CONDITION OF FETURES AND NEWBORNS FROM WOMEN WITH INFERTILITY TREATED WITH ASSISTED REPRODUCTIVE TECHNOLOGIES AND WITH CONCOMITANT INTRAHEPATIC CHOLESTASIS

2021 ◽  
Vol 74 (7) ◽  
pp. 1713-1717
Author(s):  
Ebaye Nsan Ekom Nsed ◽  
Oleksandra H. Boichuk ◽  
Svitlana M. Heryak ◽  
Iryna M. Nikitina ◽  
Stefan V. Khmil ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
Pregnant Women ◽  
Intrahepatic Cholestasis ◽  
Skin Diseases ◽  
Assisted Reproductive Technologies ◽  
Reproductive Technologies ◽  
Peroral Administration ◽  
Placental Alkaline Phosphatase ◽  
Omega 3 ◽  
Complex Therapy

The aim: Improving the effects of pregnancy on the fetus and newborn through early diagnosis and timely comprehensive therapy of pregnant women with intrahepatic cholestasis. Materials and methods: We have conducted a complex examination of 60 women who got pregnant owing to assisted reproductive technologies, with concomitant intrahepatic cholestasis, and 20 practically healthy women with a physiological course of pregnancy and labor (reference group), aged between 18 and 42. The research did not involve pregnant women with chronic liver diseases, viral hepatitis, skin diseases. Womens who underwent the suggested complex drug therapy with Ursofalc, L-arginine and Omega 3, with peroral administration for 14 days according to the following scheme: Ursofalc – 250 mg once a day, L-arginine – 5 ml 3 times a day, Omega 3 – 1 capsule a day. The complex examination of pregnant women with IHC was conducted before and after treatment. We analyzed the data of anamnesis, carried out anthropometric measurements, clinical biochemical examinations of the women with IHC, including the measurement of the levels of alanine aminotransferase, aspartate aminotransferase, total and direct bilirubin, total and placental alkaline phosphatase, leucine aminopeptidase, 5’-nucleotidase, cholic, deoxycholic and chenodeoxycholic acids as wells as their total level. Results: Almost 40 % of women with intrahepatic cholestasis gave birth to babies with asphyxia, including severe one in 11.1 % of cases, 1/3 of the newborns were premature, 40% had signs of hypotrophy, and 66.7 % experienced a disturbed course of early neonatal adaptation. There was also a higher level of perinatal mortality. The newborns from women who had undergone the suggested complex therapy presented no cases of hypotrophy, prenatal infection or cerebral circulation disorder. Conclusions: Thus, functional hepatic disorders in women with infertility play a certain role in the carrying of pregnancy after ART, in the development of pregnancy complications and adverse consequences for women and their newborns. The conducted research shows that early diagnosis and timely complex therapy of pregnant women with intrahepatic cholestasis makes it possible to influence the pathogenesis of perinatal complications and improve the consequences of pregnancy for the fetus and the newborn.

Psycho-emotional state of women with intrahepatic cholestasis of pregnant women after the use of assisted reproductive technologies

2020 ◽  
pp. 31-35
Author(s):  
O.G. Boychuk ◽  
◽  
T.V. Kolomiichenko ◽  
N.E.N. Ebae ◽  
◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pregnant Women ◽  
Intrahepatic Cholestasis ◽  
Comparison Group ◽  
Assisted Reproductive Technologies ◽  
Reproductive Technologies ◽  
Intrahepatic Cholestasis Of Pregnancy ◽  
Psychoemotional State ◽  
Cholestasis Of Pregnancy

We can assume a deterioration in the psychoemotional state and a decrease in the quality of life in women after assisted reproductive technologies (ART) with intrahepatic cholestasis of pregnancy (ICP), but no scientific information was found on this issue. The objective: to assess the psychoemotional state of pregnant women with ICP after using ART. Materials and methods. We examined 40 pregnant women after ART with the manifestations of ICP (main group) and 40 – without the manifestations of ICP (comparison group). The presence of vegetative dysfunction syndrome was assessed (according to A.M. Wayne); quality of sleep, especially falling asleep and waking up (A.M. Vein, Yu.I. Levin); anxiety level using the test Spielberg in the modification by Hanin, the presence and severity of depression on the Beck scale; quality of life according to the questionnaire SF-36. The data were processed by methods of variation statistics. Results. In pregnant women after ART with ICP, the total number of points on the A.M. Vein questionnaire is 3.5 times higher than the threshold value of 15 points (median 52 [45, 60] points versus 36 [28; 45] points in the absence of ICP, p<0.05). 80.0% of these women reported sleep disorders. The incidence of significant sleep quality disturbances is 37.5%. Patients demonstrate a higher median level of both personal and situational anxiety. Manifestations of depression were noted in 55.0% patients against 27.5% in the comparison group (p<0.05). Women with ICP have lower ratings for their quality of life, both on physical and psychological health scales. The decrease in the integral indicator of physical health (70 [58; 89] versus 84 [75; 92], p<0.05) is a reflection of the physical discomfort associated with ICP. Conclusions. After using ART, women with ICP need to assess the vegetative and psychoemotional state, correct the revealed disorders to normalize the quality of life, and achieve positive perinatal outcomes. Keywords: assisted reproductive technologies, intrahepatic cholestasis of pregnancy, vegetative dysfunction syndrome, anxiety, depression, quality of life.

scholarly journals Assessment of correction effectivenes of psychoemitional state in pregnant women after application of assisted reproductive technologies

2021 ◽  
Vol 26 (4) ◽  
pp. 131-138
Author(s):  
V.O. Beniuk ◽  
V.G. Ginzburg ◽  
L.M. Vygivska ◽  
I.V. Maidannyk ◽  
O.O. Chorna ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Assisted Reproductive Technologies ◽  
Reproductive Technologies ◽  
Control Group ◽  
Omega 3 ◽  
Perinatal Complications ◽  
Art Program ◽  
Reactive Anxiety ◽  
Personal Anxiety

To determine the role and effectiveness of the proposed the­rapeutic and preventive complex in the correction of psychoemotional state in the dynamics of pregnancy in pregnant women after assisted reproductive technologies (ART) application in order to improve the tactics of antenatal obser­vation and prevention of obstetric and perinatal complications. 299 pregnant women were comprehensively examined and a set of therapeutic and preventive measures was carried out: the main group included 249 women whose pregnancy occurred as a result of ART application. The control group consisted of 50 pregnant women with spon­taneous pregnancy. The complex of measures for pregnant women after ART application included: micronized pro­gesterone, magnesium oxide, folic acid, L-arginine aspartate, Omega-3 polyunsaturated fatty acids and long-term psychological correction – before ART program, at 8-10 weeks of pregnancy, at 16-18 weeks of pregnancy and at 28-30 weeks of pregnancy. Introduction of the proposed complex of psychoemotional correction contributed to the formation of reactive anxiety and personal anxiety levels at a moderate level in women of subgroups IA-44 (89.8%) and 43 (87.6%), IIA – 43 (89.6%) and 44 (91.7%) and IIIA – 30 (83.3%) and 26 (72.2%), which is considered to be an adaptive, physiological type during pregnancy. The positive effect of the proposed complex of psychoemotional correction demonstrates the improvement of processes of formation of type of component gestational dominant, its return to the optimal type in women of subgroup IA – 41 (83.6%), IIA – 39 (81.3%) and IIIA – 26 (72.2%) that is close to the physiological course of pregnancy and contributes to the reduction of perinatal and obstetric complications among pregnant women of these subgroups.

Features of psychoemotional condition and stress-assosiatate hormons bioproduction in pregnant women after application of assisted reproductive technologies

2018 ◽  
pp. 118-121
Author(s):  
L.M. Vygivska ◽  
◽  
I.A. Usevych ◽  
I.V. Maidannyk ◽  
V.F. Oleshko ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Emotional State ◽  
Assisted Reproductive Technologies ◽  
Past History ◽  
Reproductive Technologies ◽  
Main Group ◽  
Psychological Status ◽  
Perinatal Complications ◽  
History Of ◽  
High Level

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.

scholarly journals Inositol and vitamin D may naturally protect human reproduction and women undergoing assisted reproduction from COVID-19 risk

2021 ◽  
pp. 113-117
Author(s):  
M.S. Bezerra Espinola ◽  
M. Bertelli ◽  
M. Bizzarri
Keyword(s):  
Vitamin D ◽  
Immune System ◽  
Pregnant Women ◽  
Assisted Reproductive Technologies ◽  
Respiratory Infections ◽  
Phosphatidyl Inositol ◽  
Reproductive Technologies ◽  
Human Reproduction ◽  
Risk Category ◽  
Virus Species

In late 2019, the new Coronavirus has been identified in the city of Wuhan (China) then COVID-19 spreads like wildfire in the rest of the world. Pregnant women represent a risk category for increased abortion rates and vertical transmission with adverse events on the newborns has been recently confirmed. The scientific world is struggling for finding an effective cure for counteracting symptomatology. Today, there are many therapeutic proposes but none of them can effectively counteract the infection. Moreover, many of these compounds show important side effects not justifying their use. Scientific literature reports an immune system over-reaction through interleukins- 6 activation. In this regard, the possibility to control the immune system represents a possible strategy for counteracting the onset of COVID-19 symptomatology. Vitamin D deficiency shows increased susceptibility to acute viral respiratory infections. Moreover, Vitamin D seems involved in host protection from different virus species by modulating activation and release of cytokines. Myo-inositol down-regulates the expression of IL-6 by phosphatidyl-inositol-3-kinase pathway. Furthermore, myo-inositol is the precursor of phospholipids in the surfactant and it is applied for inducing surfactant synthesis in infants for treating respiratory distress syndrome. This review aims to summarize the evidence about COVID-19 infection in pregnant women and to encourage the scientific community to investigate the use of Vitamin D and Myo-inositol which could represent a possible preventive treatment for pregnant women or women undergoing assisted reproductive technologies.

scholarly journals Hair Cortisol Concentrations as a Biomarker to Predict a Clinical Pregnancy Outcome after an IVF Cycle: A Pilot Feasibility Study

2020 ◽  
Vol 17 (9) ◽  
pp. 3020
Author(s):  
Diana C. Santa-Cruz ◽  
Rafael A. Caparros-Gonzalez ◽  
Borja Romero-Gonzalez ◽  
Maria Isabel Peralta-Ramirez ◽  
Raquel Gonzalez-Perez ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Assisted Reproductive Technologies ◽  
Reproductive Technologies ◽  
Clinical Pregnancy ◽  
Hair Cortisol ◽  
Pregnancy Test ◽  
Resilience Scale ◽  
Depression Subscale ◽  
Positive Pregnancy Test ◽  
Pilot Feasibility Study

Our objective was to examine the feasibility of hair cortisol concentrations (HCC) as a biomarker to predict clinical pregnancy outcomes and investigate its potential associations with perceived anxiety, resilience, and depressive symptoms. A total of 43 participants were assessed using HCC, the state trait anxiety inventory (STAI), resilience scale (RS), and the depression subscale of the symptom checklist 90-R (SCL-90-R). Participants were approached at their second consultation with the reproductive endocrinologist (T1), before scheduling their IVF cycle, and then 12 weeks after (T2), at their post-transfer visit with the study coordinators, before the human chorionic gonadotropin (HCG) pregnancy test. The logistic regression model revealed that HCC at T2 predicted 46% of a positive pregnancy test [R2 = 0.46, (ß = 0.11, p < 0.05)]. Pregnant women had higher levels of resilience at T2 (M = 149.29; SD = 17.56) when compared with non-pregnant women at T2 (M = 119.96; SD = 21.71). Significant differences were found between both groups in depression at T2 (t = 3.13, p = 0.01) and resilience at T2 (t = −4.89, p = 0.01). HCC might be a promising biomarker to calculate the probability of pregnancy in women using assisted reproductive technologies (ART).

scholarly journals Enterosorption as concomitant therapy for early toxicosis in pregnant women after assisted reproductive technologies against the background of constipation

2021 ◽  
pp. 42-46
Author(s):  
Iu.V. Davydova ◽  
◽  
A.Y. Lymanskaya ◽  
Keyword(s):  
Quality Of Life ◽  
Pregnant Women ◽  
Rating Scale ◽  
Assisted Reproductive Technologies ◽  
Severe Heart Failure ◽  
Well Being ◽  
Reproductive Technologies ◽  
Active Surface Area ◽  
Significant Deterioration

The aim is to evaluate the effectiveness of the drug «Atoxil Plus» use in the group of pregnant women after assisted reproductive technologies (ART) with early mild toxicosis against the background of constipation. Materials and methods. The effectiveness of the drug «Atoxil Plus» (Orisil-Pharma) in 37 pregnant women with early mild toxicosis on the background of constipation was studied. The pregnant women in the study had no other comorbidities (pathology of the gastrointestinal tract, severe heart failure, infectious diseases, etc.). Taking into account that the definition of the quality of life indicator is an integral indicator of the effectiveness of treatment, the quality of life of pregnant women was assessed according to the «Gastrointestinal Simptom Rating Scale» (GSRS), a special questionnaire, before and after complex treatment of early toxicosis using the drug «Atoxil Plus». GSRS includes 15 questions to assess the following domains: the presence of abdominal pain, heartburn, constipation, diarrhea and signs of dyspepsia. The lower the results for the studied domains, the better. All pregnant women used the «Atoxil Plus» (2 g 3 times/day) for 10–14 days. Any general or local laxatives were excluded from the treatment regimen. Results. Treatment of early pregnancy toxicosis is important, given the loss of electrolytes, microelements, water and significant deterioration in the quality of life. High sorption capacity of Atoxil Plus in relation to microorganisms and bacterial toxins, the possibility of moderate therapeutic doses use due to the large active surface area, the increased binding rate of bacteria and their toxins provide quick therapeutic effect. Against the background of the «Atoxil Plus» enterosorbent use, not only does the constipation frequency not increase, which is very important during pregnancy, but the number of bowel movements is normalized due to the presence of lactulose in the medication, especially given the significant amount of gestagens pregnant women receive after ART. Conclusions. The non-invasive nature of the use of Atoxil Plus, its oral administration, high efficacy in pregnant women with early toxicosis, which manifests itself in improving the quality of life and general well-being, a high safety profile make it possible to recommend this drug as a treatment for early mild toxicosis against the background of constipation in pregnant women after ART. The study was conducted in accordance with the principles of the Declaration of Helsinki. The research protocol was approved by the Local Ethics Committee of the institution mentioned in the work. Informed consent of women was obtained for the research. The authors declare no conflict of interest. Key words: pregnant women, assisted reproductive technologies, constipation, treatment, sorbents.

scholarly journals Perinatal outcomes of quadruplet pregnancy

2021 ◽  
Vol 15 (4) ◽  
pp. 371-378
Author(s):  
S. A. Kalashnikov ◽  
D. R. Kudratova
Keyword(s):  
Pregnant Women ◽  
Assisted Reproductive Technologies ◽  
Risk Group ◽  
Perinatal Outcomes ◽  
Reproductive Technologies ◽  
Cervical Length ◽  
Massive Bleeding ◽  
Extremely Low Birth Weight ◽  
Comprehensive Examination ◽  
Level 3

Introduction. A significantly increased frequency of multiple pregnancies including more than two fetuses is a consequence of using assisted reproductive technologies and ovulation stimulations. However, such pregnancies remain poorly investigated. Aim: to study the course and perinatal outcomes of quadruplet pregnancies.Materials and Methods. 7 pregnant women with quadruplets were examined. A comprehensive examination, including fetometry, monitoring of the cervical length, Doppler examination, and treatment of all complications were performed for all pregnant women. Results. Quadruplet pregnancy belongs to the peak risk group for the frequency of multiple gestational complications: cervical incompetence (85.7 %), anemia (71.4 %), preeclampsia (57.1 %), fetal growth retardation (71.4 %), premature birth (100.0 %), massive bleeding during delivery (33.3 %), extremely low birth weight newborns (30.8 %), respiratory disorders (100.0 %), intraventricular hemorrhages (38.5 %).Conclusion. Women with quadruplet pregnancies should be monitored and give a birth in level 3 perinatal centers. Delivery should be preferentially performed by caesarean section. The data obtained additionally underline that as few as a single embryo should solely transferred.

scholarly journals The effect of combined oral contraceptives and hormone therapy during assisted reproductive technologies on the function of the hemostatic system in non-pregnant and pregnant women

2020 ◽  
Vol 7 (1) ◽  
pp. 10-18
Author(s):  
E. V. Kirakosyan ◽  
E. A. Sosnova
Keyword(s):  
Pregnant Women ◽  
Hormone Therapy ◽  
Oral Contraceptives ◽  
World Literature ◽  
Assisted Reproductive Technologies ◽  
Reproductive Technologies ◽  
Combined Oral Contraceptives ◽  
Vitro Fertilization ◽  
Hemostatic System

A review of 130 sources of world literature was conducted in the databases Scopus, Web of Science, MedLine, Cochrane CENTRAL, Cochrane Database of Systematic Reviews (CDSR), Database of Abstracts of Reviews of Effectiveness (DARE), EMBASE, Global Health, CyberLeninka, RSCI on the problem of the effect of combined oral contraceptives and hormone therapy during assisted reproductive technologies on the function of the hemostatic system in non-pregnant and pregnant women. In this review, we have summarized and analyzed information on the effect of sex hormones entering the womans body from the outside on individual links and the hemostatic system as a whole, determined the relationship between drug administration and thrombotic complications, optimized the sequence of diagnosis of conditions predisposing to thrombosis, substantiated the tactics of preparation and management patients taking exogenous hormones before and during pregnancy, including through in vitro fertilization.

scholarly journals Management of patients with atopic dermatitis during pregnancy

2021 ◽  
Author(s):  
Е.А. Орлова ◽  
О.П. Виноградова ◽  
Е.М. Костина ◽  
Ю.А. Кандрашкина
Keyword(s):  
Atopic Dermatitis ◽  
Pregnant Woman ◽  
Early Diagnosis ◽  
Pregnant Women ◽  
Clinical Studies ◽  
Allergic Diseases ◽  
Close Attention ◽  
Trigger Factors ◽  
Complex Therapy ◽  
Degree Of Risk

Проблема особенностей течения аллергических заболеваний на фоне беременности, а также рациональные и безопасные подходы к их лечению находятся в фокусе пристального внимания специалистов. В статье представлена клинико-патогенетическая характеристика атопического дерматита у беременных женщин. Уделяется внимание принципам диагностики атопического дерматита при беременности. Ранняя диагностика особенно важна при наступлении беременности, поскольку у детей, рожденных в семье, где оба родителя страдают атопией, риск развития атопического дерматита равняется 75%. В первую очередь для профилактики возможных обострений атопического дерматита у беременных необходимо решить вопрос с ликвидацией триггерных факторов и исключить контакт с аллергенами, особое внимание следует уделять гипоаллергенной диете. Рассматриваются вопросы выбора тактики ведения и терапии дерматоза с учетом клинических исследований, оценки степени риска для беременной и плода. Обсуждаются особенности применения эмолентов, топических глюкокортикостероидов, топических противозудных средств, седативных и антигистаминных препаратов в составе комплексной терапии беременных с атопическим дерматитом. The problem of the peculiarities of the course of allergic diseases during pregnancy, as well as rational and safe approaches to their treatment, is in the focus of close attention of specialists. The article presents the clinical and pathogenetic characteristics of atopic dermatitis in pregnant women. Attention is paid to the principles of diagnosis of atopic dermatitis during pregnancy. Early diagnosis is especially important when pregnancy occurs, since children born to a family where both parents have atopy have a 75% risk of developing atopic dermatitis. First of all, for the prevention of possible exacerbations of atopic dermatitis in pregnant women, it is necessary to resolve the issue of eliminating trigger factors and exclude contact with allergens, special attention should be paid to a hypoallergenic diet. The issues of the choice of tactics of management and therapy of dermatosis are considered, taking into account clinical studies, assessment of the degree of risk for the pregnant woman and the fetus. The features of the use of emollients, topical glucocorticosteroids, topical antipruritic agents, sedatives and antihistamines as part of the complex therapy of pregnant women with atopic dermatitis are discussed.

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