CERVICAL INSUFFICIENCY: ANAMNESIS, PREGNANCY AND CONSEQUENCES OF PREGNANCY (RETROSPECTIVE ANALYSIS)

Cervical insufficiency (CI) remains one of the leading causes of miscarriage and premature birth. Purpose of the study: to determine the frequency of CI, the characteristics of the anamnesis, the course of pregnancy, childbirth, the state of the newborn and the identification of potential risk factors. Material and research methods. 8728 birth histories were analyzed, among which 166 (1.9%) stories of women whose pregnancy was complicated by CI were found. The main group consisted of 166 pregnant women with CI, the control group included 55 women without CI and other severe obstetric- gynecological and somatic pathologies. The results obtained and their discussion. The incidence of CI on average over 5 years was 1.9%. With CI, there is a significantly lower percentage of young women, and at the age of 35 and over - 27.1% of pregnant women versus 10.9% in the control group. Only one third (33.7%) of women with CI can be considered somatically healthy. The morbidity structure is dominated by endocrine pathology (30.7%), among which metabolic syndrome / obesity (19.9%) and diseases of the urinary excretory system (27.7%) are distinguished. High frequency of pathology of the cardiovascular system (21.1%) and autonomic dysfunction syndrome (25.9%), hepatobiliary pathology (15.1%), gastrointestinal diseases (19.3), allergic manifestations (16.9%). A third of patients (28.9%) have a combination of two or more somatic diseases. Every fourth woman has a history of an infectious pathology of the urinary excretory sphere (25.9). In 27.7% of patients - a combination of several infectious pathologies. Half of the patients (53.0%) had a complicated gynecological history: cervical ectopy (33.7%), chronic infectious diseases of the genital area (16.3%) and PCOS: (13.9%), synechiae of the uterine cavity (6.6 %) and congenital malformations of the genitals (3.0%). The combination of several gynecological pathologies was observed in 18.1% of women. Every fourth woman underwent an excision of the cervix (25.9%), 42.8% - intrauterine interventions with the expansion of the cervical canal, 59.2% of them two or more times. According to the obstetric anamnesis, spontaneous miscarriages and medical abortions in 27.7% and 33.7% of women, in 18.1% - a missed pregnancy, every fourth patient has premature birth (25.9%), and every 10th patient has suffered injuries cervix. With a current pregnancy, the threat of premature birth is most often noted (51.2%), in second place is an exacerbation of infection of the genitourinary sphere (41.0%) and the threat of premature birth (38.0%). High incidence of placental dysfunction (30.7%), gestational diabetes (13.9%), fetal growth retardation (12.0%) and preeclampsia (7.3%). Premature birth in 38.0% of cases, in 31.9% - premature rupture of membranes, delivery by cesarean section in 19.3% of cases. Noteworthy is the high frequency of intrauterine infection (13.9%). Conclusion. Based on the results of a retrospective analysis, after a more detailed assessment of possible risk factors for CI, the most informative ones will be identified and proposed for use in clinical practice.

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

Biomedical update ◽

10.52739/bio-up.2.2021.10-15 ◽

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.

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Risk Factors for premature birth in a hospital

Revista Latino-Americana de Enfermagem ◽

10.1590/1518-8345.0775.2750 ◽

2016 ◽

Vol 24 (0) ◽

Cited By ~ 7

Author(s):

Margarita E. Ahumada-Barrios ◽

German F. Alvarado

Keyword(s):

Risk Factors ◽

Prenatal Care ◽

Pregnant Women ◽

Premature Birth ◽

Bivariate Analysis ◽

Control Group ◽

Case Group ◽

Retrospective Case ◽

History Of ◽

Inadequate Prenatal Care

Abstract Objective: to determine the risk factors for premature birth. Methods: retrospective case-control study of 600 pregnant women assisted in a hospital, with 298 pregnant women in the case group (who gave birth prematurely <37 weeks) and 302 pregnant women who gave birth to a full-term newborn in the control group. Stata software version 12.2 was used. The Chi-square test was used in bivariate analysis and logistic regression was used in multivariate analysis, from which Odds Ratios (OR) and Confidence Intervals (CI) of 95% were derived. Results: risk factors associated with premature birth were current twin pregnancy (adjusted OR= 2.4; p= 0.02), inadequate prenatal care (< 6 controls) (adjusted OR= 3.2; p <0.001), absent prenatal care (adjusted OR= 3.0; p <0.001), history of premature birth (adjusted OR= 3.7; p <0.001) and preeclampsia (adjusted OR= 1.9; p= 0.005). Conclusion: history of premature birth, preeclampsia, not receiving prenatal care and receiving inadequate prenatal care were risk factors for premature birth.

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Prevention of pregnancy complications and delivery at low placentation

Bukovinian Medical Herald ◽

10.24061/2413-0737.xxv.3.99.2021.13 ◽

2021 ◽

Vol 25 (3 (99)) ◽

pp. 83-88

Author(s):

S. Pecheriaha ◽

I. Marynchyna

Keyword(s):

Pregnant Women ◽

Pregnancy Complications ◽

Uterine Cavity ◽

Main Group ◽

Late Gestation ◽

Lower Percentage ◽

Control Group ◽

Early Gestation ◽

Placental Dysfunction ◽

Pregnancy And Delivery

Objective is to evaluate the effectiveness of the developed method of preventing pregnancy complications with low placentation from early gestation.Material and methods. We have examined 119 pregnant women with low placentation. This diagnosis was made at 6-7 weeks of gestation on the basis of echographic research. The main group consisted of 64 pregnant women with low chorionic location who underwent prevention from pregnancy complications in early gestation by the complex of medicines developed by us and a control group -55 women with low placentation who had not undergone complications prophylaxis from early gestational periods. The prophylactic complex included Luteina, ginkgo biloba extract, folio and biolectra. To assess the effectiveness of the therapy in the study groups, we analyzed the course of pregnancy in early and late gestation, as well as complications of pregnancy and delivery.Results. The frequency of pregnancy pathologies in the main group, where the prevention of pregnancy complications from early gestation with low placentation, was significantly lower than in the control group. According to the study, the risk of abortion with bleeding and without bleeding in the first and second trimesters significantly decreased in the main group of pregnant women (p<0.05). In the third trimester of gestation in the group where the prevention of pregnancy complications was significantly reduced, the incidence of preterm birth, premature detachment of the low-lying placenta, fetoplacental dysfunction, fetal developmental delay syndrome and fetal distress during pregnancy (p<0.05). Also, in the main group there was a lower percentage of premature births and births that ended by cesarean section.Conclusions. 1. The place of attachment of the placenta in the uterine cavity is closely related to its function, the development of placental dysfunction, pregnancy and delivery. 2. Studies have shown the effectiveness of our proposed comprehensive drug prevention of complications of pregnancy with low placentation, which in turn has led to improved pregnancy and delivery and has become an effective means of preventing placental dysfunction.

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EPIDEMIOLOGY OF THE PREVALENCE OF PHENOTOPIC SIGNS UNDIFFERENTIATED CONNECTIVE TISSUE DYSPLASIA SYNDROME IN WOMAN WITH MISCARRIAGES

Wiadomości Lekarskie ◽

10.36740/wlek202104112 ◽

2021 ◽

Vol 74 (4) ◽

pp. 880-883

Author(s):

Tunzala V. Ibadova ◽

Volodymyr V. Maliar ◽

Vitalii V. Maliar ◽

Vasyl V. Maliar

Keyword(s):

Preterm Birth ◽

Connective Tissue ◽

Pregnant Women ◽

Premature Birth ◽

Control Group ◽

Cervical Insufficiency ◽

Group I ◽

Therapeutic Measures ◽

Connective Tissue Dysplasia ◽

Group Ii

The aim: Study of the relationship between cervical insufficiency and dysplastic stigma in miscarriages. Materials and methods: 80 pregnant women were examined at 23-27 weeks of gestation.) Group I included 40 pregnant women with the threat of premature birth, with habitual miscarriage and correction of cervical insufficiency (CI) by using pessary in the anamnesis. Group II consisted of 20 pregnant women with the threat of premature birth and correction of CI by using pessary without the burden of habitual miscarriage, the control group of 20 almost healthy pregnant women. Results: The studies revealed phenotypic signs of dysplastic stigmatization in 39 (97.5 + 2.5%) pregnant women of group I, in 18 (90.0 + 6.9%) group II and in 4 (20.0 + 9.2%) control, which indicates a high prevalence of connective tissue dysplasia in women with CI, which also has a laboratory reflection in the form of increased excretion per day of oxyproline and a decrease in total glycosaminoglycans in both groups at risk of preterm birth. Conclusions: The most common gestational complication in women with connective tissue dysplasia is the risk of premature birth. Improving existing and finding new diagnostic and therapeutic measures for women with UDСTD will reduce the risk of preterm birth.

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COVID 19 INFECTION AS A RISK FACTOR FOR PREMATURE DETACHMENT OF THE NORMALLY LOCATED PLACENTA

Medical Journal ◽

10.51922/1818-426x.2021.3.77 ◽

2021 ◽

pp. 77-81

Author(s):

D.A. Nikitin ◽

◽

V.S. Verbitski ◽

L.N. Vasileva ◽

M.S. Verbitskaya ◽

...

Keyword(s):

Risk Factor ◽

Cesarean Section ◽

Pregnant Women ◽

Retrospective Analysis ◽

Premature Birth ◽

Maternity Hospital ◽

Medical Institution ◽

Control Group ◽

Clinical Hospital ◽

In Pregnancy

A retrospective analysis of childbirth was carried out in 298 women with confirmed COVID-19 infection (main group) who received treatment in the maternity hospital of the 6th City Clinical Hospital of Minsk in the period from April 14, 2020 to February 14, 2021. The control group included pregnant women who gave birth during 2017—2019 in this medical institution (total 12 812). There was an increase in the incidence of premature birth from 2.7 % in pregnant women in the control group to 5.7 % in patients with COVID-19. The pathology in pregnancy significantly increased the frequency of cesarean section — 45.6 % in patients with COVID -19 Women with COVID-19 infection significantly more often have such a severe complication as premature abruption of normally located placenta (P < 0.05).

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Evaluation of the effectiveness of the appointment of acetylsalicylic acid for the prevention of obstetric complications by the method of logistic regression

Reproductive health of woman ◽

10.30841/2708-8731.5.2021.240021 ◽

2021 ◽

Vol 5 ◽

pp. 19-27

Author(s):

V.О. Herasymchuk ◽

O.S. Zahorodnia ◽

D.Yu. Krukovets

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Acetylsalicylic Acid ◽

Pregnant Women ◽

Fetal Growth ◽

Premature Birth ◽

Reproductive Technologies ◽

Negative Sign ◽

Control Group ◽

Second Trimester

Preeclampsia remains to be an urgent problem in the modern medicine, the main reason for which is the lack of high efficiency of treatment. One of the few methods with proven effectiveness is the prophylactic administration of aspirin at the beginning of the second trimester of pregnancy. At the same time, microcirculation disorders that underlie the development of preeclampsia are pathogenetically significant for other gestational complications.The objective: a study of the effectiveness of aspirin prescription for the prevention of preeclampsia and other complications during pregnancy using the logistic regression method.Materials and methods. The control group included 43 pregnant women with clinical criteria for preeclampsia. Forty six pregnant women with risk factors for preeclampsia who took acetylsalicylic acid from the 16-18 weeks of gestation formed the I group, and 46 pregnant women with risk factors for preeclampsia who did not take acetylsalicylic acid were included in the the II group. In all patients, on the basis of anamnesis data, risk factors and the course of the second trimester of pregnancy were analyzed, their correlation analysis and the use of acetylsalicylic acid were carried out, logistic regressions and simple decision trees were constructed.Results. The proposed logistic regression models have demonstrated their veracity by confirming the influence of traditional risk factors for the development of preeclampsia. At the same time, the use of these models allowed not only to prove the preventive effect of aspirin on the development of preeclampsia (the coefficient is statistically significant, with a negative sign), but also the ability to reduce the severity of preeclampsia. In addition, the negative sign of the coefficient was obtained when studying the effect of taking aspirin on such complications of pregnancy as premature birth and fetal growth retardation.Conclusions. 1. The use of a database of patients, statistical and model analysis of this dataset, allows you to establish and evaluate the relationship, their statistical significance between different factors. Based on the results of the research we can say with great confidence about the significant effect of prophylactic aspirin intake on reducing the risk of preeclampsia. 2. Taking aspirin reduces the likelihood of fetal growth retardation and premature birth. 3. The use of assisted reproductive technologies is positively correlated with the risk of developing preeclampsia. The influence of other traditional factors on the development of preeclampsia was proved by the method of logistic regression, which confirms the veracity of the proposed statistical model.

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Pathogenetic approach of preterm labour treatment in the background of chronic infection source

HEALTH OF WOMAN ◽

10.15574/hw.2017.119.54 ◽

2017 ◽

pp. 54-58

Author(s):

S.N. Heryak ◽

◽

N.V. Petrenko ◽

V.Yu. Dobryanskа ◽

O.A. Yakimchuk ◽

...

Keyword(s):

Risk Factors ◽

Pregnant Women ◽

Premature Birth ◽

Conventional Therapy ◽

Preterm Labor ◽

Pain Syndrome ◽

Control Group ◽

Channel Blockers ◽

Treatment And Prevention ◽

Micronized Progesterone

The objective was to study the effectiveness of the application of the sublingual form of micronized progesterone for the treatment and prevention of premature birth in women with concomitant risk factors against the background of the infectious inflammatory component in the anamnesis. Materials and methods. The study was conducted in two stages. At the first stage, 100 stories of pregnant women with preterm labor were analyzed at a period of 22-36 weeks, which were inpatient treatment in the Ternopil Regional Clinical Perinatal Center «Mother and Child». A comprehensive assessment of risk factors for the development of preterm labor and the effectiveness of their management was carried out. At the second stage of the study, 27 pregnant women (group 1) who were hospitalized with a threat of premature birth and had an anamnesis history, were treated with natural micronized progesterone Lutein in a dose of 100 mg sublingually twice a day. The comparison group (group 2) included 30 pregnant women, who before traditional hospitalization began traditional tocolytic therapy with calcium channel blockers. The control group included 20 pregnant women with a physiological pregnancy. Results. As a result of the proposed therapy, a decrease in the intensity of the pain syndrome in patients taking micronized progesterone was observed at 25 min faster (p <0.05) than after conventional therapy (85.2 ± 7.4 min in the 1st group and 110.6 ± 9.8 min - in the second group). At the same time, anxiety level was 16.1 ± 1.8 points in patients of the 1st group, which corresponded to its absence, while the patients of the 2nd group continued to be in a state of moderate anxiety (19.3 ± 1.4 points). Pregnant women with a threat of preterm birth who had an inflammatory process of any localization in the past had a significant increase in the level of proinflammatory cytokines (IL-2, IL-6, TNF-?) and a decrease in the level of anti-inflammatory cytokines (IL-4, IL- 10) in comparison with the indicators of healthy pregnant women. The use of micronized progesterone and conventional therapy positively affects these indicators. Conclusion. The use of the sublingual form of micronized progesterone in the preparation of Lutein at a dose of 200 mg per day is pathogenetically grounded and provides a rapid arrest of the manifestations of premature birth in women with miscarriage in the background of chronic foci of infection. Key words: premature birth, inflammation, micronized progesterone.

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Decompensation placental dysfunction: diagnostics and delivery tactics

HEALTH OF WOMAN ◽

10.15574/hw.2017.118.66 ◽

2017 ◽

pp. 66-68

Author(s):

V.I. Boyko ◽

◽

S.A. Tkachenko ◽

Keyword(s):

Pregnant Women ◽

Key Words ◽

Retrospective Analysis ◽

Control Group ◽

Present Stage ◽

Placental Dysfunction ◽

Perinatal Pathology ◽

Delivery Times ◽

Case Rate ◽

Major Factors

The objective: depression of frequency of perinatal pathology at women with decompensation form of placental dysfunction by improvement of the main diagnostic and treatment-and-prophylactic actions. Patients and methods. 154 pregnant women in gestation term from 22 to 40 weeks were surveyed. Depending on features of course of pregnancy and families of all surveyed it was divided into 4 groups. The group of the retrospective analysis was made by 45 pregnant women with decompensation placental dysfuction, the group of prospective research included 109 pregnant women of whom the main group was made by 38 women with decompensation form of placental dysfunction, the group of comparison included 47 pregnant women with the compensated form of placental dysfunction. The control group was made by 24 pregnant women with the uncomplicated course of pregnancy and labors. The complex of the conducted researches included clinical, ehografical, dopplerometrical, laboratory, morphological and statistical methods. Results. Use of advanced algorithm of diagnostic and treatment-and-prophylactic actions allows to increase efficiency of diagnostics of decompensation form of placental dysfunction for 33.3%, and rational tactics of a delivery leads to depression of perinatal pathology for 22.7%. Conclusion. Decompensation placental dysfuction is one of the main reasons for perinatal mortality and a case rate at the present stage. Use of the algorithm of diagnostic and treatment-and-prophylactic actions improved by us allows major factors of risk of this complication and the indication for change of tactics and delivery times. Key words: decompensation placental dysfunction, diagnostics, delivery tactics.

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The Predictive Value of the Mother’s Risk Factors in Formation of Fetal Developmental Delay

Global Pediatric Health ◽

10.1177/2333794x21999149 ◽

2021 ◽

Vol 8 ◽

pp. 2333794X2199914

Author(s):

Maka Chigladze

Keyword(s):

Risk Factors ◽

Pregnant Women ◽

Predictive Value ◽

Negative Impact ◽

Deficiency Anemia ◽

Control Group ◽

Case Group ◽

Retrospective Case ◽

Standards Of Living ◽

Poor Nutrition

The research aimed at studying the mother’s social-hygienic and medical biological risk factors and determining their predictive value. The retrospective case-control study was conducted with 142 pregnant women participating in it. In the case group there were involved 92 mothers whose pregnancy was completed by the birth of a newborn baby suffering from the intrauterine growth restriction. The control group was made of 50 pregnant women, whose pregnancy was completed by the birth of a healthy neonate. The research resulted in specifying the risk factors of high priority: the low standards of living (OR 3.61), chronic stress (OR-3.06), sleeping disorder (OR-3.33) and poor nutrition (OR-3.81). As regards the coexisting pathology the following was revealed: endocrine pathology (OR-3.27), ischemic heart disease (OR-4.35), arterial hypertension (OR-6.47), iron deficiency anemia (OR-4.11), pathology of respiratory system (OR-3.42), chronic genital inflammatory and infectious processes. The preeclampsia (92%) and low amniotic fluid (89%) were detected to have the high predictive value. The awareness of risk factors allows us to employ the timely measures for the reduction of negative impact on the fetus and neonate.

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Modern view on the problem of optimization of therapy in pregnant women with functional cervical insufficiency

Reports of Vinnytsia National Medical University ◽

10.31393/reports-vnmedical-2018-22(1)-33 ◽

2018 ◽

Vol 22 (1) ◽

pp. 173-177

Author(s):

V. F. Oleshko

Keyword(s):

Blood Serum ◽

Pregnant Women ◽

Main Group ◽

Control Group ◽

Cervical Insufficiency ◽

Progesterone Concentration ◽

Therapeutic Dosage ◽

Hormonal Balance ◽

Magnesium Orotate ◽

Micronized Progesterone

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.

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