Experience in the use of cognitive psychocorrection of the emotional state of women with complicated pregnancy in the third trimester

In the article the data of experimentalpsychological investigation of pregnant women with complicated course of gestation are drawn to determine the peculiarities of their psychological status. One hundred pregnant women in the third trimesterwere examined, 64 of them demonstrated symptoms of late gestosis. The investigation revealed high level of both reactive and personal anxiety in women with complicated course of pregnancy. All the women of this group were subjected to supporting psychotherapy, which was directed to the decreasing psychological troubles. The basic aim of cognitive psychocorrection was to overcome different systemic presuppositions, to help the pregnant women to elaborate an alternative behavioral pattern and to change their attitude to themselves, to form the sense of self-confidence. The results received testify to the expediency of including psychotherapy (supporting and cognitive psychocorrection) into the complex of treatment.

Features of vascular-platelet and coagulation hemostasis in relation to parameters of macular blood fl ow in women with preeclampsia

Background. Recently, more and more attention has been paid to the development of vascular retinal disorders after suffering preeclampsia. It is noted that the key role in this process is assigned to the systemic endothelial dysfunction that persists for a long time after delivery.Aim: to elucidate the features of vascular-platelet and coagulation hemostasis in relation to the indicators of blood flow in the macular region in women with preeclampsia.Materials and methods. The main group included 45 women with preeclampsia in the third trimester of pregnancy (35–36 weeks). Their age ranged from 19 to 40 years (27 ± 5.2 years). The comparison group was represented by 20 women with physiological pregnancy in the third trimester (35–36 weeks). Their age averaged 26 ± 5.1 years (18–38 years). Somatically healthy non-pregnant women (20 people) were included in the control group. Their age ranged from 19 to 38 years (26 ± 5.4 years). A comparative analysis of the studied parameters of macular blood fl ow, vascular-platelet and coagulation hemostasis between the groups was carried out.Results. When studying the number of platelets in pregnant women, it turned out that in patients with preeclampsia, this indicator was statistically signifi cantly lower compared to the comparison and control groups (p < 0.05). The level of fi brinogen in women with complicated pregnancies was statistically significantly higher than in women with physiological pregnancy and in somatically healthy nonpregnant women (p < 0.05). In addition, retinal microcirculation disorders were observed in women of the main group.Conclusions. The revealed disorders of vascular-platelet and coagulation hemostasis in women during the period of complicated pregnancy were accompanied by disorders of macular blood fl ow in the form of a decrease in the total average density of vessels in the superfi cial vascular plexus, subfoveolar thickness of the choroid and an increase in the area of the avascular zone relative to the group of women with physiological pregnancy and somatically healthy nonpregnant women.

Pregnancy Complications Can Foreshadow Future Disease—Long-Term Outcomes of a Complicated Pregnancy

During gestation, the maternal body should increase its activity to fulfil the demands of the developing fetus as pregnancy progresses. Each maternal organ adapts in a unique manner and at a different time during pregnancy. In an organ or system that was already vulnerable before pregnancy, the burden of pregnancy can trigger overt clinical manifestations. After delivery, symptoms usually reside; however, in time, because of the age-related metabolic and pro-atherogenic changes, they reappear. Therefore, it is believed that pregnancy acts as a medical stress test for mothers. Pregnancy complications such as gestational hypertension, preeclampsia and gestational diabetes mellitus foreshadow cardiovascular disease and/or diabetes later in life. Affected women are encouraged to modify their lifestyle after birth by adjusting their diet and exercise habits. Blood pressure and plasmatic glucose level checking are recommended so that early therapeutic intervention can reduce long-term morbidity. Currently, the knowledge of the long-term consequences in women who have had pregnancy-related syndromes is still incomplete. A past obstetric history may, however, be useful in determining the risk of diseases later in life and allow timely intervention.

FEATURES OF PREGNANCY AND DELIVERY IN ADOLESCENT WOMEN

Aim: to assess the risk of adverse consequences of adolescent pregnancy for mother and foetus in women from Lviv region. Material and methods. Complications of pregnancy and childbirth in adolescent women were studied retrospectively at the Lviv Regional Clinical Hospital. Results and discussion. 134 cases of adolescent childbirths for 2013 to 2017 were analyzed. The analysis of data on the course of pregnancy in adolescent women showed that the vast majority of them had complicated pregnancy and were at risk of preterm childbirth. A significant proportion of young women, 78 (58.2%), significantly more often required the therapy during pregnancy. Assessment of the health status of newborns showed that ¼ (24.6%) of young women gave birth to premature babies, and almost 1/3 of children, 51 (38.0%), from young mothers had a complicated early neonatal period. Within the spectrum of complications, the commonest diagnosis was "prematurity" in 33 (24.6%) children from young mothers. The pathological course of the early neonatal period in 51 (38.0%) children of the main group required transfer to other departments for further treatment. 82 (61.2%) children from this group were discharged home, while in the control group all 100 (100.0%) children were discharged from maternity home. Conclusions. The study has demonstrated that the risk factors for perinatal pathology in newborns from adolescent women included probably complicated pregnancy, risk of spontaneous abortion (17.9%), preterm birth (24.6%), and the childbirth of premature infants with impaired condition at birth, who needed treatment in other medical institutions (38.0%). Adolescent pregnant women are at risk for obstetric and perinatal complications.

Risk factors for delayed speech development in children of early and preschool age

Speech is the most critical component of the neuropsychic development of a child. Over the past decade, an increase in the prevalence of delayed speech development (DSD) in children has been recorded worldwide. Timely diagnosis and correction of DSD at the early stages can lead to good results and minor violations of speech development in the future. Objective. To execute a comparative analysis of risk factors and the leading causes of the DSD development in children of early and preschool age in the Belgorod region from 2019 to 2021. Materials and methods. The analysis of 165 medical records of children examined and treated at the Belgorod Medical Center for the period from 2019 to 2021 was carried out. Results. DSD was found to be more common in children aged 1.5 to 3 years (79.5%), much less common in children over the age of 4 years (6.6%).DSD in boys (69.7%) occurs more than two times more common than girls (30.9%). The average age of mothers of DSD children ranged from 30 to 35 years. More than 50% of all DSD children are premature babies. All mothers of the examined patients had a complicated pregnancy and delivery in their history. Children living in the city (62.5%) had a 25% higher probability of DSD occurrence than children from rural areas (37.5%). According to the results of the study, lesions of the visual organs, residual and perinatal lesions of the central nervous system were the most common forms of pathology in DSD children. Conclusion. It is necessary to improve the early diagnosis and prevention of the DSD in children. Early detection of deviations in the child’s speech development will allow timely drug therapy and comprehensive systematic corrective work.

Mode of Delivery of Women with Complicated Pregnancy in a Tertiary Level Hospital in Bangladesh

Introduction: Every year, a great number of women die from pregnancy or childbirth related complications, which can be prevented. In developing countries, they don’t have access to maternal health services and cannot afford high quality care. Maternal death is usually occurs due to three delays: in decision making to seek care, reaching care and receiving care. Right decision at the right time regarding mode of delivery has a direct impact on healthy outcome of pregnancy as well as the maternal wellbeing. Objectives: To find out the outcome of complicated pregnancy. Materials and Methods: This cross-sectional observational study was conducted at obstetrics and gynaecology department of Dhaka Medical College Hospital from January to June 2011. Total 107 mothers who delivered recently with or without pregnancy complications were selected purposively. Data were collected by face to face interview with semi structured questionnaires. Verbal consents were taken prior to interview. Results: Among the respondents about 68.2% had antenatal complications and about 31.8% had no antenatal complication. Among the women having antenatal complications, 83.6% delivered by caesarean section and only 16.4% delivered by normal vaginal delivery. There was significant association of antenatal complications with mode of delivery by caesarean section. Conclusion: Women having antenatal complications had significant association with caesarean section. Though every pregnancy is at risk but early detection of complications, timely referral and timely intervention can save lives of many women during the process of child birth. JAFMC Bangladesh. Vol 16, No 2 (December) 2020: 31-34

Gestational diabetes triggers postpartum cardiac hypertrophy via activation of calcineurin/NFAT signaling

Population-based studies identified an association between a prior pregnancy complicated by gestational diabetes mellitus (GDM) and cardiac hypertrophy and dysfunction later in life. It is however unclear whether GDM initiates this phenotype and what are the underlying mechanisms. We addressed these questions by using female rats that express human amylin (HIP rats) as a GDM model and their wild-type (WT) littermates as the normal pregnancy model. Pregnant and two months postpartum HIP females had increased left-ventricular mass and wall thickness compared to non-pregnant HIP females, which indicates the presence of concentric hypertrophy. These parameters were unchanged in WT females during both pregnancy and postpartum periods. Hypertrophic Ca2+-dependent calcineurin/NFAT signaling was stimulated two months after giving birth in HIP females but not in the WT. In contrast, the CaMKII/HDAC hypertrophy pathway was active immediately after giving birth and returned to the baseline by two months postpartum in both WT and HIP females. Myocytes from two months postpartum HIP females exhibited slower Ca2+ transient relaxation and higher diastolic Ca2+ levels, which may explain calcineurin activation. No such effects occurred in the WT. These results suggest that a GDM-complicated pregnancy accelerates the development of pathological cardiac remodeling likely through activation of calcineurin/NFAT signaling.

The role of monoamines in the development of complicated pregnancy in chronic arterial hypertension

In the Russian Federation, the frequency of hypertensive disorders during gestation is 7-29%, while 80% of cases are chronic arterial hypertension. The mechanism of the complicated course of pregnancy in hypertensive disorders is not clear and is debatable. The article presents the features of the monoamine status in pre-pregnant women with chronic arterial hypertension.

Immunohistochemical features of the collagen’ formation in the uterus of fetuses with a gestational term of 21-28 weeks from mothers, whose pregnancy was complicated by preeclampsia of different stage of severity

In the following article we are going to provide the results of research on uterus’ structure in case of fetuses with a gestational term of 21-28 weeks from mothers, whose pregnancy was complicated by PE of different severity stage (15 cases) comparing to one in case of fetuses from mothers with a physiological pregnancy (15 cases). All fetuses have died intranatally as a result of an acute disorder in uterine-placental and uterine-fetal circulation. The research methods: macroscopic, organometric, histological, immunohistochemical, morphometric and statictical. By applying an organometric method we have revealed a probable decrease of indexes of weight, length and thickness of the uterine’ wall in case of fetuses from mothers with PE comparing to ones in case of fetuses from healthy mothers. The observative histological research had not revealed any significant changes in the strucutre of the organs’ wall in case of fetuses from the study groups. Thus, all organs were represented by mucous, muscular and serous membranes with a clear boundary between them. The comparative morphometric research had revealed the following features of the uterus’ wall structure in case of fetuses from mothers with PE. The indexes of thickness of all structural components of the organ’s wall were clearly decreased comparing to ones in case of fetuses from mothers with a physiological pregnancy. In the uterine endometrium of fetuses from mothers with PE of moderate stage of severity the features of proliferative (hormonal) activity are taking place, however, in the meanwhile, in case of organs of fetuses from mothers with PE of severe stage of severity we could notice a probable decrease of glands’ number as well as a lack of a proliferative activity in them (hypoplastic changes). By applying immunohistochemical method with using MCAT to CD 95 we have disclosed a probable increase of an apoptotic index in organs of fetuses from mothers with a complicated pregnancy towards one in case of fetuses from healthy mothers. Among the specific features of the uterine myometrium strucutre in case of fetuses from mothers with PE we could name the following ones: decrease of the vascular component percentage as well as increase growth of the connective tissue. Moreover, the structure of the connective tissue is represented mostly by the collagen of the III type, while, in case of organs of fetuses from healthy mothers the collagen of the I type prevails. In walls of the vessels of arterial type in case of uterus of fetuses from mothers with PE we could notice an increased glow of the collagen of the III type as well as a probable decrease of glow in case of collagen of the IV type. However, in case of organs’ vessels of fetuses from healthy mothers we could notice an increse of glow of the collagen of the IV type. There is a fact, which attracts an attention to it. Namely, all aforementioned changes in the uterine wall in case of fetuses from mothers with PE are minimally manifested, when the mild course of disease took place, and was maximally manifested in case of severe one. All changes in the uterus in case of fetuses from mothers with PE of different stage of severity, that were postulated above, could contribute to formation of glanduar hyperplasia, endometrial polyps, precancerous diseases as well as endometrial cancer in the subsequent ontogenesis, as well as it could lead to impaired pregnancy and infertility. All aforementioned changes in organs of fetuses from mothers, whose pregnancy was complicated by PE of different stage of severity, were connected with changes in the vascular bed of the mother-placenta-fetus system as well as with endocrine disorders, that take place in case of this pathology, in the organism of pregnant woman.