scholarly journals Placental dysfunction as a basic pathology of perinatal complications

2021 ◽  
pp. 107-112
Author(s):  
О.V. Kravchenko
Keyword(s):  
Pregnant Women ◽  
Genital Tract ◽  
Pregnancy Termination ◽  
Perinatal Complications ◽  
Placental Dysfunction ◽  
Group I ◽  
Genital Tract Infections ◽  
Group Ii ◽  
Tract Infections ◽  
Micronized Progesterone

Research aim was to study the features of perinatal complications depending on the nature and timing of therapy in pregnant women with primary placental dysfunction.Materials and methods. 82 pregnant women with verified placental dysfunction (chorionic hypoplasia at 12–13 weeks) against the background of the threat of pregnancy termination and genital tract infections were included. All examined were divided into 2 groups: group I consisted of 42 pregnant women who started treatment before 16 weeks of gestation, group II consisted of 40 pregnant women whose treatment was started after 16 weeks of gestation. Women in group I received micronized progesterone, venotonic Normoven, Magnicum and Artihol. Antibacterial sanitation was carried out before 16 weeks of gestation. Group II also received micronized progesterone only. Antibacterial sanitation in this group was carried out after 16 weeks of gestation.Research results. After antibiotic therapy in group I monoinfections value decreased from 26.8 to 9.5%, mixed infections value decreased from 56.1 to 20.7%, while in group II the effectiveness of antibacterial therapy after 16 weeks was significantly lower. Statistically significant differences in weight, volume and area of the placenta in patients of studied groups were obtained. Assessing perinatal complications showed that the frequency of gestosis, premature birth, intrauterine growth retardation and intrauterine infection of the fetus were almost 2 times less frequent in group I than in group II.Conclusions. Placental dysfunction, which developed in the first trimester against the background of the threat of pregnancy termination and genital tract infections, is the basic pathology for complications of the perinatal period. A timely prescribed set of medical supplies, including micronized progesterone, venotonic Normoven, Artihol and Magnicum, was as an effective method of preventing perinatal complications in pregnant women with primary placental dysfunction. Antibiotic therapy up to 16 weeks of gestation does not fully prevent the development of perinatal complications, but it can significantly reduce the level of severe gestational pathology.

Effectiveness of pregravid preparation in women of high infectious risk

2018 ◽  
pp. 31-35
Author(s):  
T.G. Romanenko ◽  
◽  
O.M. Sulimenko ◽  
Keyword(s):  
High Risk ◽  
Bacterial Vaginosis ◽  
Pregnant Women ◽  
Risk Group ◽  
Intrauterine Infection ◽  
Vaginal Candidiasis ◽  
Placental Dysfunction ◽  
Infectious Risk ◽  
Group I ◽  
Group Ii

The article presents the results of the effectiveness of the combined antimicrobial drug Guinex Forte, the effect of which is caused by metronidazole and miconazole, and the Orgil tablets at the stage of pregravid preparation in women of high-risk group, with regard to the development of placental insufficiency of infectious genesis and intrauterine infection. The objective: is to demonstrate the effectiveness of pregravid preparation for the normalization of vaginal biocenosis in pregnant women of high infectious risk. Materials and methods. 150 pregnant women were investigated, of which 100 with a high risk of infectious risk for placental dysfunction and intrauterine infection: Group I – 50 pregnant women who did not undergo pregravid preparation; Group II – 50 pregnant women who planned pregnancy and conducted pregravid preparation for prevention and treatment of bacterial vaginosis and vaginal candidiasis; Control group consisted of 50 pregnant women who gave birth again, without obstetrical and extragenital pathology in history. per vaginum. Results. In pregnant women in Group II, an intermediate type of dysbiosis was 1.2 times less likely than in pregnant women of group I, and vice versa, normocenosis was achieved 9.7 times more often in pregnant women who received pregravid preparation. After the therapy in the pregravid period, in pregnant women of group II in the first trimester of pregnancy quantitative and qualitative indices of biocenosis of the vagina were approaching, in most cases, to normal. In general, the spectrum of the microflora decreased from 21 to 14 species due to the reduction of pathogenic forms of staphylococci, streptococci, enterobacteria, E. coli, klebsiela, cornebacteria and clostridia. In patients of group II, the concentration of representatives of resident flora increased (lactobacillus Lg 5.06±0.7 CFU / ml and bifidobacterium-Lg 4.4±0.6 CFU / ml) and close to normal. Conclusion. Our proposed scheme of therapy and prevention of dysbiotic conditions in the pregravid period, in women of high infectious risk group led to a decrease in bacterial contamination of maternity paths of pregnant women in group II, which contributes to the restoration of vaginal microbiocenosis and positively affects the course of pregnancy, the condition of the fetus and the newborn. Key words: pregravid preparation, bacterial vaginosis, vulvovaginal candidiasis, placental dysfunction of infectious genesis, intrauterine infection.

scholarly journals Use of Noninvasive Cerclage in Combination of Micronized Progesterone in Miscarriage Of Multifetal Pregnancy

2017 ◽  
Vol 24 (4) ◽  
Author(s):  
Iryna Nikitina ◽  
Alla Boychuk ◽  
Valentina Kondratiuk ◽  
Tatyana Babar
Keyword(s):  
High Risk ◽  
Pregnant Women ◽  
The State ◽  
Control Group ◽  
Group I ◽  
Prophylactic Measures ◽  
Neonatal Adaptation ◽  
Group Ii ◽  
Multifetal Pregnancy ◽  
Micronized Progesterone

We represent the results of the combined method of treatment and prevention of miscarriage in women with a multiple pregnancy and a high risk of the threat of termination the pregnancy because of using the obstetric unloading pessaries, combined with micronized progesterone. The efficiency of this method of treatment is evidenced by the rapid elimination of clinical symptoms of threatened abortion, accelerating the regression of ultrasound markers, reducing the number of complications in of pregnant women and reducing the time of their stay in hospital.Goal: To evaluate the effectiveness of the handling the obstetric pessary in combination with micronized progesterone at women with multifetal pregnancy and a high risk of miscarriage.Materials and methods. We analyzed 120 cases of multifetal pregnancies with signs of miscarriage within the terms from 16 to 28 weeks. The first group of the examined women was: 40 pregnant women with twins and signs of miscarriage, who in the scheme of treatment and prophylactic measures were offered to use the unloading obstetric pessaries in combination with continuous therapy by natural micronized progesterone until 36 weeks of pregnancy. The second group included 40 pregnant women with twins, who were laid seam on the cervix because of istmicocervical insufficiency and were applied short-term courses of therapy by gestagens. The control group comprised 40 pregnant women with twins at the age of 16-28 weeks of pregnancy who were conducted the therapy about the threat of miscarriage according to the current clinical protocols (Order of the Ministry of Health of Ukraine No. 624). It was carried out the analysis of the course of pregnancy, childbirth, the postpartum period and the state of neonatal adaptation in the surveyed groups.Results of the research and their discussion. In the first group, urgent childbirth occurred in 34 (85%) cases, in group II in 29 (72.5%) cases, in control group – in 25 (62.5%) cases. Cesarean delivery was performed in 7 (17.5%) patients of group I pregnant women, in 9 (22.5%) of group II patients and in 11 (27.5%) in the pregnant group. When studying the state of neonatal adaptation of newborns in the examined groups, the following results were obtained. The average weight of the newborns in group I was 3245 ±280 g, in group II 2865 ±365 g, in the control group - 2975 ±325 g (p>0.05). The evaluation of the state of newborns on the Apgar scale, respectively at the 1st and 5th minutes, was respectively: in newborns of the I group, 7.5 ± 1.4 and 8.4 ± 1.3 points, in group II - 7.3 ± 1.6 and 8.2 ± 1.1 points, in the control group – 7.2 ± 1.6 and 8.6 ± 1.2 (р 1-р 2> 0.05).Conclusions. Comprehensive prophylaxis of non-pregnancy in multiple pregnancies, combining the use of a traumatic cardiac cervix with the help of unloading obstetric pussies with progesterone preparations, allows prolonging pregnancy, preventing the development of prematurity, contributes to the improvement of perinatal indicators.

scholarly journals Characteristics of early pregnancy and prevention of gestational and perinatal complications in women with metabolic syndrome

2017 ◽  
Vol 14 (4) ◽  
pp. 57-66
Author(s):  
Igor' S. Lipatov ◽  
Yurii V. Tezikov ◽  
Andrei D. Protasov ◽  
Nadezhda V. Martynova ◽  
Anna A. Bukreeva ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Pregnant Women ◽  
Early Pregnancy ◽  
Perinatal Outcomes ◽  
Preventive Treatment ◽  
Number Needed To Treat ◽  
Perinatal Complications ◽  
Group Iii ◽  
Placental Dysfunction ◽  
Group I

Introduction. Based on the knowledge of early gestational disorders related to metabolic syndrome (MS), pathogenetically relevant preventive treatment meeting the requirements of perinatal pharmacology can be developed. Aim. To reveal clinical and laboratory characteristics of early pregnancy and develop pathogenetically relevant preventive monotherapy for unfavorable gestational and perinatal outcomes in women with metabolic syndrome. Material and methods. A total of 230 women were investigated and divided into four groups: Group I consisted of 68 pregnant women with MS who refused any preventive measures; Group II comprised 97 women with MS who received periconceptional preventive monotherapy with dydrogesterone, a progestagen; Group III consisted of 35 healthy primigravidas women with physiological course of gestation; Group IV comprised 30 healthy non-pregnant women. Laboratory testing during IIII trimesters allowed to assess the dynamics demonstrated by markers of lipid spectrum, endothelial dysfunction, apoptosis, decidualization, energy metabolism, and immunomodulation. Results. A balance between factors of physiological damage and gestational adaptation in the course of physiological pregnancy has been shown to be of primary significance. In women with MS, embryo-placental dysfunction develops during early pregnancy, and this stage is preceding for major obstetric syndromes. Preventive administration of dydrogesterone in women with MS appeared highly effective: NNT (number needed to treat) was 1.33 (95% CI 0.91.8); OR 5.2 (95% CI 4.65.7). Conclusion. Pregestational changes and atherogenic profile of gestational process determine the course of early pregnancy in women with MS with the development of embryo-placental dysfunction and major obstetric syndromes. High efficacy in the prevention of unfavorable gestational and perinatal outcomes was shown by preventive dydrogesterone monotherapy.

scholarly journals Algorithm for the diagnosis and treatment of primary placental dysfunction in pregnant women of risk groups

2021 ◽  
pp. 33-38
Author(s):  
O.V. Kravchenko
Keyword(s):  
Blood Flow ◽  
Pregnant Women ◽  
Risk Groups ◽  
The State ◽  
Uterine Arteries ◽  
Placental Dysfunction ◽  
Early Stages ◽  
Tract Infections ◽  
Complex Drug ◽  
Micronized Progesterone

Research objective: to evaluate the effectiveness of diagnosis and complex therapy of placental dysfunction (PD) in early stages of gestation.Materials and methods. We examined 110 pregnant women with risk for the primary PD. Exclusion criteria were multiple pregnancies, anomalies of fetal development and internal genital organs of the mother, pregnancy resulting from assisted reproductive technologies.The diagnosis of PD was established in 56 women (group I) based on the assessing the state of extraembryonic structures and blood flow in the spiral and uterine arteries at 12–13 weeks of gestation. The rest of the patients (54 women) entered the control group without PD (group II).Results. All pregnant women with verified PD at 12–13 weeks were prescribed complex drug treatment, which included micronized progesterone, venotonic Normoven, Magnicum, and Artihol. As a result of treatment, already at 22–24 weeks of gestation, the average value of blood flow (resistance index) in the uterine and spiral arteries did not differ significantly in the groups. There was no significant difference in fetometry and placentometry indices at 35–36 weeks of gestation. Complications of the gestational period in patients in the study groups were also almost the same.Conclusions. History of hormonal disorders and miscarriage, clinical signs of miscarriage in early gestation, abnormal embryo placement, extragenital pathology, and genital tract infections are risk factors for PD. Determination of the state of extraembryonic structures at 7–8 weeks of pregnancy (ovum volume, blood flow in the corpus luteum) and at 12–13 weeks (chorion volume, vascularization index, blood flow in the spiral and uterine arteries) can serve as a verification criterion for the PD development. Complex drug therapy, which began from the early stages of gestation (micronized progesterone, Normoven, Magnicum, Artihol) has established itself as an effective method of treating primary PD in pregnant of risk groups.

scholarly journals Features of delivery tactics in pregnant women with placental dysfunction and taking into account the concentration of vitamin D

2020 ◽  
Vol 17 (1) ◽  
pp. 70-77
Author(s):  
G. S. Manasova ◽  
N. V. Didenkul ◽  
N. V. Shapoval ◽  
N. V. Kuzmin ◽  
K. V. Korotkaya
Keyword(s):  
Vitamin D ◽  
Pregnant Women ◽  
Caesarean Section Rate ◽  
Control Group ◽  
Compensatory Mechanisms ◽  
Placental Dysfunction ◽  
Group I ◽  
High Prevalence ◽  
Group Ii ◽  
Abdominal Delivery

The high prevalence of the vitamin D (VD) deficiency states (VDDS) among adults, as well as the data on the pleiotropic effects of calcitriol suggests its participation in the development of various complications and pregnancy outcomes. The objective of the present study is to analyze the pregnancy course and delivery tactics of pregnant women with placental dysfunction (PD) depending on the calcitriol availability. We examined 56 patients with PD (I – main group) and 40 conditionally healthy women with physiological pregnancy (II – control group). In addition to the standard clinical and laboratory examination, the level of vitamin D in the blood was determined by ELISA. The statistical analysis used the software Biostat, Statistica 6.0. In 76.8 % of group I women, the VD content corresponded to the deficit (38.4 %) and to the suboptimal status (38.4 %), (RR = 3.0; 95 % CI 2.39–3.76). In group II, VDDS was not detected and the suboptimal status was diagnosed in 31.45 %. The average VD level in group I was significantly lower than that in group II (31.4 ± 8.6 ng/ml vs 43.54 ± 11.2 ng/ml; Uemp = 42.5; p < 0.05). The caesarean section rate in group I was 3.4 times higher than that in group II (42.85 % vs 12.5 %; F = 0.00001; p < 0.01). The weight of newborns in group II significantly exceeded the weight of children in group I (3643.24 ± 136 g vs 3299.11 ± 128 g; t = 4.17; p < 0.01); a strong direct correlation was found between the weight of the newborn and the VD level in the blood of pregnant women (r = 0.71). VDDS increases 2 times the risk of abdominal delivery (RR = 1.27; 95 % CI 0.95–1.66). The VD status of a pregnant woman can have a certain influence on the formation of optimal adaptive-compensatory mechanisms in the utero-placental-fetal system and on the pregnancy outcome for mother and fetus.

Clinical efficacy of prevention of obstetric and perinatal complications in pregnant women with primary hypertension against the background of iodine deficiency

2018 ◽  
pp. 99
Author(s):  
N.I. Mushak ◽  
Keyword(s):  
Pregnant Women ◽  
Iodine Deficiency ◽  
Preterm Labor ◽  
Preventive Measures ◽  
Primary Hypertension ◽  
Control Group ◽  
Perinatal Complications ◽  
Group I ◽  
Objective Reduction ◽  
Group Ii

The objective: reduction in the incidence of obstetric and perinatal complications in pregnant women with primary hypertension in conditions of endemic iodine deficiency based on the study of pregnancy and childbirth course, fetal and newborn conditions after the introduction of the developed complex of preventive and therapeutic measures. Materials and methods. A clinical analysis of 100 pregnant women has been conducted: – control group (KG) – 30 healthy pregnant women living in conditions of endemic iodine deficiency, give birth to the first time, without somatic pathology, had vaginal delivery; – And the group – 30 pregnant women with primary hypertension, who live in conditions of endemic iodine deficiency and received the usual medical and preventive measures; – II group – 40 pregnant women with primary hypertension who live in conditions of endemic iodine deficiency and received the method of prevention of obstetric and perinatal complications developed by us. Clinical and statistical analysis of the course of pregnancy, childbirth and condition of the fetus and the newborn after the introduction of the developed complex of treatment and preventive measures has been carried out. The obtained data are processed by the statistical method using the Microsoft Excel computer program. Results. Due to the use of proposed by us method, we managed to reliably reduce the frequency of gestational anemia (I group – 43.3% vs. 22.5% in group II, p<0.05), development of gestational diabetes (I group – 13.3% vs. 5.0% in the 2nd group, p<0.05), the threat of preterm labor (I group – 16.6% vs. 7.5% in the second group, p<0.05), placental dysfunction (group I – 63.3% vs. 22.5% in the second group, p<0.05); violation of microbiocenosis of the genital tract (group I – 53.3% vs. 17.5% in group ІІ, p<0.05). In addition, a significant reduction in the level of combined preeclampsia (group I – 40.0% vs. 20.0% in group II, p<0.05) and change in the incidence of FGR syndrome (group I – 40.0% vs. 22.5% in the second group, p <0.05). Significant decline in the incidence of developmental delivery complications: premature rupture of fetal membranes (I group – 26.7% vs. 15.0% in group II, p<0.05); preterm labor (group I – 13.3% vs. 5.0% in group II, p<0.05); Fetal distress (group I – 36.6% versus 15.0% in group II, p<0.05). It should be noted that the absence of PDNLP in pregnant group II versus 6.7% incidence of pregnant in group I. Reduction in the level of various forms of newborn asphyxiation: from 26.7% in group I to 15.0% in group II, p<0.05 against the background of the use of the proposed method, severe asphyxia was absent in newborns from pregnancy group II versus 3.3% cases in group І. The total incidence of newborns in the early neonatal period has significantly decreased by 1.7 times (60.0% in group I versus 35.0% in group II, p<0.05). There is no perinatal loss in group II, which also confirms the effectiveness of our proposed method. Conclusions. The proposed therapeutic and prophylactic technique for the prevention of obstetric and perinatal complications in pregnant women with primary hypertension in the background of natural iodine deficiency has made it possible to reliably reduce the frequency of obstetric and perinatal complications. This makes it possible for the proposed method to be recommended for use in therapeutic practice. Key words: course of pregnancy, childbirth, condition of newborn, obstetric and perinatal complications, primary arterial hypertension, iodine deficiency.

scholarly journals Prevalence study of genital tract infections in pregnant women referred to health centers in Iran

2014 ◽  
Vol 44 ◽  
pp. 232-236 ◽  
Author(s):  
Mahmoud MOBASHERI ◽  
Narges SAEEDI VARNAMKHAST ◽  
Ali KARIMI ◽  
Shayesteh BANAEIYAN
Keyword(s):  
Pregnant Women ◽  
Genital Tract ◽  
Health Centers ◽  
Prevalence Study ◽  
Genital Tract Infections ◽  
Tract Infections

Genital tract infections in HIV‐infected pregnant women in South West London

2020 ◽  
pp. 095646241989983
Author(s):  
A Hegazi ◽  
N Ramskill ◽  
M Norbrook ◽  
T Morgan ◽  
E Dwyer ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Genital Tract ◽  
Male Partner ◽  
Sub Saharan Africa ◽  
Vaginal Candidiasis ◽  
Obstetric Outcomes ◽  
Transmitted Infection ◽  
Genital Tract Infections ◽  
Tract Infections ◽  
In Pregnancy

There are minimal UK data on the prevalence of genital tract infections in HIV‐infected pregnant women. British HIV Association guidelines suggest sexually transmitted infection (STI) screening as early as possible in pregnancy with consideration given to repeat at 28 weeks’ gestation. A retrospective case notes review of HIV-infected pregnant women at four South London HIV Centres (1 January 2004–1 January 2014) was carried out. Five hundred and ninety-eight pregnancies in 384 patients were identified. Median age 32 years (interquartile range [IQR] 27–36) and 96% (n = 346) were heterosexually infected. HIV was diagnosed antenatally in 21% of pregnancies (n = 107). Seventy-seven per cent of women (n = 384) were of Black African ethnicity and 75% were born in sub-Saharan Africa with 14% UK-born. The majority of pregnancies (279/507) were reported to be unplanned with 42 women proceeding to termination of pregnancy. A regular male partner was reported in 95% of pregnancies (n = 539) with median relationship duration (n = 347) of four years (IQR 1.5–7.0); 11/324 (3.4%) women reported additional sexual partners during the pregnancy. 76.6% (n = 427) of women had an initial STI screen which was done in the first trimester in 52.1%; 32.1% of women had a repeat STI screen in pregnancy, 96% of which was done in the third trimester. Overall, 61 (14.3%) women were diagnosed with at least one STI during their pregnancy. Vaginal candidiasis and bacterial vaginosis were diagnosed in 27.6% (n = 100) and 21.7% (n = 73) of pregnancies, respectively. STI prevalence was low and obstetric outcomes favourable in this cohort of women. Further information about STI prevalence in this population may impact future screening guidelines.

scholarly journals Diagnosis of Genital Tract Infections in Pregnant Women With Pulmonary Tuberculosis

2014 ◽  
Vol 18 (1 (69)) ◽  
Author(s):  
V. V. Harbuziuk ◽  
S. P. Poliova
Keyword(s):  
Pulmonary Tuberculosis ◽  
Pregnant Women ◽  
Genital Tract ◽  
Premature Delivery ◽  
Effective Prevention ◽  
Qualitative And Quantitative ◽  
Vaginal Microflora ◽  
Genital Tract Infections ◽  
Quantitative Changes ◽  
Tract Infections

The article presents data on the diagnosis of genital tract infections in patients with pulmonary tuberculosis, whose pregnancy ended in premature delivery. It is shown that in this contingent of pregnant women, vaginal microflora undergoes qualitative and quantitative changes, early detection of which contributes to the effective prevention of a preterm birth. 

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