Influence of Arterial Hypertension on the Pregnancy in Women with RH-Negative Blood

2015 ◽  
Vol 22 (3) ◽  
pp. 56-62
Author(s):  
Тамазаева ◽  
Kh. Tamazaeva ◽  
Омаров ◽  
N.S. Omarov
Keyword(s):  
Arterial Hypertension ◽  
Pregnant Women ◽  
High Titer ◽  
Perinatal Outcomes ◽  
Control Group ◽  
Threatened Premature Birth ◽  
Definition Of ◽  
D Antigen ◽  
Work Up

The purpose of the study was to assess the role of arterial hypertension (AH) in the development of immunization in women with Rh-negative blood to optimize perinatal outcomes. Subject and methods. A prospective comparatively study was conducted in 3 groups of pregnant women with Rh-negative blood. The 1-st group (n=148) was with hypertensive disease (HD), the 2-nd group (n=144) - with gestational arterial hypertension (GAH); the 3-rd group (n=110) - without somatic pathology. The immune-hematological studies included a definition of the partial D antigen using gel method. Results. It was definited that the pregnancy of these patients accompanied by the high frequency of early gestational toxicosis, threatened premature birth, preeclampsia, placental insufficiency as well as expressed changes immu-nological properties of blood, which are pathogenetic basis of fetal and neonatal rhesus hemolytic disease. Antibodies (AB) in the blood serum of patients with hypertension were detected in the first half of pregnancy (up to 20 weeks) in 1.2-1.4 times more often than in healthy women, high titer of AB rate in patients with HD was significantly higher compared to other groups. Disadvantageous combination of immunoglobulins subclasses Gl and G3 was found in the group of pregnant women with HD (11.4%) and GAH (10,8%), significantly less frequently (6,45%) in the control group. Conclusion. To improve maternal, fetal and neonatal gestation outcomes the authors justified the necessity of prenatal work-up and delivery of these women.

Shear-wave elastography for detection of placenta percreta: a case-controlled study

2021 ◽  
pp. 028418512199776
Author(s):  
Dilek Sen Dokumaci ◽  
Hacer Uyanikoglu
Keyword(s):  
Prenatal Diagnosis ◽  
Pregnant Women ◽  
Shear Wave ◽  
Perinatal Outcomes ◽  
Shear Wave Elastography ◽  
Placenta Percreta ◽  
Controlled Study ◽  
Control Group ◽  
Roc Curve Analysis

Background Prenatal diagnosis of placenta percreta (PP) is important to be able to provide effective management and a multidisciplinary approach to minimize the complications. Purpose To evaluate the role of shear-wave elastography (SWE) in the prenatal diagnosis of PP. Material and Methods A total of 18 women with PP and 20 pregnant women with normal placenta in the second or third trimesters were included in this prospective study. SWE was used to determine the elasticities of the placenta (in the maternal edge of the placenta) and myometrium. The obstetric data regarding grayscale and Doppler ultrasonography, and perinatal outcomes were reviewed. A mean placental SW velocity (SWV) cut-off value was determined to predict the presence of placental adherence. Results The SWV values of the PP group in the maternal edge of the placenta were significantly higher than those of the control group (1.95 ± 0.19 m/s and 1.69 ± 0.23 m/s; P = 0.001). Myometrial SWV was also higher in the PP group compared to the control group (2.25 ± 0.39 m/s and 1.90 ± 0.71 m/s; P = 0.002). A receiver operating characteristic (ROC) curve analysis was performed and the best cut-off value of placental SWV was determined as 1.92 m/s with sensitivity of 58% and specificity of 80%, to predict the placental adherence in patients with PP. Conclusion Placental stiffness was significantly higher in patients with PP than in pregnant women with normally localized placenta. Thus, we thought that SWE of the placenta might be used as an alternative method in the diagnosis of PP.

scholarly journals The Role of Inflammation in the Pathogenesis of Preeclampsia

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Michał Michalczyk ◽  
Aleksander Celewicz ◽  
Marta Celewicz ◽  
Paula Woźniakowska-Gondek ◽  
Rafał Rzepka
Keyword(s):  
Arterial Hypertension ◽  
Pregnant Women ◽  
Intrauterine Growth Restriction ◽  
Perinatal Outcomes ◽  
Underlying Mechanism ◽  
Perinatal Morbidity ◽  
Intrauterine Growth ◽  
Antiangiogenic Factors ◽  
Significant Factors

Preeclampsia (PE) affects 5-8% of pregnant women, and it is the major cause of perinatal morbidity and mortality. It is defined as arterial hypertension in women after 20 weeks of gestation which cooccurs with proteinuria (300 mg/d) or as arterial hypertension which is accompanied by one of the following: renal failure, liver dysfunction, hematological or neurological abnormalities, intrauterine growth restriction, or uteroplacental insufficiency. Currently, pathophysiology of preeclampsia poses a considerable challenge for perinatology. Preeclampsia is characterized by excessive and progressive activation of the immune system along with an increase in proinflammatory cytokines and antiangiogenic factors in fetoplacental unit as well as in vascular endothelium in pregnant women. A single, major underlying mechanism of preeclampsia is yet to be identified. This paper discusses the current understanding of the mechanisms which underlie the development of the condition. Some significant factors responsible for PE development include oxidative stress, abnormal concentration and activity in mononuclear phagocytic system, altered levels of angiogenic and antiangiogenic factors, and impaired inflammatory response triggered by inflammasomes. Detailed understanding of pathophysiology of inflammatory process in PE can largely contribute to new, targeted anti-inflammatory therapies that may improve perinatal outcomes in PE patients.

Markers of endothelial dysfunction in pregnant after flu during pregnancy: performance and prognostic significance

10.12737/7374 ◽  
2014 ◽  
Vol 8 (1) ◽  
pp. 0-0
Author(s):  
Калиматова ◽  
D. Kalimatova ◽  
Шатунова ◽  
E. Shatunova
Keyword(s):  
Endothelial Dysfunction ◽  
Pregnant Women ◽  
Prognostic Significance ◽  
Perinatal Outcomes ◽  
Correlation Coefficients ◽  
Control Group ◽  
Endothelial Protein C Receptor ◽  
Definition Of ◽  
Somatic Diseases ◽  
Endothelial Growth Factor

It was performed the study of endothelial dysfunction markers dynamics in pregnant with influenza and evaluation of the prognostic significance of these parameters. It analyzed the data 44 included pregnant women (average age of 28,2±7,3 years) diagnosed with flu mean (n=26) and severe (n=18) degrees. 22 pregnant women with no evidence of infectious and somatic diseases in the control group (mean age 27,2±5,4 years). The diagnosis of highly pathogenic H1N1 was confirmed using virological examination, all patients were hospitalized. Found that pregnant women who have had the flu during gestation, it reveals significant shifts of the levels of markers of endothelial dysfunction in blood plasma: reducing the concentration of vascular endothelial growth factor (VEGF) reduced compared with healthy pregnant women and increased levels of endothelial protein C receptor along with increasing concentrations endothelin-1. It is shown that with increasing severity of flu during pregnancy, the severity of the imbalance of these markers is increased. The presence of significant correlation coefficients significant moderate force between the frequency of complications of pregnancy, childbirth and perinatal outcomes and degree of changes in the concentrations of markers of endothelial dysfunction. It is concluded that high prognostic value of assessing these factors, it is proposed to include them in the definition of an algorithm for pregnant women with influenza.

scholarly journals Interrelation of polymorphic allelic rs619203 option of a gene receptor of a tirozinkinaza (ROS1) with cardiovascular diseases at patients with an ischemic stroke

2015 ◽  
Vol 6 (2) ◽  
pp. 6-11
Author(s):  
D. A Nikulin ◽  
V. A Shulman ◽  
S. V Prokopenko ◽  
S. Yu Nikulina ◽  
A. A Chernova ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Cardiovascular Diseases ◽  
Arterial Hypertension ◽  
Genetic Research ◽  
Control Group ◽  
Homozygous Genotype ◽  
Analysis Of Results ◽  
Definition Of ◽  
Body Weight Index

Studying of interrelation of polymorphic allelic rs619203 option of a gene of ROS1 with cardiovascular diseases at persons with the ischemic stroke is carried out. For the purpose of studying of a role of single nucleotide polymorphism of rs619203 of a gene of ROS1 in development of strokes of a genotiping 124 patients with ischemic stroke and cardiovascular pathology and 475 people of group of control. Persons with ischemic stroke are divided into subgroups according to a sex, the affected artery, the diseases which are available cardiovascular, risk factors, such as the raised body weight index, the burdened heredity on a stroke, smoking. For verification of the diagnosis by all patient standard neurologic examination, a computer tomography of a brain, and also the retrospective analysis of results of the previous inspections (are conducted at their existence), for definition of a genotype on ROS1 gene ONP - molecular and genetic research DNA. The received results showed prevalence of a homozygous genotype of GG on extended allel among patients from ischemic stroke having the arterial hypertension in comparison with control group. Thus, the genotype of GG has conditionally protective effect concerning development of ischemic stroke in persons with arterial hypertension.

scholarly journals Prediction of Adverse Perinatal Outcomes and Preeclampsia in Pregnant Women with Chronic Arterial Hypertension

2021 ◽  
Vol 11 (4) ◽  
pp. 422-427
Author(s):  
Victor Radzinsky ◽  
Bakhtykei Gasanova ◽  
Miroslava Polina ◽  
Natalya Douglas ◽  
Praskovya Zakharova ◽  
...  
Keyword(s):  
Blood Flow ◽  
Arterial Hypertension ◽  
Pregnant Women ◽  
High Efficiency ◽  
Blood Pressure Monitoring ◽  
Perinatal Outcomes ◽  
Left Ventricular ◽  
Control Group ◽  
Study Cohort ◽  
Adverse Perinatal Outcomes

The objective of this study was to determine predictors and develop a prognostic model for preeclampsia (PE) and adverse perinatal outcomes in pregnant women with chronic arterial hypertension (CAH). Methods and Results: The study cohort included pregnant women (n=376) with hypertensive disorders: Group 1 –pregnant women with CAH (n=134), Group 2 – with PE on the background of CAH (n=242). Healthy pregnant women made up the control group (n=34). The diagnosis of pregnant women with CAH was made on the basis of existing national and foreign recommendations that an increase in SBP ≥140 mmHg and/or DBP ≥90 mmHg indicates CAH. All patients underwent the following examinations: a survey on a special questionnaire; an anthropometric examination; physical examination; an assessment of the content of uric acid (UA) in the blood serum and microalbuminuria (MAU) in the urine at 6-8 and 16-17 weeks of pregnancy; 12-lead ECG, echocardiography, 24-hour ambulatory blood pressure monitoring, sonography of the uterus, fetus, and placenta at 6-8 and 16-18 weeks. It was found that an inappropriate left ventricular mass (LVM) in pregnant women with CAH, a certain “phenotype” of 24-hour ABPM and indicators of metabolic disorders demonstrate the systemic nature of organ damage and appear to be a predictor of adverse perinatal outcomes and the development of PE. The revealed changes in the LV structure, which are more significant in PE on the background of CAH, suggest the association of concentric left ventricular hypertrophy and disorders of uteroplacental blood flow. Detecting abnormal blood flow from early pregnancy will reduce not only perinatal morbidity and premature birth, but also the probability of organ (LV myocardium, kidney) damage in women with CAH. To predict the risks of adverse perinatal outcomes in pregnant women with CAH and PE, a number of factors were identified that have a statistically significant relationship with the studied complications. The developed model makes it possible to predict the probability of PE and unfavorable perinatal outcomes in pregnant women suffering from CAH with high efficiency (91.1%).

INOVASIA Study: A Randomized Open Controlled Trial to Evaluate Pravastatin to Prevent Preeclampsia and its Effects on sFlt1/PLGF Levels

2021 ◽  
Author(s):  
Muhammad Ilham Aldika Akbar ◽  
Angelina Yosediputra ◽  
Raditya Eri Pratama ◽  
Nur Lailatul Fadhilah ◽  
Sulistyowati Sulistyowati ◽  
...  
Keyword(s):  
High Risk ◽  
Pregnant Women ◽  
Controlled Trial ◽  
Intervention Group ◽  
Perinatal Outcomes ◽  
Neonatal Morbidity ◽  
Clinical Risk Factor ◽  
Control Group ◽  
Significant Deterioration ◽  
Plgf Ratio

Objectives To evaluate the effect of pravastatin to prevent preeclampsia (PE) in pregnant women at a high risk of developing preeclampsia and the maternal and perinatal outcomes and the sFlt1/PLGF ratio. Study Design This is an open labelled RCT part of INOVASIA trial. Pregnant women at a high risk of developing PE were recruited and randomized into an intervention group (40) and a control group (40). The inclusion criteria consisted of pregnant women with positive clinical risk factor and abnormal uterine artery doppler examination at 10-20 weeks gestational age. The control group received low dose aspirin (80 mg/day) and calcium (1 g/day), while the intervention group received additional pravastatin (20 mg twice daily) starting from 14-20 weeks gestation until delivery. Research blood samples were collected before the first dose of pravastatin and before delivery. The main outcome was the rate of maternal preeclampsia, maternal-perinatal outcomes, and sFlt-1, PLGF, sFlt-1/PlGF ratio and sEng levels. Results The rate of preeclampsia was (non-significantly) lower in the pravastatin group compared with the control group (17.5% vs 35%). The pravastatin group also had a (non-significant) lower rate of severe preeclampsia, HELLP syndrome, acute kidney injury and severe hypertension. The rate of (iatrogenic) preterm delivery was significantly (p=0.048) lower in the pravastatin group (n=4) compared with the controls (n=12). Neonates in the pravastatin group had significantly higher birthweights (2931 + 537 vs 2625 + 872 g; p=0.006), lower Apgar scores < 7 (2.5 vs 27.5%, p=0.002), composite neonatal morbidity (0 vs 20%, p=0.005) and NICU admission rates (0 vs 15%, p=0.026). All biomarkers show a significant deterioration in the control group compared with non significant changes in the pravastatin group. Conclusions Pravastatin holds promise in the secondary prevention of preeclampsia and placenta-mediated adverse perinatal outcomes by improving the angiogenic imbalance.

scholarly journals Dysmetabolic mechanisms of preeclampsia development

2021 ◽  
Vol 17 (4) ◽  
pp. 346-356
Author(s):  
I. S. Lipatov ◽  
Yu. V. Tezikov ◽  
A. R. Azamatov
Keyword(s):  
Insulin Resistance ◽  
Pregnant Women ◽  
Metabolic Disorders ◽  
Hematological Parameters ◽  
Control Group ◽  
Metabolic Disturbances ◽  
Group Iii ◽  
Inflammatory Status ◽  
Group I

Background: An in-depth study of dismetabolic mechanisms in the genesis of pre-eclampsia (PE) has been updated because pregnancy is considered as a natural model of metabolic syndrome (MS), as well as the metabolic disorders are important in development of essential hypertension.Aims: to reveal clinical and laboratory parallels in pregnancy complicated by PE without MS and pregnancy proceeding on the background of MS to assess the role of metabolic disturbances in the development of PE.Materials and methods: 82 women with MS were examined in the dynamics of pregnancy and were divided into 2 groups depending on the implementation of PE: group I consisted of 50 women with PE on the background of MS, group II 32 women with MS without PE. We formed group III consisting of 44 pregnant women with PE without accompanying diseases to assess the pathogenetic value of metabolic disorders in the development of PE. The IV (control) group consisted of 30 healthy women with physiological pregnancy. Metabolic, hematological parameters, hormones, markers of the proinflammatory state, endothelial hemostasiological dysfunction, decidualization and placental angiogenesis, accumulation dynamics and distribution loci of adipose tissue were determined in all pregnant women.Results: In the groups of pregnant women with PE, changes similar to MS were revealed: pronounced diabetic and atherogenic disorders with the development of pathological insulin resistance, hyperinsulinemia and leptinemia, endothelial-platelet link hyperactivation, thrombotic and inflammatory status, visceral type of fat deposition, hyperuricemia, hypersympathicotonia. It is proved that in the hierarchy of mechanisms of PE formation, placental dysfunction is a secondary alteration factor, which additionally potentiates the insulin resistance increase and the effects of structural and functional destabilization of the vascular endothelium.Conclusions: The direction of metabolic changes during pregnancy, the common development of PE and MS indicate the important role of dismetabolic mechanisms in the formation of PE.

THIS STUDY ASSESSES THE ROLE OF NST IN DETECTING FETAL COMPROMISE IN CASES OF REDUCED MATERNAL PERCEPTION OF FETAL MOVEMENT

2021 ◽  
pp. 62-65
Author(s):  
Archana Kiran ◽  
Umapada Mondal ◽  
Debarshi jana
Keyword(s):  
Pregnant Women ◽  
Stress Test ◽  
Perinatal Outcomes ◽  
Fetal Monitoring ◽  
Well Being ◽  
Fetal Movement ◽  
Obstetrics And Gynaecology ◽  
Fetal Movements ◽  
Modern Era

Introduction:In modern era of medicine, antenatal fetal monitoring is an essential way that assess the fetal well being. Aims and objectives: This study was performed to test the association between non-stress test ( NST) results and fetal and perinatal outcomes in pregnant women with perceived decrease in fetal movements attending our hospital. To determine the role of Non stress test on fetal and prenatal outcome of pregnant women with perceived decrease in fetal movements attending labor room. Materials and methods: Study is carried out at 'Imambara District Hospital', at the Dept. Of obstetrics and gynaecology, Hooghly, WB. All the pregnant mother with decreased fetal movement perception in the 3rdtrimester, attending OBG (OPD) and ANC or getting admitted in Dept. OF OBSTETRICS AND GYNAECOLOGY, at IMAMBARADIST. HOSPITAL, Chinsurah, Hooghly, WB. 1st May 2018 – April 30, 2019. Conclusion: The antenatal surveillance of cases with reduced perception of fetal movement by mother with NST can effectively screen for identication of high risk foetuses and segregate the cases that are at risk for poor perinatal outcome.

THE ROLE OF SECRETING FUNCTION OF DECIDUA IN THE DEVELOPMENT OF COMPLICATIONS OF GESTATION PROCESS IN PREGNANT WOMEN WITH A PAST HISTORY OF CHRONIC ENDOMETRITIS

2020 ◽  
Vol 73 (11) ◽  
pp. 2416-2420
Author(s):  
Olena О. Taranovska ◽  
Volodymyr К. Likhachov ◽  
Ludmyla М. Dobrovolska ◽  
Oleg G. Makarov ◽  
Yanina V. Shymanska
Keyword(s):  
Pregnant Women ◽  
Past History ◽  
Control Group ◽  
Predisposing Factor ◽  
Chronic Endometritis ◽  
The Past ◽  
Early Stages ◽  
History Of ◽  
In The Beginning

The aim: To determine the serum FAMG in the I and II trimester of pregnancy in women with a past history of chronic endometritis, and to clarify its impact on the development of pathology of pregnancy. Materials and methods: The level of FAMG was determined at 6-8 and 16-18 weeks of gestation in 135 pregnant women with a past history of chronic endometritis, who received treatment of chronic endometritis at the stage of pregravid preparation and 168 women who became pregnant without its prior treatment. The dependence of the development of pre-eclampsia on the level of FAMG at the early stages of pregnancy has been evaluated. Results: At 6-8 weeks of pregnancy, the level of FAMG in women with a past history of chronic endometritis was 20.6% lower (122.4 ± 7.6 ng/ml) compared to the control group. In FAMG of 90.3 ± 4.3 ng/ml at 6-8 weeks of gestation, spontaneous abortion occurred in 100% of cases within the next 2 weeks. FAMG lower than 122,1 ± 3,0 ng/ml can be the predisposing factor for the development of pre-eclampsia. Conclusions: Reduced FAMG in the beginning of pregnancy in women with untreated chronic endometritis in the past history increases the incidence of miscarriages at the early stages by 2.6 times, and by 1.8 times the probability of preeclampsia development. Treatment of chronic endometritis at the stage of pregravid preparation promotes the increase of FAMG by 24,6% compared to untreated women that reduces the probability of complications during the subsequent course of pregnancy.

scholarly journals Physical activity during pregnancy and its influence on delivery time: a randomized clinical trial

PeerJ ◽  
2019 ◽  
Vol 7 ◽  
pp. e6370 ◽  
Author(s):  
Raquel Rodríguez-Blanque ◽  
Juan Carlos Sánchez-García ◽  
Antonio Manuel Sánchez-López ◽  
María José Aguilar-Cordero
Keyword(s):  
Physical Exercise ◽  
Pregnant Women ◽  
Intervention Program ◽  
Total Duration ◽  
Perinatal Outcomes ◽  
Exercise Group ◽  
University Hospital ◽  
Control Group ◽  
Beneficial Effects ◽  
The Difference

Introduction During pregnancy, women often change their lifestyle for fear of harmful effects on the child or themselves. In this respect, many women reduce the amount of physical exercise they take, despite its beneficial effects. Objective To determine the duration of labor in pregnant women who completed a program of moderate physical exercise in water and subsequently presented eutocic birth. Methods A randomized trial was performed with 140 healthy pregnant women, divided into an exercise group (EG) (n = 70) and a control group (CG) (n = 70). The women who composed the study population were recruited at 12 weeks of gestation. The intervention program, termed SWEP (Study of Water Exercise during Pregnancy) began in week 20 of gestation and ended in week 37. Perinatal outcomes were determined by examining the corresponding partographs, recorded by the Maternity Service at the Granada University Hospital Complex. Results The intervention phase of the study took place from June through October 2016, with the 120 women finally included in EG and CG (60 in each group). At term, 63% of the women in EG and 56% of those in CG had a eutocic birth. The average total duration of labor was 389.33 ± 216.18 min for the women in EG and 561.30 ± 199.94 min for those in CG, a difference of approximately three hours (p < 0.001). Conclusions The women who exercised in water during their pregnancy presented a shorter duration of labor than those who did not. The difference was especially marked with respect to the duration of the first and second stages of labor.

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