BACKGROUND: Early reproductive loss is a complex problem, the solution of which requires a systematic approach to the study of the morphogenesis of gravid transformation. Violations of the morphofunctional characteristics of the endometrium are associated with chronic endometritis, which entails implantation pathology and the development of pregnancy, while formulating indications for the use of IVF methods. Chronic endometritis disrupts the differentiation of stromal cells and intermediate filaments with subsequent pathology of decidualization and gravid transformation. AIM: The aim of this study was to evaluate vimentin expression in decidual cells of the gravid endometrium in an undeveloped first-trimester pregnancy after IVF, depending on its transformation in patients with chronic endometritis. MATERIALS AND METHODS: Histological and immunohistochemical studies were performed on 40 samples of abortion material with normal chorionic villi karyotype from a non-developing pregnancy after IVF in patients with chronic endometritis and 15 samples of abortion material from a progressive pregnancy, surgically terminated at the woman’s request at similar terms. Two groups were formed — I group with a full-fledged gravid transformation in a non-developing pregnancy after IVF (n = 20) and II group with an incomplete gravid transformation in a non-developing pregnancy after IVF (n = 20). Histological examination was performed according to the standard procedure. Immunohistochemical study was performed using a one-step protocol with antigen unmasking. Primary monoclonal antibodies to vimentin (Clon V9, Diagnostic BioSystems Inc., Spain) were used at a 1 : 1000 dilution. Vimentin expression was evaluated in the compact layer of the gravid endometrium. RESULTS: A full-fledged gravid transformation of the endometrial stroma in the abortion material in study group I and the control group was represented by mature deciduocytes of the epithelioid type, round or polygonal in shape, with a light vesicular nucleus. With an incomplete gravid transformation, the compact layer of the gravid endometrium was represented by fibroblasts with varying degrees of cytoplasmic development, from mild changes to the formation of pre-decidual and immature decidual cells. A decrease in vimentin expression was verified in the gravid endometrium after IVF compared to the control group. In case of an incomplete gravid transformation, a decrease in vimentin expression was also verified compared to the control group and study group I. CONCLUSIONS: The presence of chronic endometritis in patients with infertility and chronic endometritis not only causes pathology of the original endometrium, but also disrupts decidualization, leading to reproductive loss with normal embryo karyotype.
背景：早期生殖损失是一个复杂的问题，要解决这个问题，就必须系统地研究妊娠转化的形态发生。子宫内膜形态功能特征的破坏与慢性子宫内膜炎有关，慢性子宫内膜炎会导致着床病理和妊娠的发生，同时也是体外受精方法的适应症。慢性子宫内膜炎会破坏基质细胞和中间丝的分化，进而导致蜕膜化和葡萄胎。目的：本研究旨在根据慢性子宫内膜炎患者的转化情况，评估试管婴儿后未发育的头胎妊娠子宫内膜蜕膜细胞中的波形蛋白表达情况。材料与方法：对慢性子宫内膜炎患者体外受精后未发育妊娠的 40 份绒毛核型正常的流产材料样本和 15 份进展期妊娠的流产材料样本进行了组织学和免疫组化研究。实验分为两组--I 组为体外受精后未发育妊娠中的完全葡萄胎（20 人），II 组为体外受精后未发育妊娠中的不完全葡萄胎（20 人）。组织学检查按照标准程序进行。免疫组化研究采用抗原解蔽一步法。波形蛋白单克隆抗体（Clon V9，西班牙 Diagnostic BioSystems 公司）的稀释度为 1:1000。对妊娠子宫内膜紧密层中的波形蛋白表达进行评估。结果：在研究组 I 和对照组的流产材料中，子宫内膜基质的完全妊娠转化表现为成熟的上皮样蜕膜细胞，呈圆形或多角形，核呈浅泡状。在妊娠转化不完全的情况下，妊娠子宫内膜的致密层以成纤维细胞为代表，其细胞质发育程度不一，从轻度变化到形成蜕膜前细胞和未成熟蜕膜细胞。与对照组相比，体外受精后妊娠子宫内膜中的波形蛋白表达量减少。与对照组和研究 I 组相比，在不完全妊娠转化的情况下，也证实了波形蛋白表达的下降：不孕症和慢性子宫内膜炎患者存在慢性子宫内膜炎，不仅会导致原子宫内膜病变，还会破坏蜕膜化，导致胚胎核型正常的生殖损失。
{"title":"Role of vimentin in the morphogenesis of endometrial decidualization during pregnancy with IVF methods","authors":"Tat'yna G. Tral', G. Tolibova","doi":"10.17816/jowd630372","DOIUrl":"https://doi.org/10.17816/jowd630372","url":null,"abstract":"BACKGROUND: Early reproductive loss is a complex problem, the solution of which requires a systematic approach to the study of the morphogenesis of gravid transformation. Violations of the morphofunctional characteristics of the endometrium are associated with chronic endometritis, which entails implantation pathology and the development of pregnancy, while formulating indications for the use of IVF methods. Chronic endometritis disrupts the differentiation of stromal cells and intermediate filaments with subsequent pathology of decidualization and gravid transformation. \u0000AIM: The aim of this study was to evaluate vimentin expression in decidual cells of the gravid endometrium in an undeveloped first-trimester pregnancy after IVF, depending on its transformation in patients with chronic endometritis. \u0000MATERIALS AND METHODS: Histological and immunohistochemical studies were performed on 40 samples of abortion material with normal chorionic villi karyotype from a non-developing pregnancy after IVF in patients with chronic endometritis and 15 samples of abortion material from a progressive pregnancy, surgically terminated at the woman’s request at similar terms. Two groups were formed — I group with a full-fledged gravid transformation in a non-developing pregnancy after IVF (n = 20) and II group with an incomplete gravid transformation in a non-developing pregnancy after IVF (n = 20). Histological examination was performed according to the standard procedure. Immunohistochemical study was performed using a one-step protocol with antigen unmasking. Primary monoclonal antibodies to vimentin (Clon V9, Diagnostic BioSystems Inc., Spain) were used at a 1 : 1000 dilution. Vimentin expression was evaluated in the compact layer of the gravid endometrium. \u0000RESULTS: A full-fledged gravid transformation of the endometrial stroma in the abortion material in study group I and the control group was represented by mature deciduocytes of the epithelioid type, round or polygonal in shape, with a light vesicular nucleus. With an incomplete gravid transformation, the compact layer of the gravid endometrium was represented by fibroblasts with varying degrees of cytoplasmic development, from mild changes to the formation of pre-decidual and immature decidual cells. A decrease in vimentin expression was verified in the gravid endometrium after IVF compared to the control group. In case of an incomplete gravid transformation, a decrease in vimentin expression was also verified compared to the control group and study group I. \u0000CONCLUSIONS: The presence of chronic endometritis in patients with infertility and chronic endometritis not only causes pathology of the original endometrium, but also disrupts decidualization, leading to reproductive loss with normal embryo karyotype.","PeriodicalId":16623,"journal":{"name":"Journal of obstetrics and women's diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141829874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUND: Despite the availability of visual examination of the cervix, cervical screening in Russia has not been widespread enough, and therefore the incidence of cervical cancer remains consistently high. In recent years, the vaginal microbiota is given special attention as a risk factor for the development of precancerous diseases of the cervix. AIM: The aim of this study was to compare the cervicovaginal microbiota in patients with high-grade squamous intraepithelial lesions (HSIL) or negative for intraepithelial lesions or malignancy (NILM). MATERIALS AND METHODS: Microorganisms isolated from the cervicovaginal microbiota were identified in 40 patients using the mass spectrometry method. 20 women had severe cervical dysplasia, and the other 20 were healthy women without precancerous cervical lesions. RESULTS: Corynebacterium spp. and Streptococcus spp. were found more often in the cervicovaginal microbiome in patients with high-grade squamous intraepithelial lesions than in women negative for intraepithelial lesions or malignancy. CONCLUSIONS: The data obtained suggest that the presence of Corynebacterium spp. and Streptococcus spp. in the cervicovaginal microbiota is associated with the presence of severe cervical intraepithelial changes.
{"title":"The role of cervicovaginal microbiota in the occurrence of severe cervical intraepithelial dysplasia","authors":"A. Kazakova, Svetlana M. Chechko, Evgeny F. Kira","doi":"10.17816/jowd624931","DOIUrl":"https://doi.org/10.17816/jowd624931","url":null,"abstract":"BACKGROUND: Despite the availability of visual examination of the cervix, cervical screening in Russia has not been widespread enough, and therefore the incidence of cervical cancer remains consistently high. In recent years, the vaginal microbiota is given special attention as a risk factor for the development of precancerous diseases of the cervix. \u0000AIM: The aim of this study was to compare the cervicovaginal microbiota in patients with high-grade squamous intraepithelial lesions (HSIL) or negative for intraepithelial lesions or malignancy (NILM). \u0000MATERIALS AND METHODS: Microorganisms isolated from the cervicovaginal microbiota were identified in 40 patients using the mass spectrometry method. 20 women had severe cervical dysplasia, and the other 20 were healthy women without precancerous cervical lesions. \u0000RESULTS: Corynebacterium spp. and Streptococcus spp. were found more often in the cervicovaginal microbiome in patients with high-grade squamous intraepithelial lesions than in women negative for intraepithelial lesions or malignancy. \u0000CONCLUSIONS: The data obtained suggest that the presence of Corynebacterium spp. and Streptococcus spp. in the cervicovaginal microbiota is associated with the presence of severe cervical intraepithelial changes.","PeriodicalId":16623,"journal":{"name":"Journal of obstetrics and women's diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141828048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
O. V. Ryazanova, V. I. Shadenkov, R. Kapustin, I. Kogan
BACKGROUND: Women with gestational diabetes mellitus are at high risk of operative delivery. Meanwhile, hyperglycemia affects the metabolism of narcotic analgesics, while increasing their need. Thus, the anesthesiologist is faced with the question of what method of anesthesia to choose for a particular cesarean section. AIM: The aim of this study was to estimate the features of the perioperative period of cesarean section in patients with gestational diabetes mellitus. MATERIALS AND METHODS: This prospective, controlled, single-center study enrolled 101 patients who were delivered by planned cesarean sections from April to November 2023. Group 1 included patients with gestational diabetes mellitus on diet therapy (n = 28), group 2 comprised patients with gestational diabetes mellitus on insulin therapy (n = 29), and group 3 (control) included women with a normal pregnancy without carbohydrate metabolism disturbances (n = 44). RESULTS: The highest initial values of mean arterial pressure were in group 2 and amounted to 91.8 ± 7.0 mmHg. In group 1, the mean arterial pressure was within 89.1 ± 6.4 mmHg, and in group 3, that was 85.9 ± 9.1 mmHg, which was significant (p 0.05). The sympathetic block developed longer in patients of group 2. In group 1, the sensory block was recorded at the ThIV–ThV level after 10.1 minutes and the motor block (Bromage score 3) after 12.2 minutes compared to 7.8 and 8.6 minutes, respectively, in group 2, and 4.5 and 5.1 minutes, respectively, in group 3. In group 2, authors observed the most rapid regression of the block (79.4 minutes after the injection of local anesthetic), which required an earlier start of the transversus abdominis plane block (after 65.3 minutes). The sympathetic block regressed after 86.2 and 138.1 minutes in patients of groups 1 and 3, respectively (p 0.05), when the transversus abdominis plane block was performed. Thus, immediately after cesarean section, women with gestational diabetes mellitus (especially on insulin therapy) had a higher need for analgesics than those without gestational diabetes mellitus. CONCLUSIONS: During cesarean section under spinal anesthesia in patients with gestational diabetes mellitus, the rate of development of the sympathetic block is reduced (especially in women who received insulin therapy). At the same time, block regression in these patients occurs much faster, which requires an earlier start of postoperative anesthesia. An increased need for systemic analgesics has been demonstrated during the postoperative period in women with gestational diabetes mellitus, mainly with insulin therapy.
{"title":"Peculiarities of anesthesia for caesarean section in patients with gestational diabetes mellitus","authors":"O. V. Ryazanova, V. I. Shadenkov, R. Kapustin, I. Kogan","doi":"10.17816/jowd629429","DOIUrl":"https://doi.org/10.17816/jowd629429","url":null,"abstract":"BACKGROUND: Women with gestational diabetes mellitus are at high risk of operative delivery. Meanwhile, hyperglycemia affects the metabolism of narcotic analgesics, while increasing their need. Thus, the anesthesiologist is faced with the question of what method of anesthesia to choose for a particular cesarean section. \u0000AIM: The aim of this study was to estimate the features of the perioperative period of cesarean section in patients with gestational diabetes mellitus. \u0000MATERIALS AND METHODS: This prospective, controlled, single-center study enrolled 101 patients who were delivered by planned cesarean sections from April to November 2023. Group 1 included patients with gestational diabetes mellitus on diet therapy (n = 28), group 2 comprised patients with gestational diabetes mellitus on insulin therapy (n = 29), and group 3 (control) included women with a normal pregnancy without carbohydrate metabolism disturbances (n = 44). \u0000RESULTS: The highest initial values of mean arterial pressure were in group 2 and amounted to 91.8 ± 7.0 mmHg. In group 1, the mean arterial pressure was within 89.1 ± 6.4 mmHg, and in group 3, that was 85.9 ± 9.1 mmHg, which was significant (p 0.05). The sympathetic block developed longer in patients of group 2. In group 1, the sensory block was recorded at the ThIV–ThV level after 10.1 minutes and the motor block (Bromage score 3) after 12.2 minutes compared to 7.8 and 8.6 minutes, respectively, in group 2, and 4.5 and 5.1 minutes, respectively, in group 3. In group 2, authors observed the most rapid regression of the block (79.4 minutes after the injection of local anesthetic), which required an earlier start of the transversus abdominis plane block (after 65.3 minutes). The sympathetic block regressed after 86.2 and 138.1 minutes in patients of groups 1 and 3, respectively (p 0.05), when the transversus abdominis plane block was performed. Thus, immediately after cesarean section, women with gestational diabetes mellitus (especially on insulin therapy) had a higher need for analgesics than those without gestational diabetes mellitus. \u0000CONCLUSIONS: During cesarean section under spinal anesthesia in patients with gestational diabetes mellitus, the rate of development of the sympathetic block is reduced (especially in women who received insulin therapy). At the same time, block regression in these patients occurs much faster, which requires an earlier start of postoperative anesthesia. An increased need for systemic analgesics has been demonstrated during the postoperative period in women with gestational diabetes mellitus, mainly with insulin therapy.","PeriodicalId":16623,"journal":{"name":"Journal of obstetrics and women's diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141829707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
O. Budilovskaya, E. Spasibova, K. V. Shalepo, T. Khusnutdinova, A. Krysanova, Anna A. Siniakova, O. Bespalova, A. Savicheva
BACKGROUND: A microbial imbalance in the vaginal biotope leads to the development of vaginal infections and is associated with urinary tract infections. The ineffectiveness of the therapy and the frequent recurrence of these infections are important reasons for searching for alternative treatment strategies. A progressive solution to this issue has been the use of oral probiotics with a targeted effect on the intestinal and vaginal microflora. AIM: The aim of this study was to evaluate the antagonistic and antibacterial activity of the probiotic strains Lactobacillus rhamnosus HN001 and Lactobacillus acidophilus La-14, which are the components of the oral probiotic, against opportunistic microorganisms of intestinal origin, while assessing the sensitivity of these strains to antimicrobial drugs. MATERIALS AND METHODS: The probiotic strains Lactobacillus rhamnosus HN001 and Lactobacillus acidophilus La-14 included in the oral probiotic Duogynal® were cultivated and the grown colonies were identified using the matrix-assisted laser desorption/ionization time-of-flight mass spectrometry method (Bruker Daltonics GmbH Co., Germany). To study the antagonism of the probiotic strains of lactobacilli and opportunistic pathogenic microorganisms, the following 11 clinical isolates were collected: Escherichia coli (two isolates), Klebsiella pneumoniae, Klebsiella oxytoca, Enterobacter asburiae, Proteus mirabilis, Citrobacter freundii, Staphylococcus aureus, Enterococcus faecalis, Streptococcus agalactiae, and Candida albicans. To assess the sensitivity of the probiotic strains to antimicrobial drugs, the Gram Positive AST panel (Autobio Diagnostics Co., Ltd, China) was used. RESULTS: When the microorganisms were co-cultivated with the probiotic lactobacilli (Lactobacillus rhamnosus HN001 and Lactobacillus acidophilus La-14), we noted a decrease in pH and the death of opportunistic microorganisms such as Escherichia coli, Klebsiella pneumoniae, Klebsiella oxytoca, Enterobacter asburiae, Proteus mirabilis, Citrobacter freundii, Staphylococcus aureus, Enterococcus faecalis, and Streptococcus agalactiae, as well as yeast-like fungi Candida albicans. When studying antibiotic resistance, it was found that the both strains of lactobacilli were resistant to ampicillin, vancomycin, daptomycin, clindamycin, linezolid, moxifloxacin, nitrofurantoin, oxacillin, oritavancin, penicillin, rifampin, teicoplanin, tigecycline, trimethoprim/sulfamethoxazole, cefoxitin, ceftarolin, and ciprofloxacin. CONCLUSIONS: The oral probiotic, which contains a combination of two lactobacilli (Lactobacillus rhamnosus HN001 and Lactobacillus acidophilus La-14), has pronounced antagonistic activity against opportunistic microorganisms. These strains are resistant to most antibacterial drugs used in widespread clinical practice, which may be the basis for recommending the use of this probiotic drug together with prescribed antibiotics for prevention of vaginal or intestinal dysbiosis.
{"title":"Antagonistic and antibacterial activity of Lactobacillus rhamnosus HN001 and Lactobacillus acidophilus La-14 included in the oral probiotic","authors":"O. Budilovskaya, E. Spasibova, K. V. Shalepo, T. Khusnutdinova, A. Krysanova, Anna A. Siniakova, O. Bespalova, A. Savicheva","doi":"10.17816/jowd630698","DOIUrl":"https://doi.org/10.17816/jowd630698","url":null,"abstract":"BACKGROUND: A microbial imbalance in the vaginal biotope leads to the development of vaginal infections and is associated with urinary tract infections. The ineffectiveness of the therapy and the frequent recurrence of these infections are important reasons for searching for alternative treatment strategies. A progressive solution to this issue has been the use of oral probiotics with a targeted effect on the intestinal and vaginal microflora. \u0000AIM: The aim of this study was to evaluate the antagonistic and antibacterial activity of the probiotic strains Lactobacillus rhamnosus HN001 and Lactobacillus acidophilus La-14, which are the components of the oral probiotic, against opportunistic microorganisms of intestinal origin, while assessing the sensitivity of these strains to antimicrobial drugs. \u0000MATERIALS AND METHODS: The probiotic strains Lactobacillus rhamnosus HN001 and Lactobacillus acidophilus La-14 included in the oral probiotic Duogynal® were cultivated and the grown colonies were identified using the matrix-assisted laser desorption/ionization time-of-flight mass spectrometry method (Bruker Daltonics GmbH Co., Germany). To study the antagonism of the probiotic strains of lactobacilli and opportunistic pathogenic microorganisms, the following 11 clinical isolates were collected: Escherichia coli (two isolates), Klebsiella pneumoniae, Klebsiella oxytoca, Enterobacter asburiae, Proteus mirabilis, Citrobacter freundii, Staphylococcus aureus, Enterococcus faecalis, Streptococcus agalactiae, and Candida albicans. To assess the sensitivity of the probiotic strains to antimicrobial drugs, the Gram Positive AST panel (Autobio Diagnostics Co., Ltd, China) was used. \u0000RESULTS: When the microorganisms were co-cultivated with the probiotic lactobacilli (Lactobacillus rhamnosus HN001 and Lactobacillus acidophilus La-14), we noted a decrease in pH and the death of opportunistic microorganisms such as Escherichia coli, Klebsiella pneumoniae, Klebsiella oxytoca, Enterobacter asburiae, Proteus mirabilis, Citrobacter freundii, Staphylococcus aureus, Enterococcus faecalis, and Streptococcus agalactiae, as well as yeast-like fungi Candida albicans. When studying antibiotic resistance, it was found that the both strains of lactobacilli were resistant to ampicillin, vancomycin, daptomycin, clindamycin, linezolid, moxifloxacin, nitrofurantoin, oxacillin, oritavancin, penicillin, rifampin, teicoplanin, tigecycline, trimethoprim/sulfamethoxazole, cefoxitin, ceftarolin, and ciprofloxacin. \u0000CONCLUSIONS: The oral probiotic, which contains a combination of two lactobacilli (Lactobacillus rhamnosus HN001 and Lactobacillus acidophilus La-14), has pronounced antagonistic activity against opportunistic microorganisms. These strains are resistant to most antibacterial drugs used in widespread clinical practice, which may be the basis for recommending the use of this probiotic drug together with prescribed antibiotics for prevention of vaginal or intestinal dysbiosis.","PeriodicalId":16623,"journal":{"name":"Journal of obstetrics and women's diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141829729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ainura M. Burkitova, Gulnura M. Burkitova, V. Bolotskikh
This analytical review article compares elective induction of labor with expectant management for a tendency to post-term pregnancy and examines its impact on maternal and neonatal outcomes and caesarean section rates. Currently, the issue of management tactics during pregnancy beyond 41 weeks remains hotly debated and requires further research.
{"title":"A modern view of pregnancy management tactics with a tendency to post-term pregnancy","authors":"Ainura M. Burkitova, Gulnura M. Burkitova, V. Bolotskikh","doi":"10.17816/jowd630054","DOIUrl":"https://doi.org/10.17816/jowd630054","url":null,"abstract":"This analytical review article compares elective induction of labor with expectant management for a tendency to post-term pregnancy and examines its impact on maternal and neonatal outcomes and caesarean section rates. Currently, the issue of management tactics during pregnancy beyond 41 weeks remains hotly debated and requires further research.","PeriodicalId":16623,"journal":{"name":"Journal of obstetrics and women's diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141829957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
E. Alekseenkova, Z. Tonyan, Yulia A. Nasykhova, E. Kopteeva, R. Kapustin, I. Kogan
BACKGROUND: Being strongly affected by maternal and fetal genetic factors, intrauterine environment plays a critical role in fetal growth. Intrauterine conditions, in turn, are largely determined by the genetic factors. AIM: The aim of this study was to evaluate the effect of the IGF1R rs907806 and GHSR rs572169 genetic variants on the weight of newborns. MATERIALS AND METHODS: This prospective study included 221 mother-newborn pairs. The inclusion criteria were singleton pregnancy and informed consent to participate in the study. The exclusion criteria were severe somatic, oncological and acute illnesses three months prior or during pregnancy, gestational diabetes mellitus, refusal to participate in the study at any stage, and insufficient data. The study groups included patients with type 1 diabetes mellitus (group I), type 2 diabetes mellitus (group II), and no carbohydrate metabolism disorders (group III). Cord blood samples were obtained after delivery. The IGF1R rs907806 and GHSR rs572169 genotypes were determined by polymerase chain reaction with restriction fragment length polymorphism analysis. The main outcomes were delivery of a large for gestational age fetus (weight of more than the 90th percentile INTERGROWTH-21st). The secondary outcomes were diabetic fetopathy, diabetic cardiomyopathy, and neonatal hypoglycemia. RESULTS: In group III, the minor G allele of the IGF1R rs907806 variant was more frequent in large-for-gestational-age newborns (p = 0.017; odds ratio 3.039; 95% confidence interval 1.244–7.424) than in those with a weight of less than 90th percentile. For the GHSR rs572169 variant, no similar trend was observed. This pattern was pronounced in the male newborns only (rs907806 AA vs. AG+GG; p = 0.046; odds ratio 4.229, 95% confidence interval 1.181–15.139). In newborns with hypoglycemia, a higher frequency of the GG genotype of the GHSR rs572169 (GA) variant was observed in the total sample (p = 0.004) and the type 1 diabetes mellitus group (p = 0.0496). CONCLUSIONS: The IGF1R rs907806 variant may affect birthweight in the male newborns of mothers without carbohydrate metabolism disorders. The observed association of neonatal hypoglycemia with the GG genotype of the GHSR rs572169 variant requires further investigation. Genetic factors can contribute to prognostic models of perinatal complications, while improving their early diagnosis opportunities.
{"title":"IGF1R rs907806 and GHSR rs572169 genetic variants in fetal macrosomia","authors":"E. Alekseenkova, Z. Tonyan, Yulia A. Nasykhova, E. Kopteeva, R. Kapustin, I. Kogan","doi":"10.17816/jowd625728","DOIUrl":"https://doi.org/10.17816/jowd625728","url":null,"abstract":"BACKGROUND: Being strongly affected by maternal and fetal genetic factors, intrauterine environment plays a critical role in fetal growth. Intrauterine conditions, in turn, are largely determined by the genetic factors. \u0000AIM: The aim of this study was to evaluate the effect of the IGF1R rs907806 and GHSR rs572169 genetic variants on the weight of newborns. \u0000MATERIALS AND METHODS: This prospective study included 221 mother-newborn pairs. The inclusion criteria were singleton pregnancy and informed consent to participate in the study. The exclusion criteria were severe somatic, oncological and acute illnesses three months prior or during pregnancy, gestational diabetes mellitus, refusal to participate in the study at any stage, and insufficient data. The study groups included patients with type 1 diabetes mellitus (group I), type 2 diabetes mellitus (group II), and no carbohydrate metabolism disorders (group III). Cord blood samples were obtained after delivery. The IGF1R rs907806 and GHSR rs572169 genotypes were determined by polymerase chain reaction with restriction fragment length polymorphism analysis. The main outcomes were delivery of a large for gestational age fetus (weight of more than the 90th percentile INTERGROWTH-21st). The secondary outcomes were diabetic fetopathy, diabetic cardiomyopathy, and neonatal hypoglycemia. \u0000RESULTS: In group III, the minor G allele of the IGF1R rs907806 variant was more frequent in large-for-gestational-age newborns (p = 0.017; odds ratio 3.039; 95% confidence interval 1.244–7.424) than in those with a weight of less than 90th percentile. For the GHSR rs572169 variant, no similar trend was observed. This pattern was pronounced in the male newborns only (rs907806 AA vs. AG+GG; p = 0.046; odds ratio 4.229, 95% confidence interval 1.181–15.139). In newborns with hypoglycemia, a higher frequency of the GG genotype of the GHSR rs572169 (GA) variant was observed in the total sample (p = 0.004) and the type 1 diabetes mellitus group (p = 0.0496). \u0000CONCLUSIONS: The IGF1R rs907806 variant may affect birthweight in the male newborns of mothers without carbohydrate metabolism disorders. The observed association of neonatal hypoglycemia with the GG genotype of the GHSR rs572169 variant requires further investigation. Genetic factors can contribute to prognostic models of perinatal complications, while improving their early diagnosis opportunities.","PeriodicalId":16623,"journal":{"name":"Journal of obstetrics and women's diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141828302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L. V. Kaushanskaya, Z. Gatagazheva, Z. Uzdenova, Malika M. Gatagazheva, Khava A. Arsanukaeva, Nesredin A. Makhmudov, Darya P. Minigulova
BACKGROUND: Uterine fibroids are one of the most common gynecological diseases. The application of innovative techniques such as focused ultrasound ablation and uterine artery embolization has improved the quality of life of many patients. However, despite significant advances in innovative therapies, there is no certainty about the long-term efficacy of focused ultrasound ablation and uterine artery embolization. AIM: The aim of this study was to compare the efficacy of focused ultrasound ablation and uterine artery embolization treatments of uterine fibroids. MATERIALS AND METHODS: This study analyzed observations of 112 patients with uterine fibroids. Patients in the first group were treated with focused ultrasound ablation (n = 44). The second group of patients underwent uterine artery embolization (n = 68). RESULTS: The study groups differed in the reduction of myomatous node sizes one, three, six and 12 months after surgery, depending on the chosen treatment method (p 0.001). In the first group, fibroid volume decreased by 14% after a month and by 35% after 12 months. In the second group, it decreased by 20% after a month and by 54% after a year. CONCLUSIONS: Treatment with the uterine artery embolization method reduced fibroid volume by 54%, which is 19% more effective than the focused ultrasound ablation method.
{"title":"Evaluation of the effectiveness of innovative methods of focused ultrasound and uterine artery embolization in the treatment of uterine fibroids","authors":"L. V. Kaushanskaya, Z. Gatagazheva, Z. Uzdenova, Malika M. Gatagazheva, Khava A. Arsanukaeva, Nesredin A. Makhmudov, Darya P. Minigulova","doi":"10.17816/jowd629136","DOIUrl":"https://doi.org/10.17816/jowd629136","url":null,"abstract":"BACKGROUND: Uterine fibroids are one of the most common gynecological diseases. The application of innovative techniques such as focused ultrasound ablation and uterine artery embolization has improved the quality of life of many patients. However, despite significant advances in innovative therapies, there is no certainty about the long-term efficacy of focused ultrasound ablation and uterine artery embolization. \u0000AIM: The aim of this study was to compare the efficacy of focused ultrasound ablation and uterine artery embolization treatments of uterine fibroids. \u0000MATERIALS AND METHODS: This study analyzed observations of 112 patients with uterine fibroids. Patients in the first group were treated with focused ultrasound ablation (n = 44). The second group of patients underwent uterine artery embolization (n = 68). \u0000RESULTS: The study groups differed in the reduction of myomatous node sizes one, three, six and 12 months after surgery, depending on the chosen treatment method (p 0.001). In the first group, fibroid volume decreased by 14% after a month and by 35% after 12 months. In the second group, it decreased by 20% after a month and by 54% after a year. \u0000CONCLUSIONS: Treatment with the uterine artery embolization method reduced fibroid volume by 54%, which is 19% more effective than the focused ultrasound ablation method.","PeriodicalId":16623,"journal":{"name":"Journal of obstetrics and women's diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141828084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
G. Safarian, K. V. Ob’edkova, J. Ryzhov, I. Krikheli, L. Dzhemlikhanova, M. Makhmadalieva, M. S. Mazurenko, N. I. Tapil'skaya, A. Gzgzyan, O. Bespalova
BACKGROUND: The effectiveness of in vitro fertilization cycles / frozen-thawed embryo transfer cycles depends on a number of factors, the endometrial one being of great importance. Adequate endometrial and subendometrial blood supply is considered necessary for successful implantation. Currently, the possibilities of non-invasive assessment of the implantation properties of the endometrium are limited to the use of ultrasound. AIM: The aim of this study was to assess the performance of endometrial and subendometrial three-dimensional power Doppler angiography combined with the Virtual Organ Computer-aided Analysis (VOCAL) method in frozen-thawed embryo transfer cycles on hormone replacement therapy and compare the obtained data among the women examined. MATERIALS AND METHODS: This prospective study included 20 women. Doppler measurements were carried out three times — on the day of progesterone initiation, the day before embryo transfer and on the day of embryo transfer. The VOCAL software assessed the endometrial and subendometrial volume and blood flow indices such as vascularization index, flow index, and vascularization flow index. Patients were divided into two study groups depending on the onset of clinical pregnancy. RESULTS: On the day of progesterone initiation among patients who got pregnant, we observed higher vascularization (3.52 ± 1.99 vs. 1.05 ± 1.36; p = 0.03) and vascularization flow (1.54 ± 0.98 vs. 0.63 ± 0.55; p = 0.03) indices compared to women with a negative result. Moreover, endometrial vascularization index on the day of progesterone initiation was positively correlated with the estrogen dose among both pregnant (r = 0.61; p = 0.04) and non-pregnant (r = 0.9; p = 0.0008) women. No differences in subendometrial blood flow indices depending on the onset of pregnancy were obtained, just as endometrial blood flow indices the day before embryo transfer and on the day of embryo transfer were comparable between women in the both study groups. CONCLUSIONS: Three-dimensional power Doppler angiography evaluated by the Virtual Organ Computer-aided Analysis (VOCAL) method is a promising tool for non-invasive assessment of endometrial receptivity in frozen-thawed embryo transfer programs. However, further studies are required on a larger patient sample to form conclusions that are more accurate.
背景：体外受精周期/冷冻-解冻胚胎移植周期的有效性取决于多种因素，其中子宫内膜因素至关重要。充足的子宫内膜和子宫内膜下血液供应被认为是成功植入的必要条件。目前，对子宫内膜植入特性的无创评估仅限于使用超声波。目的：本研究旨在评估子宫内膜和子宫内膜下三维动力多普勒血管造影结合虚拟器官计算机辅助分析（VOCAL）方法在接受激素替代疗法的冻融胚胎移植周期中的表现，并比较受检女性所获得的数据。材料与方法：这项前瞻性研究包括 20 名女性。多普勒测量共进行了三次--在开始使用黄体酮当天、胚胎移植前一天和胚胎移植当天。VOCAL 软件评估了子宫内膜和子宫内膜下体积以及血流指数，如血管化指数、血流指数和血管化血流指数。根据临床妊娠的开始时间，将患者分为两个研究组。结果：与结果为阴性的女性相比，我们观察到在开始使用黄体酮的当天，妊娠患者的血管化指数（3.52 ± 1.99 vs. 1.05 ± 1.36; p = 0.03）和血管化血流指数（1.54 ± 0.98 vs. 0.63 ± 0.55; p = 0.03）较高。此外，妊娠妇女（r = 0.61；p = 0.04）和非妊娠妇女（r = 0.9；p = 0.0008）在开始使用黄体酮当天的子宫内膜血管化指数与雌激素剂量呈正相关。子宫内膜下血流指数在妊娠开始时没有差异，胚胎移植前一天和胚胎移植当天的子宫内膜血流指数在两个研究组的妇女中也不相上下。结论通过虚拟器官计算机辅助分析（VOCAL）方法评估的三维动力多普勒血管造影是一种很有前途的工具，可用于无创评估冷冻解冻胚胎移植项目中的子宫内膜受孕率。不过，还需要对更多的患者样本进行进一步研究，才能得出更准确的结论。
{"title":"Assessment of endometrial and subendometrial three-dimensional power Doppler angiography evaluated by the VOCAL method in frozen-thawed embryo transfer cycles on hormone replacement therapy","authors":"G. Safarian, K. V. Ob’edkova, J. Ryzhov, I. Krikheli, L. Dzhemlikhanova, M. Makhmadalieva, M. S. Mazurenko, N. I. Tapil'skaya, A. Gzgzyan, O. Bespalova","doi":"10.17816/jowd627896","DOIUrl":"https://doi.org/10.17816/jowd627896","url":null,"abstract":"BACKGROUND: The effectiveness of in vitro fertilization cycles / frozen-thawed embryo transfer cycles depends on a number of factors, the endometrial one being of great importance. Adequate endometrial and subendometrial blood supply is considered necessary for successful implantation. Currently, the possibilities of non-invasive assessment of the implantation properties of the endometrium are limited to the use of ultrasound. \u0000AIM: The aim of this study was to assess the performance of endometrial and subendometrial three-dimensional power Doppler angiography combined with the Virtual Organ Computer-aided Analysis (VOCAL) method in frozen-thawed embryo transfer cycles on hormone replacement therapy and compare the obtained data among the women examined. \u0000MATERIALS AND METHODS: This prospective study included 20 women. Doppler measurements were carried out three times — on the day of progesterone initiation, the day before embryo transfer and on the day of embryo transfer. The VOCAL software assessed the endometrial and subendometrial volume and blood flow indices such as vascularization index, flow index, and vascularization flow index. Patients were divided into two study groups depending on the onset of clinical pregnancy. \u0000RESULTS: On the day of progesterone initiation among patients who got pregnant, we observed higher vascularization (3.52 ± 1.99 vs. 1.05 ± 1.36; p = 0.03) and vascularization flow (1.54 ± 0.98 vs. 0.63 ± 0.55; p = 0.03) indices compared to women with a negative result. Moreover, endometrial vascularization index on the day of progesterone initiation was positively correlated with the estrogen dose among both pregnant (r = 0.61; p = 0.04) and non-pregnant (r = 0.9; p = 0.0008) women. No differences in subendometrial blood flow indices depending on the onset of pregnancy were obtained, just as endometrial blood flow indices the day before embryo transfer and on the day of embryo transfer were comparable between women in the both study groups. \u0000CONCLUSIONS: Three-dimensional power Doppler angiography evaluated by the Virtual Organ Computer-aided Analysis (VOCAL) method is a promising tool for non-invasive assessment of endometrial receptivity in frozen-thawed embryo transfer programs. However, further studies are required on a larger patient sample to form conclusions that are more accurate.","PeriodicalId":16623,"journal":{"name":"Journal of obstetrics and women's diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141829058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
O. Bespalova, E. Komarova, E. Lesik, K. V. Ob’edkova, N. I. Tapil'skaya, I. Kogan
BACKGROUND: The development of new systems for the cultivation of embryos of model objects and the creation of embryonic models based on stem cells allow for describing the events of early embryogenesis in more detail. However, these models have a number of limitations, endorsing only indirect extrapolation of the knowledge gained to events occurring in vivo. Despite certain limitations, including those related to some differences between embryos developing in vivo and in vitro, implantation conditions in vivo and in vitro, and limited time for culturing human embryos, the study of post-implantation development has great prospects. AIM: The aim of this study was to evaluate the viability and potential for the development of human embryos from the blastocyst stage during their prolonged coculture with the endometrium in culture media designed to support the growth to the blastocyst stage. MATERIALS AND METHODS: Embryos obtained through assisted reproductive technology were cultured from the blastocyst stage to day 19st of development in culture media designed to support the growth to the blastocyst stage, in the presence of the endometrium. On day 19st, embryos and endometrial fragments were assessed under an inverted microscope using Hoffman modulation contrast. RESULTS: During visual assessment under an inverted microscope on day 19st of development and days 13–14st of coculture with the endometrium, viable developing embryos without signs of degradation were recorded, both freely located in a mass of undifferentiated cells and in direct contact with the endometrium. CONCLUSIONS: The data obtained indicate the ability of the embryo to further develop in the presence of the endometrium from the blastocyst stage to day 19st in in culture media that supports the growth to the blastocyst stage. This may serve as an experimental model for both evaluating endometrial receptivity in vitro and studying intercellular communication during implantation.
{"title":"ABC of the future: prolonged coculture of human embryos with endometrium in a nutrient medium in vitro","authors":"O. Bespalova, E. Komarova, E. Lesik, K. V. Ob’edkova, N. I. Tapil'skaya, I. Kogan","doi":"10.17816/jowd629131","DOIUrl":"https://doi.org/10.17816/jowd629131","url":null,"abstract":"BACKGROUND: The development of new systems for the cultivation of embryos of model objects and the creation of embryonic models based on stem cells allow for describing the events of early embryogenesis in more detail. However, these models have a number of limitations, endorsing only indirect extrapolation of the knowledge gained to events occurring in vivo. Despite certain limitations, including those related to some differences between embryos developing in vivo and in vitro, implantation conditions in vivo and in vitro, and limited time for culturing human embryos, the study of post-implantation development has great prospects. \u0000AIM: The aim of this study was to evaluate the viability and potential for the development of human embryos from the blastocyst stage during their prolonged coculture with the endometrium in culture media designed to support the growth to the blastocyst stage. \u0000MATERIALS AND METHODS: Embryos obtained through assisted reproductive technology were cultured from the blastocyst stage to day 19st of development in culture media designed to support the growth to the blastocyst stage, in the presence of the endometrium. On day 19st, embryos and endometrial fragments were assessed under an inverted microscope using Hoffman modulation contrast. \u0000RESULTS: During visual assessment under an inverted microscope on day 19st of development and days 13–14st of coculture with the endometrium, viable developing embryos without signs of degradation were recorded, both freely located in a mass of undifferentiated cells and in direct contact with the endometrium. \u0000CONCLUSIONS: The data obtained indicate the ability of the embryo to further develop in the presence of the endometrium from the blastocyst stage to day 19st in in culture media that supports the growth to the blastocyst stage. This may serve as an experimental model for both evaluating endometrial receptivity in vitro and studying intercellular communication during implantation.","PeriodicalId":16623,"journal":{"name":"Journal of obstetrics and women's diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141830341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
N. G. Istomina, Elizaveta A. Shcherbakova, A.N. Baranov, Tatyana B. Lebedeva
BACKGROUND: Bacterial, viral and protozoal infections can cause miscarriage, antenatal death, congenital organ abnormalities or other limited consequences depending on the pathogen. The role of infection processes identified during pregnancy on placental pathology and fetal growth restriction. AIM: The aim of this study was to conduct a comparative analysis of infections identified in pregnant women with different types of fetal growth restriction, as well as to assess a potential impact of identified infections on the outcomes of fetal growth restriction in newborns in the same groups. MATERIALS AND METHODS: We performed a retrospective analysis of outcomes for 394 pregnant women with an established diagnosis of fetal growth restriction, who had given birth from 2018 to 2022 in the Perinatal Center of the Arkhangelsk Regional Clinical Hospital. Maternal and neonatal case histories were obtained using a continuous sampling method. Considering the transition to new criteria for establishing the diagnosis of fetal growth restriction in Russia, we formed four study groups, of which only 139 cases met the Delphi criteria of clinical guidelines by Russian Society of Obstetricians and Gynecologists, 2021. In the selected groups, we analyzed the results of microscopic and microbiological tests of various localizations in mothers during antepartum examination, as well as postpartum examination of the placenta and culture tests in newborns in their relation to adverse outcomes. RESULTS: A high prevalence (25–70.4%) of positive bacteriological findings was revealed in all of the study groups. The frequency was highest in the group of pregnant women with fetal growth restriction before 32 weeks (90–92%). Combined infections (two or more localizations) were noted in 59.2% of pregnant women in groups with early fetal growth restriction compared to 23.3% in late fetal growth restriction groups. In all cases, we observed a direct relationship between the severity of fetal growth restriction and the prevalence of infections. The range of infections identified during routine examination of pregnant women is quite limited; Candida spp. (from 40.8% in the control group to 75% in the comparison group), Escherichia coli (from 22.9 to 33.3%, respectively), and Chlamydia trachomatis (from 4.5 to 23.5%, respectively) being identified most commonly. In a morphological study of the placenta, infectious and inflammatory lesions were the most significant and ranged from 100 to 81.4% of cases in groups with early and late fetal growth restriction, respectively, with signs of hematogenous transmission prevailed. When analyzing infectious lesions in fetuses, we have found the presence of three and more localizations of the infectious process in 90 to 45% of cases with a fatal outcome for early and late fetal growth restriction, respectively. In the control groups, similar rates were 40 and 15.8%. When assessing the distribution of various types of infectious process in newb
{"title":"The spectrum of infections identified in pregnant women with different types of fetal growth restriction","authors":"N. G. Istomina, Elizaveta A. Shcherbakova, A.N. Baranov, Tatyana B. Lebedeva","doi":"10.17816/jowd626378","DOIUrl":"https://doi.org/10.17816/jowd626378","url":null,"abstract":"BACKGROUND: Bacterial, viral and protozoal infections can cause miscarriage, antenatal death, congenital organ abnormalities or other limited consequences depending on the pathogen. The role of infection processes identified during pregnancy on placental pathology and fetal growth restriction. \u0000AIM: The aim of this study was to conduct a comparative analysis of infections identified in pregnant women with different types of fetal growth restriction, as well as to assess a potential impact of identified infections on the outcomes of fetal growth restriction in newborns in the same groups. \u0000MATERIALS AND METHODS: We performed a retrospective analysis of outcomes for 394 pregnant women with an established diagnosis of fetal growth restriction, who had given birth from 2018 to 2022 in the Perinatal Center of the Arkhangelsk Regional Clinical Hospital. Maternal and neonatal case histories were obtained using a continuous sampling method. Considering the transition to new criteria for establishing the diagnosis of fetal growth restriction in Russia, we formed four study groups, of which only 139 cases met the Delphi criteria of clinical guidelines by Russian Society of Obstetricians and Gynecologists, 2021. In the selected groups, we analyzed the results of microscopic and microbiological tests of various localizations in mothers during antepartum examination, as well as postpartum examination of the placenta and culture tests in newborns in their relation to adverse outcomes. \u0000RESULTS: A high prevalence (25–70.4%) of positive bacteriological findings was revealed in all of the study groups. The frequency was highest in the group of pregnant women with fetal growth restriction before 32 weeks (90–92%). Combined infections (two or more localizations) were noted in 59.2% of pregnant women in groups with early fetal growth restriction compared to 23.3% in late fetal growth restriction groups. In all cases, we observed a direct relationship between the severity of fetal growth restriction and the prevalence of infections. The range of infections identified during routine examination of pregnant women is quite limited; Candida spp. (from 40.8% in the control group to 75% in the comparison group), Escherichia coli (from 22.9 to 33.3%, respectively), and Chlamydia trachomatis (from 4.5 to 23.5%, respectively) being identified most commonly. In a morphological study of the placenta, infectious and inflammatory lesions were the most significant and ranged from 100 to 81.4% of cases in groups with early and late fetal growth restriction, respectively, with signs of hematogenous transmission prevailed. When analyzing infectious lesions in fetuses, we have found the presence of three and more localizations of the infectious process in 90 to 45% of cases with a fatal outcome for early and late fetal growth restriction, respectively. In the control groups, similar rates were 40 and 15.8%. When assessing the distribution of various types of infectious process in newb","PeriodicalId":16623,"journal":{"name":"Journal of obstetrics and women's diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141831204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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