scholarly journals The influence of the heliogeophysical factors on the clotting of blood of pregnant women with placental insufficiency

2018 ◽  
Vol 3 (3) ◽  
pp. 34-40
Author(s):  
E.V. Osipova ◽  
◽  
A.V. Ukhova ◽  
V.V. Sukhovskaya ◽  
N.V. Protopopova ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Placental Insufficiency ◽  
Heliogeophysical Factors

Maternal-Fetal Management in Trombophilia Related and Placenta-Mediated Pregnancy Complications

2018 ◽  
Vol 69 (9) ◽  
pp. 2396-2401
Author(s):  
Costin Berceanu ◽  
Elena Loredana Ciurea ◽  
Monica Mihaela Cirstoiu ◽  
Sabina Berceanu ◽  
Anca Maria Ofiteru ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Pregnancy Complications ◽  
Case Control Study ◽  
Case Control ◽  
Placental Insufficiency ◽  
Management Options ◽  
Specific Therapy ◽  
Pregnancy Morbidity ◽  
The Impact ◽  
Control Study

It is widely accepted that thrombophilia in pregnancy greatly increases the risk of venous thromboembolism. Pregnancy complications arise, at least partly, from placental insufficiency. Any change in the functioning of the gestational transient biological system, such as inherited or acquired thrombophilia, might lead to placental insufficiency. In this research we included 64 pregnant women with trombophilia and 70 cases non-trombophilic pregnant women, with or without PMPC, over a two-year period. The purpose of this multicenter case-control study is to analyze the maternal-fetal management options in obstetric thrombophilia, the impact of this pathology on the placental structure and possible correlations with placenta-mediated pregnancy complications. Maternal-fetal management in obstetric thrombophilia means preconceptional or early diagnosis, prevention of pregnancy morbidity, specific therapy as quickly as possible and fetal systematic surveilance to identify the possible occurrence of placenta-mediated pregnancy complications.

scholarly journals Plasma levels of melatonin, certain cytokines and placental growth factor at non-pharmacological correction of pineal function in pregnant women with intrauterine growth restriction

2020 ◽  
Vol 8 (2) ◽  
Author(s):  
A. Berbets ◽  
Keyword(s):  
Immune System ◽  
Growth Factor ◽  
Pineal Gland ◽  
Pregnant Women ◽  
Inflammatory Cytokines ◽  
Proinflammatory Cytokines ◽  
Placental Growth Factor ◽  
Placental Insufficiency ◽  
Tnf Α ◽  
Anti Inflammatory

The pineal gland produces the important hormone melatonin, the level of which in the blood of pregnant women decreases in case of placental insufficiency. The effect of dysfunction of the pineal gland on the immune system of pregnant women and on the angiogenic activity of the placenta during pregnancy remains insufficiently studied. Objective: to establish the effect of our method of non-drug correction of function of pineal gland on the state of the cytokine part of the immune system and on the synthesis of placental growth factor (PlGF) in pregnant women with placental insufficiency manifesting as fetal intrauterine growth restriction (IUGR). Material and methods. 46 pregnant women with IUGR at 30-36 weeks of gestation were examined. The group was divided into two subgroups: with non-drug correction of the pineal gland function (n = 25) and without correction (n = 21). The method of correction included a set of measures of following of lighting regimen, activity and sleep for 14 days. The control group consisted of 20 women with uncomplicated pregnancy. Levels of melatonin, PlGF, TNF-α, IL-1β, IL-6, IL-4, IL-10 were determined in the venous blood by enzyme-linked immunosorbent assay. Results. It was established that the concentration of melatonin in the blood of pregnant women with IUGR was significantly reduced, as well as the concentration of PlGF (p < 0.01). Significant changes were also found in pregnant women with placental insufficiency, namely, increased concentrations of proinflammatory cytokines, such as TNF-α (p < 0.05), IL-1-β (p < 0.001) and IL-6 (p < 0.05), comparing to healthy pregnant women. Also, in the group of pregnant women with IUGR the levels of anti-inflammatory cytokines IL-4 (p <0.001) and IL-10 (p < 0.001) were elevated in comparison to the control group. After application of the developed complex of non-drug correction of pineal gland function, the concentration of melatonin in the blood of pregnant women in the subgroup of correction increased significantly, comparing to the subgroup without correction (p < 0.001), as well as the level of PlGF (p < 0.05). Also, significantly lower levels of proinflammatory cytokines TNF-α, IL-1-β and IL-6 were observed in pregnant women in the subgroup of correction (p < 0.01). Regarding anti-inflammatory cytokines, under the influence of the developed complex of measures there was a decrease in the level of IL-4 and an increase in the level of IL-10 (p < 0.01). Conclusions. When the measures, aimed at non-drug correction of function of pineal gland, are applied in pregnant women with placental insufficiency, manifested as IUGR, the following changes are observed: increased of plasma levels of melatonin and placental growth factor, decreased of levels of proinflammatory cytokines. We suggest that the pineal gland exerts its effect on the immune system through melatonin, which moderates the activity of pro- and anti-inflammatory cytokines, thereby reducing the influence of inflammation on placental tissue, what results in increasing of concentrations of placental growth factor in the blood of pregnant women.

scholarly journals Features of the morphological structure of the placenta in pregnant women with preeclampsia

2021 ◽  
pp. 10-15
Author(s):  
Volodymyr I. Chermak ◽  
Ihor I. Chermak ◽  
Chukwuanyinonso O. Ikeotuonye ◽  
Anatolii Ya. Senchuk
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
High Frequency ◽  
Morphological Changes ◽  
Morphological Structure ◽  
Morphological Features ◽  
Placental Insufficiency ◽  
Control Group ◽  
Basic Group ◽  
Adaptive Reactions

To study morphological features of the placenta in women in labor, pregnancy which complicated by preeclampsia we studied 26 placentae, of which 17 were from pregnant women with mild to moderate preeclampsia (basic group) and 9 from healthy women (control group). Histologically the study was conducted with methodically recommendations of T.D. Zadorozhnaya et al. for light microscopy. During the study of morphological features of the placenta in women in labor with preeclampsia were installed morphological changes in the placenta, which reflect a tendency to develop compensatory-adaptive reactions following their stress and exhaustion, which is a sign of placental insufficiency. Received data allow claiming a high frequency of development placental insufficiency in pregnant women with risk factors such as chronic salpingo-oophoritis, anemia, late preeclampsia, and inflammation diseases kidney.

scholarly journals Analysis of L-carnitine effectiveness in complex treat-ment of pregnant women with placental insufficiency

2021 ◽  
Vol 38 (5) ◽  
pp. 15-23
Author(s):  
G. H. Mamedli ◽  
G. I. Babaeva ◽  
M. E. Azizova ◽  
U. M. Sirajli ◽  
G. G. Hajizade
Keyword(s):  
Pregnant Women ◽  
Fetal Development ◽  
Placental Insufficiency ◽  
Complex Treatment ◽  
Fetal Blood ◽  
Mean Values ◽  
Treat Ment ◽  
The Mean ◽  
Positive Effect ◽  
Basic Treatment

Objective. To increase the effectiveness of treatment of placental insufficiency in pregnant women with the inclusion of L-carnitine (Inestom) in complex therapy. Materials and methods. A total of 76 pregnant women aged 18 to 39 years were examined at 2240 weeks of gestation. All the examined patients were divided into two groups. Patients of the first group (n = 37) received only basic treatment, which included the use of a complex of vasodilators, tocolytics, drugs that improve microcirculation and rheological properties of blood. Patients of the second group (n = 39) received L-carnitine along with basic therapy (Inestom, Help SA Pharmaceuticals, Greece). Results. The use of the drug Inestom as a part of the complex treatment of placental insufficiency led to the normalization of utero-placental-fetal blood flow and intrauterine fetal development in 94.7 % of pregnant women. After the course of drug therapy, there was an increase in the total score of cardiotography, which in the first group of patients was 7.08 0.06 before treatment and 7.13 0.11 after treatment (p 0.05), and in the second group 7.12 0.11 before treatment and 7.95 0.05 after (p 0.05). The results of antenatal dopplerometry showed that in pregnant women who received Inestom as a part of the complex treatment, there was a decrease in the mean values of all vascular resistance indices. Conclusions. The use of Inestom in the complex treatment of placental insufficiency has a positive effect on the state of hemodynamics in the "mother-placenta-fetus" system, and affects the intrauterine state of the fetus.

scholarly journals Modern approaches to the diagnosis of placental insufficiency according to cardiotocography

2018 ◽  
Vol 5 (3) ◽  
pp. 96-101
Author(s):  
I. M. Ordiyants ◽  
U. T. Mekhdieva ◽  
A. M. Savicheva
Keyword(s):  
Blood Pressure ◽  
Body Temperature ◽  
Pregnant Women ◽  
Pressure Pulse ◽  
Automated Analysis ◽  
Well Being ◽  
Placental Insufficiency ◽  
The Real ◽  
Pregnancy And Childbirth ◽  
Average Blood Pressure

Purpose.The goal is to determine the real possibili es of assessing the fetal condi on in the ante- and intranatal periods according to the data of cardiotocography.Paents and methods.73 pa ents with physiological pregnancy at 24-40 weeks were prospec vely examined. The prac cal signifi cance of the g6b plus General MEDITECH automated fetal monitor, which allows to determine the condi on of the mother and fetus at the same  me, was evaluated.Results.The average blood pressure in the examined women was 127.2 ± 3.6 by 73.7 ± 2.3 mm. gt; pillars, pulse – 76 ± 1,5 beats/min. As for the contrac le capacity of the uterus, 47 (64,4%) pregnant women in 24–30 weeks. associated with diagnosis, and 19 (26%) – are harbingers of the forthcoming birth. The average SpO2was 99.12 ± 0.11%. Regardless of the gesta onal age, in 7 (9.6%) pregnant women – 97%, 40 (54.8%) – 99% and 21 (28.8%) – 100%. In order to assess the fetal condi on by the nature of his heartbeat, we performed an automated CTG analysis according to W. Fisher, D. Redman, FIGO: according to W. Fisher, depending on the gesta onal age of 6–7 points, 12 (16.4%) pregnant women in 25–26 weeks and 9 (12.3%) – 40 weeks, which according to the ball scale corresponds to a suspicious type. The Doze–Redman criteria were met in 47 (64.4%) pregnant women and were not met – in 26 (35.6%). Interpreta on according to FIGO guidelines as normal was detected in 64 (87.7%) pregnant women and in 9 (12.3%) – doub ul. Depending on the period of pregnancy, this group consisted of the same 9 (12.3%) pregnant women in a period of 40 weeks.Conclusion.Automated analysis allows for the correla on between the main indicators of the well-being of the maternal organism (SpO2, blood pressure, pulse, body temperature, ECG) and fetal CTG parameters (Fisher scale, Dowz Redman criteria and FIGO guidelines) to develop obstetric tac cs for each specifi c pa ent during pregnancy and childbirth.

Великі акушерські синдроми – сучасні можливості профілактики

2018 ◽  
pp. 67-72
Author(s):  
T.G. Romanenko ◽  
◽  
O.M. Sulimenko ◽  
Keyword(s):  
Statistical Analysis ◽  
High Risk ◽  
Pregnant Women ◽  
Fetal Distress ◽  
Placental Insufficiency ◽  
Control Group ◽  
Fetal Growth Retardation ◽  
Prophylactic Measures ◽  
Pathological Pregnancy ◽  
Micronized Progesterone

The objective: was to reduce the incidence and severity of the development of «Great Obstetrical Syndromes»: miscarriage of pregnancy, placental insufficiency, fetal growth retardation and / or fetal distress, preeclampsia, premature detachment of a normally located placenta, premature delivery, by developing an algorithm for prophylaxis during pregnancy in women at high risk for their development. Materials and methods. Clinical and statistical analysis of pregnancy in 88 pregnant women with high risk of decompensation of placental insufficiency was conducted. Depending on the method of preventing complications, 2 groups were formed. The I group included 58 pregnant women who were offered the following algorithm: micronized progesterone 200 mg PV from 6 to 20 weeks of gestation; from 21 to 26 weeks of gestation and from 31 to 36 weeks; phleboprotector with ultra-micronized fractions of bioflavonoids (Flego) 15 ml per os; with subsequent appointment from 21 to 26 weeks of gestation; and from 31 to 36 weeks. Group II included 30 pregnant women who had abandoned any proposed prophylactic measures. The control group consisted of 30 healthy pregnant women. Clinical and statistical analysis of pregnancy in the study groups was conducted. During statistical processing, personal computer and software Microsoft Excel XP and Statistica 6.0 Windows, methods of descriptive statistics, correlation analysis were used. The reliability of the difference between the indicators is estimated by the Student-Fisher criterion. Results. The method of prophylaxis of «Great Obstetrical Syndromes» by sequential administration from the early stages of pregnancy of micronized progesterone with the following appointment – from the second trimester of pregnancy – showed a high efficacy of the phleboprotector, which is manifested in a significantly lower number of cases of preeclampsia in the main group of 3.5% (2) versus 50% (15) in the control group, placental insufficiency was 13.8% (8) versus 100% (30); fetal growth retardation was 5.2% (3) versus 56.7% (17); fetal distress was 3.5% (2) versus 43 , 3% (13), preterm labor 1.7% (1) versus 13.3% (4) and in the absence of premature detachment normal but located on the placenta, severe forms of preeclampsia and placental insufficiency. Conclusions. Pregnant of «Great Obstetrical Syndromes» risk groups need timely prophylactic measures to reduce the likelihood of a pathological pregnancy and improve perinatal outcomes. The proposed prophylaxis scheme significantly lowered the incidence of large obstetric syndromes and improved neonatal outcomes. Key words: great obstetrical syndromes, pathological pregnancy, placental dysfunction, phleboprotector.

Clinical significance of predictive and diagnostic indices of fetal pathology associated with placental insufficiency in women with endometriosis

2021 ◽  
Vol 70 (5) ◽  
pp. 37-48
Author(s):  
Igor S. Lipatov ◽  
Yury V. Tezikov ◽  
Mikhail S. Amosov
Keyword(s):  
Pregnant Women ◽  
Growth Retardation ◽  
Pregnancy Complications ◽  
Placental Insufficiency ◽  
Information Value ◽  
Placental Alkaline Phosphatase ◽  
Fetal Hypoxia ◽  
Ovarian Endometriosis ◽  
Group I ◽  
Fetal Pathology

BACKGROUND: Modern achievements of pharmacology, surgery and reproductive medicine have determined an increase in the implementation of reproductive function in endometriosis of various localization. The onset of pregnancy in presence of impaired endometrial receptivity and progesterone resistance, pro-inflammatory and pro-thrombotic status, abnormal functioning of the immune system, structural changes in the reproductive organs leads to impaired formation of the embryo (feto) placental system, early reproductive losses, complicated pregnancy and adverse perinatal outcomes. In this regard, the endometriosis and pregnancy issue requires close study and specific proposals to optimize pregnancy management. AIM: The aim of this study was to develop predictive (PIs) and diagnostic (DIs) indices of placenta-associated fetal pathology in pregnant women with endometriosis, to determine their prognostically and diagnostically significant parameters. MATERIALS AND METHODS: This prospective study in the dynamics of gestation included a comprehensive clinical and laboratory examination of 175 pregnant women with endometriosis (100 subjects with adenomyosis and 75 subjects with ovarian endometriosis). To develop PIs and DIs, two comparison groups with fetal pathology due to placental insufficiency were retrospectively identified, depending on the location of endometriosis. Group I consisted of 49 pregnant women with adenomyosis and placental insufficiency isolated from other pregnancy complications, accompanied by growth retardation and/or chronic fetal hypoxia; Group II comprised 29 pregnant women with ovarian endometriosis and placental insufficiency isolated from other pregnancy complications, accompanied by growth retardation and/or chronic fetal hypoxia. The control group (Group III) included 30 healthy pregnant women with a normal course of gestation. The examination was performed at 10-14 weeks, 20-24 weeks, and 28-34 weeks of gestation and included an assessment of placental insufficiency markers such as placental growth factor (PlGF), placental -1-microglobulin (PAMG-1), tumor necrosis factor (TNF), lymphocytes with membrane receptor FasR (L CD95+), C-reactive protein, placental alkaline phosphatase (PAPh), and fetal hemoglobin (HbF). The information value of individual parameters and indices was determined by ROC analysis, odds ratio, and clinical epidemiology tests. RESULTS: Pregnancy in presence of endometriosis in 100% of cases was complicated by placental insufficiency of varying severity (with fetal pathology in 81.5% of cases), the frequency of which had statistically significant differences between the groups of pregnant women with adenomyosis and ovarian endometriosis (2 = 4.06, p = 0.04). To predict growth retardation and / or chronic fetal hypoxia, we have developed PI I (PlGF / TNF 100) and PI II (PAMG-1 / PlGF 100), which characterize the state of placental angio-and vasculogenesis depending on systemic inflammatory response level. For early diagnosis of fetal pathology, we have proposed DI I (CRP / PAPh 100), DI II (HbF / PlGF 100) and DI III (L CD95+ / PAPh 100), which allow for diagnosing placental alterations with impaired placental energy supply due to an increase in inflammatory status. Evaluation of prognostic and diagnostic significance of PIs and DIs showed that the most informative tools are PI I (Se = 86.1%, Sp = 80.5%) and DI I (Se = 88.3%, Sp = 83.7%). CONCLUSIONS: The use of PIs allows for risk stratification of pregnant women from the 1st trimester of gestation to address the issue of the prevention method. The clinical capabilities of DIs optimize obstetric tactics for the timely prescription of therapy for placental insufficiency and targeted diagnosis of fetal pathology. Pregnant women with endometriosis should be classified as a high perinatal risk group, and therefore the proposed PIs and DIs should be included in the dynamic examination complex.

Prediction of placental insufficiency in pregnant women with different somatotypes

2020 ◽  
Vol 69 (4) ◽  
pp. 23-28
Author(s):  
Kristina G. Tomayeva
Keyword(s):  
Pregnant Women ◽  
Preventive Measures ◽  
Risk Groups ◽  
Serum Levels ◽  
Placental Insufficiency ◽  
Fetal Growth Retardation ◽  
Fetal Hypoxia ◽  
Body Type ◽  
Effective Implementation ◽  
Placental Dysfunction

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.

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