POSTTRAUMATIC SYNDROME DURING PREGNANCY: EXPECTATIONS AND REALITY

I. Zhabchenko, S. Tertychnaya-Telyuk
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Abstract

Aim of the research is to study identification of peculiar issues associated with psycho-emotional state and the related stress-associated hormones and micronutrients in pregnant-displace individuals for further improvement of programmes for antenatal research. Materials and methods. In order to reach the research objective, a dynamic prospective clinical-paraclinical examination of 96 pregnant women (experimental group) – temporary displaced individuals with gestation period of more than 22 weeks who have been treated and gave birth to their children in the Central Municipal Hospital in Rubizhne and Perinatal Centre in Severodonetsk, Lugansk region. The control group consists of 39 randomly selected pregnant women for the purposes of prospective research that are living in the areas under the control of Ukraine government. All pregnant women were examined (clinical-laboratory and special midwifery examinations), the evaluation of psycho-emotional state of examined pregnant women was conducted with the help of screening by performing clinical interviews together with routine questioning. The questionnaires that contained the questions of Spielberg’s tests in the modification of Khanin were composed in advance. Concentration of stress-associated hormones in the blood serum, Ca and Mg was identified using the method of solid-phase immuno-ferment analysis. Results. According to the Spielberg’s test, the average score of reactive anxiety in the experimental group exceeded the analogous indicator in the control group by 1.6 times. The indicators of personal anxiety exceeded the normal indicator in the control group by 2.2 times. Of the pregnant women in the experimental group had the concentration of cortisol in the blood serum exceeded the upper physiological standard by 5.5 % and exceeded the analogous indicator in the control group by 43.4 %. The increase concentration of prolactin was yet observed in the II trimester of pregnancy if compared to the upper level of physiological standard by 13.3 %; if compared to the average indicator of this hormone in the control group - by 20.3 %. In the III trimester - concentration in both groups was within normal ranges, but in the experimental group this indicator was higher by 10.5 %. In the experimental group of pregnant women the concentration of Ca in the blood serum in comparison to the physiological standard was higher by 19.2 % and by 9.6 % higher if compared to the analogous indicator in the control group of pregnant women. At the same time, the pregnant women in the experimental group have low concentration of Mg. Conclusions. Taking into account the identified patterns, it is useful to categorise the pregnant women from among the internally displaced individuals as the group of high risk with respect to the development of obstetric and perinatal complications.
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怀孕期间的创伤后综合症:期望和现实
这项研究的目的是研究确定与怀孕流离失所者的心理情绪状态有关的特殊问题以及与压力有关的激素和微量营养素,以进一步改进产前研究方案。材料和方法。为了达到研究目标,对96名怀孕妇女(实验组)进行了动态的前瞻性临床-临床旁检查,这些妇女是妊娠期超过22周的临时流离失所者,她们在鲁比日涅市中央医院和卢甘斯克州北罗顿涅茨克围产期中心接受治疗并分娩。对照组由39名随机选择的孕妇组成,这些孕妇生活在乌克兰政府控制下的地区,用于前瞻性研究。对所有孕妇进行检查(临床-实验室检查和特殊助产检查),通过临床访谈和常规询问相结合的方式对检查孕妇的心理-情绪状态进行评估。问卷中包含了斯皮尔伯格在修改《可汗》中所做的测试的问题。采用固相免疫发酵法测定血清中应激相关激素、钙、镁的浓度。结果。根据斯皮尔伯格的测试,实验组的反应性焦虑平均得分比对照组的类似指标高出1.6倍。对照组的个人焦虑指标是正常指标的2.2倍。实验组孕妇血清皮质醇浓度超过生理上标准5.5%,超过对照组类似指标43.4%。妊娠中期催乳素浓度较生理标准上水平升高13.3%;如果与对照组中这种激素的平均指标相比-降低了20.3%。在妊娠晚期,两组浓度均在正常范围内,但实验组该指标高出10.5%。实验组孕妇的血钙浓度比生理标准高19.2%,比对照组孕妇的类似指标高9.6%。同时,实验组孕妇Mg浓度较低。结论。考虑到已确定的模式,将国内流离失所者中的孕妇归类为产科和围产期并发症发展的高风险群体是有用的。
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