scholarly journals Prevention of premature birth in pregnant women with vaginal candidiasis

2019 ◽  
pp. 52-57 ◽  
Author(s):  
D. N. Kokoeva ◽  
M. K. Medzhidova ◽  
N. A. Lomova ◽  
N. E. Kan ◽  
V. L. Tyutyunnik

Candida vulvovaginitis is an infectious lesion of the vulvar and vaginal mucosa caused by Candida yeast fungi. Vaginal candidiasis during pregnancy is associated with spontaneous miscarriages, premature rupture of the fetal membranes, premature birth, and low birth weight babies. Considering the potential risk of premature delivery at fungal invasion at the level of the lower reproductive tract of a pregnant woman, the search for a complex of preventive measures and timely treatment of сandida vulvovaginitis during gestation is of particular interest. The article presents the results of the use of the drug Zalain in 36 pregnant women, with a gestation period of 28 weeks or more with acute candidal vulvaginitis. In the course of the work, the results of local therapy with Zalain were evaluated and its clinical efficacy in the prevention of preterm labor was confirmed. The results of treatment contribute to a significant reduction in the frequency of initiation of preterm labor, as well as a persistent effect for 2-4 weeks after completion of the course in the postpartum period and the absence of early and distant manifestations of candidiasis in newborns.

2018 ◽  
Vol 67 (2) ◽  
pp. 16-25
Author(s):  
Olga V. Kosyakova ◽  
Olesya N. Bespalova

Premature birth is one of the most important problems of modern obstetrics because it is a leading cause of childhood morbidity and mortality in all countries. Annually, > 1 million premature newborns worldwide die from various types of complications, and most of the survivors become disabled. Moreover, according to WHO analysis, most of these children can be saved by developing measures for the early identification of preterm births, which will provide additional time for effective intervention. Currently, available diagnostic methods do not adequately assess the risks of premature delivery owing to the low predictive value of the methods. This makes it necessary to search for predictors of preterm labor that can improve the accuracy of diagnostic techniques. The desired predictors should have a pathogenetic basis, and most importantly, they must contribute to the early detection of life-threatening premature births. The hormone relaxin could be considered to be a promising marker of premature birth because its role in the pathogenesis of premature birth is unquestionable, and the evaluation of its levels is possible during the early stages of pregnancy.


1995 ◽  
Vol 3 (2) ◽  
pp. 60-63
Author(s):  
William F. O'Brien ◽  
German F. Leparc ◽  
Jodi Holbrook

Objective: The purpose of this study was to evaluate the possible association between Lewis phenotype status in pregnant women and preterm labor (PTL) or preterm rupture of the membranes (PROM).Methods: Red blood cell (RBC) Lewis phenotype was determined in 113 pregnant women admitted for PTL or PROM and in 121 controls. The results were controlled for the influence of race on Lewis phenotype.Results: Pregnancy was associated with a higher frequency in women with the a–b– phenotype. There was no association between RBC Lewis phenotype and the occurrence of PTL or PROM.Conclusions: A susceptibility to PTL or PROM is not due to a lack of Lewis antigen expression on the plasma membrane of the vaginal mucosa.


2015 ◽  
Vol 22 (2) ◽  
pp. 67-71
Author(s):  
Кузибаева ◽  
R. Kuzibaeva

Premature delivery is the leading cause of perinatal morbidity and mortality of newborns. The article presents the analysis of preterm birth in the perinatal center of Tula region. Depending on the causes of premature birth the author formed three groups. The 1-st group (n=32) included spontaneous preterm births, the 2nd group (n=115) -premature birth as a result of prenatal rupture of membranes, the 3st group (n=180) included preterm births for medical reasons. In all three groups, the demographic data, age, and parity were analyzed. The problem is the development of complex diagnostic techniques for the purpose of prognosis and preventive measures for pregnant women, because at present the obtained results do not allow us to accurately predict a preterm birth and to identify clearly the criteria for their possible development. Reduction of morbidity and mortality in newborns can be achieved through the timely identification of pregnant women at high risk, methods of prevention of preterm birth, quality of treatment and nursing of low-birth-weight infants [1]. This is of paramount importance not only in the formation of a healthy generation from a very early period of their lives and health, but also for the reproductive potential of women in the future [8].


2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Seyed-Abdolvahab Taghavi ◽  
Solmaz Heidari ◽  
Shayesteh Jahanfar ◽  
Shakiba Amirjani ◽  
Amireh Aji-ramkani ◽  
...  

Abstract Background The purpose of the present study was to evaluate obstetric, maternal, and neonatal outcomes in COVID-19 compared to healthy pregnant women in Iran. Results A case-control study was conducted on 55 COVID-19 as the case and 55 matched control pregnant women in Hormozgan, Iran. Patients were considered to be cases if they had a positive COVID-19 test plus a positive chest X-ray result. Our measures were COVID-19 symptoms, including laboratory evaluations, clinical symptoms, and maternal and neonatal outcomes. The most prevalent symptoms related to COVID-19 were fever (69.09%) and cough (58.18%). Less common symptoms included fatigue, diarrhea, shortness of breath, sore throat, and myalgia. Hydroxychloroquine/chloroquine (58.18%) and antibiotic therapy (45.45%) were the most prevalent management in COVID-19 patients. Based on our findings, maternal and obstetric outcomes—neonatal in case groups—such as mode of delivery, premature rupture of membrane, postpartum hemorrhage, perineal resection rate, neonates’ birth weight, Apgar score, and neonatal asphyxia rate were similar to pregnant women without COVID-19. We observed a higher incidence rate of premature delivery in COVID-19 cases (25 vs. 10%) (p < 0.05). In the present study, we found that women with COVID-19 had a more than twofold increased odds of preterm labor. History of preterm delivery was also associated with high twofold odds of preterm labor. Conclusion We observed a higher incidence rate of premature delivery in COVID-19 cases. Women with COVID-19 had a more than twofold increased odds of preterm labor. Considering prematurity has high morbidity and is regarded as the primary cause of mortality in children under 5 years old, more case-control studies are needed to ascertain the results.


2017 ◽  
pp. 54-58
Author(s):  
S.N. Heryak ◽  
◽  
N.V. Petrenko ◽  
V.Yu. Dobryanskа ◽  
O.A. Yakimchuk ◽  
...  

The objective was to study the effectiveness of the application of the sublingual form of micronized progesterone for the treatment and prevention of premature birth in women with concomitant risk factors against the background of the infectious inflammatory component in the anamnesis. Materials and methods. The study was conducted in two stages. At the first stage, 100 stories of pregnant women with preterm labor were analyzed at a period of 22-36 weeks, which were inpatient treatment in the Ternopil Regional Clinical Perinatal Center «Mother and Child». A comprehensive assessment of risk factors for the development of preterm labor and the effectiveness of their management was carried out. At the second stage of the study, 27 pregnant women (group 1) who were hospitalized with a threat of premature birth and had an anamnesis history, were treated with natural micronized progesterone Lutein in a dose of 100 mg sublingually twice a day. The comparison group (group 2) included 30 pregnant women, who before traditional hospitalization began traditional tocolytic therapy with calcium channel blockers. The control group included 20 pregnant women with a physiological pregnancy. Results. As a result of the proposed therapy, a decrease in the intensity of the pain syndrome in patients taking micronized progesterone was observed at 25 min faster (p <0.05) than after conventional therapy (85.2 ± 7.4 min in the 1st group and 110.6 ± 9.8 min - in the second group). At the same time, anxiety level was 16.1 ± 1.8 points in patients of the 1st group, which corresponded to its absence, while the patients of the 2nd group continued to be in a state of moderate anxiety (19.3 ± 1.4 points). Pregnant women with a threat of preterm birth who had an inflammatory process of any localization in the past had a significant increase in the level of proinflammatory cytokines (IL-2, IL-6, TNF-?) and a decrease in the level of anti-inflammatory cytokines (IL-4, IL- 10) in comparison with the indicators of healthy pregnant women. The use of micronized progesterone and conventional therapy positively affects these indicators. Conclusion. The use of the sublingual form of micronized progesterone in the preparation of Lutein at a dose of 200 mg per day is pathogenetically grounded and provides a rapid arrest of the manifestations of premature birth in women with miscarriage in the background of chronic foci of infection. Key words: premature birth, inflammation, micronized progesterone.


Author(s):  
Yu. Ya. Krut ◽  
A. A. Shevchenko ◽  
V. G. Syusyuka

The aim of the study – to ascertain predictors of a threat of premature birth. Materials and Methods. 63 patients participated in the gestation period of 22–34 weeks in a prospective open study. Pregnant women were divided into two groups. Thus, the group I included 44 pregnant women, with the threat of PL, and the group II included 19 patients with normal course of pregnancy. All women were tested for body mass index (BMI), progesterone, insulin and cortisol on the day of admission. Statistical processing of materials was carried out by using the software package "Statistica 6.0" (StatSoft, USA) and MedCalc. 10.2.0.0. To determine the predictors of the occurrence of a TPL, the method of binary logistic regression analysis was used. All statistical tests were two-sided; the p-0.05 level was considered as significant. Results and Discussion. An analysis of the results of the observation of 63 pregnant women was provided. In 12 women, pregnancy ended in preterm labor, which was 19 % of the total. The following indicators fell to the dependent predictors of TPL occurrence: body mass index (BMI) ≤ 24 kg/m² significantly increased the odds ratio (OR) of TPL 7.76 times; insulin level <8.65 µMU/ml significantly increased ORR of TPL 5.14 times; OR of TPL increases in 7.02 times, in case that the level of cortisol is less than 577.9 ng/ml; progesterone <139.5 ng/ml increases the odds ratio of TPL in 4.39 times. Taking into account the data of univariate regression analysis, multivariate models of independent predictors of TPL were created. According to the first model (p = 0.0001), independent risk factors for miscarriage include: the age of pregnant women over 25 years, an insulin level more than 8.7 μMO/ml, and the level of cortisol less than 577.9ng/ml. According to the second model (p <0.0001), independent risk factors which increase the risk of TPL occurrence are: BMI less than 24 kg/m2, insulin level more than 8.7 μMO/ml, cortisol level less than 577.9ng / ml. However, the most interesting is the third model (p <0.0001) of independent risk factors for TPL. It includes four indicators: the level of progesterone, less than 139.5 ng/ml, the level of cortisol, less than 577.9 ng/ml, the BMI, less than 24 kg/m2 and the age of pregnant, more than 25 years. Conclusions. It was found that in pregnant women with a threat of preterm birth the age and BMI are the most informative, and in combination with the hormonal examination of women are of primary importance. The obtained results indicate the expedien­cy of inclusion to the standard examination of pregnant women with a threat of premature birth, a comprehensive determination of the level of progesterone, insulin and cortisol, which will enable to identify the risk group for this complication in time and to propose preventive measures.


2016 ◽  
pp. 86-89
Author(s):  
S. Zhuk ◽  
◽  
O. Schurevska ◽  

The objective: to study the psychological characteristics of women’s status in one of the most common complications of pregnancy - the threat of termination of pregnancy, depending on the level of stress load. Patients and methods. We have studied the psychological status (the Holmes-Rahe level of psychosocial stress, the Spielberg-Hanin level of anxiety, V.I.Dobryakov’s related to a pregnancy test, diagnosis of psychological defense mechanisms, assessment of quality of life) 60 pregnant women with threat of premature birth in the third trimester of pregnancy. Surveyed women were divided into 2 groups: group 1 included 30 pregnant women – forced migrant of Donetsk and Lugansk area and 2 group – 30 pregnant women who resided in Kiev. Results. At the same clinical picture of the threat of premature birth we detected discrepancy between the subjective assessment of their condition in women – forced migrants: a high level of situational and personal anxiety, decrease in physical (physical functioning, role-physical functioning) and psychological (social functioning, role emotional functioning) health, doubtful and pathological subtypes of gestational dominant. This creates prerequisites for complications of pregnancy, childbirth and postpartum future period and requires the participation of psychologists in the work with this category of patients. Conclusion. So, revealed a discrepancy between the objective clinical signs similar obstetric pathology (on the example of threatened abortion) in pregnant women with different levels of stress load and their subjective evaluation of their condition that affects their psychological status. This should be reflected in individually tailored therapy and be mainstreamed into the work of obstetricians and gynecologists with these patients, and requires mandatory participation of psychologists in the work with this category of patients. Key words: pregnancy, the threat of premature birth, stress, psychological status.


2016 ◽  
pp. 160-164
Author(s):  
D.N. Maslo ◽  

The objective: frequency decrease perinatal pathologies at women after ART on the basis of studying clinical-ehografical, endocrinological, biochemical, dopplerometrical, cardiotokografical and morphological researches, and also improvement of algorithm of diagnostic and treatment-and-prophylactic actions. Patients and methods. The work basis is made spent by us from 2012 on 2015 by complex inspection of 300 pregnant women from which 250 were after ART and 50 – firstlabours which pragnency without ART, and also their newborns. For the decision of an object in view of research spent to two stages. At 1 stage spent prosperctive research which included 150 pregnant women: з them 100 women pregnancy at which has come out ART (1 group) and 50 healthy women (control group). At 2 stage spent prospective randomization in which result of patients after ART have divided on two equal groups by therapy principle: 2 basic group - 75 pregnant women after ART at which used the algorithm improved by us; 3 group of comparison - 75 pregnant women after ART which have been spent on the standard treatment-and-prophylactic actions. Results. The results suggest that women after using ART is a high frequency of reproductive losses in the first trimester (10.0%), 3.0% of spontaneous abortion from 16 to 22 weeks, and 3.0% "early" premature delivery (22 to 28 weeks of pregnancy). The frequency of violations of the functional state of placenta in women after using IVF is 63.0%, which is the main cause of high levels of perinatal losses (40.0 ‰), and delivery by cesarean section (96.0%). Placental dysfunction in women after using ART characterized by retrohorialnyh hematoma (21.0%); size mismatch fruit (30.0%) and hypertonicity of the uterus (73.0%) against changes in fruit-placental blood flow - increased resistance index in umbilical artery and increased vascular resistance in the uterine arteries. Endocrinological and biochemical changes in placental dysfunction in women after using IVF starting from 28 weeks of pregnancy and are in significant reduction in progesterone, placental b1-microglobulin, B2-microglobulin of fertility and trophic в-glycoprotein. Conclusion. The received results: use of the algorithm of diagnostic and treatment-and-prophylactic actions improved by us allows to lower frequency of spontaneous interruption of pregnancy till 22 weeks – from 13.0% to 5.7%; «early» premature birth – from 3.0% to 1.0%; placentary dysfunction from 63.0% to 40.6%; cesarean sections – from 96.0% to 56.5%, and also perinatal losses – from 40.0‰ to 16.2‰. Key words: pregnancy, childbirth, auxiliary reproductive technologies.


GYNECOLOGY ◽  
2017 ◽  
Vol 19 (6) ◽  
pp. 11-15 ◽  
Author(s):  
T E Karapetyan ◽  
V V Muravieva ◽  
A S Ankirskaya ◽  
L A Lyubasovskaya ◽  
T V Priputnevich

The aim of the study was to evaluate the effectiveness of treatment of women with opportunistic vaginal infections during pregnancy. Materials and methods. A prospective cohort study included 330 pregnant women, of whom 151 were diagnosed with bacterial vaginosis (BV), 37 had aerobic vaginitis (AB), 109 had vulvovaginal candidiasis (VC), 20 had a combination of VC + BV. When carrying out antibiotic therapy in the early stages of pregnancy, the principle of local treatment was observed. Results. Most often (46.0%), vaginal infections were detected when women were treated early in pregnancy. In the treatment of BV in the early stages of pregnancy with antiseptic chlorhexidine, a positive result of therapy was noted in 97.6% of women. Therapy with metronidazole or clindamycin BV in women who applied in the II and III trimesters, gave a positive result, respectively, in 90.0% and 89.5% of cases. The course of therapy with chlorhexidine pregnant women with AB was effective in 91.7% of cases with treatment in the first trimester and 92.0% in treatment in the II and III trimesters. In the treatment of VC in early pregnancy, natamycin was effective in 95.0% of women. In the II and III trimesters, econazole treatment was successful in 88.2% and 88.6%, respectively. In the treatment of combination of BV + VC in early gestation, the complex course of chlorhexidine + natamycin was effective in 76.5% of women, in II and III trimesters Neo-Penotran Forte was effective in 93.8% of pregnant women. Relapses of vaginal infections were observed in 34 pregnant women (10.3%). Superinfection with fungi was noted in 9.3% of cases of BV treatment and in 8.1% of pregnant women with AB. Among women observed from early pregnancy, there were no cases of premature birth, manifestations of intrauterine infections were noted in 5.3% of newborns. At treatment in the II and III trimesters, premature birth was in 6.5% and 13.5% of women, and manifestations of intrauterine infections - in 15.3% of newborns. Thus, microbiological monitoring of timely detection and treatment of opportunistic vaginal infections in pregnant at-risk groups showed the advisability of treating these infections in early gestation.


2020 ◽  
Vol 26 (6) ◽  
pp. 664-674 ◽  
Author(s):  
Cinzia Pagano ◽  
Luana Perioli ◽  
Paola Calarco ◽  
Alessandro Di Michele ◽  
Maria C. Tiralti ◽  
...  

Background: 18β- glycyrrhetinic acid (Gly) is the major bioactive component of licorice roots and rhizomes of the Glycyrrhiza glabra species. It shows many activities such as antiviral, anti-inflammatory, antioxidant, antimicrobial, and antifungal, however, its use in the health field is very limited due to the low water solubility. Methods: This paper deals with the development of a new technological approach for Gly dissolution rate enhancement. It consists of Gly intercalation (guest) in the interlamellar spaces between the inorganic spaces (host) of the anionic clays “hydrotalcites” (HTlc) to obtain hybrids MgAl-HTlc-Gly and ZnAl-HTlc-Gly. Gly can find applications in both systemic and local therapies, thus advantages of the use of the hybrids in these two fields were investigated. Results: Gly dissolution rate from hybrids in the intestinal environment, site in which it is preferentially absorbed, resulted enhanced (ZnAl-HTlc-Gly > MgAl-HTlc-Gly) compared to the crystalline form, thereby, making them suitable for oral administration as dry powder in hard capsules. : For a local therapy, bioadhesive, vaginal emulgels loaded with the hybrids were developed. These showed suitable mucoadhesive property to the vaginal mucosa, necessary to prolong the residence time in the application site. The emulgel containing ZnAl-HTlc-Gly showed a faster and higher release profile than that containing MgAl- HTlc-Gly. Conclusions: The obtained results suggest that Gly intercalation into HTlc, especially in ZnAl-HTlc, allows to enhance Gly dissolution when the hybrids are formulated both as oral or topical products.


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