The prevalence of type 1 diabetes mellitus has increased significantly among women of reproductive age over the past two decades. Despite improved glycemic control and intensified insulin therapy, patients with diabetes still suffer from many reproductive problems, which often makes this group of patients potential participants in assisted reproductive technology programs under certain conditions. Diabetic nephropathy is one of the most serious complications of type 1 diabetes mellitus. It ranks first in the structure of chronic kidney disease and is a common cause of end-stage renal failure, disability, and mortality. Early diagnosis and identification of specific markers of diabetic nephropathy will allow for timely initiation of nephroprotective therapy to slow the progression of diabetic kidney damage. This review article is based on the results of the PubMed, Frontiers, and ResearchGate search queries from 2016 to 2023. We analyzed worldwide and domestic data on the impact of type 1 diabetes mellitus on kidney function, the influence of sex hormones on diabetic nephropathy, and the importance of the personalized approach to this group of patients at the pre-pregnancy stage, especially those planning treatment within assisted reproductive technology programs.
{"title":"Evaluation of renal function in patients with type 1 diabetes mellitus implementing reproductive function in assisted reproductive technology protocols","authors":"T.V. Veretekhina, M. Yarmolinskaya","doi":"10.17816/jowd623553","DOIUrl":"https://doi.org/10.17816/jowd623553","url":null,"abstract":"The prevalence of type 1 diabetes mellitus has increased significantly among women of reproductive age over the past two decades. Despite improved glycemic control and intensified insulin therapy, patients with diabetes still suffer from many reproductive problems, which often makes this group of patients potential participants in assisted reproductive technology programs under certain conditions. Diabetic nephropathy is one of the most serious complications of type 1 diabetes mellitus. It ranks first in the structure of chronic kidney disease and is a common cause of end-stage renal failure, disability, and mortality. Early diagnosis and identification of specific markers of diabetic nephropathy will allow for timely initiation of nephroprotective therapy to slow the progression of diabetic kidney damage. \u0000This review article is based on the results of the PubMed, Frontiers, and ResearchGate search queries from 2016 to 2023. We analyzed worldwide and domestic data on the impact of type 1 diabetes mellitus on kidney function, the influence of sex hormones on diabetic nephropathy, and the importance of the personalized approach to this group of patients at the pre-pregnancy stage, especially those planning treatment within assisted reproductive technology programs.","PeriodicalId":16623,"journal":{"name":"Journal of obstetrics and women's diseases","volume":"67 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140378123","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}
Arterial hypertension remains a leading cause of maternal morbidity and mortality while leading to significant economic costs in health care. Properly selected treatment tactics allow for prolonging pregnancy and levelling out various complications arising from the disease. However, there are still some questions about the effectiveness and safety of prescribed therapy due to possible side effects of the drugs. The aim of this study was to evaluate the efficacy and complications of hypotensive therapy during pregnancy, childbirth and the postpartum period. We analyzed the literature on eLibrary, Scopus, Cochrane Library, PubMed.
{"title":"Hypotensive therapy in obstetric practice","authors":"A. M. Ziganshin, Alina A. Maksyutova","doi":"10.17816/jowd569131","DOIUrl":"https://doi.org/10.17816/jowd569131","url":null,"abstract":"Arterial hypertension remains a leading cause of maternal morbidity and mortality while leading to significant economic costs in health care. Properly selected treatment tactics allow for prolonging pregnancy and levelling out various complications arising from the disease. However, there are still some questions about the effectiveness and safety of prescribed therapy due to possible side effects of the drugs. The aim of this study was to evaluate the efficacy and complications of hypotensive therapy during pregnancy, childbirth and the postpartum period. We analyzed the literature on eLibrary, Scopus, Cochrane Library, PubMed.","PeriodicalId":16623,"journal":{"name":"Journal of obstetrics and women's diseases","volume":"106 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140379848","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}
The adhesive process in the abdomen in the postoperative period is still a stumbling block for modern medicine. This is due to the fact that surgical activity is increasing, but there is no common solution for precaution. Complications associated with adhesions after urgent gynecological interventions are some of the causes of infertility, which becomes a problem for not only healthcare and society, the patient and their future, but also the government, as it leads to population decline. This review is focused on the study of the adhesive process etiology in surgical gynecology and the pathogenesis traits. We analyzed the literature on the Web of Science, eLibrary, Scopus, and PubMed/Medline using the following keywords: “adhesions,” “adhesive process,” “review,” “operations,” “pathogenesis of formation of adhesions,” and “reproductive dysfunction”. The research included full-text sources and literature reviews on the studied subject. Articles not related directly to the topic of the adhesive process in the postoperative period were excluded from the review. This literature review has demonstrated that despite the ongoing research of scientists all over the world into postoperative adhesion, its etiology and pathogenesis remain not fully understood and disclosed. This dictates the need to continue studying the adhesive process and searching for new solutions in prevention. As far as the attention of surgeons and reproductive specialists is focused on the issues of preventing the adhesive process, we are confident that in the near future, scientists will find a unified solution to this complex problem and practical healthcare specialists will successfully implement it.
术后腹部的粘连过程仍然是现代医学的绊脚石。这是因为手术活动越来越多，但却没有共同的预防方案。妇科紧急干预后与粘连相关的并发症是导致不孕不育的部分原因，这不仅是医疗保健和社会、病人及其未来的问题，也是政府的问题，因为它会导致人口下降。本综述主要研究妇科手术中粘连过程病因及发病特征。我们使用以下关键词对 Web of Science、eLibrary、Scopus 和 PubMed/Medline 上的文献进行了分析："粘连"、"粘连过程"、"综述"、"手术"、"粘连形成的发病机制 "和 "生殖功能障碍"。研究包括研究主题的全文来源和文献综述。与术后粘连过程这一主题没有直接关系的文章不在综述范围之内。本文献综述表明，尽管全世界的科学家都在对术后粘连进行研究，但对其病因和发病机理仍未完全了解和揭示。因此有必要继续研究粘连过程并寻找新的预防方案。只要外科医生和生殖专家将注意力集中在预防粘连过程的问题上，我们相信，在不久的将来，科学家们将找到解决这一复杂问题的统一方案，而实际的医疗专家们也将成功地实施这一方案。
{"title":"Postoperative adhesions in urgent gynecological practice — the analysis of etiological and pathophysiological factors","authors":"O. V. Gudz, A. N. Sulima","doi":"10.17816/jowd562924","DOIUrl":"https://doi.org/10.17816/jowd562924","url":null,"abstract":"The adhesive process in the abdomen in the postoperative period is still a stumbling block for modern medicine. This is due to the fact that surgical activity is increasing, but there is no common solution for precaution. Complications associated with adhesions after urgent gynecological interventions are some of the causes of infertility, which becomes a problem for not only healthcare and society, the patient and their future, but also the government, as it leads to population decline. \u0000This review is focused on the study of the adhesive process etiology in surgical gynecology and the pathogenesis traits. We analyzed the literature on the Web of Science, eLibrary, Scopus, and PubMed/Medline using the following keywords: “adhesions,” “adhesive process,” “review,” “operations,” “pathogenesis of formation of adhesions,” and “reproductive dysfunction”. The research included full-text sources and literature reviews on the studied subject. Articles not related directly to the topic of the adhesive process in the postoperative period were excluded from the review. \u0000This literature review has demonstrated that despite the ongoing research of scientists all over the world into postoperative adhesion, its etiology and pathogenesis remain not fully understood and disclosed. This dictates the need to continue studying the adhesive process and searching for new solutions in prevention. As far as the attention of surgeons and reproductive specialists is focused on the issues of preventing the adhesive process, we are confident that in the near future, scientists will find a unified solution to this complex problem and practical healthcare specialists will successfully implement it.","PeriodicalId":16623,"journal":{"name":"Journal of obstetrics and women's diseases","volume":"111 30","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140380380","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}
Nataliia A. Zvereva, Yuliya P. Milyutina, A. Arutjunyan, I. Evsyukova
BACKGROUND: The growth of neurological and mental diseases in the offspring of patients with pre- and gestational diabetes mellitus determines the need to study the regulatory function of the serotoninergic system of the brain in newborns. This plays a key role in its morphofunctional development in early ontogenesis, which is necessary for timely diagnosis of disorders and prevention of long-term consequences. AIM: The aim of this study was to evaluate serotonin levels in full-term newborns with diabetic fetopathy from mothers with pre- and gestational diabetes mellitus. MATERIALS AND METHODS: The main group consisted of 45 newborns with diabetic fetopathy, of whom 30 individuals were from mothers with type 1 diabetes mellitus and 15 ones from mothers with gestational diabetes mellitus. The control group comprised 20 healthy full-term newborns from healthy mothers without pregnancy complications. Serotonin concentrations were determined in platelet-rich plasma of blood from the umbilical cord vein, and in a platelet suspension prepared from venous blood taken on the first day of life, using high-performance liquid chromatography with electrochemical detection. RESULTS: Platelet-rich plasma serotonin level in umbilical cord blood taken from newborns of the main group was more than two times lower compared to children of healthy mothers. This parameter in venous blood taken from mothers with type 1 diabetes (0.744 ± 0.117 µmol/l) corresponded to that in healthy patients, while in mothers with gestational diabetes mellitus, it was significantly lower and amounted to 0.331 ± 0.071 µmol/l (p 0.05). Moreover, platelet-rich plasma serotonin level in all newborns correlated with that in their mothers (R = 0.505; p 0.05). Serotonin levels in venous blood platelets of newborns of the main group was almost 2.5 times lower than in healthy ones. CONCLUSIONS: The data obtained indicate the need to use platelet serotonin values as a biochemical marker of disorders of functional brain development in children with diabetic fetopathy.
{"title":"Evaluation of serotonin levels in full-term newborns of diabetic mothers","authors":"Nataliia A. Zvereva, Yuliya P. Milyutina, A. Arutjunyan, I. Evsyukova","doi":"10.17816/jowd569397","DOIUrl":"https://doi.org/10.17816/jowd569397","url":null,"abstract":"BACKGROUND: The growth of neurological and mental diseases in the offspring of patients with pre- and gestational diabetes mellitus determines the need to study the regulatory function of the serotoninergic system of the brain in newborns. This plays a key role in its morphofunctional development in early ontogenesis, which is necessary for timely diagnosis of disorders and prevention of long-term consequences. \u0000AIM: The aim of this study was to evaluate serotonin levels in full-term newborns with diabetic fetopathy from mothers with pre- and gestational diabetes mellitus. \u0000MATERIALS AND METHODS: The main group consisted of 45 newborns with diabetic fetopathy, of whom 30 individuals were from mothers with type 1 diabetes mellitus and 15 ones from mothers with gestational diabetes mellitus. The control group comprised 20 healthy full-term newborns from healthy mothers without pregnancy complications. Serotonin concentrations were determined in platelet-rich plasma of blood from the umbilical cord vein, and in a platelet suspension prepared from venous blood taken on the first day of life, using high-performance liquid chromatography with electrochemical detection. \u0000RESULTS: Platelet-rich plasma serotonin level in umbilical cord blood taken from newborns of the main group was more than two times lower compared to children of healthy mothers. This parameter in venous blood taken from mothers with type 1 diabetes (0.744 ± 0.117 µmol/l) corresponded to that in healthy patients, while in mothers with gestational diabetes mellitus, it was significantly lower and amounted to 0.331 ± 0.071 µmol/l (p 0.05). Moreover, platelet-rich plasma serotonin level in all newborns correlated with that in their mothers (R = 0.505; p 0.05). Serotonin levels in venous blood platelets of newborns of the main group was almost 2.5 times lower than in healthy ones. \u0000CONCLUSIONS: The data obtained indicate the need to use platelet serotonin values as a biochemical marker of disorders of functional brain development in children with diabetic fetopathy.","PeriodicalId":16623,"journal":{"name":"Journal of obstetrics and women's diseases","volume":"122 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140380885","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}
S. Y. Borovaya, A. V. Yakimova, Tatiana A. Ageeva, V. A. Mudrov
BACKGROUND: At the beginning of the pandemic COVID-19, the attention of obstetricians and gynecologists was focused on studying the impact of SARS-CoV-2 on obstetric and perinatal outcomes. Currently, the dynamics of mutations in genes encoding SARS-CoV-2 proteins determines the emergence of a large number of new strains of the virus that are highly virulent. Given this fact, the problem of assessing the impact of COVID-19 on pregnancy outcomes also remains relevant. AIM: The aim of this study was to assess the impact of the novel coronavirus infection (COVID-19) transmitted at different stages of gestation on perinatal outcomes and structural changes in the placenta. MATERIALS AND METHODS: In 2022–2023, a prospective analysis of 113 cases of childbirth in women who had the novel coronavirus infection during pregnancy was carried out in obstetric institutions in Novosibirsk. The total sample of subjects was divided into three study groups using cluster analysis. Group 1 included 25 women who had SARS-CoV-2 at a gestation period of up to 16 weeks; Group 2 consisted of 61 patients who underwent COVID-19 at gestation period of 17 to 34 weeks; and Group 3 comprised 27 pregnant women in whom COVID-19 was detected after 34 weeks of pregnancy. The control group included 65 pregnant women who had a negative smear test result for SARS-CoV-2. Pathological examination of the placenta included macro- and microscopic studies. Statistical processing of the results was carried out using the IBM SPSS Statistics Version 25.0 program. RESULTS: The most common fetal distress was observed in patients of Groups 1 and 2 (p = 0.002). We found an inverse correlation between the gestational age at which a woman suffered coronavirus infection and the volumetric density of capillaries and intervillous fibrinoid, as well as the percentage of formation of the syncytial-capillary membrane and villi with symplastic buds. On the contrary, a direct correlation between the gestational age and the volumetric density of connective tissue was found. Intervillusitis was more often observed in the placentas of women of Groups 1 and 2. Histitocytic infiltration was characteristic of the placentas of patients of Group 2. CONCLUSIONS: The frequency of adverse perinatal outcomes and the intensity of structural changes in the placenta depend on the gestation period in which the patient suffered the novel coronavirus infection. The most significant structural changes in the placenta were detected in patients of Group 2.
{"title":"Assessment of the impact of COVID-19 experienced at different stages of gestation on perinatal outcomes and structural changes in the placenta","authors":"S. Y. Borovaya, A. V. Yakimova, Tatiana A. Ageeva, V. A. Mudrov","doi":"10.17816/jowd624435","DOIUrl":"https://doi.org/10.17816/jowd624435","url":null,"abstract":"BACKGROUND: At the beginning of the pandemic COVID-19, the attention of obstetricians and gynecologists was focused on studying the impact of SARS-CoV-2 on obstetric and perinatal outcomes. Currently, the dynamics of mutations in genes encoding SARS-CoV-2 proteins determines the emergence of a large number of new strains of the virus that are highly virulent. Given this fact, the problem of assessing the impact of COVID-19 on pregnancy outcomes also remains relevant. \u0000AIM: The aim of this study was to assess the impact of the novel coronavirus infection (COVID-19) transmitted at different stages of gestation on perinatal outcomes and structural changes in the placenta. \u0000MATERIALS AND METHODS: In 2022–2023, a prospective analysis of 113 cases of childbirth in women who had the novel coronavirus infection during pregnancy was carried out in obstetric institutions in Novosibirsk. The total sample of subjects was divided into three study groups using cluster analysis. Group 1 included 25 women who had SARS-CoV-2 at a gestation period of up to 16 weeks; Group 2 consisted of 61 patients who underwent COVID-19 at gestation period of 17 to 34 weeks; and Group 3 comprised 27 pregnant women in whom COVID-19 was detected after 34 weeks of pregnancy. The control group included 65 pregnant women who had a negative smear test result for SARS-CoV-2. Pathological examination of the placenta included macro- and microscopic studies. Statistical processing of the results was carried out using the IBM SPSS Statistics Version 25.0 program. \u0000RESULTS: The most common fetal distress was observed in patients of Groups 1 and 2 (p = 0.002). We found an inverse correlation between the gestational age at which a woman suffered coronavirus infection and the volumetric density of capillaries and intervillous fibrinoid, as well as the percentage of formation of the syncytial-capillary membrane and villi with symplastic buds. On the contrary, a direct correlation between the gestational age and the volumetric density of connective tissue was found. Intervillusitis was more often observed in the placentas of women of Groups 1 and 2. Histitocytic infiltration was characteristic of the placentas of patients of Group 2. \u0000CONCLUSIONS: The frequency of adverse perinatal outcomes and the intensity of structural changes in the placenta depend on the gestation period in which the patient suffered the novel coronavirus infection. The most significant structural changes in the placenta were detected in patients of Group 2.","PeriodicalId":16623,"journal":{"name":"Journal of obstetrics and women's diseases","volume":"121 32","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140381047","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}
Until recently, researchers and clinicians have used the World Health Organization classification of ovulatory disorders (1973), which was based on the levels of gonadotropins and estrogens in the blood serum (mainly follicle-stimulating hormone) and classified ovulatory disorders depending on the hypothalamic-pituitary-ovarian axis dysfunction levels. This review article presents a new classification system for ovulation disorders developed by the International Federation of Gynecology and Obstetrics (FIGO) in 2022. The first level of this classification system is based on an anatomical approach (hypothalamus, pituitary gland, ovaries), which is complemented by a separate category for polycystic ovary syndrome. At the second level, each anatomical category is classified according to the putative etiopathogenetic mechanisms underlying ovulation disorders. The third level suggests the presence of specific nosologies, which represent the direct cause of ovulation disorders. This new classification should be used after a preliminary examination that reveals the presence of an ovulation disorder. This review discusses various ovulation disorders and provides tools for their diagnosis in accordance with international guidelines and domestic recommendations.
{"title":"New International Federation of Gynecology and Obstetrics ovulatory disorders classification system 2022. Diagnostic assessment of ovulatory dysfunction","authors":"Y. V. Kovalyova","doi":"10.17816/jowd191384","DOIUrl":"https://doi.org/10.17816/jowd191384","url":null,"abstract":"Until recently, researchers and clinicians have used the World Health Organization classification of ovulatory disorders (1973), which was based on the levels of gonadotropins and estrogens in the blood serum (mainly follicle-stimulating hormone) and classified ovulatory disorders depending on the hypothalamic-pituitary-ovarian axis dysfunction levels. \u0000This review article presents a new classification system for ovulation disorders developed by the International Federation of Gynecology and Obstetrics (FIGO) in 2022. The first level of this classification system is based on an anatomical approach (hypothalamus, pituitary gland, ovaries), which is complemented by a separate category for polycystic ovary syndrome. At the second level, each anatomical category is classified according to the putative etiopathogenetic mechanisms underlying ovulation disorders. The third level suggests the presence of specific nosologies, which represent the direct cause of ovulation disorders. This new classification should be used after a preliminary examination that reveals the presence of an ovulation disorder. This review discusses various ovulation disorders and provides tools for their diagnosis in accordance with international guidelines and domestic recommendations.","PeriodicalId":16623,"journal":{"name":"Journal of obstetrics and women's diseases","volume":"123 42","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140379879","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}
This review article summarizes current ideas about gestational diabetes mellitus as an independent risk factor for long-term neuropsychiatric morbidity in offspring. Herein, we describe the genetic programming patterns of morphofunctional brain development during intrauterine life, which provide the basis for short- and long-term functions of the central nervous system. The results of experimental and clinical studies are presented that explain the pathophysiological mechanisms of the harmful effects on the fetal brain of hyperglycemia, hyperinsulinemia, hyperlepthyremia, oxidative stress, and systemic inflammation in the mother with pregnancy complicated by diabetes mellitus. We also discuss structural brain abnormalities and neuropsychiatric consequences. The article substantiates the need for the prevention of neuropsychiatric diseases in the offspring of women with obesity and other concomitant pathology at the stage of family planning, and at the onset of pregnancy, the expediency of early screening, treatment of gestational diabetes mellitus and neuroprotection in the perinatal period of the child’s life.
{"title":"Gestational diabetes mellitus as a risk factor for neuropsychiatric pathology in offspring","authors":"I. Evsyukova","doi":"10.17816/jowd624209","DOIUrl":"https://doi.org/10.17816/jowd624209","url":null,"abstract":"This review article summarizes current ideas about gestational diabetes mellitus as an independent risk factor for long-term neuropsychiatric morbidity in offspring. Herein, we describe the genetic programming patterns of morphofunctional brain development during intrauterine life, which provide the basis for short- and long-term functions of the central nervous system. The results of experimental and clinical studies are presented that explain the pathophysiological mechanisms of the harmful effects on the fetal brain of hyperglycemia, hyperinsulinemia, hyperlepthyremia, oxidative stress, and systemic inflammation in the mother with pregnancy complicated by diabetes mellitus. We also discuss structural brain abnormalities and neuropsychiatric consequences. The article substantiates the need for the prevention of neuropsychiatric diseases in the offspring of women with obesity and other concomitant pathology at the stage of family planning, and at the onset of pregnancy, the expediency of early screening, treatment of gestational diabetes mellitus and neuroprotection in the perinatal period of the child’s life.","PeriodicalId":16623,"journal":{"name":"Journal of obstetrics and women's diseases","volume":"109 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140380399","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}
Yu. P. Milyutina, Margarita O. Shengelia, O. Bespalova, Olga V. Pachuliya, A. A. Blazhenko, Kirill А. Denisov, A. P. Sazonova, A. Korenevsky
BACKGROUND:Congenital malformations of the central nervous system have extremely severe consequences, which makes it important to study their development and diagnosis during embryogenesis. Therefore, particularly relevant are studies in the field of prevention of fetal сongenital malformations. AIM:The aim of this study was to assess the micronutrient status (vitamin D, serum and erythrocyte folic acid, vitamin B12) and homocysteine levels in women with induced abortion in the second trimester of pregnancy based on fetal indications (fetal сongenital malformations). MATERIALS AND METHODS:This prospective cohort study enrolled 53 women with induced abortion for medical reasons from the fetus in the second trimester of gestation. All pregnant women were divided into two groups. Group 1 included 28 individuals without an established chromosomal abnormality in the fetus: with fetal сongenital malformations and no neural tube defects (n= 16) or with fetal сongenital malformations and neural tube defects (n= 12). Group 2 consisted of 25 pregnant women with established chromosomal abnormalities in the fetus. RESULTS:In pregnant women with fetal сongenital malformations and neural tube defects, blood serum vitamin B12level correlated with erythrocyte folic acid level and was lower compared with women with fetal сongenital malformations and no neural tube defects (p 0.05). No significant differences were found for other parameters. In pregnant women with fetal сongenital malformations, homocysteine level did not differ from that in women with normal fetal development at this stage of pregnancy. Meanwhile, folic acid and vitamin B12levels in women with fetal сongenital malformations were lower compared with pregnant women without this pathology (p 0.001). CONCLUSIONS:The features of micronutrient status found in patients with fetal сongenital malformations, in particular with neural tube defects, and the relationships between its individual parameters indicate complex etiologies of these pathologies. The data obtained indicate the expediency of assessing one-carbon metabolic parameters in the mother not only during pregnancy, but also at the stage of preconception preparation, as well as the need for additional research related to adequate control of vitamin intake and assessment of methionine cycle gene polymorphism.
{"title":"Micronutrient status of pregnant women with fetal congenital malformations","authors":"Yu. P. Milyutina, Margarita O. Shengelia, O. Bespalova, Olga V. Pachuliya, A. A. Blazhenko, Kirill А. Denisov, A. P. Sazonova, A. Korenevsky","doi":"10.17816/jowd472088","DOIUrl":"https://doi.org/10.17816/jowd472088","url":null,"abstract":"BACKGROUND:Congenital malformations of the central nervous system have extremely severe consequences, which makes it important to study their development and diagnosis during embryogenesis. Therefore, particularly relevant are studies in the field of prevention of fetal сongenital malformations. AIM:The aim of this study was to assess the micronutrient status (vitamin D, serum and erythrocyte folic acid, vitamin B12) and homocysteine levels in women with induced abortion in the second trimester of pregnancy based on fetal indications (fetal сongenital malformations). MATERIALS AND METHODS:This prospective cohort study enrolled 53 women with induced abortion for medical reasons from the fetus in the second trimester of gestation. All pregnant women were divided into two groups. Group 1 included 28 individuals without an established chromosomal abnormality in the fetus: with fetal сongenital malformations and no neural tube defects (n= 16) or with fetal сongenital malformations and neural tube defects (n= 12). Group 2 consisted of 25 pregnant women with established chromosomal abnormalities in the fetus. RESULTS:In pregnant women with fetal сongenital malformations and neural tube defects, blood serum vitamin B12level correlated with erythrocyte folic acid level and was lower compared with women with fetal сongenital malformations and no neural tube defects (p 0.05). No significant differences were found for other parameters. In pregnant women with fetal сongenital malformations, homocysteine level did not differ from that in women with normal fetal development at this stage of pregnancy. Meanwhile, folic acid and vitamin B12levels in women with fetal сongenital malformations were lower compared with pregnant women without this pathology (p 0.001). CONCLUSIONS:The features of micronutrient status found in patients with fetal сongenital malformations, in particular with neural tube defects, and the relationships between its individual parameters indicate complex etiologies of these pathologies. The data obtained indicate the expediency of assessing one-carbon metabolic parameters in the mother not only during pregnancy, but also at the stage of preconception preparation, as well as the need for additional research related to adequate control of vitamin intake and assessment of methionine cycle gene polymorphism.","PeriodicalId":16623,"journal":{"name":"Journal of obstetrics and women's diseases","volume":"31 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139244287","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}
R. Kapustin, Tatyana K. Kascheeva, E. Shelaeva, E. Alekseenkova, E. Kopteeva, O. Arzhanova, T. B. Postnikova, I. Kogan
BACKGROUND:An increase in the number of pregnant women with various extragenital and gynecological pathologies and motivation for delayed motherhood form a large cohort of patients with a high risk of adverse obstetric outcomes. In this regard, it is necessary to study new approaches that allow stratification of these risks and personalization of pregnancy management and timing of delivery. AIM:The aim of this study was to compare the predictive values of using blood placental growth factor and pregnancy-associated plasma protein-A levels in combined first-trimester screening for the prediction of preeclampsia and fetal growth restriction in a high-risk pregnancy. MATERIALS AND METHODS:This retrospective cohort study enrolled 158 women, who received antenatal care or gave birth on the premises from April 1, 2020 through December 31, 2022. The following comparison groups were defined: pregestational diabetes mellitus (n= 34; group I), chronic arterial hypertension (n= 25; group II); obesity (body mass index more than30 kg/m2;n= 31; group III), older women (40 years and older) with an assisted reproductive technologies pregnancy (n= 8; group IV), and the control group (n= 60; group V). The endpoints of the study were determined as preeclampsia (early and late forms), fetal growth restriction, and the effect of acetylsalicylic acid administration on the risk of placenta-related complications. Various models were used to evaluate the diagnostic value of pregnancy-associated plasma protein-A and placental growth factor in predicting preeclampsia and fetal growth restriction, including maternal characteristics and history, as well as mean arterial pressure, uterine artery pulsatility index, placental growth factor and pregnancy-associated plasma protein-A levels. Statistical data processing was performed using Prism 9 GraphPad (USA). RESULTS:In all high-risk groups, there was a significant decrease in placental growth factor levels compared to the control group (p= 0.032). In patients who have developed preeclampsia, placental growth factor levels were statistically lower. Pregnancy-associated plasma protein-A and placental growth factor have demonstrated the greatest validity for predicting preeclampsia [area under curve 0.88 (0.81–0.94), and 0.93 (0.88–0.99)], early [area under curve 0.88 (0.77–0.95), and0.95 (0.88–0.99)]and late [area under curve 0.86 (0.72–0.9), and 0.91 (0.81–0.97)] forms. Fetal growth restriction prediction was less effective. Administration of acetylsalicylic acid from week 12 to weeks 35–36 of pregnancy contributed to a decrease in the overall risk of developing preeclampsia (relative risk 0.39; 95% confidence interval 0.23–0.65) and fetal growth restriction (in the fetal growth restriction subgroup) (relative risk 0.38; 95% confidence interval 0.12–0.96). CONCLUSIONS:The most effective approach for predicting preeclampsia and fetal growth restriction should include assessment of maternal factors, mean arterial pressure, ut
{"title":"Different risk-assessment models for prediction of preeclampsia and fetal growth restriction in the first trimester in a high-risk pregnancy – which models are better?","authors":"R. Kapustin, Tatyana K. Kascheeva, E. Shelaeva, E. Alekseenkova, E. Kopteeva, O. Arzhanova, T. B. Postnikova, I. Kogan","doi":"10.17816/jowd567815","DOIUrl":"https://doi.org/10.17816/jowd567815","url":null,"abstract":"BACKGROUND:An increase in the number of pregnant women with various extragenital and gynecological pathologies and motivation for delayed motherhood form a large cohort of patients with a high risk of adverse obstetric outcomes. In this regard, it is necessary to study new approaches that allow stratification of these risks and personalization of pregnancy management and timing of delivery. AIM:The aim of this study was to compare the predictive values of using blood placental growth factor and pregnancy-associated plasma protein-A levels in combined first-trimester screening for the prediction of preeclampsia and fetal growth restriction in a high-risk pregnancy. MATERIALS AND METHODS:This retrospective cohort study enrolled 158 women, who received antenatal care or gave birth on the premises from April 1, 2020 through December 31, 2022. The following comparison groups were defined: pregestational diabetes mellitus (n= 34; group I), chronic arterial hypertension (n= 25; group II); obesity (body mass index more than30 kg/m2;n= 31; group III), older women (40 years and older) with an assisted reproductive technologies pregnancy (n= 8; group IV), and the control group (n= 60; group V). The endpoints of the study were determined as preeclampsia (early and late forms), fetal growth restriction, and the effect of acetylsalicylic acid administration on the risk of placenta-related complications. Various models were used to evaluate the diagnostic value of pregnancy-associated plasma protein-A and placental growth factor in predicting preeclampsia and fetal growth restriction, including maternal characteristics and history, as well as mean arterial pressure, uterine artery pulsatility index, placental growth factor and pregnancy-associated plasma protein-A levels. Statistical data processing was performed using Prism 9 GraphPad (USA). RESULTS:In all high-risk groups, there was a significant decrease in placental growth factor levels compared to the control group (p= 0.032). In patients who have developed preeclampsia, placental growth factor levels were statistically lower. Pregnancy-associated plasma protein-A and placental growth factor have demonstrated the greatest validity for predicting preeclampsia [area under curve 0.88 (0.81–0.94), and 0.93 (0.88–0.99)], early [area under curve 0.88 (0.77–0.95), and0.95 (0.88–0.99)]and late [area under curve 0.86 (0.72–0.9), and 0.91 (0.81–0.97)] forms. Fetal growth restriction prediction was less effective. Administration of acetylsalicylic acid from week 12 to weeks 35–36 of pregnancy contributed to a decrease in the overall risk of developing preeclampsia (relative risk 0.39; 95% confidence interval 0.23–0.65) and fetal growth restriction (in the fetal growth restriction subgroup) (relative risk 0.38; 95% confidence interval 0.12–0.96). CONCLUSIONS:The most effective approach for predicting preeclampsia and fetal growth restriction should include assessment of maternal factors, mean arterial pressure, ut","PeriodicalId":16623,"journal":{"name":"Journal of obstetrics and women's diseases","volume":"180 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139246052","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}
A clinical case of widespread pulmonary endometriosis in a 65-year-old woman 25 years after surgical menopause is exposed. It is known from the history that earlier patient had endometriosis, as well as extragenital endometriosis involving the ureters. Conspicuous is the fact that menopausal hormone therapy was not prescribed, which could explain the recurrence of the disease. However, the presence of extragenital endometriosis lesions in the lungs and pelvic endometriotic infiltration may indicate reactivation of endometriosis. Taking into account the altered metabolism of estrogens in the endometriosis implants and low level of estradiol in peripheral blood, the use of aromatase inhibitors may be one of the strategies for the treatment of common forms of endometriosis, including extragenital, in the postmenopausal period.
{"title":"Pulmonary endometriosis 25 years after surgical menopause (clinical case report)","authors":"M. Yarmolinskaya, E. Suslova","doi":"10.17816/jowd569225","DOIUrl":"https://doi.org/10.17816/jowd569225","url":null,"abstract":"A clinical case of widespread pulmonary endometriosis in a 65-year-old woman 25 years after surgical menopause is exposed. It is known from the history that earlier patient had endometriosis, as well as extragenital endometriosis involving the ureters. Conspicuous is the fact that menopausal hormone therapy was not prescribed, which could explain the recurrence of the disease. However, the presence of extragenital endometriosis lesions in the lungs and pelvic endometriotic infiltration may indicate reactivation of endometriosis. Taking into account the altered metabolism of estrogens in the endometriosis implants and low level of estradiol in peripheral blood, the use of aromatase inhibitors may be one of the strategies for the treatment of common forms of endometriosis, including extragenital, in the postmenopausal period.","PeriodicalId":16623,"journal":{"name":"Journal of obstetrics and women's diseases","volume":"61 9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139242964","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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