Pub Date : 2023-06-30DOI: 10.30841/2708-8731.4.2023.285761
G. Makurina, V. Siusiuka, A. Chornenka, A. Shevchenko, L. О. Cherneda
The article is devoted to the literature review on the correction of age-related skin changes in women. Skin aging is a physiological process that is caused by the constant action of unmodified factors, for example, endocrine disorders, shortening of telomeres, etc., in combination with periodic influence of modified (exposomal) factors. Ultraviolet radiation takes first place among external factors affecting the progression of degenerative changes in skin, however, in women, involutional changes in skin are primarily associated with a fading of synthetic function of ovaries. During the first five years from the onset of menopause, content of collagen fibers I and III types is reduced by 30% in combination with a further reduction of 2% annually for the next 15 years.Involutive transformations occur in all layers of skin and are visually characterized by the presence of wrinkles, roughness of the epidermal surface (with photoaging) or a decrease in its thickness (with chronic aging), dryness, pigmentation disorders in the form of uneven hyperpigmented spots, telangiectasias, oval deformations.Today, there are many methods of aesthetic correction of age-related skin changes. In the arsenal of a cosmetologist there are both invasive (PRP-therapy, microneedling, microneedle radio wave lifting, administration of preparations based on calcium hydroxyapatite, polylactic and hyaluronic acid, etc.) and minimally invasive (administration of botulinum neuroprotein, application of chemical acid peelings, IPL-therapy and laser polishing, photodynamic therapy) methods. Patients prefer minimally traumatic procedures due to the fact that they almost do not disturb the processes of socialization, however, each of these methods has both advantages and disadvantages.Modification of a woman life quality in peri- and menopause in form of changes in lifestyle and eating behavior, increasing physical activity, quitting smoking and limiting the use of alcoholic beverages is an integral part of therapeutic care. However, the appointment of menopausal hormonal therapy, including the use of estrogens, progestogens and combined hormonal drugs, allows to achieve a stable and long-lasting effect from cosmetology procedures and home care.
{"title":"Modern approaches to the correction of age-related skin changes in women","authors":"G. Makurina, V. Siusiuka, A. Chornenka, A. Shevchenko, L. О. Cherneda","doi":"10.30841/2708-8731.4.2023.285761","DOIUrl":"https://doi.org/10.30841/2708-8731.4.2023.285761","url":null,"abstract":"The article is devoted to the literature review on the correction of age-related skin changes in women. Skin aging is a physiological process that is caused by the constant action of unmodified factors, for example, endocrine disorders, shortening of telomeres, etc., in combination with periodic influence of modified (exposomal) factors. Ultraviolet radiation takes first place among external factors affecting the progression of degenerative changes in skin, however, in women, involutional changes in skin are primarily associated with a fading of synthetic function of ovaries. During the first five years from the onset of menopause, content of collagen fibers I and III types is reduced by 30% in combination with a further reduction of 2% annually for the next 15 years.Involutive transformations occur in all layers of skin and are visually characterized by the presence of wrinkles, roughness of the epidermal surface (with photoaging) or a decrease in its thickness (with chronic aging), dryness, pigmentation disorders in the form of uneven hyperpigmented spots, telangiectasias, oval deformations.Today, there are many methods of aesthetic correction of age-related skin changes. In the arsenal of a cosmetologist there are both invasive (PRP-therapy, microneedling, microneedle radio wave lifting, administration of preparations based on calcium hydroxyapatite, polylactic and hyaluronic acid, etc.) and minimally invasive (administration of botulinum neuroprotein, application of chemical acid peelings, IPL-therapy and laser polishing, photodynamic therapy) methods. Patients prefer minimally traumatic procedures due to the fact that they almost do not disturb the processes of socialization, however, each of these methods has both advantages and disadvantages.Modification of a woman life quality in peri- and menopause in form of changes in lifestyle and eating behavior, increasing physical activity, quitting smoking and limiting the use of alcoholic beverages is an integral part of therapeutic care. However, the appointment of menopausal hormonal therapy, including the use of estrogens, progestogens and combined hormonal drugs, allows to achieve a stable and long-lasting effect from cosmetology procedures and home care.","PeriodicalId":21003,"journal":{"name":"Reproductive health of woman","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81860728","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}
Pub Date : 2023-06-30DOI: 10.30841/2708-8731.4.2023.285759
N.Y. Zhylka, O. Shcherbinska, I.P. Netskar
The maternal mortality (MM) rate is considered an integrated indicator of women’s reproductive health, which reflects not only the state of general health, including reproductive one, the quality of medical care for pregnant women and the level of organizational work of maternity institutions, but also the combined interaction of these factors with economic, ecological, sanitary-cultural, social-hygienic and other ones.The objective: to highlight the current problem of MM in Ukraine and the world, finding its main factors and ways to solve it.Materials and methods. Bibliosemantic, analytical, statistical and conceptual methods were used. The research period is 2010–2022.Results. The MM rate is currently an extreme problem worldwide. The World Health Organization (WHO) emphasizes that MM is unacceptably high. In 2020, almost 287,000 women died during and after pregnancy and childbirth. Almost 95% of all maternal deaths in 2020 occurred in low-income and lower-middle-income countries, and most of them were preventable.Conclusions. In Ukraine, there is a negative wave-like situation with the MM indicator, that is fluctuations from decrease to increase. And even the decrease in the MM indicator does not reach its level in developed countries. In 2022, 19.3 per 100,000 live births were registered. The main reasons for the high rates of MM in Ukraine are: the imperfection of the health care system in relation to the formation of reproductive health in adolescents, the loss of the potential of the family planning system, the insufficient level of accessibility of Ukrainian women to reproductive health care services, the low level of organization of perinatal assistance and its effectiveness, lack of a monitoring system for compliance with quality criteria of clinical protocols, as well as an insufficient level of socio-economic support of the population.The implementation of measures of the WHO Global Strategy and goals for the prevention of maternal mortality by 2030 will contribute to the reduction of the MM indicator, namely, the increase in the availability and quality of medical and sanitary services in the health care system of adolescents, mothers and newborns, in reproductive health, for the prevention of maternal mortality, improving the efficiency of the health care system.
{"title":"Situational analysis of the problem of maternal mortality in Ukraine and ways to solve it","authors":"N.Y. Zhylka, O. Shcherbinska, I.P. Netskar","doi":"10.30841/2708-8731.4.2023.285759","DOIUrl":"https://doi.org/10.30841/2708-8731.4.2023.285759","url":null,"abstract":"The maternal mortality (MM) rate is considered an integrated indicator of women’s reproductive health, which reflects not only the state of general health, including reproductive one, the quality of medical care for pregnant women and the level of organizational work of maternity institutions, but also the combined interaction of these factors with economic, ecological, sanitary-cultural, social-hygienic and other ones.The objective: to highlight the current problem of MM in Ukraine and the world, finding its main factors and ways to solve it.Materials and methods. Bibliosemantic, analytical, statistical and conceptual methods were used. The research period is 2010–2022.Results. The MM rate is currently an extreme problem worldwide. The World Health Organization (WHO) emphasizes that MM is unacceptably high. In 2020, almost 287,000 women died during and after pregnancy and childbirth. Almost 95% of all maternal deaths in 2020 occurred in low-income and lower-middle-income countries, and most of them were preventable.Conclusions. In Ukraine, there is a negative wave-like situation with the MM indicator, that is fluctuations from decrease to increase. And even the decrease in the MM indicator does not reach its level in developed countries. In 2022, 19.3 per 100,000 live births were registered. The main reasons for the high rates of MM in Ukraine are: the imperfection of the health care system in relation to the formation of reproductive health in adolescents, the loss of the potential of the family planning system, the insufficient level of accessibility of Ukrainian women to reproductive health care services, the low level of organization of perinatal assistance and its effectiveness, lack of a monitoring system for compliance with quality criteria of clinical protocols, as well as an insufficient level of socio-economic support of the population.The implementation of measures of the WHO Global Strategy and goals for the prevention of maternal mortality by 2030 will contribute to the reduction of the MM indicator, namely, the increase in the availability and quality of medical and sanitary services in the health care system of adolescents, mothers and newborns, in reproductive health, for the prevention of maternal mortality, improving the efficiency of the health care system.","PeriodicalId":21003,"journal":{"name":"Reproductive health of woman","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84849202","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}
Pub Date : 2023-06-30DOI: 10.30841/2708-8731.4.2023.285769
O. Zahorodnia, Yu. B. Motsyuk, T.V. Amerkhanova
Childbirth is the result of a rapid biological reaction, in which the humoral and cellular links of immunity take part. Therefore, all attempts to stop the uterine premature contractile activity at the level of the myometrium have only a temporary effect. This review deals with the modern scientific data about the role of immune mechanisms in the labor activity origin from the point of view of the possibilities of predicting its anomalies and pathogenetically based treatment of premature labor.Cytokine balance plays a role already in the process of implantation, during the interaction between the endometrium and the fertilized egg. The increased content of pro-inflammatory cytokines in the endometrium is more typical for the women with normal implantation than for the patients with recurrent reproductive losses. Endometrial decidualization, vascular remodeling occurs under the influence of pro-inflammatory mediators. The traditional view of the preterm labor pathogenesis assumes its infectious nature, which is confirmed by the prevalence of infection in premature newborns and is explained by the activation of pro-inflammatory mediators.Modern opinions regarding the primacy of the inflammatory response in premature rupture of the fetal membranes are outlined. The heterogeneity of the inflammatory response in different patients found an explanation in the polymorphism of genes encoding the main receptors of the immune response – TOLL receptors. The discovery of numerous proteins of the acute inflammation phase led to the search for their role in the implementation of labor activity. So far, the ability to stimulate labor activity has been shown for FCGR3A protein and haptoglobin.Inadequate consideration of the inflammatory reaction role, in particular its systemic nature, in the pathogenesis of premature labor has led to an overestimation of the possibilities of tocolytic therapy. Meta-analyses indicate that the use of tocolytics, despite the effective increase in the duration of pregnancy, does not improve the condition and prognosis of the newborn. Most tocolytic drugs have a point of application of a part of the myocyte, contact with which blocks its contraction. However, all of them, with the exception of indomethacin, do not affect the immunological causes of the development of premature labor, and therefore do not eliminate their effect on the fetus.The inflammatory reaction does not always have an infectious origin, so the management of routinely prescribing antibacterial drugs to prevent premature births has also not spread. At present, it should be recognized that powerful inflammatory processes underlying labor activity, premature in particular, in most cases determine the inevitability of premature birth.Research on finding the regulation of inflammatory mechanisms for the regulation of labor activity can be considered promising, but they are in the early theoretical stages. For a modern doctor, the systemic nature of the inflammatory re
{"title":"Labour as a manifestation of systemic inflammatory reaction (Literature review)","authors":"O. Zahorodnia, Yu. B. Motsyuk, T.V. Amerkhanova","doi":"10.30841/2708-8731.4.2023.285769","DOIUrl":"https://doi.org/10.30841/2708-8731.4.2023.285769","url":null,"abstract":"Childbirth is the result of a rapid biological reaction, in which the humoral and cellular links of immunity take part. Therefore, all attempts to stop the uterine premature contractile activity at the level of the myometrium have only a temporary effect. This review deals with the modern scientific data about the role of immune mechanisms in the labor activity origin from the point of view of the possibilities of predicting its anomalies and pathogenetically based treatment of premature labor.Cytokine balance plays a role already in the process of implantation, during the interaction between the endometrium and the fertilized egg. The increased content of pro-inflammatory cytokines in the endometrium is more typical for the women with normal implantation than for the patients with recurrent reproductive losses. Endometrial decidualization, vascular remodeling occurs under the influence of pro-inflammatory mediators. The traditional view of the preterm labor pathogenesis assumes its infectious nature, which is confirmed by the prevalence of infection in premature newborns and is explained by the activation of pro-inflammatory mediators.Modern opinions regarding the primacy of the inflammatory response in premature rupture of the fetal membranes are outlined. The heterogeneity of the inflammatory response in different patients found an explanation in the polymorphism of genes encoding the main receptors of the immune response – TOLL receptors. The discovery of numerous proteins of the acute inflammation phase led to the search for their role in the implementation of labor activity. So far, the ability to stimulate labor activity has been shown for FCGR3A protein and haptoglobin.Inadequate consideration of the inflammatory reaction role, in particular its systemic nature, in the pathogenesis of premature labor has led to an overestimation of the possibilities of tocolytic therapy. Meta-analyses indicate that the use of tocolytics, despite the effective increase in the duration of pregnancy, does not improve the condition and prognosis of the newborn. Most tocolytic drugs have a point of application of a part of the myocyte, contact with which blocks its contraction. However, all of them, with the exception of indomethacin, do not affect the immunological causes of the development of premature labor, and therefore do not eliminate their effect on the fetus.The inflammatory reaction does not always have an infectious origin, so the management of routinely prescribing antibacterial drugs to prevent premature births has also not spread. At present, it should be recognized that powerful inflammatory processes underlying labor activity, premature in particular, in most cases determine the inevitability of premature birth.Research on finding the regulation of inflammatory mechanisms for the regulation of labor activity can be considered promising, but they are in the early theoretical stages. For a modern doctor, the systemic nature of the inflammatory re","PeriodicalId":21003,"journal":{"name":"Reproductive health of woman","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79516496","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}
Pub Date : 2023-06-30DOI: 10.30841/2708-8731.4.2023.285765
V. Benyuk, A. Chebotarova, N. M. Hychka, Tetiana Kovaliuk, S. Beniuk, I. Usevych, V. Kurochka, V.O. Polovynka
The improvement of the providing medical services quality to pregnant women remains an urgent issue in modern obstetrics. Women with perinatal losses deserve special attention, especially in the second half of pregnancy. Changes in the hemostasis system are an integral part of the development of pregnancy. The tendency to hypercoagulation has significant pathogenetic significance and can be the cause of a number of complications – miscarriage in the I trimester of pregnancy and preeclampsia, premature birth, antenatal fetal death (AFD) – in the II and III trimesters of pregnancy. Also, pregnancy is a background process for the activation of a number of diseases, in particular hereditary thrombophilia.The objective: to evaluate the changes in the hemostasis system in women with antenatal fetal death and the effectiveness of the use of low molecular weight heparins for the correction of disorders in the hemostasis system in this category of patients during childbirth and in the postpartum period.Materials and methods. 72 women were examined, including 42 pregnant women with AFD (main group) and 30 pregnant women with a physiological course of pregnancy, childbirth and the postpartum period (control group). The state of the hemostasis system was studied using a standard coagulogram. D-dimer was determined by immunoturbometric analysis.To assess the state of the hemostasis system, the following biochemical tests were used: procoagulant link – fibrinogen content and indicators: prothrombin index, activated partial thrombin time (APTT), thrombin time (TP), ancistrone time (AT), soluble fibrinogen-monomer complex (SFMC), factor X (FX); to evaluate the antithrombin system, the content of antithrombin-III (AT-III), protein C were determined; to characterize the state of the fibrinolytic system – the amount of plasminogen, α2-antiplasmin, fibrinogen degradation products (FDC).Thrombophilia markers and antiphospholipid antibodies were also determined. The preference was given to vaginal childbirth. During childbirth, mechanical compression of the lower limbs was applied using special compression stockings (compression level 2). In 12 hours after delivery thromboprophylaxis with low molecular weight heparins was started, the drug of choice being enoxaparin sodium. After 48 hours of the postpartum period, a comparative analysis of coagulogram indicators was performed to further determine the timing of thromboprophylaxis.Results. Analysis of family thrombotic anamnesis revealed risk factors in 12 (28.6%) patients of the main group. In close relatives of the first line, the presence of peripheral vein thrombosis was found – 5 (41.7%) cases, myocardial infarction under the age of 45 – 3 (25.0%) cases, pulmonary embolism – 1 (8.3%) case, transient ischemic attack of the brain – 3 (25.0%).In the control group only 2 (6.6%) patients had a family history of venous thromboembolism in first-line relatives. The analysis of the coagulation system shows significantly hig
{"title":"Features of disorders and methods of correction of the hemostasis system in women with antenatal fetal death","authors":"V. Benyuk, A. Chebotarova, N. M. Hychka, Tetiana Kovaliuk, S. Beniuk, I. Usevych, V. Kurochka, V.O. Polovynka","doi":"10.30841/2708-8731.4.2023.285765","DOIUrl":"https://doi.org/10.30841/2708-8731.4.2023.285765","url":null,"abstract":"The improvement of the providing medical services quality to pregnant women remains an urgent issue in modern obstetrics. Women with perinatal losses deserve special attention, especially in the second half of pregnancy. Changes in the hemostasis system are an integral part of the development of pregnancy. The tendency to hypercoagulation has significant pathogenetic significance and can be the cause of a number of complications – miscarriage in the I trimester of pregnancy and preeclampsia, premature birth, antenatal fetal death (AFD) – in the II and III trimesters of pregnancy. Also, pregnancy is a background process for the activation of a number of diseases, in particular hereditary thrombophilia.The objective: to evaluate the changes in the hemostasis system in women with antenatal fetal death and the effectiveness of the use of low molecular weight heparins for the correction of disorders in the hemostasis system in this category of patients during childbirth and in the postpartum period.Materials and methods. 72 women were examined, including 42 pregnant women with AFD (main group) and 30 pregnant women with a physiological course of pregnancy, childbirth and the postpartum period (control group). The state of the hemostasis system was studied using a standard coagulogram. D-dimer was determined by immunoturbometric analysis.To assess the state of the hemostasis system, the following biochemical tests were used: procoagulant link – fibrinogen content and indicators: prothrombin index, activated partial thrombin time (APTT), thrombin time (TP), ancistrone time (AT), soluble fibrinogen-monomer complex (SFMC), factor X (FX); to evaluate the antithrombin system, the content of antithrombin-III (AT-III), protein C were determined; to characterize the state of the fibrinolytic system – the amount of plasminogen, α2-antiplasmin, fibrinogen degradation products (FDC).Thrombophilia markers and antiphospholipid antibodies were also determined. The preference was given to vaginal childbirth. During childbirth, mechanical compression of the lower limbs was applied using special compression stockings (compression level 2). In 12 hours after delivery thromboprophylaxis with low molecular weight heparins was started, the drug of choice being enoxaparin sodium. After 48 hours of the postpartum period, a comparative analysis of coagulogram indicators was performed to further determine the timing of thromboprophylaxis.Results. Analysis of family thrombotic anamnesis revealed risk factors in 12 (28.6%) patients of the main group. In close relatives of the first line, the presence of peripheral vein thrombosis was found – 5 (41.7%) cases, myocardial infarction under the age of 45 – 3 (25.0%) cases, pulmonary embolism – 1 (8.3%) case, transient ischemic attack of the brain – 3 (25.0%).In the control group only 2 (6.6%) patients had a family history of venous thromboembolism in first-line relatives. The analysis of the coagulation system shows significantly hig","PeriodicalId":21003,"journal":{"name":"Reproductive health of woman","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75413095","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}
Pub Date : 2023-06-30DOI: 10.30841/2708-8731.4.2023.285760
V. I. Medved, S. I. Zhuk, D. Konkov, S.K. Litvinov, O.L. Ocheretna
Nausea and vomiting, or early toxicosis, is a common disorder during pregnancy, affecting up to 80% of pregnant women. The severe form is known as excessive vomiting of pregnancy – hyperemesis gravidarum (HG) and is a debilitating and potentially life-threatening illness during pregnancy which is characterized by persistent nausea and/or vomiting, weight loss, malnutrition and dehydration, increases the risk of adverse maternal and perinatal outcomes.Without the methodical intervention of experienced clinicians, life-threatening complications can develop. Effective prevention and treatment strategies for HG require an understanding of both pathophysiological and psychosocial factors, awareness of potential risks and complications, and proactive assessment and treatment methods using innovative clinical tools. HG is characterized by dehydration, electrolyte and metabolic imbalance, as well as nutritional deficiency, which can lead to hospitalization. The severity of nausea and vomiting during pregnancy can be assessed using the Unique Gestational Vomiting Qualification (scale PUQE-24), which has been shown to be a relatively accurate assessment of the patient’s lifestyle, including hours of sleep.For high-quality differential diagnosis, a focused anamnesis collection and examination are necessary, since the diagnosis of this condition is mainly determined clinically. Laboratory tests are useful tools for evaluating complications such as electrolyte or metabolic imbalances or kidney damage. In addition, they help to determine the etiology in refractory cases.Hypotheses that contribute to the understanding of the pathogenesis of HG have been based on associations that are causal, sequential, or coincidental. Much efforts are needed to precisely establish these relationships in well-designed studies. HG is the most common indication for hospitalization in the first half of pregnancy. Numerous nutrient deficiencies have been identified, such as thiamine deficiency, which can lead to Wernicke’s encephalopathy, vitamin K deficiency, and severe hypokalemia.It is noteworthy that, in addition to the above-mentioned physical complications, HG is also associated with psychological adverse consequences. Although it has been associated with serious complications, little is known about its prognostic factors.The purpose of this systematic review was to find and critically evaluate studies that determined the priority areas of clinical management of vomiting in pregnant women, based on the differentiation and pathophysiological component, the analysis of the safety profile of non-pharmacological agents to prevent the development of the above-mentioned gestational pathology, and the clarification of an effective strategy of interprofessional teams to improve care coordination and outcomes in pregnant women with nausea and vomiting.A systematic data search was carried out in the databases MEDLINE, ISI Web of Science, PubMed, Scopus, Google Scholar, Cochrane Databa
恶心和呕吐，或早期中毒，是怀孕期间常见的疾病，影响多达80%的孕妇。严重的形式被称为妊娠过度呕吐-妊娠剧吐(HG)，是一种使人虚弱并可能危及生命的孕期疾病，其特征是持续恶心和/或呕吐、体重减轻、营养不良和脱水，增加了孕产妇和围产期不良结局的风险。如果没有经验丰富的临床医生进行有条理的干预，就可能出现危及生命的并发症。有效的预防和治疗策略需要了解HG的病理生理和社会心理因素，了解潜在的风险和并发症，并使用创新的临床工具进行积极的评估和治疗方法。HG的特点是脱水、电解质和代谢失衡，以及营养缺乏，可导致住院。妊娠期恶心和呕吐的严重程度可以使用独特的妊娠呕吐鉴定标准(PUQE-24)进行评估，该标准已被证明是对患者生活方式(包括睡眠时间)的相对准确的评估。对于高质量的鉴别诊断，有针对性的记忆收集和检查是必要的，因为这种情况的诊断主要是临床确定的。实验室检查是评估诸如电解质或代谢失衡或肾脏损害等并发症的有用工具。此外，它们有助于确定难治性病例的病因。有助于理解HG发病机制的假设是基于因果、顺序或巧合的关联。要在设计良好的研究中精确地建立这些关系，需要付出很多努力。HG是妊娠前半期最常见的住院指征。许多营养缺乏已被确定，如硫胺素缺乏症，可导致韦尼克脑病，维生素K缺乏症和严重的低钾血症。值得注意的是，除了上述生理并发症外，HG还与心理不良后果有关。虽然它与严重的并发症有关，但对其预后因素知之甚少。本系统综述的目的是找到并批判性地评估研究，以确定孕妇呕吐的临床管理优先领域，基于区分和病理生理成分，分析非药物药物的安全性，以防止上述妊娠病理的发展。并阐明跨专业团队的有效策略，以改善孕妇恶心和呕吐的护理协调和结果。系统检索了2010-2023年乌克兰MEDLINE、ISI Web of Science、PubMed、Scopus、谷歌Scholar、Cochrane系统评价数据库和乌克兰专业出版物效果评价摘要数据库。主要结果是预测孕妇呕吐和HG的发生，预防干预的有效性，恶心/呕吐的减少或停止;呕吐次数;住院时间。次要结局包括预防策略有效性、孕产妇/胎儿/新生儿不良结局、生活质量指标和经济成本等其他参数。预防措施:生姜、指压/针灸、饮食、催眠疗法。预防战略的经济评价也考虑到了围产期结果。治疗策略，主要是输液治疗，将在以下回顾中回顾和分析。综述中提出的循证医学结果可用于制定关于妊娠期恶心、呕吐和HG临床管理的临床指南、方案、共识或临床建议。
{"title":"The evidence bases of etiopathophysiology and preventive clinical management of nausea and vomiting in pregnancy","authors":"V. I. Medved, S. I. Zhuk, D. Konkov, S.K. Litvinov, O.L. Ocheretna","doi":"10.30841/2708-8731.4.2023.285760","DOIUrl":"https://doi.org/10.30841/2708-8731.4.2023.285760","url":null,"abstract":"Nausea and vomiting, or early toxicosis, is a common disorder during pregnancy, affecting up to 80% of pregnant women. The severe form is known as excessive vomiting of pregnancy – hyperemesis gravidarum (HG) and is a debilitating and potentially life-threatening illness during pregnancy which is characterized by persistent nausea and/or vomiting, weight loss, malnutrition and dehydration, increases the risk of adverse maternal and perinatal outcomes.Without the methodical intervention of experienced clinicians, life-threatening complications can develop. Effective prevention and treatment strategies for HG require an understanding of both pathophysiological and psychosocial factors, awareness of potential risks and complications, and proactive assessment and treatment methods using innovative clinical tools. HG is characterized by dehydration, electrolyte and metabolic imbalance, as well as nutritional deficiency, which can lead to hospitalization. The severity of nausea and vomiting during pregnancy can be assessed using the Unique Gestational Vomiting Qualification (scale PUQE-24), which has been shown to be a relatively accurate assessment of the patient’s lifestyle, including hours of sleep.For high-quality differential diagnosis, a focused anamnesis collection and examination are necessary, since the diagnosis of this condition is mainly determined clinically. Laboratory tests are useful tools for evaluating complications such as electrolyte or metabolic imbalances or kidney damage. In addition, they help to determine the etiology in refractory cases.Hypotheses that contribute to the understanding of the pathogenesis of HG have been based on associations that are causal, sequential, or coincidental. Much efforts are needed to precisely establish these relationships in well-designed studies. HG is the most common indication for hospitalization in the first half of pregnancy. Numerous nutrient deficiencies have been identified, such as thiamine deficiency, which can lead to Wernicke’s encephalopathy, vitamin K deficiency, and severe hypokalemia.It is noteworthy that, in addition to the above-mentioned physical complications, HG is also associated with psychological adverse consequences. Although it has been associated with serious complications, little is known about its prognostic factors.The purpose of this systematic review was to find and critically evaluate studies that determined the priority areas of clinical management of vomiting in pregnant women, based on the differentiation and pathophysiological component, the analysis of the safety profile of non-pharmacological agents to prevent the development of the above-mentioned gestational pathology, and the clarification of an effective strategy of interprofessional teams to improve care coordination and outcomes in pregnant women with nausea and vomiting.A systematic data search was carried out in the databases MEDLINE, ISI Web of Science, PubMed, Scopus, Google Scholar, Cochrane Databa","PeriodicalId":21003,"journal":{"name":"Reproductive health of woman","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78416346","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}
Pub Date : 2023-06-30DOI: 10.30841/2708-8731.4.2023.285764
K.V. Sereda
Failure to conceive in a couple, that does not prevent fertilization for 12 months or more, is defined as infertility. This diagnosis is special one both because of the social component and of the involvement of two persons in it, as well as because of polyetiological factors. Pathology of the cervical epithelium is a common problem among women of reproductive age. In patients with infertility, it has its own significance as a factor for fertility disorders. In addition, there is a possible influence of different methods of treatment of pathology of the cervical canal on the course of pregnancy that occurred after treatment.The objective: to study the prevalence of cervical pathology in patients with various types of infertility.Materials and methods. The results of liquid cytology and human papillomavirus (HPV) testing were analyzed in 416 women, who were divided into four groups: I group included 108 patients with infertility associated with anovulation, II group – 101 patients with infertility of tubal origin, III group – 102 women with a male infertility factor in marriage, IV group – 105 women who applied for a preventive examination.Results. The general frequency of early cervical lesions of severity various degrees was differed significantly in the groups of the examined persons – from the lowest 25.9% in the group of patients with infertility associated with anovulation, and 35.2% in the group of women who applied for a preventive examination, to 50.9 % among women with infertility of tubal origin and 52.4% – in the group with a male infertility factor.In the last two mentioned groups, the frequency of severe intraepithelial lesions (7.8% and 7.9%, respectively) was higher than in the other groups, where it was established at a level of no more than 1.5%. A higher rate of HPV infection was also established in the groups infertility of tubal origin – 68.6%, male infertility – 63.4%, while in the group of patients with anovulation infertility its prevalence was at the level of 35.1%, which does not exceed the rate of healthy women in control group – 25.7%.Conclusions. 1. Patients with infertility of tubal origin and male factor infertility have a higher frequency of early cervical changes (50.9% and 52.9%, respectively) than healthy women of reproductive age (35.2%). 2. In cases of tubal and male factor infertility, the frequency of HPV infection is higher than the rate of the cervical epithelium lesions detected by the cytological method (68.6% and 63.4%, respectively), which allows us to recommend the HPV test to include in the list of mandatory examinations during preparation for the program of assisted reproductive technologies.
{"title":"Pathology of cervical epithelium in women with various forms of infertility","authors":"K.V. Sereda","doi":"10.30841/2708-8731.4.2023.285764","DOIUrl":"https://doi.org/10.30841/2708-8731.4.2023.285764","url":null,"abstract":"Failure to conceive in a couple, that does not prevent fertilization for 12 months or more, is defined as infertility. This diagnosis is special one both because of the social component and of the involvement of two persons in it, as well as because of polyetiological factors. Pathology of the cervical epithelium is a common problem among women of reproductive age. In patients with infertility, it has its own significance as a factor for fertility disorders. In addition, there is a possible influence of different methods of treatment of pathology of the cervical canal on the course of pregnancy that occurred after treatment.The objective: to study the prevalence of cervical pathology in patients with various types of infertility.Materials and methods. The results of liquid cytology and human papillomavirus (HPV) testing were analyzed in 416 women, who were divided into four groups: I group included 108 patients with infertility associated with anovulation, II group – 101 patients with infertility of tubal origin, III group – 102 women with a male infertility factor in marriage, IV group – 105 women who applied for a preventive examination.Results. The general frequency of early cervical lesions of severity various degrees was differed significantly in the groups of the examined persons – from the lowest 25.9% in the group of patients with infertility associated with anovulation, and 35.2% in the group of women who applied for a preventive examination, to 50.9 % among women with infertility of tubal origin and 52.4% – in the group with a male infertility factor.In the last two mentioned groups, the frequency of severe intraepithelial lesions (7.8% and 7.9%, respectively) was higher than in the other groups, where it was established at a level of no more than 1.5%. A higher rate of HPV infection was also established in the groups infertility of tubal origin – 68.6%, male infertility – 63.4%, while in the group of patients with anovulation infertility its prevalence was at the level of 35.1%, which does not exceed the rate of healthy women in control group – 25.7%.Conclusions. 1. Patients with infertility of tubal origin and male factor infertility have a higher frequency of early cervical changes (50.9% and 52.9%, respectively) than healthy women of reproductive age (35.2%). 2. In cases of tubal and male factor infertility, the frequency of HPV infection is higher than the rate of the cervical epithelium lesions detected by the cytological method (68.6% and 63.4%, respectively), which allows us to recommend the HPV test to include in the list of mandatory examinations during preparation for the program of assisted reproductive technologies.","PeriodicalId":21003,"journal":{"name":"Reproductive health of woman","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78388267","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}
Pub Date : 2023-06-30DOI: 10.30841/2708-8731.4.2023.285768
O.M. Susidko, O.A. Lubkovska, O. Kovalishin
The objective: to determine the microbiota profile of vagina, cervical canal and endometrium by chronic endometritis (CE) in patients with a history of infertility.Materials and methods. A prospective study and clinical-laboratory analysis of the microbiocenosis of the vagina, cervical canal and uterine cavity in women with CE and infertility in history was conducted. The 1st group included 100 women of reproductive age with CE and infertility, the 2nd group – 40 women of reproductive age without impaired fertility.The scope of research is pH-metry of vaginal secretions, assessment of vaginal microbiocenosis based on Gram-stained smear microscopy, polymerase chain reaction method, cultural research of vaginal secretions, study of the microflora of the cervical canal and the uterine body.Results. In women with CE and a history of infertility, normobiocenosis of the vagina was found in only 32 patients (32.0±3.1%). In other cases, bacterial vaginosis, vulvovaginal candidiasis, and bacterial vulvovaginitis were detected. Microscopy and PCR-diagnostics of secretions from the cervical canal and uterine cavity in women with CE determined Streptococcus agalactiae, Enterococcus faecalis, Chlamidia trachomatis, Ureaplasma urealyticum, Mycoplasma genitalium, HPV, Gardnerella, HSV 1st or 2nd types and CMV.Conclusions. A characteristic feature of the vaginal flora in chronic endometritis is a high level of dysbiotic changes combined with high rates of insemination by opportunistic flora. The microbiota of the cervical canal and endometrium during inflammatory processes of the endometrium is characterized by the predominance of obligate anaerobic microorganisms in the form of associations with viral infection, which are significantly more often (more than 2 times) detected in the endocervix compared to the endometrium.
{"title":"Biocenosis of the vaginal tract in patients with fertility on the background of chronic endometritis","authors":"O.M. Susidko, O.A. Lubkovska, O. Kovalishin","doi":"10.30841/2708-8731.4.2023.285768","DOIUrl":"https://doi.org/10.30841/2708-8731.4.2023.285768","url":null,"abstract":"The objective: to determine the microbiota profile of vagina, cervical canal and endometrium by chronic endometritis (CE) in patients with a history of infertility.Materials and methods. A prospective study and clinical-laboratory analysis of the microbiocenosis of the vagina, cervical canal and uterine cavity in women with CE and infertility in history was conducted. The 1st group included 100 women of reproductive age with CE and infertility, the 2nd group – 40 women of reproductive age without impaired fertility.The scope of research is pH-metry of vaginal secretions, assessment of vaginal microbiocenosis based on Gram-stained smear microscopy, polymerase chain reaction method, cultural research of vaginal secretions, study of the microflora of the cervical canal and the uterine body.Results. In women with CE and a history of infertility, normobiocenosis of the vagina was found in only 32 patients (32.0±3.1%). In other cases, bacterial vaginosis, vulvovaginal candidiasis, and bacterial vulvovaginitis were detected. Microscopy and PCR-diagnostics of secretions from the cervical canal and uterine cavity in women with CE determined Streptococcus agalactiae, Enterococcus faecalis, Chlamidia trachomatis, Ureaplasma urealyticum, Mycoplasma genitalium, HPV, Gardnerella, HSV 1st or 2nd types and CMV.Conclusions. A characteristic feature of the vaginal flora in chronic endometritis is a high level of dysbiotic changes combined with high rates of insemination by opportunistic flora. The microbiota of the cervical canal and endometrium during inflammatory processes of the endometrium is characterized by the predominance of obligate anaerobic microorganisms in the form of associations with viral infection, which are significantly more often (more than 2 times) detected in the endocervix compared to the endometrium.","PeriodicalId":21003,"journal":{"name":"Reproductive health of woman","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83454783","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}
Pub Date : 2023-06-30DOI: 10.30841/2708-8731.4.2023.285762
A.Ye. Husieva
Pregnancy is a unique period in a woman’s life with an increased likelihood of psychological changes and emotional disorders such as depression, anxiety and stress. Almost 70% of women experience various changes in their mental state during pregnancy. There is a need to consider the physiology and psychology of a pregnant woman not as a separate process, but as a single integrated system and to promote the search for new methods of regulating psychoemotional states.The objective: to determine the relationship between psychoemotional stress reactions and pregnancy, taking into account the age factor.Materials and methods. Special psychometric testing of 100 pregnant women of different ages and at different stages of gestation was carried out. Each of the research participants was asked to complete a survey using three questionnaires. The Spielberger–Hanin scale, the psychological stress measure (PSM-25) and the impact of event scale – revised (IES-R) of a traumatic event were used for analysis. The average age of the examined patients was 30.9±5.54 years; 48 persons were ≤30 years old, 49 women were 31–40 years old, and 3 patients were ≥41 years old.Statistical processing of the results was carried out in the program for working with electronic spreadsheets Microsoft Excel 2016 and the program for comprehensive data analysis - STATISTICA 10 for Windows. Graphic design was done with Microsoft Excel 2016.Results. According to the Spielberger–Hanin survey, 14% of women had a low level of reactive anxiety, 52% – a moderate level, and 34% – a high level. Only 7% of women had a low level of personal anxiety, and their average value was close to a moderate level, 44% of patients had a moderate level and 49% had a high level.According to the data of impact of event scale – revised (IES-R) of a traumatic event, which has 3 subscales, it was established that a low level of the subscale of intrusion among the interviewed pregnant women was found in 16% of women (n=16), an average level in 23%, an elevated level in 15% and high one – in 46%. A low level of the avoidance subscale was determined in 16% of women, an average level – in 12%, a high level – 14%, and a high level – 58%.According to the results of the psychological stress measure PSM-25, the majority of women had a low level of stress – 77%, medium level – 22%, high level – 1%.Conclusions. According to the results of the study, the majority of women had a high level of anxiety during pregnancy, the prevalence of which was the highest one among women 31 to 40 years old; the lowest rate was among pregnant women younger than 30 years old.It is necessary to develop measures aimed at psychoprophylaxis of pregnant women, at their conscious attitude to pregnancy, childbirth and subsequent motherhood.
怀孕是女性一生中一个独特的时期，心理变化和情绪障碍(如抑郁、焦虑和压力)的可能性增加。几乎70%的女性在怀孕期间会经历各种各样的精神状态变化。有必要考虑孕妇的生理和心理，而不是作为一个独立的过程，而是作为一个单一的综合系统，并促进对调节心理情绪状态的新方法的探索。目的:在考虑年龄因素的情况下，确定心理应激反应与怀孕之间的关系。材料和方法。对100名不同年龄、不同妊娠阶段的孕妇进行了专项心理测试。每位研究参与者都被要求完成一份使用三份问卷的调查。采用斯皮尔伯格-哈宁量表、心理应激量表(PSM-25)和创伤性事件影响量表(IES-R)进行分析。患者平均年龄30.9±5.54岁;年龄≤30岁48例，31-40岁49例，年龄≥41岁3例。结果的统计处理在电子表格Microsoft Excel 2016程序和综合数据分析程序STATISTICA 10 for Windows中进行。图形设计使用Microsoft Excel 2016.Results完成。根据斯皮尔伯格和哈宁的调查，14%的女性有低水平的反应性焦虑，52%的女性有中等水平，34%的女性有高水平。只有7%的女性有低水平的个人焦虑，其平均值接近中等水平，44%的患者有中等水平，49%的患者有高水平。根据创伤性事件影响量表修订(IES-R)的3个分量表数据，在受访孕妇中，有16% (n=16)的侵入性分量表为低水平，23%为平均水平，15%为高水平，46%为高水平。16%的女性被确定为低水平的回避子量表，平均水平为12%，高水平为14%，高水平为58%。根据心理压力量表PSM-25的结果，大多数女性的压力水平为低(77%)，中等水平(22%)，高水平(1%)。根据研究结果，大多数女性在怀孕期间焦虑水平较高，其中31至40岁的女性患病率最高;最低的是30岁以下的孕妇。有必要制定措施，对孕妇进行精神预防，培养她们对怀孕、分娩和随后成为母亲的自觉态度。
{"title":"Pregnancy and psychoemotional stress reactions. Age factor","authors":"A.Ye. Husieva","doi":"10.30841/2708-8731.4.2023.285762","DOIUrl":"https://doi.org/10.30841/2708-8731.4.2023.285762","url":null,"abstract":"Pregnancy is a unique period in a woman’s life with an increased likelihood of psychological changes and emotional disorders such as depression, anxiety and stress. Almost 70% of women experience various changes in their mental state during pregnancy. There is a need to consider the physiology and psychology of a pregnant woman not as a separate process, but as a single integrated system and to promote the search for new methods of regulating psychoemotional states.The objective: to determine the relationship between psychoemotional stress reactions and pregnancy, taking into account the age factor.Materials and methods. Special psychometric testing of 100 pregnant women of different ages and at different stages of gestation was carried out. Each of the research participants was asked to complete a survey using three questionnaires. The Spielberger–Hanin scale, the psychological stress measure (PSM-25) and the impact of event scale – revised (IES-R) of a traumatic event were used for analysis. The average age of the examined patients was 30.9±5.54 years; 48 persons were ≤30 years old, 49 women were 31–40 years old, and 3 patients were ≥41 years old.Statistical processing of the results was carried out in the program for working with electronic spreadsheets Microsoft Excel 2016 and the program for comprehensive data analysis - STATISTICA 10 for Windows. Graphic design was done with Microsoft Excel 2016.Results. According to the Spielberger–Hanin survey, 14% of women had a low level of reactive anxiety, 52% – a moderate level, and 34% – a high level. Only 7% of women had a low level of personal anxiety, and their average value was close to a moderate level, 44% of patients had a moderate level and 49% had a high level.According to the data of impact of event scale – revised (IES-R) of a traumatic event, which has 3 subscales, it was established that a low level of the subscale of intrusion among the interviewed pregnant women was found in 16% of women (n=16), an average level in 23%, an elevated level in 15% and high one – in 46%. A low level of the avoidance subscale was determined in 16% of women, an average level – in 12%, a high level – 14%, and a high level – 58%.According to the results of the psychological stress measure PSM-25, the majority of women had a low level of stress – 77%, medium level – 22%, high level – 1%.Conclusions. According to the results of the study, the majority of women had a high level of anxiety during pregnancy, the prevalence of which was the highest one among women 31 to 40 years old; the lowest rate was among pregnant women younger than 30 years old.It is necessary to develop measures aimed at psychoprophylaxis of pregnant women, at their conscious attitude to pregnancy, childbirth and subsequent motherhood.","PeriodicalId":21003,"journal":{"name":"Reproductive health of woman","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75306573","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}
Pub Date : 2023-06-30DOI: 10.30841/2708-8731.4.2023.285766
S. Vasyliuk, О.М. Makarchuk, О.М. Ostrovska, I. Labiak, M. Rymarchuk, S. Krymets, V. І. Gudyvok, D.S. Martyniuk
The article presents a review of scientific literature on the main causes of rectal bleeding in pregnant women. Anatomical, biochemical and hormonal changes during pregnancy often lead to the progression of typical benign diseases (chronic hemorrhoids, anal fissure, etc.), radical surgical treatment of which can be carried out in the puerperal period. However, Crohn’s disease, ulcerative colitis or malignant colorectal polyps can be triggered by pregnancy and affect its course – this requires immediate examination and drug therapy. Pregnancy causes many physiological changes that affect the interpretation of routine biochemical and hematological examination methods. It is known that pregnancy requires increased iron content, the pregnancy courses often with anemia. The erythrocytes sedimentation rate varies significantly depending on the severity of anemia and the pregnancy term. Therefore, it is necessary to carefully analyze the main clinical manifestations of various intraluminal diseases that can potentially cause rectal bleeding in pregnant women.This article also describes the directions of diagnostic search and treatment strategy of rectal bleeding during pregnancy. Chronic hemorrhoids often accompany pregnancy in the third trimester. Some researchers indicate that up to 75% of pregnant women have complaints which are typical for chronic hemorrhoids. An anal fissure in lateral positions should cause suspicion of Crohn’s disease, tuberculosis, syphilis, human immunodeficiency virus, acquired immunodeficiency syndrome, dermatological diseases (most often psoriasis) and anal carcinoma.Bleeding in sexually acquired proctitis is usually mild and is often accompanied by minor purulent discharge. Rectal bleeding can be a sign of both ulcerative colitis and Crohn’s proctitis or sigmoiditis, but it is more typical for ulcerative colitis. Other associated clinical features are diarrhea, abdominal pain, urge to defecate, and specific extraintestinal manifestations (peripheral arthropathy, sacroiliitis, ankylosing spondylitis, conjunctivitis, iridocyclitis, episcleritis, aphthous skin ulcers, erythema nodosum, or pyoderma gangrenosum). If the bleeding is caused by a benign polyp, endoscopic polypectomy solves the bleeding problem.Therefore, rectal bleeding in pregnant women is diagnosed quite often. In most cases, it is caused by benign diseases of the rectum (chronic hemorrhoids or anal fissure), which are amenable to conservative therapy and usually do not threaten the life and health of a woman or a child. However, there is a rate of pregnant women whose rectal bleeding is caused by colorectal diseases, which require a comprehensive approach to diagnosis and treatment. In these women, the benefit and risk should be determined when choosing a diagnostic and treatment algorithm.
{"title":"Rectal bleeding in pregnant women","authors":"S. Vasyliuk, О.М. Makarchuk, О.М. Ostrovska, I. Labiak, M. Rymarchuk, S. Krymets, V. І. Gudyvok, D.S. Martyniuk","doi":"10.30841/2708-8731.4.2023.285766","DOIUrl":"https://doi.org/10.30841/2708-8731.4.2023.285766","url":null,"abstract":"The article presents a review of scientific literature on the main causes of rectal bleeding in pregnant women. Anatomical, biochemical and hormonal changes during pregnancy often lead to the progression of typical benign diseases (chronic hemorrhoids, anal fissure, etc.), radical surgical treatment of which can be carried out in the puerperal period. However, Crohn’s disease, ulcerative colitis or malignant colorectal polyps can be triggered by pregnancy and affect its course – this requires immediate examination and drug therapy. Pregnancy causes many physiological changes that affect the interpretation of routine biochemical and hematological examination methods. It is known that pregnancy requires increased iron content, the pregnancy courses often with anemia. The erythrocytes sedimentation rate varies significantly depending on the severity of anemia and the pregnancy term. Therefore, it is necessary to carefully analyze the main clinical manifestations of various intraluminal diseases that can potentially cause rectal bleeding in pregnant women.This article also describes the directions of diagnostic search and treatment strategy of rectal bleeding during pregnancy. Chronic hemorrhoids often accompany pregnancy in the third trimester. Some researchers indicate that up to 75% of pregnant women have complaints which are typical for chronic hemorrhoids. An anal fissure in lateral positions should cause suspicion of Crohn’s disease, tuberculosis, syphilis, human immunodeficiency virus, acquired immunodeficiency syndrome, dermatological diseases (most often psoriasis) and anal carcinoma.Bleeding in sexually acquired proctitis is usually mild and is often accompanied by minor purulent discharge. Rectal bleeding can be a sign of both ulcerative colitis and Crohn’s proctitis or sigmoiditis, but it is more typical for ulcerative colitis. Other associated clinical features are diarrhea, abdominal pain, urge to defecate, and specific extraintestinal manifestations (peripheral arthropathy, sacroiliitis, ankylosing spondylitis, conjunctivitis, iridocyclitis, episcleritis, aphthous skin ulcers, erythema nodosum, or pyoderma gangrenosum). If the bleeding is caused by a benign polyp, endoscopic polypectomy solves the bleeding problem.Therefore, rectal bleeding in pregnant women is diagnosed quite often. In most cases, it is caused by benign diseases of the rectum (chronic hemorrhoids or anal fissure), which are amenable to conservative therapy and usually do not threaten the life and health of a woman or a child. However, there is a rate of pregnant women whose rectal bleeding is caused by colorectal diseases, which require a comprehensive approach to diagnosis and treatment. In these women, the benefit and risk should be determined when choosing a diagnostic and treatment algorithm.","PeriodicalId":21003,"journal":{"name":"Reproductive health of woman","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86664453","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}
Pub Date : 2023-05-31DOI: 10.30841/2708-8731.3.2023.283319
А. В. Камінський, І. Л. Харун, Kaminskiy Anatolii, Kharun Iryna
The objective: to identify and evaluate the changes in immune homeostasis in women with recurrent pregnancy loss (RPL) who had posttraumatic stress disorder (PTSD), and to establish the relationship between psycho-emotional status, the immune system and the role of chronic stress in the pathogenesis of autoimmune disorders as a cause of RPL.Materials and methods. An examination of 150 women of reproductive age was carried out, who were divided into three groups: I group (main group) – 100 patients with RPL and PTSD; II group (comparison one) – patients with RPL without PTSD (30 women) and the III group (control one) – 20 patients with PTSD who are planning pregnancy.Indicators of cellular immunity were studied and antiphospholipid syndrome was diagnosed. The electronic database of primary data was created using the Microsoft Excel 2016 spreadsheet program. Statistical data analysis was performed using the Statistica10.0 statistical analysis package.Results. Based on the results of the screening it was found that there are non-specific antibodies to anionic phospholipids, also known as antiphospholipid antibodies, in some patients of the main group. In the presence of antiphospholipid antibodies, the number of NK cells (CD3-CD16/56+) doubled, increasing the probability of the pregnancy interruption that had already occurred. There was also an increased number of NK cells (CD3-CD16/56+) in the blood of patients with PTSD compared to the control group – the patients with PTSD who are planning pregnancy.Conclusions. The results of the study confirmed the connection between PTSD and RPL and demonstrated significant immune homeostasis disorders, as well as the structural and morphological changes in the reproductive system.Women with RPL may have PTSD, which affects the pathogenesis of autoimmune disorders and RPL. These results lead to more deep understanding of RPL and will help in the development of new preventive and therapeutic measures.
{"title":"Substantiation for the relationship and «closed loop effect» between post-traumatic stress disorder and recurrent pregnancy loss","authors":"А. В. Камінський, І. Л. Харун, Kaminskiy Anatolii, Kharun Iryna","doi":"10.30841/2708-8731.3.2023.283319","DOIUrl":"https://doi.org/10.30841/2708-8731.3.2023.283319","url":null,"abstract":"The objective: to identify and evaluate the changes in immune homeostasis in women with recurrent pregnancy loss (RPL) who had posttraumatic stress disorder (PTSD), and to establish the relationship between psycho-emotional status, the immune system and the role of chronic stress in the pathogenesis of autoimmune disorders as a cause of RPL.Materials and methods. An examination of 150 women of reproductive age was carried out, who were divided into three groups: I group (main group) – 100 patients with RPL and PTSD; II group (comparison one) – patients with RPL without PTSD (30 women) and the III group (control one) – 20 patients with PTSD who are planning pregnancy.Indicators of cellular immunity were studied and antiphospholipid syndrome was diagnosed. The electronic database of primary data was created using the Microsoft Excel 2016 spreadsheet program. Statistical data analysis was performed using the Statistica10.0 statistical analysis package.Results. Based on the results of the screening it was found that there are non-specific antibodies to anionic phospholipids, also known as antiphospholipid antibodies, in some patients of the main group. In the presence of antiphospholipid antibodies, the number of NK cells (CD3-CD16/56+) doubled, increasing the probability of the pregnancy interruption that had already occurred. There was also an increased number of NK cells (CD3-CD16/56+) in the blood of patients with PTSD compared to the control group – the patients with PTSD who are planning pregnancy.Conclusions. The results of the study confirmed the connection between PTSD and RPL and demonstrated significant immune homeostasis disorders, as well as the structural and morphological changes in the reproductive system.Women with RPL may have PTSD, which affects the pathogenesis of autoimmune disorders and RPL. These results lead to more deep understanding of RPL and will help in the development of new preventive and therapeutic measures.","PeriodicalId":21003,"journal":{"name":"Reproductive health of woman","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84258511","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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