scholarly journals DIAGNOSTIC FEATURES OF COMPLICATED CHOLELITHIASIS IN PREGNANT WOMEN

2019 ◽  
Vol 26 (1) ◽  
pp. 168-174
Author(s):  
Karen D. Antinyan ◽  
Evgenii S. Babenko ◽  
Vladimir M. Durleshter
Keyword(s):  
Pregnant Women ◽  
Conflict Of Interest ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Abdominal Ultrasound ◽  
Perinatal Complications ◽  
Laparoscopic Ultrasonography ◽  
Endoscopic Retrograde ◽  
Diagnostic Features ◽  
Ultrasound Diagnostics ◽  
Long Time

The aimis to describe modern approaches used in the diagnostics of cholelithiasis in pregnant women.Results.Cholelithiasis diagnostics in pregnant women is a rather difficult task, frequently taking a long time and significantly worsening the prognosis for both the mother and the fetus. Abdominal ultrasound is the “gold standard” for the diagnosis of cholelithiasis in pregnant women, allowing the diagnosis to be clarified and the treatment tactics to be adjusted. The possibilities of such modern methods as endoscopic ultrasound diagnostics, magnetic resonance cholangiopancreatography, endoscopic retrograde cholangiopancreatography, and laparoscopic ultrasonography used in difficult diagnostic cases are presented.Conclusion.The use of a maximal range of diagnostic studies in pregnant women makes it possible to establish the diagnosis as soon as possible and to reduce the frequency of surgical and related perinatal complications. As a result, the prolongation of pregnancy and a decrease in maternal and intrauterine mortality can be achieved.Conflict of interest: the authors declare no conflict of interest.

scholarly journals Clinical Characteristics of Paediatric Pancreatitis Caused by Pancreaticobiliary Malformation: A Single-Centre Retrospective Analysis

2021 ◽  
Vol 9 ◽  
Author(s):  
Jing Guo ◽  
Qian-ru Jia ◽  
Mei Sun
Keyword(s):  
Recurrence Rate ◽  
Age Of Onset ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Abdominal Ultrasound ◽  
Endoscopic Retrograde ◽  
Number Of Patients ◽  
Initial Onset ◽  
Clinical Profiles ◽  
The Difference ◽  
Enhanced Computed Tomography

Background/Aims: To investigate the clinical profiles of children with pancreatitis caused by pancreaticobiliary malformation.Methods: We retrospectively analysed the clinical data of children diagnosed with pancreatitis at our institute from June 2017 to January 2021.Results: A total of 195 patients and 169 control subjects were included in this study. Twenty-six (13.3%) patients had pancreaticobiliary malformation-related pancreatitis. The average age of onset in the pancreaticobiliary malformation pancreatitis (PMP) group was lower than that in the non-PMP group, and the difference was statistically significant. The number of patients in the PMP group that had jaundice was significantly higher than that of the non-PMP group (P < 0.05). Logistic regression analysis showed that total bilirubin (TB) and γ-glutamyltransferase (GGT) (odds ratio = 1.096, P < 0.01) were independent predictors of pancreaticobiliary malformation-related pancreatitis in children. The positive detection rate of pancreaticobiliary malformation was 68% for abdominal ultrasound, 38.4% for abdominal enhanced computed tomography, and 91.3% for magnetic resonance cholangiopancreatography (MRCP). The recurrence rate (34.6%) in the PMP group was higher than that in the non-PMP group (15.4%, P < 0.05); surgical therapy had the lowest recurrence rate. Age at initial onset of pancreatitis was younger and the period to recurrence was shorter in the PMP group than in the non-PMP group (P < 0.05).Conclusion: Pancreaticobiliary malformation is one of the major causes of paediatric pancreatitis. Elevated TB and GGT in patients with pancreatitis may be suggestive for underlying pancreaticobiliary malformation not solely to pancreatitis. MRCP should be used when pancreatitis due to pancreaticobiliary malformation is suspected. Surgery or endoscopic retrograde cholangiopancreatography-guided intervention may be helpful but further study is needed.

scholarly journals Management of ampullary tumours in children: still a challenge

2017 ◽  
Vol 99 (5) ◽  
pp. e139-e141
Author(s):  
P Fernandez-Eire ◽  
JL Vazquez Castelo ◽  
M Herreros Villaraviz ◽  
B Fernandez Caamaño ◽  
J Gonzalez-Carreró ◽  
...  
Keyword(s):  
Magnetic Resonance Cholangiopancreatography ◽  
Biliary Tree ◽  
Abdominal Ultrasound ◽  
High Morbidity ◽  
Low Grade ◽  
Endoscopic Retrograde ◽  
Ampullary Adenoma ◽  
Villous Tumour ◽  
Pancreatic Duct Dilatation

This study describes the case of the youngest patient ever reported with ampullary adenoma. The incidence of ampullary adenomas in childhood is unknown. Endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound are used in adults to assess and treat these lesions, although there are no instruments designed specifically for use in young children. A six-year-old girl was admitted for abdominal pain, vomiting, pruritus and weight loss. Abdominal ultrasound showed biliary tree (8mm) and pancreatic duct dilatation (4mm). Magnetic resonance cholangiopancreatography and computed tomography confirmed these findings, and also showed displacement of the ampulla to the left upper quadrant. An upper endoscopy confirmed a large ampullary adenoma.A laparotomy was performed and a 5cm villous tumour arising from the ampulla was excised. The postoperative course was uneventful. The histology demonstrated adenoma of the ampulla (intestinal type) without low-grade dysplasia. all clinical and radiological parameters are normal at 20 months follow-up.We describe the case of the youngest patient ever reported with ampullary adenoma. Pancreaticoduodenectomy carries high morbidity and mortality rates, and therefore it should be avoided in absence of histologically proven malignancy. We believe that surgical ampullectomy is a safe and oncologically correct procedure until better endoscopic instruments for peadiatric use will be designed.

scholarly journals A case of right hepatic duct entering cystic duct successfully treated by laparoscopic subtotal cholecystectomy through preoperatively placed biliary stent

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Hiroki Hirao ◽  
HiroHisa Okabe ◽  
Daisuke Ogawa ◽  
Daisuke Kuroda ◽  
Katsunobu Taki ◽  
...  
Keyword(s):  
Cystic Duct ◽  
Hepatic Duct ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Endoscopic Retrograde ◽  
Case Presentation ◽  
Endoscopic Nasobiliary Drainage ◽  
Subtotal Cholecystectomy ◽  
Upper Abdominal ◽  
The Right ◽  
Nasobiliary Drainage

Abstract Background Laparoscopic cholecystectomy is a well-established surgical procedure and is one of the most commonly performed gastroenterological surgeries. Therefore, strategy for the management of rare anomalous cystic ducts should be determined. Case presentation A 56-year-old woman was admitted to our hospital owing to upper abdominal pain and diagnosed with acute cholecystitis. Magnetic resonance cholangiopancreatography suspected that several small stones in gallbladder and the right hepatic duct drained into the cystic duct. Endoscopic retrograde cholangiopancreatography confirmed the cystic duct anomaly, and an endoscopic nasobiliary drainage catheter (ENBD) was placed at the right hepatic duct preoperatively. Intraoperative cholangiography with ENBD confirmed the place of division in the gallbladder, and laparoscopic subtotal cholecystectomy was safely performed. Conclusions The present case exhibited rare right hepatic duct anomaly draining into the cystic duct, which might have caused biliary tract disorientation and bile duct injury (BDI) intraoperatively. Any surgical technique without awareness of this anomaly preoperatively might insufficiently prevent BDI, and preoperative ENBD would facilitate safe and successful surgery.

INDIVIDUALIZED SPORTS MANAGEMENT SCHEME FOR PREGNANT WOMEN IN CHINA

2019 ◽  
Vol 19 (08) ◽  
pp. 1940055
Author(s):  
LIN YANG ◽  
QI LUO ◽  
YANG LU ◽  
SONG ZHANG ◽  
YIMIN YANG ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Health Care Services ◽  
Health Management ◽  
Moderate Intensity ◽  
Women's Sports ◽  
Perinatal Complications ◽  
Monitoring Methods ◽  
Target Heart Rate ◽  
Moderate Intensity Exercise ◽  
Women’S Sports

In recent years, pregnant women in China generally face problems such as unbalanced and excessive nutrition, lack of proper exercise during pregnancy, which shows a significant increase in weight during pregnancy, leading to an increasing trend of perinatal complications. At present, there is less sports health management system for pregnant women throughout pregnancy. In view of this, based on the existing research in related fields, this study deeply explores the appropriate monitoring methods of pregnant women’s sports in China. In this study, effective and convenient testing methods and evaluation criteria were proposed for pregnant women’s sports and psychology. The research idea was a method based on the pulse wave to detect pregnant women’s cardiac reserve capacity, and grading the Diastolic/Systolic value of pregnant women as a reference for grading individualized target heart rate range of moderate intensity exercise. The effective time and energy expenditure of pregnant women were assessed by monitoring the exercise process. The purpose is to help and guide pregnant women in the whole process of pregnancy self-movement management, and thus improve the quality of maternal health care services in China.

scholarly journals Lactate dehydrogenase levels in preeclampsia and its correlation with maternal and perinatal outcome

2019 ◽  
Vol 8 (4) ◽  
pp. 1505
Author(s):  
Nirmala Bhandari ◽  
Anjali Gupta ◽  
Simmi Kharb ◽  
Meenakshi Chauhan
Keyword(s):  
Lactate Dehydrogenase ◽  
Pregnant Women ◽  
Perinatal Outcome ◽  
Serum Lactate Dehydrogenase ◽  
Hypertensive Disorder ◽  
Perinatal Complications ◽  
Maternal Complications ◽  
Singleton Pregnancy ◽  
Intracellular Enzyme ◽  
Potential Marker

Background: Hypertensive disorder of pregnancy occurs in approximately 6-8% of all pregnancies. The most serious consequences for the mother and the baby are the result of preeclampsia and eclampsia. Lactate Dehydrogenase (LDH) is an intracellular enzyme. Recently LDH has been suggested as potential marker to predict severity of pre-eclampsia. The objective of the present study was to compare the serum lactate dehydrogenase levels in women with preeclampsia and normal pregnant women and to correlate lactate dehydrogenase levels with maternal and perinatal outcome in preeclampsia.Methods: An observational prospective study was conducted on 200 antenatal women attending the labour room emergency. Women with singleton pregnancy and cephalic presentation, from 28 weeks onwards were enrolled in the study. Out of 200, 100 were normal pregnant women and 100 were preeclamptic women. Serum LDH levels were measured in all women and maternal and perinatal outcome was assessed in terms of LDH levels.Results: Higher levels of LDH was observed in pregnant women with preeclampsia (627.38±230.04 IU/l) as compared to normal pregnant women (224.43±116.61 IU/l). The maternal complications were found to be maximum in women with LDH > 800 IU/l.  Abruption was the most common complication. The perinatal mortality and neonatal deaths were found to have significant correlation with high LDH levels.Conclusions: Maternal and perinatal complications were associated with higher LDH levels in preeclampsia patients. Serum LDH levels can be offered to all patients of preeclampsia and can be used to predict the prognosis of preeclampsia.

Features of psychoemotional condition and stress-assosiatate hormons bioproduction in pregnant women after application of assisted reproductive technologies

2018 ◽  
pp. 118-121
Author(s):  
L.M. Vygivska ◽  
◽  
I.A. Usevych ◽  
I.V. Maidannyk ◽  
V.F. Oleshko ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Emotional State ◽  
Assisted Reproductive Technologies ◽  
Past History ◽  
Reproductive Technologies ◽  
Main Group ◽  
Psychological Status ◽  
Perinatal Complications ◽  
History Of ◽  
High Level

The article represents the results of a prospective clinical and paraclinical examination of women with a history of infertility, pregnancy in which occurred as a result of the assisted reproductive technologies application. The objective: was to study the dynamics of pregnancy features of the psycho - emotional state and the concentration of stress-associated hormones in the serum of pregnant women after the application of assisted reproductive technologies in order to improve the tactics of antenatal care and prevention of obstetric and perinatal complications. Materials and methods. The main group consisted of 80 pregnant women with endocrine infertility, in which pregnancy occurred as a result of therapeutic cycles of ART, control – 50 first-pregnant women with spontaneous fertilization, taken in an arbitrary order of clinical, statistical and laboratory and instrumental studies. In pregnant women of the study groups, in order to determine the psycho emotional state in the screening mode, a clinical interview was conducted by filling out questionnaires that contained the Spilberger test questions in modification of Y.L. Hanina and «Test of relationof pregnant» by the method of I.V. Dobryakova. In the dynamics of pregnancy, the concentration of prolactin (PRL) and cortisol (K) was determined by the enzyme immunoassay on the Reader-MSR-1000 apparatus using test systems manufactured by Hema-Medicament (Russia). Results. Pregnant women with infertility in past history were characterized by a state of chronic stress. According to the results of the Spielberger test in modification Y .L. Hanina every second pregnant of main group had a high level of reactive and every fourth personal anxiety. Almost 90.0% of pregnant women after art are characterized by the presence of pathological PKGD, among which an alarming and depressive type was registered in every sixth and twelfth pregnant woman, respectively. The obtained data are confirmed by the results of the study of the level of K and PRL. For women with a history of infertility and pregnancy, which is the result of therapeutic cycles of ART, inherent in increasing concentrations of stress-associated hormones – cortisol and prolactin, which is one of the reasons for the complicated course of pregnancy and requires reasonable pathogenetic correction. Conclusion. For women who are pregnant as a result of the use of therapeutic cycles of art characterized by a high level of personal and reactive anxiety and PKGD, which confirm the presence of neuropsychiatric and afferent disorders. Increasing the concentration of stress-associated hormones is one of the causes of complicated pregnancy and requires a reasonable pathogenetic correction. Key words: pregnancy, infertility, assisted reproductive technologies, psychological status, cortisol, prolactin.

PERINATAL ASPECTS OF PREGNANCY AND CHILDBIRTH ON THE BACKGROUND OF VITAMIN D LACK IN PREGNANT WOMEN

2021 ◽  
Vol 74 (10) ◽  
pp. 2585-2587
Author(s):  
Vitaliy V. Maliar
Keyword(s):  
Vitamin D ◽  
Blood Serum ◽  
Pregnant Women ◽  
Perinatal Outcomes ◽  
Fetal Distress ◽  
Test System ◽  
Perinatal Complications ◽  
Pregnancy And Childbirth ◽  
Wide Range ◽  
Pregnancy And Delivery

The aim: To study the features of the course of gestation and perinatal outcomes of delivery in women with vitamin D lack. Materials and methods: The article presents the results of studies of the characteristics of the course of pregnancy and delivery outcomes in 50 patients with vitamin D lack compared with a group of 50 somatically healthy pregnant women with normal level of 25 (OH) D. In order to establish a lack of vitamin D in pregnant women in the 10-12, 20-22, 30-32 weeks of gestation electrochemiluminiscence method by using a test system EURIMMUN (Germany) in the blood serum level of 25-hydroxycalciferol (25 (OH) D) in pregnant women. Results: When analyzing the structure of complications in women with vitamin D lack during pregnancy and childbirth we found out that risk of premature birth and premature births dominated among all the complications, respectively (58.0% and 36.0%) against (12.0% and 16.0%), p <0.05. Vitamin D lack in pregnant women is often associated with a wide range of obstetric and perinatal complications, namely: preeclampsia, gestational diabetes, bacterial vaginosis , premature rupture of membranes, placental abruption, abnormal labor activity, fetal distress that required delivery by Caesarean section. Conclusions: An analysis of the course of pregnancy and childbirth in women of thematic groups proved the expediency of an individual approach to the therapy of obstetric pathology among women with vitamin D lack. Despite the level of 25 (OH) D in the blood serum of a pregnant woman of 30 ng / ml and below, it is advisable to prescribe vitamin D for prophylaxes and treatment of Vitamin D deficiency in mother and fetus.

Features of the genesial and somatic anamnesis at pregnant women with an undifferentiated dysplasia of connecting tissue

2017 ◽  
pp. 83-85
Author(s):  
A.L. Kostiuk ◽  
Keyword(s):  
Pregnant Women ◽  
Key Words ◽  
Clinical Laboratory ◽  
Perinatal Complications ◽  
Early Diagnostics

The objective: to study features of the somatic and genesial anamnesis at pregnant women with an undifferentiated dysplasia of connecting tissue for possibility of early diagnostics of the subsequent obstetric and perinatal complications. Patients and methods. 100 patients with clinical-laboratory signs an undifferentiated dysplasia of connecting tissue are surveyed. On the basis of the received results of the patient were divided into two groups: the main – 50 women (expression і6 points) regarded as patients with the expressed undifferentiated dysplasia of connecting tissue and group of comparison – 50 women (expression <6 points), regarded as patients without the connecting tissue expressed by an undifferentiated dysplasia. Results. Results of the conducted researches testify to an important role of the established features of the somatic and genesial anamnesis at pregnant women with clinical-laboratory and functional signs of an undifferentiated dysplasia of a connecting tissue. Conclusion. The received results need to be used for carrying out pregravidarny preparation and forecasting of possible obstetric and perinatal complications at pregnancy. Key words: undifferentiated dysplasia of connecting tissue, genesial and somatic anamnesis.

Pregnancy against the background of bacterial vaginosis: modern ways of solving the problem

2018 ◽  
pp. 23-30
Author(s):  
O.V. Gorbunova ◽  
◽  
N.P. Goncharuk ◽  
H.V. Zarichanska ◽  
N.A. Ermolovich ◽  
...  
Keyword(s):  
Bacterial Vaginosis ◽  
Pregnant Women ◽  
Local Therapy ◽  
Perinatal Complications ◽  
Aerobic Vaginitis ◽  
Vaginal Microflora ◽  
Keywords Screening ◽  
High Concentrations ◽  
Combined Drugs ◽  
Selection Of

Pregnancy against the background of bacterial vaginosis is accompanied by a high risk of obstetric and perinatal complications. Therefore, bacterial vaginosis must be treated in pregnant women. Screening and therapy are performed at the beginning of the II or III trimester of pregnancy. The survival of colonies of pathogenic microorganisms in biofilms is significantly increased, so they can remain viable even at high concentrations of antiseptic. The main advantage of using local combined antiseptic agents is the ability to achieve the maximum concentration of the antibiotic exactly in the place of the greatest accumulation of pathogens with the ability to influence biofilms. The objective: was to compare the efficacy and safety of various regimens of therapy with topical combined drugs (Lynda and Meratin Combi) in pregnant women with bacterial vaginosis. Materials and methods. The biocenosis of the vagina was investigated in 351 pregnant women in the II trimester. The diagnosis of bacterial vaginosis was established if the patient had any three of the Amsel criteria. Results. Microbiological screening of the vaginal biocenosis in the II trimester of pregnancy showed that normocenosis among the surveyed was 18.5%; bacterial vaginosis – 31.6%; vulvovaginal candidiasis – 26.5%; aerobic vaginitis – 22.8%, trichomonas vaginitis – 0.6%. Against the background of bacterial vaginosis, the threat of miscarriage, placental dysfunction occurred 6 times more often, anemia and preeclampsia three times more often, gestational pyelonephritis twice more often than in healthy pregnant women. In most patients, the sensitivity of the vaginal microflora to metronidazole and ornidazole is the same, but depends on the dose of the antiseptic, the sensitivity to miconazole was almost twice as high as to nystatin. This confirms the need for a differentiated selection of antiseptics for local therapy of bacterial vaginosis during pregnancy. Conclusion. A more rapid dynamics of the disappearance of the main symptoms of bacterial vaginosis and the normalization of the pH of the vaginal secretion were noted after the use of the drug Limenda. In order to prevent relapse of the disease, it is necessary to carry out the second stage of treatment with probiotics to restore its own lactoflora. Keywords: screening of vaginal biocenosis in the II trimester of pregnancy; complications of pregnancy against the background of bacterial vaginosis; treating bacterial vaginosis during pregnancy; biofilms; sensitivity of the vaginal microflora to antiseptics; topical treatment of bacterial vaginosis; Limenda; Meratin Kombi.

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