PERINATAL ASPECTS OF PREGNANCY AND CHILDBIRTH ON THE BACKGROUND OF VITAMIN D LACK IN PREGNANT WOMEN

2021 ◽  
Vol 74 (10) ◽  
pp. 2585-2587
Author(s):  
Vitaliy V. Maliar
Keyword(s):  
Vitamin D ◽  
Blood Serum ◽  
Pregnant Women ◽  
Perinatal Outcomes ◽  
Fetal Distress ◽  
Test System ◽  
Perinatal Complications ◽  
Pregnancy And Childbirth ◽  
Wide Range ◽  
Pregnancy And Delivery

The aim: To study the features of the course of gestation and perinatal outcomes of delivery in women with vitamin D lack. Materials and methods: The article presents the results of studies of the characteristics of the course of pregnancy and delivery outcomes in 50 patients with vitamin D lack compared with a group of 50 somatically healthy pregnant women with normal level of 25 (OH) D. In order to establish a lack of vitamin D in pregnant women in the 10-12, 20-22, 30-32 weeks of gestation electrochemiluminiscence method by using a test system EURIMMUN (Germany) in the blood serum level of 25-hydroxycalciferol (25 (OH) D) in pregnant women. Results: When analyzing the structure of complications in women with vitamin D lack during pregnancy and childbirth we found out that risk of premature birth and premature births dominated among all the complications, respectively (58.0% and 36.0%) against (12.0% and 16.0%), p <0.05. Vitamin D lack in pregnant women is often associated with a wide range of obstetric and perinatal complications, namely: preeclampsia, gestational diabetes, bacterial vaginosis , premature rupture of membranes, placental abruption, abnormal labor activity, fetal distress that required delivery by Caesarean section. Conclusions: An analysis of the course of pregnancy and childbirth in women of thematic groups proved the expediency of an individual approach to the therapy of obstetric pathology among women with vitamin D lack. Despite the level of 25 (OH) D in the blood serum of a pregnant woman of 30 ng / ml and below, it is advisable to prescribe vitamin D for prophylaxes and treatment of Vitamin D deficiency in mother and fetus.

scholarly journals КОМПЛЕКС ПРОФІЛАКТИЧНИХ ЗАХОДІВ ДЛЯ ВАГІТНИХ ПІСЛЯ ДРТ З ВИСОКИМ РИЗИКОМ ПРЕЕКЛАМПСІЇ

World Science ◽  
2020 ◽  
pp. 1-6
Author(s):  
Камінський В’ячеслав Володимирович ◽  
Коломійченко Тетяна Василівна ◽  
Жданович Олексій Ігоревич ◽  
Рогава Ірина Володимирівна
Keyword(s):  
Pregnant Women ◽  
Perinatal Outcomes ◽  
Fetal Distress ◽  
Pregnancy And Childbirth ◽  
System Reduction ◽  
Vascular Regulation ◽  
Prophylactic Measures ◽  
Neonatal Adaptation ◽  
Gynecological Care

The purpose of the study: to evaluate the effectiveness of the proposed set of preventive measures for pregnant women after ART with a high risk of preeclampsia. Material and methods. To test the effectiveness of the proposed set of prophylactic measures, 60 pregnant women after ART were selected, which were randomly divided into 2 groups: 30 women who received the recommended complex (main group) and 30 women (comparison group), whose preeclampsia was prevented by order of the Ministry of Health. № 417 "Guidelines for the provision of outpatient obstetric and gynecological care." Results. The use of the recommended measures improves lipid metabolism (significant reduction of triglycerides and low density cholesterol), eliminates vitamin D deficiency, balances the cytokine profile (reduction of proinflammatory focus), reduces the prothrombotic potential of the hemostasis system (reduction of D-dimer and background marker damage). Improving the general condition and the use of psychotherapy can reduce the manifestations of vegetative-vascular dystonia, anxiety and improve quality of life. Such changes provide a more favorable background for the development of gestation. The incidence of preeclampsia decreased by 43.8% (from 26.7 to 15.0%), and mainly due to early preeclampsia, the incidence of which decreased by 78%, no cases of severe preeclampsia were reported. The frequency of placental insufficiency, fetal distress and growth retardation is reduced. The frequency of birth of children in a state of asphyxia is reduced by 2 times (up to 20.0 vs. 46.7%), severe asphyxia is not observed. Significantly lower and the frequency of violations of the period of neonatal adaptation (30.0 vs. 53.3%). Conclusions. The use of treatment and prophylactic complex to prevent preeclampsia in pregnant women after ART can improve a woman's homeostasis, balance vegetative-vascular regulation, reduce the incidence of preeclampsia by 43.8% (from 26.7 to 15.0%) and other complications of pregnancy and childbirth, improve perinatal outcomes. Proven medical, social and economic efficiency of the developed complex allows to recommend it for implementation in medical practice.

scholarly journals Prevention of complications of pregnancy and childbirth of patients with a burdensome gynecological anamnesis

2021 ◽  
Vol 6 ◽  
pp. 56-60
Author(s):  
T. P. Andriichuk
Keyword(s):  
Pregnant Women ◽  
Fetal Distress ◽  
The Body ◽  
Prevention Measures ◽  
Perinatal Complications ◽  
Pregnancy And Childbirth ◽  
Placental Dysfunction ◽  
Treatment And Prevention ◽  
Prophylactic Measures ◽  
The Mean

The objective: determination of the effectiveness of prevention and medicinal correction of placental dysfunction in pregnant women with chronic salpingo-oophoritis.Materials and methods. The study included 100 pregnant women (basic group) with chronic salpingo-oophoritis, of these, I group (50 women) included patients who received proposed treatment and prevention approach, II group (50 women) received a common set of treatment and prevention measures. The proposed treatment-and-prophylactic approach included prophylactic administration to pregnant women with chronic salpingo-oophoritis from the 8th to the 10th and from the 16th to the 18th week inclusive of natural micronized progesterone at a dose of 100 mg intravaginally twice a day for two weeks. Venotonik and angioprotector were prescribed prophylactically at dose 600 mg from 18 weeks to 37-38 weeks of pregnancy. For therapeutic purposes (blood flow disorders in the uterine arteries and vessels of the umbilical cord that are determined by Doppler), the drug was prescribed at dose 600 mg twice a day for 3–4 weeks.Results. A lower frequency of obstetric and perinatal complications was found in the women in I group than in the patients in the II group. Thus, the rate of placental dysfunction was 6.0±3.36% vs. 34.0±6.7%, respectively, oligohydramnios – 6.0±3.36% and 12.0±4.59%, polyhydramnios – 10.0±4.24% and 22.0±5.86%, fetal distress during childbirth – 6.0±3.36% and 14.0±4.91%, cesarean section – 12.0±4.6% and 24.0±4.27%. In the group of patients with treatment-and-prophylactic approach, the mean of the body weight of newborns was 3486.7±312.71 g, and in women who received a common set of treatment-and-prophylactic measures – 3099.8±295.69 g. The mean of the assessment of the condition of newborns by the Apgar scale at the 1st minute – 7.92±1.54 and 6.81±1.16 points, respectively.Conclusions. The use of micronized natural progesterone and the drug diosmin 600 mg in pregnant women with a history of chronic salpingo-oophoritis reduces the rate of obstetric and perinatal complications during pregnancy.

Comparative analysis of perinatal complications in intrahepatic cholestasis of pregnant women

2021 ◽  
Vol 9-10 (219-220) ◽  
pp. 28-33
Author(s):  
Makpal Beketova ◽  
◽  
Serik Iskakov ◽  
Keyword(s):  
Pregnant Women ◽  
Intrahepatic Cholestasis ◽  
Perinatal Outcomes ◽  
Fetal Distress ◽  
Neonatal Outcomes ◽  
Control Group ◽  
Perinatal Complications ◽  
Perinatal Risk ◽  
Ultrasound Doppler ◽  
Hepatic Transaminases

Intrahepatic cholestasis of pregnancy is associated with a higher incidence of adverse neonatal outcomes, including preterm birth, neonatal respiratory distress syndrome, meconium aspiration syndrome (MAS), and stillborn foetuses. Despite the successes achieved in the problem of Intrahepatic cholestasis of pregnant women (ICPW), a significant number of unfavorable outcomes for the mother and the fetus are associated with insufficiently developed possibilities for predicting them. Unsatisfactory results of pregnancy, childbirth and perinatal indicators, which cause a number of medical and social problems, can be reduced with the availability of effective methods for predicting and, if it, successful prevention and treatment of ICPW. Purpose of the study. To study the relationship between clinical and laboratory parameters in pregnant women with ICP W with obstetric and perinatal outcomes. Material and methods. A retrospective analysis of 600 birth histories and exchange cards of pregnant women in the period from 2015 to 2019 with ICPW was carried out, of which 301 pregnant women with intrahepatic cholestasis in the main group, and 299 pregnant women without intrahepatic cholestasis in the control group. Results and discussion. The most frequent complications of pregnancy and childbirth in ICPW were preterm labor, threatening fetal healthcare, preeclampsia, and postpartum hemorrhage. In patients with ICPW, an increase in the level of hepatic transaminases was significantly associated with a high perinatal risk. Respiratory disorders prevailed in the structure of diseases in newborns. An increase in the incidence of unfavorable neonatal outcomes (fetal distress, low Apgar score, low gestational age) is associated with severe hyperenzymemia in severe forms of ICPW. Conclusions. An increase in the level of hepatic transaminases is significantly associated with a high perinatal risk. The isolated use of ultrasound doppler in ICPW does not allow to reliably assess the risk of unfavorable perinatal outcomes. Analysis of the results of ultrasound doppler, with an increase in the level of transaminases, is insufficient to assess the degree of risk of antenatal death or a threatening condition of the fetus. Keywords: Intrahepatic cholestasis, pregnancy, perinatal outcomes.

On the possibility of targeted prophylaxis of calcitriol-associated pregnancy complications at the preclinical stage

2020 ◽  
pp. 43-50
Author(s):  
N.V. Didenkul ◽  
Keyword(s):  
Vitamin D ◽  
Pregnancy Complications ◽  
Comparison Group ◽  
Reproductive Potential ◽  
Perinatal Outcomes ◽  
Fetal Distress ◽  
Optimal Level ◽  
Initial Study ◽  
Management Plan ◽  
Placental Dysfunction

According to recent studies, in the vitamin D deficiency state (VDD), pregnancy can be complicated and the optimal level of VD in the blood is one of the conditions for the realization of reproductive potential. The objective: the possibility to preventing calcitriol-associated pregnancy complications by the correcting VD deficiency at the preconception period. Materials and methods. 57 women with VDD were examined. A history of all women had a pregnancy complicated by placental dysfunction (PD); 27 of them were observed from the preconception period (main group – IA) and 30 – from the 1st trimester of pregnancy (comparison group – IB). The VD status by the blood level of the 25-hydroxyvitamin D by ELISA was determined. Women of both groups, in addition to the vitamin-mineral complex (VMC) were prescribed supplementation colecalciferol at a dose of 4.000 IU per day. Pregnant women of both groups received VMCs up to 16 weeks. After optimizing the level (3–4 months), women continued to take VD at a dose of 2.000 IU per day throughout pregnancy. Results. At the initial study, the VD level was 15.72±2.59 ng/ml in ІА and 16.1±1.99 ng/ml in ІВ group (U=883; p>0.05); after treatment increased to 38.31±3.29 ng/ml and 36.13±2.99 ng/ml (U=900; p>0.05). In group IA, the course of pregnancy was characterized by a lower frequency of complications: PD was diagnosed in 22.2% in group IA and 50% in group IB (F=0.0001; p<0.01); fetal distress in 3.7% and 10% (F=0.16; p<0.05): signs of amnionitis – in 18.5% and 33.3% (F=0.035; p<0.05); placental hypertrophy or hypotrophy – in 7.4% and 36.7% (F=0.00001; p<0.01), preeclampsia in 3.7% and 6.7% of women (F=0,54; p<0.05). The frequency of cesarean section in the comparison group was significantly higher (40% VS 25.9%, F=0.034; p<0.05). Conclusions. During pregnancy, which occurred in conditions of VDD, the frequency of some pregnancy complications, including preeclampsia, the threat of miscarriage, placental dysfunction was in 2–4 times higher than in women with optimized VD status. One of the directions of the individual management plan for women with a negative obstetric history can be the determination of the level of VD in the blood and correction of the VDD at the preconception period. This approach is a pathogenetically substantiated and promising direction for the prevention of some pregnancy complications and improvement of perinatal outcomes. Keywords: pregnancy, deficiency vitamin D, placental dysfunction, preconception period.

A retrospective analysis of gestational complications, perinatal outcomes in women with thyroid dysfunction

2017 ◽  
pp. 41-46
Author(s):  
Yu.P. Vdovychenko ◽  
◽  
N.F. Alipovа ◽  
Keyword(s):  
Risk Prediction ◽  
Thyroid Dysfunction ◽  
Perinatal Outcomes ◽  
Fetal Distress ◽  
Threshold Level ◽  
Thyroid Peroxidase ◽  
Perinatal Complications ◽  
Perinatal Pathology ◽  
Outcomes Evaluation ◽  
Risk Of Preeclampsia

The objective: A study of features of the course of pregnancy and perinatal outcomes in women with thyroid dysfunction. Analysis of the risk prediction of gestational and perinatal complications, depending on the level of antibodies to thyroid peroxidase (AB-TPO). Patients and methods. A retrospective study of 526 histories and stories birth of generations of women-carriers of antibodies to thyroid peroxidase and 489 of their newborns The group of comparison was formed of 40 stories birth somatically healthy women without the elevated levels of AB-TPO and 40 stories of their newborns. The analysis of the course of pregnancy and perinatal outcomes, evaluation of risk prediction of gestational and perinatal complications, depending on the level of AB-TPO. Results. Established that women carriers of AB-TPO age has the older category; among extragenital diseases most often identified diseases of otolaryngology and neurocirculatory dystonia. Obstetric anamnesis burdened by the pregnancy miscarriage and perinatal losses. In the structure of gestational and perinatal complications, the principal place is the threatened miscarriage, preeclampsia, fetal distress, asphyxia of newborns. Discovered the effect of the starting threshold level of AB-TPO on the risk of occurrence impendence interruption of pregnancy (AB-TPO=315 IU/ml); the risk of miscarriage (AB-TPO=339.8 IU/ml); the risk of fetal distress (AB-TPO = of 247.5 IU/ml); the risk of neonatal asphyxia (AB-TPO=234.8 IU/ml). Didn’t discovere influence of starting threshold level of AB-TPO on the risk of preeclampsia and pathological birht. Conclusion. Women carriers of the AB-TPO constitute a group of high risk of obstetric and perinatal pathology. Discovered the influence of the starting threshold level of AB-TPO on the risk of gestational complications. Key words: pregnancy, level of antibodies to thyroid peroxidase, miscarriage, gestational and perinatal complications.

RISK FACTORS FOR REDUCING VITAMIN D SUPPLY IN ADOLESCENTS WITH ARTERIAL HYPERTENSION AND OBESITY

2021 ◽  
Vol 100 (2) ◽  
pp. 187-191
Author(s):  
S.S.K. Zeid ◽  
◽  
L.V. Yakovleva ◽  
Keyword(s):  
Vitamin D ◽  
Arterial Hypertension ◽  
Comparison Group ◽  
Vitamin D Insufficiency ◽  
Test System ◽  
White Coat Hypertension ◽  
Control Group ◽  
Internal Factors ◽  
Wide Range ◽  
Normal Body Weight

The aim of the study is to determine the contribution of external and internal factors, such as the season, body mass index (BMI), age, sex, degree of AH, the formation of insufficiency and/or deficiency of 25 (OH)D in adolescents with arterial hypertension (AH). Materials and methods: the core group consisted of 87 adolescents with primary AH, which then were divided into two subgroups depending on BMI (Subgroup 1 – overweight and obese, Subgroup 2 – with normal body weight). The control group consisted of 23 adolescents with the phenomenon of «white coat hypertension» (WHT). The level of 25(OH)D in the blood serum was determined by immunoextraction with further with further quantitative determination by enzyme immunoassay using StarFax 2100 analyzer (USA). A DIA source Immuno assays S.A. test system. (Belgium) was used. All calculations were carried out according to the instruction in which the norm was 25(OH)D>/=30–100 ng/ml; insufficiency – 10–29 ng/ml; deficiency – > 10 ng/ml. Results: the level of 25(OH)D in peripheral blood fluctuated in a wide range – from 5,1 to 50,2 ng/ml, the median level of 25(OH)D was 17,8 ng/ml [12,2; 23,5]. According to the results of the study, only 4 (3,6%) children had a normal vitamin D level, 95 (86,4%) had vitamin D insufficiency and 11 (10%) had a deficiency. The median values of 25(OH)D in children of the comparison group were statistically significantly higher than in children with AH of the 1st and 2nd subgroups – 23,3 ng/ml [20,8; 26,0], 14,9 ng/ml [10,8; 19,5] and 17,1 ng/ml [11,8; 23,7], respectively, p=0,001. Conclusion: according to the results of the multivariate analysis, 25(OH)D in the observed adolescents depends on many factors, such as age (6,7%), gender differences (5,7%), etc. The seasons have the greatest influence on its level (62,3%) and BMI (21,4%), the least – AH (3,9%).

Peculiarities of pregnancy and delivery course in women after the application of assisted reproductive technologies against obesity (Based on the retrospective analysis)

2018 ◽  
pp. 122-126
Author(s):  
I.A. Zhabchenko ◽  
◽  
O.R. Sudmak ◽  
Keyword(s):  
In Vitro Fertilization ◽  
Pregnant Women ◽  
Retrospective Analysis ◽  
Perinatal Outcomes ◽  
Reproductive Technologies ◽  
Ischemic Lesion ◽  
Vitro Fertilization ◽  
Pregnancy And Delivery

The objective: to study the structure and frequency of complications of pregnancy, deliveries and perinatal outcomes in three groups of women: women with infertility and obesity, treated by application of in vitro fertilization (hereinafter IVF), pregnant women after IVF application with normal body weight, and pregnant women on the background of obesity which did not have an infertility in past history. Materials and methods. A retrospective analysis of 221 case histories of pregnancies and labors in women who were treated and gave birth in the Pregnancy and delivery pathology Department of SI «Institute of Pediatrics, Obstetrics and Gynecology named after Acad. O. M. Lukyanova of NAMS of Ukraine» for 2012 – 2016 years was carried out. Results. The overwhelming majority of pregnant women after IVF on the background of obesity are primaparas, who have a complicated obstetric history, hormonal changes in the form of progesterone deficiency predominantly and chronic inflammatory processes. Pregnancy with a combination of infertility, treated by the means of IVF application, and obesity, in most cases is accompanied by a long-term threat of termination of pregnancy (48.8%), threatening preterm deliveries (56%), placental dysfunction (41.5%), premature rupture of the amniotic membranes (41.5%), other problems during pregnancy, at the same time, every second woman (58.5%) had a combination of several complications, and required a long-term and repeated inpatient treatment (53.7%). The specific gravity of surgical delivery was 90%, and 16.2% of such deliveries were complicated by pathological blood loss. The number of preterm deliveries was 17.1%, with perinatal losses up to 11.3‰. Among full-term newborns 21.3% of newborns had malnutrition of the I degree and 17% of them had hypoxic-ischemic lesion of CNS. Conclusion. The course of pregnancy, delivery and the postpartum period in the studied contingent of women has a significant frequency of complications, mainly the coinciding ones, which affects on the consequences of perinatal outcomes and requires further study of this problem and the development of differentiated algorithms for antenatal observation. Key words: pregnancy, obesity, in vitro fertilization, complications, delivery, newborn.

Prophylaxis of obstetric and perinatal pathology at women with pathological increase of body weight during pregnancy

2018 ◽  
pp. 7-79
Author(s):  
S.Yu. Vdovichenko ◽  
◽  
T.D. Fakhrutdinova ◽  
Keyword(s):  
Health Care ◽  
Body Weight ◽  
Pregnant Women ◽  
Key Words ◽  
Perinatal Outcomes ◽  
Perinatal Complications ◽  
Perinatal Pathology ◽  
Fetoplacental Complex ◽  
The Right ◽  
Selection Of

The objective: depression of obstetric and perinatal complications at pregnant women with pathological increase of body weight during pregnancy on the basis of studying of clinical-functional, endocrinologic, metabolic, morphological features of condition of fetoplacental complex and development of advanced algorithm of treatment-and-prophylactic actions. Materials and methods. We conducted examination of 264 patients who consisted on the account concerning pregnancy in female consultations of Kiev. By a method of selection of 178 women were included in retrospective research and 86 – in prospective. The main group was made by 39 pregnant women with whom led individual discussions, control – 142 women, that received traditional references in female consultation. Results. Use of the algorithm improved by us allows to improve obstetric (decrease of frequency of a preeclampsia by 12.3%; anomalies of a patrimonial deyalnost for 8.4%) and perinatal outcomes (depression of level of an asphyxia at a delivery for 9.4% and post-natal adaptation for 7.8%) deliveries of women with an excessive increase of body weight during pregnancy. Conclusion. The received results grant the right to recommend the algorithm improved by us for wide use in practical health care. Key words: obstetric and perinatal pathology, pathological increase of body weight, prophylaxis.

Influence of pregnancy on iron and copper exchange rates in women with normal body weight and women with obesity

2021 ◽  
Vol 66 (4) ◽  
pp. 205-209
Author(s):  
E. L. Makarova ◽  
N. A. Terekhina
Keyword(s):  
Body Weight ◽  
Blood Serum ◽  
Pregnant Women ◽  
Copper Metabolism ◽  
The Body ◽  
Reproductive Age ◽  
Perinatal Complications ◽  
Effective Prevention ◽  
Normal Body ◽  
Normal Body Weight

The number of obese pregnant women increases annually and reaches 20-30%. The metabolism of hormones and minerals changes in the presence of a large amount of adipose tissue in the body of a pregnant woman, which leads to a number of obstetric and perinatal problems. The aim of the work is to study and compare the influence of the gestational process on the indicators of iron and copper metabolism in the blood serum of women with normal body weight and women with obesity. In the blood serum of 125 women of reproductive age, the content of hemoglobin, iron, transferrin, ferritin, copper and ceruloplasmin was determined. The influence of pregnancy on the indicators of iron and copper metabolism in the blood serum of women was revealed. Pregnancy in women with normal body weight increases the content of transferrin and ceruloplasmin. Correlation of ceruloplasmin and ferritin content with body mass index of obese pregnant women was revealed. In pregnancy with concomitant obesity, hyperferritinemia is formed with a reduced content of hemoglobin and serum iron. Knowledge of the indicators of iron and copper metabolism is necessary to optimize the observation of pregnant women, effective prevention and prediction of obstetric and perinatal complications.

MATERNALAND PERINATAL OUTCOMES WITH COVID-19: A TERTIARY CARE CENTRE STUDY

2021 ◽  
pp. 31-32
Author(s):  
Sweety Sinha ◽  
Anjana Sinha ◽  
Ankita Ankita
Keyword(s):  
Pregnant Women ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Perinatal Outcomes ◽  
Neonatal Infection ◽  
Fetal Distress ◽  
Rt Pcr ◽  
Tertiary Care Centre ◽  
Polymerase Chain ◽  
Poor Outcomes

Background: With the exponential increase in the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2/COVID-19) worldwide, an increasing proportion of pregnant women are now infected during their pregnancy. The knowledge gained from previous human coronavirus outbreaks suggests that pregnant women and their fetuses are particularly susceptible to poor outcomes. The aim of this study was to summarize the maternal and perinatal outcomes of pregnant women infected with COVID-19 during their pregnancy. Methods:Eligibility criteria included pregnant women positive for COVID-19 as detected by real-time polymerase chain reaction (PCR). Results: Atotal of 40 pregnant women positive for COVID-19 as conrmed by RT-PCR, were included in the study. 5% cases had preterm deliveries and LSCS was the preferred mode of delivery in 28 of 40 i.e., 70% cases. There was a tendency for low Apgar score at birth, higher rates of fetal distress, meconium, NICU admissions. There was one IUD only in this study. The treatment patterns of COVID-19 infection among pregnant women during their pregnancy or following delivery was mostly supportive in the form of oxygen and antibiotic therapy. Conclusions: Although the majority of mothers were discharged without any major complications, severe maternal morbidity as a result of COVID-19 were reported. Vertical transmission of the COVID-19 could not be ruled out. Pregnant infected women had different symptoms, and they were given mostly supportive treatments than the general infected population. Careful monitoring of pregnancies with COVID-19 and measures to prevent neonatal infection are warranted.

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