Pub Date : 2022-12-29DOI: 10.30841/2708-8731.8.2022.273298
Dzhanetti Beraya
The objective: to study the structure of gynecological pathology and the hormonal background in women with infertility and various types of thyroid pathology. Materials and methods. The anamnesis of infertile patients was studied. The women, depending on the pathology of the thyroid gland and the method of fertilization were divided into the following groups: the 1st group included 119 women with infertility without thyroid pathology who became pregnant after the use of assisted reproductive technologies (ART); the 2nd group – 47 patients who became pregnant with the help of ART and in whom antibodies to thyroid peroxidase (anti-TPO antibodies) were detected; the 3rd group – 30 women with compensated hypothyroidism, whose pregnancy occurred with ART; the 4th group – 39 women without thyroid pathology and with spontaneous pregnancy; the 5th group – 128 patients with compensated hypothyroidism and spontaneous pregnancy. The concentrations of the following hormones in the blood plasma in the early follicular phase were determined in all the patients: luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol, prolactin, testosterone, cortisol, 17-hydroxyprogesterone, dehydroepiandrosterone sulfate.Results. There were no significant differences between the women with infertility and thyroid pathology and the patients with spontaneous pregnancy without thyroid pathology regarding the age of menarche onset, the period of regularity onset of the menstrual cycle after menarche. The most frequent disorder of the menstrual cycle in patients of the 1st (26.9 %), 2nd (25.5 %) and 3rd (26.6 %) groups was dysmenorrhea. Oligomenorrhea was more often detected in women with infertility and thyroid pathology who became pregnant with the help of ART (25.5 % of patients in the 2nd group and 23.3% – in the 3rd group), compared to women with spontaneous pregnancy. The endocrine factor of infertility was most often determined in women with infertility who became pregnant after ART and had thyroid pathology: in the presence of anti-TPO antibodies, this factor was found in 29.8 % of women, hypothyroidism – 23.3 %. External genital endometriosis as a cause of infertility prevailed among patients with infertility without thyroid pathology, who became pregnant after ART (34.4 %), and women with compensated hypothyroidism, whose pregnancy occurred with the help of ART (26.6 %). In patients with infertility and anti-TPO antibodies, who became pregnant after ART, a significant increase of LH concentration was found compared to the patients with spontaneous pregnancy without thyroid diseases. A significant increase of FSH level was also determined in women of the 1st group compared to healthy patients with spontaneous pregnancy. Conclusions. In women with infertility and various types of thyroid pathology the disorders of the ovarian-menstrual cycle such as dysmenorrhea and oligomenorrhea are typical. The main factor of infertility in patients without thyroid disea
{"title":"Features of gynecological pathology in women with infertility and pathology of the thyroid gland","authors":"Dzhanetti Beraya","doi":"10.30841/2708-8731.8.2022.273298","DOIUrl":"https://doi.org/10.30841/2708-8731.8.2022.273298","url":null,"abstract":"The objective: to study the structure of gynecological pathology and the hormonal background in women with infertility and various types of thyroid pathology. Materials and methods. The anamnesis of infertile patients was studied. The women, depending on the pathology of the thyroid gland and the method of fertilization were divided into the following groups: the 1st group included 119 women with infertility without thyroid pathology who became pregnant after the use of assisted reproductive technologies (ART); the 2nd group – 47 patients who became pregnant with the help of ART and in whom antibodies to thyroid peroxidase (anti-TPO antibodies) were detected; the 3rd group – 30 women with compensated hypothyroidism, whose pregnancy occurred with ART; the 4th group – 39 women without thyroid pathology and with spontaneous pregnancy; the 5th group – 128 patients with compensated hypothyroidism and spontaneous pregnancy. The concentrations of the following hormones in the blood plasma in the early follicular phase were determined in all the patients: luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol, prolactin, testosterone, cortisol, 17-hydroxyprogesterone, dehydroepiandrosterone sulfate.Results. There were no significant differences between the women with infertility and thyroid pathology and the patients with spontaneous pregnancy without thyroid pathology regarding the age of menarche onset, the period of regularity onset of the menstrual cycle after menarche. The most frequent disorder of the menstrual cycle in patients of the 1st (26.9 %), 2nd (25.5 %) and 3rd (26.6 %) groups was dysmenorrhea. Oligomenorrhea was more often detected in women with infertility and thyroid pathology who became pregnant with the help of ART (25.5 % of patients in the 2nd group and 23.3% – in the 3rd group), compared to women with spontaneous pregnancy. The endocrine factor of infertility was most often determined in women with infertility who became pregnant after ART and had thyroid pathology: in the presence of anti-TPO antibodies, this factor was found in 29.8 % of women, hypothyroidism – 23.3 %. External genital endometriosis as a cause of infertility prevailed among patients with infertility without thyroid pathology, who became pregnant after ART (34.4 %), and women with compensated hypothyroidism, whose pregnancy occurred with the help of ART (26.6 %). In patients with infertility and anti-TPO antibodies, who became pregnant after ART, a significant increase of LH concentration was found compared to the patients with spontaneous pregnancy without thyroid diseases. A significant increase of FSH level was also determined in women of the 1st group compared to healthy patients with spontaneous pregnancy. Conclusions. In women with infertility and various types of thyroid pathology the disorders of the ovarian-menstrual cycle such as dysmenorrhea and oligomenorrhea are typical. The main factor of infertility in patients without thyroid disea","PeriodicalId":21003,"journal":{"name":"Reproductive health of woman","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79721579","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 : 2022-12-29DOI: 10.30841/2708-8731.8.2022.273294
N. Lemish
The objective: to develop a method for predicting the individual risk for great obstetric syndromes (GOS).Materials and methods. An analysis of the somatic, reproductive, and obstetric anamnesis was conducted in 572 pregnant women with clinical manifestations of GOS, in 81 of them (prediction group) signs of placental dysfunction were detected based on clinical, functional, laboratory, and ultrasound data. Control group (CG) – 50 practically healthy pregnant women with a favorable reproductive history and an uncomplicated course of this pregnancy.Functional, biophysical, hormonal, immunological and hemocoagulation indicators were calculated to determine the informative (prognostic) significance. Quantitative signs were divided into diagnostic intervals, and qualitative signs were assigned a code. The following indicators were included in the standard protocol: age, data on somatic and gynecological history, data on the pregnancy course, results of functional and laboratory examinations. Statistical processing of research results was carried out using standard Microsoft Excel 5.0 and Statistica 6.0 programs. Results. In the I trimester of pregnancy the concentration of placental lactogen (PL) in the prediction group was 29.4 % lower than the CG indicator, estradiol (E2) amount – by 27.4 %, estriol (E3) – by 28.6 %, progesterone (PG) – by 34.4%, human chorionic gonadotropin (hCG) – by 28.3 % lower, and cortisol (CR) – by 36.1 % higher. At the beginning of the II trimester of pregnancy in the prediction group the level of PL was already reduced by 33.8 %, E2 – by 26.2 %, E3 – by 32.3 %, PG – by 37.4 %, hCG – by 30.6 %, and CR – increased by 43.6 % compared to CG.The indicators of placenta hormonal activity in the early stages of pregnancy and at the beginning of the II trimester can be prognostic signs of further disruption of the adaptive compensatory and adaptive reactions of the fetal placental complex (FPC) in the II and III trimesters of pregnancy. Among a wide range of hemostasiological indicators in the I trimester of pregnancy in the prediction group the most informative were: activated partial thromboplastin time (-23 %) and activated recalcification time (+16.2 %), the changes of which remained at the beginning of the II trimester (-40% and - 11.7% respectively). During the evaluation of thromboelastogram data, the value of “r+k” was fixed by 33.3 % lower in the I trimester and by 36 % – at the beginning of the II trimester of pregnancy. As a result of the analysis the indicators with a high information value (more than 3.0 c.u.) were selected for quantitative assessment of the degree of individual risk for the development of maladaptive disorders in the FPC. The clinical trial of the scoring method of prediction proved its high sensitivity (91.8 %) and specificity (85.6 %). Conclusions. A multi-faceted analysis of anamnestic data, features of the pregnancy course, basic clinical, laboratory and functional indicators in women with clinical
{"title":"Basic principles and structure of risk assessment of Great obstetrical syndromes","authors":"N. Lemish","doi":"10.30841/2708-8731.8.2022.273294","DOIUrl":"https://doi.org/10.30841/2708-8731.8.2022.273294","url":null,"abstract":"The objective: to develop a method for predicting the individual risk for great obstetric syndromes (GOS).Materials and methods. An analysis of the somatic, reproductive, and obstetric anamnesis was conducted in 572 pregnant women with clinical manifestations of GOS, in 81 of them (prediction group) signs of placental dysfunction were detected based on clinical, functional, laboratory, and ultrasound data. Control group (CG) – 50 practically healthy pregnant women with a favorable reproductive history and an uncomplicated course of this pregnancy.Functional, biophysical, hormonal, immunological and hemocoagulation indicators were calculated to determine the informative (prognostic) significance. Quantitative signs were divided into diagnostic intervals, and qualitative signs were assigned a code. The following indicators were included in the standard protocol: age, data on somatic and gynecological history, data on the pregnancy course, results of functional and laboratory examinations. Statistical processing of research results was carried out using standard Microsoft Excel 5.0 and Statistica 6.0 programs. Results. In the I trimester of pregnancy the concentration of placental lactogen (PL) in the prediction group was 29.4 % lower than the CG indicator, estradiol (E2) amount – by 27.4 %, estriol (E3) – by 28.6 %, progesterone (PG) – by 34.4%, human chorionic gonadotropin (hCG) – by 28.3 % lower, and cortisol (CR) – by 36.1 % higher. At the beginning of the II trimester of pregnancy in the prediction group the level of PL was already reduced by 33.8 %, E2 – by 26.2 %, E3 – by 32.3 %, PG – by 37.4 %, hCG – by 30.6 %, and CR – increased by 43.6 % compared to CG.The indicators of placenta hormonal activity in the early stages of pregnancy and at the beginning of the II trimester can be prognostic signs of further disruption of the adaptive compensatory and adaptive reactions of the fetal placental complex (FPC) in the II and III trimesters of pregnancy. Among a wide range of hemostasiological indicators in the I trimester of pregnancy in the prediction group the most informative were: activated partial thromboplastin time (-23 %) and activated recalcification time (+16.2 %), the changes of which remained at the beginning of the II trimester (-40% and - 11.7% respectively). During the evaluation of thromboelastogram data, the value of “r+k” was fixed by 33.3 % lower in the I trimester and by 36 % – at the beginning of the II trimester of pregnancy. As a result of the analysis the indicators with a high information value (more than 3.0 c.u.) were selected for quantitative assessment of the degree of individual risk for the development of maladaptive disorders in the FPC. The clinical trial of the scoring method of prediction proved its high sensitivity (91.8 %) and specificity (85.6 %). Conclusions. A multi-faceted analysis of anamnestic data, features of the pregnancy course, basic clinical, laboratory and functional indicators in women with clinical","PeriodicalId":21003,"journal":{"name":"Reproductive health of woman","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80053433","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 : 2022-12-29DOI: 10.30841/2708-8731.8.2022.273301
О.V. Golyanovskiy, S. V. Frolov
Sleep disorders (dyssomnia) during pregnancy are of high prevalence and may be associated with negative peri- and postnatal outcomes. However, these conditions are often not effectively diagnosed and treated. In this review a systematic evaluation of the effectiveness of different methods of therapy to improve the quality of sleep and in the presence of insomnia during pregnancy was conducted.Systematic search in PubMed, Psycinfo and Medline databases was conducted without limiting the publication date till November 3, 2022. The relevant studies included pregnant women of any age and gestation; they included the clinical intervention schemes aimed at improving sleep quality; the data before and after treatment for one or more sleep-related results were reported. 16 studies were selected with a total of 988 pregnant women. According to the results of researches the effectiveness of different types of interventions was established: cognitive-behavioral therapy for sleep disorders, pharmacotherapy, acupuncture, yoga, relaxation and phytotherapy. The recent publications have determined that sleep disorders have a connection with the adverse pregnancy outcomes, including fetal growth restriction, premature births, weakness of uterine labor activity and high delivery frequency of caesarean section.There is an extremely high relevance and need for high-quality randomized controlled studies about sleep disorders during pregnancy and implementation of effective standard obstetric care programs. There is a necessity to improve psychological care and sleep care during pregnancy to maintain a positive pregnancy course, childbirth and postpartum period. Future clinical studies should be randomized and include a sufficient number of women for statistical efficacy, including checking the effectiveness of cognitive-behavioral insomnia therapy to prevent pregnancy/childbirth complications and somatic diseases in the long-term period.
{"title":"Sleep disorders and effectiveness of various methods of insomnia therapy in pregnant women (Literature review)","authors":"О.V. Golyanovskiy, S. V. Frolov","doi":"10.30841/2708-8731.8.2022.273301","DOIUrl":"https://doi.org/10.30841/2708-8731.8.2022.273301","url":null,"abstract":"Sleep disorders (dyssomnia) during pregnancy are of high prevalence and may be associated with negative peri- and postnatal outcomes. However, these conditions are often not effectively diagnosed and treated. In this review a systematic evaluation of the effectiveness of different methods of therapy to improve the quality of sleep and in the presence of insomnia during pregnancy was conducted.Systematic search in PubMed, Psycinfo and Medline databases was conducted without limiting the publication date till November 3, 2022. The relevant studies included pregnant women of any age and gestation; they included the clinical intervention schemes aimed at improving sleep quality; the data before and after treatment for one or more sleep-related results were reported. 16 studies were selected with a total of 988 pregnant women. According to the results of researches the effectiveness of different types of interventions was established: cognitive-behavioral therapy for sleep disorders, pharmacotherapy, acupuncture, yoga, relaxation and phytotherapy. The recent publications have determined that sleep disorders have a connection with the adverse pregnancy outcomes, including fetal growth restriction, premature births, weakness of uterine labor activity and high delivery frequency of caesarean section.There is an extremely high relevance and need for high-quality randomized controlled studies about sleep disorders during pregnancy and implementation of effective standard obstetric care programs. There is a necessity to improve psychological care and sleep care during pregnancy to maintain a positive pregnancy course, childbirth and postpartum period. Future clinical studies should be randomized and include a sufficient number of women for statistical efficacy, including checking the effectiveness of cognitive-behavioral insomnia therapy to prevent pregnancy/childbirth complications and somatic diseases in the long-term period.","PeriodicalId":21003,"journal":{"name":"Reproductive health of woman","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74258754","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 : 2022-12-29DOI: 10.30841/2708-8731.8.2022.273300
O.V. Islamova, M. Kyrylchuk, L. Bulyk
The objective: to establish probable clinical and paraclinical risk factors for the development of gestational hypertensive disorders (GHD) in pregnant women after the use of assisted reproductive technologies (ART).Materials and methods. A clinical and statistical analysis of the birth histories of 362 women who became pregnant after the use of ART was carried out. Among them, 103 patients with had pre-gestational arterial hypertension (AH) and were included in the 1st group, 51 patients with increased blood pressure for the first time after 20 weeks of pregnancy – GHD, were included in the 2nd group, and 208 women without hypertensive disorders (HD) neither before nor after pregnancy were included in the 3rd group (control one). To determine the prognostic value of probable clinical and paraclinical risk factors for the GHD development in patients after ART, the following factors were analyzed: place of residence, age during pregnancy, obstetric, gynecological and reproductive history, marriage status, body mass index. The assess of commonly known factors was also evaluated for the risk of development for GHD. The influence of method of artificial insemination is also considered.Statistical processing of the results was carried out using standard Microsoft Excel 7.0 and “Statistica 6.0” programs. Results. The research demonstrated that HD is a common complication in pregnant women after the use of ART and accounts for 42.5 %. The frequency of women ≥40 years old was significantly higher in the 1st (42.8 %) and 2nd (25.5 %) groups than in the 3d one (15.5 %), as well as the prevalence of secondary infertility among the examined female patients – 23.3 %, 37.2 % and 6.3 %, respectively. Diabetes was found in women of the 1st (7.8 %) and 2nd (5.9 %) groups statistically more often compared to the control group (1.9 %), multiple pregnancy – in 45.6 %, 52.9 % and 27.0 % cases, respectively; 11.8% of patients in the 2nd group were diagnosed with autoimmune diseases.In patients with pregestational AH and GHD there was the high frequency of secondary infertility which is significantly more compared to the control group (p<0.05). Therefore, it can be assumed that this factor may influence the development of GHD in the future.The use of donor eggs was significantly more frequent in women of the 2nd group (21.5 %) compared to patients of the 1st (4.9 %) and control (5.3 %) groups (p<0.05). Transfer of cryopreserved embryos was used in 54.3 % of pregnant women of the 1st group and in 45.1 % of pregnant women in the 2nd group, which is reliable compared to the indicators of the control group (17.7 %; p<0.05). This makes possible to state that the use of donor eggs and the transfer of cryopreserved embryos can lead to an increase in the risk of GHD development in the future.In the group of pregnant women with pregestational AH, there were significantly more patients with an intergenetic interval of 10 years or more. This suggests that a large intergenetic int
{"title":"Probable clinical and paraclinical factors of the occurrence of gestational hypertensive disorders in pregnant women after the use of assisted reproductive technologies","authors":"O.V. Islamova, M. Kyrylchuk, L. Bulyk","doi":"10.30841/2708-8731.8.2022.273300","DOIUrl":"https://doi.org/10.30841/2708-8731.8.2022.273300","url":null,"abstract":"The objective: to establish probable clinical and paraclinical risk factors for the development of gestational hypertensive disorders (GHD) in pregnant women after the use of assisted reproductive technologies (ART).Materials and methods. A clinical and statistical analysis of the birth histories of 362 women who became pregnant after the use of ART was carried out. Among them, 103 patients with had pre-gestational arterial hypertension (AH) and were included in the 1st group, 51 patients with increased blood pressure for the first time after 20 weeks of pregnancy – GHD, were included in the 2nd group, and 208 women without hypertensive disorders (HD) neither before nor after pregnancy were included in the 3rd group (control one). To determine the prognostic value of probable clinical and paraclinical risk factors for the GHD development in patients after ART, the following factors were analyzed: place of residence, age during pregnancy, obstetric, gynecological and reproductive history, marriage status, body mass index. The assess of commonly known factors was also evaluated for the risk of development for GHD. The influence of method of artificial insemination is also considered.Statistical processing of the results was carried out using standard Microsoft Excel 7.0 and “Statistica 6.0” programs. Results. The research demonstrated that HD is a common complication in pregnant women after the use of ART and accounts for 42.5 %. The frequency of women ≥40 years old was significantly higher in the 1st (42.8 %) and 2nd (25.5 %) groups than in the 3d one (15.5 %), as well as the prevalence of secondary infertility among the examined female patients – 23.3 %, 37.2 % and 6.3 %, respectively. Diabetes was found in women of the 1st (7.8 %) and 2nd (5.9 %) groups statistically more often compared to the control group (1.9 %), multiple pregnancy – in 45.6 %, 52.9 % and 27.0 % cases, respectively; 11.8% of patients in the 2nd group were diagnosed with autoimmune diseases.In patients with pregestational AH and GHD there was the high frequency of secondary infertility which is significantly more compared to the control group (p<0.05). Therefore, it can be assumed that this factor may influence the development of GHD in the future.The use of donor eggs was significantly more frequent in women of the 2nd group (21.5 %) compared to patients of the 1st (4.9 %) and control (5.3 %) groups (p<0.05). Transfer of cryopreserved embryos was used in 54.3 % of pregnant women of the 1st group and in 45.1 % of pregnant women in the 2nd group, which is reliable compared to the indicators of the control group (17.7 %; p<0.05). This makes possible to state that the use of donor eggs and the transfer of cryopreserved embryos can lead to an increase in the risk of GHD development in the future.In the group of pregnant women with pregestational AH, there were significantly more patients with an intergenetic interval of 10 years or more. This suggests that a large intergenetic int","PeriodicalId":21003,"journal":{"name":"Reproductive health of woman","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73678811","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 : 2022-12-29DOI: 10.30841/2708-8731.8.2022.273291
І. Mironyuk, G. Slabkiy, О.S. Shcherbinska, V.J. Bilak-Lukianchuk
According to experts’ data, the war between Ukraine and Russia may become one of the bloodiest in modern history – the scale of losses on both sides is already much higher than in a typical war of the modern era. The objective: to determine the consequences of the war with the Russian Federation for the public health of Ukrainian population in the regions temporarily occupied by Russian army and located in the war zone.Materials and methods. The research materials were the data from scientific literature and personal practical experience in the organization of public health care. The method of the system approach, the bibliosemantic method and the method of structural and logical analysis were used. Results. The analysis of the was consequences with the Russian Federation for public health in the regions that are temporarily occupied and are located in the zone of active hostilities shows that they are complex and include medical-demographic, socio-economic and behavioral-biological groups. The main negative medico-demographic consequences include: an increase in the incidence of socially significant and infectious diseases, mental exhaustion with an increase in the level of psychological and mental problems with a high risk of post-traumatic stress disorder development with an increase in the general and premature mortality of the population without receiving medical help and self-medication and a high level of forced population migration. The main socio-economic consequences that negatively affect the state of public health include: the tragic loss of relative persons, housing and property, a decrease in the economic level of the population, the loss of social status of the large part of the population, a low level of access to the Internet and mobile communications connection or its complete absence (forced isolation), the significant damage of the infrastructure of the energy supply system for life, a low level of access to medical services and medicines. The main behavioral and biological consequences that negatively affect the state of public health include: the loss of previously stable conditions of quality life, living in unfavorable sanitary and hygienic conditions and in constant stress, the loss of motivation for behavior directed at a responsible attitude to personal health.Conclusions. The war with the Russian Federation has a significant negative impact on the state of public health in Ukraine.
{"title":"Consequences of the war with the russian federation for the public health of Ukraine","authors":"І. Mironyuk, G. Slabkiy, О.S. Shcherbinska, V.J. Bilak-Lukianchuk","doi":"10.30841/2708-8731.8.2022.273291","DOIUrl":"https://doi.org/10.30841/2708-8731.8.2022.273291","url":null,"abstract":"According to experts’ data, the war between Ukraine and Russia may become one of the bloodiest in modern history – the scale of losses on both sides is already much higher than in a typical war of the modern era. The objective: to determine the consequences of the war with the Russian Federation for the public health of Ukrainian population in the regions temporarily occupied by Russian army and located in the war zone.Materials and methods. The research materials were the data from scientific literature and personal practical experience in the organization of public health care. The method of the system approach, the bibliosemantic method and the method of structural and logical analysis were used. Results. The analysis of the was consequences with the Russian Federation for public health in the regions that are temporarily occupied and are located in the zone of active hostilities shows that they are complex and include medical-demographic, socio-economic and behavioral-biological groups. The main negative medico-demographic consequences include: an increase in the incidence of socially significant and infectious diseases, mental exhaustion with an increase in the level of psychological and mental problems with a high risk of post-traumatic stress disorder development with an increase in the general and premature mortality of the population without receiving medical help and self-medication and a high level of forced population migration. The main socio-economic consequences that negatively affect the state of public health include: the tragic loss of relative persons, housing and property, a decrease in the economic level of the population, the loss of social status of the large part of the population, a low level of access to the Internet and mobile communications connection or its complete absence (forced isolation), the significant damage of the infrastructure of the energy supply system for life, a low level of access to medical services and medicines. The main behavioral and biological consequences that negatively affect the state of public health include: the loss of previously stable conditions of quality life, living in unfavorable sanitary and hygienic conditions and in constant stress, the loss of motivation for behavior directed at a responsible attitude to personal health.Conclusions. The war with the Russian Federation has a significant negative impact on the state of public health in Ukraine.","PeriodicalId":21003,"journal":{"name":"Reproductive health of woman","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85315207","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 : 2022-11-30DOI: 10.30841/2708-8731.7.2022.272472
N. Lemish
The objective: to establish the risk factors for development of great obstetrical syndromes (GOS) on the basis of a prospective analysis of somatic, reproductive, obstetric anamnesis in pregnant women with clinical manifestations of GOSMaterials and methods. We conducted the analyses of somatic, reproductive and obstetrical history of 572 pregnant with clinical symptoms of GOS, who had the following complications: 21 – preeclampsia, 38 – preterm deliveries, 13 – placental abruption, 457 – gestational anemia, 27 – intrauterine growth retardation, 16 – fetal distress, that were diagnosed based on clinical, functional, laboratory, ultrasound, cardiotocographic and morphological investigations. All these complications are included in the group of GOS.Statistical analyze was conducted by using standard programs of Microsoft Excel 5.0 and Statistica 6.0.Results. The average age of the pregnant women was 26.5±2.3 years, most of them were in young reproductive age. The prevailing diseases in the structure of somatic pathology were thyroid gland pathology – 427 (74.6 %) persons, anemia 182 (31.8 %), arterial hypertension – 114 (19.9 %), kidney diseases – 241 (42.1 %) and diseases of gastro-intestinal tract –187 (32.7 %). Disorders of menstrual cycle were determined in 137 (23.9 %) women, chronic pelvic inflammatory diseases – 98 (17.1 %), background diseases of cervix (erosion, cervical dysplasia) had 142 (24.8 %) patients in anamnesis, colpitis – 296 (51.7 %), polycystic ovaries – 74 (12.9 %). The following pregnancy complications were diagnosed as preeclampsia – in 21 (3.7 %) persons, threatened preterm interruption of pregnancy in different gestational terms – in every third pregnant women (192 individuals – 33.7 %), anemia – 457 (79.9 %), preterm delivery – 38 (6.6 %) women, placental abruption – 13 (2.3 %), fetal growth retardation – in 27 cases (4.7 %), fetal distress – 16 (2.8 %). The rate of cesarean section in this group was 28.8 %.Conclusions. The identified peculiarities of somatic, reproductive history and obstetrical and perinatal pathology in pregnant with complications from GOS group allowed to define the following risk factors of their development: young reproductive age, significant frequency of socio-hygienic, medical and demographic and socio-psychological problems, complicated somatic, gynecological and reproductive history.
{"title":"Peculiarities of clinical characteristics of pregnant with symptoms of Great obstetrical syndromes","authors":"N. Lemish","doi":"10.30841/2708-8731.7.2022.272472","DOIUrl":"https://doi.org/10.30841/2708-8731.7.2022.272472","url":null,"abstract":"The objective: to establish the risk factors for development of great obstetrical syndromes (GOS) on the basis of a prospective analysis of somatic, reproductive, obstetric anamnesis in pregnant women with clinical manifestations of GOSMaterials and methods. We conducted the analyses of somatic, reproductive and obstetrical history of 572 pregnant with clinical symptoms of GOS, who had the following complications: 21 – preeclampsia, 38 – preterm deliveries, 13 – placental abruption, 457 – gestational anemia, 27 – intrauterine growth retardation, 16 – fetal distress, that were diagnosed based on clinical, functional, laboratory, ultrasound, cardiotocographic and morphological investigations. All these complications are included in the group of GOS.Statistical analyze was conducted by using standard programs of Microsoft Excel 5.0 and Statistica 6.0.Results. The average age of the pregnant women was 26.5±2.3 years, most of them were in young reproductive age. The prevailing diseases in the structure of somatic pathology were thyroid gland pathology – 427 (74.6 %) persons, anemia 182 (31.8 %), arterial hypertension – 114 (19.9 %), kidney diseases – 241 (42.1 %) and diseases of gastro-intestinal tract –187 (32.7 %). Disorders of menstrual cycle were determined in 137 (23.9 %) women, chronic pelvic inflammatory diseases – 98 (17.1 %), background diseases of cervix (erosion, cervical dysplasia) had 142 (24.8 %) patients in anamnesis, colpitis – 296 (51.7 %), polycystic ovaries – 74 (12.9 %). The following pregnancy complications were diagnosed as preeclampsia – in 21 (3.7 %) persons, threatened preterm interruption of pregnancy in different gestational terms – in every third pregnant women (192 individuals – 33.7 %), anemia – 457 (79.9 %), preterm delivery – 38 (6.6 %) women, placental abruption – 13 (2.3 %), fetal growth retardation – in 27 cases (4.7 %), fetal distress – 16 (2.8 %). The rate of cesarean section in this group was 28.8 %.Conclusions. The identified peculiarities of somatic, reproductive history and obstetrical and perinatal pathology in pregnant with complications from GOS group allowed to define the following risk factors of their development: young reproductive age, significant frequency of socio-hygienic, medical and demographic and socio-psychological problems, complicated somatic, gynecological and reproductive history.","PeriodicalId":21003,"journal":{"name":"Reproductive health of woman","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80385762","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 : 2022-11-30DOI: 10.30841/2708-8731.7.2022.272463
V. O. Beniuk, V. Kurochka, K.I. Susak, Y. Drupp, O. Bălă
The problem of adenomyosis is particularly relevant for patients of reproductive age, as it is accompanied by the significant disturbances of menstrual and generative functions. The article presents the results of studying the condition of the hypothalamic-pituitary-ovarian system in women of reproductive age with adenomyosis.The objective: to study the state of the hypothalamic-pituitary-ovarian system in women of reproductive age with benign endometrial and myometrial pathology.Materials and methods. The main group included 120 women of reproductive age with benign endometrial and myometrial pathology (adenomyosis, endometrial hyperplasia and combined pathology), and the control group included 40 healthy women without gynecological pathology. The functional state of the hypothalamic-pituitary-ovarian system was evaluated by the levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), estradiol (E2) and progesterone (P) in blood serum in different phases of the menstrual cycle.Results. In women with adenomyosis, endometrial hyperplasia and combined pathology, there is hyperproduction of gonadotropic hormones with an increase of their secretion level compared to a group of healthy women: the average concentration of FSH, regardless of the phase of the menstrual cycle, increased by 1.9 times (p<0.05), LH – 2.2 times, PRL – 2 times, which indicates the presence of hyperprolactinemia. Both in the I and II phases of the menstrual cycle, the occurrence of additional FSH and LH peaks from basal hormone secretion was determined in patients of the main group, which reached the level of hormone concentration in the ovulatory peak. In the patients of the main group, hyperestrogenemia during the entire menstrual cycle and hypoprogesteronemia were detected. The expression of hormonal shifts depended on gynecological pathology (adenomyosis, endometrial hyperplasia and combined pathology) and the functional state of the woman.Conclusions. The indicators of gonadotropic and prolactin-stimulating activity of the pituitary gland in women with benign uterine pathology confirm the participation of FSH, LH and prolactin in the complex processes of regulation of the reproductive system.
{"title":"Hormonal homeostasis in women of reproductive age with adenomyosis","authors":"V. O. Beniuk, V. Kurochka, K.I. Susak, Y. Drupp, O. Bălă","doi":"10.30841/2708-8731.7.2022.272463","DOIUrl":"https://doi.org/10.30841/2708-8731.7.2022.272463","url":null,"abstract":"The problem of adenomyosis is particularly relevant for patients of reproductive age, as it is accompanied by the significant disturbances of menstrual and generative functions. The article presents the results of studying the condition of the hypothalamic-pituitary-ovarian system in women of reproductive age with adenomyosis.The objective: to study the state of the hypothalamic-pituitary-ovarian system in women of reproductive age with benign endometrial and myometrial pathology.Materials and methods. The main group included 120 women of reproductive age with benign endometrial and myometrial pathology (adenomyosis, endometrial hyperplasia and combined pathology), and the control group included 40 healthy women without gynecological pathology. The functional state of the hypothalamic-pituitary-ovarian system was evaluated by the levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), estradiol (E2) and progesterone (P) in blood serum in different phases of the menstrual cycle.Results. In women with adenomyosis, endometrial hyperplasia and combined pathology, there is hyperproduction of gonadotropic hormones with an increase of their secretion level compared to a group of healthy women: the average concentration of FSH, regardless of the phase of the menstrual cycle, increased by 1.9 times (p<0.05), LH – 2.2 times, PRL – 2 times, which indicates the presence of hyperprolactinemia. Both in the I and II phases of the menstrual cycle, the occurrence of additional FSH and LH peaks from basal hormone secretion was determined in patients of the main group, which reached the level of hormone concentration in the ovulatory peak. In the patients of the main group, hyperestrogenemia during the entire menstrual cycle and hypoprogesteronemia were detected. The expression of hormonal shifts depended on gynecological pathology (adenomyosis, endometrial hyperplasia and combined pathology) and the functional state of the woman.Conclusions. The indicators of gonadotropic and prolactin-stimulating activity of the pituitary gland in women with benign uterine pathology confirm the participation of FSH, LH and prolactin in the complex processes of regulation of the reproductive system.","PeriodicalId":21003,"journal":{"name":"Reproductive health of woman","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77045804","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 : 2022-11-30DOI: 10.30841/2708-8731.7.2022.272468
A. Pylypenko, V. Medved
The objective: to evaluate the clinical and prognostic value and meaning of the ratio of the anti-angiogenic factor of soluble fms-like tyrosine kinase-1 (sFlt-1) to the angiogenic factor of the placental growth factor (PlGF) in the dynamics of pregnancy as markers of various variants of placental dysfunction. Materials and methods. A retrospective cohort study of 40 pregnant women, who were distributed by gestation term (up to 34 weeks and after 34 weeks) and the level of sFlt-1:PlGF ratio (<38 is low level, > 110 – high level) was performed. The statistical comparison of the sFlt-1:PlGF ratio with the development of hypertensive disorders during pregnancy and fetal growth retardation (FGR), as well as the duration of the period from research to childbirth was calculated. Results. Preeclampsia (PE) developed in 12 persons out of 40 pregnant women. The sFlt-1:PlGF ratio in the period till 27 weeks of pregnancy in groups of women with PE and without it does not differ with a statistically significant level (p=0.3). In other gestation terms the sFlt-1:PlGF ratio in women with and without placental dysfunction is statistically significant (p<0.05). The sFlt-1:PlGF ratio >38 increases the risk of PE more than 4 times (RR = 4.6) and is statistically significant in a period till 34 weeks [95 % CI: 1.4-14,9]. After 34 weeks of pregnancy the sFlt-1:PlGF ratio >110 has a higher sensitivity (Se=0.75).An analysis of the sFlt-1:PlGF ratio for the purpose of FGR predicting, both in combination with hypertensive disorders during pregnancy or without them, demonstrated its high importance during pregnancy up to 34 weeks (p=0.001). A strong reverse correlation (ƿ= -0.7) was found between the value of the sFlt-1:PlGF ratio and the number of days from the date of research till childbirth at the level of significance of 0.0001 in pregnant women up to 34 weeks. Conclusions. The predictive value of the conventional method of assessing the preeclampsia (PE) risk and the preventive efficiency of acetylsalicylic acid is low. In the absence of clinical manifestation of PE the determination of the sFlt-1:PlGF ratio for a predication till 27 weeks of pregnancy is not informative, so it is not recommended. If the sFlt-1:PlGF ratio is > 38 in the period till 34 weeks, the relative risk is 4.6 [95 % CI: 1.4–14.9]. If the level of the sFlt-1:PlGF ratio is high at first investigation there is no sense to repeat the research in dynamics. In the case of low the sFlt-1:PlGF ratio for a reasonable suspicion of PE development, repeated research can help make an adequate clinical decision. The determination of the sFlt-1:PlGF ratio for a predication or confirmation of fetal growth retardation till 34 weeks is clinically reasonable and informative. There is a strong reverse correlation between the sFlt-1:PlGF ratio and the number of days before the current birth.
{"title":"To the question of the clinical predictive value of the sFlt-1:PlGF ratio is related to the placental dysfunction","authors":"A. Pylypenko, V. Medved","doi":"10.30841/2708-8731.7.2022.272468","DOIUrl":"https://doi.org/10.30841/2708-8731.7.2022.272468","url":null,"abstract":"The objective: to evaluate the clinical and prognostic value and meaning of the ratio of the anti-angiogenic factor of soluble fms-like tyrosine kinase-1 (sFlt-1) to the angiogenic factor of the placental growth factor (PlGF) in the dynamics of pregnancy as markers of various variants of placental dysfunction. Materials and methods. A retrospective cohort study of 40 pregnant women, who were distributed by gestation term (up to 34 weeks and after 34 weeks) and the level of sFlt-1:PlGF ratio (<38 is low level, > 110 – high level) was performed. The statistical comparison of the sFlt-1:PlGF ratio with the development of hypertensive disorders during pregnancy and fetal growth retardation (FGR), as well as the duration of the period from research to childbirth was calculated. Results. Preeclampsia (PE) developed in 12 persons out of 40 pregnant women. The sFlt-1:PlGF ratio in the period till 27 weeks of pregnancy in groups of women with PE and without it does not differ with a statistically significant level (p=0.3). In other gestation terms the sFlt-1:PlGF ratio in women with and without placental dysfunction is statistically significant (p<0.05). The sFlt-1:PlGF ratio >38 increases the risk of PE more than 4 times (RR = 4.6) and is statistically significant in a period till 34 weeks [95 % CI: 1.4-14,9]. After 34 weeks of pregnancy the sFlt-1:PlGF ratio >110 has a higher sensitivity (Se=0.75).An analysis of the sFlt-1:PlGF ratio for the purpose of FGR predicting, both in combination with hypertensive disorders during pregnancy or without them, demonstrated its high importance during pregnancy up to 34 weeks (p=0.001). A strong reverse correlation (ƿ= -0.7) was found between the value of the sFlt-1:PlGF ratio and the number of days from the date of research till childbirth at the level of significance of 0.0001 in pregnant women up to 34 weeks. Conclusions. The predictive value of the conventional method of assessing the preeclampsia (PE) risk and the preventive efficiency of acetylsalicylic acid is low. In the absence of clinical manifestation of PE the determination of the sFlt-1:PlGF ratio for a predication till 27 weeks of pregnancy is not informative, so it is not recommended. If the sFlt-1:PlGF ratio is > 38 in the period till 34 weeks, the relative risk is 4.6 [95 % CI: 1.4–14.9]. If the level of the sFlt-1:PlGF ratio is high at first investigation there is no sense to repeat the research in dynamics. In the case of low the sFlt-1:PlGF ratio for a reasonable suspicion of PE development, repeated research can help make an adequate clinical decision. The determination of the sFlt-1:PlGF ratio for a predication or confirmation of fetal growth retardation till 34 weeks is clinically reasonable and informative. There is a strong reverse correlation between the sFlt-1:PlGF ratio and the number of days before the current birth.","PeriodicalId":21003,"journal":{"name":"Reproductive health of woman","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90143604","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 : 2022-11-30DOI: 10.30841/2708-8731.7.2022.272470
A. Rybin
The objective: to analyse of the experience of cytoreductive surgery using and hypenermic intraperitoneal chemperfusion (HIPEC) in patients with ovarian cancer IIIC stage, as well as overall and relapse-free survival in such patients. Materials and methods. 119 patients with ovarian cancer of the IIIC stage were involved into the study from 2013 to 2020 and they were treated at the University Clinic of Odessa National Medical University. Patients were divided into two groups: the clinical control group (n=53) included persons after suboptimal cytoreduction; the patients of the main group (n=66) had optimal or complete cytoreduction, and in some cases with subsequent intraoperative hyperthermic intraperitoneal chemotherapy. During the initial analysis of these groups, time (preoperative period, duration of surgery, number of postoperative bed-days), as well as the presence of complications in the postoperative period were determined. Results. In the main group there was an increase operation time due to large surgery volumes and the implementation of the HIPEC procedure with primary cytoreduction (p=0.001). In the postoperative period, an increase in the number of bed-days in the hospital in patients of the main group in relation to the control group was established, especially in those who had HIPEC (p=0.001). There was an increase in the number of surgical complications of class III-IV according to the Clavien-Dindo classification (from 5 % to 22.2 %) in patients after HIPEC. An increase in relapse-free survival from 10 months in the control group to 13-19 months in the main group was revealed. The recurrence median in the postoperative period in the control group was 10±1.3 months, and after interval cytoreduction and primary cytoreduction with HIPEC – 13±1.5 and 19±6.3 months, respectively. The index of relapse-free survival in the first 6 months in the control group was 63.2 %, in patients after optimal or complete cytoreduction – 88.0 %, in patients after optimal or complete cytoreduction and HIPEC – 90.4 %. One-year recurrence-free survival rate was 37.5 %, 63.2 % and 60.1 %, respectively, the average values of overall survival – 27.7±4.1 months versus 24.5±1.8 and 24.1±2.2 months, respectively. Conclusions. Cytoreductive surgery and methods of intraoperative hyperthermic intraperitoneal chemotherapy are perspective options of treatment of patients with peritoneal carcinomatosis by ovarian cancer regarding recurrence of the disease and survival, although they are accompanied by more postoperative complications and number of bed-days in hospital.
{"title":"The results of personificated ovarian cancer patients with peritoneal carcinomatosis treatment","authors":"A. Rybin","doi":"10.30841/2708-8731.7.2022.272470","DOIUrl":"https://doi.org/10.30841/2708-8731.7.2022.272470","url":null,"abstract":"The objective: to analyse of the experience of cytoreductive surgery using and hypenermic intraperitoneal chemperfusion (HIPEC) in patients with ovarian cancer IIIC stage, as well as overall and relapse-free survival in such patients. Materials and methods. 119 patients with ovarian cancer of the IIIC stage were involved into the study from 2013 to 2020 and they were treated at the University Clinic of Odessa National Medical University. Patients were divided into two groups: the clinical control group (n=53) included persons after suboptimal cytoreduction; the patients of the main group (n=66) had optimal or complete cytoreduction, and in some cases with subsequent intraoperative hyperthermic intraperitoneal chemotherapy. During the initial analysis of these groups, time (preoperative period, duration of surgery, number of postoperative bed-days), as well as the presence of complications in the postoperative period were determined. Results. In the main group there was an increase operation time due to large surgery volumes and the implementation of the HIPEC procedure with primary cytoreduction (p=0.001). In the postoperative period, an increase in the number of bed-days in the hospital in patients of the main group in relation to the control group was established, especially in those who had HIPEC (p=0.001). There was an increase in the number of surgical complications of class III-IV according to the Clavien-Dindo classification (from 5 % to 22.2 %) in patients after HIPEC. An increase in relapse-free survival from 10 months in the control group to 13-19 months in the main group was revealed. The recurrence median in the postoperative period in the control group was 10±1.3 months, and after interval cytoreduction and primary cytoreduction with HIPEC – 13±1.5 and 19±6.3 months, respectively. The index of relapse-free survival in the first 6 months in the control group was 63.2 %, in patients after optimal or complete cytoreduction – 88.0 %, in patients after optimal or complete cytoreduction and HIPEC – 90.4 %. One-year recurrence-free survival rate was 37.5 %, 63.2 % and 60.1 %, respectively, the average values of overall survival – 27.7±4.1 months versus 24.5±1.8 and 24.1±2.2 months, respectively. Conclusions. Cytoreductive surgery and methods of intraoperative hyperthermic intraperitoneal chemotherapy are perspective options of treatment of patients with peritoneal carcinomatosis by ovarian cancer regarding recurrence of the disease and survival, although they are accompanied by more postoperative complications and number of bed-days in hospital.","PeriodicalId":21003,"journal":{"name":"Reproductive health of woman","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86707791","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 : 2022-11-30DOI: 10.30841/2708-8731.7.2022.272466
O. Deinichenko, V.G. Sіusіuka, Y. Krut, M. Pavlyuchenko, O.D. Kyryliuk, N.Y. Boguslavska
During intrauterine life a fetus with growth restriction does hemodynamic, metabolic and hormonal adjustments to cope with the adverse uterine environment, and these changes can become permanent and irreversible. Despite the progress in the knowledge of delayed fetal development, the biomarkers are able to identify this pathology at an early stage and stratify its severity, both before and after childbirth, are still not determined. The objective: to evaluate the prognostic value of the angiogenesis marker level, hormonal profile and Doppler examination for fetal growth restriction (FGR) in pregnant women with chronic arterial hypertension (CAH).Materials and methods. A prospective examination of 61 pregnant women with CAH 1-2 degrees was conducted, which included an analysis of the clinical and anamnestic characteristics and the study of the pregnancy course in the first trimester (11-12 weeks). To determine the level of risk factors for the FGR development the examined pregnant women were divided into groups: women with CAH with FGR (n=10), and pregnant women with CAH without FGR (n=51).Human chorionic gonadotropin (CHG), progesterone (PG) and estradiol (E) were determined in blood serum. Angiogenesis markers – placental growth factor (P1GF) as a pro-angiogenic factor and soluble fms-like tyrosine kinase (sFlt-1) as an anti-angiogenic factor were studied, the ratio of sFlt-1/PLGF (coefficient K) was calculated. All patients had Doppler examination of vascular blood flow in the left and right uterine arteries (pulsation index – PI, resistance index – RI and systolic-diastolic ratio – SDR). The ultrasound examination was done with the ultrasound machine “Mylab Six System”. Statistical analysis was performed using program Statistica® for Windows 13.0. A single-factor logistic regression analysis and a method of building logistics regression, which was evaluated by means of receive operating characteristic curve (ROC-curve) according to the area under the curve (AUC) were used to determine the prognostic level of markers, the 95 % confidence interval was calculated. Results. In the first trimester of pregnancy in women with CAH the PLGF level was < 8.2 pg/ml (sensitivity – 80.0 %, specificity – 60.78 %), area under the ROC curve (AUC) – 0.697 (95 % CI: 0.566–0.808; p =0.0128), which indicate an increased risk of FGR development. The growth of sFl-1 > 1802.59 ng/ml (sensitivity – 70.0 %, specificity – 64.71 %), area under the ROC-curve (AUC) 0.678 (95 % CI: 0.547–0.792; p=0.05) increase the risk of FGR development. The coefficient K in 11-12 weeks of pregnancy was ≥ 95.36 units (sensitivity – 100.0 %, specificity – 43.14 %), area under ROC-curve (AUC) – 0.735 (95 % CI: 0.607–0.840; p=0.0128), which indicate an increase the risk of FGR development. PG/PlGF ratio is 7.21 (sensitivity – 70.0 %, specificity – 70.59 %) and area under the ROC-curve (AUC) 0.702 (95 % CI: 0.571–0.812; p = 0.0118) also indicate the increase the risk of FGR development, as we
{"title":"Prediction of the development of fetal growth retardation in pregnant women with chronic arterial hypertension","authors":"O. Deinichenko, V.G. Sіusіuka, Y. Krut, M. Pavlyuchenko, O.D. Kyryliuk, N.Y. Boguslavska","doi":"10.30841/2708-8731.7.2022.272466","DOIUrl":"https://doi.org/10.30841/2708-8731.7.2022.272466","url":null,"abstract":"During intrauterine life a fetus with growth restriction does hemodynamic, metabolic and hormonal adjustments to cope with the adverse uterine environment, and these changes can become permanent and irreversible. Despite the progress in the knowledge of delayed fetal development, the biomarkers are able to identify this pathology at an early stage and stratify its severity, both before and after childbirth, are still not determined. The objective: to evaluate the prognostic value of the angiogenesis marker level, hormonal profile and Doppler examination for fetal growth restriction (FGR) in pregnant women with chronic arterial hypertension (CAH).Materials and methods. A prospective examination of 61 pregnant women with CAH 1-2 degrees was conducted, which included an analysis of the clinical and anamnestic characteristics and the study of the pregnancy course in the first trimester (11-12 weeks). To determine the level of risk factors for the FGR development the examined pregnant women were divided into groups: women with CAH with FGR (n=10), and pregnant women with CAH without FGR (n=51).Human chorionic gonadotropin (CHG), progesterone (PG) and estradiol (E) were determined in blood serum. Angiogenesis markers – placental growth factor (P1GF) as a pro-angiogenic factor and soluble fms-like tyrosine kinase (sFlt-1) as an anti-angiogenic factor were studied, the ratio of sFlt-1/PLGF (coefficient K) was calculated. All patients had Doppler examination of vascular blood flow in the left and right uterine arteries (pulsation index – PI, resistance index – RI and systolic-diastolic ratio – SDR). The ultrasound examination was done with the ultrasound machine “Mylab Six System”. Statistical analysis was performed using program Statistica® for Windows 13.0. A single-factor logistic regression analysis and a method of building logistics regression, which was evaluated by means of receive operating characteristic curve (ROC-curve) according to the area under the curve (AUC) were used to determine the prognostic level of markers, the 95 % confidence interval was calculated. Results. In the first trimester of pregnancy in women with CAH the PLGF level was < 8.2 pg/ml (sensitivity – 80.0 %, specificity – 60.78 %), area under the ROC curve (AUC) – 0.697 (95 % CI: 0.566–0.808; p =0.0128), which indicate an increased risk of FGR development. The growth of sFl-1 > 1802.59 ng/ml (sensitivity – 70.0 %, specificity – 64.71 %), area under the ROC-curve (AUC) 0.678 (95 % CI: 0.547–0.792; p=0.05) increase the risk of FGR development. The coefficient K in 11-12 weeks of pregnancy was ≥ 95.36 units (sensitivity – 100.0 %, specificity – 43.14 %), area under ROC-curve (AUC) – 0.735 (95 % CI: 0.607–0.840; p=0.0128), which indicate an increase the risk of FGR development. PG/PlGF ratio is 7.21 (sensitivity – 70.0 %, specificity – 70.59 %) and area under the ROC-curve (AUC) 0.702 (95 % CI: 0.571–0.812; p = 0.0118) also indicate the increase the risk of FGR development, as we","PeriodicalId":21003,"journal":{"name":"Reproductive health of woman","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82862566","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：