitis or bacterial vaginosis and signs of threatened abortion in the first trimester (p 0.05). Conclusion. Etiotropic therapy of vaginal infections diagnosed in the first trimester of pregnancy in women with a history of miscarriage was highly effective. In 40% of women, vaginal microbiocenosis normalized, and the clinical symptoms of vaginosis/vaginitis disappeared. Differences in the frequency of adverse pregnancy outcomes in women with vulvovaginitis or bacterial vaginosis in the first trimester and in women with normal vaginal microbiocenosis were not significant. However, the treatment of vaginal infections in the group of pregnant women with a history of miscarriage did not significantly affect the frequency of pregnancy and childbirth complications.


2020 ◽  
pp. 42-46
Author(s):  
N. Kovyda ◽  
◽  
N. Honcharuk ◽  

The objective: Analysis of pregnancy, delivery and the condition of newborns in women with uterus scar after previous Cesarean section. Materials and methods. Observations and retrospective analysis of individual maps of pregnant women, birth record and condition of newborns in 180 women with uterus scar after previous Cesarean section from 2014-2019. Results. It was found that women in I group had no history of miscarriage, and in II group this indicator was 6.7%. We were determined that the threat of early pregnancy was observed twice often in II group as in I group. Failure uterus scar during pregnancy was diagnosing in 21.1% of women of I group against 18.9% of women of II group, as well as during childbirth in 10% of women of II group against none of women of I group. In addition, 76.7% of women of I group were born by vaginal delivery against 24.4% of women of II group. In addition, 10% of newborns in women of I group on the Apgar scale were rated 6-7 points against 65.5% in a state of varying degrees of hypoxia in women of II group. Conclusion. Pregnancy and childbirth in women with uterus scar after previous Cesarean section were accompanying by complications of fetal and neonatal disorders. More pronounced changes were observing during pregnancy, delivery and changes in the condition of newborns in women of II group against with women of I group, which can be explaining by better pre-pregnancy preparation of women of I group and better monitoring during pregnancy. Keywords: сesarean section, pre-pregnancy preparation of women, the condition of newborns.


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