scholarly journals PECULIARITIES OF THE FUNCTIONAL STATE OF THE MOTHER-PLACENTA–FETUS SYSTEM IN PREGNANT WOMEN WITH PLACENTAL DYSFUNCTION

2018 ◽  
Vol 17 (3) ◽  
pp. 24-28
Author(s):  
L. M. Yuryeva
Keyword(s):  
Blood Flow ◽  
Pregnant Women ◽  
Vascular Resistance ◽  
Functional State ◽  
Newborn Infants ◽  
Mean Value ◽  
Control Group ◽  
Fetal Blood ◽  
Peripheral Vascular ◽  
Placental Dysfunction

Among the causes that lead to antenatal affliction of the fetus, namely its hypoxia, hypotrophy, ante- and intranatal distress, is placental dysfunction (PD). Perinatal mortality in PDs is 10.3‰ in newborn infants, 49 ‰ – in preterm infants. Perinatal morbidity with PD reaches 70‰, and mortality rate – 20%. Objective. To investigate the functional state of the fetoplacental complex (FPС) in pregnant women with PD. Material and methods. The functional status of the FPC in 104 patients with PD (main group) and in 136 women with uncomplicated pregnancy and delivery (control group) using ultrasound placentalography, Dopplerometry was examined. Research results. The ultrasound characteristics of the placental dysfunction were the following: discrepancy between the degree of maturity of the placenta of the gestation period, true thickening of the placenta, its hypoplasia, reduction of echogenicity of the placenta, oligohydramnios. Dopplerometric signs of disorder of the utero-placental blood flow were high peripheral vascular resistance, both in dominant and in subdominant UA, asymmetry of blood flow in UA. Hemodynamics of fetal-placental circulation against the ground of PD was characterized by a decrease in the final diastolic blood flow velocity, which was manifested by an increase resistance in the peripheral vascular of the fetal part of the placenta,  decrease in placental coefficient. The peculiarity of fetal blood flow in pregnant women with PD was the decrease in the mean value of vascular resistance indices in the middle cerebral artery of the fetus and a significant decrease in the cerebral-umbilical index. Conclusions. In pregnant women with placental dysfunction hemodynamic changes in the utero-placental complex are associated with decrease in the intensity of placental-fetal blood flow and in 16.3% of cases by centralization of the fetal circulation. Timely Dopplerometry is important both in the diagnosis of the compensatory capabilities of the FPK, and during determination of reasonable suggested obstetrical tactics.

scholarly journals Prevention of primary placental dysfunction with low location of the chorion

2020 ◽  
Vol 24 (4 (96)) ◽  
pp. 80-84
Author(s):  
S. Pecheriaha ◽  
I. Marynchyna
Keyword(s):  
Blood Flow ◽  
Pregnant Women ◽  
Gestational Age ◽  
Ginkgo Biloba ◽  
Ginkgo Biloba Extract ◽  
Main Group ◽  
Control Group ◽  
Low Grade ◽  
Doppler Examination ◽  
Placental Dysfunction

Objective is to develop new methods to prevent primary placental dysfunction (PD) in early gestational age with low placentation.Material and methods. We have examined 119 pregnant women with low placentation. This diagnosis was made from 6-7 weeks of gestation on the basis of echographic research. The main group consisted of 64 pregnant women with low chorionic location, which was used to prevent PD from the early gestational age by the complex of medicines developed by us and a control group of 55 women with low placentation that had not undergone PD prophylaxis from early gestational periods. The treatment and prophylactic complex included: Luteina, ginkgo biloba extract, folio and biolectra. In the main and control groups, all pregnant women underwent Doppler examination in the uterine and spiral arteries, as well as determined the volume of the chorion and the volume of blood flow in the chorion.Results. Doppler examination in the main group showed a decrease in all indices of resistance in the uterine and spiral arteries, as well as a significant increase in chorionic volume and vascularization index in three-dimensional ultrasound compared with the control group.Conclusions. The proposed treatment and prophylactic complex agents (Luteina, ginkgo biloba extract, folio and biolectra) helps to normalize uterine-chorionic blood flow, restore effective embryo-chorionic relationships and significantly reduces the frequency of further development of primary placental dysfunction in pregnant women with low-grade pregnancy.

FETUS STATE ASSESSMENT AND PECULIARITIES OF NEONATAL PERIOD COURSE IN CHILDREN BORN TO WOMEN OF LATE REPRODUCTIVE AGE IN THE CHECHEN REPUBLIC

2021 ◽  
Vol 100 (1) ◽  
pp. 59-66
Author(s):  
Kh.M. Omarova ◽  
◽  
E.S.-A. Ibragimova ◽  
T.Kh.-M. Khashayeva ◽  
I.Kh. Magomedova ◽  
...  
Keyword(s):  
Blood Flow ◽  
Pregnant Women ◽  
Neurological Disorders ◽  
Neonatal Period ◽  
Reproductive Technologies ◽  
The State ◽  
Control Group ◽  
Fetal Blood ◽  
Early Neonatal Period ◽  
Brain Artery

Objective of the research: conduct a Doppler ultrasound (DUS) assessment of utero-placentalfetal blood flow and the condition of newborns in the early neonatal period from women of the late reproductive period (LRP), depending on the parity of delivery, using the example of women in the Chechen Republic. Material and methods: retrospective multicenter study. DUS assessment of the state of utero-placental-fetal blood flow and the state of newborns in the early neonatal period was performed in 95 pregnant women, including: group 1–35 primiparous of LRP and their 35 newborns, group 2 – 35 multi-pregnant (MP) of LRP and their 35 newborns. The 3 control group included 25 healthy pregnant women aged 18 to 25 years and their 25 newborns. DUS was performed on Aloka SD SSD 3500 device (Japan), and a transvaginal sensor was used if necessary. Newborns were assessed on the APGAR score at 1 and 5 minutes after birth. Of the instrumental methods for examining newborns, brain ultrasound examination (neurosonography) was used. Results: analyzing the DUS results of LRP pregnant, depending on the labor parity, it was found that in the 1st group there was an increase in resistance in both uterine arteries (61%), an increase in the resistance index and pulsation index, a decrease in diastolic blood flow, characteristic of arteries with high resistance. Hemodynamic parameters in the mid-brain artery (MBA) of the fetus remained normal in all pregnant women. LRP women often born children in a state of asphyxia, with neurological disorders, and these children often has more complex postnatal adaptation and concomitant pathology. Among LRP women, primiparous has significantly more severe disorders. Conclusion: the data of uteroplacental fetal blood flow of the 1st group correspond to blood flow disorders of the IA degree, which indirectly indicates a compensatory reaction of the vascular system of uteroplacental fetal blood flow, as well as the absence of a tendency to an increase in the severity of fetoplacental insufficiency. It is possible that high incidence of neurological disorders in children born to LRP women is associated with age-related changes in their germ cells, use of assisted reproductive technologies, intake of hormonal drugs at an early stage of pregnancy and environmental factors associated with iodine deficiency in the region which includes the North Caucasus.

Ultrasound diagnosis conditions of the uterus scar in pregnant and non-pregnant women

2020 ◽  
pp. 39-43
Author(s):  
N. Kovyda ◽  
◽  
N. Honcharuk ◽  
Keyword(s):  
Blood Flow ◽  
Cesarean Section ◽  
Pregnant Women ◽  
Vascular Resistance ◽  
Ultrasound Examination ◽  
Ultrasound Diagnosis ◽  
Control Group ◽  
Previous Cesarean Section ◽  
Uterine Arteries ◽  
Previous Cesarean

The dynamic increase in the number of caesarean section in Ukraine and around the world remains one of the main topics of discussion, which is intensively discussing by leading scientists. The traditional assessment of the ability of the uterus scar during pregnancy, based mainly on the analysis of clinical and anamnestic data, is not high informative, and the ambiguous conclusions of the sonographic study indicate the need for further detailed study. Therefore, there is reason to believe that the development of criteria for ultrasound assessment of the condition of the uterus scar after previous cesarean section will use them to predict the possibility of spontaneous delivery in the future and remains relevant. The objective: study the features of ultrasound diagnosis of the condition of the scar on the uterus in pregnant and non-pregnant women. Materials and methods. Observations and retrospective analysis of medical records of pregnant women and birth histories in 150 women with a scar on the uterus after a previous cesarean section for the period from 2014–2019. Results. In women who became pregnant up to a year after the previous cesarean section, the most pronounced changes in blood flow were in the uterine arteries, especially during gestation 28–34 weeks. Also, in women with a failed uterus scar, changes in blood flow were most often observed in the uterine arteries at all levels and were significantly higher, compared with women with a capable uterus scar and women from the control group. In women with an insolvent uterus scar, the most pronounced changes in the indices of vascular resistance was observed in the uterine arteries, in particular the right uterine artery. Conclusion. The peculiarities of blood flow and vascular resistance in different vessels of the myometrium depending on the gestation period and the timing of pregnancy after a previous cesarean section. The obtained detailed ultrasound examination and mathematical calculation of the results of ultrasound examination of the uterus and postoperative uterus scar after previous cesarean section in non-pregnant women allowed to create a scale for assessing the condition of the uterus scar after previous cesarean section in non-pregnant women. Keywords: cesarean section, uterus scar, ultrasound, pre-pregnancy preparation of women.

scholarly journals Fetal blood flow velocity waveforms in relation to changing peripheral vascular resistance

1987 ◽  
Vol 15 (2) ◽  
pp. 119-127 ◽  
Author(s):  
M.J. Noordam ◽  
J.W. Wladimiroff ◽  
F.K. Lotgering ◽  
P.C. Struijk ◽  
H.M. Tonge
Keyword(s):  
Blood Flow ◽  
Flow Velocity ◽  
Vascular Resistance ◽  
Blood Flow Velocity ◽  
Peripheral Vascular Resistance ◽  
Fetal Blood ◽  
Peripheral Vascular

Decompensation placental dysfunction: diagnostics and delivery tactics

2017 ◽  
pp. 66-68
Author(s):  
V.I. Boyko ◽  
◽  
S.A. Tkachenko ◽  
Keyword(s):  
Pregnant Women ◽  
Key Words ◽  
Retrospective Analysis ◽  
Control Group ◽  
Present Stage ◽  
Placental Dysfunction ◽  
Perinatal Pathology ◽  
Delivery Times ◽  
Case Rate ◽  
Major Factors

The objective: depression of frequency of perinatal pathology at women with decompensation form of placental dysfunction by improvement of the main diagnostic and treatment-and-prophylactic actions. Patients and methods. 154 pregnant women in gestation term from 22 to 40 weeks were surveyed. Depending on features of course of pregnancy and families of all surveyed it was divided into 4 groups. The group of the retrospective analysis was made by 45 pregnant women with decompensation placental dysfuction, the group of prospective research included 109 pregnant women of whom the main group was made by 38 women with decompensation form of placental dysfunction, the group of comparison included 47 pregnant women with the compensated form of placental dysfunction. The control group was made by 24 pregnant women with the uncomplicated course of pregnancy and labors. The complex of the conducted researches included clinical, ehografical, dopplerometrical, laboratory, morphological and statistical methods. Results. Use of advanced algorithm of diagnostic and treatment-and-prophylactic actions allows to increase efficiency of diagnostics of decompensation form of placental dysfunction for 33.3%, and rational tactics of a delivery leads to depression of perinatal pathology for 22.7%. Conclusion. Decompensation placental dysfuction is one of the main reasons for perinatal mortality and a case rate at the present stage. Use of the algorithm of diagnostic and treatment-and-prophylactic actions improved by us allows major factors of risk of this complication and the indication for change of tactics and delivery times. Key words: decompensation placental dysfunction, diagnostics, delivery tactics.

Optimisation of tactics of conducting pregnancy and labours at women after auxiliary reproductive technologies

2016 ◽  
pp. 160-164
Author(s):  
D.N. Maslo ◽  
Keyword(s):  
Pregnant Women ◽  
Resistance Index ◽  
First Trimester ◽  
Reproductive Technologies ◽  
Premature Delivery ◽  
Control Group ◽  
Uterine Arteries ◽  
Placental Dysfunction ◽  
Placental Blood ◽  
Two Stages

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.

scholarly journals Состояние гемодинамики у беременных с ожирением

2015 ◽  
Author(s):  
М. М Матлубов ◽  
А. А. Семенихин ◽  
С. А Рузибаев ◽  
Н. И Закирова ◽  
О. В Ким
Keyword(s):  
Adverse Effect ◽  
Body Mass Index ◽  
Pregnant Women ◽  
Cardiovascular System ◽  
Functional State ◽  
Control Group ◽  
Hemodynamic Status ◽  
Uncomplicated Pregnancy ◽  
Normal Body Weight ◽  
Survey Results

СОСТОЯНИЕ ГЕМОДИНАМИКИ У БЕРЕМЕННЫХ С ОЖИРЕНИЕМ - В данной статье представлены изменения состояния гемодинамики у беременных с ожирением при неосложнённой беременности. В исследование включены результаты комплексного обследования 84 беременных в возрасте от 23 до 28 лет с ожирением различной степени выраженности при сроках гестации 36-38 недель. В контрольную группу вошла 21 беременная аналогичного возраста и срока гестации с нормальной массой тела. У всех наблюдаемых пациентов беременность согласно консультациям акушер-гинекологов была признана неосложнённой. Степень ожирения оценивали по индексу массы тела. Проведённое исследование показало, что избыточный вес тела по мере её прогрессирования оказывает крайне неблагоприятное влияние на гемодинамику и функциональное состояние сердечно-сосудистой системы в целом, снижает коронарные резервы. Наиболее выраженные нарушения функционального состояния сердечно-сосудистой системы имеют место при ожирении II и III степеней.<br />СТАН ГЕМОДИНАМІКИ У ВАГІТНИХ З ОЖИРІННЯМ - Уданій статті представлено зміни стану гемодинаміки у вагітних з ожирінням при неускладненій вагітності. У дослідження включені результати комплексного обстеження 84 вагітних у віці від 23 до 28 років з ожирінням різного ступеня вираження при термінах гестації 36-38 тижнів. У контрольну групу ввійшла 21 вагітна аналогічного віку та терміну гестації з нормальною масою тіла. У всіх спостережуваних пацієнтів вагітність згідно з консультаціями акушер-гінекологів була визнана неусклад- неною. Ступінь ожиріння оцінювали за індексом маси тіла. Проведене дослідження показало, що надлишкова маса тіла в міру її прогресування украй несприятливо впливає на гемо- динаміку і функціональний стан серцево-судинної системи в цілому, знижує коронарні резерви. Найбільш виражені порушення функціонального стану серцево-судинної системи мають місце при ожирінні II і III ступенів.<br />HEMODYNAMIC STATUS OF PREGNANT WOMEN WITH OBESITY - In this article are represented the changes in hemodynamic status of pregnant women with obesity in uncomplicated pregnancy. In the study was included the full survey results of 84 pregnant women aged between 23 and 28 years with obesity of varying severity at 36-38 weeks gestation. The control group included 21 pregnant women of similar age and gestational age with normal body weight. All observed patients, pregnancy according obstetrical consultation was recognized uncomplicated. The degree of obesity was assessed by body mass index. Researchers conducted showed that overweight as its progression has a very adverse effect on hemodynamics and functional state of the cardiovascular system as a whole, reduces coronary reserve. The most pronounced violation of the functional state of the cardiovascular system occurs in obesity 2nd and 3rd degree.<br />Ключевые слова: беременность, ожирение, гемодинамика.<br />Ключові слова: вагітність, ожиріння, гемодинаміка

scholarly journals Role of calcitriol in modulating of placental dysfunction in pregnant women with chronic kidney disease

2020 ◽  
Vol 17 (4) ◽  
pp. 493-499
Author(s):  
G. S. Manasova ◽  
N. V. Didenkul ◽  
L. V. Mnich ◽  
Z. V. Chumak ◽  
N. V. Kuzmin
Keyword(s):  
Vitamin D ◽  
Kidney Disease ◽  
Pregnant Women ◽  
Kidney Diseases ◽  
Active Form ◽  
Decisive Role ◽  
Control Group ◽  
National Academy Of Sciences ◽  
Placental Dysfunction ◽  
Group I

The pleiotropic effects of vitamin D (VD), whose active form is synthesized in the kidneys, play a certain role both in forming and functioning the feto-placental system, including various pregnancy complications. The aim of the study was to evaluate the vitamin D status in pregnant women with placental dysfunction (PD) and chronic inflammatory kidney disease (CIKD). During 24–34 pregnancy weeks, 56 pregnant women with PD were examined (main group ‒ I); 24 patients (42.85 %) had chronic pyelonephritis (group IA). The control group (group II) had 31 conditionally healthy pregnant women. The total VD level in the blood was determined by ELISA; in addition to the general clinical standard examination, the urine also underwent bacteriological examination. The VD mean level in pregnant women with PD and CIKD was significantly lower than that in the control group (31.08 ± 7.2 and 45.42 ± 9.67 ng/ml (p <0.01)). Only 33.33 % of pregnant women in group IA had a VD optimum, as well as 93.55 % (p < 0.01) in the control group and 17.86 % in group I. 8.33 % of pregnant women had a VD deficiency in group IA (RR = 2.09; CI 95 % ‒ 1.8‒2.42). The patients with a VD-deficiency were absent in the control group. 58.33 % of women in group ІА had a suboptimal VD level and 6.45% in the control group (RR = 3.57; CI 95 % ‒ 1.62‒7.88). Bacteriuria was observed in all pregnant women with a VD-deficient or suboptimal level. At the optimum VD level, bacteriuria was diagnosed twice less (χ2 = 66.67; p <0.01). In patients with an inadequate VD level, CIKD was diagnosed 3.8 times more (RR = 3.57; CI 95 % ‒ 1.62‒7.88). 494 Proceedings of the National Academy of Sciences of Belarus. Medical series, 2020, vol. 17, no. 4, pp. 493–499 A significantly calcitriol reduction in pregnant women with placental dysfunction suggests that the deficiency or the suboptimal level of vitamin D and inflammatory kidney diseases may be the interdependent processes that play a decisive role in the formation of placental dysfunction.

Anatomo-functional state of organs of small tangs in poor responders

2018 ◽  
pp. 50-54
Author(s):  
G.V. Strelko ◽  
Keyword(s):  
Blood Flow ◽  
Functional Status ◽  
Vascular Resistance ◽  
Functional State ◽  
Color Doppler ◽  
Ovarian Response ◽  
Treatment Programs ◽  
Poor Responders ◽  
Surgical Interventions

The objective: study of the anatomical and functional status of the uterus and ovaries in poor responders in ART programs. Materials and methods. Determination of the anatomical features and functional status of the uterus and ovaries in «poor responders» to exclude a clinically significant pathology that would affect the success of the ART program was performed by ultrasound scanning with the study of topografts, sizes, contours, echostructure of the uterus and ovary and determination of the volume of the ovaries and the number of antral follicles. Blood flow in the vessels of the stroma of the ovaries, as one of the important criteria for assessing the possible ovarian response, was assessed using color Doppler mapping. Results. «Poor responders» patients have a smaller sise of ovaries and a reduced number of antral folicles, which can be explained by the surgical interventions carried out according to the type of ovarian resection and the cysts removal. In addition, during the transition from the follicular to luteal phase, there is no decrease in the vascular resistance of the dominant follicle, which slows the process of ovulation and reduces the likelihood of fertilization in conditions of increased vascular resistance. Conclusion. Ultrasound examination of the uterus and ovaries and doplerometric investigation of peryfollicular blood flow allows us to thoroughly approach both the evaluation of the ovarian response and the endometric readiness for implantation, which dictates the need for an individual selection of preconceptional preparation and treatment programs for ART. Key words: anatomical and functional state, pelvic organs, ovarian reserve, peryfollicular blood flow, poor responders.

scholarly journals Algorithm for the diagnosis and treatment of primary placental dysfunction in pregnant women of risk groups

2021 ◽  
pp. 33-38
Author(s):  
O.V. Kravchenko
Keyword(s):  
Blood Flow ◽  
Pregnant Women ◽  
Risk Groups ◽  
The State ◽  
Uterine Arteries ◽  
Placental Dysfunction ◽  
Early Stages ◽  
Tract Infections ◽  
Complex Drug ◽  
Micronized Progesterone

Research objective: to evaluate the effectiveness of diagnosis and complex therapy of placental dysfunction (PD) in early stages of gestation.Materials and methods. We examined 110 pregnant women with risk for the primary PD. Exclusion criteria were multiple pregnancies, anomalies of fetal development and internal genital organs of the mother, pregnancy resulting from assisted reproductive technologies.The diagnosis of PD was established in 56 women (group I) based on the assessing the state of extraembryonic structures and blood flow in the spiral and uterine arteries at 12–13 weeks of gestation. The rest of the patients (54 women) entered the control group without PD (group II).Results. All pregnant women with verified PD at 12–13 weeks were prescribed complex drug treatment, which included micronized progesterone, venotonic Normoven, Magnicum, and Artihol. As a result of treatment, already at 22–24 weeks of gestation, the average value of blood flow (resistance index) in the uterine and spiral arteries did not differ significantly in the groups. There was no significant difference in fetometry and placentometry indices at 35–36 weeks of gestation. Complications of the gestational period in patients in the study groups were also almost the same.Conclusions. History of hormonal disorders and miscarriage, clinical signs of miscarriage in early gestation, abnormal embryo placement, extragenital pathology, and genital tract infections are risk factors for PD. Determination of the state of extraembryonic structures at 7–8 weeks of pregnancy (ovum volume, blood flow in the corpus luteum) and at 12–13 weeks (chorion volume, vascularization index, blood flow in the spiral and uterine arteries) can serve as a verification criterion for the PD development. Complex drug therapy, which began from the early stages of gestation (micronized progesterone, Normoven, Magnicum, Artihol) has established itself as an effective method of treating primary PD in pregnant of risk groups.

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