Purpose - to assess the prognostic value of a comprehensive study of the influence of indicators of angiogenic/antiangiogenic profile in women with retrochorial hematoma (RCH) in the І trimester, uterine artery (UA) dopplerometry data in stratifying the risks of developing placental dysfunction in these women. Materials and methods. A prospective analysis of the course of pregnancy was carried out in 137 women with a threat of miscarriage aged 20 to 47 years, who made up two comparison groups: the Group I - 60 patients with RCH, the Group II - 77 patients with a threat of abortion without hematoma. Results. The average age of women of the Group I was 31.2±0.6 years, of the Group II - 32.2±0.6 years. The gestational age at enrollment was equal 6.1±0.55 weeks in the Group I and 7.2±0.61 weeks in the Group II. A direct, reliable correlation of weak strength was established in pairs: the presence of the human chorionic gonadotropin (hCG) and the pulsatility index (PI) in UA >95 percentile, hCG and a higher level of hCG in the I and II trimesters of pregnancy. A reduced level of PAPP-A was significantly associated with cases of preeclampsia (PE) in the anamnesis, increased Body Mass Index, a high level of PI in UA, including with PI levels >95 percentile, as well as with a reduced level of free estriol. Significant inverse correlations were established between the level of PLGF and indicators of PE in history, the level of PI in UA and the content of hCG. At the same time, the level of alpha-fetoprotein in the studied patients was directly associated with increased levels of PI in UA and hCG. It was established that the risk of early PE was more inherent for women with the presence of PCH in the І trimester of pregnancy, while the percentage of the development of late PE with and/or without fetal growth retardation was more often higher in women with a threat of termination of pregnancy in the І trimester trimesters without the formation of RHG. Conclusions. The occurrence of RHG at the stage of early placentation increases the risks of developing placental dysfunction and obstetric complications associated with it. PRISCA-1, PLGF, PI of UA, as well as the calculation of the risk of developing PE in the trimester І using the FMF calculator should be used to form a risk group for the development of placenta-associated complications. Indicators of PI of UA >99 percentile in the І trimester of pregnancy in combination with a decrease in PAPP-A ˂0.45 MoM should be considered critical. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patients was obtained for conducting the studies. No conflict of interests was declared by the authors.
{"title":"Assessment of indicators of complex stratification of the risks of preeclampsia in patients with retrochorial hematomas","authors":"M. Yushchenko, Y. Duka","doi":"10.15574/pp.2022.92.9","DOIUrl":"https://doi.org/10.15574/pp.2022.92.9","url":null,"abstract":"Purpose - to assess the prognostic value of a comprehensive study of the influence of indicators of angiogenic/antiangiogenic profile in women with retrochorial hematoma (RCH) in the І trimester, uterine artery (UA) dopplerometry data in stratifying the risks of developing placental dysfunction in these women. Materials and methods. A prospective analysis of the course of pregnancy was carried out in 137 women with a threat of miscarriage aged 20 to 47 years, who made up two comparison groups: the Group I - 60 patients with RCH, the Group II - 77 patients with a threat of abortion without hematoma. Results. The average age of women of the Group I was 31.2±0.6 years, of the Group II - 32.2±0.6 years. The gestational age at enrollment was equal 6.1±0.55 weeks in the Group I and 7.2±0.61 weeks in the Group II. A direct, reliable correlation of weak strength was established in pairs: the presence of the human chorionic gonadotropin (hCG) and the pulsatility index (PI) in UA >95 percentile, hCG and a higher level of hCG in the I and II trimesters of pregnancy. A reduced level of PAPP-A was significantly associated with cases of preeclampsia (PE) in the anamnesis, increased Body Mass Index, a high level of PI in UA, including with PI levels >95 percentile, as well as with a reduced level of free estriol. Significant inverse correlations were established between the level of PLGF and indicators of PE in history, the level of PI in UA and the content of hCG. At the same time, the level of alpha-fetoprotein in the studied patients was directly associated with increased levels of PI in UA and hCG. It was established that the risk of early PE was more inherent for women with the presence of PCH in the І trimester of pregnancy, while the percentage of the development of late PE with and/or without fetal growth retardation was more often higher in women with a threat of termination of pregnancy in the І trimester trimesters without the formation of RHG. Conclusions. The occurrence of RHG at the stage of early placentation increases the risks of developing placental dysfunction and obstetric complications associated with it. PRISCA-1, PLGF, PI of UA, as well as the calculation of the risk of developing PE in the trimester І using the FMF calculator should be used to form a risk group for the development of placenta-associated complications. Indicators of PI of UA >99 percentile in the І trimester of pregnancy in combination with a decrease in PAPP-A ˂0.45 MoM should be considered critical. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patients was obtained for conducting the studies. No conflict of interests was declared by the authors.","PeriodicalId":330226,"journal":{"name":"UKRAINIAN JOURNAL OF PERINATOLOGY AND PEDIATRICS","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132706764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background. Congenital malformations of the gastrointestinal (GI) tract are common birth defects detected in the neonatal period and usually present with signs of GI obstruction which at times can be life threatening. Anorectal malformations are among the more frequent congenital anomalies. The co-occurrence of congenital heart defect (CHD) along with GI malformation can significantly affect the natural history of either defect. Purpose - to study the prevalence of GI malformations in children with CHD and study the risk factors. Materials and methods. A total 100 patients of GI malformations were enrolled out of which 66 (66%) were males and 34 (34%) were females. All patients with any GI malformations (anorectal malformation, tracheoesophageal fistulae, anterior abdominal wall defects) presenting to Neonatal Intensive Care Unit (NICU), Paediatric Cardiac unit, Pediatric and Pediatric surgery outpatient department (OPD) as well as In-patient department (IPD) between October 2019 to October 2021 were included in study. A detailed history and examination was done followed by echocardiography and the prevalence of CHD among GI malformation was observed and risk factors were studied. Results. Most common GI anomaly was anorectal malformation (71%) followed by tracheoesophageal fistula (17%), CHD was seen in 14 children. Most common heart defect was ventricular septal defect (VSD) (43%) followed by patent ductus arteriosus (PDA) (36%) and atrial septal defect (ASD) (14%). Among cases with anorectal malformation, CHDs was seen in 10% and the most common defect was VSD (43%). Forty one percent of cases with tracheoesophageal fistula had CHDs with PDA (57%) being the most common underlying defect. Functional heart defects were present in 28 children of GI malformations. Conclusions. The coexistence and severity of CHD in patients with GI malformation can have prognostic implications. Thus, early cardiac evaluation should be performed in every case of GI malformation, preferably with echocardiography. This is likely to help in the risk stratification as well as management of such children. The study was performed in accordance with the principles of the Declaration of Helsinki. Study is approved by Ethical Committee of the Institution. Informed consent of patients was obtained for the study. No conflict of interests was declared by the authors.
{"title":"Congenital heart defects in children with Gastro-intestinal malformations","authors":"A. Khanam, S. Abqari, R. Khan","doi":"10.15574/pp.2022.92.22","DOIUrl":"https://doi.org/10.15574/pp.2022.92.22","url":null,"abstract":"Background. Congenital malformations of the gastrointestinal (GI) tract are common birth defects detected in the neonatal period and usually present with signs of GI obstruction which at times can be life threatening. Anorectal malformations are among the more frequent congenital anomalies. The co-occurrence of congenital heart defect (CHD) along with GI malformation can significantly affect the natural history of either defect. Purpose - to study the prevalence of GI malformations in children with CHD and study the risk factors. Materials and methods. A total 100 patients of GI malformations were enrolled out of which 66 (66%) were males and 34 (34%) were females. All patients with any GI malformations (anorectal malformation, tracheoesophageal fistulae, anterior abdominal wall defects) presenting to Neonatal Intensive Care Unit (NICU), Paediatric Cardiac unit, Pediatric and Pediatric surgery outpatient department (OPD) as well as In-patient department (IPD) between October 2019 to October 2021 were included in study. A detailed history and examination was done followed by echocardiography and the prevalence of CHD among GI malformation was observed and risk factors were studied. Results. Most common GI anomaly was anorectal malformation (71%) followed by tracheoesophageal fistula (17%), CHD was seen in 14 children. Most common heart defect was ventricular septal defect (VSD) (43%) followed by patent ductus arteriosus (PDA) (36%) and atrial septal defect (ASD) (14%). Among cases with anorectal malformation, CHDs was seen in 10% and the most common defect was VSD (43%). Forty one percent of cases with tracheoesophageal fistula had CHDs with PDA (57%) being the most common underlying defect. Functional heart defects were present in 28 children of GI malformations. Conclusions. The coexistence and severity of CHD in patients with GI malformation can have prognostic implications. Thus, early cardiac evaluation should be performed in every case of GI malformation, preferably with echocardiography. This is likely to help in the risk stratification as well as management of such children. The study was performed in accordance with the principles of the Declaration of Helsinki. Study is approved by Ethical Committee of the Institution. Informed consent of patients was obtained for the study. No conflict of interests was declared by the authors.","PeriodicalId":330226,"journal":{"name":"UKRAINIAN JOURNAL OF PERINATOLOGY AND PEDIATRICS","volume":"2014 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128020977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The incidence of placenta previa is 0.2-0.9% but continues to be one of the most serious factors in the development of obstetric’s bleeding and perinatal losses. The situation is aggravated by the fact that placenta previa is combined with various variations of abnormal (deep) attachment of the placenta to the uterus (placenta adhaerens, accreta, increta, percreta). Placenta previa, placenta accreta, and vasa previa cause significant maternal and perinatal morbidity and mortality. With the increasing incidence of both cesarean delivery and pregnancies using assisted reproductive technology, these 3 conditions are becoming more common. Placental accretion remains the main cause of maternal hemorrhage and obstetric hysterectomy, resulting in significantly high maternal morbidity and mortality. Risk factors for placenta previa include prior cesarean delivery, pregnancy termination, intrauterine surgery, smoking, multifetal gestation, increasing parity, and maternal age. Advances in ultrasound have facilitated prenatal diagnosis of abnormal placentation allowing the development of multidisciplinary management plans to achieve the best outcomes for mother and baby. Purpose - to review the literature on abnormal placentation, including an evidence-based approach to diagnosis, management and treatment; to follow the evolution of this obstetric pathology in recent years and the complications that may arise. Identification of risk factors, correct antenatal and preoperative diagnosis, multidisciplinary treatment and counseling will help in the overall management of women with placenta accreta and reduce maternal morbidity. According to the literature, it can be concluded that true placenta previa or placenta percreta, as well as suspected placenta previa (for example, in cases with a history of caesarean section in anamnesis), should be managed and delivered by caesarean section in a tertiary health facility. In no case should the placenta be separated if edematous blood vessels with visible placental blood flow after laparotomy are found in the area of attachment of the placenta to the anterior wall of the uterus, as well as when the diagnosis is placenta percreta or placenta increta. As a tactic, not only primary hysterectomy should be considered, but also conservative therapy or delayed hysterectomy (two-stage hysterectomy). In a situation where placenta accreta or partial placenta accreta cannot be accurately diagnosed, a good understanding of hemostasis with balloon catheter occlusion, various methods of suture hemostasis, and total hysterectomy procedures should be considered. No conflict of interests was declared by the author.
{"title":"Pathological attachment of the placenta: diagnosis, management and delivery","authors":"G. Ishchenko","doi":"10.15574/pp.2022.92.42","DOIUrl":"https://doi.org/10.15574/pp.2022.92.42","url":null,"abstract":"The incidence of placenta previa is 0.2-0.9% but continues to be one of the most serious factors in the development of obstetric’s bleeding and perinatal losses. The situation is aggravated by the fact that placenta previa is combined with various variations of abnormal (deep) attachment of the placenta to the uterus (placenta adhaerens, accreta, increta, percreta). Placenta previa, placenta accreta, and vasa previa cause significant maternal and perinatal morbidity and mortality. With the increasing incidence of both cesarean delivery and pregnancies using assisted reproductive technology, these 3 conditions are becoming more common. Placental accretion remains the main cause of maternal hemorrhage and obstetric hysterectomy, resulting in significantly high maternal morbidity and mortality. Risk factors for placenta previa include prior cesarean delivery, pregnancy termination, intrauterine surgery, smoking, multifetal gestation, increasing parity, and maternal age. Advances in ultrasound have facilitated prenatal diagnosis of abnormal placentation allowing the development of multidisciplinary management plans to achieve the best outcomes for mother and baby. Purpose - to review the literature on abnormal placentation, including an evidence-based approach to diagnosis, management and treatment; to follow the evolution of this obstetric pathology in recent years and the complications that may arise. Identification of risk factors, correct antenatal and preoperative diagnosis, multidisciplinary treatment and counseling will help in the overall management of women with placenta accreta and reduce maternal morbidity. According to the literature, it can be concluded that true placenta previa or placenta percreta, as well as suspected placenta previa (for example, in cases with a history of caesarean section in anamnesis), should be managed and delivered by caesarean section in a tertiary health facility. In no case should the placenta be separated if edematous blood vessels with visible placental blood flow after laparotomy are found in the area of attachment of the placenta to the anterior wall of the uterus, as well as when the diagnosis is placenta percreta or placenta increta. As a tactic, not only primary hysterectomy should be considered, but also conservative therapy or delayed hysterectomy (two-stage hysterectomy). In a situation where placenta accreta or partial placenta accreta cannot be accurately diagnosed, a good understanding of hemostasis with balloon catheter occlusion, various methods of suture hemostasis, and total hysterectomy procedures should be considered. No conflict of interests was declared by the author.","PeriodicalId":330226,"journal":{"name":"UKRAINIAN JOURNAL OF PERINATOLOGY AND PEDIATRICS","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128623719","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}
Inflammation of the appendages of the uterus as a separate pathology and in appendicular-genital syndrome (AGS) leads to a violation ovarian, histogematic and follicular barriers, which in the future can cause reproductive function disorders, primary infertility, menstrual cycle disorders, the development of adhesions in the pelvis, as well as pain syndrome. Purpose - to analyze the frequency of detection of ACS among the children's population; to draw the attention of medical personnel to this pathology. Materials and methods. In the period 2019-2022, to the Pediatric Surgery Clinic of the National Pirogov Memorial Medical University 310 patients with acute appendicitis and gynecological pathology were hospitalized. Of them, 227 (73.23%) girls were operated on for acute appendicitis, 70 (22.58%) patients had a gynecological problem. ACS was detected in 13 (4.19%) patients. Results. Specific weight AGS among monopathology of the appendix and uterine appendages was 4.19%. All children from AGS had abdominal pain syndrome at the time of hospitalization. Most of the patients had localization of the pain syndrome in the right pubic area and above the pubis. According to the ultrasound examination of pathological changes in the appendages of the uterus were noted in 10 (76.92%) patients, signs of inflammatory transformation of the appendix were observed in 5 (38.46%) patients. All children from AGS were operated. In 4 (30.77%) patients, surgical intervention was completed by removal of the uterine appendage due to tissue necrosis on the background of torsion. Conclusions. So, when pathology of the uterus and appendages and appendix were detected, it should be followed conductrevision of abdominal organs. According to clinical protocols and our judgment, it is necessary to remove the appendix in case of catarrhal changes in the wall of the appendix. Indications for adnexectomy are necrosis of uterine appendages, malignant neoplasms of uterine appendages. In doubtful cases, a diagnostic laparoscopy should be performed regarding the localization of the pathology focus. The research was carried out in accordance with the principles of the Declaration of Helsinki. The research protocol was approved by the Local Ethics Committee of the institution mentioned in the work. Informed consent of the children's parents was obtained for the research. No conflict of interests was declared by the authors.
{"title":"Appendicular-genital syndrome in the structure of \"acute abdomen\" in girls","authors":"Y. Korobko, V. Konoplitsky, S. Klymenko","doi":"10.15574/pp.2022.92.16","DOIUrl":"https://doi.org/10.15574/pp.2022.92.16","url":null,"abstract":"Inflammation of the appendages of the uterus as a separate pathology and in appendicular-genital syndrome (AGS) leads to a violation ovarian, histogematic and follicular barriers, which in the future can cause reproductive function disorders, primary infertility, menstrual cycle disorders, the development of adhesions in the pelvis, as well as pain syndrome. Purpose - to analyze the frequency of detection of ACS among the children's population; to draw the attention of medical personnel to this pathology. Materials and methods. In the period 2019-2022, to the Pediatric Surgery Clinic of the National Pirogov Memorial Medical University 310 patients with acute appendicitis and gynecological pathology were hospitalized. Of them, 227 (73.23%) girls were operated on for acute appendicitis, 70 (22.58%) patients had a gynecological problem. ACS was detected in 13 (4.19%) patients. Results. Specific weight AGS among monopathology of the appendix and uterine appendages was 4.19%. All children from AGS had abdominal pain syndrome at the time of hospitalization. Most of the patients had localization of the pain syndrome in the right pubic area and above the pubis. According to the ultrasound examination of pathological changes in the appendages of the uterus were noted in 10 (76.92%) patients, signs of inflammatory transformation of the appendix were observed in 5 (38.46%) patients. All children from AGS were operated. In 4 (30.77%) patients, surgical intervention was completed by removal of the uterine appendage due to tissue necrosis on the background of torsion. Conclusions. So, when pathology of the uterus and appendages and appendix were detected, it should be followed conductrevision of abdominal organs. According to clinical protocols and our judgment, it is necessary to remove the appendix in case of catarrhal changes in the wall of the appendix. Indications for adnexectomy are necrosis of uterine appendages, malignant neoplasms of uterine appendages. In doubtful cases, a diagnostic laparoscopy should be performed regarding the localization of the pathology focus. The research was carried out in accordance with the principles of the Declaration of Helsinki. The research protocol was approved by the Local Ethics Committee of the institution mentioned in the work. Informed consent of the children's parents was obtained for the research. No conflict of interests was declared by the authors.","PeriodicalId":330226,"journal":{"name":"UKRAINIAN JOURNAL OF PERINATOLOGY AND PEDIATRICS","volume":"90 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132705065","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}
I. Luk’yanova, I. Gordienko, G. Medvedenko, G. Grebinichenko, B. Tarasyuk
Congenital malformations (CM) in fetuses and neonates belong to main causes of perinatal morbidity and mortality. Provision organs malformation and malfunction in such cohorts is less studied. The purpose - to analyze the course of pregnancy, the data of ultrasound imaging of provisional organs in the presence of CM of central nervous system (CNS) and/or of nephro-urinary system (NUS) in the fetus and newborn. Materials and methods. The results of prenatal and postnatal ultrasound, anamnestic and general clinical data of a sample of cases with prenatally diagnosed CM of CNS and/or NUS for the period 2017-2021 were analyzed. Results. There were 45 newborns with CNS malformations, and 54 newborns with CM of NUS. Malformations of NUS and/or CNS in the examined newborns were combined with anomalies of other systems in a third of cases - 29.6% and 31.1%, respectively. According to the results of prenatal ultrasound examinations, polyhydramnios (16.7%) was most often recorded in the pregnancies with fetal CM of NUS, and cases of fetal CM of CNS most commonly were registered placental hyperplasia (35.6%), fetal growth retardation (24.4%) and fetal distress (26.7%). Postnatally in both cohorts (with NUS malformations and with CNS malformations) a high rate of following complications were recorded: prematurity (16.7% and 15.6%, respectively), birth asphyxia (48% and 55.6%, respectively), and early neonatal death (11% and 6.6%). Сonclusions. Pregnant women with CM of CNS and/or NUS in the fetus belong to the group of high perinatal risk because of the high rate of perinatal complications. Information about the identified high perinatal risks in fetuses and newborns with CM of the CNS and/or NUS should be provided to parents and taken into account when planning management of pregnancy and labor.
{"title":"Pathology of provisional organs, complications of pregnancy and labor, and the condition of newborn with congenital defects of the urinary and nervous systems","authors":"I. Luk’yanova, I. Gordienko, G. Medvedenko, G. Grebinichenko, B. Tarasyuk","doi":"10.15574/pp.2022.91.15","DOIUrl":"https://doi.org/10.15574/pp.2022.91.15","url":null,"abstract":"Congenital malformations (CM) in fetuses and neonates belong to main causes of perinatal morbidity and mortality. Provision organs malformation and malfunction in such cohorts is less studied. The purpose - to analyze the course of pregnancy, the data of ultrasound imaging of provisional organs in the presence of CM of central nervous system (CNS) and/or of nephro-urinary system (NUS) in the fetus and newborn. Materials and methods. The results of prenatal and postnatal ultrasound, anamnestic and general clinical data of a sample of cases with prenatally diagnosed CM of CNS and/or NUS for the period 2017-2021 were analyzed. Results. There were 45 newborns with CNS malformations, and 54 newborns with CM of NUS. Malformations of NUS and/or CNS in the examined newborns were combined with anomalies of other systems in a third of cases - 29.6% and 31.1%, respectively. According to the results of prenatal ultrasound examinations, polyhydramnios (16.7%) was most often recorded in the pregnancies with fetal CM of NUS, and cases of fetal CM of CNS most commonly were registered placental hyperplasia (35.6%), fetal growth retardation (24.4%) and fetal distress (26.7%). Postnatally in both cohorts (with NUS malformations and with CNS malformations) a high rate of following complications were recorded: prematurity (16.7% and 15.6%, respectively), birth asphyxia (48% and 55.6%, respectively), and early neonatal death (11% and 6.6%). Сonclusions. Pregnant women with CM of CNS and/or NUS in the fetus belong to the group of high perinatal risk because of the high rate of perinatal complications. Information about the identified high perinatal risks in fetuses and newborns with CM of the CNS and/or NUS should be provided to parents and taken into account when planning management of pregnancy and labor.","PeriodicalId":330226,"journal":{"name":"UKRAINIAN JOURNAL OF PERINATOLOGY AND PEDIATRICS","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133219987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The article briefly summarizes data on the role of micro- and macrocirculatory disorders in the pathogenesis of COVID-19. Focused attention on similarities of clinical and pathogenetic features of rheumatic diseases, COVID-19 and its complications. The review analyzed and compared the data of the assessment of the main instrumental studies of the functional state of blood vessels in patients with rheumatic diseases in general and in patients with rheumatic diseases who suffered from COVID-19 (capillaroscopy and occlusion test). A conclusion was made about the presence of endothelial dysfunction in rheumatic diseases and its features in patients with rheumatic diseases after transmission of COVID-19. This leads to the opinion about the expediency of timely detection of secondary disorders of the functional state of blood vessels in patients with rheumatic diseases who are convalescents of COVID-19, and justifies the use of an occlusion test for this purpose. No conflict of interests was declared by the authors.
{"title":"Vascular disorders in patients with rheumatic diseases who have transferred COVID-19","authors":"O. Oshlyanska, O. Okhotnikova, L. Kvashnina","doi":"10.15574/pp.2022.91.61","DOIUrl":"https://doi.org/10.15574/pp.2022.91.61","url":null,"abstract":"The article briefly summarizes data on the role of micro- and macrocirculatory disorders in the pathogenesis of COVID-19. Focused attention on similarities of clinical and pathogenetic features of rheumatic diseases, COVID-19 and its complications. The review analyzed and compared the data of the assessment of the main instrumental studies of the functional state of blood vessels in patients with rheumatic diseases in general and in patients with rheumatic diseases who suffered from COVID-19 (capillaroscopy and occlusion test). A conclusion was made about the presence of endothelial dysfunction in rheumatic diseases and its features in patients with rheumatic diseases after transmission of COVID-19. This leads to the opinion about the expediency of timely detection of secondary disorders of the functional state of blood vessels in patients with rheumatic diseases who are convalescents of COVID-19, and justifies the use of an occlusion test for this purpose. No conflict of interests was declared by the authors.","PeriodicalId":330226,"journal":{"name":"UKRAINIAN JOURNAL OF PERINATOLOGY AND PEDIATRICS","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115548485","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}
V. Konoplitsky, O.S. Golovashchenko, S. S. Blazhko, Y. Korobko
Teratoma (from the Greek τέρατος - monster, ομα - tumor) is a tumor formed from monocytes, common location of which is the ovaries in females, testicles in males, sacrococcygeal area in children, as well as the brain. Teratoma of the ovary is one of the types of germinogenic tumors, which has synonyms of embryo, «parasitic fetus», «complex cell tumor», «mixed teratogenic neoplasm», «monodermoma». The aim - to analyze the clinical symptoms and diagnostic and treatment tactics for the combined pathology of the appendix and pelvic organs in girls, to draw the attention of the medical staff to the pathology called appendicular-genital syndrome. Clinical case. We observed torsion of the left uterine appendages in an 11-year-old girl, which caused diffuse serous-purulent peritonitis and secondary phlegmonous appendicitis. Thus, in this case, we can talk about the appendiсular-genital syndrome, which had its origin in the left appendages of the uterus as a result of organic damage and their twisting. Patient Hanna B., 11 years old, was hospitalized on January 25, 2021, in the surgical department № 1 of the Vinnytsia Regional Clinical Hospital with abdominal pain localized above the bosom, in the right and left iliac regions, which lasted for 4 days. During this period, there was also a rise in body temperature within subfebrile values. They were not treated independently. Until the moment of hospitalization, the girl had never had menstruation. The patient was operated on the day of admission to the emergency department due to the presence of the «acute abdomen» clinic. During the surgical intervention, the following findings were revealed: the left uterine appendages were black, swollen with under-capsular hemorrhages, which included a neoplasm with the dimensions and a hyperemic, swollen, injected appendix, which was mace-like thickened at the apex. In connection with the appearance of complications in the form of peritonitis and the development of secondary appendicitis, operative treatment had the following volume. Left tubovariectomy, appendectomy, sanitation and drainage of the abdominal cavity were performed. Conclusions. In case of suspicion of appendicular-genital syndrome, it is necessary to use a laparoscopic technique instead of an open one after carrying out pre-operative medical and diagnostic measures. It is laparoscopic surgery that has an advantage over appendictomous access in the right pubic region, because during laparoscopic intervention there is a wider field for examination of the pelvic cavity with the help of a camera. The research was carried out in accordance with the principles of the Helsinki Declaration. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.
{"title":"Clinical case of four-day torsion of ovarian teratoma and secondary appendicitis in a child","authors":"V. Konoplitsky, O.S. Golovashchenko, S. S. Blazhko, Y. Korobko","doi":"10.15574/pp.2022.91.73","DOIUrl":"https://doi.org/10.15574/pp.2022.91.73","url":null,"abstract":"Teratoma (from the Greek τέρατος - monster, ομα - tumor) is a tumor formed from monocytes, common location of which is the ovaries in females, testicles in males, sacrococcygeal area in children, as well as the brain. Teratoma of the ovary is one of the types of germinogenic tumors, which has synonyms of embryo, «parasitic fetus», «complex cell tumor», «mixed teratogenic neoplasm», «monodermoma». The aim - to analyze the clinical symptoms and diagnostic and treatment tactics for the combined pathology of the appendix and pelvic organs in girls, to draw the attention of the medical staff to the pathology called appendicular-genital syndrome. Clinical case. We observed torsion of the left uterine appendages in an 11-year-old girl, which caused diffuse serous-purulent peritonitis and secondary phlegmonous appendicitis. Thus, in this case, we can talk about the appendiсular-genital syndrome, which had its origin in the left appendages of the uterus as a result of organic damage and their twisting. Patient Hanna B., 11 years old, was hospitalized on January 25, 2021, in the surgical department № 1 of the Vinnytsia Regional Clinical Hospital with abdominal pain localized above the bosom, in the right and left iliac regions, which lasted for 4 days. During this period, there was also a rise in body temperature within subfebrile values. They were not treated independently. Until the moment of hospitalization, the girl had never had menstruation. The patient was operated on the day of admission to the emergency department due to the presence of the «acute abdomen» clinic. During the surgical intervention, the following findings were revealed: the left uterine appendages were black, swollen with under-capsular hemorrhages, which included a neoplasm with the dimensions and a hyperemic, swollen, injected appendix, which was mace-like thickened at the apex. In connection with the appearance of complications in the form of peritonitis and the development of secondary appendicitis, operative treatment had the following volume. Left tubovariectomy, appendectomy, sanitation and drainage of the abdominal cavity were performed. Conclusions. In case of suspicion of appendicular-genital syndrome, it is necessary to use a laparoscopic technique instead of an open one after carrying out pre-operative medical and diagnostic measures. It is laparoscopic surgery that has an advantage over appendictomous access in the right pubic region, because during laparoscopic intervention there is a wider field for examination of the pelvic cavity with the help of a camera. The research was carried out in accordance with the principles of the Helsinki Declaration. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.","PeriodicalId":330226,"journal":{"name":"UKRAINIAN JOURNAL OF PERINATOLOGY AND PEDIATRICS","volume":"52 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129541895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The system of diets according to groups of diseases (Pevzner’s diets), developed back in the 1920s, was the basis of medical nutrition in the USSR and for about 20 years in Ukraine. The lack of diseases effective treatment schemes and measures caused such a long period of its use. The aim of present investigation is to highlight the main principles of modern concept of medical nutrition in pediatrics and to describe main aspects of methodology of its apporintment. In recent decades, ideas about the pathogenesis of various pathologies have changed, new effective methods of therapy have been introduced, and modern challenges (such as overweight or food allergies) have intensified. On the one hand, this required individualization, and on the other, it made it possible to liberalize the diet of patients. According to the new concept of dietary nutrition, all patients need a diet that is adequate in terms of energy value and balanced in terms of the composition of the most important nutrients, taking into account the stage of the disease and individual characteristics of the child’s organism (intolerance of certain products, food preferences etc.). A peculiarity of the methodology of prescribing medical nutrition for children is taking into account the physiological needs of the child for his age. The persons responsible for the organization of medical nutrition in health care institutions are a nutritionist and a dietitian nurse. No conflict of interests was declared by the authors.
{"title":"Modern concept and organization of medical nutrition for children in health care institutions of Ukraine","authors":"A.M. Antoshkina, A. Horobets, M.M. Vasijukova","doi":"10.15574/pp.2022.91.68","DOIUrl":"https://doi.org/10.15574/pp.2022.91.68","url":null,"abstract":"The system of diets according to groups of diseases (Pevzner’s diets), developed back in the 1920s, was the basis of medical nutrition in the USSR and for about 20 years in Ukraine. The lack of diseases effective treatment schemes and measures caused such a long period of its use. The aim of present investigation is to highlight the main principles of modern concept of medical nutrition in pediatrics and to describe main aspects of methodology of its apporintment. In recent decades, ideas about the pathogenesis of various pathologies have changed, new effective methods of therapy have been introduced, and modern challenges (such as overweight or food allergies) have intensified. On the one hand, this required individualization, and on the other, it made it possible to liberalize the diet of patients. According to the new concept of dietary nutrition, all patients need a diet that is adequate in terms of energy value and balanced in terms of the composition of the most important nutrients, taking into account the stage of the disease and individual characteristics of the child’s organism (intolerance of certain products, food preferences etc.). A peculiarity of the methodology of prescribing medical nutrition for children is taking into account the physiological needs of the child for his age. The persons responsible for the organization of medical nutrition in health care institutions are a nutritionist and a dietitian nurse. No conflict of interests was declared by the authors.","PeriodicalId":330226,"journal":{"name":"UKRAINIAN JOURNAL OF PERINATOLOGY AND PEDIATRICS","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122520635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The purpose - to evaluate the clinical status of newborns in women with pregnancy complicated by preterm premature rupture of membranes (pPROM) and its relationship with the course of pregnancy and childbirth, the duration of the latency period between pPROM and delivery (LP), as well as with the levels of vitamin 25(OH)D and the expression of antimicrobial peptides (β-defensins 2) in the mother’s blood. Materials and methods. The condition and morbidity of newborns with preterm birth due to pPROM have been carefully studied. The levels of vitamin 25(OH)D and the expression of antimicrobial peptides (β-defensins 2) in the blood serum of 109 women with singleton pregnancy complicated by pPROM at 23-36 weeks of gestation and 20 pregnant women of the control group with intact membranes, who subsequently gave birth to full-term babies, were studied by enzyme-linked immunosorbent assay. Results. No significant relationship between the condition of newborns and the duration of LP was found. Medical tactics of pregnancy management with pPROM led to the presence of a direct relationship between the prolongation of LP and the prevention of respiratory distress syndrome with dexamethasone/betamethasone (r=+0.36; p<0.001), tocolytic therapy with nifedipine (r=+0.30; p<0.01) against the background of antibacterial therapy. Groups of pregnant women with different duration of LP were statistically comparable in terms of gestation at the time of delivery. The average content of vitamin 25(OH)D in the blood of pregnant women with pPROM was reduced by half (26.3±0.9 pg/ml vs. 52.9±2.4 pg/ml), and the expression level of β-defensins 2 - by 1.4 times compared to the control group (78.4±1.8 pg/ml vs. 107.4±2.6 pg/ml). It has been confirmed that the level of vitamin 25(OH)D in the blood of women with pregnancy complicated by pPROM is directly associated with the gestational age of the newborn (r=+0.22; p<0.05) and the corresponding assessments of its condition. Reliable associations of the expression level of β-defensins 2 in the mother's blood with the indicators of the course of pregnancy and perinatal period, as well as with certain characteristics of the condition of newborns were found. Conclusions. No reliable association between the condition of newborns and the LP was found, which can be explained by the adequate tactics of managing pregnant women with pPROM. A significant decrease in the levels of vitamin 25(OH)D and the expression of antimicrobial peptides (β-defensins 2) in blood serum of the examined pregnant women with pPROM compared to the control group was determined. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patients was obtained for conducting the studies. No conflict of interests was declared by the authors.
目的:探讨妊娠合并早产胎膜早破(pPROM)新生儿的临床状况及其与妊娠、分娩进程、pPROM至分娩潜伏期(LP)持续时间、母亲血液中维生素25(OH)D水平及抗菌肽(β-防御素2)表达的关系。材料和方法。新生儿因pPROM而早产的情况和发病率已被仔细研究。采用酶联免疫吸附法研究了109例妊娠23-36周单胎妊娠合并pPROM的孕妇和20例胎膜完好的对照组分娩足月婴儿的血清中维生素25(OH)D水平和抗微生物肽(β-防御素2)的表达。结果。新生儿状况与LP持续时间无显著关系。pPROM妊娠管理的医疗策略导致LP延长与地塞米松/倍他米松预防呼吸窘迫综合征之间存在直接关系(r=+0.36;P <0.001)，硝苯地平溶胎治疗(r=+0.30;P <0.01)。不同LP持续时间的孕妇组在分娩时的妊娠情况具有统计学可比性。与对照组相比，pPROM孕妇血液中维生素25(OH)D的平均含量降低了一半(26.3±0.9 pg/ml vs. 52.9±2.4 pg/ml)， β-防御素2 -的表达水平降低了1.4倍(78.4±1.8 pg/ml vs. 107.4±2.6 pg/ml)。已证实妊娠合并pPROM妇女血液中维生素25(OH)D水平与新生儿胎龄直接相关(r=+0.22;P <0.05)，并进行相应的病情评价。发现母体血液中β-防御素2的表达水平与孕期、围产期指标以及新生儿状况的某些特征之间存在可靠的关联。结论。新生儿的状况和LP之间没有可靠的联系，这可以通过适当的策略来解释处理pPROM孕妇。与对照组相比，检测了pPROM孕妇血清中维生素25(OH)D水平和抗菌肽(β-防御素2)表达的显著降低。这项研究是按照《赫尔辛基宣言》的原则进行的。研究方案经参与机构当地伦理委员会批准。获得患者的知情同意进行研究。作者未声明存在利益冲突。
{"title":"Perinatal outcomes of preterm premature rupture of membranes before 36 weeks of pregnancy","authors":"Y. Dubossarska, Ye. O. Puziy","doi":"10.15574/pp.2022.91.22","DOIUrl":"https://doi.org/10.15574/pp.2022.91.22","url":null,"abstract":"The purpose - to evaluate the clinical status of newborns in women with pregnancy complicated by preterm premature rupture of membranes (pPROM) and its relationship with the course of pregnancy and childbirth, the duration of the latency period between pPROM and delivery (LP), as well as with the levels of vitamin 25(OH)D and the expression of antimicrobial peptides (β-defensins 2) in the mother’s blood. Materials and methods. The condition and morbidity of newborns with preterm birth due to pPROM have been carefully studied. The levels of vitamin 25(OH)D and the expression of antimicrobial peptides (β-defensins 2) in the blood serum of 109 women with singleton pregnancy complicated by pPROM at 23-36 weeks of gestation and 20 pregnant women of the control group with intact membranes, who subsequently gave birth to full-term babies, were studied by enzyme-linked immunosorbent assay. Results. No significant relationship between the condition of newborns and the duration of LP was found. Medical tactics of pregnancy management with pPROM led to the presence of a direct relationship between the prolongation of LP and the prevention of respiratory distress syndrome with dexamethasone/betamethasone (r=+0.36; p<0.001), tocolytic therapy with nifedipine (r=+0.30; p<0.01) against the background of antibacterial therapy. Groups of pregnant women with different duration of LP were statistically comparable in terms of gestation at the time of delivery. The average content of vitamin 25(OH)D in the blood of pregnant women with pPROM was reduced by half (26.3±0.9 pg/ml vs. 52.9±2.4 pg/ml), and the expression level of β-defensins 2 - by 1.4 times compared to the control group (78.4±1.8 pg/ml vs. 107.4±2.6 pg/ml). It has been confirmed that the level of vitamin 25(OH)D in the blood of women with pregnancy complicated by pPROM is directly associated with the gestational age of the newborn (r=+0.22; p<0.05) and the corresponding assessments of its condition. Reliable associations of the expression level of β-defensins 2 in the mother's blood with the indicators of the course of pregnancy and perinatal period, as well as with certain characteristics of the condition of newborns were found. Conclusions. No reliable association between the condition of newborns and the LP was found, which can be explained by the adequate tactics of managing pregnant women with pPROM. A significant decrease in the levels of vitamin 25(OH)D and the expression of antimicrobial peptides (β-defensins 2) in blood serum of the examined pregnant women with pPROM compared to the control group was determined. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patients was obtained for conducting the studies. No conflict of interests was declared by the authors.","PeriodicalId":330226,"journal":{"name":"UKRAINIAN JOURNAL OF PERINATOLOGY AND PEDIATRICS","volume":"20 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114059848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The purpose - to substantiate the principles of prevention and treatment of major gestational complications in women with a history of combined infertility. Materials and methods. The patients were divided into the groups, depending on the prescribed treatment regimen: the group 1 - 52 pregnant women with a history of combined infertility who received basic therapy with a positive urinary test for pregnancy (dydrogesterone 10 mg 2 times a day for up to 12 weeks, folic acid - 400 mcg per day up to 14 weeks of pregnancy). The group 2 - 50 pregnant women with combined infertility who received our improved regimen (5-methyltetrahydrofolate - 600 mg, iodine - 200 mcg, micronized progesterone - 200 mg, cardioaspirin - 150 mg, calcium with vitamin D3, omega-3, -6, -9 polyunsaturated fatty acids - 1000 mg, magnesium with vitamin В6). Statistical processing of data was performed by the methods of variation statistics. Results. More often, gestational complications in the trimester II were in pregnant women of the group 1, who took the basic treatment regimen, than in patients of the group 2, who used the therapeutic complex improved by us. Thus, polyhydramnios was detected almost 2.5 times more often in patients of the group 1 (11.5%) versus 4% of pregnant women of the group 2; and oligohydramnios was confirmed 3 times more often in women of the group 1 (7.7%), while in pregnant women of the group 2 only in 2%. Isthmic-cervical insufficiency developed in every 5 women (21.2%) in the group 1 and almost three times less often - in 8% of women in the group 2. Anomalies of placental attachment, namely: placenta previa and its low location occurred 2.5 times more often in women of the group 1 (15.4%) compared with pregnant women of the group 2 (in 6%). Premature maturation of the placenta, which was manifested by structural changes in it on ultrasound, was manifested almost three times more often in women of the group 1 - in 17.3% versus 6% of pregnant women in the group 2. Gestational anemia was found in women of the group 1 (19.2%), which is half as often as in the group 2 (12%). Gestational diabetes was also half as common in women of the group 1 (30.8%) compared to the group 2 (20%). Exacerbation of chronic pyelonephritis was almost twice as common in women of the group 1 (7.7%) compared with the group 2 (4%). But pregnant women of the group 1 (23.1%) had vaginitis 4 times more often than the group 2 (6%). Conclusions. The use of the monitoring algorithm developed by us and a set of therapeutic and preventive measures in women with a history of infertility has significantly improved the results of their pregnancies. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.
{"title":"Therapeutic and preventive measures aimed at reducing the frequency of gestational complications in women with combined history of infertility","authors":"L. Tumanova, O. Kolomiets","doi":"10.15574/pp.2022.91.6","DOIUrl":"https://doi.org/10.15574/pp.2022.91.6","url":null,"abstract":"The purpose - to substantiate the principles of prevention and treatment of major gestational complications in women with a history of combined infertility. Materials and methods. The patients were divided into the groups, depending on the prescribed treatment regimen: the group 1 - 52 pregnant women with a history of combined infertility who received basic therapy with a positive urinary test for pregnancy (dydrogesterone 10 mg 2 times a day for up to 12 weeks, folic acid - 400 mcg per day up to 14 weeks of pregnancy). The group 2 - 50 pregnant women with combined infertility who received our improved regimen (5-methyltetrahydrofolate - 600 mg, iodine - 200 mcg, micronized progesterone - 200 mg, cardioaspirin - 150 mg, calcium with vitamin D3, omega-3, -6, -9 polyunsaturated fatty acids - 1000 mg, magnesium with vitamin В6). Statistical processing of data was performed by the methods of variation statistics. Results. More often, gestational complications in the trimester II were in pregnant women of the group 1, who took the basic treatment regimen, than in patients of the group 2, who used the therapeutic complex improved by us. Thus, polyhydramnios was detected almost 2.5 times more often in patients of the group 1 (11.5%) versus 4% of pregnant women of the group 2; and oligohydramnios was confirmed 3 times more often in women of the group 1 (7.7%), while in pregnant women of the group 2 only in 2%. Isthmic-cervical insufficiency developed in every 5 women (21.2%) in the group 1 and almost three times less often - in 8% of women in the group 2. Anomalies of placental attachment, namely: placenta previa and its low location occurred 2.5 times more often in women of the group 1 (15.4%) compared with pregnant women of the group 2 (in 6%). Premature maturation of the placenta, which was manifested by structural changes in it on ultrasound, was manifested almost three times more often in women of the group 1 - in 17.3% versus 6% of pregnant women in the group 2. Gestational anemia was found in women of the group 1 (19.2%), which is half as often as in the group 2 (12%). Gestational diabetes was also half as common in women of the group 1 (30.8%) compared to the group 2 (20%). Exacerbation of chronic pyelonephritis was almost twice as common in women of the group 1 (7.7%) compared with the group 2 (4%). But pregnant women of the group 1 (23.1%) had vaginitis 4 times more often than the group 2 (6%). Conclusions. The use of the monitoring algorithm developed by us and a set of therapeutic and preventive measures in women with a history of infertility has significantly improved the results of their pregnancies. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.","PeriodicalId":330226,"journal":{"name":"UKRAINIAN JOURNAL OF PERINATOLOGY AND PEDIATRICS","volume":"1947 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129248182","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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