SOME INDICES OF MORPHOFUNCTIONAL ACTIVITY OF LYMPHOCYTES IN THE PERIPHERAL BLOOD OF WOMEN WITH COMPLICATED PREGNANCY

2016 ◽  
Vol 1 (61) ◽  
pp. 84-89
Author(s):  
Ягупова ◽  
Anastasiya Yagupova ◽  
Супрун ◽  
Stefaniya Suprun ◽  
Соловьева ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Optical Density ◽  
Peripheral Blood ◽  
Clinical Manifestations ◽  
Perinatal Outcomes ◽  
High Tech ◽  
Glycerophosphate Dehydrogenase ◽  
Complicated Course ◽  
Complicated Pregnancy ◽  
Morphometric Assessment

The aim of the research was to study some indices of morphofunctional state of lymphocytes in the peripheral blood under a complicated course of pregnancy in women of Khabarovsk. 96 women were examined in different trimesters of gestation. Two main groups depending on the type of complications were formed: the first group consisted of pregnant women with vaginitis, the second group had women whose pregnancy was complicated with clinical manifestations in the form of edemas, proteinuria and hypertensive disorders. The group of comparison included the women without complications. In the peripheral blood of the women under study with the method of high tech automated digital system of blood smear test VISION HEMA there was done a morphometric assessment of lymphocytes and with histochemical methods there was found a level of fermentation activity of succinate dehydrogenase (SDH), α-glycerophosphate dehydrogenase (α-GPDH) and lactate dehydrogenase (LDH). By morphometric studies of lymphocytes of the peripheral blood in pregnant women of the first group in the III trimester of gestation the indices of the square of the cell, of cytoplasm, cytoplasm brightness, the square of the nucleus and the brightness of the nucleus were 102.33±9.83 mсm², 36.84±4.88 mсm², 181.39±6.94 units of optical density, 65.69±6.87 mсm², 97.44±6.88 units of optical density, respectively (in the group of the comparison these data were 121.31±4.44 mсm²; 46.14±2.52 mсm²; 167.74±3.44 units of optical density; 75.33±2.66 mkm², 88.00±3.36 units of optical density, respectively). In the second group of women the same data in the same period of pregnancy corresponded to the following values: 128.44±4.89 mсm², 57.15±3.87 mсm², 173.53±4.65 units of optical density, 70.95±3.39 mсm² and 91.13±4.93 units of optical density (in the group of comparison there were the following data: 109.92±3.57 mсm², 39.63±1.53 mсm², 158.96±2.63 units of optical density, 75.37±3.23 mсm², 82.16±2.58 units of optical density, respectively). By the results of histochemical studies the level of activity of enzymes SDH, α-GPDH, LDH in the first group of pregnancy was 15.38±2.10, 10.72±0.58 and 20.53±2.36 pellet/cell, respectively. And just the other way round in pregnant women of the second group there was revealed a statistically reliable suppression of fermentation activity of these enzymes: 9.11±0.75 (p<0.05); 9.61±1.06 (p>0.05); 8.31±1.20 (p<0.05) pellet/cell in regard to the data in the group of comparison (12.84±1.21; 12.18±1.13 and 13.09±0.78 pellet/cell, respectively). Thus the changes of morphometric indices characterizing parameters of the cell, the nucleus and lymphocytes cytoplasm in a complex study with their fermentation activity can be extra diagnostic criteria of the formation of different complications during pregnancy. The obtained data allow to justify in-time application of medications for the correction of metabolic disorders of immune competent cells with the aim to decrease unfavorable perinatal outcomes.

Clinical manifestations and maternal and perinatal outcomes in pregnant women with obstetric antiphospholipid syndrome at a high complexity institution: Descriptive study

2020 ◽  
Vol 27 (2) ◽  
pp. 73-79
Author(s):  
Carolina Restrepo Ocampo ◽  
Laura Arango Gutiérrez ◽  
Libia María Rodríguez Padilla ◽  
Miguel Antonio Mesa Navas ◽  
Carlos Jaime Velásquez Franco ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Antiphospholipid Syndrome ◽  
Clinical Manifestations ◽  
Perinatal Outcomes ◽  
Descriptive Study ◽  
High Complexity ◽  
Obstetric Antiphospholipid Syndrome

scholarly journals Clinical manifestations and perinatal outcomes of pregnant women with COVID-19: a systematic review and meta-analysis

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Jeong Yee ◽  
Woorim Kim ◽  
Ji Min Han ◽  
Ha Young Yoon ◽  
Nari Lee ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pregnant Women ◽  
Fetal Death ◽  
Web Of Science ◽  
Meta Analysis ◽  
Clinical Manifestations ◽  
Perinatal Outcomes ◽  
Current Review ◽  
The Mean ◽  
The Impact

Abstract This systematic review and meta-analysis aimed to evaluate the impact of COVID-19 on pregnant women. We searched for qualified studies in PubMed, Embase, and Web of Science. The clinical characteristics of pregnant women with COVID-19 and their infants were reported as means and proportions with 95% confidence interval. Eleven studies involving with 9032 pregnant women with COVID-19 and 338 infants were included in the meta-analysis. Pregnant women with COVID-19 have relatively mild symptoms. However, abnormal proportions of laboratory parameters were similar or even increased, compared to general population. Around 30% of pregnant women with COVID-19 experienced preterm delivery, whereas the mean birth weight was 2855.9 g. Fetal death and detection of SARS-CoV-2 were observed in about 2%, whereas neonatal death was found to be 0.4%. In conclusion, the current review will serve as an ideal basis for future considerations in the treatment and management of COVID-19 in pregnant women.

scholarly journals A systematic review and meta-analysis of pregnancy and COVID-19: Signs and symptoms, laboratory tests, and perinatal outcomes

2020 ◽  
Author(s):  
Soheil Hassanipour ◽  
Saeed Bagheri Faradonbeh ◽  
Khalil Momeni ◽  
Zahra Heidarifard ◽  
Mohammad-Javad Khosousi ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Laboratory Tests ◽  
Post Partum ◽  
Meta Analysis ◽  
Clinical Manifestations ◽  
Perinatal Outcomes ◽  
Signs And Symptoms ◽  
Lymphocyte Ratio ◽  
Laboratory Test Results ◽  
Common Sign

Background: Coronavirus Disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 appeared in December 2019 in Wuhan, China. Objective: To investigate the clinical manifestations including signs and symptoms, laboratory results, and perinatal outcomes in pregnant women with COVID-19. Materials and Methods: Scholarly databases such as PubMed via LitCovid hub, Embase, Scopus, Web of sciences, and Google scholar were searched on April 7, 2020. Meta-analysis was performed via comprehensive meta-analysis software using the Mantel-Haenszel method. The event rate with 95% CI was calculated for each variable. Results: Ten studies were selected. The pooled prevalence for fever, post-partum fever, cough, myalgia, fatigue, dyspnea, sore throat, and diarrhea were 66.8%, 37.1%, 35%, 24.6 %, 14.9%, 14.6%, 11.5%, and 7.6%, respectively. Laboratory test results were 49.8% for lymphopenia, 47.7% for leukocytosis, 83.7% for elevated neutrophil ratio, 57% for elevated C-reactive protein, and 71.4% for decreased lymphocyte ratio. The rate of cesarean section for delivery in all cases was 84%. Of the newborns of the corona positive mothers, only one had a positive test result. Also, there was only one death due to a decreased lymphocyte ratio. Conclusion: Fever was the most common sign and symptom in pregnant women with COVID-19. Among the laboratory tests, the highest amount was related to elevated neutrophil ratio. It seems that due to the differences between pregnant women and the general population, special measures should be considered to treat these patients. Key words: COVID-19, Pregnancy, Diagnosis, Signs and symptoms, Meta-analysis.

Frequency and weight of complications of pregnancy and childbirth at women with tuberculosis of various localization in Krasnoyarskiy kraY

2014 ◽  
Vol 63 (3) ◽  
pp. 58-65
Author(s):  
Svetlana Anatolyevna Vetushenko ◽  
Tatyana Grigoryevna Zakharova
Keyword(s):  
Pregnant Women ◽  
Premature Birth ◽  
Clinical Manifestations ◽  
Perinatal Outcomes ◽  
Maternity Hospital ◽  
Obstetric Complications ◽  
Medical Monitoring ◽  
Pregnancy And Childbirth ◽  
Prevention And Treatment

The purpose of researches - to reveal clinical manifestations of obstetric complications at pregnant women with tuberculosis of various localization on the basis of results of medical monitoring, and also to establish the complications of fetoplatsentarny insufficiency taking place in the studied period, at pregnant women with tuberculosis according to localizations of tubercular process. During medical monitoring stories of families of 210 women with tuberculosis of various localization and a condition of their newborns during 2006-2013 on the basis of interdistrict maternity hospital N 4 of Krasnoyarsk, profiled on this pathology are analysed. As a result of the analysis of structure of obstetric complications at women with tuberculosis in the territory of Krasnoyarsk Kray it is established: from 210 pregnant women at 76 there were no complications; at 133 pregnant women with FPN clinical manifestations are noted it are 43 cases of a hypoxia of a fruit, 31 cases of SZRP, 14 cases of SZRP with a hypoxia, thus clinical manifestations were accompanied by lack of water and abundance of water at the level of 22 and 4 cases respectively; in the same group the increase in number of complications of pregnancy by a preeklampsiya, anomalies of patrimonial activity, premature birth at the level of 51, 16 and 28 cases respectively is looked through. From only 133 pregnant women with placentary insufficiency 11 cases of childbirth without clinical manifestations of FPN are noted. The revealed number of clinical manifestations of placentary insufficiency and other complications of pregnancy says that at pregnant women with a disease of tuberculosis these indicators many times is more, than at pregnant women without disease of tuberculosis. The established structure of obstetric complications at pregnant women with tuberculosis of various localization highlighted prevalence of FPN proceeding with heavy clinical manifestations, such as SZRP, the fruit hypoxia, and also revealed most often meeting complications of pregnancy, such as a preeklampsiya, abnormal patrimonial activity, premature birth. It is the indication for development of effective measures of prevention and treatment of these complications, their forecasting from early terms of pregnancy for improvement of perinatal outcomes.

scholarly journals OBSTETRIC AND PERINATAL OUTCOMES IN PREGNANCY WITH DIFFERENT SEVERITY AND TIME OF THE MANIFESTATION OF PREECLAMPSIA

2018 ◽  
pp. 110-113
Author(s):  
M. B. Amor ◽  
O. P. Gnatko ◽  
N. G. Skuriatina
Keyword(s):  
Pregnant Women ◽  
Fetal Growth ◽  
Growth Retardation ◽  
Severe Disease ◽  
Asymptomatic Bacteriuria ◽  
Clinical Manifestations ◽  
Perinatal Outcomes ◽  
Medical Documentation ◽  
Fetal Growth Retardation ◽  
Perinatal Complications

The aim of the study – to conduct a retrospective analysis of the course of pregnancy and delivery to determine the nature of obstetric and perinatal complications in preeclampsia. Materials and Methods. The analysis was based on the results of the evaluation of the medical documentation (individual medical records of the pregnant woman, birth histories, developmental histories of the newborn) in 224 pregnant women with preeclampsia and 80 pregnant women without preeclampsia. In addition to the results of the clinical and laboratory examination, the analysis included the severity of preeclampsia and the time of clinical manifestations. The results of the study were statistically processed by methods of mathematical analysis with the determination of the mean values ​​(M ± m), Student's t-test and significance factor (р˂0.050 difference was statistically significant. Results and Discussion. According to the results of the analysis, mild preeclampsia was found in 32.6 % of cases, modera­te PE – in 37.5 %, severe PE – in 29.9 % of cases. The early onset of PE (up to 34 weeks) was observed in 35.7 % of pregnant women, and later onset (after 34 weeks) in 64.7 %. The analysis of the incidence of early and late PE cases at various severity levels showed that, in the case of early PE, severe disease was 2.9 times more frequent, and the moderate disease was 2.7 times more frequent than the mild disease. In the late PE, the mild PE was 1.9 times more frequent than the severe PE and 1.2 times more frequent than the moderate PE. In addition to PE, 31.7 % of women had other complications of pregnancy. The most common complications include asymptomatic bacteriuria (16.9 %), abnormal placental location (14.1 %), placental dysfunction (32.4 %), and fetal growth retardation (21.1 %). Term delivery occurred in 81.6 % of cases, premature births were in 18.3 %. Complications include premature rupture of membranes, anomalies of labor, premature detachment of the normally located placenta, postpartum hemorrhage. Among perinatal complications, fetal growth retardation, hemodynamic disorders, fetal distress, newborn asphyxia have been observed. The adverse outcome for a child in severe PE was 3 times higher than for mild PE. Conclusion. The analysis showed that obstetric and perinatal outcomes in preeclampsia are associated with the time of this pregnancy complication and its severity.

scholarly journals Assessment of perinatal outcomes of pregnant women with severe versus simple malaria

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0247053
Author(s):  
Alfred Kwizera ◽  
Diomede Ntasumumuyange ◽  
Maria Small ◽  
Stephen Rulisa ◽  
Alexandra N. Moscovitz ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Severe Malaria ◽  
Clinical Manifestations ◽  
Perinatal Outcomes ◽  
Outcome Data ◽  
Neonatal Deaths ◽  
Normal Term ◽  
Significant Difference ◽  
Term Delivery ◽  
Adverse Perinatal Outcomes

Objective Malaria in pregnancy is associated with adverse perinatal outcomes. The objective was to compare outcomes of simple and severe malaria and to determine whether they vary by trimester or severity of infection. Methods Prospective cohort study performed in 3 hospitals in Rwanda. Both hospitalized and non-hospitalized pregnant patients with confirmed malaria were enrolled and followed until 7 days postpartum. Demographic, clinical manifestations and perinatal outcomes were recorded. Results There were 446 pregnant women with confirmed malaria and outcome data; 361 (80.9%) had simple malaria. Severe malaria was more common as pregnancy progressed; out of 85 with severe malaria, 12.9%, 29.4% and 57.6% were in the 1st, 2nd and 3rd trimesters (p<0.0001). Overall, a normal term delivery occurred in 57.6%, with preterm delivery in 24.9% and abortion in 13.5%. Adverse perinatal outcomes increased with trimester of infection (p<0.0001). Eight of the 9 early neonatal deaths had 3rd trimester infection (p<0.0001). There were 27 stillbirths; 63.7% were associated with 3rd trimester infection. A significant difference in perinatal outcomes between simple and severe malaria was seen: 64% of women with simple malaria had a normal term delivery as compared to 30.6% with severe malaria (p<0.0001). All complications were significantly greater with severe malaria. Conclusion Overall poor outcomes are seen in malaria with significant differences in perinatal outcomes between simple and severe malaria and by trimester of infection. In addition to vector control and exposure prevention, efforts need to be made in screening, treatment education and monitoring pregnancies affected by malaria.

Obstetric and perinatal outcomes in women with threatened interruption of pregnancy, living in the armed conflict zone

2020 ◽  
pp. 21-24
Author(s):  
I.Yu. Romanenko ◽  
Keyword(s):  
Pregnant Women ◽  
Inflammatory Diseases ◽  
Perinatal Outcomes ◽  
Control Group ◽  
Operative Delivery ◽  
Pregnancy And Childbirth ◽  
Group I ◽  
History Of ◽  
Complicated Course ◽  
Female Genital

The objective: was to evaluate the course of pregnancy, childbirth and perinatal outcomes of delivery of women with threatened interruption of pregnancy (TIP), living in the Lugansk region, to improve treatment and preventive measures and prevent obstetric and perinatal complications in such women. Materials and methods. A prospective clinical and statistical analysis of the course of pregnancy and childbirth of 86 pregnant women in first and second trimesters of pregnancy were hospitalized regarding TIP in the hospitals located in the Luhansk region was performed (group I). The control group consisted of 64 pregnant women with non-complicated obstetric anamnesis and physiological course of pregnancy with similar gestational period of pregnancy and place of residence (group II). Results. In women of group I, a history of female genital inflammatory diseases was significantly more frequent, and a complicated course of pregnancy and childbirth was registered. The number of cases of acute respiratory viral infection (ARVI) was in 4, isthmic-cervical insufficiency (ICI) was in 3 times more often than in healthy pregnant women, asymptomatic bacteriuria, recurring TIP, gestational pyelonephritis and ureaplasma infection were found only in pregnant women of group I, the number of cases of anemia there was no significant difference. 13 (15.12%) of women of group I and 3 (4.69%) of group II (p=0.041) had spontaneous preterm birth at 33–37 weeks of gestation; operative delivery was registered in 23 (26.74%) and 8 (12.50%) cases, respectively (p=0.033). It was established that recurrent TIP, ARVI during this pregnancy, ICI, gestational pyelonephritis are statistically significant risk factors for preterm delivery and operative delivery. Premature rupture of the membranes was found in 1.58, weakness of labor – in 2.2, premature detachment of a normally located placenta – in 6, fetal distress – in 1.9 times more often in women of group I, central placenta previa was noted only in group I. Conclusions. The complicated course of the first and second trimesters of pregnancy, in particular, recurrent TIP, ARVI during this pregnancy, ICI, gestational pyelonephritis, had a direct effect on frequency increase of premature termination of pregnancy and operative delivery in patients of the main group compared with women of the control group. The presence of a history of chronic female genital inflammatory diseases, sexually transmitted infections, ARVI during this pregnancy, TIP in the first and second trimesters, allows pregnant women to be at high risk of developing gestational complications in order to conduct timely treatment. Key words: pregnancy, the threat of abortion, childbirth, the condition of newborns.

scholarly journals The Fluctuation of Regulatory T Cells during Pregnancy and Obstetrical Complications

2020 ◽  
Author(s):  
Yuan-Yuan Zhao ◽  
Ning Li ◽  
Hongchu Bao ◽  
Nayoung Sung ◽  
Xiaolu Zhang ◽  
...  
Keyword(s):  
T Cells ◽  
Regulatory T Cells ◽  
Pregnant Women ◽  
T Cell Activation ◽  
Peripheral Blood ◽  
Cell Activation ◽  
Recurrent Pregnancy Loss ◽  
Normal Pregnancy ◽  
Phenotypic Characteristics ◽  
Complicated Pregnancy

Abstract Background: Regulatory T cells (Tregs) are critical immunomodulators during pregnancy by preventing maternal T-cell activation against fetal cells. However, how characteristics of maternal Tregs vary during pregnancy is still unclear. We analyzed the proportion and phenotypic characteristics of peripheral blood Tregs in normal pregnant women, women with recurrent pregnancy loss (RPL) or gestational diabetes mellitus (GDM), and non-pregnant women.Methods: We investigated the proportion of CD4+ Tregs, CD8+ Tregs and the expression of PD-1, GITR, HLA-G and CTLA-4 on them in the peripheral blood of normal pregnancies during 1st (n = 28), 2nd (n = 43), and 3rd trimester (n = 33); In addition, we evaluated pregnancies in the 1st trimester complicated by RPL (n = 21), in the 2nd (n = 17) and 3rd trimester (n = 28) complicated by GDM. Non-pregnant women (n = 57) were also investigated using flow cytometry.Results: During normal pregnancy, the proportion of CD4+ Tregs in all trimester and CD8+ Tregs in 2nd and 3rd trimester were higher(P ＜ 0.05，respectively) compared with non-pregnancy women. Moreover, the proportion of CD4+ Tregs was higher in 2nd trimester compared to 1st and 3rd trimester (P ＜ 0.01) while the proportion of CD8+ Tregs was higher in 3rd trimester compared to 1st and 2nd trimester (P ＜ 0.05). Compared to non-pregnant studies, the proportion of GITR+/CD8+ Tregs and HLA-G+/CD8+ Tregs in all trimester were higher(P ＜ 0.05, respectively). Moreover, the proportion of PD-1+/CD4+ Tregs, GITR+/CD4+ Tregs, PD-1+/CD8+ Tregs and CTLA-4+/CD8+ Tregs in 3rd trimester were significantly higher compared to 1st, 2nd trimester and non-pregnant group(P ＜ 0.05, respectively).In RPL and GDM groups, the proportions of CD4+ Tregs in all trimesters were decreased while the proportions of CD8+ Tregs in all trimesters were increased compared to normal pregnant group (P ＜ 0.05，respectively).In RPL group, the proportion of PD-1+/CD4+ Tregs, GITR+/CD4+ Tregs and HLA-G+/CD4+ Tregs were decreased compared to 1st trimester normal pregnant group (P ＜ 0.05，respectively). In 2nd trimester GDM group, the proportion of HLA-G+/CD4+ Tregs were decreased compared to 2nd trimester normal pregnant group (P ＜ 0.05，respectively). In 3rd trimester GDM group, the proportion of PD-1+/CD4+ Tregs, GITR+/CD4+ Tregs, PD-1+/CD8+ Tregs, GITR+/CD8+ Tregs and HLA-G+/CD8+Tregs were decreased compared to 3rd trimester normal pregnant group (P ＜ 0.05, respectively).Conclusions: The proportion of CD4+ Tregs and CD8+ Tregs increased during pregnancy, the proportions and subsets of CD4+ Tregs decreased and those of CD8+ Tregs increased in pregnancies complicated by RPL and GDM, indicating that regulatory T cells play a role in pregnancy maintenance, and the abnormal expression of Tregs might be related to the complicated pregnancy.

scholarly journals STRATIFICATION OF PREGNANT WOMEN AT EARLY GESTATIONAL AGES BY MEANS OF OBJECTIVATION OF "PHYSIOLOGICAL ALTERATION" FACTORS, MECHANISMS OF GESTATIONAL ADAPTATION AND FETOPLACENTAL DYSFUNCTION

2016 ◽  
Vol 1 (4) ◽  
pp. 6-13
Author(s):  
Yu V Tezikov ◽  
I S Lipatov ◽  
O B Kalinkina ◽  
L Yu Gogel ◽  
T S Belokoneva ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Early Pregnancy ◽  
Clinical Symptoms ◽  
Clinical Manifestations ◽  
Perinatal Outcomes ◽  
Early Morning ◽  
Blood Biochemical ◽  
Biochemical Indices ◽  
Hemostatic Disorders ◽  
Blood Biochemical Indices

Aim - allocation of clinical and pathogenetic variants of early gestosis in pregnant women based on clinical manifestations and markers of leading pathogenetic syndromes of gestational maladjustment. Materials and methods. 45 healthy pregnant women and 160 pregnant women with early morning sickness of varying severity were examined in the 1st trimester of gestation. The comparison group consisted of 33 healthy non-pregnant women. The survey included assessment of clinical symptoms, identification of the markers of inflammatory response, energy balance of reproductive system, functional activity of the endometrium, vascular endothelial and hemostatic disorders, and blood biochemical indices. Results. The study enabled quantitative objectivation of the factors of “physiological damage” and “the mechanisms of gestational adaptation” during physiological gestation, defining fetoplacental dysfunction as the key link of maladjustment in early pregnancy. The prevalence of pathogenetic mechanisms of the formation of early pregnancy toxicosis determined the allocation of 4 clinical-pathogenetic variants of the course of this complication of gestation. Conclusion. Differentiated approach to clinical and laboratory manifestations of early gestosis in pregnant women, taking into account the variants of the clinical course of this complication and severity assessment, enables targeted therapy and predicting the risk of development of severe forms and late obstetric complications, reduces the risk of adverse perinatal outcomes.

Epidemiological and clinical aspects of chronic pyelonephritis in pregnant women and osteopathic follow-up of pregnant women with chronic pyelonephritis

2020 ◽  
pp. 124-134
Author(s):  
E. N. Nenashkina ◽  
E. S. Tregubova ◽  
V. O. Belash
Keyword(s):  
Medical Treatment ◽  
Pregnant Women ◽  
Clinical Manifestations ◽  
Perinatal Outcomes ◽  
Chronic Pyelonephritis ◽  
Clinical Aspects ◽  
Present Stage ◽  
Treatment Methods

The article considers current issues of epidemiology, etiology and pathogenesis of chronic pyelonephritis in pregnant women at the present stage, and demonstrates its effect on the gestational process and perinatal outcomes. The article presents classification of chronic pyelonephritis in pregnant women, the main clinical manifestations, as well as the possibilities for diagnosis of the disease. Both medical and non-medical treatment methods are considered. Particular attention is paid to osteopathic diagnosis and correction of somatic dysfunctions in pregnant women in order to prevent exacerbations of chronic pyelonephritis and reduce the risk of obstetric complications.

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