scholarly journals The pharmacological safety of a combined pharmaceutical composition for the correction of placental dysfunction in pregnant women

2020 ◽  
Vol 0 (4(65)) ◽  
pp. 35-39
Author(s):  
N. Seliukova ◽  
S. Kustova ◽  
M. Kudrya ◽  
N. Ustenko ◽  
M. Boiko ◽  
...  
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.


2016 ◽  
pp. 25-28
Author(s):  
J.M. Melnik ◽  
◽  
A.A. Shlyahtina ◽  

The article presents the predictors of placental dysfunction on the early stage of pregnancy. The objective: the search for prognostic markers and criteria for the occurrence of placental insufficiency in the early stages of the gestational process to optimize the pregnancy and labor with improved perinatal outcomes. Patients and methods. To solve this goal in the period from 2013 to 2015 were conducted a comprehensive survey of 334 pregnant women, which depending on the peculiarities of pregnancy and childbirth were divided into groups. The control group consisted of 236 pregnant women with uncomplicated gestational period, no morphological signs of placental dysfunction. The study group included 98 patients with a complicated pregnancy who had revealed violations of the fetal-placental relations, which was confirmed by morphological examination of the placenta in the postpartum period. Results. It was found that pregnant women with placental insufficiency in the first trimester of pregnancy have higher levels of interleukin-1B (IL-1v) and interleukin-3 (IL-3) in comparison with physiological pregnancy, as well as there is a direct significant correlation between IL-1v and pulsative index (PI) in the spiral (r=0.84) and uterine artery (r=0.77), and the inverse correlation between the level of IL-3 and PI in the terminal branches of the umbilical artery (r=-0.69). Verified an inverse relationship between the concentration of endothelin-1, the level of vascular endothelial growth factor (r=-0.87) and placental growth factor (r=-0.73), and also a direct link between the content of endothelin-1 and PI in spiral arteries (r=0.89), uterine artery (r=0.83) and the terminal branches of the umbilical artery (r=0.79). Conclusion. Thus, it is proven that early predictors of placental dysfunction can be considered the concentration of endothelin-1, vascular endothelial growth factor, placental growth factor, interleukin-1, interleukin-3, and the indices of pulsative index. Key words: placental dysfunction, predictors, endothelin-1, vascular endothelial growth factor, placental growth factor, interleukin, pulsative index.


Author(s):  
G. S. Manasova ◽  
N. V. Didenkul ◽  
L. V. Mnich ◽  
Z. V. Chumak ◽  
N. V. Kuzmin

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.


2018 ◽  
pp. 31-35
Author(s):  
T.G. Romanenko ◽  
◽  
O.M. Sulimenko ◽  

The article presents the results of the effectiveness of the combined antimicrobial drug Guinex Forte, the effect of which is caused by metronidazole and miconazole, and the Orgil tablets at the stage of pregravid preparation in women of high-risk group, with regard to the development of placental insufficiency of infectious genesis and intrauterine infection. The objective: is to demonstrate the effectiveness of pregravid preparation for the normalization of vaginal biocenosis in pregnant women of high infectious risk. Materials and methods. 150 pregnant women were investigated, of which 100 with a high risk of infectious risk for placental dysfunction and intrauterine infection: Group I – 50 pregnant women who did not undergo pregravid preparation; Group II – 50 pregnant women who planned pregnancy and conducted pregravid preparation for prevention and treatment of bacterial vaginosis and vaginal candidiasis; Control group consisted of 50 pregnant women who gave birth again, without obstetrical and extragenital pathology in history. per vaginum. Results. In pregnant women in Group II, an intermediate type of dysbiosis was 1.2 times less likely than in pregnant women of group I, and vice versa, normocenosis was achieved 9.7 times more often in pregnant women who received pregravid preparation. After the therapy in the pregravid period, in pregnant women of group II in the first trimester of pregnancy quantitative and qualitative indices of biocenosis of the vagina were approaching, in most cases, to normal. In general, the spectrum of the microflora decreased from 21 to 14 species due to the reduction of pathogenic forms of staphylococci, streptococci, enterobacteria, E. coli, klebsiela, cornebacteria and clostridia. In patients of group II, the concentration of representatives of resident flora increased (lactobacillus Lg 5.06±0.7 CFU / ml and bifidobacterium-Lg 4.4±0.6 CFU / ml) and close to normal. Conclusion. Our proposed scheme of therapy and prevention of dysbiotic conditions in the pregravid period, in women of high infectious risk group led to a decrease in bacterial contamination of maternity paths of pregnant women in group II, which contributes to the restoration of vaginal microbiocenosis and positively affects the course of pregnancy, the condition of the fetus and the newborn. Key words: pregravid preparation, bacterial vaginosis, vulvovaginal candidiasis, placental dysfunction of infectious genesis, intrauterine infection.


2020 ◽  
Vol 69 (4) ◽  
pp. 23-28
Author(s):  
Kristina G. Tomayeva

Hypothesis/aims of study. Poor placental vascularization can lead to placental insufficiency, due to which the metabolism of nutrients and microelements between the maternal and fetal blood circulations subsequently decreases. Due to poor perfusion of placental vessels, placental dysfunction occurs. Chronic fetal hypoxia causes fetal growth retardation. The aim of this study was to assess the frequency of placental insufficiency in women with different somatotypes and to develop a model for predicting the risk of this pathology. Study design, materials and methods. A total of 390 women were examined, of whom 110 were macrosomatic, 173 mesosomatic, and 107 microsomatic. Somatometry was performed according to R.N. Dorokhov for women in the early stages of pregnancy (up to 9-10 weeks). Placental insufficiency markers (VEGF, PlGF, IL-6, and endocan-1) were determined spectrophotometrically in blood serum at the gestational age of 1213 and 2223 weeks using ELISA methods. Results. Placental insufficiency was significantly more prevalent among the women of the macro- and microsomatic body type compared with those of mesosomatotypes (p 0.05). In pregnant women with subsequent placental insufficiency, VEGF and PlGF serum levels at 1213 weeks were lower, when compared to those in patients who did not develop pathology (p 0.05), and the levels of serum endocan-1 and IL-6 were higher in comparison with those in individuals who did not develop pathology (p 0.05). Using multiple regression analysis, we obtained the regression equation (formula), which predicts the development of placental insufficiency in women of different somatotypes. Conclusion. The resulting formula allows us to accurately predict the development of placental insufficiency and to form high-risk groups among women for the development of this disease. This will contribute to the effective implementation of therapeutic and preventive measures to avert the development of this pathology.


2018 ◽  
Vol 9_2018 ◽  
pp. 41-47 ◽  
Author(s):  
Voevodin S.M. Voevodin ◽  
Shemanayeva Т.V. Shemanayeva ◽  
Shchegolev A.I. Shchegolev ◽  
Parkhomenko Yu.G. Parkhomenko Yu ◽  
◽  
...  

2018 ◽  
Vol 24 (2) ◽  
Author(s):  
Nataliya Henyk ◽  
Nataliya Yakumchuk

 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.


2017 ◽  
Vol 14 (4) ◽  
pp. 57-66
Author(s):  
Igor' S. Lipatov ◽  
Yurii V. Tezikov ◽  
Andrei D. Protasov ◽  
Nadezhda V. Martynova ◽  
Anna A. Bukreeva ◽  
...  

Introduction. Based on the knowledge of early gestational disorders related to metabolic syndrome (MS), pathogenetically relevant preventive treatment meeting the requirements of perinatal pharmacology can be developed. Aim. To reveal clinical and laboratory characteristics of early pregnancy and develop pathogenetically relevant preventive monotherapy for unfavorable gestational and perinatal outcomes in women with metabolic syndrome. Material and methods. A total of 230 women were investigated and divided into four groups: Group I consisted of 68 pregnant women with MS who refused any preventive measures; Group II comprised 97 women with MS who received periconceptional preventive monotherapy with dydrogesterone, a progestagen; Group III consisted of 35 healthy primigravidas women with physiological course of gestation; Group IV comprised 30 healthy non-pregnant women. Laboratory testing during IIII trimesters allowed to assess the dynamics demonstrated by markers of lipid spectrum, endothelial dysfunction, apoptosis, decidualization, energy metabolism, and immunomodulation. Results. A balance between factors of physiological damage and gestational adaptation in the course of physiological pregnancy has been shown to be of primary significance. In women with MS, embryo-placental dysfunction develops during early pregnancy, and this stage is preceding for major obstetric syndromes. Preventive administration of dydrogesterone in women with MS appeared highly effective: NNT (number needed to treat) was 1.33 (95% CI 0.91.8); OR 5.2 (95% CI 4.65.7). Conclusion. Pregestational changes and atherogenic profile of gestational process determine the course of early pregnancy in women with MS with the development of embryo-placental dysfunction and major obstetric syndromes. High efficacy in the prevention of unfavorable gestational and perinatal outcomes was shown by preventive dydrogesterone monotherapy.


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