R. Kapustin, Elizaveta M. Tcybuk, E. Kopteeva, E. Alekseenkova, S. Chepanov, E. Shelaeva, O. Arzhanova, A. Korenevsky, I. Kogan
BACKGROUND:Early screening for preeclampsia has shown high efficiency for low-risk groups, however, the presence of systemic vascular disease in patients with diabetes mellitus complicates their use and requires the development of additional approaches to predicting preeclampsia in this group of patients. AIM:The aim of this study was to evaluate the effectiveness of early prediction of preeclampsia with extended combined screening in patients with pregestational types of diabetes mellitus. MATERIALS AND METHODS:This study included 75 pregnant women: 40 patients with type 1 diabetes mellitus, and 35 patients with type 2 diabetes mellitus. To determine the risk of further preeclampsia development, we evaluated biochemical, biophysical and anamnestic factors, along with the serum levels of placental growth factor, soluble fms-like tyrosine kinase 1, and soluble endoglin at 11+0to 13+6gestational weeks. The main outcome assessed was the development of preeclampsia. RESULTS:In patients with further development of preeclampsia (35% in type 1 and 40 % in type 2 diabetic women), we observed higher soluble fms-like tyrosine kinase 1 / placental growth factor ratios, as well as elevated serum soluble endoglin (type 1 diabetes mellitus) and soluble fms-like tyrosine kinase 1 (type 2 diabetes mellitus) levels. Isolated determination of placental growth factor showed no significant differences in the levels of this angiogenic factor in preeclampsia. A multivariate predictive model for preeclampsia demonstrated high prognostic parameters: for patients with type 1 diabetes mellitus, area under the curve was 0.96 (95% confidence interval 0.931.00), with positive predictive value 76.7% and negative predictive value 90.1%; for patients with type 2 diabetes mellitus, area under the curve was 0.94 (95% confidence interval 0.861.00), with positive predictive value 88.5% and negative predictive value 97.1%. CONCLUSIONS:Specific biochemical and biophysical markers of preeclampsia combined with maternal risk factors and assessment of carbohydrate metabolism can increase the predictive value of early screening studies for preeclampsia in women with pregestational diabetes mellitus.
{"title":"Extended combined screening for preeclampsia prediction in women with diabetes mellitus","authors":"R. Kapustin, Elizaveta M. Tcybuk, E. Kopteeva, E. Alekseenkova, S. Chepanov, E. Shelaeva, O. Arzhanova, A. Korenevsky, I. Kogan","doi":"10.17816/jowd321321","DOIUrl":"https://doi.org/10.17816/jowd321321","url":null,"abstract":"BACKGROUND:Early screening for preeclampsia has shown high efficiency for low-risk groups, however, the presence of systemic vascular disease in patients with diabetes mellitus complicates their use and requires the development of additional approaches to predicting preeclampsia in this group of patients. \u0000AIM:The aim of this study was to evaluate the effectiveness of early prediction of preeclampsia with extended combined screening in patients with pregestational types of diabetes mellitus. \u0000MATERIALS AND METHODS:This study included 75 pregnant women: 40 patients with type 1 diabetes mellitus, and 35 patients with type 2 diabetes mellitus. To determine the risk of further preeclampsia development, we evaluated biochemical, biophysical and anamnestic factors, along with the serum levels of placental growth factor, soluble fms-like tyrosine kinase 1, and soluble endoglin at 11+0to 13+6gestational weeks. The main outcome assessed was the development of preeclampsia. \u0000RESULTS:In patients with further development of preeclampsia (35% in type 1 and 40 % in type 2 diabetic women), we observed higher soluble fms-like tyrosine kinase 1 / placental growth factor ratios, as well as elevated serum soluble endoglin (type 1 diabetes mellitus) and soluble fms-like tyrosine kinase 1 (type 2 diabetes mellitus) levels. Isolated determination of placental growth factor showed no significant differences in the levels of this angiogenic factor in preeclampsia. A multivariate predictive model for preeclampsia demonstrated high prognostic parameters: for patients with type 1 diabetes mellitus, area under the curve was 0.96 (95% confidence interval 0.931.00), with positive predictive value 76.7% and negative predictive value 90.1%; for patients with type 2 diabetes mellitus, area under the curve was 0.94 (95% confidence interval 0.861.00), with positive predictive value 88.5% and negative predictive value 97.1%. \u0000CONCLUSIONS:Specific biochemical and biophysical markers of preeclampsia combined with maternal risk factors and assessment of carbohydrate metabolism can increase the predictive value of early screening studies for preeclampsia in women with pregestational diabetes mellitus.","PeriodicalId":16623,"journal":{"name":"Journal of obstetrics and women's diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87748725","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}
Preterm birth remains a leading cause of perinatal mortality and morbidity in preterm infants and leads to significant annual health care costs. A special role in preventing premature birth belongs to tocolytic therapy, which allows for prolonging pregnancy and avoiding various complications. However, questions arise about the efficacy and safety of this therapy, which can be manifested by various isolated and combined side effects. The aim of the study was to assess the effectiveness and complications of tocolytic therapy. We analyzed the literature on eLibrary, Medline, Scopus, Cochrane Library, PubMed, ScienceDirect, etc.
{"title":"Tocolytics in obstetric practice","authors":"A. M. Ziganshin, Elena V. Akbulatova","doi":"10.17816/jowd115201","DOIUrl":"https://doi.org/10.17816/jowd115201","url":null,"abstract":"Preterm birth remains a leading cause of perinatal mortality and morbidity in preterm infants and leads to significant annual health care costs. A special role in preventing premature birth belongs to tocolytic therapy, which allows for prolonging pregnancy and avoiding various complications. However, questions arise about the efficacy and safety of this therapy, which can be manifested by various isolated and combined side effects. The aim of the study was to assess the effectiveness and complications of tocolytic therapy. We analyzed the literature on eLibrary, Medline, Scopus, Cochrane Library, PubMed, ScienceDirect, etc.","PeriodicalId":16623,"journal":{"name":"Journal of obstetrics and women's diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76162522","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}
Nikolay I. Polenov, M. Yarmolinskaya, Karina A. Zakuraeva, Valentina Yu. Krutikova, Elena V. Potapova, I. Kogan, Nodari D. Shengelia
BACKGROUND:Uterine fibroids are the most common benign tumor of the female reproductive system. A number of factors affect endometrial receptivity in patients with uterine fibroids such as transcription factorsHOXA10andHOXA11, cytokines (growth factors and inflammatory markers), etc. The negative effect of myomatous nodes, which deform the uterine cavity, on endometrial receptivity has been well studied and is beyond doubt, while the influence of intramural and intramural-subserosal fibroids on the endometrium is debatable. An important point is to define clear criteria that justify myomectomy in patients without clinical symptoms of the disease who are planning pregnancy, in particular, with the help of assisted reproductive technology. This article presents the results of studies on the impact of uterine fibroids of different locations on the endometrium. The data were obtained from foreign literature sources and such electronic databases as PubMed, CyberLeninka, and Google Scholar in the period from 2000 to 2022. This survey also reflects the main aspects of federal clinical recommendations and demonstrates the results of our own research. AIM:The aim of this study was to determine the effect of intramural and intramural-submucosal myomatous nodes nodes on the perfusion and metabolic characteristics of the endometrium. MATERIALS AND METHODS:We conducted a comprehensive examination of 20 patients of reproductive age with uterine fibroids who underwent surgical treatment in Gynecological Department One with Operating Unit of the Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott (Saint Petersburg, Russia) and the Gynecological Department of N.A. Semashko City Hospital No. 38 (Saint Petersburg, Russia). Two groups were formed: group I consisted of 10 patients with multiple uterine fibroids (FIGO types 2 and 3); group II included 10 patients with intramural and intramural-subserosal myomatous nodes (FIGO types 4 to 6). Studies of endometrial perfusion and metabolism were carried out using a fiber optic system that implements fluorescence spectroscopy and laser Doppler flowmetry, including the LAKK-M diagnostic complex (Lazma Ltd., Russia) and a laparoscopic fiber optic probe, followed by registration of optical signals. RESULTS:In the group of patients with uterine fibroids that deform the uterine cavity, we revealed a statistically significant decrease in the microcirculation index in endometrial tissues and an increase in fluorescence signals at a wavelength of 365 nm. This may indicate hypoxic phenomena in endometrial tissues of patients with FIGO types 2 and 3 fibroids. These findings are some of the significant pathogenetic causes of implantation disorders and abnormalities in the physiological course of pregnancy in patients of this study group. CONCLUSIONS:The data obtainedsubstantiate the need to continue research in this direction in order to develop perfusion-metabolic criteria that allow for optimiz
{"title":"Analysis of the impact of uterine fibroids of different locations and sizes on the perfusion and metabolic characteristics of the endometrium","authors":"Nikolay I. Polenov, M. Yarmolinskaya, Karina A. Zakuraeva, Valentina Yu. Krutikova, Elena V. Potapova, I. Kogan, Nodari D. Shengelia","doi":"10.17816/jowd120126","DOIUrl":"https://doi.org/10.17816/jowd120126","url":null,"abstract":"BACKGROUND:Uterine fibroids are the most common benign tumor of the female reproductive system. A number of factors affect endometrial receptivity in patients with uterine fibroids such as transcription factorsHOXA10andHOXA11, cytokines (growth factors and inflammatory markers), etc. The negative effect of myomatous nodes, which deform the uterine cavity, on endometrial receptivity has been well studied and is beyond doubt, while the influence of intramural and intramural-subserosal fibroids on the endometrium is debatable. An important point is to define clear criteria that justify myomectomy in patients without clinical symptoms of the disease who are planning pregnancy, in particular, with the help of assisted reproductive technology. This article presents the results of studies on the impact of uterine fibroids of different locations on the endometrium. The data were obtained from foreign literature sources and such electronic databases as PubMed, CyberLeninka, and Google Scholar in the period from 2000 to 2022. This survey also reflects the main aspects of federal clinical recommendations and demonstrates the results of our own research. \u0000AIM:The aim of this study was to determine the effect of intramural and intramural-submucosal myomatous nodes nodes on the perfusion and metabolic characteristics of the endometrium. \u0000MATERIALS AND METHODS:We conducted a comprehensive examination of 20 patients of reproductive age with uterine fibroids who underwent surgical treatment in Gynecological Department One with Operating Unit of the Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott (Saint Petersburg, Russia) and the Gynecological Department of N.A. Semashko City Hospital No. 38 (Saint Petersburg, Russia). Two groups were formed: group I consisted of 10 patients with multiple uterine fibroids (FIGO types 2 and 3); group II included 10 patients with intramural and intramural-subserosal myomatous nodes (FIGO types 4 to 6). Studies of endometrial perfusion and metabolism were carried out using a fiber optic system that implements fluorescence spectroscopy and laser Doppler flowmetry, including the LAKK-M diagnostic complex (Lazma Ltd., Russia) and a laparoscopic fiber optic probe, followed by registration of optical signals. \u0000RESULTS:In the group of patients with uterine fibroids that deform the uterine cavity, we revealed a statistically significant decrease in the microcirculation index in endometrial tissues and an increase in fluorescence signals at a wavelength of 365 nm. This may indicate hypoxic phenomena in endometrial tissues of patients with FIGO types 2 and 3 fibroids. These findings are some of the significant pathogenetic causes of implantation disorders and abnormalities in the physiological course of pregnancy in patients of this study group. \u0000CONCLUSIONS:The data obtainedsubstantiate the need to continue research in this direction in order to develop perfusion-metabolic criteria that allow for optimiz","PeriodicalId":16623,"journal":{"name":"Journal of obstetrics and women's diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91056157","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}
Margarita Yu. Vasileva, I. Smirnov, V. V. Ishkaraeva, N. Yakovleva, E. Vasilyeva, S. Chepanov, Lyudmila V. Kalosha, Olga N. Tamakhina, S. Selkov, I. Zazerskaya
BACKGROUND:Over the years, preeclampsia has remained a common pathology of pregnancy. Its severe form poses a significant threat to the health of the woman and the fetus. To assess the risk of developing preeclampsia, biochemical screening for placental growth factor and soluble tyrosine kinase-1 is carried out. The soluble glycoprotein endoglin, which regulates angiogenesis by influencing cell activation, adhesion, and migration, can supplement the idea of the imbalance of vascular factors in severe preeclampsia. A holistic study of anti- and proangiogenic factors can significantly complement the diagnosis of preeclampsia at the preclinical stage and a look at the course and treatment of this pregnancy complication. AIM:The aim of this work was to evaluate the concentrations of anti- and proangiogenic factors (soluble glycoprotein endoglin, soluble tyrosine kinase-1, placental growth factor) and compare the obtained data with the clinical manifestations of severe preeclampsia. MATERIALS AND METHODS:This case-control study included 81 pregnant women. The main group consisted of patients with severe preeclampsia (n= 41), while the control group comprised individuals with normal pregnancy (n= 40). To determine soluble glycoprotein endoglin levels in biological fluids, we used a new ELISA kit developed in the Laboratory of Hybridoma Technology, Academician A.M. Granov Russian Research Center for Radiology and Surgical Technologies (Saint Petersburg, Russia). placental growth factor and soluble tyrosine kinase-1 concentrations were assessed by electrochemiluminescence immunoassay using commercial Roche Diagnostics kits. Statistical analysis was performed using the StatTech v.3.0.6 program (Stattech Ltd., Russia). RESULTS:When analyzing the concentrations of anti- and proangiogenic factors (soluble glycoprotein endoglin in the blood serum and urine, soluble tyrosine kinase-1, placental growth factor and the ratio of these factors), depending on the study group, statistically significant results were obtained (p 0.05). The diagnostic significance of serum and urine soluble glycoprotein endoglin levels in predicting the probability of severe preeclampsia was assessed by the method of ROC curve analysis. Statistically significant differences (p 0.05) were found in the analysis of the concentrations of anti- and pro-angiogenic factors depending on the clinical manifestations such as systolic blood pressure 160 mm Hg (except for placental growth factor level), a multiple increase in urine soluble glycoprotein endoglin level with massive proteinuria, an increase in soluble glycoprotein endoglin levels in biological fluids with an increase in edematous syndrome. Correlation analysis revealed a significant relationship between anti- and proangiogenic factors and the term of delivery, as well as urine soluble glycoprotein endoglin level and the duration of the treatment. CONCLUSIONS:The data obtained complement the concept of severe preeclampsia. Knowing t
{"title":"Prognostic value of anti- and proangiogenic factors in severe preeclampsia","authors":"Margarita Yu. Vasileva, I. Smirnov, V. V. Ishkaraeva, N. Yakovleva, E. Vasilyeva, S. Chepanov, Lyudmila V. Kalosha, Olga N. Tamakhina, S. Selkov, I. Zazerskaya","doi":"10.17816/jowd159396","DOIUrl":"https://doi.org/10.17816/jowd159396","url":null,"abstract":"BACKGROUND:Over the years, preeclampsia has remained a common pathology of pregnancy. Its severe form poses a significant threat to the health of the woman and the fetus. To assess the risk of developing preeclampsia, biochemical screening for placental growth factor and soluble tyrosine kinase-1 is carried out. The soluble glycoprotein endoglin, which regulates angiogenesis by influencing cell activation, adhesion, and migration, can supplement the idea of the imbalance of vascular factors in severe preeclampsia. A holistic study of anti- and proangiogenic factors can significantly complement the diagnosis of preeclampsia at the preclinical stage and a look at the course and treatment of this pregnancy complication. \u0000AIM:The aim of this work was to evaluate the concentrations of anti- and proangiogenic factors (soluble glycoprotein endoglin, soluble tyrosine kinase-1, placental growth factor) and compare the obtained data with the clinical manifestations of severe preeclampsia. \u0000MATERIALS AND METHODS:This case-control study included 81 pregnant women. The main group consisted of patients with severe preeclampsia (n= 41), while the control group comprised individuals with normal pregnancy (n= 40). To determine soluble glycoprotein endoglin levels in biological fluids, we used a new ELISA kit developed in the Laboratory of Hybridoma Technology, Academician A.M. Granov Russian Research Center for Radiology and Surgical Technologies (Saint Petersburg, Russia). placental growth factor and soluble tyrosine kinase-1 concentrations were assessed by electrochemiluminescence immunoassay using commercial Roche Diagnostics kits. Statistical analysis was performed using the StatTech v.3.0.6 program (Stattech Ltd., Russia). \u0000RESULTS:When analyzing the concentrations of anti- and proangiogenic factors (soluble glycoprotein endoglin in the blood serum and urine, soluble tyrosine kinase-1, placental growth factor and the ratio of these factors), depending on the study group, statistically significant results were obtained (p 0.05). The diagnostic significance of serum and urine soluble glycoprotein endoglin levels in predicting the probability of severe preeclampsia was assessed by the method of ROC curve analysis. Statistically significant differences (p 0.05) were found in the analysis of the concentrations of anti- and pro-angiogenic factors depending on the clinical manifestations such as systolic blood pressure 160 mm Hg (except for placental growth factor level), a multiple increase in urine soluble glycoprotein endoglin level with massive proteinuria, an increase in soluble glycoprotein endoglin levels in biological fluids with an increase in edematous syndrome. Correlation analysis revealed a significant relationship between anti- and proangiogenic factors and the term of delivery, as well as urine soluble glycoprotein endoglin level and the duration of the treatment. \u0000CONCLUSIONS:The data obtained complement the concept of severe preeclampsia. Knowing t","PeriodicalId":16623,"journal":{"name":"Journal of obstetrics and women's diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82173409","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}
Aygul I. Gareyeva, A. S. Kovalchuk, D. Lioznov, D. S. Sudakov, Evgenia M. Nesvit, A. Kucheryavenko
BACKGROUND:HIV and COVID-19 remain some of global health problems today. Complications of these diseases, pregnancy and labor, as well as the perinatal condition of newborns can make a significant contribution to the deterioration of the demographic situation in this country. Summarizing the foreign and domestic literature, one may assess the impact of each individual pathogen on the condition of the pregnant woman and the fetus. However, we have not found data on the associative or antagonistic form of symbiosis of these pathogens, as well as on the joint effect on the pregnancy, labor and the condition of newborns in the available literature. AIM:The aim of this work was to analyze the outcomes of labor in women with the new coronavirus infection (COVID-19) and HIV infection. MATERIALS AND METHODS:We performed a retrospective analysis of birth histories of 63 women who were delivered in S.P. Botkin Clinical Infectious Diseases Hospital (Saint Petersburg, Russia) in the period from April 2020 to March 2022. Of these, 26 birth histories are of women with a combination of HIV infection and COVID-19, and 37 birth histories of women with HIV infection alone. We assessed the severity of COVID-19 in pregnant women with HIV infection, the course of labor, complications during childbirth and the condition of newborns. RESULTS:The groups did not differ in the duration of labor, the frequency of labor abnormalities, the volume of blood loss during delivery, the frequency of postpartum complications and the condition of newborns after one and five minutes on the Apgar scale. The duration of the anhydrous interval was significantly longer in women with HIV infection who did not suffer from COVID-19. The frequency of cesarean section was significantly higher in pregnant women with HIV infection and COVID-19. According to pathological examination, inflammatory changes in the placenta and signs characteristic of viral infection occurred more often in the group of women with HIV infection and COVID-19. CONCLUSIONS:The presence of COVID-19 affects the course of labor in patients with HIV infection. However, the frequency of caesarean section in the group of patients with HIV infection and COVID-19 was significantly higher due to obstetric reasons, and was not related to the severity of the mothers condition and the prenatal state of the fetus due to the infectious process. Inflammatory changes in the placenta and signs of a viral infection are more common in patients with COVID-19 and HIV infection. These data suggest that the combined course of these diseases may have a greater negative impact on the fetus than in women with HIV infection who do not suffer from COVID-19.
{"title":"Labor in women with the new coronavirus infection (COVID-19) and HIV infection","authors":"Aygul I. Gareyeva, A. S. Kovalchuk, D. Lioznov, D. S. Sudakov, Evgenia M. Nesvit, A. Kucheryavenko","doi":"10.17816/jowd133620","DOIUrl":"https://doi.org/10.17816/jowd133620","url":null,"abstract":"BACKGROUND:HIV and COVID-19 remain some of global health problems today. Complications of these diseases, pregnancy and labor, as well as the perinatal condition of newborns can make a significant contribution to the deterioration of the demographic situation in this country. Summarizing the foreign and domestic literature, one may assess the impact of each individual pathogen on the condition of the pregnant woman and the fetus. However, we have not found data on the associative or antagonistic form of symbiosis of these pathogens, as well as on the joint effect on the pregnancy, labor and the condition of newborns in the available literature. \u0000AIM:The aim of this work was to analyze the outcomes of labor in women with the new coronavirus infection (COVID-19) and HIV infection. \u0000MATERIALS AND METHODS:We performed a retrospective analysis of birth histories of 63 women who were delivered in S.P. Botkin Clinical Infectious Diseases Hospital (Saint Petersburg, Russia) in the period from April 2020 to March 2022. Of these, 26 birth histories are of women with a combination of HIV infection and COVID-19, and 37 birth histories of women with HIV infection alone. We assessed the severity of COVID-19 in pregnant women with HIV infection, the course of labor, complications during childbirth and the condition of newborns. \u0000RESULTS:The groups did not differ in the duration of labor, the frequency of labor abnormalities, the volume of blood loss during delivery, the frequency of postpartum complications and the condition of newborns after one and five minutes on the Apgar scale. The duration of the anhydrous interval was significantly longer in women with HIV infection who did not suffer from COVID-19. The frequency of cesarean section was significantly higher in pregnant women with HIV infection and COVID-19. According to pathological examination, inflammatory changes in the placenta and signs characteristic of viral infection occurred more often in the group of women with HIV infection and COVID-19. \u0000CONCLUSIONS:The presence of COVID-19 affects the course of labor in patients with HIV infection. However, the frequency of caesarean section in the group of patients with HIV infection and COVID-19 was significantly higher due to obstetric reasons, and was not related to the severity of the mothers condition and the prenatal state of the fetus due to the infectious process. Inflammatory changes in the placenta and signs of a viral infection are more common in patients with COVID-19 and HIV infection. These data suggest that the combined course of these diseases may have a greater negative impact on the fetus than in women with HIV infection who do not suffer from COVID-19.","PeriodicalId":16623,"journal":{"name":"Journal of obstetrics and women's diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88530680","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. Sulima, Zoya V. Gunar, Alexandr M. Adamov, A.E. Gordeychik, A. Mkrtchian, A. Davydova, N. Y. Tkacheva
This article describes a rare clinical case of progressive ectopic pregnancy in the cervix in a female patient of reproductive age, the incidence of which is less than 1% of all ectopic pregnancies. The exact etiopathogenetic mechanism of cervical pregnancy is still unknown. Misdiagnosis of cervical pregnancy can lead to a fatal outcome with massive bleeding and is associated with the risk of hysterectomy and complete loss of fertility in patients of reproductive age. This article presents the results of a pathoanatomical study confirming the diagnosis and adequacy of the performed therapeutic measures. We demonstrated the complexity of diagnosing this pathology, as well as the possibility and conditions for performing an organ-preserving surgery. The presented clinical case will allow doctors of various specialties to know more about this rare form of ectopic pregnancy, to suspect and successfully diagnose cervical pregnancy in the early stages of gestation, which will avoid or reduce the development of severe and sometimes life-threatening complications.
{"title":"Organ-preserving treatment in progressive cervical pregnancy. A clinical case","authors":"A. Sulima, Zoya V. Gunar, Alexandr M. Adamov, A.E. Gordeychik, A. Mkrtchian, A. Davydova, N. Y. Tkacheva","doi":"10.17816/jowd320930","DOIUrl":"https://doi.org/10.17816/jowd320930","url":null,"abstract":"This article describes a rare clinical case of progressive ectopic pregnancy in the cervix in a female patient of reproductive age, the incidence of which is less than 1% of all ectopic pregnancies. The exact etiopathogenetic mechanism of cervical pregnancy is still unknown. Misdiagnosis of cervical pregnancy can lead to a fatal outcome with massive bleeding and is associated with the risk of hysterectomy and complete loss of fertility in patients of reproductive age. \u0000This article presents the results of a pathoanatomical study confirming the diagnosis and adequacy of the performed therapeutic measures. We demonstrated the complexity of diagnosing this pathology, as well as the possibility and conditions for performing an organ-preserving surgery. The presented clinical case will allow doctors of various specialties to know more about this rare form of ectopic pregnancy, to suspect and successfully diagnose cervical pregnancy in the early stages of gestation, which will avoid or reduce the development of severe and sometimes life-threatening complications.","PeriodicalId":16623,"journal":{"name":"Journal of obstetrics and women's diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85910489","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}
M. E. Blokh, V. Anikina, S. Savenysheva, Maria I. Levintsova
BACKGROUND: The number of infertile women has been increasing since 2015, with a 1015% increase in IVF cycles every year. The data on mental health of women using assisted reproductive technology are contradictory; there is little research on the dynamics of mental health outcomes from pregnancy to postpartum. AIM: The aim of this study was to evaluate the dynamics of mental health measures in the groups of pre- and postpartum women using assisted reproductive technology and to compare these groups with women who conceived spontaneously. MATERIALS AND METHODS: This study had three stages: during pregnancy, within one month after delivery, and in four to nine months after childbirth, and included 59 women who used assisted reproductive technology (34.0 4.60 years old) and 85 women with natural pregnancy (30.6 4.39 years old). All the women had singleton, planned pregnancy, with the most of them at more than 20 weeks pregnant. Drop out within research stages was approximately 2030%. We used the Achenbach System of Empirically Based Assessment, socio-demographic and obstetric data gathering, as well as a postpartum telephone interview. RESULTS: Women in the assisted reproductive technology group were less likely (р = 0.000) to attend or plan to attend childbirth preparation courses. In this study group, emergency (40%) and planned (26%) caesarean sections were used more often (p = 0.001); in 17% of cases, they gave birth before 37 weeks of gestation (vs. 1.9% in the group of women with natural pregnancy); and only 51% of women undergoing assisted reproductive technology used breast feeding (vs. 78% in the group of women with natural pregnancy). No significant differences in Apgar scores and the number of problems in childs health straight after the delivery were shown. In 49 months after the childs birth in the group of women using assisted reproductive technology, the number of somatic disorders was significantly higher (р = 0.046) compared to the group of women with natural pregnancy. The analysis of the dynamics of mental health measures revealed an increase of withdrawal (p = 0.010) and thought problems (p = 0.001) in the group of women using assisted reproductive technology. In the group of women with natural pregnancy, the analysis revealed a decrease in the number of mental health problems such as anxiety / depression, somatic problems, delinquent behavior, as well as DSM-associated anxiety disorder and avoidance (р 0.05). CONCLUSIONS: Mental health measures of women undergoing assisted reproductive technology, their dynamics after childbirth, the number of preterm births and cesarean sections, as well as feeding type altogether may be a risk factor for the mental health and development of the children. These women may require additional support.
{"title":"The dynamics of mental health measures of pre- and postpartum women undergoing assisted reproductive technology","authors":"M. E. Blokh, V. Anikina, S. Savenysheva, Maria I. Levintsova","doi":"10.17816/jowd119976","DOIUrl":"https://doi.org/10.17816/jowd119976","url":null,"abstract":"BACKGROUND: The number of infertile women has been increasing since 2015, with a 1015% increase in IVF cycles every year. The data on mental health of women using assisted reproductive technology are contradictory; there is little research on the dynamics of mental health outcomes from pregnancy to postpartum. \u0000AIM: The aim of this study was to evaluate the dynamics of mental health measures in the groups of pre- and postpartum women using assisted reproductive technology and to compare these groups with women who conceived spontaneously. \u0000MATERIALS AND METHODS: This study had three stages: during pregnancy, within one month after delivery, and in four to nine months after childbirth, and included 59 women who used assisted reproductive technology (34.0 4.60 years old) and 85 women with natural pregnancy (30.6 4.39 years old). All the women had singleton, planned pregnancy, with the most of them at more than 20 weeks pregnant. Drop out within research stages was approximately 2030%. We used the Achenbach System of Empirically Based Assessment, socio-demographic and obstetric data gathering, as well as a postpartum telephone interview. \u0000RESULTS: Women in the assisted reproductive technology group were less likely (р = 0.000) to attend or plan to attend childbirth preparation courses. In this study group, emergency (40%) and planned (26%) caesarean sections were used more often (p = 0.001); in 17% of cases, they gave birth before 37 weeks of gestation (vs. 1.9% in the group of women with natural pregnancy); and only 51% of women undergoing assisted reproductive technology used breast feeding (vs. 78% in the group of women with natural pregnancy). No significant differences in Apgar scores and the number of problems in childs health straight after the delivery were shown. In 49 months after the childs birth in the group of women using assisted reproductive technology, the number of somatic disorders was significantly higher (р = 0.046) compared to the group of women with natural pregnancy. The analysis of the dynamics of mental health measures revealed an increase of withdrawal (p = 0.010) and thought problems (p = 0.001) in the group of women using assisted reproductive technology. In the group of women with natural pregnancy, the analysis revealed a decrease in the number of mental health problems such as anxiety / depression, somatic problems, delinquent behavior, as well as DSM-associated anxiety disorder and avoidance (р 0.05). \u0000CONCLUSIONS: Mental health measures of women undergoing assisted reproductive technology, their dynamics after childbirth, the number of preterm births and cesarean sections, as well as feeding type altogether may be a risk factor for the mental health and development of the children. These women may require additional support.","PeriodicalId":16623,"journal":{"name":"Journal of obstetrics and women's diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86005815","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}
T. Khusnutdinova, E. Shipitsyna, A. Krysanova, A. Savicheva, R. Kapustin
BACKGROUND: Urinary tract infections are among the most common infectious diseases in women and are the most frequent cause of infectious complications of pregnancy, especially in pregnant women with type 1 diabetes mellitus. For adequate treatment of urinary tract infections in pregnant women with type 1 diabetes mellitus, it is requisite to regularly monitor antimicrobial resistance of uropathogens in order to update empirical schemes of antibacterial therapy. AIM: The aim of this study was to determine the spectrum of uropathogens and the activity of antibacterial drugs against pathogens of community-acquired urinary tract infections in pregnant women with type 1 diabetes mellitus or without diabetes mellitus. MATERIALS AND METHODS: We analyzed 91 strains obtained from pregnant women with or without type 1 diabetes mellitus. The sensitivity of microorganisms to all antibacterial drugs was evaluated by the disk diffusion method. RESULTS: In the group of pregnant women with type 1 diabetes mellitus in the etiological structure of uropathogens, enterobacteria accounted for 84.8%, Escherichia coli (71.7%) and Klebsiella spp. (13.0%) being the most common. In the group of pregnant women without diabetes mellitus in the structure of uropathogens, enterobacteria accounted for 75.6%, while E. coli was the causative agent of urinary tract infections in 62.2% of women and Klebsiella spp. in 11.1%. Gram-positive uropathogens were isolated much less frequently. In the group of pregnant women with type 1 diabetes mellitus, piperacillin/tazobactam, carbapenems, nitrofurantoin, and amikacin (100%), as well as fosfomycin and gentamicin (97%), had the maximum antibacterial activity against E. coli. The sensitivity of E. coli to various cephalosporins varied in the range of 84.990.9%. In the group of pregnant women without diabetes mellitus and with urinary tract infections, the highest E. coli sensitivity rates were observed for piperacillin/tazobactam, carbapenems, fosfomycin, nitrofurantoin, gentamicin, and amikacin (100%). E. coli sensitivity to second and third generation cephalosporins varied in the range of 75.082.1%, and it was 96.4% to cefepime. Ampicillin and amoxicillin/clavulanate demonstrated the least activity against E. coli in the two study groups. The rate of extended spectrum beta-lactamase production by uropathogenic enterobacteria in pregnant women with type 1 diabetes mellitus was 15.8% of the strains, and in pregnant women without diabetes mellitus, it was 18.1%. CONCLUSIONS: There were no significant differences in the activity of antibacterial drugs against the pathogens of community-acquired urinary tract infections in pregnant women with or without diabetes mellitus.
{"title":"Antibiotic resistance of pathogens causing community-acquired urinary tract infections in pregnant women with diabetes mellitus","authors":"T. Khusnutdinova, E. Shipitsyna, A. Krysanova, A. Savicheva, R. Kapustin","doi":"10.17816/jowd115215","DOIUrl":"https://doi.org/10.17816/jowd115215","url":null,"abstract":"BACKGROUND: Urinary tract infections are among the most common infectious diseases in women and are the most frequent cause of infectious complications of pregnancy, especially in pregnant women with type 1 diabetes mellitus. For adequate treatment of urinary tract infections in pregnant women with type 1 diabetes mellitus, it is requisite to regularly monitor antimicrobial resistance of uropathogens in order to update empirical schemes of antibacterial therapy. \u0000AIM: The aim of this study was to determine the spectrum of uropathogens and the activity of antibacterial drugs against pathogens of community-acquired urinary tract infections in pregnant women with type 1 diabetes mellitus or without diabetes mellitus. \u0000MATERIALS AND METHODS: We analyzed 91 strains obtained from pregnant women with or without type 1 diabetes mellitus. The sensitivity of microorganisms to all antibacterial drugs was evaluated by the disk diffusion method. \u0000RESULTS: In the group of pregnant women with type 1 diabetes mellitus in the etiological structure of uropathogens, enterobacteria accounted for 84.8%, Escherichia coli (71.7%) and Klebsiella spp. (13.0%) being the most common. In the group of pregnant women without diabetes mellitus in the structure of uropathogens, enterobacteria accounted for 75.6%, while E. coli was the causative agent of urinary tract infections in 62.2% of women and Klebsiella spp. in 11.1%. Gram-positive uropathogens were isolated much less frequently. In the group of pregnant women with type 1 diabetes mellitus, piperacillin/tazobactam, carbapenems, nitrofurantoin, and amikacin (100%), as well as fosfomycin and gentamicin (97%), had the maximum antibacterial activity against E. coli. The sensitivity of E. coli to various cephalosporins varied in the range of 84.990.9%. In the group of pregnant women without diabetes mellitus and with urinary tract infections, the highest E. coli sensitivity rates were observed for piperacillin/tazobactam, carbapenems, fosfomycin, nitrofurantoin, gentamicin, and amikacin (100%). E. coli sensitivity to second and third generation cephalosporins varied in the range of 75.082.1%, and it was 96.4% to cefepime. Ampicillin and amoxicillin/clavulanate demonstrated the least activity against E. coli in the two study groups. The rate of extended spectrum beta-lactamase production by uropathogenic enterobacteria in pregnant women with type 1 diabetes mellitus was 15.8% of the strains, and in pregnant women without diabetes mellitus, it was 18.1%. \u0000CONCLUSIONS: There were no significant differences in the activity of antibacterial drugs against the pathogens of community-acquired urinary tract infections in pregnant women with or without diabetes mellitus.","PeriodicalId":16623,"journal":{"name":"Journal of obstetrics and women's diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87543849","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}
Margarita O. Shengelia, O. Bespalova, Olga V. Pachuliia, Nodari D. Shengeliia, Alexander V. Baldin, Y. Nasykhova, A. Glotov
The article shows the genetic causes of recurrent fetal malformations on the example of a clinical case of hereditary short-rib thoracic dysplasia type 3. Congenital malformations of the fetus are most often sporadic; however, in rare cases, this pathology can recur in one married couple, and the formation of congenital anomalies during subsequent pregnancy can both have general syndromes and affect various systems and organs. Short-rib thoracic dysplasia type 3 is a rare genetic disorder with autosomal recessive inheritance. Patients for whom the carriage of pathogenic alleles in genes associated with congenital skeletal anomalies has been confirmed require a detailed clinical examination. Such married couples want expert-level medical genetic counseling with performing additional genetic tests, if necessary. This may clarify the diagnosis, which will determine further tactics for preparing the couple for the next pregnancy on their own or using assisted reproductive technology programs and / or surrogate motherhood.
{"title":"Repeated clinical case of fetal congenital malformation in a family with hereditary short-rib thoracic dysplasia type 3","authors":"Margarita O. Shengelia, O. Bespalova, Olga V. Pachuliia, Nodari D. Shengeliia, Alexander V. Baldin, Y. Nasykhova, A. Glotov","doi":"10.17816/jowd112166","DOIUrl":"https://doi.org/10.17816/jowd112166","url":null,"abstract":"The article shows the genetic causes of recurrent fetal malformations on the example of a clinical case of hereditary short-rib thoracic dysplasia type 3. \u0000Congenital malformations of the fetus are most often sporadic; however, in rare cases, this pathology can recur in one married couple, and the formation of congenital anomalies during subsequent pregnancy can both have general syndromes and affect various systems and organs. \u0000Short-rib thoracic dysplasia type 3 is a rare genetic disorder with autosomal recessive inheritance. Patients for whom the carriage of pathogenic alleles in genes associated with congenital skeletal anomalies has been confirmed require a detailed clinical examination. Such married couples want expert-level medical genetic counseling with performing additional genetic tests, if necessary. This may clarify the diagnosis, which will determine further tactics for preparing the couple for the next pregnancy on their own or using assisted reproductive technology programs and / or surrogate motherhood.","PeriodicalId":16623,"journal":{"name":"Journal of obstetrics and women's diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88252067","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 article presents a modern review of the main classifications of adenomyosis based on the clinical course, the prevalence of the pathological process, the results of ultrasound and magnetic resonance imaging, and histological verification. The analysis is based on domestic and foreign literature, federal clinical recommendations, and results of our own research. Despite the large number of different classifications of the disease, there are still shortcomings noted in this review. Based on the available rubricators, we emphasized the need to create a classification of adenomyosis with an assessment of the clinical picture, genetic and molecular profiles, the results of non-invasive assessment methods, and a correlation with the histological conclusion. A unified classification would solve many problems in scientific and practical activities for accurate and early diagnosis of adenomyosis, identification of risk groups for patients with an aggressive course of the pathological process, selection of reasonable recommendations, and timely appointment of pathogenetic therapy.
{"title":"Modern approaches to classification of adenomyosis","authors":"M. Yarmolinskaya, M. Shalina, S. V. Nagorneva","doi":"10.17816/jowd121307","DOIUrl":"https://doi.org/10.17816/jowd121307","url":null,"abstract":"This article presents a modern review of the main classifications of adenomyosis based on the clinical course, the prevalence of the pathological process, the results of ultrasound and magnetic resonance imaging, and histological verification. The analysis is based on domestic and foreign literature, federal clinical recommendations, and results of our own research. Despite the large number of different classifications of the disease, there are still shortcomings noted in this review. Based on the available rubricators, we emphasized the need to create a classification of adenomyosis with an assessment of the clinical picture, genetic and molecular profiles, the results of non-invasive assessment methods, and a correlation with the histological conclusion. A unified classification would solve many problems in scientific and practical activities for accurate and early diagnosis of adenomyosis, identification of risk groups for patients with an aggressive course of the pathological process, selection of reasonable recommendations, and timely appointment of pathogenetic therapy.","PeriodicalId":16623,"journal":{"name":"Journal of obstetrics and women's diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83992682","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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