PLACENTAL DYSFUNCTION IN PREGNANT WOMEN WITH DIABETES. MODERN APPROACHES TO CHILDBIRTH

2020 ◽  
pp. 25-28
Author(s):  
D. Yu. Tertyshnyk ◽  
Iryna Borysivna Borzenko ◽  
O. A. Liashchenko ◽  
O. B. Ovcharenko ◽  
M. O. Medviedieva
Keyword(s):  
Diabetes Mellitus ◽  
Endothelial Dysfunction ◽  
Pregnant Women ◽  
Foley Catheter ◽  
The Body ◽  
Reproductive Age ◽  
Enzyme Linked Immunosorbent Assay ◽  
Key Words Diabetes ◽  
Placental Dysfunction ◽  
Fetoplacental Complex

Diabetes mellitus is a common chronic disease in the women of reproductive age. Pregnant women with this disease often have placental dysfunction, which manifests itself in fetal growth retardation, dehydration and requires delivery by a cesarean section. To evaluate the effect of antiprogesterone use on cervical maturation and optimization of delivery in pregnant women with placental dysfunction resulted from diabetes, 120 women were examined according to generally accepted norms. Ultrasound examination with Doppler velocimetry of the fetoplacental complex vessels and measurement of the uterus neck, hormonal examination to determine the level of hormones (progesterone, oxytocin, prostaglandin E2) by enzyme−linked immunosorbent assay, endothelial dysfunction factors (VEGF, endothelin, еNOS), assessment of uterus neck according to Bishops' score and the course of childbirth by cardiotocography and partogram, the newborn condition on the Apgar scores, newborn weight, glycometric condition of the mother. Preparation of pregnant women for childbirth was carried out by intracervical injection of prostaglandins of group E2 (dinoprostone); Foley catheter; antiprogesterone drug (mifepristone). The research has found that diabetes complicates the course of pregnancy with placental dysfunction in almost every second pregnant woman due to endothelial dysfunction, especially in the fetoplacental complex, which can be determined at an earlier stage of pregnancy by studying endothelial factors. The need for initiating the premature birth in pregnant women with diabetes is stipulated by the impairments in mother and fetus (placental dysfunction, diabetic fetopathy, distress), which requires preparation of the cervix for the labor induction. The most effective pre−induction of pregnant women with diabetes was the pathogenetic method of intracervical administration of antiprogesterone, which did not have a negative effect on the body of mother and child. Key words: diabetes mellitus, placental dysfunction, pregnant women, antiprogesterone.

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.

scholarly journals Altered Bioavailability of Nitric Oxide and L-Arginine Is a Key Determinant of Endothelial Dysfunction in Preeclampsia

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Worlanyo Tashie ◽  
Linda Ahenkorah Fondjo ◽  
William K. B. A. Owiredu ◽  
Richard K. D. Ephraim ◽  
Listowell Asare ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Blood Pressure ◽  
Endothelial Dysfunction ◽  
Pregnant Women ◽  
Positive Association ◽  
Neonatal Morbidity ◽  
Sub Saharan Africa ◽  
Enzyme Linked Immunosorbent Assay ◽  
Low Birth Weight Infants ◽  
Significant Positive Association

Background. Preeclampsia is a major cause of maternal and neonatal morbidity and mortality in sub-Saharan Africa. Evidence indicates that endothelial dysfunction is central to the pathogenesis of preeclampsia. This study assessed the level of the components of the arginine-nitric oxide pathway to evaluate endothelial dysfunction in normotensive pregnancies and pregnancies complicated with preeclampsia. Methods. This case-control study was conducted among pregnant women who visited Comboni Hospital from January 2017 to May 2018. A total of 180 pregnant women comprising 88 preeclamptic women (PE) and 92 healthy normotensive pregnant women (NP) were recruited. Sociodemographic, clinical, and obstetric data were obtained using validated questionnaires. Blood pressure and anthropometrics were measured, and blood samples were collected for the estimation of nitric oxide (NO∙), L-arginine, asymmetric dimethylarginine (ADMA), and 3-nitrotyrosine using an enzyme-linked immunosorbent assay technique. Results. The mean NO∙ ( p = 0.010 ) and L-arginine/ADMA ratio ( p < 0.0001 ) was significantly lower in PE compared to NP while mean L-arginine ( p = 0.034 ), ADMA ( p < 0.0001 ), and 3-nitrotyrosine ( p < 0.0001 ) were significantly higher in PE than NP. ADMA showed a significant positive association with systolic blood pressure ( β = 0.454 , p = 0.036 ) in severe PE. Women with PE had significant intrauterine growth restriction ( p < 0.0001 ) and low birth weight infants ( p < 0.0001 ) when compared to NP. Conclusion. Preeclampsia is associated with reduced NO∙ bioavailability, L-arginine/ADMA ratio, and elevated levels of ADMA and 3-nitrotyrosine. Measurements of the levels of these parameters can help in the early prediction of endothelial dysfunction in preeclampsia. Exogenous therapeutic supplementation with L-arginine during pregnancy to increase the L-arginine/ADMA ratio should be considered to improve endothelial function in preeclampsia and pregnant women at risk of developing preeclampsia.

scholarly journals The Role of Soluble L-Selectin with Polymorphism in Iraqi Arabs Patients with Diabetes Mellitus Type 2

2018 ◽  
Vol 9 (01) ◽  
Author(s):  
Asmaa M. Salih Almohaidi ◽  
Kebaa Ahmed Saeed
Keyword(s):  
Diabetes Mellitus ◽  
Serum Level ◽  
Healthy Subjects ◽  
Diabetes Mellitus Type 2 ◽  
The Body ◽  
Diabetes Mellitus Type ◽  
Enzyme Linked Immunosorbent Assay ◽  
Control Group

Diabetes mellitus type 2 [DMT2] is a disturbance of metabolism and complex diseases influenced by environmental, genetic agents, and linked with inflammation, happens when the pancreas either does not use the insulin as it should or the body does not make enough insulin, lead to insulin resistance [IR] alongside with gradual loss of ß-cell secretory ability. The aim of this study was to investigate the role of soluble L-selectin (sL-selectin) in diabetes mellitus type 2 patients in Iraqi Arabs patient. Study includes seventy six Iraqi Arabs patients (male and female) having newly diagnosed type 2 diabetes mellitus (T2DM), with Fifty three Iraqi Arabs healthy subjects matched in age, sex and ethnic group. Patients and healthy subjects were genotyped, by PCR-RFLP analysis, and mesure serum level of L-selectin by enzyme-linked immunosorbent assay (sandwich ELISA) test include 65 patients and 23 controls. The statistical analysis of serum level of sL-selectin in study groups showed that the mean of sL-selectin level high significantly increased in patients group (10.708±1.1007) compared to control group (7.055±0.767) respectively. Thus, our results suggest soluble L-selectin play a role in the development of DMT2 in Iraqi Arabs patients. Present results showed that genotype PS associated with increase the susceptibility of DMT2.

scholarly journals Gambaran Kondisi Ibu Hamil dengan Diabetes Mellitus di RSD dr. Soebandi Jember Tahun 2013-2017 (Description of Pregnant Women Condition with Diabetes Mellitus in RSD dr. Soebandi Jember on 2013-2017)

2018 ◽  
Vol 6 (1) ◽  
pp. 46
Author(s):  
Meggeria Dyah Matrika Tito Putri ◽  
Pudjo Wahjudi ◽  
Irma Prasetyowati
Keyword(s):  
Diabetes Mellitus ◽  
Pregnant Women ◽  
Maternal Age ◽  
Maternal Education ◽  
Case Series ◽  
Sampling Technique ◽  
The Body ◽  
Family History Of Diabetes ◽  
Low Education ◽  
History Of

Abstract Diabetes Mellitus or diabetes is a chronic metabolic disease disorder caused by pancreas does not produce enough insulin or the body can’t effectively use produced insulin. In pregnant women with a family history of diabetes mellitus, the prevalence of pregnancy with diabetes mellitus is 5.1%. This research aim to determine description of pregnant women condition with diabetes mellitus in RSD dr. Soebandi Jember. This research used descriptive method with case series design. The sample size of 19 pregnant women with diabetes mellitus was selected by total sampling technique. The results showed that the high maternal age (52.6%), low education (89.5%), unemployment or housewife (89.2%), had a genetic 78.9%), BMI overweight (57.9%), glucosuria (89.5%), history of pre-eclampsia (57.9%), low parity (79%), never miscarried (84.2%). Based on the result of the research, it was concluded that maternal education, maternal job, genetic, overweight BMI, glucosuria, and history of pre-eclampsia had an effect towards the occurrence of pregnant women with diabetes mellitus, also maternal age, parity and history of miscarriage had no effect on the occurrence of pregnant women with diabetes mellitus. To raise awareness of the risks of pregnancy with diabetes mellitus can be done with screening for diabetes mellitus.  Keywords: diabetes mellitus, pregnant women, RSD dr. Soebandi.  

Inverse relation between fruit and vegetable intake and the risk of gestational diabetes mellitus

2019 ◽  
Vol 89 (1-2) ◽  
pp. 37-44 ◽  
Author(s):  
Parvin Mirmiran ◽  
Somayeh Hosseinpour-Niazi ◽  
Lida Moghaddam-Banaem ◽  
Minoor Lamyian ◽  
Azita Goshtasebi ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Vegetable Intake ◽  
Vegetable Consumption ◽  
Reproductive Age ◽  
Oral Glucose ◽  
Dietary Intakes ◽  
Fruit And Vegetable

Abstract. Background: The aim of this study was to investigate the association of intakes of fruit, vegetable and dairy with gestational diabetes mellitus (GDM). Methods: This prospective study was conducted over a 17 month period, on a random sample of pregnant women (n = 1026), aged 18–45 y, in their first half of pregnancy, attending prenatal clinics in five hospitals’ affiliated to universities of medical sciences in different districts of Tehran, Iran. Dietary intakes were assessed during gestational age ≤ 6 weeks using a 168-item validated semi-quantitative food frequency questionnaire. Between 24 and 28 weeks of gestation, all pregnant women underwent a scheduled 100 g 3-h oral glucose tolerance test. Diagnosis of GDM was based on criteria set by the American Diabetes Association. Results: Of 1026 study participants, 71 had GDM, with a mean age and pre-pregnancy BMI of 26.7 ± 4.3 y and 25.4 ± 4.5 Kg/m2, respectively. High fruit and vegetable intakes were negatively associated with GDM risk. Compared with women who consumed < 2.1 servings/day, odds ratio (ORs) for those who consumed ≥ 4.9 servings/day was 0.44 (95% CI: 0.20–0.93), after adjustment for confounding factors. Fruit and vegetable intakes were significantly and inversely associated with the GDM; ORs (95% CIs) for GDM among participants with the highest, compared to the lowest quartiles were 0.48 (0.18–0.89) for fruit and 0.46 (0.22–0.99) for vegetables intake. No association was found between dairy products and GDM. Conclusions: Fruit and vegetable consumption in women of reproductive age have beneficial effects in the prevention of GDM.

scholarly journals Comparative characteristics of the fetoplacental complex in women with type 1 diabetes and in pregnant women with gestational diabetes

2019 ◽  
Vol 23 (4) ◽  
pp. 652-658
Author(s):  
A.P. Dnistryanska ◽  
O.S. Musienko ◽  
L.V. Yaremchuk
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Gestational Diabetes ◽  
Pregnant Women ◽  
Termination Of Pregnancy ◽  
Fetoplacental Complex ◽  
Biophysical Profile ◽  
Patients With Diabetes ◽  
History Of

Annotation. In the structure of causes of maternal mortality, extragenital pathology accounts for 25%. Among them, endocrine pathology is 6%, diabetes accounts for 31.9%. 1% of women of childbearing age suffer from type 1 diabetes, and 2–17% has gestational diabetes (GD). The aim is to compare the condition of the fetoplacental complex in the third trimester of pregnancy in 9 pregnant women with type 1 diabetes (group 1) and in 12 women with GD (group 2) who were observed at “Vinnitsa City Clinical Hospital and child” for 2016–2019. The control group included 10 patients with physiological pregnancy. Women with diabetes had a history of gynecological diseases: colpitis (8 patients (88.8%)), cervical erosion (2 (22.2%)), chronic adnexitis (5 (55.5%)). Among the complications of previous pregnancies in the group of patients with diabetes mellitus (5 births) were unauthorized miscarriages (1 (11.1%)), the risk of termination of pregnancy (5 (55%)). In women with a history of GD, colpitis was observed in 3 (24.9%), which is significantly less than in women with type 1 diabetes. There were 2 pregnant women with GD: preterm births (16.6%). Among the complications of pregnancy in 1 patient was the threat of abortion in previous cases. Changes in the indexes of hemodynamics of the uterine-placental complex were evaluated on the basis of cardiotocography, ultrasound on ultrasound machine “Logic-5” with 2D measurement, Doppler, evaluation of the biophysical profile of the fetus (BPF). Statistical data processing was performed by calculating Student coefficients (+) using the Microsoft Excel program. It was established that in the 1st trimester of pregnancy, 5 (55.5%) women with type 1 diabetes were diagnosed with a threat of termination of pregnancy (TTP), and in the 1st (11.1%), they had a retroplacental hematoma. Two (22.2%) women with GD were diagnosed with TTF. In the 2nd trimester, 2 women with GD remained symptomatic of TTF. Six (66.7%) women with type 1 diabetes have symptoms of TTF. In the 1 pregnant woman developed pyelonephritis. Childbirth in 8 (88.8%) women with type 1 diabetes ended through natural birth canal, in 1 woman — a caesarean section. The weight of the child was 4435±2 g. In women with GD the weight of the child was 3756±12. In 7 (77.8%) patients, fetal weight exceeded 4000 g. BPF in the group of patients with diabetes was significantly different from the group with GD at 37–38 weeks of pregnancy. BPF in the 1st group — 7.6±0.2, in the 2nd group — 8.7±0.2, resistance index (RI): 1st group — 0.61±0.01, 2-ha group — 0.57±0.01, CO/K: in the 1st group — 3.2±0.1, in the 2nd group — 3.1±0.1. The correlation between the level of GD compensation and pathological changes in the fetoplacental complex has been established. The data obtained indicate that early screening of this pathology and appropriate compensation for carbohydrate metabolism in the presence of diabetes mellitus should be noted as one of the methods for the prevention of the development of complications in GD.

scholarly journals Food Quality and Nutritional Status of Pregnant and Lactating Women in The Non-Lotted Area on the Outskirts of Ouagadougou, Burkina Faso

2021 ◽  
Author(s):  
Zoubga W. Adama ◽  
Zongo Urbain ◽  
Somé W. Jérôme ◽  
Nikiema P. Augustin ◽  
Savadogo Aly
Keyword(s):  
Nutritional Status ◽  
Pregnant Women ◽  
Urban Areas ◽  
Dietary Diversity ◽  
The Body ◽  
Reproductive Age ◽  
Acute Malnutrition ◽  
Severe Malnutrition ◽  
Lactating Women ◽  
Significant Difference

Background: To contribute to the fight against malnutrition among women of reproductive age, this study aimed to evaluate the quality of food and the nutritional status of pregnant and lactating women. Methods: This cross-sectional study was conducted from June 2018 to September 2018 to explore the frequency and distribution of the dietary, socioeconomic, and health characteristics of pregnant and lactating women as well as their nutritional status. The target population consisted of 124 pregnant women and 118 nursing women age between 15 to 49 years. Results: The prevalence of acute malnutrition was 30.9% among women in general, 1.6% with severe malnutrition according to the mid-upper arm circumference (MUAC). In terms of the body mass index (BMI), the prevalence of malnutrition among lactating women was 13.5%; 10.5% with moderate malnutrition and 3.5% with severe malnutrition. The women aged between 15 to 49 years had poor dietary diversity. The mean dietary diversity score (DDS) was estimated at 4.14±0.86. This score was 4.19±0.87 in pregnant women and 4.09 ± 0.85 in lactating women. However, no statistically significant difference was observed between them (P = 0.20 and OR = 0.82) [0.4; 1.4]. A substantial proportion (19.8%) of women had a low DDS (< 5), with a rate of 16.9% among pregnant women and 22.9% among lactating women. Conclusion: This study revealed the presence of food and nutrition insecurity in semi-urban areas, particularly in "undeveloped" areas. Improving the living conditions of the populations in these localities, in parallel with nutritional education actions, could help to reduce the disease.

scholarly journals Prevention of the fetoplacental complex disorders in women at risk and the risk of preterm birth (Literature review)

2021 ◽  
Vol 2 ◽  
pp. 32-36
Author(s):  
O.V. Laba
Keyword(s):  
Preterm Birth ◽  
Pregnant Women ◽  
Placental Abruption ◽  
Reproductive Potential ◽  
Fetal Distress ◽  
Smoking During Pregnancy ◽  
Complex Disorders ◽  
Placental Dysfunction ◽  
Fetoplacental Complex ◽  
The Impact

The obstetrician-gynaecologist practitioners consider a woman’s health from her reproductive potential support standpoint, and the problem of miscarriage is considered as one of the most important health problems in the world. The difficulty in solving the premature birth problem is the presence of many factors and preconditions that determine the risks of miscarriage. The article provides an overview of current international guidelines for assessing the root causes and preconditions for preterm birth. The problem of preterm birth risks is discussed, taking into account both the socio-economic living conditions of pregnant women and the factors that accompany the formation of the pathogenesis of preterm birth (placental dysfunction). There were examination and evaluation of the clinical significance of the factors that can lead to dysfunction of the fetoplacental complex (partial placental abruption, low placentation, placental dysfunction, premature placental maturation, placental malnutrition/hypertrophy, polyhydramnios/dehydration, placental abruption syndrome and growth retardation syndrome, fetal-placental blood flow, acute/chronic fetal distress). It was noted that hemodynamic disorders in the placenta depend on both the nature and duration of adverse factors. Those factors are pregnancy in unfavourable terms for the birth of children (up to 18 and after 40 years), high frequency of extragenital pathology, complicated reproductive history, genital infectious diseases (chlamydial infections, trichomoniasis, urogenital mycoplasmosis), smoking during pregnancy, the impact of environmental and economical character.Attention is paid to the hemodynamic disorders assessment (vascularization of the lower uterus) in pregnant women and determination of their role in the fetoplacental dysfunction development. The role of the hemodynamic disorders in the placenta is considered as the morphological and biochemical adaptive reactions abnormality. 

scholarly journals BIOCHEMICAL MARKERS OF ENDOTHELIAL DYSFUNCTION IN PATIENTS WITH ACUTE INFLAMMATORY DISEASES OF THE ORGANISM OF THE PELVIC ORGANS AGAINST THE BACKGROUND OF DIFFERENT TREATMENT OPTIONS

2019 ◽  
Vol 6 (1) ◽  
pp. 27-31
Author(s):  
Natalia A. Burova ◽  
S. V Serdyukov ◽  
K. A Sadovskaya ◽  
N. A Zharkin
Keyword(s):  
Endothelial Dysfunction ◽  
Inflammatory Diseases ◽  
Early Period ◽  
Main Group ◽  
Reproductive Age ◽  
Enzyme Linked Immunosorbent Assay ◽  
Endothelin 1 ◽  
Pelvic Organs ◽  
Healthy Women ◽  
Vasomotor Function

Inflammatory diseases of the pelvic organs (IDPO) remain one of the most pressing and debatable problems of modern gynecology. Currently, IDPO acquired an erased course due to immune and vascular changes at the local and systemic level, leading to endothelial dysfunction, which, in the absence of acomprehensive, step-by-step treatment, causes chronicity and disrupts the fertility of women. We examined 184 patients with acute episodes of IDPO divided into 2 groups: the main group included 94 patients and the comparison group consisted of 90 patients. All patients started comprehensive drug anti-inflammatory therapy. Patients of the main group additionally received a vaginal laser-magnetopuncture from the 2nd to the 7th day of treatment. To assess the state of endothelial function, the enzyme-linked immunosorbent assay (ELISA) in the serum was used to determine the level of a metabolite of nitric oxide (NO) iNOS - inhibited endothelial NO synthase and endothelin-1. Similar markers were determined in the blood serum of 20 healthy women volunteers of the reproductive age. As a result of the study, in the acute phase of inflammation there was found an increase in both the vasodilator NO and the vasoconstrictor - endothelin-1, which was 2.5 times higher than in healthy women, which confirms the presence of endothelial dysfunction in IDPO patients, which cannot be stopped when carrying out traditional therapy. The use of improved complex treatment with the inclusion of preformed exposure factors contributed to the reduction in the production of NO and endothelin-1, the normalization of epithelial cells and the restoration of the vasomotor function of the endothelium. The use of laser-magnetic vaginal exposure in the early period of treatment and rehabilitation of IDPO patients may help prevent chronic inflammation and normalize the specific functions of the female body.

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