scholarly journals Prevention of pregnancy complications and delivery at low placentation

2021 ◽  
Vol 25 (3 (99)) ◽  
pp. 83-88
Author(s):  
S. Pecheriaha ◽  
I. Marynchyna

Objective is to evaluate the effectiveness of the developed method of preventing pregnancy complications with low placentation from early gestation.Material and methods. We have examined 119 pregnant women with low placentation. This diagnosis was made at 6-7 weeks of gestation on the basis of echographic research. The main group consisted of 64 pregnant women with low chorionic location who underwent prevention from pregnancy complications in early gestation by the complex of medicines developed by us and a control group -55 women with low placentation who had not undergone complications prophylaxis from early gestational periods. The prophylactic complex included Luteina, ginkgo biloba extract, folio and biolectra. To assess the effectiveness of the therapy in the study groups, we analyzed the course of pregnancy in early and late gestation, as well as complications of pregnancy and delivery.Results. The frequency of pregnancy pathologies in the main group, where the prevention of pregnancy complications from early gestation with low placentation, was significantly lower than in the control group. According to the study, the risk of abortion with bleeding and without bleeding in the first and second trimesters significantly decreased in the main group of pregnant women (p<0.05). In the third trimester of gestation in the group where the prevention of pregnancy complications was significantly reduced, the incidence of preterm birth, premature detachment of the low-lying placenta, fetoplacental dysfunction, fetal developmental delay syndrome and fetal distress during pregnancy (p<0.05). Also, in the main group there was a lower percentage of premature births and births that ended by cesarean section.Conclusions. 1. The place of attachment of the placenta in the uterine cavity is closely related to its function, the development of placental dysfunction, pregnancy and delivery. 2. Studies have shown the effectiveness of our proposed comprehensive drug prevention of complications of pregnancy with low placentation, which in turn has led to improved pregnancy and delivery and has become an effective means of preventing placental dysfunction.

2017 ◽  
pp. 50-53
Author(s):  
I.E. Basiuga ◽  

The objective: to improve the treatment of placental dysfunction in pregnant women with oligohydramnios regarding their psychological condition. Patients and methods. Survey was conducted in 120 pregnant women with oligohydramnios the gestational age of 27-29 weeks (main group) and 30 physiologically healthy pregnant women (control group) on the basis of the city clinical hospital of Ivano-Frankivsk. Results. During the study of psychological features we have not yet determined significant differences in the level of personal anxiety with oligohydramnios as compared with pregnant women with physiological gestation. Also, was found the division of examined for low, medium, and high levels of this indicator between the two pregnant groups. In particular, approximately half of the individuals had an average level of personal anxiety – 14 (46.67±9.11%) and 57 healthy pregnant women (47.50±4.56%) with oligohydramnios, third – highest, respectively 11 (36.67±8.80%) and 39 (32.50±4.58%), the lowest level recorded in 5 (16.67±6.80 per cent) and 24 (20.00±3.65%) patients. A comprehensive approach to correction of the condition of water shortage has been applied in women of the main group, which included: psychological support for couples with sessions with a psychologist to control emotions. Establishing emotional contact with a woman, trust relationships, discussion of physical and emotional changes is a part of pregnancy. Conclusion. In the result of the researches, the approach proposed by us to the treatment of pregnancy with oligohydramnios, allowed to reduce the stress of compensatory mechanisms of the fetoplacental unit, which contributed to the reduction of anxiety in pregnant and have improved not only obstetric but also perinatal outcomes in women of the main group. Key words: pregnancy, placental dysfunction, oligohydramnios, Cytoflavin.


2020 ◽  
pp. 63-65
Author(s):  
O.І. Krotik ◽  

The objective: to identify the features of pregnancy, childbirth, the postpartum period in patients with sexually transmitted infections. Materials and methods. A retrospective analysis of 150 pregnancy and childbirth histories was performed: the main group included 100 pregnant women with a history of sexually transmitted infections (STIs) and episodes of manifestations during this pregnancy and 50 pregnant women in the control group without this pathology. The exclusion criteria were pregnant women with sexually transmitted infections whose pregnancies ended in short-term abortions. Results. The threat of abortion was detected in 46% of the main group, against 26% of the control group. Oligohydramnios 13% in the main group against 8% in the control group. Preeclampsia in the main group 12%, against 5% in the control group. FGR in the main group 10% vs. 6% in the control. Placental dysfunction in the main group of 20% vs. 16% in the control. Bacterial vaginosis was 67% in the main group versus 14% in the control group. The risk of miscarriage, premature birth in the main group is 20% compared with the control group of 4%. Premature rupture of membranes was observed in 33% of women in the main group against 16% in the control group. Conclusions. The threat of abortion occurred in women of the main group (46%), which is 1.7 times more often than in the control group (26%). Oligohydramnios was observed in (13%) of the main group, which is 1.6 times more than in the control group (8%). Preeclampsia occurred 2 times more often in the main group (12%) than in the control group (6%). FGR occurred 1.7 times more often in the main group (10%) than in the control group (6%). Placental dysfunction was 1.25 times more common in the main group (20%) than in the control group (16%). A high percentage of bacterial vaginosis (67%) was observed in patients of the main group, which is 4.8 times higher than in the control group (14%). The risk of miscarriage, premature birth in the main group was higher (20%) and was observed 5 times more often than in the control group (4%). Premature rupture of membranes is observed in (33%) women in the main group, which is 2 times higher than in the control group (16%). Keywords: sexually transmitted infections (STIs), pregnancy, childbirth.


Author(s):  
A. V. KAMINSKYI ◽  
O. I. ZHDANOVYCH ◽  
T. V. KOLOMIICHENKO ◽  
R. I. ISMAILOV ◽  
S. M. YANUTA

Cervical insufficiency (CI) remains one of the leading causes of miscarriage and premature birth. Purpose of the study: to determine the frequency of CI, the characteristics of the anamnesis, the course of pregnancy, childbirth, the state of the newborn and the identification of potential risk factors. Material and research methods. 8728 birth histories were analyzed, among which 166 (1.9%) stories of women whose pregnancy was complicated by CI were found. The main group consisted of 166 pregnant women with CI, the control group included 55 women without CI and other severe obstetric- gynecological and somatic pathologies. The results obtained and their discussion. The incidence of CI on average over 5 years was 1.9%. With CI, there is a significantly lower percentage of young women, and at the age of 35 and over - 27.1% of pregnant women versus 10.9% in the control group. Only one third (33.7%) of women with CI can be considered somatically healthy. The morbidity structure is dominated by endocrine pathology (30.7%), among which metabolic syndrome / obesity (19.9%) and diseases of the urinary excretory system (27.7%) are distinguished. High frequency of pathology of the cardiovascular system (21.1%) and autonomic dysfunction syndrome (25.9%), hepatobiliary pathology (15.1%), gastrointestinal diseases (19.3), allergic manifestations (16.9%). A third of patients (28.9%) have a combination of two or more somatic diseases. Every fourth woman has a history of an infectious pathology of the urinary excretory sphere (25.9). In 27.7% of patients - a combination of several infectious pathologies. Half of the patients (53.0%) had a complicated gynecological history: cervical ectopy (33.7%), chronic infectious diseases of the genital area (16.3%) and PCOS: (13.9%), synechiae of the uterine cavity (6.6 %) and congenital malformations of the genitals (3.0%). The combination of several gynecological pathologies was observed in 18.1% of women. Every fourth woman underwent an excision of the cervix (25.9%), 42.8% - intrauterine interventions with the expansion of the cervical canal, 59.2% of them two or more times. According to the obstetric anamnesis, spontaneous miscarriages and medical abortions in 27.7% and 33.7% of women, in 18.1% - a missed pregnancy, every fourth patient has premature birth (25.9%), and every 10th patient has suffered injuries cervix. With a current pregnancy, the threat of premature birth is most often noted (51.2%), in second place is an exacerbation of infection of the genitourinary sphere (41.0%) and the threat of premature birth (38.0%). High incidence of placental dysfunction (30.7%), gestational diabetes (13.9%), fetal growth retardation (12.0%) and preeclampsia (7.3%). Premature birth in 38.0% of cases, in 31.9% - premature rupture of membranes, delivery by cesarean section in 19.3% of cases. Noteworthy is the high frequency of intrauterine infection (13.9%). Conclusion. Based on the results of a retrospective analysis, after a more detailed assessment of possible risk factors for CI, the most informative ones will be identified and proposed for use in clinical practice.


2020 ◽  
Vol 24 (4 (96)) ◽  
pp. 80-84
Author(s):  
S. Pecheriaha ◽  
I. Marynchyna

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.


2017 ◽  
pp. 41-45
Author(s):  
L.I. Vorobey ◽  

The objective: to improve the effectiveness of gestational complications prevention in women with a previous perinatal losses (PL) by diagnostic methods optimization. Patients and methods. 85 pregnant women with previous perinatal losses were examined. Group II (control group) included 89 pregnant women without PL. The relationship between neurovegetative violations and pregnancy complications in women with adverse obstetric history were found using the heart rate variability method and determination of mother–placenta–fetus system status. Results. The overbalance of the sympathetic effects, mostly in the third trimester, was observed in pregnant women with previous perinatal losses, unlike the control group (p<0,05). This may be explained due to depletion of compensatory reserves of autonomic nervous system. In the second trimester increased sympathetic tone was established after stress tests in women of the main group, probably, because of the compensatory-adaptive reactions of all parts of the autonomic nervous system realization. Conclusion. Vegetative homeostasis violations with increased sympathetic tone cause placental dysfunction with metabolic changes, fetal growth retardation and other gestational complications. The dominance of sympathetic tone in pregnant women with previous perinatal losses and hormonal function of mother–placenta–fetus system indicate an imbalance of neurohumoral regulation and can be the diagnostic and prognostic sign of pregnancy complications. Key words: neurovegetative regulation, perinatal losses, placental dysfunction, cardiointervalography.


2021 ◽  
Vol 8 (3) ◽  
pp. 182-187
Author(s):  
V.V. Lazurenko ◽  
I.B. Borzenko ◽  
O.A. Lyashchenko ◽  
O.B. Ovcharenko ◽  
D.Yu. Tertyshnyk

The aim of the study was to improve the modern diagnosis of placental dysfunction and its complications. Materials and methods. The study involved a prospective survey of 70 pregnant women divided into the main group (pregnant women with placental dysfunction) (n = 50) and the control group (n = 20). The main group was divided into subgroups of pregnant women with placental dysfunction and fetal growth retardation (n = 30) and pregnant women with placental dysfunction without fetal growth retardation (n = 20). The control group comprised 20 pregnant women with physiological gestation. Apart from history taking, the study comprised obstetric and general clinical examination, evaluation of endothelium- dependent vasodilation, serum concentrations of soluble forms of vascular and platelet- endothelial molecules of cell adhesion 1, indicators of athrombogenicity of the vascular growth wall, uterine-placental-fetal blood circulation, pathomorphological and histometric examination of the placenta. Results. Based on the obtained clinical-morphological and endotheliotropic criteria, a personalized clinical algorithm for managing pregnant women with placental dysfunction was developed and implemented. Conclusions. Assessment of pregnancy results in a prospective clinical study showed that the proposed algorithm for personalization of the risk of perinatal abnormalities not only helped to avoid antenatal mortality, but also to prevent intranatal and early neonatal losses in patients with placental dysfunction and fetal growth retardation.


2017 ◽  
pp. 66-68
Author(s):  
V.I. Boyko ◽  
◽  
S.A. Tkachenko ◽  

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.


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.


2018 ◽  
pp. 40-45
Author(s):  
O.V. Bulavenko ◽  
◽  
L.R. Ostapiuk ◽  
V.O. Rud ◽  
A.S. Voloshinovskii ◽  
...  

The problem of postpartum pyo-inflammatory diseases requires the introduction of new approaches to its solution and optimization of diagnostic and therapeutic developments. The objective: was to determine the optimal time for manual vacuum aspiration of the uterus in postpartum endometritis, correction of therapeutic tactics and control of patients in the framework of the method of fluorescence spectroscopy. Materials and methods. The main group – 170 women with postpartum pyo-inflammatory diseases, control group – 40 women with uncomplicated course of the postpartum period. Their blood serum was examined using the method of fluorescence spectroscopy, in particular after manual vacuum aspiration of the uterus. Results. Fluorescence spectra were studied for 40 women of control group and 170 women of the main group, among them in 44 (25.8%) – in the dynamics during the treatment after manual vacuum aspiration of the uterine cavity. In 93.2% of the patients in the main group after it an increase in fluorescence intensity and max displacement in the short-wave region were recorded, which was a reliable sign of improving the condition of the patients. Conclusion. The use of the method of fluorescence spectroscopy in postpartum endometritis after manual vacuum aspiration of the uterus significantly helps to improve the monitoring of the process of treatment and, if necessary, to correct it in order to recover the patients in time. Key words: endometritis, manual vacuum aspiration of the uterus, the method of fluorescence spectroscopy.


2018 ◽  
Vol 22 (1) ◽  
pp. 173-177
Author(s):  
V. F. Oleshko

A functional cervical insufficiency plays an important role in the etiology of miscarriage and premature birth. The aim of research was to estimate the hormonal balance indexes during the course of pregnancy in pregnant women with functional cervical insufficiency and to correct the revealed violations in order to prevent obstetric complications. 101 pregnant women with confirmed diagnosis of a functional cervical insufficiency in term of gestation 22–32 weeks of pregnancy (the main group) and 34 pregnant women and women in labor with physiological condition of the cervix (the control group) were examined. The content of estradiol, progesterone, cortisol and prolactin was examined in the blood serum. On the second stage of examination 63 pregnant women obtained general basic therapy (I main group) and 38 pregnant women (II main group) received a developed treatment complex which included progesterone support by the micronized progesterone 200–400 mg twice a day up to 34–35 weeks of pregnancy, magnesium support by the magnesium orotate dehydrate in the therapeutic dosage and arginine glutamate in the therapeutic dosage. The correction of cervical insufficiency was performed with the help of a cervical pessary (according to indications). The examination of hormonal balance revealed an accurate decease of progesterone concentration on the background of high concentration of estradiol and increased levels of stress-associated hormones. Propitious influence of the developed therapy is proved by increase of progesterone concentration in the blood serum, normalization in stress-associated hormones balance according to gestational age. All this provideded the decrease of specific weight of threatened preterm labors, placental dysfunction, vaginitis, bacterial vaginosis and delay the labors up to 38–39 weeks of gestation in 97,4% of pregnant women (82,5% in the I main group). Prescription of micronized progesterone, magnesium orotate dehydrate, arginine glutamate to pregnant women with a cervical insufficiency is reasonable and effective one comparing with general and traditional therapy.


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