scholarly journals Hormonal and ultrasound features of formation of feto-placental complex in women with beneficial tumours of the uterus

2019 ◽  
pp. 184-190
Author(s):  
E. F. Khamidullina ◽  
L. Yu. Davidyan ◽  
D. R. Kasymova ◽  
A. Yu. Bogdasarov
Keyword(s):  
Pregnant Women ◽  
Ultrasound Imaging ◽  
Comparison Group ◽  
Clinical Manifestations ◽  
Uterine Fibroids ◽  
Genetic Mutation ◽  
Main Group ◽  
Biochemical Tests ◽  
Almost All ◽  
Ultrasound Features

The purpose and objectives of the study is to identify the hormonal, biochemical and ultrasound features of the gestation course in women with beneficial tumours of the uterus. Results. We conducted a complete clinical examination and prospective observation of 182 pregnant women. Of which, 98 puerperas with a verified diagnosis of uterine fibroids and/or endometriosis, which developed before gestation, but did not prevent the onset of pregnancy, were included into the main group. The comparison group included 84 women with physiological pregnancy. The studies showed that 14 pregnant women in the main group had C677T (Ala222Val) T/T mutation, while only 2 women in the comparison group had a decrease in enzyme activity due to genetic mutation. Accordingly, the homocysteine level was almost 3 times lower in the comparison group than in the main group. The women with hyperhomocisteinemia (HHC) and uterine fibroid in the main group showed the lowest estriol level and hCG level, while women without HHC had higher estriol level and hCG levels. It was found that almost all patients with HHC had subclinical hypothyroidism. Ultrasound imaging and biochemical tests at the beginning of the 2nd trimester: no ultrasound markers of fetal anomalies were identified in women from both groups; however, signs of retrochorial hematoma were detected in 57 women from the main group, which was confirmed by clinical manifestations and previous ultrasound imaging in earlier gestation periods. Conclusion. Thus, placenta formation in women with HHC and uterine fibroids is accompanied by relative hormonal insufficiency, which is clinically manifested as a threat of miscarriage in the early stages, but carrying a child is possible due to appropriate management of a patient as part of the preserving therapy. However, the issue of preventing the development of fetoplacental insufficiency is a valid one for further investigation.

PECULIARITY OF ADAPTATION OF BABIES ARE BORN PREMATURELY FROM MOTHERS WITH UNDIFFERENTIATED CONNECTIVE TISSUE DYSPLASIA

2021 ◽  
Vol 74 (10) ◽  
pp. 2566-2568
Author(s):  
Tunzala V. Ibadova ◽  
Vitalii V. Maliar ◽  
Volodymyr V. Maliar ◽  
Vasyl V. Maliar
Keyword(s):  
Connective Tissue ◽  
Premature Infants ◽  
Distress Syndrome ◽  
Comparison Group ◽  
Clinical Manifestations ◽  
Main Group ◽  
Phenotypic Markers ◽  
Group I ◽  
Neonatal Respiratory Distress ◽  
Connective Tissue Dysplasia

The aim: To evaluate the peculiarity of clinical manifestations of neonatal respiratory distress syndrome (NRDS) in deeply premature infants from mothers with phenotypic markers of undifferentiated connective tissue dysplasia (UCTD). Materials and methods: The study represent the results of a retrospective clinical and statistical analysis of 268 premature birth report card and newborn report sheet. .The main (1 group) included 50 pregnants with obvious phenotypic markers of UCTD, the comparison group (group 2) consisted of 50 pregnant women without phenotypic markers of UDCTD. Results: According to the study, in 12 (24%) pregnant women of the main group at the time of admission to the clinic had contractions,which required specific therapy. Cervical cerclage was performed in 38 (76%) patients of the main group due to the presence of cervical insufficiency (CI). In these cases, the severity of the CI on the Steinber scale was 7.2 ± 0.4 points in the main group against 4.4 ± 0.2 points in the comparison group (p <0.05). Group I patients were more likely to have complications of labor such as:premature rupture of membranes, uterine contraction abnormalities and fetal distress, which required in most cases cesarean delivery (7% and 2%), respectively (p <0.05). The incidence of neonatal complications requiring respiratory support was 67% in group I and 48% in group II. According to our observations, the clinical manifestations of bronchopulmonary dysplasia were twice as high in infants of the main group (66%) against (44%) of the comparison group (p <0.05). Conclusions:1.Neonatal respiratory distress syndrome in premature infants is more often associated from mothers with UDCTD. 2. The high importance of steroid prophylaxis of NRDS and antioxidant therapy in reducing the frequency of mechanical ventilation and the development of bronchopulmonary pathology, especially in infants from mothers with UDCTD syndrome, has been proven. 3. The possibility of diagnosing disorders of functional maturation of the lungs in the fetal period using a non-invasive method of ultrasonography has been confirmed.

scholarly journals Specific Characteristics of Bioelectric Activity of the Brain in Women with Placental Dysfunction Considering the Type of Psychological Component of Gestation Dominant

2018 ◽  
Vol 24 (2) ◽  
Author(s):  
Nataliya Henyk ◽  
Nataliya Yakumchuk
Keyword(s):  
Pregnant Women ◽  
Comparison Group ◽  
Clinical Symptoms ◽  
Gestational Hypertension ◽  
Fetal Distress ◽  
Main Group ◽  
Software Complex ◽  
Placental Dysfunction ◽  
Psychological Component ◽  
Attitude Test

 The study of the influence of the autonomic nervous system on the course of pregnancy, childbirth and fetal state remains relevant. Changes in the parameters of electroencephalography may be detected long before the onset of clinical symptoms in the complicated course of pregnancy.  The objective of the research was to evaluate electroencephalography in women with placental dysfunction and gestational complications taking into account the type of psychological component of gestation dominant.  Materials and methods. Electroencephalography was performed in 60 pregnant women at the age of 19 to 45 years with gestational hypertension and fetal distress during pregnancy. The main group included 40 patients, who were stratified according to the type of psychological component of gestation dominant: 10 patients with euphoric type, 20 pregnant women with anxious and depressive type, 10 patients with hypogestognostic type. The comparison group comprised 20 patients with optimal type of psychological component of gestation dominant and normal course of the first half of pregnancy. The assessment of psychological component of gestation dominant was carried out according to the method proposed by Dobriakov I.V. - "Pregnant woman attitude test". Registrations, spectral and coherent analysis of electroencephalography were performed using BrainTest-24 hardware and software complex.  \textbf{Results and discussion. }Electroencephalography of the patients of the comparison group was in line with current concepts regarding the physiological norm. In the main group, there were the following changes in electroencephalography: non-sinusoidal forms of alpha-oscillations (77.5%), high index of fast rhythms, flashes of spike waves under load, disturbances of the frontal occipital gradient with the focus on the anterior sections of the hemispheres.  Conclusions. The use of electroencephalography in women with different types of psychological component of gestation dominant in case of progressive placental dysfunction and preeclampsia on its background allows identifying characteristic changes, modifying the program of therapeutic measures, differentiating obstetric tactics and terms of delivery.

scholarly journals OBSTETRICIANS’ TACTICS IN THE DELIVERY BY PATIENTS WITH BREECH POSITION OF THE FOETUS AFFECTED BY THE UTERINE MYOMA

2018 ◽  
pp. 118-121
Author(s):  
O. M. Krupnyk
Keyword(s):  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Clinical Manifestations ◽  
Uterine Fibroids ◽  
Statistical Processing ◽  
Uterine Myoma ◽  
Control Group ◽  
Full Time ◽  
Obstetric Delivery ◽  
Microsoft Office

The aim of the study – improvement of pregnancy outcomes in women with pelvic presentation on the background of uterine myoma by developing optimal obstetric delivery tactics. Materials and Methods. In order to achieve the stated goal, a prospective analysis of cases of first- and second-time delivering patients with full-term one fetus pregnancy in pelvic presentation (incomplete and complete) amid the uterine myoma – the main group (MG) – (n = 30) was conducted. Into the control group (CG) – (n = 30) were included the first- and second-time bearing women without fetal myoma with full-time pregnancy and the pelvic presentation. Statistical processing of the results was performed using the Microsoft Office Excel 2017 software. Results and Discussion. The analysis of the presented data shows that among pregnant women with pelvic prevalence of fetuses on the background of uterine fibroids, more frequent cases are registered: clinical manifestations of the threat of interruption of pregnancy MG – 26 (86.7 %), CG – 9 (30 %) and pre-eclampsia MG – 8 (26.7 %), CG – 3 (10 %) (p < 0.05). Raising the risk of complications of pregnancy and the expected birth of the uterine myoma requires pre-planning for the most part the operational method of delivery of MG – 19 (63.3 %). Exception, in the absence of other contraindications, there may be women with single myomatous nodes in sizes up to 5 cm – 11 (36.7 %). Only the extension of the cesarean section requires only pregnant women with uterine myoma 7 (36.8 %), and most of these interventions occur during precarious surgical delivery 4 (20 %). Conclusion. Consequently, the presented data indicate the expediency and validity of taking into account the presence of uterine myoma at BP in order to develop an optimal obstetric tactic for the delivery of such patients in order to improve their pregnancy outcomes.

scholarly journals Optimization of healing in patients with odontogenic phlegmon of the maxillofacial region

2020 ◽  
Vol 24 (6) ◽  
pp. 387-390
Author(s):  
O. V. Shvets ◽  
Tatiana V. Gaivoronskaya ◽  
E. E. Esaulenko ◽  
N. I. Bykova
Keyword(s):  
Comparative Effectiveness ◽  
Comparison Group ◽  
Clinical Manifestations ◽  
Main Group ◽  
Maxillofacial Region ◽  
Traditional Treatment ◽  
Parameter Group ◽  
Antioxidant Agents ◽  
Complex Therapy ◽  
Group 2

Aim. This study aims to increase the efficiency of the wound process in patients with odontogenic phlegmons of the maxillofacial region by using energotropic and antioxidant agents. Material and methods. The clinical study included 42 patients with odontogenic phlegmons of the maxillofacial region. The patients were divided into two groups: comparison group (patients received traditional treatment) and main group (patients received treatment with Cytoflavin in the treatment regimen). Results. In the main group, the appearance of the first granulations occurred 2.1 times faster (on average on the 3rd day) in comparison with the granulation tissue in patients of the comparison group. Signs of edge epithelialization of wounds appeared almost 3 days earlier (on average on the 6th day) in the main group than in the comparison group; on the 7th day, secondary sutures were already applied, which was 1.6 times faster than the same parameter group 2, clearly suggesting the acceleration of reparative processes. Conclusion. The dynamics of clinical manifestations indicates the comparative effectiveness of using Cytoflavin as part of complex therapy. This finding is confirmed by the accelerated terms of wound healing, the appearance of granulations, epithelialization of the wound edges, and the imposition of secondary sutures.

scholarly journals Peculiarities of early diagnosis and tactics of treatment in an acute pancreatitis in pregnant women

2018 ◽  
Vol 85 (6) ◽  
pp. 13-17
Author(s):  
Ya. P. Feleshtynskyi ◽  
О. V. Golyanovskyi ◽  
Т. P. Pavliv
Keyword(s):  
Acute Pancreatitis ◽  
Early Diagnosis ◽  
Pregnant Women ◽  
Comparison Group ◽  
Early Stage ◽  
Treatment Algorithm ◽  
Main Group ◽  
Diagnosis And Treatment ◽  
Treatment Results ◽  
Standard Methods

Objective. Improvement of the treatment results of an acute pancreatitis in pregnant women, using enhanced early diagnosis and tactics of treatment. Маterials and methods. Analysis of the diagnosis and treatment results was conducted in 123 pregnant women, suffering an acute pancreatitis. In the main group (61 pregnant women) the elaborated algorithm of diagnosis and treatment for an acute pancreatitis in the period 2012 - 2018 yrs was applied, while in a comparison group (62 pregnant women) - the standard methods of diagnosis and treatment in an acute pancreatitis for the period of 2006 - 2012 yrs. Results. In the main group in 100% of the patients an acute pancreatitis was revealed on early stage. This have had guaranteed the effect obtaining from the conservative therapy in 27 (44.3%) pregnant women, using miniinvasive surgical interventions - in 31 (50.8%) and to prevent postoperative lethality. In a comparison group in 26 (41.9%) patients an acute pancreatitis diagnosis was established in (8 ± 2.1) days after the disease beginning. In a comparison group the conservative treatment effect was observed in 21 (33.9%) patients only. Two (3.2%) pregnant women died. Conclusion. Application of the diagnostic-treatment algorithm, comparing with standard methods, permits to diagnose an acute pancreatitis in pregnant women on early stage, to reduce the complications and lethality rate.

scholarly journals Complex estimation of mitochondrial changes of immunocompetent blood cells in pregnant women with urgent and premature birth

2021 ◽  
Vol 23 (3) ◽  
pp. 557-568
Author(s):  
S. V. Suprun ◽  
N. I. Kuderova ◽  
E. N. Suprun ◽  
O. N. Morozova ◽  
G. P. Evseeva ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Blood Cells ◽  
Energy Supply ◽  
Comparison Group ◽  
Pathological Condition ◽  
Main Group ◽  
Energy Deficiency ◽  
Medical Standards ◽  
Immune Imbalance ◽  
Far Eastern

Inflammation is among the factors promoting development of premature rupture of the membranes (PPROM). Upon the conditions of physiological immune imbalance in pregnancy, inflammation modifies its course and can even change the immune response. Appropriate indexes may be quantitative and functional. We used a marker of mitochondrial membrane potential (MPM, Ay) as an integral index of the functional state of immunocompetent blood cells (IBC) in 159 women who were examined at 8-14 weeks of gestation; they were observed up to 34-36 weeks. Of these cohort, 121 women were referred to a comparison group. The main group (n = 46) consisted of pregnant women with PPROM at the term of 28-33 weeks. The examination was carried out according to current medical standards, with informed consent, being approved by the Ethics committee at the Khabarovsk branch of Far Eastern Scientific Centre of Physiology and Pathology of Respiration — Research Institute of Maternity and Childhood Protection. Additionally, MPM and lymphocyte populations were determined by flow cytometry. The degree of disturbed energy supply in the IBC was based on the data of simultaneous determination of lymphocyte, granulocyte and monocyte numbers with reduced MPM values (application for invention No. 2020115963), thus revealing 3 degrees of energy deficiency: 1st degree, monovariant IBC composition with reduced MPM; 2nd degree, bivariant composition, 3rd degree, total changes. A relative and absolute decrease in CD3 (72% vs 78% and 1624 vs 1980), CD8 (28% vs 33% and 651 vs 851), an increase in CD19 (14% vs 9% and 304 vs 219) were revealed in pregnant women with PPROM. When assessing MPM values in the IBC populations, a decreased proportion of women without energy deficiency from the 1st to the 2nd trimester (from 41% to 30%), due to the 3rd degree of energy deficiency (from 17% to 26%) was detected. A shift of affected pools at the 2nd degree of energy deficiency in favor of lymphocytic-granulocytic association (from 7% to 25%) from lymphocytic-monocytic compartment (from 73% to 50%) was found. From the 2nd to 3rd trimester, we have detected redistribution of granulocyte pools at the 1st degree (0 to 8%) and from the lymphocytic-granulocytic association (25% and 5%) to monocytic-granulocytic (25% and 40%). In the group with PPROM, there was a decreased proportion of pregnant women without energy deficiency (13% and 27%), as well as with the 1st and 2nd degrees (17% vs 31% and 9% vs 17%), due to the 3rd degree of energy deficiency (61% and 26 %), relative to the comparison group. The IBC pools of in the main group were redistributed at the 1st degree in favor of granulocytes (25% and 8%), at the 2nd, in favor of the lymphocytic-monocytic association (100% and 55%) from the granulocytic-monocytic (0% and 40%). Such imbalance of bioenergetic processes in the IBC can be an important factor of pathologically ongoing inflammation. These changes could be caused by both higher incidence of infections in such patients and by alloimmune interactions between mother and fetus. However, they may also determine the pathological course of inflammation. Preterm birth, which is usually caused by PPROM, is a multifactorial pathological condition. However, independent on specific triggers, the changes in energy supply of IBC, at least, may serve as a significant biomarker of probability for this disorder.

Clinical Features of Urinary Infections in Pregnant Women with Type 1 Diabetes Mellitus

2020 ◽  
Vol 27 (3) ◽  
pp. 18-31
Author(s):  
I. V. Alekseenko ◽  
L. A. Ivanova
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Urinary Tract ◽  
Type 1 Diabetes Mellitus ◽  
Pregnant Women ◽  
Comparison Group ◽  
Pregnancy Termination ◽  
Main Group ◽  
Tract Infections

Aim. To study clinical manifestations of urinary tract infections in pregnant women with type 1 diabetes mellitus (DM).Materials and methods. Pregnant women with urinary tract infections (UTIs) were examined: 110 with type 1 diabetes mellitus (main group) and 133 without diabetes mellitus (comparison group). The diagnosis of UTI was based on the clinical picture (for manifestation forms) and confirmed by a dual culture method using both the classical approach and DipStreak tests. The determination of the sensitivity of the isolated microorganisms to antibacterial drugs was carried out by the disk diffusion test on Mueller-Hinton agar using paper disks. Instrumental research included ultrasound of the kidneys, urinary tract and fetoplacental complex.Results. In the main group, UTIs were pyelonephritis, asymptomatic bacteriuria (AB) and low AB (102–104 CFU/ml) was detected in 38, 69 and 31 patients, respectively. In the comparison group, pyelonephritis, AB and low AB was detected in 41, 63 and 29 patients, respectively. In the main group, the classic course of pyelonephritis was observed in 44.7%, low-symptomatic — in 26.3%, “according to the type of carbohydrate metabolism decompensation” — in 21%, and the obstetric variant — in 7.9% of patients. In the comparison group, the classic version of pyelonephritis was in 70.7%, low-symptomatic — in 24.4%, asymptomatic — in 4.9%. Bilateral pyelonephritis in pregnant women with type 1 diabetes mellitus prevailed over unilateral: 65.8 vs 34.2%. During AB, in patients with type 1 diabetes mellitus, hyperglycemia was observed in 23.1% (n = 16), the threat of pregnancy termination in 53.6% (n = 37), and moderate preeclampsia in 17.4% (n = 12). In patients with low AB, glycemia above the target values was recorded in 16.1% (n = 5), the threat of pregnancy termination in 38.7% (n = 12), and moderate preeclampsia in 12.9% (n = 4).Conclusion. Based on the specifics of the clinical manifestations of UTIs in pregnant women with type 1 diabetes mellitus, the following types of pyelonephritis can be distinguished: classic, low-symptom, “decompensation of carbohydrate metabolism” and obstetric. The classical course of pyelonephritis in pregnant women with type 1 diabetes mellitus is statistically significantly less common (p <0.05) as compared with pregnant women without diabetes mellitus. The features of AB in pregnant women with type 1 diabetes mellitus are the development of hyperglycemia and obstetric complications.

Hepatoprotective therapy with low molecular weight sugar drug for pregnant women with liver dysfunction amid early toxicosis and hepatotoxicity

2021 ◽  
Vol 20 (2) ◽  
pp. 19-28
Author(s):  
E.V. Mozgovaya ◽  
◽  
M.A. Kryshnya ◽  
E.V. Shelaeva ◽  
S.V. Nagorneva ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Pregnant Women ◽  
Bile Acids ◽  
Alanine Aminotransferase ◽  
Clinical Manifestations ◽  
Main Group ◽  
Control Group ◽  
Low Molecular Weight ◽  
Sugar Solution ◽  
Drug Induced

Objective. To assess the efficacy and safety of low molecular weight sugar solution as a hepatoprotector in the first trimester of pregnancy in patients with liver functional disorders against the background of early toxicosis and / or hepatotoxicity. Patients and methods. The study included 70 patients: the main group (n = 30) – pregnant women with functional hepatopathies who received therapy with drug Heptrong; the control group (n = 30) – pregnant women who received standard treatment, of which 15 patients had hepatotoxicity (essential phospholipid therapy) and 15 patients with early toxicosis (intravenous saline fluid therapy, Cerucal), as well as 10 pregnant women with early toxicosis who were treated without drugs (the placebo group). Results. Pregnant women with early toxicosis noted a decrease in its clinical manifestations against the use of the drug Heptrong after 2.3 ± 0.8 days from the onset of therapy; by the end of therapy, all patients had no vomiting, and nausea stopped in 80%, which was not observed in comparison groups. The normalization of alanine aminotransferase (≤40 U/L) occurred in 80% of pregnant women in the main group (p < 0.01) and in 66% (p < 0.01) when treating with essential phospholipids. The normalization of alanine aminotransferase (≤40 U/L) occurred in 90% (p < 0.01) and 33.3% (p = 0.03), respectively. A significant decrease in the level of bile acids (from 8.49 ± 2.1 μmol/L to 2.74 ± 1.1 μmol/L; p < 0.05) and improvement in the indicators of the antioxidant system – an increase in total antiradical activity (from 804.0.0 ± 10.5 μmol/L to 839.0 ± 11.0 μmol/L; p < 0.05) and a decrease in the level of conjugated dienes (from 3.77 ± 0.2 μmol/L to 3.26 ± ± 0.1 μmol/L; p < 0.05) – were observed only in the main group. A number of other indicators of the “liver panel” tended to improve only in the main group. Conclusion. Heptrong is an effective hepatoprotective drug, which considerably improves the state of pregnant women during early toxicosis and helps to reduce liver transaminases and bile acids in pregnant women with hepatotoxicity. Due to the antiinflammatory and pronounced antioxidant effect, which is not observed in standard pharmacological treatment, Heptrong can be used to prevent late obstetric complications. Key words: Heptrong, drug-induced hepatopathies, “liver panel” indicators, early toxicosis

scholarly journals A Disorder of Menstrual Function Regularization and its Influence on a Female Reproductive Potential

2017 ◽  
Vol 24 (3) ◽  
Author(s):  
Oksana Makarchuk ◽  
Volodymyr Dziombak
Keyword(s):  
Risk Factors ◽  
Menstrual Cycle ◽  
Pregnant Women ◽  
Luteal Phase ◽  
Comparison Group ◽  
Inflammatory Diseases ◽  
Main Group ◽  
The Body ◽  
Obstetric Complications ◽  
Menstrual Function

Obstetric complications in women of reproductive age are often the result of puberty disorders which remain underestimated and not taken into account in pregnancy monitoring programs in such patients, leading to an increase of habitual non-carrying of pregnancy and negative obstetric effects.The objective of the research is to carry out a comprehensive multivariate assessment of the disturbances of the body adaptive processes in teenage girls, taking into account the data of anamnesis regarding the specifics of menstrual function regularization during puberty, and to determine the main factors of complicated pregnancy in this category of patients.Materials and methods. To carry out the task, 110 pregnant women with a disorder of menstrual function regularizationhave been prospectively examined (the main group); the examination was performed at the preconception stage and in the periods of 6-12, 22-24 and 32-36 weeks of pregnancy. The comparison group consisted of 30 patients with a normal menstrual cycle. In order to identify risk factors and predict complications, the odds ratio (OR) and its 95% confidence interval were used.Results. Extragenital pathology plays a significant role in the formation of pathological course of puberty and obstetric complications; 87.27% ofsuch cases were demonstrated in our study. Among the disorders of the ovarian-menstrual cycle, the structural significance is characteristic to the failure of the luteal phase and anovulatory disorders (78.18% of cases). Gynaecologic pathology includes inflammatory diseases of the pelvic organs (35.45%), cervical background processes (41.66%), ovarian tumour lesions (21.81), and primary infertility(14.54%). The obtained results of the structure of pregnancy complications in patients of the main group show reproductive losses in early pregnancy (11.8%), subchorionic hematoma (28.18%) and the threat of late spontaneous abortion; these data are notedthree times more often than in the comparison group. Many cases of preeclampsia (28.18%), gestational anaemia in more than half of the observations, fetal distress during pregnancy (32.72%) and birth of children with a low weight (17.27%) are associated with the development of the primary placental dysfunction and pathology of vascular and thrombocytic component of haemostasis.Conclusions. Analysis of the obtained data confirmed that pregnant women with a disorder of menstrual function regularization in puberty are characterized by a significant number of complications during pregnancy and delivery, high rates of spontaneous abortions and missed miscarriages; all these factsshould be considered as potential risk factors. The key factors are the following: endocrine imbalance by type of oligomenorrhea and luteal phase deficiency (OR – 9.16; 2.21-23.24), inflammatory diseases of the genital tract, such as asymptomatic bacteriuria and bacterial vaginosis (OR – 14.26; 3.26-32.12), premature deliveryin past medical history, the risk of spontaneous miscarriages and subchorionic hematoma.

scholarly journals Fluid resuscitation patients with burn sepsis

2020 ◽  
pp. 42-43
Author(s):  
O.M. Kovalenko ◽  
O.I. Osadcha ◽  
A.A. Kovalenko ◽  
A.S. Grisha ◽  
O.M. Lynnyk ◽  
...  
Keyword(s):  
Comparison Group ◽  
Total Body Surface Area ◽  
Clinical Manifestations ◽  
Main Group ◽  
Oxidation Products ◽  
Control Group ◽  
Carbonyl Groups ◽  
Septic Complications ◽  
Endogenous Intoxication ◽  
Lipid Oxidation Products

Objective. The purpose the of the study is to improve the fluid therapy regimens for burn sepsis patient. Materials and methods. The study is based on the observation 52 patients with burn sepsis aged 23 to 65 years, with a total body surface area more than 35 % at the Kyiv City Clinical Hospital № 2 during 2016-2019. Patients were divided into two groups: the main group – 30 patients were treated with crystalloids, plasma, albumin and Rheosorbilact (RSL); control group – 16 patients received treatment without using of RSL. Clinical and biochemical parameters of endogenous intoxication (tissue destruction products, medium weight molecules (MWM), concentrations of lipid oxidation products (LOP) – by diene conjugate content and oxidatively modified proteins (OMP) – by carbonyl groups) were studied. Results and discussion. Syndrome of endogenous intoxication was an increase in burn sepsis patients, which correlated with an increase in the number of LOP, OMP, MWM, namely an increase in the hydrophobic (most toxic) fraction of MWM, which is 2-3 times higher than in healthy, sick and both groups. MWM and hydrophobic fraction remained high during the observation period in patients of the comparison group. MWM decreased by 1.35 times in patients of the main group relative to the group of crystalloids. The level of carbonyl groups of serum OMP in patients of the comparison group was 50 % higher than in the main group. The indicators of LOP exceeded 1.45 times in the comparison group, which testified to the continuation of oxidative stress and the continuation of systemic inflammation. Acute respiratory distress syndrome (ARDS) was characterized by the appearance of bilateral infiltrates in the lungs, according to radiography. This common organ dysfunction was detected in 75 % of patients in the comparison group and in 63 % of patients in the RSL-group. The duration of mechanical ventilation in the main group decreased by 1,6 days. Conclusions. The use of Rheosorbylact for patients with burn sepsis at a dose of 15 ml/kg has led to a decrease in the manifestations of intoxication syndrome, reduction of MWM, LOP, OMP, clinical manifestations of systemic inflammatory response, septic complications by 1.3 times, septic shock from 16 to 12 %, and the incidence of ARDS from 75 to 63 %.

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