scholarly journals EVALUATION OF HORMONAL ASPECTS BY CERVICAL INSUFFICIENCY IN WOMEN WITH HISTORY OF INFERTILITY

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).

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.


Author(s):  
Antonina Kotenok ◽  
Liliya Vygivska ◽  
Іgor Maidannyk ◽  
Viktor Оleshko

                                  The issue of preserving the reproductive health of the nation in Ukraine is very acute. The psycho-emotional state of a woman is of particular importance for the prolongation of pregnancy and the normal course of labor. Violation of adaptive mechanisms which are aimed at restructuring the functional systems of the body during pregnancy and on the eve of childbirth, as well as the state of chronic stress contribute to the increase in the of obstetric and perinatal complications frequency and have an adverse effect on the course of pregnancy. The aim of the reaserch was to study the dynamics of psycho-emotional state features in pregnant women after assisted reproductive technologies (ART) application in order to improve the tactics of antenatal surveillance. To achieve this goal, 299 pregnant women were comprehensively examined in the dynamics of prospective observation, which were distributed as follows – the main group included 249 women whose pregnancy occurred as a result of the ART application. The control group consisted of 50 pregnant women with spontaneous pregnancy and its physiological course, which were registered for pregnancy at 6-8 weeks. The women of main group whose pregnancy occurred as a result of ART application were divided into three groups, depending on the factor that caused infertility. The first group included 94 women with tubal-peritoneal factor of infertility, the second group was formed by 87 women with endocrine factor of infertility, the third group included 68 women whose infertility was caused by the male factor. Pregnant women of the study groups by age, marital and social status, place of residence were representative, which allowed further to judge the differences caused by etiological factors of infertility. In order to determine the psycho-emotional state of pregnant women in the study groups in the screening mode, a clinical interview was conducted by filling out questionnaires that contained the constituent questions of the STAI tests in the modification of Yu. L. Khanin and the "Pregnant Attitude Test" by the method of I. V. Dobryakov. The obtained test results indicate that the average score of reactive anxiety in pregnant women of the main group exceeded the same indicator of the control group and was: 49 - pregnant women with tubal-peritoneal type of infertility, 56 - pregnant women with endocrine type of infertility, 44 - pregnant women with male factor of infertility, 24 - control group. According to the results of testing, a significant difference was revealed in the indicators of personal anxiety. The values of indicators of personal anxiety were: 51 - pregnant women with tubal-peritoneal type of infertility, 54 - pregnant women with endocrine type of infertility, 31  -pregnant women with male factor of infertility, 31 - control group. Low level of personal anxiety was observed in 26 (27,6%) pregnant women of I group, 29 (33,3%) pregnant women of II group, which is significantly less in comparison with the indicator of pregnant women of the control group – 33 (66,0%) and III group - 33 (48,5%) (p < 0,05). Moderate type of personal anxiety was observed in 46 (48.9%) pregnant women of group and 40 (45.9%) pregnant women of II group compared to the indicator of the control group – 11 (22, 0%) (p < 0,05). Moderate type of personal anxiety was determined in 25 (36,7%) cases in pregnant women of III group and did not differ significantly from the indicators of I, II and control groups (p > 0,05). A high level of personal anxiety was observed in 22 (23,5%) pregnant women of group I, 18 (20,8%) pregnant women of group II, which is significantly higher in comparison with the indicator of pregnant women of the control group – 6 (12,0%) (p < 0,05). Thus, the study of the psycho-emotional state of pregnant women after the application of ART deviations in the level of personal and reactive anxiety and pathological types of gestational dominant, which are inherent in pregnant women of the main group. Taking into account the above, we consider it appropriate to involve a psychologist to work with the examined pregnant women in order to correct the identified abnormalities.


2021 ◽  
Vol 8 (3) ◽  
pp. 149-154
Author(s):  
Tat’yana A. Kamaeva

PURPOSE: improving the efficiency of diagnosis of placental insufficiency using modern diagnostic methods. MATERIALS AND METHODS: The analysis of individual cards, analysis of the gynecological history and somatic morbidity of 426 pregnant women who did not have somatic pathologies and underwent screenings in accordance with the current regulations were performed. The main group of them consisted of 290 women, who showed signs of chronic placental insufficiency at different stages of pregnancy. The control group consisted of 136 women who had no signs of placental insufficiency throughout their pregnancy. RESULTS: It was revealed that the main reasons for the development of chronic placental insufficiency of the main group are preeclampsia (68.4%), the threat of termination of pregnancy (34.7%), burdened obstetric and gynecological history (32.5%), isoserological incompatibility (25.6%), pyelonephritis during pregnancy (14.2%) and anemia of pregnant women (13.2%). It was revealed that visualization of the fetoplacental complex and measurement of peripheral resistance in the umbilical artery during the second trimester of pregnancy are not very informative. To reduce the negative impact of fetoplacental insufficiency and its timely diagnosis, it is necessary to use radiation methods for examining the motherplacentafetus system. CONCLUSIONS: For timely diagnosis of fetoplacental insufficiency and reduction of its negative impact, it is necessary to use radiation methods of studying the mother-placenta-fetus system.


Somatechnics ◽  
2015 ◽  
Vol 5 (1) ◽  
pp. 88-103 ◽  
Author(s):  
Kalindi Vora

This paper provides an analysis of how cultural notions of the body and kinship conveyed through Western medical technologies and practices in Assisted Reproductive Technologies (ART) bring together India's colonial history and its economic development through outsourcing, globalisation and instrumentalised notions of the reproductive body in transnational commercial surrogacy. Essential to this industry is the concept of the disembodied uterus that has arisen in scientific and medical practice, which allows for the logic of the ‘gestational carrier’ as a functional role in ART practices, and therefore in transnational medical fertility travel to India. Highlighting the instrumentalisation of the uterus as an alienable component of a body and subject – and therefore of women's bodies in surrogacy – helps elucidate some of the material and political stakes that accompany the growth of the fertility travel industry in India, where histories of privilege and difference converge. I conclude that the metaphors we use to structure our understanding of bodies and body parts impact how we imagine appropriate roles for people and their bodies in ways that are still deeply entangled with imperial histories of science, and these histories shape the contemporary disparities found in access to medical and legal protections among participants in transnational surrogacy arrangements.


2020 ◽  
Vol 73 (11) ◽  
pp. 2416-2420
Author(s):  
Olena О. Taranovska ◽  
Volodymyr К. Likhachov ◽  
Ludmyla М. Dobrovolska ◽  
Oleg G. Makarov ◽  
Yanina V. Shymanska

The aim: To determine the serum FAMG in the I and II trimester of pregnancy in women with a past history of chronic endometritis, and to clarify its impact on the development of pathology of pregnancy. Materials and methods: The level of FAMG was determined at 6-8 and 16-18 weeks of gestation in 135 pregnant women with a past history of chronic endometritis, who received treatment of chronic endometritis at the stage of pregravid preparation and 168 women who became pregnant without its prior treatment. The dependence of the development of pre-eclampsia on the level of FAMG at the early stages of pregnancy has been evaluated. Results: At 6-8 weeks of pregnancy, the level of FAMG in women with a past history of chronic endometritis was 20.6% lower (122.4 ± 7.6 ng/ml) compared to the control group. In FAMG of 90.3 ± 4.3 ng/ml at 6-8 weeks of gestation, spontaneous abortion occurred in 100% of cases within the next 2 weeks. FAMG lower than 122,1 ± 3,0 ng/ml can be the predisposing factor for the development of pre-eclampsia. Conclusions: Reduced FAMG in the beginning of pregnancy in women with untreated chronic endometritis in the past history increases the incidence of miscarriages at the early stages by 2.6 times, and by 1.8 times the probability of preeclampsia development. Treatment of chronic endometritis at the stage of pregravid preparation promotes the increase of FAMG by 24,6% compared to untreated women that reduces the probability of complications during the subsequent course of pregnancy.


2018 ◽  
Vol 25 (3) ◽  
pp. 40-45
Author(s):  
E. V. BURDYUKOVA ◽  
A. N. ARKHANGELSKAYA ◽  
S. N. ALEKSEENKO ◽  
I. A. YAKIREVICH ◽  
E. A. DMITRIEVA ◽  
...  

Aim. To evaluate the effectiveness of the developed special sports complex in the prevention of hypodynamia and obesity among firefighters-rescuers.Materials and methods. A survey of 490 men with no history of chronic infectious and non-infectious diseases aged 20-59 was conducted. 328 people were the main group, 162 people were the control group. The baseline data included anthropometric development indicators, bioimpedance test results, the extraction of biochemical blood test results; the body mass index (BMI) and the ratio of waist and hip circumference were determined. A questionnaire was conducted to identify hypodynamia (according to the IPAQ questionnaire) and the nutrition structure (according to the questionnaire on the food label literacy questionnaire, past). Both questionnaires were adapted to the Russian Federation. Statistica for Windows 8.0 was used for statistical processing. We used a comparison of the means of the Student method. To compare the values expressed in percent, the method of inverse trigonometric Fisher transformations was used.Results. We have developed and proposed for firefighters-rescuers, included in the main group, special sports complexes, which were used for 6 months. These complexes represent additional physical training by the developed method. There are two of them: one with an emphasis on the prevention and rehabilitation of people with osteochondrosis of the lumbar spine, and the other for cervical and thoracic localization, including with a syndrome of shoulder-scapular periarthritis.Classes were held 3 times a week, the duration of 1 session was 45-50 minutes. The choice of the complex was carried out at the request of firefighters-rescuers. The first complex was selected by 52 people. Based on the results of the study, against the background of the use of sports complexes, there was a 2-fold decrease in the incidence of obesity. Such a high efficiency is due to the fact that obesity of the I degree prevailed among the firefighters-rescuers. In addition, the frequency of occurrence of dyslipidemia, hyperglycemia, and hypodynamia decreased.Conclusion. The use of this sports complex can reduce the risk factors for development of disability among rescue firefighters by preventing hypodynamia and reducing the incidence of hyperglycemia and dyslipidemia, as factors in the development of obesity.


2021 ◽  
pp. 26-31
Author(s):  
V.O. Beniuk ◽  
L.M. Vygivska ◽  
I.V. Maidannyk ◽  
T.V. Kovaliuk ◽  
O.O. Chorna ◽  
...  

Study objective: to determine the role and effectiveness of the proposed therapeutic and preventive complex and psychoemotional correction of hormonal disorders in the pregnancy dynamics after assisted reproductive technologies (ART) to improve the antenatal observation and prevention of obstetric and perinatal complications.Materials and methods. The study included 299 pregnant women: the main group included 249 women whose pregnancy occurred as an ART result; the control group included 50 pregnant women with spontaneous pregnancy. Therapeutic and prophylactic complex for pregnant women after ART included: micronized progesterone, magnesium oxide, folic acid, L-arginine aspartate, ω3-polyunsaturated fatty acids and long-term psychological correction on the eve of the ART program, at 8–10, 16–18 and 28–30 weeks of pregnancy. Results. There was a significant increase in the β-chorionic gonadotropin (β-hCG) level in women of the study groups in the first trimester of pregnancy against the background of the proposed treatment. Mean β-HCG value at 7–8 weeks of gestation in the subgroup IA exceeded the subgroup IB by 37% (p <0.05), in subgroup IIA it exceeded the subgroup IIB by 33% (p <0.05). The mean β-hCG value in subgroups IIIA and IIIB did not have a significant difference in the dynamics of the first trimester compared with the control group and among themselves (p >0.05).Mean progesterone value at 7–8 weeks of gestation in subgroup IA increased by 38% in comparison with pregnant women who received the conventional treatment complex (p <0.05), in subgroup IIA it was 73% higher than in subgroup IIB (p <0.05). There was no significant difference in the progesterone level in subgroups IIIA and IIIB in the dynamics of the first trimester.The average cortisol value at 23–24 weeks of pregnancy in subgroup IA decreased by 42% (p <0.05), in pregnant women with endocrine infertility against the background of the proposed treatment complex it was 62% less than in subgroup IIB (p <0.05). The average cortisol level in women with a male factor of infertility was 63% lower than in subgroup IIIB against the background of the proposed complex (p <0.05).Conclusion. Advanced therapy with micronized progesterone in combination with magnesium saturation, L-arginine aspartate, folic acid, ω-3 polyunsaturated fatty acids, as well as long-term psychoemotional correction is appropriate and effective compared to conventional therapy for pregnant women.


2021 ◽  
Vol 66 (8) ◽  
pp. 485-488
Author(s):  
A. V. Kust ◽  
N. Y. Sotnikova ◽  
A. I. Malyshkina ◽  
D. N. Voronin

To determine the level of CD20 + IL-10 + B-lymphocytes in pregnant women with the threat of termination of pregnancy at 5-12 weeks and recurrent miscarriage in history and compare the data obtained with the end of gestation. A survey of 65 women at a gestational age of 5-12 weeks was carried out. The main group consisted of 33 women with a threatening recurrent miscarriage at the time of the examination, the comparison group consisted of 10 pre-pregnant women with a threatening sporadic miscarriage at the time of the examination, the control group consisted of 22 pregnant women without signs of a threatening miscarriage. The main group, depending on the outcomes of pregnancy, is divided into 2 subgroups: subgroup A - pregnancy ended in undeveloped pregnancy or miscarriage (9 women), subgroup B - pregnancy ended in childbirth (24 women). The relative content of CD20 + IL-10 + B-lymphocytes was determined by flow cytometry on FACSCanto II (Becton Dickinson, USA). Women in the main group had a significantly lower level of CD20 + IL-10 + B-lymphocytes in comparison with the rest of the surveyed. A retrospective analysis revealed that among women of subgroup A there was a sharp decrease in CD20 + IL-10 + cells compared with subgroup B. Prediction of a non-developing pregnancy and spontaneous miscarriage up to 22 weeks of gestation in pregnant women with threatened spontaneous miscarriage and a history of recurrent miscarriage is possible with the relative content of CD20 + IL-10 + equal to or less than 4.5% (sensitivity 100%, specificity 82.6%, accuracy 87.9%).


2021 ◽  
Vol 70 (4) ◽  
pp. 73-79
Author(s):  
Anna I. Malyshkina ◽  
Natalia Y. Sotnikova ◽  
Dmitriy N. Voronin ◽  
Alena V. Kust

BACKGROUND:The frequency of recurrent miscarriage is up to 5 % of all desired pregnancies and is mainly due to immunological disorders. Dysfunction in the regulation of the functional activity of B lymphocytes is the pathogenetic link in multiple obstetric complications, including habitual miscarriage. AIM:The aim of this study was to characterize the regulation of the functional activity of peripheral B lymphocytes in pregnant women with threatened spontaneous miscarriage and a history of habitual miscarriage. MATERIALS AND METHODS:We examined 88 women aged 18-40 years at a gestation period of 5-12 weeks. The main group consisted of 36 patients with threatened spontaneous miscarriage at the time of examination and a history of habitual miscarriage. The control group included 28 women with uncomplicated pregnancy. The comparison group consisted of 24 primary pregnant patients with threatened spontaneous abortion at the time of examination. BAFF and APRIL levels in the blood serum were determined by enzyme immunoassay. The content of CD19+BAFFR+B lymphocytes in the lymphocyte gate was evaluated in the peripheral blood by flow cytometry using monoclonal antibodies. Akt mRNA expression was assessed using real-time reverse-transcription quantitative polymerase chain reaction. CD19+В lymphocytes were isolated by direct magnetic separation. RESULTS:In the main group, there was an increase in expression of BAFF receptors on peripheral CD19+B lymphocytes and a decrease in the serum BAFF concentration compared to the parameters in the other study groups. We also found a pronounced trend towards a decrease in the serum APRIL level in the main and comparison groups of patients compared to healthy pregnant women. Besides, Akt mRNA expression in peripheral CD19+B lymphocytes was increased in the main group. CONCLUSIONS:Threatened habitual abortion is associated with the deficit of the regulatory influence of BAFF and APRIL, which is expressed in the disruption of B cell homeostasis and the weakening of humoral effector mechanisms.


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