子痫前期妇女胎盘功能障碍矫正的选择

Amrullo Karimov, D. M. Davlietova
{"title":"子痫前期妇女胎盘功能障碍矫正的选择","authors":"Amrullo Karimov, D. M. Davlietova","doi":"10.32902/2663-0338-2020-3.2-111-112","DOIUrl":null,"url":null,"abstract":"Background. Placental dysfunction (PD) is one of the most common complications of pregnancy, which has not only medical but also social significance. The links of the PD pathogenesis include endothelial dysfunction, hemodynamic disorders of the placental vessels, disorders of arterial and venous blood flow in the placenta. \nObjective. To study diagnostic methods and possibilities of PD correction in women with preeclampsia (PE). \nMaterials and methods. The study involved 68 women with PE in the II and III trimesters of pregnancy, treated at the multidisciplinary clinic of the Tashkent Medical Academy during 2017-2019. Patients underwent standard clinical, laboratory and instrumental examination with color Doppler mapping of vessels of the uterine-placental-fetal system and ultrasound evaluation of the fetoplacental system. \nResults and discussion. Premature aging of the placenta was found in 77.3 % of cases, turbid amniotic fluid – in 59.09 %, oligohydramnion – in 27.3 %. Disorders of uteroplacental blood flow were detected in 28.3 % of cases, placentofetal blood flow – in 26.7 %. Impaired blood flow at both levels without critical values occurred in 10 % of pregnant women. In case of insufficiency of a blood circulation of 2nd grade the syndrome of fetal growth restriction was observed in 16,7 % of cases. Compensated forms of PD were subject to the comprehensive treatment with the addition of infusions of L-arginine (Tivortin, “Yuria-Pharm”) in the inpatient phase and oral administration of Tivortin aspartate in the outpatient phase. The length of the fetal thigh in the group of L-arginine at the beginning of treatment was 47.33 mm, which was by 9.04 % less than this parameter in physiological pregnancy. After treatment with Tivortin, in the full-term period, no significant difference was found. In pregnant women who received L-arginine at 25-29 weeks of pregnancy, after 2 weeks, the resistance indices (RI) of the umbilical artery and uterine artery decreased from 0.68±0.09 to 0.58±0.05 and from 0,58±0.16 to 0.43±0.08, respectively. The RI of the middle cerebral artery increased from 1.05±0.23 to 1.27±0.19. Parameters of RI dynamics indicate that the early treatment with Tivortin is more effective than late. \nConclusions. 1. Regardless of the presence of fetal growth restriction syndrome in women with disorders of uterine-placental-fetal circulation, it is advisable to include L-arginine in the treatment to prevent this condition. 2. Ultrasound examination is a reliable method for evaluating the effectiveness of PD treatment.","PeriodicalId":13681,"journal":{"name":"Infusion & Chemotherapy","volume":"93 1","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2020-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Options of the placental dysfunction correction in women with preeclampsia\",\"authors\":\"Amrullo Karimov, D. M. Davlietova\",\"doi\":\"10.32902/2663-0338-2020-3.2-111-112\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Background. Placental dysfunction (PD) is one of the most common complications of pregnancy, which has not only medical but also social significance. The links of the PD pathogenesis include endothelial dysfunction, hemodynamic disorders of the placental vessels, disorders of arterial and venous blood flow in the placenta. \\nObjective. To study diagnostic methods and possibilities of PD correction in women with preeclampsia (PE). \\nMaterials and methods. The study involved 68 women with PE in the II and III trimesters of pregnancy, treated at the multidisciplinary clinic of the Tashkent Medical Academy during 2017-2019. Patients underwent standard clinical, laboratory and instrumental examination with color Doppler mapping of vessels of the uterine-placental-fetal system and ultrasound evaluation of the fetoplacental system. \\nResults and discussion. Premature aging of the placenta was found in 77.3 % of cases, turbid amniotic fluid – in 59.09 %, oligohydramnion – in 27.3 %. Disorders of uteroplacental blood flow were detected in 28.3 % of cases, placentofetal blood flow – in 26.7 %. Impaired blood flow at both levels without critical values occurred in 10 % of pregnant women. In case of insufficiency of a blood circulation of 2nd grade the syndrome of fetal growth restriction was observed in 16,7 % of cases. Compensated forms of PD were subject to the comprehensive treatment with the addition of infusions of L-arginine (Tivortin, “Yuria-Pharm”) in the inpatient phase and oral administration of Tivortin aspartate in the outpatient phase. The length of the fetal thigh in the group of L-arginine at the beginning of treatment was 47.33 mm, which was by 9.04 % less than this parameter in physiological pregnancy. After treatment with Tivortin, in the full-term period, no significant difference was found. In pregnant women who received L-arginine at 25-29 weeks of pregnancy, after 2 weeks, the resistance indices (RI) of the umbilical artery and uterine artery decreased from 0.68±0.09 to 0.58±0.05 and from 0,58±0.16 to 0.43±0.08, respectively. The RI of the middle cerebral artery increased from 1.05±0.23 to 1.27±0.19. Parameters of RI dynamics indicate that the early treatment with Tivortin is more effective than late. \\nConclusions. 1. Regardless of the presence of fetal growth restriction syndrome in women with disorders of uterine-placental-fetal circulation, it is advisable to include L-arginine in the treatment to prevent this condition. 2. Ultrasound examination is a reliable method for evaluating the effectiveness of PD treatment.\",\"PeriodicalId\":13681,\"journal\":{\"name\":\"Infusion & Chemotherapy\",\"volume\":\"93 1\",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2020-12-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Infusion & Chemotherapy\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.32902/2663-0338-2020-3.2-111-112\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Infusion & Chemotherapy","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.32902/2663-0338-2020-3.2-111-112","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

摘要

背景。胎盘功能障碍(PD)是妊娠期最常见的并发症之一,不仅具有医学意义,而且具有社会意义。PD发病的环节包括内皮功能障碍、胎盘血管血流动力学紊乱、胎盘内动、静脉血流量紊乱。目标。探讨女性子痫前期PD矫正的诊断方法及可能性。材料和方法。该研究涉及68名妊娠二、三期PE患者,2017-2019年期间在塔什干医学院多学科诊所接受治疗。患者接受标准的临床、实验室和仪器检查,包括子宫-胎盘-胎儿系统血管的彩色多普勒测绘和胎儿-胎盘系统的超声评估。结果和讨论。胎盘早衰占77.3%,羊水混浊占59.09%,羊水过少占27.3%。子宫胎盘血流异常占28.3%,胎盘胎儿血流异常占26.7%。10%的孕妇出现两种水平的血流受损,但没有达到临界值。在2年级血液循环不足的情况下,胎儿生长受限综合征在16.7%的病例中被观察到。代偿型PD在住院期接受l -精氨酸(Tivortin,“Yuria-Pharm”)输注的综合治疗,在门诊期口服天冬氨酸Tivortin。治疗初期l -精氨酸组胎儿大腿长度为47.33 mm,比生理妊娠时缩短9.04%。经替沃汀治疗后,足月无明显差异。妊娠25 ~ 29周服用l -精氨酸的孕妇,2周后脐动脉和子宫动脉阻力指数(RI)分别由0.68±0.09降至0.58±0.05,由0.58±0.16降至0.43±0.08。大脑中动脉的RI由1.05±0.23增加到1.27±0.19。RI动力学参数表明,早期使用Tivortin治疗比晚期治疗更有效。结论:1。无论子宫-胎盘-胎儿循环紊乱的妇女是否存在胎儿生长受限综合征,建议在治疗中加入l-精氨酸以预防这种情况。2. 超声检查是评价PD治疗效果的可靠方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
Options of the placental dysfunction correction in women with preeclampsia
Background. Placental dysfunction (PD) is one of the most common complications of pregnancy, which has not only medical but also social significance. The links of the PD pathogenesis include endothelial dysfunction, hemodynamic disorders of the placental vessels, disorders of arterial and venous blood flow in the placenta. Objective. To study diagnostic methods and possibilities of PD correction in women with preeclampsia (PE). Materials and methods. The study involved 68 women with PE in the II and III trimesters of pregnancy, treated at the multidisciplinary clinic of the Tashkent Medical Academy during 2017-2019. Patients underwent standard clinical, laboratory and instrumental examination with color Doppler mapping of vessels of the uterine-placental-fetal system and ultrasound evaluation of the fetoplacental system. Results and discussion. Premature aging of the placenta was found in 77.3 % of cases, turbid amniotic fluid – in 59.09 %, oligohydramnion – in 27.3 %. Disorders of uteroplacental blood flow were detected in 28.3 % of cases, placentofetal blood flow – in 26.7 %. Impaired blood flow at both levels without critical values occurred in 10 % of pregnant women. In case of insufficiency of a blood circulation of 2nd grade the syndrome of fetal growth restriction was observed in 16,7 % of cases. Compensated forms of PD were subject to the comprehensive treatment with the addition of infusions of L-arginine (Tivortin, “Yuria-Pharm”) in the inpatient phase and oral administration of Tivortin aspartate in the outpatient phase. The length of the fetal thigh in the group of L-arginine at the beginning of treatment was 47.33 mm, which was by 9.04 % less than this parameter in physiological pregnancy. After treatment with Tivortin, in the full-term period, no significant difference was found. In pregnant women who received L-arginine at 25-29 weeks of pregnancy, after 2 weeks, the resistance indices (RI) of the umbilical artery and uterine artery decreased from 0.68±0.09 to 0.58±0.05 and from 0,58±0.16 to 0.43±0.08, respectively. The RI of the middle cerebral artery increased from 1.05±0.23 to 1.27±0.19. Parameters of RI dynamics indicate that the early treatment with Tivortin is more effective than late. Conclusions. 1. Regardless of the presence of fetal growth restriction syndrome in women with disorders of uterine-placental-fetal circulation, it is advisable to include L-arginine in the treatment to prevent this condition. 2. Ultrasound examination is a reliable method for evaluating the effectiveness of PD treatment.
求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
自引率
0.00%
发文量
0
期刊最新文献
Evaluation of the effectiveness of immunomodulator BI-V in the complex therapy of children and adolescents with multiple drug-resistant pulmonary tuberculosis Features of the course of pulmonary tuberculosis against the background of coronavirus infection according to computed tomography of the chest organs Risks of recurrence in people with pulmonary tuberculosis New and little-known possibilities of edaravone in the treatment of cerebral stroke and extracranial pathology Severe community-acquired pneumonia: principles of diagnostics and intensive therapy
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1