scholarly journals Renal Dysfunction in Pre-eclampsia Patients: Prediction and Differential Diagnosis. Part 2

Doctor Ru ◽  
2020 ◽  
Vol 19 (8) ◽  
pp. 7-13
Author(s):  
V.F. Bezhenar ◽  
◽  
A.V. Smirnov ◽  
R.R. Temirbulatov ◽  
K.A. Gabelova ◽  
...  
Keyword(s):  
Cystatin C ◽  
Prognostic Value ◽  
Perinatal Outcomes ◽  
Angiogenic Factors ◽  
Second Trimester ◽  
Diagnostic Significance ◽  
Study Objective ◽  
Hypertensive Disorders ◽  
Group I ◽  
Study Results

Study Objective: To assess the prognostic value, sensitivity, and specificity of biomarkers of acute renal injury (ARI), and of angiogenic factors, in the development of pre-eclampsia (PE) in the second trimester of pregnancy, and determine their diagnostic significance for PE, as well as to compare obstetric and perinatal outcomes experienced by patients. Study Design: This was a comparative, group, prospective and retrospective study. Materials and Methods: The patient groups studied in the first, second, and third phases are described in Part 1 of this article. Based on the distinguishing diagnostic criterion and the outcomes of pregnancy, the 138 patients were divided into three groups. Group I (main) consisted of 66 (47.8%) patients who developed hypertensive disorders during pregnancy, 30 (21.7%) of whom were included in subgroup 1 (CKD) and 36 (26.1%) in subgroup 2 (no CKD). Group II (comparison) was made up of 32 patients with CKD who did not have hypertensive disorders. Group III (control) comprised 40 women with normal pregnancies and no history of reproductive disorders. The fourth phase involved a retrospective analysis of biomarker levels and assessment of their prognostic value for the development of PE. All participants underwent clinical and laboratory examinations and had measurements taken for sFlt-1, PlGF, S-endoglin, cystatin C, uKIM-1, podocalyxin, and α1- and β2-microglobulins. Obstetric and perinatal outcomes were traced. Study Results: Levels of the following parameters had the greatest prognostic value in the second trimester of pregnancy: PlGF (94%), sFlt-1 (92%), sFlt-1/PlGF (94%), ΔPlGF (93.3%), ΔsFlt-1 (92%), ΔsFlt-1/PlGF (94%), S-endoglin (94%), and sNGAL (94%). The sensitivity of the sFlt-1/PlGF ratio at this stage of pregnancy was 89.1%, making this parameter a promising predictive marker of PE. Logistic regression analysis showed that it is most reasonable to measure sFlt-1/PlGF and sNGAL levels in the first trimester; and in the second trimester, ΔsFlt-1/PlGF (between the first and second trimesters) and sFlt-1/PlGF as well as levels of PlGF, S-endoglin, uKIM-1, urinary podocalyxin, and sNGAL. In both subgroups of patients with PE, there were critical hemodynamic disruptions in the fetal-placental-maternal system: six (20%) and eight (22.2%) cases in subgroups 1 and 2, respectively. Pre-term delivery in patients with pre-existing intrauterine growth retardation led to the necessity of putting 22 (73.3%) newborns from the first subgroup and seven (19.4%) newborns from the second subgroup on mechanical ventilation (p<0.0001). Conclusion: Some weeks before the clinical onset of PE, at weeks 16-24 of pregnancy, patients develop placental dysfunction, decreases or slight increases in PlGF levels, and elevation of sFlt-1 levels, reflecting an imbalance between pro-angiogenic and anti-angiogenic factors; there is also an increase in the levels of markers of ARI (sNGAL, uKIM-1, β2- and α1-microglobulins, and urinary podocalyxin). The clinical information obtained about perinatal outcomes indirectly confirms the role of the cascade of pathogenic events in chronic placental insufficiency, in the development of generalized endothelial dysfunction. Keywords: pre-eclampsia, predictive diagnosis, chronic kidney disease, sFlt-1, PlGF, S-endoglin, cystatin C, KIM-1, podocalyxin, α1-microglobulin, β2-microglobulin.

scholarly journals Disorders of the Cervix and Characteristics of Colposcopy in Pregnant Women

Doctor Ru ◽  
2020 ◽  
Vol 19 (8) ◽  
pp. 32-39
Author(s):  
T.N. Bebneva ◽  
◽  
G.B. Dikke ◽  
◽  
◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Pregnant Women ◽  
Pap Smear ◽  
Open Label ◽  
Study Objective ◽  
Group Iii ◽  
Study Materials ◽  
Group I ◽  
Hpv Status ◽  
Study Results

Study Objective: To determine the frequency of disorders of the cervix and identify characteristics of colposcopy specific to pregnant women infected with the human papillomavirus (HPV). Study Design: This was an open-label, non-interventional, comparative, cohort clinical study. Materials and Methods: Three hundred and thirty pregnant women participated in the study. They were divided into four groups: Group I (n = 73) was made up of women without any disorders of the cervix and with a negative test for human papillomavirus (HPV); Group II (n = 75) consisted of women with disorders of the cervix who did not have HPV; Group III (n = 96) comprised those who did not have disorders of the cervix, but had HPV; and Group IV (n = 86) consisted of patients with disorders of the cervix and HPV. Examinations performed included HPV testing with serotyping, cervical cytology (Pap smear), and colposcopy. Study Results: HPV was detected in 55.2% of the patients (182/330), 44.5% of whom (81/182) had types 16/18 HPV. The prevalence of grades I and II disorders of the cervix (mild and moderate) in women who had HPV as well as disorders of the cervix was 17.5% (15/86) according to colposcopy data and 9.3% (8/86) detected by cytology (р = 0.06). The total frequency of these disorders, irrespective of HPV status, was 9.3% (15/161) and 5.6% (9/161), respectively (р = 0.29). Interpretation of the colposcopy data in pregnant women was difficult in some cases due to changes in the cervix, which explains the 3.7% discrepancy between colposcopy and cytology in detecting disorders of the cervix. Conclusion: HPV screening may be done first in pregnant women, followed by cytology in HPV-positive patients. Colposcopy may be reserved for women with high-grade squamous intraepithelial lesions to exclude invasive cancer. Keywords: pregnancy, human papillomavirus, disorders of the cervix, risk factors, colposcopy.

scholarly journals Effect of the Low Molecular Heparin Therapy on Foetal DNA Level in Non-Invasive Prenatal DNA Screening

Doctor Ru ◽  
2021 ◽  
Vol 20 (8) ◽  
pp. 19-22
Author(s):  
I.Yu. Barkov ◽  
◽  
N.K. Tetruashvili ◽  
Yu.S. Bulatova ◽  
L.V. Kim ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Heparin Therapy ◽  
Nucleotide Polymorphisms ◽  
Perinatal Medicine ◽  
Cross Sectional ◽  
Study Objective ◽  
Non Invasive ◽  
Group I ◽  
Study Results ◽  
Group Ii

Study Objective: To evaluate the effect of low molecular heparin (LMH) therapy on non-invasive prenatal DNA screening (NIPS) for chromosomal pathologies. Study Design: cross-sectional study. Materials and Methods. We have examined two groups of pregnant women: group I included 49 patients with constantly low foetal DNA (twice lower than 4%) selected out of 1,505 women examined at Kulakov National Medical Scientific Centre of Obstetrics, Gynaecology and Perinatal Medicine of the Ministry of Health of Russia during the last 2 years. 17 women were administered LMH and 32 women did not receive it. Group II included 113 pregnant women with a normal foetal DNA fraction (at least 4%), that were selected randomly out of patients who were examined during the same period. 56 pregnant women were administered LMH and 57 were not. Next Generation Sequencing was used as an NIPS method. In order to determine the foetal DNA level, we amplified DNA loci with single nucleotide polymorphisms. Study Results. In group I (low foetal DNA fraction), where no LMH therapy was initiated, median values were 3.5% (3.2–3.8%); if LMH was administered, these values made 3.6% (3.4–3.9), while in group II — 7.7% (6.1–9.5%) and 7.9% (6.0–10.5%), respectively; no significant differences (p = 0.29 and p = 0.7, respectively) were recorded in both cases. Conclusion. Use of LMH does not affect NIPS; therefore, it is not necessary to adjust the LMH therapy in pregnant women prior to NIPS. Keywords: non-invasive prenatal DNA screening, heparin, anticoagulants, low molecular heparins, habitual abortion, pregnancy complications.

scholarly journals The Efficacy of Physical Therapy in Treatment of Pelvic Floor Distress in Women of Reproductive Age

Doctor Ru ◽  
2020 ◽  
Vol 19 (8) ◽  
pp. 71-76
Author(s):  
M.R. Orazov ◽  
◽  
E.S. Silantieva ◽  
R.A. Soldatskaya ◽  
M.E. Belkovskaya ◽  
...  
Keyword(s):  
Physical Therapy ◽  
Pelvic Floor ◽  
Vaginal Delivery ◽  
High Intensity ◽  
Controlled Study ◽  
Study Objective ◽  
Electromagnetic Stimulation ◽  
Group I ◽  
Study Results ◽  
Group Ii

Study Objective: To compare the efficacy of two physical therapy techniques in the treatment of pelvic floor distress (PFD). Study Design: This was a prospective, randomized, double-blind, controlled study. Materials and Methods: Health information about ninety-five women who had had vaginal delivery and suffered from PFD was reviewed in the study. In Group I (n = 50) patients were treated using high-intensity focused electromagnetic (HIFEM) technology, and in Group II (n = 45) electrical stimulation therapy was delivered via an intracavity sensor. Assessments in the study included physical examination, instrumental investigations, and a discussion with patients (completion of a questionnaire and a scale-based assessment). To establish reference values for the parameters used in the study, a control group was made up of 30 apparently healthy women who had had a vaginal delivery. Study Results: Ultrasound of the pelvic floor showed that in Groups I and II the anteroposterior diameter of the levator hiatus (LH) decreased by 3.12 mm and 1.16 mm, respectively (2.7-fold difference), and the transverse diameter of the LH decreased by 3.04 mm and 1.04 mm (2.9-fold difference). The area of the LH decreased by 1.38 cm2 in Group I and 0.08 cm2 in Group II. After treatment the mean Pelvic Floor Distress Inventory (PFDI-20) score was 1.9 times lower (p<0.001) in Group I and the number of women who reported a feeling of looseness in the vagina and urinary incontinence using a bimodal scale for complaint assessment was 1.5 and 1.9 times lower, respectively, than in Group II. Conclusion: Electromagnetic stimulation demonstrated higher efficacy than stimulation via an intracavitary sensor in the treatment of PFD. Keywords: pelvic floor distress, genital prolapse, high-intensity focused electromagnetic stimulation.

scholarly journals Cervical Canal Microbiota Features in Second Trimester of Pregnancy in Insuficiencia Istmicocervical with Clinical Signs of Vulvovaginitis Depending on Vaginal Discharge рH

Doctor Ru ◽  
2021 ◽  
Vol 20 (6) ◽  
pp. 12-19
Author(s):  
N.V. Spiridonova ◽  
◽  
M.A. Kaganova ◽  
O.O. Devyatova ◽  
A.A. Bezrukova ◽  
...  
Keyword(s):  
Vaginal Discharge ◽  
Clinical Signs ◽  
Cervical Canal ◽  
Study Group ◽  
Second Trimester ◽  
Study Objective ◽  
Bacteriological Test ◽  
Study Results ◽  
Staphylococcus Spp ◽  
Lactobacillus Spp

Study Objective: To study the microbiological composition of cervical canal in insuficiencia istmicocervical (IIC) in patients with vulvovaginitis depending on vaginal discharge рH. Study Design: perspective study. Materials and Methods. The study included 67 patients of reproductive age with clinical signs of vulvovaginitis and IIC. Where vaginal discharge рН was > 4.5, patients were prescribed empirical Metrogil Plus; these women comprised the study group (n = 40). Where vaginal discharge рН was ≤ 4.5, patients were prescribed empirical Tergynan; these women were controls (n = 27). Baseline anthropometric, social, clinical and anamnestic data, pregnancy characteristics and parity were recorded; then women underwent examination, and samples were collected for analysis (bacterioscopy, vaginal discharge рН measurement, bacteriological test). On day 9–11 of hospitalisation, patients had another speculum examination; clinical symptoms dynamics, pH and bacterioscopic test results were evaluated. Satisfaction with therapy, compliance and therapy-related arverse events were recorded. Study Results. Various Staphylococcus spp. were the most prevalent cause of the conditions in the study group (n = 17; 42.5%). In controls this value was 12 (44.4%). Staphylococcus spp. were mostly opportunistic saprophytic flora and usually were not pathogens, except for Staphylococcus haemolyticus, which was found in 11 (27.5%) patients in the study group and in 3 (11.1%) controls. Lactobacillus spp. Was diagnosed more often in controls than in the study group: 12 (44.4%) vs. 9 (22.5%) (р = 0.05). The control group was diagnosed only with Lactobacillus crispatus, Lactobacillus jensenii; they also prevailed in the study group, together with Lactobacillus gasseri, Lactobacillus paracasei. At рН > 4.5, cervical canal culture was characterised with a variety of opportunistic pathogens and normal flora. After the therapy, patients in both groups did not complain of vaginal discharges. Physical examination demonstrated normal vaginal wall colour and moderate discharges. Vaginal discharge pH was significantly lower in the study group and was normal in controls. Conclusion. The majority of patients with vulvovaginitis and IIC in the second trimester of pregnancy had lower prevalence as well as lower absolute and relative amount of Lactobacillus spp. in their cervical canal discharge. At the same time, increase in vaginal рН is associated with changes in the quality ratio of lactic acid bacilli. Keywords: cervical canal microbiota, insuficiencia istmicocervical, vaginal discharge рH, vulvovaginitis

scholarly journals Estrogen (ESR1) and Progesterone (PRG) Receptor Genes in Benign Mammary Dysplasia in Women of Reproductive Age with Endometrial Hyperplasia

Doctor Ru ◽  
2021 ◽  
Vol 20 (6) ◽  
pp. 68-72
Author(s):  
A.A. Persidskaya ◽  
◽  
R.G. Guseinova ◽  
I.M. Ordiyants ◽  
◽  
...  
Keyword(s):  
Gene Polymorphism ◽  
Endometrial Hyperplasia ◽  
Study Groups ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Study Objective ◽  
Group Iii ◽  
Esr1 Gene ◽  
Group I ◽  
Study Results

Study Objective: To identify the role of estrogen (ESR1) and progesterone (PRG) receptor genes in benign mammary dysplasia (BMD) in women of reproductive age with endometrial hyperplasia (EH). Study Design: prospective controlled cohort study. Materials and Methods. We examined 105 women aged 18 to 49 years old who were divided into three groups: group I — 36 BMD patients; group II — 27 women with EH without atypia; and group III — 42 BMD patients with EH without atypia. Patients with mammary disorders were divided into subgroups of diffuse and nodal BMD. We studied polymorphism of estrogen (ESR1) and progesterone (PRG) receptor genes and the ratio of their isoforms in blood serum. ESR1 and PRG gene polymorphism was analysed using polymerase chain reaction with fluorescent genotyping detection with TaqMan probes. Study Results. In PvuII C/T polymorphism of ESR1 gene there were significant differences between women with diffuse and nodal BMD in СС allele (p = 0.014), but not between study groups. Analysis of the rate of Xbal A/G alleles of ESR1 gene revealed significant differences between group I and group III in GG allele (p = 0.015), while there were no differences between women with diffuse and nodal BMD. The rate of polymorphism in Val660Leu and +331G/A alleles of PRG gene was not statistically significant in study groups; also, there were no statistically significant differences in diffuse and nodal BMD. Conclusion. Combined hyperplastic processes in endometrium and mammary glands depend on the specificity in the polymorphism system of estrogen and progesteron receptor genes. Associations between various combinations of susceptibility genes demonstrate the presence of specificity for each clinical and pathogenic variant of BMD (diffuse or local forms). Keywords: benign mammary dysplasia; endometrium hyperplasia; estrogen receptors; progesterone receptors; ESR1, PRG gene polymorphism

scholarly journals Characteristics of Sexual Development of Ethnic Khanty and Alien Population in the Middle Ob Region

Doctor Ru ◽  
2021 ◽  
Vol 20 (3) ◽  
pp. 45-49
Author(s):  
O.A. Baitrak ◽  
◽  
V.V. Mescheryakov ◽  
Ya.V. Girsh ◽  
◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Sexual Development ◽  
Cross Sectional ◽  
Study Objective ◽  
Facial Hair ◽  
Autonomous District ◽  
Study Materials ◽  
Group I ◽  
Study Results ◽  
Secondary Sex Characters

Study Objective: To work out the sexual development standards for ethnic Khanty 7 to 17 years old and their comparative analysis with similar parameters of alien population in the Middle Ob Region of the same age. Study Design: cross-sectional cohort comparative study. Materials and Methods. The study included 2,554 children born in Yugra – Khanty-Mansiysk autonomous district and alien adolescents, and 2,431 ethnic Khanty children aged 7 to 17 years with health group I–II. Sexual development formulas were developed on the basis of publications by J.M. Tanner (1969–1970) and M. V. Maksimova (1977). Sexual development formulas were evaluated; the results were analysed in two groups of children and adolescents — ethnic Khanty and alien population in the Middle Ob Region. We compared the mean age (M ± SD) when each of the secondary sex characters appeared and formed. Study Results. We found out that the Khanty develop secondary sex characters later than the alien population, both in girls and boys. Secondary sex characters are formed at the same age in both groups due to faster rate in the Khanty, save for axillary pilosis: in Khanty adolescents, this character is formed later. A distinctive feature of sexual development of Khanty boys is absence of stage P5 of pubic pilosis according to J. M. Tanner and of facial hair. Conclusion. The patterns we found necessitate the use of a differentiated approach to evaluation of sexual development of the Khanty and alien population of Yugra – Khanty-Mansiysk autonomous district. Use of the standards developed for other population groups may cause overdiagnosis of sexual development retardation in children and adolescents in this ethnic group. Keywords: sexual development, children, ethic characteristics, the Khanty.

Efficacy of intrauterine administration of autologous peripheral blood mononuclear cells prior to embryo transfer in patients with recurrent implantation failures in assisted reproductive technology programmes

GYNECOLOGY ◽  
2018 ◽  
Vol 20 (2) ◽  
pp. 28-33
Author(s):  
T S Amyan ◽  
S G Perminova ◽  
L V Krechetova ◽  
V V Vtorushina
Keyword(s):  
Embryo Transfer ◽  
Peripheral Blood Mononuclear Cells ◽  
Peripheral Blood ◽  
Mononuclear Cells ◽  
Peripheral Blood Mononuclear ◽  
Study Objective ◽  
Study Results ◽  
Blood Mononuclear Cells ◽  
History Of ◽  
Group 2

Study objective. To evaluate the efficacy of intrauterine administration of autologous peripheral blood mononuclear cells (PBMC) prior to embryo transfer in patients with recurrent implantation failures in IVF program. Materials and methods. The study enrolled 129 patients with recurrent implantation failures in an IVF programme. Group 1 - 42 patients who had intrauterine administration of autologous PBMC activated with hCG (Pregnyl 500 IU). Group 2 - 42 patients who had intrauterine administration of autologous PBMC without hCG activation. Group 3 (placebo) - 45 patients who had intrauterine administration of saline. Study results. In the hCG-activated PBMC group, the rates of positive blood hCG tests, implantation, and clinical pregnancy were significantly higher than the respective rates in the non-activated PBMC group and in the placebo group, both in a stimulated cycle and in an FET cycle (р≤0.05). Conclusion. Intrauterine administration of autologous PBMC prior to embryo transfer in an IVF/ICSI programme increases the efficacy of IVF program in patients with a history of recurrent implantation failures.

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