Alternate Title: Characteristics of childbirth in women–temporarily displaced persons who have experienced stress as a result of military aggression. (English)

المؤلفون: Геряк, С. М., Кучмій, В. Ю., Буряк, М. В., Багній, Л. В.

المصدر: Reproductive Health of Woman; 2024, Vol. 72 Issue 2, p18-23, 6p

مصطلحات موضوعية: CHILDBIRTH & psychology, CROSS-sectional method, PSYCHOTHERAPY, REPRODUCTIVE health, HUMAN services programs, PSYCHOLOGY of refugees, REHABILITATION, PUERPERIUM, PREGNANT women, RETROSPECTIVE studies, LABOR (Obstetrics), HYDROCORTISONE, ANXIETY, PSYCHOLOGY of military personnel, DESCRIPTIVE statistics, LONGITUDINAL method, PRENATAL care, ANALGESIA, AGGRESSION (Psychology), PSYCHOLOGICAL stress, MEDICAL records, ACQUISITION of data, PSYCHOSES, WOMEN'S health, SEROTONIN, ABRUPTIO placentae, PREGNANCY complications, CHILDBIRTH

مستخلص: The negative impact of stress on women-temporarily displaced persons (TDP) is accompanied by the development of obstetric complications and perinatal stress. At the same time, the lack of systematicity and a single evidence-based approach to the management of such pregnant women often leads to completely opposite recommendations for treatment and rehabilitation. The objective: to study the features of manifestations and the possibilities of correction of psycho-emotional disorders, as well as the features of the course of childbirth in pregnant women-TDP. Materials and methods. Retrospective analysis and prospective cross-sectional study of 569 histories of pregnancy and child-birth: TDP women and 30 pregnant women who permanently lived in the region (control group) were conducted. In accordance with the implementation of antenatal measures of psychoprophylaxis and analgesia during childbirth, women- TDP were divided into two groups: 409 women in labor (main group), who had stress prevention during childbirth and medical analgesia, and 130 patients (comparison group), who did not have psychoprophylactic measures. Assessment of the psycho-emotional state was carried out by determining the index of stress resistance, cortisol and serotonin levels in the blood. Results. It was established that, due to a full-scale war during pregnancy and childbirth, women-TDP there is a decrease of stress resistance index compared to healthy women, which is manifested by a high level of anxiety and a low level of functional possibilities of mental adaptation to childbirth and a very low threshold of pain sensitivity. During pregnancy these women had pronounced clinical manifestations of stress and anxiety, accompanied by increased levels of the stress-associated hormones serotonin and cortisol both before childbirth and in the postpartum period. An increased level of anxiety during childbirth and before its end was found in 93.1% of women-TDP, which increased the frequency of operative delivery for emergency indications (fetal distress, labor abnormalities, placental abruption). Conducting psychotherapeutic correction before childbirth contributed to the stabilization of the psycho-emotional state and the normalization of the concentration of stress-associated hormones (serotonin and cortisol), which was manifested in an increase in the number of women with a high and moderate level of stress resistance and a normal course of childbirth, a decrease in the frequency of obstetric and perinatal complications three times compared to pregnant women without psychotherapy during pregnancy and childbirth. Conclusions. In pregnant women who are temporarily displaced persons and experienced stress as a result of military aggression, there is a decrease in the index of stress resistance, which is accompanied by an increased level of the stress-associated hormones serotonin and cortisol both before childbirth and in the postpartum period and leads to an increase in the frequency of obstetric and perinatal complications during delivery. Conducting psychotherapeutic correction and medical analgesia during childbirth helps to stabilize the psycho-emotional state, normalize the concentration of stress-associated hormones (serotonin and cortisol), increase the level of stress resistance, and reduce the frequency of obstetric and perinatal complications three times compared to pregnant women who did not receive psychotherapy during pregnancy and childbirth. [ABSTRACT FROM AUTHOR]

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Alternate Title: Prediction of the healing efficiency of episiotomy wounds using hydrogel dressings with lidocaine M. B. Liashko, D. O. Govsieiev. (English)

المؤلفون: Ляшко, М. Б., Говсєєв, Д. О.

المصدر: Reproductive Health of Woman; 2024, Vol. 72 Issue 1, p15-24, 10p

مصطلحات موضوعية: WOUND healing, POSTOPERATIVE care, RISK assessment, PREDICTION models, MATERNAL health services, STATISTICAL sampling, FISHER exact test, PUERPERIUM, TREATMENT effectiveness, RANDOMIZED controlled trials, MANN Whitney U Test, CHI-squared test, DESCRIPTIVE statistics, MULTIVARIATE analysis, EPISIOTOMY, LONGITUDINAL method, ODDS ratio, SURGICAL complications, HYDROCOLLOID surgical dressings, MEDICAL records, ANTHROPOMETRY, DATA analysis software, CONFIDENCE intervals, SURGICAL site, LIDOCAINE, CHILDBIRTH, EVALUATION, DISEASE risk factors

مصطلحات جغرافية: UKRAINE

مستخلص: The objective: to study the factors affecting the healing process of an episiotomy wound and the effectiveness of using hydrogel dressings with lidocaine for its healing. Materials and methods. The prospective randomized study includes the analysis of anamnestic data from the medical cards of 123 primiparous women with episiotomy wounds who gave birth in the Kyiv City Maternity Hospital No. 5 during 2021– 2022. The women were divided into two groups: a comparison group – 63 patients who received standard treatment, and a research group – 60 patients who additionally used hydrogel dressings with lidocaine on the wound. The healing of episiotomy wounds was evaluated according to the REEDA scale. Factors that may influence episiotomy wound healing were studied in patients of both groups: anthropometric indicators (age, height, body mass index), interventions during childbirth, and indicators of obstetric and gynecological history (term of gestation, volume of blood loss during childbirth, body weight of the newborn, etc.). Statistical analysis was performed using the Fisher, Mann–Whitney, Student and chisquare tests of the statistical package EZR v. 1.54. Results. Age (p=0.689) and body mass index (p=0.974) of patients in both groups did not show statistically significant differences. The duration of the second period of labor on average was 72 min (57.6–86.4) in the comparison group versus 43.2 min (28.8–57.6) in the research group with a statistically significant difference (p<0.001). No statistically significant differences were found between the two groups regarding the term of delivery, the volume of blood loss, the weight of the newborn, the risk of pregnancy loss, the frequency of labor induction, the weakness of labor activity, manual revision of the uterine cavity, and vacuum extraction of the fetus. The frequency of use of different types of anesthesia during childbirth also did not differ (р=0.396). REEDA scale assessment revealed a reduced risk of high sum scores in the research group (odds ratio (OR) = 0.16, 95% confidence interval (CI): 0.07–0.38), that supports the efficacy of hydrogel dressings with lidocaine. Analysis of the duration of the second labor period and gestational term also revealed an association with the risk of a high sum of points on the REEDA scale (OR = 1.22, 95% CI: 1.02–1.45 per 0.01 days; OR = 1.65, 95% CI: 1.16–2.35 per week of pregnancy). A multivariate model which included research group, body mass index, duration of the second labor period, gestational term confirmed a reduced risk according to the REEDA scale in this group (OR = 0.19, 95% CI: 0.08–0.47). The four-factor model had a high accuracy (AUC = 0.81, 95% CI: 0.73–0.88), indicating a strong relationship between the selected factors and the risk of complications after episiotomy. Conclusions. The use of hydrogel dressings with lidocaine and taking into account some aspects of childbirth, namely, the duration of childbirth and gestational period, can contribute to the improvement of the course of healing of episiotomy wounds. Such a comprehensive approach supports the effectiveness and significance of using hydrogel dressings with lidocaine in the practice of modern obstetrics to improve the results of treatment of patients with an episiotomy wound. In the future, studies on the effectiveness of using hydrogel dressings for the treatment of episiotomy wounds are necessary. [ABSTRACT FROM AUTHOR]

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Alternate Title: Features of disorders and methods of correction of the hemostasis system in women with antenatal fetal death. (English)

المؤلفون: Бенюк, В. О., Чеботарьова, А. С., Гичка, Н. М., Ковалюк, Т. В., Бенюк, С. В., Усевич, І. А., Курочка, В. В., Половинка, В. О.

المصدر: Reproductive Health of Woman; 2023, Vol. 67 Issue 4, p50-58, 9p

مصطلحات موضوعية: THROMBOEMBOLISM risk factors, ENOXAPARIN, CHILDBIRTH, PROTHROMBIN time, PARTIAL thromboplastin time, BIOMARKERS, VEINS, HEMOSTASIS, PREGNANT women, COMPRESSION garments, PERINATAL death, RISK assessment, BLOOD coagulation disorders, LOW-molecular-weight heparin, PUERPERIUM, FIBRINOGEN, THROMBIN time, DESCRIPTIVE statistics, PLASMINOGEN activators, ANTIFIBRINOLYTIC agents, FIBRIN fibrinogen degradation products

مستخلص: The improvement of the providing medical services quality to pregnant women remains an urgent issue in modern obstetrics. Women with perinatal losses deserve special attention, especially in the second half of pregnancy. Changes in the hemostasis system are an integral part of the development of pregnancy. The tendency to hypercoagulation has significant pathogenetic significance and can be the cause of a number of complications – miscarriage in the I trimester of pregnancy and preeclampsia, premature birth, antenatal fetal death (AFD) – in the II and III trimesters of pregnancy. Also, pregnancy is a background process for the activation of a number of diseases, in particular hereditary thrombophilia. The objective: to evaluate the changes in the hemostasis system in women with antenatal fetal death and the effectiveness of the use of low molecular weight heparins for the correction of disorders in the hemostasis system in this category of patients during childbirth and in the postpartum period. Materials and methods. 72 women were examined, including 42 pregnant women with AFD (main group) and 30 pregnant women with a physiological course of pregnancy, childbirth and the postpartum period (control group). The state of the hemostasis system was studied using a standard coagulogram. D-dimer was determined by immunoturbometric analysis. To assess the state of the hemostasis system, the following biochemical tests were used: procoagulant link – fibrinogen content and indicators: prothrombin index, activated partial thrombin time (APTT), thrombin time (TP), ancistrone time (AT), soluble fibrinogen-monomer complex (SFMC), factor X (FX); to evaluate the antithrombin system, the content of antithrombin-III (AT-III), protein C were determined; to characterize the state of the fibrinolytic system – the amount of plasminogen, α2 -antiplasmin, fibrinogen degradation products (FDC). Thrombophilia markers and antiphospholipid antibodies were also determined. The preference was given to vaginal childbirth. During childbirth, mechanical compression of the lower limbs was applied using special compression stockings (compression level 2). In 12 hours after delivery thromboprophylaxis with low molecular weight heparins was started, the drug of choice being enoxaparin sodium. After 48 hours of the postpartum period, a comparative analysis of coagulogram indicators was performed to further determine the timing of thromboprophylaxis. Results. Analysis of family thrombotic anamnesis revealed risk factors in 12 (28.6%) patients of the main group. In close relatives of the first line, the presence of peripheral vein thrombosis was found – 5 (41.7%) cases, myocardial infarction under the age of 45 – 3 (25.0%) cases, pulmonary embolism – 1 (8.3%) case, transient ischemic attack of the brain – 3 (25.0%). In the control group only 2 (6.6%) patients had a family history of venous thromboembolism in first-line relatives. The analysis of the coagulation system shows significantly higher fibrinogen values (the main group – 5.3±0.2 g/l, the control group – 4.3±0.1 g/l; p<0.05), functional FX activity (the main group – 149.3±3.1%, control group – 107.3±2.7%; p<0.05), SFMC (main group – 15.9±1.2 μg/ml, control group – 7.8±0.9 μg/ml; p<0.05) and D-dimer (main group – 4.4±0.25 μg/ml, control group – 0.7±0.2 μg/ml; p< 0.05) in pregnant women of the main group. An increase in these indicators is a predictor of thrombus formation, activation of blood coagulation by the internal pathway with a decrease in the antithrombin reserve due to FX. During the correlation analysis, a strong direct relationship (r=0.8633) was established between the indicators of SFMC and FX in the blood serum of pregnant women of the main group, the combination of which determines the tendency to clot formation. Determination of markers for the most common types of thrombophilia shows the dominance of hereditary forms (prothrombin, Leiden mutation, MTHFR) in 43% of pregnant women of the main group. The implementation of the proposed treatment approach contributed to a significant decrease in the average concentration of fibrinogen 48 hours after delivery in postpartum women of the main group (main group: before delivery – 5.3±0.2 g/l, after 48 hours after delivery – 3.9±0.3 g/l; control group: 48 hours after delivery – 3.2±0.2 g/l; p<0.05) in combination with a synergistic decrease in the average indicators of SFMC (main group: before delivery – 15.9±1.2 μg/ml, 48 hours after delivery – 6.2±0.2 μg/ml; control group: 48 hours after delivery – 5.4±0.3 μg/ml; p<0.05) and FX (main group: before delivery – 149.3±3.1%, after 48 hours after delivery – 103.1±3.6%; control group: after 48 hours after delivery – 117.1±4.1%; p<0.05). Conclusions. Increased coagulation function was confirmed in pregnant women with antenatal fetal death (AFD). Thanks to the proposed method of correcting disorders in the hemostasis system, a decrease in the frequency of postpartum thromboembolism in women with AFD is achieved, as well as an improvement in the main indicators of the hemostasis system. This prevents the emergence of a chronic form of the syndrome of disseminated intravascular blood coagulation which is developed in the cases of AFD. [ABSTRACT FROM AUTHOR]

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المؤلفون: Julia Czarnota, Katarzyna Cichoń, Małgorzata Chyćko, Agata Kromer, Magdalena Alicja Zapała, Agnieszka Gawryś, Agnieszka Środoń, Monika Łapaj, Joanna Wilk, Małgorzata Maria Cholewa

المصدر: Journal of Education, Health and Sport, Vol 32, Iss 1 (2023)

مصطلحات موضوعية: obsessive-compulsive disorder, pregnancy, OCD, puerperium, Education, Sports, GV557-1198.995, Medicine

الوصف: Introduction and purpose of the work: The period of pregnancy and puerperium is the time of increased vulnerability for mother’s mental deterioration. While disorders such as perinatal depression have been detailed, an impact of pregnancy on the course of other mental disorders such as OCD is less investigated. The purpose of this work was to draw attention to the factors that may influence exacerbation of obsessions and compulsions in pregnancy and during the postpartum period. The most common obsessions and compulsions of pregnant women and the influence of mother’s OCD on the newborn have also been described in this research. State of knowledge: Factors such as mother’s age, duration of pregnancy, method of delivery may be predictors of aggravation of obsessions and compulsions. Gestational diabetes, thyroid hormones levels, personality disorders of the mother, stress, cultural beliefs also have an impact on mother’s OCD. Infant being infected or hurt are the most common obsession subjects while cleaning and checking the baby happen to be the most frequent compulsions. Summary: It is important to disseminate knowledge about the course of OCD during pregnancy and postpartum period and pay attention to the inflammatory factors for earlier diagnosis and treatment. More research about factors worsening OCD through pregnancy are needed to be conducted.

وصف الملف: electronic resource

Relation: https://apcz.umk.pl/JEHS/article/view/43710; https://doaj.org/toc/2391-8306

URL الوصول: https://doaj.org/article/8e6ac1217d3445d597e2ccb4743ccdf8

Alternate Title: Reduction of obstetric injuries by increasing of the birth canal elasticity. (English)

المؤلفون: Жук, С. І., Сальніков, С. М., Захурдаєва, Л. Д., Лахно, Ю. М., Дерба, К. І., Андреішина, Д. Дж.

المصدر: Reproductive Health of Woman; 2023, Vol. 66 Issue 3, p36-43, 7p

مصطلحات موضوعية: THERAPEUTIC use of hyaluronic acid, EPISIOTOMY, BIRTH injuries, ANTI-infective agents, PREGNANT women, ACTIVITIES of daily living, VAGINA, COMPARATIVE studies, VAGINAL medication, PUERPERIUM, DESCRIPTIVE statistics, DELIVERY (Obstetrics), LACTIC acid, SOFT tissue injuries, PERINEUM, THERAPEUTICS

مستخلص: The objective: to evaluate the therapeutic effect of a vaginal gel containing hyaluronic acid and decamethoxine for the prevention of obstetric injuries reduction of the birth canal during childbirth, as well as to improve the course of the postpartum period. Materials and methods. An analysis of the course of vaginal births in the fetal head presentation of 500 births that took place in the communal non-commercial enterprise «Kyiv City Maternity Hospital No. 2» during 2021–2022 was carried out. The main group included 250 pregnant women who were given a vaginal gel containing decamethoxine, sodium hyaluronate and lactic acid during childbirth and in the postpartum period. The comparison group consisted of 250 pregnant women who did not use the specified gel during childbirth and in the postpartum period. Results. The average age of patients in the main and the comparison group was 28.92±1.32 and 27.17±1.56 years, respectively. In both groups, primiparous women prevailed – 157 (62.80%) persons in the main group, 158 (63.20%) – in the comparison group, 93 (37.20%) and 92 (36.80%) women had the second labor respectively. There was a tendency to decrease the time of the second period of labor in women of the main group compared to the comparison group. The frequency of episiotomy was 1.63 times lower in the main group than in the comparison group (p<0.05), the rate of soft tissue injuries in childbirth – 1.32 times lower (109 (43.60%) and 144 (57.60%) women respectively; p=0.002). During the week of the postpartum period, the number of patients with discomfort in the vagina and perineum was 2.49 times less in the main group (59 (23.60%) persons) than in the comparison group (147 (58.80%) women; p<0.001), with pain – 1.85 times (88 (35.20%) and 163 (65.20%) individuals respectively; p<0.001). 132 (52.80%) women of the comparison group complained on the limitations in their daily activities due to the mentioned symptoms, which was 2.16 times more than in the main group (61 (24.40%) persons; p<0.001). Conclusions. The use of vaginal gel, which contains hyaluronic acid and decamethoxine, during childbirth and in the postpartum period for prevention of obstetric injuries and improvement the course of the postpartum period is effective, which led to a 1.32- fold decrease of women with vaginal and perineal tears (p<0.05) and 1.63 times – the frequency of episiotomy (р<0.05) and improvement of the course of the postpartum period. [ABSTRACT FROM AUTHOR]

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Alternate Title: Phytotheraphy for pregravidal preparation of women with hormonal disorders. (English)

المؤلفون: Герасимова, Т. В., Гопчук, О. М.

المصدر: Reproductive Health of Woman; 2022, Issue 8, p16-19, 4p

مصطلحات موضوعية: COMPETENCY assessment (Law), HORMONE metabolism, HERBAL medicine, PITUITARY diseases, PREMATURE infants, GYNECOLOGISTS, PLANTS, PUERPERAL disorders, PREGNANCY complications, PUERPERIUM, PSYCHIATRIC somatic therapies, MARITAL status, WOMEN'S health

مستخلص: The problem of hormonal disbalance in a woman’s organism remains relevant both for gynecologists and other related specialists. In the era of intensification of life, stress and psycho-emotional overload have become constant companions of modern women and leave their negative influence on the work of the endocrine and nervous systems. The article is devoted to the phytotherapy role in the correction of dyshormonal conditions for pregravid preparation. The course of the gestational process depends significantly on the reproductive, somatic and psychological health of the married couple before the onset of pregnancy. The pregravid preparation allows to reduce reproductive losses, the number of complications of pregnancy and childbirth, the frequency of premature births and postpartum complications, as well as to improve the quality of children’s health. The pregnancy preparation consists of four stages: determination of the level of reproductive health, study and correction of somatic health indicators, psychological counseling and determination of a woman’s adaptive potential. At the stage of pre-gravid preparation, it often turns out that young women and women of older reproductive age algodysmenorrhea is the most often among complaints. The difficulties of individual selection of medicinal products, the need for their long-term use, and therefore the possibility of the side effects development and addiction, prove the necessity to find new methods of treatment that are safe for long-term use. A whole spectrum of medications is available to the practicing doctor to correct hormonal disorders such as luteal phase insufficiency, hyperprolactinemia, algodysmenorrhea. The use of the monophytopreparation which includes Vitex agnus-castus dry extract makes possible to correct dyshormonal disorders in women of various age groups, including the stage of pregravid preparation. The results of the conducted research clearly demonstrated the high efficiency of the use of this phytotherapy medication by primary algodysmenorrhea, which allows to recommend it for the treatment of this pathology with the possibility of long-term safe use. [ABSTRACT FROM AUTHOR]

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Alternate Title: To the question of the clinical predictive value of the sFlt-1:PlGF ratio is related to the placental dysfunction. (English)

المؤلفون: Пилипенко, А. В., Медведь, В. І.

المصدر: Reproductive Health of Woman; 2022, Issue 7, p21-29, 9p

مصطلحات موضوعية: RISK factors of preeclampsia, PREECLAMPSIA prevention, PLACENTAL growth factor, HYPERTENSION, CHILDBIRTH, RESEARCH, PREDICTIVE tests, NEOVASCULARIZATION inhibitors, CONFIDENCE intervals, PLACENTA diseases, CELL receptors, RETROSPECTIVE studies, ACQUISITION of data, FETAL growth retardation, COMPARATIVE studies, PREECLAMPSIA, MEDICAL records, PUERPERIUM, ASPIRIN, STATISTICAL correlation, LONGITUDINAL method

مستخلص: 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 strongreverse 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. [ABSTRACT FROM AUTHOR]

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المؤلفون: Skliarov P., Zubkov O.

المصدر: Науковий вісник ветеринарної медицини, Vol 2, Iss 168, Pp 7-17 (2021)

مصطلحات موضوعية: cattle, puerperium, reproductive function, forecasting programs., Veterinary medicine, SF600-1100

الوصف: The postpartum period plays a crucial role in restoring reproductive function and, consequently, the milk productivity of cows. Its importance lies in the fact that it marks the transition from pregnancy and birth to lactation and preparation for new fruiting. The course of puerperium depends on the condition of the mother's body, the course of pregnancy and childbirth, feeding conditions, maintenance, care and operation. In this regard, the aim of the work was to develop a program for predicting the course of the postpartum period in cows. The development of the program for predicting the course of the postpartum period in cows was carried out with the participation and advice of employees of the Department of Veterinary Reproductology of Kharkiv State Zooveterinary Academy on the basis of "Peremoha AVK" MVC "Ekaterinoslavsky" Dnipro district of Dnipropetrovsk region. The study is conducted in the late dry period (last 2-3 weeks of pregnancy). Obtained by the results of clinical, laboratory (morphological and biochemical) and special (sonographic) studies, the evaluation parameters were part of the algorithm developed on the principle of database management system in MS Exel program – indicators for assessing the clinical condition of the animal, homeostasis, completeness of feeding and activity movement of the cow, the condition of her breast and fetoplacental complex (fetal weight, placental size, diameter of the middle uterine artery) and colpocytograms. Each indicator corresponds to two variants of objective values with their own scale. The conclusion is determined by the sum of points for all items of the program. To do this, you only need to enter certain information into the program that determines one or another option: the sum of scores 51- 100 indicates a low probability of pathological processes, less than 50 – high. The use of the program itself makes it possible to obtain objective information and timely take appropriate measures to prevent the occurrence and development of pathological processes, maintaining the health and life of women in labor.

وصف الملف: electronic resource

Relation: http://nvvm.btsau.edu.ua/sites/default/files/visnyky/vet/skliarov_zubkov_2_2021.pdf; https://doaj.org/toc/2310-4902; https://doaj.org/toc/2415-7589

URL الوصول: https://doaj.org/article/2c6f250e2f7f49b4a12236923ba8518e

Alternate Title: Management of pregnancy, delivery, and postpartum in patients of advanced maternal age with pregnancies obtained by assisted reproductive technologies. (English)

المؤلفون: Рубінштейн, А. М.

المصدر: Reproductive Health of Woman; 2022, Vol. 56 Issue 4, p16-22, 7p

مصطلحات موضوعية: ANEMIA prevention, HEMORRHAGE prevention, CHILDBIRTH, SURGICAL blood loss, POSTPARTUM depression, MEDICAL screening, COMPARATIVE studies, SLEEP, MATERNAL age, HUMAN reproductive technology, PREGNANCY complications, PARITY (Obstetrics), PUERPERIUM, DESCRIPTIVE statistics, DELIVERY (Obstetrics), POSTNATAL care, STATISTICAL sampling, ANXIETY, LABOR (Obstetrics), WOMEN'S health, MENTAL illness

مصطلحات جغرافية: UKRAINE

مستخلص: The objective: to reduce the frequency of obstetrical and perinatal complications in women of late reproductive age, whose pregnancy occurred with the help of assisted reproductive technologies (ART). Materials and methods. 150 nulliparous women of late reproductive age with a singleton pregnancy and fetal head presentation without severe somatic and gynecological pathology and fetal malformations, were examined. All patients were randomly divided into three groups: the main group (50 pregnant women after the ART program (n1 ), who received the developed algorithm – diagnosis, prevention and therapy of gestational anemia, diagnosis and prevention of intranatal complications, prevention of prolonged pregnancy, prevention of hemorrhagic complications, screening, prevention and therapy of perinatal psychological disorders; comparison group (50 patients with ART pregnancy, n2 ), and control group (50 patients with spontaneous pregnancy, n3 ). Pregnancy, childbirth and the postpartum period in the patients of the comparison group and the control group were conducted in accordance with the orders of the Ministry of Health of Ukraine. All women had a complete clinical and laboratory examination during pregnancy, childbirth and in the postpartum period, as well as a study of the level of anxiety, sleep quality, and assessment of the development of postpartum depression. Results. During the pregnancy course the percentage of patients with gestational anemia significantly decreased in the main group and was 2.0% versus 30.0% in the comparison group and 18.0% in the control group (р1.2;р1.3<0.05). In the postpartum period, the rate of anemia was also significantly lower in the main group than in the comparison and control groups. 26% of patients in the comparison group and 14% – in the control group had labor induction in the term of 40–41 weeks, in the same gestational term 20% of patients in the main group were delivered by the plan caesarean section because of the absence of spontaneous onset of regular labor activity. There was no significant difference in the frequency of normal delivery and cesarean section between the main and comparison groups, but the extensive frequency of urgent cesarean section was significantly lower in the main group and it was 52% versus 83.3% in the comparison group and 86.7% – in the control group (р1.2;р1.3<0.05). The mean volume of blood loss in the main group was significantly less than in the comparison group – 300.0 (250.0; 642.5) ml versus 690.0 (300.0; 800.0) ml (р1.2<0.001) and did not significantly differ from this indicator in the control group - 300.0 (250.0; 600.0) ml. Mean volumes of blood loss separately during vaginal delivery and caesarean section in the main group were also significantly lower than in the comparison group, and were 250.0 (200.0; 280.0) ml versus 300.0 (255.0; 350.0) ml (р1.2=0.004) and 650.0 (610.0; 740.0) ml versus 750.0 (700.0; 800.0) ml (р1.2=0.01), respectively . As pregnancy progressed, the patients in the comparison and control groups were more prone to high anxiety and sleep disturbances. For the patients of the comparison group, in contrast to the women of the main group, there was a significant increase in the time required to fall asleep, the frequency of awakenings during the night, women more often needed to use sleeping pills and complained of excessive sleepiness during the day and, accordingly, had significantly lower indicators of subjective evaluation sleep quality. At 35–37 weeks of pregnancy, the rate of patients with high levels of state and trait anxiety was significantly lower in the main group than in the comparison group (28.0% vs. 66.0% and 14.0% vs. 52.0%, respectively; p1,2<0.05). Immediately after delivery, levels of both state and trait anxiety decreased slightly in all study groups, but the validity of the differences remained constant. The frequency of patients with a moderate risk of the postnatal depression development was 16% in the main group, 36% – in the comparison group (p1.2<0.05) and 20% – the control one. In 6-8 weeks after childbirth, on the background of gaining the necessary experience, there is a moderate improvement in the quality of sleep and a significant decrease in anxiety levels in all groups. The rate of patients with a moderate risk of depression development in this term remained lower in the main group than in the comparison group (12% vs. 38% ; p1.2<0.05), in the control group this indicator was 18% . Conclusions. The study proved the feasibility, efficacy, and safety of the treatment and diagnostic algorithm for prevention the obstetrical and perinatal complications in patients in late reproductive age who became pregnant after the use of ART. [ABSTRACT FROM AUTHOR]

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المؤلفون: Karolina Detka, Anna Zwierzyńska, Jakub Gruszka, Grzegorz Świercz, Olga Adamczyk-Gruszka

المصدر: Journal of Education, Health and Sport, Vol 11, Iss 7, Pp 98-108 (2021)

مصطلحات موضوعية: puerperium, newborn, lactation, Education, Sports, GV557-1198.995, Medicine

الوصف: IntroductionThe mammary gland is a paired skin gland of women, responsible for the lactation process. It is synchronized with the operation of the endocrine system. The production of breast milk takes place after childbirth through the action of the hormonal and nervous systems. Secretion is controlled by prolactin and oxytocin. Its composition includes: proteins, fats, carbohydrates, minerals and vitamins. It is rich in stem cells. The function of the gland is to secure the nutritional and energy needs of the newborn.Aim of the workThe aim of the study was to evaluate and compare the knowledge of the patients of the Department of Obstetrics and Gynaecology, WSZZ in Kielce about lactation and breastfeeding before and during the Covid-19 pandemic –a comparative study.Material and methods420 puerperae participated in the study. The first pre-COVID-19 pandemic group included 196 women, the second group during the pandemic period included 224 respondents. Among the puerperae, women aged over 30 constituted the most numerous age group.The Bioethics Committee of UJK (Jan Kochanowski University of Kielce) approved the study No. 16/2021.Statistical analysis was performed with the use of the Statistica computer program.ResultsThe patients living in the city have more knowledge about lactation and breastfeeding than the patients from rural areas.The older the patient and the greater the number of completed pregnancies and deliveries, the greater the knowledge about lactation and breastfeeding.The assessment of the involvement of medical personnel depends on the time when the patient gave birth.The period of the COVID-19 pandemic has impacted the knowledge about reducing the risk of breast cancer in women.The patients from the pandemic period are more knowledgeable about breastfeeding and lactation than patients in the pre-pandemic period.

وصف الملف: electronic resource

Relation: https://apcz.umk.pl/czasopisma/index.php/JEHS/article/view/34705; https://doaj.org/toc/2391-8306

URL الوصول: https://doaj.org/article/0aef0245061e4d2a9ea114e45b5d6dfe