scholarly journals Features of childbirth and the condition of newborns in women with menstrual dysfunction in the puberty

2020 ◽  
Vol 5 ◽  
pp. 16-20
Author(s):  
O. A. Kovalishin

The issue of preserving the reproductive health of women for many years does not lose its relevance. Fundamental studies of recent decades have made it possible to determine the basic mechanisms of functioning of the female reproductive system, but studies of the characteristics of pregnancy, complications in childbirth and the condition of newborn children in women with menstrual dysfunction in the puberty remain single.The objective: аccording to laboratory and instrumental methods of research, to study the characteristics of childbirth and the condition of newborns in women with menstrual dysfunction in the puberty.Materials and methods. According to the nature of the disorders, the main group of pregnant women (n=120) who had a menstrual pathology in the puberty were divided into 3 subgroups (n=40): the first – pregnant women with primary oligomenorrhea in the anamnesis, the second – with a late age menarche, the third – with puberty bleeding. The control group included pregnant women (n=40) with the correct rhythm of menstruation in puberty.Results. During the clinical study, significant differences in the biological readiness of the body for childbirth in all subgroups of the main group of pregnant women were noted compared with the control group. In 35 (29,2%) pregnant women with menstrual dysfunction during the puberty, an «unripe» or insufficiently «mature» cervix was observed in the expected period of labor, which was important in the violation of labor activity during spontaneous labor in the occipital presentation and an increase in the frequency of delivery using cesarean section (CS) operation. Caesarean section was performed in 51 (42,5%) pregnant women of the main group: planned CS in 39 (32,5%), urgent delivery in 12 (10,0%). In the group of pregnant women with the correct rhythm of menstruation, spontaneous delivery occurred in 37 (92,5%) women, planned CS due to the narrowed pelvis and large fetus in 2 (5,0%), emergency CS – 1 (2,5%) case. The frequency of complications during childbirth (violation of labor, premature rupture of the membranes, bleeding) in the main group is 4 times higher than in the control group (p<0,001), in a comparative aspect, the differences between the subgroups are not significant. 95,2% of newborns from mothers with menstrual dysfunction in the puberty were born in a satisfactory condition. The Apgar score is significantly higher in newborns from mothers receiving pregravid preparation. The frequency of individual conditions that occur in the perinatal period is the highest in newborns from mothers with a history of primary oligomenorrhea.Conclusion. The results of the studies confirm the presence of the biological unpreparedness of the body for the normal course of labor in women with menstrual dysfunction in the puberty, as evidenced by violations of labor, the main predictor of which is placental dysfunction. The frequency of individual conditions that occur in the perinatal period is significantly higher than in newborns from mothers who had the correct rhythm of menstruation. It is possible to reduce the frequency of obstetric and perinatal complications in women with reduced reproductive potential by optimizing the pregravid preparation program and introducing a scientifically based complex of treatment and preventive measures.

2020 ◽  
pp. 30-36
Author(s):  
O.A. Kovalishin ◽  

Studying the hemodynamic features of the pelvic organs in women is of great clinical importance, since it makes it possible to assess the degree of restoration of endometrial regeneration after menstruation, the possibility of implanting a fertilized egg and developing the placenta. In women with menstrual dysfunction in the puberty, determining the qualitative and quantitative parameters of uterine hemodynamics may be useful in choosing treatment tactics, evaluating its effectiveness, and will also help significantly in predicting the prospects for the restoration of their reproductive health. The objective: using ultrasound and dopplerometry to study the uterine hemodynamics and assess the ability of the endometrium to implant in women with menstrual dysfunction in the pubertal period. Materials and methods. To achieve this goal, 120 women of reproductive age from 19 to 32 years old were studied. According to the nature of the violations, the main group of women (n=90) with pathology of menstrual function in the puberty was divided into 3 subgroups (n=30): the first – women with primary oligomenorrhea in the anamnesis, the second – with late age menarche, the third – with puberty bleeding. The control group included women (n=30) with the correct rhythm of menstruation in puberty. Results. Based on a comparative analysis of the echographic parameters of the size of the uterus in women with menstrual irregularities in the puberty (main group) and women with the correct rhythm of menstruation (control group), it was found that in the middle stage of endometrial secretion, the uterus is 1,2 times smaller in women the main group (p<0.05) due to the width of the uterus (p<0.001). The ratio between the length of the body and cervix in the examined groups did not significantly differ. The thickness of the front wall of the uterus is less than the control values in women with late menarche (p<0.05) and puberty bleeding (p<0.01), which served as a predictor of the absence of combined uterine pathology. An echographic study of the thickness of the endometrium in the late stage of the proliferation phase in the group of women examined did not establish any significant differences with the control group. In the middle stage of the secretion phase, the endometrial thickness was less in women with menstrual dysfunction in puberty – 9.50±0.27 mm compared to 11.38±0.48 mm in the group with the correct rhythm of menstruation (p<0.001), but remained within the limits of reference values. To assess the functional activity and the possibility of secretory transformation of the endometrium, dopplerometry of the uterine arteries was performed, which did not reveal significant differences in women of the main and control groups. Conclusion. An analysis of the relationship between body and cervical lengths proves the absence of signs of genital infantilism in patients with menstrual dysfunction in the pubertal period. Dopplerometric studies of hemodynamics in the arteries of the uterus in this group of women in different phases of the menstrual cycle indicate an adequate blood supply to the uterus. And although as a result of the inferior phase of endometrial proliferation, its thickness in the middle stage of secretion remained insufficient (9.52±0.42 mm; p<0.01), normal blood flow in the radial and basal arteries of the uterus contributed to the successful implantation of a blastocyst. Keywords: menarche, oligomenorrhea, pubertal bleeding, uterine hemodynamics, endometrial proliferation, dopplerometry.


2020 ◽  
pp. 63-68
Author(s):  
O. V. Grishchenko ◽  
T.I. Goman

Pregnancy is a period accompanied by significant functional changes in a woman’s body, which are necessary both to satisfy her own needs and to ensure intensive growth and development of the fetus. Adequate consumption of macro- and micronutrients is currently extremely important, since malnutrition or excessive nutrition increases the risk of obstetric and perinatal complications. The article discusses the problem and causes of vitamin D deficiency and deficiency in pregnant women living in a big city. The mechanisms of its action and the classical and “non-classical” effects of the regulation of the most important body functions are shown. As a marker of the level of vitamin D in blood plasma, the content of 25-hydroxycalciferol (25 (OH) D) is used. This indicator reflects both the formation of vitamin D in the skin under the influence of ultraviolet radiation, and its entry into the body with food of animal and vegetable origin. As a result of the study, it was found that the vast majority of modern pregnant women living in the city, even with an uncomplicated pregnancy, have a deficiency of vitamin D. The frequency of the diagnosed deficiency in pre-pregnant and re-pregnant women is shown. It should be noted that the frequency of diagnosing vitamin D deficiency was higher in pregnant women with a history of breastfeeding. This suggests that re-pregnant women who have been breastfeeding for a long time are at high risk of deficiency and vitamin D deficiency compared with pregnant women, will give birth for the first time. Showing the results of level 25 (OH) D before and after correction, while taking various doses of cholecalciferol. The obtained vitamin D levels indicate that the nutritional behavior of the examined pregnant women and the qualitative characteristics of the products do not fully support a sufficient level of cholecalciferol. For the field of reproductive medicine today the problem of prevention and reduction of complications of the perinatal period remains relevant. Given the importance of vitamin D for the normal course of pregnancy and the development of the fetus, one of the promising directions in the prevention of complications of the gestational period is the development and implementation of methods for eliminating and preventing vitamin D deficiency in the health care system, both at the stage of pregravid preparation and during pregnancy.


Author(s):  
O.M. Perkhulyn

Introduction. Today, the frequency of infertility is increasing worldwide. Infertility, associated with anovulation, is especially challenging for the medical correction especially. The leading aspect of this problem is hormonal disorders in the body of a woman. The aim of this study was to assess the level of estradiol and progesterone in the blood serum of pregnant women with cervical insufficiency and infertility associated with anovulation in the history. Materials and methods. The main group included 30 pregnant women with the II trimester of pregnancy, who had cervical insufficiency and infertility associated with anovulation in the past medical history. They got pregnant after assisted reproductive technologies. The control group included 30 pregnant women without cervical insufficiency and with physiological gestation. Estradiol and progesterone levels in blood serum were determined at 20-22 and 30-32 weeks of gestation. Results. The average age of the women in the basic group was statistically higher relative to the control one – 31.30±1.16 and 27.30±0.92 years, respectively (p=0.02). There was no difference in the number of pregnancies in women between both groups. In the main group, 73.33% of the persons were primagravida, 10.00 % of patients had two pregnancies, and 16.67 % - three pregnancies. 56.67 % of the women in the control group were primagravida, 26.67 % had two pregnancies, 16.66 % - three pregnancies. Although primaparas predominated in both groups, the number of such women was in 1.47 times higher in the main group (93.33 %) than in control (63.33 % of patients; χ2=6.28, p=0.01); 6.67 % and 26.67 % women had two labors respectively and 10.00 % of healthy patients - three labors. The concentration of estradiol at the 20-22 and 30-32 weeks of pregnancy in women of the main group almost corresponded to physiological parameters. However, the progesterone level in women with cervical insufficiency and a history of infertility was by 13.44 % lower than in healthy pregnant women at 20-22 weeks, and by 17.02% at 30-32 weeks (p=0.003). Conclusions. In pregnant women with cervical insufficiency and infertility associated with anovulation, the level of estradiol in the II and III trimesters of gestation mainly corresponds to the level of physiological pregnancy. However, they have the decrease in progesterone concentration in the III trimester of pregnancy relative to healthy pregnant women (p<0.003).


Author(s):  
Kovalyshyn O. A.

The study of hemodynamic features of the pelvic organs in women is of great clinical importance, since it allows assessing the degree of recovery of endometrial regeneration after menstruation, the possibility of implantating a fertilized egg and placental development. Women who have had menstrual dysfunction in puberty, the determination of qualitative and quantitative parameters of uterine hemodynamics can be useful while choosing treatment tactics, evaluating its effectiveness, and will also provide significant assistance in predicting the prospects for their reproductive health. The purpose of the study. To examine the hemodynamics of uterus and assess the ability of endometrium to implant in women with menstrual dysfunction in puberty with the help of ultrasound and dopplerometry.Materials and methods. To achieve the set goals, 120 women of reproductive age from 19 to 32 years old were examined. By the nature of the disorders, the main group of women (n = 90) with menstrual dysfunction in puberty were divided into 3 subgroups (n = 30): the first group - women with primary oligomenorrhea, the second one - with late menarche, the third one - with pubertal bleeding. The control group consisted of women (n = 30) with the correct rhythm of menstruation in puberty. Results. On the basis of a comparative analysis of the echographic parameters of the size of the uterus in women with menstrual dysfunctions in puberty (main group) and women with the correct rhythm of menstruation (control group), it was found that, on the average stage of endometrial secretion, the volume of the uterus is 1, 2 times smaller in women of the main group (p˂0.05) due to the width of the body of the uterus (p˂0.001). The ratio between the length of the body and cervix in the examined groups did not differ significantly. The thickness of the anterior wall of the uterus is less than the control values in women with late menarche (p˂0.05) and pubertal bleeding (p˂0.01), which was a predictor of the absence of combined uterine pathology. Echographic examination of the thickness of the endometrium at a late stage of the proliferation phase in the examined women did not reveal significant differences with the control group. In the middle stage of the secretion phase, the thickness of the endometrium was less in women, who had menstrual dysfunction in puberty - 9.50 ± 0.27 mm versus 11.38 ± 0.48 mm in the group with the correct menstruation rhythm (p <0.001), but remained within the reference values. Dopplerometry of uterine arteries was performed to assess the functional activity and the possibility of sectorial transformation of the endometrium, which did not reveal significant differences in women of the main and control groups. Conclusions. An analysis of the ratio between the body length and the cervix of the uterus proves the absence of signs of genital infantilism in patients with menstrual dysfunctions in puberty. Doppler studies of hemodynamics in the arteries of uterus in this group of women in different phases of the menstrual cycle indicate an adequate blood supply to the uterus. Although the inferior phase of proliferation of endometrial thickness in its middle stages remained insufficient secretion (9,52 ± 0,42 mm; p <0.01), however, the normal blood flow in the radial and basal uterine arteries contributed to the successful implantation of the blastocyst.


2019 ◽  
Vol 72 (2) ◽  
pp. 175-180
Author(s):  
Viacheslav M. Husiev ◽  
Daria S. Khapchenkova

Introduction: The article presents information about the peculiarities of the course of pregnancy and childbirth in women with a syphilitic infection in the anamnesis. The peculiarities of the state of newborn babies born from mothers who have suffered syphilis are described. To date, the incidence of syphilis in Ukraine has a clear tendency to decline, but still remains quite high. The maximum incidence of syphilis is observed in women aged 15-20 years. The combination of pregnancy and syphilitic infection in an anamnesis is an unfavorable factor in regard to high risk of perinatal complications, the frequency of which does not tend to decrease. The aim - study the features of the course of pregnancy and childbirth in women with a syphilitic infection in the anamnesis, the evaluation of the state of newborns. Materials and methods: A prospective examination of 57 healthy women and their newborns (control group) and 60 pregnant women with a history of syphilitic infection (the main group) had been conducted. All pregnant women had undergone ultrasound examination, including feto- and placentometry, an estimate of the amount of amniotic fluid. The effect of the transferred syphilis on the state of the newborn had been assessed in accordance with the results of the clinical examination of an anthropometric data, including an Apgar score. Results: It is stated that the incidence of latent (41,66%) and forms with a prolonged course (20,00%) of syphilitic infection. The threat of premature childbirth was almost 3,5 times higher than in women with syphilis, cases of an anemia in pregnant women – 2 times, hypertensive disorders of pregnant women were 2,4 times more common in women of the main group, fetal development retardation syndrome 6,4 times, while a greater percentage of this disorder was recorded among women in the main group who were ill with latent forms and suffered secondary recurrent syphilis (35%). In 20% of the cases, pregnancy in women with syphilis has been completed by the cesarean section, an abnormality of the contractile capacity of the uterus was significantly higher – 23,33%. The adaptive capacity of the newborns in the main group has been significantly lower, compared to the control group. Conclusions: Syphilitic infection in the anamnesis complicates the course of pregnancy with numerous pathological conditions. Syphilitic infection, borne before pregnancy, affects not only the course of pregnancy, but also the course of childbirth and the postpartum period. The pathological conditions in infants are due to a decrease in resistance to birth stress, early depletion of adaptive resources of newborns under the influence of a syphilitic infection of the mother. In children who have experienced chronic intrauterine hypoxia, the risk of hemorrhagic syndrome is significantly higher due to increased permeability of the vascular wall. Such children have a tendency to develop neurological disorders and respiratory system lesions.


2018 ◽  
pp. 118-121
Author(s):  
L.M. Vygivska ◽  
◽  
I.A. Usevych ◽  
I.V. Maidannyk ◽  
V.F. Oleshko ◽  
...  

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.


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.


2020 ◽  
Vol 18 (5) ◽  
pp. 569-574
Author(s):  
M. A. Pavlovskaya ◽  
◽  
L. V. Gutikova ◽  
Y. V. Kukharchyk ◽  
◽  
...  

Background. The problem of genital endometriosis is relevant both in medical and in social aspects.Aim of the research. To analyze the course of pregnancy, childbirth and their outcomes in genital endometriosis to justify the critical terms of the complicated course of pregnancy and determine approaches for the development of therapeutic and preventive measures.Material and methods. The main group – 160 pregnant women, previously treated for genital endometriosis. The control group was 50 healthy women with a normal pregnancy. The generally accepted clinical laboratory and instrumental methods of the research were used. Statistical analysis of the data was carried out using the software package Statistica 10.0. Results. Gestational periods of 6-12 weeks, 18-22 weeks, 30-34 weeks of pregnancy are critical for women of the main group. The course of pregnancy is complicated by the threat of an early miscarriage (50%), placental disorders (65%), chronic hypoxia (35%) and fetal growth retardation (20%), anomalies of labor (60%).Conclusions. The complicated course of pregnancy in patients with genital endometriosis justifies the need to develop a comprehensive program for the prevention of gestational and perinatal complications.


2019 ◽  
Vol 72 (4) ◽  
pp. 562-567
Author(s):  
Volodymyr K. Likhachov ◽  
Yanina V. Shymanska ◽  
Yulia S. Savelieva ◽  
Viktoriya L. Vashchenko ◽  
Ludmyla М. Dobrovolska

Introduction: During pregnancy in the body of a healthy woman there are physiological and psychological changes that contribute to the bearing a child and prepare the female for future labour and motherhood. In women who experience failure at the stage of fertilization or during pregnancy, as a result of prolonged negative emotional states, psycho-emotional stress develops. The aim of the research was to study the psycho-emotional state of women with infertility in history, whose pregnancy resulted from extracorporal fertilization (IVF), and to develop methods for reducing their anxiety. Materials and methods: At the first stage, the initial psycho-emotional state of 60 women in the second trimester, whose pregnancy resulted from IVF (Group I), was studied; the control group consisted of 20 healthy women with a physiological course of pregnancy (Group II). At the second stage, 10 art therapy exercises with a requestioning of pregnant women from Group I were conducted for improving their psycho-emotional state. Results: Women of Group I had a high level of both situational anxiety (SA) and the personal one (PA). The prevalent type of the psychological component of gestational dominant was anxiety and euphoric types (58.3%). In one third of women with burdened gynecological history examined mild or masked depression was diagnosed. 43 pregnant women from Group I used a method of psychocorrection – art therapy, which included colouring “antistress” pictures of perinatal topic, making flowers from paper and creating a collage of dreams. Conclusions: After the art therapy course, a high level of SA (from 46.5% to 7.0%) and OA (from 48.8% to 32.6%) decreased, the index of the optimal type of the psychological component of gestational dominant increased from 25.6% to 53.5%. The number of women without depression increased from 62.8% to 93%.


2021 ◽  
Vol 66 (4) ◽  
pp. 205-209
Author(s):  
E. L. Makarova ◽  
N. A. Terekhina

The number of obese pregnant women increases annually and reaches 20-30%. The metabolism of hormones and minerals changes in the presence of a large amount of adipose tissue in the body of a pregnant woman, which leads to a number of obstetric and perinatal problems. The aim of the work is to study and compare the influence of the gestational process on the indicators of iron and copper metabolism in the blood serum of women with normal body weight and women with obesity. In the blood serum of 125 women of reproductive age, the content of hemoglobin, iron, transferrin, ferritin, copper and ceruloplasmin was determined. The influence of pregnancy on the indicators of iron and copper metabolism in the blood serum of women was revealed. Pregnancy in women with normal body weight increases the content of transferrin and ceruloplasmin. Correlation of ceruloplasmin and ferritin content with body mass index of obese pregnant women was revealed. In pregnancy with concomitant obesity, hyperferritinemia is formed with a reduced content of hemoglobin and serum iron. Knowledge of the indicators of iron and copper metabolism is necessary to optimize the observation of pregnant women, effective prevention and prediction of obstetric and perinatal complications.


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