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

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.

scholarly journals DIAGNOSTIC CRITERIA FOR UNDIFFERENTIATED CONNECTIVE TISSUE DYSPLASIA IN PATIENTS WITH ARTERIAL HYPERTENSION

2020 ◽  
pp. 49-54
Author(s):  
Ye. H. Zaremba ◽  
N. O. Rak ◽  
O. V. Zaremba ◽  
O. V. Zaremba-Fedchyshyn ◽  
M. M. Virna ◽  
...  
Keyword(s):  
Connective Tissue ◽  
Arterial Hypertension ◽  
Control Group ◽  
Severe Dysplasia ◽  
Moderate Severity ◽  
Group Iii ◽  
Group I ◽  
Connective Tissue Dysplasia ◽  
Group Ii

The aim – to improve the diagnosis efficiency of patients with arterial hypertension (AH) combined with undifferentiated connective tissue dysplasia (UCTD) based on the study of clinical course, the severity of UCTD external and internal symptoms with determining the levels of IL-1, IL-6, TNF-a, free and general blood oxyproline. Material and Methods. The study implied examination of 90 patients (52 women and 38 men) with AH of stage 2 from first to third degrees with manifestations of UCTD, who were on inpatient treatment in the Cardiology Department of the Lviv City Communal Clinical Emergency Hospital. The mean age of patients was (61.14±2.58) years. Patients were divided into 3 groups depending on the stage and degree of hypertension. Group I (n=16) included patients with hypertension of the first degree, group II (n=35) – with AH of the second degree, group III (n=39) – with AH of the third degree. The control group consisted of 20 patients with hypertension without manifestations of CTD. Patients underwent clinical (checkup, palpation, percussion, auscultation), laboratory (determination of IL-1, IL-6, TNF-a, free and general oxyprolin blood levels) and instrumental studies (ECG, echocardiography, DBPM, ultrasound examination of internal organs and vessels of the lower extremities, ultrasound duplex examination of the carotid and vertebral arteries, radiological examination of the osteoarticular system), consultations of an ophthalmologist, neurologist, traumatologist and dentist. Results. As a result of the study, in the group I of patients (n=16) UCTD of slight degree of severity was revealed in 13 (81 %), of medium degree – in 3 (19 %) persons. In the group II of patients (n=35), UCTD of moderate severity was found in 30 (86 %), severe – in 5 patients (14 %). In the group III of patients (n=39), UCTD of moderate severity was found in 32 patients (82 %), severe – in 7 (18 %). In the study of the level of TNF-a, an increase compared to the control group was detected, particularly, in the group I of patients its level exceeded in 37.4 times, in the group II – in 39.6 times, in the group III – in 46.2 times (p<0.001). IL-1b increased by 2.6-fold (р<0.05) in the group I of patients compared to the control group, 3.1-fold (р<0.01) – in the group II, and by 3.7-fold, that was the foremost (р<0.001), in patients of the group III. In turn, IL-6 in the group I of patients exceeded the indicators of the control group by 4.3 times (p<0.001), in the group II – 4.8 times (p<0.001), in the group III – 5.7 times (р<0.001). The study of the level of free oxyproline revealed its increase in comparison with the control group, namely in the group I of patients exceeded in 6.12 times, in the group II – in 6.81 times, in the group III – by 7.56 times (р<0.01). The study of the general of bound oxyproline revealed its increase in comparison with the control group, namely in the group I of patients exceeded by 6.98 times, in the group II – by 7.79 times, in the group III – by 9.42 times (p<0.01), which indicates an increase in fibrillogenesis and more pronounced destructive and inflammatory processes in connective tissue. Conclusions. Patients with AH of the stage 2 from first to third degrees with manifestations of UCTD have increased levels of IL-1, IL-6 and TNF-a, which are not only sensitive markers of inflammation, but also play an important role in the pathogenesis and progression of vascular lesions, occurrence and destabilization of atherosclerotic plaques and thrombotic vessels occlusion. The determination of blood oxyprolin in patients with hypertension combined with UCTD confirms the presence of CTD, namely the decay of collagen is more pronounced in patients with severe dysplasia.

scholarly journals Disorders of social functioning and quality of life in patients with gastroesophageal reflux disease while combined with undifferentiated connective tissue dysplasia

2020 ◽  
Vol 3 (1) ◽  
pp. 11-16
Author(s):  
Iryna Romash
Keyword(s):  
Quality Of Life ◽  
Gastroesophageal Reflux Disease ◽  
Connective Tissue ◽  
Gastroesophageal Reflux ◽  
Social Functioning ◽  
Reflux Disease ◽  
Control Group ◽  
Group I ◽  
Group Ii

Introduction. It has been scientifically confirmed that the risk of developing gastroesophageal reflux disease (GERD) increases especially with generalized or regional disruption of connective tissue structure, which is widespread among the population. Patients with such comorbid pathology may have a wide range of symptoms that may go beyond the general symptoms of heartburn and regurgitation. The symptoms and complications of GERD affect general health, daily and social functioning, physical and emotional activity. It also affects the quality of life (QoL) associated with health through frequent breaks during sleep, work and social activities. Purpose. study the dynamics of the level of quality of life and social functioning in patients with gastroesophageal reflux disease in combination with the syndrome of undifferentiated connective tissue dysplasia. Methodology. A total of 120 patients were included in the study: 65 men and 55 women: in 75 of them (Group II) GERD occurred on the background of UCTD, in 45 (Group I) as an independent disease. The control group consisted of 12 healthy individuals. The study was comprehensive. The Medical Outcomes Study 36-Item Short-Form Health Status (SF-36),the Gastrointestinal Symptom Rating Scale (GSRS) and the scale of "Personal and social performance" (PSP) -  were used to study patients in detail. Results and Discussion. Analyzing the results obtained on the basis of the GSRS questionnaire (Table 1), in patients with GERD on the background of UCTD, compared with patients of group I and the control group, there is a significant increase in three and four from the five scales. QoL in patients of Group II on the scale "Abdominal pain" were 14.3 ± 0.4 points, in Group I - 5.6 ± 1.3 points, in the Control Group - 2.4 ± 0.8 points, on the scale "Reflux syndrome": 13.7 ± 0.9, 10.5 ± 1.3 and 3.1 ± 0.9, respectively. "Dyspeptic syndrome" - 15.3 ± 0.4 points in Group II, 12.2 ± 0.6- in Group I and 6.1 ± 0.3- in the control group. "Constipation syndrome" 9.5 ± 0.8, 5.6 ± 1.03 and 5.7 ± 0.4, respectively (p <0,05). Conclusions: In this research we investigated the effect of comorbid pathology on QoL in patients with GERD, which developed against the background of UCTD. The results confirm that patients with such combined pathology have a lower level of quality of life and social functioning, and the tactics of treatment of such patients should take into account these changes

scholarly journals Use of Noninvasive Cerclage in Combination of Micronized Progesterone in Miscarriage Of Multifetal Pregnancy

2017 ◽  
Vol 24 (4) ◽  
Author(s):  
Iryna Nikitina ◽  
Alla Boychuk ◽  
Valentina Kondratiuk ◽  
Tatyana Babar
Keyword(s):  
High Risk ◽  
Pregnant Women ◽  
The State ◽  
Control Group ◽  
Group I ◽  
Prophylactic Measures ◽  
Neonatal Adaptation ◽  
Group Ii ◽  
Multifetal Pregnancy ◽  
Micronized Progesterone

We represent the results of the combined method of treatment and prevention of miscarriage in women with a multiple pregnancy and a high risk of the threat of termination the pregnancy because of using the obstetric unloading pessaries, combined with micronized progesterone. The efficiency of this method of treatment is evidenced by the rapid elimination of clinical symptoms of threatened abortion, accelerating the regression of ultrasound markers, reducing the number of complications in of pregnant women and reducing the time of their stay in hospital.Goal: To evaluate the effectiveness of the handling the obstetric pessary in combination with micronized progesterone at women with multifetal pregnancy and a high risk of miscarriage.Materials and methods. We analyzed 120 cases of multifetal pregnancies with signs of miscarriage within the terms from 16 to 28 weeks. The first group of the examined women was: 40 pregnant women with twins and signs of miscarriage, who in the scheme of treatment and prophylactic measures were offered to use the unloading obstetric pessaries in combination with continuous therapy by natural micronized progesterone until 36 weeks of pregnancy. The second group included 40 pregnant women with twins, who were laid seam on the cervix because of istmicocervical insufficiency and were applied short-term courses of therapy by gestagens. The control group comprised 40 pregnant women with twins at the age of 16-28 weeks of pregnancy who were conducted the therapy about the threat of miscarriage according to the current clinical protocols (Order of the Ministry of Health of Ukraine No. 624). It was carried out the analysis of the course of pregnancy, childbirth, the postpartum period and the state of neonatal adaptation in the surveyed groups.Results of the research and their discussion. In the first group, urgent childbirth occurred in 34 (85%) cases, in group II in 29 (72.5%) cases, in control group – in 25 (62.5%) cases. Cesarean delivery was performed in 7 (17.5%) patients of group I pregnant women, in 9 (22.5%) of group II patients and in 11 (27.5%) in the pregnant group. When studying the state of neonatal adaptation of newborns in the examined groups, the following results were obtained. The average weight of the newborns in group I was 3245 ±280 g, in group II 2865 ±365 g, in the control group - 2975 ±325 g (p>0.05). The evaluation of the state of newborns on the Apgar scale, respectively at the 1st and 5th minutes, was respectively: in newborns of the I group, 7.5 ± 1.4 and 8.4 ± 1.3 points, in group II - 7.3 ± 1.6 and 8.2 ± 1.1 points, in the control group – 7.2 ± 1.6 and 8.6 ± 1.2 (р 1-р 2> 0.05).Conclusions. Comprehensive prophylaxis of non-pregnancy in multiple pregnancies, combining the use of a traumatic cardiac cervix with the help of unloading obstetric pussies with progesterone preparations, allows prolonging pregnancy, preventing the development of prematurity, contributes to the improvement of perinatal indicators.

scholarly journals Hypothyroidism and Pregnancy outcome

2021 ◽  
Vol 9 (3) ◽  
Author(s):  
Emad Alsharu ◽  
Bassam Nussair ◽  
Jameel Marabha ◽  
Ala Hindawi
Keyword(s):  
Pregnant Women ◽  
Pregnancy Outcome ◽  
Preterm Labor ◽  
Labor Pain ◽  
Control Group ◽  
Group I ◽  
Antenatal Clinics ◽  
Group Ii ◽  
Hypothyroid Patients ◽  
In Pregnancy

OBJECTIVE: To evaluate maternal and perinatal outcomes among ladies treated for hypothyroidism in pregnancy at antenatal clinics of King Hussein Medical Centre.   METHODS: This study was conducted at antenatal clinics of King Hussein medical center during the period from April 2018 to April 2020. We studied 200 pregnant women with hypothyroidism as a study group (group I) who were compared to 200 euthyroid pregnant women as a control group (group II).    RESULTS:   The incidence of obstetric complications in group I vs group II found to be as the followings: Pre-eclampsia 12%(24) vs 9%(18), miscarriage 10%(20) vs 4%(8), while preterm labor was 20%(40) vs 22%(44), the antepartum hemorrhage 5%(10) vs 4%(8), Post-partum hemorrhage 7%(14) vs 5%(10) respectively.   There were no significant statistical differences in these outcomes in both groups and preterm labor pain was the most frequent pregnancy complication encountered (20% vs, 22 %)   CONCLUSION:  Proper treatment of hypothyroid patients before pregnancy and throughout pregnancy would probably eliminate the potential risk of developing maternal and fetal complications, treated hypothyroid patients hold no significant differences in pregnancy-related complications once compared to euthyroid women.       Keywords: Hypothyroidism, Pregnancy, Outcome

scholarly journals ВПЛИВ МІСЦЕВОЇ ТА ЗАГАЛЬНОЇ МЕТАБОЛІЧНОЇ ТЕРАПІЇ НА СТАН ЗОРОВОГО АНАЛІЗАТОРА В ДІТЕЙ ІЗ НАБУТОЮ МІОПІЄЮ, АСОЦІЙОВАНОЮ З СИНДРОМОМ НЕДИФЕРЕНЦІЙОВАНОЇ ДИСПЛАЗІЇ СПОЛУЧНОЇ ТКАНИНИ

2018 ◽  
Author(s):  
Т. Ye. Tsybulska ◽  
O. Ye. Pashkova
Keyword(s):  
Visual Acuity ◽  
Connective Tissue ◽  
Morphological Changes ◽  
Eye Drops ◽  
Metabolic Abnormalities ◽  
Supporting Function ◽  
Metabolic Therapy ◽  
Group I ◽  
Connective Tissue Dysplasia ◽  
Group Ii

Significant role in the formation of myopic refraction in children plays the syndrome of undifferentiated connective tissue dysplasia (SUCTD). On the background of metabolic abnormalities of the connective tissue occur morphological changes in the connective tissue of the sclera, which change its supporting function and contribute to the development and progression of myopia. This substantiates the expediency of the appointment of local and general metabolic therapy in the treatment of this category of children.The aim of the study – to evaluate the effect of local metabolic therapy on the state of the visual analyzer in children with acquired myopia associated with SU CTD.Materials and Methods. Оphthalmologic examination was performed on 65 children (130 eyes) from 7 to 12 years old with acquired myopia and phenotypic features of SU CTD . I group – 35 patients (70 eyes) received complex metabolic therapy for 2 months with the preparation "Cardonat", "Magnesium V6", and also eye drops "Tioretin A". The second group of observation included 15 children (30 eyes) with acquired myopia and SUDST who did not receive general and local therapy.Results and Discussion. After treatment in children of the group I, visual acuity is increased by an average of 0.15 c.u., obtained in 82.8 % of patients (58 eyes), reserves of absolute accommodation, reserve of relative accommodation by an average of 1.5 dpi and 2.5 dpi (p<0.05). In group II, on the contrary, the reduction of uncompressed visual acuity was determined at 0.09 c.u. (p<0.05), the indicators of accommodation function did not change significantly, remaining low. In the group I, only 17.1 % of patients (12 eyes) experienced an increase in clinical refraction by an average of 0.25–0.5 dpi, (p>0.05). In the group II, this indicator increased by an average of 0.42 dpi (p<0.05). The increase in the axial length of the eye was an average of 0.12 mm in the group I; 0.22 mm in the group II (p<0.05).Conclusions. Metabolic therapy by using Cardonate, Magnesium V6 and eye drops "Thioretin A" in children with myopia associated with SU CTD increases the visual acuity without correction on average by 1.8 times, increases the absolute accommodation and reserves of relative accommodation on average 2.1 and 1.9 times respectively.

scholarly journals Comparing Efficacy of Cerclage and Adjunctive Therapy (Cerclage & Pessary) in Prevention of Preterm Birth in Pregnant Women with Cervical Insufficiency: A Randomized Clinical Trial.

2020 ◽  
Author(s):  
Mitra Arjmandifar ◽  
Maryam Moshfeghi ◽  
Maryam Mohammadi ◽  
Mahya Eftekhari
Keyword(s):  
Clinical Trial ◽  
Survival Analysis ◽  
Preterm Birth ◽  
Pregnant Women ◽  
Randomized Clinical Trial ◽  
Gestational Age ◽  
Adjunctive Therapy ◽  
Intervention Group ◽  
Control Group ◽  
Cervical Insufficiency

Abstract Background: Cervical insufficiency is the responsible factor for 15-25% of pregnancy loss in the second trimester. Midwifery specialists sometimes prefer to use adjunctive therapy in combination with cerclage surgery for management of cervical insufficiency. The aim of this study was to evaluate the effectiveness of adjunctive pessary therapy after cerclage in improving perinatal and neonatal outcome and increasing satisfaction in women with cervical insufficiency.Methods: This concurrent randomized clinical trial was conducted at the infertility department of Royan Institute, Tehran, Iran from May 2018 to May 2020. In this trial, 170 singleton pregnant women, diagnosed with cervical insufficiency, of gestational age 14 to 26 weeks, were enrolled. Patients were randomized 1:1 to receive either cervical cerclage or pessary after cerclage. The primary outcomes were gestational age at the time of delivery and the percentage of preterm labor (<37 weeks). The secondary outcomes were the method of delivery, neonatal outcomes, maternal adverse events and maternal satisfaction of interventions.Results: Preterm birth before 37 weeks of gestation occurred in 16 women (19.3%) in the pessary group and 17 women (21%) in the control group (between-group difference, 1.11%; 95%CI 0.518−2.388%). In the survival analysis to 37 WK of gestation, the incidence of preterm birth was not significantly different between the two groups (Relative Risk (RR), 1; 95%CI, 0.161-6.202). Based on survival analysis, the incidence of vaginal bleeding and pelvic pain significantly differed between the two groups (RR, 2.68; 95%CI (1.31-5.46)) and (RR, 1.73; 95%CI (1.04-2.87), respectively. The mean score of satisfaction in the intervention group (5.73) was significantly higher than the control group (5.25), (between-group difference, 0.47; 95%CI (0.10-0.84).Conclusions: The placement of an adjunctive pessary for pregnant women with singleton pregnancy and a cervical insufficiency, did not result in a lower rate of preterm delivery before 37 weeks of gestation compared to cerclage alone. However, the complications of pregnancy after the intervention until delivery, were less in these women, while the level of satisfaction was higher. Trial registration: Iranian Registry of Clinical Trials (IRCT20180302038914N1), May 5,2018.

scholarly journals Features of delivery tactics in pregnant women with placental dysfunction and taking into account the concentration of vitamin D

2020 ◽  
Vol 17 (1) ◽  
pp. 70-77
Author(s):  
G. S. Manasova ◽  
N. V. Didenkul ◽  
N. V. Shapoval ◽  
N. V. Kuzmin ◽  
K. V. Korotkaya
Keyword(s):  
Vitamin D ◽  
Pregnant Women ◽  
Caesarean Section Rate ◽  
Control Group ◽  
Compensatory Mechanisms ◽  
Placental Dysfunction ◽  
Group I ◽  
High Prevalence ◽  
Group Ii ◽  
Abdominal Delivery

The high prevalence of the vitamin D (VD) deficiency states (VDDS) among adults, as well as the data on the pleiotropic effects of calcitriol suggests its participation in the development of various complications and pregnancy outcomes. The objective of the present study is to analyze the pregnancy course and delivery tactics of pregnant women with placental dysfunction (PD) depending on the calcitriol availability. We examined 56 patients with PD (I – main group) and 40 conditionally healthy women with physiological pregnancy (II – control group). In addition to the standard clinical and laboratory examination, the level of vitamin D in the blood was determined by ELISA. The statistical analysis used the software Biostat, Statistica 6.0. In 76.8 % of group I women, the VD content corresponded to the deficit (38.4 %) and to the suboptimal status (38.4 %), (RR = 3.0; 95 % CI 2.39–3.76). In group II, VDDS was not detected and the suboptimal status was diagnosed in 31.45 %. The average VD level in group I was significantly lower than that in group II (31.4 ± 8.6 ng/ml vs 43.54 ± 11.2 ng/ml; Uemp = 42.5; p < 0.05). The caesarean section rate in group I was 3.4 times higher than that in group II (42.85 % vs 12.5 %; F = 0.00001; p < 0.01). The weight of newborns in group II significantly exceeded the weight of children in group I (3643.24 ± 136 g vs 3299.11 ± 128 g; t = 4.17; p < 0.01); a strong direct correlation was found between the weight of the newborn and the VD level in the blood of pregnant women (r = 0.71). VDDS increases 2 times the risk of abdominal delivery (RR = 1.27; 95 % CI 0.95–1.66). The VD status of a pregnant woman can have a certain influence on the formation of optimal adaptive-compensatory mechanisms in the utero-placental-fetal system and on the pregnancy outcome for mother and fetus.

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

2021 ◽  
pp. 30-38
Author(s):  
A. V. KAMINSKYI ◽  
O. I. ZHDANOVYCH ◽  
T. V. KOLOMIICHENKO ◽  
R. I. ISMAILOV ◽  
S. M. YANUTA
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Retrospective Analysis ◽  
High Frequency ◽  
Premature Birth ◽  
Uterine Cavity ◽  
Lower Percentage ◽  
Control Group ◽  
Cervical Canal ◽  
Cervical Insufficiency

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.

scholarly journals Prediction of preterm birth by evaluating the fetal adrenal gland volume and blood flow: a pilot study

2018 ◽  
Vol 7 (10) ◽  
pp. 3906
Author(s):  
Ali Saber Ali ◽  
Mostafa Hussein ◽  
Ahmed N. Fetih ◽  
Abdelghafar M. Ahmed ◽  
Ahmed M. Abbas
Keyword(s):  
Blood Flow ◽  
Preterm Birth ◽  
Adrenal Gland ◽  
Pregnant Women ◽  
Women's Health ◽  
Gland Volume ◽  
Group I ◽  
Group Ii ◽  
Health Hospital ◽  
Adrenal Gland Volume

Background: The aim of the current study was to estimate the risk of preterm birth (delivery < 37 weeks of gestation) by evaluating the fetal adrenal gland volume and blood flow at Women’s Health Hospital, Assiut University, Egypt.Methods: A pilot prospective cohort study included pregnant women presented to our hospital with threatened preterm labor between December 2016 and May 2018. All women were recruited consecutively at the emergency unit of Women’s Health Hospital at Assiut University. The fetal adrenal gland volume was assessed using 3-dimensional images of the fetal adrenal with the aid of Virtual Organ Computer-Aided Analysis (VOCAL) software. Doppler evaluation of the fetal adrenal blood vessels was carried out. The RI, PI and S/D ratio was calculated for every case. The neonatal outcomes at delivery were assessed and compared with respect to the duration of actual delivery from the time of evaluation. The obtained data were analyzed by SPSS software (version 22.0) and p<0.05 was taken as the significant level.Results: The study included 30 pregnant women at the final analysis. Women were classified according to the time of actual delivery into two groups. Group (I, n=13) those who delivered within 7 days and group (II, n=17) those who delivered 7 days or more. No difference between both groups regarding the baseline characteristics. No difference regarding the mode of delivery (p=0.708). All Doppler indices were statistically in-different between both groups. The fetal adrenal gland volume was significantly lower in group II than group I (p=0.001). On ROC analysis, the area under the curve (AUC) for prediction of preterm birth based on the fetal adrenal gland volume was (AUC= 0.873). The ROC curve shows that the best cut off value using the volume was ≥0.461 with 76.92% sensitivity and 88.24% specificity for prediction of preterm birth with an overall accuracy of 83.3%.Conclusions: Fetal adrenal gland volume was identified as a significant predictor of delivery in pregnant women who had spontaneous preterm births with intact membranes.

Clinical efficacy of prevention of obstetric and perinatal complications in pregnant women with primary hypertension against the background of iodine deficiency

2018 ◽  
pp. 99
Author(s):  
N.I. Mushak ◽  
Keyword(s):  
Pregnant Women ◽  
Iodine Deficiency ◽  
Preterm Labor ◽  
Preventive Measures ◽  
Primary Hypertension ◽  
Control Group ◽  
Perinatal Complications ◽  
Group I ◽  
Objective Reduction ◽  
Group Ii

The objective: reduction in the incidence of obstetric and perinatal complications in pregnant women with primary hypertension in conditions of endemic iodine deficiency based on the study of pregnancy and childbirth course, fetal and newborn conditions after the introduction of the developed complex of preventive and therapeutic measures. Materials and methods. A clinical analysis of 100 pregnant women has been conducted: – control group (KG) – 30 healthy pregnant women living in conditions of endemic iodine deficiency, give birth to the first time, without somatic pathology, had vaginal delivery; – And the group – 30 pregnant women with primary hypertension, who live in conditions of endemic iodine deficiency and received the usual medical and preventive measures; – II group – 40 pregnant women with primary hypertension who live in conditions of endemic iodine deficiency and received the method of prevention of obstetric and perinatal complications developed by us. Clinical and statistical analysis of the course of pregnancy, childbirth and condition of the fetus and the newborn after the introduction of the developed complex of treatment and preventive measures has been carried out. The obtained data are processed by the statistical method using the Microsoft Excel computer program. Results. Due to the use of proposed by us method, we managed to reliably reduce the frequency of gestational anemia (I group – 43.3% vs. 22.5% in group II, p<0.05), development of gestational diabetes (I group – 13.3% vs. 5.0% in the 2nd group, p<0.05), the threat of preterm labor (I group – 16.6% vs. 7.5% in the second group, p<0.05), placental dysfunction (group I – 63.3% vs. 22.5% in the second group, p<0.05); violation of microbiocenosis of the genital tract (group I – 53.3% vs. 17.5% in group ІІ, p<0.05). In addition, a significant reduction in the level of combined preeclampsia (group I – 40.0% vs. 20.0% in group II, p<0.05) and change in the incidence of FGR syndrome (group I – 40.0% vs. 22.5% in the second group, p <0.05). Significant decline in the incidence of developmental delivery complications: premature rupture of fetal membranes (I group – 26.7% vs. 15.0% in group II, p<0.05); preterm labor (group I – 13.3% vs. 5.0% in group II, p<0.05); Fetal distress (group I – 36.6% versus 15.0% in group II, p<0.05). It should be noted that the absence of PDNLP in pregnant group II versus 6.7% incidence of pregnant in group I. Reduction in the level of various forms of newborn asphyxiation: from 26.7% in group I to 15.0% in group II, p<0.05 against the background of the use of the proposed method, severe asphyxia was absent in newborns from pregnancy group II versus 3.3% cases in group І. The total incidence of newborns in the early neonatal period has significantly decreased by 1.7 times (60.0% in group I versus 35.0% in group II, p<0.05). There is no perinatal loss in group II, which also confirms the effectiveness of our proposed method. Conclusions. The proposed therapeutic and prophylactic technique for the prevention of obstetric and perinatal complications in pregnant women with primary hypertension in the background of natural iodine deficiency has made it possible to reliably reduce the frequency of obstetric and perinatal complications. This makes it possible for the proposed method to be recommended for use in therapeutic practice. Key words: course of pregnancy, childbirth, condition of newborn, obstetric and perinatal complications, primary arterial hypertension, iodine deficiency.

Sign in / Sign up

Export Citation Format

Share Document