scholarly journals Fetoplacental Angiogenesis in Preeclampsia. Clinical and Morphological Aspects

2020 ◽  
Vol 16 (28) ◽  
pp. 6-11
Author(s):  
N.Yu. Sakvarelidze ◽  
S.G. Tsakhilovа ◽  
V.S. Muradova ◽  
N.V. Zharkov ◽  
A.S. Zikova ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Structural Changes ◽  
Perinatal Outcomes ◽  
Placental Insufficiency ◽  
Trophoblast Invasion ◽  
Morphometric Study ◽  
Control Group ◽  
Singleton Pregnancy ◽  
Placental Angiogenesis ◽  
Group I

Purpose. To study placental angiogenesis in pregnant women with preeclampsia (PE), based on a comparison of the results of a clinical examination and a morphometric study of sequins with this pathology. Material and methods. In the present work, we studied 30 pregnant women with PE, whose average age was 29 ± 1.4 years. The pregnant women were divided into two groups. Group I (n = 21) consisted of pregnant women with PE, among whom 10 patients were within 34 weeks of gestation, and 11 – at 34–39 weeks. Group II (n = 9) – control group, with physiological pregnancy. The inclusion criteria were: singleton pregnancy, the presence of preeclampsia according to the ICD-10 classification, the patient's voluntary informed consent to the study. Exclusion criteria: extragenital pathology, multiple births, congenital malformations of the fetus. There were no significant differences in somatic and gynecological status among pregnant women in the surveyed groups. Results. Vascular endothelial growth factor (VEGF) and its receptors, VEGF R1 and VEGF R2, are of priority importance in the development of placental angiogenesis. The balance of interaction between VEGF and R1 and R2 receptors leads to adequate vascularization of the villi in the early stages of trophoblast invasion into the spiral arteries of the uterus. Conclusion. As a result of the morphological study, it can be assumed that hemodynamic parameters according to Doppler and angioarchitectonics of the placentas are an important factor in the pathogenesis of placental insufficiency and fetal growth retardation. In the absence of disturbances in uteroplacental-fetal hemodynamics, endothelial dysfunction should be considered as compensated, in which favorable perinatal outcomes are expected. Structural changes in the fetoplacental complex with impaired blood flow in the uterine arteries and umbilical cord arteries in PE are regarded as subcompensated and decompensated forms of placental insufficiency

scholarly journals Assessment of the health status of infants born from women of the late reproductive period

2021 ◽  
Vol 66 (3) ◽  
pp. 128-133
Author(s):  
Kh. M. Omarova ◽  
E. S.-А. Ibragimova ◽  
T. Kh.-M. Khashaeva ◽  
I. Kh. Magomedova ◽  
R. G. Omarova ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Assisted Reproductive Technologies ◽  
Neurological Diseases ◽  
Perinatal Outcomes ◽  
Reproductive Technologies ◽  
Reproductive Period ◽  
Reproductive Age ◽  
Control Group ◽  
Age Related ◽  
Group I

Objective. To assess the condition of newborns from women of the late reproductive period (LRP), depending on the parity of births.Material and methods. The authors examined 130 pregnant women and their 130 newborns. Group I consisted of 60 primiparous women of late reproductive period and their 60 newborns, Group II included 40 multiparous women of the late reproductive period and their 40 newborns, Group III (control group) consisted of 30 healthy pregnant women aged from 18 to 25 years and their 30 newborns. The authors performed a retrospective analysis of the gestation course and perinatal outcomes. Ultrasound and neurosonography were used among the instrumental research methods.Results. Women of the late reproductive period gave birth to children in a state of asphyxia twice more often, who develop neurological disorders 1,5 times more often and complex postnatal adaptation and disorders of the perinatal period are twice more likely. Among women of the late reproductive period, primiparous women gave birth to children with the most severe disorders.Conclusion. The high incidence of neurological diseases in children born from women of the late reproductive period is associated with age-related changes in their germ cells, the implementation of assisted reproductive technologies, and the intake of hormonal drugs in early pregnancy. The data obtained should be taken into account by obstetricians in the course of pregnancy in women of late reproductive age; they should be included in the group of high risk of developing neurological disorders in children.

scholarly journals Causes of patients’ obstetric complications after ART

2017 ◽  
Vol 66 (3) ◽  
pp. 25-33 ◽  
Author(s):  
Olga N. Arzhanova ◽  
Yulia M. Paikacheva ◽  
Anna V. Ruleva ◽  
Roman V. Kapustin ◽  
Natalya G. Nichiporuk
Keyword(s):  
Pregnant Women ◽  
Older Women ◽  
Main Group ◽  
High Risk Group ◽  
Placental Insufficiency ◽  
Physical Disorder ◽  
Singleton Pregnancy ◽  
Art Programs ◽  
Group I ◽  
Singleton Pregnancies

Chronic placental insufficiency remains a major cause of perinatal morbidity and mortality. In this regard, prediction of this pregnancy complications becomes particularly relevant. Currently, the frequency of pregnancy as result of assisted reproductive technology (ART) increases among the population. Pregnancies after ART administration compare to naturally occurred are accompanied by a higher risk of miscarriage as well as the formation of placental insufficiency. Older women with endocrine and physical disorder participate in the ART programs most frequently. The aim of our study was to investigate the course of pregnancy, after ART administration, selection groups threatened by the development of placental insufficiency. 261 medical records of women with singleton pregnancies after ART have been studied. It was the main group. 167 women had a chronic placental insufficiency. There were allocated two groups of pregnant women: group I – 86 patients with placental insufficiency and preeclampsia, group II – 81 women with placental insufficiency indeed. The comparison group consisted of 30 women without infertility with a normal singleton pregnancy. The development of placental insufficiency in the main group (after ART) depends on a large causes of somatic pathology due to age of pregnant women as well. Therefore, patients after ART have to allocate in the high risk group of developing preeclampsia and placental insufficiency.

Obstetric and perinatal outcomes in women with threatened interruption of pregnancy, living in the armed conflict zone

2020 ◽  
pp. 21-24
Author(s):  
I.Yu. Romanenko ◽  
Keyword(s):  
Pregnant Women ◽  
Inflammatory Diseases ◽  
Perinatal Outcomes ◽  
Control Group ◽  
Operative Delivery ◽  
Pregnancy And Childbirth ◽  
Group I ◽  
History Of ◽  
Complicated Course ◽  
Female Genital

The objective: was to evaluate the course of pregnancy, childbirth and perinatal outcomes of delivery of women with threatened interruption of pregnancy (TIP), living in the Lugansk region, to improve treatment and preventive measures and prevent obstetric and perinatal complications in such women. Materials and methods. A prospective clinical and statistical analysis of the course of pregnancy and childbirth of 86 pregnant women in first and second trimesters of pregnancy were hospitalized regarding TIP in the hospitals located in the Luhansk region was performed (group I). The control group consisted of 64 pregnant women with non-complicated obstetric anamnesis and physiological course of pregnancy with similar gestational period of pregnancy and place of residence (group II). Results. In women of group I, a history of female genital inflammatory diseases was significantly more frequent, and a complicated course of pregnancy and childbirth was registered. The number of cases of acute respiratory viral infection (ARVI) was in 4, isthmic-cervical insufficiency (ICI) was in 3 times more often than in healthy pregnant women, asymptomatic bacteriuria, recurring TIP, gestational pyelonephritis and ureaplasma infection were found only in pregnant women of group I, the number of cases of anemia there was no significant difference. 13 (15.12%) of women of group I and 3 (4.69%) of group II (p=0.041) had spontaneous preterm birth at 33–37 weeks of gestation; operative delivery was registered in 23 (26.74%) and 8 (12.50%) cases, respectively (p=0.033). It was established that recurrent TIP, ARVI during this pregnancy, ICI, gestational pyelonephritis are statistically significant risk factors for preterm delivery and operative delivery. Premature rupture of the membranes was found in 1.58, weakness of labor – in 2.2, premature detachment of a normally located placenta – in 6, fetal distress – in 1.9 times more often in women of group I, central placenta previa was noted only in group I. Conclusions. The complicated course of the first and second trimesters of pregnancy, in particular, recurrent TIP, ARVI during this pregnancy, ICI, gestational pyelonephritis, had a direct effect on frequency increase of premature termination of pregnancy and operative delivery in patients of the main group compared with women of the control group. The presence of a history of chronic female genital inflammatory diseases, sexually transmitted infections, ARVI during this pregnancy, TIP in the first and second trimesters, allows pregnant women to be at high risk of developing gestational complications in order to conduct timely treatment. Key words: pregnancy, the threat of abortion, childbirth, the condition of newborns.

scholarly journals FEATURES OF THE COURSE OF MULTIPLE PREGNANCY AGAINST THE BACKGROUND OF FETAL GROWTH RETARDATION

2020 ◽  
Vol 8 (4) ◽  
pp. 433-438
Author(s):  
A.B. Sukharev ◽  
T.V. Kopytsia ◽  
V.I. Boyko
Keyword(s):  
Pregnant Women ◽  
Fetal Growth ◽  
Multiple Pregnancy ◽  
Placental Insufficiency ◽  
Multiple Births ◽  
Growth Delay ◽  
Control Group ◽  
Multiple Pregnancies ◽  
Group I

In most European countries in recent years, the frequency of multiple births ranges from 11 to 14 per 1000. These pregnancies have a high number of complications. Perinatal mortality in multiple births is more than 6 times higher than in singleton pregnancies. Severe neurological abnormalities under the age of 1 year have from 10% to 25% of twins. According to most researchers, the main cause of perinatal losses in multiple births is deep prematurity and severe fetal growth delay. It has now been proven that placental insufficiency is the main reason of developmental delay, discordant fetal growth, antenatal death of one of the fetuses. A fetus that develops and is born in conditions of chronic placental insufficiency is more vulnerable and at high risk of developing perinatal pathology. The purpose of the research was to study the frequency and structure of complications of the pregnancy and labor of women with multiple pregnancies, complicated uteroplacental insufficiency and fetal discordance. The study was carried out at the city clinical maternity house during 2013–2019. The information was gathered from literature and by interviewing pregnant women with twins. 20 pregnant women (group I) with dichorionic, diamnionic twins with the presence of placental insufficiency and fetal discordance of more than 20%. Group II consisted of 20 pregnant women with twins but fetal discordance did not exceed 20%. However, the control group ІІІ consisted of 30 women without complications and ended in physiological labor. The general, somatic, obstetric and gynecological anamnesis, especially the course of pregnancy, childbirth, the state of the cervix by vaginal and ultrasound examination were studied. The results of the study show that in the anamnesis of pregnant women with fetal discordance, take place in vitro fertilization and infections of the respiratory and urinary tract. Multiple pregnancies which were accompanied by fetal discordance exceeding 20% ​​is accompanied by impaired uteroplacental circulation. Labor with twins complicated by impaired uteroplacental circulation occurs in a large number of complications. The results can be applied to the using various medications for the correction of disorders of the uteroplacental circulation.

INOVASIA Study: A Randomized Open Controlled Trial to Evaluate Pravastatin to Prevent Preeclampsia and its Effects on sFlt1/PLGF Levels

2021 ◽  
Author(s):  
Muhammad Ilham Aldika Akbar ◽  
Angelina Yosediputra ◽  
Raditya Eri Pratama ◽  
Nur Lailatul Fadhilah ◽  
Sulistyowati Sulistyowati ◽  
...  
Keyword(s):  
High Risk ◽  
Pregnant Women ◽  
Controlled Trial ◽  
Intervention Group ◽  
Perinatal Outcomes ◽  
Neonatal Morbidity ◽  
Clinical Risk Factor ◽  
Control Group ◽  
Significant Deterioration ◽  
Plgf Ratio

Objectives To evaluate the effect of pravastatin to prevent preeclampsia (PE) in pregnant women at a high risk of developing preeclampsia and the maternal and perinatal outcomes and the sFlt1/PLGF ratio. Study Design This is an open labelled RCT part of INOVASIA trial. Pregnant women at a high risk of developing PE were recruited and randomized into an intervention group (40) and a control group (40). The inclusion criteria consisted of pregnant women with positive clinical risk factor and abnormal uterine artery doppler examination at 10-20 weeks gestational age. The control group received low dose aspirin (80 mg/day) and calcium (1 g/day), while the intervention group received additional pravastatin (20 mg twice daily) starting from 14-20 weeks gestation until delivery. Research blood samples were collected before the first dose of pravastatin and before delivery. The main outcome was the rate of maternal preeclampsia, maternal-perinatal outcomes, and sFlt-1, PLGF, sFlt-1/PlGF ratio and sEng levels. Results The rate of preeclampsia was (non-significantly) lower in the pravastatin group compared with the control group (17.5% vs 35%). The pravastatin group also had a (non-significant) lower rate of severe preeclampsia, HELLP syndrome, acute kidney injury and severe hypertension. The rate of (iatrogenic) preterm delivery was significantly (p=0.048) lower in the pravastatin group (n=4) compared with the controls (n=12). Neonates in the pravastatin group had significantly higher birthweights (2931 + 537 vs 2625 + 872 g; p=0.006), lower Apgar scores < 7 (2.5 vs 27.5%, p=0.002), composite neonatal morbidity (0 vs 20%, p=0.005) and NICU admission rates (0 vs 15%, p=0.026). All biomarkers show a significant deterioration in the control group compared with non significant changes in the pravastatin group. Conclusions Pravastatin holds promise in the secondary prevention of preeclampsia and placenta-mediated adverse perinatal outcomes by improving the angiogenic imbalance.

scholarly journals Dysmetabolic mechanisms of preeclampsia development

2021 ◽  
Vol 17 (4) ◽  
pp. 346-356
Author(s):  
I. S. Lipatov ◽  
Yu. V. Tezikov ◽  
A. R. Azamatov
Keyword(s):  
Insulin Resistance ◽  
Pregnant Women ◽  
Metabolic Disorders ◽  
Hematological Parameters ◽  
Control Group ◽  
Metabolic Disturbances ◽  
Group Iii ◽  
Inflammatory Status ◽  
Group I

Background: An in-depth study of dismetabolic mechanisms in the genesis of pre-eclampsia (PE) has been updated because pregnancy is considered as a natural model of metabolic syndrome (MS), as well as the metabolic disorders are important in development of essential hypertension.Aims: to reveal clinical and laboratory parallels in pregnancy complicated by PE without MS and pregnancy proceeding on the background of MS to assess the role of metabolic disturbances in the development of PE.Materials and methods: 82 women with MS were examined in the dynamics of pregnancy and were divided into 2 groups depending on the implementation of PE: group I consisted of 50 women with PE on the background of MS, group II 32 women with MS without PE. We formed group III consisting of 44 pregnant women with PE without accompanying diseases to assess the pathogenetic value of metabolic disorders in the development of PE. The IV (control) group consisted of 30 healthy women with physiological pregnancy. Metabolic, hematological parameters, hormones, markers of the proinflammatory state, endothelial hemostasiological dysfunction, decidualization and placental angiogenesis, accumulation dynamics and distribution loci of adipose tissue were determined in all pregnant women.Results: In the groups of pregnant women with PE, changes similar to MS were revealed: pronounced diabetic and atherogenic disorders with the development of pathological insulin resistance, hyperinsulinemia and leptinemia, endothelial-platelet link hyperactivation, thrombotic and inflammatory status, visceral type of fat deposition, hyperuricemia, hypersympathicotonia. It is proved that in the hierarchy of mechanisms of PE formation, placental dysfunction is a secondary alteration factor, which additionally potentiates the insulin resistance increase and the effects of structural and functional destabilization of the vascular endothelium.Conclusions: The direction of metabolic changes during pregnancy, the common development of PE and MS indicate the important role of dismetabolic mechanisms in the formation of PE.

scholarly journals Stage stratification of pregnant women at risk of preeclampsia

2021 ◽  
pp. 174-184
Author(s):  
Yu. V. Tezikov ◽  
I. S. Lipatov ◽  
A. R. Azamatov ◽  
E. M. Zumorina ◽  
M. S. Amosov
Keyword(s):  
Pregnant Women ◽  
Perinatal Outcomes ◽  
Individual Risk ◽  
Laboratory Examination ◽  
Group I ◽  
Tnf Α ◽  
Basic Link ◽  
Mechanisms Of Development ◽  
The Individual ◽  
Risk Of Preeclampsia

Introduction. Pre-eclampsia (PE) continues to be the leading problem in obstetrics. The existing methods for predicting PE show insufficient efficiency, and therefore the search for new predictors of PE remains relevant.The goal of the study. To develop a method for staged stratification of pregnant women to the risk of PE according on the basis of the revealed dismetabolic features of the pathogenesis of this complication of gestation.Material and methods. A dynamic clinical and laboratory examination of 180 pregnant women with independent factors of high risk of PE was carried out. PE was revealed in 89 women who made up group I. Group II (control) consisted of 30 healthy pregnant women with the physiological gestation.Results and discussion. A statistically significant increase in diabetogenic and atherogenic changes characteristic of physiological pregnancy, changes in hormonal, endothelial-hemostasiological, pro-inflammatory and placental parameters aimed at the energy and plastic supply of the fetus was revealed in women with PE. The results of laboratory examination, statistical data processing showed that the most significant pathogenetic mechanisms of development of PE are pathological insulin resistance (IR) and hyperinsulinemia (HI), which act as the basic link and initiate atherogenic transformation of the lipid profile, pro-inflammatory and immunometabolic disorders, prothrombotic status, hyperleptinemia, hyperuricemia, antiangiogenic state and endothelial dysfunction, which indicates a  pronounced pathogenetic and clinical similarity of  PE and metabolic syndrome. The  revealed features of the pathogenesis of PE were reflected in the method of staged risk stratification of pregnant women: the models for assessing the individual risk of PE implementation included the levels of insulin, PlGF, PAMG-1, and TNF-α at 11–14 weeks of gestation; levels of insulin, uric acid, TNF-α, and mean platelet volume at 18-21 weeks of gestation (I trimester – AUC = 0.886, Se = 86.7%, Sp = 84.3%; II trimester - AUC = 0.874, Se = 83.3%, Sp = 87.2%, р < 0.001).Conclusion. Practical application of the developed pathogenetically substantiated method of staged stratification of pregnant women by the risk of PE implementation will justify the appointment and enhancement of preventive measures, reduce the incidence of severe and complicated forms of PE, and improve gestational and perinatal outcomes.

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 CHANGES OF PSYCHO-EMOTIONAL STATE IN THE INFERTILE PREGNANT FEMALES DUE TO THE ANAMNESIS AND IVF

2019 ◽  
Vol 72 (4) ◽  
pp. 562-567
Author(s):  
Volodymyr K. Likhachov ◽  
Yanina V. Shymanska ◽  
Yulia S. Savelieva ◽  
Viktoriya L. Vashchenko ◽  
Ludmyla М. Dobrovolska
Keyword(s):  
Pregnant Women ◽  
Art Therapy ◽  
Emotional State ◽  
Healthy Woman ◽  
The Body ◽  
Control Group ◽  
Emotional States ◽  
Psychological Component ◽  
Group I ◽  
High Level

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%.

scholarly journals Role of calcitriol in modulating of placental dysfunction in pregnant women with chronic kidney disease

2020 ◽  
Vol 17 (4) ◽  
pp. 493-499
Author(s):  
G. S. Manasova ◽  
N. V. Didenkul ◽  
L. V. Mnich ◽  
Z. V. Chumak ◽  
N. V. Kuzmin
Keyword(s):  
Vitamin D ◽  
Kidney Disease ◽  
Pregnant Women ◽  
Kidney Diseases ◽  
Active Form ◽  
Decisive Role ◽  
Control Group ◽  
National Academy Of Sciences ◽  
Placental Dysfunction ◽  
Group I

The pleiotropic effects of vitamin D (VD), whose active form is synthesized in the kidneys, play a certain role both in forming and functioning the feto-placental system, including various pregnancy complications. The aim of the study was to evaluate the vitamin D status in pregnant women with placental dysfunction (PD) and chronic inflammatory kidney disease (CIKD). During 24–34 pregnancy weeks, 56 pregnant women with PD were examined (main group ‒ I); 24 patients (42.85 %) had chronic pyelonephritis (group IA). The control group (group II) had 31 conditionally healthy pregnant women. The total VD level in the blood was determined by ELISA; in addition to the general clinical standard examination, the urine also underwent bacteriological examination. The VD mean level in pregnant women with PD and CIKD was significantly lower than that in the control group (31.08 ± 7.2 and 45.42 ± 9.67 ng/ml (p <0.01)). Only 33.33 % of pregnant women in group IA had a VD optimum, as well as 93.55 % (p < 0.01) in the control group and 17.86 % in group I. 8.33 % of pregnant women had a VD deficiency in group IA (RR = 2.09; CI 95 % ‒ 1.8‒2.42). The patients with a VD-deficiency were absent in the control group. 58.33 % of women in group ІА had a suboptimal VD level and 6.45% in the control group (RR = 3.57; CI 95 % ‒ 1.62‒7.88). Bacteriuria was observed in all pregnant women with a VD-deficient or suboptimal level. At the optimum VD level, bacteriuria was diagnosed twice less (χ2 = 66.67; p <0.01). In patients with an inadequate VD level, CIKD was diagnosed 3.8 times more (RR = 3.57; CI 95 % ‒ 1.62‒7.88). 494 Proceedings of the National Academy of Sciences of Belarus. Medical series, 2020, vol. 17, no. 4, pp. 493–499 A significantly calcitriol reduction in pregnant women with placental dysfunction suggests that the deficiency or the suboptimal level of vitamin D and inflammatory kidney diseases may be the interdependent processes that play a decisive role in the formation of placental dysfunction.

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