Mechanisms of adaptation of the pregnant women with miscarriage in the dynamics of the saving therapy

2016 ◽  
pp. 77-82 ◽  
Author(s):  
V.O. Potapov ◽  
◽  
A.V. Zharkih ◽  
V.G. Susjuka ◽  
V.O. Plotnik ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Emotional State ◽  
Individual Characteristics ◽  
Control Group ◽  
Autonomic Balance ◽  
Hormonal Profile ◽  
Abortion Clinic ◽  
The Impact

The aim of the study: to evaluate the impact of the saving therapy in the implementation of adaptive mechanisms in pregnant women with recurrent pregnancy loss based on the study of the psycho-emotional state, autonomic balance and hormonal profile. Materials and methods. There were surveyed 67 pregnant women at the gestational age of 7-14 weeks with singleton pregnancy. The main group consisted of 35 women with threatening abortion clinic who were treated in the gynecological Department of the hospital № 9 Zaporozhye city and received natural micronized PG Utrozhestan® (Besins Healthcare) vaginally 200 mg twice a day. The control group consisted of 32 women without clinical manifestations of threatened abortion. The inclusion criteria were complaints of pain in lower abdomen and poor or moderate bleeding from the genital tract on the background of intrauterine pregnancy. Exclusion criteria were: hyperandrogenism, polycystic ovarian syndrome, menstrual irregularities, anomalies development of genital organs, habitual miscarriage, presence of fetal malformations and pregnancy with a copious bloody discharge. Results. Found that in pregnant women with threatening abortion clinic there is an increase of reactive anxiety, which is caused by an emotional reaction to a stressful situation and evidence of psycho-emotional maladjustment. Given that more than half of pregnant women with the clinic of miscarriage have a high level of personal anxiety, which is stable individual characteristics and reflects the predisposition of a subject to anxiety, this fact should be considered as a risk factor for this disease. Violations of the hormonal balance in pregnant women with recurrent pregnancy loss, characterized by increasing levels of cortisol and cortisone-insulin index, which is a stress response in this population of pregnant women. Similar changes are characteristic for the system mother-placenta-fetus that are caused by the decreased levels of estriol. Conclusion. Saving therapy using vaginal micronized progesterone (Utrozhestan®), including in the group of pregnant women with a poor prognosis (the presence of retrohorial hematoma), has a positive impact on the normalization of psycho-emotional state, autonomic balance, hormonal profile, and is also characterized by a lack of androgenic activity, which gives grounds to recommend cough medicine® for inclusion in the scheme of treatment of miscarriage. Key words: surrogacy pregnancy, autonomic regulation, level of anxiety, the hormonal profile, stress, adaptation, treatment, Utrozhestan®.

scholarly journals Study of bad obstetric history cases attending tertiary care centre, Tirupati

2021 ◽  
Vol 8 (4) ◽  
pp. 535-540
Author(s):  
Gowthami B ◽  
Sowjanya Kumari J ◽  
Lakshmi Narayanamma V
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Control Group ◽  
Chronic Hypertension ◽  
Age Group ◽  
Obstetric History

To assess the obstetric and medical risk factors in patients with bad obstetric history (BOH) and outcome of pregnancy in case of BOH. A prospective cross-sectional study was conducted in Government maternity hospital, Tirupati for a period of 1 year from December 2017 to November 2018. All pregnant women who were fulfilling inclusion criteria of BOH, as study group and all possible variable were compared with control group, who got selected randomly from the rest of deliveries. And analysed the results in terms of sociodemographic factors, risk factors, pregnancy complications, mode of delivery, maternal and foetal outcome. Of 102 pregnant women in BOH, 76.5% were in age group between 21-30yrs, and 14.7% in age group >30yrs. Primary Recurrent pregnancy loss (RPL) was 51% and that of secondary recurrent pregnancy loss was 49%.History of hypertensive disorders including preeclampsia, eclampsia and chronic hypertension, noted in 11.8% cases, which was higher than previous studies, indicating changing trends in incidence.In foetal complications IUGR (0% vs 9.8%, p=0.026) and IUFD (0% Vs 7.8%, p=0.05) were more in BOH group and statistically significant also. Even though the maternal complications were more in BOH group, there was no statistical significance (P=0.075).Among the various causes of RPL found in the present study, endocrine causes were seen in 12.7%, Anatomical causes were found in 11.8% and in about 63.7% cases no definite cause was found and aetiology was unexplained. Present study, supporting the change in definition of recurrent pregnancy loss from 3 consecutive losses to 2. So early evaluation and with appropriate interventions in most of couples outcomes were fruitful.

Evaluation of the Effects of 1,25 Vitamin D3 on Regulatory T Cells and T Helper 17 Cells in Vitamin D-deficient Women with Unexplained Recurrent Pregnancy Loss

2020 ◽  
Vol 13 (4) ◽  
pp. 306-317
Author(s):  
Elham Abdollahi ◽  
Seyed Abdolrahim Rezaee ◽  
Nafiseh Saghafi ◽  
Maryam Rastin ◽  
Vicki Clifton ◽  
...  
Keyword(s):  
Vitamin D ◽  
T Cells ◽  
Regulatory T Cells ◽  
Pregnant Women ◽  
Th17 Cells ◽  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Mononuclear Cells ◽  
Control Group ◽  
Peripheral Blood Mononuclear

Background: Vitamin D insufficiency and deficiency can be associated with adverse effects on pregnancy outcomes, which may include recurrent pregnancy loss through the mechanisms that are yet unknown. The aim of this study was to evaluate the effect of 1,25VitD3 on regulatory T cells (Tregs) and T helper17 (Th17) cell populations In vitro in unexplained recurrent pregnancy loss (URPL) patients and healthy women. Methods: Samples from 20 non-pregnant women with a history of URPL were compared to 20 normal non-pregnant women. Peripheral blood mononuclear cells (PBMC) were divided into 3 wells for each subject: in the presence of 1, 25 VitD3 (50 nM, for 16 hours), PHA (positive control) (10μM), and without any treatment (as a baseline or negative control). The percentage of regulatory T cells and Th17 cells was measured by flow cytometry at baseline and then after cell culture experiments. Results: Our study indicated that the percentage of Tregs in patients with URPL was significantly lower than the control group (2.42 ± 0.27 vs. 3.41 ± 0.29, P= 0.01). The percentage of Th17 cells was significantly greater in URPL patients compared to the control group (2.91 ± 0.33 vs. 1.18± 0.15, P=0.001). 1, 25VitD3 treatment significantly increased the percentage of Tregs from the baseline in the URPL group compared to that in the control group (1.23 ± 0.03 vs. 1.00 ± 0.03, P= 0.01). Conclusion: Vitamin D deficiency may be a contributor to recurrent pregnancy loss and suggests supplementation of women with Vit D pre-pregnancy may be protective against URPL.

scholarly journals Review of experiences: recurrent pregnancy loss with reproductive outcome in pregnant women

2019 ◽  
Vol 8 (3) ◽  
pp. 1120
Author(s):  
Urvi Gupta ◽  
M. Alwani ◽  
Susmit Kosta
Keyword(s):  
Reproductive Success ◽  
Prenatal Care ◽  
Pregnant Women ◽  
Success Rate ◽  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Neonatal Period ◽  
Healthcare Services ◽  
Control Group ◽  
Prenatal Visits

Background: Recurrent pregnancy loss (RPL) is an important reproductive health issue, affecting 2%–5% of couples. Research into why miscarriage happens is the only way we can save lives and prevent future loss. In this study we estimate the percentage of babies who survived beyond the neonatal period in a RPL clinic and to identify associated factors.Methods: A retrospective cohort study including 128 women seen at a clinic for RPL in loss group between 2016 and 2018 and a control group including 180 pregnant women seen at a low-risk prenatal care unit. Reproductive success rate was defined as an alive-birth, independent of gestational age at birth and survival after the neonatal period. All the date was statically reviewed and analyzed.Results: Out of 115 who conceived, 105 (91.3%) had reproductive success rate. There were more full-term pregnancies in the control than in the loss group (155/180; 89.6% versus 67/115; 58.3%; p<0.01). The prenatal visits number was satisfactory for 97(84.3%) women in the loss group and 112(62.2%) in the control (p<0.01). In this, the beginning of prenatal care was earlier (13.5 ±4.3versus 18.3±6.1weeks). During pregnancy, the loss group women increased the weight more than those in the control group (57.4% versus 47.8% p=0.01). Although cervix cerclage was performed in 41/115 (35.7%) women in the loss group, the pregnancy duration mean was smaller (34.6±5.1 weeks versus 38.2±2.5 weeks; p<0.01) than in the control group. Due to gestational complications, cesarean delivery predominated in the loss group (71/115; 61.7%versus 69/180; 38.3%, p<0.01).Conclusions: A very good reproductive success rate can be attributed to greater availability of healthcare services to receive pregnant women, through prenatal visits scheduled or not, cervical cerclage performed on time and available hospital care for the mother and newborn.

scholarly journals Diagnostic significance of assessing peripheral natural killer cells in women with recurrent pregnancy loss

2021 ◽  
Vol 15 (1) ◽  
pp. 61-69
Author(s):  
K. E. Gotsiridze ◽  
N. P. Kintraya
Keyword(s):  
Pregnant Women ◽  
Peripheral Blood ◽  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Comparison Group ◽  
Nk Cell ◽  
Complete Blood Count ◽  
Control Group ◽  
Tnf Α ◽  
Ifn Γ

Aim: to assess peripheral blood NK cell (pNK) counts in women with recurrent pregnancy loss.Materials and Methods. There were examined 102 women: 28 non-pregnant (immediately after repeatedly terminated pregnancy, group IA) and 34 pregnant women with history of previous recurrent pregnancy loss (group IB). Control and comparison groups were consisted of healthy women lacking any recorded miscarriage: 20 non-pregnant (group IIA) and 20 pregnant women (group IIB), respectively. Along with assessing complete blood count range, all subjects were analyzed percentage of pNK cell CD16bright(+) CD56dim(-) cytotoxic phenotype by using fluorescence microscopy as well as level of cytokines IL-2, IL-6, IL-10, tumor necrosis factor (TNF-α), vascular endothelial growth factor (VEGF) and interferon-gamma (IFN-γ) using ELISA.Results. It was found that the level of NK cell cytotoxic phenotype - percentage of CD16+CD56- was elevated in both groups: groups: group IA - 36.5 % collared with the control group IIA - 27.5% (р < 0.05); in group IB up to 37.0 %, in comparison group IIB - 27.4% (р < 0.01). It was further corroborated by increased level of serum cytokine IL-6 IL-6 comprising in group IA vs. IIA - 28.5 pg/ml vs. 14.2 pg/ml (р < 0.01) as well as in group IB vs. IIB up to 16.7 pg/ml vs. 12.2 pg/ml (р < 0.01), respectively. However, level of serum IL-2 and IL-10 did not significantly differ in all groups examined. Interestingly, level of VEGF in subjects aged 21-30 years was elevated: in non-pregnant (group IA) vs. control (group IIA) - up to 548.5 pg/ml vs. 310.8 pg/ml (р < 0.01); pregnant women (IB) vs. comparison group (IIB) - insignificantly elevated up to 476.1 pg/ml vs. 381.5 pg/ml, respectively. In contrast, no significant changes were observed in 31-40-year group. Concentration of IFN-γ in group IA vs. control group (IIA) was increased up to 9.2 pg/ml vs.8.64 pg/ml; group IB vs. comparison group - up to 8.36 pg/ml vs. 7.56 pg/ml, respectively.Conclusion. Elevated percentage of cytotoxic CD16+CD56- NK cells in peripheral blood results in imbalance of immune-related parameters that directly correlated with increased serum level of IL-2, IL-6, TNF-α that may alter maternal immune tolerance to the fetus and subsequently resulting in recurrent pregnancy loss. Hence, the aforementioned data may be used as diagnostic and prognostic criteria in recurrent pregnancy losses.

scholarly journals Thyroid Autoimmunity is a Risk Factor for Recurrent Pregnancy Loss

2018 ◽  
Vol 30 (1) ◽  
pp. 49-55
Author(s):  
Sharmin Sultana ◽  
Mosammat Nargis Shamima ◽  
Sahela Jesmin ◽  
Nargis Zahan ◽  
Md Abu Zahid ◽  
...  
Keyword(s):  
Risk Factor ◽  
Pregnant Women ◽  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Recurrent Miscarriage ◽  
Control Group ◽  
Genital Organ ◽  
Thyroid Antibodies ◽  
History Of ◽  
The Mean

This was a hospital based case control study. The study included patients attending in outdoor and indoor Department of Obstetrics and Gynaecology of Rajshahi Medical College, Hospital since July 2014 to June 2016. The aim of this study was to determine thyroid antibodies is a risk factor for recurrent pregnancy loss. Sixty seven pregnant or non pregnant women with history of recurrent miscarriage during 1st trimester were selected as case group and another sixty seven pregnant women who reached their 12 weeks uneventfully with no history of recurrent miscarriage were selected as control group. Patients with other cause of recurrent miscarriage such as metabolic or endocrinologic disorders, genital organ anomaly, uterine fibroid were excluded from the study. Thyroid function test and thyroid antibodies (FT4, TSH and TPO-Ab) were measured for the two groups. The result of this study showed that the percentage of positive TPO-Ab in target and control group is 67.16% and 5.95% respectively. The study observed that the mean serum concentrations of FT4 in the control subject was significantly higher than the mean of the target group (p-value <0.05). The TSH concentration was increased in miscarriage women with positive antibodies compared with the concentration of TSH in the control group with positive antibodies. The conclusions are that there is a deficiency in thyroid hormones or thyroid’s functional capacity is unable to meet the extra demands of pregnancy which may be one of the causes of recurrent miscarriage. Moreover positive thyroid antibodies pregnant women can reach term and have babies when the concentration of TSH is low during the first trimester, so the risk of miscarriage could be high in positive thyroid antibodies.TAJ 2017; 30(1): 49-55

scholarly journals Association of recurrent pregnancy loss and anticardiolipin antibodies: prevalence and prognosis of subsequent pregnancy in women with recurrent pregnancy loss

2017 ◽  
Vol 7 (1) ◽  
pp. 74
Author(s):  
Malathi Verabelly ◽  
Swapnarani Seedipally
Keyword(s):  
Pregnant Women ◽  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Systemic Disease ◽  
Anticardiolipin Antibodies ◽  
Obstetric Complications ◽  
Control Group ◽  
Study Group ◽  
Study Objective ◽  
History Of

Background: Anticardiolipin antibodies (ACA) are found with increased prevalence in women with unexplained recurrent pregnancy loss but their impact on future pregnancy is not clearly known. Therefore, present study objective was to compare the prevalence of ACA in patients with recurrent pregnancy loss and normal healthy pregnant women.Methods: This prospective observational study from 100 pregnant women attending the outpatient department of Obstetrics and Gynaecology were studied. Study included 50 pregnant women with a history of three or more consecutive unexplained pregnancy loss as a study group and 50 pregnant women with two or more live children with no history of any previous pregnancy loss as a control group. Exclusion criteria included cases with any uterine anomaly, uterine structural abnormalities, induced abortions, infections, systemic disease, Rh-ve pregnancy, coagulation disorders and personal or family history of thrombosis.Results: Overall, 9 patients tested positive for ACA, of which one (2%) patient was from the control group and remaining 8 (16%) were from study group. Overall, 42 (84%) patients had negative test for ACA in the study group and 49 (98%) patients in the control group. The live birth rate among study group was only 34 (68%) whereas all 50 (100%) pregnant women in the control group.Conclusions: The findings described here in demonstrate that, ACA -positive patients are also the primary predictor of adverse pregnancy outcome and obstetric complications. Therefore, the role of early detection of ACA in all pregnant women is very important to prevent foetal outcomes and obstetric complications. 

scholarly journals Does recurrent pregnancy loss have an inflammatory background?

2021 ◽  
Vol 38 (4) ◽  
pp. 420-424
Author(s):  
Huri GÜVEY ◽  
Samettin ÇELİK ◽  
Canan SOYER ÇALIŞKAN ◽  
Burak YAŞAR ◽  
Bahadır YAZICIOĞLU ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Recurrent Miscarriage ◽  
Control Group ◽  
Study Group ◽  
Reactive Protein ◽  
Randomized Controlled Studies ◽  
Significant Difference ◽  
Living Children

Although several pathophysiological mechanisms are defined in etiology recurrent pregnancy loss, still causes of half of the cases haven’t revealed yet. It is reported that inflammatory processes take place in the etiology of the disease. In our study, we aimed to reveal the relationship between recurrent pregnancy loss with white blood cell count (WBC), C-reactive protein (CRP) and ferritin levels. We included our study 90 pregnant women having recurrent miscarriage history and 101 pregnant women without recurrent miscarriages, 191 patients in total. Maternal and gestational age, height, weight, body mass index (BMI), gravidity, parity, abortion and living children count and WBC, CRP and ferritin levels of these pregnant were evaluated retrospectively. According to outcomes, while the age (p = 0.01; p<0.05), gravidity (p = 0.00; p<0.01) and abortion counts (p = 0.004; p<0.01) of the study group were found significantly to be higher than that of the control group, weight measurement of them was significantly lower than that of the control group (p = 0.04; p <0.05). Height and BMI measurements, parity and living children counts of the groups showed no statistically significant difference (p>0.05). While WBC levels of the study group was found to be lower (p=0.045, p<0,05) than that of control group, there was no significant difference regarding ferritin and CRP levels (p> 0.05). In our study, WBC, CRP and ferritin parameters did not indicate the inflammatory background in recurrent pregnancy loss. We think that further prospective randomized controlled studies are required regarding these parameters.

scholarly journals Correlation of methylation status in MTHFR promoter region with recurrent pregnancy loss

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Mai Mahmoud Shaker ◽  
Taghreed Abdelmoniem shalabi ◽  
Khalda said Amr
Keyword(s):  
Dna Methylation ◽  
Dna Sequences ◽  
Promoter Region ◽  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Methylation Status ◽  
Control Group ◽  
Case Group ◽  
Methyl Radical ◽  
Fertile Women

Abstract Background DNA methylation is an epigenetic process for modifying transcription factors in various genes. Methylenetetrahydrofolate reductase (MTHFR) stimulates synthesis of methyl radical in the homocysteine cycle and delivers methyl groups needed in DNA methylation. Furthermore, numerous studies have linked gene polymorphisms of this enzyme with a larger risk of recurrent pregnancy loss (RPL), yet scarce information is available concerning the association between epigenetic deviations in this gene and RPL. Hypermethylation at precise DNA sequences can function as biomarkers for a diversity of diseases. We aimed by this study to evaluate the methylation status of the promoter region of MTHFR gene in women with RPL compared to healthy fertile women. It is a case–control study. Hundred RPL patients and hundred healthy fertile women with no history of RPL as controls were recruited. MTHFR C677T was assessed by polymerase chain reaction-restriction fragment length polymorphism (RFLP). Quantitative evaluation of DNA methylation was performed by high-resolution melt analysis by real-time PCR. Results The median of percentage of MTHFR promoter methylation in RPL cases was 6.45 [0.74–100] vs. controls was 4.50 [0.60–91.7], P value < 0.001. In the case group, 57 hypermethylated and 43 normo-methylated among RPL patients vs. 40 hypermethylated and 60 normo-methylated among controls, P< 0.005. Frequency of T allele in C677T MTHFR gene among RPL patients was 29% vs. 23% among the control group; C allele vs. T allele: odds ratio (OR) = 1.367 (95% confidence interval (CI) 0.725–2.581). Conclusion Findings suggested a significant association between hypermethylation of the MTHFR promoter region in RPL patients compared to healthy fertile women.

scholarly journals Association of Tumor Necrosis Factor-α -308G>A, -238G>A and -376G>A polymorphisms with recurrent pregnancy loss risk in the Greek population

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Sofoklis Stavros ◽  
Despoina Mavrogianni ◽  
Myrto Papamentzelopoulou ◽  
Evaggelos Basamakis ◽  
Hend Khudeir ◽  
...  
Keyword(s):  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Pcr Amplification ◽  
Greek Population ◽  
Control Group ◽  
Increased Risk ◽  
Tnf Α ◽  
Caucasian Women ◽  
Factor Α ◽  
And Control

Abstract Background Promoter region SNPs in TNF-α have been studied in association with Recurrent Pregnancy Loss (RPL) occurrence in various populations. Among them, −238G > A, −308G > A and − 376G > A have been frequently investigated for their potential role in recurrent abortions. The aim of the present study is to evaluate the correlation among TNF-α 238, TNF-α 308 and TNF-α 376 polymorphisms and recurrent pregnancy loss risk in Greek women. Methods This study included 94 Caucasian women with at least two miscarriages of unexplained aetiology, before the 20th week of gestation. The control group consisted of 89 Caucasian women of proven fertility, with no history of pregnancy loss. DNA samples were subjected to PCR amplification using specific primers. Sanger sequencing was applied to investigate the presence of TNF-α 238, TNF-α 308, TNF-α 376 polymorphisms in all samples. Results The TNF-α 238 and TNF-α 308 variants were both detected in RPL and control groups (7.45% vs 4.49 and 45.16% vs 36.73%, respectively), but with no statistically significant association (p-value 0.396 and 0.374, respectively). The TNF-α 376 variant was not detected at all in both control and RPL groups. When TNF-α 238 and TNF-α 308 genotypes were combined no association with RPL was detected (p-value = 0.694). In subgroup analysis by parity, RPL patients carrying the A allele reported less previous births. Conclusions This is the first study demonstrating TNF-α 238 and TNF-α 308 gene expression and the absence of TNF-α 376 variant in Greek women with RPL. However, no association emerged between each polymorphism studied and the occurrence of recurrent pregnancy loss. Accordingly, TNF-α -308G > A, −238G > A and -376G > A variants are not considered genetic markers for identifying women at increased risk of recurrent pregnancy loss in the Greek population.

scholarly journals CHANGES OF PSYCHO-EMOTIONAL STATE IN THE INFERTILE PREGNANT FEMALES DUE TO THE ANAMNESIS AND IVF

2019 ◽  
Vol 72 (4) ◽  
pp. 562-567
Author(s):  
Volodymyr K. Likhachov ◽  
Yanina V. Shymanska ◽  
Yulia S. Savelieva ◽  
Viktoriya L. Vashchenko ◽  
Ludmyla М. Dobrovolska
Keyword(s):  
Pregnant Women ◽  
Art Therapy ◽  
Emotional State ◽  
Healthy Woman ◽  
The Body ◽  
Control Group ◽  
Emotional States ◽  
Psychological Component ◽  
Group I ◽  
High Level

Introduction: During pregnancy in the body of a healthy woman there are physiological and psychological changes that contribute to the bearing a child and prepare the female for future labour and motherhood. In women who experience failure at the stage of fertilization or during pregnancy, as a result of prolonged negative emotional states, psycho-emotional stress develops. The aim of the research was to study the psycho-emotional state of women with infertility in history, whose pregnancy resulted from extracorporal fertilization (IVF), and to develop methods for reducing their anxiety. Materials and methods: At the first stage, the initial psycho-emotional state of 60 women in the second trimester, whose pregnancy resulted from IVF (Group I), was studied; the control group consisted of 20 healthy women with a physiological course of pregnancy (Group II). At the second stage, 10 art therapy exercises with a requestioning of pregnant women from Group I were conducted for improving their psycho-emotional state. Results: Women of Group I had a high level of both situational anxiety (SA) and the personal one (PA). The prevalent type of the psychological component of gestational dominant was anxiety and euphoric types (58.3%). In one third of women with burdened gynecological history examined mild or masked depression was diagnosed. 43 pregnant women from Group I used a method of psychocorrection – art therapy, which included colouring “antistress” pictures of perinatal topic, making flowers from paper and creating a collage of dreams. Conclusions: After the art therapy course, a high level of SA (from 46.5% to 7.0%) and OA (from 48.8% to 32.6%) decreased, the index of the optimal type of the psychological component of gestational dominant increased from 25.6% to 53.5%. The number of women without depression increased from 62.8% to 93%.

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