Optimization of postpartum management in women with physiological childbirth

Aim of study was to reduce the frequency of inflammatory complications by optimizing therapeutic approaches during the postpartum period. 150 patients were examined after physiological delivery (main group) and divided into two study groups (I and II). The first group included 100 postpartum patients who took probiotics for 1 month, beginning 3–5 days after delivery. The second group consisted of 50 postpartum patients who were not prescribed probiotics. The control group included 50 patients of reproductive age. The probiotic used in the experiment is the drug PROBEEZ® FEMINA. The materials used for the immunological study were washings of cervical mucus.

ASSESSMENT OF THE LABOR COURSE AND POSTNATAL PERIOD DEPENDING ON THE TYPES OF CONDUCTING ANTINATAL PREPARATION

The aim – to conduct a comparative assessment of the condition of newborns, dependingon different types of antenatal preparation.Material and methods. The study was carried out on the basis of the maternitydepartment for pregnants and parturient women with obstetric pathology of the StateInstitution “Institute of Pediatrics of Obstetrics and Gynecology named after V.I. acad.EAT. Lukyanova National Academy of Medical Sciences of Ukraine ". The first groupincluded 45 pregnant women who underwent a course of psychophysical training withpositive motivation for partner childbirth. The second group consisted of 45 pregnantwomen, also underwent a course of psychophysical training with positive motivation forpartner labor, but had a desire not to carry out pain relief during childbirth, therefore,they chose training using the method of transcranial electrical stimulation (TES) of brainstructures. All pregnant women underwent a determination of their psychoemotional stateto define the level of situational anxiety according to the method of Ch.D. Spielberger andYu.L. Khanin. The second group of pregnant women was tested after the fourth EFTprocedure and again the day before delivery. The threshold of pain sensitivity of apregnant woman in each group was also determined. Subjective assessment was carriedout for women in labor on the first day after delivery and using a verbal descriptivescale for assessing pain (Verbal Descriptor Scale, 1990). To assess the condition of thefetus during childbirth, cardiotocographic studies were carried out, and after birth – anassessment on the Apgar scale at the first and fifth minutes.Results. In women who underwent a course of psychophysical training with positivemotivation for partner childbirth together with the method of transcranial electricalstimulation, physiological childbirth proceeded 1.2 times more often than in womenpatients who did not undergo prenatal training (88.9 % versus 75.6 %, respectively).Allchildbirth, occurred in the second group, began on their own and did not require laborinduction, but in the first group this indicator was 6.3% of cases.Conclusions. It has been established that prenatal preparation has a positive effect notonly on the condition of the woman, but also on the condition of the fetus and newborn.Psychophysical preparation for childbirth with motivation for partner support using theTES method significantly increases the pain tolerance threshold, improves the courseof childbirth and the possibility of adaptive mechanisms of the mother and fetus, asevidenced by the assessment of points on the Apgar scale, adaptation of newborns, earlyattachment to the breast, joint stay of mother and child.

Neurohumoral and biochemical markers of prolonged second stage of labor

Objective: to study the role of neurohumoral and biochemical changes in the pathogenesis of prolonged second stage of labor.Material and methods. To achieve the above objective, we examined 35 parturient women with prolonged second stage of labor and 45 parturient women with physiological labor. We studied the levels of progesterone, estradiol, relaxin, serotonin, cholesterol, thiobarbituric acid reactive substances (TBARS), total antioxidant capacity of plasma, products of final protein oxidation, as well as the total concentrations of nitrite and nitrate ions (NOx) in blood plasma.Results. In the women with prolonged second stage of labor, the levels of estradiol and progesterone were significantly higher than in those with physiological childbirth (p1 = 0.037, p2 = 0.029). The women giving birth by operation had higher estradiol (p = 0.017) and progesterone (p = 0.07) levels than those giving birth physiologically. The level of relaxin was lower in the women with prolonged second period of labor than in those with physiological labor (p = 0.084), especially in the case of operative delivery (p = 0.041), the risk of which increases 4.1 times when the relaxin concentration is less than 36.4 ng/l. Compared to the patients giving physiological childbirth, the patients with prolonged second stage of labor who delivered by cesarean section had significantly higher TBARS levels (p = 0.043). Its concentration > 180.3 μmol/l increases the risk of cesarean section almost by 12 times (p = 0.003).Conclusion. The hormonal aspect of the pathogenesis of prolonged second stage of labor is characterized by higher concentrations of steroid hormones — estradiol and progesterone, as well as by a lower level of relaxin in plasma. The biochemical aspect of the pathogenesis is represented by an increased concentration of lipid peroxidation products, which can be identified with severe physical fatigue in childbirth. The detected changes can be applied in the complex diagnostics of prolonged second stage of labor.

Somatic dysfunctions in children of the first year of life: features of formation

Introduction. The health status of children of the first year of life is primarily affected by the course of pregnancy and childbirth, as well as hereditary factors. During the newborn period, reversible disorders may occur, which can be estimated as somatic dysfunction (SD). The formation of SD in young children has its own causes and features, which have not been studied in detail until now.The goal of research — is to study the features of the osteopathic status in children of the first year of life with different patterns of pregnancy and delivery methods for their mothers.Materials and methods. Since 2015, for 5 years, a prospective multicenter study has been conducted to investigate the osteopathic status of children of the first year of life under a single protocol in 6 cities of Russia, organized by the Institute of Osteopathy (St. Petersburg) and the Department of Osteopathy of Mechnikov North-West State Medical University. A total of 360 full-term infants aged 1 to 12 months with perinatal hypoxic-ischemic lesions of the central nervous system, and practically healthy ones were examined. All children underwent an osteopathic examination, and a detailed history of pregnancy and childbirth was collected. Based on the results of the obstetric history analysis the following groups were selected: physiological course of pregnancy, ending in physiological childbirth through the natural birth canal — 62 people; physiological course of pregnancy, ending with operative delivery — 25 people; physiological course of pregnancy, ending in complicated labor through the natural birth canal — 20 people; pregnancy with complications, ending in physiological childbirth through the natural birth canal — 104 people. Statistical processing of the obtained results was carried out by nonparametric methods using the Statistica 10.0 software.Results. In children born by physiological childbirth with complicated pregnancy, a smaller number of local SD (p=0,04) and a larger number of global SD were detected, but the difference with the subgroup of the pregnancy physiological course did not reach the statistical significance. In children whose mothers had a physiological course of pregnancy, but childbirth proceeded with complications and required the use of obstetric assistance, the significantly more number of regional SD were revealed (p<0,0001) compared with children born in physiological childbirth. The latter had a greater number of local SD of the craniosacral system (p=0,035). In children born by caesarean section and in children born through the natural birth canal without complications, the number of global, regional and local SD did not differ statistically significantly. Osteopathic examination of children in the first year of life showed that the first three places in the structure of dominant SD were occupied by SD of the neck, head, and dura mater.Conclusion. Based on the data obtained as a result of the study, it can be assumed the presence of numerous factors that can lead to the formation of various SD in children of the first year of life during pregnancy and especially during childbirth. It is necessary to further study the features of the osteopathic state in children in the postnatal period.

Influence of SARS-CoV-2 acute respiratory viral disease on pregnancy and childbirth

Acute Respiratory Viral Disease SARS - CoV2 - 19 is a new poorly understood disease with an unpredictable course. This article is devoted to the analysis of coronavirus disease and its impact on the condition of newborns.The objective: to identify and investigate the relationship between the detected and revealed SARS-CoV-2 disease and the course of pregnancy and childbirth, dependence on the term in which the diagnosis was established and the consequences of the disease on the course of pregnancy, childbirth and the condition of newborns; to investigate the frequency of detected complications during pregnancy and the peculiarities of the course of pregnancy with combined pathology.Materials and methods. We analyzed 57 stories of pregnancy and childbirth of women who were admitted to the Uzhgorod City Maternity Hospital in the period from May 2020 to January 2021 with a positive result of the SARS-CoV-2 PLR study.Results. Of 57 patients, pregnancy is ongoing in 18 women, and in 39 it has already ended. Of these, 17 (29.8%) women had vaginal physiological childbirth, 21 (36.8%) women had pathological course of labor, of which 16 (28%) patients underwent cesarean section. In general, 34 pregnant women (59.6%) were asymptomatic. A mild course of the disease was in 20 pregnant women (35%), and a severe course was in three patients (5.2%). As a result of 39 births, 41 children were born (two biochorial twins). Of these, 38 children were born alive (92.7%), stillborn - 4 (5.3%). 31 children were born on time (81.6%). The physiological course of the early neonatal period was observed in all full-term newborns. Perinatal loss was observed in three women at 23, 25 and 28 weeks.Conclusions. In children born of mothers with COVID-19, there was no increase in the frequency of the pathological course of the early neonatal period or detected signs of acute respiratory viral infection. It was also found that there is no clear correlation between the severity of the course of coronavirus infection and complications in pregnant women. So, with a relatively easy mile, even an asymptomatic course, threatening complications were observed, since premature detachment of a normally located placenta was evident, but there was no clear correlation between coronavirus, while with a moderate course of pregnancy, we observed a fairly good result of delivery. The sample of patients is very small and does not allow us to draw definitive conclusions about the effect of coronavirus on pregnancy and fetal health. But these data give us the basis for the next studies on the influence of the new SARS-CoV-2 virus on the course of the gestational process, childbirth and the condition of newborns.

Designing architecture of soothing labor–delivery–recovery–postpartum unit: a study protocol

Background The physical environment profoundly affects women's well-being during childbirth in family-centered unit. A LDRP, which is an acronym for labor, delivery, recovery, and postpartum that describes a maternity unit designed for family-centered care. This study aimed to design soothing LDRP healing architecture based on recognizing the emotional elements of Iranian women. Methods This study will be conducted in four consecutive phases; including review of literature to provide documentation based on architectural knowledge and the effects of each architectural component on the parturient psychological conditions, qualitative study to extract women's needs and suggestions for physiological childbirth, architectural designing of the soothing LDRP based on the results of the first and second phases and qualitative study for evaluation of the designed program. Discussion Designing soothing LDRP architecture based on safe child birth unit standards and favorable psychological environment will provide a positive childbirth experience for Iranian women and their family. But, the preferences and demands of families will be based on Iranian socio-cultural context, therefore the using of this design will be limited in other societies with different cultures.

F. Westemark. Experimentelle Untersuchungen über die Wehenthätigkeit des menschlichen Uterus bei der physiologischen Geburt. (Skandinavisches Arch. für Physiologie. 1893). The forced activity of the human uterus during physiological childbirth. Experimental research

Westermark's article is divided into five chapters with a historical introduction. In the last day, the works of Schatz [1]), Poullet [2]), Polaillon [3]), Acconci [4]), Dhnhoffа [5]). [1] Arch. f. Gynk. 1872. Bd. III, p. 58. [2] Archives de Tocologie. Fvrier 1880. [3] Arch. de Physiologie 1880, p. 1.